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We at Passy Muir believe that communication is the essence of the human spirit; it is essential to individual rights and dignity. We are committed in our efforts to offer tracheostomized and ventilator-dependent patients a step towards independence and dignity through speech. When properly assessed and placed by a healthcare professional, speaking valves allow tracheostomy patients to communicate. In addition to voice and speech production, Passy Muir Valves improve swallow, secretion management, and the sense of smell and taste.

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The Center for Human Nutrition provides evaluation, education, and treatment to people who have disease-related nutrition problems. Additionally, the Center is involved with a multitude of programs to promote health and wellness. Both of these efforts are driven by a dedicated team of registered dietitians, dietetic technicians, nurses, pharmacists, physicians, and surgeons who work together to provide comprehensive support for patients with specialized nutrition needs.

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The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. The medical records of 31 patients having gastrostomy 27 patients and jejunostomy 4 feeding tubes inserted in our Department were retrospectively studied. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded.

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Over the last 2 decades, research has failed to demonstrate benefits of tube feeding in patients with advanced dementia. Racial disparities were examined because black race has been strongly associated with greater feeding tube use. The Brown University institutional review board approved this study with a waiver of informed consent. Data were derived from federally mandated Minimum Data Set MDS assessments completed quarterly, as required, on all residents in US nursing homes between January 1,and October 31,


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