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Grant support

We would like to thank Sehrs Food Area S.L., Nutricia Danone S.A, Nestle Health Science S.A., Fundacio per a la Recerca en Gastroenterologia (FUREGA), Fundacio el Maresme por Discapacitats, Fundacio Salut del Consorci Sanitari del Maresme, Escola Superior d'Hosteleria de Barcelona (ESHOB), Lifemere (Rose Cup), Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd-isciii), Aigues de Mataro S.A. and the Mataro City Council for their support of the intervention in this school. We would also like to thank the Plan for Research and Innovation in Health (PERIS), Generalitat de Catalunya, which contributed with the intensification grant of Alicia Costa (SLT017/20/000220) and Alberto Martin (SLT008/18/00162; SLT017/10/000219),the CIBERehd-isciii for a Strategic Action on Oropharyngeal Dysphagia (EHD20PI02) and promotion of this project at their annual congress (Link: Experience in patient-centred research CIBEREHD) as a model of research based on patient centricity, and the Territorial Competitiveness Specialization Project (PECT) of Mataro-Maresme (PRE/161/2019) financed by the Government of Catalunya-Generalitat de Catalunya within the framework of the European Regional Developments Funds of Catalonia Operational Programme 2014-2020.

Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

Costa, AliciaCorresponding Author

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February 12, 2025
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Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

Publicated to:Nutrients. 13 (7): 2413- - 2021-07-01 13(7), DOI: 10.3390/nu13072413

Authors: Costa, Alicia; Martin, Alberto; Arreola, Viridiana; Riera, Stephanie A; Pizarro, Ana; Carol, Cristina; Serras, Laia; Clave, Pere

Affiliations

Fac Odontol Barcelona UIC, Dept Periodoncia, Sant Cugat Del Valles 08195, Spain - Author
Fundacio El Maresme, Escola lArboc, Mataro 08301, Spain - Author
Fundacio El Maresme, Unitat Suport Tecn, Mataro 08301, Spain - Author
Fundacio Recerca Gastroenterol Furega, Barcelona 08008, Spain - Author
Hosp Mataro, Unitat Dietet & Nutr, Mataro 08304, Spain - Author
Hosp Mataro, Unitat Explorac Func Digest CSdM UAB, Mataro 08304, Spain - Author
Inst Salut Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid 28029, Spain - Author
Univ Autonoma Barcelona, Dept Med, Cerdanyola Del Valles 08035, Spain - Author
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Abstract

Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L'Arboc, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II-III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions.

Keywords

2017 world workshopBody-compositioCerebral palsyChild growth standardsDehydrationDietary intakesDysphagiaEnergy-expenditureEuropean-societyFeeding difficultiesFeeding problemsGross motor functionMalnutritionNeurological disabilityOral healtOropharyngeal dysphagiaPediatric-gastroenterologyPeri-implant diseasesSwallowing disordersZero hunger

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrients due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 15/90, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.38. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 10.96 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-25, the following number of citations:

  • WoS: 24
  • Open Alex: 24

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-25:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 153.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 190 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 12.35.
  • The number of mentions on the social network X (formerly Twitter): 15 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Continuing with the social impact of the work, it is important to emphasize that, due to its content, it can be assigned to the area of interest of ODS 2 - Zero hunger, with a probability of 75% according to the mBERT algorithm developed by Aurora University.

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Costa Izurdiaga, Alicia) .

the author responsible for correspondence tasks has been Costa Izurdiaga, Alicia.