testing 4mar2017 iddsi framework updated zs edit...
TRANSCRIPT
!"#$%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
!
&''(&%)*+,-./*0%!-$5#1C%E-5"/2$%
The IDDSI Framework and Descriptors are licensed under the CreativeCommons Attribution-‐Sharealike 4.0 International License
https://creativecommons.org/licenses/by-‐sa/4.0/ March 4, 2017
2
INTRODUCTION
The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded in 2013 with the goal of developing new global standardised terminology and definitions to describe texture modified foods and thickened liquids used for individuals with dysphagia of all ages, in all care settings, and all cultures.
Three years of ongoing work by the International Dysphagia Diet Standardisation Committee has culminated in a final dysphagia diet framework consisting of a continuum of 8 levels (0-‐7). Levels are identified by numbers, text labels and colour codes.
This document provides details regarding Testing Methods for use with the IDDSI Framework.
This document is to be read in conjunction with the Complete IDDSI Framework, IDDSI Evidence and IDDSI Frequently Asked Questions (FAQs) documents (http://iddsi.org/resources/framework/).
The IDDSI Committee would like to acknowledge the interest and participation of the global community including patients, caregivers, health professionals, industry, professional associations and researchers. We would also like to thank our sponsors for their generous support.
Please visit the www.iddsi.org for further information
The IDDSI Committee:
Co-‐Chairs: Peter Lam (CAN) & Julie Cichero (AUS);
Committee Members: Jianshe Chen (CHN), Roberto Dantas (BRA), Janice Duivestein (CAN), Ben Hanson (UK), Jun Kayashita (JPN), Caroline Lecko (UK), Mershen Pillay (ZAF), Luis Riquelme (USA), Soenke Stanschus (GER), Catriona Steele (CAN).
Past Committee Members: Joe Murray (USA)
The International Dysphagia Diet Standardisation Initiative Inc. (IDDSI) is an independent, not-‐for-‐profit entity. IDDSI is grateful to a large number of agencies, organizations and industry partners for financial and other support. Sponsors have not been involved with the design or development of the IDDSI framework.
Development of the IDDSI framework (2012-‐2015) IDDSI would like to thank and acknowledge the following sponsors for their generous support in the development of the IDDSI framework:
• Nestlé Nutrition Institute (2012-‐2015) • Nutricia Advanced Medical Nutrition (2013-‐2014) • Hormel Thick & Easy (2014-‐2015) • Campbell’s Food Service (2013-‐2015) • apetito (2013-‐2015) • Trisco (2013-‐2015) • Food Care Co. Ltd. Japan (2015) • Flavour Creations (2013-‐2015) • Simply Thick (2015) • Lyons (2015)
Implementation of the IDDSI framework is in progress. IDDSI is extremely grateful to all sponsors supporting implementation http://iddsi.org/about-‐us/sponsors/
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
#!
%!"-%&''(&%$D$5-,+5#3%*-9#-.%$7CC-$5-2%5"+5%6#Y7#2$%+12%J//2%$"/762%;-%36+$$#J#-2%#1%5"-%3/15-a5%/J%5"-%4"D$#/6/C#3+6%4*/3-$$-$%#19/69-2%#1%/*+6%4*/3-$$#1CF%/*+6%5*+1$4/*5%+12%J6/.%#1#5#+5#/1>%!/%5"#$%-12F%2#JJ-*-15%2-9#3-$%+*-%1--2-2%5/%;-$5%2-$3*#;-%5"-%;-"+9#/7*%/J%5"-%;/67$%M(5--6-%-5%+6>F%G?H]O>%%
'*#10$%+12%/5"-*%6#Y7#2$%:337*+5-%,-+$7*-,-15%/J%J67#2%J6/.%4*/4-*5#-$%#$%+%3/,46-a%5+$0>%!/%2+5-F%;/5"%*-$-+*3"%+12%-a#$5#1C%1+5#/1+6%5-*,#1/6/C#-$F%"+9-%$572#-2%/*%*-3/,,-12-2%5"-%36+$$#J#3+5#/1%/J%2*#10$%;+$-2%/1%9#$3/$#5D>%%T/.-9-*F%9#$3/$#5D%,-+$7*-,-15%#$%1/5%+33-$$#;6-%5/%,/$5%36#1#3#+1$%/*%3+*-C#9-*$>%%
)7*5"-*,/*-F%9#$3/$#5D%#$%1/5%5"-%/16D%*-6-9+15%4+*+,-5-*A%5"-%J6/.%/J%+%2*#10%+$%#5%#$%3/1$7,-2%#$%#1J67-13-2%;D%,+1D%/5"-*%9+*#+;6-$%#13672#1C%2-1$#5DF%D#-62%$5*-$$F%5-,4-*+57*-F%4*/476$#/1%4*-$$7*-%+12%J+5%3/15-15%Mb`@-+*D%-5%+6>F%G?H?S%(/4+2-%-5%+6>F%G??IF%(/4+2-%-5%+6>F%G??c+F;S%T+22-%-5%+6>G?H]+F;O>%!"-%$D$5-,+5#3%*-9#-.%2-,/1$5*+5-2%.#2-%9+*#+;#6#5D%#1%5-$5#1C%5-3"1#Y7-$%7$-2%+12%J/712%5"+5%/5"-*%0-D%4+*+,-5-*$%$73"%+$%$"-+*%*+5-$F%$+,46-%5-,4-*+57*-F%2-1$#5D%+12%D#-62%$5*-$$%.-*-%*+*-6D%*-4/*5-2%M(5--6-%-5%+6>F%G?H]S%8#3"-*/%-5%+6>F%G?H_O>%'*#10$%5"#30-1-2%.#5"%2#JJ-*-15%5"#30-1#1C%+C-15$%,+D%"+9-%5"-%$+,-%,-+$7*-,-15%/J%+44+*-15%9#$3/$#5D%+5%/1-%4+*5#376+*%$"-+*%*+5-F%+12%D-5%"+9-%9-*D%2#JJ-*-15%J6/.%3"+*+35-*#$5#3$%#1%4*+35#3-%M(5--6-%-5%+6>%G?H]S%b`@-+*D%-5%+6>FG?H?S%)71+,#%-5%+6>F%G?HGS%:$"#2+%-5%+6>F%G??IS%Z+*3#+%-5%+6>F%G??]O>%%&1%+22#5#/1%5/%9+*#+5#/1$%#1%J6/.%+$$/3#+5-2%.#5"%2*#10%3"+*+35-*#$5#3$F%J6/.%*+5-$%27*#1C%$.+66/.#1C%+*-%-a4-35-2%5/%2#JJ-*%2-4-12#1C%/1%+%4-*$/1`$%+C-%+12%6-9-6%/J%#,4+#*,-15%/J%$.+66/.#1C%J7135#/1%Mb`@-+*D%-5%+6>F%G?H?O>%
)/*%5"-$-%*-+$/1$F%+%,-+$7*-,-15%/J%9#$3/$#5D%"+$%!"#%;--1%#13672-2%#1%5"-%&''(&%2-$3*#45/*$>%&1$5-+2F%+%C*+9#5D%J6/.%5-$5%7$#1C%+%H?%,@%$6#4%5#4%$D*#1C-%#$%*-3/,,-12-2%5/%Y7+15#JD%5"-%6#Y7#2`$%J6/.%3+5-C/*D%M$+,46-%*-,+#1#1C%J*/,%H?%,@%+J5-*%H?%$-3%/J%J6/.O>%!"-%3/15*/66-2%3/12#5#/1$%+*-%;*/+26D%*-4*-$-15+5#9-%/J%2*#10#1C%5"*/7C"%+%$5*+.%/*%;-+0-*>%%
!"-%&''(&%)6/.%5-$5%#$%+6$/%$#,#6+*%#1%2-$#C1%+12%,-+$7*-,-15%4*#13#46-$%5/%5"-%L/$5"7,7$%)711-6%5"+5%#$%7$-2%#1%5"-%2+#*D%#127$5*D%5/%,-+$7*-%6#Y7#2%5"#301-$$%M9+1%d6#-5F%G??GS%W755-*%-5%+6>F%G?HHO>%&1%J+35%5"-%L/$5"7,7$%J711-6%6//0$%6#0-%+%6+*C-%$D*#1C-%M9+1%d6#-5F%G??GS%W755-*%-5%+6>F%G?HHO>%E-+$7*-$%5+0-1%7$#1C%5"-%L/$5"7,7$%J711-6%#13672-%5"-%5#,-%J/*%+%$4-3#J#-2%+,/715%/J%$+,46-%5/%J6/.F%+12%,+$$%6-J5%+J5-*%+%2-J#1-2%4-*#/2%/J%J6/.>%%d+1%d6#-5%MG??GO%1/5-$%5"+5%5"-%C-/,-5*D%/J%5"-%L/$5"7,7$%J711-6%3/15+#1$%+%$"-+*%+12%-6/1C+5#/1%3/,4/1-15%5"+5%,/*-%36/$-6D%,+53"-$%J6/.%3/12#5#/1$%.#5"#1%5"-%/*+6%3+9#5D>%%
:65"/7C"%5"-%$D*#1C-%3"/$-1%J/*%7$-%.#5"%5"-%&''(&%)6/.%5-$5%#$%$#,46-F%5"-%5-$5%"+$%;--1%J/712%5/%3+5-C/*#$-%+%.#2-%*+1C-%/J%6#Y7#2$%*-6#+;6DF%+12%#1%+C*--,-15%.#5"%37**-156D%-a#$5#1C%6+;/*+5/*D%5-$5$%+12%-a4-*5%e72C-,-15>%%&5%"+$%+6$/%;--1%J/712%5/%;-%$-1$#5#9-%-1/7C"%5/%2-,/1$5*+5-%$,+66%3"+1C-$%#1%5"#301-$$%+$$/3#+5-2%.#5"%3"+1C-%#1%$-*9#1C%5-,4-*+57*->%%
%
!-$5#1C%E-5"/2$%J/*%7$-%.#5"%5"-%%&''(&%)*+,-./*0%
The IDDSI Framework and Descriptors are licensed under the CreativeCommons Attribution-‐Sharealike 4.0 International License
https://creativecommons.org/licenses/by-‐sa/4.0/ March 4, 2017
4
IDDSI Flow Test The IDDSI Flow test uses a 10 mL slip tip hypodermic syringe, as shown in the image below.
Although 10 mL syringes were initially thought to be identical throughout the world based on reference to an ISO standard (ISO 7886-‐1), it has subsequently been determined that the ISO document refers only to the nozzle of the syringe and that variability in barrel length and dimensions may exist between brands. Specifically the IDDSI Flow test uses a reference syringe with a measured length of 61.5 mm from the zero line to the 10 mL line (BDTM syringes were used for the development of the tests – manufacturer code 301604). IDDSI is aware that there are some syringes that are labeled as 10 mL, but in fact have a 12 mL capacity. Results using a 12 mL syringe will be different to those from a true 10 mL syringe. As a result it is important to check the barrel length as shown on the diagram below. Details for conducting the test are shown below.
Videos showing the IDDSI Flow Test can also be viewed at: http://iddsi.org/framework/drink-‐testing-‐methods/
Drinks and liquids such as gravy, sauces and nutritional supplements are best assessed using the IDDSI Flow Test (Levels 0-‐3). For extremely thick drinks (Level 4), that do not flow through a 10 mL syringe in 10 seconds and are best consumed with a spoon, the IDDSI Fork Test and/or Spoon Tilt Test are recommended as methods for determining consistency.
The IDDSI Framework and Descriptors are licensed under the CreativeCommons Attribution-‐Sharealike 4.0 International License
https://creativecommons.org/licenses/by-‐sa/4.0/ March 4, 2017
5
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
&!
)//2$%U-$-+*3"%5/%2+5-%#1%5"-%+*-+%/J%J//2%5-a57*-%,-+$7*-,-15%*-Y7#*-$%3/,46-a%+12%-a4-1$#9-%,+3"#1-*D%$73"%+$%)//2%!-a57*-%:1+6D$-*$>%Z#9-1%5"-%2#JJ#3765D%.#5"%+33-$$%5/%$73"%-Y7#4,-15%+12%5"-%-a4-*5#$-%*-Y7#*-2%J/*%5-$5#1C%+12%#15-*4*-5+5#/1F%,+1D%-a#$5#1C%1+5#/1+6%5-*,#1/6/C#-$%"+9-%7$-2%2-5+#6-2%2-$3*#45/*$%5/%2-$3*#;-%J//2%5-a57*-%#1$5-+2>%%!"-%$D$5-,+5#3%*-9#-.%2-,/1$5*+5-2%5"+5%5"-%4*/4-*5#-$%/J%"+*21-$$F%3/"-$#9-1-$$%+12%$6#44-*#1-$$%.-*-%#,4/*5+15%J+35/*$%J/*%3/1$#2-*+5#/1%M(5--6-%-5%+6>F%G?H]O>%&1%+22#5#/1F%$#\-%+12%$"+4-%/J%J//2%$+,46-$%"+9-%;--1%#2-15#J#-2%+$%*-6-9+15%J+35/*$%J/*%3"/0#1C%*#$0%MW-11-2D%-5%+6>F%G?H=S%8"+4#1%-5%+6>F%G?H_S%Q+4+1-$-%)//2%(+J-5D%8/,,#$$#/1F%G?H?S%E/*6-D%-5%+6>F%G??=S%E7%-5%+6>F%HhhHS%V-*\6+1/9#3"%-5%+6>%HhhhS%K/6+3"%-5%+6>F%Hhh=S%8-15*-%J/*%'#$-+$-%8/15*/6%+12%L*-9-15#/1F%G??GF%U#,,-66%-5%+6>F%Hhh]S%(-#2-6%-5%+6>F%G??GO>%%&1%9#-.%/J%5"#$%#1J/*,+5#/1F%,-+$7*-,-15%/J%J//2$%1--2$%5/%3+457*-%;/5"%5"-%,-3"+1#3+6%4*/4-*5#-$%M->C>%"+*21-$$F%3/"-$#9-1-$$F%+2"-$#9-1-$$%-53>O%+12%5"-%C-/,-5*#3+6%/*%$"+4-%+55*#;75-$%/J%5"-%J//2>%!"-%&''(&%2-$3*#45#/1$%/J%J//2%5-a57*-%+12%3"+*+35-*#$5#3$F%J//2%5-a57*-%*-Y7#*-,-15$%+12%*-$5*#35#/1$%"+9-%;--1%C-1-*+5-2%J*/,%-a#$5#1C%1+5#/1+6%5-*,#1/6/C#-$%+12%5"-%6#5-*+57*-%2-$3*#;#1C%4*/4-*5#-$%5"+5%#13*-+$-%*#$0%J/*%3"/0#1C>%%%:%3/,;#1+5#/1%/J%5-$5$%,+D%;-%*-Y7#*-2%5/%2-5-*,#1-%."#3"%3+5-C/*D%+%J//2%J#5$%#15/>%%!-$5#1C%,-5"/2$%J/*%47*--$F%$/J5F%J#*,%+12%$/6#2%J//2$%#13672-A%!"-%)/*0%'*#4%5-$5F%(4//1%!#65%5-$5F%)/*0%/*%(4//1%L*-$$7*-%!-$5F%8"/4$5#30%!-$5%+12%)#1C-*%5-$5>%d#2-/$%$"/.#1C%-a+,46-$%/J%5"-$-%5-$5#1C%,-5"/2$%3+1%;-%J/712%+5A!"554ABB#22$#>/*CBJ*+,-./*0BJ//2<5-$5#1C<,-5"/2$B%%%%
)/*0%'*#4%!-$5)!"#30%2*#10$%+12%J67#2%J//2$%M@-9-6$%_%+12%=O%3+1%;-%5-$5-2%;D%+$$-$$#1C%."-5"-*%5"-D%J6/.%5"*/7C"%5"-%$6/5$B4*/1C$%/J%+%J/*0%+12%3/,4+*#1C%+C+#1$5%5"-%2-5+#6-2%2-$3*#45#/1$%/J%-+3"%6-9-6>%)/*0%2*#4%5-$5$%+*-%2-$3*#;-2%#1%-a#$5#1C%N+5#/1+6%5-*,#1/6/C#-$%#1%:7$5*+6#+F%&*-6+12F%N-.%X-+6+12%+12%5"-%R1#5-2%W#1C2/,%M:5"-*5/1%-5%+6>F%G??IS%&:(@!%+12%&*#$"%N75*#5#/1%P%'#-5-5#3%&1$5#575-%G??hS%N+5#/1+6%L+5#-15%(+J-5D%:C-13DF%U/D+6%8/66-C-%(4--3"%P%@+1C7+C-%!"-*+4#$5$F%V*#5#$"%'#-5-5#3%:$$/3#+5#/1F%N+5#/1+6%N7*$-$%N75*#5#/1%Z*/74F%T/$4#5+6%8+5-*-*$%:$$/3#+5#/1%G?HHO>%%%&,+C-$%J/*%@-9-6%_%<%@#Y7#2#$-2BE/2-*+5-6D%!"#30%+*-%$"/.1%;-6/.>%%%%)))))))))
'()*+!+,-.,/!-(!)0!1-,,-*+2+3(401+!35(-675!358!
3)08+2*(-07+!-9!4!9-(:!
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
;!
&,+C-$%J/*%@-9-6%=%<%L7*--2B[a5*-,-6D%!"#30%+*-%$"/.1%;-6/.>%))
)
))
)
))
))))
)))
(4//1%!#65%!-$5%!"-%$4//1%5#65%5-$5%#$%7$-2%5/%2-5-*,#1-%5"-%$5#30#1-$$%/J%5"-%$+,46-%M+2"-$#9-1-$$O%+12%5"-%+;#6#5D%/J%5"-%$+,46-%5/%"/62%5/C-5"-*%M3/"-$#9-1-$$O>%!"-%(4//1%!#65%!-$5%#$%2-$3*#;-2%#1%-a#$5#1C%N+5#/1+6%5-*,#1/6/C#-$%#1%:7$5*+6#+F%&*-6+12F%N-.%X-+6+12%+12%5"-%R1#5-2%W#1C2/,%M:5"-*5/1%-5%+6>F%G??IS%&:(@!%+12%&*#$"%N75*#5#/1%P%'#-5-5#3%&1$5#575-%G??hS%N+5#/1+6%L+5#-15%(+J-5D%:C-13DF%U/D+6%8/66-C-%(4--3"%P%@+1C7+C-%!"-*+4#$5$F%V*#5#$"%'#-5-5#3%:$$/3#+5#/1F%N+5#/1+6%N7*$-$%N75*#5#/1%Z*/74F%T/$4#5+6%8+5-*-*$%:$$/3#+5#/1%G?HHO>%%!"-%(4//1%!#65%!-$5%#$%7$-2%4*-2/,#1+156D%J/*%,-+$7*-$%/J%$+,46-$%#1%6-9-6$%=%+12%]>%!"-%$+,46-%$"/762A%
• V-%3/"-$#9-%-1/7C"%5/%"/62%#5$%$"+4-%/1%5"-%$4//1%• :%J766%$4//1J76%,7$5%$6#2-B4/7*%/JJ%5"-%$4//1%#J%5"-%$4//1%#$%5#65-2%/*%57*1-2%$#2-.+D$%/*%$"+0-1%
6#C"56DS%5"-%$+,46-%$"/762%$6#2-%/JJ%-+$#6D%.#5"%9-*D%6#556-%J//2%6-J5%/1%5"-%$4//1S%#>->%5"-%$+,46-%$"/762%1/5%;-%$5#30D%
• :%$3//4-2%,/712%,+D%$4*-+2%/*%$67,4%9-*D%$6#C"56D%/1%+%46+5-)
))))
(#5$%#1%+%,/712%/*%4#6-%+;/9-%5"-%J/*0%
:%$,+66%+,/715%,+D%J6/.%5"*/7C"%+12%J/*,%+%5+#6%;-6/.%5"-%J/*0%
'/-$%1/5%2/66/4F%J6/.%/*%2*#4%3/15#17/7$6D%5"*/7C"%5"-%J/*0%4*/1C$%
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
<!
(/J5F%J#*,%+12%"+*2%J//2%5-a57*-%+$$-$$,-15))/*%$/J5F%"+*2%/*%J#*,%J//2F%5"-%J/*0%"+$%;--1%3"/$-1%5/%+$$-$$%J//2%5-a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a#,7,%.#25"%/J%5"-%3"#62`$%J#J5"%J#1C-*1+#6%M6#556-$5%J#1C-*O%$"/762%1/5%3+7$-%+%3"/0#1C%*#$0%+$%5"#$%,-+$7*-,-15%#$%7$-2%5/%4*-2#35%5"-%#15-*1+6%2#+,-5-*%/J%+1%-12/5*+3"-+6%57;-%#1%5"-%4+-2#+5*#3%4/476+5#/1%M!7*0#$5+1#%-5%+6>F%G??hO>)
%%%%8/,46#+13-%.#5"%=,,%4+*5#36-%$#\-%3+1%;-%2-,/1$5*+5-2%.#5"%+%J/*0%+$%$"/.1%#1%5"-%#,+C-$%/44/$#5->%%%%%%%%
:$$-$$#1C%J/*%H],,%MH>]3,O%4+*5#36-%$#\-%3/,46#+13-%)/*%"+*2%+12%$/J5%$/6#2%J//2$F%+%,+a#,7,%J//2%$+,46-%$#\-%/J%H>]%a%H>]%3,%#$%*-3/,,-12-2F%."#3"%#$%5"-%+44*/a#,+5-%$#\-%/J%5"-%+2765%"7,+1%5"7,;%1+#6%ME7*2+1F%G?HHO>%!"-%-15#*-%.#25"%/J%+%$5+12+*2%J/*0%+6$/%,-+$7*-$%+44*/a#,+5-6D%H>]3,%+$%$"/.1%#1%5"-%#,+C-$%;-6/.>%H>]%a%H>]%3,%4+*5#36-%$#\-%#$%*-3/,,-12-2%J/*%@-9-6%f < (/J5%P%V#5-<$#\-2%5/%*-273-%*#$0%+$$/3#+5-2%.#5"%+$4"Da#+5#/1%J*/,%3"/0#1C%/1%J//2%MV-*\6+1/9#3"%-5%+6>F%G??]S%V/*2$0D%-5%+6>F%HhhfS%@#5,+1%-5%+6>F%G??_O>%%%%%%%%
%%
%
!!
"!
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
=!
)/*0%L*-$$7*-%!-$5%+12%(4//1%L*-$$7*-%!-$5%%:%J/*0%3+1%;-%+446#-2%5/%5"-%J//2%$+,46-%5/%/;$-*9-%#5$%;-"+9#/7*%."-1%4*-$$7*-%#$%+446#-2>%L*-$$7*-%+446#-2%5/%5"-%J//2%$+,46-%"+$%;--1%Y7+15#J#-2%;D%+$$-$$,-15%/J%5"-%4*-$$7*-%1--2-2%5/%,+0-%5"-%5"7,;%1+#6%;6+13"%1/5#3-+;6D%5/%."#5-F%+$%2-,/1$5*+5-2%;D%5"-%+**/.$%#1%5"-%#,+C-%+5%6-J5>%%%%%%
!"-%4*-$$7*-%+446#-2%5/%,+0-%5"-%5"7,;%1+#6%;6+13"%"+$%;--1%,-+$7*-2%+5%i%HI%0L+>%!"#$%4*-$$7*-%#$%3/1$#$5-15%.#5"%5/1C7-%J/*3-%7$-2%27*#1C%$.+66/.#1C%M(5--6-%-5%+6>F%G?H=O>%&1%5"-%#,+C-%+5%*#C"5F%4*-$$7*-%#$%;-#1C%2-,/1$5*+5-2%#1%0#6/4+$3+6$%7$#1C%+1%&/.+%b*+6%L-*J/*,+13-%&1$5*7,-15>%!"#$%#$%/1-%2-9#3-%5"+5%3+1%;-%7$-2%5/%,-+$7*-%5/1C7-%4*-$$7*->%%%
%)/*%+$$-$$,-15%7$#1C%5"-%)/*0%L*-$$7*-%!-$5F%#5%#$%*-3/,,-12-2%5"+5%5"-%J/*0%;-%4*-$$-2%/15/%5"-%J//2%$+,46-%;D%46+3#1C%5"-%5"7,;%/15/%5"-%;/.6%/J%5"-%J/*0%Me7$5%;-6/.%5"-%4*/1C$O%715#6%;6+13"#1C%#$%/;$-*9-2F%+$%$"/.1%#1%5"-%#,+C-%+5%6-J5>%&5%#$%+44*-3#+5-2%5"+5%J/*0$%+*-%1/5%*-+2#6D%+9+#6+;6-%#1%$/,-%4+*5$%/J%5"-%./*62>%L*-$$7*-%+446#-2%7$#1C%5"-%;+$-%/J%+%5-+$4//1%,+D%4*/9#2-%+%7$-J76%+65-*1+5#9->%%
%8"/4$5#30%!-$5%+12%)#1C-*%5-$5%:$$-$$,-15%.#5"%3"/4$5#30$%"+$%;--1%#13672-2%#1%5"-%&''(&>%)#1C-*%5-$5$%"+9-%;--1%#13/*4/*+5-2%#1%*-3/C1#5#/1%5"+5%5"#$%,+D%;-%5"-%,/$5%+33-$$#;6-%,-5"/2%#1%$/,-%3/715*#-$>%%%%%%%%%%%%%%%%%%%
%
&,+C-%7$-2%.#5"%4-*,#$$#/1%;D%&bL&%E-2#3+6%
!"-%&''(&%)*+,-./*0%+12%'-$3*#45/*$%+*-%6#3-1$-2%712-*%5"-%%8*-+5#9-8/,,/1$%:55*#;75#/1<("+*-+6#0-%=>?%&15-*1+5#/1+6%@#3-1$-%%
"554$ABB3*-+5#9-3/,,/1$>/*CB6#3-1$-$B;D<$+B=>?B%E+*3"%=F%G?HI%
>?!
!*+1$#5#/1+6%J//2%5-a57*-%+$$-$$,-15%!*+1$#5#/1+6%J//2%5-a57*-$%+*-%5"/$-%5"+5%$5+*5%+$%/1-%5-a57*-%M->C>%J#*,%$/6#2O%+12%3"+1C-%#15/%+1/5"-*%5-a57*-%$4-3#J#3+66D%."-1%,/#$57*-%M->C>%.+5-*%/*%$+6#9+O%#$%+446#-2F%/*%."-1%+%3"+1C-%#1%5-,4-*+57*-%/337*$%M->C>%"-+5#1CO>%%!"#$%J//2%5-a57*-%#$%7$-2%#1%2-9-6/4,-15+6%5-+3"#1C%/*%*-"+;#6#5+5#/1%/J%3"-.#1C%$0#66$>%)/*%-a+,46-%#5%"+$%;--1%7$-2%#1%5"-%2-9-6/4,-15%/J%3"-.#1C%#1%5"-%4+-2#+5*#3%4/476+5#/1%+12%2-9-6/4,-15+6%2#$+;#6#5D%4/476+5#/1%MZ#$-6%HhhHS%'/9-D%-5%+6>F%G?H_O>%%!/%+$$-$$%."-5"-*%+%$+,46-%J#5$%5"-%2-J#1#5#/1%/J%+%5*+1$#5#/1+6%J//2F%5"-%J/66/.#1C%,-5"/2%#$%+446#-2A%%R$-%+%$+,46-%5"-%$#\-%/J%5"-%5"7,;%1+#6%MH>]%3,%a%H>]%3,OF%46+3-%H%,6%/J%.+5-*%/1%5"-%$+,46-%+12%.+#5%/1-%,#175->%:446D%J/*0%4*-$$7*-%7$#1C%5"-%;+$-%/J%5"-%J/*0%715#6%5"-%5"7,;1+#6%;6+13"-$%5/%."#5->%!"-%$+,46-%#$%+%5*+1$#5#/1+6%J//2%5-a57*-%#J%+J5-*%*-,/9#1C%5"-%J/*0%4*-$$7*-A%• !"-%$+,46-%"+$%;--1%$Y7+$"-2%+12%2#$#15-C*+5-2%+12%1/%6/1C-*%6//0$%6#0-%#5$%/*#C#1+6%$5+5-%."-1%5"-%
J/*0%#$%6#J5-2%• !"-%$+,46-%3+1%;-%-+$#6D%;*/0-1%+4+*5%7$#1C%3"/4$5#30$%.#5"%,#1#,+6%4*-$$7*->%• !"-%$+,46-%;*-+0$%+4+*5%3/,46-5-6D%;D%*7;;#1C%5"-%$+,46-%;-5.--1%5"-%5"7,;%+12%#12-a%J#1C-*%+12%
2/-$%1/5%*-57*1%5/%#5$%#1#5#+6%$"+4->%• b*%#5%"+$%,-65-2%$#C1#J#3+156D%+12%1/%6/1C-*%6//0$%6#0-%#5$%/*#C#1+6%$5+5-%M->C>%#3-%3"#4$O>%%%
%%
%%
%%%%
%
%
)757*-%$572#-$%)7*5"-*%./*0%#$%*-Y7#*-2%5/%2-9-6/4%+1%#1-a4-1$#9-%;75%+337*+5-%5//6%5/%+$$#$5%.#5"%J//2%5-a57*-%+1+6D$#$>%
!
!"7,;%1+#6%;6+13"-2%5/%."#5-%
(+,46-%$Y7+$"-$%+12%J*+357*-$F%+12%2/-$%1/5%*-57*1%5/%#5$%/*#C#1+6%$"+4-%."-1%4*-$$7*-%#$%*-6-+$-2!
• :446D%H%,6%/J%.+5-*%5/%$+,46-%• K+#5%H%,#175-%
2344-.5678/79):-4;.+70<)=*0051>>/::</?-@9>A@6.+B-@C>D1)! &''(&%!-$5#1C%E-5"/2$%! &''(&%[9#2-13-%! &''(&%)*-Y7-156D%:$0-2%j7-$5#/1$%M):j$O%
!
The IDDSI Framework and Descriptors are licensed under the CreativeCommons Attribution-‐Sharealike 4.0 International License
https://creativecommons.org/licenses/by-‐sa/4.0/ March 4, 2017
11
References Ashida I, Iwamori H, Kawakami SY, Miyaoka Y, Murayama A. Analysis of physiological parameters of masseter muscle activity during chewing of agars in healthy young males. J Texture Stud. 2007;38:87–99. Atherton M, Bellis-‐Smith N, Cichero JAY, Suter M. Texture modified foods and thickened fluids as used for individuals with dysphagia: Australian standardised labels and definitions. Nutr Diet. 2007;64:53–76. Berzlanovich AM, Muhm M, Sim E et al. Foreign body asphyxiation—an autopsy study. Am J Med 1999;107: 351–5. Centre for Disease Control and Prevention. Non-‐fatal choking related episodes among children, United States 2001. Morb Mortal Wkly Rep. 2002; 51: 945–8. Chapin MM, Rochette LM, Abnnest JL, Haileyesus, Connor KA, Smith GA. Nonfatal choking on food among children 14 years or younger in the United States, 2001-‐2009,Pediatrics. 2013; 132:275-‐281. Cichero JAY, Steele CM, Duivestein J, Clave P, Chen J, Kayashita J, Dantas R, Lecko C, Speyer R, Lam P. The need for international terminology and definitions for texture modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep. 2013;1:280–91. Dovey TM, Aldridge VK, Martin CL. Measuring oral sensitivity in clinical practice : A quick and reliable behavioural method. Dysphagia. 2013; 28:501-‐510. Funami T, Ishihara S, Nakauma M, Kohyama K, Nishinari K. Texture design for products using food hydrocolloids. Food Hydrocolloids. 2012;26:412–20. Garcia JM, Chambers ET, Matta Z, Clark M. Viscosity measurementsof nectar-‐ and honey-‐thick liquids: product, liquid, and time comparisons. Dysphagia. 2005;20:325–35. Gisel EG. Effect of food texture on the development of chewing of children between six months and two years of age. Dev Med Child Neurol. 1991;33:69–79. Hadde EK, Nicholson TM, Cichero JAY. Rheological characterisation of thickened fluids under different temperature, pH and fat contents. Nutrition & Food Science, 2015a; 45 (2): 270 – 285. Hadde Ek, Nicholson TM, Cichero JAY. Rheological characterization of thickened milk components (protein, lactose and minerals). J of Food Eng. 2015b; 166:263-‐267. IASLT & Irish Nutrition and Dietetic Institute. Irish consistency descriptors for modified fluids and food. 2009. http://www.iaslt.ie/info/policy.php Accessed 29 April 2011.
ISO-‐7886-‐1: 1993 (E) Sterile hypodermic syringes for single use: Part 1: syringes for manual use. International Standards Organisation www.iso.org Japanese Food Safety Commission, Risk Assessment Report: choking accidents caused by foods, 2010. Kennedy B, Ibrahim JD, Bugeja L, Ranson D. Causes of death determined in medicolegal investigations in residents of nursing homes: A systematic review. J Am Geriatr Soc. 2014; 62:1513-‐1526. Kutter A, Singh JP, Rauh C & Delgado A. Improvement of the prediction of mouthfeel attributes of liquid foods by a posthumus funnel. Journal of Texture Studies, 2011, 41: 217-‐227.
The IDDSI Framework and Descriptors are licensed under the CreativeCommons Attribution-‐Sharealike 4.0 International License
https://creativecommons.org/licenses/by-‐sa/4.0/ March 4, 2017
12
Morley RE, Ludemann JP, Moxham JP et al. Foreign body aspiration in infants and toddlers: recent trends in British Columbia.J Otolaryngol 2004; 33: 37–41. Mu L, Ping H, Sun D. Inhalation of foreign bodies in Chinese children: a review of 400 cases. Laryngoscope 1991; 101: 657–660. Murdan S. Transverse fingernail curvature in adults: a quantitative evaluation and the influence of gender, age and hand size and dominance. Int J Cosmet Sci, 2011, 33:509-‐513. National Patient Safety Agency, Royal College Speech and Language Therapists, British Dietetic Association, National Nurses Nutrition Group, Hospital Caterers Association. Dysphagia diet food texture descriptions.2011. http://www.ndr-‐uk.org/Generalnews/ dysphagia-‐diet-‐food-‐texture-‐descriptors.html, Accessed 29 April 2011. O’Leary M, Hanson B, Smith C. Viscosity and non-‐Newtonian features of thickened fluids used for dysphagia therapy. J of Food Sci, 2010: 75(6): E330-‐E338. Peyron MA, Mishellany A, Woda A. Particle size distribution of food boluses after mastication of six natural foods. J Dent Res, 2004; 83:578–582. Rimmell F, Thome A, Stool S et al. Characteristics of objects that cause choking in children. JAMA 1995; 274: 1763–6. Seidel JS, Gausche-‐Hill M. Lychee-‐flavoured gel candies. A potentially lethal snack for infants and children. Arch Pediatr Adolesc Med 2002; 156: 1120–22. Sopade PA, Halley PJ, Cichero JAY, Ward LC. 2007. Rheological characterization of food thickeners marketed in Australia in various media for the management of dysphagia. I: water and cordial. J Food Eng 79:69–82. Sopade PA, Halley PJ, Cichero JAY, Ward LC, Liu J, Teo KH. 2008a. Rheological characterization of food thickeners marketed in Australia in various media for the management of dysphagia. II. Milk as a dispersing medium. J Food Eng 84(4):553–62. Sopade PA, Halley PJ, Cichero JAY, Ward LC, Liu J, Varliveli S. 2008b. Rheological characterization of food thickeners marketed in Australia in various media for the management of dysphagia. III. Fruit juice as a dispersing medium. J Food Eng 86(4):604–15. Steele, C, Alsanei, Ayanikalath et al.The influence of food texture and liquid consistency modification on swallowing physiology and function: A systematic review. Dysphagia. 2015; 30: 2-‐26.
Steele, C., Molfenter, S., Péladeau-‐Pigeon, M., Polacco, R. and Yee, C. Variations in tongue-‐palate swallowing pressures when swallowing xanthan gum-‐thickened liquid.Dysphagia.2014;29:1-‐7. Turkistani A, Abdullah KM, Delvi B, Al-‐Mazroua KA. The ‘best fit’ endotracheal tube in children. MEJ Anesth 2009, 20:383-‐387. Van Vliet T. On the relation between texture perception and fundamental mechanical parameters of liquids and time dependent solids. Food Quality and Preference, 2002: 227-‐236. Woda, A, Nicholas E, Mishellany-‐Dutour A, Hennequin M, Mazille MN, Veyrune JL, Peyron MA. The masticatory normative indicator. Journal of Dental Research, 2010; 89(3): 281-‐285.
Wolach B, Raz A, Weinberg J et al. Aspirated bodies in the respiratory tract of children: eleven years experience with 127patients. Int J Pediatr Otorhinolaryngol 1994; 30: 1–10.