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In Reply: In response to Dr Schultz and colleagues, there is evidence that ongoing support is required after a guideline is successfully implemented.¹ Minimally, this support should be provided in the form of ongoing active reminders and educational interventions that are repeated at regular intervals. Ideally, the timing of the educational intervals should match the influx of new trainees. It is likely that ongoing adherence is improved as more interventions (such as timely performance feedback) are included in the ongoing support package.

With regard to energy intake and volumes, Figure 4 in our article presented energy intake per day from days 1 to 7. To consider volumes delivered instead of energy intake, most of the enteral nutrition used in Australia and New Zealand (ANZ) is prepared at an energy density of 1 kcal per mL. Applying this correction to all reported energy intakes for enteral nutrition will yield values for . . . [Full Text of this Article]

Gordon S. Doig, PhD
gdoig@med.usyd.edu.au

Fiona Simpson, MND
University of Sydney
Sydney, Australia

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