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[Modern principles of assessing the effectiveness of dietetic nutrition in internal diseases].

Modern dietology is based on the metabolic principle. In all internal diseases it is composing a balanced diet adapted, above all, to metabolic disorders inherent in a given malady, that is envisaged. The range of current investigation methods permits it to ensure a strict control over the proportions of nutritional components in the dietary and to establish the limits of permissible increase or restriction of the content of each of them. Substance is given to dietetic approaches to various nosological forms of the disease that include the nutritional pattern, caloricity, qualitative and quantitative content of the nutrients.

Amino Acids↗

PubMed1984

[Legal requirements, quality criteria, therapeutic interest and dietetics of mineral waters: study of the case of the natural mineral water of Evian].

The considerable increase in mineral water sales as a daily drink reflects more or less the continued confidence in spa treatments, and this has caused the Public Authorities to set up very strict regulations in this field. We explain the main provisions of these regulations, compare mineral water with ordinary drinking water and complete this report with a study on the representative case of Evian Mineral water since it is the most exported water in the world. We emphasize the key points regarding the origin of the water which must be very well protected, its mineralization leading to its part played in dietetics and daily consumption, its use in spas and the research on its therapeutic effects, its bottling and the controls enabling its original high quality to be maintained. The conclusion reviews the motivations for the mineral water consumer: taste, quality, favorable effects on health. These motivations linked together have a varying importance according to the persons or situations involved. They result in precise requirements to be met by the producing companies in three fields: quality, advertising, credibility and scientific research.

Balneology↗

PubMed1984

Next please: a review of dietetic out-patient attendance.

During a 12-month period all new out-patients referred for dietetic advice to the Mid-Ulster Hospital, Magherafelt were carefully monitored with respect to age, sex, weight, reason for referral and source of referral. Their degree of interest and compliance with their diet as measured by their follow-up rate was recorded. Weight-reduction patients provided the bulk of new referrals, and the main source of patients generally was the hospital out-patient department. Diabetic and weight-reduction patients showed similar trends in follow-up rates with 46 per cent and 42 per cent of the total referrals respectively being classified as 'regular' attenders. Weight loss in weight-reduction patients who returned for reviews was encouraging, being on average 5.0 kg per patient. Drop-out rates for all patients were high.

Adolescent↗

PubMed1984

Leadership in clinical dietetics: meeting the challenge to roles in nutritional support.

The success of efforts to improve nutrition training of other health professionals poses a threat to the position of clinical dietitians as authorities in nutrition. In situations in which no dietitians are present or dietitians' skills are not recognized, pharmacists and nurses are especially likely to take over nutritional support roles traditionally assigned to the clinical dietitian. At the University of California, San Francisco, where dietitians are included in nutrition education and patient care programs and where understanding of the role of the dietitian is a stated educational goal, a preliminary survey suggests that conflicts occur in roles that are shared by members of nutritional support teams. Factors contributing to role conflicts include not only inadequate education of other health professionals but also problems of job expectations, education, training, and self-image among dietitians. Improved training in clinical nutrition, acquisition of better team and patient care skills, documentation of the effectiveness of dietetic services, and efforts to improve status and visibility would help alleviate role conflicts and ensure clinical dietitians a more rewarding place in the health care system.

Allied Health Personnel↗

PubMed1983

A profile of clinical dietetics practice in Pennsylvania.

Clinical dietitians in Pennsylvania (N = 185) responded to a survey (based on the practice description developed by the Clinical Dietetics Profession Team of the Continuing Professional Education Development Project) in which they rated time spent on and perceived importance of 11 responsibilities and 120 tasks in their practice. Practitioners spent the most time on responsibilities and tasks that they perceived to be most important. Responsibilities rated high in terms of time spent and importance were nutrition care implementation, nutrition care planning, nutrition assessment, and nutrition care evaluation. Dietitians reported spending a considerable amount of time on activities related to documentation.

Attitude of Health Personnel↗

PubMed1984

A computer-managed clinical evaluation system: implications for competency-based dietetic education programs.

Instruments for evaluating clinical performance of students were developed, tested, and designed for a computer-managed evaluation system for the competency-based dietetic internship program at Emory University, Atlanta. The development, evaluation, and utilization of the instruments are described. The method of development included: (a) analysis of validated competencies and performance criteria to determine aspects of behavior appropriate to measure in clinical settings, (b) specification of major areas to be evaluated, (c) specification of component behaviors within each of the major areas, (d) specification of criteria to be used in evaluating component behaviors, and (e) definition of the rating continuum. Validation of the instruments consisted of determinations of content validity, interrater reliability, and practicality. Results of the use of the computer-managed evaluation system indicated that the instruments were valid, reliable, and practical to use for evaluating students' clinical performance.

Computers↗

PubMed1982

Cost-effectiveness of undergraduate programs in dietetics.

This study compares traditional undergraduate programs in dietetics with the new coordinated programs in six institutions which offer both. Cost is defined as the direct cost of instruction; effectiveness is defined as the proportion of graduates who pass the Registration Examination. Results show that although traditional and coordinated programs were equivalent in cost and in number of graduates, traditional programs produced fewer students eligible to take the examination and therefore fewer who passed it. Traditional undergraduate programs were, then, less effective in providing professionally qualified entry-level dietitians, according to this survey.

Competency-Based Education↗

PubMed1983

Dietetic technicians' performance: supervisory and self-assessments.

The performance of dietetic technicians was examined from two perspectives. Supervisors provided evaluation data, and technicians reported priority of various task functions. The survey sample consisted of ADA technician members and graduates of ADA-approved programs. Most of the technicians reported they were functioning in positions requiring backgrounds primarily in nutrition care or with equal emphasis on food service management and nutrition. Few were in positions with a food service management emphasis. Supervisors' ratings indicated the technicians' performance was satisfactory to above average, with general to little or no supervision needed.

Allied Health Personnel↗

PubMed1983

Dietetics training for American Indians and Alaskan natives.

The response to training has been enthusiastic. Even in these times of limited funds, applications to attend training exceed the available space. From the first class in October 1968 through September 1982, nearly 1,300 Indian and Alaskan native hospital food service employees and employees representing tribal programs throughout the country have received training from the courses and workshops provided by the Nutrition and Dietetics Training Program. With the increasing involvement of Native Americans in their own health care programs, the need for training in foods and nutrition will continue.

Alaska↗

PubMed1983

Hospital dietetics and food service in developing countries: II. Lebanon.

A survey of 15 hospitals in Lebanon revealed that food service personnel in most hospitals had no training in nutrition, dietetics, or food service management. Kitchen sanitation was inadequate. Therapeutic diets were usually incorrectly planned and seldom used. The need for training food service personnel was recognized only in hospitals with some trained persons on the staff.

Data Collection↗

PubMed1978

Introducing dietetics into general practice.

A dietetic clinic, initially monthly, now weekly, is held in a general medical practice with four partners. In one year 462 patients were seen (207 new and 255 repeat visits); 68% were on reducing diets and 8% were diabetics. Advice was given on a variety of therapeutic diets, ante-natal and infant feeding. The elderly were visited at home. Patients were pleased to have dietary advice available in general practice. Results of weight reductions have been encouraging. Prescriptions for appetite suppressants and laxatives have dropped.

Aged↗

PubMed1980

A prenatal nutrition project using dietetic students in physicians' offices.

A prenatal nutritional counseling project utilizing senior dietetic students in private physicians' offices was developed. The objectives were to provide sound nutritional information to pregnant women and a realistic work experience for students committed to a career in nutritional counseling. The results were positive for the patients, the participating physicians, and the student nutritionists. Further research is indicated to determine the specific effect of nutritional counseling on pregnancy outcomes.

Arizona↗

PubMed1977

Legal issues facing dietetic practice.

Malpractice is today's sword of Damocles threatening not only physicians but the entire health care community. For dietitians--clinical and administrative alike--there are a number of areas which could be sources of litigation involving negligence or lack of competency. Is the right therapeutic diet served to the right patient at the right time? A word to the wise would be: Always have records to substantiate professional judgments and actions, even though this means increased paper work. Another potential pitfall--which could result in revocation of licensure or accreditation--involves the standards of the Joint Commission on Accreditation of Hospitals (JCAH). Is scrupulous attention being paid to the JCAH's principles and four standards for dietetic practice? Violation of, for instance, Standard II relating to sanitation practices could bring about sanctions by the local or state health agency. Labor laws, too, have implications for dietitians. The recent change in the Taft-Hartley law brings hospitals under the jurisdiction of the National Labor Relations Board. Care must be taken not to violate its regulations. The federal Occupational Safety and Health Act is also concerned with sanitary and working conditions of employees. In contrast to such restrictive legislation, however, is the Health Professions Educational Assistance Act of 1976 which opens up new educational opportunities from which dietitians could benefit.

Accreditation↗

PubMed1997

Position of the American Dietetic Association: natural resource conservation and waste management.

ADA members are encouraged to evaluate their personal and professional practices and take action to more effectively conserve natural resources and protect the environment. Dietetics professionals' knowledge of the complexity of the issues associated with environmental concerns should be increased through participation in continuing education activities. Knowledgeable members should be proactive in implementing programs to conserve natural resources and protect the environment and participate in the legislative process within their states and communities. ADA supports programs designed to preserve natural resources and protect the environment. ADA is committed to enhancing the quality of life for future generations.

Air Pollution↗

PubMed2006

Measuring effectiveness of dietetic interventions in child obesity: a systematic review of randomized trials.

OBJECTIVES: To assess the effectiveness of dietetic treatment for obese children and to report details of dietary interventions. DATA SOURCES: English-language articles from 1975 to 2003 available from health and medical databases. STUDY SELECTION: Randomized controlled trials with subjects younger than 18 years of age that included a dietary intervention in isolation or in combination with lifestyle modifications and/or psychological therapies. One person searched the databases; 2 people independently critically appraised the articles for methodological quality and then extracted data using standardized tools. DATA EXTRACTION: Thirty-seven randomized controlled trials met the inclusion criteria; 17 contained sufficient information for a Forest plot of the standardized effects. Eight studies had a true control and were included in a meta-analysis. The random effects model was reported if the Q noncombinability chi(2) statistic was significant at the 10% level because it has low power as a strict test of homogeneity. DATA SYNTHESIS: The 2 strongly qualified meta-analyses suggest that interventions that include a dietary treatment do achieve relative weight loss. Details of the dietary intervention or participant food intake are rarely described. CONCLUSIONS: It is not possible to evaluate the effectiveness of dietary treatment for childhood obesity because of the lack of high-quality studies and the heterogeneity of designs, treatment combinations, outcome measures, and follow-up. There is an urgent need to improve the quality of studies in this area because childhood obesity poses major health risks for populations, yet there is limited evidence on which to base treatment strategies.

Adolescent↗

PubMed1979

[Enzymatic determination of glucose and saccharose in selected dietetic foods].

The need to enlarge the offer of dietetic foods requires more sensitive methods for the determination of certain food constituents. Thus, the exact estimation of glucose and saccharose in foods for diabetics is of particular importance. The enzymatic determination of the two sugars is suited for these purposes. The enzymatic method used by the authors is described. On the basis of results from their own investigations, the authors compare the values yielded by the enzymatic method with those obtained by means of the Luff-Schoorl procedure. The differences observed were more or less great from one food to another.

Diet, Reducing↗

PubMed1987

Changes in the fatty acid composition of dietetic ready-to-cook chicken meat products during frozen storage.

A study was made on the fatty acid composition of dietetic ready-to-cook products of boneless chicken legs or breasts prepared by curing using several curing mixtures during frozen storage. Leg muscles were found to be richer in unsaturated fatty acids than breast muscles, substantial differences having been found in the contents of palmitoleic and linolenic acids. During frozen storage, the contents of unsaturated fatty acids were reduced, especially intensively in the leg muscle ready-to-cook products. The fastest changes occurred in linolenic and linolic acids and partly in palmitic acid. The level of oleic acid remained substantially unchanged throughout the storage period. Irrespective of the changes found, the ratio of unsaturated and saturated fatty acids in all the groups studied remained greater than 1 for both types of meat. The application of citrate in the curing mixture had a favourable effect on the changes, in that a minimum alteration in the contents of unsaturated fatty acids was achieved.

Animals↗

PubMed2005

Consumer needs regarding dietetic products for pregnant and lactating women and for baby foods.

This meeting discussed the regulation, marketing and communication needs of these products from a consumer point of view. It was agreed, that clear and consistent messages are needed from health professionals, public authorities, industry and also the media. There is also a need to better understand the context in which choices of products are made. Research into these topics is reviewed in this paper, but it is obvious that more research into consumer and health professional behaviour is needed. This will allow best practices for communication of the use of dietetic foods for the important consumer group of lactating mothers and young parents.

Breast Feeding↗