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PubMedDate not supplied

Role of home total parenteral nutrition in management of obliterative peritonitis.

Two patients with obliterative peritonitis complicating enterocutaneous fistulae received total parenteral nutrition prior to surgical closure. One patient managed on home parenteral nutrition for 8 mo experienced psychosocial and nutritional rehabilitation at a daily cost of $37. Experience with the other patient confirmed that a significant resolution of obliterative inflammatory changes can occur during a 4-mon period of bowel rest when septic foci have been drained adequately. In-hospital management was required by this patient, and daily charges greatly exceeded those accrued by the other patient who could be managed at home. A home parenteral nutrition program is a cost-effective means of providing time for resolution of obliterative peritonitis.

Adult↗
PubMed1990

Effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women.

The purpose of this study was to test the effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women. A pretest-posttest nonequivalent control group design was used with a 2-3 month retest of the experimental group. The sample consisted of 506 experimental and 206 control group women who were clients of the Public Health Foundation's Nutrition Program for Women, Infants and Children in Los Angeles County. The program included a slide-tape presentation, and educational and resource brochures in English and Spanish. Knowledge, attitudes, and sexual and drug use practices were measured using a structured questionnaire that was developed in English and Spanish. Content validity and reliability of the questionnaire were established. A 2-way repeated measures ANOVA examined differences in pretest-posttest knowledge, attitudes, and practices for experimental and control groups and for both racial/ethnic groups. The experimental group made significant gains over the control group on pretest-posttest measures of knowledge and attitudes. Both experimental and control groups made significant changes in practice. Changes in knowledge were retained on retest; changes in practices came close to significance on retest. Blacks and Latinas differed on pretest knowledge and attitudes but not practices. Blacks had more knowledge and positive attitudes on pretest. However, posttest improvements for both knowledge and attitudes were greater in Latinas than in blacks. A multiple regression analysis revealed that the best predictors of knowledge, attitudes and practices were racial/ethnic group, education, and religion. It is concluded that a didactic audio visual program can positively affect the knowledge and possibly the practices of participants and that these are retained over time but that changes in attitudes will take further efforts.

Acquired Immunodeficiency Syndrome↗
PubMed1997

An assessment of the use and impact of ancillary prenatal care services to Medicaid women in managed care.

OBJECTIVES: Managed care plans under Medicaid are becoming a usual source of care for low-income pregnant women. This study describes an ancillary prenatal care service intervention developed by one managed care organization (MCO) for Medicaid-enrolled women, assesses the extent to which the intervention services were used, and appraises the influence of the intervention on prenatal care participation. METHOD: There were 226 intervention and 258 control women with a single live birth delivered between 28 and 44 weeks gestation who (1) were enrolled in the MCO's Medicaid program, (2) were high-risk based on a prenatal risk assessment, and (3) started prenatal care prior to 26 weeks gestation. Less than adequate and intensive prenatal care utilization were chosen as intervention outcomes measures. RESULTS: Family planning, a 2-month postpartum baby visit, a maternal postpartum visit, and a WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) referral were among the most self-selected intervention services for this population; home health aide and breast-feeding support were the least requested services. Over 90% of those needing family planning or breast-feeding services received the services, while over 20% of the intervention group refused child care, food assistance and family violence referrals, and home health aide and smoking cessation services. The intervention group had a significantly lower risk of less than adequate utilization of prenatal care (OR = .32; 95% CI: 0.17-0.60) and was more likely to have an intensive number of prenatal care visits (OR = 1.61; 95% CI: 1.05-2.48). CONCLUSIONS: The ability of managed care organizations to provide ongoing prenatal care to Medicaid populations in a cost-effective manner depends partly on their development of packages of prenatal services that foster positive preventive health care utilization behaviors and good pregnancy outcomes. The results of this project suggest that the intervention was beneficial in the area of improving utilization of prenatal care.

Adolescent↗
PubMedDate not supplied

[Postoperative enteral nutrition in patients with cancer of the neck and head].

Nutritional management of patients with head and neck cancer have received little attention in the literature, but its role in the management of patients undergoing surgical, chemotherapeutic, or radiotherapeutic treatment is gaining more importance. We present the nutritional results obtained in 69 patients who underwent oncological surgery for head and neck malignant tumours. Nutritional requirements were administered by enteral via, through a nasogastric tube. The results show no deterioration of the nutritional status during the postoperative period, with a positive nitrogenun balance from the beginning of the nutritional program. Results were measured using two anthropological measures (PCT and CMB) and two laboratory datas (Albuminum and transferrin).

Enteral Nutrition↗
PubMed1981

Changes in nitrogen metabolism in catabolic patients given three different parenteral nutrition regimens.

Nitrogen metabolism was investigated in 24 catabolic patients (15 men and 9 women) given three different parenteral nutrition regimens for 10-12 days. Energy was supplied as either carbohydrates alone (glucose group) or as carbohydrates and fats (lipid group) and nitrogen as amino acids. In the third group (amino acid group) amino acids were given in excess and less energy was supplied as carbohydrate. Each patient served as his own control. On the basis of daily urinary urea excretion all infused amino acid was retained in the body in the glucose and lipid groups during parenteral nutrition, but in the amino acid group 54% of infused amino acids were metabolized in gluconeogenesis apparently for energy production. In the glucose and lipid groups nitrogen balance rose to a "plateau" within 2-4 days but in the amino acid group within 5-7 days. The increment of nitrogen balance, 0.169 +/- 0.030 g N/kg/day, in the glucose group was greater than that, 0.140 +/- 0.037 g N/kg/day, in the lipid group (p less than 0.05) and that, 0.122 +/- 0.044 g N/kg/day, in the amino acid group (p less than 0.01). The initially low values of serum and liver protein did not change in the glucose and lipid groups, but in the amino acid group serum protein rose from 53.7 +/- 6.5 g/l to 61.1 +/- 5.9 g/l (less than 0.01) and liver protein from 47.4 +/- 7.2 mg/mgDNA to 65.0 +/- 22.6 mg/mgDNA (p less than 0.05). It seems tht a parenteral nutrition program rich in amino acids stimulates the vital protein synthesis of the liver more than regimens with abundance of non-nitrogen energy sources and poorer in amino acids. Nitrogen balance does not reveal information about the important protein metabolism of the liver. The results of this study support the opinion that during parenteral nutrition carbohydrates improve nitrogen balance more than isocaloric amount of fat.

Adult↗
PubMed2001

Evaluating the effectiveness of a home-based fall risk reduction program for rural community-dwelling older adults.

BACKGROUND: We investigated the effectiveness of a low-cost, multifactor fall risk reduction program in a group of rural community-dwelling older adults. The goal of the program was to provide health care workers and communities with a primary prevention tool that can be used to teach seniors about fall-related risks. The long-term goal of this program is to reduce the incidence of falling among community-dwelling older adults. METHODS: Complete data were collected on 37 community-dwelling subjects, aged 67 to 90, who participated in a 10-week fall risk reduction program. The subjects were randomly assigned to an intervention group or to a control group. The intervention group received fall risk education, home-based exercise programming, nutrition counseling, and environmental hazards education. Both groups completed a variety of physiologic, psychometric, and environmental fall-related risk assessments before and after the intervention period. RESULTS: The intervention group showed statistically significant improvement in balance, bicep endurance, lower extremity power, reduction of environmental hazards, falls efficacy, and nutritious food behavior during the study period. CONCLUSIONS: The low-cost, home-based fall risk reduction program for community-dwelling older adults was effective in reducing some of the studied fall-related risk factors over a 10-week period.

Accidental Falls↗
PubMed1984

Nutribusiness: an aspect of the political economy of persistent hunger.

The failure of nutrition programs to significantly impact on the prevalent hunger in underdeveloped countries is attributed to nutribusiness. This term conceptually links the activities of profit-motivated capitalist enterprises to the continuous generation of poverty and hunger. The actors are all part of a hierarchy dominated by multinational corporate interests and including bilateral and multilateral aid agencies, nutrition institutes, and nutrition professionals at various levels. Although many lower-level nutrition workers are unwittingly caught up in the system, most of the higher-level professionals are conscious of their roles, which they selfishly perform for personal advancement. The Philippine nutrition system is examined as an example of nutribusiness, albeit in a very obvious and extreme form. On the available evidence, the conclusion is drawn that in countries dominated by capitalist production, nutrition activities amount to nutribusiness. Consequently, the elimination and prevention of persistent hunger in underdeveloped countries must start with their disengagement from the world capitalist system and their pursuit of socialist transformation.

Allied Health Personnel↗
PubMed2002

[Microgravity and weightlessness: experimental model accelerates nutritional pathology].

Short space flights affect nutritional intakes, body composition and functional parameters. Prolonged space flights (SF) over weeks or months further worsen these alterations and result in acute or chronic physical deterioration at earth return. Current planning of SF to Mars, with microgravity conditions for more than 2 years, stresses the need for developing and optimising a nutritional program and physical countermeasures to prevent body mass atrophy and functional body alterations. This review presents the models of microgravity simulation on earth and the main effects of weightlessness on body composition, protein metabolism, hormonal profile and muscle function. It summarizes contradictory findings related to the oxidative stress related to SF. It discusses potential countermeasures (nutrition, physical activity) to the negative effects of microgravity on human body. Future research possibilities in ground and space medicine are evoked.

Aerospace Medicine↗
PubMed2005

Review of the South African nutrition policy 1994-2002 and targets for 2007: achievements and challenges.

Primary and secondary nutrition interventions are essential in South Africa, a country with mortality rates of 45.2 deaths per 1000 live births and 61 per 1000 for children younger than 5 y and an estimated prevalence of 8.3% for low birth weight. In addition, the National Food Consumption Survey has recently reported that approximately one in five children 1 to 9 y of age in South Africa are stunted (21.6%) and 1 in 10 (10.3%) is underweight for age. The prevalence of stunting was highest in children 1 to 3 y old (25.5%) and lowest in those 7 to 9 y old (13%). In terms of overnutrition, the survey also reported overweight and obesity in 17.1% of the sample at the national level. In this overview, the focus areas of the Integrated Nutrition Program are examined and critically discussed to determine whether targets planned for 2002 were met and how they are envisioned to change by 2007.

Adolescent↗
PubMed1999

[Adult body height in women in Cordoba, Argentina, and exploration of the current trend (1978-198)].

The objective of this work was to contribute local data concerning the full adult height of women in Cordoba, Argentina, and to explore the possibility of a secular trend in their heights. For the study, 513 women were examined during May and June 1994. All of the women were between 18 and 40 years of age and were mothers of children who were included in a study on lactation, feeding, growth, and development in Córdoba. The measurements were carried out applying standardized techniques and using as a reference standard the 50th-percentile level data from the U.S. National Center for Health Statistics. The mean full height of the Córdoba population studied was 157.9 cm, 0.97 standard deviation (SD) below the reference norm. For the women from the highest of six socioeconomic strata, the mean height was 159.7 cm (-0.67 SD); the mean for women from the lowest stratum was 156.2 cm (-1.25 SD). The difference in the means of those two socioeconomic groups was statistically significant (P < 0.001). Of the population studied, 2.3% (6.4% of the lowest social stratum) were shorter than 145 cm. In order to explore the possibility of a secular trend, the resulting data were categorized into two groups according to the mother's age at the time of the anthropometric examination, one group with a mean age of 24 and a second group with a mean age of 34. The younger women had a mean adult height 0.4 cm greater than that of the older women (P = 0.47). This secular increase in height is notably smaller than that reported for other Argentine provinces (1.2 and 1.4 cm/decade) and somewhat lower than the average reported in population studies in Australia, Belgium, the United States, Japan, and Norway (0.6 cm/decade). The authors conclude that in the period analyzed, 1978-1988, the living conditions in the city of Córdoba have not improved in a way that is reflected in a significant increase in the height of adult women. The authors recommend that maternal health and nutrition programs concentrate their resources on the mothers from the lowest socioeconomic stratum who are shorter than 145 cm.

Adolescent↗
PubMed2001

5 a day fruit and vegetable intervention improves consumption in a low income population.

OBJECTIVE: This study evaluated the Michigan Farmers' Market Nutrition Program in one Michigan county to determine its effect on fruit and vegetable consumption behavior. SUBJECTS/SETTING: Subjects were selected from WIC and Community Action Agency populations: 564 low income women completed the pretest; 455 completed the posttest. Attrition rate was 19.3%. INTERVENTION: Subjects were assigned to one of 4 interventions: education about the use, storage and nutritional value of fruits and vegetables, distribution of farmers' market coupons, both education and coupons, or no intervention. DESIGN: Education-only and coupon and education groups were randomly assigned; clinic appointment timing determined assignment to no-intervention and coupon-only groups. MAIN OUTCOME MEASURES: A self-administered questionnaire before and after intervention measured attitudes about fruit and vegetable consumption and intake of fruits and vegetables. WIC records documented redemption of coupons. STATISTICAL ANALYSES: Data analysis included 2-way multivariate analysis of covariance, univariate analysis of covariance, logistic regression, and covariance structure modeling. RESULTS: Both the education interventions and the coupon interventions had positive effects. Coupons had a direct effect on increasing fruit and vegetable consumption behavior but no effect on attitudes. Education had a direct effect on attitudes and seemed to exert an effect on consumption behavior through attitudes. The maximum impact of the intervention was achieved through a combination of education and coupons. APPLICATIONS: This study demonstrated that a low-income population may be more likely to increase its fruit and vegetable consumption behavior when incentives such as coupons improve affordability.

Analysis of Variance↗
PubMedDate not supplied

Nutrition intervention in pediatric patients with thermal injuries who require laparotomy.

Increased intra-abdominal pressure is a complication of thermal injuries that is most commonly noted during burn shock or sepsis. Severely elevated intra-abdominal pressure requires surgical treatment by laparotomy to avert cardiac, respiratory, and renal compromise. The purpose of this retrospective study was to examine the manipulation of the nutrition program and outcomes in response to such a procedure. Open laparotomy for increased intra-abdominal pressure was necessary for 6 patients admitted to a pediatric burn facility from March 1993 to April 1999. One patient was excluded from the review because he died 2 days after the burn injury (1 day after the laparotomy) and nutrition intervention was not initiated. Four of the five remaining patients received parenteral nutrition within 48 hours of surgery. One patient did not receive parenteral nutrition because the enteral regimen was at the goal by 5 days after the laparotomy. Trophic enteral feedings were initiated in all 5 patients within 48 hours of the operations. Tube feedings were gradually increased and the parenteral nutrition rate was decreased in accordance with gastrointestinal tolerance (abdominal girth, bowel motility). Enteral nutrition was started before abdomen closure in all of the patients. No mechanical, infectious, or mortality-related complications related to the initiation of enteral nutrition after open laparotomies were noted. Surgical intervention by open laparotomy interrupts the postburn nutrition regimen but does not preclude the safe postoperative delivery and advancement of enteral feedings.

Adolescent↗
PubMed1983

[Soy beans as an alternative in infant nutrition in a community of northeastern Brazil].

The use of a powdered soy extract (30% protein) as a supplement in infant feeding for children from 2-24 months who had stopped breastfeeding was tested for acceptance and impact in two semi-rural communities in the State of Bahia in Northeast Brazil. The product was supplied gratuitously by a Brazilian soy bean processing firm. The introduction of the product was one aspect of a University-sponsored integrated community-action program. Nutritional status was determined by weight for age, using the Gomez classification (Marcondes, Class IV). There was a statistically significant difference in improvement in the nutritional status of those children who received the soy supplement.

Anthropometry↗
PubMed1999

Staging of dietary patterns among African American women.

This article describes the development of a behavioral staging algorithm for use in the Eat Well, Live Well Nutrition Program, a peer-delivered community-based program for African American women (N = 301). The authors examined whether increased frequency in performing low-fat eating behaviors and lower percentage calories from fat intake resulted as a participant moved through five stages of readiness to change each of five low-fat dietary patterns. Frequency of performing low-fat dietary behaviors was significantly different (p<.05) between four stages for the pattern of avoid fried foods, three stages for modify meats, and two stages for the patterns of substitution, avoid fat as seasoning, replacement. Percentage calories from fat were significantly different (p<.05) between four stages for the pattern of replacement, three stages for avoid fried foods and modify meats, and two stages for substitution and avoid fat as seasoning. Implications of these findings for the tailoring of community-based dietary programs are presented.

Adult↗
PubMed1993

[Needs of caregivers and needs of the dying regarding food].

The need for food in dying patients varies from one individual to the next. This requires the nursing staff to establish a precise history of the eating and drinking habits of these patients and their families. The necessary care is based on this history, on the professional knowledge of the nursing personnel, and on the ethical guidelines of the Swiss Association of Nursing Personnel, published in 1990. Care and nutrition programs must be reevaluated daily and adapted to the changing situation of the patient. The paper presents six major strategies drawn up by Brown and Chekryn in 1987 in order to assist nursing staff in coping with dehydration problems. Five (non-representative) interviews with experienced nurses throw light on the importance of giving special consideration to the nutritional needs of dying patients.

Attitude↗
PubMed1982

Nutritional support of central catecholaminergic tone may aid smoking withdrawal.

Nicotine increases the release and turnover of catecholamines in the brain, and many features of the tobacco withdrawal syndrome--such as drug craving, poor concentration, impaired motor performance, drowsiness, fatigue, increased appetite with hyperphagia--may reflect diminished central catecholaminergic tone. Support of central catecholamine synthesis with the nutrients tyrosine and glucose tolerance factor (which enhance brain tyrosine levels) may lessen tobacco withdrawal symptoms and may increase the chance of success in smoking cessation programs. Nutritional measures of this type would probably be safer and more appropriate for long-term use than central-stimulant drugs.

Catecholamines↗
PubMed1996

Potential cost savings for Medi-Cal, AFDC, food stamps, and WIC programs associated with increasing breast-feeding among low-income Hmong women in California.

OBJECTIVE: To determine the potential cost savings for four social service programs if breast-feeding rates increased among Hmong women in California. DESIGN: Cost-savings analysis. SUBJECTS/SETTING: Hmong women in California. In this population, breast-feeding is currently uncommon, and use of contraceptives is minimal. MAIN OUTCOME MEASURES: Savings were based on estimates of the resulting decrease in infant morbidity, maternal fertility, and formula purchases (Special Supplemental Nutrition Program for Women, Infants, and Children) if women breast-fed each child for at least 6 months. Costs were projected over a 7.5-year period and future values were discounted with annual interest rates of 2% or 4%. RESULTS: Substantial savings estimates were associated with breast-feeding for all four programs. The total projected savings over the 7.5-year period ranges from $3,442 to $4,944 (4% discount) to $4,475 to $6,0960 (0% discount) per family enrolled in all four programs. This translates into an estimated yearly savings of between $459 and $659 (4% discount) and $597 and $808 (0% discount) per family. APPLICATIONS: Although health care providers generally accept that breast-feeding is the preferred method for feeding infants, many still view the choice as a neutral one; that is, they consider low breast-feeding rates in the United States a cultural choice with no cost to society. This analysis provides evidence that breast-feeding is economically advantageous for individuals and society.

Aid to Families with Dependent Children↗
PubMed2001

The "fetal origins" hypothesis: challenges and opportunities for maternal and child nutrition.

The "fetal origins" hypothesis postulates that conditions, most likely nutritional, "program" the fetus for the development of chronic diseases in adulthood. Associations between the newborn's size at birth and various determinants or consequences of chronic diseases have been identified in many, but not all, of the available studies. It remains to be established whether these associations are causal. Remarkably little information is available on the specific role of maternal nutritional status. The role of birth weight remains difficult to interpret except as a proxy for events in intrauterine life. Unfortunately, birth weight does not make an important contribution to the population attributable risk of cardiovascular disease; lifestyle factors during adulthood make much greater contributions. Data from experimental species suggest possible mechanisms for the origin of chronic disease early in life. It is too soon to use this research as a basis for new interventions directed at pregnant women for the purpose of reducing chronic disease in their offspring.

Birth Weight↗