[Planning of nutrition education in school programs].
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Curriculum↗
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Nutritional assessment in health programs.
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Adolescent↗
Post-baccalaureate activities of community nutrition graduates.
A comparison was made of the employment status of graduates of three types of programs in community nutrition. Graduates of community nutrition programs were less likely to be employed in dietetics or nutrition-related positions; were less likely to be registered dietitians or to have fulfilled requirements for professional registration; and were less likely to recommend the profession than were graduates of coordinated undergraduate programs or of programs in general dietetics or foods and nutrition. Implications for student counseling and professional accreditation are discussed.
Community Health Services↗
Developing nutrient criteria for food-specific dietary guidelines for the general public.
Consumers are asking for specific information about which foods and, in particular, which brands of packaged foods to choose when they eat or purchase food. Point-of-purchase nutrition intervention programs that identify specific foods in restaurants and grocery stores are particularly promising community-based strategies for providing that type of information. However, such strategies demand consistent criteria for determining which foods and/or products should be labeled. This article describes the process of developing and validating criteria and the subsequent uses of the criteria in community nutrition intervention programs. Steps in the process include (a) identifying the scientific basis for the criteria, (b) developing food-group-specific nutrient criteria based on a referent meal pattern, (c) developing the eligibility of single servings of specific foods for labeling based on the nutrient criteria of the food group to which the specific food belongs, and (d) validating the criteria by reviewing actual food products in the grocery stores and restaurants. We conclude that the use of criteria provides a consistent standard for evaluating specific foods and food items in nutrition evaluation programs.
Diet↗
[Percutaneous endoscopic gastrostomy and gastrojejunostomy. Experience and its role in domiciliary enteral nutrition].
UNLABELLED: Percutaneous Endoscopic Gastrostomy (PEG) and its variation Percutaneous Endoscopic Gastrojejunostomy (PEGJ), has become the method of choice to achieve an enteral access route in patients who require long term enteral nutrition, especially in the area of the At Home Enteral Nutrition (AHEN). We present our experience on the first PEG's and PEGJ's carried out in our hospital. MATERIAL: We studied 48 patients (14 women and 34 men) in whom a PEG/Percutaneous Endoscopic Gastrojejunostomy (PEGJ) was indicated, as they required enteral nutrition for prolonged periods of time (> 4 weeks) and/or they presented obstructive dysphagia, neuromotor dysphagia, or incorrigible vomiting in the two cases in whom PEGJ was carried out. 34 patients underwent the Ponsky-Gauderer technique, 6 patients underwent the Sacks-Vine technique, and 2 patients underwent a PEGJ. 24 hours after the PEGJ enteral nutrition (EN) was begun in a progressive manner. During the hospitalization period there was a daily follow up of the patient. In those cases in which At Home Enteral Nutrition was programmed, the patients/families were trained in the techniques and the care of the PEG and the EN, and the control was carried out through the Nutrition out patient department. RESULTS: PEG was successfully carried out in 42 patients (88%). 35 patients had previously been given EN through a naso-gastric tube (NGT), while in 7 cases the PEG was the first enteral access route. The average duration of the PEG was 212 days, and 27 patients (64%) needed the PEG for more than 3 months. The mean caloric supply was 1921 +/- 200 kcal/day. The mode of administration was by means of an intermittent infusion by gravity in 31 cases, and by continuous infusion using a volumetric pump in 11 patients. Two patients with pregnancy induced hyperemesis underwent a PEGJ in the 3rd and the 4th month of pregnancy, with the pregnancy being successfully brought to term and ending in vaginal deliveries. Carrying out a PEG permitted release from hospital and the programming of At Home Enteral Nutrition in 30 patients. With respect to the evolution of the patients, 22 patients have died during the course of the study. 18 patients remain in follow up in an ambulatory Enteral Nutrition program, and in the two patients with pregnancy induced hyperemesis, the PEGJ was removed after the pregnancy was successfully ended. There were no complications of any kind in 21 patients. The most common complication was the infection of the gastrostomy, which occurred in 13 patients. There was an accidental removal of the gastrostomy tube in 3 patients. In 3 cases there was an eversion of the gastric mucosa through the ostomy within the first 24-hours, and 20 days after the PEG respectively. In 2 cases there was an incarceration of the gastrostomy tube in the abdominal wall. Only two patients showed an important reflux of the gastric contents. There were no deaths as a result of PEG complications. CONCLUSION: From our experience we can conclude the advantages of PEG as a long term nutritional support, showing a low incidence of complications, and the endoscopic technique has a zero mortality.
Adult↗
Position of the American Dietetic Association: nutrition standards in day-care programs for children.
ADA supports the achievement of comprehensive nutrition standards in day-care programs. Recommended standards focus on meeting the child's nutrition needs in a safe and pleasant environment that promotes sound physical, social, and emotional development. Staff and parents should be informed of the child care program's role in meeting the nutrition needs of enrolled children. Parents should be encouraged to participate actively in the program's nutrition activities to assure continuity in the child's nutrition education.
Child↗
Design and development of food safety knowledge and attitude scales for consumer food safety education.
OBJECTIVE: The objective of this study was to design and develop food safety knowledge and attitude scales based on food-handling guidelines developed by a national panel of food safety experts. DESIGN: Knowledge (n=43) and attitude (n=49) questions were developed and pilot-tested with a variety of consumer groups. Final questions were selected based on item analysis and on validity and reliability statistical tests. SUBJECTS/SETTING: Knowledge questions were tested in Washington State with participants in low-income nutrition education programs (pretest/posttest n=58, test/retest n=19) and college students (pretest/posttest n=34). Attitude questions were tested in Ohio with nutrition education program participants (n=30) and college students (non-nutrition majors n=138, nutrition majors n=57). STATISTICAL ANALYSES PERFORMED: Item analysis, paired sample t tests, Pearson's correlation coefficients, and Cronbach's alpha were used. RESULTS: Reliability and validity tests of individual items and the question sets were used to reduce the scales to 18 knowledge questions and 10 attitude questions. The knowledge and attitude scales covered topics ranked as important by a national panel of experts and met most validity and reliability standards. The 18-item knowledge questionnaire had instructional sensitivity (mean score increase of more than three points after instruction), internal reliability (Cronbach's alpha >.75), and produced similar results in test-retest without intervention (coefficient of stability=.81). Knowledge of correct procedures for hand washing and avoiding cross-contamination was widespread before instruction. Knowledge was limited regarding avoiding food preparation while ill, cooking hamburgers, high-risk foods, and whether cooked rice and potatoes could be stored at room temperature. The 10-item attitude scale had an appropriate range of responses (item difficulty) and produced similar results in test-retest ( P </=.01). Internal consistency ranged from alpha=.63 to .89. Students anticipating a career where food safety is valued had higher attitude scale scores than participants of extension education programs. CONCLUSIONS: Uses for the knowledge questionnaire include assessment of subject matter knowledge before instruction and knowledge gain after instruction. The attitude scale assesses an outcome variable that may predict food safety behavior.
Consumer Product Safety↗
A synthesis of research on nutrition education at the elementary school level.
This literature review emphasizes the importance of teacher training, teaching strategies, parental involvement, curricular concerns, administrative support, and social/cultural factors on the impact of nutrition education programs at the elementary school level. The characteristics, implementation, and effectiveness of selected elementary nutrition education programs are reviewed, and instructional methods and materials shown effective through research are identified and discussed.
Culture↗
ASPEN. American Society for Parenteral and Enteral Nutrition. 14th clinical congress program. January 28-31, 1990, San Antonio, TX. Abstracts.
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Animals↗
Nutrition standards in child care programs: technical support paper. The American Dietetic Association.
ADA supports achievement of comprehensive nutrition standards in child care programs. The standards recommended here focus on meeting the child's nutrition needs and providing a safe and pleasant environment that promotes acquisition of habits that prevent disease and enable healthy growth and development. Nutrition and health professionals can play a powerful role in advocating and assisting the acceptance of child care nutrition standards by parents, caregivers, foodservice personnel, and directors and policy makers for child care programs.
Child↗
Selected chronic disease 'risk factors' in two elementary school populations. A pilot study.
Ninety-five first-grade elementary school students (aged 5 to 6 years) in two New York City area schools participated in a pilot test of a chronic disease primary prevention program stressing nutrition, antismoking, and physical activity. Program components included a health knowledge questionnaire; measurement of height, weight, skin-fold thickness, total serum cholesterol level, and blood pressure; and a modified Harvard step test of pulse rate recovery after exercise and subsequent classroom health education. The proportion of students with test values higher than specified critical levels was much greater in school M compared with school S. These measures will be repeated after one year to determine the feasibility and potential effectiveness of certain classroom health education activities.
Blood Pressure↗
Final regulations for the nutrition labeling of raw fruits, vegetables, and fish.
In August 1996, the US Food and Drug Administration published regulations that revised the guidelines for voluntary nutrition labeling of raw fruits, vegetables, and fish; revised the criteria for retailers' compliance with the guidelines; and updated the nutrition labeling values for the 20 most frequently consumed raw fruits, vegetables, and fish. These actions were in response to the requirements of the Nutrition Labeling and Education Act of 1990 and make the voluntary nutrition labeling program more consistent with mandatory nutrition labeling of other foods. The provisions of the final rule are important for dietitians who develop nutrition education materials for retail stores and for dietitians who instruct patients and clients in selecting foods according to nutrition labeling information.
Animals↗
[Development of a methodology for the assessment of the nutritional status at the level of household units].
The results of statistical analysis may be questionable when data measured by different units are compared. This is the case when nutritional status, which is quantitated individually, is compared with social variables (such as family income, patterns of education, housing, etc.), measured by households. In a nutritional anthropology study, the anthropometric measures of children have to be plotted against these social factors. Therefore, a method to evaluate the nutritional status of children at household level was devised; this procedure reduced the variables to one single unit. The "Analysis of Main Components" (ACP) was found satisfactory, using the family average of the following indexes: weight/height, weight/age and height/age. Also, two new indexes were created by giving a numerical value to the slightly modified Waterlow's classification. As a result, households were automatically divided into three groups: 1) households with well-nourished children, 2) households with children at risk of malnutrition, and 3) households with malnourished children. This was accomplished using the "ANADA" package created by PRIAD, University of Costa Rica, and a Burroughs B6920 computer. The method is useful for nutritional anthropology programs as well as for nutritional surveillance activities.
Anthropometry↗
Enteral nutrition practices: similarities and differences between dietitians and physicians in Connecticut.
There has been little evaluation of attitudes, beliefs, and practices of health professionals involved in the provision of enteral nutrition support. A study was undertaken to define and describe enteral feeding practices of registered dietitians (R.D.s) and physicians (M.D.s) in Connecticut. Survey questionnaires were returned by 74.5% of R.D.s and 53.3% of M.D.s. Data were analyzed for 195 respondents. Overall, there were more similarities than differences between R.D.s and M.D.s. Malnutrition was the most frequent indication for tube feedings. Dietitians and physicians selected formulas on the basis of nutrient needs of the patients, but R.D.s gave significantly more weight to formula design and nutrient composition than did M.D.s. Lactose-free low-residue, high-calorie high-nitrogen, and elemental diets were considered to be the most desirable products to include in a hospital formulary. Dietitians more frequently monitored nutrition-related parameters, whereas M.D.s followed metabolic parameters of patients on tube feeding. Physicians relied on R.D.s to recommend formulas and to provide them with enteral nutrition information. The results from this study may be useful in planning nutrition education programs, evaluating standards for enteral nutrition practice, and improving utilization of enteral nutrition therapy.
Attitude of Health Personnel↗
Self-instructional program on pediatric parenteral nutrition.
A self-instructional package on pediatric parenteral nutrition was designed and its effectiveness in educating health-care practitioners was studied. Participants included eight medical students, 10 pediatricians, 10 pharmacists and 10 pharmacy students at a teaching hospital. Each participant reviewed the program and completed 25-point pre- and posttests. Participants consistently scored higher on the posttest than on the pretest. Further, participants felt that they better understood parenteral nutrition therapy and that they better understood how to write or check orders as a result of their participation in the program. It is suggested that a self-instructional package is an effective method of educating practitioners and students in total parenteral nutrition.
Health Occupations↗
An integrated approach to intestinal failure: results of a new program with total parenteral nutrition, bowel rehabilitation, and transplantation.
Intestinal failure can be treated with bowel rehabilitation, total parenteral nutrition, or intestinal transplantation. Little has been done to integrate these therapies for patients with intestinal insufficiency or failure and to develop an algorithm for appropriate use and timing. We established a multidisciplinary program using bowel rehabilitation, total parenteral nutrition, or intestinal transplantation as appropriate in a large population. Evaluation included clinical, pathologic, and psychosocial assessments and assignment to therapy based on the results of this evaluation. Of 59 patients evaluated for life-threatening complications of intestinal failure, 68% were considered appropriate candidates for transplantation, 10% were managed with rehabilitation, and 17% were maintained on optimized long-term parenteral nutrition. Nineteen transplants were performed, with 78% patient survival and 66% graft survival. Patient survival among isolated intestine recipients was 90%. All patients managed with rehabilitation were weaned from parenteral nutrition within 6 months. Long-term management with parenteral nutrition resulted in a significant number of deaths both among patients waiting for a transplant and those who were poor candidates for transplant. Intestinal rehabilitation, when successful, is optimal. For patients with irreversible intestinal failure, isolated intestinal transplantation holds particular promise. Parenteral nutrition is plagued by high failure rates among this population of debilitated patients compared with the general parenteral nutrition population. Integration of these therapies, with individualization of care based on a multidisciplinary approach and perhaps with earlier isolated intestinal transplantation for patients with irreversible intestinal failure, should optimize survival.
Adolescent↗
[Quasi-experimental evaluation of a nutritional educational intervention among home support assistants for the elderly].
BACKGROUND: The French National Program on Nutrition and Health has defined two specific objectives targeting older persons: (i) to improve their status in calcium and vitamin D and (ii) to prevent undernutrition. Home help provides support in activities of daily living, including meals, to dependent persons. The objective of our study was to evaluate the impact of a nutritional education intervention on knowledge and practices among home support assistants for the elderly. METHODS: Three facilities providing home support in Gironde (France) selected 132 home support assistants to follow an education program and 134 controls. Nutrition training was conducted in the intervention group by a dietician during two half-day sessions in May-June 2004. A non randomized controlled trial design was used for evaluation. Nutritional knowledge (20 questions) and practice (5 questions) of home support assistants were assessed by questionnaire before (April 2004) and after (September 2004) the training period in each group. Satisfaction of the intervention group was also assessed. RESULTS: The intervention group included 101 participants and the control group 106 persons who answered both questionnaires before and after the education program. The intervention group was significantly younger (p < 0.05), less educated (p = 0.01) and had less often participated to previous nutrition training (p < 0.001) than the control group. There was no significant difference between the two groups before intervention for their mean scores of knowledge or practices. The intervention group significantly improved its knowledge score (mean gain 2.5 points, p < 0.001) after the training period, whereas the score remained unchanged in the control group (mean gain 0.5 points, p = 0.06). The impact of the nutritional education was very significant (p < 0.0001) after adjustment for the characteristics which differed between the two groups. The practice scores did not differ significantly after intervention in multivariate analyses. Satisfaction of trained home support assistants was very high. CONCLUSION: An education program of home support assistants for elderly persons can improve their nutritional knowledge, but this study cannot conclude that the intervention was efficient to improve the nutritional status of older persons.
Adult↗
Nutrition components and assessment procedures of a university employee wellness program: a case study.
This article describes the various nutrition components and data collection tools developed and implemented within the Montana State University Employee Wellness Program. Nutrition components included a variety of classes, seminars, follow-up support groups, and individual consultations. Tools included surveys and computerized data input cards. It is important for dietetic professionals to initiate the development and implementation of a quality nutrition component within university employee wellness programs.
Data Collection↗