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PubMed1991

Plan IV and V dietetics program recruitment strategies and their perceived success.

A recruitment effort is essential to the vitality of the dietetics profession. To gather information about recruitment strategies and to identify recruitment techniques perceived to be successful, we surveyed 258 program directors of approved Plan IV and V programs listed in the 1989 Directory of Dietetic Programs. One hundred thirty-nine questionnaires were completed, a response rate of 55%. On-campus students were recruited primarily from general education or basic nutrition classes or by means of written information placed in campus offices. High school, community college, and junior high school students were usually contacted through career information days, although high school students were contacted more frequently than were community college or junior high school students. Almost half of the respondents made a special effort to recruit underrepresented groups. A variety of strategies had a significant positive relationship with perceived recruitment success. Some involved personal contact-for example, meeting with high school science and home economics teachers, attending career information days at community colleges, and having a full-time faculty member assigned to meet with prospective majors. Other strategies involved the development of printed materials and displays. Department or school names that were directly related to nutrition, dietetics, health, science, or professional management were perceived as having a positive effect on promoting the dietetics program. Recruitment strategies perceived to be successful may be a useful starting point for recruitment efforts. The findings indicate recruiting strategies can be categorized into two groups--those that involve personal contact and those that involve the use and development of the print and graphic media.

Data Collection↗
PubMed1990

Assessment of student selection practices and beliefs in dietetic internship programs.

With declining college enrollment, the health professions, including dietetics, are recognizing a need to assess and monitor student selection more closely. In this survey of 102 dietetic internship programs, program directors and a sample of their faculty members were asked to describe their current selection practices and to identify the beliefs they hold about the information obtained from various components of their procedures. Differences in beliefs between program directors and other faculty members were compared by t-test analysis. The five major categories of internship selection procedures are presented with information items faculty members believe are derived from each category, and the results are compared with those of previous surveys of dietetic selection practices. Major findings are that the intern selection process has changed significantly since 1978, with greater emphasis on work experience and extracurricular activities; the number of applicants per position has doubled despite a doubling of dietetic internship programs; and program directors and faculty members agree on the major selection practices but not on the information obtained from a given category. In the discussion, the findings are evaluated against a broad background of health profession education literature; implications are raised for intern selection committees and for the applicant.

Dietetics↗
PubMed1985

Linking clinical dietetic practice with educational development in Tennessee.

Does the setting for health care delivery affect the development of competence in clinical dietetics? A survey was conducted to compare clinical dietetic practice in hospitals and in public health agencies in Tennessee. It was found that the nature of practitioners--their demographic characteristics, credentials, and roles in practice--could not be differentiated. There was, however, a difference between groups when the high-priority counseling performance situations (problem-solving encounters) were compared, suggesting that there is a difference in competence needed for clinical dietetic practice. A Delphi probe was conducted among educators and practitioners in Tennessee to identify anticipated priorities among clients' needs and problems in future counseling intervention without regard to the setting for health care delivery. In clinical education, selecting a general set of performance situations representative of practice in a variety of settings enables practitioners to develop breadth of competence. Future practitioners need to be able to modify and create roles to address societal needs and expectations in systems not yet envisioned. The articulation of dietetic and public health nutrition education programs that have a common purpose is a step in that direction.

Adult↗
PubMed1985

Evaluating student performance in clinical dietetics.

The focus of this study was on the development and field-testing of a set of behaviorally anchored rating scales for evaluating the clinical performance of dietetic students. The scales emphasized the application of skills and knowledge. A variation of the Smith-Kendall technique was used to develop the scales. The 42 participants involved in instrument development included dietetic students, didactic and clinical instructors, and dietetic practitioners. The completed instrument contained 8 dimension statements and 70 behavioral anchors. The instrument was field-tested in 16 clinical rotations within 8 dietetic education programs. Evaluators not only rated student performance but also critiqued the format and content of the scales. The mid-to-upper portions of each scale were used most frequently, and little score variation within or across programs was noted. The scales were deemed appropriate for formative evaluation; however, some evaluators who had to grade students' performance expressed a desire for performance standards defined in terms of grades. Because the process used to develop the instrument facilitated the articulation of performance criteria, it is recommended as a practical approach to setting performance standards.

Behavior↗
PubMed1984

Current hospital practices in clinical dietetics.

A study was undertaken to elucidate current practices in clinical dietetics. Objectives of the study were to (a) identify operational, functional, and attitudinal factors associated with clinical dietetic practice; (b) ascertain whether there is a link between practice and professional image; and (c) determine whether there are significant differences in practice between large and small hospitals, as reported by dietitians. A questionnaire was developed and sent to a stratified sample of 200 hospitals in which the chief clinical dietitian had agreed to participate in the study. Responses were received from 177 (88.5%) hospitals. Data indicate new trends in such areas as departmental organization, location of offices, dress, and involvement in the nutrition care of patients. Further changes are needed in the development and implementation of standards of dietetic practice, the management role of clinical dietitians, and the availability of computers to facilitate decision making in clinical practice. There are only a few differences in organization and practice between large and small hospitals. In comparison with 1972, clinical dietetic practice has changed remarkably.

Attitude of Health Personnel↗
PubMed1983

Hospital dietetics and food service in developing countries: I. The Middle East.

A survey of hospital food service and dietetics was conducted in the largest hospitals of six Middle Eastern countries: Bahrain, Jordan, Kuwait, Lebanon, Saudi Arabia, and Syria. There were very few individuals with training in food service and dietetics in any of the countries. The effect of this lack of training on hospital food service and dietetics is discussed. Recommendations are made that would result in improvements in hospital food service and dietetics in the Middle East.

Developing Countries↗
PubMed1981

The A.D.A. role delineation for the field of clinical dietetics: 1. Philosophical overview and historical background.

"Role delineation" involves identifying responsibilities and supporting skill and knowledge components which must be demonstrated by practitioners as they deliver quality services. As part of its efforts to meet demands for competent clinical dietetic practitioners, the American Dietetic Association conducted a role delineation study for entry-level clinical dietetic personnel. A.D.A.'s efforts in role delineation are situated in the history and future needs of the profession. This investigation was federally funded to identify the "actual" and "appropriate" role responsibilities and supporting skills and knowledge for clinical dietetic personnel. A series of assumptions delimit the conditions underlying role performance. To address the needs of A.D.A. members and organizational entities, immediate use of the A.D.A.-endorsed study products is planned.

Clinical Competence↗
PubMed1976

Delegation of functions by dietitians to dietetic technicians.

Questionnaires were sent to 197 randomly selected hospitals in the continental United States. Replies were used as a basis for determinign the degree to which dietitians are willing to delegate tasks to dietetic technicians. No significant difference was found between the percentage of task functions clinical dietitians were willing to delegate to clinical dietetic techncians and the number that administrative dietitians were willing to delegate to administrative dietetic technicians. Dietitians who serve in both capacities are willing to delegate a significantly higher percentage of ther clinical task functions than their administrative functions. Comparing dietitians who graduated before 1968 with those graduating in 1968 or later, no significant difference was found between the two groups of administrative dietitians; however, the clinical dietitians who graduated in 1968 or later were willing to delegate significantly more duties. No significant difference was found in the average number of task functions dietitians working in different size hospitals were willing to delegate. For task functions which 33 per cent or more of dietitians were unwilling to delegate, it appears that those who do not feel this would be ideal also feel it is impractical. Dietitians who have performed a given function do not appear more or less willing to delegate it than those who have not performed that task. Thus, while a substantial number of dietitians were willing to delegate to the dietetic technician, there was also reservation as to the type of task functions, some of which the dietitians apparently feel should remain a function of the dietitian's role. This is especially true of the administrative dietitian.

Allied Health Personnel↗
PubMed2000

[Effect of thermal treatment on total dietetic fiber, soluble and insoluble contents in legumes].

During the seventies it was proposed that the deficient intake of dietetic fiber contributed both to the overweight and the suffering of brain vascular and digestive diseases. At the moment, its beneficial effect (which is proportional to the type of fiber consumed) has been widely demonstrated for its action on related diseases. The purpose of this paper was to prove that thermal treatment modifies the content of Total Dietetic Fiber (TDF). Soluble Dietetic Fiber (SDF) and Insoluble Dietetic Fiber (IDF) in lentil (Lens culinaris) and black beans (Phaseolus vulgaris), both species of high intake in the country, especially in Caracas. The determination of TDF and its fractions (SDF and IDF) was performed through the application of the gravimetric enzymatic method (21). The results indicate significant differences (Kruskal-Wallis Test 95% of confidence) in the contents of TDF and its fractions, between the crude legumes and those subject to thermal treatment. The IDF was predominant in all cases and according to its positive effects-apparently favors the consumers of these legumes. On the basis of these findings, it is considered important to continue the analysis of the TDFs constituents generated after the cooking of these legumes.

Dietary Fiber↗
PubMed2003

Toxic metals and metalloids in dietetic products.

AIM: To determine the concentrations of cadmium, lead, mercury, and metalloid arsenic in the samples of some dietetic products marketed in Croatia, and to compare the values obtained with maximum allowed amounts (MAA) according to the law. METHOD: Metal and metalloid concentrations were measured in 30 dietetic products from the group of industrial food supplements and food additives. The measurements were performed by the method of atomic absorption spectrometry. The concentrations of cadmium, lead, mercury, and arsenic were compared with the maximum allowed amounts for these substances in corn and corn products, and their estimated daily intake with the recommendations of the World Health Organization. RESULT: Two out of 30 samples contained cadmium, 5 samples contained lead, and as many as 16 samples contained mercury in concentrations exceeding maximum allowed amounts. The concentration of arsenic was below maximum allowed amount in all samples. In total, the concentrations of metals exceeding maximum allowed amount were found in 17 out of 30 samples. Extremely high contamination with heavy metals was detected in a sample based on zinc oxide, in which the concentration of cadmium (0.418 mg/kg) was four times higher than the maximum allowed amount, and of lead (6.074 mg/kg) 15 times higher than the maximum allowed amount. The highest concentration of mercury (1.117 mg/kg), 35-fold maximum allowed amount, was found in a ginseng-based sample. CONCLUSIONS: Cadmium, lead, mercury, and arsenic were present in some dietetic products in concentrations exceeding maximum allowed amounts. Dietetic products control should match respective legal provisions of the European Union requirements, and requires continual monitoring.

Arsenic↗
PubMed1990

Nutrition in the management of HIV antibody positive patients: a longitudinal study of dietetic out-patient advice.

The efficacy of a dietetic service was evaluated in an AIDS clinic; 17 asymptomatic (CDC II) and 17 symptomatic (CDC IV) patients participated in a 12 week evaluation of out-patient dietetic advice. The symptomatic group, classified as CDC stage IV according to the Centre for Disease Control classification, were significantly lighter (P less than 0.05) and had significantly lower values for usual weight, current body mass index, mid-upper arm and mid-arm muscle circumferences and triceps and subscapular skinfold thicknesses (P less than 0.05) at the outset of the study. There were no significant differences in nutrient intakes between the two groups. After 12 weeks of dietetic intervention which included personalised advice, prescription of food supplements and the provision of a special food allowance as social welfare payments for the unemployed, there were significant increases in the intakes of most nutrients, the effect being greater with the symptomatic CDC IV group. It is concluded that dietetic intervention has a significant role to play in the management of HIV antibody positive patients.

Adult↗
PubMed1982

[Effect of dietetic fruit products prepared with sorbitol and pectin on the blood sugar and insulin levels in diabetic patients].

The effect of four kinds dietetic fruit products, sweetened by Sorbitol (pectin nectar, apricot nectar, apple and strawberry jam) on blood sugar and insulin needs of the patients was studied in 40 patients with insulin-dependent diabetes. The results were compared with those, obtained with the consumption of similar fruit products, sweetened by industrial sugar. The study was performed by an apparatus for automatic regulation of blood sugar (artificial endocrine pancreas--Biostator), which supplies the organism of the patients, overloaded with the respective product, with insulin, depending on the degree of glycemia and guarantees "normal" utilization of the product. The results obtained reveal that the blood sugar is slightly increased with the dietetic products, the peak of the blood sugar curve is lower and less insulin is supplied automatically by the biostator during the loading with the product. All values are lower, with a statistical significance, for the dietetic products as compared with the non-dietetic ones (p less than 0.05 to 0.001). Those data provide grounds to recommend the products studied as proper to be included in the diet of the diabetic patients.

Blood Glucose↗
PubMed2004

Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years.

It is the position of the American Dietetic Association that children ages 2 to 11 years should achieve optimal physical and cognitive development, attain a healthy weight, enjoy food, and reduce the risk of chronic disease through appropriate eating habits and participation in regular physical activity. The health status of American children has generally improved over the past three decades. However, the number of children who are overweight has more than doubled among 2- to 5-year-old children and more than tripled among 6- to 11-year-old children, which has major health consequences. This increase in childhood overweight has broadened the focus of dietary guidance to address children's over consumption of energy-dense, nutrient-poor foods and beverages and physical activity patterns. Health promotion will help reduce diet-related risks of chronic degenerative diseases, such as cardiovascular disease, type 2 diabetes, cancer, obesity, and osteoporosis. This position paper reviews what US children are eating and explores trends in food and nutrient intakes as well as the impact of school meals on children's diets. Dietary recommendations and guidelines and the benefits of physical activity are also discussed. The roles of parents and caregivers in influencing the development of healthy eating behaviors are highlighted. The American Dietetic Association works with other allied health and food industry professionals to translate dietary recommendations and guidelines into achievable, healthful messages. Specific recommendations to improve the nutritional well-being of children are provided for dietetics professionals, parents, and caregivers.

Child↗
PubMed2005

Position of the American Dietetic Association: Promoting and supporting breastfeeding.

It is the position of the American Dietetic Association (ADA) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources. ADA emphasizes the essential role of dietetics professionals in promoting and supporting breastfeeding by providing up-to-date, practical information to pregnant and postpartum women, involving family and friends in breastfeeding education and counseling, removing institutional barriers to breastfeeding, collaborating with community organizations and others who promote and support breastfeeding, and advocating for policies that position breastfeeding as the norm for infant feeding. ADA also emphasizes its own role by providing up-to-date information to the public, encouraging empirical research, providing continuing education opportunities, providing cultural sensitivity and cultural competence training to dietetics professionals, and encouraging universities to review and update undergraduate and graduate training programs.

Adult↗
PubMed2005

Position of the American Dietetic Association: fortification and nutritional supplements.

It is the position of the American Dietetic Association (ADA) that the best nutritional strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of foods. Additional nutrients from fortified foods and/or supplements can help some people meet their nutritional needs as specified by science-based nutrition standards such as the Dietary Reference Intakes. Dietetics professionals are trained to assess dietary adequacy as well as the need for dietary modification. This position paper addresses increasing the nutrient density of foods or diets through fortification or supplementation when diets fail to deliver consistently adequate amounts of vitamins and minerals. The discussion presents points to consider that relate to both public health and individual applications. Many resources may be used to help guide the dietetics professional to determine responsible, evidence-based recommendations relating to nutrient fortification or supplementation.

Diet↗
PubMed2005

Position of the American Dietetic Association: the impact of fluoride on health.

The American Dietetic Association reaffirms that fluoride is an important element for all mineralized tissues in the body. Appropriate fluoride exposure and usage is beneficial to bone and tooth integrity and, as such, has an important, positive impact on oral health as well as general health throughout life. Fluoride is an important element in the mineralization of bone and teeth. The proper use of topical and systemic fluoride has resulted in major reductions in dental caries (tooth decay) and its associated disability. The Centers for Disease Control and Prevention have named fluoridation of water as one of the 10 most important public health measures of the 20th century. Nearly 100 national and international organizations recognize the public health benefits of community water fluoridation for preventing dental caries. However, by the year 2000, over one third of the US population (over 100 million people) were still without this critical public health measure. Fluoride also plays a role in bone health. However, the use of high doses of fluoride for prevention of osteoporosis is considered experimental at this point. Dietetics professionals should routinely monitor and promote the use of systemic and topical fluorides, especially in children and adolescents. The American Dietetic Association strongly reaffirms its endorsement of the appropriate use of systemic and topical fluorides, including water fluoridation, at appropriate levels as an important public health measure throughout the life span.

Bone and Bones↗
PubMed2005

Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care.

It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by liberalization of the diet prescription. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person's individual medical condition, needs, desires, and rights. In 2003, ADA designated aging as its second "emerging" area. Nutrition care in long-term settings must meet two goals: maintenance of health and promotion of quality of life. The Nutrition Care Process includes assessment of nutritional status through development of an individualized nutrition intervention plan. Medical nutrition therapy must balance medical needs and individual desires and maintain quality of life. The recent paradigm shift from restrictive institutions to vibrant communities for older adults requires dietetics professionals to be open-minded when assessing risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss and undernutrition and a spiral of negative health effects. Facilities are adopting new attitudes toward providing care. "Person-centered" or "resident-centered care" involves residents in decisions about schedules, menus, and dining locations. Allowing residents to participate in diet-related decisions can provide nutrient needs, allow alterations contingent on medical conditions, and simultaneously increase the desire to eat and enjoyment of food, thus decreasing the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.

Aged↗
PubMed2006

Position of the American Dietetic Association: local support for nutrition integrity in schools.

It is the position of the American Dietetic Association that the schools and the community have a shared responsibility to provide all students with access to high-quality foods and school-based nutrition services as an integral part of the total education program. Educational goals, including the nutrition goals of the National School Lunch Program and the School Breakfast Program, should be supported and extended through school district wellness policies that create overall school environments that promote access to healthful school meals and physical activity and provide learning experiences that enable students to develop lifelong healthful eating habits. The National School Lunch and School Breakfast Programs are an important source of nutrients for school-age children, and especially for those of low-income status. The American Dietetic Association was actively involved in the 2004 reauthorization of these programs, ensuring access through continued funding, promoting nutrition education and physical activity to combat overweight and prevent chronic disease, and promoting local wellness policies. The standards established for school meal programs result in school meals that provide nutrients that meet dietary guidelines, but standards do not apply to foods and beverages served and sold outside of the school meal. Labeled as competitive foods by the US Department of Agriculture, there is a growing concern that standards should be applied to food in the entire school environment. Legislation has mandated that all school districts that participate in the US Department of Agriculture's Child Nutrition Program develop and implement a local wellness policy by the school year 2006-2007. Resources are available to assist in the development of wellness policies, and dietetics professionals can assist schools in developing policies that meet nutrition integrity standards.

Adolescent↗