McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen
Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ 2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ 2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ 2 used for the plate waste analysis. Significance was assessed at P<0.05. This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0
In a human nutrition class, students are paired with university faculty or staff volunteer participants. Students teach their service learning partners how to record their food consumption and physical activity during a typical 7-day period. Using these data, students complete nutritional assessments of their partners. (Contains 2 figures.)
Cluss, Patricia A.; Fee, LuAnn; Culyba, Rebecca J.; Bhat, Kiran B.; Owen, Kay
Background: Schools can play a major role in prevention and intervention for childhood obesity. We describe changes in elementary school cafeteria lunch sales patterns resulting from nutritional improvements in menu offerings that were part of a community-wide focus on health. Methods: Elementary school lunch sales data were collected for 1 week…
Uddin, Jasim; Biswas, Tuhin; Adhikary, Gourab; Ali, Wazed; Alam, Nurul; Palit, Rajesh; Uddin, Nizam; Uddin, Aftab; Khatun, Fatema; Bhuiya, Abbas
Mobile phone-based technology has been used in improving the delivery of healthcare services in many countries. However, data on the effects of this technology on improving primary healthcare services in resource-poor settings are limited. The aim of this study is to develop and test a mobile phone-based system to improve health, population and nutrition services in rural Bangladesh and evaluate its impact on service delivery. The study will use a quasi-experimental pre-post design, with intervention and comparison areas. Outcome indicators will include: antenatal care (ANC), delivery care, postnatal care (PNC), neonatal care, expanded programme on immunization (EPI) coverage, and contraceptive prevalence rate (CPR). The study will be conducted over a period of 30 months, using the existing health systems of Bangladesh. The intervention will be implemented through the existing service-delivery personnel at various primary-care levels, such as community clinic, union health and family welfare centre, and upazila health complex. These healthcare providers will be given mobile phones equipped with Apps for sending text and voice messages, along with the use of Internet and device for data-capturing. Training on handling of the Smartphones, data-capturing and monitoring will be given to selected service providers. They will also be trained on inputs, editing, verifying, and monitoring the outcome variables. Mobile phone-based technology has the potential to improve primary healthcare services in low-income countries, like Bangladesh. It is expected that our study will contribute to testing and developing a mobile phone-based intervention to improve the coverage and quality of services. The learning can be used in other similar settings in the low-and middle-income countries.
Gill, K S
India has achieved self-sufficiency in the production of food grains, yet the production of milk, legumes, vegetables, oils and fats, eggs, and meat is far short of the needs of the population. The Indian diet predominantly comprises cereals, and the diets of expectant and nursing mothers as well as children are grossly deficient in protective foods. Serious nutritional inadequacies have resulted in low birth weight, retarded growth, and nutritional deficiencies (protein energy malnutrition in preschool children, vitamin A deficiency, iron deficiency in women of reproductive age, and iodine deficiency disorders among neonates and schoolchildren). General malnutrition is prevalent in 25% of the rural and 20% of the urban population. Deficiency symptoms of vitamin B complex and vitamin C are also not uncommon. 37% of the population of India lives below the poverty limit, the literacy rate is only 52.1% (39.4% for women), safe drinking water is scarce, nutritional ignorance is rampant, there is a lack of personal hygiene, and poor sanitation all account for malnutrition. A number of government and nongovernmental organizations' programs have attempted to raise the level of nutrition and the standard of living of the people. Some of them include the integrated child development services, special nutritional program, national vitamin A deficiency prophylaxis program, national anemia prophylaxis program, national goiter control program, midday meal program, special class feeding programs, universal immunization program, nutritional and health education through the mass media as well as the observance of world food day and world health day. The national health policy gives high priority to the promotion of family planning, the provision of primary health care, and the acceleration of welfare programs for women and children. As a result of policies and programs of health and nutrition, the infant, child, and maternal mortality rates have declined and life expectancy at
... INDIAN TRIBES FOR SUPPORT AND NUTRITION SERVICES § 1326.15 Nutrition services. (a) In addition to providing nutrition services to older Indians, a tribal organization may: (1) Provide nutrition services to... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1326.15 Section 1326.15 Public...
... Perdue Pledges Support on the Long Road to Recovery 4/5 USDA Continues Disaster Assistance in Puerto Rico USDA is continuing its efforts to address the nutrition needs of Puerto Rican residents affected by Hurricanes ...
Briggs, Marilyn; Mueller, Constance G.; Fleischhacker, Sheila
It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…
... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Agency Information Collection Activities... Nutrition Assistance Program (D-SNAP) AGENCY: Food and Nutrition Service, USDA. ACTION: Notice. SUMMARY: In... State agencies in order to receive approval from the Food and Nutrition Service (FNS) to operate a D...
Seward, Kirsty; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin
Introduction Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. PMID
Good nutrition is essential to health and quality of life. As a United Nations agency dedicated to helping Member States achieve their social and economic goals, the International Atomic Energy Agency (IAEA) recognizes the importance of good nutrition and is working to address the problems underlying poor nutrition. In fact, many Agency activities serve basic human needs, by applying nuclear science to increase food production, improve health care, improve management of water resources, and assess sources of environmental pollution. Global progress in reducing malnutrition throughout the human life cycle has been slow and patchy. In its 2000 Report on the World Nutrition Situation, the United Nations Sub Committee on Nutrition estimated that in developing countries 182 million children under five years of age are chronically undernourished and 150 million are underweight. An estimated 30 million infants are born each year with impaired growth due to poor nutrition during pregnancy. Worldwide, renewed international commitments have been made to address this situation, and the IAEA is a vital partner in these efforts. Nuclear science provides valuable tools for monitoring factors that influence nutrition, such as micronutrients, body composition, and breast milk uptake. Through its sub-programme on nutrition, the Agency is helping countries to use isotope applications and other nuclear techniques to their nutritional problems and is supporting leading-edge research on the interaction between nutrition and environmental pollution and infection with the ultimate goal of improving human nutrition
Hayes, Dayle; Contento, Isobel R; Weekly, Carol
It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. Through the continued use of multidisciplinary teams, local school needs will be better identified and addressed within updated wellness policies. Updated nutrition standards are providing students with a wider variety of fruits, vegetables, and whole grains, while limiting sodium, calories, and saturated fat. Millions of students enjoy school meals every day in the US, with the majority of these served to children who are eligible for free and reduced-priced meals. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as farm to school and school gardens, wellness policies, nutrition education and promotion, food and beverage marketing at school, and consideration of roles and responsibilities. It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association, and Society for Nutrition Education and Behavior that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. To maximize impact, the Academy, School Nutrition Association, and Society for Nutrition Education and Behavior recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus; nutrition initiatives such as farm to school and school gardens; wellness policies; nutrition education and promotion; food and beverage marketing at school; and consideration of
With a view to improve animal nutrition, studies have been carried out on the utilization of animal feeds using radioisotopes. Improvement of the nutritive value of straws, digestibility and VFA production by alkali treatment and other treatments has been studied by injecting VFA labelled with C 14 and H 3 . Microbial protein synthesis rates in ruminants were studied using C 14 and S 35 labelled mixed culture of bacterial protozca. Results obtained are helpful in understanding the metabolism in rumens and the microbial proteins available to the host animals on various dietary regimen. (A.K.)
Sunguya, Bruno F; Poudel, Krishna C; Mlunde, Linda B; Urassa, David P; Yasuoka, Junko; Jimba, Masamine
Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.
Michigan State Univ., East Lansing. Cooperative Extension Service.
Definitions, advantages, and functions of nutrition are the starting point for this food service training manual, which includes lessons on proteins, carbohydrates, minerals, and water- and fat-soluble vitamins. Energy foods for child nutrition programs are also identified, as are balanced diets and meal pattern guidelines. Class activities,…
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Nutrition services. 1308.20 Section 1308.20 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...
Wimsatt-Fraim, Teresa S.
A program was conducted to improve the quality of food service through the training of 44 food and nutrition service employees in a 200-bed hospital. A 12-week quality control program was implemented to address four key areas: food temperatures, food accuracy, food quality, and dietary personnel. Learning strategies, emphasizing critical thinking…
The paper stresses the difficulties to establish nutritional standard due to the fact that non-existent previous parameters because it is an new type of accident, becoming necessary an elaboration and use of nutritional plans coherent with probable demands, needs and complications of the patients. It is shown how that was accomplished without any prejudice to the other inpatients. The role of the nutritionists in all evolutional phase of the contaminated persons is described ed, introducing many types of diets used in accordance with individual and general demands. One case in which parenteral nutrition was utilized is analysed. The patients discharge from hospital conditions is explained and was a fact that all patients gained weight, concluding the writer says that was not possible to perform a deeper evaluation because of the great risk of contamination always present. (author)
... 7 Agriculture 1 2010-01-01 2010-01-01 false Administrator, Food and Nutrition Service. 2.57... for Food, Nutrition, and Consumer Services § 2.57 Administrator, Food and Nutrition Service. (a... delegations of authority are made by the Under Secretary for Food, Nutrition, and Consumer Services to the...
Benchmarking is a tool that originated in business to enable organisations to compare their services with industry-wide best practice. Early last year the Department of Health published The Essence of Care, a benchmarking toolkit adapted for use in health care. It focuses on eight elements of care that are crucial to patients' experiences. Nurses and other health care professionals at a London NHS trust have begun a trust-wide benchmarking project. The aim is to improve patients' experiences of health care by sharing and comparing information, and by identifying examples of good practice and areas for improvement. The project began with two of the eight elements of The Essence of Care, with the intention of covering the rest later. This article describes the benchmarking process for nutrition and some of the consequent improvements in care.
Vicente Delgado, Almudena; Gómez Enterría, Pilar; Tinahones Madueño, Francisco
Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.
Sk Masum Billah
Full Text Available In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC and management of sick children younger than five years.Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children.Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19% healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average.Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should
The difficulty is that as we go into the Space Station world, the cost, effort, hardware, food trash, and food waste that the food service system will generate (which is quite tolerable on a 7 day mission), probably will be intolerable on a 90 day Space Station mission. The challenge in the food service supply is not so much packaging but systems engineering. The big constraints are in the supply pipeline. Those constraints and the possible tradeoffs are discussed.
Kim, Sonia A.; Blanck, Heidi M.; Cradock, Angie; Gortmaker, Steven
Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention’s (CDC’s) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a...
Egan, M C; Kaufman, M
Budget deficits and inflationary medical care costs threaten nutrition services, which until recently have been funded largely by federal, state, and local revenues. Nutritionists and dietitians responding to demands in the marketplace should develop innovative programs and pursue new sources for financing through the private sector, third-party payers, business/industry health promotion, and consumer fees for their services, as well as targeted federal, state, and locally funded food assistance, nutrition education, and health care programs. Trail-blazing dietitians are successfully offering their services in health maintenance organizations (HMOs), hospital or industry fitness programs, private practice, voluntary health agencies, and official agency programs. With the new federalism, nutritionists must articulate their role in comprehensive health care and market their services at the state and local levels in addition to the federal level. Nutrition services are defined to include assessment, planning, counseling, education, and referral to supportive agencies. Data management, managerial, and marketing skills must be developed for dietitians to compete effectively. Basic educational preparation and continuing education for practicing professionals must develop these competencies.
Kim, Sonia A; Blanck, Heidi M; Cradock, Angie; Gortmaker, Steven
Effective nutrition and obesity policies that improve the food environments in which Americans live, work, and play can have positive effects on the quality of human diets. The Centers for Disease Control and Prevention's (CDC's) Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) conducts transdisciplinary practice-based policy research and evaluation to foster understanding of the effectiveness of nutrition policies. The articles in this special collection bring to light a set of policies that are being used across the United States. They add to the larger picture of policies that can work together over time to improve diet and health.
Full text: The developing regions of the world are undergoing a rapid demographic and epidemiological transition. The number of child deaths and disease, and their causes, are important markers for this change and serve as indices of human development. More important to society at large is the change in the pattern of child growth of the survivors. Although they survive, a large proportion of children in developing countries fail to grow physically and develop mentally, thereby affecting not only health but also educational performance and economic productivity. National development is retarded at its root. In societies undergoing demographic transition, decreases in fertility rates usually lag behind changes in mortality by several decades. Thus, rapid population growth is typical of this transition. Dietary determinants of nutrition and health of populations undergoing transition also change. Typically, predominantly cereal-based food consumption patterns change to ones incorporating a greater proportion of animal food products, higher total fat and saturated fats, and a progressive inclusion of industrially processed food in the diet. The rural poor come to the cities and become the urban poor. They tend to live in precarious housing in unsanitary environments. Working merely for subsistence, they place great demands on governments to provide health and education services. The political dimension of these unsatisfied demands, in terms of unmet basic human needs, characterises life in developing societies. This situation not only fuels political struggles but is also the cause of great frustration to concerned scientists and health professionals. The impact of nutrition on infant survival and child growth is at the heart of what matters in the developing regions of the world. Most countries undergoing the nutrition transition have supplementary feeding programs and other major nutrition interventions targeted mainly at the urban and rural poor. For example, a
Ruel, Marie T; Alderman, Harold
Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise women's nutrition, time
agricultural productivity, improving nutrition, and raising incomes of men and women smallholder farmers. IDRC accomplishes this through joint partnerships with Global. Affairs Canada and the Australian Centre for International. Agricultural Research. Our researchers use a variety of approaches to: • Increase productivity of ...
Micronutrient efficiency and development of nutrient-dense crops continue to be one of the most important global challenges. Se is an essential micronutrient to humans and serves as a cancer preventative agent. In order to improve Se nutritional and health promoting values in food crops, a better un...
Improving the nutritional status of malnourished children using soybean ... source of high quality and inexpensive protein and oil, to improvement of nutritional status of ... Soybean products were found to affect weight gain of children (P = 0.04).
McGloughlin, Martina Newell
The first generation of biotechnology products commercialized were crops focusing largely on input agronomic traits whose value was often opaque to consumers. The coming generations of crop plants can be grouped into four broad areas each presenting what, on the surface, may appear as unique challenges and opportunities. The present and future focus is on continuing improvement of agronomic traits such as yield and abiotic stress resistance in addition to the biotic stress tolerance of the present generation; crop plants as biomass feedstocks for biofuels and "bio-synthetics"; value-added output traits such as improved nutrition and food functionality; and plants as production factories for therapeutics and industrial products. From a consumer perspective, the focus on value-added traits, especially improved nutrition, is undoubtedly one of the areas of greatest interest. From a basic nutrition perspective, there is a clear dichotomy in demonstrated need between different regions and socioeconomic groups, the starkest being inappropriate consumption in the developed world and under-nourishment in Less Developed Countries (LDCs). Dramatic increases in the occurrence of obesity and related ailments in affluent regions are in sharp contrast to chronic malnutrition in many LDCs. Both problems require a modified food supply, and the tools of biotechnology have a part to play. Developing plants with improved traits involves overcoming a variety of technical, regulatory and indeed perception hurdles inherent in perceived and real challenges of complex traits modifications. Continuing improvements in molecular and genomic technologies are contributing to the acceleration of product development to produce plants with the appropriate quality traits for the different regions and needs. Crops with improved traits in the pipeline, the evolving technologies and the opportunities and challenges that lie ahead are covered. Copyright © 2010. Published by Elsevier B.V.
34Companies are recognizing that treating customers and associates like people has a very high value" (21:20). 2 Customer service has become more that... customer service is also a strategy with the focus towards people , not product (24:1). Customers are demanding quality service for several reasons...34 (39:45). External Customers . External customers are an organization’s ultimate consumers . They purchase the end product or service an organization
Biofortification of maize flour with grain amaranth for improved nutrition. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE ... African Journal of Food, Agriculture, Nutrition and Development. Journal Home ...
They are also assessing the extent of childhood obesity and developing ... former Head of Department, Nutrition and Food Science, at the University of Ghana. ... President of the Ghana Nutrition Association, and Africa's representative on the ...
Utilizing the comment section of patient satisfaction surveys, Clark Memorial Hospital in Jeffersonville, IN went through a thoughtful process to arrive at an experience that patients said they wanted. Two Lean Six Sigma tools were used--the Voice of the Customer (VoC) and the Affinity Diagram. Even when using these tools, a facility will not be able to accomplish everything the patient may want. Guidelines were set and rules were established for the Process Improvement Team in order to lessen frustration, increase focus, and ultimately be successful. The project's success is driven by the team members carrying its message back to their areas. It's about ensuring that everyone is striving to improve the patients' experience by listening to what they say is being done right and what they say can be done better. And then acting on it.
Vergnano, D; Bergero, D; Valle, E
Nutrition plays a very important role in the healthy and in the ill horse. Although research in this field clearly shows that incorrect nutritional practices may lead to severe pathologies, inappropriate feeding plans often continue to be used. A clinical nutrition counselling (CNC) service could thus be of great use to both horse owners and veterinarians. The aim of this study was to provide information on equine patients referred to the CNC service of the University of Turin and to provide standard dietary protocols as used in our Veterinary Teaching Hospital for the most common nutrition-related pathologies. The data were obtained by retrospective analysis of the nutritional records of referred equine patients. The data collected included information about anamnesis, nutritional assessment, current diet, referring person and follow-up of each patient. Sixty-one horses were included in the study. The majority were adult males. The most common breeds were the Italian Saddle Horse and the Friesian Horse. Old horses (>19 years) had a statistically lower BCS than brood mares or other adult horses (p equine gastric ulcer syndrome. All horses received first-cut meadow hay; 85% also ate concentrates. Young horses (equine population. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.
Barker, Mary; Dombrowski, Stephan U; Colbourn, Tim; Fall, Caroline H D; Kriznik, Natasha M; Lawrence, Wendy T; Norris, Shane A; Ngaiza, Gloria; Patel, Dilisha; Skordis-Worrall, Jolene; Sniehotta, Falko F; Steegers-Theunissen, Régine; Vogel, Christina; Woods-Townsend, Kathryn; Stephenson, Judith
The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions. On the basis of these strategies, we suggest a model specifying pathways to effect. Pathways are incorporated into a life-course framework using individual motivation and receptiveness at different preconception action phases, to guide design and targeting of preconception interventions. Interventions for individuals not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases should consider social and environmental determinants, to avoid exacerbating health and gender inequalities, and be underpinned by a social movement that touches the whole population. We propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly. Modern marketing techniques could be used to promote a social movement based on an emotional and symbolic connection between improved preconception maternal health and nutrition, and offspring health. We suggest that speedy and scalable benefits to public health might be achieved through strategic engagement with the private sector. Political theory supports
Wiegers, E.S.; Dorp, van M.; Torgerson, S.
This report is a synthesis of existing global knowledge on improving nutrition through agriculture using a smallholder value chain approach. The smallholder value chain model used by the desk review concentrates on both producers and consumers and is centred around three pathways: improved nutrition
Reducing malnutrition-related maternal and childhood morbidity and mortality in Africa requires a systematic and coordinated strategy. This paper discusses a health sector strategy which includes: i) advocating for action in nutrition at all levels; ii) integration of the essential nutrition actions into six key contact points ...
Mousavi, Maryam; Hayatshahi, Alireza; Sarayani, Amir; Hadjibabaie, Molouk; Javadi, Mohammadreza; Torkamandi, Hassan; Gholami, Kheirollah; Ghavamzadeh, Ardeshir
Parenteral nutrition (PN) is a well-documented supportive care which maintains the nutritional status of patients. Clinical pharmacists are often involved in providing PN services; however, few studies have investigated the effect of a clinical pharmacy-based PN service in resource-limited settings. We designed a randomized clinical trial to compare the clinical pharmacist-based PN service (intervention group) with the conventional method (control group) for adult patients undergoing hematopoietic stem cell transplantation in Shariati Hospital, Tehran, Iran (2011-2012). In the intervention group, the clinical pharmacists implemented standard guidelines of nutrition support. The conventional method was a routine nutrition support protocol which was pursued for all patients in the bone marrow transplantation wards. Main study outcomes included nutritional status (weight, albumin, total protein, pre-albumin, and nitrogen balance), length of hospital stay, time to engraftment, rate of graft versus host disease, and mortality rate. Patients were followed for 3 months. Fifty-nine patients were randomly allocated to a study group. The overall intake (oral and parenteral) in the control group was significantly lower than standard daily needed calories (P nutritional outcomes were either preserved or improved in the intervention group while the nutritional status in the control group was deteriorated (P values nutrition support service significantly improved nutritional status and clinical outcomes in comparison with the suboptimal conventional method. Future studies should assess the cost effectiveness of clinical pharmacists' PN services.
... of States, Districts, and Schools That Required Teaching Nutrition and Dietary Behavior, by School Level 100 80 60 40 20 0 72. ... no comparable variable existed in both survey years. Nutrition Services • 68.6% of schools offered breakfast to students and 63.0% participated ...
Stanfield, J P
The decision was made about 12 years ago in the Department of Pediatrics and Child Health of Makerere University to see if childhood malnutrition could be cured and prevented in a rural area of Uganda, surrounding a small 10-bedded maternity center some 20 miles north of Kampala. The staff included 2 midwives and another midwife who had had training in health visiting, and a community development foreman. There were weekly visits from the Church of Uganda Mengo Hospital by a doctor and sister and a similar visit from an agricultural assistant from Makerere University Department of Agriculture. A small shelter was built on the grounds of the maternity center for the purpose of conducting antenatal and children's clinics. From the beginning the intention was to involve the community, and this was done through the local pastor and the community development foreman assisted by the midwife with health-visiting experience. A local club was formed, and members decided to start by improving and cleaning the local sources of water. At the clinic infants and children were weighed and seen every fortnight until they had been immunized, and thereafter at any time their mothers were anxious about them. Any child who showed early signs of faltering in weight or of clinical malnutrition was followed by a midwife health visitor from the large children's clinic. The mothers were taught about mixing the food to give the children adequate calories and protein. The principles which appeared to be significant in the improvement of child nutrition at the village level were the following: identification; involvement of mothers; communication with the people; involvement of influential persons; indoctrination; integration in village life; and staff effectiveness.
Minaei, Mina; Zarei, Maryam
Full text: Nutrition counseling is one of the nutritional activities for improving child nutrition. It is the best way for decreasing malnutrition in children. Goal: To improve nutritional status of children under 6 through nutrition counseling in rural area with high prevalence of malnutrition. Methods: An international study with a total of 660 children with their mothers and with duration of seven months started in Lali district (in Khozestan province of Iran). Data gathered with using a demographic questionnaire and anthropometric measurements in children. Afterwards, malnourished children determined and referred to nutrition counseling centers. After training mothers, planning a diet and monitoring nutritional status were determined. Results: The prevalence of stunting, wasting and underweight in studied children at the beginning of the study were 9.6%, 6.2% and 4.8% respectively, which reached 8.7%, 3.3% and 2.4% by the end of the project (P<0.05). The intervention was most efficient in children suffering growth retardation, with a cure rate of 91%; only 48.6% of malnourished children referred to the center health were cured. Conclusion: Results obtained from this study showed that over 90% of children suffering growth retardation were cured. This means establishing nutrition counseling centers to encourage proper nutrition behaviors, evaluate current issues and find possible solutions, persuade mothers to improve child nutrition status making use of practical and specific methods appropriate with the tradition of the region has had an important role in improving the nutrition status of the children in the region. (author)
Nguyen, Phuong H; Hoang, Minh V; Hajeebhoy, Nemat; Tran, Lan M; Le, Chung H; Menon, Purnima; Rawat, Rahul
Alive & Thrive Vietnam, a 6-year initiative (2009-2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. This research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP. Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam.
Nguyen, Phuong H.; Hoang, Minh V.; Hajeebhoy, Nemat; Tran, Lan M.; Le, Chung H.; Menon, Purnima; Rawat, Rahul
Background Alive & Thrive Vietnam, a 6-year initiative (2009–2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. Objective This research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP. Design and methods Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Results Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. Conclusion A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam. PMID:26328947
Phuong H. Nguyen
Full Text Available Background: Alive & Thrive Vietnam, a 6-year initiative (2009–2014, has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. Objective: This research aims to estimate maternal willingness to pay (WTP for nutrition counseling services and to examine potential factors associated with their WTP. Design and methods: Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1, which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Results: Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. Conclusion: A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam.
Girke, Jutta; Seipt, Claudia; Markowski, Andrea; Luettig, Birgit; Schettler, Anika; Momma, Michael; Schneider, Andrea S
Patients with end-stage cancer and advanced chronic bowel disease are often malnourished, which has a negative effect on patients' outcome, well-being, and activity. It is inconclusive whether these patients benefit from home parenteral nutrition. This prospective exploratory study investigates its influence on nutrition state, muscle strength, mobility, and quality of life. Patients ≥18 years old with an indication for home parenteral nutrition were included and followed for 2-24 months. Nutrition parameters, activity, and quality of life were assessed. Forty-eight patients participated (mean age 11.5 years), and 85% were severely malnourished (subjective global assessment score, class C). Four weeks after parenteral nutrition, patients with tumors demonstrated a deterioration in phase angle (from 3.9 to 3.4) and extracellular mass:body cell mass ratio (from 1.6 to 2.1), while patients with bowel disease improved (from 3.4 to 4.0 and 2.1 to 1.6, respectively); grip strength remained constant in both groups (difference: 1.11 and -2.11, respectively). Activity improved in patients with bowel disease but stayed the same in the tumor group (P = .02 and P = .33, respectively). When the groups were pooled, emotional and social functioning domain scores (P parenteral nutrition. Both groups seem to benefit from home parenteral nutrition without harmful side effects. If the indication is determined early, the patients' disease course could perhaps be improved. © 2016 American Society for Parenteral and Enteral Nutrition.
Martorell, Reynaldo; Melgar, Paul; Maluccio, John A; Stein, Aryeh D; Rivera, Juan A
This article reviews key findings about the long-term impact of a nutrition intervention carried out by the Institute of Nutrition of Central America and Panama from 1969 to 1977. Results from follow-up studies in 1988-89 and 2002-04 show substantial impact on adult human capital and economic productivity. The 1988-89 study showed that adult body size and work capacity increased for those provided improved nutrition through age 3 y, whereas the 2002-04 follow-up showed that schooling was increased for women and reading comprehension and intelligence increased in both men and women. Participants were 26-42 y of age at the time of the 2002-04 follow-up, facilitating the assessment of economic productivity. Wages of men increased by 46% in those provided with improved nutrition through age 2 y. Findings for cardiovascular disease risk factors were heterogeneous; however, they suggest that improved nutrition in early life is unlikely to increase cardiovascular disease risk later in life and may indeed lower risk. In conclusion, the substantial improvement in adult human capital and economic productivity resulting from the nutrition intervention provides a powerful argument for promoting improvements in nutrition in pregnant women and young children.
Downs Shauna M
Full Text Available Abstract Background Although the mandate of recreational facilities is to enhance well-being, many offer foods inconsistent with recommendations for healthy eating. Little is known regarding recreational facility food environments and how they might be improved, as few studies exist. The Alberta Nutrition Guidelines for Children and Youth (ANGCY are intended to ensure access to healthy food choices in schools, childcare and recreational facilities. This study investigated awareness, adoption and implementation of the ANGCY among recreational facilities in Alberta, Canada, one year following their release. Methods A cross-sectional telephone survey was conducted from June - December, 2009 (n = 151 with managers of publicly funded recreational facilities that served food. The questionnaire included 10 closed and 7 open ended questions to assess the organizational priority for healthy eating, awareness, adoption and implementation of the ANGCY. Chi-squared tests examined quantitative variables, while qualitative data were analysed using directed content analysis. Greenhalgh's model of diffusion of complex innovations within health service organizations constituted the theoretical framework for the study. Results One half of respondents had heard of the ANGCY, however their knowledge of them was limited. Although 51% of facilities had made changes to improve the nutritional quality of foods offered in the past year, only a small fraction (11% of these changes were motivated by the ANGCY. At the time of the survey, 14% of facilities had adopted the ANGCY and 6% had implemented them. Barriers to adoption and implementation were primarily related to perceived negative attributes of the ANGCY, the inner (organizational context, and negative feedback received during the implementation process. Managers strongly perceived that implementing nutrition guidelines would limit their profit-making ability. Conclusions If fully adopted and implemented, the ANGCY
Muehlhoff, Ellen; Wijesinha-Bettoni, Ramani; Westaway, Elizabeth; Jeremias, Theresa; Nordin, Stacia; Garz, Julia
Agriculture and food systems play a central role in nutrition by supplying nutritious, healthy and affordable foods. When integrated with nutrition education for behaviour change, agricultural interventions that supply diverse affordable foods from all food groups have great scope for improving young child and family diets. In 2014, process reviews were conducted in Cambodia and Malawi of food security projects that provided agricultural support and community-based nutrition education on improved infant and young child feeding (IYCF). In both countries, household visits were carried out with mothers/caregivers, and interviews and Focus Group Discussions (FGDs) were conducted with purposively selected project stakeholders (53 in Cambodia, 170 in Malawi), including government staff from the agriculture and health sectors. Results highlight that adoption of improved IYCF practices was facilitated by participation in nutrition education and practical cooking sessions, and supportive family and community structures. Barriers faced by families and caregivers were identified, such as women's workload and lack of access to high quality foods, namely fruits, vegetables, legumes, nuts and animal source foods. Implementation challenges regarding coordination of cross-sectoral targeting strategies and capacities of extension services to sustain community-based IYCF nutrition education need to be addressed to improve programme effectiveness and impact. The project lessons from Cambodia and Malawi are useful for integrated agriculture-IYCF nutrition education programmes to help ensure better young child nutrition outcomes. © 2017 John Wiley & Sons Ltd.
Ptomey, Lauren T; Wittenbrook, Wendy
It is the position of the Academy of Nutrition and Dietetics that nutrition services provided by registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs), who work under RDN supervision, are essential components of comprehensive care for adults with intellectual and developmental disabilities (IDD) and children and youth with special health care needs (CYSHCN). Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community based, and culturally competent. Individuals with IDD and CYSHCN have many risk factors requiring nutrition interventions, including growth alterations (eg, failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, drug-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Furthermore, these individuals are also more likely to develop comorbid conditions, such as obesity or endocrine disorders that require nutrition interventions. Poor nutrition-related health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Timely and cost-effective nutrition interventions can promote health maintenance and reduce risk and cost of comorbidities and complications. Public policy for individuals with IDD and CYSHCN has evolved, resulting in a transition from institutional facilities and programs to community and independent living. The expansion of public access to technology and health information on the Internet challenges RDNs and NDTRs to provide accurate scientific information to this rapidly growing and evolving population. RDNs and NDTRs with expertise in this area are best prepared to provide appropriate nutrition information to promote wellness and improve quality of life. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Childhood obesity prevention and improved nutrition through farm-to-school food ... Increased demand for healthy foods will be evaluated by comparing dietary ... International Water Resources Association, in close collaboration with IDRC, ...
Improving food and nutrition security in the Philippines through school ... Implementation of the Community Health Assessment Program in the Philippines ... This project will address the effects of fast-paced economic growth in the Greater ...
... the Under Secretary for Food, Nutrition, and Consumer Services § 2.55 Deputy Under Secretary for Food... made by the Under Secretary for Food, Nutrition, and Consumer Services to the Deputy Under Secretary for Food, Nutrition and Consumer Services, to be exercised only during the absence or unavailability...
Vir, Sheila C
The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non-nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision-making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre-conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition-specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
Turner, Rachel; Hawkes, Corinna; Jeff, Waage; Ferguson, Elaine; Haseen, Farhana; Homans, Hilary; Hussein, Julia; Johnston, Deborah; Marais, Debbi; McNeill, Geraldine; Shankar, Bhavani
Concern about food security and its effect on persistent undernutrition has increased interest in how agriculture could be used to improve nutritional outcomes in developing countries. Yet the evidence base for the impact of agricultural interventions targeted at improved nutrition is currently poor. To map the extent and nature of current and planned research on agriculture for improved nutrition in order to identify gaps where more research might be useful. The research, which was conducted from April to August 2012, involved developing a conceptual framework linking agriculture and nutrition, identifying relevant research projects and programs, devising and populating a "template" with details of the research projects in relation to the conceptual framework, classifying the projects, and conducting a gap analysis. The study identified a large number of research projects covering a broad range of themes and topics. There was a strong geographic focus on sub-Saharan Africa, and many studies were explicitly concerned with nutritional impacts on women and children. Although the study revealed a diverse and growing body of research, it also identified research gaps. Few projects consider the entire evidence chain linking agricultural input or practice to nutritional outcomes. There is comparatively little current research on indirect effects of agriculture on nutrition, or the effect of policies or governance, rather than technical interventions. Most research is focused on undernutrition and small farmer households, and few studies target consumers generally, urban populations, or nutrition-related non-communicable diseases. There is very little work on the cost-effectiveness of agricultural interventions. On the basis of these findings, we make suggestions for research investment and for broader engagement of researchers and disciplines in developing approaches to design and evaluate agricultural programs for improved nutrition.
Russia's new coal export industry has quickly produced a generation of extremely experienced operators. While improvements are happening, can buyers also expect the service, flexibility and quality control that they get from other export sources? In the light of the first-ever Coaltrans Russia conference held in April the article reports on developments in Russia's coal industry, quoting from many of the papers presented. 5 photos.
Laramee, S H
Managed care systems are transforming the health care system in the United States. Dietitians will need to review practice opportunities in new and different settings, and develop additional skills to make a successful transition to the transformed health care environment. The shift in health care financing from a fee-for-service model to a capitated system will have the most dramatic impact on the profession. Not all the answers are available, but the focus for the future is clear--customer satisfaction, outcomes research, and cost-effective nutrition services.
Brynningsen, P K; Damsgaard, Else Marie; Husted, Steen
INTRODUCTION: Nutritional status among stroke patients has received limited attention despite the fact, that it may have an influence on clinical outcome. Previous studies have estimated that 15-20 % of patients suffer from malnutrition in the acute phase of stroke, but so far no studies have...... focused on the late rehabilitation phase after stroke in the patients own home, where the attention on nutrition may be reduced. AIMS: To determine the prevalence of malnutrition during 6 months of stroke rehabilitation, and to investigate the association between nutritional status, functional recovery...... improvement for serum proteins, and 22 % of the patients were malnourished 6 months after stroke. Udgivelsesdato: null-null...
Ramakrishnan, Usha; Lowe, Alyssa; Vir, Sheila; Kumar, Shuba; Mohanraj, Rani; Chaturvedi, Anuraag; Noznesky, Elizabeth A; Martorell, Reynaldo; Mason, John B
Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. To evaluate the implementation of maternal nutrition programs in India. The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.
Auchincloss, Amy H; Leonberg, Beth L; Glanz, Karen; Bellitz, Samantha; Ricchezza, Andrew; Jervis, Allison
To assess the nutritional value of meals at full-service national restaurant chains with outlets in the Philadelphia region in 2011. Chains were eligible if nutritional information for all menu items was on company Web pages or printed menus at Philadelphia outlets. Nutrient profiles were analyzed for 2,615 items from 21 eligible chains (out of 29) and compared with United States Department of Agriculture guidelines. Adult meals (entree, side dish, and one-half appetizer) approximated 1,495 kcal, 28 g saturated fat, 3,512 mg sodium, and 11 g fiber; and rose to 2,020 kcal after including a beverage and one-half dessert. Better calorie and fat profiles were observed for entrees tagged "healthy choice" or aimed at seniors or children; however, sodium far exceeded recommended limits. Foods served at full-service restaurant chains are high in calories, saturated fat, and sodium. Standard definitions are needed for "healthy choice" tags and for entrees targeted to vulnerable age groups. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Rizal Z. Tamin
Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.
Foundation, Global Affairs Canada and IDRC. The 5.5-year, ... South and South East Asia. ... in post-harvest processing, which is largely done by women in South Asia. ... services allowed mainly indigenous and women fishers to invest in fish.
Sauer, R. L. (Editor)
The proceedings of the Workshop on Food Service and Nutrition for the Space Station, held in Houston, Texas, on April 10 and 11, 1984 was given. The workshop was attended by experts in food technology from industry, government, and academia. Following a general definition of unique space flight requirements, oral presentations were made on state of the art food technology with the objective of using this technology to support the space flight requirements. Numerous areas are identified which in the opinion of the conferees, would have space flight application. But additional effort, evaluation, or testing to include Shuttle inflight testing will be required for the technology to be applied to the Space Station.
Wang, Dongxu; Stewart, Donald; Yuan, Yanfei; Chang, Chun
To demonstrate the effectiveness of health-promoting school framework to promoting healthy eating behaviours and nutrition knowledge among Chinese middle school students, their parents and school staff. Three schools were randomly selected from 15 rural middle schools, then were randomly assigned to either (i) school using HPS framework (HPS school), (ii) school with improved health education only (HE school) or (iii) school received no intervention (control school). Nutrition knowledge and eating behaviours were measured at baseline and 3-month after interventions, using the same instrument. Students and parents in the HPS school had the largest improvement in nutrition knowledge, from 4.92 to 8.23 and 4.84 to 7.74, followed by those in the HE school, from 4.98 to 8.09 and 4.78 to 5.80. School staff in the HE school had the largest improvement in nutrition knowledge (from 4.40 to 8.45), followed by those in the HPS school (from 5.20 to 9.15). Students in the HPS school had the largest improvement in eating behaviours (from 3.16 to 4.13), followed by those in the HE school (from 2.78 to 3.54). There was a statistical difference in the improvement of nutrition knowledge of all target population and of eating behaviours of students after interventions across three schools (p health education can increase nutrition knowledge among Chinese middle school students, their parents and school staff. However, HPS framework was more effective than health education only. Noticeably, HPS framework had a positive impact on students' eating behaviours, which should be in the subject of further research. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
A. Z. Farrakhov
Full Text Available The questions of support of infants with complete and high-quality nutrition as a measure of national medico-social service when switching to artificial or mixed feeding are discussed in the article. The data on the main approaches to support of the infants of the first 3 years of life with specialized nutrition in the Russian Federation is represented. The authors describe such causes of inefficiency of activity of municipal «milk kitchens» as lack of standards for children food products, out of date production technologies, risk of contamination and of breaking the sanitary regulations, irrational usage of resources and low consumer qualities of the service. Necessity of development of new approaches to provide infants with free milk products is demonstrated. Branch target program «Bәlәkәch — Malysh» on free provision of infants of the first 3 years of life with special milk products and milk formulas on pediatrician prescriptions in order to improve the quality of life and health condition, patronized by the President of the Republic of Tatarstan, is characterized, as well as its first results are assessed in the article. The main directions of this program are listed. The comparative characteristic of certain indices of the new scheme of management of free milk nutrition for infants during the period of 2011–2013 are shown. The measures of this program aimed at widening of amount of children receiving free nutrition, increase of quantity of consumed milk products, ensuring of regularity of service, significant decrease of federal resources expenses and providing of precise compliance of standard expanses and improvement of the quality of milk nutrition for children through provision them with appropriate and high-quality products are proved to be very effective.
The aim of the research: to improve the food value indicators of cold-smoked organic meat and implement the quality requirements, which are raised for a national meat products of the company X. To answer the purpose it has been created a new recipe for cold-smoked sausage and cold-smoked minced sausage by using the produced meat in the farm X. It has been evaluated the compliance of the national products quality with the index of food value of improved cold-smoked meat products. It has bee...
Full Text Available Following a competition announcement of the Federal Ministry of Research and Education (BMBF a project dealing with the improvement of the nutritional value of oilseed rape (Brassica napus for food applications and human nutrition was worked out and started in autumn 1999. A number of partners (Figure 2 are carrying out a complex project reaching from the discovery, characterisation, isolation and transfer of genes of interest up to breeding of well performing varieties combined with important agronomic traits. Economic studies and processing trials as well as nutritional investigations of the new qualities are undertaken. B. napus seed quality aspects with respect to seed coat colour, oil composition, lecithin and protein fractions and antioxidants like tocopherols and resveratrol will be improved.
Larsen, Anna Folke; Lilleør, Helene Bie
the impact on early childhood nutrition, measured as height-for-age, of an agricultural intervention that improved food security among smallholder farmers by providing them with a “basket” of new technology options. We find that height-for-age measures among children from participating households increased...
Partnerships with other campus college units can provide ways of improving Extension's impact documentation. Nutrition programs have relied upon knowledge gained and people's self report of behavior change. Partnering with the College of Nursing, student nurses provided blood screenings during the pre and 6 month follow-up of a pilot heart risk…
Agriculture has made remarkable advances in the past decades, but progress in improving the nutrition and health of the poor in developing countries is lagging behind. Long-time IDRC partner, the Consultative Group on International Agricultural Research (CGIAR) is launching 15 new cutting-edge programs to tackle the ...
Cowpeas are grown for their leaves and grains both of which are used as relish or side dishes together with the staple food. Little information is available on the nutritional quality of local and improved cowpea varieties grown in Tanzania as well as the recipes in which they are ingredients. This study was done to investigate ...
... accessed by the Internet or mobile phone and improved processes that deliver services faster and more... ``Conversations with America'' to Further Improve Customer Service). However, with advances in technology and... major initiative (signature initiative) that will use technology to improve the customer experience; (b...
Takehara, Kazuhiro; Sakamoto, Kazuhiro; Takahashi, Rina; Kawai, Masaya; Kawano, Shingo; Munakata, Shinya; Sugimoto, Kiichi; Takahashi, Makoto; Kojima, Yutaka; Fukunaga, Tetsu; Kajiyama, Yoshiaki; Kawasaki, Seiji
Superior mesenteric artery syndrome (SMAS) is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA) and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i.e., the aorta-SMA angle). Here, we report the case of a 78-year-old woman diagnosed with SMAS after a laparoscopic right hemicolectomy for cecal cancer, whose condition was improved by enteral nutritional therapy. We used her controlling nutritional status (CONUT) score as a nutrition assessment and noted the changes in the aorta-SMA angle over the course of the disease. This patient appeared to develop SMAS, on the basis of a worsened CONUT score and a decreased aorta-SMA angle, owing to the inflammation resulting from the intraoperative dissection of the tissues around the SMA and prolonged postoperative fasting. After the initiation of enteral nutritional therapy, the patient exhibited body weight gain and an improved aorta-SMA angle and CONUT score. Hence, assessment of the aorta-SMA angle and CONUT score is an important preoperative consideration.
Full Text Available Superior mesenteric artery syndrome (SMAS is a relatively rare disease that involves bowel obstruction symptoms, such as vomiting and gastric distension, owing to the compression of the third portion of the duodenum from the front by the superior mesenteric artery (SMA and from the rear by the abdominal aorta and the spine. SMAS is diagnosed on the basis of an upper gastrointestinal examination series indicating the obstruction of the third portion of the duodenum or a computed tomography scan indicating the narrowing of the branch angle between the aorta and the SMA (i.e., the aorta-SMA angle. Here, we report the case of a 78-year-old woman diagnosed with SMAS after a laparoscopic right hemicolectomy for cecal cancer, whose condition was improved by enteral nutritional therapy. We used her controlling nutritional status (CONUT score as a nutrition assessment and noted the changes in the aorta-SMA angle over the course of the disease. This patient appeared to develop SMAS, on the basis of a worsened CONUT score and a decreased aorta-SMA angle, owing to the inflammation resulting from the intraoperative dissection of the tissues around the SMA and prolonged postoperative fasting. After the initiation of enteral nutritional therapy, the patient exhibited body weight gain and an improved aorta-SMA angle and CONUT score. Hence, assessment of the aorta-SMA angle and CONUT score is an important preoperative consideration.
Physical activity is affected by nutritional modifications and, in turn, influences growth, cognition, social behavior, work performance and other functions. Studies in preschool children showed that: 1. A decrease in energy intake during four to seven days reduced the time allocated to energy-demanding activities and increased sedentary activities. 2. Children with mild weight deficit were more sedentary than well-nourished counterparts. 3. Children became more active when nutritional status improved. 4. A 10% reduction in energy intake reduced total energy expenditure by 15% without affecting weight gain nor basal metabolism. Studies of men working in non-mechanized agriculture showed that: 1. Dietary improvements led to faster salaried work, reduction of napping time and greater physical activity after work. 2. An increase in energy intake increased total daily energy expenditure, tending to maintain energy balance and relatively stable body weight within the cyclic variations of the agricultural year. 3. Food supplementation did not necessarily improve productivity. Other labor incentives without dietary improvements increased energy expenditure during working hours, which resulted in weight loss. In conclusion, good health and nutrition provide the biological basis for adequate physical activity that may improve cognitive development, social interactions, economic productivity and the quality of life of an individual or a population, but other incentives are required for the optimal expression of that biologic potential.
Full Text Available IT service desk is a complex service that IT service company provides to its customers. This article provides a methodology which uses discrete-event simulation to help IT service management to make decision and to plan service strategy. Simulation model considers learning ability of service desk agents and growth of knowledge database of the company. Model shows how the learning curve influences the time development of service desk quality and efficiency. This article promotes using simulation to define quantitative goals for the service desk improvement.
Russo, Massimo; Vita, Gian Luca; Stancanelli, Claudia; Mazzeo, Anna; Vita, Giuseppe; Messina, Sonia
Transthyretin familial amyloid polyneuropathy (TTR-FAP) is an inherited amyloidosis, leading to death in about ten years in most cases due to cardiac failure or wasting syndrome. Previous studies showed that modified body mass index was related to time before death, duration of gastrointestinal disturbances, malabsorption and functional capacity. We report two patients in whom nutritional status worsened despite diet modification, hypercaloric supplement and two relevant therapeutic approaches such as liver transplant and tafamidis meglumine, respectively. The first patient, a 52-year-old lady carrying Thr49Ala mutation, had a disease duration of twelve years and had lost weight up to 35 kg because of daily diarrhea. The second patient, a 63-year-old man with Glu89Gln mutation and a disease duration of fifteen years, was in the New York Heart Association (NYHA) Functional Classification class III and his weight was 39 kg. In both cases, a peripherally inserted central catheter was placed for parenteral nutrition. It allowed to improve their nutritional status and clinical conditions, with body weight gains of 11 and 8 kg in a one year follow-up, respectively. Moreover, reduction of autonomic symptoms including postural hypotension, nausea and diarrhoea was recorded with ameliorated quality of life. Our experience suggests that parenteral nutrition may be useful in reducing complications and disabilities in TTR-FAP patients, even when all dietary adjustments have been ineffective. Reasonably, the improvement in nutritional status may prolong survival in TTR-FAP patients. Copyright © 2016 Elsevier B.V. All rights reserved.
Midor, Katarzyna; Kučera, Marian
At the time when economy is growing, there is strong competition in the market, and customers have increasingly higher expectations as regards quality of service and products. Under such conditions, organizations need to improve. One of the areas of improvement for an organization is to research the level of customer satisfaction. The article presents results of customer satisfaction surveys conducted by the Servqual method in a pharmaceutical service company. Use of this method allowed to improve the services provided by that pharmaceutical wholesaler, identify areas that need to be improved as soon as possible in order to improve the level of service provided.
Valliant, Melinda W.; Pittman Emplaincourt, Heather; Wenzel, Rachel Kieckhaefer; Garner, Bethany Hilson
Eleven female participants from a NCAA Division I volleyball team were evaluated for adequate energy and macronutrient intake during two off-seasons. Total energy and macronutrient intake were assessed by food records and results were compared against estimated needs using the Nelson equation. Dietary intervention was employed regarding the individual dietary needs of each athlete as well as a pre- and post-sports nutrition knowledge survey. Post dietary intervention, total energy, and macronutrient intake improved, as well as a significant improvement in sports nutrition knowledge (p < 0.001). Nutrition education is useful in improving dietary intake and nutrition knowledge of female athletes. PMID:22822449
In this joint project, West Virginia University and the University of Maryland collaborated in developing improved methods for analyzing and managing public transportation services. Transit travel time data were collected using GPS tracking services ...
Griffiths, M; Nobbe, E
As an experimental project, the Nutrition Communication and Behavior Change Component (NCBC) of the Indonesian Nutrition Development Program (UPGK) showed how social marketing could further the national program's goal of significantly improving the nutrition of Indonesia's young children and pregnant and nursing women. The social marketing approach successfully developed nutrition communication materials that were responsive to the needs, desires, and resources of the communities, particularly of the mothers and volunteer nutrition workers. Between 1977-79 Dr. I.B. Mantra, NCBC Director, established administrative and community infrastructures modeled after UPGK in 5 culturally diverse areas in Indonesia. In mid-1979, with technical assistance from Manoff International, the project departed from the approach of the national plan and embarked upon an unprecedented course with the formative evaluation of educational messages and a communication strategy. The success of the NCBC Component was to be judged by whether education -- as the sole intervention -- could produce significant improvements in the nutritional status of children and the improved nutrient intake of pregnant and lactating women in project communities. The 1st step was to design and execute qualitative research on the health and nutritional problems of children under 3 and pregnant and nursing women, consisting of in-depth household interviews, concept testing with mothers, and focus group interviews with kaders and community opinion leaders. Surveying was based on issues identified earlier by the Ministry of Health as most severe for the population overall. The qualitative investigation identified the need for change or reinforcement in particular nutrition-related behaviors. The target audience of mothers was segmented according to their needs during designated maternal stages and by the age-related dietary needs of their children under 3 years of age. This meant that only the most useful
Pretlow, Cassi; Sobel, Karen
Service blueprinting is a process that businesses use for analyzing and improving service. Originally presented in the Harvard Business Review in 1984, it has retained a strong following ever since. At present, it is experiencing a revival at numerous academic institutions. The authors of this article present the process of service blueprinting.…
Zammuto, Raymond F.; And Others
A study investigated the quality of services in four student enrollment services administrative sub-units (recruiting, admissions, records and registration, financial aid) at a public comprehensive university, using student and staff evaluations and program evaluations. Specific changes needed to improve service delivery are identified and…
Jensen, Jørgen Dejgård
’ nutritional knowledge, food intake and health and on the firm’s profitability, mainly in terms of reduced absenteeism and presenteeism. Conclusions: Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%–2%. On larger worksites......Aims: This paper investigates whether and how worksite nutrition policies can improve employee productivity. Methods: The questions are pursued through a literature review, including a systematic search of literature – combined with literature identified from backward references – on randomized......, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field....
Neonatal Intensive Care (NICU) patients have individual nutritional requirements often requiring Patient Specific Parenteral Nutrition (PSPN). From October 2015, the national PSPN compounding service availability changed from 7 days per week service to 5 days per week (i.e. no weekend and limited bank holiday ordering available). The aim of this study was to examine the introduction of a 5 day only PSPN supply on neonatal patient parenteral nutrition availability in a tertiary NICU.
Boulter, D.; Evans, I.M.
In assessing the nutritional limitation of legume proteins it is essential to consider both sulphur amino acids, methionine and cysteine. The possibility of using total seed sulphur as a criteria for screening for improved protein quality is discussed. In some species when relatively large amounts of S-methyl-cysteine are present, total sulphur determinations would be invalid unless that amino acid were extracted with ethanol before the sulphur determination. Methods for sulphur determination are discussed and evaluated. (author)
Mabhaudhi, Tafadzwanashe; Chibarabada, Tendai; Modi, Albert
Whereas sub-Saharan Africa's (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region's agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.
Full Text Available Whereas sub-Saharan Africa’s (SSA water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.
Briggs, George M.
Good nutrition and adequate nutritious food are not only essential to good health but also represent the difference between life and death. Nutrition is the world's number one problem today, along with war and population control. Good nutrition means providing, with care and love, all 45 essential nutrients in adequate amounts to each child -- one…
Moran, Alyssa; Lederer, Ashley; Johnson Curtis, Christine
Most hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City's Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. This study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. The study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Eight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Nutritional content of regular-diet menus were compared with the HHFI nutrition standards. Nutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. At baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, Pfood service operations, indicating feasibility of this framework in a range of hospital settings. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Lopez, M Barroso; Everaerts, L; Meinhard, H; Baehler, P; Haimyr, N; Guijarro, J M
Using the framework of ITIL best practises, the service managers within CERN-IT have engaged into a continuous improvement process, mainly focusing on service operation. This implies an explicit effort to understand and improve all service management aspects in order to increase efficiency and effectiveness. We will present the requirements, how they were addressed and share our experiences. We will describe how we measure, report and use the data to continually improve both the processes and the services being provided. The focus is not the tool or the process, but the results of the continuous improvement effort from a large team of IT experts providing services to thousands of users, supported by the tool and its local team. This is not an initiative to address user concerns in the way the services are managed but rather an on-going working habit of continually reviewing, analysing and improving the service management processes and the services themselves, having in mind the currently agreed service levels and whose results also improve the experience of the users about the current services.
Shewry, P.R.; Bright, S.W.J.; Burgess, S.R.; Miflin, B.J.
The poor nutritional quality of barley grain is determined by the low level of lysine in the prolamin storage proteins (hordein). These account for between 35 to 50% of the total grain nitrogen, depending on the nutritional status of the plant. There is a reduced proportion of hordein in mutant high lysine lines but these also have reduced synthesis of storage carbohydrates and hence low yields. Three strategies for improvement are discussed. Increases in the lysine content of hordein may be difficult to achieve because of the presence of complex families of structural genes. It would also be necessary to insert a large number of additional lysine residues. Two more promising approaches are to increase the level of expression of genes coding for lysine-rich globulin storage proteins and to increase the pool of free lysine by selecting mutant lines with relaxed feedback regulation of lysine synthesis. (author)
The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...
This presentation centred around the philosophy, goals, and initiatives associated with Gaz Metropolitain's performance improvement plan. Various aspects of the plan including customer surveys, new customer service policies, the creation of small working units, the decentralization of the Montreal service department, and customer-harmonized shift schedules were explored. Implementation of new service plans and contracts, the formation of improvement groups related to human resources, human resource and productivity management, leadership training, and the use of performance indicators were also explained
Nicola M. Capstaff
Full Text Available Despite being some of the most important crops globally, there has been limited research on forages when compared with cereals, fruits, and vegetables. This review summarizes the literature highlighting the significance of forage crops, the current improvements and some of future directions for improving yield and nutritional quality. We make the point that the knowledge obtained from model plant and grain crops can be applied to forage crops. The timely development of genomics and bioinformatics together with genome editing techniques offer great scope to improve forage crops. Given the social, environmental and economic importance of forage across the globe and especially in poorer countries, this opportunity has enormous potential to improve food security and political stability.
Bell, Colin; Pond, Nicole; Davies, Lynda; Francis, Jeryl Lynn; Campbell, Elizabeth; Wiggers, John
Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale. Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green). Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets. Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention
A teaching improvement program is suggested that is based on four models now in use. Designed for individual, departmental, and institutional levels it includes diagnosis, help with problem-identification, linkage to new information, involvement of authorities, increase in organizational health, support for implementation, and more diagnosis. (JT)
Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna
Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.
Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A
A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.
Yusoff, Hafzan; Wan Daud, Wan Nudri; Ahmad, Zulkifli
This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia. This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb = 7 - 11.9 g/dL for girls; Hb = 7 - 12.9 g/dL for boys). They were divided into 2 groups. The first group received nutrition education package (Nutrition education, NE), whereas another group was entitled to receive non-nutrition education intervention (Non-Nutrition Education, NNE) (supplement only). Both interventions were implemented for 3 months. The changes in awareness among respondents of both groups were evaluated using multi-choices questionnaire. Nutrition education receiver group (NE) demonstrated improvement in awareness at post-intervention. No substantial improvement was demonstrated by the counterpart group (NNE). Multimedia nutrition education program conducted at school setting was in fact practical and effective in improving awareness on iron deficiency among anemic adolescents.
Reinsma, Kate; Nkuoh, Godlove; Nshom, Emmanuel
Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers' knowledge, and improves breastfeeding, complementary feeding, and children's linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP's infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children's linear growth. A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children's linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times more likely to be stunted at
Full Text Available Abstract Background Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers’ knowledge, and improves breastfeeding, complementary feeding, and children’s linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF. The study objective was to evaluate the effects of NIP’s infant feeding counselors on exclusive breastfeeding (EBF, complementary feeding (CF, and children’s linear growth. Methods A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359 and non-NIP sites (n = 415 from Infant Welfare Clinics (IWCs in the Northwest (NWR and Southwest Regions (SWR of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children’s linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. Results After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94 more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver
Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.
Full Text Available The problems of consumer services at domestic enterprises are showed. The shortcomings in the service of enterprise operation are analyzed. The basic features of the functioning of the service system forming medium are determined. The authors develop the measures to improve the quality of services which can contribute to their development, expansion of the customer base, increase in sales volume (goods and services as well as improving efficiency and profitability. Taking into account the current environment of enterprises the proposed measures are formed. The article proves the expediency of the use of the client-oriented approach to a customer, the use of software programs and the improvement of the CRM-system at enterprises, the introduction of «7P» concept.
Forbes, Scott C; Little, Jonathan P; Candow, Darren G
Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.
Dewi, Emy Shinta; Kartasurya, Martha Irene; Sriatmi, Ayun
Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritionalresearch and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated thatfood remains of patient were still below the minimal standard of service. Objective of this study wasto analyze the implementation of nutritional service in the RSUD Tugurejo Semarang.This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as maininformants. Triangulat...
Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service.
Rabito, Estela Iraci; Marcadenti, Aline; da Silva Fink, Jaqueline; Figueira, Luciane; Silva, Flávia Moraes
There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality. A specific questionnaire was administered to complete the 4 screening tools. Outcomes measures included length of hospital stay, transfer to the intensive care unit, presence of infection, and incidence of death. A total of 752 patients were included. The nutrition risk was 29.3%, 37.1%, 33.6%, and 31.3% according to the NRS-2002, MUST, MST, and SNAQ, respectively. All screening tools showed satisfactory performance to identify patients at nutrition risk (area under the receiver operating characteristic curve between 0.765-0.808). Patients at nutrition risk showed higher risk of very long length of hospital stay as compared with those not at nutrition risk, independent of the tool applied (relative risk, 1.35-1.78). Increased risk of mortality (2.34 times) was detected by the MUST. The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.
Nakaya, Yutaka; Okita, Kiwamu; Suzuki, Kazuyuki; Moriwaki, Hisataka; Kato, Akinobu; Miwa, Yoshiyuki; Shiraishi, Koichi; Okuda, Hiroaki; Onji, Morikazu; Kanazawa, Hidenori; Tsubouchi, Hirohito; Kato, Shinzo; Kaito, Masahiko; Watanabe, Akiharu; Habu, Daiki; Ito, Susumu; Ishikawa, Tomohisa; Kawamura, Naohiro; Arakawa, Yasuyuki
A late evening snack improves the catabolic state in patients with advanced liver cirrhosis. We tested whether long-term (3 mo) late evening snacking that included a branched-chain amino acid (BCAA)-enriched nutrient mixture produces a better nutritional state and better quality of life than ordinary food in patients with hepatitis C virus-positive liver cirrhosis. In a multicenter, randomized study, 48 patients with liver cirrhosis received late-evening supplementation with the BCAA-enriched nutrient mixture or ordinary food, such as a rice ball or bread, for 3 mo. During the study period, each patient was instructed on energy and protein intake. Blood biochemical data, nitrogen balance, respiratory quotient, and health-related quality of life (Short Form 36 questionnaire) were evaluated at baseline and at the end of the study. Total and late-evening energy intakes were similar in the two groups at 3 mo. Serum albumin level, nitrogen balance, and respiratory quotient were significantly improved by the BCAA mixture but not by ordinary food. The parameters of the Short Form 36 did not statistically significantly improve over 3 mo in either group. Long-term oral supplementation with a BCAA mixture is better than ordinary food in a late evening snack at improving the serum albumin level and the energy metabolism in patients with cirrhosis.
Nassul S Kabunga
Full Text Available The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.
This study assessed the views of 153 national experts in nutrition, health and aging services in ALFs, including gerontological nutrition (39%), food services (14%), aging and disability (22%), geriatric medicine (9%) and assisted living (16%) on the practices that serve as indicators of the quality...
Paquet, Catherine; St-Arnaud-Mckenzie, Danielle; Ferland, Guylaine; Dubé, Laurette
Ensuring nutritionally adequate food intake in institutions is a complex and important challenge for dietitians. To tackle this problem, we argue that dietitians need to adopt a systematic, integrative, and patient-centered approach to identify and manage more effectively organizational determinants of the quality of food intake under their control. In this study, we introduce such an approach, the blueprint-based case study, that we applied in the context of a midterm care facility for elderly patients. Data gathered through interviews and field observations were used to develop, from the perspective of key patient encounters, detailed representations of the food, nutrition, and nursing activities necessary to ensure adequate food intake. These service "blueprints" were developed to illustrate all activities that might potentially impact on the nutritional, sensory, functional, and social quality of patients' meals. They were also used as roadmaps to develop a case study analysis in which critical areas were identified and opportunities for improvement put forth, while considering services' resources and priorities. By providing a precise, objective, yet comprehensive mapping of the service operations and management, the blueprint-based case study approach represents a valuable tool to determine the optimal allocation of resources to insure nutritionally adequate food intake to patients.
The Internet transport technology was designed to be robust, resilient to link or node outages, and with no single point of failure. The resulting connectionless system supports what is called a "best effort datagram delivery service", the perfo rmance of which is often greatly unpredictable. To improve the predictability of IP-based networks, several Quality of Service technologies have been designed over the past decade. The first one, RSVP, based on reservation of resources, is operational...
The objective of this study is to improve motivation of the employees in the Service Department. What motivates employees in this century beyond the normal norms of job security and money. The study is based on improving the motivation of the Service Department of Company X. This research was based on the service’s department low score in motivation after the results of the 2012 annual staff survey. The research aims to find out the cause(s) for the low motivation and also find a solution tha...
Glaser, P. E.
Commercial activities in space represent diverse markets where international competitors will be motivated by economic, technical and political considerations. These considerations are given and discussed. The space station program, industrial participation and the potential benefits of commercial activities in space are described. How food service and nutrition affects habitability, effects on physical condition, dietary goals, food preparation and meal service are detailed.
Song, SuJin; Song, Won O
Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.
"Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.
Yousafzai, Aisha K.; Rasheed, Muneera A.; Bhutta, Zulfiqar A.
Background: Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more…
Johansson, U.; Rasmussen, H.H.; Mowe, M.
BACKGROUND & AIMS: Undernutrition is a problem in hospitals, with lack of nutritional routines. Recently, guidelines concerning the nutritional care process were developed from ESPEN. This study was conducted to assess the present status of nutritional routines among doctors and nurses in internal...... medicine (IM) and medical gastroenterology (MG), in comparison with the ESPEN guidelines. METHOD: A questionnaire-based investigation among doctors and nurses working in departments of internal medicine and gastroenterology in Scandinavia, based on further analysis of previous data. RESULTS: Overall, 4512...... (1753 doctors, 2759 nurses) answered the questionnaire, of which 1155 were from internal medicine and 193 from gastroenterology. A similar, non-significant, discrepancy in attitudes and nutritional routines was noted in gastroenterologists and internists. Concerning basic nutritional education, 46...
Brynningsen, P K; Damsgaard, Else Marie; Husted, Steen
INTRODUCTION: Nutritional status among stroke patients has received limited attention despite the fact, that it may have an influence on clinical outcome. Previous studies have estimated that 15-20 % of patients suffer from malnutrition in the acute phase of stroke, but so far no studies have...... focused on the late rehabilitation phase after stroke in the patients own home, where the attention on nutrition may be reduced. AIMS: To determine the prevalence of malnutrition during 6 months of stroke rehabilitation, and to investigate the association between nutritional status, functional recovery...... and 6 months. Nutritional status was evaluated by body weight, body mass index (BMI), mid upper arm circumference (MAC), triceps skinfold thickness (TSF) and serum concentrations of albumin and transferrin. Malnutrition was defined if the patients had 2 or more abnormal nutritional variables. RESULTS...
Yousafzai, Aisha K; Rasheed, Muneera A; Bhutta, Zulfiqar A
Early child nutritional deficiencies are prevalent in low- and middle-countries with consequences linked not only to poor survival and growth, but also to poor development outcomes. Children in disadvantaged communities face multiple risks for nutritional deficiencies, yet some children may be less susceptible or may recover more quickly from malnutrition. A greater understanding is needed about factors which moderate the effects of nutrition-related risks and foster resilience to protect against or ameliorate poor development outcomes. A literature review was undertaken from August to December 2011 and updated in August 2012. Key word searches using terms Nutrition, Malnutrition, Child Development, Responsive Care, Stimulation, Low and Middle Income Countries and Resilience were undertaken using PubMed and Psychinfo. Dietary adequacy is critical for growth and development, but current evidence indicates that nutrition supplementation alone is insufficient to foster resilience to protect against, mitigate, and recover from nutritional threats and to promote healthy development. The combination of nutrition interventions with stimulation and responsive care is necessary. Combined nutrition and psychosocial stimulation approaches can potentially work effectively together to promote protective factors and mitigate risks for poor cognitive, motor, social, and affective functioning helping children to adapt in times of adversity. However, there are gaps in our existing knowledge to combine nutrition and psychosocial stimulation interventions effectively and promote these interventions at scale. Research needs to address barriers at the level of family, community, programme, and policy which have prevented thus far the uptake of combined nutrition and psychosocial intervention strategies. Further investigations are needed on how to provide support to caregivers, enabling them to implement appropriate care for feeding and stimulation. Finally, the effect of combined
Raine, Kim D
Improving the nutritional health of the public continues to be a major challenge. Our mission of advancing health through food and nutrition has become increasingly complex, particularly as food environments shape the availability, affordability, and social acceptability of food and nutrition "choices". Promoting nutritional health requires that dietitians expand our knowledge in understanding the determinants of healthy eating and of social change strategies that advocates for and acts on improving food environments. While no single strategy can solve the challenges of public health nutrition, we can each identify unique strengths and opportunities. If we practice in complementary ways, using those strengths for collective action will make us stronger together toward social change supporting improved nutritional health of the public.
Jun 6, 2016 ... Improved food processing and preparation methods, coupled with education programs, have contributed to improved nutrition, with mothers learning to incorporate chickpeas into complementary foods. Hawassa University has become a center of excellence on nutrition in Ethiopia — the University of ...
Deng, Zhu-Juan; Mao, Guang-Xu; Wang, Yu-Jun; Liu, Li; Chen, Yan
To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program"). The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area". In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (PNutrition Improvement Program", the prevalence rate of growth retardation decreased (PNutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".
Full Text Available People in most cultures would probably agree that politeness is needed during their interaction. However there may be differing opinions as to when they should be polite. In tourism industry, tourism service providers’ act as hosts and tourists act as guests. Typically hosts will try to act politely and use appropriate politeness norms when serving guests to ensure their satisfaction. The research findings show that the tourism service providers in Central Java use various unggah-ungguh ‘politeness norms’ when serving English speaking tourists and Indonesian speaking tourists. Besides that, there are some violations made by the tourism service providers in using unggah-ungguh ‘politeness norms’. The research findings also show that there are similar and different perspectives on unggah-ungguh ‘politeness norms’ between English speaking tourists with Western culture backgrounds and Indonesian speaking tourists with Indonesian culture backgrounds towards the politeness norms used by the tourism service providers in Central Java. The findings imply the needs of energizing unggah-ungguh ‘politeness norms’ which is discovered from well known noble Javanese values used by the tourism service providers for tourism service improvement.
Yousey, Yvonne; Leake, Jacquelyn; Wdowik, Melissa; Janken, Janice K
To improve the nutritional status of homeless children by implementing an educational program for their mothers and the cafeteria staff at a homeless shelter. Program evaluation including before and after measures of mothers' nutritional knowledge and nutritional quality of foods served in the cafeteria. Fifty-six mothers with children aged 18 months to 6 years and 3 cafeteria staff. Four nutrition classes developed by a registered nutritionist were taught to mothers by clinic nurses; 3 nutrition classes were taught to the cafeteria staff by the nutritionist. Mothers scored higher on posttests than on pretests, indicating improved nutritional knowledge. Minimal differences in the nutritional quality of foods served to residents were observed after staff education. This project demonstrates the challenges of altering the nutritional status of children in a homeless shelter. Despite mothers showing better knowledge of nutritional requirements for children, the types of food served in the cafeteria were an obstacle to them in practicing what they had learned. The cafeteria staff's ability to demonstrate their learning was impeded by the constraints of food donations. Educational strategies may need to be augmented by policies to improve the nutritional status of children in homeless shelters.
Yamori, Y; Horie, R
(1) To demonstrate the importance of nutrition, especially sodium restriction and increased potassium and protein intakes, in the prevention of hypertension and stroke in a pilot study involving senior citizens. (2) To design a population-based intervention in the Shimane Prefecture of Japan concerning dietary factors such as low sodium and high potassium, protein, magnesium, calcium and dietary fibre in the prevention of stroke. The intervention study was carried out at a senior citizens' residence and included general health education along with a reduction of dietary salt intake and increases in vegetable and protein, especially from seafood. Sixty-three healthy senior citizens (average age: 74.8 +/- 7.7 years) had their daily meals modified to a low sodium/potassium ratio for four weeks without their knowledge by the use of a potassium chloride substitute for salt, soy sauce and bean paste, which contains much less sodium and more potassium. Monosodium L-glutamate monohydrate used for cooking was changed to monopotassium L-glutamate monohydrate. Blood pressure was measured with the patient in the sitting position. Daily dietary sodium and potassium intakes were assessed by flame photometry from 24-hour urine specimens. Extensive intervention programs were introduced into the Shimane Prefecture, which has a population of 750,000, through health education classes for housewives, home visits by health nurses and an educational TV program for dietary improvement. The mortality from stroke was monitored for 10 years and compared with the average in Japan. The blood pressure lowering effect of reducing the dietary sodium/potassium ratio was confirmed through a pilot intervention study at the senior citizens' residence. The mortality rates for stroke in the middle-aged population from the Shimane Prefecture during the 10 years after the introduction of dietary improvement had a steeper decline in hemorrhagic, ischemic and all strokes than the average for Japan.
Ben Oumlil, A; Rao, C P
Health care service markets in general and hospital care service markets in particular are characterized by many competitive developments. Hence, hospital marketing managers are forced to respond to these emerging competitive pressures. However, in formulating appropriate marketing management strategies, hospital managers need to have detailed knowledge about consumers and their behaviors in the marketplace. This paper focuses on the Nutrition Care division of the Department of Nutrition Service at a hospital and its venture into new service development. This case study is intended to emphasize the significance of acquiring adequate knowledge of customers in the health care services industry. It particularly emphasizes the critical role that this type of information concerning customer behavior plays in the development and implementation of an appropriate business expansion strategy. Furthermore, the aim of this case study is to help the reader to relate the acquired marketing information to the problem at hand, and make the appropriate marketing management decision.
Hung, Dorothy Y
Performance of preventive services is an important indicator of high-quality health care, but many recommended services are not regularly offered in primary care practices. Health risk assessments, counseling, and referral to community-based programs help address risk behaviors, many of which are leading causes of preventable death and disability in the United States. This study examined various influences on the delivery of preventive services designed to address smoking, excessive consumption of alcohol, unhealthy diets, and sedentary lifestyles. More than 300 health care providers in 52 practices nationwide have contributed data to this study. Staff participation in quality improvement enhanced work relationships and also diminished the effect of practice size on the performance of preventive care. The use of nurse practitioners, allied health professionals, clinician reminders, and patient registries were positively associated with care delivery.
Holdsworth, Michelle; Kruger, Annamarie; Nago, Eunice; Lachat, Carl; Mamiro, Peter; Smit, Karlien; Garimoi-Orach, Chris; Kameli, Yves; Roberfroid, Dominique; Kolsteren, Patrick
Setting research priorities for improving nutrition in Africa is currently ad hoc and there is a need to shift the status quo in the light of slow progress in reducing malnutrition. This study explored African stakeholders' views on research priorities in the context of environmental and socio-demographic changes that will impact on nutritional status in Africa in the coming years. Using Multi-Criteria Mapping, quantitative and qualitative data were gathered from 91 stakeholders representing 6 stakeholder groups (health professionals, food Industry, government, civil society, academics and research funders) in Benin, Mozambique, South Africa, Tanzania, Togo and Uganda. Stakeholders appraised six research options (ecological nutrition, nutritional epidemiology, community nutrition interventions, behavioural nutrition, clinical nutrition and molecular nutrition) for how well they could address malnutrition in Africa. Impact (28.3%), research efficacy (23.6%) and social acceptability (22.4%) were the criteria chosen the most to evaluate the performance of research options. Research on the effectiveness of community interventions was seen as a priority by stakeholders because they were perceived as likely to have an impact relatively quickly, were inexpensive and cost-effective, involved communities and provided direct evidence of what works. Behavioural nutrition research was also highly appraised. Many stakeholders, particularly academics and government were optimistic about the value of ecological nutrition research (the impact of environmental change on nutritional status). Research funders did not share this enthusiasm. Molecular nutrition was least preferred, considered expensive, slow to have an impact and requiring infrastructure. South Africa ranked clinical and molecular nutrition the highest of all countries. Research funders should redirect research funds in Africa towards the priorities identified by giving precedence to develop the evidence for effective
Rochman, C.; Nasrudin, D.; Helsy, I.; Rokayah; Kusbudiah, Y.
Increased wellness for a person becomes a necessity now and for the future. Various ways people do to get fit include following and understanding nutrition. This review will inventory the concepts of science involved to understand the nutritional program and its impact on fitness levels. The method used is a quantitative and qualitative descriptive mixed method based on treatment to a number of nutrition group participants in a nutrition group in Bandung. The concepts of science that are the subject of study are the concepts of physics, chemistry, and biology. The results showed that the ability of science literacy and respondent's wellness level varies and there is a relationship between science literacy with one's wellness level. The implications of this research are the need for science literacy and wellness studies for community based on educational level and more specific scientific concepts.
Brynningsen, Peter Krogh; Husted, Steen; Damsgaard, Else Marie Skjøde
focused on the late rehabilitation phase after stroke in the patients own home, where the attention on nutrition may be reduced. AIMS: To determine the prevalence of malnutrition during 6 months of stroke rehabilitation, and to investigate the association between nutritional status, functional recovery......INTRODUCTION: Nutritional status among stroke patients has received limited attention despite the fact, that it may have an influence on clinical outcome. Previous studies have estimated that 15-20 % of patients suffer from malnutrition in the acute phase of stroke, but so far no studies have......, length of stay in hospital and infectious complications. SUBJECTS AND METHODS: 89 patients with ischemic stroke consecutively admitted to a geriatric stroke rehabilitation unit had their nutritional status evaluated in the hospital at 1 week and 5 weeks after stroke, and in their own home at 3 months...
Jun 27, 2011 ... help the human body and animals to reduce the oxidative damage (Yang ... antioxidant level and some nutritional quality of low cost substrate ..... anti-aging, anti-carcinogen, anti-inflammation, anti- ... in muscle food. J. Agric.
Hedtke, James C.
To help keep personnel exposure as low as reasonably achievable and reduce critical path outage time, most nuclear plants of PWR design in the USA are now using improved equipment to service their steam generators (SGs) during outages. Because of the success of this equipment in the USA, two Belgian plants and one English plant have purchased this equipment, and other nuclear plants in Europe are also considering procurement. The improved SG servicing equipment discussed in this paper discusses consists of nozzle dams, segmented multi-stud tensioner, primary manway cover handling tool set, shield door and fastener cleaner. This equipment is specifically designed for the individual plant application and can also be specified for replacement SG projects. All of the equipment can be used without modification of the existing SGs. (author)
McClinchy, Jane; Dickinson, Angela; Barron, Duncan; Thomas, Hilary
In primary care, leaflets are often used to communicate health information. Increasingly, primary healthcare practitioners need to provide dietary advice. There is limited research exploring how nutrition information leaflets are used in primary care. The present study explored practitioner and lay experiences with respect to providing and receiving nutrition information in primary care, focusing in particular on the use of leaflets for nutrition information. A qualitative design was used incorporating focus groups with 57 practitioners based at seven general practitioner practices and a purposive sample of 30 lay participants attending six Consumer Health Organisations within one primary care trust. Focus groups were taped and transcribed verbatim and data were analysed thematically, assisted by computer software n6® (QSR International Pty Ltd, Melbourne, Australia). Practitioners discussed barriers to giving nutritional advice, access to leaflets, lay receptiveness to advice and their perceptions about the value of leaflets to lay people. Food was not considered in terms of its nutritional components by lay participants and the need for nutritional information was not perceived to be relevant until they had received a medical diagnosis. Lay participants discussed the importance of receiving nutritional advice relating to their medical diagnosis and the altered status of written information that was delivered personally. Practitioner and lay groups suggested improvements to ensure that nutritional advice be supported by relevant and appropriate written information. This research has underlined the continuing importance of nutrition information leaflets and concludes that there is particular value in involving lay participants in the development of nutrition information leaflets. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.
Santos, J E P; Bisinotto, R S; Ribeiro, E S; Lima, F S; Greco, L F; Staples, C R; Thatcher, W W
The establishment and maintenance of pregnancy in lactating dairy cows is a complex biological event that is influenced by a multitude of factors, from the reproductive biology of the cow to managerial aspects of the dairy farm. It is often mentioned in the scientific literature that fertility in dairy cows has declined concurrent with major advances in milk production. Some of this decline is attributed to the negative genetic correlation between milk production and reproduction. In the United States, yearly production per cow has increased steadily at a rate of 1.3% in the last decade and it is likely that this trend will continue in the years to come. At this rate, the average cow in the United States will be producing over 14 tons of milk per year in 2050 and technologies will have to be developed to allow these cows to reproduce to maintain the sustainability of dairy production. Despite high production, it is not uncommon for dairy herds with rolling herd averages for milk yield above 11,000 kg to overcome the challenges of reproduction and obtain satisfactory reproductive performance. Among other things, those herds have been able to mitigate some of the mechanisms that suppress reproduction in dairy cows such as extended postpartum anovulatory period, poor estrous detection, low pregnancy per insemination and, to a lesser extent, the high pregnancy loss. The success of those farms comes from an integrated approach to fertility that includes adequate cow comfort, elaborated transition cow management and nutrition, aggressive postpartum health monitoring program with preventative and curative measures to mitigate the negative effects of diseases on reproduction, and a sound reproductive program that includes manipulation of the ovarian cycle to allow for increased insemination rate. More recently, introduction of fertility traits in selection programs have created new opportunities for improved reproduction without neglecting economically important production
Yoong, Sze Lin; Jones, Jannah; Marshall, Josephine; Wiggers, John; Seward, Kirsty; Finch, Meghan; Fielding, Alison; Wolfenden, Luke
Childcare services represent a key setting to implement nutritional interventions to support the development of healthy eating behaviours in young children. Childcare-specific nutritional guidelines outlining recommendations for provision of food in care have been developed. Despite this, research suggests that few childcare services currently implement these guidelines. This study aimed to examine the impact of providing printed educational materials on childcare service cooks' intentions to use nutritional guidelines and provide fruit and vegetables on their menu. A randomised controlled trial was conducted with 77 childcare services (38 control and 39 intervention). Intervention service cooks were mailed a two-page educational material together with a menu planning checklist. Intervention development and evaluation was guided by the theory of planned behaviour. Outcome data assessing intentions to use nutritional guidelines and serves of fruit and vegetables provided on menus (primary outcomes) as well as secondary outcomes (attitudes, behavioural regulation and social norms) were collected via a telephone interview with cooks. Relative to the comparison group, cooks in the intervention arm had significantly higher intentions to use the guidelines (p value 0.0005), accompanied by significant changes in perceived behavioural control (p value 0.0008) and attitudes (p value 0.0071). No significant difference in serves of fruit (p value 0.7278) and vegetables (p value 0.0573) was observed. The use of educational materials can improve childcare service cooks' intentions to use nutritional guidelines; however, as a standalone strategy, it may not improve provision of food on menus.
Fardet, Anthony; Rock, Edmond
The reductionist approach has been predominant to date in human nutrition research and has unraveled some of the fundamental mechanisms at the basis of food nutrients (e.g., those that involve deficiency diseases). In Western countries, along with progress in medicine and pharmacology, the reductionist approach helped to increase life expectancy. However, despite 40 y of research in nutrition, epidemics of obesity and diabetes are growing each year worldwide, both in developed and developing countries, leading to a decrease in healthy life years. Yet, interactions between nutrition-health relations cannot be modeled on the basis of a linear cause-effect relation between 1 food compound and 1 physiologic effect but rather from multicausal nonlinear relations. In other words, explaining the whole from the specific by a bottom-up reductionist approach has its limits. A top-down approach becomes necessary to investigate complex issues through a holistic view before addressing any specific question to explain the whole. However, it appears that both approaches are necessary and mutually reinforcing. In this review, Eastern and Western research perspectives are first presented, laying out bases for what could be the consequences of applying a reductionist versus holistic approach to research in nutrition vis-à-vis public health, environmental sustainability, breeding, biodiversity, food science and processing, and physiology for improving nutritional recommendations. Therefore, research that replaces reductionism with a more holistic approach will reveal global and efficient solutions to the problems encountered from the field to the plate. Preventive human nutrition can no longer be considered as "pharmacology" or foods as "drugs." © 2014 American Society for Nutrition.
In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality
Scollan, Nigel D; Price, Eleri M; Morgan, Sarah A; Huws, Sharon A; Shingfield, Kevin J
The nutritional value of meat is an increasingly important factor influencing consumer preferences for poultry, red meat and processed meat products. Intramuscular fat content and composition, in addition to high quality protein, trace minerals and vitamins are important determinants of nutritional value. Fat content of meat at retail has decreased substantially over the past 40 years through advances in animal genetics, nutrition and management and changes in processing techniques. Evidence of the association between diet and the incidence of human non-communicable diseases has driven an interest in developing production systems for lowering total SFA and trans fatty acid (TFA) content and enrichment of n-3 PUFA concentrations in meat and meat products. Typically, poultry and pork has a lower fat content, containing higher PUFA and lower TFA concentrations than lamb or beef. Animal genetics, nutrition and maturity, coupled with their rumen microbiome, are the main factors influencing tissue lipid content and relative proportions of SFA, MUFA and PUFA. Altering the fatty acid (FA) profile of lamb and beef is determined to a large extent by extensive plant and microbial lipolysis and subsequent microbial biohydrogenation of dietary lipid in the rumen, and one of the major reasons explaining the differences in lipid composition of meat from monogastrics and ruminants. Nutritional strategies can be used to align the fat content and FA composition of poultry, pork, lamb and beef with Public Health Guidelines for lowering the social and economic burden of chronic disease.
Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W.; Rimm, Eric B.; Willett, Walter C.
The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations. PMID:26066922
Leung, Cindy W; Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W; Rimm, Eric B; Willett, Walter C
The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations.
Jancloes, Michel; Thomson, Madeleine; Costa, María Máñez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary
A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4–6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers. PMID:24776719
Lee, Yee Ming; Kwon, Junehee; Park, Eunhye; Wang, Yujia; Rushing, Keith
Purpose/Objectives: This study investigated the use of electronic and paper-based point-of-service (POS) systems in school nutrition programs (SNPs), including associated challenges and the desired skills and existing training practices for personnel handling such systems. Methods: A questionnaire was developed based on interviews with 25 SNP…
Daugherty, Jamie B.
A grant from a regional nonprofit organization for the 2012-2013 academic year facilitated the revision of an existing course learning objective in a Culinary Nutrition lab course--performing effective culinary demonstrations--to include a service-learning experience. This course is a graduation requirement in a research- and science-based…
Johnston, Francis E.
The Agatston Urban Nutrition Initiative (AUNI) presents a fruitful partnership between faculty and students at a premier research university and members of the surrounding community aimed at addressing the problem of childhood obesity. AUNI uses a problem-solving approach to learning by focusing course activities, including service-learning, on…
Berezowska, A.; Fischer, A.R.H.; Ronteltap, A.; Kuznesof, S.; Macready, A.; Fallaize, R.; Trijp, van J.C.M.
Background: Personalised nutrition (PN) may provide major health benefits to consumers. A potential barrier to the uptake of PN is consumers' reluctance to disclose sensitive information upon which PN is based. This study adopts the privacy calculus to explore how PN service attributes contribute to
Berezowska, A.; Fischer, A.R.H.; Ronteltap, A.; Lans, van der I.A.; Trijp, van J.C.M.
Through a Privacy Calculus (i.e. risk–benefit trade-off) lens, this study identifies factors that contribute to consumers’ adoption of personalised nutrition services. We argue that consumers’ intention to adopt personalised nutrition services is determined by perceptions of Privacy Risk,
There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...
Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Jacques, Paul; Tennstedt, Sharon
There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services. Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence. Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.
nutrition care is proved to be an effective intervention for improving nutritional status in hemodialysis patients.
Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves
Full Text Available Instant fried noodles have become one of the food products regularly consumed among people of all socioeconomic levels in both urban and rural areas. Oat bran is rich in β-glucan, a soluble fiber in oat. The objective of this study was to utilize oat bran, produced from dehulled oats by dry milling and cooking extrusion to improve the nutritional quality of wheat noodle and to evaluate the noodle quality. Three types of oat bran concentrate (OBC: OBCXF, OBCXEF, OBC native were used to replace wheat flour in noodle production, each type at the levels of 5, 10, and 15% (w/w. The experimental design was 3×3 factorial randomized complete block design. The flours and products were analyzed for moisture, protein, fat, β- glucan, RVA and color. The texture of the products was determined using texture analyzer and sensory test. Protein contents of OBCXF, XEF, native and wheat flour were 22.05, 23.21, 22.00 and 13.16%, respectively. OBC β-glucan content was 16-17%. Increasing the amount of various OBC in the mixes caused the increase in protein content and β-glucan in the products. The texture of the noodles with 5% replacement with OBC was not significantly different from that of wheat noodle. The tensile force was in the range of 17.10-17.96 g. The sensory acceptability of the noodles replaced with 5-10% OBC was not significantly different from wheat noodle (p<0.05. Noodle with 10% OBC-XEF had the highest scores in texture, elasticity and accept- ability. Thus, instant fried noodle having its wheat partially replaced with 10-15% OBC contained β-glucan in the range of 0.80-1.27 g/serving (50 g, which met the FDA approved health claim which requires 0.75 g/ serving, and contained dietary fiber in the range of 3.0-4.5 g/serving. By using 10-15% OBC in the formulation, it was possible to satisfactorily make instant fried noodles.
The response of Spunta potato (Solanum tuberosum L.) plants to different rates of potassium (60 and 120 kg Fed-1 ) in presence or absence of Ca nutrition was studied. The study was performed in sandy-loam soil under a drip-irrigation system during fall seasons of 1996 and 1997 years. Plants fertilised with high rate of K ...
The aim of this article is to review why the first 1000 days of life are a vulnerable period of human development and the long-term effects of a nutrition experiment carried out in Guatemala (1969-1977). In 1969-77, a supplement called Atole, containing high quality protein, energy and micronutrients, was provided to women during pregnancy and lactation and to children nutritional requirements, greater susceptibility to infections, high sensitivity to programming effects and full dependence on others for care, nutrition, and social interaction. Compared with Fresco, Atole improved total nutrient intakes (protein, energy, and micronutrients) and reduced stunting, but only in children nutrition intervention. This provides a powerful argument for promoting improvements in nutrition in pregnant women and young children in low income countries. © 2017 Wiley Periodicals, Inc.
Chang, Linda; Popovich, Nicholas G; Iramaneerat, Cherdsak; Smith, Everett V; Lutfiyya, M Nawal
To create, implement, and evaluate a PharmD course on primary care nutrition. A 2-credit hour elective course was offered to second- and third-year pharmacy students. It was informed by the Socratic method using a minimum number of formal lecture presentations and featured problem-based learning exercises, case-based scenarios, and scientific literature to fuel informed debate. A single group posttest design with a retrospective pretest was used to assess students' self-efficacy. There was a significant overall improvement in students' self-efficacy in their ability to practice primary care nutrition. Completion of a nutrition course improved students' confidence in providing primary care nutrition and empowered them to speak more comfortably about the role of nutrition in the prevention of chronic diseases.
Fardet, Anthony; Rock, Edmond
The reductionist approach has been predominant to date in human nutrition research and has unraveled some of the fundamental mechanisms at the basis of food nutrients (e.g., those that involve deficiency diseases). In Western countries, along with progress in medicine and pharmacology, the reductionist approach helped to increase life expectancy. However, despite 40 y of research in nutrition, epidemics of obesity and diabetes are growing each year worldwide, both in developed and developing countries, leading to a decrease in healthy life years. Yet, interactions between nutrition-health relations cannot be modeled on the basis of a linear cause-effect relation between 1 food compound and 1 physiologic effect but rather from multicausal nonlinear relations. In other words, explaining the whole from the specific by a bottom-up reductionist approach has its limits. A top-down approach becomes necessary to investigate complex issues through a holistic view before addressing any specific question to explain the whole. However, it appears that both approaches are necessary and mutually reinforcing. In this review, Eastern and Western research perspectives are first presented, laying out bases for what could be the consequences of applying a reductionist versus holistic approach to research in nutrition vis-à-vis public health, environmental sustainability, breeding, biodiversity, food science and processing, and physiology for improving nutritional recommendations. Therefore, research that replaces reductionism with a more holistic approach will reveal global and efficient solutions to the problems encountered from the field to the plate. Preventive human nutrition can no longer be considered as “pharmacology” or foods as “drugs.” PMID:25022992
Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L
The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge
Yu, Shu-Yan; Shie, An-Jin
The purpose of this study was to develop an integrated model to improve service processes in ageing-home-care. According to the literature, existing service processes have potential service failures that affect service quality and efficacy. However, most previous studies have only focused on conceptual model development using New Service Development (NSD) and fail to provide a systematic model to analyse potential service failures and facilitate managers developing solutions to improve the se...
Hunter, Danny; Özkan, Isa; Moura de Oliveira Beltrame, Daniela; Samarasinghe, Wellakke Lokuge Gamini; Wasike, Victor Wafula; Charrondière, U Ruth; Borelli, Teresa; Sokolow, Jessica
How can we ensure that 9 billion people will have access to a nutritious and healthy diet that is produced in a sustainable manner by 2050? Despite major advances, our global food system still fails to feed a significant part of humanity adequately. Diversifying food systems and diets to include nutrient-rich species can help reduce malnutrition, while contributing other multiple benefits including healthy ecosystems. While research continues to demonstrate the value of incorporating biodiversity into food systems and diets, perverse subsidies, and barriers often prevent this. Countries like Brazil have shown that, by strategic actions and interventions, it is indeed possible to create better contexts to mainstream biodiversity for improved nutrition into government programs and public policies. Despite some progress, there are few global and national policy mechanisms or processes that effectively join biodiversity with agriculture and nutrition efforts. This perspective paper discusses the benefits of biodiversity for nutrition and explores what an enabling environment for biodiversity to improve nutrition might look like, including examples of steps and actions from a multi-country project that other countries might replicate. Finally, we suggest what it might take to create enabling environments to mainstream biodiversity into global initiatives and national programs and policies on food and nutrition security. With demand for new thinking about how we improve agriculture for nutrition and growing international recognition of the role biodiversity, the 2030 Agenda for Sustainable Development presents an opportunity to move beyond business-as-usual to more holistic approaches to food and nutrition security.
Action research was conducted in May and June 2004 aimed at improving service delivery of ... improve service delivery. (Quinby,1985). Furthermore, the intervention stage in which the development of ..... Educational leadership,. 42, 17-21.
This work explores the ways in which academic librarians specializing in areas related to user services consider the courses they took as part of obtaining their library and information science (LIS) degree prepared them to deal with issues of customer service in their current work. Effective customer service is a central aspect of accomplishing…
van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A
Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Müller-Richter, Urs; Betz, C; Hartmann, S; Brands, R C
Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management. This article presents the basics of perioperative metabolism and nutrition management of head and neck cancer patients and makes recommendations for clinical practice. Implementing a nutrition management system in head and neck cancer clinics will improve the clinical outcome and the survival of the patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Baltazar Luna, E; Omaña Guzmán, L I; Ortiz Hernández, L; Ñamendis-Silva, S A; De Nicola Delfin, L
To determine the nutritional status of patients admitted to hospital for the first time the hematology service and who have not received treatment for cancer, to know if the nutritional status assessed by the EGS-GP and serum albumin related mortality of patients A longitudinal, prospective, analytical. EGS-Through GP assessed the nutritional status of patients, we used SPSS 19.0 for data analysis. Evaluaron 119 patients, 52.1% female and 47.9% male. The most common diagnosis was non-Hodgkin lymphoma in 43.7%. According to the EGS-GP 50.4% of patients had some degree of malnutrition or was at risk of suffering of which: 31.1% had moderate and 19.3% had severe malnutrition. The 49.6% of patients had an adequate nutritional status. 30.3% of the patients who died, 37% had severe malnutrition and 50% severe decrease in albumin concentration. The prevalence of malnutrition in hematological patients treated at the National Cancer Institute of Mexico that have not received medical treatment was high. There is an association between nutritional status and mortality in this patient group. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.
Percival, Cheryl; Hussain, Asmah; Zadora-Chrzastowska, Sonja; White, Gillian; Maddocks, Matthew; Wilcock, Andrew
National guidelines recommend screening patients with thoracic cancer to identify those requiring nutritional support. To help quantify this area of need, the associated workload and explore its impact, we report findings from a dedicated rehabilitation service. Patients were screened soon after diagnosis to determine the prevalence of malnutrition, and various aspects compared between malnourished and not malnourished groups. A nutritional care plan was instigated and all contacts recorded, together with follow-up body weight. Of 243 patients seen, 35% were malnourished which was associated with a palliative treatment intent (P group received oral nutritional supplements, but also experienced problems tolerating them. Over one month, neither the pattern nor magnitude of the change in weight differed between malnourished and not malnourished groups. Overall, weight was stable, increased or decreased in 52 (27%), 80 (42%) and 59 (31%) respectively, with no difference in overall survival (P = 0.16). Our data provides a pragmatic insight into the implications of following national guidance on nutritional screening and support in this patient group. Nutritional support failed to prevent weight loss in some patients, and did not appear to impact on survival; new assessments and treatments for cachexia are required. Copyright © 2013 Elsevier Ltd. All rights reserved.
Koh, Hock Lye; Teh, Su Yean; Wong, Chin Keat; Lim, Hooi Kie; Migin, Melissa W.
Fast food restaurants are popular among price-sensitive youths and working adults who value the conducive environment and convenient services. McDonald's chains of restaurants promote their sales during lunch hours by offering package meals which are perceived to be inexpensive. These promotional lunch meals attract good response, resulting in occasional long queues and inconvenient waiting times. A study is conducted to monitor the distribution of waiting time, queue length, customer arrival and departure patterns at a McDonald's restaurant located in Kuala Lumpur. A customer survey is conducted to gauge customers' satisfaction regarding waiting time and queue length. An android app named Que is developed to perform onsite queuing analysis and report key performance indices. The queuing theory in Que is based upon the concept of Poisson distribution. In this paper, Que is utilized to perform queuing analysis at this McDonald's restaurant with the aim of improving customer service, with particular reference to reducing queuing time and shortening queue length. Some results will be presented.
Full Text Available This paper aims to develop a pleading for the transfer of best practices to improving the operational activity in the Romanian public institutions. The practice of implementation demonstrates that the perception of many executives in the Romanian private enterprises regarding the set of tools to improve processes and assimilation of lean philosophy is not a very favorable and encouraging one. It can be said that only some large enterprises had successfully introduced in their daily practice and organization the improvement principles, the operational optimization and the elimination of waste sources. In the SMEs, and especially in the services the experiences are isolated, but they have demonstrated the usefulness (the frequency of saving goals indicate, indeed, the need for proliferation of continuous improvement principles. Regarding the public organizations, the implementation of the new management system of designing and operating the current practices is pretty unknown, accepted at declarative level, but becomes, when is planned and implemented rather a burden on managers who should take on this challenge. Both in public management and private management, today the focus is on people and relationships (processes and projects, starting of course with the work organization. The good practices successfully proved in the private management in the recent decades are transferred today to public institutions; and the Romanian public organizations tend to adapt, also in terms of processes optimization. The study aims to analyze the functioning of the hypothetical management system of processes improvements, respectively the applying of lean tools and principles within the public Romanian institution. They are treated some dysfunctions observed within the process of understanding the utility aspects and throughout the assuming of operational improvement goals within these organizations. The qualitative observations, the critical interpretations and
Noznesky, Elizabeth A; Ramakrishnan, Usha; Martorell, Reynaldo
Maternal underweight and anemia are highly prevalent in Bihar, especially among adolescent girls aged 15 to 19 years. Although numerous programs and platforms exist for delivering efficacious interventions for improving maternal nutrition, the coverage and quality of these interventions are low. To examine existing interventions for reducing maternal undernutrition in Bihar and identify barriers to and opportunities for expanding their coverage and quality. The research was conducted in New Delhi and Bihar between May and August 2010. Forty-eight key informant interviews were conducted with policy makers, program managers, and service providers at multiple levels. Secondary data were collected from survey reports and program documents. All data were analyzed thematically. Barriers to the delivery and uptake of interventions to improve maternal nutrition include the shortage of essential inputs, low prioritization of maternal undernutrition, sterilization bias within the family planning program, weak management systems, poverty, gender inequality, caste discrimination, and flooding. In order to overcome barriers and improve service delivery, the current government and its partners have introduced structural reforms within the public health system, launched new programs for underserved groups, developed innovative approaches, and experimented with new technologies. Since coming to power, the Government of Bihar has achieved impressive increases in the coverage of prioritized health services, such as institutional deliveries and immunization. This success presents it with an excellent opportunity to further reduce maternal and infant mortality by turning its attention to the serious problem of maternal undernutrition and low birthweight.
Lorefält, B; Wilhelmsson, S
The purpose of this study was with a multifaceted intervention model improve the nutritional status of elderly people living in residential homes to increase their energy intake and to maintain improvements over time. Three different municipal residential homes in the south-east of Sweden. The study population consisted of 67 elderly people. A within-subjects design was used which means that the participants were their own controls. A multifaceted intervention model was chosen, which included education on both theoretical and practical issues, training and support for staff, and individualized snacks to the residents. Nutritional status was measured by Mini Nutritional Assessment (MNA), the consumption of food was recorded by the staff using a food record method for 3 consecutive days. The length of night-time fasting has been calculated from the food records. Nutritional status improved after 3 months of intervention and was maintained after 9 months. Weight increased during the whole study period. Night-time fasting decreased but not to the recommended level. This study shows that it is possible by a multifaceted intervention model to increase energy intake including expanding snacks and thereby improve and maintain nutritional status over a longer period in the elderly living in residential homes. This result was possible to achieve because staff received education and training in nutritional issues and by provision of support during a period when new routines were introduced.
Valla, Frederic V; Ford-Chessel, Carole; Meyer, Rosan; Berthiller, Julien; Dupenloup, Christine; Follin-Arbelet, Nathalie; Hubert, Anna; Javouhey, Etienne; Peretti, Noel
The cornerstone of an optimal nutrition approach in PICUs is to evaluate the nutritional status of any patient. Anthropometric measurements and nutritional indices calculation allow for nutritional status assessment, which is not often part of routine management, as it is considered difficult to perform in this setting. We designed a study to evaluate the impact of a training program by the PICU nutritional support team on the implementation of routine anthropometric measurements on our PICU. A prospective study was performed over a 2-year period, which included: a baseline evaluation of nutritional assessment, knowledge, anthropometric measurements (weight, height, and head and mid upper arm circumferences), and nutritional indices calculation in patient files. This was followed by a training program to implement the newly developed nutrition assessment guidelines, which included anthropometrical measurements and also the interpretation of these. The impact of this nutritional assessment program was reviewed annually for 2 years after the implementation. PICU--Lyon, France. PICU nursing and medical staff, and patients admitted in February 2011, 2012, and 2013. Training program. Ninety-nine percent of staff (n = 145) attended the individual teaching. We found significant progress in nutritional awareness and confidence about nutritional assessment following the teaching program. In addition, an improvement in staff knowledge about undernutrition and its consequences were found. We enrolled 41, 55, and 91 patients in 2011, 2012, and 2013, respectively. There was a significant increase in anthropometric measurements during this time: 32%, 65% (p = 0.002), and 96% in 2013 (p Nutritional indices were calculated in 20%, 74% (p nutritional assessment teaching program that highlights both the importance and techniques of anthropometrical measurements has successfully been implemented in a PICU. It managed to improve staff knowledge and nutritional practice.
Full Text Available OBJECTIVE: To explore the feasibility and implementation efficiency of Nutritional Report Cards (NRCs in helping children make healthier food choices at school. METHODS: Pilot testing was conducted in a rural New York school district (K-12. Over a five-week period, 27 parents received a weekly e-mail containing a NRC listing how many meal components (fruits, vegetables, starches, milk, snacks, and a-la-carte foods their child selected. We analyzed choices of students in the NRC group vs. the control group, both prior to and during the intervention period. Point-of-sale system data for a-la-carte items was analyzed using Generalized Least Squares regressions with clustered standard errors. RESULTS: NRCs encouraged more home conversations about nutrition and more awareness of food selections. Despite the small sample, the NRC was associated with reduced selection of some items, such as the percentage of those selecting cookies which decreased from 14.3 to 6.5 percent. Additionally, despite requiring new keys on the check-out registers to generate the NRC, checkout times increased by only 0.16 seconds per transaction, and compiling and sending the NRCs required a total weekly investment of 30 minutes of staff time. CONCLUSIONS: This test of concept suggests that NRCs are a feasible and inexpensive tool to guide children towards healthier choices.
Sutliffe, Jay T; Carnot, Mary Jo; Fuhrman, Joel H; Sutliffe, Chloe A; Scheid, Julia C
Worksite dietary interventions show substantial potential for improving employee health and well-being. The aim of this pilot study was to determine the effect of a worksite nutrition intervention on improving well-being. Thirty-five university employees participated in a 6-week nutrition intervention. The dietary protocol emphasized the daily consumption of greens, beans/legumes, a variety of other vegetables, fruits, nuts, seeds, and whole grains, referred to as a micronutrient-dense, plant-rich diet. Participants were encouraged to minimize the consumption of refined foods and animal products. Significant improvements in sleep quality, quality of life, and depressive symptoms were found. Findings reveal that a worksite nutrition intervention is effective at improving sleep quality, quality of life, and depressive symptoms with a projected improvement in work productivity and attendance.
Jay T. Sutliffe
Full Text Available Background. Worksite dietary interventions show substantial potential for improving employee health and well-being. The aim of this pilot study was to determine the effect of a worksite nutrition intervention on improving well-being. Methods. Thirty-five university employees participated in a 6-week nutrition intervention. The dietary protocol emphasized the daily consumption of greens, beans/legumes, a variety of other vegetables, fruits, nuts, seeds, and whole grains, referred to as a micronutrient-dense, plant-rich diet. Participants were encouraged to minimize the consumption of refined foods and animal products. Results. Significant improvements in sleep quality, quality of life, and depressive symptoms were found. Conclusions. Findings reveal that a worksite nutrition intervention is effective at improving sleep quality, quality of life, and depressive symptoms with a projected improvement in work productivity and attendance.
Full Text Available Contemporary concepts of business of service organisations, focus their researches on measuring quality of the services and identification of mistakes. The aim of strategies is the improvement of quality. Marketing concepts shows that the constant creation of new products and the modification of characteristics on the old products, makes possible market strategy that stimulates development of activities. This paper is focusing on the improving of service using the strategies that can innovate and improve the services. Paper seeks to demonstrate one of possible observations and importance of performance, combined with blueprinting of services and benchmarking as a useful strategies for improving and innovation of services.
Behrman, Pamela; Demirci, Jill; Yanez, Betina; Beharie, Nisha; Laroche, Helena
Deep cuts have been proposed to federally funded nutrition assistance programs, including the Supplemental Nutrition Assistance Program (SNAP); the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and federally subsidized school breakfast and lunch programs. Yet, these programs help parents afford healthy meals for their families, pregnant and postpartum mothers access supplemental foods and health services for themselves and their infants and young children, and children obtain the nutrition necessary for optimal school performance. Participation in these programs is linked with reductions in perinatal morbidity and mortality, improved childhood growth trajectories, enhanced school performance, and reductions in food insecurity and poverty. Given these compelling health and economic benefits, the Society of Behavioral Medicine urges Congress to protect and increase funding for federally funded nutrition assistance programs, specifically SNAP, WIC, and school breakfast and lunch programs. Per the recent (2017) recommendations of the School Nutrition Association, Congress should also resist any attempts to "block-grant" subsidized school breakfast and lunch programs, which could reduce access to these programs. It is further recommended that Congress improve the scope of implementation- and outcomes-based assessments of these programs. Finally, we recommend efforts to increase awareness of and participation in SNAP, WIC, and federally funded school meal programs for eligible individuals, children, and families.
Wöstmann, Bernd; Michel, Karin; Brinkert, Bernd; Melchheier-Weskott, Andrea; Rehmann, Peter; Balkenhol, Markus
Recent research suggests that there is a correlation between nutrition, oral health, dietary habits, patients' satisfaction and their socio-economic status. However, the dependent and independent variables have remained unclear. This exploratory interventional study aimed to identify the impact of denture improvement on the nutritional status as well as the oral health-related quality of life in geriatric patients. Forty-seven patients who were capable of feeding themselves (minimum age: 60 years) and with dentures requiring repair or replacement were selected from a random sample of 100 residents of two nursing homes. Before and 6 months after the dentures were optimised a Mini Nutritional Assessment (MNA) and a masticatory function test were carried out. Nutritional markers (pre-albumin, serum albumin, zinc) were determined and an OHIP-G14 (Oral Health Impact Profile, German version) was recorded in order to determine the effect of the optimised oral situation on the patient's nutritional status and oral health-related quality of life. Despite the highly significant improvement in masticatory ability after the optimisation of the dentures, no general improvement regarding the nutritional status was observed since the albumin, zinc and MNA values remained unchanged and pre-albumin even decreased. Since masticatory ability and masticatory efficiency are not the only factors affecting this, prosthetic measures alone apparently cannot effect a lasting improvement in nutritional status as masticatory ability and masticatory efficiency are not the only factors of influence. Nutrition is not only a matter of masticatory function, but also depends on other influencing factors (e.g. habits, taste and cultural customs as well as financial and organisational aspects).
Background Prices are an important determinant of food choices. Consequently, food price policies (subsidies and/or taxes) are proposed to improve the nutritional quality of diets. The aim of the present study was to explore the impact of food price policies on the expenditures and nutritional quality of the food baskets chosen by low- and medium-income households. Methods Experimental economics was used to examine two price manipulations: i) a fruit and vegetable price subsidy named “fruit and vegetables condition”; ii) a healthy-product subsidy coupled with an unhealthy-product tax named “nutrient profile condition”. The nutrient profiling system called SAIN,LIM was used. This system classifies each individual food according to its overall nutritional quality which then allows for a food item to be taxed or subsidized. Women from low- (n = 95) and medium-incomes (n = 33) selected a daily food basket, first, at current prices and then at manipulated prices. The redistributive effects of experimental conditions were assessed by comparing the extent of savings induced by subsidies and of costs generated by the tax on the two income groups. Energy density (kcal/100 g), free sugars (% energy) and the mean adequacy ratio (MAR) were used as nutritional quality indicators. Results At baseline (before price manipulations), low-income women selected less expensive and less healthy baskets than medium-income ones. After price manipulations expenditures for both income group decreased significantly, whereas, the nutritional quality improved (energy density decreased, the MAR increased). Additionally, the redistributive effects were less favourable for low-income women and their nutritional quality improvements from baseline were significantly lower. Conclusion Low-income women derived fewer financial and nutritional benefits from implemented food subsidies and taxes than medium-income women. This outcome suggests that food price policies may improve diet
Darmon, Nicole; Lacroix, Anne; Muller, Laurent; Ruffieux, Bernard
Prices are an important determinant of food choices. Consequently, food price policies (subsidies and/or taxes) are proposed to improve the nutritional quality of diets. The aim of the present study was to explore the impact of food price policies on the expenditures and nutritional quality of the food baskets chosen by low- and medium-income households. Experimental economics was used to examine two price manipulations: i) a fruit and vegetable price subsidy named "fruit and vegetables condition"; ii) a healthy-product subsidy coupled with an unhealthy-product tax named "nutrient profile condition". The nutrient profiling system called SAIN,LIM was used. This system classifies each individual food according to its overall nutritional quality which then allows for a food item to be taxed or subsidized. Women from low- (n = 95) and medium-incomes (n = 33) selected a daily food basket, first, at current prices and then at manipulated prices. The redistributive effects of experimental conditions were assessed by comparing the extent of savings induced by subsidies and of costs generated by the tax on the two income groups. Energy density (kcal/100 g), free sugars (% energy) and the mean adequacy ratio (MAR) were used as nutritional quality indicators. At baseline (before price manipulations), low-income women selected less expensive and less healthy baskets than medium-income ones. After price manipulations expenditures for both income group decreased significantly, whereas, the nutritional quality improved (energy density decreased, the MAR increased). Additionally, the redistributive effects were less favourable for low-income women and their nutritional quality improvements from baseline were significantly lower. Low-income women derived fewer financial and nutritional benefits from implemented food subsidies and taxes than medium-income women. This outcome suggests that food price policies may improve diet quality while increasing socio
Full Text Available Although Phaseolus species are still difficult to transform, progress in this field now opens the way to engineering beans with a higher nutritional value. The opportunities for gene engineering in nutritional quality improvement, the strategies which canbe adopted and the constraints we are still facing are briefly outlined, using the enhancement of the seed methionine content and the reduction in antinutritional factors as examples.
Gorisek, Aleksandra Sasa
People need food and water to survive, but nutritious food is central to healthy living. Energy-dense fat, protein and carbohydrates need to be accompanied by vitamins and minerals (micronutrients) to ensure proper nutrition. Malnutrition, an inappropriate balance of nutrients, can occur with too much or too little of food. The IAEA works with other agencies to evaluate interventions in Member States that are designed to address the problem of malnutrition. Stable isotope techniques can be used to validate the information collected through the use of questionnaires and simple measurements. Capacity building through training and the provision of equipment enables nutritionists worldwide to use these methods in community settings as they are safe, non-invasive and can be used with adults and children of all ages
Full Text Available Introduction: The home meals service (HMS is a little-developed resource in the Basque Country, and is dependent on social services. The aim of this study is to establish the nutritional status, eating habits and main social and healthcare characteristics of the users of this service.Material and Methods: A descriptive and transversal study carried out in 2 phases: (a phase 1: an assessment of nutritional status and eating habits using an abbreviated version of the Mini Nutritional Assessment and a questionnaire on food consumption. (b phase 2: the assessment of the dependency risk at home and quality of life related to health by means of Barber and EuroQoL-5D questionnaires.Results: Eighty users (35 men, 45 women fulfilled the criteria for inclusion; average age: 83.62 years (± 5.53. Nutritional status: the prevalence of malnutrition was 11% and that of risk of malnutrition 39%. Eating habits: the meal provided guaranteed a minimal provision of legumes, pasta, rice or potatoes (once or twice a week, fish (once or twice a week, and meat (three or four times a week. In spite of this, the frequency of consumption of vegetables, fish, rice, eggs or meat was less than recommended in over 70% of the group. Social and healthcare profile: 127 users (60 men, 67 women took part; average age: 83.82 years (± 6.17. Barber’s questionnaire: living alone: 48%; housebound through illness: 20%. Poor hearing: 44%; poor sight: 34%; although: 30% needed help, 95% were receiving support. EuroQoL-5D: Serious problems reported: 4.7% had difficulties with mobility; 7.9% with personal care; 23.6% had problems with carrying out daily activities; 15% reported pain or discomfort; 3.9% anxiety/depression. Perceived health status: 32.3% considered their health to be good or very good, 34,6% fair, and 33% bad or very bad.Conclusions: The group studied consists of a vulnerable people, with social and health problems and more malnutrition than the older population living at
Culine, S; Chambrier, C; Tadmouri, A; Senesse, P; Seys, P; Radji, A; Rotarski, M; Balian, A; Dufour, P
Malnutrition is a predictor of poor outcomes in patients with cancer. Little is known about the benefit of nutritional support in these patients. The purpose of this study was to assess the impact of home parenteral nutrition (HPN) on quality of life (Qol) in cancer patients. We performed an observational prospective study to determine the impact of HPN on Qol in a population of patients with heterogeneous cancer. Physicians, patients and family members had to complete a questionnaire before HPN administration and 28 days after the course of HPN. Qol was evaluated using the self-administered questionnaire FACT-G. We included 767 patients with cancer of whom 437 ended the study. Mean patient age was 63±11.4 years and 60.5% were men. Primary gastrointestinal cancer was reported in 50% of patients and 65.3% were presenting metastases. Malnutrition was reported in 98.3%. After 28 days of HPN intake, significant improvement was observed in the Qol (49.95±5.82 vs. 48.35±5.01 at baseline, pnutrition risk index had also improved significantly. Most patients (78%) had perceived a positive impact of the HPN. A significant improvement in patient's well-being was perceived also by family members and physicians. Our data suggest that preventing and correcting malnutrition using HPN in patients with cancer might have a significant benefit on their well-being. Randomized controlled studies are required to confirm this finding.
Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas
Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the
Beck, Anne Marie; Tolstrup Andersen, Ulla; Leedo, Eva
(70 + years and at nutritional risk) at discharge. INTERVENTIONS: Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing......OBJECTIVES: The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes. DESIGN: Twelve-week randomized controlled trial. SETTING AND SUBJECTS: Geriatric patients...... an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone. MAIN MEASURES: Nutritional status (weight...
Andrews, Michael C; Itsiopoulos, Catherine
Athletes require sufficient nutrition knowledge and skills to enable appropriate selection and consumption of food and fluids to meet their health, body composition, and performance needs. This article reports the nutrition knowledge and dietary habits of male football (soccer) players in Australia. Players age 18 years and older were recruited from 1 A-League club (professional) and 4 National Premier League clubs (semiprofessional). No significant difference in general nutrition knowledge (GNK; 54.1% ± 13.4%; 56.8% ± 11.7%; M ± SD), t(71) = -0.91, p = .37, or sports nutrition knowledge (SNK; 56.9% ± 15.5%; 61.3% ± 15.9%), t(71) = -1.16, p = .25) were noted between professional (n = 29) and semiprofessional (n = 44) players. In general, players lacked knowledge in regard to food sources and types of fat. Although nutrition knowledge varied widely among players (24.6-82.8% correct responses), those who had recently studied nutrition answered significantly more items correctly than those who reported no recent formal nutrition education (62.6% ± 11.9%; 54.0% ± 11.4%), t(67) = 2.88, p = .005). Analysis of 3-day estimated food diaries revealed both professionals (n = 10) and semiprofessionals (n = 31) consumed on average less carbohydrate (3.5 ± 0.8 gC/kg; 3.9 ± 1.8 gC/kg) per day than football-specific recommendations (FIFA Medical and Assessment Research Centre [F-MARC]: 5-10 gC/kg). There was a moderate, positive correlation between SNK and carbohydrate intake (n = 41, ρ = 0.32, p = .04), indicating that players who exhibited greater SNK had higher carbohydrate intakes. On the basis of these findings, male football players in Australia would benefit from nutrition education targeting carbohydrate and fat in an attempt to improve nutrition knowledge and dietary practices.
Giovinazzo, Giovanna; Ingrosso, Ilaria; Paradiso, Annalisa; De Gara, Laura; Santino, Angelo
The plant polyphenol trans-resveratrol (3, 5, 4'-trihydroxystilbene) mainly found in grape, peanut and other few plants, displays a wide range of biological effects. Numerous in vitro studies have described various biological effects of resveratrol. In order to provide more information regarding absorption, metabolism, and bioavailability of resveratrol, various research approaches have been performed, including in vitro, ex vivo, and in vivo models. In recent years, the induction of resveratrol synthesis in plants which normally do not accumulate such polyphenol, has been successfully achieved by molecular engineering. In this context, the ectopic production of resveratrol has been reported to have positive effects both on plant resistance to biotic stress and the enhancement of the nutritional value of several widely consumed fruits and vegetables. The metabolic engineering of plants offers the opportunity to change the content of specific phytonutrients in plant - derived foods. This review focuses on the latest findings regarding on resveratrol bioproduction and its effects on the prevention of the major pathological conditions in man.
Pray, Carl; Ledermann, Samuel
In Africa and South Asia, where nutrition insecurity is severe, two of the most prominent production technologies are genetically modified (GM) crops and certified organic agriculture. We analyze the potential impact pathways from agricultural production to nutrition. Our review of data and the literature reveals increasing farm-level income from cash crop production as the main pathway by which organic agriculture and GM agriculture improve nutrition. Potential secondary pathways include reduced prices of important food crops like maize due to GM maize production and increased food production using organic technology. Potential tertiary pathways are improvements in health due to reduced insecticide use. Challenges to the technologies achieving their impact include the politics of GM agriculture and the certification costs of organic agriculture. Given the importance of agricultural production in addressing nutrition security, accentuated by the post-2015 sustainable development agenda, the chapter concludes by stressing the importance of private and public sector research in improving the productivity and adoption of both GM and organic crops. In addition, the chapter reminds readers that increased farm income and productivity require complementary investments in health, education, food access and women's empowerment to actually improve nutrition security. © 2016 S. Karger AG, Basel.
Lázaro-Martín, N I; Catalán-González, M; García-Fuentes, C; Terceros-Almanza, L; Montejo-González, J C
To analyze the nutritional management practices in Intensive Care (ICU) to detect the need for improvement actions. Re-evaluate the process after implementation of improvement actions. Prospective observational study in 3 phases: 1) observation; 2) analysis, proposal development and dissemination; 3) analysis of the implementation. ICU of a hospital of high complexity. Adult ICU forecast more than 48h of artificial nutrition. Parenteral nutrition (PN), enteral nutrition (EN) (type, average effective volume, complications) and average nutritional ratio. A total of 229 patients (phase 1: 110, phase 3: 119). After analyzing the initial results, were proposed: increased use and precocity of EN, increased protein intake, nutritional monitoring effectiveness and increased supplementary indication NP. The measures were broadcast at specific meetings. During phase 3 more patients received EN (55.5 vs. 78.2%, P=.001), with no significant difference in the start time (1.66 vs. 2.33 days), duration (6.82 vs. 10,12 days) or complications (37,7 vs. 47,3%).Use of hyperproteic diets was higher in phase 3 (0 vs. 13.01%, P<.05). The use of NP was similar (48.2 vs. 48,7%) with a tendency to a later onset in phase 3 (1.25±1.25 vs. 2.45±3.22 days). There were no significant differences in the average nutritional ratio (0.56±0.28 vs. 0.61±0.27, P=.56). The use of EN and the protein intake increased, without appreciating effects on other improvement measures. Other methods appear to be necessary for the proper implementation of improvement measures. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.
Johnson, Kiersten B.; Jacob, Anila; Brown, Molly Elizabeth
Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P5.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystems services of forests are important factors in improving human health and nutrition outcomes.
Murphy, Sarah Anne
Summarizing specific tools for measuring service quality alongside tips for using these tools most effectively, this book helps libraries of all kinds take a programmatic approach to measuring, analyzing, and improving library services.
Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study ... Journal Home > Vol 24, No 3 (2010) > ... Results: Past experience on antenatal care service utilization did not come out as a predictor for ...
Long-time IDRC partner, the Consultative Group on International Agricultural Research ... and intake of nutritious foods, to improve agricultural labour productivity, ... IWRA/IDRC webinar on climate change and adaptive water management.
Hoppen dos Santos, Joni; Ferreira Pires, Luis; Goncalves da Silva, Eduardo; Iacob, Maria Eugenia; Janssen, M.; Macintosh, A.; Scholl, H.J.; Tambouris, E.; Wimmer, M.A.; de Bruijn, H.; Tan, Y.H
In recent years, public organisations have been challenged to offer electronic services. This has caused a proliferation of disconnected web sites or web portals, often reflecting the internal structures (departments or sections) of these organizations. This paper shows that electronic public
Mangieri, Christopher Wesley; Strode, Matthew A
Laparoscopic sleeve gastrectomy (LSG) is an increasingly performed procedure in the bariatric surgery armamentarium. This study evaluates our experience with LSG at Dwight D. Eisenhower Army Medical Center (DDEAMC) during the time period of 2008-2010. We found that the inclusion of formal nutritional education significantly increased our weight loss results following LSG. This is a retrospective review from our LSG caseload from 2008 to 2010. During that time, we performed 159 LSG. In our review, we performed comparative data of all operative years during 2008-2010 for up to 3 years postoperatively. Our main focus was in regard to weight loss as measured by percentage of excess body weight loss (%EWL), percentage of total weight loss (%TWL), and percentage of excess BMI loss (%EBL). We also evaluated the effect of LSG on diabetes mellitus (DM) and hypertension (HTN) postoperatively. We found an improvement in our %EWL, %TWL, and %EBL rates in our LSG cases following the inclusion of formal nutritional education. There was a mean increase in %EWL of 15 %, %TWL of 7 %, and %EBL of 21 %, which were statistically significant, that was present at all postoperative years of follow-up. We determined the only variable that changed in our bariatric program starting in 2010 was the inclusion of formal nutritional education. We also found a statistically significant improvement in resolution of HTN with the inclusion of formal nutritional education. The addition of formal nutritional education can enhance weight loss following bariatric surgery. We have shown a significant improvement in weight loss results following LSG with the implementation of formal nutritional education; this is the only study to our knowledge evaluating formal nutritional education and LSG.
DiFilippo, Kristen N; Huang, Wen-Hao; Andrade, Juan E; Chapman-Novakofski, Karen M
We conducted a systematic review to determine if the use of nutrition apps resulted in improved outcomes, including knowledge and behavior, among healthy adults. Using app(s), cellular phone, iPads, mobile phone, mobile telephone, smart phone, mobile and mHealth as search terms with diet, food and nutrition as qualifiers we searched PubMed, CINAHL (January 2008-October 2013) and Web of Science (January 2008-January 2014). Inclusion criteria were peer-reviewed randomized controlled trials, non-controlled trials, and cohort studies published in English that used apps to increase nutrition knowledge or improve behavior related to nutrition. Studies that were descriptive, did not include apps, focused on app development, app satisfaction app feasibility, text messaging, or digital photography were excluded. We evaluated article quality using the Academy of Nutrition and Dietetics Evidence Analysis Manual. Data was extracted for knowledge, behavior and weight change. Our initial search identified 12,010 titles from PubMed, 260 from CINAHL and 4762 from Web of Science; of these, only four articles met all search criteria. Positive quality ratings were given to three articles; only one reported knowledge outcomes (non-significant). All four articles evaluated weight loss and suggested an advantage to using nutrition apps. Behavioral changes in reviewed studies included increased adherence to diet monitoring (p app (p = 0.024). Few studies, however, have explored the use of nutrition apps as supportive educational interventions. Most apps focus on weight loss with inconsistent outcomes. We conclude that using apps for education needs additional research which includes behavior theory within the app and improved study design. © The Author(s) 2015.
Full Text Available How can we ensure that 9 billion people will have access to a nutritious and healthy diet that is produced in a sustainable manner by 2050? Despite major advances, our global food system still fails to feed a significant part of humanity adequately. Diversifying food systems and diets to include nutrient-rich species can help reduce malnutrition while contributing other multiple benefits including healthy ecosystems. While research continues to demonstrate the value of incorporating biodiversity into food systems and diets, perverse subsidies and barriers often prevent this. Countries like Brazil have shown that by strategic actions and interventions it is indeed possible to create better contexts to mainstream biodiversity for improved nutrition into government programs and public policies. Despite some progress, there are few global and national policy mechanisms or processes that effectively join biodiversity with agriculture and nutrition efforts. This perspective paper discusses the benefits of biodiversity for nutrition and explores what an enabling environment for biodiversity to improve nutrition might look like, including examples of steps and actions from a multi-country project that other countries might replicate. Finally, we suggest what it might take to create enabling environments to mainstream biodiversity into global initiatives and national programs and policies on food and nutrition security. With demand for new thinking about how we improve agriculture for nutrition, and growing international recognition of the role biodiversity, the 2030 Agenda for Sustainable Development presents an opportunity to move beyond business-as-usual, to more holistic approaches to food and nutrition security.
Sacheck, Jennifer M.; Morgan, Emily H.; Wilde, Parke; Griffin, Timothy; Nahar, Elizabeth; Economos, Christina D.
Purpose/Objective: This case study identified common elements of three diverse New England school districts that were real-world models of improving school meals. Methods: School districts that had greater than 1,000 students, [greater than or equal to]3 schools, and [greater than or equal to]40% of students who qualified for free- or…
Williams, CS; Saunders, M
Traditional survey based measures of service quality are argued to be problematic when reflecting individual services and turning measurement into action. This paper reviews developments to an alternative measurement approach, the Service Template Process and offers an extension to it. The extended process appears able to measure service users’ and deliverers’ perceptions of service quality independently. It also enables participants to jointly agree an agenda for quality improvement. The e...
Williams, R; Virtue, K; Adkins, A
Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.
San Mateo City Elementary School District, CA.
This inservice training guide on nutrition activities for preschool and elementary school teachers consists of 14 lesson plans for two workshops and more than 20 related instructional handouts that can be copied for teachers. The first workshop for teachers provides a rationale for nutrition education ine elementary curriculum as well as…
African Journal of Biotechnology ... This study evaluated the potential use and improves the health beneficial properties of the soybean waste manufacturing products by solid-state fermentation of six GRAS ... Key words: Solid state fermentation, yeast, waste soybean manufacturing products, antioxidant, protein, fiber.
Informing policy through agriculture and food security research. Improving the uptake of agricultural and food security research into policy and practice is a central objective of IDRC's Agriculture and Food Security program. To maximize the impact of proven solutions, the program set out to inform and engage both Canadian ...
...The Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension of a currently approved collection, and allow 60 days for public comment in response to the notice. This notice solicits comments on information needed to determine patients' satisfaction with the quality of food and nutrition services.
Van Riper, Cynthia L; Wallace, Lee Shelly
It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication-nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.
Ong Ken K
Full Text Available Abstract Background Improving nutrition knowledge among children may help them to make healthier food choices. The aim of this study was to assess the effectiveness and acceptability of a novel educational intervention to increase nutrition knowledge among primary school children. Methods We developed a card game 'Top Grub' and a 'healthy eating' curriculum for use in primary schools. Thirty-eight state primary schools comprising 2519 children in years 5 and 6 (aged 9-11 years were recruited in a pragmatic cluster randomised controlled trial. The main outcome measures were change in nutrition knowledge scores, attitudes to healthy eating and acceptability of the intervention by children and teachers. Results Twelve intervention and 13 control schools (comprising 1133 children completed the trial. The main reason for non-completion was time pressure of the school curriculum. Mean total nutrition knowledge score increased by 1.1 in intervention (baseline to follow-up: 28.3 to 29.2 and 0.3 in control schools (27.3 to 27.6. Total nutrition knowledge score at follow-up, adjusted for baseline score, deprivation, and school size, was higher in intervention than in control schools (mean difference = 1.1; 95% CI: 0.05 to 2.16; p = 0.042. At follow-up, more children in the intervention schools said they 'are currently eating a healthy diet' (39.6% or 'would try to eat a healthy diet' (35.7% than in control schools (34.4% and 31.7% respectively; chi-square test p Conclusions The 'Top Grub' card game facilitated the enjoyable delivery of nutrition education in a sample of UK primary school age children. Further studies should determine whether improvements in nutrition knowledge are sustained and lead to changes in dietary behaviour.
Improved maternal nutrition to decrease children’s long-term risk of non-communicable diseases (NCDs) and obesity The nutritional well-being of pregnant women affects not only their health and their fetuses' development but also children's long-term risk of developing NCDs or obesity, according...... to a new report from WHO/Europe. "Good maternal nutrition. The best start in life" was launched under the auspices of the Minister of Health of Latvia during a consultation on maternal nutrition, in Riga on 27–28 June 2016. While the importance of good nutrition in the early development of children has...... – affects not only her child's health as an infant but also the child's risk of obesity and related chronic diseases as an adult. In short, maternal nutrition can truly have an intergenerational impact. Fighting NCDs and obesity through measures to improve maternal nutrition: NCDs are the leading cause...
Segal, Leonie; Opie, Rachelle S
Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of "junk foods" is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs.
Full Text Available Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden.Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into; i population level socio-educational approaches to enhance diet knowledge; ii pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods; iii regulations to modify the food environment, and iv the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of ‘junk foods’ is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians per 10,000 persons or 75 nurses per 10,000 persons.Given the major role of diet in health it is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs.
Academy for Educational Development, Washington, DC.
The LINKAGES Project is intended to improve breastfeeding and related complementary feeding and maternal dietary practices. The project, in consultation with technical experts and program managers, identified a set of recommended feeding and dietary practices intended to break the cycle of poor health and nutrition that passes from generation to…
UNCLASSIFIED Nutritional Composition of Australian Combat Ration Packs and Options for Improvement Executive Summary In 2008/09...Krispie 1x43g Confectionary Spread – Choc 1x50g Freeze Dried Rice 1x55g Fruit Grains, Mix Berry 1x15g Confectionary Spread – Vanilla
The book takes account of the key fact that to maximize their potential, people must have lifelong access to the information and services offered through books and libraries. Whether to address concerns of an ageing population or to enable all citizens to contribute fully through meaningful education and work opportunities, more emphasis is being given to promoting library services to people who have disabilities. This book is a compendium of articles focused on serving adults with disabilities in an international setting. From this book, librarians, policy makers and constituents will underst
Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.
Richter, Eva; Denecke, Almut; Klapdor, Silke; Klapdor, Rainer
, body cell mass (BCM), extracellular mass (ECM), cell content and ECM/BCM Index). Two patients, who were receiving PN for over two or three periods, showed reproducibility of the results; while when PN was interrupted all BIA parameters degraded and they ameliorated with the restart of PN. Gr2: In these patients PN was started in the late stage of the tumor disease in order to allow for a--from the retrospective point of view--last, but ineffective chemotherapy. The data indicated that the weight loss could be retarded, even if the effects on body weight and BIA parameters were found to be less pronounced compared to Gr1. The mean energy supply of both groups, however, was similar: 8,823 kcal (Gr1) per week compared to 9,572 kcal (Gr2) per week. The majority of patients claimed to be quicker and more powerful under PN and to some extent the appetite was enhanced. A timely onset of PN with sufficient calories leads to an improved nutritional status of patients with PaCa disease. PN enhances the quality of life, the administration of tumor therapy without interruption and therefore may lead to a better success of the entire therapy. For late-stage tumor patients (Gr2) the quality of life can, at least, be improved. The success of PN is significantly dependent upon the patients' compliance, which could be achieved through intensive consulting and support of all patients and their relatives.
Al-Mudhwahi, Ali A
This paper intends to review the feasibility of scaling-up nutrition activities through integrated outreach activities to respond to development challenges. Evaluating the efficiency and effectiveness of current packages of outreach services during the period of 2006-2014 is the aim of this review for better access to basic and social services and economic opportunities in Yemen. The two components of health system performance are related to: (i) the levels of coverage for health interventions; and (ii) financial risk protection, with a focus on equity. In this sense, Yemen's intervention coverage indicators of the health-related MDGs, such as immunization, integrated management of childhood illnesses (IMCI), reproductive health (RH) and disease control including non-communicable diseases (NCDs) have shown good progress. Yet, malnutrition is still highly prevalent among under-five children in the country. Coverage indicators of the outreach approach in Yemen, which started in 2006, indicate a strong role of the integrated services in reaching under-five children of the most vulnerable communities with basic health services including preventive and curative ones. As well, these activities respond to the financial risk protection challenges with enhancing efficiency in the provision of health services. Considering that nutrition is part of the package of integrated outreach services, inter-related measures of universal coverage in Yemen are to be addressed together with setting the impact indicators for essential health services coverage targeting the neediest populations. Coverage of health services encompasses the full targeted population in the most malnutrition-affected areas, especially the west coast of the country, for intervention and for the age group these services are directed to.
Rodríguez Rejón, Ana Isabel; Ruiz López, María Dolores; Malafarina, Vincenzo; Puerta, Antonio; Zuñiga, Antonia; Artacho, Reyes
Institutionalization is a risk factor for malnutrition. Low energy intake and/or nutrient deficiencies are considered to be the main causes. To evaluate the quality of meals and meal service as well as the nutritional value of the main menus (regular menu, menu for diabetics, and pureed menu) offered in three long-term care (LTC) homes located in the metropolitan area of Granada (Spain). Cross-sectional study. A validated "quality of meals and meal service" set of indicators was applied. The menus were assessed by weighed food records on 14 consecutive days. The results were compared with the dietary reference intakes (DRIs) and the recommended number of servings. Important deficiencies in the quality of meals and meal service have been reported. Average energy varies from 1,788 to 2,124 kcal/day in the regular menus, from 1,687 to 1,924 kcal/day in the menus for diabetics, and from 1,518 to 1,639 kcal/day in the pureed menus. Average protein varied from 71.4 to 75.4 g/day, from 72.6 to 76.1 g/day, and from 50.5 to 54.7 g/day, respectively. None of the menus complied with the recommendations for fiber, potassium, magnesium, iodine, vitamin D, vitamin E, folate, nor for vegetables, fruit, milk products, olive oil, legumes, or nuts. It is necessary to ensure the implementation of regular routines for controlling the quality of meals and meal service as well as the nutritional value of the menus offered in LTC homes.
Full Text Available Business obligations, the manner and pace of life today, and a large number of options when it comes to eating out, require that at least one meal is consumed outside the residence or using the services of catering and retail facilities. With this in mind, restaurants are forced to fight in the market and to differentiate the specific offer to attract a particular segment of the market. Differentiation is possible through monitoring the trends and timely adjustments to more demanding consumer needs. In this way, restaurateurs also contribute to greater customer satisfaction through quality service, which also has a positive effect on the restaurant and sales performance. Based on the results of the survey of 82 respondents, it was concluded that nutritional information shown within menus is of no importance, and also that such information does not affect the selection of dishes. Although nutritional information can be helpful in selecting more favourable and healthy food, neither men nor women care about it.
Lokkerbol, J.; Does, R.J.M.M.; de Mast, J.; Schoonhoven, M.
Purpose - The purpose of this paper is to create actionable knowledge, thereby supporting and stimulating practitioners to improve processes in the financial services sector. Design/methodology/approach - This paper is based on a case base of improvement projects in financial service organizations.
Chen, Yen-Ting; Chou, Tsung-Yu
This paper applied Grey Relational Analysis (GRA) to Quality Function Deployment (QFD) to identify service improvement techniques for an academic library. First, reader needs and their importance, and satisfaction degrees were examined via questionnaires. Second, the service improvement techniques for satisfying the reader needs were developed by…
Rahman, Adam; Agarwala, Ravi; Martin, Claudio; Nagpal, Dave; Teitelbaum, Michael; Heyland, Daren K
Malnutrition is a predictor of poor outcome following cardiac surgery. We define nutrition therapy after cardiac surgery to identify opportunities for improvement. International prospective studies in 2007-2009, 2011, and 2013 were combined. Sites provided institutional and patient characteristics from intensive care unit (ICU) admission to ICU discharge for a maximum of 12 days. Patients had valvular, coronary artery bypass graft (CABG) surgery, or combined procedures and were mechanically ventilated and staying in the ICU for ≥3 days. There were 787 patients from 144 ICUs. In total, 120 patients (15.2%) had valvular surgery, 145 patients (18.4%) had CABG, and 522 patients (66.3%) underwent a combined procedure. Overall, 60.1% of patients received artificial nutrition support. For these patients, 78% received enteral nutrition (EN) alone, 17% received a combination of EN and parenteral nutrition (PN), and 5% received PN alone. The remaining 314 patients (40%) received no nutrition. The mean (SD) time from ICU admission to EN initiation was 2.3 (1.8) days. The adequacy of calories was 32.4% ± 31.9% from EN and PN and 25.5% ± 27.9% for patients receiving only EN. In EN patients, 57% received promotility agents and 20% received small bowel feeding. There was no significant relationship between increased energy or protein provision and 60-day mortality. Postoperative cardiac surgery patients who stay in the ICU for 3 or more days are at high risk for inadequate nutrition therapy. Further studies are required to determine if targeted nutrition therapy may alter clinical outcomes.
Omidvari, Amir-Houshang; Vali, Yasaman; Murray, Susan M; Wonderling, David; Rashidian, Arash
Given the prevalence of under-nutrition and reports of inadequate nutritional management of patients in hospitals and the community, nutritional screening may play a role in reducing the risks of malnutrition. Screening programmes can invoke costs to health systems and patients. It is therefore important to assess the effectiveness of nutritional screening programmes. To examine the effectiveness of nutritional screening in improving quality of care (professional practice) and patient outcomes compared with usual care. We searched the following databases: CENTRAL (The Cochrane Library), MEDLINE, EMBASE and CINAHL up to June 2012 to find relevant studies. Randomised controlled studies, controlled clinical trials, controlled before-after studies and interrupted time series studies assessing the effectiveness of nutritional screening were eligible for inclusion in the review. We considered process outcomes (for example patient identification, referral to dietitian) and patient outcomes (for example mortality, change in body mass index (BMI)). Participants were adult patients aged 16 years or over. We included studies conducted in different settings, including hospitals, out-patient clinics, primary care or long term care settings. We independently assessed the risk of bias and extracted data from the included studies. Meta-analysis was considered but was not conducted due to the discrepancies between the studies. The studies were heterogeneous in their design, setting, intervention and outcomes. We analysed the data using a narrative synthesis approach. After conducting initial searches and screening the titles and abstracts of the identified literature, 77 full text papers were retrieved and read. Ultimately three studies were included. Two controlled before-after studies were conducted in hospital settings (one in the UK and one in the Netherlands) and one cluster randomised controlled trial was conducted in a primary care setting (in the USA).The study conducted in
Key words: nutrition, children, pastoral community, Tanzania. Introduction. Nutritional ... adequate diet, availability of education, health services and healthy environment ..... improve growth or hemoglobin status of rural. Tanzanian infants from ...
Tamás, Cecília; Kisgyörgy, Boglárka N; Rakszegi, Mariann; Wilkinson, Mark D; Yang, Moon-Sik; Láng, László; Tamás, László; Bedo, Zoltán
An amaranth (Amaranthus hypochondriacus) albumin gene, encoding the 35-kDa AmA1 protein of the seed, with a high content of essential amino acids, was used in the biolistic transformation of bread wheat (Triticum aestivum L.) variety Cadenza. The transformation cassette carried the ama1 gene under the control of a powerful wheat endosperm-specific promoter (1Bx17 HMW-GS). Southern-blot analysis of T(1) lines confirmed the integration of the foreign gene, while RT-PCR and Western-blot analyses of the samples confirmed the transcription and translation of the transgene. The effects of the extra albumin protein on the properties of flour, produced from bulked T(2) seeds, were calculated using total protein and essential amino acid content analysis, polymeric/monomeric protein and HMW/LMW glutenin subunit ratio measurements. The results indicated that not only can essential amino acid content be increased, but some parameters associated with functional quality may also be improved because of the expression of the AmA1 protein.
World is suffering from food shortages and rising prices of animal food, in particular. Therefore, attention turned to fill the shortfall by increasing the production and consumption of pulses. Beans are the most important types of legumes consumed in the countries of the Middle East. But there are some factors that reduce the expansion in the consumption of beans and some factors discourage feeding the trypsin inhibitor,phytic acid, causes of gases and allergens in some people, which negatively affect the bioavailability to absorb the vital minerals and proteins in addition to the length of time needed for cooking beans. There have been attempts to use gamma rays to improve strength and Leakage and cooking recipes for legumes, and reached results in other studies to reduce the efficiency of trypsin inhibitor in beans treated at a dose of 10 kGy as well as achieving the highest percentage reduction in phytic acid content of the same seed above. Also it was found that gamma rays affect negatively on the causes of gases in the beans, radiation works to break down some of the Oligosaccharides and turn it into simple sugars, as well as to break down some of the compounds which are responsible of disease in beans.
Quidde, J; von Grundherr, J; Koch, B; Bokemeyer, C; Escherich, G; Valentini, L; Buchholz, D; Schilling, G; Stein, A
Multimodality treatment improves the chance of survival but increases the risk for long-term side effects in young cancer survivors, so-called" Adolescents and Young Adults"(AYAs). Compared to the general population AYAs have a 5 to 15-fold increased risk of cardiovascular morbidity. Thus, improving modifiable lifestyle risk factors is of particular importance. The INAYA trial included AYAs between 18 and 39 years receiving an intensified individual nutrition counseling at four time points in a 3-month period based on a 3-day dietary record. At week 0 and 12 AYAs got a face-to-face counseling, at week 2 and 6 by telephone. Primary endpoint was change in nutritional behavior measured by Healthy Eating Index - European Prospective Investigation into Cancer and Nutrition (HEI-EPIC). Twenty-three AYAs (11 female, 12 male, median age 20 years (range 19-23 years), median BMI: 21.4 kg/m 2 (range: 19.7-23.9 kg/m 2 ) after completion of cancer treatment for sarcoma (n = 2), carcinoma (n = 2), blastoma (n = 1), hodgkin lymphoma (n = 12), or leukemia (n = 6) were included (median time between diagnosis and study inclusion was 44 month). The primary endpoint was met, with an improvement of 20 points in HEI-EPIC score in 52.2 % (n = 12) of AYAs. At baseline, median HEI-EPIC score was 47.0 points (range from 40.0 to 55.0 points) and a good, moderate and bad nutritional intake was seen in 4.3, 73.9 and 21.7 % of AYAs. At week 12, median HEI-EPIC improved significantly to 65.0 points (range from 55.0 to 76.0 points) (p ≤ 0.001) and a good, moderate and bad nutritional intake was seen in 47.8, 52.2 and 0 % of AYAs. No change was seen in quality of life, waist-hip ratio and blood pressure. Intensified nutrition counseling is feasible and seem to improve nutritional behavior of AYAs. Further studies will be required to demonstrate long-term sustainability and confirm the results in a randomized design in larger cohorts. Clinical trial identifier
Nii, Maria; Maeda, Keisuke; Wakabayashi, Hidetaka; Nishioka, Shinta; Tanaka, Atsuko
Malnutrition affects the activities of daily living (ADLs) in convalescent patients with cerebrovascular disorders. We investigated the relationship between nutritional improvement, energy intake at admission, and recovery of ADLs. We evaluated 67 patients with cerebrovascular disorders admitted to our rehabilitation hospital between April 2013 and April 2015. These patients received interventions from the rehabilitation nutritional support team according to the following criteria: weight loss of 2 kg or more and body mass index of 19 kg/m(2) or lower. Exclusion criteria included a body mass index of 25 kg/m(2) or higher, duration of intervention of less than 14 days, or transfer to an acute care hospital because of clinical deterioration. We assessed nutritional status using the Geriatric Nutritional Risk Index (GNRI) and ADL using the Functional Independence Measure (FIM) score, FIM gain, and FIM efficiency. The mean age of the patients was 78.7 ± 8.0 years. The numbers of patients in each category of cerebrovascular disorder were 39 with cerebral infarction, 16 with intracerebral hemorrhage, 8 with subarachnoid hemorrhage, and 4 others. Compared with the counterpart group, the group with an improvement in GNRI had a greater gain in FIM (median 17 and 20, respectively; P = .036) and a higher FIM efficiency (.14 and .22, respectively; P = .020). Multivariate stepwise regression analysis showed that an improvement in GNRI, increasing energy intake at admission, and intracerebral hemorrhage were associated independently with greater FIM efficiency. This study suggested that nutritional improvement and energy intake at admission are associated with recovery of ADL after cerebrovascular disorders. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Darmon, Nicole; Lacroix, Anne; Muller, Laurent; Ruffieux, Bernard
Unhealthy eating is more prevalent among women and people with a low socioeconomic status. Policies that affect the price of food have been proposed to improve diet quality. The study's objective was to compare the impact of food price policies on the nutritional quality of food baskets chosen by low-income and medium-income women. Experimental economics was used to simulate a fruit and vegetable subsidy and a mixed policy subsidizing healthy products and taxing unhealthy ones. Food classification was based on the Score of Nutritional Adequacy of Individual Foods, Score of Nutrients to Be Limited nutrient profiling system. Low-income (n = 95) and medium-income (n = 33) women selected a daily food basket first at current prices and then at policy prices. Energy density (ED) and the mean adequacy ratio (MAR) were used as nutritional quality indicators. At baseline, low-income women selected less healthy baskets than medium-income women (less fruit and vegetables, more unhealthy products, higher ED, lower MAR). Both policies improved nutritional quality (fruit and vegetable quantities increased, ED decreased, the MAR increased), but the magnitude of the improvement was often lower among low-income women. For instance, ED decreased by 5.3% with the fruit and vegetable subsidy and by 7.3% with the mixed subsidy, whereas decreases of 13.2 and 12.6%, respectively, were recorded for the medium-income group. Finally, both policies improved dietary quality, but they increased socioeconomic inequalities in nutrition. © 2016 S. Karger AG, Basel.
May 21, 2013 ... ... with the municipality on a large-scale solid waste storage and recycling plant. ... As a result, not only were infrastructure and planning processes improved, but ... Clean water initiative in Peru led by former IDRC awardee.
Firkins, J L; Yu, Z
Metagenomics and high-throughput sequencing have greatly expanded our knowledge of the rumen microbiome. Surveys of all 4 cellular microbial groups (bacteria, archaea, protozoa, and fungi) reveal profound diversity. Even so, evidence exists for core members to perform key degradative or fermentative roles for the host. Some core members are functionally similar yet taxonomically diverse, and noncore members are particularly diverse and probably vary among diets, animals, and over time after feeding. Gains in functional knowledge are being made and offer much potential not only to improve fiber digestibility, decrease methane emissions, and improve efficiency of nitrogen usage but also to help explain the differences in nutrient digestibility or feed efficiency among animals fed the same diet. Integrated research using metagenomics, bioinformatics, traditional ruminant nutrition, and statistical inferences have provided opportunities for ruminant nutritionists and rumen microbiologists to work synergistically to improve nutrient utilization efficiency while minimizing output of wastes and emissions of methane and ammonia. Examples we highlight include residual feed intake, rumen biohydrogenation of unsaturated fatty acids, and dietary inclusion of ionophores. However, there are still some quantitative limitations in approaches being used. This review addresses knowledge gained and current limitations and challenges that remain.
Korenev, N M; Novikova, V N; Gaĭdaĭ, V Ia; Bulaga, L P; Komlik, P V
The protection and promotion of schoolchildren's health might be ensured by means of differential approach to the use of different forms of organization of medical provision and its further improvement with due regard for regional conditions. The development of All-union programme "Schoolchildren" is needed which would provide for a scientific base for improving organizational and health-promoting activities at general education schools and boarding schools.
Teasdale, Scott B; Latimer, Geogina; Byron, Annette; Schuldt, Vanessa; Pizzinga, Josephine; Plain, Janice; Buttenshaw, Kerryn; Forsyth, Adrienne; Parker, Elizabeth; Soh, Nerissa
This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change. Selective narrative review. Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings. Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.
Berezowska, Aleksandra; Fischer, Arnout R H; Ronteltap, Amber; Kuznesof, Sharron; Macready, Anna; Fallaize, Rosalind; van Trijp, Hans C M
Personalised nutrition (PN) may provide major health benefits to consumers. A potential barrier to the uptake of PN is consumers' reluctance to disclose sensitive information upon which PN is based. This study adopts the privacy calculus to explore how PN service attributes contribute to consumers' privacy risk and personalisation benefit perceptions. Sixteen focus groups (n = 124) were held in 8 EU countries and discussed 9 PN services that differed in terms of personal information, communication channel, service provider, advice justification, scope, frequency, and customer lock-in. Transcripts were content analysed. The personal information that underpinned PN contributed to both privacy risk perception and personalisation benefit perception. Disclosing information face-to-face mitigated the perception of privacy risk and amplified the perception of personalisation benefit. PN provided by a qualified expert and justified by scientific evidence increased participants' value perception. Enhancing convenience, offering regular face-to face support, and employing customer lock-in strategies were perceived as beneficial. This study suggests that to encourage consumer adoption, PN has to account for face-to-face communication, expert advice providers, support, a lifestyle-change focus, and customised offers. The results provide an initial insight into service attributes that influence consumer adoption of PN. © 2014 S. Karger AG, Basel.
Koefoed, Mette; Kromann, Charles Boy; Hvidtfeldt, Danni
OBJECTIVE: Malnutrition is common in dialysis patients and is associated with adverse clinical outcomes. Despite an increased focus on improved nutrition in dialysis patients, it is claimed that the prevalence of malnutrition in this group of patients has not changed during the last decades. Direct......: Relative body weight, triceps skinfold, MAMC, body mass index, and prevalence of protein-caloric malnutrition as defined in the original study from 1986. RESULTS: Average relative body weight, triceps skinfold, MAMC, and body mass index were significantly higher in 2014 compared with 1986. The prevalence...... of protein-caloric malnutrition was significantly lower in 2014 (18%) compared with 1986 (52%). CONCLUSIONS: The nutritional status of maintenance dialysis patients has improved during the last 3 decades. The reason for this improvement could not be identified in the present study, but the most likely...
Pietka, Magdalena; Watrobska-Swietlikowska, Dorota; Szczepanek, Kinga; Szybinski, Piotr; Sznitowska, Małgorzata; Kłęk, Stanisław
Modern home parenteral nutrition (HPN) requires the preparation of tailored admixtures. The physicians' demands for their composition are often at the variance with pharmaceutical principles, which causes the necessity of either the preparation of ex tempore admixtures or stability testing ensuring long shelf life. Both approaches are not cost-effective. The aim of the study was to use the cooperation among physicians and pharmacists to assure both: cost-effectiveness and patient-tailored HPN admixtures. The first part of the study consisted of the thorough analysis of prescriptions for the most demanding 47 HPN patients (27 females and 20 males, mean age 53.1 year) treated at one HPN center to create few as possible long-shelf life admixtures. The second part of the study consisted of stability testing and modifications. The analysis showed over 137 variations needed to cover all macro- and micronutrients requirements. Their cost as ex-tempore solutions was extremely high (over 110 000 EURO/month) due to logistics and similarly high if stability test for variation were to be performed (68 500 EURO). Therefore prescription was prepared de novo within team of physicians and pharmacists and four base models were designed. Water and electrolytes, particularly magnesium and calcium showed to be the major issues. Stability tests failed in one admixture due to high electrolytes concentration. It was corrected, and the new formula passes the test. Five basic models were then used for creation of new bags. Cost of such an activity were 3 700 EURO (pcooperation within the members of nutritional support team could improve the cost-effectiveness and quality of HPN. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Hughes, Roger; Margetts, Barrie
The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.
Full Text Available Good nutrition is a prerequisite for a healthy and active life, especially for agriculture-dependent households. However, diets in most households in Tanzania lack diversity because the intake of meat, poultry, fish, and vegetables and fruits is low. This study estimates factors influencing dietary diversity of the household, children under five years, and women using primary survey data. It qualitatively assesses male dietary patterns and men's potential role in improving the nutritional status of the entire household. The findings show that the most consumed foods within the household are cereals, vegetables, oils and fats, spices, condiments and beverages. Children (d = 0.4; p<0.05 and women (d = 0.5; p<0.01 in female-headed households have low dietary diversity compared to those in male-headed households. Women and children access less diverse diets since 46% and 26%, achieved minimum dietary diversity respectively. Production of vegetables (coef. 0.34; p<0.05 play an important role in improving the dietary diversity of women. Gender (coef. 0.05; p<0.10 and education of the household head (coef. 0.02; p<0.01, food preparation and nutrition training (coef. 0.10; p<0.05 are important factors influencing dietary diversity of the members of a household. Results suggest that there is a need to support community-based programs to provide information on food and the importance of vegetables, their preparation, consumption and utilization to address food and nutrition challenges. Men can contribute towards improving household nutrition security by reducing consumption of food away from the home, especially during periods of food shortages. We recommend the use of complementary quantitative research to determine the patterns and dynamics of men's dietary diversity and compare it with that of other household members.
Aguayo, Víctor M; Menon, Purnima
The latest available data indicate that 38% of South Asia's children aged 0-59 months are stunted. Such high prevalence combined with the region's large child population explain why South Asia bears about 40% of the global burden of stunting. Recent analyses indicate that the poor diets of children in the first years of life, the poor nutrition of women before and during pregnancy and the prevailing poor sanitation practices in households and communities are important drivers of stunting, most likely because of underlying conditions of women's status, food insecurity, poverty, and social inequalities. With this evidence in mind, UNICEF Regional Office for South Asia convened the Regional Conference: Stop Stunting: Improving Child Feeding, Women's Nutrition, and Household Sanitation in South Asia (New Delhi, November 10-12, 2014). The Conference provided a knowledge-for-action platform with three objectives: (1) share state-of-the-art research findings on the causes of child stunting and its consequences for child growth and development and the sustainable growth and development of nations; (2) discuss better practices and the cost and benefits of scaling up programmes to improve child feeding, women's nutrition, and household sanitation in South Asia; and (3) identify implications for sectoral and cross-sectoral policy, programme, advocacy and research to accelerate progress in reducing child stunting in South Asia. This overview paper summarizes the rationale for the focus on improving child feeding, women's nutrition, and household sanitation as priority areas for investment to prevent child stunting in South Asia. It builds on the invited papers presented at or developed as a follow on to the Stop Stunting Conference. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program.
Hopkins, Laura C; Gunther, Carolyn
The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. There is critical need for policy
A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program
Laura C. Hopkins
Full Text Available Background: The USDA child meal programs (CMPs (National School Lunch Program (NSLP, School Breakfast Program (SBP, and Summer Food Service Program (SFSP were established in 1946 (NSLP and 1975 (SBP and SFSP to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003. Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in
DeLorme, Autumn L; Gavenus, Erika R; Salmen, Charles R; Benard, Gor Ouma; Mattah, Brian; Bukusi, Elizabeth; Fiorella, Kathryn J
A growing body of research emphasizes the need to engage social networks in maternal and child nutrition interventions. However, an understanding of how interventions functionally engage not only mothers but fathers, grandparents, friends, and other social network members remains limited. This study uses an adaptation of a social-ecological model to analyze the multiple levels at which the Kanyakla Nutrition Program operates to change behavior. This study analyzes focus group data (four groups; n = 35, 7 men and 28 women) following the implementation of the Kanyakla Nutrition Program, a novel nutrition intervention engaging social networks to increase nutrition knowledge, shift perceptions, and promote positive practices for infant and young child feeding and community nutrition in general. Participant perspectives indicate that the Kanyakla Nutrition Program contributed to nutrition knowledge and confidence, changed perceptions, and supported infant and child feeding practices at the individual, interpersonal, and institutional levels. However, many respondents report challenges in transcending barriers at the broader community and systems levels of influence, where environmental and economic constraints continue to affect food access. Analysis of the Kanyakla Nutrition Program suggests that for interventions addressing household level determinants of nutrition, simultaneously engaging the household's network of interpersonal and community relationships can play a role in building momentum and consensus to address persistent structural barriers to improved nutrition. Copyright © 2017 Elsevier Ltd. All rights reserved.
Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima
Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Meyers, J. C.; Hawkins, M. D.; Timofeyeva, M. M.
NOAA's National Weather Service (NWS) Climate Services Division (CSD) is developing a comprehensive climate user requirements process with the ultimate goal of producing climate services that meet the needs of NWS climate information users. An important part of this effort includes engaging users through periodical surveys conducted by the Claes Fornell International (CFI) Group using the American Customer Satisfaction Index (ACSI). The CFI Group conducted a Climate Services Satisfaction (CSS) Survey in May of 2009 to measure customer satisfaction with current products and services and to gain insight on areas for improvement. The CSS Survey rates customer satisfaction on a range of NWS climate services data and products, including Climate Prediction Center (CPC) outlooks, drought monitoring, and ENSO monitoring and forecasts, as well as NWS local climate data services. In addition, the survey assesses the users of the products to give the NWS insight into its climate customer base. The survey also addresses specific topics such as NWS forecast category names, probabilistic nature of climate products, and interpretation issues. The survey results identify user requirements for improving existing NWS climate services and introducing new ones. CSD will merge the survey recommendations with available scientific methodologies and operational capabilities to develop requirements for improved climate products and services. An overview of the 2009 survey results will be presented, such as users' satisfaction with the accuracy, reliability, display and functionality of products and services.
Guthrie, Joanne F; Newman, Constance; Ralston, Katherine; Prell, Mark; Ollinger, Michael
Many school food services sell extra foods and beverages, popularly referred to as “competitive foods,” in addition to USDA school meals. On the basis of national survey data, most competitive foods and beverages selected by students are of low nutritional value. Recent federal legislation will allow schools that participate in USDA school meal programs to sell competitive foods only if the food items they sell meet nutrition standards based on the Dietary Guidelines for Americans. Concerns have been raised about the potential effects of limiting competitive foods on local school food service finances. However, national data indicate that only in a subset of schools do food services receive large amounts of revenues from competitive foods. These food services are typically located in secondary schools in more affluent districts, serving higher proportions of students who do not receive free or reduced price meals. Compared to other food services, these food services couple higher competitive food revenues with lower school meal participation. Increasing school meal participation could increase meal revenues to offset any loss of competitive food revenues. Replacing less-healthful competitive items with healthier options could also help maintain school food service revenues while improving the school food environment. Nationally consistent nutrition standards for competitive foods may encourage development and marketing of healthful products.
Fink, Jaqueline da Silva; Marcadenti, Aline; Rabito, Estela Iraci; Silva, Flávia Moraes
Recently, the European Society for Clinical Nutrition and Metabolism (ESPEN) provided novel consensus criteria for malnutrition diagnosis. This study aimed to evaluate the applicability of this instrument in combination with different nutrition screening tools (1) to identify malnutrition and (2) to predict morbidity and mortality in hospitalized patients. Observational prospective study in 750 adults admitted to the emergency service of a tertiary public hospital. Subjective Global Assessment (SGA-reference method) and the new ESPEN criteria were used to assess nutrition status of patients, who were initially screened for nutrition risk using 4 different tools. Outcome measures included length of hospital stay, occurrence of infection, and incidence of death during hospitalization, analyzed by logistic regression. There was a lack of agreement between the SGA and ESPEN definition of malnutrition, regardless of the nutrition screening tool applied previously (κ = -0.050 to 0.09). However, when Malnutrition Screening Tool and Nutritional Risk Screening-2002 (NRS-2002) were used as the screening tool, malnourished patients according to ESPEN criteria showed higher probability of infection (relative risk [RR], 1.54; 95% confidence interval [CI], 1.02-2.31 and RR, 2.06; 95% CI, 1.37-3.10, respectively), and when the NRS-2002 was used, the risk for death was 2.7 times higher (hazard ratio, 2.69; 95% CI, 1.07-6.81) in malnourished patients than in well-nourished patients. Although the new ESPEN criteria had a poor diagnostic value, it seems to be a prognostic tool among hospitalized patients, especially when used in combination with the NRS-2002.
Full Text Available The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition and dietary services using external and internal auditors. Eleven hospitals were evaluated for their nutrition and dietary services using an evaluation checklist based on food safety requirements in the current legislation. The checklist was applied by an internal auditor (a technical supervisor and an external auditor (a professional with experience in food services between August and October 2011. According to the number of items on the evaluation checklist that were considered adequate, the hospital facilities were ranked as excellent, good, regular, bad, or very bad. The results obtained by the auditors were compared. According to these results, it can be said that most of the hospital nutrition and dietary services were rated as good for overall quality by the internal auditor, while the external auditor classified them as Regular. There was a clear difference between the evaluations of the auditors, both in terms of the number of items considered adequate and the overall requirements' average score. It can be concluded that hospital nutrition and dietary services should meet safety requirements in order to provide food. These facilities should have external audits conducted as a way to prevent routine problems from being perpetuated.
Brug, Hans; Oenema, Anke; Ferreira, Isabel
Abstract Background The present paper intends to contribute to the debate on the usefulness and barriers in applying theories in diet and physical activity behavior-change interventions. Discussion Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the the...
The International Atomic Energy Agency is working to ensure improved health for all, particularly children and women, in partnership with its 132 Member States, other United Nations organizations, and donors. Its programme of technical activities is fully supportive of the recommendations adopted in 1990 by the international community during the World Summit for Children, particularly the statement 'enhancement of children's health and nutrition is a first duty'. (IAEA)
The International Atomic Energy Agency is working to ensure improved health for all, particularly children and women, in partnership with its 132 Member States, other United Nations organizations, and donors. Its programme of technical activities is fully supportive of the recommendations adopted in 1990 by the international community during the World Summit for Children, particularly the statement 'enhancement of children's health and nutrition is a first duty'. (IAEA)
Smith, Zachary L; Gonzaga, Jason E; Haasler, George B; Gore, Elizabeth M; Dua, Kulwinder S
Patients with locally advanced esophageal cancer can have significant dysphagia. Nutritional support during neoadjuvant therapy is often delivered via nasoenteric or percutaneous feeding tubes. These approaches do not allow for per-oral feeding. Evaluate the safety and efficacy of fully covered self-expanding metal esophageal stents for nutritional support during neoadjuvant therapy. This was a pilot, prospective study at a single tertiary center. From March 2012 to May 2013, consecutive patients with esophageal cancer eligible for neoadjuvant therapy were enrolled. Metal stents were placed prior to starting neoadjuvant therapy. Data were collected at baseline and predetermined intervals until an endpoint (surgery or disease progression). Outcomes included dysphagia grade, satisfaction of swallowing score, nutritional status (weight, serum albumin), impact on surgery, and adverse events. Fourteen stents were placed in 12 patients (59.1 ± 9.5 years, 11 men, 1 woman). Dysphagia grade (pre 3.4 ± 0.5 vs post 0.2 ± 0.4, p esophageal cancer, self-expanding metal stents are safe and effective in relieving dysphagia and maintaining nutrition. They allow patients to eat orally, thereby improving patient satisfaction. The presence of an in situ stent did not interfere with surgery.
Cullen, Karen Weber; Watson, Kathy; Zakeri, Issa
We assessed the effect of the Texas Public School Nutrition Policy on middle school student lunchtime food consumption. Three years of lunch food records were collected from middle school students in southeast Texas: baseline (2001-2002), after local district changes (2002-2003), and 1 year after implementation of the Texas Public School Nutrition Policy (2005-2006). Students recorded amount and source of foods and beverages they consumed. Analysis of variance and covariance and nonparametric tests were used to compare intake after the policy change with intake during the 2 previous years. After implementation of the nutrition policy, student lunch consumption of vegetables, milk, and several nutrients increased (protein, fiber, vitamins A and C, calcium, and sodium), and consumption of less desirable items (sweetened beverages, snack chips) decreased, as did percentage of energy from fat. Most of the desired nutrients and foods (vegetables and milk) were obtained from the National School Lunch Program meal. Fewer sweetened beverages, candy, chips, and dessert foods were purchased and consumed, but more of these items were brought from home and purchased from the snack bar. Overall, state school nutrition policies can improve the healthfulness of foods consumed by students at lunch.
Extension service delivery is too often merely seen as a vehicle for spreading scientific and technical progress and technology transfer. In the real sense, however, dissemination of knowledge is not a one way affair from scientists to producers. The study was conducted to assess extension service delivery on improved ...
through multiple rounds of internal testing and quality assurance procedures. Recruitment for the Phase II survey was initiated on August 25, 2017...Award Numbers: W81XWH-15-1-0701 Title: Improving Acceptance, Integration, and Health Among LGBT Service Members Principal Investigators...burden to Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis
Information Communication Technology in Nigerian Libraries. Murtala Aliyu ... The focus of this paper is on how to improve services in libraries and information centers in. Nigeria by ..... games, video and educational materials. Database on ...
Improving Customer Service at the Agricultural Development Banks in Ghana: An Application of the Queuing Theory. ... African Journal of Management Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue ...
Rolim, Mara Diana; Lima, Sheyla Maria Lemos; de Barros, Denise Cavalcante; de Andrade, Carla Lourenço Tavares
The scope of this article is to evaluate the SISVAN as a tool for planning, management and evaluation of food and nutrition actions in primary healthcare in the Unified Health System (SUS). It involved a cross-sectional study composed of a stratified random sample of the municipalities in the State of Minas Gerais. The subjects of the research were municipal officials of SISVAN who filled out a structured questionnaire. Descriptive analysis of the data was performed with the construction of simple and bivariate tables. It was observed that those responsible for SISVAN, collect (50%) and input (55%) weight, height, and food consumption data; whereas 53%, 59% and 71% do not analyze and do not recommend or perform nutrition actions, respectively. This being the case, most of those responsible do not use the information for planning, management and evaluation of food and nutrition traits. The findings show that the SISVAN is not used to its full potential; the data generated have not been used for planning, management and evaluation of nutrition services in primary healthcare in the SUS.
Feldt-Rasmussen, B.; Lange, M.; Sulowicz, W.
Nutritional markers, such as lean body mass (LBM) and serum albumin, predict outcome in dialysis patients, in whom protein-energy malnutrition is associated with increased morbidity and mortality. The metabolic effects of human growth hormone (hGH) may improve the nutritional and cardiovascular...
Full Text Available Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming, an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1 to determine whether a discernible impact of home visits by FMs can be described; (2 to identify subgroups among these families in need of more specific interventions; (3 to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM were analyzed (secondary analysis, and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology statement. Based on the FMs reports, a significant improvement (p < 0.001 regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015. Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition
Iannotti, Lora L; Lutter, Chessa K; Bunn, David A; Stewart, Christine P
Eggs have been consumed throughout human history, though the full potential of this nutritionally complete food has yet to be realized in many resource-poor settings around the world. Eggs provide essential fatty acids, proteins, choline, vitamins A and B12 , selenium, and other critical nutrients at levels above or comparable to those found in other animal-source foods, but they are relatively more affordable. Cultural beliefs about the digestibility and cleanliness of eggs, as well as environmental concerns arising from hygiene practices and toxin exposures, remain as barriers to widespread egg consumption. There is also regional variability in egg intake levels. In Latin American countries, on average, greater proportions of young children consume eggs than in Asian or African countries. In China and Indonesia, nutrition education and social marketing have been associated with greater amounts of eggs in the diets of young children, though generally, evidence from interventions is minimal. Homestead chicken-and-egg production with appropriate vaccination, extension service, and other supports can simultaneously address poverty and nutrition in very poor rural households. With undernutrition remaining a significant problem in many parts of the world, eggs may be an uncracked part of the solution. © 2014 International Life Sciences Institute.
Fluker, Shelly-Ann; Whalen, Ursula; Schneider, Jason; Cantey, Paul; Bussey-Jones, Jada; Brady, Donald; Doyle, Joyce P
Clinical guidelines recommend that physicians counsel patients on diet and exercise; however, physician counseling remains suboptimal. To determine if incorporating performance improvement (PI) methodologies into a needs assessment for an internal medicine (IM) residency curriculum on nutrition and exercise counseling was feasible and enhanced our understanding of the curricular needs. One hundred and fifty-eight IM residents completed a questionnaire to assess their knowledge, attitudes, and practices (KAP) about nutrition and exercise counseling for hypertensive patients. Residents' baseline nutrition and exercise counseling rates were also obtained using chart abstraction. Fishbone diagrams were created by the residents to delineate perceived barriers to diet and exercise counseling. The KAP questionnaire was analyzed using descriptive statistics. Chart abstraction data was plotted on run charts and average counseling rates were calculated. Pareto charts were developed from the fishbone diagrams depicting the number of times each barrier was reported. Almost 90% of the residents reported counseling their hypertensive patients about diet and exercise more than 20% of the time on the KAP questionnaire. In contrast, chart abstraction revealed average counseling rates of 3% and 4% for nutrition and exercise, respectively. The KAP questionnaire exposed a clinical knowledge deficit, lack of familiarity with the national guidelines, and low self-efficacy. In contrast, the fishbone analysis highlighted patient apathy, patient co-morbidities, and time pressure as the major perceived barriers. We found that incorporating PI methods into a needs assessment for an IM residency curriculum on nutrition and exercise counseling for patients at risk of cardiovascular disease was feasible, provided additional information not obtained through other means, and provided the opportunity to pilot the use of PI techniques as an educational strategy and means of measuring outcomes. Our
Full Text Available Public service management reforms have not yet contributed to poverty eradication and generally socio-economic development of many African countries. The reforms suggested and implemented to date still prove to be weak in addressing the many challenges faced by the public service in delivering goods and services to the population. The failure of the current public service management calls for a consideration of business-driven approaches and practices that facilitate effectiveness, efficiency, competitiveness and flexibility in goods and services provision. The critical social theory methodology and the literature review technique described and raised awareness on service delivery chaos in South Africa. A public service reform that focuses on operations and quality management is one of the ways of improving and sustaining service delivery in South Africa. Operations management is an essential tool for the planning, execution, control, monitoring and evaluation of production processes. Quality management, in the other hand, is essential to ensure best quality of goods and services produced by the public service within acceptable time and available resources to meet or exceed people’s expectations. The operations and quality management framework proposed in this article is a potential alternative to the current service delivery crisis in South Africa.
O'Toole, Terrence P.; Anderson, Susan; Miller, Clare; Guthrie, Joanne
Background: Schools are in a unique position to promote healthy dietary behaviors and help ensure appropriate nutrient intake. This article describes the characteristics of both school nutrition services and the foods and beverages sold outside of the school meals program in the United States, including state- and district-level policies and…
Jacob, Raphaëlle; Lamarche, Benoît; Provencher, Véronique; Laramée, Catherine; Valois, Pierre; Goulet, Claude; Drapeau, Vicky
Coaches are a major source of nutrition information and influence for young athletes. Yet, most coaches do not have training in nutrition to properly guide their athletes. The aim of this study was to evaluate the effectiveness of an intervention aimed at improving the accuracy of coaches' recommendations on sports nutrition. This was a quasi-experimental study with a comparison group and an intervention group. Measurements were made at baseline, post-intervention, and after a 2-month follow-up period. Coaches' recommendations on sports nutrition during the follow-up period were recorded in a diary. High school coaches from various sports (n=41) were randomly assigned to a comparison group or an intervention group. Both groups attended two 90-minute sessions of a theory-based intervention targeting determinants of coaches' intention to provide recommendations on sports nutrition. The intervention group further received an algorithm that summarizes sports nutrition guidelines to help promote decision making on sports nutrition recommendations. Nutrition knowledge and accuracy of coaches' recommendations on sports nutrition. χ(2) analyses and t-tests were used to compare baseline characteristics; mixed and general linear model analyses were used to assess the change in response to the intervention and differences in behaviors, respectively. Coaches in the intervention vs comparison group provided more nutrition recommendations during the 2-month post-intervention period (mean number of recommendations per coach 25.7±22.0 vs 9.4±6.5, respectively; P=0.004) and recommendations had a greater accuracy (mean number of accurate recommendations per coach 22.4±19.9 [87.1%] vs 4.3±3.2 [46.1%], respectively; Psports nutrition knowledge level over time and helped them to provide more accurate recommendations on sports nutrition. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Full Text Available Cloud computing is changing the way that organizations utilize IT resources with a corresponding impact on the role of IT management. To help organizations with managing their business informatics, Management of Business Informatics (MBI framework has been developed. The problem was that this framework did not explicitly reflect managing cloud services from cloud service consumer perspective and specifically did not address managing of cloud service improvement from consumer perspective. Therefore, analysis of MBI framework was performed from cloud service consumer viewpoint to design extension of MBI framework towards cloud service improvement management. Proposal of MBI framework extension in an output of research process according to Design Science Research Methodology and its evaluation approach is based on methodology for the design and implementation of case studies for scientific purposes and on descriptive evaluation method using scenario.
Gelli, Aulo; Becquey, Elodie; Ganaba, Rasmane; Headey, Derek; Hidrobo, Melissa; Huybregts, Lieven; Verhoef, Hans; Kenfack, Romain; Zongouri, Sita; Guedenet, Hannah
The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso. Communities will be randomly assigned to one of three treatment arms, including: (1) SELEVER intervention group; (2) SELEVER with an intensive WASH component; and (3) control group without intervention. Primary outcomes include the mean probability of adequacy of diets for women and children (aged 2-4 years at baseline), infant and young child feeding practices of caregivers of children aged 0-2 years, and household poultry production and sales. Intermediate outcomes along the agriculture and nutrition pathways will also be measured, including child nutrition status and development. The evaluation will follow a mixed-methods approach, including a panel of child-, household-, community-, and market-level surveys, and data collection points during post-harvest and lean seasons, as well as one year after implementation completion to examine sustainability. To our knowledge, this study is the first to rigorously examine from a food systems perspective, the simultaneous impact of scaling-up nutrition-specific and nutrition-sensitive interventions through a livestock value-chain and community-intervention platform, across nutrition, health, and agriculture domains. The findings of this evaluation will provide evidence to support the design of market-based nutrition
Hafzan Yusoff; Wan Nudri Wan Daud; Zulkifli Ahmad
Background This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia. Methods: This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb = 7 ? 11.9 g/dL for girls; Hb =...
... nutrition assistance program benefits to be so distributed. (v) Develop food plans for use in establishing supplemental nutrition assistance benefit levels, and assess the nutritional impact of Federal food programs... eating qualities of food served in homes and institutions. (iv) Develop materials to aid the public in...
Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…
Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle
Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for
Birla, Deep Shikha; Malik, Kapil; Sainger, Manish; Chaudhary, Darshna; Jaiwal, Ranjana; Jaiwal, Pawan K
Rice is a staple food for more than 3 billion people in more than 100 countries of the world but ironically it is deficient in many bioavailable vitamins, minerals, essential amino- and fatty-acids and phytochemicals that prevent chronic diseases like type 2 diabetes, heart disease, cancers, and obesity. To enhance the nutritional and other quality aspects of rice, a better understanding of the regulation of the processes involved in the synthesis, uptake, transport, and metabolism of macro-(starch, seed storage protein and lipid) and micronutrients (vitamins, minerals and phytochemicals) is required. With the publication of high quality genomic sequence of rice, significant progress has been made in identification, isolation, and characterization of novel genes and their regulation for the nutritional and quality enhancement of rice. During the last decade, numerous efforts have been made to refine the nutritional and other quality traits either by using the traditional breeding with high through put technologies such as marker assisted selection and breeding, or by adopting the transgenic approach. A significant improvement in vitamins (A, folate, and E), mineral (iron), essential amino acid (lysine), and flavonoids levels has been achieved in the edible part of rice, i.e., endosperm (biofortification) to meet the daily dietary allowance. However, studies on bioavailability and allergenicity on biofortified rice are still required. Despite the numerous efforts, the commercialization of biofortified rice has not yet been achieved. The present review summarizes the progress and challenges of genetic engineering and/or metabolic engineering technologies to improve rice grain quality, and presents the future prospects in developing nutrient dense rice to save the everincreasing population, that depends solely on rice as the staple food, from widespread nutritional deficiencies.
Keshtkaran, Ali; Hashemi, Neda; Kharazmi, Erfan; Abbasi, Mehdi
Quality function deployment (QFD) is one of the most effective quality design tools. This study applies QFD technique to improve the quality of the burn unit services in Ghotbedin Hospital in Shiraz, Iran. First, the patients' expectations of burn unit services and their priorities were determined through Delphi method. Thereafter, burn unit service specifications were determined through Delphi method. Further, the relationships between the patients' expectations and service specifications and also the relationships between service specifications were determined through an expert group's opinion. Last, the final importance scores of service specifications were calculated through simple additive weighting method. The findings show that burn unit patients have 40 expectations in six different areas. These expectations are in 16 priority levels. Burn units also have 45 service specifications in six different areas. There are four-level relationships between the patients' expectations and service specifications and four-level relationships between service specifications. The most important burn unit service specifications have been identified in this study. The QFD model developed in the study can be a general guideline for QFD planners and executives.
Uberoi, Ravinder S; Nayak, Yogamaya; Sachdeva, Pritindira; Sibal, Anupam
Patient satisfaction surveys help a great deal in identifying ways of improving a hospital's services. Ultimately, that translates into better care and happier patients. Moreover, it shows the staff and the community that the hospital is serious about quality and is looking for ways to improve. This article describes how the Voice of the Customer (VOC) Survey can be used as a tool for improving services. Regular monitoring of VOC scores is essential for minimizing the gaps between service delivery and patient expectations. The present study showcases the various initiatives undertaken to improve the VOC scores from an original 4.40 to 4.77 (on a 5 point scale) at the hospital under study.
Vio, F.; Uauy, R.
In the last 10-20 years, the development of science and technology applied to nutrition has been impressive. Nutrition can no longer be underestimated as a scientific discipline; nutrition embraces now modern physiology and biochemistry (including molecular biology), anthropology and the social sciences and requires real expertise from many sources, including the nuclear sector. Isotopic-based nuclear techniques provide reliable biological indicators that give, at the decision-maker level, important information to target and track progress in food and nutrition programs. They serve as tools for evaluating nutritional status of populations and individuals for micronutrients and vitamins, nutrient intake and bioavailability, body composition and energy balance. The information provided verifies the nature of the nutrition problem, helps implement or redirect on-going programs, guides in the processing of local foods and provides indicators of important long-term health improvements or broader social and economic advances. As a result of the investment in human resources undertaken by IAEA in recent years, under its mandate to promote the peaceful uses of nuclear technology, nutritionists in developing countries are now more aware of the significance and benefits of isotopic techniques. This includes stable isotopic methods that are biologically safe and have no adverse environmental impacts. Equipment is being increasingly made available by national investments in the science base. Sometimes IAEA has given specific and direct support but in many instances support previously provided for other nuclear sectors could be harnessed to address nutritional problems. In summary, the objectives now are to meet the nutrition challenges facing countries by the use of isotopes in nutritional evaluations, bearing in mind that isotopic and nuclear techniques are tools, not solutions by themselves. IAEA does not manage or fund nutrition investigations or interventions at the public
Vio, F; Uauy, R [Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago (Chile)
In the last 10-20 years, the development of science and technology applied to nutrition has been impressive. Nutrition can no longer be underestimated as a scientific discipline; nutrition embraces now modern physiology and biochemistry (including molecular biology), anthropology and the social sciences and requires real expertise from many sources, including the nuclear sector. Isotopic-based nuclear techniques provide reliable biological indicators that give, at the decision-maker level, important information to target and track progress in food and nutrition programs. They serve as tools for evaluating nutritional status of populations and individuals for micronutrients and vitamins, nutrient intake and bioavailability, body composition and energy balance. The information provided verifies the nature of the nutrition problem, helps implement or redirect on-going programs, guides in the processing of local foods and provides indicators of important long-term health improvements or broader social and economic advances. As a result of the investment in human resources undertaken by IAEA in recent years, under its mandate to promote the peaceful uses of nuclear technology, nutritionists in developing countries are now more aware of the significance and benefits of isotopic techniques. This includes stable isotopic methods that are biologically safe and have no adverse environmental impacts. Equipment is being increasingly made available by national investments in the science base. Sometimes IAEA has given specific and direct support but in many instances support previously provided for other nuclear sectors could be harnessed to address nutritional problems. In summary, the objectives now are to meet the nutrition challenges facing countries by the use of isotopes in nutritional evaluations, bearing in mind that isotopic and nuclear techniques are tools, not solutions by themselves. IAEA does not manage or fund nutrition investigations or interventions at the public
Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad
Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (PService quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.
Online and In-Person Nutrition Education Improves Breakfast Knowledge, Attitudes, and Behaviors: A Randomized Trial of Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children.
Au, Lauren E; Whaley, Shannon; Rosen, Nila J; Meza, Martha; Ritchie, Lorrene D
the same time points. Overall, this study demonstrates that both in-person and online nutrition education were effective in increasing breakfast-related knowledge in WIC participants, reducing breakfast skipping, and improving other breakfast-related behaviors, showing the potential usefulness for online education modalities for future WIC services. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Freeman, Shauna; Kester, Ross; Greenbrook, Sally; O’Connor, Ruairi; Rawlings, Sarah
A guiding principle for today’s National Health Service is for services to reflect the needs and choices of patients and carers. There is evidence that meaningful patient involvement and engagement of people in their own care supports relationships with NHS professionals, and improves the quality and experience of healthcare. This paper reviews the Service Pledge for Breast Cancer, developed by the charity Breakthrough Breast Cancer as a tried and tested route to delivering effective patient involvement and examines some implications for radiotherapy services. The Service Pledge, which has benefitted an estimated 19,000 patients across the UK, is a tool that enables healthcare professionals and patients to work in partnership to improve local breast cancer services. Based on the results of a patient survey and in depth interviews to determine to what extent standards of care are being met at each participating hospital, improvement goals are identified helping turn the patient voice into constructive action. Improvement goals resulting from the Service Pledge range from small changes that make a real difference to patients, through to much larger changes to local breast services. To date, there has been limited involvement of radiotherapy staff in the Service Pledge, yet radiographers play an important role in the treatment of breast cancer as most patients will be offered radiotherapy. However, radiotherapy services have been criticised for not being patient -centred and for not providing enough information, psychological and emotional support before, during and after treatment. It is contended that radiographers are ideally placed to address many of these concerns and engage further with patients through projects such as the Service Pledge, empowering their patients to voice what is most important to them and driving the quality improvements that emerge.
Patwardhan, Anjali; Patwardhan, Prakash
In the recent climate of consumerism and consumer focused care, health and social care needs to be more responsive than ever before. Consumer needs and preferences can be elicited with accepted validity and reliability only by strict methodological control, customerisation of the questionnaire and skilled interpretation. To construct, conduct, interpret and implement improved service provision, requires a trained work force and infrastructure. This article aims to appraise various aspects of consumer surveys and to assess their value as effective service improvement tools. The customer is the sole reason organisations exist. Consumer surveys are used worldwide as service and quality of care improvement tools by all types of service providers including health service providers. The article critically appraises the value of consumer surveys as service improvement tools in health services tool and its future applications. No one type of survey is the best or ideal. The key is the selection of the correct survey methodology, unique and customised for the particular type/aspect of care being evaluated. The method used should reflect the importance of the information required. Methodological rigor is essential for the effectiveness of consumer surveys as service improvement tools. Unfortunately so far there is no universal consensus on superiority of one particular methodology over another or any benefit of one specific methodology in a given situation. More training and some dedicated resource allocation is required to develop consumer surveys. More research is needed to develop specific survey methodology and evaluation techniques for improved validity and reliability of the surveys as service improvement tools. Measurement of consumer preferences/priorities, evaluation of services and key performance scores, is not easy. Consumer surveys seem impressive tools as they provide the customer a voice for change or modification. However, from a scientific point
Jahn, Jaquelyn L; Cohen, Juliana Fw; Gorski-Findling, Mary T; Hoffman, Jessica A; Rosenfeld, Lindsay; Chaffee, Ruth; Smith, Lauren; Rimm, Eric B
In 2012, Massachusetts enacted school competitive food and beverage standards similar to national Smart Snacks. These standards aim to improve the nutritional quality of competitive snacks. It was previously demonstrated that a majority of foods and beverages were compliant with the standards, but it was unknown whether food manufacturers reformulated products in response to the standards. The present study assessed whether products were reformulated after standards were implemented; the availability of reformulated products outside schools; and whether compliance with the standards improved the nutrient composition of competitive snacks. An observational cohort study documenting all competitive snacks sold before (2012) and after (2013 and 2014) the standards were implemented. The sample included thirty-six school districts with both a middle and high school. After 2012, energy, saturated fat, Na and sugar decreased and fibre increased among all competitive foods. By 2013, 8 % of foods were reformulated, as were an additional 9 % by 2014. Nearly 15 % of reformulated foods were look-alike products that could not be purchased at supermarkets. Energy and Na in beverages decreased after 2012, in part facilitated by smaller package sizes. Massachusetts' law was effective in improving the nutritional content of snacks and product reformulation helped schools adhere to the law. This suggests fully implementing Smart Snacks standards may similarly improve the foods available in schools nationally. However, only some healthier reformulated foods were available outside schools.
Poddar, Kavita H; Hosig, Kathy W; Anderson-Bill, Eileen S; Nickols-Richardson, Sharon M; Duncan, Susan E
Dairy intake by college students is markedly lower than recommendations. Interventions to improve dairy intake based on Social Cognitive Theory (SCT) have potential to successfully change behavior by improving mediators that influence dietary choices. We aimed to use SCT to improve social support, self-efficacy, outcome expectations, self-regulation, and behavior related to dairy intake in college students. We conducted a randomized nutrition education intervention. Participants included 211 college students (mean age 20.2 ± 0.1 years; 63% women and 37% men) recruited from a university campus. Participants in the intervention group (n=107) and comparison group (n=104) received an 8-week dairy intake or stress management intervention, respectively, via electronic mail. Data collection included dairy intake from 7-day food records and SCT variables from questionnaires administered during January 2008 and April 2008. Changes in dairy intake and SCT variables (ie, social support, self-efficacy, outcome expectations, and self-regulation). Multivariate analysis of covariance, with age and sex as covariates (Peducation via electronic mail based on an SCT model improved total dairy intake and self-regulation. Participants reported increased dairy intake and better use of self-regulation strategies. Future interventions should focus on benefits of consuming low-fat vs higher-fat dairy foods. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Zebiak, S.; Brasseur, G.; Members of the CSP Coordinating Group
Throughout the world, climate services are required to address urgent needs for climate-informed decision-making, policy and planning. These needs were explored in detail at the first International Conference on Climate Services (ICCS), held in New York in October 2011. After lengthy discussions of needs and capabilities, the conference culminated in the creation of the Climate Services Partnership (CSP). The CSP is an informal interdisciplinary network of climate information users, providers, donors and researchers interested in improving the provision and development of climate services worldwide. Members of the Climate Services Partnership work together to share knowledge, accelerate learning, develop new capacities, and establish good practices. These collaborative efforts will inform and support the evolution and implementation of the Global Framework for Climate Services. The Climate Services Partnership focuses its efforts on three levels. These include: 1. encouraging and sustaining connections between climate information providers, users, donors, and researchers 2. gathering, synthesizing and disseminating current knowledge on climate services by way of an online knowledge management platform 3. generating new knowledge on critical topics in climate service development and provision, through the creation of focused working groups on specific topics To date, the Climate Services Partnership has made progress on all three fronts. Connections have been fostered through outreach at major international conferences and professional societies. The CSP also maintains a website and a monthly newsletter, which serves as a resource for those interested in climate services. The second International Conference on Climate Services (ICCS2) will be held in Berlin in September. The CSP has also created a knowledge capture system that gathers and disseminates a wide range of information related to the development and provision of climate services. This includes an online
Tsai, Yafang; Wu, Shih-Wang
The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82.3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with SPSS 12.0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.
van der Spuy, Dorothy A; Cader, Shihaam; van der Spuy, Gian D; Westwood, Anthony T
To determine the nutritional status of children attending a cystic fibrosis clinic in a tertiary hospital in South Africa and compare it to previously reported 10-year rates. Weights and heights were measured of 69 (37 male and 32 female) children aged between 1 year and 18 years. Expected weight-for-age, expected height-for-age, expected weight-for-height and body mass index (BMI) were compared with international standards for underweight, stunting, wasting and BMI goal. The nutritional status of the patients has improved over the last 10 years, most significantly for wasting, which decreased from 58.3% in 1996 to 15.9% in 2006 (95% confidence interval (CI), 1.315-14.09, P nutritional status, although deficits remain. The normalisation of mean weight-for-age and weight-for-height with far fewer wasted patients is encouraging. Interventions are needed in some areas to ensure that all children show progress. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Full Text Available There is considerable global evidence on the effectiveness of cash transfers in improving health and nutrition outcomes; however, the evidence from South Asia, particularly India, is limited. In the context of India where more than a third of children are undernourished, and where there is considerable under-utilization of health and nutrition interventions, it is opportune to investigate the impact of cash transfer programs on the use of interventions. We study one conditional cash transfer program, Mamata scheme, implemented in the state of Odisha, in India that targeted pregnant and lactating women. Using survey data on 1161 households from three districts in the state of Odisha, we examine the effect of the scheme on eight outcomes: 1 pregnancy registration; 2 receipt of antenatal services; 3 receipt of iron and folic acid (IFA tablets; 4 exposure to counseling during pregnancy; 5 exposure to postnatal counseling; 6 exclusive breastfeeding; 7 full immunization; and 8 household food security. We conduct regression analyses and correct for endogeneity using nearest-neighbor matching and inverse-probability weighting models. We find that the receipt of payments from the Mamata scheme is associated with a 5 percentage point (pp increase in the likelihood of receiving antenatal services, a 10 pp increase in the likelihood of receiving IFA tablets, and a decline of 0.84 on the Household Food Insecurity Access Scale. These results provide the first quantitative estimates of effects associated with the Mamata scheme, which can inform the design of government policies related to conditional cash transfers.
these stressors on LGBT service members is poorly understood, with very little data available on the unique physical and mental health needs of these...Bullying • Overall health • Healthcare utilization • Lost duty days • Sick call visits • Physical health symptoms • Sexual/gender identity disclosure...Award Numbers: W81XWH-15-1-0699 Title: Improving Acceptance, Integration and Health among LGBT Service Members Principal Investigators: Jeremy
lifting of the bans – remains alive and well, with some LGBT service members experiencing interpersonal and institutional discrimination ...being among LGBT service members and improve unit cohesion. The military has always been a leader in understanding and implementing gender and...matters. These should be people that you know and who know you. These should be people you have had contact with in the past 3 months or so – either in
Full Text Available The study deals with enhancing the reliability of freight cars by improving the corporate service system. Assessing of the quality of spare parts suppliers is discussed. An algorithm for supplier selection and an evaluation method, based on cluster analysis of indicators of supplier reliability, is proposed. Alternative developments for a service network, in view of expanding of the car fleet powered by natural gas-based fuel have been considered.
Gerritsen, Sarah; Anderson, Sarah E; Morton, Susan Mb; Wall, Clare R
Pre-school nutrition-related behaviours influence diet and development of lifelong eating habits. We examined the prevalence and congruence of recommended nutrition-related behaviours (RNB) in home and early childhood education (ECE) services, exploring differences by child and ECE characteristics. Telephone interviews with mothers. Online survey of ECE managers/head teachers. New Zealand. Children (n 1181) aged 45 months in the Growing Up in New Zealand longitudinal study. A mean 5·3 of 8 RNB were followed at home, with statistical differences by gender and ethnic group, but not socio-economic position. ECE services followed a mean 4·8 of 8 RNB, with differences by type of service and health-promotion programme participation. No congruence between adherence at home and in ECE services was found; half of children with high adherence at home attended a service with low adherence. A greater proportion of children in deprived communities attended a service with high adherence, compared with children living in the least deprived communities (20 and 12 %, respectively). Children, across all socio-economic positions, may not experience RNB at home. ECE settings provide an opportunity to improve or support behaviours learned at home. Targeting of health-promotion programmes in high-deprivation areas has resulted in higher adherence to RNB at these ECE services. The lack of congruence between home and ECE behaviours suggests health-promotion messages may not be effectively communicated to parents/family. Greater support is required across the ECE sector to adhere to RNB and promote wider change that can reach into homes.
Yoong, Sze Lin; Wolfenden, Luke; Finch, Meghan; Williams, Amanda; Dodds, Pennie; Gillham, Karen; Wyse, Rebecca
Centre-based childcare services represent a promising setting to target the prevention of excessive weight gain in preschool-aged children. Staff training is a key component of multi-strategy interventions to improve implementation of effective physical activity and nutrition promoting practices for obesity prevention in childcare services. This randomised controlled trial aimed to examine whether an active telephone-based strategy to invite childcare-service staff to attend a training workshop was effective in increasing the proportion of services with staff attending training, compared with a passive strategy. Services were randomised to an active telephone-based or a passive-recruitment strategy. Those in the active arm received an email invitation and one to three follow-up phone calls, whereas services in the passive arm were informed of the availability of training only via newsletters. The proportion of services with staff attending the training workshop was compared between the two arms. One hundred and twenty-eight services were included in this study. A significantly larger proportion (52%) of services in the active arm compared with those in the passive-strategy arm (3.1%) attended training (d.f.=1, χ2=34.3; Pstaff attending training. Further strategies to improve staff attendance at training need to be identified and implemented. SO WHAT?: Active-recruitment strategies including follow-up telephone calls should be utilised to invite staff to participate in training, in order to maximise the use of training as an implementation strategy for obesity prevention in childcare services.
Full Text Available Purpose: The objective of this research is to determine the service improvement priority based on tourist judgements and experiences on service quality in a zoological park. Design/methodology/approach: A powerful integrated model was developed to acquire accurate critical service attributes and their priority ranks that can promote tourist satisfaction and tourist loyalty. Drawing on relevant literature, a model was proposed based on tourists’ perspective by integrating structural equation model (SEM with SERVQUAL and refined Kano models. Findings and Originality/value: Based on the analysis of data through some quantitative tools, the study helped in prioritizing the critical service attributes, which, if adopted, improved, and implemented, could lead to satisfaction of tourists. This will help a zoological park to propose more efficient and value-added improvement policies of the service Research limitations/implications: The primary limitation in the scope its sample. Because the study involved only one Zoological Park in Indonesia, the results cannot be generalized across a national wide spectrum. Originality/value: The study was the first to successfully apply an integrated model in tourism sector, which has previously not been used. The study has hopefully opened up an area of research and methodology that could provide considerable further benefits for researchers interested in this topic. Moreover, the integrated model has proven to be useful in determining the priority rank of critical service quality attributes.
Ouyang, Zhiyun; Zheng, Hua; Xiao, Yi; Polasky, Stephen; Liu, Jianguo; Xu, Weihua; Wang, Qiao; Zhang, Lu; Xiao, Yang; Rao, Enming; Jiang, Ling; Lu, Fei; Wang, Xiaoke; Yang, Guangbin; Gong, Shihan; Wu, Bingfang; Zeng, Yuan; Yang, Wu; Daily, Gretchen C
In response to ecosystem degradation from rapid economic development, China began investing heavily in protecting and restoring natural capital starting in 2000. We report on China's first national ecosystem assessment (2000-2010), designed to quantify and help manage change in ecosystem services, including food production, carbon sequestration, soil retention, sandstorm prevention, water retention, flood mitigation, and provision of habitat for biodiversity. Overall, ecosystem services improved from 2000 to 2010, apart from habitat provision. China's national conservation policies contributed significantly to the increases in those ecosystem services. Copyright © 2016, American Association for the Advancement of Science.
Full Text Available This article aims to exemplify how, starting from the evaluation of customer satisfaction on service quality, the hotel units’ management, can apply different measures and strategies to improve it. To achieve the target, a marketing research survey is conducted based on a sample of 120 customers of Hotel „Kronwell” at the end of 2013. After analysing customer’ responses a series of measures have been taken to improve the quality of services offered by this hotel, then at the end of 2015 a new research was achieved, based on the same questionnaire. The results of this research highlight the increasing of customer satisfaction as a result of improving the quality of hotel services, supported by growth in net profit, turnover and decrease of employees’ number.
Fazri Nur Yusuf
Full Text Available Studies on potentials of feedback over English language teaching seem not to have not been well-revealed, including studies on the use of feedback to improve English pre-service teachers’ competence. The present study investigates to what extent a multimodal feedback can influence pre-service teachers’ teaching, and which teaching aspects are influenced. Twenty five pre-service teachers taking Microteaching Course served as respondents supervised by a course advisor. The data were collected by teacher observation in a rating-scale form, self-appraisal, and interviews. The data were analyzed by using correlated sample t-test and the eight teaching components proposed by Brown (2001. The results showed that after multimodal feedback provision, pre-service teachers indicated an improvement significantly in seven out of eight teaching aspects. The provision of multimodal feedback could improve their teaching competence on preparation, instructional objective elicitation, mastery of instructional materials, use of media, and classroom management, including classroom language. But, the results do not indicate that they perform well on reflection and follow-up due to some reasons. In addition, the results evince that multimodal feedback provision could improve pre-service teachers’ pedagogical competence when the multimodal feedback is integrated with content, interpersonal relationship, and management.
Dan Booth is the director of hospitality services for MaineGeneral Health. For this 450-bed health care organization, he directs six departments, which include environmental services, food and nutrition, security, laundry services, telecommunications, and transportation. In this article he describes how his Take a Nurse to Lunch program operates, what its benefits are, and how it was implemented.
Dupont, B; Dao, T; Joubert, C; Dupont-Lucas, C; Gloro, R; Nguyen-Khac, E; Beaujard, E; Mathurin, P; Vastel, E; Musikas, M; Ollivier, I; Piquet, M-A
Malnutrition and jaundice are independent prognostic factors in cirrhosis. To assess the impact of enteral nutrition on the survival of alcoholic cirrhotic patients with jaundice but without acute alcoholic hepatitis. The study was a multicentre prospective randomised controlled trial comparing effects of enteral nutrition vs. a symptomatic support in patients with alcoholic cirrhosis and jaundice (bilirubin ≥51 µmol/L) but without severe acute alcoholic hepatitis. A total of 99 patients were randomised to receive either the conventional symptomatic treatment (55 patients) or the symptomatic support associated with 35 kcal/Kg/day of enteral nutrition during 4 weeks followed by an oral nutritional support during 2 months (44 patients). Randomisation was stratified on nutritional status. One-year survival curves were compared using the Kaplan-Meier method and Logrank test. Populations in both arms were similar. One-year survival was similar in the overall population (27/44 patients (61.4%) in the enteral nutrition arm vs. 36/55 (65.5%) in the control arm; Logrank P = 0.60) and in the subgroup suffering from malnutrition [18/29 patients (62.1%) in the enteral nutrition arm vs. 20/32 (62.5%) in the control arm; Logrank P = 0.99]. There was no statistical difference for bilirubin, prothrombin rate, Child-Pugh score, albumin or nutritional assessment. Complications during treatment (bleeding, encephalopathy, infection) occurred in 23% of patients in the enteral nutrition group (10/44) vs. 16% (9/55) of the control patients (P = 0.59). Enteral nutrition does not improve the survival and hepatic or nutritional parameters of cirrhotic patients with jaundice. © 2012 Blackwell Publishing Ltd.
Davies, Deborah J
This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients' journey through the service, identifying areas to standardise practice, and creating service pathways. The clients' journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.
Kathryn K. Davies
Full Text Available Complex problems often result from the multiple interactions between human activities and ecosystems. The interconnected nature of ecological and social systems should be considered if these "wicked problems" are to be addressed. Ecosystem service approaches provide an opportunity to link ecosystem function with social values, but in practice the essential role that social dynamics play in the delivery of outcomes remains largely unexplored. Social factors such as management regimes, power relationships, skills, and values, can dramatically affect the definition and delivery of ecosystem services. Input from a diverse group of stakeholders improves the capacity of ecosystem service approaches to address wicked problems by acknowledging diverse sets of values and accounting for conflicting world views. Participatory modeling can incorporate both social and ecological dynamics into decision making that involves stakeholders, but is itself a complex social undertaking that may not yield precise or predictable outcomes. We explore the efficacy of different types of participatory modeling in relation to the integration of social values into ecosystem services frameworks and the generation of four important elements of social capital needed to address wicked problems: enhancing social learning and capacity building; increasing transparency; mediating power; and building trust. Our findings indicate that mediated modeling, group mapping, and mental/conceptual modeling are likely to generate elements of social capital that can improve ecosystem service frameworks. Participatory simulation, system dynamic modeling, and Bayesian belief networks, if utilized in isolation, were found to have a low likelihood of generating the social capital needed to improve ecosystem services frameworks. Scenario planning, companion modeling, group model building, and participatory mapping all generate a moderate to high level of social capital elements that improve the
Korre, Maria; Sotos-Prieto, Mercedes; Kales, Stefanos N
Cardiovascular disease (CVD) causes almost half of all on-duty deaths in US firefighters and is an important and costly cause of morbidity. In addition, cancer is a growing health concern in this population. Obesity and obesity-associated, cardiometabolic risk clustering are major, modifiable risk factors for fire service CVD and cancer risk. The Mediterranean diet (MedDiet) is proven effective in primary and secondary CVD prevention. It is also associated with a decreased risk of cancer and other chronic diseases. Moreover, it can be adapted into successful workplace interventions. Emerging data from our group regarding the US Fire Service show that greater compliance with the MedDiet is associated with improved CVD risk profiles and less weight gain among career firefighters. Moreover, the fact that career firefighters take a considerable number of meals communally on the job also represents an excellent opportunity for a workplace Mediterranean Diet Nutritional Intervention (MDNI). The devastating effects of obesity, CVD, and cancer on the US fire service are recognized, but currently few effective preventive programs exist. The consistently positive health benefits from following a MedDiet and promising preliminary data in the fire service justify translational research to determine the most effective means of delivering MDNIs to US firefighters. Therefore, a high priority should be assigned to efforts, which can help further disseminate and implement our program of novel behavior change strategies, "Survival Mediterranean Style," throughout the US fire service and eventually to other occupations.
Full Text Available Cardiovascular disease (CVD causes almost half of all on-duty deaths in US firefighters and is an important and costly cause of morbidity. In addition, cancer is a growing health concern in this population. Obesity and obesity-associated, cardiometabolic risk clustering are major, modifiable risk factors for fire service CVD and cancer risk. The Mediterranean diet (MedDiet is proven effective in primary and secondary CVD prevention. It is also associated with a decreased risk of cancer and other chronic diseases. Moreover, it can be adapted into successful workplace interventions. Emerging data from our group regarding the US Fire Service show that greater compliance with the MedDiet is associated with improved CVD risk profiles and less weight gain among career firefighters. Moreover, the fact that career firefighters take a considerable number of meals communally on the job also represents an excellent opportunity for a workplace Mediterranean Diet Nutritional Intervention (MDNI. The devastating effects of obesity, CVD, and cancer on the US fire service are recognized, but currently few effective preventive programs exist. The consistently positive health benefits from following a MedDiet and promising preliminary data in the fire service justify translational research to determine the most effective means of delivering MDNIs to US firefighters. Therefore, a high priority should be assigned to efforts, which can help further disseminate and implement our program of novel behavior change strategies, “Survival Mediterranean Style,” throughout the US fire service and eventually to other occupations.
Munk, T; Seidelin, Winnie; Rosenbom, E
Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk.......Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk....
An innovative brioche enriched in protein and energy improves the nutritional status of malnourished nursing home residents compared to oral nutritional supplement and usual breakfast: FARINE+ project.
Van Wymelbeke, Virginie; Brondel, Laurent; Bon, Francis; Martin-Pfitzenmeyer, Isabelle; Manckoundia, Patrick
To compare the effects of a 12-week nutritional intervention, in which an innovative protein-and-energy-enriched brioche, an oral nutritional supplement or a usual breakfast were eaten, on food intake and nutritional status in nursing home residents. Three-armed, multicentre, controlled trial. Eight nursing homes in Burgundy, France. Sixty-eight malnourished participants aged between 70 and 99 years old. Participants were randomly assigned to one of three groups according to the breakfast provided: brioche group, one portion of 65 g brioche enriched in protein and energy (12.8 g and 180 kcal) added to usual breakfast; supplement group, 200-ml of a ready-to-use, energy-dense liquid (14 g protein and 200 kcal) added to usual breakfast or control group, a usual breakfast only. Total energy intakes were assessed for three days at different periods of the study (day 0, day 30 and day 90); blood parameters, nutritional status (mini nutritional assessment, weight) and functional capacities (grip strength and activity level) were measured at the beginning and at the end of the nutritional intervention study (day 0 and day 90). The participants of the brioche group had higher total energy intakes at day 30 (p value 0.004) and at day 90 (p value 0.018) compared with the supplement group and the control group. At the end of the interventional study, 72% of the participants in the brioche group had reached the recommended minimum level of protein of 0.8 g/kg/day, compared with 53% in the supplement group and 36% in the control group (p value 0.036). In addition, between day 0 and day 90 in the brioche group, blood levels of vitamins B 9 , B 2 , D (all p value <0.001), B 6 (p value 0.026) and B 12 (p value 0.036) had increased and plasma homocysteine had decreased (p value 0.024). The protein-and-energy-enriched brioche effectively increased energy and protein intakes and improved the nutritional status of elderly people living in nursing homes. It could be a good
de Silva, Prasanna
Concern has been expressed from both within and outwith psychiatry about the relative lack of improvement of mental health services. Critical psychiatry is an emerging school of thought, mainly the product of practicing clinicians, which could be useful in remedying this situation. This article outlines, for psychiatrists and doctors of other specialities, practices which could be improved, and the competencies required to achieve this, in terms of knowledge, skills and attitudes.
Zanatta, Mateus; Amaral, Fernando Gonçalves
Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.
Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân
Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.
Full Text Available Abstract Background The present paper intends to contribute to the debate on the usefulness and barriers in applying theories in diet and physical activity behavior-change interventions. Discussion Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the theories we use lack a strong empirical foundation, and the available theories are not always used in the most effective way. Furthermore, many of the commonly-used theories provide at best information on what needs to be changed to promote healthy behavior, but not on how changes can be induced. Finally, many theories explain behavioral intentions or motivation rather well, but are less well-suited to explaining or predicting actual behavior or behavior change. For more effective interventions, behavior change theory needs to be further developed in stronger research designs and such change-theory should especially focus on how to promote action rather than mere motivation. Since voluntary behavior change requires motivation, ability as well as the opportunity to change, further development of behavior change theory should incorporate environmental change strategies. Conclusion Intervention Mapping may help to further improve the application of theories in nutrition and physical activity behavior change.
Martinez, Homero; Palar, Kartika; Linnemayr, Sebastian; Smith, Alexandria; Derose, Kathryn Pitkin; Ramírez, Blanca; Farías, Hugo; Wagner, Glenn
Food insecurity and malnutrition negatively affect adherence to antiretroviral therapy (ART) and are associated with poor HIV clinical outcomes. We examined the effect of providing household food assistance and nutrition education on ART adherence. A 12-month prospective clinical trial compared the effect of a monthly household food basket (FB) plus nutrition education (NE) versus NE alone on ART adherence on 400 HIV patients at four clinics in Honduras. Participants had been receiving ART for an average of 3.7 years and were selected because they had suboptimal adherence. Primary outcome measures were missed clinic appointments, delayed prescription refills, and self-reported missed doses of ART. These three adherence measures improved for both groups over 12 months (p < 0.01), mostly within 6 months. On-time prescription refills improved for the FB plus NE group by 19.6 % more than the group receiving NE alone after 6 months (p < 0.01), with no further change at 12 months. Change in missed appointments and self-reported missed ART doses did not significantly differ by intervention group.
Jensen, Jørgen Dejgård
This paper investigates whether and how worksite nutrition policies can improve employee productivity. The questions are pursued through a literature review, including a systematic search of literature--combined with literature identified from backward references--on randomized controlled or quasi-experimental worksite intervention trials and observational cross-sectional studies. Studies were selected on the basis of topic relevance, according to publication title and subsequently according to abstract content. A quality appraisal of the studies was based on study design and clarity in definition of interventions, as well as environmental and outcome variables. The search identified 2,358 publications, 30 of which were found suitable for the review. Several of the reviewed studies suggest that diet-related worksite interventions have positive impacts on employees' nutritional knowledge, food intake and health and on the firm's profitability, mainly in terms of reduced absenteeism and presenteeism. Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%-2%. On larger worksites, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field.
See Section 5.1.2) - Client Relationship Management ( CRM ) processes-specifically, Solution Design and Solution Delivery - Worldwide Project Management ...plex systems life-cycle management , rapid solutions development, custom development, package selection and implementation, maintenance, minor...CarnegieMellon ___ Software Engineering Institute Software Process Improvement Journey: IBM Australia Application Management Services Robyn Nichols
Financial decentralisation, on the other hand, attempted to assign responsibilities and taxes between the centre and local governments, to enable the transfer of grants and other resources to different parts of the country, and to improve service delivery. This paper will review different government, public and academic ...
Elbæk, Mikael Karstensen; Heller, Alfred; Pedersen, Gert Schmeltz
A re-implementation of the research database of the Technical University of Denmark, DTU, is based on Fedora. The backbone consists of content models for primary and secondary entities and their relationships, giving flexible and powerful extraction capabilities for interoperability and reporting....... By adopting such an abstract data model, the platform enables new and improved services for researchers, librarians and administrators....
Glen D. Alexander
Two years ago, Ohio State Park developed a methodology of measuring customer satisfaction, to gauge the effectiveness of our customer service. What follows is a discussion of our installation of systems to measure and improve customer satisfaction, the interpretation of the data, and the positive results we have enjoyed.
Harris, Lesley Ellen
Explains e-commerce and discusses how it can be used by special libraries. Highlights include library goals; examples of successful uses of e-commerce; how e-commerce can improve information services, including access to information, new information resources, delivery of information, and broadening information markets; and developing an…
Full Text Available Outsourcing logistics has established itself in the area of the LSP (Logistics Service Provider, which offers a range of services to its customers. In this line, transportation is characterized as one of the most important services, and therefore efficient fleet management is essential for establishing a high level of customer service. With advances in technology and vehicle tracking systems, this approach of management has gained new possibilities for the improvement of logistics services. By studying the specific case of an LSP, this paper investigates the use of these technologies in the management of their business and services. The results indicate that the LSP seeks to increase its services and to streamline information in order to respond to customer needs in real time. It is also evident in this case under study that the combination of the technology available together with the fleet management system has become a distinguishing feature for this LSP, one which increases their skills and important information for both customers and business.
Full Text Available Nowadays, with increasing service industries, service marketing and service quality have become an important challenge to organizations. The attempts of organizations in this situation are witnesses to this matter. In the past years, the organizations tried to reach service quality appropriation and satisfaction of self-external customers by concepts and approaches of external marketing. One of the important features of service is the direct interaction with customers and having customer-oriented behaviors. Furthermore, with introducing the internal marketing and the important roles of it, an internal customer of organizations, on achievement of organizational plans, was noted to internal marketing more and more than before. So, the study researchers are going to argue about internal marketing and the effect of it on organizational citizenship behaviors and service quality and the important role of it on development and improvement of service quality by using organizational citizenship behaviors. For this purpose, first the researchers have studied internal marketing and its important components and then have done the same to the other items and finally have applied a quantitative study on all of them. It should be mentioned that the researchers have employed SPSS 17.0 and Lisrel 8.54 for data analysis. The findings of the present study illustrated that there is an appropriate interaction among all the items, which has been studied here and the structural equations for the conceptual framework of this study are goodness of fit.
Donini, L M; Castellaneta, E; De Guglielmi, S; De Felice, M R; Savina, C; Coletti, C; Paolini, M; Cannella, C
Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.
Pankow, Jennifer; Willett, Jennifer; Yang, Yang; Swan, Holly; Dembo, Richard; Burdon, William M; Patterson, Yvonne; Pearson, Frank S; Belenko, Steven; Frisman, Linda K
In a study aimed at improving the quality of HIV services for inmates, an organizational process improvement strategy using change teams was tested in 14 correctional facilities in 8 US states and Puerto Rico. Data to examine fidelity to the process improvement strategy consisted of quantitative ratings of the structural and process components of the strategy and qualitative notes that explicate challenges in maintaining fidelity to the strategy. Fidelity challenges included (1) lack of communication and leadership within change teams, (2) instability in team membership, and (3) issues with data utilization in decision-making to implement improvements to services delivery.
Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim
Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve
Bornet , Francis; Paineau , Damien; Beaufils , François; Boulier , Alain; Cassuto , Dominique-Adèle; Chwalow , Judith; Combris , Pierre; Couet , Charles; Jouret , Béatrice; Lafay , Lionel; Laville , Martine; Mahé , Sylvain; Ricour , Claude; Romon , Monique; Simon , Chantal
Abstract Background/Objectives: The ELPAS study was an 8-month randomized controlled dietary modification trial designed to test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in 2026 free-living children and parents (Paineau et al., 2008). It resulted in significant nutritional changes, with beneficial effects on body mass index in adults. In these ancillary analyses, we investigated dietary changes throughout the intervention. ...
Full Text Available Nearly half of the world population suffers from micronutrient malnutrition, particularly Zn deficiency. It is important to understand genetic variation for uptake and translocation behaviors of Zn in relevant crop species to increase Zn concentration in edible parts. In the present study, genetic variation in grain Zn concentration of 319 finger millet genotypes was assessed. Large genetic variation was found among the genotypes, with concentrations ranging from 10 to 86 μg g− 1 grain. Uptake and translocation studies with Zn/65Zn application in 12 selected low-Zn genotypes showed wide variation in root uptake and shoot translocation, with genotypes GEC331 and GEC164 showing greater uptake and translocation. Genotypes GEC164 and GEC543 showed increased grain Zn concentration. Genotypes GEC331 and GEC164 also showed improved yield under Zn treatment. Appreciable variation in grain Zn concentration among finger millet genotypes found in this study offers opportunities to improve Zn nutrition through breeding.
Adequate intake of zinc from the daily diet is indispensable to maintain health. However, the dietary zinc content often fails to fulfill the recommended daily intake, leading to zinc deficiency and also increases the risk of developing chronic diseases, particularly in elderly individuals. Therefore, increased attention is required to overcome zinc deficiency and it is important to improve zinc nutrition in daily life. In the small intestine, the zinc transporter, ZIP4, functions as a component that is essential for zinc absorption. In this manuscript, we present a brief overview regarding zinc deficiency. Moreover, we review a novel strategy, called "ZIP4-targeting", which has the potential to enable efficient zinc absorption from the diet. ZIP4-targeting strategy is possibly a major step in preventing zinc deficiency and improving human health.
Plants are one of the most important resources of human foods and medicines. Rapidly increasing knowledge on nutrition, medicine, and plant biotechnology has dramatically changed the concepts about food, health and agriculture, and brought in a revolution on them. Nutritional therapy and phytotherapy have emerged as new concepts and healing systems have quickly and widely spread in recent years. Strong recommendations for consumption of nutraceuticals, natural plant foods, and the use of nutritional therapy and phytotherapy have become progressively popular to improve health, and to prevent and treat diseases. With these trends, improving the dietary nutritional values of fruits, vegetables and other crops or even bioactive components in folk herbals has become targets of the blooming plant biotechnology industry. This review attempts to display and remark on these aspects. It summarizes the progress made on nutraceuticals, nutritional therapy, phytonutrients, phytotherapy, and their related epidemiological investigations and clinical studies. It also covers markets of these health-promoting products and disease-preventing or healing systems, as well as regulations behind them that direct the development of biotechnology study and application. Finally, related patents are listed and briefly analyzed, regarding of plant biotechnological research and progress on transgenic crops to improve nutritional value, phytotherapy efficiency, or to produce pharmaceutically important secondary metabolites or high-valued protein medicines such as vaccines and antibodies.
Boltong, Anna G; Loeliger, Jenelle M; Steer, Belinda L
This study aimed to measure the prevalence of malnutrition risk and assessed malnutrition in patients admitted to a cancer-specific public hospital, and to model the potential hospital funding opportunity associated with implementing routine malnutrition screening. A point-prevalence audit of malnutrition risk and diagnosable malnutrition was conducted. A retrospective audit of hospital funding associated with documented cases of malnutrition was conducted. Audit results were used to estimate annual malnutrition prevalence, associated casemix-based reimbursement potential and the clinical support resources required to adequately identify and treat malnutrition. Sixty-four percent of inpatients were at risk of malnutrition. Of these, 90% were assessed as malnourished. Twelve percent of malnourished patients produced a positive change in the diagnosis-related group (DRG) and increased allocated financial reimbursement. Identifying and diagnosing all cases of malnutrition could contribute an additional AU$413644 reimbursement funding annually. Early identification of malnutrition may expedite appropriate nutritional management and improve patient outcomes in addition to contributing to casemix-based reimbursement funding for health services. A successful business case for additional clinical resources to improve nutritional care was aided by demonstrating the link between malnutrition screening, hospital reimbursements and improved nutritional care. What is known about the topic? It is known that between 20 and 50% of hospital patients are malnourished and oncology patients are 1.7 times more likely to be malnourished than are other hospitalised patients. Despite the existence of practice guidelines for malnutrition screening of at-risk oncology patients, these are not routinely implemented. Identification of malnutrition in hospitalised patients is linked to casemix funding via DRG. Casemix reimbursement for malnutrition can be enhanced if: (1) malnutrition risk is
Bibiloni, Maria Del Mar; Fernández-Blanco, Jordi; Pujol-Plana, Noemí; Martín-Galindo, Núria; Fernández-Vallejo, Maria Mercè; Roca-Domingo, Mariona; Chamorro-Medina, Juan; Tur, Josep A
To assess the results of a nutritional education programme developed by using available local resources to improve diet quality and decrease overweight and obesity prevalence among children. A longitudinal intervention study by means of nutritional education (INFADIMED) in children (aged 3-7 years) from Vilafranca del Penedès (Barcelona, Spain), recruited from preschool centres and primary schools, with an intervention or INFADIMED group (n=319; 50.2% female) and a control group (n=880; 49.8% female). Weight, height and body mass index were measured in both groups at the beginning and at the end of the programme. Adherence to the Mediterranean diet was also assessed using the KIDMED test. Consumption of fruit or juices, vegetables, yogurt and/or cheese, pasta or rice, and nuts increased, while skipping breakfast, consumption of bakery products for breakfast, and/or consumption of sweets several times per day decreased in the INFADIMED group. INFADIMED also changed, from the beginning to the end of the study, the adherence to a Mediterranean diet: high (39.2% to 70.5%), acceptable (49.2% to 28.2%), and low (11.6% to 1.3%). Approximately 2.6% of the participants in the control group and 11.3% of the participants in the INFADIMED group who were overweight and obese changed to normal weight (odds ratio: 4.08; 95% confidence interval: 2.37-7.04). INFADIMED is a nutritional education programme with benefits on both diet quality and overweight and obesity prevalence among children. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
information used to provide nutritional information to mothers in Maternal and Child Health ... interest in providing quality health care services and there is significant improvement in the ..... and information and Communication Technologies.
Reeves, Sue; Wake, Yvonne; Zick, Andrea
Objective: To investigate meals, price, nutritional content, and nutrition and portion size information available on children's menus in fast-food and table-service chain restaurants in London, since the United Kingdom does not currently require such information but may be initiating a voluntary guideline. Methods: Children's menus were assessed…
Castillo Carlos Fernando; Alvarez Elizabeth; Gomez Eduardo; Llano, German A; Castano Zapata, Jairo
Nutritional solutions, silica, resistance, downy mildew. The downy mildew (Peronospora sparsa), is one of the most important diseases of rose in Colombia, causing losses up to 8%. The objective of this research was to determine a preventive control of the disease, through the improvement of the nutritional balance of the plant. The first phase, involved the effect of different concentrations of N, K, Ca, B and Mn, on the incidence and severity of the disease, and in the second one, the evaluation of the best five treatments of the first phase. The treatments were applied to the varieties Charlotte, Classy and Malibu during 4 weeks, using a splitting plot design with six replications. After one month the plants were inoculated with the fungus at a concentration of 3x104 sporangia mL.The results of the area under the disease progress curve (AUDPC), showed that the plants of Charlotte with 200 ppm of Si had the lowest expression of the disease. In Classy, the best treatment was the standard solution, demonstrating that the effects of the treatments depend of the variety. Charlotte and Malibu showed susceptibility, while Classy, partial resistance to the disease.
Bell, A C; Swinburn, B A
To determine differences in the contribution of foods and beverages to energy consumed in and out of school, and to compare consumption patterns between school canteen users and noncanteen users. Cross-sectional National Nutrition Survey, 1995. Australia. SUBJECTS ON SCHOOL DAYS: A total of 1656 children aged 5-15 y who had weekday 24-h dietary recall data. An average of 37% of total energy intake was consumed at school. Energy-dense foods and beverages such as fat spreads, packaged snacks, biscuits and fruit/cordial drinks made a greater contribution to energy intake at school compared to out of school (Pfoods and soft drinks contributed 11 and 3% of total energy intake; however, these food groups were mostly consumed out of school. Fruit intake was low and consumption was greater in school. In all, 14% of children purchased food from the canteen and they obtained more energy from fast food, packaged snacks, desserts, milk and confectionary (Pfoods and beverages are over-represented in the Australian school environment. To help prevent obesity and improve nutrition in schools, biscuits, snack bars and fruit/cordial drinks brought from home and fast food, packaged snacks, and confectionary sold at canteens should be replaced with fruit and water.
Patra, Amlan K; Saxena, Jyotisna
Tannins (hydrolysable and condensed tannin) are polyphenolic polymers of relatively high molecular weight with the capacity to form complexes mainly with proteins due to the presence of a large number of phenolic hydroxyl groups. They are widely distributed in nutritionally important forage trees, shrubs and legumes, cereals and grains, which are considered as anti-nutritional compounds due to their adverse effects on intake and animal performance. However, tannins have been recognised to modulate rumen fermentation favourably such as reducing protein degradation in the rumen, prevention of bloat, inhibition of methanogenesis and increasing conjugated linoleic acid concentrations in ruminant-derived foods. The inclusion of tannins in diets has been shown to improve body weight and wool growth, milk yields and reproductive performance. However, the beneficial effects on rumen modulation and animal performance have not been consistently observed. This review discusses the effects of tannins on nitrogen metabolism in the rumen and intestine, and microbial populations (bacteria, protozoa, fungi and archaea), metabolism of tannins, microbial tolerance mechanisms to tannins, inhibition of methanogenesis, ruminal biohydrogenation processes and performance of animals. The discrepancies of responses of tannins among different studies are attributed to the different chemical structures (degree of polymerisation, procyanidins to propdelphinidins, stereochemistry and C-C bonding) and concentrations of tannins, and type of diets. An establishment of structure-activity relationship would be required to explain differences among studies and obtain consistent beneficial tannin effects. Copyright © 2010 Society of Chemical Industry.
Palermo, Mariantonella; Paradiso, Roberta; De Pascale, Stefania; Fogliano, Vincenzo
Hydroponic cultivation allows the control of environmental conditions, saves irrigation water, increases productivity, and prevents plant infections. The use of this technique for large commodities such as soybean is not a relevant issue on fertile soils, but hydroponic soybean cultivation could provide proteins and oil in adverse environmental conditions. In this paper, the compositions of four cultivars of soybean seeds and their derivates, soy milk and okara, grown hydroponically were compared to that of the same cultivar obtained from soil cultivation in an open field. Besides proximal composition, the concentrations of phytic acid and isoflavones were monitored in the seeds, soy milk, and okara. Results demonstrated that, independent from the cultivar, hydroponic compared to soil cultivation promoted the accumulation of fats (from 17.37 to 21.94 g/100 g dry matter) and total dietary fiber (from 21.67 to 28.46 g/100 g dry matter) and reduced isoflavones concentration (from 17.04 to 7.66 mg/kg dry matter), whereas protein concentration was unaffected. The differences found in seed composition were confirmed in the respective okara products, but the effect of cultivation system was not significant looking at the soy milk composition. Data showed that hydroponic cultivation improved the nutritional quality of soybean seeds with regard to fats and dietary fiber. They also suggest that specific cultivars should be selected to obtain the desired nutritional features of the soybean raw material depending on its final destination.
Oguntibeju, O O; Esterhuyse, A J; Truter, E J
The link between dietary fats and cardiovascular disease has created a growing interest in dietary red palm oil research. Also, the link between nutrition and health, oxidative stress and the severity or progression of disease has stimulated further interest in the potential role of red palm oil (a natural antioxidant product) to improve oxidative status by reducing oxidative stress in patients with cardiovascular disease, cancer and other chronic diseases. In spite of its level of saturated fatty acid content (50%), red palm oil has not been found to promote atherosclerosis and/or arterial thrombosis. This is probably due to the ratio of its saturated fatty acid to unsaturated fatty acid content and its high concentration of antioxidants such as beta-carotene, tocotrienols, tocopherols and vitamin E. It has also been reported that the consumption of red palm oil reduces the level of endogenous cholesterol, and this seems to be due to the presence of the tocotrienols and the peculiar isomeric position of its fatty acids. The benefits of red palm oil to health include a reduction in the risk of arterial thrombosis and/or atherosclerosis, inhibition of endogenous cholesterol biosynthesis, platelet aggregation, a reduction in oxidative stress and a reduction in blood pressure. It has also been shown that dietary red palm oil, taken in moderation in animals and humans, promotes the efficient utilisation of nutrients, activates hepatic drug metabolising enzymes, facilitates the haemoglobinisation of red blood cells and improves immune function. This review provides a comprehensive overview of the nutritional, physiological and biochemical roles of red palm oil in improving wellbeing and quality of life.
Benjamin, Sara E; Haines, Jess; Ball, Sarah C; Ward, Dianne S
A large percentage of children in the United States spend part of their day in out-of-home child care. As rates of obesity continue to rise, especially among young children, child care has become a focus for nutrition and physical activity intervention. Parental involvement is an important component of these efforts. During summer 2006, parents of children in child care were surveyed to better understand their perceived quality of meals, snacks, and physical activity at the child-care center, and their recommendations for improvement. Parents of children who attended 94 licensed child-care centers in North Carolina were invited to complete a brief survey of perceived quality of meals, snacks, and physical activity at their centers using close-ended questions. Open-ended questions were used to identify suggestions for improvement. Five hundred eight parents from 91 child-care centers completed the questionnaire. The majority of parents reported quality of meals and snacks at the center as either excellent (30% meals, 27% snacks) or good (42% meals, 46% snacks). The main recommendations for improving meals and snacks were to increase fruits and vegetables and provide a variety of healthful foods. The majority of parents categorized the quality of physical activity at the center as excellent (36%) or good (46%), and suggested more structured, outdoor activities for children. Findings from this study provide insight into key areas of concern for parents regarding the nutrition and activity environment of child-care centers. This information may be used to create or modify interventions or policies and to help motivate parents to become advocates for change in child care.
Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps
Mika, Claudia; Herpertz-Dahlmann, Beate; Heer, Martina; Holtkamp, Kristian
In patients with anorexia nervosa (AN), an assessment of changes in body composition and nutritional status is crucial for adequate nutritional management during refeeding therapies. Phase-sensitive multifrequency bioelectrical impedance analysis (BIA) is an inexpensive and noninvasive technique with which to determine nutritional status and body composition. We investigated 21 female adolescents with AN (initial BMI 15.5 +/- 1.1 kg/m(2)) 4 times between wk 3 and 15 of inpatient refeeding and 19 normal-weight, age-matched female controls. From wk 3 to 15, BMI, fat mass, body cell mass (BCM), total body water (TBW), intracellular water (ICW) but not extracellular mass (ECM), and extracellular water (ECW) increased significantly. Reactance (Xc), phase angle (PhA), and the ECM/BCM index as parameters of nutritional status improved significantly in patients and no longer differed from controls in wk 15, although the BMI of patients was significantly lower than those of controls. Changes in the ECM/BCM index were due to accretion of BCM, which was associated with an increase of ICW. Multifrequency phase-sensitive BIA seems to be a promising tool for the assessment of changes in nutritional status and body composition in patients with AN. An individually determined and controlled hyperenergetic diet as part of a multidimensional, interdisciplinary treatment program for eating disorders seems to quickly improve the nutritional status of AN patients.
Sadegholvad, Sanaz; Yeatman, Heather; Omidvar, Nasrin; Parrish, Anne-Maree; Worsley, Anthony
Background: The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts’ views of the best strategies to improve school-leavers’ knowledge of nutrition and food systems. Methods: In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo. Results: The experts’ suggested strategies to improve Iranian school-leavers’ knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge. Conclusions: Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely. PMID:27857832
Sadegholvad, Sanaz; Yeatman, Heather; Omidvar, Nasrin; Parrish, Anne-Maree; Worsley, Anthony
The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts' views of the best strategies to improve school-leavers' knowledge of nutrition and food systems. In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo. The experts' suggested strategies to improve Iranian school-leavers' knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge. Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely.
Baños, R M; Cebolla, A; Oliver, E; Alcañiz, M; Botella, C
Possessing sufficient nutritional knowledge is a necessary component in the prevention and treatment of obesity. A solid understanding of nutrition can help people make appropriate food selections and can also help correct irrational ideas or myths people may believe about food. It is a challenge to provide this information to children in ways that are exciting. Thus, we propose an online video game platform to deliver the information. The objective of this study was to study the efficacy and acceptability of an online game called 'ETIOBE Mates' that was designed to improve children's nutritional knowledge; furthermore, we compare it with the traditional paper-pencil mode of information delivery. A sample of 228 children participated in the study. Participants were divided into two groups: an experimental group (who used ETIOBE Mates) and a control group (who were given a pamphlet). Both groups increased their scores for nutritional knowledge. The interaction between group × time was also statistically significant; it indicated that acquisition of nutritional knowledge was superior in the experimental group. The children considered the serious games platform to be a useful medium for improving their nutritional knowledge. Online games can be an effective method of delivery for preventive and treatment tasks that are otherwise tedious for children.
Davis, Jaimie N; Martinez, Lauren C; Spruijt-Metz, Donna; Gatto, Nicole M
To evaluate the effect of an exploratory 12-week nutrition, cooking, and gardening trial (LA Sprouts) on preference for fruit and vegetables (FV); willingness to try FV; identification of FV; self-efficacy to garden, eat, and cook FV; motivation to garden, eat, and cook FV; attitudes toward FV; nutrition and gardening knowledge; and home gardening habits. Randomized controlled trial. Four elementary schools. Three hundred four predominately Hispanic/Latino third- through fifth-grade students were randomized to either the LA Sprouts group (n = 167 students) or control group (n = 137 students). Twelve-week after-school nutrition, cooking, and gardening intervention. Determinants of dietary behavior as measured by questionnaire at baseline and postintervention. Analyses of covariance. After the 12-week program, compared with controls, LA Sprouts participants improved scores for identification of vegetables (+11% vs +5%; P = .001) and nutrition and gardening knowledge (+14.5% vs -5.0%; P = .003), and were more likely to garden at home (+7.5% vs -4.4%; P = .003). The LA Sprouts program positively affected a number of determinants of dietary behaviors that suggest possible mechanisms by which gardening and nutrition education act to improve dietary intake and health outcomes. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Clark, Alena; Bezyak, Jill; Testerman, Nora
This study assessed current meal planning/cooking behaviors and dietary intake of individuals with severe mental illnesses and determined differences after a 6-week nutrition education cooking class. Eighteen individuals with severe mental illnesses participated in a 6-week nutrition education cooking class and completed pre- and posttest 24-hr recalls and a postretrospective survey. Paired samples t tests were used. Participants met their calories needs, but they consumed high amounts of sodium and fat and low amounts of fiber. Significant increases in calcium, vitamin D, grains, and fruit occurred from pre- to posttest (p cooking and grocery shopping skills improved. Participants desire nutrition education programming that includes simple messages, hands-on cooking demonstrations, and health-related incentives. More research is needed to determine how nutrition education programs lead to sustained knowledge and behavior change within this specialized population. (c) 2015 APA, all rights reserved).
Inayati, Dyah A; Scherbaum, Veronika; Purwestri, Ratna C; Wirawan, Nia N; Suryantan, Julia; Hartono, Susan; Bloem, Maurice A; Pangaribuan, Rosnani V; Biesalski, Hans K; Hoffmann, Volker; Bellows, Anne C
To assess the impact of intensive nutrition education (INE) with or without the provision of micronutrient powder (MNP) on the nutritional status of mildly wasted children in Nias, Indonesia, two groups of mildly wasted (>=-1.5 to children aged >=6 to children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program (NNE) with or without MNP (n=50 both respectively). WHZ, weight, height, haemoglobin (Hb) level, and morbidity data were assessed at admission, during the study, and at individual discharge. Children's weight gain (g/kg body weight/day) was highest in INE+MNP group (2.2±2.1), followed by INE (1.1±0.9), NNE+MNP (0.3±0.5) and NNE (0.3±0.4) group. In both MNP intervention groups (INE+MNP, NNE+MNP), supplements significantly increased Hb value (g/L) of respective children (10.0±10.0; pchildren who reached discharge criterion was highest among the INE+MNP (70.6%; n=36), followed by INE (64.1%; n=41), NNE+MNP (26.0%; n=13), and NNE (20.0%; n=10) groups (pchildren in the INE+MNP group (29.9 days), followed by INE (40.0 days), NNE+MNP (80.6 days), and NNE (86.2 days) respectively (pnutrition education supported by MNP supplementation produced the best results regarding weight gain and haemoglobin status of mildly wasted children.
Katoch, Rajan; Thakur, Neelam
This review highlights the advances in the knowledge of RNA interference (RNAi) and discusses recent progress on the functionality of different components RNAi machinery operating in the organisms. The silencing of genes by RNA interference has become the technology of choice for investigation of gene functions in different organisms. The refinement in the knowledge of the endogenous RNAi pathways in plants along with the development of new strategies and applications for the improvement of nutritional value of important agricultural crops through suppression of genes in different plants have opened new vistas for nutritional security. The improvement in the nutritional status of the plants and reduction in the level of toxins or antinutrients was desired for long, but the available technology was not completely successful in achieving the tissue specific regulation of some genes. In the recent years, a number of economically important crop plants have been tested successfully for improving plant nutritional value through metabolic engineering using RNAi. The implications of this technology for crop improvement programs, including nutritional enrichment, reduction of antinutrients, disease, and insect control have been successfully tested in variety of crops with commercial considerations. The enhancement of the nutraceutical traits for the desired health benefits in common crop plants through manipulation of gene expression has been elaborated in this article. The tremendous potential with RNAi technology is expected to revolutionize the modern agriculture for meeting the growing challenges is discussed.
Full Text Available Abstract Background The Exercise and Nutrition Routine Improving Cancer Health (ENRICH study is investigating a novel lifestyle intervention aimed at improving the health behaviors of adult cancer survivors and their carers. The main purpose of the study is to determine the efficacy of lifestyle education and skill development delivered via group-based sessions on the physical activity and dietary behaviors of participants. This article describes the intervention development, study design, and participant recruitment. Methods/Design ENRICH is a randomized controlled trial, conducted in Australia, with two arms: an intervention group participating in six, two-hour face-to-face sessions held over eight weeks, and a wait-list control group. Intervention sessions are co-facilitated by an exercise physiologist and dietician. Content includes healthy eating education, and a home-based walking (utilizing a pedometer and resistance training program (utilizing elastic tubing resistance devices. The program was developed with reference to social cognitive theory and chronic disease self-management models. The study population consists of cancer survivors (post active-treatment and their carers recruited through community-based advertising and referral from health professionals. The primary outcome is seven-days of sealed pedometry. Secondary outcomes include: self-reported physical activity levels, dietary intake, sedentary behavior, waist circumference, body mass index, quality of life, and perceived social support. The outcomes will be measured at baseline (one week prior to attending the program, eight-weeks (at completion of intervention sessions, and 20-weeks. The intervention group will also be invited to complete 12-month follow-up data collection. Process evaluation data will be obtained from participants by questionnaire and attendance records. Discussion No trials are yet available that have evaluated the efficacy of group-based lifestyle
The Republic of the Marshall Islands has 60 dispensary sites, each staffed by 1 health assistant, to cover 80-800 people/site on 34 atolls. Until the spring of 1994, only curative services were available on a regular basis, and preventive services were provided by traveling health teams from the urban centers. In 1994, the health assistants in selected outer islands were trained to administer immunizations from vaccines which are sent regularly by air. Additional project sites are being selected. In 1993, 2 dispensaries initiated a project to 1) increase the number of women with access to prenatal care during the first trimester, 2) increase immunization levels, 3) improve access to preventive services, and 4) improve reporting and record-keeping systems. This project includes an important training component for the health assistant, the wife of the health assistant, the traditional birth attendant, the youth peer educator, community leaders, and a member of the local council. By 1994, this project was expanded to 13 dispensaries on 2 atolls. In 1995, 18 more dispensaries on 4 more atolls will be able to offer these additional services.
Gross-Fengels, W.; Weber, M.
By means of complete service control and standardized accounting processes, radiological information systems clearly contribute to improved results. They provide the prerequisites for the establishment of expanded networks and allow comprisons with comparable institutions. The quality of patient care can be improved since, for example, the production time from referral to finished result becomes shorter. Direct access to patient and findings data from several positions is possible. Preliminary results can be viewed immediately. The patient's history is accessible to authorized users at all times. The exact reproducibility and assignment of services leads to more clarity. By means of the information available form RIS, rapid adaptive processes can be undertaken. The system assists the to fulfill the requirements of health regulations. The above-mentioned relationships demonstrate that the EDP systems are well accepted by physicians, medical assistants, and administrators and represent an indispensable aid for solving problems. (orig.) [de
Daniela Baldeón Clavijo
Full Text Available (Received: 2015/03/18 - Accepted: 2015/05/27Three levels of paste Plukenetia volubilis (Sacha Inchi consisting of 10, 15% and 20% were evaluated to replace the weight percent lard conventionally used to improve the nutritional quality of the common hamburger, compared with a reference group. The experimental units were 10 burgers, weighing 100 g. each and a total of 120 were analyzed in a completely randomized design with three replications. The research was conducted in the Universidad Estatal Amazónica and bromatológics and microbiological analyzes to determine the quality of the raw material and products are made in laboratory of the Faculty of Chemical Sciences of the Universidad Central del Ecuador. As supplements sensory tests and studies Benefit / Cost performed. The results show the variation of 10% pulp Sacha Inchi as the most recommended for use in industry.
Hart, Miranda; Ehret, David L; Krumbein, Angelika; Leung, Connie; Murch, Susan; Turi, Christina; Franken, Philipp
Arbuscular mycorrhizal (AM) fungi can affect many different micronutrients and macronutrients in plants and also influence host volatile compound synthesis. Their effect on the edible portions of plants is less clear. Two separate studies were performed to investigate whether inoculation by AM fungi (Rhizophagus irregularis, Funneliformis mosseae, or both) can affect the food quality of tomato fruits, in particular common minerals, antioxidants, carotenoids, a suite of vitamins, and flavor compounds (sugars, titratable acids, volatile compounds). It was found that AM fungal inoculation increased the nutrient quality of tomato fruits for most nutrients except vitamins. Fruit mineral concentration increased with inoculation (particularly N, P, and Cu). Similarly, inoculated plants had fruit with higher antioxidant capacity and more carotenoids. Furthermore, five volatile compounds were significantly higher in AM plants compared with non-AM controls. Taken together, these results show that AM fungi represent a promising resource for improving both sustainable food production and human nutritional needs.
Darmokusumo, H V
In May 1984, the Minister of Manpower in Indonesia, the Chairman of the BKKBN, and representatives of the employers' and workers' organizations of Indonesia issued a joint decree pledging that they would work together to enhance the implementation of the family planning program among workers in the organized sector. 1 objective of the decree is to improve workers' productivity and the standard of living of workers and their families by implementing a family planning program. 1 baseline survey and a clinic-based survey in 5 provinces revealed that 90% of women workers are between 21-40, or are of reproductive age, and are sexually active. Only about 50% are practicing family planning; the other 50% are afraid to practice family planning due to potential side effects of various methods. This fear was most often caused by negative rumors spread by unsatisfied family planning clients. Placing materials for family planning promotion such as instructional posters and video programs advertising contraceptive services in the work setting may increase knowledge and help alleviate some of this fear. Other studies of family planning services show that employees prefer female medical doctors or midwives as service providers, employees are willing to pay for services (but can only afford a small fee), and family planning service points should be near employees' work sites.
Amaral, Creusa Sayuri Tahara; Rozenfeld, Henrique; Costa, Janaina Mascarenhas Hornos; Magon, Maria de Fatima de Andrade; Mascarenhas, Yvone Maria
The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) ). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements.
Roberts, Stephen M; Pobocik, Rebecca S; Deek, Rima; Besgrove, Ashley; Prostine, Becky A
The objective of this study was to learn about the experiences of principals and school food service directors with the Texas Public School Nutrition Policy. Semistructured qualitative interviews were conducted to gain first hand reactions to the new nutrition policy. Data were gathered from Texas middle schools. Principals and food service directors from 24 schools randomly selected from 10 Texas Education regions were interviewed. Participants were interviewed about their reactions to the implementation of the Texas School Nutrition Policy. Two researchers, using thematic analysis, independently analyzed each interview. Differences in coding were reconciled and themes were generated. The themes that surfaced included resistance to the policy, policy development process, communication, government role, parental role, food rewards, fund raising, and leadership. Resistance to the policy was not extreme. In the future a wider array of school personnel who are affected by school food regulations should be included in the development of new policies. It is critical to communicate with all concerned parties about the policy.
Elin W. Blakstad
Full Text Available Background: Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g infants. Early growth may influence the risk of metabolic syndrome later in life. Objective: To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1 in VLBW infants participating in a randomized nutritional intervention study. Design: Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA. Metabolic markers were measured at birth and 5 months CA. Results: Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: pinteraction=0.006; head growth: pinteraction=0.002. The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35 and nutrient supply (0.35≤r≤0.45. Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53. Conclusion: Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy.Clinical Trial Registration (ClinicalTrials.gov no.: NCT01103219
Yoon, So Ra; Lee, Jong Hwa; Lee, Jae Hyang; Na, Ga Yoon; Lee, Kyun-Hee; Lee, Yoon-Bok; Jung, Gu-Hun; Kim, Oh Yoen
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed, short-chain carbohydrates that play an important role in inducing functional gut symptoms. A low-FODMAP diet improves abdominal symptoms in patients with inflammatory bowel disease and irritable bowel syndrome. However, there were no study for the effect of FODMAP content on gastrointestinal intolerance and nutritional status in patients receiving enteral nutrition (EN). In this randomized, multicenter, double-blind, 14-day clinical trial, eligible hospitalized patients receiving EN (n = 100) were randomly assigned to three groups; 84 patients completed the trial (low-FODMAP EN, n = 30; moderate-FODMAP EN, n = 28; high-FODMAP EN, n = 26). Anthropometric and biochemical parameters were measured; stool assessment was performed using the King's Stool Chart and clinical definition. Baseline values were not significantly different among the three groups. After the 14-day intervention, diarrhea significantly improved in the low-FODMAP group than in the moderate- and high-FODMAP groups (P nutritional status and facilitating prompt recovery from illness.
Ramli, Rindra M.; Ba-Rayyan, Faten A.
Analyze the questions received in LibAnswers (ticketing system) in order to improve the quality of our virtual reference services. Tickets that were received between June 2015 to April 2017 were analyzed and categorized. It was noted that most questions asked revolved around electronic resources issues as well as circulation/access issues.
Ramli, Rindra M.
Analyze the questions received in LibAnswers (ticketing system) in order to improve the quality of our virtual reference services. Tickets that were received between June 2015 to April 2017 were analyzed and categorized. It was noted that most questions asked revolved around electronic resources issues as well as circulation/access issues.
Wang, Yaosheng; Liu, Fulai; Andersen, Mathias Neumann
stomatal conductance during the treatment. At the end of the experiment, N accumulation and 15N recovery was highest in FI, intermediate in PRI and lowest in DI. In addition, PRI plants consistently allocated more N into the upper and middle leaf layers than in the FI and DI treatments. The improved N...... nutrition and distribution in the canopy may indicate that PRI plants have a greater photosynthetic capacity than DI plants; this is confirmed by the observed positive linear relationship between specific leaf N content and δ13C. It is concluded that PRI improves N nutrition and optimises N distribution...
Full Text Available Abstract Background Malnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal. However, specific health-related data in school-aged children in these two countries are scarce. In the frame of a larger multi-stakeholder project entitled “Vegetables go to School: Improving Nutrition through Agricultural Diversification” (VgtS, a study has been designed with the objectives to: (i describe schoolchildren’s health status in Burkina Faso and Nepal; and to (ii provide an evidence-base for programme decisions on the relevance of complementary school garden, nutrition, water, sanitation and hygiene (WASH interventions. Methods/Design The studies will be conducted in the Centre Ouest and the Plateau Central regions of Burkina Faso and the Dolakha and Ramechhap districts of Nepal. Data will be collected and combined at the level of schools, children and their households. A range of indicators will be used to examine nutritional status, intestinal parasitic infections and WASH conditions in 24 schools among 1144 children aged 8–14 years at baseline and a 1-year follow-up. The studies are designed as cluster randomised trials and the schools will be assigned to two core study arms: (i the ‘complementary school garden, nutrition and WASH intervention’ arm; and the (ii ‘control’ arm with no interventions. Children will be subjected to parasitological examinations using stool and urine samples and to quality-controlled anthropometric and haemoglobin measurements. Drinking water will be assessed for contamination with coliform bacteria and faecal streptococci. A questionnaire survey on nutritional and health knowledge, attitudes and practices (KAP will be administered to children and their caregivers, also assessing socioeconomic, food-security and WASH conditions at household level. Focus group and key-informant interviews on children’s nutrition and hygiene perceptions and behaviours will be
Nguyen, Phuong H; Kim, Sunny S; Keithly, Sarah C; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul; Menon, Purnima
structural and process attributes. Provided that service utilization is improved through demand generation, this model has the potential to impact IYCF practices and child nutrition. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.
Marshall, Andrea P; Lemieux, Margot; Dhaliwal, Rupinder; Seyler, Hilda; MacEachern, Kristen N; Heyland, Daren K
Critically ill patients are at increased risk of developing malnutrition-related complications because of physiological changes, suboptimal delivery, and reduced intake. Strategies to improve nutrition during critical illness recovery are required to prevent iatrogenic underfeeding and risk of malnutrition. The purpose of this study was to assess the feasibility and acceptability of a novel family-centered intervention to improve nutrition in critically ill patients. A 3-phase, prospective cohort feasibility study was conducted in 4 intensive care units (ICUs) across 2 countries. Intervention feasibility was determined by patient eligibility, recruitment, and retention rates. The acceptability of the intervention was assessed by participant perspectives collected through surveys. Participants included family members of the critically ill patients and ICU and ward healthcare professionals (HCPs). A total of 75 patients and family members, as well as 56 HCPs, were enrolled. The consent rate was 66.4%, and 63 of 75 (84%) of family participants completed the study. Most family members (53/55; 98.1%) would recommend the nutrition education program to others and reported improved ability to ask questions about nutrition (16/20; 80.0%). Family members viewed nutrition care more positively in the ICU. HCPs agreed that families should partner with HCPs to achieve optimal nutrition in the ICU and the wards. Health literacy was identified as a potential barrier to family participation. The intervention was feasible and acceptable to families of critically ill patients and HCPs. Further research to evaluate intervention impact on nutrition intake and patient-centered outcomes is required.
Munk, T; Seidelin, W; Rosenbom, E; Nielsen, A L; Klausen, T W; Nielsen, M A; Thomsen, T
Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk. A historically controlled intervention pilot study was conducted. Forty patients at nutritional risk were offered a novel hospital menu as a supplement to the ordinary hospital menu. The menu consisted of 36 naturally energy-enriched small dishes served on demand 24 h a day. Energy and protein intake were calculated as the mean over a period of 3 days. No significant difference in energy and protein intake was observed between the groups; however, a significant (P = 0.001) time gradient in total energy intake was observed in the intervention group. Moreover, a significant (P = 0.03) time gradient in energy intake received from the novel menu was observed. The dishes from the novel menu were mainly ordered from 11.00 h to 14.00 h and from 17.00 h to 18.00 h. No overall significant differences in energy and protein intake between the groups were found. However, the present pilot study revealed a significant time gradient in total energy intake (P = 0.001) and in energy intake from the novel menu (P = 0.03). This indicates the need to include a run-in period when investigating novel hospital menus as a support for patients at nutritional risk. Additionally, food service, available 24 h a day, appears to be unnecessary. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.
Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and
Yashpal P Jadeja
Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD. PEW is one of the strongest predictors of mortality in patients with CKD. The International Society of Renal Nutrition and Metabolism (ISRNM expert panel has defined PEW as a, "state of decreased body stores of protein and energy fuels (body protein and fat masses". The ISRNM panel has also proposed diagnostic criteria of PEW with four categories. Cachexia is a severe form of PEW. The proposed causes of PEW are multi-factorial and include nutritional and non-nutritional mechanisms. The literature indicates that PEW can be mitigated or corrected with an appropriate diet and enteral nutritional support that targets dietary protein intake. Dietary requirements and enteral nutritional support must also be considered in patients with CKD and diabetes mellitus and in children with CKD, in addition to dialysis patients. Features of ideal dietary supplement have also been discussed. Dietary interventions such as enteral feeding with high-protein meals or supplements might improve the nutritional status and outcomes in dialysis patients.
Litchfield, I; Hinckley, P
Sickness absence rates in the UK continue to exceed those in much of the developed world, with an annual cost to employers of £29 billion. Rates of sickness absence in the public sector are higher than those in the private sector, with the exception of the fire service where they are consistently lower. To understand the influences that increase attendance among operational firefighters. A series of semi-structured interviews undertaken with operational staff to explore their attitudes to sickness absence. Review and analysis of participant responses identified a number of key themes, namely employee well-being, including physical fitness and mental health; employee engagement with the fire service as manifested by culture, experience, nature of the job and leadership; organizational factors including the staffing model and relationship with occupational health services and policy, which describes both refinements to and implementation of targeted policies. Previously observed factors such as improved fitness and the distinct firefighter culture play a role, yet other factors emerged that could explain the differences. These include the greater work-life balance offered by their shift patterns, the terms and conditions of employment and perhaps most importantly the evolution of precisely targeted policies that understand the unique nature of the operational fire service. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.
Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F
To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.
Murphy Denis J.
Full Text Available The last few decades have seen huge advances in our understanding of plant biology and in the development of new technologies for the manipulation of crop plants. The application of relatively straightforward breeding and selection methods made possible the “Green Revolution” of the 1960s and 1970s that effectively doubled or trebled cereal production in much of the world and averted mass famine in Asia. During the 2000s, much attention has been focused on genomic approaches to plant breeding with the deployment of a new generation of technologies, such as marker-assisted selection, next-generation sequencing, transgenesis (genetic engineering or GM and automatic mutagenesis/selection (TILLING, TargetIng Local Lesions IN Genomes. These methods are now being applied to a wide range of crops and have particularly good potential for oil crop improvement in terms of both overall food and non-food yield and nutritional and technical quality of the oils. Key targets include increasing overall oil yield and stability on a per seed or per fruit basis and very high oleic acid content in seed and fruit oils for both premium edible and oleochemical applications. Other more specialised targets include oils enriched in nutritionally desirable “fish oil”-like fatty acids, especially very long chain !-3 acids such as eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA, or increased levels of lipidic vitamins such as carotenoids, tocopherols and tocotrienes. Progress in producing such oils in commercial crops has been good in recent years with several varieties being released or at advanced stages of development.
Huang, Jeannie S; Chun, Stanford; Cheung, Christopher; Poon, Linda; Terrones, Laura
US hospitals routinely provide food to hospitalized children. The nutritional content of provided foods has not been evaluated. We performed our study to examine meal orders of hospitalized youth and determine whether the nutritional contents of ordered meals meet dietary guidelines. We performed a cross-sectional evaluation among hospitalized youth ≥1 y receiving all nutritional intake by mouth and not on a clear liquid diet. Meal orders from hospitalized youth were analyzed for nutritional content. Daily calories, fiber, protein, fat content, and sugar-sweetened beverages ordered were determined and compared with published dietary recommendations. Distribution analyses and odds ratios for meeting v. not meeting dietary recommendations were calculated for select factors and adjusted for hospital length of stay. 969 meal orders from 247 patients [13 (1, 26) [median (min, max)] years, 50% male, 47% Hispanic] at a tertiary care pediatric hospital were reviewed. Forty-four percent of daily meals exceeded caloric recommendations, 9% met fiber recommendations, 36% met fat recommendations, all met protein requirements, and 53% included sugar-sweetened beverages. Overweight/obese boys <13 y hospitalized ≤7 d were more likely to place meal orders exceeding daily caloric recommendations while Hispanic overweight/obese youth hospitalized ≤7 d were more likely to order sugar-sweetened beverages than inpatient counterparts. Pediatric hospital meal orders commonly do not meet dietary guidelines. Hospitals should encourage youth and families to order within nutritional guidelines to prevent additional health risk. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Maria Luz George
Full Text Available This paper presents the impact of integrating interventions like nutrition gardening, livestock rearing, product diversification and allied income generation activities in small and marginal coconut homesteads along with nutrition education in improving the food and nutritional security as well as the income of the family members. The activities were carried out through registered Community Based Organizations (CBOs in three locations in Kerala, India during 2005-2008. Data was collected before and after the project periods through interviews using a pre-tested questionnaire containing statements indicating the adequacy, quality and diversity of food materials. Fifty respondents each were randomly selected from the three communities, thereby resulting in a total sample size of 150. The data was analysed using SPSS by adopting statistical tools like frequency, average, percentage analysis, t – test and regression. Participatory planning and implementation of diverse interventions notably intercropping and off-farm activities along with nutrition education brought out significant improvements in the food and nutritional security, in terms of frequency and quantity of consumption as well as diet diversity. At the end of the project, 96%of the members became completely food secure and 72% nutritionally secure. The overall consumption of fruits, vegetables and milk by both children and adults and egg by children recorded increase over the project period. Consumption of fish was more than the Recommended Dietary Intake (RDI level during pre and post project periods. Project interventions like nutrition gardening could bring in surplus consumption of vegetables (35% and fruits (10% than RDI. In spite of the increased consumption of green leafy vegetables and milk and milk products over the project period, the levels of consumption were still below the RDI levels. CBO-wise analysis of the consumption patterns revealed the need for location
Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Pow, Janette; Elliott, Lawrie; Raeside, Robert; Themessl-Huber, Markus; Claveirole, Anne
Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provision, however, is lacking. Our aim was to assess the views of staff as to the conditions required for partnership working. This study was a cross-sectional survey of 687 staff offering sexual health education, information or support to young people in the Healthy Respect intervention area in Scotland. Views of each variable were scored and structural equation modelling was used to assess the theoretical model. Responses were received from 284 (41%) staff. Greater strength of partnership was directly associated with increasing the number of referrals. Establishing professional roles between organizations was also associated with increasing the number of referrals. Strength of partnership was indirectly associated with working more effectively with young people and this relationship depended on clear communication, trust, established professional roles and shared resources. Effective partnership working depends on a number of interdependent relationships between organizations, which act synergistically to improve organizational outcomes. Effective partnership working leads to improved service delivery though there is a need for better controlled studies which demonstrate the effect on health outcomes.
Erika B. Laconi
Full Text Available Cocoa pod is among the by-products of cocoa (Theobroma cacao plantations. The aim of this study was to apply a number of treatments in order to improve nutritional quality of cocoa pod for feeding of ruminants. Cocoa pod was subjected to different treatments, i.e. C (cocoa pod without any treatment or control, CAm (cocoa pod+1.5% urea, CMo (cocoa pod+3% molasses, CRu (cocoa pod+3% rumen content and CPh (cocoa pod+3% molasses+Phanerochaete chrysosporium inoculum. Analysis of proximate and Van Soest’s fiber fraction were performed on the respective treatments. The pods were then subjected to an in vitro digestibility evaluation by incubation in rumen fluid-buffer medium, employing a randomized complete block design (n = 3 replicates. Further, an in vivo evaluation of the pods (35% inclusion level in total mixed ration was conducted by feeding to young Holstein steers (average body weight of 145±3.6 kg with a 5×5 latin square design arrangement (n = 5 replicates. Each experimental period lasted for 30 d; the first 20 d was for feed adaptation, the next 3 d was for sampling of rumen liquid, and the last 7 d was for measurements of digestibility and N balance. Results revealed that lignin content was reduced significantly when cocoa pod was treated with urea, molasses, rumen content or P. chrysosporium (pCAm>CRu>CMo. Among all treatments, CAm and CPh treatments significantly improved the in vitro dry matter and organic matter digestibility (p<0.05 of cocoa pod. Average daily gain of steers receiving CAm or CPh treatment was significantly higher than that of control (p<0.01 with an increase of 105% and 92%, respectively. Such higher daily gain was concomitant with higher N retention and proportion of N retention to N intake in CAm and CPh treatments than those of control (p<0.05. It can be concluded from this study that treatment with either urea or P. chrysosporium is effective in improving the nutritive value of cocoa pod.
Sato, Nanae; Hayashi, Fumi; Yoshiike, Nobuo
This quasi-experimental study determined whether the nutrition education program we developed to promote chewing food properly influenced children's chewing habits successfully. Four kindergarten classes in Japan (150 children, aged 5-6 years) were studied; one class received the educational program in the classroom and at home (Group A) and three classes received the program in the classroom only (Group B). The educational program was integrated into the classes' daily curriculum for five weeks. It included storytelling with large picture books, chewing consciously while eating lunch, singing a song with gestures, and greetings before and after meals (both groups). Group A also used a paper textbook and was provided information by the leaflet to encourage guardians to implement the program at home. Chewing habits before and after intervention were evaluated: (1) guardians completed seven questionnaire items related to chewing habits and chewing movement and (2) the number of chews and time spent eating the test meal were measured by a portable chewing sensor. Both approaches improved the children's chewing habits; however, no difference was found between the two groups. We concluded that this intervention could be used to improve chewing habits in young children even without active involvement of their guardians.
Magdy M. Ismail
Full Text Available As is well known, the date fruits are good sources of many nutrients. Also, yoghurt especially bio-yoghurt has a lot of nutritional and healthy benefits. The aim of this study was to combine the benefits of date and bio-yoghurt in one product which can be made by simple manner. Six treatments of yoghurt were made from cow's milk fortified with 10 and 15% rutub date and using classic or ABT-5 cultures. Changes in rheological, chemical, microbial and organoleptic properties of yoghurt were monitored during refrigerated storage (4°C of yoghurt for 15 d. Results showed that fortification with date accelerates the rates of fermentation and lowered coagulation time. For rheological analyses, curd tension, viscosity and water holding capacity values increased whereas curd syneresis values decreased in bio-yoghurt fortified with date. Redox potential values were lower in date yoghurt as compared with control. Acidity, carbohydrate, total solids, dietary fiber and ash contents of yoghurt supplemented with date were higher than those of control. Supplementation of date increased mineral contents (K, Ca, P, Mg, Na and Fe, total nitrogen, water soluble nitrogen, total phenols and total volatile fatty acids of yoghurt. The addition of date improved the viability of lactic acid bacteria and bifidobacteria. The bifidobacteria counts were sufficient to yield numbers of beneficial organisms that were higher than the accepted threshold (106cfu.g-1 for a probiotic effect. Also, date adding improved the body, texture and flavor of the yoghurt.
Full Text Available Bark, especially from Acacia mangium is a by-product from wood processing industries that commonly found in Indonesiaand in big amount will cause environmental problems. One of the alternatives to utilize bark is for animal feed. The aims of this experiment are to improve the nutritive value of bark by alkali treatments (urea and sodium hydroxide and to determine the level of substitution of elephant grass by bark. The experiment consisted of 3 in vitro studies and 1 in sacco study. In vitro studies consisted of 1 the use of urea or NaOH by wetting and incubation-method, 2 the use of different concentration of Na OH (0-4% by soaking method, 3 determination of substitution level of elephant grass by treated bark. In sacco study was conducted at 0, 6, 12, 24, 48 and 72 hours of incubation to compare the degradation of treated bark to elephant grass. The results show that urea treatment did not improve DM or OM digestibilities of bark. Soaking bark in 4% NaOH solution was more effective than wetting and incubation-method in improving in vitro digestibility. (49.26% vs19.56% for soaking and dry-method, respectively. In sacco studyl shows that treated bark had a very high solubility at 0 hour incubation but the degradation at 72 hours incubation was not significantly different from that of 0 hour incubation. The gas produced at in vitro study of treated bark was very low indicated that there was no degradation of bark at all. The level of substitution of elephant grass by treated bark up to 30% gave a non-significant digestibility value to that of 100% elephant grass. In conclusion, bark after tannin-extraction was a better feedstuff for animal feed. The soaking method in 4% NaOH solution improved the digestibility of bark significantly and the level of substitution of elephant grass by treated bark was 30%.
Byker, Carmen J.; Misyak, Sarah; Shanks, Justin; Serrano, Elena L.
Farmers' markets have emerged as one health strategy to improve the access and availability of fresh foods for limited-resource audiences using federal nutrition assistance programs, although their effectiveness on dietary intake is not well understood. The review reported here evaluates the strengths and weaknesses of existing research about…
Nayan, N.; Sonnenberg, A.S.M.; Hendriks, W.H.; Cone, J.W.
Aim: This study evaluated differences between two strains of Ceriporiopsis subvermispora on improving the nutritive value and in vitro degradability of wheat straw. Methods and Results: Wheat straw was treated with the fungi for 7 weeks. Weekly samples were analysed for ergosterol content, in vitro
Nicholas, J.; Powell, R.; Smith, R.
In 2005 the Welsh Local Government Association (WLGA) commissioned the National Foundation for Educational Research (NFER) to gather evidence on local authority (LA) and school approaches to nutrition in schools in order to inform the work of the WLGA Schools Food Task and Finish Group. This report presents the findings of that research.…
Full Text Available Creativity in the learning process by teachers is very important in order to support the task at school. Teacher creativity allows teachers to apply various learning methods that encourage students' interest to learn from the classroom. Besides, creativity for teachers is needed to support student development. This study aims to determine the level of creativity of teachers through group guidance services. Subjects in this study involved 10 teachers at Gemma Insani Indonesia Depok. Data analysis used a quantitative approach with pre-test and post-test control group of one design. The results show effective group guidance to improve teacher creativity at Gemma Insani Indonesia Depok.
Full Text Available Although the school-age children’s mortality rate is low, they face diseases that keep them from succeeding in school; therefore, the objective of a School Health and Nutrition (SHN program is to improve the health and nutrition status of school children which leads to improved school performance. The program activities include iron supplementation and deworming; health and nutrition education; capacity building of partners, teachers, and students; and provision of safe drinking water and toilets. In 2009 Save the Children (SC is implementing the SHN program in four districts of Nepal reaching 1,127 primary schools and 354,170 students in the districts, representing almost 90% of enrolled children in these districts. Implementation is in partnership with local Non-Government Organizations (NGOs and in close coordination with the Department of Education (DOE and Child Health Division (CHD, Department of Health Services (DHS. In the past, many successful school based health, hygiene and nutrition programs were implemented in Nepal from time to time, but these initiatives were temporary projects. The National SHN Strategy 2006 successfully brought the two key ministries together along with other stakeholders to create a sustainable program. The National SHN Strategy 2006 emphasized implementing comprehensive SHN package by building the capacity of teachers, health workers, School Management Committees (SMC including students at all levels. Currently, the SHN program is progressing towards successful nation-wide expansion through the government system.Bien que le taux de mortalité des enfants d’âge scolaire soit faible, ces enfants sont frappés par des maladies qui les empêchent d’avoir de bons résultats scolaires ; par conséquent, l’objectif du programme School Health and Nutrition (SHN est d’améliorer la santé et la nutrition des enfants scolarisés afin d’améliorer leurs résultats. Les initiatives du programme incluent
Full Text Available Background: Changes in lifestyle and eating habits have put women at risk of obesity and overweight more than ever. This aim of this study was to investigate the effect of Pender’s Health Promotion Model (HPM to improve the nutritional behavior of overweight and obese women admitted to Fatemiyeh Hospital clinics in Hamadan, west Iran in 2015. Methods: n this quasi-experimental study, 108 eligible women were selected and randomly assigned to two groups: one experimental and one control. Data were gathered using three questionnaires: demographics, Pender’s HPM constructs, and nutritional behavior. The questionnaires were filled out by both groups as pre-test and two months later. A Pender’s HPM-based intervention was conducted for the experimental group. The data were analyzed by paired and independent t-tests, ANCOVA, and Spearmans’ correlation coefficient in SPSS/16. The level of significance was considered to be <0.05. Results: The mean score of nutritional behavior was 41.75±3.28 and 42.36±3.69 before the intervention and 79.09±5.27 and 49.72±9.49 after it in the experimental and control groups, respectively. The difference was significant only between before and after the intervention in the experimental group (P<0.001. Furthermore, the mean scores of the following variables were significantly different between before and after the intervention in the experimental group: nutritional behavior, perceived benefits, perceived self-efficacy, commitment to action, interpersonal and situational influences, behavior-related affect, and perceived barriers (P<0.001. Conclusion: The results showed that Pender’s HPM-based training improved nutritional behavior and some constructs of the model. Therefore, this educative model can be used by healthcare providers to improve the nutritional and other health promoting behaviors.
Hai Viet Nguyen
Full Text Available Background: Despite substantial achievement in reducing malnutrition rates in Vietnam, there has been an increasing rate of overweight individuals in urban areas, which may result in a high burden of non-communicable diseases. Nutritional counseling clinics have been introduced in several settings; however, little is known about the preference for this service among urban clients. This study aimed to assess the preference and willingness to pay (WTP for nutritional counseling services among urban clients. Methods: We interviewed 429 clients who attended Hanoi Medical University Nutritional Counseling Clinic (Hanoi, Vietnam. WTP was determined using double-bounded dichotomous-choice questions and open-ended questions. Results: In total, 78.6% respondents were willing to use nutritional counseling services. The mean amount of WTP for one-time service and one-year package was 96,100VND (~$4.3 and 946,400VND (~$41.9, respectively. Clients’ willingness to use the service was higher among females, those seeking counseling for elderly people and those who preferred face-to-face counseling services (p<0.05. WTP was higher among those who were over 35 years old, those seeking services for the elderly people, those having poor nutritional status, and those having under-6 year old children (p<0.05. Conclusions: The preference and WTP for nutritional counseling services in urban Hanoi were relatively high. Scaling up this service is necessary to actively prevent and control the spread of non-communicable diseases.
Negash, Canaan; Belachew, Tefera; Henry, Carol J; Kebebu, Afework; Abegaz, Kebede; Whiting, Susan J
Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. A baseline survey of 200 eligible, randomly selected mother-child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved (p nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.
Burton, K L O; Bau, K; Lewis, J; Aroyan, K R; Botha, B; Botman, A G M; Stewart, K; Waugh, M-C A; Paget, S P
The decision for families to proceed with botulinum toxin-A (BoNT-A) injections for managing childhood conditions involving hypertonia can be complex. Family-centred care is a service model that facilitates supporting families in this decision-making process. Understanding families' experiences of services is critical to developing family-centred care. The aim of this project was therefore to increase understanding of the experiences of families of children attending a BoNT-A service in order to improve the service and its family-centred approach to care. Sixteen staff of a BoNT-A service participated in a patient journey mapping exercise. Nine families of the service participated in in-depth interviews. Interviews were audio-recorded and transcribed verbatim. Data from the staff session and interviews were analysed independently using grounded, hermeneutic thematic analysis. Staff sessions revealed 5 core themes that related to impacting on the family experience. Family interviews revealed 4 core themes, with 7 subthemes and 1 latent theme. Areas of importance identified by families relating to BoNT-A treatment included acknowledgement of individual needs, care coordination, empowerment of families and patients, consistency in service delivery, and the distressing nature of appointment and decision-making. Comparison of the data from the staff patient journey mapping and family interviews suggested that staff have a good but incomplete understanding of the factors important to families, highlighting the need for consumer engagement in establishing family-centred care. The themes identified can guide the provision of family-centred BoNT-A injection clinics. © 2017 John Wiley & Sons Ltd.
Full Text Available Although entomopathogenic fungi (EPF are best known for their ability to protect crops against insect pests, they may have other beneficial effects on their host plants. These effects, which include promoting plant growth and conferring resistance against abiotic stresses, have been examined in recent years to acquire a better understanding of them. The primary purposes of the present study were (i to ascertain in vitro whether three different strains of EPF (viz., Metarhizium, Beauveria and Isaria would increase the Fe bioavailability in calcareous or non-calcareous media containing various Fe sources (ferrihydrite, hematite and goethite and (ii to assess the influence of the EPF inoculation method (seed dressing, soil treatment or leaf spraying on the extent of the endophytic colonization of sorghum and the improvement in the Fe nutrition of pot-grown sorghum plants on an artificial calcareous substrate. All the EPFs studied were found to increase the Fe availability during the in vitro assay. The most efficient EPF was M. brunneum EAMa 01/58-Su, which lowered the pH of the calcareous medium, suggesting that it used a different strategy (organic acid release than the other two fungi that raised the pH of the non-calcareous medium. The three methods used to inoculate sorghum plants with B. bassiana and M. brunneum in the pot experiment led to differences in re-isolation from plant tissues and in the plant height. These three inoculation methods increased the leaf chlorophyll content of young leaves when the Fe deficiency symptoms were most apparent in the control plants (without fungal inoculation as well as the Fe content of the above-ground biomass in the plants at the end of the experiment. The total root lengths and fine roots were also increased in response to fungal applications with the three inoculation methods. However, the soil treatment was the most efficient method; thus, its effect on the leaf chlorophyll content was the most
Amaral, Creusa Sayuri Tahara; Rozenfeld, Henrique; Costa, Janaina Mascarenhas Hornos; Magon, Maria de Fátima de Andrade; Mascarenhas, Yvone Maria
The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) ). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Stoneman, Alice; Atkinson, David; Davey, Maureen; Marley, Julia V
Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI. A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change. Well
Wendy A. Abbott
Full Text Available Objective - To demonstrate how evidence based practice has contributed to informaing decisions and resolving issues if concern in service delivery at Bond University Librray. Methods - This paper critically analyses three evidence based research projects conducted at Bond University Library. Each project combined a range of research methods including surveys, literature reviews and the analysis of internal performance data to find solutions to problems in library service delivery. The first research project investigated library opening hours and the feasability of twenty-four hour opening. Another project reseached questions about the management of a collection of feature films on DVD and video. The thrd project investigated issues surrounding the teaching of EndNote to undergarduate students. Results - Despite some deficiencies in the methodologies used, each evidence based research project had positive outcomes. One of the highlights asn an essential feature of the process at Bond University Library was the involvement of stakeholders. The ability to build consensus and agree action plans with stakeholders was an important outcome of that process. Conclusion - Drawing on the experience of these research projects, the paper illustrates the benefits of evidence based information practice to stimulate innovation and improve library services. Librarians, like most professionals, need to continue to develop the skills and a culture to effectively carry out evidence based practice.
Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason
Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060
Hoopingarner, K.R.; Zaloudek, F.R.
Recent NRC sponsored aging research work on nuclear service diesel generators has resulted in a recommendation that an improved engine management program should be adopted for aging mitigation and reliability improvement. The center of attention should be to ensure diesel-generator operational readiness. This report emphasizes a ''healthy engine concept'' and recommends parameters to be monitored to determine engine condition. The proposed program and approach recommended in this report represent balanced management where diesel generator testing, inspections, monitoring, trending, training, and maintenance all have appropriate importance. Fast-starting and fast-loading test of nuclear service diesels causes very rapid wear of certain engine components. This report documents this aging and wear mechanism and recommends ways to largely eliminate this unique aging stressor. Current periodic intrusive maintenance and engine overhaul practice have been found to be less favorable for safety assurance than engine overhauls based on monitoring and trending results or on a need to correct specific engine defects. This report recommends that the periodic overhaul requirements be re-evaluated. Diesel generator research on aging and wear is sponsored by the US Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research. The research reported in this report was conducted by Pacific Northwest Laboratory (PNL), which is operated for the Department of Energy by Battelle Memorial Institute. 23 refs., 3 figs., 8 tabs
Clarkson, Michael; Migaud, Herve; Metochis, Christoforos; Vera, Luisa M; Leeming, Daniel; Tocher, Douglas R; Taylor, John F
The present study investigated nutritional programming in Atlantic salmon to improve utilisation of a vegetable-based diet. At first exogenous feeding, fry were fed either a marine-based diet (Diet Mstimulus, 80% fishmeal (FM)/4% fish oil (FO)) or a vegetable-based diet (Diet Vstimulus, 10% FM/0% FO) for 3 weeks. Subsequently, all fish were then fed under the same conditions with a commercial, marine-based, diet for 15 weeks and thereafter challenged with a second V diet (Diet Vchallenge, 10% FM/0% FO) for 6 weeks. Diploid and triploid siblings were run in parallel to examine ploidy effects. Growth performance, feed intake, nutrient utilisation and intestinal morphology were monitored. Fish initially given Diet Vstimulus (V-fish) showed 24 % higher growth rate and 23 % better feed efficiency compared with M-fish when later challenged with Diet Vchallenge. There was no difference in feed intake between nutritional histories, but increased nutrient retentions highlighted the improved utilisation of a V diet in V-fish. There were generally few significant effects of nutritional history or ploidy on enteritis scores in the distal intestine after the challenge phase as only V-triploids showed a significant increase (Pnutritional programming and the ability to respond better when challenged later in life may be attributed to physiological and/or metabolic changes induced by the stimulus. This novel study showed the potential of nutritional programming to improve the use of plant raw material ingredients in feeds for Atlantic salmon.
Morrison, D.; Barnes, R. J.; Potter, M.; Nylund, S. R.; Patrone, D.; Weiss, M.; Talaat, E. R.; Sarris, T. E.; Smith, D.
The great promise of Virtual Observatories is the ability to perform complex search operations across the metadata of a large variety of different data sets. This allows the researcher to isolate and select the relevant measurements for their topic of study. The Virtual ITM Observatory (VITMO) has many diverse geophysical datasets that cover a large temporal and spatial range that present a unique search problem. VITMO provides many methods by which the user can search for and select data of interest including restricting selections based on geophysical conditions (solar wind speed, Kp, etc) as well as finding those datasets that overlap in time. One of the key challenges in improving discoverability is the ability to identify portions of datasets that overlap in time and in location. The difficulty is that location data is not contained in the metadata for datasets produced by satellites and would be extremely large in volume if it were available, making searching for overlapping data very time consuming. To solve this problem we have developed a series of light-weight web services that can provide a new data search capability for VITMO and others. The services consist of a database of spacecraft ephemerides and instrument fields of view; an overlap calculator to find times when the fields of view of different instruments intersect; and a magnetic field line tracing service that maps in situ and ground based measurements to the equatorial plane in magnetic coordinates for a number of field models and geophysical conditions. These services run in real-time when the user queries for data. They will allow the non-specialist user to select data that they were previously unable to locate, opening up analysis opportunities beyond the instrument teams and specialists, making it easier for future students who come into the field.
Andreas C. Soteriou; Richard B. Chase
Delivering high quality service during the service encounter is central to competitive advantage in service organizations. However, achieving such high quality while controlling for costs is a major challenge for service managers. The purpose of this paper is to present an approach for addressing this challenge. The approach entails developing a model linking service process operational variables to service quality metrics to provide guidelines for service resource allocation. The approach en...
Full Text Available Consuming a balanced diet, such as the food groups represented on MyPlate, is key to improving health disparities. Despite the best of intentions, however, the dietary guidelines can be culturally challenging, particularly when it comes to dairy consumption. Many African and Hispanic Americans avoid milk and dairy products—key contributors of three shortfall nutrients (calcium, potassium and vitamin D—because many people in these populations believe they are lactose intolerant. However, avoiding dairy can have significant health effects. An emerging body of evidence suggests that yogurt and other dairy products may help support reduced risk of heart disease, hypertension, obesity, and type 2 diabetes—conditions that disproportionately impact people of color. For this reason, the National Medical Association and the National Hispanic Medical Association issued a joint consensus statement recommending African Americans consume three to four servings of low-fat dairy every day. Cultured dairy products could play an important role in addressing these recommendations. Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children.
Full Text Available Rice straw is an important roughage resource for ruminants in many rice-producing countries. In this study, a rice brittle mutant (BM, mutation in OsCesA4, encoding cellulose synthase and its wild type (WT were employed to investigate the effects of a cellulose synthase gene mutation on rice straw morphological fractions, chemical composition, stem histological structure and in situ digestibility. The morphological fractions investigation showed that BM had a higher leaf sheath proportion (43.70% vs 38.21%, p0.05 was detected in neutral detergent fiber (NDFom and ADL contents for both strains. Histological structure observation indicated that BM stems had fewer sclerenchyma cells and a thinner sclerenchyma cell wall than WT. The results of in situ digestion showed that BM had higher DM, NDFom, cellulose and hemicellulose disappearance at 24 or 48 h of incubation (p<0.05. The effective digestibility of BM rice straw DM and NDFom was greater than that of WT (31.4% vs 26.7% for DM, 29.1% vs 24.3% for NDFom, p<0.05, but the rate of digestion of the slowly digested fraction of BM rice straw DM and NDF was decreased. These results indicated that the mutation in the cellulose synthase gene could improve the nutritive value of rice straw for ruminants.
Castillo, Carlos Fernando; Alvarez, Elizabeth; Gomez, Eduardo; Llano, German; Castano Zapata, Jairo
The downy mildew (Peronospora sparsa), is one of the most important diseases of rose in Colombia, causing losses up to 8%. The objective of this research was to determine a preventive control of the disease, through the improvement of the nutritional balance of the plant. The first phase, involved the effect of different concentrations of N, K, Ca, B and Mn, on the incidence and severity of the disease, and in the second one, the evaluation of the best five treatments of the first phase. The treatments were applied to the varieties Charlotte, Classy and Malibu during 4 weeks, using a splitting plot design with six replications. After one month the plants were inoculated with the fungus at a concentration of 3x104 sporangia mL. The results of the area under the disease progress curve (AUDPC), showed that the plants of Charlotte with 200 ppm of Si had the lowest expression of the disease. In Classy, the best treatment was the standard solution, demonstrating that the effects of the treatments depend of the variety. Charlotte and Malibu showed susceptibility, while Classy, partial resistance to the disease.
Lu HE,Bin ZHANG,Xingchun WANG,Hongying LI,Yuanhuai HAN
Full Text Available Foxtail millet is a minor yet important crop in some areas of the world, particularly northern China. It has strong adaptability to abiotic stresses, especially drought, and poor soil. It also has high nutritional value. Foxtail millet is rich in essential amino acids, fatty acids and minerals, and is considered to be one of the most digestible and non-allergenic grains available and has significant importance for human health. Given foxtail milletrsquo;s ability to adapt to abiotic stresses associated with climate change, it is more important than ever to develop breeding strategies that facilitate the increasing demand for high quality grain that better satisfies consumers. Here we review research on foxtail millet quality evaluation, appearance, cooking and eating quality at the phenotypic level. We review analysis of the main nutrients in foxtail millet, their relationships and the biochemical and genetic factors affecting their accumulation. In addition, we review past progress in breeding this regionally important crop, outline current status of breeding of foxtail millet, and make suggestions to improve grain quality.
Full Text Available Organically produced chicken eggs have more nutritional and sensory properties, and they do not contain any harmful substances to the health of the consumer. Research has shown that, unlike what is expected, there is no significant difference between dry matter, lipid and fatty acids of eggs produced in cages and organic. It has been reported that sold the organic egg about two times fee according to the cage egg has only psychological and ethical motivation. The Council of the European Union considers it necessary for chickens to have access to green roughage materials as well as basal rations in the production of organic eggs. However, if this access is provided, the organically produced egg may respond to consumer expectations. The studies shows that the 4m2 outdoor area allocated per chicken according to Turkey's Organic Agriculture Legislation is not enough to meet these demands. This situation necessitate an increase in the outdoor area separated to the chickens so as to provide rotation with the various plants or the supply of additional green feed materials to the outdoor area. Thus, in addition to obtaining a product with functional food characteristics, a production mode in which animal welfare is increased by the decrease of pecking and cannibalism will be attained. In this review, it is mentioned what applications are increasing the chemical contents such as carotenoids, fatty acids and improving the sensory properties such as color, smell and taste in organic egg production.
Al-Masri, M. R.
The effects of 100 KGy of gamma irradiation on dry matter and organic matter digestibility determined in vitro to improve the nutritive value of three types of blocks containing different feed stuffs were investigated. The compositions of the blocks were type I (wheat bran 28%, dried poultry manure 31%, molasses 20%, urea 10%, Ca(OH)2 6%, salt 5%). Type II (wheat bran 22%, dried poultry manure 10%, sugarbeet 30%, molasses 20%, urea 8%, Ca(OH)2 6%, salt 4%). Type III (olive-oil cake 35%. Wheat bran 30%, urea 100%, cement 15%, salt 10%). The results indicate that there was a significant difference (0.05) between the treated samples and the control for NDF, dry matter and organic matter digestibility. Gamma irradiation resulted in a significant increase (P<0.05) in dry matter and organic matter digestibility and a significant decrease (P<0.05) in NDF contents for the three types of feed blocks. Dry matter digestibility increased by 5% for all block types whereas organic matter digestibility increased by 7%, and 10% for block types I, II and III respectively. The increase in organic matter digestibility was probably due to a decrease in NDF content resulting from gamma irradiation. NDF decreased by 25%, 19% and 16% for block types I, II and III respectively. (author). 23 refs., 4 figs., 2 tabs
Košutić Milenko B.
Full Text Available This paper investigates the effects of simultaneous addition of sunflower (3, 6 or 9 g/100 g of sample and dry residue of wild oregano (0.5 or 1 g/100 g of sample on the essential amino acids pattern and antioxidant potential of flake products. The accepted experimental design plan was 34. Data point that Score and PDCAAS values in flake products increase with increasing share of sunflower. Maximum value of phenolic compounds and antioxidant activity were experienced of TPC 2.84 mg/g, DPPH 0.75 mg/ml, FRAP 1.57 mg/g with the product having maximum shares of sunflower and dry residue of wild oregano. Tukey’s HSD test showed statistically significant differences between most of the mean values of amino acids content and antioxidant activity in the observed corn flakes. The response surface method has been applied for evaluation of amino acid content and antioxidative potential of corn flakes. Sunflower in flake products positively contributed to the protein nutritive value and dry residues of wild oregano elevated antioxidant potential of flake products and also contributed to the food waste valorisation in the food industry. Corn flakes are new products with improved essential amino acid pattern, antioxidant activity and functional properties due to added dry residue of wild oregano and sunflower. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 46005 and Grant no. TR 31027
Dreznik, Yael; Horesh, Nir; Gutman, Mordechai; Gravetz, Aviad; Amiel, Imri; Jacobi, Harel; Zmora, Oded; Rosin, Danny
Preoperative preparation of patients with Crohn's disease is challenging and there are no specific guidelines regarding nutritional support. The aim of this study was to assess whether preoperative nutritional support influenced the postoperative outcome. A retrospective, cohort study including all Crohn's disease patients who underwent abdominal surgery between 2008 and 2014 was conducted. Patients' characteristics and clinical and surgical data were recorded and analyzed. Eighty-seven patients were included in the study. Thirty-seven patients (42.5%) received preoperative nutritional support (mean albumin level 3.14 vs. 3.5 mg/dL in the non-optimized group; p nutritional status prior to surgery. Preoperative albumin level, after adequate nutritional preparation, was similar between the 2 groups. The 2 groups differ neither in demographic and surgical data, overall post-op complication (p = 0.85), Clavien-Dindo score (p = 0.42), and length of stay (p = 0.1). Readmission rate was higher in the non-optimized group (p = 0.047). Nutritional support can minimize postoperative complications in patients with low albumin levels. Nutritional status should be optimized in order to avoid hazardous complications. © 2017 S. Karger AG, Basel.
Full Text Available Leucaena silage was supplemented with different levels of molasses and urea to study its nutritive value and in vitro rumen fermentation efficiency. The ensiling study was randomly assigned according to a 3×3 factorial arrangement in which the first factor was molasses (M supplement at 0%, 1%, and 2% of crop dry matter (DM and the second was urea (U supplement as 0%, 0.5%, and 1% of the crop DM, respectively. After 28 days of ensiling, the silage samples were collected and analyzed for chemical composition. All the nine Leucaena silages were kept for study of rumen fermentation efficiency using in vitro gas production techniques. The present result shows that supplementation of U or M did not affect DM, organic matter, neutral detergent fiber, and acid detergent fiber content in the silage. However, increasing level of U supplementation increased crude protein content while M level did not show any effect. Moreover, the combination of U and M supplement decreased the content of mimosine concentration especially with M2U1 (molasses 2% and urea 1% silage. The result of the in vitro study shows that gas production kinetics, cumulation gas at 96 h and in vitro true digestibility increased with the increasing level of U and M supplementation especially in the combination treatments. Supplementation of M and U resulted in increasing propionic acid and total volatile fatty acid whereas, acetic acid, butyric acid concentrations and methane production were not changed. In addition, increasing U level supplementation increased NH3-N concentration. Result from real-time polymerase chain reaction revealed a significant effect on total bacteria, whereas F. succinogenes and R. flavefaciens population while R. albus was not affected by the M and U supplementation. Based on this study, it could be concluded that M and urea U supplementation could improve the nutritive value of Leucaena silage and enhance in vitro rumen fermentation efficiency. This study also
Raphael, Bram P; Schumann, Caitlin; Garrity-Gentille, Sara; McClelland, Jennifer; Rosa, Carolyn; Tascione, Christina; Gallotto, Mary; Takvorian-Bené, Melissa; Carey, Alexandra N; McCarthy, Patrick; Duggan, Christopher; Ozonoff, Al
Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016. We excluded patients with a history of HPN and strictly palliative care goals. Univariate analysis was performed for primary outcomes: Community-acquired CLABSI and 30-day readmission rate. Twenty-six families participated in the pilot initiative with median (interquartile range) patient age 1.5 (5.7) years old, diagnosis of short bowel syndrome in 16 (62%), and in-state residence in 17 (55%). Ishikawa (fishbone) diagram identified causes of post-discharge HPN complications. Areas of focus during telemedicine visit included central venous catheter care methods, materials, clinical concerns, and equipment. Compared to historical comparison group, the telemedicine group experienced CLABSI rates of 1.0 versus 2.7 per 1,000 line days and readmission rates of 38% versus 17% (p = 0.03, 0.02, respectively). Telemedicine visits identified opportunities for improvement for families newly discharged on HPN. In a small cohort of patients who experienced telemedicine visits, we found lower CLABSI rates alongside higher readmission rates compared with a historical comparison group. Further studies are needed to optimize telemedicine in delivering care to this high-risk population.
Amiri, Parisa; Hamzavi Zarghani, Najmeh; Nazeri, Pantea; Ghofranipour, Fazlollah; Karimi, Mehrdad; Amouzegar, Atieh; Mirmiran, Parvin; Azizi, Fereidoun
Because of their increased need for iodine, pregnant women are among the high-risk groups for iodine deficiency. The purpose of this study was to evaluate the effectiveness of an educational program on the iodine nutrition status of pregnant women. In this randomized controlled trial, 100 pregnant women were randomly selected from five healthcare centers in the southern region of Tehran, the capital of Iran. In the intervention group, pregnant women received a four-month educational program, which included two face-to-face educational sessions, using a researcher-designed educational pamphlet in the second and third trimesters, and two follow-up telephone calls. Knowledge, attitude, and practice (KAP) scores, urinary iodine concentration (UIC), and salt iodine content were assessed at baseline and four months after the intervention. At baseline, there were significant associations between knowledge and attitude (r = 0.38, p = 0.03) between practice and UIC (r = 0.28, p = 0.01) and between UIC and iodine content of salt (r = 0.24, p = 0.009). Although a significant difference was found in mean KAP scores between the two groups after the educational intervention, scores were significantly higher in the intervention group compared with controls (p educational intervention increasing KAP among women regarding the importance of iodine and iodized salt consumption during pregnancy, their iodine status did not improve. Considering the main socio-environmental determinants of iodine deficiency, in particular, the monitoring of salt fortification, prescribing iodine containing supplements as well as improving health literacy in pregnant women seem essential strategies.
Vi, Minhthuan; Yang, Xueqin; Zeng, Xianlu; Chen, Rui'an; Guo, Liqiong; Lin, Junfang; He, Qianyun; Zheng, Qianwang; Wei, Tao
Hericium erinaceus is a popular culinary and medicinal mushroom in China because of its broad beneficial effects. In this study we evaluated the effects of stimulation with 7 growth regulators at 5 different concentrations on improving the production of nutritional and bioactive compounds by H. erinaceus. Results showed that among all the tested regulators, gibberellic acid (GA) increased protein content (165%), free amino acids (100%), polysaccharides (108%), and polyphenols (26%). Spraying nephthyl acetic acid increased polysaccharides and triterpenoids to 4.37 and 17.27 g/100 g, respectively. Spraying chitosan significantly increased polyphenols by 42%. The addition of triacontanol, indole acetic acid, and 2,4-dichlorophenoxyacetic acid improved the production of proteins, free amino acids, polysaccharides, and polyphenols, but not to the extent that GA did. These results indicate that adding certain growth regulators can effectively improve the production of nutritional and bioactive compounds in H. erinaceus.
Batura, Neha; Hill, Zelee; Haghparast-Bidgoli, Hassan; Lingam, Raghu; Colbourn, Timothy; Kim, Sungwook; Sikander, Siham; Pulkki-Brannstrom, Anni-Maria; Rahman, Atif; Kirkwood, Betty; Skordis-Worrall, Jolene
There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation at scale is seldom possible without first considering the relative cost and cost-effectiveness of these interventions. An evidence gap in this area may deter large-scale implementation, particularly in low- and middle-income countries. We conduct a literature review to establish what is known about the cost-effectiveness of early childhood nutrition and development interventions. A set of predefined search terms and exclusion criteria standardized the search across five databases. The search identified 15 relevant articles. Of these, nine were from studies set in high-income countries and six in low- and middle-income countries. The articles either calculated the cost-effectiveness of nutrition-specific interventions (n = 8) aimed at improving child growth, or parenting interventions (stimulation) to improve early childhood development (n = 7). No articles estimated the cost-effectiveness of combined interventions. Comparing results within nutrition or stimulation interventions, or between nutrition and stimulation interventions was largely prevented by the variety of outcome measures used in these analyses. This article highlights the need for further evidence relevant to low- and middle-income countries. To facilitate comparison of cost-effectiveness between studies, and between contexts where appropriate, a move towards a common outcome measure such as the cost per disability-adjusted life years averted is advocated. Finally, given the increasing number of combined nutrition and stimulation interventions being tested, there is a significant need for evidence of cost
A disease-specific enteral nutrition formula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: results of a randomized, controlled, multicenter trial.
Fietkau, Rainer; Lewitzki, Victor; Kuhnt, Thomas; Hölscher, Tobias; Hess, Clemens-F; Berger, Bernhard; Wiegel, Thomas; Rödel, Claus; Niewald, Marcus; Hermann, Robert M; Lubgan, Dorota
In patients with head and neck and esophageal tumors, nutritional status may deteriorate during concurrent chemoradiotherapy (CRT). The aim of this study was to investigate the influence of enteral nutrition enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on body composition and nutritional and functional status. In a controlled, randomized, prospective, double-blind, multicenter study, 111 patients with head and neck and esophageal cancer undergoing concurrent CRT received either an enteral standard nutrition (control group) or disease-specific enteral nutrition Supportan®-containing EPA+DHA (experimental group) via percutaneous endoscopic gastrostomy. The primary endpoint was the change of body cell mass (BCM) following CRT at weeks 7 and 14 compared with the baseline value. Secondary endpoints were additional parameters of body composition, anthropometric parameters, and nutritional and functional status. The primary endpoint of the study, improvement in BCM, reached borderline statistical significance. Following CRT, patients with experimental nutrition lost only 0.82 ± 0.64 kg of BCM compared with 2.82 ± 0.77 kg in the control group (P = .055). The objectively measured nutritional parameters, such as body weight and fat-free mass, showed a tendency toward improvement, but the differences were not significant. The subjective parameters, in particular the Kondrup score (P = .0165) and the subjective global assessment score (P = .0065) after follow-up improved significantly in the experimental group, compared with the control group. Both enteral regimens were safe and well tolerated. Enteral nutrition with EPA and DHA may be advantageous in patients with head and neck or esophageal cancer by improving parameters of nutritional and functional status during CRT. © 2013 American Cancer Society.
Full Text Available This research aims to identify the current state of process management for municipal subsidies and is proposing to improve the process by reducing motion, deadlines and excessive actions and to eliminate duplication of processes and overproduction. Time spent and process effi ciency is the subject tackled in this research. Several areas of action that affect the overall process as departments, regulations, time, experts, movements, materials and procedures have been explored. Lean six sigma/DMAIC model is used as an adequate mechanism for the implementation of this project which aims to improve the quality of service. The result of the research is not limited to only one specific process, the applied model in this study can be used to improve many processes in municipalities. Currently, in order to receive a fi nal response from municipal authorities for subsidies allocation, 41hr of process time, 160 hr of calendar time and 232 hr of wait time are needed. The process effi ciency is only 10%.
Heijden, van der G.A.H.; Schepers, J.J.L.; Nijssen, E.J.; Ordanini, A.
This study examines how frontline service employees (FSEs) can learn from recovery services and improve their performance accordingly. While research recognizes that FSEs can fulfill an innovation role by sourcing customer knowledge and developing ideas for performance improvement, it remains
Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John
Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830
Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio
a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic...
Shaw, Dorothy; Cook, Rebecca J
Universal access to reproductive health is a target of Millennium Development Goal (MDG) 5B, and along with MDG 5A to reduce maternal mortality by three-quarters, progress is currently too slow for most countries to achieve these targets by 2015. Critical to success are increased and sustainable numbers of skilled healthcare workers and financing of essential medicines by governments, who have made political commitments in United Nations forums to renew their efforts to reduce maternal mortality. National essential medicine lists are not reflective of medicines available free or at cost in facilities or in the community. The WHO Essential Medicines List indicates medicines required for maternal and newborn health including the full range of contraceptives and emergency contraception, but there is no consistent monitoring of implementation of national lists through procurement and supply even for basic essential drugs. Health advocates are using human rights mechanisms to ensure governments honor their legal commitments to ensure access to services essential for reproductive health. Maternal mortality is recognized as a human rights violation by the United Nations and constitutional and human rights are being used, and could be used more effectively, to improve maternity services and to ensure access to drugs essential for reproductive health. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available All academic information on the web or elsewhere has its creator, that is, a subject who has created the information. The subject can be an individual, a group, or an institution, and can be a nation depending on the nature of the relevant information. Most information is composed of a title, an author, and contents. An essay which is under the academic information category has metadata including a title, an author, keyword, abstract, data about publication, place of publication, ISSN, and the like. A patent has metadata including the title, an applicant, an inventor, an attorney, IPC, number of application, and claims of the invention. Most web-based academic information services enable users to search the information by processing the meta-information. An important element is to search information by using the author field which corresponds to a personal name. This study suggests a method of efficient indexing and using the adjacent operation result ranking algorithm to which phrase search-based boosting elements are applied, and thus improving the accuracy of the search results of personal names. It also describes a method for providing the results of searching co-authors and related researchers in searching personal names. This method can be effectively applied to providing accurate and additional search results in the academic information services.
van Veen, Merel R; Hoedjes, Meeke; Versteegen, Joline J; van de Meulengraaf-Wilhelm, Nienke; Kampman, Ellen; Beijer, Sandra
To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed among those nurses. . A cross-sectional study. . A web-based survey among oncology nurses in the Netherlands. . 355 oncology nurses provided advice on nutrition; of these, 327 provided advice on PA. . From May to July 2013, oncology nurses were invited to complete an online questionnaire. Pearson's chi-squared tests and uni- and multivariate logistic regression analyses were conducted. . Oncology nurses' perception of having sufficient or insufficient knowledge to be able to provide advice on nutrition and PA, the content of the advice, and the information sources on which the advice was based. . 43% of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition, and 46% perceived insufficient knowledge to provide advice on PA. Factors associated with perceiving insufficient knowledge on nutrition were being aged younger, having lower education, and providing counseling during treatment only. Those nurses were more likely to suggest taking oral nutritional supplements or visiting a dietitian and were less likely to provide information on fluid intake. Nurses perceiving insufficient knowledge about PA used oncology guidelines less often. . Almost half of the oncology nurses providing advice on nutrition and PA perceived themselves as having insufficient knowledge to be able to provide such advice. In particular, younger oncology nurses and oncology nurses with an intermediate vocational education may benefit most from education about these topics. . Educational training for oncology nurses should include nutrition and PA. Oncology nurses should collaborate with dietitians to discuss what information should be provided to patients by
Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.
Robert, Rebecca C; Creed-Kanashiro, Hilary M; Villasante, Ruben; Narro, M Rocio; Penny, Mary E
Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.
Venner, Mary Ann; Keshmiripour, Seti
This article will describe how merging service points in an academic library is an opportunity to improve customer service and utilize staffing resources more efficiently. Combining service points provides libraries with the ability to create a more positive library experience for patrons by minimizing the ping-pong effect for assistance. The…
Suyama, Yohji; Adachi, Kyoichi; Notsu, Yoshitomo; Satoh, Emi; Nariai, Yukiko; Hashimoto, Yohko; Sumi, Asako; Kawaguchi, Mikiko; Ishimura, Norihisa
Serum prealbumin level is useful for assessment of changes in nutritional status but it is markedly affected by the inflammation. In this study, we examined the efficacy of the corrected rapid turnover protein increment index (CRII) for prealbumin, which is calculated as [prealbumin level/C-reactive protein (CRP) level on the assessment day]/[prealbumin level/CRP level on the day of starting nutritional care], for prediction of improvement of nutritional status in patients with malnutrition. ...
Curriculum Review, 2008
When former chef and food broker, Tony Geraci was invited by his district superintendent to review New Hampshire's largest school food service program, he never imagined that he would be responsible for running one of the nation's most successful sustainable food service programs. The CONVAL District sustainable food program, create by Geraci and…
Akulima, Muhamed; Ikamati, Rudia; Mungai, Margaret; Samuel, Muhula; Ndirangu, Meshack; Muga, Richard
Estimated 236,548 People Living with HIV (PLHIV) were in Central-Eastern Kenya in 2013. Kiambu County had 46,656 PLHIV with 42,400 (91%) adults and 4,200(9%) children (1-14yrs). Amref Health Africa in Kenya, supported through USAID-APHIAplus KAMILI project, initiated two food banks to respond to poor nutritional status of the HIV infected children. Quality Improvement Teams were used to facilitate food-banking initiatives. The study aimed at assessing and demonstrating roles of community food-banking in improving nutrition status of HIV-infected children in food insecure regions. A pre and post-test study lasting 12 months (Oct 2013 to September 2014) conducted in Kiambu County, Kenya covering 103 HIV infected children. Two assessments were conducted before and after the food banking initiative and results compared. Child Status Index (CSI) and the Middle Upper Arm Circumference (MUAC) tools were used in data collection at households. Paired T-test and Wilcoxon test were applied for analysing MUAC and CSI scores respectively using the SPSS. There was a significant improvement in the children's nutrition status from a rating of 'bad' in CSI Median (IQR) score 2(2-1) before food banking to a rating of 'fair' in CSI Median (IQR) score 3(4-3) after food banking intervention (p=banking (p=banking is a community-based nutritional intervention that can address factors of food access, affordability and availability. Food banking is a sustainable way to contribute to quality nutrition and reduced related deaths among HIV infected children.
Stobaugh, Heather C; Bollinger, Lucy B; Adams, Sara E; Crocker, Audrey H; Grise, Jennifer B; Kennedy, Julie A; Thakwalakwa, Chrissie; Maleta, Kenneth M; Dietzen, Dennis J; Manary, Mark J; Trehan, Indi
Background: Children who recover from moderate acute malnutrition (MAM) have high rates of relapse in the year after nutritional recovery. Interventions to decrease these adverse outcomes are needed to maximize the overall effectiveness of supplemental feeding programs (SFPs). Objective: We evaluated the effectiveness of a package of health and nutrition interventions on improving the proportion of children who sustained recovery for 1 y after MAM treatment. We further explored factors related to sustained recovery. Design: We conducted a cluster-randomized clinical effectiveness trial involving rural Malawian children aged 6-62 mo who were enrolled on discharge from an SFP for MAM. We enrolled 718 children at 10 control sites and 769 children at 11 intervention sites. In addition to routine health and nutrition counseling, the intervention group received a package of health and nutrition interventions that consisted of a lipid nutrient supplement, deworming medication, zinc supplementation, a bed net, and malaria chemoprophylaxis. A survival analysis was used to determine the effectiveness of the intervention as well as to identify factors associated with sustained recovery. Results: Of 1383 children who returned for the full 12-mo follow-up period, 407 children (56%) and 347 children (53%) sustained recovery in the intervention and control groups, respectively. There was no significant difference in relapse-free survival curves between the treatment and control groups ( P = 0.380; log-rank test). The risk factors for relapse or death after initial recovery were a smaller midupper arm circumference on SFP admission ( P = 0.01) and discharge ( P nutrition services in addition to traditional SFP treatment has no significant effect on improving sustained recovery in children after treatment of MAM. This trial was registered at clinicaltrials.gov as NCT02351687. © 2017 American Society for Nutrition.
Jordan, Irmgard; Kuchenbecker, Judith; Reinbott, Anika; Krawinkel, Michael B; Muehlhoff, Ellen
Full text: Poor nutritional status in early infancy is associated with growth faltering and increased risk for morbidity. Main causes for undernutrition are a diet poor in quality and quantity, feeding practices, and hygiene. Programmes emphasize on affordable ways for improving diets for low-income families. Little is known about the period needed for behaviour changes. Longitudinal studies were conducted in Malawi and Cambodia looking at infant and young child feeding as well as growth of children below two years. At baseline 6-9 months old children and their caregivers participating in a nutrition education(NE) program of FAO were invited. The recruited children were matched by age (days) and sex with children living in an area without NE (control). Baseline data was collected prior the NE carried out by trained volunteers twice a month based on locally adopted teaching materials. The children and their caregivers were visited every three months for a total period of 12 months. At baseline the mean age of the children in Malawi was 227 days, all breastfed (n = 149). In Cambodia the mean age was 230 days and 90% of them were still breastfed (n = 96). The mean HAZ was -1.53 in Malawi and -0.87 in Cambodia. Minimum acceptable diet(MAD) was received by 42% and 34% of the children in the intervention areas of Malawi and Cambodia respectively. After three months MAD was achieved by 88% in Malawi and 45% in Cambodia. The rates in the control area in Malawi increased as well from 22% at baseline to 52% three months later. A similar change could be observed in Cambodia with 28% of the children receiving MAD at baseline and 38% three months later. Hygiene behaviour was one focus of the NE in both countries. In Malawi soap usage before feeding the child increased to 32% (p< 0.001), and before food preparation to 33% (both p < 0.001). Also washing before eating the food increased to 22%. In the control area no significant changes in terms of soap usage could be observed. In
S K Makkar
Full Text Available Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase
Makkar, S K; Rath, N C; Packialakshmi, B; Zhou, Z Y; Huff, G R; Donoghue, A M
Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM) as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS) challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase resistance of
Sammarco, Chiara; Iera, Antonio
In the Internet of Things (IoT) research arena, many efforts are devoted to adapt the existing IP standards to emerging IoT nodes. This is the direction followed by three Internet Engineering Task Force (IETF) Working Groups, which paved the way for research on IP-based constrained networks. Through a simplification of the whole TCP/IP stack, resource constrained nodes become direct interlocutors of application level entities in every point of the network. In this paper we analyze some side effects of this solution, when in the presence of large amounts of data to transmit. In particular, we conduct a performance analysis of the Constrained Application Protocol (CoAP), a widely accepted web transfer protocol for the Internet of Things, and propose a service management enhancement that improves the exploitation of the network and node resources. This is specifically thought for constrained nodes in the abovementioned conditions and proves to be able to significantly improve the node energetic performance when in the presence of large resource representations (hence, large data transmissions).
Teng, Jen-Hao; Chen, Chi-Fa [Department of Electrical Engineering, I-Shou University, No. 1, Section 1, Syuecheng Road, Dashu Township, Kaohsiung Country 840 (Taiwan); Liu, Yi-Hwa [Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei (Taiwan); Chen, Chia-Yen [Department of Computer Science, The University of Auckland (New Zealand)
Distributed generator (DG) resources are small, self-contained electric generating plants that can provide power to homes, businesses or industrial facilities in distribution feeders. They can be used to reduce power loss and improve service reliability. However, the values of DGs are largely dependent on their types, sizes and locations as they were installed in distribution feeders. A value-based method is proposed in this paper to enhance the reliability and obtain the benefits for DG placement. The benefits of DG placement described in this paper include power cost saving, power loss reduction, and reliability enhancement. The costs of DG placement include the investment, maintenance and operating costs. The proposed value-based method tries to find the best tradeoff between the costs and benefits of DG placement and then find the optimal types of DG and their corresponding locations and sizes in distribution feeders. The derived formulations are solved by a genetic algorithm based method. Test results show that with proper types, sizes and installation site selection, DG placement can be used to improve system reliability, reduce customer interruption costs and save power cost; as well as enabling electric utilities to obtain the maximal economical benefits. (author)
Ferreira, Nathália Luíza; Rodrigues, Maria Tereza; Abreu, Mery Natali; Lopes, Aline Cristine
Dyslipidemias are relevant to public health because are one of the major risk factors for Non-Communicable Diseases and Disorders, especially cardiovascular diseases. Identify factors associated with dyslipidemias on users of Primary Health Care Center. Users were assessed through the nutritional anamnesis (demographic data, consumption of foods and nutrients and morbidity) and anthropometry. Was performed descriptive analysis, t-Student, Chi-Square and Mann Whitney tests (ppercentage of adequacy monounsaturated fatty acids (MUFA) (p=0.007). In contrast, had higher proportion of adequacy of lipid (p=0.017), lower mean weight (p=0.044) and lower inadequate intake of fatty meat (p=0.005). Multivariate analysis showed that insufficient consumption of MUFA (p=0.005) and inadequate intake of lard (p=0.021) were the main variables which influenced the presence of dyslipidemia. The results show that important dietary changes for the prevention and control of dyslipidemia have not been implemented, demonstrating the importance of nutritional interventions aimed at to clarify new dietary strategies, such as reduce consumption of sugar and to maintain an adequate consumption of lipid fractions.
Oguntibeju, O.O.; Schalkwyk, F.V; Heever, WMJ. V.den.; Veldman, F.J.
Nutrition intervention aimed at preventing or reversing weight loss and wasting in HIV infection may help to improve quality of life and prolong survival. Micronutrient supplementation may help to strengthen the immune system and reduce the severity and impact of opportunistic infections in people living with HIV / AIDS. HIV contributes to malnutrition for physiological reasons related to the infection itself. HIV /AIDS, being a disease of the immune system, new strategies, including specific dietary nutrients (nutrient supplementation) to improve immune functions, quality of life and prolong survival in infected individuals, could provide additional/alternative approaches for therapeutic treatment in HIV infected subjects. Several vitamins and minerals are important in fighting HIV infection and its resultant effects, hence nutritional supplementation has been advocated. This review focuses on the importance of vitamin/mineral supplementation in HIV / AIDS subjects. (author)
Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?
Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna
Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.
Albrechtova, Jana; Latr, Ales; Nedorost, Ludovit; Pokluda, Robert; Posta, Katalin; Vosatka, Miroslav
The aim of this paper was to test the use of dual microbial inoculation with mycorrhizal and saprotrophic fungi in onion cultivation to enhance yield while maintaining or improving the nutritional quality of onion bulbs. Treatments were two-factorial: (1) arbuscular mycorrhizal fungi (AMF): the mix corresponding to fungal part of commercial product Symbivit (Glomus etunicatum, G. microaggregatum, G. intraradices, G. claroideum, G. mosseae, and G. geosporum) (M1) or the single-fungus inoculum ...
Sahel, Amina; DeBrouwere, Vincent; Dujardin, Bruno; Kegels, Guy; Belkaab, Nejoua; Alaoui Belghiti, Abdelali
The purpose of this paper is to present an innovative quality improvement intervention developed in Morocco and discuss its implementation. Until 2004, the Moroccan Ministry of Health (MoH) encouraged pilots of quality improvement approaches but none of them were revealed to be sustainable. Internal assessments pinpointed factors such as lack of recognition of the participating team's efforts and lack of pressure on managers to become more accountable. In 2005, Morocco opted for an intervention called "Quality Contest" (QC) targeting health centres, hospitals and health district offices and combining quality measurement with structures ranking, performance disclosure and reward system. The QC is organized every 18 months. After the self-assessment and external audit step, the participating structures are ranked according to their scores. Their performances are then disseminated and the highest performing structures are rewarded. The results showed an improvement in performance among participating structures, constructive exchange of successful experiences between structures, as well as communication of constraints, needs and expectations between MoH managers at central and local levels; the use of peer-auditors was appreciated as it enabled an exchange of best practices between auditors and audited teams but this was mitigated by the difficulty of ensuring their neutrality; and the recognition of efforts was appreciated but seemed insufficient to ensure a sense of justice and maintain motivation. This intervention is an example of MoH leadership that has succeeded in introducing transparency and accountability mechanisms (ranking and performance disclosure) as leverage to change the management culture of the public health services; setting up a reward system to reinforce motivation and adapting continuously the intervention to enhance its sustainability and acceptability.
During the past decades, malnutrition has attracted increasing scientific attention and is by now regarded as a true geriatric syndrome characterized by multifactorial causality, identified by symptoms and accompanied by frailty, disability and poor outcome. This viewpoint summarizes our present knowledge and the usual current handling of malnutrition in older people and highlights the urgent need for action in this field. Age-related changes in the complex system of appetite regulation, resulting in the so-called anorexia of aging, predispose older adults to a decrease in food intake which may lead to malnutrition, if additional risk factors like health or social problems occur. Consequently, malnutrition is widespread in the older population, notably in those who are institutionalized. Despite the fact that effective interventions are available, prevention and treatment of malnutrition do not currently receive appropriate attention. As an important first step towards better awareness, screening for malnutrition should become a mandatory integral part of the comprehensive geriatric assessment. Furthermore, practical local guidelines should be implemented in all geriatric hospital wards and nursing homes in order to improve nutritional care in the daily routine. Important to note is that reasonable nutritional management is not possible without qualified staff in adequate numbers allowing appropriate individual nutritional care. Regarding future research, studies at the cellular, metabolic and clinical levels and the linking of information from different research approaches are required to better understand the transition from good nutritional health and independence of old people to malnutrition, functional impairment and poor health. In parallel to well-designed observational and intervention studies, standardized documentation of nutritional information in daily routine would enable the uniform collection of data for research as well as for political decisions
Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent
Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P nutrition; particularly anabolic signaling S6K1 (P parenteral nutrition is effective to promote muscle protein metabolism. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
Rajesh K Chudasama
Full Text Available Background: The ICDS program aims at enhancing survival and development of children from the vulnerable sections of the society. The present study was conducted to assess supplementary nutrition (SN activities and its related issues at anganwadi centres. Material and methods: Total 60 anganwadi centres were selected including 46 anganwadi centres (AWCs from rural area and 14 AWCs from urban area during April 2012 to March 2013 from 12 districts of Gujarat. Five AWCs were selected from one district randomly. Detailed information was collected related to beneficiary’s coverage for SN, type of food provided under SN, and various issues related to supplementary nutrition at anganwadi centres.Results: High coverage of receiving SN among enrolled was reported in pregnant mothers (88.3%, lactating mothers (91.7% and adolescents (86.7%. Only 25% AWCs were providing hot cooked food (HCF to 3 to 6 years children. Less than half of the AWCs were providing ready to eat (RTE food to 6 months to 3 years children (48.3%, pregnant (46.7% and lactating (46.7% mothers, and adolescents (45.0%. Total 38.3% AWCs reported shortage of SN supply, more in rural (41.3% compare to urban (28.6%. Various problems were reported by anganwadi workers related to SN like lack of storage facility, non availability of separate kitchen, poor quality of food, irregular supply, inadequate supply, and fuel problem. Conclusion: The regular and adequate supply of SN will improve the provision of hot cooked food, ready to eat food and take home ration to the beneficiaries as per the norms, leading to improvement of overall nutritional status of the community.
Krassie, J; Smart, C; Roberts, D C
A review of the literature was undertaken to identify the nutritional needs of elderly MOW consumers and factors affecting the ability of existing programs to meet those needs. The focus was on the Australian experience but drawing on the world literature. Keyword search of English language based computer databases of the medical and health literature. Several studies suggest the nutritional intake of MOW consumers is below recommended levels, although the risk of nutritional deficiency has not always been identified. The literature indicates the effectiveness of Meals on Wheels programs are affected by a range of issues including the appropriateness of nutritional standards, menu selection, portion control, level of consumption and customer satisfaction. The literature recommends control of time and temperatures associated with food handling procedures, along with education of providers and customers, to assist in the provision of a safe food supply. Meals on Wheels is an important service, providing meals to housebound consumers. While the effectiveness of such programs is dependent on a range of variables, the nutritional impact of the service and the standard of food hygiene are fundamental assessment criteria. This work was supported by a grant from the NSW Meals on Wheels Association, Australia. European Journal of Clinical Nutrition (2000) 54, 275-280
Full Text Available Background: Health professionals play a key role in the delivery of nutrition interventions. Improving the quality of nutrition training in health professional schools is vital for building the necessary human resource capacity to implement effective interventions for reducing malnutrition in West Africa. This study was undertaken to assess the current status of nutrition training in medical, nursing and midwifery schools in West Africa. Design: Data were collected from 127 training programs organized by 52 medical, nursing, and midwifery schools. Using a semi-structured questionnaire, we collected information on the content and distribution of nutrition instruction throughout the curriculum, the number of hours devoted to nutrition, the years of the curriculum in which nutrition was taught, and the prevailing teaching methods. Simple descriptive and bivariate analyses were performed. Results: Nutrition instruction occurred mostly during the first 2 years for the nursing (84%, midwifery (87%, and nursing assistant (77% programs and clinical years in medical schools (64%. The total amount of time devoted to nutrition was on average 57, 56, 48, and 28 hours in the medical, nursing, midwifery, and nursing assistant programs, respectively. Nutrition instruction was mostly provided within the framework of a dedicated nutrition course in nursing (78%, midwifery (87%, and nursing assistant programs (100%, whereas it was mainly embedded in other courses in medical schools (46%. Training content was heavily weighted to basic nutrition in the nursing (69%, midwifery (77%, and nursing assistant (100% programs, while it was oriented toward clinical practice in the medical programs (64%. For all the programs, there was little focus (<6 hours contact time on public health nutrition. The teaching methods on nutrition training were mostly didactic in all the surveyed schools; however, we found an integrated model in some medical schools (12%. None of the
Gonzalez-Padron, Tracy; Ferguson, Jeffery M.
Service-marketing education provides students customer service skills sought by employers who recognize the relationship between service and profit. Students in service marketing benefit from active-learning activities with actual organizations to apply customer service frameworks taught in the course. The purpose of this paper is to describe an…
Wang, Dongxu; Stewart, Donald; Chang, Chun
Purpose: The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents' knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing. Design/methodology/approach: A cluster-randomised intervention trial…
Full Text Available The needs of decision makers in China are being used to develop climate science and climate services through the Climate Science for Services Partnership. Focusing on examples of work for the energy and urban sectors, this paper outlines the approach taken and gives case studies of climate service development. We find that there is great opportunity for climate service development within the existing China Framework for Climate Services, and for enhancing the science that underpins such services. We also find challenges unique to the socio-economic and cultural environment in China, which must be taken into account when developing climate services here, as well as challenges common to all climate service development.
Dec 22, 2010 ... Small Grants Competition for Distribution Sector Research ... restrictive business practices in international money transfer services and find ways to .... through its own methodology on analyzing the financial services market [.
This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...
Mikkelsen, Bent Egberg; He, Chen
food coordinators in public schools in Denmark, Finland, Germany, and Italy. A questionnaire was adapted to fit the different languages and food cultures in the countries.. The data suggest that schools with organic supply tend to develop organisational environments that a more supportive for healthy......The discussion about nutritional advantages of organic consumption has traditionally focused on the properties of the food it self. Studies have shown however that change of consumption patterns towards organic food seems to induce changed dietary patterns. The current research was a part of the i......POPY study and was conducted to investigate if such changes can be found in school food settings. In other words does organic food schemes at school and related curricular activities help to create environments that are supportive for healthier eating among children? The research was carried out among school...
Aunsholt, Lise; Qvist, Niels; Sangild, Per Torp
BACKGROUND: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would...... be well tolerated in patients with short bowel syndrome. METHODS: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient......, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow's milk allergy. CONCLUSION: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly...
During the nuclear power plant's (NPPs) operating lifetime, the operating organisation should examine the systems, structures and components (SSCs) for possible deterioration so as to determine whether they are acceptable for continued safe operation or whether remedial measures should be taken. In-service inspection (ISI) provides the systematic framework for these examinations. An effective ISI programme ensures both that the safety of the plant is not adversely affected after the commencement of operation and that the levels of reliability and availability of all plant SSCs remain in accordance with the assumptions and intent of the design and, consequently, a cost effective electricity generation is guaranteed. This report was prepared under one of the IAEA projects, 'Integrated NPP life cycle management including decommissioning'. The main objective of an integrated life cycle management programme is to enable NPPs to compete, without compromising safety, successfully in the changing energy markets throughout their service life and to facilitate life extension and eventual decommissioning through improved engineering, technological, economic and managerial actions. The Technical Working Group on NPP Life Management and other advisory groups nominated by the Member States provide recommendations on high priority needs of Member States in this area. The purpose of this TECDOC is to: discuss and evaluate the status of ISI and its evolution in NPPs of IAEA Member States; discuss and evaluate the criteria for effective ISI and the constitutive elements; discuss and evaluate the implication of the introduction of risk informed ISI (RI-ISI) concepts; generate a common recommendation as to how to benefit from utilising the potential of RI-ISI concepts for further development and, possibly, improvement of ISI effectiveness. The specific concept of this report is to treat the two key issues, i.e. inspection qualification and RI-ISI, and their complementarities, to
Yose Rizal Damuri
While the importance of services sector in creating value added and employment has been recognized, the role of services as providers of major inputs to production sector are often forgotten and overlooked. This paper stresses the importance of services sector in supporting economic activities in general; the role that has become increasingly more critical in the wake of global production network. It argues that development of the services sector is crucial to supporting an economyâ€™s partic...
Bates, Jason; Sharratt, Martin; King, John
This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.
Alvarez, Maria Lucrecia
Wheat-derived products provide the basic nutrition for more than a billion of people in the world (about 40% of humankind). Humans consume more proteins from wheat than from any other source. However, the nutritional quality of wheat proteins is limited by the low content of lysine, one of the essential amino acids that we should incorporate through the diet. As part of this thesis work, we obtained transgenic wheat lines expressing the CI-2 gene from barley under the control of a promoter th...
Full Text Available Background: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT. Methods: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS and the in-patient cost were also compared between these two groups. Results: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB, transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively. The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037 and complications related infections (12% vs. 44%, P = 0.012, in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103. Furthermore, the average LOS was decreased by 4.5 days (P = 0.001 and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05 in the NST group. Conclusions: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.
Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Sim...
Boak, George; Dickens, Victoria; Newson, Annalisa; Brown, Louise
The purpose of this paper is to analyse the introduction of distributed leadership and team working in a therapy department in a healthcare organisation and to explore the factors that enabled the introduction to be successful. This paper used a case study methodology. Qualitative and quantitative information was gathered from one physiotherapy department over a period of 24 months. Distributed leadership and team working were central to a number of system changes that were initiated by the department, which led to improvements in patient waiting times for therapy. The paper identifies six factors that appear to have influenced the successful introduction of distributed learning and team working in this case. This is a single case study. It would be interesting to explore whether these factors are found in other cases where distributed leadership is introduced in healthcare organisations. The paper provides an example of successful introduction of distributed leadership, which has had a positive impact on services to patients. Other therapy teams may consider how the approach may be adopted or adapted to their own circumstances. Although distributed leadership is thought to be important in healthcare, particularly when organisational change is needed, there are very few studies of the practicalities of how it can be introduced.
Full Text Available This paper aims to contribute to the theoretical model of managing intellectual capital with an emphasis on the relational capital. Relational capital is especially relevant in the service sector, where differentiation is mostly based on non-price competition. Development of relational capital which strengthens the image through satisfaction of internal and external users encourages innovation and allows each process to be enriched with new knowledge. To illustrate this concept, the paper presents an empirical study of the participants of international students’ conference, coming from nine faculties from Bosnia and Herzegovina, Serbia and Croatia. Paper intends to define the steps to follow in developing a model of relational capital management at universities, taking in consideration the interaction between students' needs, defined through five levels and relationships with higher education institutions. The aim of research is also to encourage innovative processes in Bosnia and Herzegovina and region, which are not always needed to be directly connected to curricular activities, but are derived from them. The results indicate the motives and motivation of both students and professors at fifth level of interaction. It also presents possible ways to expand cooperation in the fifth stage of interaction between students and higher education institutions. As the image of the company and its employees and clients is interconnected, this research points to elements that can be improved in further interaction, in order to achieve effects on each side.
Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.
Furuta, Michiko; Komiya-Nonaka, Manae; Akifusa, Sumio; Shimazaki, Yoshihiro; Adachi, Munehisa; Kinoshita, Toshinori; Kikutani, Takeshi; Yamashita, Yoshihisa
Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture
Desombre, T; Eccles, G
This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.
Full Text Available Due to higher energy consumption, physically active people have higher nutritional requirements. In addition to other important factors for sports, such as good health and physical predisposition, adequate nutrition is a fundamental component. Sports nutrition must be well planned and individually adapted based on physical characteristics, tendencies towards gaining or losing weight, frequency, duration and intensity of training sessions. Studies have shown that a well-balanced ratio of macro and micronutrients, with the support of supplements and adequate hydration, can significantly improve athletic performance and plays a key role in achieving better results. An optimally designed nutritional program, with realistic and achievable goals, which complements a well-planned training program, is the basis for success in sports. Only when nutritional requirements are met, deficits can be prevented and performance in sport pushed to the limit.
Nazri, Cut; Yamazaki, Chiho; Kameo, Satomi; Herawati, Dewi M D; Sekarwana, Nanan; Raksanagara, Ardini; Koyama, Hiroshi
associated with participation. The logistic regression showed that monitoring the nutritional status of children under five was the main reason that mothers participated in Posyandu. Mothers who were satisfied with the Posyandu services were more likely to attend than those who were dissatisfied. Respondents with intention to participate in Posyandu every month were more likely to attend than those who did not intend to attend every month. Households with low income were more likely to participate in Posyandu than households with high income. Household income, mothers' satisfaction with Posyandu services, attitude towards Posyandu benefits and intention to attend Posyandu affect the participation frequency of the mother. In addition, monitoring the nutritional status of children under five was the main reason respondents attend Posyandu. Improving the quality of Posyandu services and providing qualified resources are needed to promote mothers' participation.
Ackatia-Armah, Nana M; Addy, Nii Antiaye; Ghosh, Shibani; Dubé, Laurette
As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers' "reflective trust" in community health nurses develops as a key influencer in their health-related decision-making and behavior. Between December 2012 and June 2013, our ethnographic study gathered data in three adjacent rural and semi-rural communities in Ghana's Eastern Region, using interviews with 39 nursing mothers, three focus groups - with mothers, health-workers, and community leaders - as well as 941 h of participant observation. We focused on interactions between mothers and nurses, highlighting tensions between communities' traditions and messages that nurses bring, which are often based on modern science. We also investigated how mothers come to exhibit reflective trust in the nurses to make sense of traditional and scientific knowledge on infant feeding, and integrate them into their own feeding decisions. Our findings have global implications for effectively sustaining and scaling health and nutrition efforts through community approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.
Perera, Thushanthi; Frei, Simone; Frei, Balz; Wong, Siew Sun; Bobe, Gerd
Poor food choices in childhood are core contributors to obesity and chronic diseases during adolescence and adulthood. Food choices and dietary behaviors develop in childhood and are difficult to change in adulthood. Nutrition education in elementary schools can provide children with the information and skills to develop healthy food choices and…
Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.
Lomborg, Johannes Peter; Toft, Søren
status (enriched or deficient) and that courtship intensity predicts mating success in males of the same nutritional status. We used wolf spiders, Pardosa prativaga, which have an elaborate display of courtship behaviors, including encircling, palp vibrations, abdomen vibrations, hopping, etc. Viability...
Veen, van Merel R.; Hoedjes, Meeke; Versteegen, Joline J.; Meulengraaf-Wilhelm, van de Nienke; Kampman, Ellen; Beijer, Sandra
Purpose/Objectives: To assess what percentage of oncology nurses perceived themselves as having insuffcient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources
Veen, M.R. van; Hoedjes, M.; Versteegen, J.J.; Meulengraaf-Wilhelm, N. van de; Kampman, E.; Beijer, S.
PURPOSE/OBJECTIVES: To assess what percentage of oncology nurses perceived themselves as having insufficient knowledge to provide advice on nutrition and/or physical activity (PA), which characteristics were associated with nurses' perception, and whether the content and information sources differed
Mathey, M.F.A.M.; Siebelink, E.; Graaf, de C.; Staveren, van W.A.
Taste and smell losses occur with aging. These changes may decrease the enjoyment of food and may subsequently reduce food consumption and negatively influence the nutritional status of elderly persons, especially those who are frail. The objective of this study was to determine if the addition of
Our objective was to evaluate the Kids Café Program (KCP) nutrition education intervention and assess its impact on children's diet quality and body mass index (BMI) percentile. An experimental design consisting of pretest-posttest comparison groups using mixed methods was used to evaluate the 6-ses...
Smith, Teresa M; Blaser, Casey; Geno-Rasmussen, Cristy; Shuell, Julie; Plumlee, Catherine; Gargano, Tony; Yaroch, Amy L
The National Early Care and Education Learning Collaboratives (ECELC) project aims to facilitate best practices in nutrition, physical activity, screen time, and breastfeeding support and infant feeding among early care and education (ECE) programs across multiple states. The project uses a train-the-trainer approach with 5, in-person learning-collaborative sessions, technical assistance, and action planning. We describe the longitudinal practice-based evaluation of the project and assess whether ECE programs evaluated (n = 104) sustained changes in policies and practices 1 year after completing the project. The number of best practices increased from pre-assessment to post-assessment (P professional development and training focused on improving best practices for environment-level child nutrition and physical activity, which is one strategy among many that are warranted for obesity prevention in young children.
Full Text Available Abstract Background Despite major policy initiatives in the United Kingdom to enhance women's experiences of maternity care, improving in-patient postnatal care remains a low priority, although it is an aspect of care consistently rated as poor by women. As part of a systems and process approach to improving care at one maternity unit in the South of England, the views and perspectives of midwives responsible for implementing change were sought. Methods A Continuous Quality Improvement (CQI approach was adopted to support a systems and process change to in-patient care and care on transfer home in a large district general hospital with around 6000 births a year. The CQI approach included an initial assessment to identify where revisions to routine systems and processes were required, developing, implementing and evaluating revisions to the content and documentation of care in hospital and on transfer home, and training workshops for midwives and other maternity staff responsible for implementing changes. To assess midwifery views of the quality improvement process and their engagement with this, questionnaires were sent to those who had participated at the outset. Results Questionnaires were received from 68 (46% of the estimated 149 midwives eligible to complete the questionnaire. All midwives were aware of the revisions introduced, and two-thirds felt these were more appropriate to meet the women's physical and emotional health, information and support needs. Some midwives considered that the introduction of new maternal postnatal records increased their workload, mainly as a consequence of colleagues not completing documentation as required. Conclusions This was the first UK study to undertake a review of in-patient postnatal services. Involvement of midwives at the outset was essential to the success of the initiative. Midwives play a lead role in the planning and organisation of in-patient postnatal care and it was important to obtain their
Black, Andrew P; D'Onise, Katina; McDermott, Robyn; Vally, Hassan; O'Dea, Kerin
Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities. A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes. The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F&V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities. Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.
Dragos Constantin Vasile
The actors on the today business stage have no more well-defined roles with clear and rigid borders between them. Hospitality industry in particular is a good example how it has been blurred the roles that customers play in dealing with service providers. The study reveals that customers can influence the quality of hospitality service through performing a qualitycontrol function. This involves a series of activities to be achieved by them: (1) on-the-spot quality control, (2) service failure...
Full Text Available in the management of water services. Simulta- neously, franchising would support the development of local micro-enterprises and broad-based black economic empower- ment, all within the public sector service delivery environment. The CSIR and its partners have..., and to the private sector. Furthermore, the programme is establishing and supporting locally-based small enterprises (mostly women-headed) for the provision of appropriate and locally-based service solutions. It is creating jobs and entrepreneurial opportunities and...
Hosam Farouk El-Sofany
The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great co...
Spiegel, Gail; Bortsov, Andrey; Bishop, Franziska K; Owen, Darcy; Klingensmith, Georgeanna J; Mayer-Davis, Elizabeth J; Maahs, David M
Youth with type 1 diabetes do not count carbohydrates accurately, yet it is an important strategy in blood glucose control. The study objective was to determine whether a nutrition education intervention would improve carbohydrate counting accuracy and glycemic control. We conducted a randomized, controlled nutrition intervention trial that was recruited from February 2009 to February 2010. Youth (12 to 18 years of age, n = 101) with type 1 diabetes were screened to identify those with poor carbohydrate counting accuracy, using a previously developed carbohydrate counting accuracy test covering commonly consumed foods and beverage items presented in six mixed meals and two snacks. All participants (n = 66, age = 15 ± 3 years, 41 male, diabetes duration = 6 ± 4 years, hemoglobin A1c [HbA1c] = 8.3% ± 1.1%) were randomized to the control or intervention group at the baseline visit. The intervention group attended a 90-minute class with a registered dietitian/certified diabetes educator and twice kept 3-day food records, which were used to review carbohydrate counting progress. Carbohydrate counting accuracy (measured as described) and HbA1c were evaluated at baseline and 3 months to determine the effectiveness of the intervention. t Tests, Spearman correlations, and repeated measures models were used. At baseline, carbohydrate content was over- and underestimated in 16 and 5 of 29 food items, respectively. When foods were presented as mixed meals, participants either significantly over- or underestimated 10 of the 9 meals and 4 snacks. After 3 months of follow-up, HbA1c decreased in both the intervention and control groups by -0.19% ± 0.12% (P = 0.12) and -0.08% ± 0.11% (P = 0.51), respectively; however, the overall intervention effect was not statistically significant for change in HbA1c or carbohydrate counting accuracy. More intensive intervention might be required to improve adolescents' carbohydrate counting accuracy and nutrition management of type 1
Wongputtisin, P; Khanongnuch, C; Kongbuntad, W; Niamsup, P; Lumyong, S; Sarkar, P K
Soya bean hull (SBH) is a cheap and high-fibre content feed ingredient that obtained after soya bean oil extraction. Microbial fermentation was expected to improve SBH qualities before applying to animals, especially monogastric animals. Two bacterial strains, Bacillus subtilis MR10 and TK8 that were isolated from Tua-nao, a traditional fermented soya bean in northern Thailand, were used for fermented soya bean hull (FSBH) production. Both could easily grow at 37°C in SBH as the sole substrate. MR10 produced the highest β-mannanase activity (400 U g(-1) SBH) on day 2, while TK8 produced the highest cellulase activity (14·5 U g(-1) SBH) on day 3. After fermentation, the nutritional quality of SBH was obviously improved by an increase in soluble sugars, soluble proteins, crude protein and crude lipid, and a decrease in the content of raffinose family oligosaccharides. Scavenging activity (%) of SBH against ABTS radical cation was also increased from 14 to 27 and 20% by MR10 and TK8 fermentation, respectively. According to the GRAS property of these both strains and various improvements of nutritional values, the fermented SBH proved to be a potential feed ingredient, especially for the monogastric animals. Normally, soya bean hull has been recognized as only a worthless by-product from soya bean oil production process because of its low utilizable nutrients. Our study introduced an alternative way to utilize this worthless residue using biotechnological knowledge. The nutritional quality of soya bean hull was improved by microbial fermentation. Fermented soya bean hull can be used as a cheap, safe and high-nutrient feed ingredient for livestock production, especially monogastric animals, to promote their growth performances, instead of using antibiotics in some regions of the world. © 2014 The Society for Applied Microbiology.
Full Text Available Basing on the survey of respondents, a marketing research was carried out on military service people’s consumer motivations and benefits for the existing dry product package and ways to improve it, as well as on the attitude towards the consumption of instant cereals. The results of the survey showed that military service people were not satisfied with the existing daily field product package; the majority were not comfortable with the sameness of the assortment, cooking time, inconvenient packaging, and lack of individual flatware. It is found that the most important factors for military service people when choosing instant cereals are taste, composition/safety, nutritional and energy value, and the least important are the shape and design of packaging. The analysis of the responses about the nature of the most common negative body changes resulting from the respondents’ professional activity indicates that the development of instant cereals on the basis of natural components is promising, as these components can prevent fatigue and certain diseases. 68% of the people interviewed are already comfortable with the inclusion of instant cereals with improved consumer properties into the daily field product package, and other consumers’ attitude to them can be significantly improved by explaining to them the benefits of this product. A potential consumer wants to get a product that has a meat and fruit flavor with improved consumer properties, and what is the most important, the product should be tasty, of high quality, and harmless. Military service people will be the main consumers, regardless of their age, occupation, and education.The application of the marketing research on servicemen’s consumer preferences made it possible to identify those consumer preferences that must be taken into account when improving the set of dry products and developing new instant cereals in order to meet the potential consumers’ demand for these products
Campbell, Jeffery L.
Recent research reveals that janitorial services account for nearly 30 percent of facility budgets, which translates into billions of dollars annually. With janitorial services consuming such a large share of budgets, other industry findings are alarming. Most cleaning systems: 1) have no quantifiable standards; 2) are based solely on appearance;…
This paper therefore examines teacher education, especially in-service teacher education and how it has been practised elsewhere. It is hoped that education policy makers will take note of some of the issues raised in this paper as the one day workshop which has hitherto been the most used strategy of in-service teacher ...
Full Text Available In this paper, using an Ordinary Least Square regression (OLS, we investigate whether intangible elements influence tourist's perception about service quality. Our empirical results based on tourist survey in Montenegro, indicate that intangible elements of tourism product have positive impact on tourist's overall perception of service quality in Montenegro.
Shaw, Kate; Spink, Amanda
The inclusion or not of chat services within Virtual Reference (VR) is an important topic for university libraries. Increasingly, email supported by a Frequently Asked Questions (FAQ) database is suggested in the scholarly literature as the preferred, cost-effective means for providing university VR services. This paper examines these issues and…
Perignon, Marlène; Dubois, Christophe; Gazan, Rozenn; Maillot, Matthieu; Muller, Laurent; Ruffieux, Bernard; Gaigi, Hind; Darmon, Nicole
Background: Food prices influence food choices. Purchasing foods with higher nutritional quality for their price may help improve the diet quality of socio-economically disadvantaged individuals. Objective: To describe the co-construction and evaluation of the 'Opticourses' prevention program promoting healthy eating among participants in deprived socio-economical situations by improving the nutritional quality of their household food purchases with no additional cost. Methods: Individuals we...
Wang, Huan; Song, Zhenfeng; Ba, Yanhui; Zhu, Lin; Wen, Ying
To describe the knowledge, attitudes and practices of type 2 diabetics in Yakeshi City and to assess the effect of implementation of nutritional and eating education in enhancing knowledge and practices regarding a healthy diet. A questionnaire-based survey was conducted with 162 diabetics to determine their nutrition knowledge, attitudes and practices; fifty-four participants received nutritional and eating education for 6 months. Diabetes-related nutrition knowledge, awareness, practice accuracy, dietary intake and glycaemic control were assessed before and after education. Yakeshi, a remote city in northern China. A total of 162 type 2 diabetics recruited from three hospitals, fifty-four of whom were selected randomly to receive education. Among the 162 respondents, most diabetics (75%) considered that controlling diet was important in the methods of controlling blood glucose. Scores for knowledge, practices and overall KAP (knowledge-attitude-practice) were low, but scores for attitude were high. Participants with diabetes education experiences, practice duration over 1 year or high education level all had higher scores for KAP (P nutrition knowledge, awareness and practice accuracy improved significantly (P nutrition knowledge and practices. Nutritional and eating education was effective in improving diabetics' nutrition knowledge and practices, and this optimal practice helped them control blood glucose effectively.
Blumenthal, Susan J; Hoffnagle, Elena E; Leung, Cindy W; Lofink, Hayley; Jensen, Helen H; Foerster, Susan B; Cheung, Lilian Wy; Nestle, Marion; Willett, Walter C
To examine the opinions of stakeholders on strategies to improve dietary quality of Supplemental Nutrition Assistance Program (SNAP) participants. Participants answered a thirty-eight-item web-based survey assessing opinions and perceptions of SNAP and programme policy changes. Survey of 522 individuals with stakeholder interest in SNAP, conducted in October through December 2011. The top three barriers to improving dietary quality identified were: (i) unhealthy foods marketed in low-income communities; (ii) the high cost of healthy foods; and (iii) lifestyle challenges faced by low-income individuals. Many respondents (70 %) also disagreed that current SNAP benefit levels were adequate to maintain a healthy diet. Stakeholders believed that vouchers, coupons or monetary incentives for purchasing healthful foods might have the greatest potential for improving the diets of SNAP participants. Many respondents (78 %) agreed that sodas should not be eligible for purchases with SNAP benefits. More than half (55 %) believed retailers could easily implement such restrictions. A majority of respondents (58 %) agreed that stores should stock a minimum quantity of healthful foods in order to be certified as a SNAP retailer, and most respondents (83 %) believed that the US Department of Agriculture should collect data on the foods purchased with SNAP benefits. Results suggest that there is broad stakeholder support for policies that align SNAP purchase eligibility with national public health goals of reducing food insecurity, improving nutrition and preventing obesity.
Cook, Alan L
.... The Order directed DoD and other federal agencies to study methods of improving service of process for child support enforcement on their employees and uniformed members, with particular emphasis...
Teixeira, Caroline San Severino; Cabral, Antônio Carlos Vieira
To determine differences in some nutritional aspects of pregnant women assisted at prenatal care services in a country town and in a metropolitan area. Pregnant women received prenatal care in the city of Belo Horizonte (BH), metropolitan area, and Paula Cândido (PC), a country town. A Food Frequency Questionnaire (FFQ) containing socioeconomic information and information about eating habits was applied. In addition,weight and height were measured on the occasion of the visits and the women were ask to give their prepregnancy weight for subsequent BMI calculation. Data were analyzed according to region and trimester of pregnancy using the SPSS software version 15.0, the t-test to compare averages and the chi-square test of independence, with the level of significance set at 5%. 240 pregnant women were included, 90 from the country town and 150 from the metropolitan area. Of these, most were married (BH = 56.6%; PC = 46.6%) and did not work outside the home (BH = 54.0%; PC = 84.4%). They predominantly had 3-4 meals/ day during the 1st and 2nd quarters (BH = 54.0 and 46%; PC = 66.7 and 63.3%, respectively) and had 5-6 meals/day during Q3 in BH (44%). There was significant weight gain only in the 1st quarter (BH: 58,0%; PC: 53.3%). Weight gain versus eating habits was significant for the variables "lunch or dinner away from home" for the 1st quarter in BH (p = 0.006), "How many times they consume milk" in the 1 st quarter in PC (p = 0.03), and "How many times they consume junk food" in the 3rd quarter in BH (p = 0.009). Pregnant woman showed proper eating habits in both regions despite the prevalence of pregestational overweight in BH and a low level of education and income, especially in the country town, an indicator that may be unfavorable for the nutrition of pregnant women during this period. Studies of association between eating habits and newborn health will provide more information about nutrition during pregnancy.
Hutchinson, Amanda D; Wilson, Carlene
A comprehensive search of the literature for studies examining physical activity or nutrition interventions in the workplace, published between 1999 and March 2009, was conducted. This search identified 29 relevant studies. Interventions were grouped according to the theoretical framework on which the interventions were based (e.g. education, cognitive-behavioural, motivation enhancement, social influence, exercise). Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals and fail safe Ns were calculated. Most theoretical approaches were associated with small effects. However, large effects were found for some measures of interventions using motivation enhancement. Effect sizes were larger for studies focusing on one health behaviour and for randomized controlled trials. The workplace is a suitable environment for making modest changes in the physical activity, nutrition and health of employees. Further research is necessary to determine whether these changes can be maintained in the long term.
Gusriadi, Depri; Sukmiwati, Mery; ', Dahlia
This study was intended to evaluate the nutritional value of instant noodlesfortified with catfish flour. Instant noodles were prepared from a mixture of wheatflour (50%), sweat potato flour (10%), egg (15%), salt (0,7%), water (23%),cooking oil (0,3%) and Carboxy Methyl Cellulose (1%). The noodles wereprepared by fortifying the mixture with catfish flour at a level of 0%, 5%, 10%,and 15 % respectively. Instant noodles was evaluated for sensory quality andproximate composition (moisture, prot...
Maria Isabel Casas
Full Text Available Agricultural outputs have resulted in food production continuously expanding. Satisfying the needs of a fast growing human population, higher yields, more efficient food processing, and food esthetic value, resulted in crop varieties with higher caloric intake but lacking many phytochemicals important for plant protection and adequate human nutrition. The increasing incidence of chronic diseases such as obesity, diabetes and cardiovascular diseases, combined with social disparity worldwide prompted the interest in developing enhanced crops that can simultaneously address the two sides of the current malnutrition sword, increasing yield while providing added nutritional value. Flavones, phytochemicals associated with the beneficial effects of the Mediterranean diet, have potent anti-inflammatory and anti-carcinogenic activities. However, many Mediterranean diet-associated vegetables are inaccessible, or lowly consumed, in many parts of the world. Maize is the most widely grown cereal crop, yet most lines used for hybrid maize production lack flavones. As a first step towards a sustainable strategy to increasing the nutritional value of maize-based diets, we investigated the accumulation and chemical properties of flavones in maize seeds of defined genotypes. We show that the pericarps of the P1-rr genotype accumulate flavones at levels comparable to those present in some flavone-rich vegetables, and are mostly present in their C- and O-glycosylated forms. Some of these glycosides can be readily converted into the corresponding more active health beneficial aglycones during food processing. Our results provide evidence that nutritionally beneficial flavones could be re-introduced into elite lines to increase the dietary benefits of maize.
Tumilowicz, Alison; Neufeld, Lynnette M; Pelto, Gretel H
'Implementation research in nutrition' is an emerging area of study aimed at building evidence-based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view--the insider's perspective--and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the 'emic' (insider's) perspective. Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography. Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the 'black box' in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. © 2015 John Wiley & Sons Ltd.
Byrnes, Angela; Banks, Merrilyn; Mudge, Alison; Young, Adrienne; Bauer, Judy
Older patients are at increased risk of malnutrition and reduced physical function. Using Enhanced Recovery After Surgery (ERAS) guidelines as an auditing framework, this study aimed to determine adherence of nutrition care to perioperative best practice in older patients. A single researcher retrieved data via chart review. Seventy-five consenting patients ≥65 years (median 72 (range 65-95) years, 61% male) admitted postoperatively to general surgical wards were recruited. Sixty per cent had a primary diagnosis of cancer and 51% underwent colorectal resection. Seventeen per cent and 4% of patients met fasting targets of 2-4 h for fluid and 6-8 h for food, respectively. Fifty-five per cent were upgraded to full diet by first postoperative day. Nil received preoperative carbohydrate loading. Minimally invasive surgery (p = 0.01) and no anastomosis formation (p = 0.05) were associated with receiving ERAS-concordant nutrition care. This study highlights areas for improvement in perioperative nutrition care of older patients at our facility.
Hosam Farouk El-Sofany
Full Text Available The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great convenience to those off-campus students who do not always have time to find Internet enabled computers to get the important educational information from their academic institutions. With the mobile or M-educational services, both the students and the instructors can access the services anytime and anywhere they want. This paper discusses those M-educational services that can be moved to the mobile platform and then presents the system prototype and architecture that integrate these services into the mobile technology platform. The paper will conclude with a description of the formative evaluation of the system prototype.
Wang, Dongxu; Stewart, Donald; Chang, Chun
Purpose: The purpose of this paper is to examine the effectiveness of a holistic school-based nutrition programme using the health-promoting school (HPS) approach, on teachers' knowledge, attitudes and behaviour in relation to nutrition in rural China. Design/methodology/approach: A cluster-randomised intervention trial design was employed. Two…
Strang, Brian J; Reddix, Bruce A; Wolk, Robert A
Parenteral nutrition-associated cholestasis (PNAC) and liver disease have been associated with soybean oil-based intravenous fat emulsions (IVFEs). The benefit of fish oil-based IVFEs in the reversal of parenteral nutrition (PN)-associated liver damage includes allowing for longer PN duration without immediate need for bowel or liver transplantation. The present case involves an infant born with short bowel syndrome (SBS) requiring long-term PN with development of PNAC and subsequent administration of a fish oil-based IVFE. An infant born with SBS was initiated on PN and enteral feeds. After failed enteral progression, bowel lengthening by serial transverse enteroplasty (STEP) resulted in postoperative ileus with delayed enteral feeding for 4 weeks. The administration of long-term PN led to development of PNAC, resulting in initiation of a fish oil-based IVFE. After 4 months, the cholestasis had resolved. Despite the STEP, at 16 months, the child required bowel tapering due to inability to advance enteral feeding. Fish oil-based IVFE was effectively used to reverse PNAC in a child with SBS. Despite early STEP, the patient was not able to tolerate enteral feedings and required bowel tapering. This case illustrates that early surgical intervention did not allow for improved feed tolerance. This resulted in a significant period without enteral nutrition, leading to development of cholestasis. The use of fish oil-based IVFE may permit a longer duration of PN administration without the development of cholestasis or liver disease, allowing for longer time for bowel adaptation prior to the need for surgical intervention. © 2016 American Society for Parenteral and Enteral Nutrition.
Aalst, van der W.M.P.
Web services are an emerging technology to implement and integrate business processes within and across enterprises. Service-orientation can be used to decompose complex systems into loosely coupled software components that may run remotely. However, the distributed nature of services complicates
Sánchez-Rico, Alejandro; Garel, Pascal; Notarangelo, Isabella; Quintana, Marcos; Hernández, Gustavo; Asteriadis, Stylianos; Popa, Mirela; Vretos, Nicholas; Solachidis, Vassilis; Burgos, Marta; Girault, Ariane
Integrated care ICT Platform to support patients, care-givers and health/social professionals in the care of dementia and Parkinson's disease with training, empowerment, sensor-based data analysis and cooperation services based on user-friendly interfaces.
1Department of Agricultural Extension and Rural Development, Landmark University, Omu –Aran, Kwara. State. 2Department ... production technologies among cassava farmers in Osun State, Nigeria. Multistage ... included fertilizer procurement, agrochemicals, cooperative facilities, social networks, tractor hiring services,.
customer orientation in the Nigerian public sector. The policy goes by ..... Graham Effect' (Arnold, Cooper and Robertson,. 1995). .... system and budgeting time and money to pursue services ... customer relationships, and facilitating a safe and.
The library as a social instrument for transformation in response to the ... To provide effective services for children and young people including requisite .... explanations clearer than they would have been without this multi-media tool especially.
Full Text Available CSIR research has found that franchising partnerships could alleviate and address many challenges in the operation and maintenance of water services infrastructure. Franchising brings appropriate training to those on-site, and also offers backup off...
Cartels often control basic services in these informal settlements, charging ... It will generate practical knowledge on how formal and informal land tenure, ... Researchers will also assess how these tools and planning processes can be used to ...
Military, LGBT, health disparities, minority stress , social networks 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...physical and mental health needs of this community. This project includes LGBT service members from all four services, Army, Air Force, Navy and...acceptance and integration of sexual minorities into traditional heterosexual work environments. Further, the findings will address possible health
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently...phases. In Phase I we (a) convened an expert panel to advise the study and (b) interview a diverse set of military service members (n=42) using a...have convened our expert panel of advisors and have completed 38 interviews with LGBT military service members. 15. SUBJECT TERMS Military, LGBT
De-Regil, Luz Maria; Jefferds, Maria Elena D; Sylvetsky, Allison C; Dowswell, Therese
Background Approximately 600 million children of preschool and school age are anaemic worldwide. It is estimated that half of the cases are due to iron deficiency. Consequences of iron deficiency anaemia during childhood include growth retardation, reduced school achievement, impaired motor and cognitive development, and increased morbidity and mortality. The provision of daily iron supplements is a widely used strategy for improving iron status in children but its effectiveness has been limited due to its side effects, which can include nausea, constipation or staining of the teeth. As a consequence, intermittent iron supplementation (one, two or three times a week on nonconsecutive days) has been proposed as an effective and safer alternative to daily supplementation. Objectives To assess the effects of intermittent iron supplementation, alone or in combination with other vitamins and minerals, on nutritional and developmental outcomes in children from birth to 12 years of age compared with a placebo, no intervention or daily supplementation. Search methods We searched the following databases on 24 May 2011: CENTRAL (2011, Issue 2), MEDLINE (1948 to May week 2, 2011), EMBASE (1980 to 2011 Week 20), CINAHL (1937 to current), POPLINE (all available years) and WHO International Clinical Trials Registry Platform (ICTRP). On 29 June 2011 we searched all available years in the following databases: SCIELO, LILACS, IBECS and IMBIOMED. We also contacted relevant organisations (on 3 July 2011) to identify ongoing and unpublished studies. Selection criteria Randomised and quasi-randomised trials with either individual or cluster randomisation. Participants were children under the age of 12 years at the time of intervention with no specific health problems. The intervention assessed was intermittent iron supplementation compared with a placebo, no intervention or daily supplementation. Data collection and analysis Two authors independently assessed the eligibility of studies
parts of the world. However, the mobile location services have obviously not yet met the hyped expectation of mass-market adoption that was expressed in 2000. The lack of adaptability and offerings tailored to different user requirements in specific contexts of use is one of the factors inhibiting......Back in 2000 and the, following two or three years, mobile location services gained a great deal of interest and they were considered as one of the few service categories where users would be willing to pay for the usage. Since 2000 countless mobile location services have been launched in different...... the take-off of the existing mobile location services both in Asia and Western Europe. Adaptability is envisioned by Wireless World Research Forum (WWRF) as one of the keys to the success of any service beyond year 2010 and one of the service capabilities that should be made available on the next...
Full Text Available The purposes of this research were to: 1 evaluate the service quality of the ground staff at Don Mueang International Airport (DMK, 2 compare the ground staff quality service perception of Thai passengers at DMK, and 3 provide guidelines for service quality improvement of the DMK airlines ground staff. A sample size of 400 Thai domestic passengers was accidentally selected at DMK. A questionnaire was used as a research tool for data collection. Five dimensions of service quality were evaluated: reliability, responsiveness, assurance, empathy, and tangibles. It was found that the service quality of ground staff was moderate. The highest dimension of service quality realization was tangibles, followed successively by reliability, assurance, empathy, and responsiveness. The passengers' perception of the ground staff's service quality varied by gender and age group. Guidelines were proposed for the improvement of ground staff service quality at DMK based on the findings. Keywords: airport, ground staff, quality of service
Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N
Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused
Stamatakos, N; Luzum, B; Wooden, W
...) at USNO has made several improvements to its combination and pre- diction products. These improvements are due to the inclusion of new input data sources as well as modifications to the combination and prediction algorithms...
Cannoosamy, Komeela; Pem, Dhandevi; Bhagwant, Suress; Jeewon, Rajesh
The purpose of the study was to assess the determinants of nutrition behaviors and body mass index and determine the impact of a nutrition education intervention (NEI) among Mauritian housewives. A pretest-posttest design was used assessing Nutrition Knowledge (NK), Nutrition Attitudes, Fruit and Vegetable Intake (FVI), body mass index (BMI). Two hundred Mauritian housewives were recruited. The NEI was in the form of a lecture and lasted for twenty minutes. Statistical tests performed revealed that the mean NK score at baseline was 65.8 ± 6.92 and a significant increase of +17.1 at post-test and +16.1 at follow-up was observed. Determinants of NK were age, presence of elderly people, and BMI. Mean nutrition attitude score at baseline was 2.37 ± 0.22 with significant increase of +0.2 (post-test) and +0.17 at follow-up. Age, level of education, presence of elders, and NK were linked to a positive attitude. FVI was predicted by age, income, presence of elders, NK, and nutrition attitudes. Baseline FVI was 4.77 ± 1.11 which increased significantly ( p nutrition behaviors.
Neufeld, Lynnette M.; Pelto, Gretel H.
Abstract ‘Implementation research in nutrition’ is an emerging area of study aimed at building evidence‐based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view – the insider's perspective – and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the ‘emic’ (insider's) perspective.Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography.Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the ‘black box’ in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. PMID:26778802
De La Cruz, T. E.; Avila R, S.; Garcia R, A.
Quinua (Chenopodium quinoa), a pseudo cereal considered as an alternative crop for areas with marginal agricultural conditions has been subjected since 1990 to a radioinduced mutagenesis programme aiming to obtain lines with low saponin content, good yields and high nutritional value. Seeds obtained from lines grown in M7 generation which exhibited yields averaging 1.5 ton/ha, were analyzed regarding grain quality and nutritive value. Evaluated parameters were diameter and thickness of the seed, weight of 100 seeds and density. Regarding to bromatological analysis, determinations were made of moisture, ash, raw fiber, proteins, oil content and carbohydrates, following the procedures indicated in Official Mexican Norms (NOM). Evaluated genotypes were the varieties Sajama, Barandales and Amarilla de Marangani and the mutant lines 20R110, 94, 20R333, 20R227, 20R342, 20R37 and the advanced line obtained by selection 640304. Mutant genotypes 20R333 and 20R342 exhibited outstanding characteristics regarding to grain quality (diameter 2.0 mm, thickness 1.2mm, weight of 100 seeds 0.42 and 0.22 g respectively and density 710 and 686 grams per liter). In the bromatological analysis the protein content ranged from 11.82 % (genotype 20 R227) to 16.8% in mutant 20R333 while mutant 20R342 exhibited 15.6%. The lipid content was minimum on Barandales and 20R333 both with 3.8%, having the genotype 20R110 the highest value among evaluated genotypes with 4.35%, line 20R342 exhibited 4.2%.. The high percentages of proteins and lipids, found among some analyzed mutants exhibit the feasibility to obtain, through radioinduced mutagenesis, lines with low saponins and high nutritive value