Hygienic-Sanitary conditions of Hospital Nutrition Services in Southern Brazil / Condições higienicossanitárias dos serviços de nutrição e dietética em hospitais do Sul do Brasil

This study evaluated the good handling practices in the ten Hospital Nutrition Services of the respective hospitals in the South of Brazil, classified as general hospitals. For data collection, there was used a Checklist for Good Handling Practices for Food Services based on current legislation. Among the results, the average of adequacy of the hospitals stand out, showing that the items related to responsibilities and edifications had the lowest adequacies, 67% and 73%, respectively, followed by the food handler block, with 76% of adequacies. The block referring to food handlers showed that few of them sanitize the hands during the change of activity. The classification of hospitals in relation to Good Handling Practices was satisfactory, however, greater failure was observed related to the practices of the food handlers, which are crucial for the safety of food produced in Hospital Nutrition Services.

Este estudo avaliou as boas práticas de manipulação em 10 serviços de nutrição e dietética de hospitais do Sul do Brasil, classificados como hospital geral. Para a coleta de dados, utilizou-se uma Lista de Verificação em Boas Práticas para Serviços de Alimentação baseada na legislação vigente. Dentre os resultados destacam-se a média de adequação dos hospitais, mostrando que os itens relacionados a responsabilidades e edificações apresentaram as menores adequações, 67% e 73%, respectivamente, seguidos com o bloco de manipuladores, com 76% de adequações. O bloco referente aos manipuladores de alimentos mostrou que poucos deles higienizam as mãos durante a troca de atividade. A classificação dos hospitais em relação à Boas Práticas de Manipulação foi satisfatória, no entanto, observou-se que falta o cumprimento de alguns itens, relacionados com as práticas dos manipuladores, que são cruciais para a segurança dos alimentos produzidos nos serviços de alimentação.

Position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior: Food and Nutrition Programs for Community-Residing Older Adults.

Given the increasing number and diversity of older adults and the transformation of health care services in the United States, it is the position of the Academy of Nutrition and Dietetics and the Society for Nutrition Education and Behavior that all older adults should have access to evidence-based food and nutrition programs that ensure the availability of safe and adequate food to promote optimal nutrition, health, functionality, and quality of life. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, in partnership with other practitioners and nutrition educators, should be actively involved in programs that provide coordinated services between the community and health care systems that include regular monitoring and evaluation of programming outcomes. The rapidly growing older population, increased demand for integrated continuous support systems, and rising cost of health care underscore the need for these programs. Programs must include food assistance and meal programs, nutritional screening and assessment, nutrition education, medical nutrition therapy, monitoring, evaluation, and documentation of evidence-based outcomes. Coordination with long-term care services and support systems is necessary to allow older adults to remain in their homes; improve or maintain their health and manage chronic disease; better navigate transitions of care; and reduce avoidable hospital, acute, or long-term care facility admissions. Funding of these programs requires evidence of their effectiveness, especially regarding health, functionality, and health care-related outcomes of interest to individuals, caregivers, payers, and policy makers. Targeting of food and nutrition programs involves addressing unmet needs for services, particularly among those at high risk for poor nutrition. Registered dietitian nutritionists and nutrition and dietetics technicians, registered must increase programmatic efforts to measure outcomes to evaluate community-based food and nutrition services.

[Differing dietary advice are given to gynaecological and prostate cancer patients receiving radiotherapy in Sweden]. / Stor variation i kostråden vid strålbehandling av lilla bäckenet - Kost har potential att förebygga följdsjukdomar till strålning och ge bättre tarmhälsa ­ men vetenskaplig evidens saknas.

Preclinical studies indicate that an optimal diet during pelvic radiotherapy may be able to prevent radiation-induced survivorship diseases that diminish cancer survivors' intestinal health. We do not yet know what this optimal diet might be because scientific studies needed to determine what dietary advice might best be given to patients during treatment. Oncology clinics in Sweden were contacted to determine the nature of dietary advice given to gynaecological and prostate cancer patients at each clinic before, during and after radiotherapy. Reports from these clinics revealed that dietary advice given to patients differs from one clinic to another. This was as expected, since it was known that the scientific evidence needed to identify the best possible diet is not yet available. Clinical studies of the effects of different diets are urgently needed if we are to prevent survivorship diseases that decrease intestinal health.

Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools.

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 United States, 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.

Phenolic compounds content and antioxidant capacity of meals provided to elementary public schools in Chile during 2011 / Contenido de compuestos fenólicos y capacidad antioxidante de alimentos entregados a las escuelas públicas de enseñanza básica en Chile durante 2011

The Chilean National School Feeding Program (NSFP) delivers breakfast and lunch meals that supply 250 and 450 kcal, respectively, along the country. In the last decades, a significant increase of obesity has been observed in primary education children, and it involves risk factors of non-communicable diseases. The dietary intake of foods containing phenolic compounds (PC) exerts favorable effects on health by reducing risk factors of prevalent diseases. The aim of the study was to measure the PC content and antioxidant capacity (AC) [ORAC and DPPH] of meals provided by the NSFP in Quillota, Chile, in 2011. The PC supply of the whole meals served ranged from 362.7 to 1,730 mg GAE. The best breakfast foods include whole grain cookie (2.59±0.3 mg GAE/g), bread with avocado, quince jelly or strawberry jam (1.61±0.13 to 2.05±0.3 mg GAE/g); while the best lunch salads include beetroot, lettuce, and cabbage/fish (1.66±0.3 to 2.35±0.1 mg GAE/g), and main courses contain legumes, or mixed vegetables. The lowest PC contents were observed in pasta and rice preparations (p<0.05). Among desserts, the best source of PC is fruit (1.81±0.04 to 6.91±0.31 mg GAE/g). The correlation between PC and AC varied according to the type of meal. PC content and AC are additional criteria for selecting the best quality meals, in addition to the nutrients and energy content. The results support the recommendation to increase the supply of fruits and vegetable/legumes preparations and fruits instead of starchy foods to scholars.

El Programa de Alimentación Escolar (PAE) para enseñanza básica en Chile distribuye, en todo el país, desayunos y almuerzos que aportan 250 y 450 kcal, respectivamente. En las últimas décadas ha aumentado significativamente la obesidad en escolares, lo que induce factores de riesgo de enfermedades no transmisibles. La ingestión de alimentos que contienen polifenoles (PF) ejerce efectos beneficiosos al reducir factores de riesgo de enfermedades prevalentes. El objetivo del estudio fue determinar el contenido de PF y la capacidad antioxidante (CA) [ORAC y DPPH] de los alimentos entregados por el PAE en Quillota, Chile, en 2011. El aporte de PF en las raciones servidas fluctuó entre 362.7 y 1,730 mg EAG. El mejor desayuno contenía galletón con granos integrales (2.59±0.3 mg EAG/g), pan con palta, dulce de membrillo o de fresas (1.61±0.13 a 2.05±0.3 mg EAG /g) y el mejor almuerzo, ensaladas de remolacha, lechuga, o col/pescado (1.66±0.3 a 2.35±0.1 mg EAG /g), y un plato principal con leguminosas o vegetales mixtos. Los contenidos menores de PF se observaron en platos con pastas y arroz (p<0.05). Entre los postres, la mejor fuente de PF es la fruta (1.81±0.04 a 6.91±0.31 mg EAG/g). La correlación entre PF y CA fluctuó según el tipo de preparación. El contenido de PF y la CA son criterios de calidad adicionales al aporte de energía y nutrientes de las preparaciones. Los resultados apoyan la recomendación de aumentar el aporte a los escolares de frutas y vegetales/leguminosas en lugar de alimentos con alto contenido de almidones.

Phenolic compounds content and antioxidant capacity of meals provided to elementary public schools in Chile during 2011.

The Chilean National School Feeding Program (NSFP) delivers breakfast and lunch meals that supply 250 and 450 kcal, respectively, along the country. In the last decades, a significant increase of obesity has been observed in primary education children, and it involves risk factors of non-communicable diseases. The dietary intake of foods containing phenolic compounds (PC) exerts favorable effects on health by reducing risk factors of prevalent diseases. The aim of the study was to measure the PC content and antioxidant capacity (AC) [ORAC and DPPH] of meals provided by the NSFP in Quillota, Chile, in 2011. The PC supply of the whole meals served ranged from 362.7 to 1,730 mg GAE. The best breakfast foods include whole grain cookie (2.59 ± 0.3 mg GAE/g), bread with avocado, quince jelly or strawberry jam (1.61 ± 0.13 to 2.05 ± 0.3 mg GAE/g); while the best lunch salads include beetroot, lettuce, and cabbage/fish (1.66 ± 0.3 to 2.35 ± 0.1 mg GAE/g), and main courses contain legumes, or mixed vegetables. The lowest PC contents were observed in pasta and rice preparations (p < 0.05). Among desserts, the best source of PC is fruit (1.81 ± 0.04 to 6.91 ± 0.31 mg GAE/g). The correlation between PC and AC varied according to the type of meal. PC content and AC are additional criteria for selecting the best quality meals, in addition to the nutrients and energy content. The results support the recommendation to increase the supply of fruits and vegetable/legumes preparations and fruits instead of starchy foods to scholars.

Análisis de la norma técnica de salud de la Unidad Productora de Servicios de Salud de Nutrición y Dietética / Analysis of technical standards in health Services Producer Unit of Nutrition and Dietetics

El proceso administrativo involucra 4 pilares fundamentales que no han cambiado de manera significativa a lo largo de la historia. Lo que si ha cambiado es la forma en que estos principios se aplican en el trabajo diario. Sin embargo, y a pesar de la gran evolución del proceso administrativo, la aplicación de estos conceptos a la Gestión en Salud, no tiene más de 20 años. La aprobación de la NTS N°103-MINSA/DGSP-V.01 Norma Técnica de Salud de la Unidad Productora de Servicios de Salud de Nutrición y Dietética pone fin a un proceso de algo más de 3 años en los que se ha buscado dotar a los Nutricionistas de herramientas técnicas y de recursos humanos que les permitan desarrollar al máximo su potencial profesional.

The administrative process involves 4 pillars that have not significantly changed throughout history. The way these principles are applied in daily work is what changed. However, despite the great evolution of the administrative process, the application of these concepts to the Health Management, has no more than 20 years. The approval f the NTS No. 103-MINSA/DGSP-V. 01 "Technical Standards in Health of the HealthServices Producer Unit of Nutrition and Dietetics" ends a process of just over 3 years in which it is have been sought to provide Nutritionists of the technical tools and human resources to order to maximize their professional performance.

Evaluating the Wellness School Assessment Tool for use in public health practice to improve school nutrition and physical education policies in New York.

BACKGROUND: Addressing the limitations of existing Local Wellness Policies (LWPs) and promoting their implementation remain priorities for health and education agencies. One gap has been the absence of a standard assessment to support LWP revision. During planning for an initiative to improve school nutrition and physical education policy, the Wellness School Assessment Tool (WellSAT) was evaluated. METHODS: Five public health practitioners used WellSAT to assess 50 LWPs. A randomized, counterbalanced design ensured each LWP was coded twice by separate raters. Models evaluated the extent to which WellSAT ratings reflected differences in the LWPs and order, familiarity and rater effects. During field testing, 18 public health practitioners used WellSAT as part of a statewide public health initiative. RESULTS: In pilot testing the majority of the variability in WellSAT scores (median = 88%; range = 76% to 100%) was attributable to differences between policies. Correlations between independent raters' strength and comprehensiveness scores were strong, r = .88 and r = .77, respectively. During field testing, WellSAT was well accepted by public health practitioners and members of the school community. CONCLUSIONS: WellSAT represents a reliable and feasible tool for health and education agencies to use in improving LWPs and aligning them with recognized standards.

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services.

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, and academic performance of our nation's children. Local school wellness policies may strengthen comprehensive nutrition services by encouraging multidisciplinary wellness teams, composed of school and community members, to work together in identifying local school needs, developing feasible strategies to address priority areas, and integrating comprehensive nutrition services with a coordinated school health program. This joint position paper affirms schools as an important partner in health promotion. To maximize the impact of school wellness policies on strengthening comprehensive, integrated nutrition services in schools nationwide, ADA, SNA, and SNE recommend specific strategies in the following key areas: nutrition education and promotion, food and nutrition programs available on the school campus, school-home-community partnerships, and nutrition-related health services.

Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: comprehensive school nutrition services.

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, and academic performance of our nation's children. Local school wellness policies may strengthen comprehensive nutrition services by encouraging multidisciplinary wellness teams, composed of school and community members, to work together in identifying local school needs, developing feasible strategies to address priority areas, and integrating comprehensive nutrition services with a coordinated school health program. This joint position paper affirms schools as an important partner in health promotion. To maximize the impact of school wellness policies on strengthening comprehensive, integrated nutrition services in schools nationwide, ADA, SNA, and SNE recommend specific strategies in the following key areas: nutrition education and promotion, food and nutrition programs available on the school campus, school-home-community partnerships, and nutrition-related health services.

A "contract for change" increases produce consumption in low-income women: a pilot study.

This study determined whether a "Contract for Change" goal-setting exercise enhanced the effectiveness of the Expanded Food and Nutrition Education/Food Stamp Nutrition Education programs to increase produce consumption in low-income (<130% of poverty) women after 4 weeks. Thirty-eight participants were randomized in this three-group parallel arm study: (a) control group participants received life-skills lessons, (b) the education group received the Expanded Food and Nutrition Education/Food Stamp Nutrition Education "Food Guide Pyramid" lessons, and (c) the contract group also received the "Food Guide Pyramid" series and completed a "Contract for Change." It was hypothesized that the contract group would have the greatest increases in advancement toward dietary change and produce consumption. Compared with controls, the contract group significantly moved toward acceptance of vegetable consumption (P < or = .05). Compared with the education group, the contract group significantly increased fruit consumption. Results suggest that nutrition professionals can effectively use goal-setting to assist low-income populations with dietary change.

Improving patient meal satisfaction with room service meal delivery.

Cancer and cancer therapies cause side effects that prevent patients from consuming adequate amounts of food. As evidenced by patient meal consumption studies conducted at patients' bedside, only 39 percent of patients surveyed consumed greater than 50 percent of their main entree. The Food and Nutrition Services Department at Memorial Sloan-Kettering Cancer Center used the organization's performance improvement process, STRAIGHT-A, to develop and execute a room service program designed to increase patient meal consumption and improve patient meal satisfaction A multidisciplinary task force developed policies and procedures and tested new menu items as part of the room service plan. After program implementation, 88 percent of patients surveyed consumed greater than 50 percent of their main entree.

Using role delineation data to design dietetics education curriculums.

This discussion indicated the basis for the knowledge and performance requirements in the Standards of Education and related several requirements to selected activities in ADA's role delineation study. The examples showed how role delineation data can be used for curriculum development. Continued study of the role delineation data will provide additional and multiple uses for this important database.

[Vitamin levels in workers in the main departments of the coke-processing industry]. / Obespechennost' vitaminami rabochikh osnovnykh tsekhov kokso- khimicheskogo proizvodstva.

Providing with vitamins was studied in workers of the main shops of coal-tar chemical industry at the Karaganda Metallurgic Plant. Insufficient providing of workers with vitamins A, C, P and B was recorded. The results of the study have necessitated measures aimed at correcting vitamin-deficiency among these workers with due account for the data obtained.

[Nutritive value of daily food rations prepared in different regions of the country. III. The levels of calcium, phosphorus, magnesium, iron and potassium]. / Wartosc odzywcza calodziennych racji pokarmowych odtwarzanych w kilku regionach kraju. Cz. III. Zawartosc wapnia, fosforu, magnezu, zelaza i potasu.

Studies on the content of macrominerals in daily diets reconstructed in 1988 on the basis of the analysis of family budgets in 1986 carried out by the Central Statistical Bureau were carried on. Two social groups i.e. manual and mental workers with medium income were considered. The diets were prepared for 5 regions (Warszawa, Lublin, Olsztyn, Poznan, Wroclaw). According to the studies the requirements for calcium and magnesium were met in about 70% and those for iron in about 84%. The content of potassium in the diets was in the range of recommended allowances while the phosphorus exceeded the allowances by about 20-30%. The comparison of the presently studied diets with the ones from 1973, 1980, 1981 showed a lower degree of realization of the recommended intake of calcium and magnesium in 1986. The content of studied minerals in the diets was usually similar in all five regions.

Nutrition education and counseling: knowledge and skill levels expected by dietetic internship directors.

Development of nutrition education and counseling skills is important in the educational preparation of dietitians. A national survey of dietetic internship directors was conducted to determine competency levels expected of students at the start of an internship, internship training given, and further preparation students need in 32 knowledge/skills areas deemed essential for delivery of nutrition education and counseling services. Completed questionnaires were received from 66 of 102 (65%) internship directors surveyed. The majority of directors expected only basic preparation for group nutrition education and individual counseling knowledge/skills areas. Internship training in nutrition education competencies was "moderate" to "extensive," whereas preparation in nutrition counseling competencies was more likely to be "extensive." Directors perceived the internship to provide adequate preparation in all but the advanced practice skills, such as behavior modification and motivational strategies, for which further preparation was recommended. The majority of internship directors reported that more than 25% of the intern practice experience was in patient counseling, with less experience in group instruction. Implications for undergraduate dietetic education are discussed in relation to internship directors' expectations as well as to present and future trends in the dietetic profession.