Proximity and information sharing in hospitals and nursing homes: Development of an instrument assessing health personnel's perceptions of proximity and information sharing with kitchen personnel.

Healthcare services are becoming increasingly specialized, potentially hampering interprofessional care. To provide holistic treatment and care, different professions and departments need to share information. Healthcare services also include support services, such as institutional food services, and health personnel and kitchen personnel need to share information about food and patients to serve food adapted to the patients' nutritional needs. Healthcare institutions mainly use formal information-sharing systems, but informal communication is considered more suitable for exchanging complex information. Physical and social proximity may facilitate informal information sharing across different professions and units. We aimed to develop and test an instrument for assessing health personnel's perceptions of physical and social proximity to, and information-sharing practices with, kitchen personnel and to describe associations between physical and social proximity and information-sharing practices. A survey questionnaire measuring proximity and information-sharing practices was developed and distributed to 368 health personnel. Scale analyses were performed to test the psychometric properties of the measures included in the questionnaire. MANOVA and regression analyses were run to assess associations between proximity and information-sharing practices. The results indicated reasonable validity of the measures, and both physical and social proximity were associated with increased informal information sharing.

Ultra-processed foods in institutional food services: what are diners eating?

Introduction. Frequent use of ultra-processed foods (UPF) leads to poor health outcomes, and the population must avoid their consumption. Objective. To assess the occurrence of ultra-processed foods (UPFs) in culinary lunch menus from various institutional food services. Materials and methods. Over one month, the five institutional food services analyzed served 1,128 culinary preparations; and a total of 3,863 ingredients were classified according to the extent and purpose of processing using the NOVA classification system. Associations between the occurrence of UPFs and the type, size, and management of food service establishments were analyzed. Five institutional food services in three municipalities (Bauru, Limeira, and Campinas), Brazil. Results. We found 8.4 % up to 12.6 % UPF ingredients used in culinary preparations. The highest frequency of UPFs was associated with private cafeterias (p = 0.002). Most UPFs were part of the recipe or the main ingredient in protein dishes and desserts (p < 0.05) and in university and hospital food services, respectively. UPF use was associated with food service size and type of management (p ≤ 0.003) and was more prevalent in protein dishes (p = 0.003) and large-size institutional food services (28.8 %). Self-managed units (p = 0.03) also use high amounts of UPFs in protein dishes (20.3 %). Conclusions. The presence of UPF rounded 10%; the validity of this value needs further studies. There are no comparative data in the scientific literature regarding the use of these ingredients in institutional food service culinary preparations. Therefore, it is necessary to stimulate reflection to promote healthy food habits and adequate nutrition for diners(AU)

Introducción. El uso frecuente de alimentos ultraprocesados (UPF) conduce a complicaciones de salud, y la población debe evitar su consumo. Objetivo. Evaluar la presencia de alimentos ultraprocesados (UPFs) en los menús de almuerzos de diversos servicios de alimentación institucionales. Materiales y métodos. Durante un mes, los cinco servicios de alimentación institucionales analizados sirvieron 1.128 preparaciones culinarias; y se clasificaron un total de 3.863 ingredientes según el alcance y el propósito del procesamiento, utilizando el sistema de clasificación NOVA. Se analizaron las asociaciones entre la ocurrencia de UPFs y el tipo, tamaño y gestión de los establecimientos de servicio de alimentos. Cinco servicios institucionales de alimentación en tres municipios (Bauru, Limeira y Campinas), Brasil. Resultados. Se encontró entre un 8,4 % hasta un 12,6 % de ingredientes UPF utilizados en las preparaciones culinarias. La mayor frecuencia de UPF se asoció a cafeterías privadas (p = 0,002). La mayoría de los UPFs formaban parte de la receta o eran el ingrediente principal en platos proteicos y postres (p < 0,05) y en los servicios de alimentación universitarios y hospitalarios, respectivamente. El uso de UPFs se asoció con el tamaño del servicio de alimentación y el tipo de gestión (p≤ 0,003) y fue más frecuente en platos proteicos (p = 0,003) y servicios de alimentación institucional de gran tamaño (28,8 %). Las unidades autogestionadas (p = 0,03) también utilizan altas cantidades de UPF en platos proteicos (20,3 %). Conclusiones. La presencia de UPF ronda el 10 %; la validez de este valor necesita más estudios. No existen datos comparativos en la literatura científica sobre el uso de estos ingredientes en las preparaciones culinarias de los servicios de alimentación institucional. Por ello, es necesario estimular la reflexión para promover hábitos alimentarios saludables y una adecuada nutrición de los comensales(AU)

Institutional food as a lever for improving health in cities: the case of New York City.

OBJECTIVES: To describe and examine the factors that most facilitate and impede the provision of healthy foods in a complex institutional food system. STUDY DESIGN: Comparative case study of three institutional food settings in New York City. METHODS: Document review and interviews with relevant city government staff. RESULTS: Factors that facilitate and impede the provision of healthy food vary across institutional food settings, and particularly between centralized and decentralized settings. Generally pro-health factors include centralized purchasing and the ability to work with vendors to formulate items to improve nutritional quality, though decentralized purchasing may offer more flexibility to work with vendors offering healthier food items and to respond to consumer preferences. Factors most often working against health in more centralized systems include financing constraints that are unique to particular settings. In less centralized systems, factors working against health may include both financing constraints and factors that are site-specific, relating to preparation and equipment. CONCLUSIONS: Making changes to institutional food systems that will meaningfully influence public health requires a detailed understanding of the diverse systems supporting and shaping public food provision. Ultimately, the cases in this study demonstrate that agency staff typically would like to provide healthier foods, but often feel limited by the competing objectives of affordability and consumer preference. Their ability to address these competing objectives is shaped by a combination of both forces external to the institution, like nutritional regulations, and internal forces, like an agency's structure, and motivation on the part of staff.

Práticas alimentares e perfil lipídico indesejável em trabalhadores petroquímicos / Eating habits and undesirable lipidic profiles in petrochemical industry workers

No universo dos trabalhadores de uma indústria petroquímica de Camaçari, Bahia - Brasil, foi realizado estudo de corte transversal, para medida da associação entre práticas alimentares e perfil lipídico indesejável. Os dados sobre hábitos alimentares e atividade física foram obtidos por questionário semi-estruturado e os dados secundários, clínico-laboratoriais e dietéticos, a partir da ficha clínica padronizada e da ficha do cardápio diário. Para análise, foram usadas as Prevalências (P), Intervalos de Confiança a 95% (IC 95%), Razões de Prevalência (RP) e regressão logística. A quota energética média, consumida diariamente, numa única refeição, na indústria, independentemente do turno de trabalho, correspondeu a 96,1% da quota energética, total, média diária, dos trabalhadores. A prevalência das práticas alimentares mais lipídicas foi de 63,9%, IC (53,6; 74,2); de colesterol total indesejável de 49,4%, IC (38,6; 60,2) e a da não participação no Programa de Qualidade de Vida, de 60,2%, IC (49,7; 70,7). A RP entre práticas alimentares e perfil lipídico indesejável, de 1,43, IC (1,02; 2,01), com p < 0,05.

A cross-sectional survey was conducted to assess the association between eating habits and undesirable lipidic profiles in the universe of petrochemical workers (n = 83) in Camaçari, Bahia, Brazil. The data concerning eating habits and physical activities were obtained using semi-structured questionnaires, while the secondary data, i.e. the clinical and laboratorial data were obtained using standardized clinical data registration forms and the daily menu records. Analysis input elements consisted of: Prevalences (P); Confidence Intervals up to 95% (IC 95%); Prevalence Quotient (RP) and Logistical Regressions. The average energetic quota ingested per day in a single meal within the industrial plant, independent of the work shift corresponded to 96.1% of the total average energetic quota for the workers. The prevalence of more lipidic eating habits was 63.9%, IC (53.6; 74.2); undesirable cholesterol 49.4%, IC (38.6; 60.2) and non-participation in the Quality of Life Program was 60.2% (IC (49,7; 70,7). The Prevalence Quotient (RP) between eating habits and undesirable lipid profile was 1.43, IC (1.02; 2.01), with p < 0.05.