Cultural perceptions of healthy weight in rural Appalachian youth.

INTRODUCTION: Rates of overweight among US children have been rising over the past three decades. Changes in lifestyle behaviors, including dietary and physical activity habits, have been examined thoroughly to identify correlates of weight status in children. Youth in rural US Appalachia are at a disproportionately greater risk for obesity and related health complications. Inadequate physical activity and poor dietary habits are two primary causes of obesity that have been noted in West Virginia adolescents. Few existing data describes the decisional balance in performing lifestyle behaviors, nor the perceptions of these youth regarding their beliefs about weight. The purpose of this study was to identify the perceptions of a healthy weight in rural Appalachian adolescents. METHODS: Ninth grade students were recruited from classroom presentations in four high schools throughout West Virginia. Interested parent-caregiver pairs returned forms to indicate interest in participation. Separate focus group interviews were conducted concurrently with adolescent and parents or caregivers to identify the cultural perceptions of a healthy weight. Questions were developed using grounded theory to explore how a healthy weight was defined, what factors dictate body weight, the perceived severity of the obesity issue, and the social or health ramifications of the condition. Verbatim transcripts were analyzed to identify dominant themes, and content analysis provided text segments to describe the themes. This article describes the data obtained from the adolescent focus groups. RESULTS: When asked what defined a healthy weight, the adolescents who participated in the focus groups placed great value on physical appearance and social acceptability. Students believed there was a particular number, either an absolute weight or body mass index value that determined a healthy weight. These numbers were usually conveyed by a physician; however, there was also a general acceptance of being 'thick' or a reliance on 'feeling healthy' as a determinant of maintaining a healthy weight. Despite these beliefs, many teens had unrealistic and unhealthy perceptions of weight. Female participants were more concerned with weight than males, some to the point of obsession. Both males and females expressed a social stigma associated with overweight. Issues of guilt and diminished self-esteem were prevalent. When asked about the extensiveness of the problem of childhood overweight, the students indicated that a degree of familiarity with being overweight has developed and 'you just get used to [seeing] it.' Because of the rising rates of chronic disease in this region, a fear was evident in these youth about the increased risk of developing these conditions in those who are overweight. Experiences with family members with diabetes and cardiovascular disease fueled these concerns, which instilled a fear of becoming overweight in many of the students. Many perceptions of healthy weight and appropriate body size were shaped by the media and entertainment industry. Additionally, some participants admitted to performing unsafe practices to reduce body mass, such as very low calorie diets or fasting. CONCLUSIONS: Youth in rural Appalachia present similar perceptions about weight as other children; however, differences in perceived healthy lifestyle habits and a general acceptance of a higher average body weight present additional challenges to addressing the increasing problem of child overweight. Despite the relative isolation of many of these communities, the media has a profound impact on weight valuation that has been intertwined with school-based health education and cultural values of health. These data will provide valuable information for the development of obesity prevention programs in rural Appalachia.

Dietetics and foodservice personnel are ready for team problem solving.

OBJECTIVE: To determine the readiness of dietetics and foodservice personnel for contributing to team problem solving. DESIGN: A descriptive, correlation study in which a five-part questionnaire was designed to collect data. SUBJECTS: Dietetics and foodservice personnel (n = 632) in eight hospital settings; 321 subjects (51%) volunteered to participate. STATISTICAL ANALYSES PERFORMED: Statistical data to summarize demographic information and two-way analysis of variance with a Scheffe post hoc analysis was used to investigate differences between dietetics and foodservice personnel on each of the subscales. RESULTS: In general, all respondents were somewhat oriented toward group problem solving and were confident in their problem-solving skills. Problem-solving expertise within the organization decreased for the respondents as the problem moved from their direct work areas to the organization level. Dietitians displayed higher self-efficacy in contributing to problem-solving teams than did foodservice personnel, indicating a 75% chance that they would contribute whereas all other respondents indicated a 50% chance of contributing. APPLICATIONS: The results of this study generate optimism for involving all dietetics and foodservice personnel in team problem solving. However, training activities are needed for both foodservice personnel and dietetics professionals.

Clinical nutrition managers have access to sources of empowerment.

OBJECTIVE: To ascertain perceived access of dietitians to power in the workplace. DESIGN: The conceptual framework was Kanter's theory of organizational power. The Conditions for Work Effectiveness Questionnaire was used to measure perceived access to sources of power: information, support, resources, and opportunities. Demographic data were collected to identify factors that may enhance empowerment. SUBJECTS/SETTINGS: The questionnaire was sent to a random sample of 348 dietitians chosen from members of the Clinical Nutrition Management dietetic practice group of the American Dietetic Association. Blank questionnaires were returned by 99 (28.4%) people not working as clinical nutrition managers, which left 249 in the sample. STATISTICAL ANALYSES: Descriptive statistics were used to organize and summarize data. One-way analysis of variance and t tests were performed to identify differences in responses based on levels of education, work setting, and information technology skills. RESULTS: Usable questionnaires were received from 178 people (71.5%). On a 5-point scale, scores for access to information (mean +/- standard deviation [SD] = 3.8 +/- 0.7), opportunity (mean +/- SD = 3.6 +/- 0.7), support (mean +/- SD = 3.2 +/- 0.9), and resources (mean +/- SD = 3.1 +/- 0.8) demonstrated that clinical nutrition managers perceived themselves as having substantial access to sources of empowerment. Those having higher levels of education, working in larger hospitals, having better-developed information technology skills, and using information technology more frequently had statistically significant higher empowerment scores (P = < or = .05) than contrasting groups in each category. APPLICATIONS/CONCLUSION: Clinical nutrition managers are empowered and able to assume leadership roles in today's health care settings. Their power may be enhanced by asserting more pressure to gain greater access to sources of power: support, information, resources, and opportunities.

Education and certification influence the nutrition and management knowledge of long-term-care foodservice managers.

OBJECTIVES: To describe nutrition knowledge, attitude toward nutrition, and management knowledge of long-term-care foodservice managers and to determine the relationship between these variables and the foodservice managers' personal and facility characteristics. DESIGN: Nutrition knowledge, management knowledge, and attitudes toward nutrition were measured using survey methodology designed for this study by modifying an instrument developed by the Nutrition Education Training Program for the Texas Department of Human Services. SUBJECTS/SETTING: Surveys were mailed to a random sample of 300 long-term-care foodservice directors from the 1,092 directors listed in the 1996 Ohio Department of Health Directory of Nursing Homes. The participants were 123 of the 300 foodservice directors (41%). STATISTICAL ANALYSES PERFORMED: Descriptive statistics, Spearman rank correlations, 1-way analysis of variance, and post hoc variance were calculated. RESULTS: Mean scores of respondents were 21.2 out of a possible 29 (73%) for the nutrition knowledge assessment, and 18.2 out of 26 (70%) for management knowledge. Dietitians and dietetic technicians scored significantly better than others on these tests. The mean score of attitudes toward nutrition was 4 on a 5-point scale (where 1 = strongly disagree to 5 = strongly agree). All participants requested more training in computers, nutrition terminology, and preparing appealing foods. APPLICATIONS: Dietitians and dietetic technicians are prepared with a wide scope of knowledge in nutrition and management. Thus, they are in an ideal position to take advantage of job opportunities in the area of foodservice management.

Reproductive inefficiency in male black-footed ferrets (Mustela nigripes).

The black-footed ferret (Mustela nigripes), once considered extinct, has benefited from captive breeding and subsequent reintroduction into native habitat. A high proportion of females (>90%) exhibit estrus in captivity during the spring breeding season. However, many males considered to be prime-breeding age (1-3 years old) fail to sire offspring. Breeding records in 1995 revealed that 40 of 73 males (55%) managed under the Black-Footed Ferret Species Survival Plan did not reproduce, despite being provided opportunity. The present study was conducted to determine the incidence and etiology of male reproductive failure in 1996 and 1997. In 1996, 38 of 69 (55%) 1- to 3-year-old males failed to sire offspring. Likewise, 35 of 60 (58%) males did not reproduce in 1997. Overall, 21% of adult males failed to sire young in three consecutive breeding seasons (1995-1997). Electroejaculate traits (ejaculate volume, sperm concentration, motility, morphology, and acrosomal integrity) from 29 proven breeder males were not different (P > 0.05) from those of 23 males that did not sire young (nonproven breeders). However, six categories of reproductive failure were identified for the 73 prime-breeding age, nonproven males: 1) underdeveloped testes (22%); 2) improper breeding position with the female (25%); 3) excessive aggression toward estrous females (9%); 4) copulation with no sperm detected at postcoital lavage (19%); 5) copulation with sperm in the vaginal lavage but no resulting pregnancy (18%); and 6) copulation with no vaginal lavage performed and no resulting pregnancy (7%). These data indicate that combined behavioral and physiologic factors, but not overall sperm quality, influence reproductive performance in male black-footed ferrets managed in captivity. Zoo Biol 19:517-528, 2000. Copyright 2000 Wiley-Liss, Inc.

Allied health professionals and attitudes toward teamwork.

This study was conducted to determine whether allied health disciplines' attitudes toward preparedness and willingness to participate in interdisciplinary teams differed. A structured questionnaire was used to measure five factors: orientation toward team problem solving, problem-solving confidence, preparedness for interdisciplinary teams, attitudes toward interdisciplinary teams, and self-efficacy in contributing to interdisciplinary teams. There were 410 completed questionnaires, for an overall return rate of 50%. Analysis of variance and Scheffe post-hoc statistical tests were applied in analyzing the data. In general, the respondents were positive for all of the factors. Medical technologists indicated the least preparation for interdisciplinary teams, whereas circulation technologists indicated the least confidence in contributing to the teams. Persons who had participated in interdisciplinary teams were more positive toward team problem solving and were certain of their abilities to contribute to a problem-solving team. Implications for educators are discussed.

Perceived differences in the importance and frequency of practice of clinical teaching behaviors.

The purpose of this study was to identify whether or not discrepancies existed between the importance of clinical teaching behaviors and the frequency with which those behaviors were practiced in the clinical setting. Surveys listing clinical teaching behaviors were distributed to preceptors and their students. Both groups completed the survey twice, ranking their perception of the importance of each behavior, as well as the frequency with which it was practiced in the clinical setting. Four different allied health disciplines from four, four-year undergraduate institutions in Ohio participated in the study. Means and standard deviations were calculated for each item. Two-tailed t-tests were applied to each set of responses, with p < 0.05 considered statistically significant. Results revealed that while both students and preceptors agreed on the importance of the items, they differed significantly (p < 0.05) with regard to the frequency with which effective clinical teaching behaviors were practiced.

Preceptor appraisals of rewards and student preparedness in the clinical setting.

The purposes of this study were to determine preceptors' expectations of students in the supervised practice setting; to identify rewarding and discouraging experiences in precepting; and to establish the perceived effect of the changing health care structure on precepting. A survey consisting of ten open-ended questions was mailed to 430 clinical instructors, representing five allied health programs. Results indicated that observing student growth was the most rewarding aspect of the preceptor role. Frustrating preceptor experiences included low student motivation and poor personal and professional behavior. Respondents expected students entering the clinical experience to have appropriate technical and communication skills. Increased pressures from health care restructuring are decreasing the internal rewards for preceptors. The findings of this study support both further preparation for students entering the clinical experience and a reward system for preceptors.

Prolonged mating in prairie voles (Microtus ochrogaster) increases likelihood of ovulation and embryo number.

Prairie voles are induced ovulators that mate frequently in brief bouts over a period of approximately 24 h. We examined 1) impact of mating duration on ovulation and embryo number, 2) incidence of fertilization, 3) temporal pattern of embryo development, 4) embryo progression through the reproductive tract over time, and 5) embryo development in culture. Mating was videotaped to determine first copulation, and the ovaries were examined and the reproductive tracts flushed at 6, 8, 10, 12, 16, 20, and 24 h and 2, 3, and 4 days after first copulation. The number of mature follicles and fresh corpora lutea and the number and developmental stage of embryos were quantified. One, two-, and four-cell embryos were cultured in Whitten's medium. Mature follicles were present at the earliest time examined (6 h). Thirty-eight percent of females that had been paired for < 12 h after the first copulation ovulated, whereas all females paired >/= 12 h after the first copulation ovulated. Virtually all (> 99%) oocytes recovered from females paired for >/= 12 h after first copulation were fertilized. Pairing time after first copulation and mean copulation-bout duration were significant (p < 0.05) determinants of embryo number. Embryos entered the uterine horns and implanted on Days 3 and 4, respectively, after first copulation (Day 0). Embryos cultured in vitro underwent approximately one cell division per day, a rate similar to that in vivo. We conclude that prairie voles ovulate reliably after pairing for >/= 12 h, although some females showed exceptional sensitivity not predicted by the variables quantified. Prolonged mating for longer than 12 h increased the total embryos produced. This mechanism likely has adaptive significance for increasing offspring number.

Age-dependent changes in sperm production, semen quality, and testicular volume in the black-footed ferret (Mustela nigripes).

The black-footed ferret (Mustela nigripes), which was extirpated from its native North American prairie habitat during the 1980s, is being reintroduced to the wild because of a successful captive-breeding program. To enhance propagation, the reproductive biology of this endangered species is being studied intensively. The typical life span of the black-footed ferret is approximately 7 yr. Female fecundity declines after 3 yr of age, but the influence of age on male reproduction is unknown. In this study, testis volume, seminal traits, sperm morphology, and serum testosterone were compared in 116 males from 1 to 7 yr of age living in captivity. Results demonstrated that testes volume during the peak breeding season was similar (P > 0.05) among males 1 to 5 yr of age, reduced (P < 0.05) among males 6 yr of age, and further reduced (P < 0.05) among males 7 yr of age. Motile sperm/ejaculate was similar in males 1 to 6 yr of age but diminished (P < 0.05) in those 7 yr of age. Males at 6 and 7 yr of age produced fewer (P < 0.05) structurally normal sperm than younger counterparts; however, serum testosterone concentrations were not reduced (P > 0.05) in older males. Histological comparison of testicular/epididymal tissue from 5- and 7-yr-old black-footed ferrets confirmed that the interval between these two ages may represent a transitional period to reproductive senescence. In summary, functional reproductive capacity of male black-footed ferrets exceeds that of females by at least 2 yr. Testes and seminal quality are indistinguishable among males 1 to 5 yr of age, with progressive reproductive aging occurring thereafter.