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Biomedical subjects

C W Shanklin

Publications and source records attributed to C W Shanklin.

At least 19 recordsLinked to original sources

Solid waste management practices in U.S. Army medical treatment facilities.

U.S. Army medical treatment facilities (MTFs) will be challenged to reduce waste as the Army internalizes as environmental ethic and privatizes solid waste management. A questionnaire was modified to survey solid waste management practices, participation in waste reduction and recycling programs, and solid waste management problems in 25 MTFs. Questionnaires were returned by 19 (76%) of the sites. Eighteen sites participated in waste reduction and recycling programs. Twelve sites used contractors to disinfect potentially infectious solid waste off site. Mean importance ratings of waste reduction and recycling were 2.00 and 1.83 (1 = very important; 5 = very unimportant), respectively. Limited staffing was ranked as the most significant waste management problem, followed by cost and regulatory compliance. More information on waste generation in MTFs is needed. The Army Medical Department should be presented as a model of environmental and natural resource stewardship for the health care industry.

Conservation of Natural Resources↗

Factors other than environmental issues influence resource allocation decisions of school foodservice directors.

OBJECTIVE: To identify resource allocation decisions and policies and procedures used by school foodservice directors that were based on the concepts of pollution prevention, product stewardship, and sustainable development. DESIGN: A questionnaire about operational characteristics (including equipment and production systems, menu selection and service style) and environmental issues was mailed to school foodservice directors. SUBJECTS/SETTING: Subjects were school foodservice directors in major cities who were members of the American School Food Service Association. Of the 389 questionnaires mailed, 168 (45.5%) were returned and used for data analysis. STATISTICAL ANALYSIS PERFORMED: Descriptive statistics, analysis of variance, and correlation were used to analyze data. RESULTS: Cost factors were rated more important (P < or = .05) than environmental factors when operational decisions were made. Labor was ranked as the most important future issue by 45.0% of respondents, but it was not the most important factor when current operational decisions were made. Less than 20.0% of the respondents indicated that their districts had specific water (3.3%), energy (14.2%), or solid waste management policies (16.0%). However, 62.6% of respondents stated that their district had a recycling program. APPLICATIONS/CONCLUSIONS: With the exception of recycling programs, school foodservice departments have not adopted a framework of pollution prevention, product stewardship, and sustainable development practices. Recycling and energy conservation programs and use of locally grown food products would minimize the environmental impact of school foodservice operations while reducing operational costs.

Conservation of Natural Resources↗

Comparison of waste composition in a continuing-care retirement community.

OBJECTIVE: To determine the composition of wastes generated in a continuing-care retirement community (CCRC) and to analyze the effects of source-reduction activities and meal delivery system change on the amount of waste generated in the facility. DESIGN: A waste stream analysis was conducted at the same CCRC during spring 1994 (period 1: baseline), spring 1995 (period 2: source reduction intervention), and fall 1995 (period 3: service delivery intervention). Weight, volume, and collapsed volume were determined for food and packaging wastes. SETTING: Tray service and wait staff service are provided to 70 residents in a health care unit, and family-style service is an optional service available to 130 residents in the independent-living units. A mean of 229 meals are served per day. INTERVENTION: Intervention included the implementation of source-reduction activities and a change in a service-delivery system in periods 2 and 3, respectively. STATISTICAL ANALYSIS PERFORMED: Descriptive statistics were used to determine the composition of waste. Analysis of variance and a multiple comparison method (least significant difference) were used to compare mean weight and volume of waste generated in period 1 with data collected during periods 2 and 3. RESULTS: Mean waste generated per meal by weight and volume ranged from 0.93 to 1.00 lb and 1.44 to 1.65 gal, respectively. Significantly less production waste by weight (0.18 lb/meal) and volume (0.12 gal/meal) was generated in period 2 than in period 1 (0.32 lb/meal and 0.16 gal/meal, respectively). Significantly less service waste by weight (0.31 lb/meal) and volume (0.05 gal/meal) was discarded in period 3 than in period 1 (0.37 lb/meal and 0.15 gal/meal, respectively). Significantly less total waste and plastic by weight was disposed of after the interventions. The study conclusions indicated that implementing source-reduction practices and changing the meal-delivery system affected the composition of waste generated. APPLICATIONS: Knowledge of waste stream composition can help other foodservice professionals and consulting dietitians identify waste-reduction activities and recycling opportunities. The quantity and type of waste generated should be considered when operational decisions are made relative to market form of food, menu choices, service-delivery systems, and production forecast and controls.

Activities of Daily Living↗

Tray service generates more food waste in dining areas of a continuing-care retirement community.

OBJECTIVE: To determine if the type of service system affects the amount of service food waste (SFW) generated in dining areas of a continuing-care retirement community. RESEARCH DESIGN: A waste stream analysis was conducted for 7 days to determine quantity of SFW generated in three service systems: health care tray service, health care dining room with wait-staff service, and ambulatory dining room with family-style service. Weight and volume were determined. SETTING: Health care tray service and wait-staff service were provided to 70 residents in a health care unit. Family-style service was provided as an optional service for 130 residents in independent-living units. An average of 229 meals were served per day. STATISTICAL ANALYSIS PERFORMED: Analysis of variance and a multiple comparison method were used to compare mean weight and volume of SFW on a per meal, per day, and per week basis. RESULTS: During the 7-day period, 482.8 lb, or 83 gal, of SFW was disposed of Health care tray service generated more SFW by weight for all three meals than either family-style service or wait-staff service, and it generated the greatest total volume of service waste. Residents eating in the dining room with family-style service disposed of significantly less SFW by weight at lunch and dinner than those receiving the other two service styles. APPLICATIONS: Changing the style of service can affect not only quantity of solid waste generated and associated disposal costs but also food and supply costs, meal acceptability, and quantity of natural resources required. The systems approach should be used to assess the feasibility of changing service system so that all costs are considered.

Aged↗

Factors influencing success of dietitians employed in business and industry.

Career opportunities in business and industry have been identified as one area of growth for the dietetics profession. The purposes of this study were to identify the skills, attributes, and knowledge areas dietitians need to succeed in business and industry; ascertain methods used to acquire these; assess factors that influenced career change; and determine the degree of perceived adequacy of academic preparation by practitioners employed in business and industry. A questionnaire, developed on the basis of a Delphi study involving 21 dietitians employed in business and industry, was administered to a national sample of 387 members of the Dietitians in Business and Industry (DIBI) dietetic practice group who were employed in business and industry. The overall response rate was 299 (77%); respondents were from 39 states. Skills, attributes, and knowledge areas were identified for specific employment classifications in business and industry. Self-motivation and work experience in business were identified as the most important methods for acquiring skills for this area of practice. Challenge of a new position and diversity of job responsibilities had the most influence on career change of respondents. Undergraduate and graduate education were rated somewhat inadequate and adequate, respectively, by the majority of respondents. The findings indicate that positions in business and industry require specific skills, attributes, and knowledge that may not necessarily be attained through traditional approaches. Self-assessment and appropriate self-development activities are essential for success.

Career Choice↗

Attributes and qualifications that employers seek when hiring dietitians in business and industry.

A study was conducted to assess the employment trends of dietitians in business and industry and to identify attributes and qualifications essential to succeed in this segment of the industry. Results of the delphi process were utilized in the design of a questionnaire which would identify attributes and qualifications essential for success. The questionnaire was administered to a random sample of 300 members of the Dietitians in Business and Industry Practice Group and 300 prospective and current employers of dietitians. Response rates of 45.7% (no. = 137) and 29.0% (no. = 87) were attained for the dietitians and employers, respectively. The majority of current employers (72%) and prospective employers (62%) and dietitians (73%) responded that the trend of hiring dietitians in business and industry was increasing. Both dietitians (53%) and employers (41%) reported that new positions were being created for dietitians in their organizations. Operational experience was more important for positions in sales, whereas clinical experience was more important for positions in manufacturing organizations. Employers ranked a master's degree in business administration (MBA) as the second most important qualification; dietitians rated the MBA as fifteenth in importance. Dietitians ranked registration status (RD) as, fourth in importance; however, employers rated registration status as least important of the qualifications. Both employers and dietitians ranked communication skills as essential to succeed in business and industry positions.

Commerce↗

Status of menu item forecasting in dietetic education.

The status of forecasting techniques included in educational programs and the need for instructional material on this topic were investigated. A survey instrument was developed to determine which forecasting techniques were included in instructional programs. The validated questionnaire was mailed to directors of coordinated undergraduate programs or to Plan IV representatives at all universities with programs approved or accredited by the ADA. The response rate was 59%, or 156 dietetic programs. Analysis of the survey data revealed that mathematical techniques (Box-Jenkins, regression, exponential smoothing, moving average) were not taught in the majority of educational programs. Educators responded that forecasting was an important concept and that continuing education concerning forecasting techniques that may be employed in foodservice management was needed. As a result of the analysis of the data, two self-instructional modules that could be utilized by both practitioners and educators to enhance the level of practice and education were developed. Graduate and undergraduate students at 11 universities and 35 randomly selected practitioners tested the self-instructional modules. For all groups--undergraduate, graduate, and practitioners--the t-statistic was significant at the p less than .0000 level; thus the modules were effective in teaching foodservice forecasting concepts.

Dietary Services↗

Documentation of time expenditures of clinical dietitians: results of a statewide time study in Texas.

The purpose of this study was to establish a profile of the amount of time expended by clinical dietitians in providing nutrition services. One hundred twenty-seven dietitians in 49 hospitals in Texas collected time data according to nutrition care activity, diet order classification, care level, and diagnosis. Frequency, mean time, standard deviation, and percentage of time were computed for each of the variables. Data were analyzed to ascertain relationships among the variables. The dietitians expended 50.7% of their time performing client-related activities, 9.8% in administrative/managerial functions, 1.0% in professional activities, 5.1% in non-professional activities, 14.0% in delay activities, and 19.5% in transit time. The diet order classification that required the largest amount of the dietitians' time according to selected components of the nutrition care process was the calorie-controlled diabetic diet. Among the four nutrition care levels, dietitians expended the greatest percentages of time providing services for patients requiring intermediate (35.4%) and advanced intermediate care (30.4%). Dietitians expended more time providing client-related activities to patients diagnosed with diseases and disorders of the endocrine and excretory systems than to other patients. Mean times provide the clinical manager with documentation for determining staffing needs and costs of services.

Dietetics↗

Forecasting menu-item demand in foodservice operations.

The state of the practice in forecasting menu-item demand in foodservice operations was determined. A survey to assess the forecasting techniques utilized by foodservice directors was administered to a random sample of 834 American Dietetic Association Members with Management Responsibilities in Health Care Delivery System. Statistical analysis of the 392 responses revealed that less than 25% of the practitioners were using mathematical models in forecasting menu-item demand. Naive models were utilized by the majority of the respondents. The moving average technique was the most frequently used (14.8%) mathematical model. Approximately 75% of the practitioners indicated that continuing education is needed relative to the forecasting techniques that may be employed in foodservice management.

Food Preferences↗

Competencies of foodservice directors/managers required in health care operations.

The purpose of this research was to determine competencies of foodservice directors/managers as required by health care administrators and to ascertain the degree to which dietetic curriculums address those competencies. Validated questionnaires were mailed to a random sample of 376 health care administrators and 154 dietetic educators from various types of educational programs. Each questionnaire included 57 competencies representing the following areas: financial, technical, personnel management, nutrition services, production, and marketing. Health care administrators were asked to rate the degree of importance for each competency. Dietetic educators assessed the degree to which each competency was addressed in their curriculums. Of the 288 returned questionnaires, 243 contained usable data. Health care administrators' mean ratings were compared with dietetic educators' mean ratings. Significant differences were noted in 44 of the 57 competencies. Dietetic educators placed significantly greater emphasis on competencies related to nutrition services and significantly less on financial competencies than did health care administrators. Significant differences also were observed for selected competencies classified as technical and production. Results indicated that dietetic educators must continually evaluate curriculums and respond to the changing needs of the health care industry.

Administrative Personnel↗

State of the art in marketing hospital foodservice departments.

The purposes of this study were to identify the state of the art relative to the utilization of marketing techniques within hospital foodservice departments throughout the United States and to determine whether any relationships existed between the degree of utilization of marketing techniques and selected demographic characteristics of the foodservice administrators and/or operations. A validated questionnaire was mailed to 600 randomly selected hospital foodservice administrators requesting information related to marketing in their facilities. Forty-five percent of the questionnaires were returned and analyzed for frequency of response and significant relationship between variables. Chi-square was used for nominal data and Spearman rho for ranked data. Approximately 73% of the foodservice administrators stated that marketing was extremely important in the success of a hospital foodservice department. Respondents (79%) further indicated that marketing had become more important in their departments in the past 2 years. Departmental records, professional journals, foodservice suppliers, observation, and surveys were the sources most often used to obtain marketing data, a responsibility generally assumed by the foodservice director (86.2%). Merchandising, public relations, and word-of-mouth reputation were regarded as the most important aspects of marketing. Increased sales, participation, good will, departmental recognition, and employee satisfaction were used most frequently to evaluate the success of implemented marketing techniques. Marketing audits as a means of evaluating the success of marketing were used to a limited extent by the respondents.

Adult↗