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PubMed2000

Assessment of hospital morbidity, mortality, and cost-effectiveness of a nutritional program for children under 5 years of age in Pala, Chad.

This paper analyses the effectiveness of case management at referral level for malnourished sick children in a rural district health system in the south of Chad (Pala district). The methodology followed was based on a cohort study of malnourished children as well as a cost-effective analysis of alternative options for nutritional rehabilitation strategies. Results show that effective case management at hospital level is possible with few resources as long as the nutritional rehabilitation programme is implemented on an integrated basis including early diagnosis of malnutrition for all children admitted to hospital and not to wait for a normal weight-for-height but discharge when the hospital is no longer the best place to avoid further mortality.

Case Management↗
PubMed1984

Evaluating primary health care and nutrition programs in the context of national development.

This paper illustrates an evaluation model incorporating research techniques of both primary health care and social anthropology. The case in point is the Jamaican Government's Community Health Aide Programme, which employs over 1300 auxiliary health workers to serve the low-income population of the island. The study demonstrates a cardinal principle of the anthropological approach--a grounded and holistic understanding of the social and environmental context is necessary to translate data into useful information. The study demonstrates connections between the distribution of care, the power of the cosmopolitan medical profession, and the Jamaican political patronage system. Finally, the impact of the program is assessed on child growth measures against the background of the Jamaican economy as it evolved from 1970 to 1980.

Community Health Workers↗
PubMed1976

Menu planning in the Nutrition Program for the Elderly. Modified Nutrient Standard Menu method.

A nutrient standard menu (NSM) planning method was developed for use in planning menus which provided one-third the Recommended Dietary Allowances for persons sixty years of age or older for nine indicator nutrients and calories, while restricting fat to less than 40 per cent of total calories. To eliminate manual calculations and make it easy for individuals untrained in dietetics or nutrition to use NSM planning, the nutrient composition of over a thousand commonly used menu items was listed in a menu planning manual in nutrient units which were one-tenth of the nutrient standard for the meal. Menus from third-party sources were monitored by selecting similar nutritionally analyzed menu items in the manual and adjusting the nutrient composition to conform to the portions actually served. Ten site managers of the Administration on Aging (AoA) evaluated the planning/monitoring method. The members of the group, on the average, were fifty-six years of age, had 1.6 years of education beyond high school, and had 4.6 years of foodservice experience. Approximately 83 per cent of the evaluators did not plan to monitor menus at their sites and had no formal training in dietetics or nutrition. Eighty-four per cent were able to plan menus satisfactorily after this brief introduction. The younger evaluators with more education grasped the concepts faster and were able to plan menus with greater accuracy. The data also indicated that previous experience in menu planning enhanced their ability to plan NSMs. Most felt the approach to be workable and applicable. Menu monitoring was more difficult for the evaluators. Seventy-five per cent were able to monitor menus satisfactorily, and all felt they could do so with more time. The data again showed that the younger individuals having more formal education were able to master the monitoring skills more easily.

Adult↗
PubMed1983

ASHP guidelines for pharmacist participation in home parenteral nutrition programs.

Pharmacists must make their own decisions as to whether they elect to participate in HPN programs. They need to determine the financial, social, and professional impact of an HPN program upon their institution. They need to consider the availability of these services from other hospitals or through private providers of home-health care. These guidelines are intended to help pharmacists make these decisions.

Home Nursing↗
PubMed1977

[Community health aide. Critical estimation of his task within the nutrition program].

Community Health Aides (CHA), locally recruited and trained, visit households and identify malnourished children by means of weighing them in monthly intervals, recording the results on "Gomez" weight-for-age charts. The CHA acts as the people's nearest adviser. In order to become a useful if not the most important member of the health team, some common mistakes and distorted views should be corrected early in her career. The weight-for-age chart is an invaluable tool to record the child's state of health. It is the trend in weight gain that is relevant and not an isolated weight point on the graph. Maternal, perinatal and neonatal histories should be taken as they help to classify the low weight child. 3/4 of the children in the Young Child Nutrition Programme (YCNP) are underweight but also underheight for age. The designation of malnutrition grade I/II/III is misleading. Either one speaks of "undernutrition" if one considers weight-for-age only or one takes other anthropometric measurements such as the height or length in order to classify Protein-Energy-Malnutrition. A physical examination and clinical records are essential in the evaluation of malnutrition - one should not rely on the graph only. By measuring the height of children, one may well be surprised to discover that many children in St. James are on the obese side. Obesity is another form of malnutrition prevalent in the wealthy societies of western industrialized countries. It is paradox that we should increase the number of obese people in a world which is threatened by shortage of food energies and proteins.

Age Factors↗
PubMed1981

Nutrient intake, adiposity, plasma total cholesterol, and blood pressure of rural participants in the (Vermont) Nutrition Program for Older Americans (Title III).

The interrelationships of obesity, hypertension, elevated plasma cholesterol (risk factors), and intakes of selected nutrients were examined among elderly subjects attending a congregate meal program in Vermont. Mean nutrient intakes were significantly higher for 22 males compared to 69 females. Mean plasma cholesterol levels were higher in females. Age, systolic and diastolic blood pressure, and indices of adiposity showed no sex differences. Intakes of total fat and animal protein increased in males but plasma cholesterol decreased with age. Systolic blood pressure in females increased while body mass index decreased with age. A higher proportion of females had plasma cholesterol levels greater than or equal 260 mg/100 ml and a higher proportion of females than males greater than 73 yr of age had blood pressures at risk level. There was a greater proportion of females than males with both elevated plasma cholesterol levels and adiposity. Similarly the females had greater incidence of the combination of any two risks. No males, compared to 9% of females, were in the all three risk category.

Aged↗
PubMed1995

Response rates to six recruitment mailing formats and two messages about a nutrition program for women 50-79 years old.

Recruiting participants for large prevention trials is time consuming and costly. In order to test various recruitment techniques, we conducted two studies of response rates to recruitment mailings for the Women's Health Trial. The potential participants, 50- to 79-year-old women, were requested to return an enclosed postcard to learn more about the trial. In the first study, we sent at random either a short or a long message to a group of University of Miami personnel (N = 862) and a Dade County cohort (N = 2964). More university women responded to the short message than to the long message (22.4% vs 16.4%, p = 0.024). Similarly, more of the Dade County cohort replied to the short message than to the long one (12.1% vs 9.6%, p = 0.027). The long message listed details of the intervention (e.g., modifying recipes) that some women may have used to decide they were not interested in participating. In the second study, we examined response rates to two different ways of addressing the mailing, i.e., handwritten envelopes and machine-printed labels; we also evaluated three methods for delivering the short message: (1) formal invitation, (2) business letter with an inside name and address of the recipient, and (3) business letter without the recipient's name and address. Response rates were similar between the methods of addressing envelopes and among the three vehicles for the message, suggesting that the least costly method of mailing should be used.

Aged↗
PubMed1996

Assessment and related immunization issues in the Special Supplemental Nutrition Program for Women, Infants and Children: a status report.

This article reports the results of a survey undertaken to determine the current level of collaboration between Women, Infants and Children (WIC) programs and immunization services. While the results of this study are encouraging, WIC needs to continue to place emphasis on using written or computerized immunization records for client screening, utilize available computer hardware and software to assist assessments, and expand the use of food voucher incentives as a strategy to improve coverage.

Health Services Accessibility↗
PubMed1990

Evaluating community-based nutrition programs: assessing the reliability of a survey of grocery store product displays.

A pilot test of a survey of grocery store product displays was conducted to measure the amount of health-education information provided and the proportion of the display devoted to "healthier" products. Inter-rater reliability ranged between 0.73 and 0.78 for the healthiness indices and between 0.30 and 0.67 for the health education measures. Test-retest reliability ranged from 0.44 to 1.0.

Food Labeling↗