Operation and Process Evaluation of a Community Meal Program for the Elderly in Rural Areas during Agricultural Off-Season Perceived by Cooking Volunteers / 대한지역사회영양학회지

OBJECTIVES: This study examined the practices of a community meal program for older adults in rural areas during the agricultural off-season. METHODS: A survey was conducted from December 12 to December 22, 2016. Self-administered questionnaires were distributed to 150 cooking volunteers, who had participated in the community meal program in 50 villages. A total of 114 responses were returned from 44 villages and used for data analysis. In addition, in-depth interviews were conducted with the volunteers of eight villages. RESULTS: Most of the cooking volunteers were 50 years old or older and they participated in serving older adults meals for good will. The cooking volunteers perceived that the older adults in their community did not eat various foods, had difficulties in grocery shopping, and frequently consumed salty foods. During the agricultural off-season, 40.9% of villages served the older adults meals 6–7 days a week and 95.5% provided meals for lunch. An average of 21 to 40 older adults were served meals in each village. The cooking volunteers reported that the food preparation and meal service times were sufficient, recipes provided were useful, and menus met the preference of the older adults. At the end of the program, they felt proud of serving meals for older adults in the community. An increased awareness of healthy eating, interest in health, and consumption of nutritious meals, a decrease in loneliness among older adults, and the promotion of fellowship in the community were rated highly. The cooking volunteers expected additional support for cooking personnel and insisted that the program should be provided for the entire agricultural off-seasons. CONCLUSIONS: The community meal program during the agricultural off-season for the elderly in rural areas was effective in improving the dietary life of older adults, relieving their feelings of isolation, and promoting fellowship of the community. The volunteers felt workload due to a shortage of volunteers but answered that they were rewarded by helping older adults in their community.

Meal and Food Provision Services for Community-dwelling Vulnerable Older Adults Perceived by Health & Welfare Service Providers in Seoul

The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for ‘home-delivered meal and side dish services are effective for checking older adults’ conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.

Effects of Nutrition Education and Personalized Lunch Service Program for Elderly at Senior Welfare Center in Jeonju / 대한지역사회영양학회지

The purpose of this study was to investigate the effects of a nutrition education and personalized lunch service program in a senior welfare center. A total of 30 elderly (14 males, 16 females) aged 62~89 years participated in this study. Nutrition education lessons (2 hour/lesson/week) were provided for 4 weeks. Also, ten weeks from week 3rd to week 12th, personalized lunch providing 1/3 personal needed energy was served 5 times for a week. After the nutrition intervention program, we compared anthropometric characteristics, blood biochemical characteristics, nutrition knowledge, dietary attitude and dietary intake using 24 hr recall with those before the intervention. The body weight (p < 0.001) and body mass index (BMI) (p < 0.001) were decreased. There were significant increases in score of nutrition knowledge (p < 0.01) and consumption of milk & milk products for snacks. There was a positive effect on fasting blood sugar (FBS) showing significant decreases in portion of impaired fasting glucose and diabetes mellitus (p < 0.05). Also, serum triglyceride (TG) was significantly decreased (p < 0.05). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), riboflavin (p < 0.01), vitamin C (p < 0.001), calcium (p < 0.05) were positively improved. The index of nutritional quality (INQ) and intakes of vitamin C (p < 0.001), riboflavin (p < 0.05), Ca (p < 0.01) and Fe (p < 0.05) were increased. In conclusion, this nutrition education and lunch service program providing 1/3 personal needed energy can be used to develop and implement a tailored nutritional intervention programs in the setting of a community senior welfare center to improve health and nutritional status of Korean elderly.

Radical Surgery for Carcinoma of the Gallbladder

BACKGROUND: Carcinomas of the gallbladder have a poor prognosis, and the only chance for cure lies in early detection and complete surgical resection. The objective of this study was to determine the outcomes of surgical treatment for gallbladder carcinomas, with special reference to the histopathologic characteristics. METHODS: Seventy patients with gallbladder carcinomas were operated on during a period of seven years. Of those 42 patients underwent a resection for cure and were included in this study. The clinicopathologic data were collected, and the survival was measured. RESULTS: The resection rate was 60.0%. Operative morbidity and mortality were 14.3% and 4.8%, respectively. The 3-year survival rate after resection was 61.1%. The survival rate was significantly higher in patients with negative lymph-node metastasis and in those with a curative resection. Regional lymph-node metastasis, venous invasion, lymphatic permeation, and perineural infiltration increased with the depth of tumor invasion. In cases limited to the mucosa, no lymph-node metastasis or other extensions were observed. In patients with stage I gallbladder carcinomas, the outcome was good after a simple cholecystectomy alone. In stage II to IV, the survival rate for patients with a radical resection was higher than that for those with a simple cholecystectomy. CONCLUSIONS: Improved survival in gallbladder carcinomas can be achieved by a radical resection, including various types of liver resections and regional lymphadenectomies. Patients with tumors limited to the mucosa can be treated for cure by a simple cholecystectomy. In more advanced stages, a radical resection should be performed.