Perspectives on history: army dietetics in southwest Asia during Operation Desert Shield/Desert Storm.

The Army dietitians deployed during Operation Desert Shield and Operation Desert Storm exemplified the commitment, dedication, patriotism, and professionalism of their predecessors. Although some were continuously on the move and all dealt with the extremes of a desert environment, were frequently handicapped with equipment shortages, and coped constantly with the monotony of limited ration variety, throughout their experiences these professionals expressed pride in participating in this national undertaking. The purposes of this article are to familiarize members of The American Dietetic Association with the responses of their colleagues in the US military to another of their nation's calls, to relate some aspects of Army dietetics experienced in Southwest Asia, and to identify the lessons learned in that engagement.

Perspectives on history: Army dietitians in the European, North African, and Mediterranean theaters of operation in World War II.

World War II necessitated the mobilization of hundreds of dietitians to serve in military hospitals in the United States and in theaters of war all over the globe. Although initially military dietitians had civilian status, on December 22, 1942, Congress passed Public Law 828, which authorized military status for Army dietitians with relative rank in the Medical Department for the duration of the war and 6 months thereafter. This article chronicles the role of Army dietitians who supported the allied troops in military hospitals in England, Europe, and North Africa during World War II. Recollections of military dietitians who served in the war are included to illustrate the circumstances under which these professionals lived and the dedication with which they worked.

Perspectives on history: military dietetics in Europe during World War I.

The histories of dietetics and the US military have been intertwined since the late 19th century. Born in the turbulent year of 1917 in an effort to make significant contributions to the United States as it prepared to enter World War I, The American Dietetic Association rapidly became a viable organization of dedicated, professional women who were committed to improving the nutritional health of the nation. Even before the organization was formed, however, dietitians were needed by the military in the United States and Europe to support the medical needs of the troops. This article also focuses on the recruitment of dietitians by the American Red Cross, the dietitians' response, and the conditions under which they worked in Europe. Several individuals, including Mary Pascoe (later Huddleson), Marjorie Hulsizer (later Copher), Mary de Garmo (later Bryan), and Lenna Frances Cooper, are featured. These military predecessors and professional leaders served our country with dedication and honor during a critical hour of need.

Impact of nutritional care upon return-to-duty rates.

Returning soldiers to duty is a primary goal of the medical department. One of the most critical factors in achieving this goal is the soldier's nutritional status--both prior to the trauma and during treatment. This article reviews the role of nutrition in healthy lifestyles, the effect of stress and the role of nutrition in wound healing, and the role of the registered dietitian in providing nutritional care. Implications for maximizing the return-to-duty rate through inclusion of a registered dietitian on the treatment team are identified.

Perspectives on history: military dietetics in the Philippines during World War II.

The history of the profession of dietetics is a history of caring, dedicated, and capable individuals. This article examines the experiences of three dietitians during World War II in the Philippines--their pre-war status and their changing environments as the Japanese invaded the Philippines in overwhelming numbers. It recounts the extreme hardships they endured for 3 years as prisoners of war of the Japanese at Santo Tomas Internment Camp (formerly Santo Tomas University) in Manila. The article covers the time before Army dietitians had military status and concludes shortly after the former prisoners returned to the United States, when they were commissioned and promoted to the rank of first lieutenant.

Comparing participants' and managers' perception of services in a congregate meals program.

Managers and participants in a Title III C meals program were surveyed to explore how differences in perception of program and service quality affect participant acceptance and evaluation of the program. A nutrition monitoring instrument was designed for managers at 14 meal sites to assess major components of the foodservice operation. A survey addressing participant perception of meal quality, meal acceptance, program administration and management, and foodservice personnel was designed and administered to 264 participants. The two surveys contained 17 identical or similar questions to determine any perceptual differences. The influence of social variables on participant response was examined. A significant positive correlation was found for age vs. food temperature, age vs. frequency of participation, and education level vs. evaluation of foodservice workers. Significant negative correlations were found for sex vs. special diets, sex vs. food aversion, education level vs. food temperature, and education level vs. evaluation of the nutrition education component. Manager vs. participant response significantly differed for food temperature, special diets, nutrition education, transportation, and accuracy of posted menus. Assessment of participant vs. manager perception of meal and service quality is recommended to management for more effective program planning, evaluation, and continuous quality assurance.

Counseling strategies for dietary management: expanded possibilities for effecting behavior change.

Successful nutrition counseling culminates when a client develops a sound working knowledge and practice of good health behaviors, compatible with his/her capabilities and environment. Attainment of that goal requires the cooperation and active participation of both the nutrition counselor and the client. Counseling methodologies abound. The incorporation of strategies and techniques from different approaches into the treatment protocol, using a multidisciplinary approach, may enhance the effectiveness of nutrition counseling in facilitating dietary behavior change. A schematic model of nutrition counseling is presented, and varying counseling theories are introduced that could be incorporated into the model.

Preparation of pooled cryoprecipitate for treatment of hemophilia A in a home care program.

Cryoprecipitate is used infrequently in home therapy for patients with hemophilia A since freezer storage is required and resuspension and pooling of thawed cryoprecipitate is cumbersome. We evaluated procedures for preparation of cryoprecipitate in an "open system" so that four to six bags of cryoprecipitate could be pooled after production and refrozen for home therapy. Factor VIII activity for pooled cryoprecipitate was 132 +/- 30 (mean +/- SD), 125 +/- 45, and 145 +/- 47 units per bag pooled in three separate studies. Cultures from cryoprecipitate pools and individual cryoprecipitate bags did not show contamination in the "open system" or with the water bath thawing procedure. The mean increment in factor VIII activity per unit per kg infused was 0.02 units per ml and the mean half-life was 10.5 hours in three patients with hemophilia A. Pooled cryoprecipitate was shown to be clinically efficacious and acceptable for use in home care programs for hemophilia A.