Feeding and Nutrition for People with Dementia in Gerontological Services: A Focus Group Study.

Purpose: This work sought to describe the experience of managers and caregivers with feeding and nutrition for older adults with dementia, in Colombian gerontological services. Participants and Methods: This is a qualitative focus group study with fourteen gerontological care centers for people with dementia. Results: The study reveals that care related to food and nutrition for people with dementia is organized based on the comprehensive assessment of the resident. Although there are basic support strategies, each caregiver requires specific knowledge, attitudes, behaviors, and institutional support, to generate a context that favors the health and quality of life of those involved. Conclusion: The experience of caring for people with dementia in aspects related to their food and nutrition, seen from the perspective of managers and caregivers of gerontological services in a developing country, strengthens specific strategies and public policies. This, in turn, reduces the burden on caregivers.

High Turnover in Clinical Dietetics: A Descriptive Analysis.

Purpose: To identify key attributes of Canadian clinical registered dietitian (RD) jobs associated with high rates of turnover.Methods: Managers of clinical RDs in Canada were eligible to complete a survey on the topic of turnover in clinical RD positions. Specifically, key details were sought regarding positions with the highest and lowest turnover in each manager's portfolio.Results: High turnover (HT) positions turned over an average of 4.0 times in a 5-year period in contrast to 0.3 times in low turnover (LT) positions. Resignation was the top reason for turnover in both HT and LT positions. HT and LT positions were of analogous full-time equivalent, had comparable caseloads, and served clients/patients with similar diagnoses including diabetes and neurological conditions.Conclusions: There is significant variation in the frequency of turnover across positions in clinical dietetics in Canada. What differentiates HT positions from LT positions remains unclear. More research is required to guide managers seeking to balance turnover and preclude uneven nutrition care quality across units and programs.

Evaluación antropométrica en gestantes atendidas en el Policlínico Turcios Lima, Pinar del Río / Anthropometric assessment in pregnant women at N0-1 Basic Working Team from Turcios Lima University Polyclinic, 2020

RESUMEN Introducción: el riesgo de complicaciones durante el embarazo o el parto, como consecuencia de una ganancia de peso inadecuada, ha generado un creciente interés en la medicina. Objetivo: describir las principales medidas antropométricas, en gestantes del Grupo de Trabajo 1, del Policlínico Universitario Turcios Lima, en el período de enero a junio de 2020. Métodos: se realizó un estudio observacional, descriptivo y transversal. El universo de estudio estuvo representado por 443 gestantes y la muestra por las 87 que cumplieron con los criterios de inclusión y exclusión. Para la obtención de la información fueron utilizadas las historias obstétricas y las Historias de Salud Familiar. Se utilizaron métodos de estadística descriptiva, frecuencia absoluta, frecuencia relativa y el método porcentual, además de la media y desviación estándar. Resultados: existió un predominio de las gestantes normopeso al inicio del embarazo, entre 20 y 29 años. Según la distribución de las gestantes de acuerdo a la ganancia de peso durante el segundo y tercer trimestre, existió una superioridad de las que tienen una ganancia de peso ideal. De acuerdo a las medidas antropométricas en el primer control las pacientes se encontraron en las medidas establecidas, la mayoría de ellas, en cuanto a la media como tendencia central, con una dispersión de la desviación estándar, cerca de los datos primarios para el perímetro braquial y la circunferencia del brazo. Conclusiones: la medición de las diferentes medidas antropométricas en la gestante permite integrar un diagnóstico integral y estratificar riesgos y complicaciones.

ABSTRACT Introduction: the risk of complications during pregnancy or delivery, as a consequence of an inadequate weight gain has generated an increasing interest in medicine. Objective: to describe the main anthropometric measures in pregnant women at N0-1 Basic Working Team from Turcios Lima University Polyclinic during January-June 2020. Methods: an observational, descriptive and cross-sectional study was carried out. The target group comprised 443 pregnant women and the sample included 87, who were intentionally taken from those who met the inclusion and exclusion criteria. To collect the information the obstetric and family-clinical histories were revised. Descriptive statistics was applied, along with absolute and relative frequencies, the percentage methods as well as the mean and standard deviation. Results: normal weight at the beginning of pregnancy and ages between 20 and 29 predominated. According to the distribution of pregnant women related to weight-gain during the second and third trimester, there was a higher rate of those having an ideal weight-gain. In relation to the anthropometric measurements at the first control, it can be emphasized, these were among the established ranges, the majority of them, regarding to the mean, as central trend, with a dispersion of the standard deviation, close to the primary data for the brachial perimeter and the circumference of the arm. Conclusions: different anthropometric measurements in pregnant women allow establishing a comprehensive diagnosis and to stratify risks and complications.

Aprimoramento e validação de conteúdo de instrumentos para avaliar a qualidade de dietas hospitalares / Improvement and validation of the content of instruments to evaluate quality of hospital diets

Introdução: A avaliação da qualidade das refeições hospitalares pode contribuir para a melhor aceitação pelo paciente. Objetivo: Aprimorar e validar o conteúdo de instrumentos para avaliar a qualidade das dietas hospitalares. Método: Estudo realizado em unidade hospitalar do Rio de Janeiro para aprimoramento de formulário próprio para fiscalização do fornecimento de refeições. Para atender a todas as dimensões da qualidade, o formulário foi desdobrado em dois instrumentos, para avaliação da qualidade sensorial (AQS) e da qualidade higiênico-sanitária (AQH), e seu conteúdo foi submetido à validação através de painel de especialistas e da técnica Delphi adaptada. Após aprovado, foi aplicado em 12 cardápios das grandes refeições para avaliação das conformidades. O estudo foi aprovado pelo Comitê de Ética da instituição. Resultados: Tanto para AQS como para AQH, os itens relacionados a "apresentação/design", "clareza semântica", "facilidade de entendimento" e "facilidade de preenchimento" obtiveram concordância na primeira rodada. Uma segunda rodada foi necessária para readequação da "capacidade de avaliação" nos dois instrumentos. Após obtenção de no mínimo 91,7% de concordância para AQS e o mínimo de 90,1% para AQH, os instrumentos foram considerados validados. A média do índice de restos foi de 22%; as grandes refeições obtiveram percentuais maiores (32,4%) que as pequenas refeições (10,6%-21,5%). Para os cardápios das grandes refeições que apresentaram "não conformidade" para peso, textura, aparência, sabor e temperatura, foram solicitadas medidas de correção. Conclusão: As inconformidades observadas nas grandes refeições podem explicar o maior índice de restos, comparado às pequenas refeições. Espera-se que a aplicação rotineira dos instrumentos contribua para a melhor avaliação dietética dos pacientes hospitalizados e minimize o risco de desnutrição. Após adaptações, outras unidades de alimentação e nutrição podem fazer uso desses instrumentos para avaliar as dimensões da qualidade das refeições fornecidas. (AU)

Introduction: The assessment of the quality of hospital diets can contribute to better acceptance of the patients. Objective: The study aimed to improve and validate the content of instruments for assessing the quality of hospital diets. Methods: Study developed at a hospital in Rio de Janeiro to improve the form used for inspection of the supply of meals. To include all dimensions of quality, the form was divided into two instruments, for evaluation of sensory quality (ESQ) and hygienic and sanitary quality (EHQ), and its content was submitted to validation through a panel of experts using the Delphi technique adapted. Once approved, the instruments were applied to 12 menus of the two large meals to assess conformities. The study was approved by the institution's Ethics and Research Committee. Results: For both ESQ and EHQ, the items related to "presentation/design", "semantic clarity", "easy to understand" and "easy to fill in" obtained agreement in the first round. A second round was necessary to readjust the "capacity to assess hygienic and sanitary quality" in both instruments. After obtaining 91.7% of agreement for ESQ and 90.1% for EHQ, the instruments were considered validated. The mean rest index was 22%; large meals obtained higher percentages of waste (32.4%) than small meals (10.6% -21.5%). For the menus of the large meals that presented "non-conformities" for weight, texture, appearance, flavor and temperature, corrective measures were requested. Conclusion: The non-conformities observed in large meals may explain the high leftover index, compared to small meals. It is expected that the routine application of the instruments may contribute to a better dietary assessment of hospitalized patients and reduce the risk of malnutrition. After adaptations, other food and nutrition units can use these instruments to assess the dimensions of the quality of the provided meals. (AU)

Comparación de instrumentos regulatorios para expendios de productos en nivel educativo medio superior y superior entre México y países latinoamericanos y miembros de la OCDE / Comparison of Regulatory Instruments for Product Sales in Secondary Schools and Universities in Mexico, Latin American Countries, and OECD Members

Antecedentes: ante la creciente incidencia y prevalencia de obesidad, por recomendación de organismos como la OMS y la OCDE, diversos países han emitido instrumentos regulatorios para normar la oferta alimentaria en las instituciones educativas. Objetivo: comparar el instrumento mexicano para el expendio de productos preparados y procesados en escuelas con instrumentos regulatorios en el ámbito internacional, y reflexionar sobre su aplicabilidad práctica. Materiales y métodos: en esta revisión documental se recolectaron instrumentos de 20 países para distintos niveles educativos, y se seleccionaron aquellos aplicables al nivel medio superior y superior. Resultados: se identificaron instrumentos heterogéneos y con distinto nivel de obligatoriedad, que dictaminan criterios nutricionales y otros elementos de la alimentación. En el nivel medio superior, 17 países regulan expendios, mientras que en el superior solo lo hacen tres. Así mismo, se muestran incrementos graduales en operatividad y cumplimiento de dichos instrumentos en los distintos países. Para el caso de México, se identificaron puntos de mejora en la aplicabilidad, monitoreo y evaluación del instrumento regulador. Conclusiones: las políticas influyen en la disponibilidad y accesibilidad de alimentos y bebidas; por lo anterior, su cumplimiento y estrecha vigilancia tendría un impacto positivo en los consumos alimentarios y los patrones dietéticos.

Background: Due to the rising incidence and prevalence of obesity and the issuance of WHO and OECD recommendations, various countries have developed regulatory instruments to standardize food offerings in educational institutions. Objective: Compare the Mexican instrument for sales of prepared and processed food products in secondary schools and universities with other international regulatory instruments, and reflect on its application and practicality. Materials and Methods: For this document revision, instruments from 20 countries were collected for various education levels, of which were selected those that apply to secondary school and universities. Results: Diverse instruments were identified with various levels of regulation, which dictate nutritional criteria and other dietary elements. At the secondary school level, 17 countries regulate sales, while at the university level only 3 countries do so. Likewise, there are gradual increases in operability and requirements among countries. In the case of Mexico, benchmarks for the applicability, monitoring, and evaluation of the regulatory tool(s) were outlined. Conclusion: Policies influence the availability and accessibility of foods and drinks; as such, compliance and close monitoring would have a positive impact on the consumption of food products and dietary patterns.

Impacto do aconselhamento nutricional na evolução antropométrica e dietética dos funcionários de uma unidade básica de saúde / Impact of nutritional counseling on the anthropometric and diet evolution of the staff of a health basic unit

Objetivo: Avaliar o impacto do aconselhamento nutricionalna evolução antropométrica e dietética dos funcionários deuma Unidade Básica de Saúde (UBS) de Belo Horizonte,Minas Gerais. Métodos: Estudo de intervenção desenvolvidocom funcionários de uma UBS com duração detrês meses. Para avaliação do perfil nutricional, utilizou-seantropometria (Índice de Massa Corporal e Circunferênciade Cintura) e análise do consumo alimentar (Registro Alimentare Questionário de Frequência Alimentar). Houveincentivo a práticas alimentares saudáveis, por meio de seisatividades de educação alimentar e nutricional e três atendimentosnutricionais individualizados. Resultados: Amostrade 22 indivíduos (44% do total de funcionários), 86,4%(n=19) mulheres, 68,2% (n=15) com intuito de reduçãode peso. A intervenção possibilitou melhora no consumodiário de leite/derivados e frutas e queda no consumo defrituras, doces e refrigerantes (p<0,05). Houve reduçãosignificativa no consumo calórico (p=0,015) e de sódio(p<0,0001), e aumento na ingestão diária de água (p=0,004).Apesar disso, não foram constatadas diferenças estatisticamentesignificativas (p>0,05) com relação à antropometriaentre os funcionários que almejavam a redução do peso.Conclusões: O aconselhamento nutricional foi capaz demelhorar o padrão alimentar dos funcionários, sugerindo--se um período maior de intervenção, a fim de se obterresultados mais satisfatórios em relação à antropometria.

Background: Assess the impact of nutritional counseling among the staff of a primary health care (PHC) unit in Belo Horizonte, Minas Gerais. Methods: Intervention study undertaken for 3 months, among the staff of a PHC unit. To assess the nutritional profile, anthropometric (body mass index and waist circumference) and food intake analyses (food record and food frequency questionnaire) were used. Healthy eating practices were encouraged through six nutritional education activities and three individualized nutritional consultations. Results: Of a sample of 22 individuals (44% of the total staff), 86.4% (n=19) were women, of whom 68.2% (n=15) wanted to lose weight. The intervention stimulated improvement of the daily intake of milk/dairy products and fruit, along with a reduction of the consumption of fried foods, sweets and soft drinks (p<0.05). There were significant reductions of caloric (p=0.015) and sodium intakes (p<0.0001), and an increase of daily water intake (p=0.004). Nevertheless, there were no statistically significant differences (p>0.05) with respect to anthropometry among the staff who sought weight reduction. Conclusions: Nutritional counseling improved the staff 's food intake pattern. A longer intervention period would provide more satisfactory anthropometric results.

Prescriçäo e uso de formulados para nutriçäo enteral pelos serviços de nutriçäo hospitalares do município de Campinas (SP) / Prescription and use of formulae for enteral nutrition by the nutrition services of the hospitals in the city of Campinas-São Paulo, Brazil

A nutrição enteral como forma de suporte nutricional é um importante recurso na prática terapêutica, respondendo de forma satisfatória aos casos de limitação à ingestão de alimentos por via oral. Contudo, não existem dados locais sobre a utilização de formulados industrializados ou artesanais pelos Serviços de Nutrição. A fim de avaliar a utilização de cada um dos tipos de formulados, bem como identificar o profissional responsável pela prescrição dos mesmos, procedeu-se a um leventamento nos hospitais de Campinas,SP, por meio de questionários. Os resultados mostram que o emprego da nutrição enteral é prática de rotina nos Serviços, e que não há diferença significativa entre a utilização de formulados industrializadas ou artesanais; mostram também que o médico é o profissional responsável pela prescrição da dieta na maior parte dos Serviços

Tube feeding is a recognized means, for dietary management of a disease, successfully surpassing the limits of patients with impaired feeding. Nevertheless, there is no local data about utilization of industrialized or domestic formulae by the Hospital Nutrition Services. In order to evaluate the utilization of both industrialized and the domestic formulae, as well as the health professional involved with diet prescription, all hospitals located in the city of Campinas, São Paulo, Brazil were interviewed. Results show that enteral nutrition is a routine for most institutions, and there is no significant deference between the use of industrialized or domestic formulae. In Campinas, the physician is responsible for the diet prescription, despite of the presence of a dietitian in the staff