Dietas y desigualdad social en la transición nutricional española: el Hospital Provincial de Valencia y el Hospital Sant Jaume de Olot; 1900-1936 / Diets and social inequality in the Spanish nutritional transition: the Hospital Provincial of Valencia and the hospital Sant Jaume of Olot, 1900-1936

Introducción: los estudios sobre la transición nutricional española (TNE) hasta mediados del siglo xx se basaban en estimaciones indirectas y muy agregadas del consumo que no permiten conocer aspectos importantes de aquel proceso. Objetivo: mostrar las nuevas posibilidades de estudio que proporcionan las dietas hospitalarias y proponer nuevos indicadores de la TNE a partir de las estimadas en el Hospital Provincial de Valencia (HPV) y en el Hospital Sant Jaume de Olot (HSJO) entre 1900 y 1936. Método: calculamos el consumo de alimentos y nutrientes de pacientes y empleados en aquellos hospitales y en diferentes subgrupos de población del primero. Contrastamos nuestros resultados con los obtenidos para España en el artículo anterior de este suplemento. Resultados: las dietas hospitalarias contribuyeron a difundir alimentos estratégicos de la TNE: primero, leche, huevos y carne fresca, y después, pescado fresco, verduras y frutas. La difusión de estos alimentos, sin embargo, fue desigual entre la población y no redujo con la misma intensidad los déficits en la ingesta de macronutrientes y micronutrientes. Conclusiones: las dietas hospitalarias confirman la mejora del estado nutricional de la población española en las décadas anteriores a la Guerra Civil y el papel pionero que tuvieron las instituciones sanitarias en este proceso. No obstante, también muestran diferentes cronologías en la reducción de los déficits de importantes nutrientes entre grupos de edad y estatus socioeconómico

Introduction: studies about the Nutritional Transition in Spain (NTS) until the mid-20th century are based on direct, and heavily aggregated, consumption estimates, a methodology that obscures important aspects of this process. Objective: to show the new possibilities of study opened by the analysis of hospital diets and to suggest new NTS indicators based on the menus provided by the Hospital Provincial in Valencia (HPV) and the Hospital Sant Jaume in Olot (HSJO), between 1900 and 1936. Method: we have calculated food and nutrient consumption among patients and hospital staff as well as among different groups of the population, and compared the results thus obtained with those calculated for the whole of Spain in the previous article in this supplement. Results: hospital menus contributed to disseminate certain strategic foodstuffs for the NTS: milk, eggs and fresh meat first, and fish, vegetables and fruit later. The public dissemination of these foodstuffs was, however, uneven, and deficits in the intake of micro- and macro-nutrients intake decreased at different paces, according to social group. Conclusions: hospital diets confirm that nutrition in Spain improved in the decades that preceded the Civil War, as well as the pioneering role that sanitary institutions played in this process. The data also suggests that the process operated at different paces in the reduction of deficits in the intake of certain nutrients according to age groups and socio-economic status

[Diets and social inequality in the Spanish nutritional transition: the Hospital Provincial of Valencia and the hospital Sant Jaume of Olot, 1900-1936]. / Dietas y desigualdad social en la transición nutricional española: el Hospital Provincial de Valencia y el Hospital Sant Jaume de Olot; 1900-1936.

INTRODUCTION: studies about the Nutritional Transition in Spain (NTS) until the mid-20th century are based on direct, and heavily aggregated, consumption estimates, a methodology that obscures important aspects of this process. OBJECTIVE: to show the new possibilities of study opened by the analysis of hospital diets and to suggest new NTS indicators based on the menus provided by the Hospital Provincial in Valencia (HPV) and the Hospital Sant Jaume in Olot (HSJO), between 1900 and 1936. METHOD: we have calculated food and nutrient consumption among patients and hospital staff as well as among different groups of the population, and compared the results thus obtained with those calculated for the whole of Spain in the previous article in this supplement. RESULTS: hospital menus contributed to disseminate certain strategic foodstuffs for the NTS: milk, eggs and fresh meat first, and fish, vegetables and fruit later. The public dissemination of these foodstuffs was, however, uneven, and deficits in the intake of micro- and macro-nutrients intake decreased at different paces, according to social group. CONCLUSIONS: hospital diets confirm that nutrition in Spain improved in the decades that preceded the Civil War, as well as the pioneering role that sanitary institutions played in this process. The data also suggests that the process operated at different paces in the reduction of deficits in the intake of certain nutrients according to age groups and socio-economic status.

Introducción: los estudios sobre la transición nutricional española (TNE) hasta mediados del siglo XX se basaban en estimaciones indirectas y muy agregadas del consumo que no permiten conocer aspectos importantes de aquel proceso.Objetivo: mostrar las nuevas posibilidades de estudio que proporcionan las dietas hospitalarias y proponer nuevos indicadores de la TNE a partir de las estimadas en el Hospital Provincial de Valencia (HPV) y en el Hospital Sant Jaume de Olot (HSJO) entre 1900 y 1936.Método: calculamos el consumo de alimentos y nutrientes de pacientes y empleados en aquellos hospitales y en diferentes subgrupos de población del primero. Contrastamos nuestros resultados con los obtenidos para España en el artículo anterior de este suplemento.Resultados: las dietas hospitalarias contribuyeron a difundir alimentos estratégicos de la TNE: primero, leche, huevos y carne fresca, y después, pescado fresco, verduras y frutas. La difusión de estos alimentos, sin embargo, fue desigual entre la población y no redujo con la misma intensidad los déficits en la ingesta de macronutrientes y micronutrientes.Conclusiones: las dietas hospitalarias confirman la mejora del estado nutricional de la población española en las décadas anteriores a la Guerra Civil y el papel pionero que tuvieron las instituciones sanitarias en este proceso. No obstante, también muestran diferentes cronologías en la reducción de los déficits de importantes nutrientes entre grupos de edad y estatus socioeconómico.

In the shadow of the asylum: the Stanley Royd Salmonella outbreak of 1984.

In August 1984, an outbreak of Salmonella at Stanley Royd Psychiatric Hospital in Yorkshire led to the deaths of 19 elderly residents. It was an incident that attracted a good deal of comment in both the local and national press, and one that had enduring relevance for ideas about psychiatric care, food handling and catering provisions, hospital management and the official inspection of medical institutions. This article examines the impact that the 1984 outbreak had on official and popular perceptions of these issues. As well as bringing to public attention the fact that large numbers of vulnerable elderly patients were long-term residents in psychiatric hospitals, the Salmonella outbreak highlighted the inadequacies of Victorian hospital buildings in modern healthcare. Throughout the press reports and official investigations examined here, the provenance of Stanley Royd was repeatedly emphasised; its Victorian fabric persistently interfered with cleaning regimes, cold storage facilities and the conveyance of food to patients. Within institutions like Stanley Royd, 'new' and 'old' risks came together--the microscopic bacterium and the crumbling nineteenth-century building--to create a strong critique of existing psychiatric care. The episode also highlighted broader problems within the NHS, such as systems of management and the status of psychogeriatrics as a specialism.

Panorama hospitalario de Zamora a mediados del siglo XVIII / Hospital Panorama in Zamora at the middle of the XVIIIth Century

El siglo XVIII fue un periodo de reformas en múltiples campos, también en el asistencial. Para avanzar en su estudio, el presente artículo profundiza en el conocimiento de la red hospitalaria a mediados de dicha centuria en los territorios que integran la actual provincia de Zamora. En este sentido, se analiza el tipo de establecimientos, su financiación, organización y funcionamiento. Como resultado, se nos dibuja un panorama salpicado de numerosos albergues rurales y algunos hospitales de curación en núcleos de cierta entidad urbana, consagrados, fundamentalmente, al acogimiento y atención religiosa de pobres transeúntes. Tales establecimientos se nutrían, sobre todo, de rentas agrarias y del producto de censos. Contaban, además, con una notable presencia eclesiástica (AU)

The XVIIIth century was an era of reforms in multiple fields, including healthcare. To advance in its study, the present article delves into the knowledge about the hospital network in the middle of said century within the territories which integrate the current province of Zamora. Accordingly, the type of establishment, its funding, organisation and operation are analysed. As a result, a panorama dotted with numerous rual refuge sand some hospitals in the centre of certain built-up areas is drawn, dedicated, basically, to the reception and religious assistance of poor vagrants, Scuh establishments were funded, above all, by agricultural income and by census rents. They counted, moreover, on a notable, ecclesiastic presence (AU)

Historical and contemporary perspectives on children's diets: is choice always in the patients' best interest?

On 29 March 1744, Thomasin Grace, a 13-year-old girl, was the first inpatient admitted to the Northampton General Infirmary (later the Northampton General Hospital). Inpatient hospital diets, then and now, are mainstays of effective patient treatment. In the mid-18th century there were four prescribed diets at Northampton: 'full', 'milk', 'dry' and 'low'. Previous opinions concerning these four diets were unfavourable, but had not been based upon an individual dietetic assessment. Thomasin would most likely have been given the milk diet, but use of the full diet cannot be excluded. 'Grace Everyman' is Thomasin's modern equivalent. Under current NHS guidelines Thomasin would be considered a paediatric patient, but in 1744 she would have been considered as an adult. This study undertakes a full dietetic analysis of all the prescribed diets available for Thomasin in 1744 and compares this against random choices for Grace from the 2009 inpatient menu from the paediatric (Paddington) ward, and the adult ward inpatient menu at the Northampton General Hospital. The results show that, for Thomasin, the 1744 milk and full diets met the current advised nutritional requirements for adequate dietary intake. However, for Grace, the present 2009 Paddington and adult ward menu, although generally meeting nutritional requirements, could, if Grace or her carer consistently chose poorly during a prolonged inpatient stay, lead to inadequate nutrition. This challenges assumptions that hospital diets were historically inadequate, and that choice in present day equates with satisfactory nutritional intake.

[Patients' diet in "Town" and "City" hospitals in Belgrade].

The roots of hospital foundation in Serbs date from the 12th century, when the hospitals in the monasteries Hilandar (1199) and Studenica (1207) were established. The "Town" Hospital of Belgrade was founded in 1841, which had the status of town and regional hospital until 1881. After that, it was transformed into a general state-owned hospital based on the Law of National Health Protection. The inhabitants of Belgrade obtained a municipal hospital again in 1935, when the "City" Hospital was founded in Zvezdara municipality, named at that period Bulbulder. By researching and observing hospital diet development of municipal hospitals in Belgrade, it was concluded that from the very beginning of the "Town" Hospital functioning there was awareness about its significance, place and role in the overall treatment of patients. Hospital diet, regardless of existing knowledge as the part of medical doctrines of particular time-periods, was often conditioned by limited hospital budgets and under the influence of different social movements and wartime periods

Militares, marineros y pobres enfermos. Contribución a la hisotria del Hospital San Juan de Dios de Cartagena de Indias (siglo XVIII) / Military sailors and the sick poor. Contribution to the history of the San Juan de Dios Hospital in Cartagena de Indias (18th century)

El artículo estudia la historia del Hospital San Juan de Dios de Cartagena de Indias, en un momento preciso de su existencia: a finales del siglo XVIII. Busca enmarcar su actividad y evolución en la dinámica de las reformas sanitarias borbónicas que entonces intentaban instaurarse en el Nuevo Reino de Granada, las cuales tenían por objeto intervenir en los aspectos relacionados con la salubridad de la sociedad, para favorecer el aumento de la población activa, disciplinar a los vasallos y aumentar la riqueza de la Corona. El texto pretende, asimismo, examinar algunos aspectos importantes de su funcionamiento, vinculados con el presupuesto, los gastos, el movimiento de población hospitalaria y los empleados; y mostrar lo que podía ofrecer esta institución a los diversos grupos sociales que entonces habitaban la ciudad

El artículo estudia la historia del Hospital San Juan de Dios de Cartagena de Indias, en un momento preciso de su existencia: a finales del siglo XVIII. Busca enmarcar su actividad y evolución en la dinámica de las reformas sanitarias borbónicas que entonces intentaban instaurarse en el Nuevo Reino de Granada, las cuales tenían por objeto intervenir en los aspectos relacionados con la salubridad de la sociedad, para favorecer el aumento de la población activa, disciplinar a los vasallos y aumentar la riqueza de la Corona. El texto pretende, asimismo, examinar algunos aspectos importantes de su funcionamiento, vinculados con el presupuesto, los gastos, el movimiento de población hospitalaria y los empleados; y mostrar lo que podía ofrecer esta institución a los diversos grupos sociales que entonces habitaban la ciudad

[Sociocultural transformations in hospital food]. / Transformações socioculturais da alimentção hospitalar.

The article seeks to identify the historical roots of food culture in hospital settings. It assumes that diet is not merely the result of technical and scientific concerns but is also historically constructed, created, and recreated in response to economic and sociocultural elements. The study conducted a preliminary survey of university, municipal, and hospital archives in Campinas, São Paulo, and included interviews with food service workers at three hospital institutions. Our conclusion is that more value has been placed on initiatives and actions related to technology than on initiatives identified with the domestic world; this may have contributed to a certain tendency for hospitals to neglect the issue of food, deemed of minor importance.

The beer ration in Victorian asylums.

Routine distribution of alcoholic beverages to mental hospital patients would be a fanciful prospect today, yet in the formative decades of lunatic asylums, beer was standard issue. A staple item in the supposedly healthy Victorian asylum diet, beer also served as inducement for patient labour. Around the mid-1880s, this commodity was abolished throughout Britain's mental institutions. This paper explores the factors that combined to condemn the beer barrel to asylum history, and, in particular, how this small comfort for immates fell foul of the medicalization of the asylum and of the professional project of psychiatry.

[Culture and nutrition. Dietetics in hospital nursing during the 17 century]. / Cultura y alimentación. Dietética en la enfermería hospitalaria en el siglo XVII.

Starting from the important role which feeding and dietetics play in our culture and specifically in activities such as medicine and nursing, this article analyzes aspects like 1., the place of dietetics and feeding found in two manuals, "Instructions for nurses to apply remedies to all kinds of illnesses" and "To attend to many accidents which in the absence of Doctors"; 2., the importance of diets in hospitals throughout the 17th century; 3., the work by nurses related to diets and alimentation during that epoch and the professional training received by these professionals in this regard.