An Assessment of Needs of Church Coordinators Providing Meals to a Homeless Shelter.

Charitable meal services are crucial in sustaining the homeless, but few use nutritional professionals to create a balanced diet or make adjustments for those with specific dietary needs. A needs assessment was conducted among church coordinators responsible for providing meals to clients at a multi-service shelter in Detroit, Michigan. A survey and focus group were used to assess the processes involved in planning, preparing, and providing meals, which provided critical information and insight concerning nutrition and factors influencing meal-planning. According to the survey, a majority of faith organizations responding tried to meet food group requirements every meal. A predominant theme from the focus group was the desire to satisfy clients resulting in a variety and abundance of food enabling poor choices. The provision of healthy options was constrained by efforts to ease meal preparation, desire to provide comfort foods, and having difficulties accommodating diets related to health problems.

A medial to lateral approach offers a superior lymph node harvest for laparoscopic right colectomy.

PURPOSE: Studies have shown improved survival with increasing amounts of harvested lymph nodes. The purpose of this study was to evaluate two laparoscopic techniques to right colectomy, laparoscopic medial to lateral (MtL) approach and laparoscopic lateral to medial (LtM) approach, in patients undergoing a right colectomy for either endoscopically unresectable polyps or carcinoma and determine which technique offers the optimal lymph node harvest. METHODS: Patients that underwent a laparoscopic right colectomy over a 5-year period were identified. Charts were reviewed with regards to demographics, surgical approach, length of stay (LOS) and number of lymph nodes harvested. Variables were statistically analyzed and outcomes compared between the two groups. A p value of less than 0.05 was considered statistically significant. RESULTS: Two hundred thirty-three patients underwent a laparoscopic right colectomy over a 5-year period for endoscopically unresectable polyps or carcinoma. Seventy-nine patients underwent a MtL approach and 154 patients underwent a LtM approach. When comparing the two groups, there were more females in the MtL group relative to the LtM group (78% vs 66%; p = 0.0015). When the outcome of number of lymph nodes harvested was examined, there was a significantly larger number of nodes harvested in the MtL (median = 24) approach compared to the LtM approach (median = 19; p = 0.0002). LOS was similar between the MtL and LtM group (median 4 days for both). CONCLUSIONS: The laparoscopic MtL approach to right colectomy yields a larger lymph node harvest compared to the laparoscopic LtM approach.