Journal of the Canadian Dietetic Association最新文献

This needs assessment was conducted to identify the perceived need for advancement and specialization through practicum programs in clinical dietetics. A questionnaire was developed and validated through a pilot study. It was mailed to a randomized sample of 950 dietitians (52%) registered with the ODA. Fifty two per cent responded, representing 27% of ODA members. Of those surveyed 89% were currently employed. The most current area of practice was clinical nutrition (55%) followed by foodservice (22%) and community nutrition (14%). Seventy two per cent of the respondents identified that they would consider enrolling in a specialized practicum. Most cited reasons for enrolling were increased knowledge/expertise (44%) and increased professional profile (25%). Areas of greatest interest were: nutrition assessment (9%), critical care/nutrition support (8%) and gerontology (7.5%). Sixty two per cent preferred the program to be offered part-time, 27% full-time and 9% were impartial. The most frequently cited length and cost per week for the program within specified part or full-time categories was: two weeks full-time (36.5%) at S200-299.00 (33%), four weeks full-time (25%) at S100-199.00 (31%) and two weeks part or full-time (23.5%) at S200-299.00 (57%). Desired ODA regions for program availability were: Toronto (34%), Kitchener/Waterloo/Hamilton (17.5%) and London (14%). Lastly, 92% of the respondents felt the program should be CDA and ODA approved and continuing education points be provided. These results indicate that dietitians are interested in pursuing professional self-development through specialized practicums.

Biotechnology allows scientists to improve foods, create new food products and provide better tools to ensure food safety. It can assist in achieving the goal of an abundant, safe and nutritious food supply for a growing population. These technologies can lead to a greater variety of food with improved taste, nutrition and cooking quality. There are valid concerns about the widespread use of biotechnology which remain to be addressed by health, scientific and consumer constituencies. Dietitians need to be informed about biotechnology in food production and processing. They need to be aware of potential benefits and risks. Dietitians are uniquely positioned to inform the public about food safety and food products of biotechnology. Dietitians can discuss this information in understandable language and with sensitivity to public values. Dietitians should participate in the development of food-related policies at local, provincial and federal levels.

The Nova Scotia Dietetic Association (NSDA) submitted seven position papers in response to a call for submissions for the Nova Scotia Government's Blueprint Committee on health system reform. The purpose of the submission was to delineate the preferred roles of dietitians/nutritionists in the reformed provincial health system. The position papers addressed the following health issues: primary health care, public health, long-term care, institutional/tertiary care, home care/home based services, health human resources, and healthy public policy. Each position paper included sections on the proposed nutrition planning structure, existing and proposed nutrition delivery structures, and expected outcomes of the proposed nutrition delivery structure. A number of actions associated with NSDA's position papers on health system reform are presented. Meanwhile, members of NSDA are continuing to work for health system reform in a proactive manner.

A survey was conducted jointly by Université de Moncton and the New Brunswick (N.B.) Department of Health and Community Services to generate information on waste management practises within health care institutions. The objectives of the survey were: 1) to identify the type of waste management methods in place in N.B. health establishments; 2) to identify the major difficulties associated with recycling food-related waste; 3) to study the attitudes and beliefs of food service managers toward waste management. Data were collected through a questionnaire mailed to food service managers. Results indicated that 86% of establishments were involved in waste reduction. There were no statistically significant differences in reduction practices between hospitals and nursing homes or between the size of these establishments (P = 0.11). The same applied for reutilization (P = 0.09) where 93% of the establishments were involved. Recycling was carried out in 64.8% of the establishments. Major obstacles to recycling included the lack of pickup services, the lack of storage space, and the absence of buyers for recyclable materials. The results of this survey will help in the formulation of policies, strategies, and recommendations for better protection of the environment.

A random sample of 10% of active Canadian Dietetic Association (CDA) members, stratified by province, was surveyed by telephone to determine perceptions of the purpose and value of Nutrition Month, factors hindering and facilitating participation, and opinions about the future direction of the campaign. Of the 439 eligible participants, 392 (89%) were contacted and 371 (85%) completed the 23-question interview. Using a 0-10 scale, respondents rated the campaign's effectiveness in raising public awareness of our profession ( x +/- SD = 5.8 + 1.9) and in educating the public about nutrition (6.7 +/- 1.6). The majority (96%) believed the Nutrition Month campaign benefits our profession as a whole and provides opportunities for personal growth (72%). However, most (76%) also believed that there are drawbacks or limitations, notably that the campaign is time-consuming (26%) and has limited reach (20%). Members feel strongly that Nutrition Month is an appropriate activity for CDA (96%) and that the campaign should remain in some form (80%). The most frequently suggested change was to increase publicity/media (22%). These results will assist CDA in planning future campaigns.

Total quality management (TQM), continuous quality improvement (CQI) and quality control are terms that are becoming very familiar to workers in the health care environment. The purpose of this article is to discuss these terms and the concepts they describe. The origins of TQM and the keen interest in its application to the health care environment today are addressed. In other environments, TQM has shown significant increases in productivity while increasing effectiveness. Its application to the health care environment is the provision of the best possible care through continuously improving service to meet or exceed the needs and expectations of the customer. The customer in the health care environment could be the patient, staff, physician and community serviced by the hospital. Characteristics of the new organizational structure are reviewed. Established techniques and processes are commonly used to identify process-improvement opportunities to assist the manager in continuously evaluating quality trends.

The choice of oral nutritional supplements (ONS) is typically made by a formulary committee without patient input. The purpose of this study was to determine if significant differences arose in the following two areas: (1) in preference of ONS between patients and dietitians/dietetic interns; and (2) between ONS from different companies as detected by either patients or dietitian/dietetic interns. ONS in the 1.0 kcal/mL and 1.5 kcal/mL lactose-free category from five companies, in all flavors, were randomly evaluated by 392 patients and 34 dietitians/dietetic interns. Each product was evaluated using a seven-point hedonic scale. When more than one brand of the same flavor was present, products were than ranked in order of preference. There were significant differences between patients and dietitians/dietetic interns in their evaluation of 7 of the 13 product lines. Significant differences were also found between same-flavored products of equal caloric density produced by different companies. Since the patients typically rated the ONS as more acceptable when a difference did exist, it would appear unnecessary for formulary committees to test products on the patient population on a regular basis.

The purpose of this project was to examine the influence of education and experience on the development of human resource management skills in dietitians. The performance of 58 experienced dietitians, 67 entry-level subjects, and 63 undergraduate students was compared using a case study about a personnel problem with a dietitian. Performance was scored by comparing subjects' answers with selections of a panel of seven experienced dietetic managers. Experienced and entry-level groups had higher proficiency scores than students. Experienced and entry-level groups scored highest and students lowest in efficiency, defined as the proportion of total information containing sections chosen that contained helpful information. Experienced dietitians examined few inappropriate sections and students the most. Overall, experienced and entry-level groups performed better in this human resource management problem than students. We conclude that supervised practice is important in the development of human resource management skills.

Along with other health care professions, The Canadian Dietetic Association is promoting outcomes assessment among its members. Defining outcomes and determining their measurement is a continuous process. Outcomes can refer to any consequence of health care, including changes in health status, knowledge, or behaviour. Establishing the link between the outcome and the interventions that led to it is important, but can be difficult. This is especially the case for the dietetic profession, in that nutrition status is often affected by factors other than our nutrition intervention. We reviewed the work of other professional associations: the American Dietetic Association, Canadian Association of Occupational Therapists, Canadian Physiotherapy Association, Canadian Psychological Association, and Canadian Nurses Association. All have formed expert committees or task forces to come to grips with the questions of outcome measurement relevant to their profession. All have found the process difficult and time-consuming. Many health professions are moving toward the position voiced by the CNA: using outcome information they will try to do what they do better, further, they will question whether they should be doing it.

The food served in contracted Second Level Lodging Homes (SLLH) in Hamilton-Wentworth was studied to assess compliance with current by-law standards, make recommendations about nutrition standards and identify educational needs. Dietitians collected food frequency data in 62 SLLH and recorded food served during one day. Only 44% of homes provided the minimum servings recommended by 1982 Canada's Food Guide. Recommended nutrient intakes for ten nutrients were met by 20% of homes. Provision of therapeutic diets was inconsistent. The study indicates the need for better nutritional standards and strategies to ensure SLLH residents access to sufficient, nutritious and personally acceptable food.