Journal of the Canadian Dietetic Association最新文献

In 1987, the public health nutritionists who work in Ontario's 42 health units and the Ministry of Health, initiated a province-wide strategic planning process. That same year, three major reports received by the Ontario Ministry of Health proposed new directions for health services. This article briefly describes the strategic planning process used by the nutritionists and presents the resulting "Strategic Plan for Nutrition in Public Health." It also reviews the three reports and illustrates how they support the priorities established by the nutritionists under four major themes: data needs and data collection; economic/environmental issues; program/service issues; and professional issues. The relevance and significance of the parallels among the reports and strategic plan are explored.

The ability to read critically and evaluate research literature will increase in importance as the dietetic profession builds a research base to support practice. In this article, the "who, why, what, where, and when" of critiquing the literature are presented. An overview of "how" to critique the literature is outlined in a 10-step process that emphasizes effective time use. At each step, a decision is made to continue reading the article or to go to the next article or journal. The process includes examination of: 1) the journal and the title of the article; 2) the authors' names; 3) the abstract; 4) the introduction; 5) the objective of the study; 6) the methods; 7) the results; 8) the discussion; and 9) the conclusions. The 10th step, reached only if the article satisfactorily addresses the previous nine, is to attempt to use the information in practice.

This paper provides an overview of the scope and diversity of community nutrition in Canada today and illustrates the many community organizations that include a nutrition component. The relationship of public health nutrition to the broader field of community nutrition is outlined, and health promotion concepts and strategies are described as a basis for community nutrition programs. Strategies such as education, mass communication/social marketing, advocacy, self-help/mutual aid, community organization, economic support, policy development/legislation, and environmental change are identified with some examples from programs in Canadian communities. Future directions are proposed as research, better surveillance and monitoring, more effective program evaluation, and a forum for the exchange of community nutrition information.

A community-based nutrition monitoring system is an information system to generate, on a regular basis, an integrated picture of the nutritious condition of a community for local decision-makers. Community-based nutrition monitoring is an extension of international nutrition surveillance and national nutrition monitoring work to the community level where much of the substantive nutrition activity happens. It represents a constructive integration of familiar concepts related to needs assessment, evaluation and program management information systems. The objectives of community-based nutrition monitoring are to provide, in a timely manner, information pertinent to program targeting, funding, priority-setting decisions; to inform and educate decision-makers and enhance the visibility of nutrition-related activities in the community and to provide a vehicle for community-wide nutrition planning. Information about food access, the needs of specific life-cycle or risk groups and chronic disease prevention can all be part of a monitoring system. The specific foci of a system depend on the policy and programming decisions actually or potentially made in the specific community. The monitoring system utilizes multiple simple indicators collected routinely and reported on a regular basis. The development of such a system is a multi-year, inter-agency effort. It presents significant challenges and opportunities to local nutritionists.

Infants who are seen in follow-up programs for high-risk neonates are at risk for growth disturbances and feeding difficulties. Since dietitians often are not included on follow-up teams, the role of a dietitian on a multi-disciplinary team at the Alberta Children's Hospital Perinatal Follow-Up Program is described. The dietitian contributes through clinical, teaching, and research activities. During 1986, the dietitian evaluated 298 infants; of these 14.5% required intensive dietary intervention while 28.9% received informal advice or written materials. Growth problems were most frequent in infants in the lowest birth-weight category (500-1000 g). Infants 8-12 months old experienced most feeding difficulties. The overall outcomes of the infants assessed by the multidisciplinary team are presented. The dietitian can make important contributions in all areas of follow-up team function.

In November 1986, the Minister of National Health and Welfare released a discussion paper called Achieving Health for All: A Framework for Health Promotion. The aim of this document is to present a new vision for health in Canada and to propose health promotion as a process to improve health for all Canadians. A framework of health challenges, health promotion mechanisms and implementation strategies is presented as a model to guide health programs and policies. Achieving Health for All builds upon the concepts and principles of health and health promotion that have been developing in Canada and other countries over the last 10-15 years. This article reviews the strengths and limitations of the framework and suggests its use in conjunction with the Ottawa Charter for Health Promotion, which was released in November, 1986. Implications of the framework for The Canadian Dietetic Association and dietitian/nutritionists are also presented. Dietetic and nutrition professionals are challenged to become familiar with the concepts and principles of Achieving Health for All and to assume a leadership role in promoting food and nutrition programs and policies as part of this new vision for health for all Canadians.

Achieving Health for All, a document released by Health and Welfare Canada, is a framework for nutrition in health promotion. Specific examples of the nutrition implications of the framework's challenges, mechanisms, and strategies are presented. Opportunities for involvement by individual dietitians/nutritionists as well as for The Canadian Dietetic Association are highlighted.