Journal of the Canadian Dietetic Association最新文献

Information technology in health care in Canada is beginning to show an impact in clinical dietetics. Good response (64%) to a survey of 307 hospitals indicated that 15 hospitals now use computers for the assessment of nutrients in patients' food intakes, in menus, and in recipes. Another 76 plan to initiate computer use. The majority of nutrition and food service departments categorize computers as potentially 'very useful' in clinical dietetics. The 15 respondents who use computers serve as models for future users. Hand calculation of nutrients is performed to some degree by 170 hospitals. Information from these respondents indicated that they share many common needs, thus encouraging a cooperation of effort in future computer applications.

This article provides insight into the complexity of hospital foodservice operations by reviewing selected published material and identifies subject areas that are well developed in the literature. A survey was made of leading professional journals, and an annotated bibliography was compiled of pertinent articles from the Journal of American Dietetic Association from 1965 to 1982. Also, the research abstracts published annually by the Society for the Advancement of Foodservice Research were consolidated for the period 1971-1982. Analysis of over 500 professional articles and research abstracts indicated that personnel management was the most studied area, followed by financial management, productivity, and computer use. Topics which seemed to be overlooked included unionization, cafeteria policies, and allocation of production labour cost.

The computer can help the clinical nutrition specialist become a productive, visible, and important professional. Currently available programs perform nutrient analysis of dietary intakes, menus, and recipes; offer simple forms of nutritional assessment, and provide creative educational applications. Many possibilities exist for new applications. Beginners are advised to acquire introductory skills and experience before initiating a computer application.

Dietetic internships for most Canadian university graduates in 1935 were only available in the United States. The first priority of the student training committee established by CDA in 1936 was to integrate the isolated attempts at student training in Canada and standardize the training programs. Fifteen hospitals were tentatively approved by the committee and a standard course outline developed. Internship program development in 1985 continues to emphasize the establishment of national standards and the administration and accreditation of dietetic programs. Many changes have occurred in dietetic training programs between 1935 and 1985 to meet the increasing demands on our profession. The founding members of our Association recognized the need to establish and maintain quality dietetic practice in 1935. Their foresight, determination, and search for excellence in those early years ensured the future of the dietetic profession in Canada.

Critically ill patients seen in an adult Intensive Care Unit often exhibit a hypermetabolic, hypercatabolic response to the stress of illness. The hypercatabolic response to trauma and sepsis is discussed in relation to macronutrient metabolism in this first of a two part article. The aim of nutrition therapy is provision of appropriate substrates to minimize the loss of lean body mass, without provoking additional metabolic stress. Selected topics in nutritional support are reviewed, with emphasis on current research and controversies in the care of the critically ill.

The trend towards deinstitutionalization for mentally handicapped adults has precipitated a need to provide these individuals with nutrition education and food preparation skills. Food, nutrition, and eating are important components of training programs for life skills, which lead to greater independence for the mentally handicapped. The types of nutrition information and learning activities needed for the mentally handicapped were determined through a literature review and a series of interviews with those working with this target group. The nutritional concerns of mentally handicapped adults include food selection to meet their nutritional needs, menu planning, food preparation, weight control, and nutrient-drug interactions. A Nutrition Resource Kit for Leaders Working with Mentally Handicapped Adults has been developed in The Regional Municipality of York in response to local demand for nutrition education programs and resources for mentally handicapped adults. The kit provides those working with mentally handicapped adults with background nutrition information, learning activities, resource materials, and references to additional resources. The topic areas covered include basic nutrition, nutritional concerns of mentally handicapped adults, nutrient-drug interactions, menu planning, shopping strategies, and food preparation. Dietitian-nutritionists can assist leaders who work with mentally handicapped adults by providing them with up-to-date nutrition information and motivating the to use available nutrition education resources.

The Regional Dietetic Services Program coordinated by the Red Deer Regional Hospital Centre is described. The Program became a reality in June 1978, in response to requests for professional dietetic assistance from the rural hospitals located in Central Alberta. The program objectives were defined, standards were determined, duties and responsibilities of Red Deer Regional Hospital Centre (the 'Agency') and the 'User' hospital were clarified, and a yearly contract was established. The dietetic consulting program was then presented to interested rural administrators and board members. When the first commitment was received, the Red Deer Regional Hospital Centre hired a part-time dietitian to implement the program. As a spin-off benefit, this program provided an avenue through which a dietitian could participate part-time in the professional and contribute to the community in a rewarding way.

A multidisciplinary audit of care delivered to diabetic patients was completed at the Royal Victoria Hospital, in Montreal. The audit of inpatient care was implemented using Criteria Mapping. A Criteria Map is based on decision-making logic and allows use of criteria relevant to individual patients. The Map includes 23 criteria: 18 medical, three dietetic, and one nursing. The charts of 17 patients discharged with a diagnosis of diabetes mellitus were reviewed. A score above 75% indicated that each discipline rendered adequate care. The medical compliance was 78.46%, dietetic 79.17%, and nursing 85.71%. Mean dossier score was 80.62%. The Criteria Map was highly satisfactory as an audit method; the results of the audit illustrated a need for more complete documentation of services, especially in the area of patient education.