Professional and Consumer Publications, Programs, Audiovisuals, and Software

Books, curricula, audiovisuals, and other resources that nutrition professionals may use for reference, continuing education, or in a formal or informal education setting are designated “professional.” Books, handouts, diet plans, and other resources specified by authors as being written for general audiences are categorized as “consumer.” Inclusion of any material in this section does not imply endorsement by the Society for Nutrition Education. Evaluative comments contained in the reviews reflect the views of the authors. Prices quoted are those provided by the publishers at the time materials were submitted. They may no longer be current when the review is published.     

Joint effects of density dependence and toxicant exposure on Drosophila melanogaster populations

Risk assessment of environmental contaminants is usually based on experiments on well-fed individuals held at low population densities. However, field populations are often subject to resource limitation. Individuals who are already stressed by crowding or food limitation may show greater susceptibility to toxicants. But density dependence could also reduce population-level impacts as toxicant-related mortalities may reduce competition for resources. This study examines the joint effects of toxicants and food availability on populations of Drosophila melanogaster. The interactions between the effects of food limitation and toxicant stress were dose dependent and strongly influenced by toxicity mechanisms. In food-limited conditions, a compensatory effect often occurred, with toxicant exposure having a lower proportional impact than at higher food levels. This provides further evidence that density-dependent population processes can produce an assimilative capacity for the effects of toxicants. But synergistic food–toxicant effects were also common and the interaction often switched between synergistic and compensatory at different toxicant concentrations and food supplies. There is no simple “less-than-additive”, “additive” or “more-than-additive” relationship between density and toxicant effects, even for a single toxicant.     

Impacts of sensory attributes and emotional responses on the hedonic ratings of odors in dairy products

Consumers often decide to purchase certain items as a result of prompt emotional responses evoked by the products; therefore, it is important to investigate the emotional responses stimulated by food samples, as well as the sensory attributes of the products. The aim of this study was to examine influences of sensory attribute and emotional response on olfactory hedonic ratings of dairy products. Additionally, we compared this effect between women and men subjects. Sensory attributes of six natural odors produced by commercial dairy products were evaluated by 9 trained panelists. In addition, 100 untrained panelists (50 women and 50 men) rated the emotional response stimulated by the 6 odors using 25 paired semantic differential scales and the hedonicity using a 9 cm line scale, respectively. Untrained panelists more liked “sweet aromatics,” “sour aromatics,” “fermented aromatics,” and “rich aromatics” over the other sensory attributes of dairy products. The olfactory hedonic ratings were increased when the odor was more characterized as “fragrant,” “attractive,” “comfortable,” “familiar,” “faint,” “natural,” or “modern.” Specific sensory attributes were found to be related to specific adjective pairs representing the emotional response. Moreover, the ratings of adjective pairs representing emotional response of odors and their influences on hedonic ratings differed significantly between sexes. In conclusion, our findings suggest that the emotional responses as well as the sensory attributes affect the hedonic ratings of odors in dairy products.     

The smoking and dietary behaviour of lambeth schoolchildren II. the relationship between knowledge, attitudes and behaviour

As part of a study designed to examine the effect of a health education programme on 10-year-old schoolchildren, information was obtained on the children's knowledge, attitudes and behaviour concerning two health hazards, namely smoking and obesity. Cross sectional analyses showed that children who smoked were as aware of the health hazards of smoking as non-smokers but were less likely to hold anti-smoking attitudes. They were also more likely to think of themselves as “naughty” and “silly”. Conversely, children who subsequently adopted smoking were less aware of the health hazards of smoking than those who remained non-smokers. There was good evidence that obese children possessed more nutritional knowledge than the non-obese, and their attitudes to diet differed little. No relationship was demonstrated between reported energy intake and obesity, either cross sectionally or longitudinally. Relationships between knowledge and attitudes towards nutrition and the development of obesity were investigated, but there was only one significant finding, namely that boys identifying correct statements about nutrition put on less fat than other boys.     

Traditional medicine and lead-containing preparations in Nigeria

Traditional medicine, its preparations and practices, plays a major role in the health care of the community of Nigeria. In many cases the native doctor (“Babalawo”) and the local herbalist (“Eleweomo”) are the only practitioners available for the treatment of illness. Even in the towns where allopathic medicine is available the limited facilities it offers make many patients rely on traditional methods. Little is known of the pharmacological action of these traditional remedies which the native doctor prescribes. Our own studies have concentrated on the metal content of such materials. Here we report on the material known as “tiro” which is used for the treatment of eye infections and disease as well as an “eye cleaner” and cosmetic. On analysis we found that all samples of tiro measured contained lead ranging from 12·8 to 81·1% (w/w), with a mean concentration over all samples determined of 50·1% (w/w). In addition, it was also found that tiro is used by some members of the Nigerian community in Britain and is brought in in decorative containers as a gift. The extent of use in this country still remains to be determined, however. The use of lead-containing preparations^* in traditional practices presents a significant health hazard to a substantial section of the world's population. We suggest urgent steps are required to encourage governments to establish education programmes to eliminate this avoidable source of morbidity among their populations.     

Evidence-based policy-making: The implications of globally-applicable research for context-specific problem-solving in developing countries

In the past 15 or so years, the “evidence-based medicine” (EBM) framework has become increasingly institutionalized, facilitating its transfer across the globe. In the late 1990s, the basic principles of EBM began to have a marked influence in a number of non-clinical public policy arenas. Policy-makers working in these areas are now being urged to move away from developing policies according to political ideologies to a more legitimate approach based on “scientific fact,” a process termed “evidence-based policy-making” (EBPM). The conceptual diffusion of EBM to non-clinical arenas has exposed epistemologically destabilizing views regarding the definition of “science,” particularly as it relates to the demands of global versus national/sub-national policy-making. Using the maternal and neonatal subfield as an ethnographic case-study, this paper explores the effects of these divergences on EBPM in 5 developing countries (Bangladesh, Burkina Faso, Ghana, Malawi and Nepal). In doing so, our analysis aims to explain why EBPM has thus far had a limited impact in the area of context-specific programmatic policy-development and implementation at the national and sub-national levels. Results highlight that the political contexts in which EBPM is played out promote uniformity of methodological and policy approaches, despite the fact that disciplinary diversity is being called for repeatedly in the public health literature. Even in situations where national EBPM diverges from international priorities, national evidence-based policies are found to hold little weight in countering global policy interests, which some informants claim are themselves legitimated, rather than informed, by evidence. Informants also highlight the way interpretations of research findings are shaped by the broader political context within which donors set priorities and distribute limited resources – contexts that are driven by the need to provide generalisable research recommendations based on scientifically replicable methods. Added to this are clear rifts between senior and junior-level experts within countries that constrain national and sub-national research agendas from serving as tools for empowered knowledge production and problem-solving. We conclude by arguing for diverse forms of research that can more effectively address context-specific problems. While such diversity may render EBPM more conflict-ridden, debate is by no means an undesirable characteristic in any evolving system of knowledge, for it has the potential to foster critical insight and localized change.     

Consumer perception of bread quality

Bread contains a wide range of important nutritional components which provide a positive effect on human health. However, the consumption of bread is declining during the last decades. This is due to factors such as changing eating patterns and an increasing choice of substitutes like breakfast cereals and fast foods. The aim of this study is to investigate consumer's quality perception of bread towards sensory, health and nutrition attributes. Four consumer segments are identified based on these attributes. The different consumer segments comprise consumers being positive to all three quality aspects of bread (“enthusiastic”) as wells as consumers perceiving bread strongly as “tasteless”, “non-nutritious” or “unhealthy”. Moreover, factors are identified which influence the consumers’ quality perception of bread. The results of our study may help health professionals and policy makers to systematically inform consumers about the positive effects of bread based on its components. Furthermore, firms can use the results to build up tailor-made marketing strategies.     

Children: Rights, education and equal opportunity

The point of departure in this paper is the concept of RIGHTS. Whereas most countries accept that children have rights as is evidenced in the UNO Declaration of Rights of the Child (1959), such rights are statements, not laws. Statements advocating benefits, care, love, education etc. are goals or beliefs. Few countries have legalised rights; consequently, children may be at risk. In countries where there is discrimination of some degree in respect of race, colour, sex, religion, national or social origin, financial standing in society, level of education and so on, the right to “rights” as stated in the UNO Declaration is further jeopardised. The implications for educational provision from early childhood and onwards in countries where “rights” are not entrenched in statutes or where child advocacy is not forceful enough for all people are examined in this paper. Consequently, the chances for equal opportunity in life are reduced in situations where the child did not receive the benefit of education. Such a child may not perish as he might as a result of being deprived of food, but “the deprivation and injustice, the degradation of an individual and the setting of his vital interests at naught would at least approach in gravity the act of allowing him to die for the want of food” (1981, Wringe). In this paper, the author argues for the Rights of the Child, particularly where discrimination and inequalities exist and where provision for early education has to contend with excessive population growth.     

Infinitesimal risk as public health crisis: News media coverage of a doctor-patient HIV contact tracing investigation

Among the most prominent health or medical stories covered in 1994 by the Australian news media was that concerning an HIV positive hospital obstetrician and the attempt by the New South Wales Health Department to trace and test 149 women on whom he had operated. All press and television coverage of the issue was reviewed. The surface news narrative of the search for missing, “innocent” mothers potentially infected with a deadly and infectious illness is shown to serve as a “hard news” pretext enabling a wider major discourse to operate about a health system accused as being captive to gay and civil libertarian politics, allowing “guilty” doctors at high risk of HIV to endanger “innocent” patients. Expert consensus held that the women were at “infinitesimal risk” of acquiring HIV. However, media accounts of the investigation all but belied this, illustrating that the news media's framing of risk has more to do with its reproduction of moral outrage components than with “scientific” notions of calculable risk.     

A Question of Balance: Nutrition, Health and Gastronomy

Given the higher proportion of manufactured foods now available which meet current dietary recommendations, the food supply in developed countries like Australia could be said to be “healthier”. Yet the “health” of the diet is often achieved at the expense of the “health” of the environment since ecological problems created by current food production and distribution methods remain unaddressed. Further, nutritional modifications which produce foods that are low in fat, sugar, salt and high in fibre do not necessarily address the concerns consumers have about the food supply. An emphasis solely on the physical health of populations, through improved diet, is out of keeping with current views on health which recognise the importance of overall well-being. Through the development of the concept of “sustaining gastronomy”, consumers, food manufacturers and producers, and food regulators can better address the problems inherent in the food system, including those of an environmental nature.     

An Academic Clinician’s Perspective on the Care of the Geriatric Patient

This paper discusses the role that the personal history plays in a patient’s perception of his or her own illness in the light of the patient’s own personal history. It demonstrates the regrettable modern tendency to regards the patient as the “bearer of a disease” rather than as a human being with personal values and experiences into which their current illness needs to be integrated. I illustrate my point by an exchange between a student and an “attending” and the “attending” and the patient. It represents only one out of unfortunately many such instances in which the pressures of “managed care” and “efficiency” have made truly knowing the patient as an individual with life experiences and personal values much more difficult.     

Prospects for improving health through reducing risk factors

Intervention against both bodily risk factors such as hypertension, high serum cholesterol, cervical dysplasia, and trisomy 21; and behavioral risk factors such as cigarette smoking, too little exercise, and excessive alcohol consumption, offers improving prospects for reducing major current causes of death. The MRFIT program and other trials of intervention in North Karelia, Finland, and in northern California, are aimed at delineating how effective this strategy may be. Already it is clear that the risk factor intervention strategy may incorporate one or both of two tactics: the “medical model,” i.e., selecting individuals for intervention efforts on the basis of medical examinations; or the “community model,” i.e., directing efforts for risk factor reduction at a total community. This new approach to prevention represents a shift away from the clinical entities as the focus of medicine toward the identification and reduction of the factors that lead to clinical disease. The aim is not just to avoid clinical disease but to maintain health in the sense of physiologic function, anatomic regularity, chemical balance, genetic integrity, immunologic status, and healthful behavior.     

Authorship: Can you Claim a Byline?

Decisions about bylines, although seemingly straightforward, can “breed ill-will,” “wreck friendships,” and “even damage careers” if decisions are not in accord with professional guidelines and common sense. Editors have attempted to promote responsible authorship by creating Uniform Requirements. According to the International Committee of Medical Journal Editors, each author must have made a substantial contribution to all 3 of the following conditions to qualify for authorship: conceiving and designing the work represented by the article or analyzing and interpreting data; drafting the article or revising it critically for important intellectual content; and giving final approval of the version to be published. Despite these guidelines, bylines continue to include grafters and guests. Researchers believe guidelines for authorship are necessary but suggest the existing Uniform Requirements may be overly restrictive and easily misinterpreted. Editors will need to work with researchers to reach consensus on realistic and appropriate guidelines for authorship. J Am Diet Assoc. 1999;99:77-79.     

Smoking and respiratory disease symptoms inrural Bangladesh

Respiratory disease (excluding tuberculosis) is a largely untargetted health problem in Bangladesh. This study emphasises both that existing morbidity is considerable and that it is sure to increase if smoking spreads further. In two poor village populations 71% of men though only 1% of women were current smokers (one or more cigarettes or bidi per day); about one in five had begun smoking before the age of 10 years. Most heavy smokers and all women smoked bidi (hand-rolled coarse tobacco sticks). Expenditure on smoking absorbed up to 5% of household income but, seemingly paradoxically, one of the lowest socio-economic groups had the heaviest consumption.For men the striking effect of smoking in increasing respiratory disease symptom prevalence at all ages is clear. Nearly all male smokers reported “cough” but so did four out of five men and women who had never smoked. There were too few women smokers for meaningful analysis. However, “morning phlegm”, “an episode of increased phlegm” and “wheezing” as well as being common for non-smokers of both sexes, were two to three times more frequent among women than men who had never smoked. In women there must certainly be other causal factors for respiratory symptoms apart from smoking, the most important are likely to be smoke from cooking fires and respiratory infections in childhood. Improving immunization coverage and the treatment of respiratory infections in childhood would be useful preventive strategies for both men and women. The most urgent public health measure is to reduce the prevalence of smoking.     

Prise en charge à long terme du grêle court (adulte)

Short bowel is the main cause for chronic intestinal failure. The small bowel is considered to be “short” when the length of the remaining gut is less than 2 meters; the anatomy of the residual intestine may influence the adaptative capacities of the gut. Almost half of the patients with a “short bowel” need a long-term parenteral support. The amount of parenteral lipids must be ranged between 1 g/kg body weight/week and 1 g/kg body weight/day in order to prevent essential fatty acids deficiency and, on the other hand, to limit the risk of lipid-related hepatopathy. Vitamins and trace-elements must be regularly provided; there is a risk of brain toxicity due to excessive iv administration of manganese. Advantages of glutamine or growth hormones are still debated.     

Health and housing conditions in public sector housing estates

This article reports some of the findings of a study of health and housing conditions ina sample of households from eight different types of council housing areas in Gateshead.Controlling for age, there were found to be marked and consistent differences in self-reported health between individuals from different areas. For all age groups up to 65 years old, those living in “bad” housing areas reported poorer health, more long-standing illness, more recent illness and more symptoms of respiratory disease and depression. The clearest associations between poor health and bad housing emerged for the generally fittest age-groups (the under 25 years). For the people over 65 years the position was reversed, with those in “good” housing areas reporting poorer health, with the exception of recent illness. This is argued to be the result of local authority lettings policy, which gives priority to re-housing the less-fit elderly.Those in “bad” housing areas were also more likely to report housing defects which affected their health and to feel that their health could be improved by a change in their housing.The study found that “bad” council housing areas did not necessarily conform to thestereotype of non-traditional construction, or high-rise flats. Some consisted of traditionally built houses, while there was a sizeable representation among the “good” housing of system-built high-rise flats. The “bad” housing areas were marked off more by their location, their poor environment and the low quality of their construction.     

Education and young people in care

The Oxford Dictionary defines Education as the, “systematic instruction, development of character and mental powers”. To “Educate” is referred to as, “to train or to instruct intellectually”. Teachers and Tutors use education to pass on their own acquired knowledge, knowledge which will either be interesting or useful for those entering into the workplace. This article will look at the issues surrounding a young person in care and their education, it will also examine why other sections of society also tend to neglect their schooling. “Good practice” will also be highlighted and recommendations put forward for both discussion and implementation in the workplace.     

“Live, Learn and Play”: Building strategic alliances between professional sports and public health

Public–private partnerships allow communities and corporate entities to pool resources to address a mission of relevance to their common constituency or consumer base. Collaborations between public health and professional sports may present unique opportunities to improve health outcomes related to physical activity since athletes are fitness icons, both for adults and children. There are many “win–win” opportunities, as sports venues regularly host huge numbers of spectators, offering food and entertainment, providing hours of exposure, and introducing new ideas for engaging fans in order to remain a competitive draw. In 2008, the San Diego Padres embarked on a communitywide fitness initiative, FriarFit, including incorporating 10-minute Instant Recess™ breaks during their Sunday homestand pre-game shows. Many lessons have been learned that may be useful to others mounting such initiatives, such as: there is more at stake in cost-benefit and risk-benefit assessment for sports executives, requiring greater caution and circumspection than is typical for public health projects; the core business of the corporate entity must be accommodated without undermining the health objectives; and health aims must be addressed in a way that is financially viable and delivers tangible value for profit-making concerns, in terms of marketing, revenues or brand enhancement.     

The “U” technique: A new method for Norplant implants removal

The standard technique for Norplant implants removal was compared with a new technique called the “U” technique, which employs the use of a modified no-scalpel vas deferens holding forceps to grasp and remove the capsules. Seventy-six women requesting Norplant implants removal were randomly assigned to Group 1 (standard removal technique) or Group 2 (“U” removal technique). Variables measured included: (a) time required for complete removal, (b) number of capsules not broken or damaged during removal, and (c) number of incisions required for removal of all six capsules. In clients with visible or palpable capsules, the standard removal technique required significantly more time to remove all six capsules, on average, than the “U” technique (19 versus 7 minutes, p < 0.001); also more capsules were damaged during removal (5.6 undamaged versus 6.0,p < 0.01). In addition, with the standard technique, five clients required two incisions for removal of all six capsules while none of the clients required more than one incision with the “U” technique. Our conclusion is that the “U” technique is a quicker and easier method of removing Norplant capsules than the standard technique.