Parenteral Nutrition Support in China and Its Modern Trends

Parenteral mutrition support (PN)is one of the most important achievements in surgical science and practice of the last 40 years.From 1971,clinical applications of PN have spread from Beijing and Shanghai to Nanking,Tianjin,and to other big cities throughout the country.Over the past decade,clinical and laboratory research activities have also expanded from what once only a few medical colleges to encompass many medical centers.     

Burns and Nutrition

In adults, burns of 40％ total body surface areas(TBSA)or greater were virtually unsurvivable but a few decades ago.Now, more than half of the adult patients with a 70％ TBSA burn survive. In children, the size of the survivable injury has increased so much that it is now possible to save a child with burns exceeding 95％ TBSA full thickness.The decrease in mortality and morbidity related to major thermal burn injuries noted in the past decade is primarily due to improvements in four major areas.     

Health Professionals’ Values Associated with Support for Food Assistance and Nutrition Education Programs

This study investigated the personal characteristics and values associated with support for food assistance and nutrition education programs in three groups of health professionals. Nearly 1500 dietitians and members of the public health and rural health associations responded to a mail survey. The membership lists were screened to eliminate duplicate mailings. Support for food assistance was positively associated with high values for food assistance, equity (support for opportunities for the poor, minorities, and women), and younger age respondents. Support for educational programs was most strongly associated with the values of equity, support for the environment and family, and being a nutritionist.     

In the Age of Viral Pandemic,Can Ingredients Inspired by Human Milk and Infant Nutrition Be Repurposed to Support the Immune System?

In 2020, with the advent of a pandemic touching all aspects of global life, there is a renewed interest in nutrition solutions to support the immune system. Infants are vulnerable to infection and breastfeeding has been demonstrated to provide protection. As such, human milk is a great model for sources of functional nutrition ingredients, which may play direct roles in protection against viral diseases. This review aims to summarize the literature around human milk (lactoferrin, milk fat globule membrane, osteopontin, glycerol monolaurate and human milk oligosaccharides) and infant nutrition (polyunsaturated fatty acids, probiotics and postbiotics) inspired ingredients for support against viral infections and the immune system more broadly. We believe that the application of these ingredients can span across all life stages and thus apply to both pediatric and adult nutrition. We highlight the opportunities for further research in this field to help provide tangible nutrition solutions to support one’s immune system and fight against infections.     

Development and Principle Content of the Guidelines of Japanese Society for Parenteral and Enteral Nutrition

Promulgation of safe and effective patient care by nu-trition support practitioners is a critical role of the Japa-nese Society for Parenteral and Enteral Nutrition (JSPEN)organization, which is quite same as that of other societiessuch as American Society for Parenteral and Enteral Nutri-tion (ASPEN), European Society for Parenteral and En-teral Nutrition (ESPEN) and so on.In order to ensurethe right nutritional support to right patient at the righttime and in the right place, the …     

Schoolteachers’ Nutrition Knowledge,Beliefs, and Attitudes Before and After an E-Learning Program

ObjectiveΤο explore teachers’ nutrition knowledge, beliefs, and attitudes and to examine the effectiveness of an electronic learning (e-learning) program in teachers’ nutrition knowledge.DesignCross-sectional and experimental design.SettingThe study took place in Greece, while schoolteachers were invited by e-mail.ParticipantsTeachers of primary and secondary education, with no exclusion criteria, were enrolled in the study between March, 2015 and 2016.Main Outcome MeasuresSchoolteachers' nutrition knowledge, beliefs, and attitudes.InterventionTeachers completed a 36-item nutrition questionnaire and then a subgroup participated in an e-learning program. After the intervention, teachers completed the same questionnaire.AnalysisPrincipal component analysis and multivariate logistic regression were used for data analysis.ResultsA total of 1,094 teachers completed the questionnaire; 619 participated in the e-learning program. Teachers showed moderate nutrition knowledge scores (ie, 65% correct answers) before the intervention, whereas their attitudes regarding acting as role models and their belief in the importance of the role of nutrition were associated with 74% (odds ratio, 1.28; 95% confidence interval, 1.13–1.45) and 79% (odds ratio, 1.21; 95% confidence interval, 1.07–1.37) increased possibility of having good nutrition knowledge, respectively. The e-learning program was effective in strengthening teachers’ nutrition knowledge (P < .001) and improving their beliefs and attitudes (P < .05).Conclusions and ImplicationsFuture research is needed to validate the current results, which can be used to design and implement similar educational programs to teachers as a means of creating health-promoting schools.     

Nutrition Curriculum Training and Implementation Improves Teachers’ Self-Efficacy,Knowledge, and Outcome Expectations

ObjectiveTo examine the effects of training and implementation of Forecasting Your Future: Nutrition Matters on teachers’ self-efficacy to teach nutrition and teachers’ nutrition knowledge and explore outcome expectations for students.MethodsA mixed-methods study, with Indiana Family and Consumer Sciences high school teachers randomized to control and intervention, was conducted using baseline surveys, implementation of new or usual curriculum, follow-up survey(s), and semistructured interviews. Self-efficacy and knowledge were analyzed by hierarchical linear modeling. Interviews were thematically analyzed using a 5-phase process to identify outcome expectations.ResultsIntervention teachers (n = 17) had greater increases in nutrition knowledge (P = 0.028) and self-efficacy (P = 0.010) compared with controls (n = 18). Interviews revealed that teachers sought to affect students’ long-term health by providing knowledge and skills to make healthy choices.Conclusions and ImplicationsThis training with updated curricula and implementation improved theoretical determinants of effective nutrition instruction. Teachers expected student learning will contribute to future eating behaviors.     

Structural Analysis of the Relationships among Elementary Teachers’ Training,Self-Efficacy,and Time Spent Teaching Nutrition

Many factors determine the time elementary teachers devote to nutrition instruction. We tested theoretical models for the relationships among time spent teaching nutrition (TTN) and several aspects of the teacher's nutrition background: nutrition training, self-efficacy, knowledge, and beliefs. We proposed two models: (1) teachers with more nutrition training would have increased self-efficacy for teaching nutrition and, because of that increased self-efficacy, would teach more nutrition (primary model); and (2) both training and self-efficacy would directly and independently influence TTN (alternative model). The models differed only in one respect: whether the influence of training on TTN is direct or mediated by self-efficacy. We used data from a 1990-92 Hawai‘i Nutrition Education and Training Program needs assessment survey (N = 324 elementary teachers) and completed a structural analysis using the CALIS procedure of SAS. The primary model fit the actual data more closely than did the alternative model. Nutrition knowledge predicted self-efficacy for teaching nutrition, but a belief that nutrition instruction was important did not predict TTN. These results indicate that in elementary teachers, self-efficacy for teaching nutrition mediates the relationship between in-service training, nutrition knowledge, and TTN.     

Nutrition—an essential component of health and health care.

Nutrition and medicine interface in a variety of ways and combine to serve as a dynamic force in health as well as in disease. A conceptual understanding of this interrelationship is critical to the continued and effective development of clinical nutrition in medical education. The physician may play an important role in critical-care medicine, long-term health care, research, education, and preventive medicine. While there is great potential for the physician to impact on nutrition status in both health and disease, there is clear evidence that greater emphasis needs to be placed on providing adequate nutrition training for every physician.     

The Reciprocal Relation Between Adolescents’ School Engagement and Alcohol Consumption,and the Role of Parental Support

While school engagement and the use of alcohol are subject to change during the course of adolescence, studies have shown that being engaged in school equates with a later onset of alcohol consumption. Cross-sectional studies also indicate that alcohol use correlates to school engagement, but the reciprocal nature of these factors has never been investigated. This study examines the reciprocal relation between school engagement and alcohol consumption during adolescence. Further, the moderating effect of perceived parental support in this reciprocal relation between school engagement and alcohol consumption is tested. Data were obtained from Dutch high school students (n?=?906, 52.5 % boys, mean age?=?12.19 years) who annually completed a digital questionnaire over 4 years (age 12 to 15). A cross-lagged autoregressive model was applied in AMOS. Results showed that more school engagement at ages 12 and 14 predicted lower levels of alcohol use 1 year later. In addition, more alcohol consumption at ages 12 and 14 predicted lower levels of school engagement 1 year later. Higher school engagement at age 13 predicted less alcohol use at age 14, whereas no significant effect of alcohol use on school engagement was found at this age period. Furthermore, a reciprocal relation was found only for adolescents who perceived high parental support. The reciprocal nature of school engagement and alcohol consumption should be a consideration in future research and prevention program development.     

A demographic,clinical, and behavioral typology of obesity in the United States: an analysis of National Health and Nutrition Examination Survey 2011–2012

Purpose

Public health reporting, randomized trials, and epidemiologic studies of obesity tend to consider it as a homogeneous entity. However, obesity may represent a heterogeneous condition according to demographic, clinical, and behavioral factors. We assessed the heterogeneity of individuals with obesity in the United States.

Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA) enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs) were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I² test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark) was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI) (0.62, 1.09), p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN) of omega-3 and enteral administration (EN) of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10), p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007). Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed.     

Editorial Committee of Chinese Journal of Clinical Nutrition

CouncilorsQian Xinzhong,D.SC.(Beijing,China)Chen Minzhang,M.D.(Beijing,China)Liao Youmou,M.D(Beijing,China)Honorary Editor in ChiefWu Weiran,M.D.(Beijing,China)Wang Baoen,M.D.(Beijing,China)Editor in chiefJiang Zhuming,M.D.(Zhu MingJiang)(Beijing,China)Editorial StaffHe Ruixiang,M.D.(Beijing,China)Zhang Lingyuan,M.D(Beijing,China)Sun Zhongmin,M.D.(Beijing,China)Wang Guiying,M.D.(Beijing,China)Associate Editor in ChiefWang Yu,M.D.(Beijng,China)Xia suisheng,M.D.(Wuhan,China)Deng Shiling,M.D.(Tianjin,China)Zhong Nanshan,M D.(Guangzhou,China)Chen Tingyuan,M.D.(Beijing,China)     

Editorial Committee of Chinese Journal of Clinical Nutrition

Councilors S邑eng Z回iyong’M.D.Jia Rumei,M.D. *【gg二ZgZ回OItg,D.*C.(Btuitg,*hna)G卜Uigzbuang,c卜m) (砰iiing,China)CMn Xuecun,M.D.Wang Jifu,M.D. Chen Minzhang,M.D.(Betting,China)(Guangzhou,China) (E吃iiing,China)Gu Z回uoyun,M.D、Z回ac Bing回u邑,M.D. I Liy Y00000,M,I)。(BOijin.China)(Taiyuan,China) O企iiing,China)Z回aug Siyuan,M.D.He Ruixiangng,M.D.Honorary Editor in Chief(Beijing,Chil。a)(Beijing,China) Wu Weiran,M、D.Huang De-clang,M.D.He Guizhen,丑.S. (Beliin…