Development of scores to measure the effects of nutrition counselling on the overall diet: A pilot study in children and adolescents

Summary An intervention study by documented dietary counselling was carried out in a sample of 9 children and adolescents (12–,15 years) living in a full-time institution in Dortmund. Three weighed dietary records were collected over 3–7 days, one before and one after each of two individual nutrition counselling sessions, which were based on the recommended intake of food groups defined by the Optimized Mixed Diet (OMD), a quantitative preventive dietary conception for children and adolescents. As univariate dietary parameters (e.g., cholesterol intake), which are often used to show the effectiveness of nutrition counselling, do not take into account the multivariate complexitiy of nutrition, we developed 3 multivariate scores to measure the effectiveness of nutrition counselling. The are definded as: Recommended Food group change Score (RFS): Average change in the amounts of the deviations (%) from the reference food groups values (OMD = 100 %) before and after counselling taking into account the aim (eat mor/less) of the counselling session, exclusively based on the food groups addressed during counselling. Total Food group change Score (TFS): Average change in the amounts of the deviations (%) from the reference food group values (OMD = 100 %) before and after counselling based on all food groups consumed. Nutrient Improvement Score (NIS): Average change in the negative deviations (%) of 8 vitamins and 8 minerals from the German reference values for nutrient intake (Deutsche Gesellschaft für Ern?hrung (DGE) = 100 %) before and after counselling. On average, the intakes of the food groups mentioned during the first counselling session improved considerably (RFS = +36 %), the change in the intake of all food groups was small (TFS = +6 %) and the nutrient intakes did not improve (NIS = 0 %). From the second counselling session the values of the RFS was +10 %, of the TFS was +6% and of the NIS +3 %. This means that the success of counselling on one dietary criterion does not guarantee success on others. Our food and nutrient based scores together with a detailed food intake assessment give an example of multivariate measurements of nutrition counselling outcomes. Received: 22 January 1999, Accepted: 22 July 1999     

Factors associated with participation or nonparticipation in a workplace wellness center

The aim of this project was to compare characteristics and factors that distinguished those individuals (n = 101) who participated in a worksite wellness program from those who did not (n = 100). This project was unique in that the majority of subjects were bluecollar workers. Factor analysis of a 35-item questionnaire resulted in six factors: perceived benefits of health promotion behaviors, perceived physical barriers of health promotion, perceived self-efficacy for health promotion behaviors, perceived psychological barriers, situational components relating to convenience of the wellness facility, and the need for social support. Discriminant analysis revealed that self-efficacy was the most useful factor in distinguishing between the two groups. Participants identified more benefits and fewer barriers to health promotion activities. Nonparticipants were older, less educated, and tended to view their age, their perceived lack of fitness, and perceived poorer health status as deterrents to regular physical activity. Nonparticipants also identified shift work, working overtime, responsibilities at home, and distance from work as important barriers to health promotion activities. Self-efficacy factors appear to warrant further investigation in future attempts to explain health promotion behaviors in this high risk group.     

Computers and caregiving: reaching out and redesigning interventions for homebound older adults and caregivers

This article discusses computer resources for homebound older adults and informal caregivers as an intervention to promote social support and mental health. Published information related to a computer network designed as an intervention for informal caregivers of persons with Alzheimer's disease is included. This information suggests that homebound older adults and informal caregivers can gain valuable information, confidence, and support by using computer resources. A review of the literature supported those findings and suggested that computer technology can facilitate continuing education and the refinement of skills for nurses. Implications for the use of computer resources in nursing education, practice, and research are presented.     

A decade of distance education: RN to BSN

TELETECHNET represents a major commitment on the part of the university. The university's strategic plan and resource allocations indicate that this educational strategy is a growing enterprise. Although challenges exist in implementing a nursing education program by television, the TELETECHNET program provides opportunities for the place-bound student to achieve advanced education.     

Magnetic targeting of nanometric magnetic fluid loaded liposomes to specific brain intravascular areas: a dynamic imaging study in mice

PURPOSE: To prospectively determine, by using dynamic imaging, whether a magnet placed over a specific area of the mouse brain could target systemically administered rhodamine-labeled magnetic fluid-loaded liposomes (MFLs) to that brain region. MATERIALS AND METHODS: Experiments were performed with a French Ministry of Agriculture permit and regional ethics committee authorization. In seven anesthetized C57BL/6 mice, a closed cranial window was implanted above the left parieto-occipital cortex. A laser-scanning confocal fluorescence microscope (LSCFM) was used to track the intravenously injected rhodamine-labeled MFLs within this cortical area, through the cranial window. The MFLs were video monitored for 2 minutes every 15 minutes for 1 hour after injection. A magnet was placed on the cranial window implanted in four mice, while no magnet was placed in three (control) mice. After dynamic in vivo imaging, static in vivo imaging was performed with a different LSCFM. Ex vivo fluorescence histologic analysis was then performed. Paired Student t testing was used to compare the cerebral blood flow and two-dimensional flow values before and 1 hour after MFL injection. For image analysis, intergroup comparisons were performed by using an independent t test. RESULTS: In vivo video monitoring through the window revealed that the rhodamine-labeled MFLs accumulated in the mouse brain microvasculature exposed to the magnet-first within superficial brain venules and then within intracerebral venules-with no significant change in blood flow (P > .05). MFLs accumulated neither in the arterioles of the mice with a magnet nor in the arterioles of the control mice. Static in vivo imaging findings confirmed the microvascular localization of the rhodamine-labeled MFLs, and histologic findings specified their accumulation on the side of the magnet only. CONCLUSION: Real-time in vivo imaging of rhodamine-labeled MFLs in the mouse brain cortex revealed that these nanosystems can be magnetically targeted, through microvessels, to selected brain areas.     

Vitamin and mineral supplements for the use of children on the German market: products, nutrients, dosages

A market survey of vitamin and mineral supplements was carried out considering various points of purchase. 37 of 146 producers offered a total of 110 supplements marketed 'directly' (42%) or 'indirectly' (58%) for the use of children. These products contained 31 different nutrients, vitamins more frequently than minerals. The number of nutrients per product ranged from 1 (23%) to over 10 (13%), maximum 26. In most cases, the daily dosage recommended by producers reached from 100 to 200% of the reference doses for nutrition labelling for vitamins and from 50 to 100% for minerals. In total, the findings point to an abundance of products, nutrients and dosages in the German market supply of vitamin and mineral supplements for the use of children.     

Follow-up of hemorheological parameters and platelet aggregation in patients with acute coronary syndromes

Pathologic hemorheological parameters and increased platelet aggregation in association with other risk factors significantly increase the possibility of the development of myocardial ischemia. Hemorheological parameters and platelet aggregation were investigated in 157 patients (mean age: 65+/-12 years) with acute coronary syndromes and in 68 healthy subjects (mean age: 36+/-6 years). Plasma fibrinogen, plasma and whole blood viscosity, red blood cell aggregation and filterability and platelet aggregation were measured in the hospital phase (after admission, on 2nd and 6th days) and monitored after discharge (at 1, 6 and 12 months). After admission all these parameters were significantly higher in patients than in control subjects (p<0.01) and almost all of them remained in the pathologic range at discharge. Some of the rheologic parameters showed a slight improvement after 1 month, but hematocrit and whole blood viscosity were higher than those after admission and of control subjects (p<0.05). After 6 and 12 months these parameters showed a small, but significant increase. Pathologically altered hemorheological parameters could be observed in patients with classical cardiovascular risk factors and significant improvement was found after elimination of them. Antiplatelet therapy was efficient in about half of the treated patients after admission; and despite a significant improvement, the proportion of ineffectively treated patients was still considerable during the follow-up. Our results support the role of abnormal hemorheological parameters in the development of myocardial ischemia and draw attention to the rheologic risk of these patients. The results of platelet aggregation measurements show the insufficiency of antiplatelet therapy at some cases and confirm the importance of guided secondary prevention.     

Longitudinal examination of 24-h urinary iodine excretion in schoolchildren as a sensitive, hydration status-independent research tool for studying iodine status

BACKGROUND: Because worldwide iodine status (IS) depends on continuous fortification, the adequacy of IS needs to be regularly monitored. OBJECTIVE: Our study aimed to evaluate IS in a longitudinal sample of healthy schoolchildren who regularly used table salt iodized with 20 microg I/g. DESIGN: Urine osmolality (Uosm) and 24-h urinary excretion rates of iodine (24-h UI), sodium, creatinine, and total urine volume (24-h Uvol) were measured in 1046 specimens that were collected at repeated intervals from 1996 to 2003 in a sample of 358 German children aged 6-12 y. Energy intake and food consumption were calculated from 3-d weighed dietary records that were collected in parallel to the urine samples. RESULTS: During the 4-y period from 1996 to 1999, the median 24-h UI increased from 87 to 93 microg I/d (P = 0.017), whereas urinary iodine concentration (UIC), Uosm, and 24-h Uvol did not change significantly. Thereafter (from 2000 to 2003), UIC stagnated and Uosm decreased (P = 0.004), whereas 24-h Uvol (P = 0.008) and 24-h UI (P = 0.002) increased. The final median 24-h UI reached 120 microg I/d. Milk, fish, egg, and meat intakes and 24-h sodium excretion were all significant predictors of IS, with an almost doubled contribution from milk intake during the second 4-y period. CONCLUSIONS: Our study shows a continuous improvement of IS in a longitudinal sample of German schoolchildren. This improvement was masked when UIC was used as an IS index, especially from 2000 to 2003 because of changes in hydration status. Thus, in research-oriented studies that focus on UIC measurements, hydration status can be a relevant confounder. Longitudinal analyses of 24-h UI in cohort studies may represent an alternative hydration status-independent tool to examine trends in IS and the contribution of relevant foods to IS.