Quality Ratings of a Hospital Foodservice Department by Inpatients and Postdischarge Patients

Objectives To examine quality of food and nutrition services using the ratings of inpatients and patients who had been discharged (postdischarge patients).Design Questionnaires were used to collect perceptions of inpatients and postdischarge patients on the quality of food and nutrition services. A 5-point scale allowed subjects to rate quality from very poor to very good.Subjects Questionnaires were completed by 252 inpatients and 437 postdischarge patients of a midwestern teaching hospital.Statistical analysis Analysis of variance was used to assess differences in quality ratings on the basis of demographic variables. Stepwise regression was used to determine variables that best predicted overall satisfaction. Paired t tests were conducted to compare matched inpatient and postdischarge ratings.Results Ratings of food and nutrition services indicated that patients were satisfied; few differences were found in ratings on the basis of patient demographics. Food quality was the best predictor of overall satisfaction for both inpatients and postdischarge patients. As patient expectations were increasingly met or exceeded, patient ratings of quality increased. The majority of patients in the matched sample gave the same ratings on the inpatient and postdischarge questionnaires.Applications Foodservice managers who desire to improve patient satisfaction should focus attention on meeting or exceeding patient expectations for food quality. J Am Diet Assoc. 1998;98:1303–1307.     

The Solution Method: 2-year trends in Weight, Blood Pressure, Exercise, Depression, and Functioning of Adults trained in Development Skills

This study describes changes observed during a 2-year period in participants enrolled in The Solution Method, a developmental skills training program for adult weight management. This Intervention is the adult application of a model of treatment previously used only in the management of pediatric obesity (The Shapedown Program). Developmental skills training integrates understandings and methods from developmental, family systems, biomedical, genetic, and behavioral theories of the etiology of obesity. Twenty-two subjects (mean age=43.4±8.5 years and mean body mass index=33.1+5.3) completed a group intervention based on this method, which was conducted by a registered dietitian and a mental health professional. Questionnaire responses indicated the extent to which their weight was a medical and/ or psychosocial risk. Subjects attended 2-hour weekly sessions for an average of 18 weeks during which they were trained in six developmental skills: strong nurturing, effective limits, body pride, good health, balanced eating, and mastery living. Data, which were collected at the beginning of treatment and at 3, 6, 12, and 24 months, included weight, blood pressure, 7-day exercise recalls, and responses to depression and functioning (psychosocial, vocational, and economic) questionnaires. Participants’ weights decreased throughout the 2-year period of the study: mean weight change was −4.2 kg (3 months), −6.0 kg (6 months), −7.0 kg (12 months), and −7.9 kg (24 months). In addition, compared with baseline values, systolic and diastolic blood pressure, exercise, and depression improved throughout the study period. These improvements were statistically significant at 24 months for weight (p<.01), systolic blood pressure (p<.02), diastolic blood pressure (p<.001), and exercise (p<.001); the results were not statistically significant for depression. Most participants reported improvement in a broad range of aspects of functioning. We conclude that this application of developmental skills training for adult weight management may produce significant long-term beneficial effects. J Am Diet Assoc. 1997;97:1133–1138.     

A COMPARISON OF GLUTATHIONE REDUCTASE AND GLUTATHIONE PEROXIDASE ACTIVITES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND HEALTHY ADULTS

A 30% increase in erythrocyte glutathione peroxidase (GP) activitywas found in patients with rheumatoid arthritis when comparedwith healthy controls (p = 0.001) whereas the increase in glutathionereductase (GR) was statistically insignificant. No correlationwas found between the activities of the enzymes and the erythrocytesedimentation rate (ESR). The enzyme activities were independentof age, sex, or type of drug treatment of the patients. A possibleinterpretation of the results is presented. KEY WORDS: Glutathione peroxidase, Glutathione reductase, Rheumatoid arthritis, Disease activity, Thiol, Peroxides     

Effect of defective connective tissue on the formation of aneurysmal-like structures in the rat testicular artery

Microscopic aneurysmal-like structures (ALS) develop spontaneously in the convoluted rat testicular artery and have been previously proposed as a model relevant to cerebral aneurysms. The effect of defects in connective tissue fibres on ALS formation was investigated by microscopy using two approaches: (i) the study of the effect of β-aminopropionitrile (BAPN), an inhibitor of the cross-linking of elastic and collagen fibres, on the incidence, size and morphology of ALS in spontaneously hypertensive rats (SHR) and their normotensive controls (WKY). The straight spermatic artery was studied for comparison. (ii) The determination of the incidence of spontaneous ALS in Brown Norway (BN) and Long Evans (LE) rats which are highly susceptible (BN) or resistant (LE) to the spontaneous rupture of the arterial internal elastic lamina. (i) BAPN increased the number and size of ALS in SHR and WKY rats and had no effect on the straight spermatic artery and (ii) ALS were more numerous and of greater size in BN than in LE rats. Taken together, these results show that defective connective tissue fibres may favour the formation and induce the enlargement of aneurysmal-like structures. By analogy, these data suggest that a lack of connective tissue fibre integrity may be of importance in cerebral aneurysm formation and development.     

不同年龄和部位女性皮肤微循环变化

目的观察不同部位皮肤血管结构和形态差异,研究年龄对真皮微循环功能的影响.方法采用活体电视毛细血管镜(Intravital Video-capillaroscopy)和激光多谱勒血流仪(laser Doppler flowrnetry)对50名年龄在20～74岁,光皮肤类型为Ⅱ～Ⅲ型白人女性志愿者的前额、眼角、前臂内侧和手背血管作初步观察.并用计算机图象处理技术,对前臂和手背活体真皮血管密度作定量分析.结果真皮乳头毛细血管襻在活体电视毛细血管镜下为点状或逗点状;乳头下的血管丛表现为线条状或网状;年轻人皮肤血管排列整齐,年龄较大者血管扩张增粗、扭曲,排列不规则.年龄与襻状血管数、襻状血管面积显著负相关;与襻状血管间距、平行血管总长正相关;真皮血流量面部高于肢端;随年龄的增加真皮血流有逐渐增加趋势.结论年龄影响真皮微循环的形态和功能.两种无创性检测技术联合应用能动态研究活体真皮血管的形态和结构,在皮肤血管性疾病的诊断和治疗方面有较高的应用前景.     

Anthropometric Characteristics of Mohawk Children Aged 6 to 11 Years: A Population Perspective

OBJECTIVE: Recent studies have concluded that Native North American children have higher proportions of overweight and obesity than children from the general North American population. This study presents anthropometric data on a representative sample of children from the Mohawk Nation that can be used for comparison with other Native American populations. DESIGN: This is a cross-sectional study comparing distributions of anthropometric characteristics of Mohawk children to the corresponding age and gender data from the Second National Health and Nutrition Examination Survey (NHANES II). Weight, height, triceps and subscapular skinfold thickness, and waist and hip circumferences were measured in 527 children. SUBJECTS/SETTING: All children in grades 1 to 6 (aged 6 to 11 years) in the 3 elementary schools of 2 Mohawk communities in Canada, for whom parental consent was obtained, were enrolled in the present study. There were no exclusion criteria. With a participation rate of 83%, the 527 children enrolled in this study represent an unbiased sample of the population from 2 Mohawk territories. RESULTS: Compared with children studied in NHANES II, Mohawk children were similar in height and triceps skinfolds but were generally heavier, had thicker subscapular skinfolds, and had greater waist and hip circumferences. These differences were greater in older children. Mohawk children who had extreme-high weight values compared with their population means were heavier than their NHANES II counterparts. APPLICATIONS/CONCLUSIONS: Results indicated that, on average, Mohawk children seem to be slightly heavier than children in NHANES II. Except for those with extreme overweight values, Mohawk children show less variation of weight and body mass index than children in NHANES II. Finally, overweight Mohawk children seem to be more likely to carry their excess body fat truncally, compared with overweight children from NHANES II. Health practitioners working with Native American populations should be careful when assessing childhood obesity. Simple comparisons of weight or body mass index with NHANES standards may lead to inappropriate risk assessments.