• Title/Summary/Keyword: Clinical nutrition management

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Analysis for the Need to Support Kindergartens based on Perception of Parent regarding Important Factors for Foodservice (유치원 학부모들의 급식 중요도 인식에 따른 급식지원 요구도 분석)

  • Jeong, Ji Yeong;Kim, Yuri;Kim, Gun Hee;Oh, Ji Eun
    • Journal of the Korean Society of Food Culture
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    • v.35 no.1
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    • pp.79-85
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    • 2020
  • This study aims to classify parents by considering important factors in the management of foodservice for children. An offline survey was conducted by enrolling 583 Korean parents whose children attended public or private kindergartens in Seoul. The important factors required for managing foodservice for children are meal service resources, menu management, and food allergy. Considering these factors, parents were grouped into 3 clusters: the allergy important group, environment important group, and high concern group. Evaluation of the demographic characteristics revealed a significant difference between clusters with respect to type of kindergarten. Parents perceived that a private kitchen is more required than a private dining room, and perceptions about the need for a private kitchen and dining room were significantly different among the clusters. Furthermore, the results reveal significant differences between clusters, when considering the need to support meal service. Therefore, the government needs to consider characteristics of the parent cluster if they plan to support the kindergarten foodservice. We believe that this study can be used as supportive data to establish a working policy.

Effect of a 12-week weight management program on the clinical characteristics and dietary intake of the young obese and the contributing factors to the successful weight loss

  • Lee, AeJin;Jeon, Kyeong Jin;Kim, Hye-Kyeong;Han, Sung Nim
    • Nutrition Research and Practice
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    • v.8 no.5
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    • pp.571-579
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    • 2014
  • BACKGROUND/OBJECTIVES: The objectives were to investigate the effect of a 12-wk intervention with behavioral modification on clinical characteristics and dietary intakes of young and otherwise healthy obese and to identify factors for successful weight loss. The goal was to lose 0.5 kg per week by reducing 300-500 kcal/day and by increasing physical activities. SUBJECTS AND METHODS: Forty four obese subjects (BMI > 25) and 19 normal weight subjects (BMI 18.5-23) finished the 12-week intervention. Obese subjects participated in 5 group educations and 6 individual counseling sessions. Normal weight subjects attended 6 individual counseling sessions for evaluations of dietary intake and exercise pattern. Anthropometric and clinical characteristics and 3-day dietary records were evaluated at baseline and week12. RESULTS: Weight and serum triglyceride and free fatty acid concentrations in obese group decreased significantly with intervention. Intakes of energy, fat, and cholesterol decreased significantly in the obese. Active participation, realistic weight loss goal setting, and weight gain after high school graduation not during childhood were identified as key factors for successful weight loss. CONCLUSIONS: The 12-week intervention with behavioral modification resulted in reduced energy and fat intakes and led to significant weight loss and improvements of clinical characteristics in the obese. The finding that those who became obese during childhood lost less weight indicates the importance of 'early' intervention.

International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando;Alrefaee, Fawaz;Chakrabarty, Anjan;de Leon, Julia C.;Geng, Lanlan;Gong, Sitang;Heine, Ralf G.;Jarvi, Anette;Ngamphaiboon, Jarungchit;Ong, Christina;Rogacion, Jossie M.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.263-275
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    • 2022
  • Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

Survey of Foodservice Management Status according to Welfare Facility Type for Disabled Persons (장애인 복지시설 유형에 따른 급식관리 실태 조사)

  • Dayoung Oh;Woori Na;Seohyeon Hwang;Jung Joo Lee;Yu Jin Yang;Hyeok, Lee;Ji Hyeon Bang;Hae-Young Lee;Cheongmin Sohn
    • Journal of the Korean Dietetic Association
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    • v.29 no.3
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    • pp.173-189
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    • 2023
  • This study aimed to determine foodservice and hygiene management statuses at welfare facilities catering to disabled persons by facility type to provide basic data for foodservice management guidelines. An online survey was distributed to workers at 1,984 welfare facilities for disabled persons in Korea, and 531 facilities responded, which represented a response rate of 26.8%. The survey requested general information about the facilities, facility users, meals, hygiene, and management. Statistical analyses were performed, and frequency analysis and the chi-square test were used to investigate responses by facility type. The survey results revealed that daycare centers were most common and accounted for 27.4% of responses. Residential facilities for the severely disabled and sheltered workshops accounted for 16.9% and 16.4%, respectively, and residential facilities by disability type accounted for 13.0%. The presence of dietitians at welfare facilities varied by facility type. Welfare centers for the disabled (94.7%) had the highest percentage of dietitians, followed by residential facilities for the severely disabled (87.8%). On the other hand, sheltered workshops and daycare centers for disabled persons had the lowest percentages of dietitians (10.3% and 4.1%, respectively). This study highlights the variations that exist in foodservice management across different welfare facilities for disabled persons and emphasizes the challenges faced by those responsible for managing foodservices and maintaining hygiene, particularly in large facilities with no dietitians. Therefore, we recommend tailored meal management guidelines be developed for each type of welfare facility for disabled persons.

Spontaneous Perforation of Colon in Previously Healthy Infants and Children: Its Clinical Implication

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.193-198
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    • 2016
  • Purpose: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. Methods: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings. Results: Eleven patients were included in the study period and showed a history of hospitalization before transfer due to management for fever, respiratory or gastrointestinal problems. Six patients showed a sudden onset of abdominal distention and only seven patients showed a pneumoperitoneum as initial radiologic findings, however there were no significant clinicopathological differences. Perforation was found evenly in all segments of the colon, most commonly at the sigmoid colon in four cases. There were no specific pathologic or serologic causes of perforation. Conclusion: When previously healthy infants and children manifest a sustained fever with a sudden onset of abdominal distention during management for fever associated with respiratory or gastrointestinal problems, there is a great likelihood of colon perforation with no pathological condition. Prompt surgical management as timely decision-making is necessary in order to achieve a good progress.

Association of the initial level of enteral nutrition with clinical outcomes in severe and multiple trauma patients (초기 경장영양 공급 수준과 다발성 외상 중환자의 임상 경과와의 상관성 연구)

  • Yang, Suyoung;Jung, Seungyoun;Lee, Ji-hyun;Kwon, Junsik;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.55 no.1
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    • pp.85-100
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    • 2022
  • Purpose: This study is aimed to examine the association between initial enteral nutrition (EN) and the clinical prognosis among patients with severe and multiple traumatic injuries, and to investigate whether this association is modified by the patients' catabolic status. Methods: This was a retrospective study of 302 adult patients with severe and multiple traumatic injuries admitted between January 2017 and September 2020 at Ajou University hospital in Suwon, Korea. The initial nutritional support by EN and parenteral nutrition were monitored up to day 7 after admission. Patients were classified into "No", "Low", and "High" EN groups according to the level of initial EN. Multivariable-adjusted logistic regression and linear regression models were used to estimate the association of the initial EN levels at hospital admission with the risk of mortality, morbidities, and levels of nutrition-associated biochemical markers. Results: High EN support was associated with reduced mortality (odds ratio, 0.07; 95% confidence interval [CI], 0.02, 0.32) and lower levels of C-reactive protein (β, -0.22; 95% CI, -8.66, 1.48), but longer stay in the intensive care unit (β, 0.19; 95% CI, 1.82, 11.32). In analyses stratified by catabolic status, there were fewer incidences of hospital-acquired infections with increasing EN levels in the moderate or higher nitrogen balance group than in the mild nitrogen balance group. Conclusion: Our observation of the inverse association between levels of initial EN administration with mortality risk and inflammatory markers may indicate the possible benefits of active EN administration to the recovery process of severe and multiple trauma patients. Further studies are warranted on whether the catabolic status modifies the association between the initial EN and prognosis.

Comparison of Students' Satisfaction with Sanitary, Environment, and Service of College Food Service by Operating System (대학급식소의 운영형태에 따른 위생, 환경과 서비스에 대한 만족도 비교)

  • Kim Su-Hyun;Kwon Sunja;Ly Sun Yung
    • Korean Journal of Community Nutrition
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    • v.10 no.3
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    • pp.331-340
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    • 2005
  • The purpose of this study was to provide basic data to improve college food service satisfaction with sanitary, environment and service by comparing 2 contract-managed and 2 self-operated college food services in Daejeon and Chungnam area. According to the results, sanitation and environment satisfaction degrees of contract-managed college food services were higher than those of self-operated food services. The satisfaction degrees with service were also higher in contract-managed food services than self-operated food services except the category of quick food delivery. In all categories comprising the food service satisfaction, the satisfaction degrees were lower in female students than in male students. There were more negative self-perceived clinical symptoms in female students than male students. The higher the negative self-perceived clinical symptoms scores were, the lower the satisfaction degrees with food service were, which suggests that かe health state of students was one of the factors that influenced college food service satisfaction. There was no difference between contract-managed and self-operated food services in terms of satisfaction with overall food taste and overall satisfaction degree. The average satisfaction degree for the contractmanaged food services in terms of price relative to food quality was lower than that for self-operated food services. According to stepwise multiple regression analysis, 'overall food taste', 'price relative to quality', 'kindness of employees', 'coping with proposed opinions' and 'quicknless of food delivery' in decreasing order, were the most relatively important attributes for overall satisfaction. There should be further studies on important management factors to improve satisfaction with sanitary, environment and service by self-operated college food service.

Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.5
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    • pp.423-429
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    • 2020
  • Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.

Clostridium difficile in Children: To Treat or Not to Treat?

  • Shim, Jung Ok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.2
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    • pp.80-84
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    • 2014
  • Clostridium difficile infection has been increasing since 2000 in children and in adults. Frequent antibiotics use, comorbidity, and the development of hypervirulent strains have increased the risk of infection. Despite the high carriage rates of C. difficile, infants rarely develop clinical infection. Discontinuing antibiotics and supportive management usually leads to resolution of disease. Antibiotics use should be stratified depending on the patient's age and severity of the disease.

Clinical Nutrition Service at Medical Centers in Seoul (서울지역 의료기관의 임상영양서비스 현황조사)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.17 no.2
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    • pp.176-189
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    • 2011
  • The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.