The elderly population in Korea is rapidly growing. As the population ages, meals become a greater concern, as physical and psychological health problems are directly affected by dietary life, especially for the lower-income elderly. Although the government provides support through a free congregate meal service, there is a lack of systematic management of this meal service. This study investigates the experience of the elderly, especially the symbolic meaning and issues regarding the congregate meal service in their dietary life, to establish strategies for improving congregate meal services. Qualitative data was collected from ten elderly receivers of meal services through in-depth interviews and data was analyzed using Colaizzi's phenomenological research methods. Overall, 90 significant statements, 13 formulated meanings, and five theme clusters were deduced. The five theme clusters for the importance of meal services to the elderly included the followings: "a real meal", "enjoyment of living", "maintenance of regular life", "place for social life" and "meal of silence". We found that the elderly regarded the congregate free meal service not only as meals to appreciate but also as a form of social life. Furthermore, the elderly did not typically express any complaints regarding congregate meal services because they are free. The results showed that it might be difficult to evaluate the quality of meal services based on the opinions of the service receivers. This study suggests it is necessary to develop multilateral evaluation methods to reflect the needs of the elderly and to improve the congregate meal services at elderly welfare centers.
The genesis of methods for defining the nutritional value of feeds and the nutrient requirements of animals, and their development in the late 19th and early 20th centuries in Europe and the USA are outlined. Current energy and protein feeding systems for ruminants are described. Particular reference is made to the Australian systems which are applicable to grazing animals as well as to those given prepared feeds, and enable the effective nutritional management of a imals at pasture by means of the decision support tool GrazFeed. The scheme for predicting intakes by cattle and sheep from pastures allows for the effects of selective grazing on the composition of the feed eaten, and for reduction in herbage intake when a supplementary feed is consumed. For herbage of any given concentration of metabolizable energy (ME) in the feed dry matter the changes with season of year in the net efficiency of use of the ME for growth and fattening and in the yield of microbial crude protein, g/MJ ME, which both vary with latitude, are defined. An equation to predict the energy requirements for maintenance (MEm) of both cattle and sheep includes predictions of the additional energy costs incurred by grazing compared with housed animals and the cost, if any, of cold stress. The equation allows for the change in MEm with feed intake. A flexible procedure predicts the composition of liveweight gain made by any given breed or sex of cattle and sheep at any stage of growth, and the variation with rate of gain. Protein requirements for maintenance, production including wool growth, and reproduction, are related to the quantities of microbial true protein and undegraded dietary protein truly digested in the small intestine.
Albino, Frank P.;Wood, Benjamin C.;Han, Kevin D.;Yi, Sojung;Seruya, Mitchel;Rogers, Gary F.;Oh, Albert K.
Archives of Plastic Surgery
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제43권6호
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pp.506-511
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2016
Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.
With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.
BACKGROUND/OBJECTIVES: Brain aging is a major risk factor for severe neurodegenerative diseases. Conversely, L-histidine and L-carnosine are known to exhibit neuroprotective effects. The aim of this study was to examine the potential for L-histidine, L-carnosine, and their combination to mediate anti-brain aging effects in neuronal cells subjected to D-galactose-induced aging. MATERIALS/METHODS: The neuroprotective potential of L-histidine, L-carnosine, and their combination was examined in a retinoic acid-induced neuronal differentiated SH-SY5Y cell line exposed to D-galactose (200 mM) for 48 h. Neuronal cell proliferation, differentiation, and expression of anti-oxidant enzymes and apoptosis markers were subsequently evaluated. RESULTS: Treatment with L-histidine (1 mM), L-carnosine (10 mM), or both for 48 h efficiently improved the proliferation, neurogenesis, and senescence of D-galactose-treated SH-SY5Y cells. In addition, protein expression levels of both neuronal markers (β tubulin-III and neurofilament heavy protein) and anti-oxidant enzymes, glutathione peroxidase-1 and superoxide dismutase-1 were up-regulated. Conversely, protein expression levels of amyloid β (1-42) and cleaved caspase-3 were down-regulated. Levels of mRNA for the pro-inflammatory cytokines, interleukin (IL)-8, IL-1β, and tumor necrosis factor-α were also down-regulated. CONCLUSIONS: To the best of our knowledge, we provide the first evidence that L-histidine, L-carnosine, and their combination mediate anti-aging effects in a neuronal cell line subjected to D-galactose-induced aging. These results suggest the potential benefits of L-histidine and L-carnosine as anti-brain aging agents and they support further research of these amino acid molecules.
Two experiments were conducted to evaluate the nutritional value of common fodder tree leaves with goats fed at 50% of total ration. In experiment 1, leaves from six fodder tree species i.e., Ailanthus aitissima, Elaeagnus angustifolic, Morus alba (Mulberry), Populus spp, Robina pseudoacacia and Salix babylonia were harvested in spring and winter from northern areas of Pakistan. Chemical composition and apparent in situ dry matter digestibility (DMD) of fodder tree leaves were measured. Results showed that crude protein (CP) values were higher (p<0.05) in all the species during spring compared to winter (17.9% vs 12.0%). The concentration of NDF in Elaeagnus and Robinia was higher in spring, whereas no seasonal difference was found in other species. In situ DMD was higher (p<0.05) in Ailanthus and Populus at spring while it was higher (p<0.05) in Elaeagnus, Mulberry and Robinia at winter. There was no (p<0.05) seasonal effect on in situ DMD of Salix. In experiment II, four iso-nitrogenous and iso-caloric rations viz., A, B, C and D were prepared containing 50% (winter harvested) sun dried leaves of Salix, Robinia, Mulberry and Elaeagnus, respectively and 50% concentrate. Dry matter and crude protein intakes were higher (p<0.05) given ration A (Salix) whereas DM and CP digestibility was lowest (p<0.05) given ration B. Nitrogen retention was higher (p<0.05) given ration A. Goats fed on fodder tree leaves and concentrate showed moderate intake and digestibility.
Kim, Ji-Yeon;Kang, Eun-Jin;Kwon, O-Ran;Kim, Gun-Hee
Nutrition Research and Practice
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제4권5호
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pp.428-432
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2010
In this study, we investigated that consumers could differentiate between levels of claims and clarify how a visual aid influences consumer understanding of the different claim levels. We interviewed 2,000 consumers in 13 shopping malls on their perception of and confidence in different levels of health claims using seven point scales. The average confidence scores given by participants were 4.17 for the probable level and 4.07 for the possible level; the score for the probable level was significantly higher than that for the possible level (P < 0.05). Scores for confidence in claims after reading labels with and without a visual aid were 5.27 and 4.43, respectively; the score for labeling with a visual aid was significantly higher than for labeling without a visual aid (P < 0.01). Our results provide compelling evidence that providing health claims with qualifying language differentiating levels of scientific evidence can help consumers understand the strength of scientific evidence behind those claims. Moreover, when a visual aid was included, consumers perceived the scientific levels more clearly and had greater confidence in their meanings than when a visual aid was not included. Although this result suggests that consumers react differently to different claim levels, it is not yet clear whether consumers understand the variations in the degree of scientific support.
This study aimed to examine factors and the correlations of burnout and job satisfaction in hospital dietitians. Burnout was classified into three sub-concepts: emotional exhaustion, depersonalization, and reduced personal accomplishment. Job satisfaction was also classified into three sub-concepts, including relationships, self-realization, and advancement opportunities. A survey was conducted with dietitians working in general hospitals of over 400 beds, in the Seoul metropolitan area. The factors that significantly influenced emotional exhaustion were health, work hours, number of intern dietitians, self-esteem, level of responsibility, while the factors that influenced depersonalization were relationships with coworkers, and role ambiguity. Personal accomplishment was influenced by age, the number of staff dietitians, the general number of managed workers, and self-esteem. In terms of job satisfaction, relationship was affected by age and relationships with supervisors, while self-realization was influenced by work hours, health, the number of patient meals, and role ambiguity. Age, job regularity, business management, role ambiguity, and relationships with supervisors also affected advancement opportunities. Emotional exhaustion, depersonalization, and reduced personal accomplishments, which represented burnout, had negative relationships with satisfaction with relationships, self-realization and advancement opportunities. Dietitians with low job satisfaction were likely to experience burnout. These results suggest that burnout and job satisfaction are influenced by internal and external factors that are individual or organizational problems encountered by hospital dietitians. Therefore, managers as well as dietitians need to understand these factors and overcome them through communication and mutual support.
This study was carried out to determine the depression symptoms and nutritional status of elderly females that ate congregate meals at lunch in rural Pocheon. The subjects were 18 elderly females aged over 65 ($75.7{\pm}4.6$ years) and information on smoking, subjective health status, depression symptoms and malnutrition risk were collected using a questionnaire administered with the help of trained research assistants. Measurements included mid-arm circumference and calf circumference. Food consumption for 3 days during breakfast and supper were determined by 24-hour recall and food consumption at lunch was determined as the difference between the amounts served and the plate waste. All data were compared between two age groups (${\leq}75$ and > 75). The subjects had the lowest nutrient adequacy ratio (NAR) for vitamin $B_6$ (0.523), followed by calcium and niacin and the lowest index of nutrient quality (INQ) for calcium (0.738). The older elderly had significantly lower NAR for vitamin $B_1$, vitamin $B_2$, vitamin $B_6$ and niacin as well as significantly lower mean adequacy ratio (MAR) compared to the young elderly. They also had significantly lower INQ for vitamin $B_1$ and vitamin C and significantly thinner arm circumference (28.3 cm vs. 31.3 cm). They consumed more than 40% of their daily intake for each nutrient at lunch. Higher proportions of nutrient intake from lunch provided evidence of the importance of congregate meals, suggesting that the government and society should support congregate meals to improve nutritional status.
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