The purpose of this study was to determine if food safety education influences food safety knowledge, attitude and behavior among inner city public school foodservice employees. Knowledge, attitude and behavior of an experimental group (n=22) was assessed before and after 3-hour food safety training and compared with a control group (n=10) that received no food safety training. We hypothesized that those who received food safety training would have improved knowledge, attitude and behavior towards food safety issues compared to those who did not receive training. Results showed that food safety training significantly increased (p<0.001) the knowledge of foodservice employees compared to those who didn’t receive the training. However, the 3-hour training did not significantly influence attitude or practice of safe food-handling techniques. Education and consistent re-training, coupled with Hazard Analysis and Critical Control Point (HACCP) system, food-handier sanitation certification and frequent supervision may help to increase food safety awareness among foodservice employees.

It is standard practice in acute-care settings to screen patients upon admission to determine whether they need a nutritional assessment; however, there is limited information on the ability of the screening tools to detect patients at nutritional risk. The purpose of this study was to determine (1) the sensitivity and specificity of the screening tool used at Jackson Memorial Hospital and (2) whether a new proposed tool would be more sensitive and specific. Dietitians screened patients upon admission using the existing and proposed tools (n=141). Sensitivity and specificity of these tools in identifying patients at nutritional risk was calculated. Mantel-Haenszel chi-square statistics were used to identify indicators correlated with nutritional risk. A revised tool was tested and found to have a higher sensitivity than the existing tool but lower specificity. Odds ratios indicated that the revised tool had a higher degree of association with nutritional risk than the existing one.

The purpose of this study was to show variations of folate intake, folate food sources, and diet by age, gender, and ethnicity in Metro-Dade Firefighters and to also determine the prevalence of obesity, physical inactivity and history heart disease. Low folate status may play a role in cardiovascular risk via its effect on homocysteine metabolism. Firefighters (n=127) recruited from randomly selected fire stations completed food-frequency and socio-demographic questionnaires. Significantly (p<.05) more African-Americans failed to meet at least 75% of the dietary reference intake (DRI) for folate than whites or Hispanics. There were significant differences in protein, vegetable, and meat intakes between age groups. Almost 78% of firefighters were overweight (BMI≥25). There were significant (p<.001) differences in BMI among ethnic groups. Older firefighters reported significantly (p<.05) more CVD risk factors than younger firefighters. Metro-Dade firefighters were found to be similar to the general US population in that most of the risk factors, overweight and obesity, high fat intakes, and low folate intake were modifiable and diet related.

Dietitians are responsible for recommending artificial nutrition and hydration (ANH) for elderly patients with a diminished mental capacity. Research is non-existent regarding how the beliefs of dietitians influence their recommendations; however, data are available on the attitudes of physicians and nurses regarding ANH. This study was designed to determine how the beliefs of dietitians and nurses affect their decisions regarding administering ANH. Dietitians and nurses, 1500 of each, were asked to agree or disagree with thirteen belief statements related to ANH. The participants also recommended ANH for eight scenarios, which depicted elderly patients with different moods and mental capacities. Results indicated dietitians significantly (p<0.001) more than nurses agreed with the belief statement "when in doubt feed". In all the scenarios, dietitians recommended ANH significantly (p<0.001) more than nurses. Nurses would recommend a trial (p<0.01) or not recommend (p<0.01) ANH more than dietitians. Also, a greater percentage of professionals had a tendency to recommend feeding for the happy patient rather than the unhappy patient. A patient's mood may influence a professional's decision as whether or not to recommend ANH. Dietitians are more likely to recommend ANH to elderly patients with a diminished mental capacity whereas nurses are less aggressive in their recommendations.

The purpose of this study was to determine the racial and ethnic differences on body image perceptions and weight concerns of fourth grade girls. A purposive sample of 182 fourth grade girls were eligible to participate, 166 were included in the data analysis. The Children's Eating Attitude Test (ChEAT) and a Dieting and Demographic Questionnaire (DDQ) were used to determine eating attitudes of fourth grade girls. A pictoral instrument that was modified from the original was used to assess body image. Anthropometric data was assessed and body mass index (BMI) values were used to classify subjects into percentiles. Results revealed that 56% of all fourth grade girls studied wanted to be thinner and 53% had tried to lose weight. Significantly more non-Hispanic white (NHW) girls reported wanting to be thinner than non-Hispanic black (NHB) and H girls (65.5% vs.32% and 47%, respectively, P=0.005) No significant racial/ethnic differences were revealed for the ChEAT scores. However, 19% of all subjects studied fell into the category indicative of anorexia nervosa. H girls who were less than the 85" %tile for BMI chose significantly smaller figures as their perceived body image (3.5±0.7) than both NHB and NHW girls (4.0±0.6 and 3.9±0.5, respectively, P<0.01). These findings demonstrated that weight concerns were prevalent among girls ages 9- 11 years. NHW and H girls may have more concerns about their body size and shape than their NHB counterparts. Implementing intervention programs at an early age may prevent eating disorders in adolescence and adulthood.

The purpose of this research was to study the nutritional status of United States Coast Guard Law Enforcement Detachment (USCG/ LEDET) personnel before and after prolonged travel at sea. To date there is no information available regarding the nutritional status of Coast Guard personnel. Forty-seven subjects were studied in total, each served as their own control. Demographic and health history data was collected at baseline. Dietary and exercise data was collected before and during the deployment. Body composition was determined before and after a deployment. The results of this study revealed that the USCG/LEDET personnel had high cholesterol and decreased fiber intakes. Cholesterol intake during deployment (516.8±239.7 mg/day) was significantly higher (p= 0. 047) than pre-deployment (448.2 ± 144.3 mg/day). Fiber intake was significantly lower than recommended (p The results of this study indicate that LEDET personnel are put at higher nutritional risk while deployed and also have increased negative health behaviors associated with risk for Cardiovascular Disease (CVD) and other related diseases. This is crucial information for the USCG so that action can be taken to improve the physical well being of their personnel.

The purpose of this study was to develop a developmentally appropriate new nutrition education tool, the Rainbow Diet for Children (RDFC), to encourage and aid parents in feeding their children according to current national recommendations. In phase I of the study, the RDFC was developed. Foods were grouped based on color. This grouping provided 11 food groups and foods that provide adequate nutrition for children ages 3-6 years. Using a focus group theoretical diets/foods selections in the RDFC were tested for nutrition adequacy. Phase II of the study consisted of actual testing of the RDFC with children. Nutrition intervention was given to children at two Montessori Schools in Miami, FL. The RDFC and the Food Guide Pyramid (FGP) were used as nutrition education tools with different groups of children. Children and their parents were encouraged to follow one of the food guides for two weeks. Fifteen healthy children followed the food guides (9 children followed the RDFC and 6 the FGP) while 7 children served as control subjects. Pre and post nutrition analyses were conducted for all three groups. A pre and post intervention comparison revealed three significant differences. For the FGP group cholesterol intake was significantly (p<0.006) increased and thiamin intake was significantly (p<0.022) decreased. For the control group there was a significant increase (p<0.005) in the vitamin A intake. For the inter group mean change scores (posttest-pretest) two significant differences were found. First, cholesterol intake in the RDFC was significantly (p<0.045) decreased while for the other two groups it increased significantly. Furthermore, the mean monounsaturated fat intake for the RDFC group significantly decreased (p<0.047) from pre to post, whereas in the other two groups it was increased. These findings support our hypothesis that it is possible to create an alternative meal planning system for 3 to 6 year old children. The RDFC group had adequate nutritional intake while following the rainbow diet meal plan.

Public health data show that African-Americans have not adopted health-promoting behaviors of diet and exercise. Spirituality, important in the lives of many African-American women, may be associated with health-promoting behaviors. This study was designed to determine how spirituality relates to health-promoting behaviors in African-American women. Burkhardt's theoretical framework for spirituality was adopted and measures were selected for the three elements of the framework: connectedness with self, others, and environment. The study used a descriptive cross sectional correlational design to investigate the relationships of the independent variables of spirituality, sociodemographics, and BMI, to the dependent variables of diet and exercise, to answer the two primary questions: What is the role of spirituality in impacting the health-promoting behaviors of African- American women? Of the independent variables of spirituality, sociodemographics, and BMI, which are the best predictors of diet and exercise? C entral and South Floridian African-American women (n=260) between 18 and 82 years of age completed several questionnaires: Rosenberg's Self-Esteem Scale, Health Promoting Lifestyle Profile II, Spiritual Perspective Scale, Brief Block Food Frequency, and socio-demographic information. Hierarchical regression identified 40% of the variability of diet to be explained by socio-demographic (education) and spirituality variables (stress management and health responsibility) (p<.001). Twenty-nine percent of the variability of exercise was explained by socio-demographic (education) and spirituality variables (stress management) (p<.001). Canonical correlation analysis identified a significant pair of canonical variates which indicated individuals with good nutrition (.95), increased physical activity (.79), and healthy eating (.42) also had better stress management (.88), better health responsibility (.67), higher spiritual growth (.66), better interpersonal relations (.50), more education (.49), and higher self-esteem (.33). The set explained 57% of the variability (p<.001). An understanding of the factors that influence these women's decision to utilize health-promoting strategies could provide health professionals with additional information to enable them to design culturally and spiritually related health messages for African-American women. The findings of this present study speak of the importance of focusing on stress management, health responsibility, spiritual growth, interpersonal relations and self-esteem along with diet and exercise; this will likely provide improvement in the health-promoting behaviors of African-American women.

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data- Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41 %) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process.

To demonstrate the extent of elder malnutrition risk in this country, a meta analysis of 30 studies that used the Nutrition Screening Initiative's "DETERMINE Your Nutritional Health Checklist" was conducted. The studies were divided into three categories: Elder Populations in Healthcare Related Systems (HS), Elder Meal Program Participants (MP), and General Community Residing Elder Population (GC). HS was sub-divided into Hospital Inpatient/Clinic Outpatient and Long Term Care/Home Care. The MP population were identified as Congregate or Home Delivered meal participants. Overall, results indicate that 63% of elders are at moderate (32%) or high (31 %) risk of malnutrition. Home Delivered Meal Participants and Hospital Inpatient/Clinic Outpatients are most likely to be at high risk of malnutrition (49.5% and 49.1%, respectively). Individuals least likely to be at high malnutrition risk are the General Community Residing Elder Population (17.5%) and Congregate Meal Participants (22.5%).