Doctor of Philosophy / Department of Hospitality Management and Dietetics / Kevin L. Sauer / Carol W. Shanklin / Management responsibilities in the dietetics profession are typically aligned with foodservice operations. Clinical Nutrition Managers (CNMs) are registered dietitians with administrative responsibilities for clinical nutrition services within a healthcare facility. However, no studies have clearly delineated the current responsibilities of CNMs or their level of educational preparedness for this important role. Conceptually, a gap exists between the necessary skills and knowledge required for CNMs. Focus groups, cognitive interviews, and pilot testing were used to develop an audit instrument to measure CNM practice. This audit included 84 tasks in eight job categories. The instrument was distributed online to a national sample of CNMs to assess their involvement, education preparedness, and gaps in education needed for the role. The relationships between responsibilities, educational preparedness, and self-efficacy to perform the job were investigated. Of the 84 tasks, 73 were deemed core activities [80% of CNMs (n=214) were involved in some capacity]. Significant differences were found in frequency of involvement based on size of facility (number of patient beds) and employer type. Generally, CNMs perceived importance of receiving education higher for a majority of the tasks (80 of 84). Mean scores for the level of educational needs met varied more between tasks. Clinical nutrition managers rated educational needs being met lowest for tasks within the managing financial resources category. Gap analyses revealed that the highest educational priorities were for ensuring compliance with regulations and managing human and financial resources. Categorical self-efficacy was predicted by both the educational gap and educational preparedness for some categories. Significant predictors for overall self-efficacy were the self-efficacy of the general (β = 0.203, p=0.007) and managing financial resources (β = 0.178, p=0.014) categories. Significant differences were found in overall self-efficacy based on education level [F(3, 209) = 3.881, p=0.010] and length of employment as a CNM [F(4, 208) = 7.517, p<0.001]. This research can serve as a current benchmark for CNM practice. Results allow educators, managers, and the professional association to better inform students and practitioners about the leadership role. These findings may also assist others in creating leadership development programs, certificates, or graduate degree options specific for CNMs.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13578号 / 論医博第2300号 / 新制||医||1069(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 生田 宏一, 教授 中島 貴子, 教授 浅野 雅秀 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-11-06T18:02:43Z No. of bitstreams: 2 Dissertação - Camila de Souza Queiroz - 2012.pdf: 913358 bytes, checksum: eee67ccbeb48729433c4d52ca1da5433 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2014-11-06T18:03:27Z (GMT) No. of bitstreams: 2 Dissertação - Camila de Souza Queiroz - 2012.pdf: 913358 bytes, checksum: eee67ccbeb48729433c4d52ca1da5433 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-11-06T18:03:27Z (GMT). No. of bitstreams: 2 Dissertação - Camila de Souza Queiroz - 2012.pdf: 913358 bytes, checksum: eee67ccbeb48729433c4d52ca1da5433 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-06-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / An alternative for managing the disease might be performing plant nutrition since mineral nutrients are directly involved in all mechanisms of the plant’ defense system as integral components of cells, membranes, enzymes and electron transport or by activation, inhibition and regulation of metabolism. In this context the study aimed at: 1- assessing the influence of soybean nutrition with micronutrients and Si in the severity of Asian soybean rust in field conditions and a greenhouse experiment; 2- evaluating the influence of soybean nutrition with different doses and ways of Ni application in the severity of Asian soybean rust in greenhouse conditions; 3- assessing fungal toxicity of the nickel sulfate for P. pachyrhizi spores in laboratory conditions. Results showed rust severity reduction in treatments with foliar application of Zn, Si and Ni, which promoted a reduction in the rate of the disease progression in the field. The grain yield was not affected by nutrition in the field; however, the treatments with Zn applications increased grain production in the greenhouse. On the other hand, the treatments with Si application reduced the disease severity although there was a grain yield reduction in the greenhouse. The Ni promoted a lower rust severity and there was an increase in the grain yield in treatments with applications of doses 20 to 40 g ha-1. Nevertheless, the rate of the progression of the disease was not reduced in the treatments with Ni. The treatments with fungicide reduced the severity of the disease, but the grain yield did not increase. In laboratory conditions the nickel sulfate reduced the germination in vitro of P. pachyrhizi spores. / Uma alternativa de manejo da ferrugem-asiática (Phakopsora pachyrhizi) na soja é a nutrição adequada das plantas, uma vez que os nutrientes minerais são diretamente envolvidos em mecanismos de defesa, como componentes integrais das células, das membranas, das enzimas e dos transportadores de elétrons ou como ativadores, inibidores e reguladores do metabolismo. Neste contexto, objetivou-se através deste trabalho avaliar a influência de micronutrientes (B, Zn, Mn e Cu), silício e níquel na severidade da ferrugem-asiática na cultura da soja em casa de vegetação, campo e laboratório. Os resultados mostraram redução da severidade da ferrugem nos tratamentos com aplicação foliar de Zn, Si e Ni os quais promoveram redução da taxa de progresso da doença no experimento de campo. A produção de grãos não foi influenciada pela nutrição no experimento em campo, entretanto, os tratamentos com Zn aplicado via foliar aumentaram a produção de grãos em casa-de-vegetação. Os tratamentos com aplicação de Si reduziram a severidade da doença, porém reduziram a produção de grãos em casa de vegetação. O sulfato de Ni promoveu menor severidade da ferrugem e incremento na produção de grãos nos tratamentos com aplicação de doses 20 – 40 g ha-1. No entanto, os tratamentos com Ni não reduziram a taxa de progresso da doença. Os tratamentos com fungicida reduziram a severidade da doença, porém não influenciaram a produção de grãos. Em laboratório, o sulfato de níquel reduziu a germinação in vitro dos esporos de P. pachyrhizi.