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A Retrospective Chart Review: Nutrition Support in the Neurologically Impaired Child
TUESDAY, OCTOBER 9
Poster Session: Wellness and Public Health Effectiveness of Oral Nutritional Supplement Use on Nutritional Status of Community-Dwelling Elderly Receiving Home-Delivered Meals
Technology to Support Practice: Dietetic Interns Train Extension Staff in Social Media and Technology Tool Use to Enhance Marketing and Time Management
Author(s): G. J. Hill,1 M. A. Gorman,1 S. Simon,2 L. Frawley,2 K. Whitten,1 L. Wanner,1 M. Parra,1 S. Luce,1 L. Lane1; 1Department of Nutritional Sciences, Texas Christian Univ., Fort Worth, TX, 2Meals on Wheels, Inc. of Tarrant County, Fort Worth, TX
Author(s): P. Fatzinger McShane,1 L. Worthington,1 E. Braunscheidel,1 C. Sargent,2 B. Paleg2; 1Dept of Nutrition and Food Science, University of Maryland, College Park, MD, 2College of Agriculture and Natural Resources Office of Information and Education Technology, University of Maryland, College Park, MD
Learning Outcome: Describe the effectiveness of providing elderly clients enrolled in a home-delivered meal program with oral nutritional supplements. Background: Oral nutritional supplements (ONS) provide a concentrated form of calories and protein that may help individuals gain or maintain weight and may benefit those who are nutritionally at-risk. Methods: A sample of elderly, newly-enrolled in a home-delivered meals program, was identified as being nutritionally at-risk using the Malnutrition Screening Tool (MST). Participants were randomly divided into control (meals only;N⫽19) and treatment (ONS⫹meals;N⫽21) groups. The ONS⫹meals group was provided with an ONS providing 350 calories and 13 grams protein/serving and directed to consume it twice daily. Both groups were followed for 90 days. On days 0 and 90, during a house visit by researchers, weight, height, and handgrip strength were measured. Additionally, the SF-36v2 health survey measuring physical and mental health and the MST and DETERMINE screening tools were administered. Results: No significant differences were observed in body weight, Body Mass Index (BMI), hand grip strength, or change in physical or mental health as measured using the SF36-v2 from Day 0 to Day 90 in either group. There was a significant difference in MST Scores from Day 0 to Day 90 in both the ONS group (N⫽22; p⫽0.0001) and the ONS⫹meals group (N⫽19; p⫽0.012) indicating decreased nutritional risk. Conclusions: The study revealed that provision of the ONS did not significantly affect weight, BMI, physical or mental health as measured by the SF36-v2 or hand-grip strength. MST scores improved in both groups. Funding Disclosure: Abbott Nutrition
Learning Outcome: The participant will be able to describe at least one advantage to allowing dietetic interns to learn and subsequently train others in technology tool use. Dietitians are being asked to provide greater numbers of deliverables in less time; these deliverables often include skill training of others. Dietetic interns must develop technology/ social media content understanding, and the ability to train others in tool relevance, terminology and actual use of technology/ social media sites. Interns must also develop effective speaking skills to reach a consumer-public who increasingly obtains information from the Internet/ social media sites. One dietetic internship required interns to develop proficiency in multiple social media and technology tools. Paired interns developed a 5-6 minute PowerPoint presentation with handouts on an assigned technology tool; interns were supervised and mentored by the Internship Technology Team and SNAP-Ed Special Projects Coordinator. Paired interns provided a short overview of technology tool, its impact in enhancing practice, and demonstrated technology tool use at the state’s SNAP-Ed Annual Fall Conference. Intern presentations were videotaped. These videotapes provided interns with feedback on their “performance” and the videotapes were made available to SNAP-Ed staff unable to attend the conference. Interns were then videotaped in a recording suite to build on their prior “video” performance and to provide the University Extension faculty with a set of short introductory technology/ social media training videos to begin to learn the terminology and tool relevance. Verbal feedback from State SNAP-Ed educators was very positive; SNAP-Ed internship preceptors observed interns both as learners, and as contributors to the SNAP-Ed program. Future dietitians need to use technology to optimize their impact in their workplace and with the public. Funding Disclosure: Funding for the SNAP-Ed program provided by USDA in cooperation with the Maryland Department of Human Resources and the University of Maryland College Park
Comparisons of Eating Behavior by Demographic Characteristics among Older Adults Participating in Government-Sponsored Programs
A Retrospective Chart Review: Nutrition Support in the Neurologically Impaired Child
Author(s): S. Wunderlich, Y. Bai, J. Brusca, M. O’ Malley, M. Austin; Health and Nutrition Sciences, Montclair State Univ., Montclair, NJ
Author(s): C. L. Strauss,1 M. L. Nahikian-Nelms,1 L. Peel,2 J. P. Winters,3 J. Clutter4; 1Medical Dietetics, The Ohio State University, Columbus, OH, 2Clinical Nutrition and Lactation, Nationwide Children’s Hospital, Columbus, OH, 3Hospice and Palliative Care, Nationwide Children’s Hospital, Columbus, OH, 4Health Sciences and Medical Dietetics, The Ohio State University, Columbus, OH
Learning Outcome: Participants will be able to determine the importance of demographic backgrounds and eating behaviors among nutritionally highrisk older persons. Identification of factors that may contribute to the nutritionally high-risk condition is of utmost importance among older adults. The purpose of this study was to determine the food behaviors of nutritionally high-risk seniors as function of their ethnic background, gender, marital status, and education level. A total of 69 seniors were identified to be at high nutritional risk using the Nutrition Screening Initiative (NSI) checklist. A supplemental questionnaire (SQ) was created to examine further the risk factors in relation to the participant’s demographic background. Descriptive statistics and Chi-Square tests were used to reveal the relationships between these variables, to identify the factors that can be effective in improving the interventions, and to determine which risk factors were prominent among these groups. Key results indicated that Asians practiced healthy food behaviors, eating ⬎2 meals per day (83.3 %) and reported daily consumption of 5 or more servings of fruits and vegetables (83.3%). Women were more likely to eat alone (pⱕ0.05). Married participants (90.9%) were most likely to consume 2 meals or more each day. College educated individuals practiced healthier eating, eating 5 servings or more of fruits and vegetables (pⱕ0.01) and 2 or more servings of milk and milk products (pⱕ0.01). Nutrition education and counseling should be tailored considering different racial and ethnic groups. Effective checklists would be invaluable for determining the areas of inadequacies and to help appropriate allocation of resources for senior nutrition intervention to enhance the health and wellbeing of older persons. Funding Disclosure: None
Learning Outcome: The reader will gain an understanding of the typical nutritional care for neurologically devastated, immobile, enterally fed infants and children. The Dietary Reference Intakes (DRIs) are used to estimate energy needs for healthy children. Other predictive equations have been developed for hospitalized children. Children who have suffered neurological devastation have energy needs that differ from both healthy children and other hospitalized children. Despite this, clinicians must be able to accurately predict the energy needs of these patients to avoid over- or under-feeding and thus, negatively affecting clinical outcomes. This study sought to retrospectively investigate patterns of energy provision and growth rates in a group of infants admitted to a Midwestern children’s hospital. Data on 24 patients was collected and analyzed. After qualitative analysis, trends for growth patterns for these children fell into one of four distinct groups. Group one demonstrated growth and energy consumption that was highly variable, unpredictable and demonstrated no consistent trend. Group two demonstrated a predictable growth pattern in that weight gain occurred with increasing kcal/kg while weight loss occurred with decreasing energy provision. Group three appeared hypermetabolic and demonstrated little to no growth regardless of the increasing kcal/kg that was provided. Group four appeared to demonstrate characteristics of hypometabolism where 4 of the 5 infants had growth above the 90th percentile while receiving lower than average kcal/kg. This variability illustrates the need for use of more accurate methods of energy needs estimation such as indirect calorimetry. The variability also calls for highly individualized nutrition care plans to be developed that will optimize nutrition support. Funding Disclosure: None
A-96
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2012 Suppl 3—Abstracts Volume 112 Number 9
Poster Session: Wellness and Public Health Effectiveness of Oral Nutritional Supplement Use on Nutritional Status of Community-Dwelling Elderly Receiving Home-Delivered Meals
Technology to Support Practice: Dietetic Interns Train Extension Staff in Social Media and Technology Tool Use to Enhance Marketing and Time Management
Author(s): G. J. Hill,1 M. A. Gorman,1 S. Simon,2 L. Frawley,2 K. Whitten,1 L. Wanner,1 M. Parra,1 S. Luce,1 L. Lane1; 1Department of Nutritional Sciences, Texas Christian Univ., Fort Worth, TX, 2Meals on Wheels, Inc. of Tarrant County, Fort Worth, TX
Author(s): P. Fatzinger McShane,1 L. Worthington,1 E. Braunscheidel,1 C. Sargent,2 B. Paleg2; 1Dept of Nutrition and Food Science, University of Maryland, College Park, MD, 2College of Agriculture and Natural Resources Office of Information and Education Technology, University of Maryland, College Park, MD
Learning Outcome: Describe the effectiveness of providing elderly clients enrolled in a home-delivered meal program with oral nutritional supplements. Background: Oral nutritional supplements (ONS) provide a concentrated form of calories and protein that may help individuals gain or maintain weight and may benefit those who are nutritionally at-risk. Methods: A sample of elderly, newly-enrolled in a home-delivered meals program, was identified as being nutritionally at-risk using the Malnutrition Screening Tool (MST). Participants were randomly divided into control (meals only;N⫽19) and treatment (ONS⫹meals;N⫽21) groups. The ONS⫹meals group was provided with an ONS providing 350 calories and 13 grams protein/serving and directed to consume it twice daily. Both groups were followed for 90 days. On days 0 and 90, during a house visit by researchers, weight, height, and handgrip strength were measured. Additionally, the SF-36v2 health survey measuring physical and mental health and the MST and DETERMINE screening tools were administered. Results: No significant differences were observed in body weight, Body Mass Index (BMI), hand grip strength, or change in physical or mental health as measured using the SF36-v2 from Day 0 to Day 90 in either group. There was a significant difference in MST Scores from Day 0 to Day 90 in both the ONS group (N⫽22; p⫽0.0001) and the ONS⫹meals group (N⫽19; p⫽0.012) indicating decreased nutritional risk. Conclusions: The study revealed that provision of the ONS did not significantly affect weight, BMI, physical or mental health as measured by the SF36-v2 or hand-grip strength. MST scores improved in both groups. Funding Disclosure: Abbott Nutrition
Learning Outcome: The participant will be able to describe at least one advantage to allowing dietetic interns to learn and subsequently train others in technology tool use. Dietitians are being asked to provide greater numbers of deliverables in less time; these deliverables often include skill training of others. Dietetic interns must develop technology/ social media content understanding, and the ability to train others in tool relevance, terminology and actual use of technology/ social media sites. Interns must also develop effective speaking skills to reach a consumer-public who increasingly obtains information from the Internet/ social media sites. One dietetic internship required interns to develop proficiency in multiple social media and technology tools. Paired interns developed a 5-6 minute PowerPoint presentation with handouts on an assigned technology tool; interns were supervised and mentored by the Internship Technology Team and SNAP-Ed Special Projects Coordinator. Paired interns provided a short overview of technology tool, its impact in enhancing practice, and demonstrated technology tool use at the state’s SNAP-Ed Annual Fall Conference. Intern presentations were videotaped. These videotapes provided interns with feedback on their “performance” and the videotapes were made available to SNAP-Ed staff unable to attend the conference. Interns were then videotaped in a recording suite to build on their prior “video” performance and to provide the University Extension faculty with a set of short introductory technology/ social media training videos to begin to learn the terminology and tool relevance. Verbal feedback from State SNAP-Ed educators was very positive; SNAP-Ed internship preceptors observed interns both as learners, and as contributors to the SNAP-Ed program. Future dietitians need to use technology to optimize their impact in their workplace and with the public. Funding Disclosure: Funding for the SNAP-Ed program provided by USDA in cooperation with the Maryland Department of Human Resources and the University of Maryland College Park
Comparisons of Eating Behavior by Demographic Characteristics among Older Adults Participating in Government-Sponsored Programs
A Retrospective Chart Review: Nutrition Support in the Neurologically Impaired Child
Author(s): S. Wunderlich, Y. Bai, J. Brusca, M. O’ Malley, M. Austin; Health and Nutrition Sciences, Montclair State Univ., Montclair, NJ
Author(s): C. L. Strauss,1 M. L. Nahikian-Nelms,1 L. Peel,2 J. P. Winters,3 J. Clutter4; 1Medical Dietetics, The Ohio State University, Columbus, OH, 2Clinical Nutrition and Lactation, Nationwide Children’s Hospital, Columbus, OH, 3Hospice and Palliative Care, Nationwide Children’s Hospital, Columbus, OH, 4Health Sciences and Medical Dietetics, The Ohio State University, Columbus, OH
Learning Outcome: Participants will be able to determine the importance of demographic backgrounds and eating behaviors among nutritionally highrisk older persons. Identification of factors that may contribute to the nutritionally high-risk condition is of utmost importance among older adults. The purpose of this study was to determine the food behaviors of nutritionally high-risk seniors as function of their ethnic background, gender, marital status, and education level. A total of 69 seniors were identified to be at high nutritional risk using the Nutrition Screening Initiative (NSI) checklist. A supplemental questionnaire (SQ) was created to examine further the risk factors in relation to the participant’s demographic background. Descriptive statistics and Chi-Square tests were used to reveal the relationships between these variables, to identify the factors that can be effective in improving the interventions, and to determine which risk factors were prominent among these groups. Key results indicated that Asians practiced healthy food behaviors, eating ⬎2 meals per day (83.3 %) and reported daily consumption of 5 or more servings of fruits and vegetables (83.3%). Women were more likely to eat alone (pⱕ0.05). Married participants (90.9%) were most likely to consume 2 meals or more each day. College educated individuals practiced healthier eating, eating 5 servings or more of fruits and vegetables (pⱕ0.01) and 2 or more servings of milk and milk products (pⱕ0.01). Nutrition education and counseling should be tailored considering different racial and ethnic groups. Effective checklists would be invaluable for determining the areas of inadequacies and to help appropriate allocation of resources for senior nutrition intervention to enhance the health and wellbeing of older persons. Funding Disclosure: None
Learning Outcome: The reader will gain an understanding of the typical nutritional care for neurologically devastated, immobile, enterally fed infants and children. The Dietary Reference Intakes (DRIs) are used to estimate energy needs for healthy children. Other predictive equations have been developed for hospitalized children. Children who have suffered neurological devastation have energy needs that differ from both healthy children and other hospitalized children. Despite this, clinicians must be able to accurately predict the energy needs of these patients to avoid over- or under-feeding and thus, negatively affecting clinical outcomes. This study sought to retrospectively investigate patterns of energy provision and growth rates in a group of infants admitted to a Midwestern children’s hospital. Data on 24 patients was collected and analyzed. After qualitative analysis, trends for growth patterns for these children fell into one of four distinct groups. Group one demonstrated growth and energy consumption that was highly variable, unpredictable and demonstrated no consistent trend. Group two demonstrated a predictable growth pattern in that weight gain occurred with increasing kcal/kg while weight loss occurred with decreasing energy provision. Group three appeared hypermetabolic and demonstrated little to no growth regardless of the increasing kcal/kg that was provided. Group four appeared to demonstrate characteristics of hypometabolism where 4 of the 5 infants had growth above the 90th percentile while receiving lower than average kcal/kg. This variability illustrates the need for use of more accurate methods of energy needs estimation such as indirect calorimetry. The variability also calls for highly individualized nutrition care plans to be developed that will optimize nutrition support. Funding Disclosure: None
A-96
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2012 Suppl 3—Abstracts Volume 112 Number 9