Search

Objective: This study compared measured resting energy expenditures to resting energy expenditures calculated using Harris-Benedict equations (HBEs) and the Cystic Fibrosis Consensus Committee equations (CFCCEs)., Design: We studied 31 preadolescent boys and girls with cystic fibrosis who ranged in age from 3.25 to 12.75 years old. The patients were afebrile and not in pulmonary distress. Measured resting energy expenditures were determined using a portable metabolic measurement cart with fully automated calibration and data management. The measured resting energy expenditures obtained were compared with values obtained using HBEs and CFCCEs., Results: For each patient, the measured resting energy expenditure value was above the predicted resting energy expenditure values derived from HBEs (P < or = .0001) and CFCCEs (P < or = .01)., Applications: The HBEs and the CFCCEs underestimated the energy expenditures of the study population by 13% and 8%, respectively. These findings support the usefulness of the measurement of energy expenditures in determining the energy needs of preadolescent patients with cystic fibrosis. In clinical practice, the resting energy expenditures would be multiplied by activity coefficients to determine the total daily energy expenditures of this population.

This study was designed to analyze the effect of vitamin B-6 supplementation on the lipoprotein profile of chronic hemodialysis patients. Individuals on chronic hemodialysis experience an acceleration of atherosclerosis, which is often accompanied by abnormal lipid metabolism. Although total plasma cholesterol is usually normal, high-density-lipoprotein (HDL) cholesterol is often low. Recently, it has been suggested that the development of atherosclerotic lesions in chronic hemodialysis patients may be the result of a decreased plasma concentration of pyridoxal 5'-phosphate (PLP) and concomitant alterations in plasma amino acid and/or lipoprotein profiles. All subjects in this study were supplemented with 0.97 mmol (200 mg) pyridoxine hydrochloride per day for 28 days; then, concentrations of PLP, total cholesterol, and lipoprotein cholesterol fractions were determined in the plasma. No significant difference was noted in PLP concentration between Group 1 (five post-menopausal women with a history of atherosclerosis who were undergoing maintenance hemodialysis therapy) and Group 2 (six subjects who were non-symptomatic). However, both groups had significant increases in PLP concentrations between the pre- and post-supplementation periods (p less than .01). In contrast, there was a statistically significant difference in total plasma cholesterol and very-low-density- and low-density-lipoprotein (VLDL and LDL) cholesterol concentrations between groups, but no significant changes in total cholesterol or VLDL and LDL cholesterol content were found during vitamin B-6 supplementation. No statistically significant differences in HDL, HDL2, and HDL3 cholesterol concentrations were observed between Group 1 and Group 2 subjects or within either group during vitamin B-6 supplementation.

The purpose of this research was to determine competencies of foodservice directors/managers as required by health care administrators and to ascertain the degree to which dietetic curriculums address those competencies. Validated questionnaires were mailed to a random sample of 376 health care administrators and 154 dietetic educators from various types of educational programs. Each questionnaire included 57 competencies representing the following areas: financial, technical, personnel management, nutrition services, production, and marketing. Health care administrators were asked to rate the degree of importance for each competency. Dietetic educators assessed the degree to which each competency was addressed in their curriculums. Of the 288 returned questionnaires, 243 contained usable data. Health care administrators' mean ratings were compared with dietetic educators' mean ratings. Significant differences were noted in 44 of the 57 competencies. Dietetic educators placed significantly greater emphasis on competencies related to nutrition services and significantly less on financial competencies than did health care administrators. Significant differences also were observed for selected competencies classified as technical and production. Results indicated that dietetic educators must continually evaluate curriculums and respond to the changing needs of the health care industry.

The purpose of this study was to establish a profile of the amount of time expended by clinical dietitians in providing nutrition services. One hundred twenty-seven dietitians in 49 hospitals in Texas collected time data according to nutrition care activity, diet order classification, care level, and diagnosis. Frequency, mean time, standard deviation, and percentage of time were computed for each of the variables. Data were analyzed to ascertain relationships among the variables. The dietitians expended 50.7% of their time performing client-related activities, 9.8% in administrative/managerial functions, 1.0% in professional activities, 5.1% in non-professional activities, 14.0% in delay activities, and 19.5% in transit time. The diet order classification that required the largest amount of the dietitians' time according to selected components of the nutrition care process was the calorie-controlled diabetic diet. Among the four nutrition care levels, dietitians expended the greatest percentages of time providing services for patients requiring intermediate (35.4%) and advanced intermediate care (30.4%). Dietitians expended more time providing client-related activities to patients diagnosed with diseases and disorders of the endocrine and excretory systems than to other patients. Mean times provide the clinical manager with documentation for determining staffing needs and costs of services.

A study was conducted to assess the employment trends of dietitians in business and industry and to identify attributes and qualifications essential to succeed in this segment of the industry. Results of the delphi process were utilized in the design of a questionnaire which would identify attributes and qualifications essential for success. The questionnaire was administered to a random sample of 300 members of the Dietitians in Business and Industry Practice Group and 300 prospective and current employers of dietitians. Response rates of 45.7% (no. = 137) and 29.0% (no. = 87) were attained for the dietitians and employers, respectively. The majority of current employers (72%) and prospective employers (62%) and dietitians (73%) responded that the trend of hiring dietitians in business and industry was increasing. Both dietitians (53%) and employers (41%) reported that new positions were being created for dietitians in their organizations. Operational experience was more important for positions in sales, whereas clinical experience was more important for positions in manufacturing organizations. Employers ranked a master's degree in business administration (MBA) as the second most important qualification; dietitians rated the MBA as fifteenth in importance. Dietitians ranked registration status (RD) as, fourth in importance; however, employers rated registration status as least important of the qualifications. Both employers and dietitians ranked communication skills as essential to succeed in business and industry positions.