The effect of a breakfast program on nutritional status, quality of life, and health care use among frail homebound older adults

The population of older adults is rapidly increasing, creating a need for community services that assist vulnerable older adults in maintaining independence and quality of life. Recent evidence confirms the importance of food and nutrition in reaching this objective. The Elderly Nutrition Program (ENP) is part of a system of federally funded community based programs, authorized through the Older Americans Act. ENP services include the home-delivered meals program, which targets frail homebound older adults at nutritional risk. Traditionally, ENP services provide a noon meal 5 days/week. This study evaluated the impact of expanding the home-delivered meals service to include breakfast + lunch, on the nutritional status, quality of life and health care utilization of program participants. ^ This cross-sectional study compared 2 groups. The Breakfast group (n = 167) received a home-delivered breakfast + lunch, 5 days/week. The Comparison group (n = 214) received lunch 5 days/week. Participants, recruited from 5 ENP programs, formed a geographically, racially/ethnically diverse sample. Participants ranged in age from 60–100 years, they were functionally limited, at high nutritional risk, low income, and they lived alone and had difficulty shopping or preparing food. Participant data were collected through in-home interviews and program records. A 24-hour food recall and information on participant demographics, malnutrition risk, functional status, health care use, and applicable quality of life factors were obtained. Service and cost data were collected from program administrators. ^ Breakfast group participants had greater energy/nutrient intakes (p < .05), fewer health care contacts (p < .05), and greater quality of life measured as food security (p < .05) and fewer depressive symptoms (p < .05), than comparison group participants. These benefits were achieved for $1.30/person/day. ^ The study identified links from improvements in nutritional status to enhanced quality of life to diminished health care utilization and expenditures. A model of health, loneliness, food enjoyment, food insecurity, and depression as factors contributing to quality of life for this population, was proposed and tested (p < .01). ^ The breakfast service is an inexpensive addition to traditional home-delivered meals services and can improve the lives of frail homebound older adults. Agencies should be encouraged to expand meals programs to include a breakfast service. ^

Relationships among dietary intake, dietary patterns, dietary quality and nutrient adequacy and substance use in Latina mother/daughter dyads

This study examined the relationships among dietary intake, substance use, socioeconomic and acculturation-related factors among Latinas in Miami-Dade County. Substance abuse is rising among Latinas. A fuller understanding of this problem is needed given the rise of the Hispanic population and the role of women in Latin society. A better understanding between substance use and dietary intake can guide nutrition interventions to reduce negative substance-related health consequences. A purposeful sample of 320 Latina mother/daughter dyads were recruited and interviewed face-to-face as part of the Latino Women's Study. Dietary intake was collected via a 24-hour recall and examined by (1) nutrient intake, (2) dietary patterns using cluster analysis, (3) quality of diet using the Healthy Eating Index (HEI) and (4) the Dietary Reference Intakes to determine nutrient adequacy. Substance use was measured with the Drug Use Frequency and the Healthy and Daily Living Form. Acculturation was measured with the Cultural Identity Scale. Three dietary patterns emerged based on the number of servings from the food groups established in MyPyramid. None were associated with substance use. Latinas who reported using cannabis, cocaine, sedatives without prescription and/or more than five alcoholic drinks on an occasion at least once a month during the previous twelve months had significantly lower HEI scores (64 vs. 60; F = 7.8, p = .005) and consumed fewer fruits (F = 16, p < .001) than non-users. Latinas classified as mothers whom reported consuming cannabis at least 1-7 times a week had significantly lower HEI scores (F = 4.23, p = .015, η2 = .027) than daughters with the same frequency of substance use. One dimension of acculturation, greater familiarity with Latin culture, was associated with good dietary quality (β = .142, p = .012) regardless of any type of substance used or income level. There was a high prevalence of inadequacy of folic acid intake (50-75%) regardless of substance use. Substance users consumed significantly more energy (1,798 vs. 1,615; p = .027) than non-users. Although effect sizes were small, associations between dietary intake and substance use among Latinas deserve further exploration while acknowledging the combined association with acculturation. ^

Efficiency and power density improvement of grid-connected hybrid renewable energy systems utilizing high frequency-based power converters

High efficiency of power converters placed between renewable energy sources and the utility grid is required to maximize the utilization of these sources. Power quality is another aspect that requires large passive elements (inductors, capacitors) to be placed between these sources and the grid. The main objective is to develop higher-level high frequency-based power converter system (HFPCS) that optimizes the use of hybrid renewable power injected into the power grid. The HFPCS provides high efficiency, reduced size of passive components, higher levels of power density realization, lower harmonic distortion, higher reliability, and lower cost. The dynamic modeling for each part in this system is developed, simulated and tested. The steady-state performance of the grid-connected hybrid power system with battery storage is analyzed. Various types of simulations were performed and a number of algorithms were developed and tested to verify the effectiveness of the power conversion topologies. A modified hysteresis-control strategy for the rectifier and the battery charging/discharging system was developed and implemented. A voltage oriented control (VOC) scheme was developed to control the energy injected into the grid. The developed HFPCS was compared experimentally with other currently available power converters. The developed HFPCS was employed inside a microgrid system infrastructure, connecting it to the power grid to verify its power transfer capabilities and grid connectivity. Grid connectivity tests verified these power transfer capabilities of the developed converter in addition to its ability of serving the load in a shared manner. In order to investigate the performance of the developed system, an experimental setup for the HF-based hybrid generation system was constructed. We designed a board containing a digital signal processor chip on which the developed control system was embedded. The board was fabricated and experimentally tested. The system's high precision requirements were verified. Each component of the system was built and tested separately, and then the whole system was connected and tested. The simulation and experimental results confirm the effectiveness of the developed converter system for grid-connected hybrid renewable energy systems as well as for hybrid electric vehicles and other industrial applications.

E=MC3 Energy Equals Management's Continued Cost Concerns

E=MC³ Energy Equals Management's Continued Cost Concern, is an essay written by Fritz G. Hagenmeyer, Associate Professor, School of Hospitality Management at Florida International University. In the writing, Hagenmeyer initially tenders: “Energy problems in the hospitality industry can be contained or reduced, yielding elevated profits as a result of applied, quality management principles. The concepts, processes and procedures presented in this article are intended to aid present and future managers to become more effective with a sharpened focus on profitability.” This article is an overview of energy efficiency and the management of such. In an expanding energy consumption market with its escalating costs, energy management has become an ever increasing concern and component of responsible hospitality management, Hagenmeyer will have you know. “In endeavoring to "manage" on a day-to-day basis a functioning hospitality building's energy system, the person in charge must take on the role of Justice with her scales, attempting to balance the often varying comfort needs of guests and occupants with the invariable rising costs of energy utilized to generate and maintain such comfort conditions, since comfort is seen as an integral part of the "service," "product," or "price/value” perception of patrons,” says Hagenmeyer. In contrast to what was thought in the mid point of this century - that energy would be abundant and cheap - the reality has set-in that this is not the case; not by a long shot. The author wants you to be aware that energy costs in buildings are a force to be reckoned with; a major expense to be sure. “Since 1973, "energy-conscious design" has begun to become part of the repertoire of architects, design engineers, and construction companies,” Hagenmeyer states. “For instance, whereas office buildings of the early 1970s might have used 400,000 British Thermal Units (BTUs) per square foot year, new buildings are going up that use 55,000 to 65,000 BTUs per square foot year,” Hagenmeyer, like an incandescent bulb, illuminates you. Hagenmeyer references Robert E. Aulbach’s article - Energy Management – when informing you that the hospitality manager should not become complacent in addressing the energy cost issue, but should and must maintain a diligent focus on the problem. Hagenmeyer also makes reference to the Middle East War and to OPEC, and their influence on energy prices. In closing, Hagenmeyer suggests an - Energy Management Action Plan – which he outlines for you.

Television Watching, Diet Quality, and Physical Activity and Diabetes among Three Ethnicities in the United States

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetes may be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications.

Television Watching, Diet Quality, Physical Activity and Diabetes Among Three Ethnicities in the United States

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetes may be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications.

Caffeine Intake and its Association with Disease Progression, Sleep Quality and Anxiety Symptoms and Nutritional Alterations in People Living with HIV in the Miami Adult Studies on HIV Cohort

Miami-Dade County has approximately 27,000 people living with HIV (PLWH), and the highest HIV incidence in the nation. PLWH have reported several types of sleep disturbances. Caffeine is an anorexic and lipolytic stimulant that may adversely affect sleep patterns, dietary intakes and body composition. High caffeine consumption (>250 mg. per day or the equivalent of >4 cups of brewed coffee) may also affect general functionality, adherence to antiretroviral treatment (ART) and HIV care. This study assess the relationship of high caffeine intake with markers of disease progression, sleep quality, insomnia, anxiety, nutritional intakes and body composition. A convenience sample of 130 PLWH on stable ART were recruited from the Miami Adult Studies on HIV (MASH) cohort, and followed for three months. After consenting, questionnaires on Modified Caffeine Consumption (MCCQ), Pittsburg Insomnia Rating Scale (PIRS), Pittsburg Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), socio-demographics, drug and medication use were completed. CD4 count, HIV viral load, anthropometries, and body composition measures were obtained. Mean age was 47.89±6.37 years, 60.8% were male and 75.4% were African-Americans. Mean caffeine intake at baseline was 337.63 ± 304.97 mg/day (Range: 0-1498 mg/day) and did not change significantly at 3 months. In linear regression, high caffeine consumption was associated with higher CD4 cell count (β=1.532, P=0.049), lower HIV viral load (β=-1.067, P=0.048), higher global PIRS (β=1.776, P=0.046), global PSQI (β=2.587, P=0.038), and GAD-7 scores (β=1.674, P=0.027), and with lower fat mass (β=-0.994, P=0.042), energy intakes (β=-1.643, P=0.042) and fat consumption (β=-1.902, P=0.044), adjusting for relevant socioeconomic and disease progression variables. Over three months, these associations remained significant. The association of high caffeine with lower BMI weakened when excluding users of other anorexic and stimulant drugs such as cocaine and methamphetamine, suggesting that caffeine in combination, but not alone, may worsen their action. In summary, high caffeine consumption was associated with better measures of disease progression; but was also detrimental on sleep quality, nutritional intakes, BMI and body composition and associated with insomnia and anxiety. Large scale studies for longer time are needed to elucidate the contribution of caffeine to the well-being of PLWH.