A study of nutrition promotion in and consumer nutrition environments of hospitals

Dietary intake is a complex, health-related behavior, and although individual-level theoretical models explain some variation in dietary intake, comprehensive theoretical models such as the ecological framework describe the multiple levels which influence diet-related behaviors. Thus, the ecological framework is a preferred model for designing comprehensive nutrition interventions. While ecological-based nutrition interventions have been described, little work has focused on interventions in the hospital setting. Because hospitals are considered the hallmarks of health, it might seem that hospitals would regularly engage in worksite nutrition promotion; however, recent publications and other anecdotal evidence have indicated otherwise. The first paper of this dissertation systematically reviewed the scientific literature between 1996 and 2012 and identified 13 outcome evaluation trials for hospital-based worksite nutrition interventions. Of these 13 interventions, only one intervention targeted three of the four levels of the ecological framework and no intervention targeted all four levels. Only half of the interventions targeted the physical environment of hospitals, thus warranting more investigation into this specific level of the ecological framework in this setting. ^ A critical type of nutrition-related physical environments is the consumer nutrition environment. Although other tools measure the consumer nutrition environments of stores and restaurants, no tool specifically measured the consumer nutrition environments of hospitals until the CDC developed the Healthy Hospital Environment Scan for Cafeterias, Vending Machines, and Gift Shops (HHES-CVG). The HHES-CVG, a tool which measures the consumer nutrition environments of hospital cafeterias, vending machines, and gifts shops, was released in November 2011, and in the second paper of this dissertation, the reliability of this tool was investigated. Two trained raters visited 39 hospitals across Southern California between February and May 2012, and based on analyses of the raters' findings, the HHES-CVG exhibited strong reliability metrics (inter-observer agreement between 74 and 100%, and an intraclass correlation coefficient of 0.961 for the overall nutrition composite score). Because the HHES-CVG was found to be a reliable tool, the third paper of this dissertation presented HHES-CVG results from the 39 hospitals. Overall, hospitals only scored about one-fourth of the total possible points for the nutrition composite score, indicating that most facilities do not have acceptable consumer nutrition environments. Some of the best practices observed in cafeterias were significantly associated with having a large facility and with having a contracted foodservice operation, but overall nutrition composite score was not associated with any specific facility or operation type. ^ The dissertation concluded that much work is needed in order to improve the consumer nutrition environments of hospitals. Practitioners and healthcare administrators should consider starting with ecological-based interventions addressing all levels including the physical environment.^

Effect of five enological practices and of the general phenolic composition on fermentation-related aroma compounds in Mencia young red wines

The effects of five technological procedures and of the contents of total anthocyanins and condensed tan- nins on 19 fermentation-related aroma compounds of young red Mencia wines were studied. Multifactor ANOVA revealed that levels of those volatiles changed significantly over the length of storage in bottles and, to a lesser extent, due to other technological factors considered; total anthocyanins and condensed tannins also changed significantly as a result of the five practices assayed. Five aroma compounds pos- sessed an odour activity value >1 in all wines, and another four in some wines. Linear correlation among volatile compounds and general phenolic composition revealed that total anthocyanins were highly related to 14 different aroma compounds. Multifactor ANOVA, considering the content of total anthocy- anins as a sixth random factor, revealed that this parameter affected significantly the contents of ethyl lactate, ethyl isovalerate, 1-pentanol and ethyl octanoate. Thus, the aroma of young red Mencia wines may be affected by levels of total anthocyanins

Providing health information to the general public: a survey of current practices in academic health sciences libraries*

A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

Preferences and consumer habits related to bread in the centre of Portugal

Purpose – Bread is one of the most consumed foods in the world, and its main function is to provide nutrients and energy for the body. Thus, the purpose of this paper was to raise awareness about the consumption habits of bread and consumer preferences in the region of Viseu (centre of Portugal), assessing the extent to which the preferences and consumption habits differ based on individual variables. Design/methodology/approach – The study was conducted by means of a questionnaire by direct interviewing. The questionnaire included sections aimed at gathering information about demographics, consumption habits and preferences related to bread. The sample consisted of 500 consented respondents. Findings – The results showed significant differences between genders regarding the type of bread eaten: women consumed less wheat bread (52 per cent against 62 per cent; p 0.029) and less unsalted bread (0.3 per cent against 3 per cent; p 0.023), but more whole bread (25 per cent against 11 per cent; p 0.001) and more bread with cereal grains (23 per cent against 11 per cent; p 0.001), thus revealing a trend for a nutritionally more adequate choice. Accordingly, women valued more the composition of the bread when purchasing it (p 0.001). It was also observed a trend for a lower consumption of wheat bread among classes with more advanced studies (47 per cent on university graduates against 60 per cent on nongraduates; p 0.004). Originality/value – This work is innovative because it was the first time the preferences and consuming habits of a sample of Portuguese population regarding bread were accessed, altogether. The results hereby obtained may be of importance both to understand the nutritional importance of bread in the diet of the Portuguese and also for the industry and manufacturers to better correspond to the buying preferences.

The Department of Transportation should improve its policies and practices on grant-related income. Report to the Secretary of Transportation.

Mode of access: Internet.

Soil biology as related to land use practices : proceedings of the VII International Soil Zoology Colloquium of the International Society of Soil Science (ISSS) /

Item 473-B-1

The Cash discount act : the Fair credit practices act : hearing before the Subcommittee on Consumer Affairs of the Committee on Banking, Finance, and Urban Affairs, House of Representatives, Ninety-sixth Congress, second session, on H.R. 6928 ... H.R. 7038 ... April 23, 1980.

Mode of access: Internet.

High pressure, low benefits [microform] : unfair practices in selling Medigap and other insurance to the elderly : hearing before the Subcommittee on Housing and Consumer Interests of the Select Committee on Aging, House of Representatives, One Hundredth Congress, first session, June 24, 1987.

"Comm. pub. no. 100-707."

Infant feeding practices [microform] : hearing before the Subcommittee on Domestic Marketing, Consumer Relations, and Nutrition of the Committee on Agriculture, House of Representatives, Ninety-seventh Congress, first session, June 22, 1981.

"Serial no. 97-P."

Employment Service : preliminary analysis of policies and practices related to performance /

"October 31,1989."

Inaccurate and unfair billing practices : hearings before Subcommittee on Consumer Credit of the Committee on Banking, Housing and Urban Affairs, United States, Ninety-third Congress, first session, on S. 1630 and S. 1914 ... May 21, 22, 23, and 24, 1973.

Mode of access: Internet.

Retail restructuring and consumer choice 2:understanding consumer choice at the household level

This paper complements the preceding one by Clarke et al, which looked at the long-term impact of retail restructuring on consumer choice at the local level. Whereas the previous paper was based on quantitative evidence from survey research, this paper draws on the qualitative phases of the same three-year study, and in it we aim to understand how the changing forms of retail provision are experienced at the neighbourhood and household level. The empirical material is drawn from focus groups, accompanied shopping trips, diaries, interviews, and kitchen visits with eight households in two contrasting neighbourhoods in the Portsmouth area. The data demonstrate that consumer choice involves judgments of taste, quality, and value as well as more ‘objective’ questions of convenience, price, and accessibility. These judgments are related to households’ differential levels of cultural capital and involve ethical and moral considerations as well as more mundane considerations of practical utility. Our evidence suggests that many of the terms that are conventionally advanced as explanations of consumer choice (such as ‘convenience’, ‘value’, and ‘habit’) have very different meanings according to different household circumstances. To understand these meanings requires us to relate consumers’ at-store behaviour to the domestic context in which their consumption choices are embedded. Bringing theories of practice to bear on the nature of consumer choice, our research demonstrates that consumer choice between stores can be understood in terms of accessibility and convenience, whereas choice within stores involves notions of value, price, and quality. We also demonstrate that choice between and within stores is strongly mediated by consumers’ household contexts, reflecting the extent to which shopping practices are embedded within consumers’ domestic routines and complex everyday lives. The paper concludes with a summary of the overall findings of the project, and with a discussion of the practical and theoretical implications of the study.