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.^

Menu labeling and food choice: A systematic review of the literature concerning the effects of menu labeling on consumer food choices

Objective: To review published literature on the impact of restaurant menu labeling on consumer food choices.^ Method: To examine all relevant studies published on the topic from 2002 to 2012.^ Results: Sixteen studies were identified as relevant and suitable for review. These studies comprised of one systematic review, one health impact assessment, and fourteen research studies conducted at restaurants, cafeterias, and laboratories. Three of ten studies conducted at restaurants and cafeterias and two of four studies conducted at laboratories found positive effects of menu labeling on consumer food choices. Conversely, the systematic review identified for this review found that five out of six studies resulted in weakly positive effects. The health impact assessment estimated positive effects; however, the results of this assessment must be cautiously interpreted since the authors used simulated data.^ Conclusion: Overall, there is insufficient evidence to provide support for the majority of the types of menu labels identified in this review on consumer food choice.^

Consumer preferences towards beef cattle in Chile : Importance of country of origin, cut, packaging, brand and price

A study was carried out to evaluate preferences for two cuts, four countries of origin, two forms of presentation, brand and different prices of beef cattle among supermarket buyers in southern Chile, and to distinguish the existence of different market segments, through a survey of 800 people. Using a fractional factorial design for conjoint analysis, it was determined overall that the origin was more important (44.5%) than price (20.8%), form of presentation (12.2%), cut (12.0%) and brand (10.5%), with preference for Chilean and Argentinean striploin, packaged on trays, with no brand at medium price. Using a cluster analysis, three market segments were distinguished. The largest (52.3%) placed great importance on origin and preferred the highest price. The second (27.5%) also valued origin with the greatest preference for Argentinean beef, and it was the only group that preferred the ribeye as the cut. The third (20.5%) placed the greatest importance on price, and was the only group that preferred Paraguayan meat. The segments differed in the importance of eating meat for their personal well-being. The low importance of packaging and brand indicates poorly developed marketing of this product. In order to properly insert brand beef in the Chilean market, communication strategies must be implemented that identify the product with superior quality and that position the brand in the consumer's mind.

Environmental consciousness, economic gain and consumer choice of energy efficient appliances in Thailand, China and India

In developing economies, consumption of electricity in residential and commercial sectors increased with economic development. In order to identify the factors for effective facilitation of standard and labeling programs, this article explores factors that affect consumer choice to energy-efficient products. Main findings are as follows: (1)Consumers in Thailand shows the highest awareness to environmental friendly concepts, followed by India and China.(2) Chosen labeled products include air-conditioners, TVs, refrigerators and washing machines, but not some popular products such as ceiling fans, electric fans or mobile phones. (3) Consumer who has higher energy conservation perception will buy energy efficient products.(4) Consumers in China, India and Thailand are sensitive to energy efficiency of products, primarily because they lead to less expenditure on electricity. (5) Labeling works to make levels of the energy efficiency of products more visible and thus helped consumers to choose the products.

Energy efficiency standard and labeling program and consumer welfare : a case of the air conditioner market in China

Improving energy efficiency is an unarguable emergent issue in developing economies and an energy efficiency standard and labeling program is an ideal mechanism to achieve this target. However, there is concern regarding whether the consumers will choose the highly energy efficient appliances because of its high price in consequence of the high cost. This paper estimates how the consumer responds to introduction of the energy efficiency standard and labeling program in China. To quantify evaluation by consumers, we estimated their consumer surplus and the benefits of products based on the estimated parameters of demand function. We found the following points. First, evaluation of energy efficiency labeling by the consumer is not monotonically correlated with the number of grades. The highest efficiency label (Label 1) is not evaluated to be no less higher than labels 2 and 3, and is sometimes lower than the least energy efficient label (Label UI). This goes against the design of policy intervention. Second, several governmental policies affects in mixed directions: the subsidies for energy saving policies to the highest degree of the labels contribute to expanding consumer welfare as the program was designed. However, the replacement for new appliances policies decreased the welfare.

A water footprint assessment of a pair of jeans: the influence of agricultural policies on the sustainability of consumer products.

This study reports the results of a water footprint (WF) assessment of five types of textiles commonly used for the production of jeans, including two different fibres (cotton and Lyocell fibre) and five corresponding production methods for spinning, dyeing and weaving. The results show that the fibre production is the stage with the highest water consumption, being cotton production particularly relevant. Therefore, the study pays particular attention to the water footprint of cotton production and analyses the effects of external factors influencing the water footprint of a product, in this case, the incentives provided by the EU Common Agricultural Policy (CAP), and the relevance of agricultural practices to the water footprint of a product is emphasised. An extensification of the crop production led to higher WF per unit, but a lower overall pressure on the basins water resources. This study performs a sustainability assessment of the estimated cotton WFs with the water scarcity index, as proposed by Hoekstra et al. (2011), and shows their variations in different years as a result of different water consumption by crops in the rest of the river basin. In our case, we applied the assessment to the Guadalquivir, Guadalete and Barbate river basins, three semi-arid rivers in South Spain. Because they are found to be relevant, the available water stored in dams and the outflow are also incorporated as reference points for the sustainability assessment. The study concludes that, in the case of Spanish cotton production, the situation of the basin and the policy impact are more relevant for the status of the basin s water resources than the actual WF of cotton production. Therefore, strategies aimed at reducing the impact of the water footprint of a product need to analyse both the WF along the value chain and within the local context.

Physical activity quantification in elder women

Cuantificación de la actividad física en mujeres mayores.

Impact of introducing longer and heavier vehicles on regional consumer price index and Spanish road freight transport system

This paper applies an integrated modeling approach to the case of Spain; the approach is based on a random utility-based multiregional input-output model and a road transport network model for assessing the effect of introducing longer and heavier vehicles (LHVs) on the regional consumer price index (CPI) and on the transportation system. The approach strongly supports the concept that changes in transport costs derived from the LHV allowance as well as the economic structure of regions have direct and indirect effects on the economy and on the transportation system. Results show that the introduction of LHVs might reduce prices paid by consumers for a representative basket of goods and services in the regions of Spain and would also lead to a reduction in the regional CPI. In addition, the magnitude and extent of changes in the transportation system are estimated by using the commodity-based structure of the approach to identify the effect of traffic changes on traffic flows and on pollutant emissions over the whole network.

Analysing the Impact of Consumer Tendency in HORECA Distribution Models

With increasing complexity of today's consumer requirements, food industry decision makers should be able to respond to consumer needs much faster than ever before. The preliminary studies showed that for improving the performance and selecting suitable distribution models, decision makers in food industries should classify different types of consumers and based on the classification prepare different distributions flows. By studying the HORECA distribution channel, this paper suggest that, logistics decision makers should investigate the relationship between consumers' characteristics and urban freight distribution strategy in order to respond to the exact needs and in the follow to reduce the logistics cost.

Instrumental Colour Evaluation and Visual Consumer Study of Commercial Beverages Made with Fruit Juice and Milk

Análisis del color de bebidas formuladas con leche y frutas mediante análisis de imagen y estudio de la aceptación del color por los consumidores

Sensory characterization and consumer acceptance of La Mancha Trujillo melons fertilized with different dosages of pomace compost

Caracterización sensorial y aceptación del consumidor de melones de la Mancha de la variedad Trujillo fertilizados con compost de orujo a diferentes dosis

MEDLINEplus: building and maintaining the National Library of Medicine's consumer health Web service

MEDLINEplus is a Web-based consumer health information resource, made available by the National Library of Medicine (NLM). MEDLINEplus has been designed to provide consumers with a well-organized, selective Web site facilitating access to reliable full-text health information. In addition to full-text resources, MEDLINEplus directs consumers to dictionaries, organizations, directories, libraries, and clearinghouses for answers to health questions. For each health topic, MEDLINEplus includes a preformulated MEDLINE search created by librarians. The site has been designed to match consumer language to medical terminology. NLM has used advances in database and Web technologies to build and maintain MEDLINEplus, allowing health sciences librarians to contribute remotely to the resource. This article describes the development and implementation of MEDLINEplus, its supporting technology, and plans for future development.