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.^

(Table 1) Oxygen isotopes in minerals at DSDP Hole 83-504B basalts

The D/H, 18O/16O and 87Sr/86Sr ratios of the basaltic basement from the Leg 83 section of DSDP Hole 504B show that in that area the oceanic crust has experienced intensive but not pervasive alteration. Isotope ratios of the basalts are very heterogeneous because of an input of oxygen, hydrogen, and strontium from seawater. The hydrogen isotopic composition of many samples displays the complete thermal history of the water-rock interactions. High-temperature mineral formations (actinolites, epidotes, and chlorites) were overgrown by a mineralization at lower temperatures (mixedlayer smectites, iddingsites, and smectites) during successive stages of cooling of the oceanic crust by cold seawater. From 87Sr/86Sr data bulk water/rock ratios up to 5:1 have been calculated. There is evidence that some primary minerals like high-An plagioclases contain oxygen from altered basalts. We have discussed the probability that there existed a seawater/crust interface, now at a depth of 620 m sub-basement, during the high-temperature water/rock interactions. This interface was covered during later magmatism by thick flows, pillow lavas, and intrusives.

Secondary minerals and geochemistry in basalts at DSDP Leg 67 Legs

Secondary minerals in basalts from Holes 495 and 500 include smectite and chlorite, both of which have partially replaced the basalt groundmass. In addition to these two minerals, amphibole, laumontite, albite, and a corrensitelike mineral are present in Holes 499B and 499C. Smectite, chlorite, talc, calcite, phillipsite, mica, and mixed-layer chlorite-montmorillonite also fill veins in the basalts of Hole 495. The secondary mineral assemblages from Site 499 are characteristic of the initial stage of greenschist facies metamorphism.

Effects of the ruminal comminution rate and microbial contamination of particles on accuracy of in situ estimates of ruminal degradability and intestinal digestibility of feedstuffs.

Effects of considering the comminution rate -kc- and the correction of microbial contamination -using 15N techniques- of particles in the rumen on estimates of ruminally undegraded fractions and their intestinal digestibility were examined generating composite samples -from rumen-incubated residues- representative of the undegraded feed rumen outflow. The study used sunflower meal -SFM- and Italian ryegrass hay -RGH- and three rumen and duodenum cannulated wethers fed with a 40:60 RGH to concentrate diet -75 g DM/kgBW0.75-. Transit studies up to the duodenum with Yb-SFM and Eu-RGH marked samples showed higher kc values -/h- in SFM than in RGH -0.577 vs. 0.0892, p = 0.034-, whereas similar values occurred for the rumen passage rate -kp-. Estimates of ruminally undegraded and intestinal digestibility of all tested fractions decreased when kc was considered and also applying microbial correction. Thus, microbial uncorrected kp-based proportions of intestinal digested undegraded crude protein overestimated those corrected and kc-kp-based by 39% in SFM -0.146 vs. 0.105- and 761% in RGH -0.373 vs. 0.0433-. Results show that both kc and microbial contamination correction should be considered to obtain accurate in situ estimates in grasses, whereas in protein concentrates not considering kc is an important source of error.

In vitro evaluation of commercial fibrolytic enzymes for improving the nutritive value of low-quality forages.

The aim of this work was to assess the effects of four doses of three commercial fibrolytic enzymes on ruminal fermentation of rice straw, maize stover and Pennisetum purpureum clon Cuba CT115 hay in batch cultures of ruminal micro-organisms from sheep. One enzyme was produced by Penicillium funiculosum (PEN) and two were from Trichoderma longibrachiatum (TL1 and TL2). Each liquid enzyme was diluted 200 (D1), 100 (D2), 50 (D3) and 10 (D4) - fold and applied to each substrate in quadruplicate over time and incubated for 120 h in rumen fluid. The D4 dose of each enzyme increased (P<0.05) the fractional rate of gas production and organic matter effective degradability for all substrates, and TL2 had similar effects when applied at D3. In 9 h incubations, PEN at D4, TL1 at all tested doses, and TL2 at D2, D3 and D4 increased (P<0.05) volatile fatty acid production and dry matter degradability for all substrates. The commercial enzymes tested were effective at increasing in vitro ruminal fermentation of low-quality forages, although effective doses varied with the enzyme.

Treatment of tropical forages with exogenous fibrolytiic enzymes: effects on chemical composition and in vitro rumen fermentation

The effects of three treatments of fibrolytic enzymes (cellulase from Trichoderma longibrachiatum (CEL), xylanase from rumen micro-organisms (XYL) and a 1:1 mixture of CEL and XYL (MIX) on the in vitro fermentation of two samples of Pennisetum clandestinum (P1 and P2), two samples of Dichanthium aristatum (D1 and D2) and one sample of each Acacia decurrens and Acacia mangium (A1 and A2) were investigated. The first experiment compared the effects of two methods of applying the enzymes to forages, either at the time of incubation or 24 h before, on the in vitro gas production. In general, the 24 h pre-treatment resulted in higher values of gas production rate, and this application method was chosen for a second study investigating the effects of enzymes on chemical composition and in vitro fermentation of forages. The pre-treatment with CEL for 24 h reduced (p < 0.05) the content of neutral detergent fibre (NDF) of P1, P2, D1 and D2, and that of MIX reduced the NDF content of P1 and D1, but XYL had no effect on any forage. The CEL treatment increased (p < 0.05) total volatile fatty acid (VFA) production for all forages (ranging from 8.6% to 22.7%), but in general, no effects of MIX and XYL were observed. For both P. clandestinum samples, CEL treatment reduced (p < 0.05) the molar proportion of acetate and increased (p < 0.05) that of butyrate, but only subtle changes in VFA profile were observed for the rest of forages. Under the conditions of the present experiment, the treatment of tropical forages with CEL stimulated their in vitro ruminal fermentation, but XYL did not produce any positive effect. These results showed clearly that effectiveness of enzymes varied with the incubated forage and further study is warranted to investigate specific, optimal enzyme-substrate combinations.

La roca magica: Uses of natural zeolites in agriculture and industry

For nearly 200 years since their discovery in 1756, geologists considered the zeolite minerals to occur as fairly large crystals in the vugs and cavities of basalts and other traprock formations. Here, they were prized by mineral collectors, but their small abundance and polymineralic nature defied commercial exploitation. As the synthetic zeolite (molecular sieve) business began to take hold in the late 1950s, huge beds of zeolite-rich sediments, formed by the alteration of volcanic ash (glass) in lake and marine waters, were discovered in the western United States and elsewhere in the world. These beds were found to contain as much as 95% of a single zeolite; they were generally flat-lying and easily mined by surface methods. The properties of these low-cost natural materials mimicked those of many of their synthetic counterparts, and considerable effort has made since that time to develop applications for them based on their unique adsorption, cation-exchange, dehydration–rehydration, and catalytic properties. Natural zeolites (i.e., those found in volcanogenic sedimentary rocks) have been and are being used as building stone, as lightweight aggregate and pozzolans in cements and concretes, as filler in paper, in the take-up of Cs and Sr from nuclear waste and fallout, as soil amendments in agronomy and horticulture, in the removal of ammonia from municipal, industrial, and agricultural waste and drinking waters, as energy exchangers in solar refrigerators, as dietary supplements in animal diets, as consumer deodorizers, in pet litters, in taking up ammonia from animal manures, and as ammonia filters in kidney-dialysis units. From their use in construction during Roman times, to their role as hydroponic (zeoponic) substrate for growing plants on space missions, to their recent success in the healing of cuts and wounds, natural zeolites are now considered to be full-fledged mineral commodities, the use of which promise to expand even more in the future.

Radioisotopes in agriculture : animal husbandry, fertilizer uptake, plant physiology, photosynthesis, and entomology : a selected list of references /

This bibliography contains 151 selected references on the uses of radioactive and stable isotopes in animal husbandry and in studies of fertilizer uptake by plants, plant physiology, photosynthesis, and entomology. These references were selected from scientific journals published during the period 1957-1958. An author index is included.

The element of uncertainty in the interpretation of feeding experiments /

Cover title.

Radioisotopes in agriculture : animal husbandry, fertilizer uptake, plant physiology, photosynthesis, and entomology : a selected bibliography /

This annotated bibliography contains 148 selected references on the uses of radioactive and stable isotopes in animal husbandry and in studies of fertilizer uptake by plants, plant physiology, photosynthesis, and entomology. These references were selected from scientific journals published during the period 1957-1958. Subject and author indexes and a list of the periodicals from which the references were selected are included.