In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.
The purpose of this study was to compare the task elements categorized into required and additional man power's implemental between present and future-oriented duties of school nutrition teachers. The survey consisted of five duties, 27 tasks, 93 task elements, and 270 work details in the task elements of school nutrition teachers. A pilot-test was first conducted on nutrition teachers to confirm the survey contents, and then a main survey was performed on 240 school nutrition teachers, using a self-administrated online method, from July 16 to September 5, 2016. To compare present and future-oriented tasks, frequency analyses were conducted. Work details in the task elements were categorized into 'required' and 'additional man power's implemental', depending on school nutrition teachers' responses, based on a 50% cut-off percentage. The results showed that 13 work details among 60 work details (21.7%) in the 'Duty C. Safety and hygiene management of school foodservice', and 15 work details out of 106 work details (14.2%) in 'Duty B. Foodservice management practices' were identified as additional man power's implemental in future oriented duties. As to 'Duty A. Nutrition management', only three work details among 55 work details (5.5%) were identified as additional man power's implemental. On the other hand, all work details in 'Duty D. Nutrition diet education and counseling and 'Duty E. Reinforce professionalism' were identified as "required" as school nutrition teachers' duties. These findings imply that school nutrition teachers perceive nutrition management and education as their primary duties to the fulfill school foodservice' mission of promoting students' health and fostering students' dietary behaviors. The study offers practical and governmental implications, which can encourage school nutrition teachers to perform their primary duties.
This study attempted to investigate use of information for school foodservice management and perception of informations offered on Office of Education homepages according to Daegu and Gyeongbuk nutrition teachers and dietitians. The most frequently used web site information source and information type were 'charged foodservice information sites'(63.5%) and 'information on nutrition or menus'(63.5%), respectively. Subjects belonging to schools that served more meals per day tended to use informations more frequently. Information on 'management of the foodservice production process' showed a low satisfaction level as compared to importance in all groups, and information on 'nutrition education' showed a similar tendency for subjects belonging to schools that served 1 meals per day. Overall, efforts for development and dissemination of information are required to improve the quality and efficiency of school foodservice.
The purpose of this survey was to investigate the status of dietitians' nutrition management in school lunch program. Questionaries were distributed to 233 dietitians of elementary schools and 10 dietitians of high schools in Seoul and Incheon provinces. The statistical analysis of data was completed using SPSS program. The results were summarized as follows : 78.4% of Seoul and 48.6% of Incheon among the whole students were served their meals in the classrooms. 70.0% of dietitians were 30-39 years old and 31.4% had a career less 5-7 years old. The standardized recipe was used in 71.6% of total schools but not effectively in both provinces. The students' nutrition and preferences were the very first to be considered in menu planning in both provinces. The nutrient value of meals was evaluated by the dietitians in most schools. Nutrition surveys of the meals which students are eating at home were surveyed in 27.3% of Seoul and 53.2% of Incheon. Students' preferences were studied regularly in 65.4% of Seoul and 78.9% of Incheon, and students evaluations of meals were carried out by the school lunch program in 74.6% of Seoul, and 68.8% of Incheon. In 49.6% of Seoul and 53.2% of Incheon, leftover foods were measured for each meal. 38.5% of Seoul used per a week and 48.6% of Incheon used per 2-3 week the processed foodstuffs. In 17.2% of Seoul and 25.2% of Incheon, nutrition education was executed by direct education, but educational methods were done mostly by letterssent to students' parents(76.9% of Seoul and 85.3% of Incheon). Evaluation studies on nutrition management, and nutrition education were hardly correlated to the dietitian's career and educational level. The number of meals served by the school lunch program have no related with the students' preferences. For improvement of nutrition management of school lunch program, it is necessary to develop new nutrition management model and nutrition education program.
In Korea, the school foodservice program has been expanding rapidly in recent years, partly as a result of increased government support. With the growth in the number of schools offering foodservice programs, food safety and sanitation concerns have been increasing. To assist with program improvement, a situation analysis was carried out, with the focus on equipment and sanitary management of school foodservice programs under flour different management systems. A questionnaire was mailed to the foodservice directors of 234 randomly selected schools chi[h included elementary, middle and high schools at the national level. Among them, one hundred and sixty-five responses reasonably completed were used for the analysis. This study classified each school's foodservice management into one of four types : independent-conventional, independent-commissary, contract-conventional, and contract-delivery. The results show that the monitoring of employees' health and personal hygiene, and employees' sanitary education was well conducted, but that the sanitary education of the voluntary parent workers was largely ignored. Eighty-six percent of the schools had their drinking water tested for sanitation, and the results showed that more effort is needed in careful management of drinking water in order to prevent foodborne illnesses and bacillary dysentery. In general, contract management showed lower scores in foodservice equipment and their efficiency, compared with independent management. A relatively high number of schools on the contract-delivery management system employed nurses and leachers instead of dietitians and foodservice directors. The adoption of the HACCP (Hazard Analysis Critical Control Point) system was lowest in contract-conventional and contract-delivery management systems, and highest in elementary schools using the independent-conventional system.
This study has attempted to collect actual spot's opinions and analyze importance-performance of indicators for the evaluation of hospital nutrition department. The results of this research were as follows: first, the average score of self-estimated performance was 3.75 based on a 5-point scale. The degrees of importance of hospital foodservice and nutrition department management were in the range of 3.71~4.85 out of 5.0 and the mean importance degree score was 4.37. Second, the average score of self-estimated performance in each category was significantly higher in the case of general special hospital compared to general hospital. Especially average performance score of nutrition management in the general special hospital was higher than that of general hospital (P<0.001). The average performance score of the hospital with more beds was significantly higher than that with less beds. Contract managed hospital's score was significantly higher than that of self-operated hospital in two categories, "facilities management" and "nutrition management" (P<0.05, P<0.01). In foodservice and nutrition management of task-separated hospitals, the average performance scores were significantly higher than those of not-separated hospitals (P<0.01, P<0.001). Third, according to the importance-performance analysis of recognition about indicators for the hospital nutrition department's operations evaluation, 'foodservice facilities management' and 'foodservice sanitation management' were in 'doing great', 'nutritional management' and 'operational management' were in 'low priority', and 'other foodservice management' was in 'overdone'. In conclusion, there's a need for institutional specific standards of sanitation for Korean hospital foodservice.
The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.
Purpose : The purpose of this study were to examine the degree of job duty importance and difficulty of nutrition teachers in elementary school and then to make their future duties and roles clearly. Methods : The duties of nutrition teachers were classified into four fields such as foodservice management, nutrition education, nutrition counseling and educational experience of Korean agricultural products, and then each field were divided into job duties and job tasks. The subjects was 139 dietitians at elementary schools in Dague and Kyungpook Province who appraised the degree of importance and difficulty of the above four job duties with the Likert 5-point scale through a questionnaire survey. Results : From the results of the survey, it was found that every dietitian had highly assessed the importance of the four job duties of nutrition teachers. In a survey of the degree of job duty importance and difficulty on the dietitians, subjects recognized the following such as haccp management in the field of foodservice management is of the most importance(4.30), and the personal management has the most difficulty (3.80). In the field of nutrition education, the work of establishment nutrition education plan is of the most importance(4.33), and the developing of nutrition education materials and programsn are the most difficulty (4.13). In the field of nutrition counselling, students of that than parents and teachers counselling is of the most importance (4.15) and the most difficulty (4.08). Finally, in the field of our agricultural products experience education, which of he work is the most importance(4.07), and difficulty (4.02). Conclusion : Therefore, it is judged that nutrition teachers in the future should not only have a foodservice management, as their main job duty, but also aid in constructing life-long health management system for students and teachers by conducting a nutrition education and counseling, and also exert their energies in the job duties of menu development and experience education utilizing our agricultural products.
The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.
The purpose of this survey was to investigate the status of dietitians' nutrition management in the elementary school lunch program. 84 elementary schools in Pusan that operated the conventional school lunch program system participated in this survey. They were grouped into schools that had started the school lunch program gofore('Previously") and after 1996("Newly"). 84.5% of dietitians were 20-29 years old and 44% of them had a career less 1 year old. 74.6% of "Previously" and 72.4% of "Newly" served their meals in the classrooms. The student's nutrition and preferences were mainly considered in menu planning in both groups. The standardized recipe was used in 90% of total schools but not effectively in both groups. The nutrient value of meals was evaluated by the dietitians in most schools. Nutrition surveys of the meals students ate at home were carried out in 27.3% of "Previously" and 13.8% of "Newly". Students preferences were studied regularly in 60% of "Previously" and 48.3% of "Newly" and students evaluations of meals served by the school lunch program in 52.7% of "Previously" and 34.5% of "Newly". In 92.7% of "Previously" and 72.4% of "Newly", nutrition education was executed but was done mostly by letterssent to students' parents(in about 95% of schools), with only 11.8% of schools educating within in their classrooms. There were few instructional media for nutrition education. The most of them used notice boards(48.0% of "Previously" and 41.6% of "Newly") . Evaluation studies on nutrition management, and nutrition education were hardly correlated to the dietitian's career and educational level. They were also not correlated to the number of meals served by the school lunch program. In conclusion, the status of the nutrition management in the elementary school lunch program was not good and schools that had started the school lunch program before ("Previously") and after 1996(Mewly") were not that different. It appears that most of the dietitians from elementary schools started the school lunch program before 1996 have followed the nutrition management method established in these schools. In order to have better management in the elementary school lunch program, we need to improve the dietitian's position and more studies in the fields fo better nutrition management and nutrition education should be done.ram, we need to improve the dietitian's position and more studies in the fields fo better nutrition management and nutrition education should be done.
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