community final review Flashcards
(134 cards)
1
Q
national school breakfast program
A
established BY the 1966 child nutrition act
2
Q
summer food service program for children
A
1975 amendment to NSL act 1946
- meals, snacks, during vacation periods
- sponsored by schools, community sites, summer camps, motels, etc
3
Q
after school snack program and special milk program
A
- 1966 child nutrition act
- cash reimbursement for each one-half pint of milk served to non NSLP children
4
Q
child and adult care food program
A
- 1978 older americans act
- cash reimbursement for meals, snacks
- serves children, elderly and disabled–TQ!!
5
Q
food distribution program on indian reservations
A
- formerly known as the needy family program
- provides monthly food packages of commodity foods to low income american-indian households on 218 reservations
6
Q
the emergency food assistance program (TEFAP)
A
- 1983
- surplus commodities distributed to needy house holds for home consumption and organizations that serve the needs
- eligibility: must be between 130-150% FPG
- gives the families a few bags of groceries to get them through the emergency
7
Q
commodity supplemental food program (CSFP)
A
- agricultural and consumer protection act 1973
- available in 13 states
- provides supplemental foods and nutrition education
- participants may not participate in WIC and CSFP simultaneously
- direct food distribution program providing supplemental foods and nutrition education
- target population:similar to WIC and persons 60 yrs and older
- food packages are designed to meet the nutritional needs of the participant
- over 470,000 participants in 2001
8
Q
senior nutrition programs
A
- congregate meals program
- home delivery meals
- nutrition services incentive program
- senior farmers market nutrition program
9
Q
congregate meals program
A
- low cost nutritious meals
- social interaction
- nutrition education
10
Q
home delivered meals
A
- > 60 YOA, regardless of income
- priority to those in need
11
Q
nutrition services incentive program
A
provides cash and commoditiy foods to local senior centers
12
Q
senior farmers market nutritional program
A
- provides coupons to low-income seniors to use at farmers markets
- also available to indian tribal governments
13
Q
emergency food services–public TQ
A
- food banks
- food pantries
- soup kitchens
- prepared and perishable food programs (dallas hunger link)
- community food security-community gardens, food recovery, gleaning, farm to school incentives
14
Q
infant mortality rate
A
number of live born infants who die within the first year of life per 1000 births
- used as an indicator of health status and quality of life of populations
- U.S. IMR is higher than many other industrialized countries
- more than twice as high in american blacks than whites
- finland, italy, japan, norway sweden has the least
- US is ranked 29th with 5.9/1000
15
Q
leading causes of IMR
A
congenital anomalies, pre-term/low birth weight, SIDS, complications of pregnancy, complications of placenta, cord, & membrane, accidents, respiratory distress, bacterial sepsis, disease of circulatory system, intruterine hypoxia and birth asphyxia
16
Q
iron deficiency in infants
A
due to continuing to breast feed after 6 months without iron supplementation
- use of cows milk earlier than recommended can lead to deficiency
- rapid infant growth
- low birthweight
- low economic status
17
Q
WIC provides
A
-food packages-high in protein, calcium, iron, vitamin A & C
-vit C rich foods
-eggs, milk, dried peas and beans, cheese, peanut butter,
-NEW- cupons for fruits and veggies from markets
tuna and carrots for BF moms (protein and vit A)
18
Q
WIC farmers market
A
- created to provide fresh nutritious fruits and veggies to WIC participants
- study reported that this incr. F&V purchase and consumption among WIC recipients
19
Q
food distribution program
A
gov suplus commodities distributed to low income families
20
Q
commodities supplemental food program
A
food distributed to women, infants, and children of low income families
21
Q
expanded food and nutrition education program (EFNEP)
A
provides funding for nutrition education
-extension agents train paraprofessionals to work with homemakers with young children
22
Q
title V maternal and child health program (1935 social security act)
A
- Federal funding to states to “promote, improve and deliver” maternal, infant and child health care programs
- Services and programs to reduce infant mortality and improve child and maternal health
- Provides nutrition assessment
- dietary counseling
- nutrition education
- referral to food assistance programs for infants, preschool and school-aged children, children with special needs, adolescents, women of childbearing age
23
Q
o Medicaid—TQ!
A
- 1965 Title XIX Social Security Act
- provides medical care to low income
- entitlement program
24
Q
o Early Periodic Screening, Diagnosis and Treatment (EPSDT)
A
- 1967 Title 19 Social Security Act
- states must develop protocols to identify eligible children
- provides screening of low-income families, assesses nutritional status of children and referral for treatment
25
o Community Health Centers
* Office of Economic Opportunity 1966
* Administered Federally through Bureau of Community Health Services
* Provide health services and training in medically underserved areas
* Focus on comprehensive primary care services through community health centers including migrant health centers
26
o Healthy Start Program
* HRSA & DHHS funded program in urban/rural areas with high IMRs
* Goal: ID and develop community-based approaches to reduce infant mortality and improve health of low income women, infants, children and their families
* Most Healthy Start families are AA, Hisp, or Native American
27
o Best Start breastfeeding national promotion program guidelines:
* Campaign tone – should be emotional to reflect strong feelings of women
* Message design – succinct and easily understood
* Spokespersons – of same economic, ethnic, and age groups as those targeted
* Educational approaches – reassurance that most women produce sufficient quantities of nutritious milk
* Professional training – motivational and training materials needed
* Program activities/components – variety of mutually reinforcing activities needed
28
o What Are Children and Adolescents Eating?
* Dietary quality of most children 2-9 y/o is less than optimal
* Children in poor families more likely to have diet rated as poor or needs improvement
* Quality continues to decline with decreased fruit, vegetables, and milk, and increased soft drinks
* 7-9 y/o have lower-quality diet than younger children
* Reduced fruit and sodium HEI scores – more fast food and salty snacks
29
o CSFII findings:
* All children are at risk of inadequate intakes of:
* - magnesium, zinc, vitamins A and E
* Teenage girls low in:
* - calcium, magnesium, and iron intake
* High consumption of:
* - total and saturated fat
* - soft drinks and sugar-sweetened beverages
* Increased portion sizes
30
o Childhood Obesity: A Problem
o In past 20 yrs % age of ovwt children has nearly doubled, ovwt adolescents tripled
o Type 2 DM, Dyslipidemia, HTN now seen in children & teens increasingly
o Criterion:
• Obesity: BMI-for-age ≥ 95th percentile
• At Risk of Overweight: BMI-for-age = 85th to < 95th percentile
31
o Childhood obesity associated with:
o Hyperinsulinemia, hypertriglyceridemia, ↓HDL conc., @ risk for CVD, type 2 DM, sleep apnea, gallbladder disease, psychosocial dysfunction, etc.
o Others include social stigmatization and low-self-esteem
o The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity
32
o Malnutrition • Primary
* Primary - lack or imbalance of nutrients in diet
| * Occurrence in: Low income, homeless/foster care youth, food insecure, dieting teen girls
33
o Malnutrition• Secondary
* Secondary - occurs as a result of a disease or illness that affects dietary intake, nutrient needs or metabolism
* Occurrence in: Low income, homeless/foster care youth, food insecure, dieting teen girls
34
o Iron deficiency anemia-
* One of most common deficiencies
* Criterion: low hemoglobin and/or hematocrit
* higher prevalence among AA, Hisp, and SE Asian children
35
o Dental caries-
* By age 18 >90% of all US children have experienced it
| * Low income & ethnic populations have higher incidence
36
o High blood cholesterol
* Evidence shows atherosclerosis begins as early as age 3
* US children have higher cholesterol levels than children of other countries
* Cholesterol level should be < 200mg/dl
* LDL-c should be < 100mg/dl
* HDL-c should be > 40mg/dl
37
o Blood Lead Levels
* Lead poisoning causes low intelligence
* Prevalent in poor families with older homes
* Sources: lead-based paints (eating paint chips), gasoline, food cans, drinking water and supplements not regulated (coral calcium, oyster shells for calcium
38
o Eating Disorders
* Have become serious health problem
* Anorexia nervosa, Bulimia nervosa
* Higher incidence in white teens than blacks ages 14-30 years
* Affects 3% of all teen girls
* Often seen in athletes in sports that have wt stds
39
o National School Lunch Program - 1946
• Provides 1/3 RDA
40
o National School Breakfast Program- 1966
* Provides 1/4 RDA
| * Both funded by Fed gov, administered by states
41
o Summer Food Program for Children
• Feeding during summer months
42
o Special Milk Program for Children - 1966
• Reimbursement for milk for programs other than school lunch/breakfast.
43
o After School Snack Program – 1998
• After school snacks provided on income eligibility basis
44
o Nutrition Programs – DHHS
| o Head Start - 1965
* one of the most successful federal programs
* provides services to children of low-income families ages 3-5 yo
* education, social, health and nutrition services
* provides meals and snacks
* nutrition assessment and nutrition education to children and parents
45
o 2004 Texas Public School Nutrition Policy
* Eliminated deep-fat frying, restr of portion size on chips, milk, fruit drinks, certain snax/sweets
* Limiting fats & sugar, offering F&V at POS daily
* Fried potato products portion size limited to 3 oz., students can only buy one serving
46
o YourSELF
• nutrition & physical activity, targeted at 7th & 8th graders. See Fig. 11-3
47
o 5 A Day the Color Way
• Produce for Better Health Foundation’s nat’l campaign to promote F&V consumption “There’s a Rainbow on my Plate.”
48
o Eat Smart. Play Hard
* National FNS nutrition education campaign which promotes healthy eating and physical activity.
* Themes: eating breakfast, healthful snacking, achieving balance and physical activity
49
o TEAM Nutrition
* Coordinated with CATCH program
* Focus on school food service personnel
* Nutrition education
* Healthy school environment
50
o VERB. It’s what you do
* Multicultural campaign by DHHS & CDC
| * Targeting ‘tweens’ ages 9-13 encourages physical activity
51
o Powerful Bones, Powerful Girls
* National bone health campaign promoting bone health in girls 9-12 years & adults who influence tweens
* Encourages Ca consumption
52
o Nutrition Edu in Private Sector
```
o AHA: variety of schoolsite programs
• HeartPower!
o American Cancer Society
• “Changing the Course”
o American Dietetic Association writes children’s info
o The Kids Café Program by ConAgra
o KidFit 4 Life – United Way
```
53
• mature
55-64
54
• young old
65-74
55
• old, old
>74
56
• very old
> 85
57
o Life expectancy
Born in 2002 Ave 77 yrs
• Men – White/Black 75 yo/75 yo
• Women – White/Black 80 yo/68 yo
58
o Understanding Baby Boomers
o Born between 1946 - 1964
o Represent almost 1/3 of US population
o Have the power to change the marketplace
o Make decisions based on personal beliefs and want to be empowered
o Constantly pressed for time (juggle careers, child care, home responsibilities, leisure
o Look for value and quality in their investments and becoming thriftier with age
o Boomers will NOT age gracefully - programs should be dynamic and upbeat
o Boomers like nostalgia
59
o Levels of Health Promotion primary
o Primary - campaigns to change behavior
• stop smoking
• exercise
• eating healthy
60
o Levels of Health Promotion- secondary
o Secondary - detect and treat disease in early stages, for at-risk populations
• screening
• health fairs
61
o Levels of Health Promotion-tertiary
o Tertiary - minimize debilitating effects of disease
* rehabilitation
* quality medical care
62
o Factors Affecting Nutrition Status of Older Americans
o Physiological
o Socioeconomic—culture, literacy
o Psychological—dementia, depression
o Environmental—family support
63
o Primary Nutrition Problems in Aging
o After age 35: functional capacity declines in nearly every organ
o Changes in absorption of nutrients
o Older adults face challenge of choosing nutrient-rich diet
• Caloric needs decr
• Nutrient needs incr
• Such as vit C, vit B12, vit B
64
o ABCD
o Anthropometric, Biochemical, Clinical (observation), Dietary
65
o Components of Nutrition Assessment for Elderly
```
o ABCD –
o Anthropometric, Biochemical, Clinical (observation), Dietary
o Functional capacity
o Medication
o Social
```
66
Nutrition Screening Initiative
Three agencies involved:
ADA
American Academy of Family Physicians
National council on Aging
Goal: To promote nutrition screening and early intervention
DETERMINE Checklist- for older person or care provider to determine need for service—TQ!!
follow up with more in-depth screening and assessment of nutritional status if at risk—TQ!!
67
Nutrition Screenings: Level I:
```
Height
Weight
Dietary data
Daily food intake
Living environment
Functional status
```
68
nutritional screening level II
```
Same data as Level I
Lab and anthropometrics
Clinical features
Mental-cognitive status
Medication use
```
69
SSI (Supplemental Security Income)
↑ income to defined poverty threshold
| given to seniors as they reach a certain age….
70
3rd Party Reimbursement system
Medicare, Medicaid, Blue Cross/Blue Shield
71
Home Health Services
Thru public/private: provide home health aids
72
Adult Day Care Centers
sponsored through Child and Adult Day Care Programs
73
Commodity Supplemental Food Program
monthly food packages to elderly households
74
Nutrition Programs – DHHS
Older Americans Act (OAA) 1965
Amended 1972 - NPOA Nutrition Program for Older Americans
Title IIIC provides:
1. Congregate Meals Programs
2. Home Delivered Meals to homebound elderly
DHHS: ENP
Elderly Nutrition Program (ENP)
Under Older American’s Act (OAA)
Improve elderly nutrition status/avoid medical problems by:
Low-cost, nutritious meals
Social interaction
Nutrition screening, assessment, education
Counseling & referral
Transportation
75
Nutrition Programs - Private
Meals on Wheels America
reaches people not reached by NPOA
standard lunch
some program provide weekend and holiday meals
76
o Health Concerns of Chronic Poverty:
```
o Unsafe drinking water
o Intestinal parasites
o Insufficient food
o Low protein diet
o Stunted growth
o Low body weight
o Illiteracy
o Disease
o Shortened life span
o Death
o Solutions?? Transform economic, political, social structures that hinder food production, distribution, & consumption.
```
77
o Major International Malnutrition Problems
o Effects of Those Most Vulnerable:
• - Inadequate weight gain during pregnancy
• - Low infant birth weights
• - Stunted growth in children
• - Higher mortality rates in infants and children under the age of 5
o Economic Burden of Malnutrition and Hunger:
• - direct health-related expenses
• - lost productivity and income
• - stunted physical and mental development-reduced lifetime earnings
78
o Children at Risk
* Breastfeeding used to be practiced worldwide but trend is less today. Fewer than half of infants are BF at 4 months.
* Urbanization of developing countries
* sending babies home with formula
* after free samples, unable to afford to purchase
* mixing powdered formula with unsanitary water causes increased infections and diarrhea.
* Weaning period - baby switches from formula or breast milk to nutrient poor gruels. Often a BF baby will be well nourished but older children are malnourished.
* Nutr Education - encourage BF all along and during the weaning period.
79
o 6 Leading Diseases that Kill Children under age 5 (2005)
* 1. Pneumonia
* 2. Diarrhea
* 3. Neonatal disorders
* 4. Malaria
* 5. Other (accidents and other)
* 6. Measles
* Most children do not die of malnutrition but the effects of it via infection & disease
80
o Major International Malnutrition Problems
o PEM-Protein-energy malnutrition
• Most widespread form of malnutrition in the world
• Kwashiorhor-protein deficiency
• Marasmus-energy deficiency (starvation)
• These are usually seen together.
• Acute PEM-thin for height
• Chronic PEM-short for age
81
o Vit A deficiency (VAD)
* Xeropthalmia - night blindness
* Partial or total blindnessà most common cause of blindness (Bitot’s spots)
* Definite assoc. with other forms of malnutrition, infection, diarrhea, mortality.
* In US vit. A in fortified milk
82
o Iron deficiency -
* 2 Billion people have Fe deficiency anemia. Results in decrease in cognitive abilities and a decrease in resistance to disease.
* In US we fortify grains; wheat flour and products made with wheat flour (cornbread mixes, breads, cereals) to increase iron intake.
* 5 mg of iron in 1 egg yolk—10 mg RDA for men; 18 mg RDA for women
83
o Iodine deficiency - cretinism (old term)
* causes physical and mental retardation in infants born to mothers with severe iodine deficiency.
* Overstimulation of the thyroid gland causes goiter. Countries with very little iodine in their soil often see goiter.
* In US, salt fortified with iodine to prevent deficiency
84
o Zinc deficiency
growth failure, weakened immunity
85
o GOBI - child survival plan by UNICEF dev. in 1983. Goal - decrease hunger related deaths worldwide.
o G- is for Growth Charts
• mothers are taught to chart child’s growth with monthly plottings. Problems are seen early.
o O-is for ORT - Oral Rehydration Therapy
• most children die of diarrhea than outright hunger.
• Diarrhea causes dehydration
• ORT saves 1 million lives per year
• packages of premixed salt/sugar solution with boiled water. Comes premixed or recipes for home use.
• contaminated water increases infection rate - diarrhea cycle increases mortality rate.
• Sanitary water is imperative for success
• very successful campaign, simple and inexpensive to implement
o B-is for Breastfeeding
• benefits are hygienic, readily available, nutritionally sound, immune benefits, bonding benefits.
• Education necessary for mothers of all backgrounds
• Solids-mixtures of grains (wheat, rice, millet, sorghum, corn) and pulses (peas and beans). Encourage cont. BF during weaning process
o I –is for Immunization
• Could prevent 2 million deaths per year from measles, diphtheria, tetanus, whooping cough, polio, TB.
• Adequate protein intake and body stores (albumin) necessary for immunizations (proteins) to be effective.
• Most countries have campaigns to get all children immunized
86
o G- is for Growth Charts
• mothers are taught to chart child’s growth with monthly plottings. Problems are seen early.
87
o O-is for ORT - Oral Rehydration Therapy
* most children die of diarrhea than outright hunger.
* Diarrhea causes dehydration
* ORT saves 1 million lives per year
* packages of premixed salt/sugar solution with boiled water. Comes premixed or recipes for home use.
* contaminated water increases infection rate - diarrhea cycle increases mortality rate.
* Sanitary water is imperative for success
* very successful campaign, simple and inexpensive to implement
88
o B-is for Breastfeeding
* benefits are hygienic, readily available, nutritionally sound, immune benefits, bonding benefits.
* Education necessary for mothers of all backgrounds
* Solids-mixtures of grains (wheat, rice, millet, sorghum, corn) and pulses (peas and beans). Encourage cont. BF during weaning process
89
o I –is for Immunization
* Could prevent 2 million deaths per year from measles, diphtheria, tetanus, whooping cough, polio, TB.
* Adequate protein intake and body stores (albumin) necessary for immunizations (proteins) to be effective.
* Most countries have campaigns to get all children immunized.
90
o World Summit for Children Goals:
o 1. Decrease infant and child mortality by 1/3 - 60 countries achieved, global decline by 11%
o 2. Global eradication of polio by 2000. 175 countries are polio-free.
o 3. Routine Immun. - 75% countries have high level of coverage of DPT x 3.
o 4. Decrease measles by 95%.
• 40% global decline between ‘90 and ‘99.
o 5. Dec diarrheal deaths by 50% - achieved
o 6. Dec by 1/3 acute respiratory infection deaths in children under 5 - improvement seen
o 7. 50% improvement in malnutrition
• 17% improvement. in dev. countries. 150 million children still malnourished
o 8. Dec LBW to less than 10% of population
• 100 dev. countries have achieved.
o 9. Vit A Deficiency - eliminate by 2000
• 40 countries routinely give high dose Vit A supplements.
o 10. Iodine deficiency -goal to eliminate
• 72% of households use iodized salt resulting in a 20% decline
91
o Women at Risk
o 50% of world’s population are women
o More susceptible to food insecurity and undernutrition than men
o Women provide first for their families-then themselves.
o Social beliefs that limit food intakes
o Development projects frequently overlook women’s needs
92
o Strategies for Women
o Basic strategies for women’s programs:
• Remove barriers-increase loans to improve food production needs
• Access to time-saving technologies (seed grinders)
• Appropriate training for self-reliance
• Teaching management and marketing skills
• Making health and day care services available
• Forming women’s support groups
• Information and technology for planned pregnancies
93
o Food Insecurity in Developing Countries
o People in the poorest countries are preoccupied with survival and elementary needs
o Causes of world hunger – see Fig. 14-7
o Overpopulation
• High birth rates in low-income countries
• Population growth threatens world’s ability to produce adequate food
o Developing countries export goods at lower cost than expensive imports they receive keeping them in debt
• Nutritious, costly foods exported into developing countries include: grains, nuts, seeds, fruits, vegetables
94
o International Trade
o Multinational companies-companies which operate in more than one country - very common today (oil, food, fashion, etc.)
• use local labor very cheaply which does not help to raise the living standard of the people.
• Acreage diverted from staple crops
• Some cropland diverted for nonfood cash crops
• Ads link Western snack foods to prosperity
95
o Distribution of Resources
```
o In developing world control over land & assets is highly inequitable
o Developing nations must be allowed to incr. agricultural productivity
o Must gain greater access to 5 things:
• Land
• Capital
• Water
• Technology
• Knowledge
```
96
o Agricultural Technology
o “If you give a man a fish, he will eat for a day. If you teach him to fish, he will eat for a lifetime”.
o 60s & 70s - Green Revolution: a movement to teach people in dev. countries to develop their land, crops, irrigation
• Cons: Required technology, chemical fertilizers, and expenses developing farmers didn’t have
o Today - movement towards implementing appropriate technology depending on available resources, ex. Manual machinery not needing oil or gas to operate. Labor often plentiful.
o Sustainable development - successful management of agric. resources to maintain or enhance natural resources
o Biotechnology:
• Development of drought-resistant crop varieties w/ incr yield& resistance to pests/plant diseases?
o Genetic Engineering:
• Mitigate problems of malnutrition by enhancing nutritional content of foods
• Long term effects?
• Box on p.481
97
o International Nutrition Programs
o WHO, Peace Corps, UNICEF, FAO
98
o International Nutrition Programs
| o WHO, Peace Corps, UNICEF, FAO
o 4 types of interventions:
• 1. Breastfeeding promotion
• 2. Nutrition education programs - infant and child feeding, schools, teachers
• 3. Food Fortification and using nutritional supplements.
• 4. Special feeding programs for vulnerable groups/supplemental foods.
• Superflour 2:1:1 (soybean, corn, wheat)
• triticale
• benniseed- flour meal of rice, sesame and peanuts
• GE foods-genetically engineered foods
99
o Echinacea
* Topically, for wound healing , chronic ulcerations, and snake bites
* Antiseptic and mild antibiotic
* Immunostimulant
* Mild anti-inflammatory
* Prevention of viral infections
* Support therapy for recurring bacterial/fungal infections
* Cancer prevention
* Protect WBC during chemo and radiation
* Colds, flu, infections
* To avoid OVERSTIMULATION, Echinacea treatment should not exceed 8 WEEKS, some references say 2 WEEKS
100
o GINKGO
```
• Traditional Chinese Medicine:
• Asthma
• Chilblains (swelling of hands and feet from exposure to damp cold)
• Digestive aid
• Prevent drunkenness
• Current Potential Health Benefits
• CVD prevention and treatment
• Heart disease and stroke
• Peripheral vascular insufficiency
• Dizziness
• Ringing in the ears
• Hearing loss
• Vertigo
• Dementia and Alzheimer’s disease
• Cerebral brain dysfunction
• Diabetic retinopathy
• Antidepressant
• Impotence
• Potential Concerns
• Side effects are typically mild:
o headache, gastrointestinal upset, dizziness
• Large amounts of the seed could be dangerous:
o tonic/clonic seizures and loss of consciousness, fever, emesis, dyspnea
• Only the leaf or seeds should be used b/c serious adverse effects have been reported with other parts of plant
```
101
o GARLIC
• Native Americans:
• Scurvy, earaches, flatulence
• Middle Ages:
• Cure for deafness
• Traditionally:
• expectorant, diaphoretic, disinfectant, and diuretic
• Prevention and treatment of atherosclerosis, heart disease, and hypertension
• Reduce blood-sugar levels
• Antibacterial agent
• Increase tone of intestinal smooth muscle and increase peristalsis
• Cancer prevention
• Immune stimulant
• Possible Concerns:
• 25 mL dose of fresh extract:
o burning of the mouth, esophagus, and stomach
o nausea, sweating, and lightheadedness
• Other adverse effects:
o heartburn, flatulence, gastrointestinal distress, allergic reactions, asthmatic reactions after repeated exposure to garlic dust, and changes in the odor of the skin and breath
102
o Ginseng
* Uses: inc strength and stamina; also as antioxidant
* More than 400 commercial products available today!
* Dosing: 100-300mg tid stand. ext.to contain 7% gensenosides or crude root up to 3 g daily for up to 3 months.
* Concerns: nervousness, allergy
* *Contraindicated with HBP and hypoglycemic effect for diabetics-caution
103
o St. John’s Wort St. John’s Wort (Nature’s Prozac)
* Uses: depression, anxiety, healing agent for minor hemorrhages, tea for bedwetting, diuretic.
* Concerns: rare, but can be fatigue, allergy, GI upsets. Skin hypersensitivity, MAO inhibitor precaution
104
o Naturopathy
• The great cornucopia
• Long history, based on natural substances and natural processes.
• Benedict Lust - came to US from Germany in 1896.
• Founded first school in NYC, 1900’s
• Lust’s 3 principles:
• 1. Eliminate evil habits
• 2. Correct bad habits
• 3. New principles of living
o Dr. James Foster - Idaho
• 1920’s very popular across nation
• 40-50’s decline
• 70-80’s resurgence seen with interest in holistic and natural methods of healing
• currently 1000 naturopaths in US
• 7 medical schools are accredited today in US and Canada
• physicians trained as primary care providers with extra training in preventive med and natural therapeutics, plus the basic sciences
105
o Six Unifying Principles: (AANP)
* 1. Healing Power of Nature
* 2. Treat the Whole Person
* 3. First, do no harm
* 4. Identify and Treat the Cause
* 5. Prevention is the Best Cure
* 6. Doctor as Teacher
106
o Strengths of naturopathy
* Primary care, general med practice
* Preventive medicine
* Natural childbirths
* Clinical nutrition
* Minor bone setting
* **Interpersonal relationship with client
107
limitations of naturopathy
* Major surgery
* Acute trauma
* Cancer treatment
108
• Homeopathic medicine
o Use of naturally occurring substances in very small doses to stimulate natural defenses.
o Based on the “law of similars”
o “homoios” Greek for similar
o “Pathos” meaning disease or suffering
109
• Homeopathic Method
o Toxicology and Casetaking
• Physical, emotional, and mental symptoms a substance causes in overdose
• Total physical, emotional, and mental symptoms of patient
110
• Traditional Chinese Medicine
o Use of acupuncture, herbs, and food to recover and sustain health.
111
o Yin and Yang
• Two opposing forces that interact with one another to maintain balance and harmony
• Yin: anything quiescent, cold, dim, and hypoactive
• Yang: anything moving, hot, bright, and hyperactive
• Each organ has an element of yin and yang within it
• If a condition of prolonged excess or deficiency of either yin or yang occurs then disease results
• Diagnose the yin yang imbalance within the body and correct the flow of qi in the channels
• Qi (Chi)
o Comprised of Moisture & Blood
o Moisture: protects, nurtures, and lubricates tissue
o Blood: foundation of bones, nerves, skin, muscles, and organs
o Spirit (shen): expression of the individual
o Essence (jing): reproductive and regenerative
• Organs
o Kidney: stores Essence and is responsible for growth, reproduction, and regeneration
o Heart: harbors spirit and governs the mind
o Spleen: assimliation of food, fluids, ideas
o Liver: storage of blood, flow of Qi, and evenness of temperment
o Lung: sets body rhythm, defends boundaries, affords inspiration
112
• Acupuncture
* Gates of the body are opened and closed to adjust circulation in the channels and expel noxious influences
* Treats disorders of Qi, Blood, and Moisture
* Uses: withdrawal from addictions, stress reduction, surgical recovery, chronic fatigue, signs of aging, decreased immunity
113
• Herbs
* Fatigue results from a lack of Qi, herbs that nourish Qi have an energizing effect
* Blood-enriching herbs improve vision, sleep, and equanimity
* Moisture herbs replenish hydration to skin
* Herbs
* combined to enhance properties and actions
* Forms: teas, liquid bottled extracts, ground in pills, and powders
114
• Regulation
o National Commission for the Certification of Acupuncturists (NCAA)
o Safe and effective practice standards for acupuncturists
o Sterile needles
115
• THE MARKETING MIX
o The four “p’s”
116
o Product
refers to all of the characteristics of the product or service that are to be exchanged with the target market
• Style, feature, packaging, quality, services
117
o Place
refers to the actual location where the exchange takes place
• Accessibility, convenience, comfort
• Hours of operation, parking
• Channels through which product/service will be delivered
• Gatekeepers=to help you reach your target market (physicians, congress, insurance, etc…
118
o Price
cost of producing the product, includes both intangible and tangible costs
• Must also be affordable for the target market
• Utilities, labor, supplies
119
o Promotion
refers to the agency or organizations information or persuasive communication with the target market
• Advertising, personal selling, publicity, sales promotion-short term incentives, promotional goals
120
healthy BMI
18.5-24.9
121
overweight BMI
>25
122
OBESE levels I, II, III
level I >30
level II >35
level III >40
123
outcome objectives
measure changes in health or nutrition outcome
| ex. by 2011 reduce iron deficiency to less than 10% among low-income children under age 2 in denton community
124
process objectives
measurable activities carried out by the community nutritionist and other team members in implementing a program
-each nutritionist will develop three print handouts related to an iron-rich diet with in 1 month
125
Steps in conducting a community needs assessment
1. Define the nutritional problem
2. Set the parameters of the assessment
3. Collect the data
4. Analyze and interpret the data
5. share the findings
6. Choose a plan of action
125
structure objectives
measurable acitivties regaurding budget, staffing patterns, management system, resources, or coordination of program activities
- " new computer software will be purchased next month for the development of education literature"
- "expenses regarding an education session will be budgeted to train staff on the use of the new software before the end of the year"
126
Qualitative data
Opinions and insight
127
Quantitative data
Vital statistics, published research studies, hospital records, local health surveys
128
DETERMINE
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Disease
Eating poorly
Tooth loss mouth pain
Economic hardship
Reduced social contact
Multiple medicines
Involuntary weight loss
Needs assistance in self care
Elderly >80 yrs
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129
Diet record
Gives accurate information of usual dietary intake BUT the person must be trained properly and must be literate
130
Sensitivity
Proportion of the population with the disease
131
Specificity
Proportion without the disease
132
Validity
Accuracy if assessing instrument
133
Reliability
Repeat ability or precision
