Kent State Interns

       In the September 2014 edition of Today’s Dietitian , David Yeager highlighted a possible breakthrough project that could advance current medical treatment and disease prevention.   Multiple labs are participating in what is known as the Human Microbiome Project, which is under the National Institutes of Health.   The project entails two phases.   The first phase, which was completed from 2007-2013, was aimed to identify and describe the microbial community that lives within the human body.   The second phase, which is started in 2013 and will continue until 2015, aims to describe the biology between the interaction of the microbes and the human body.   The ongoing study is hoping to target how health is maintained through the microbiome and how to treat disease (specifically digestive disease).          Various studies have proved that microbiota plays a key role in h...

The purpose of this article was to categorize and analyze the nutritional quality of emergency foods distributed by the Oregon Food Bank. The supplies that are distributed from food banks to soup kitchens, food pantries, and other charitable structures are most often obtained from wholesalers, manufacturers, and government sources. Food Banks distribute foods to food insecure individuals throughout the nation in attempt to reduce malnutrition by offering supposedly nutrient adequate foods. According to the article, “food-insecure populations experience higher rates of chronic conditions, such as heart disease, diabetes, high blood pressure, and obesity” (Hoisington et al, 2011). Food groups for the analysis were primarily determined by MyPyramid and the 2005 DGA. Over a year’s period (2004-2005), over 36 million pounds of food distributed by the Oregon Food Bank was analyzed. The results of the study indicated that meat/beans, grains, and vegetables were distributed more than fr...

“Virtual Nutrition Counseling” http://www.todaysdietitian.com/newarchives/040114p42.shtml             Although classic nutrition counseling has occurred in settings like a hospital or within a private practice, advances in technology have opened up a new arena for nutrition counseling.   New modes of correspondence with patients include phone meetings, video chatting, public settings and even house calls.   This way of communication benefits patients with busy schedules or who may live in remote locations.   It can also benefit RDs for the same reasons.              Virtual healthcare practices are also called telehealth and are not new within the medical field, but are gaining popularity within the dietetic profession.   Telehealth and Telenutrition have been defined by the Academy Definitions of Terms List as: “Telehealth is the use of el...

          Transitioning to electronic medical records (EMRs) from paper charts can help facilitate patient visits and help run practice more efficiently. Registered dietitians (RDs) have noted that paper charts look unprofessional when sending them to physicians and typing up patient records and notes is time and labor intensive. Paper charts can take up valuable space and can accidently be destroyed or misplaced. It is also easy for paper charts to be stolen if not locked away properly. The benefits of EMRs have interested RDs in private practice in this methodology of charting.             EMRs make housekeeping tasks easier. They can store patient’s vital stats, contact information, insurance, referring doctors, medications, and lab results in one location. EMRs also make it easy to keep notes on patients and what was discussed in sessions. Some EMRs also have billing features, whi...

The leaders from MetroHealth, Cleveland Clinic, Sisters of Charity, Akron General and University Hospitals met on September 18 at the Cleveland Convention Center to discuss the current and future state of healthcare.   Healthcare as we know it is changing.   The model of health care is changing from treating sick people to preventative care.   The leaders discussed slashing budgets by the millions.   The number of hospitals beds has decreased from 1 million to 800,00 across the country, and average occupancy at 65%. Hospitals are are forced to do things differently since there are fewer patients and hospitals are generating less revenue.   Physicians are collaborating together to share knowledge, The costs for patient services vary across hospitals, due to the difficulty of assigning a value to services such as research and staff education and then throw in the antiquated way costs are reported to Medicare, which distorts the true cost o...

           The new rule from the Centers of Medicare and Medicaid Services (CMS) took effect on July 11, 2014. The new rule issued by CMS will allow qualified RDNs and qualified food and nutrition practitioners working in hospitals the ability to order therapeutic diet orders independent from a physician’s supervision. It also provides RDNs the privilege to order nutrition related laboratory tests for monitoring therapeutic diet orders with or without supervision of a physician.             Ordering privileges for nutrition related laboratory tests are determined by hospitals in accordance with state laws and other requirements of CMS. The rule increases flexibility for health care practitioners to improve care, save on costs, and provide a more patient centered care experience.             This rule was enabled with the h...

                The goal of this article was to illustrate the common daily duties associated with being a Nutrition Service Director in school food service. The tasks performed in the article were actually taken from the day planner notebook of a Nutrition Service Director attempting to manage issues that arise in the line of work.                 For this Director, the day starts very early in the morning before any other staff arrive to prepare coffee to ensure staff satisfaction. Being the first individual in has its perks-- in this case, discovering a broken water main and contacting the correct personal to repair damages and find substitutes for last minute call offs. The day continues into answering voicemails about the daily menus to concerned parents and elaborating on the nutritional value of the foods included. With littl...

http://www.myajc.com/news/lifestyles/food-allergies-can-cause-nutrition-gaps/nhM9Q/#e8230912.3828941.735493 I received this article via email from the Academy of Nutrition and Dietetics' Knowledge Center today (9/18).  Although short, it comes back to a philosophy I feel very strongly about as an aspiring dietitian. When working with clients or patients, or managing our staff how to deal with them, let's focus on what we CAN eat rather than what we CAN'T. Parents of children with allergies know to avoid the allergen foods altogether.  However, when reviewing what those top 8 allergens are: milk, soy, shellfish, tree nuts, eggs, peanuts, wheat and fish, it is clear to see what a large nutritional gap these children may be receiving.  These gaps can lead to micronutrient deficiencies and all-around malnutrition. This article refers to a study in Italy that found advice and counseling on what foods TO eat (GF grains like quinoa or sunflower seed butter instead of ...

In the January 2014 issue of Today’s Dietitian , Mandy Corrigan, MPH, RD, LD, CNSC wrote an article focusing on 1. Creating an environment in which nutrition care is priority and 2. Proper recognition and diagnosis of hospital malnutrition.   Most hospitalized patients with declining nutritional status require nutrition intervention. Nutrition intervention is useful because it can improve or maintain nutritional status, delay short- and long-term complications, and reduce morbidity and mortality especially in undernourished patients. In the event a patient needs nutrition support, consistent administration and timing in nutrient delivery is important. Frequent interruptions due for example to bed positioning, procedures or issues with the GIT, can increase the risk of malnutrition. Patient nutrition care is one of the main responsibilities of the dietitian. Unfortunately not all facilities are able to provide adequate staffing to assess changes in health and nutritional status...

Vitamin E Shows its Value in the First 1,000 Days of Life  We all know that vitamins and minerals play a vital role in our health. A new study has found that Vitamin E is especially important within the first 1,000 days of life starting at conception. Vitamin E is one of the the most difficult vitamins to obtain from the diet alone. Very few people are able to consume the dietary recommendations for Vitamin E everyday. Many people think that Vitamin E deficiency does not happen because the recommended intake is only 15 mg a day. However, deficiency in Vitamin E is happening at an alarming rate. Some symptoms of Vitamin E deficiency are evident but, other symptoms like neurological complications, brain development, and resistance to infection are not seen until late stages of the deficiency.  Some of the best sources of Vitamin E are nuts, seeds, sunflower oil, and spinach. The average American diet does not include enough of these foods so 90 percent of men and 96 per...

     The Journal of the Academy of Nutrition and Dietetics reprint of the supplement “Management in the Dietetics Profession: Building a Framework for Success” had a great article titled “Moving into Management” that gives great practical advice for registered dietitians looking to advance their careers by going into management.      The first piece of advice is to know your personality. RDs in management should be flexible and able to go with the flow of the situations and environment. RDs in management should be action-oriented, negotiable, personable, and organized. A manager should be able to enjoy all types of individuals, have confidence and be able to think quickly on their feet by giving a decision at a moment’s notice. Even if an RD doesn’t think s/he is suited to a management position, there is the possibility to grow into the role.      A second piece of advice is to focus on your leadership skills. Manageme...

Becoming a Baby-Friendly Hospital In recent years, the benefits of breastfeeding a newborn baby have become a frequent topic of discussion.   Breastfed babies have lower rates of diabetes, childhood leukemia, sudden infant death syndrome and other illnesses.   They are also less likely to suffer from malnutrition.   In light of this information, many hospitals have implemented “baby-friendly” policies.   These policies provide all the resources a new mom who wants to breastfeed needs.   Hospital staff members are educated on the basics of lactation and how to assist the new mother.   These policies also state that the newborn baby should be breastfeeding within the first hour of birth, the baby is to remain in the mother’s room 24 hours a day, no formula is given to a baby unless medically necessary, no pacifiers are given to the baby, and there is a staff member always available to assist the new mom with an issues related to breastfeeding.   H...

                As we all may know, nutrition is a vital aspect of patient care in not only a clinical setting, but also in long term care. One of the biggest concerns is primarily preventing malnutrition in patients to ensure better health outcomes. According to the article, “Although malnutrition is a significant issue, there appears to be a lack of awareness of malnutrition among hospital staff and management, perhaps because of such issues as lack of knowledge and training regarding nutritional status and assessment, communication issues, and their inability to recognize food and nutrition as key part of care” (Walton, 2012). With the elderly population being at a higher risk of malnutrition, it is extremely important that this topic is made aware by all patient support staff.                 One specific topic that the article ...

Current Dietary Guidelines Could Increase Greenhouse Gas Emissions If Americans altered their current diet to be in line with the USDA guidelines the greenhouse gas emissions that are connected with the agriculture production could increase dramatically. The study looked at about one hundred foods, and looked at what would happen if people changed their diets to follow the USDA 2010 guidelines. The results were alarming. If every American followed the guidelines and kept their caloric intake the same the greenhouse gas emissions would increase by twelve percent. If Americans reduced their caloric intake to 2,000 calories a day this would only decrease the gas emissions by one percent. This goes to show that the current dietary guidelines are not aligned with environmental agendas. In the US in 2010, food production contributed about eight percent of the nation's greenhouse gas emissions. Cattle and dairy cows are the biggest contributor because cows do not use plant-based fe...

McDonagh, K.J., Bobrowski, P., Hoss, M.K., Paris, N., Schulte, M. (2014). The leadership gap: ensuring effective healthcare leadership requires inclusion of women at the top. Open Journal of Leadership, 3, 20-29. doi: 10.4236/ojl.2014.32003 This article points out some interesting points about women in leadership, and I thought it was relevant since our Internship program focuses on leadership, and the dietetics profession is primarily women.   The leadership focus as part of our Internship experience will help up in establishing informal leadership roles among our peers, which may lead to formal leadership roles in the organization.   Below is a brief abstract of the article.   Not too long ago, health care was associated with disease and sickness, recently there has been a change in the thinking and the focus is now on wellness, prevention, primary care, and increased patient decision making.   This shift will require a different leade...

As modern entry level dietitians begin their careers, many do not anticipate initially pursuing work in management positions. Despite these positions serving to offer rewards in both personal experience and generous salary, it may seem quite intimidating at first. The purpose of this article published by the Journal of The Academy of Nutrition and Dietetics is to encourage dietitians to be more receptive towards careers in management, as well as provide them with what to expect and how to prepare for one of these occupations. Though all dietitians are educated on management, the article suggests that there are personalities that are more fitting to the scope of responsibilities that encompass this career path. The individuals in management should be flexible and have a passion for improving processes and solving intricate problems. Those who enjoy routine and predictable outcomes may feel uncomfortable in these settings. Dietitians in operations or management should also have stro...

       In the August 2014 issue of Today’s Dietitian , the article “Building a Career Through Public Speaking,” highlighted the benefits and what it takes to be successful in public speaking.   Various health professionals were interviewed on the importance of social media and promoting yourself and your business through public speaking.   Whether you own your own business, or want to simply promote yourself as a healthcare professional, being a great public speaker can get you where you want to be!        It is important to first ask yourself, “What am I trying to accomplish?”   According to the CEO of the National Speakers Association Michelle May, it is important to ask the question, “Do you want more clients, diversify your revenue, or increase exposure?”   Start with why, and this will help you find your audience.   Next, discover what your passion is!   Whether you want to promot...

  Though parenteral nutrition (PN) administration can be effective in improving nutritional status and promoting positive outcomes in patients with severe malnutrition and for those undergoing intensive treatments, its use has been limited in its application to treat inborn errors of metabolism. The fundamental concerns of PN administration in cases involving inborn errors of metabolism are based on the notion that when complicated with other disorders PN formulas are not prepared to appropriately manage these metabolic conditions (Kaluzny et al., 2014). Poznan University of Medical Sciences researchers recently discussed the difficulty of treating metabolic diseases whereby PN is limited. These researchers have addressed four cases in which PN is found to be difficult to administer: Long-chain Hydroxyacyl-CoA Dehydrogenase (LCHAD) Deficiency Associated with Necrotizing Enterocolitis, Short-chain Dehydrogenase (SCAD) Deficiency associated with Congenital Heart Disease, Phenylk...