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Community

A group of people who are located in a particular space

Community Nutrition

A discipline that strives to prvent disease and to improve the health, nutrition, and well-being of individuals and glucose within communities

Policy

A course of action chosen by public authorities to address a given problem

Public Health

Focuses on protecting and promoting people's health through the actions of society

Bioterrism

The intentional release of disease-causing toxins, microorganisms, or other substances

Health

According to the World Health Organization, a state of complete physical, mental, and social well-being, not merely the absense of disease

Health Promotion

The process of enabling people to achieve their maximum potential for good health

Intervention

A health promotion activity aimed at changing the behavior of a target audience

Risk Factors

Factors associated with an increased probability of acquiring a disease

Surveillance

An approach to collecting data on a population's health and nutritional status in which data collection occurs regularly and repeatedly

Community dietitian/public health nutritionist

Nutrition professionals who plan and evaluate food and nutrition programs, devekop food and nutrition policies, plan, implement and evaluate health promotion and disease prevention programs

Licensure

Dietitians practitioners are licensed to ensure that only qualified, trained professionals provide nutrition services or advice to individuals requiring or seeking nutrition counseling or information

Certification

Limits the use of particular titles to persons meeting predetermined requirements, but persons not certified can still practice the occupation or profession

Entrepreneurship

Creating something of value through the creation of organization

Entrepreneur

One who undertakes the risk of a business or enterprise

Intrapreneur

A risk taker whose job is located within corporation, company, and other organization

Sustainability

The capacity of being maintained over the long term in order to meet the needs of the present without jeopardizing the ability of future generations to meet their needs

Sustainable Food Systems

Exists when production, processing, distribution, and consumptin are integrated and related practices that regenerate rather than degrate natural resources, are socially just and accessible, and support the development of local communities and economies

Grant

the act of providing a subsidy

Three major stages during grant development

1. Developing the Foundation, 2. Building the Grant Proposal, 3. Assembling the Final Product

Developing the foundation in a grant

Describing its goals, is it possible to achieve and in a timely manner, goals in line within 2020 goals, do they reflect the intended audience

Building the grant proposal

Components of the proposal- possible letter of intent, transmittal letter, abstract, grand narrative, goals and objective, methods, project design, human subject participation and, budget

Assembling the final product in a grant

Make sure there are no loose ends, follow instructions and directions

A mechanism to seek extramural funding

Grant

REP Grant

Request for proposal

RFA Grant

Request for approval

Letter if Intent (LOI)

One page concept of what you want to do before writing or completing the grant

What do you often use in a grant proposal as criteria?

Logic Model

What does a community nutritionist do?

Design policy, plan programs, coduct intervention, etc.

Community Assessment

Evaluating the community in terms of its health and nutritional status, its needs, resources, and the resources available to address those needs

Conducting a Community Nutritional Needs Assessment:

Define the nutritional problem, set the parameters of the assessment, collect data, analyze and interpret the data, share the findings of the assessment, set priorities, choose a plan of action

Dietary Assessment

Based on readings, identifying the types of dietary available- 24 hr recall, 3 day food record, food frequency questionairre

Best dietary assessment for people who have little knowledge of portion control

24 hour recall

Biochemical assessment

Measurement of biochemical functions (e.g. concentrations of nutrient by products or enzyme activities in the blood or urine) related to a nutrient's function (blood glucose for diabetes, cholesterol- HDL and LDL)

Anthropometry

measurement and study of the human body and its parts and capacities-- (height, weight, waist circumference, head circumference, skin folds, body mass index)

BMI

Weight in kilograms/2.2 divided by square of height in meters

Obesity

The presence of excess adipose (fatty) tissue in the body

Overweight

A milder form of obesity

Underweight BMI

<18.5

Normal BMI

18.5-24.9

Overweight BMI

25-29.9

Midpoint of overweight range

27.5

BMI for obesity class I

30-34.9

BMI for obesity class II

35-39.9

BMI for obesity class III

> or equal to 40

How many U.S. adults are obese?

1/3 (no state is below 20%)

Healthy People 2010 obesity goal

To lower obesity prevalence to 15%-- no state reached this goal

Nearly ____ of the states in our country have obesity rates of ____% or more

1/4 and 30

Obesity related conditions

Heart disease, stroke, type 2 diabetes and certain types of cancer

Medical costs associated with obesity in 2008 were...

$147 billion

Reasons for rising obesity?

Screen time, exercise, food procution system, increase in portion sizes

% weigh change=

(usual body weight - current body weight) / (usual weight) x 100 =

% usual weight=

(current weight/usual weight) x 100

Clinical Assessment

Evaluation for evidence of malnutrition consists of a medical history and a nutriton focused physical examination

Signs and symptoms of deficiency or excess

Hair, face and sensory organs, skin, nails, muscles, bones, teeth

Seeing brittle nails on fingers but not toes

Is environmental --- if nutritional you should see it on both

B12 can affect

Mental status

What goes down in the elderly?

B12 absorption-- the stomach acid and intrinsic factor go down so they cannot absorb it as well (some take a supplement after age 50)

Some B vitamins can affect...

Gaits

Sensitivity

The proportion of subjects with the disease or condition who have a positive test for the disease or condition

Specificity

The proportions of subjects in the sample without the disease who test negative for disease or condition

example of a highly specific test

Oral glucose tolerance test for diagnosing diabetes status--rules it out or assures you you have it

Validity

The accuracy of the assessment, instrument or measure (weights/scales are examples)

Reliability

Ability to produce the same estime of dietary intake on two seperate occasions assuming diet did not change

YAHRSI

Young Adult Health Risk Screening Initiative done at UNH in the NUTR 400 class

Food Choices can be impacted by...

Food supply, season, food costs, household income, transportation, socioeconomic factors, food preferences, health beliefs, living conditions, attitudes, religious practices

When program planning or applying for a grant you need to consider both...

The mission of the organization offering the grand and your own organizations mission

Steps in program planning

1. Review results of needs assessment 2. define program goals and objectives, 3. develop the program, 4. define the management systems, 5. identify funding sources, 6. implement the program, 7. evaluate program elements and effectiveness

Three steps in developing the program

Design the intervention, design nutrition education, develop the marketing plan

Three types of objectives

Outcome objectives, process objectives, and sturcture objectives

Parts of the program to design & develop

Design the intervention, design the nutrition education, develop the marketing plan

Epidemiology

The study of the distribution and determinants of health-related states and events in specified populations and the application of this study to the control of health problems

Determinants of Disease

Age, sex, race, genetic makeup, nutrition status, physiological status

Environmental Factors

Living conditions, occupation, geographical location, lifestyle

Why do we do nurtitional epidemiology?

To understand disease causes, morbidity/mortatlity, prevalence & progression as well as discernment of diet, health, disease and relationship

1854 Cholera Epidemic

Severe and widespread cholera in London

Dr. John Snow's hypothesis

People were getting cholera through contaminated drinking water; an infectious agent-- he removed the water pump handle on Broad Street which slowly stopped the epidemic

Crude Birth Rate

Equal to the number of live births in a year divided by the total midyear population (then usually multiplied by 1,000)

Features of someone with FAS

flat midface, short nose, thin upper lip, mino ear abnormalities, etc.

BRFSS

A monthly, state-based, random-digit-dialed telephone survery of the U.S. civilian, non-institutionalizsed population aged 18 and up

African American woman are _____ more likely to die of pregnancy-related complications than white women

4X

Women in the USA have a _____ risk of dying of pregnancy-related complications than those in ____ other countries

higher- 40

Risk

The probability or likelihood of an event occuring-in this case, the probability that people will acquire a disease

Prevalence

The number of existing causes of a disease or other condition in a given population

Saturated Fat

Solid at room temperature- most commonly found in meat and dairy products- known to lead to heart disease

Unsaturated Fat

Liquid at room temperature- known as good fat (two types- monounsaturated and polyunsaturated)- known to lower bad cholesterol without lowering good cholesterol

Monounsaturated Fats

Can help lower bad cholesterol (LDL) -extra virgin olive oils is an example- found in olive oil, sunflower oil, avocados, nuts, peanut butter

Transfat

an unsaturated fatty acid produced during the process of hydrogenation

Polyunsaturated Fats

Contain omega-3 fatty acids found in fish (tuna, salmon, halibut), as well as in corn, soybeans, walnuts and canola oil

Primary Prevention

Precent or correct risk factors (no disease)

Secondary prevention/intervention

Early detection referral and treatment (asymptomatic disease)

Tertiary intervention

Reduce complications (chronic disease)

Bulk of health is spnd on the ______ level

Tertiary intervention

Public Health

An organized effort to shape the environment to promote and protect the health of all people in the community

Great health achievements from 2001-2010

Vaccination, motor vehicle safety, safer work places, decline in deaths from heart disease and stroke, cancer prevention, etc.

Health

A state of complete physical, mental, and social well-being, not the mere absence of disease or infirmity

Key components of Community Nutrition

People- individuals served or targeted, Policy- course of action by public authorities to address a given problem or trend, Programs- Instruments used by nutritionists to improve status and health

Community Needs Assessment

An evaluation of the community in terms of its health and nutritional status, its needs, and the resources available to address those needs

Health Status

The condition of a populatio's or individual's health, including estimates of quality of life and physical and psychosocial functioning

Target Population

The population that is the focus of an assessment, study, ot intervention

Goals

Broad statements of what the activity or program is expected to acomplish

Objectives

Statements of outcomes and activities needed to reach a goal

Qualitative data

Data (such as opinions) that describe or explain, are considered subjective, and can be categorized or ranked but not quantified

Key informants

People who are "in the know" about the communtiy and whose opinions and insights can help direct the needs assessment

Stateholders

People who have a vested interest in identifying an addressing the nutritional problem

Quantitative Data

Numerical data (such as serum ferritin concentation, birth rate, and income) that can be measured and are considered objective

Vital statistics

Figures pertaining to life events, such as births, deaths, and marriages

Culture

The knowledge, beliefs, customs, laws, morals, art, and any other habits and skills acquired by humans as members of a society

Health Outcome

The effect of an intervention on the health and well-being of an individual or population

Social Group

A group of people who are interdependent and share a set of norms, beliefs, values or behaviors

Sample

A group of individuals whose beliefs, biological characteristics, or other features represent those of a larger population

Survey

A systematic study of a cross section of individuals who represent the target population

Nutrition Survey

An instrument designed to collect data on the nutritional status and dietary intake of a population group

Focus Group

An informal group of about 5 to 12 people who are asked to share their concerns, experiences, beliefs, opinions, or problems

Validity

The accuracy of the diet assessment instrument

Sensitivity

The proportion of individuals in the sample with the disease or condition who have a positive test for it

Specificity

The proportion of the individuals in the sample witout the disease or condition who have a negative test for it

Reliability

The repeatability or precision of an assessment instrument

Nutritional status indicator

A quantitative measure used as a guide to screen, diagnose, and evaluate interventions in individuals

Mission statement

A broad statement or declaration of an organization's purpose or reason for being

Intervention strategy

An appraoch for achieving a program's goals and objectives

Implementation

The set of activities directed toward putting a program into effect

Participation

The number of people who take part in a health promotion activity

Impact evaluation

The process of determining whether the program's methods and activities resulted in the desired immediate changes in the client

Formative evaluations

The process of testing and assessing certain elements of a program before it is implemented fully

Process evaluation

A measure of program activities or efforts that is, of how a program is implemented

Outcome evaluation

The process of measuring a program's effectiveness in changing one or more aspects of nutritional or health status

Structure evaluation

The process of determining adequacy of the internal processes and resources needed to deliver a program, including staff training, etc.

Fiscal or efficiency evaluation

The process of determining a programs benefits relative to its cost

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