A new telestroke network system in northern area of Okayama prefecture

Background Telestroke network can provide rapid access to specialized treatment and improves on‐site management of acute stroke patients through the “hub‐and‐spoke” model. In the northern part of Okayama Prefecture, there has been a regional gap of stroke care due to the shortage of stroke specialists and facilities. In addition, due to the novel coronavirus disease 2019 (COVID‐19), it is required to reduce the unnecessary contact with stroke patients from other hospitals. Aim We organized a novel cost‐free telestroke network with an image and video sharing for neurological diseases in the northern part of Okayama Prefecture to improve the stroke management in the area. Method We prepared the tablet device on which Skype® application was installed for each hospital and recruited the patients who visited or hospitalized in the spoke hospitals and were suspected to have some neurological diseases from April 2019 to May 2020. The patient's clinical data were recorded and analyzed. Results During the study period, 5 patients were recruited including the cases with the initial diagnosis of stroke or brain tumor. Among them, 2 cases were transferred to the hub hospital, 2 cases were transferred to other hospitals, and 1 case was treated on site under specialist's advice. Conclusion The new telestroke network system may be beneficial for acute stroke management and reducing the unnecessary patient's transfer in the rural area, especially under coexistence with COVID‐19

事例からみる嚥下調整食提供における管理栄養士および調理従事者の役割

【要旨】嚥下調整食を導入した給食施設の事例から取り組みを整理し，管理栄養士および調理従事者の役 割について考察した。嚥下調整食の実施では，喫食者に適した食形態の設定や多職種による喫食状況の把 握，物性の安定と調理負担の調整が行われていた。特に，調理従事者の業務内容が従来の調理中心の業務 から拡大傾向にあり，施設職員，委託給食会社職員ともに嚥下調整食の調理方法・技術に関する研修のほ か，嚥下に関する知識研修や病棟訪問等に参加していた。今後，管理栄養士には，喫食者の栄養状態，摂 食・嚥下機能の維持・向上を目指した嚥下調整食の開発および質の向上に加えて，調理従事者の職務設計， 人材育成に関する職務遂行，委託給食会社との協力関係構築などの能力が求められると考える。 Abstract: This study summarized the initiatives of a meal-catering facility that had introduced a dysphagia diet and considered the roles of registered dietitians and cooks. Implementing a dysphagia diet involves identifying the forms of food suitable for the patient and appointing a multi-disciplinary team for understanding their eating condition, stabilizing the physical properties of food, and adjusting the burden of cooking. Notably, the work done by cooking staff in the mealcatering facility tended to expand beyond conventional cooking-centered duties; together with the facility staff and subcontracted meal-catering staff, the cooking staff undertook training on cooking methods and techniques for dysphagia diet, and training to increase their knowledge about swallowing, as well as visits to wards. In the future, registered dietitians would be required to acquire skills involving designing the duty of cooking staff, executing the duties related to human resource development, and establishing cooperative relations with sub-contracted meal-catering companies. They would also need to develop and improve the quality of dysphagia diet aimed at maintaining and improving the nutritional status, feeding, and swallowing function of the patient

Cooking characteristics of volume cooking and weight post-cooking according to the Standard Tables of Food Composition in Japan for nutritional management

給食施設では、利用者の適正な栄養管理を行うために提供する食事の栄養量が計算されるが、実際の摂取栄養量に近づけるために調理後の成分変化を考慮した栄養価計算が求められている。本研究は食品成分表の加熱調理後の重量変化率と加熱調理食品に着目し、大量調理における調理特性を分析した。2022 年10-12 月に実施した本学の給食経営管理論実習の予定献立を対象に、食品ごとの加熱調理法をゆで、蒸し、焼き、炒め、ホイル焼きに分類し、加熱調理後の成分値収載の有無を区分した。結果は、加熱調理食品数の累計167 回、食品成分表に加熱調理後の成分値の収載がないものは約４割と高かった。食品成分表の調理法は「ゆで」が多く、大量調理に対応する調理法の種類が少ない。さらに、大量調理は食材使用量が多く調理工程が長い特徴があるため、その仕上がり重量が少量調理と異なる。調理後の栄養成分値を算出する際には、食品成分表の食品の読み替えや、重量変化率の利用を慎重に行う必要がある。In food service facilities, nutritional values of the meals are calculated to ensure proper　nutritional management of consumers. Furthermore, it is recommended that nutrient values after cooking should be considered to calculate values closer to actual nutrient intake. The purpose of this study was to examine the rate of change in weight post-cooking and characteristics of volume cooking according to the Standard Tables of Food Composition in Japan 2020. We examined meals cooked by students in two classes. The study period was from October to December 2022. We classified each food into five cooking methods, viz., boiled, steamed, baked, stir-fried, and foil-baked, and determined whether the ingredient value was listed after cooking. The results showed that the total number of cooked foods was 167, and ingredients of approximately 40% of the foods were not listed after cooking. The most used cooking method according to the Standard Tables of Food Composition is “boiled”, and few other cooking methods are mentioned for volume cooking. Furthermore, volume cooking, which uses more ingredients and is a time-consuming process, yields finished weight that differs from that of low-volume cooking. To calculate nutrient values after cooking, several factors must be considered, such as whether another similar food can be substituted if that food is not on the ingredient list and whether the percentage change in weight should be considered.departmental bulletin pape

管理栄養士養成課程学生の切砕技術と意識 : 技術向上に及ぼす要因の検討

管理栄養士養成施設であるA大学2年生を対象として調理技能調査および質問紙調査を行い,切砕技術に及ぼす要因を検討した。調理技能調査は,きゅうりの輸切り,だいこんのせん切りおよびキャベツのせん切りを課題とし,所要時間の計測と切断物の評価(調査者評価および自己評価)を行った。切断物の調査者評価はいずれも約9割の学生が「やや不揃い」「不揃い」であった。一方,自己評価は調査者評価より高い傾向にあり,学生と調査者が考える技術レベルに違いがあることが推察された。切砕操作における意識は,調査時では「揃えて切ること」,日常生活では「特に意識していない」「速く切ること」「速く揃えて切ること」を回答した学生が多かった。今後は食事提供に携わる職を目指す学生に求められる技術レベルを理解させ,日常生活の切砕操作においても均一さを意識するよう促す指導が必要である。To investigate influential factors, a knife skills survey and questionnaire were conducted among second‐year students at a university running a registered dietitian training course. The skills for slicing cucumber, Japanese radish, and cabbage were examined by both investigators and students assessing the time taken and the slices produced. For all three items, about 90% of the investigators\u27 evaluations recorded "unevenness" or “a little unevenness. "On the other hand, the self-evaluations tended to be more positive, suggesting a difference between the perceptions of students and investigators. Many students reported that they remained conscious during the survey “ to cut same-sized slices. "In response to the questionnaire item about cutting same‐sized slices on an everyday basis, many students reported that they: "were not particularly conscious," "cut quickiy," or "cut same-sized slices quickly.“ In future, therefore, lt is essential to educate students about the level of knife skills required of those wishing to work in catering and encourage an awareness of cutting food evenly in everyday life

一人暮らしの管理栄養士養成課程学生における 食事作り意識・実践の変化と課題の検討

【要旨】A 大学栄養学科 2016 年度入学生を対象に記名自記式質問紙調査を実施し，一人暮らしの者 20 名（女性 17 名，男性 3 名）の回答より 1～2 年次から 4 年次までの食事作りへの意識・実践の変化を分析した。食事作り意識の変化として，何も見ずに作ることができると考える料理が 35 項目中 5 項目有意に増加し（p＜0.05），食事の「栄養バランス」「料理・味付けの組み合わせ」等に気を付けている者が増加した。また各年次で共通して，食品選択で重視していることに「価格」，食事作りで気を付けていることに「作り方が簡単」「短時間で 食事を準備」，料理の参考に「インターネット」「高校までの家庭料理」と回答する者が多く，大学での習得知 識や教科書等を参考とする者は少なかった。食事作り実践の変化として，泡立て器，スケール，おろし器，ゴムベラの調理器具所有者は有意に増加した（p＜0.05）一方，月 1 回以上作る料理の種類は減少が見られた。食事作りを「ほぼ毎日」する者は 5 割，主食・主菜・副菜の揃った食事を「毎食食べる」者は 3 食いずれも 15% 以下と年次による大きな変動はなかった。4 年次までに料理のレパートリーの広がりや食事バランスへの意識 向上が見られた反面，実際の食事作り実践や食事内容へ反映する者は少ないことが課題として示されたことから，学生の生活状況等を考慮し，日常において継続的な食事作りと食事内容の充実に繋がる教育上の工夫が必要と考えられる。Abstract: A self-administered questionnaire survey was conducted on students enrolled in the Department of Nutrition at University A in 2016. On the basis of the answers provided by 20 students living alone (17 women, 3 men), in first and second year and then to the fourth year, we analyzed changes in awareness of and practice around meal preparation. As a change in awareness of meal preparation, the number of students who believe they can cook meals without using a recipe increased significantly for 5 out of 35 dishes (p<0.05), and the number of students paying attention to the "nutrition balance" and "combination of dishes and seasoning" of meals increased. Furthermore, regardless of academic year, many students answered that "price" is important in food selection and mentioned the phrases "easy to make" and "prepare meals in a short time" as considerations when cooking meals, and used the "Internet" and "home cooking up to high school" for reference, while few referred to the knowledge acquired at university and from textbooks. As a change in the practice of meal preparation, the number of those owning whisks, scales, graters, and rubber spatula cookware increased significantly (p <0.05), while the variety of dishes cooked at least once a month decreased. Fifty percent of the students made meals "almost every day," and fewer than 15% of the students "eat every meal" with a staple food, main dish, and side dish in regular meals three times a day, and there was no significant change from year to year. By the fourth year, students’ cooking repertoire had expanded, and awareness of the dietary balance had increased, but this was rarely reflected in students’ actual dietary preparation practice and dietary content. Considering students’ living conditions, educational measures need to be devised that lead to continuous meal preparation and enrichment of meal content in daily life

管理栄養士養成課程学生における切砕技術の変容と課題

【要旨】管理栄養士養成課程学生を対象として調理技能調査および質問紙調査を実施し，4年間の切砕技術の変容を調査した。調理技能調査の結果，1，2 年次には制限時間内に切り終わらない学生もいたが，4年次では全員が制限時間内に切り終えていた。切断物の評価は，どの年次でも「やや不揃い」，「不揃い」の学生が多かった。4 年間通して一人暮らしであった学生のうち半数以上が週 3～4 回以上食事作りをしていた。自炊を始めたことにより自身の切砕技術が向上したと考えている学生が多かった。日常の食事で「野菜そのものを買う」学生が多く，野菜を切るときに速さや均一さを「意識していない」学生が多かった。キャベツのせん切りをするときの包丁の持ち方は，全握式を選択した学生が多かった。均一さを備えた技術の習得には，切り方に応じた包丁の持ち方の指導，日常の食事作りにおいても速さや均一さの意識を持たせること，家庭で繰り返し練習させる課題の工夫が必要と考える。Abstract: Students from a registered dietitian training program were administered questionnaires and cooking skills examinations to determine changes in their knife skills over the course of their four-year program. Examination of cooking skills revealed that, while all fourth-year students were able to complete a chopping task within the designated time limit, some first and second-year students were unable to do so. Evaluations of the chopped items found many students’ work to be “unevenness” or “a little unevenness,” regardless of year group. Of those students who lived alone during the four-year program, more than half cooked meals at least three or four times a week. Many students believed that their knife skills had improved as a result of them starting to cook for themselves. Many reported buying unprocessed vegetables for everyday meals, while a high number stated that they did not pay attention to speed or evenness when chopping vegetables. When choosing a knife grip for julienning cabbage, many students selected whole grip style. To allow students to master the skills needed to chop evenly, we must provide guidance on the knife grips appropriate to each cutting technique; encourage their awareness of the speed and evenness of their chopping, even in the preparation of their own daily meals; and devise tasks that will allow them to practice through repetition at home

Agricultural High School Students' Acquisition of Knowledge and Skills regarding a Nutritionally Balanced Diet through Assisting in a School Lunch Program for Elementary and Middle School Pupils

The purpose of this research was to study whether agricultural high school students' attitudes towards social support for consumers would improve with their involvement in a school lunch program for elementary and middle school pupils. A comparison of the pre- and post-intervention data revealed the food knowledge, production skills, and attitudes towards food production for children among students at the experimental and control schools. A pilot trial study was conducted that involved growing tomatoes and distributing a newsletter on school lunches to primary and middle school children. The study was implemented from April to October every year from 2006 to 2009. A total of 92 agricultural high school students and 20 controlled agricultural students participated during these four years. The evaluation survey comprised questions about food nutrition, food production, and access to health and nutritional support services. The students who worked in assisting the school lunch program exhibited increased knowledge and skills related to producing a newsletter on produce for consumers as compared to the control student group. The students' food knowledge and production skills showed a significant positive correlation with their attitudes towards assisting in the school lunch program. Therefore, the acquisition of knowledge and skills regarding the preparation of a newsletter on produce by agricultural high school students increased significantly through the experience of supporting a school lunch program