A qualitative exploration of barriers, facilitators and best practices for implementing environmental sustainability standards and reducing food waste in veterans affairs hospitals.

Background: To improve the healthfulness of foods offered while accelerating the use of environmental sustainability practices, it is important to engage hospital food service operators in the adoption of such practices. The purpose of this study was to explore barriers, facilitators and best practices for implementing environmental sustainability standards in food service among veterans affairs (VA) hospitals in the United States.

Methods: We conducted an online survey with 14 VA hospital food service directors and then 11 qualitative interviews.

Characteristics Associated with Persistent Versus Transient Food Insecurity Among US Veterans Screened in the Veterans Health Administration.

Background: Awareness of negative health impacts associated with food insecurity among US veterans is growing. Yet, little research has examined characteristics associated with persistent vs transient food insecurity.

Objective: Our aim was to investigate characteristics associated with persistent vs transient food insecurity among US veterans.

Effectiveness of a ketogenic diet and virtual coaching intervention for patients with diabetes: A difference-in-differences analysis.

Aim: To test the effectiveness of a ketogenic diet and virtual coaching intervention in controlling markers of diabetes care and healthcare utilization.

Materials And Methods: Using a difference-in-differences analysis with a waiting list control group-a quasi-experimental methodology-we estimated the 5-month change in HbA1c, body mass index, blood pressure, prescription medication use and costs, as well as healthcare utilization. The analysis included 590 patients with diabetes who were also overweight or obese, and who regularly utilize the Veterans Health Administration (VA) for healthcare.

Diabetes Self-Management Education Support Healthy Teaching Kitchen Cooking Classes Delivered Using a Telehealth Technology.

Purpose: The purpose of the study was to evaluate the effectiveness of diabetes self-management education and support (DSMES) among veterans with diabetes using the Healthy Teaching Kitchen (HTK) by means of telehealth communication.

Methods: A retrospective chart review collected data from veterans with type 2 diabetes (T2DM) that participated in the DSMES-HTK program at 2 Veterans Affairs Northeast Ohio Healthcare System facilities between February 2013 and December 2018. A factorial design was used to compare A1C data and use of clinical video telehealth from main hub to satellite site.

Food insecurity: Comparing odds between working-age veterans and nonveterans with children.

Background: Low-income, working-age Veterans with children have risk for food insecurity. Less known is extent to which their risk compares to nonveterans.

Purpose: To evaluate odds of food insecurity for working-age Veterans with children compared to socioeconomically-matched nonveterans with children.

Healthy Teaching Kitchen Programs: Experiential Nutrition Education Across Veterans Health Administration, 2018.

Traditional clinical interventions yield few positive effects on diet. The Healthy Teaching Kitchen (HTK) program implemented by the Veterans Health Administration at sites across the United States delivers interactive nutrition and culinary education, guided instruction, and social opportunities for patients and caregivers. We report HTK outcomes of veterans' self-reported acceptability, self-efficacy for dietary change, and dietary and cooking habits.

Accuracy of Water Delivery in Enteral Nutrition Pumps.

Background: Adequate delivery of both enteral formula and water in patients receiving enteral nutrition (EN) is critical. Pump accuracy has been identified as a factor impeding enteral formula delivery; however, rarely is enteral water delivery investigated. The purpose of this study was to explore accuracy of delivering 1 L of water by EN pumps using different flush volumes and hang heights.

Capturing the Use of Dietary Supplements in Electronic Medical Records: Room for Improvement.

Of importance to federal agencies that administer health care facilities is capturing patient use of dietary supplements (DS) to avoid potential drug - supplement interactions. Digital technologies, such as use of the electronic medical record and the electronic health record (EHR) are key to monitoring health care. The particular electronic software package and the health care professional using this software influences how this documentation is recorded.

Parenteral Nutrition Electrolyte Abnormalities and Associated Factors Before and After Nutrition Support Team Initiation.

Background: Studied since the 1940s, refeeding syndrome still has no universal definition, thus making comparison of studies difficult. Negative outcomes (eg, metabolic abnormalities) may occur with the use of specialized nutrition, such as parenteral nutrition (PN). Less than half of medical institutions have a nutrition support team (NST) managing PN.

Cooking Classes: A Diabetes Self-Management Support Intervention Enhancing Clinical Values.

Purpose The purpose of this study is to examine the relationship between Healthy Teaching Kitchen (HTK) attendance among veterans who are diagnosed with type 2 diabetes mellitus (T2DM) and clinical outcomes as measured by A1C and blood pressure. Methods This retrospective chart review collected data from veterans with T2DM who participated in the Diabetes Self-Management Support (DSMS) HTK program at the Louis Stokes Cleveland VA Medical Center (LSCVAMC) between February 2013 and May 2016. Data collected included demographic information, frequency of DSMS HTK attendance, 3 A1C values, and 3 blood pressure values.

Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

Objective: Evaluate the effectiveness of nutrition education interventions for diabetes prevention.

Design: Retrospective cohort design.

Setting: Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database.

Evaluation of Veterans MOVE! Program for Weight Loss.

Objective: To evaluate the degree of weight loss in subjects enrolled in the Veterans Affairs weight management program (MOVE!).

Design: Retrospective cohort design.

Setting: Tertiary care US veterans hospital, July, 2007 to September, 2008, using a retrospective database.

Delivered volumes of enteral nutrition exceed prescribed volumes.

Background: Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment.

Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression.

Introduction: Evidence-based interventions are often poorly translated into primary care settings due to inadequate integration into organizational cultures and clinical workflows. Study designs that blend evaluation of effectiveness and implementation may enhance uptake of interventions into primary care settings. Community-Based Participatory Research (CBPR) models are useful for developing partnerships between research teams and primary care clinical partners to test blended study designs.

Behavioral health coaching for rural veterans with diabetes and depression: a patient randomized effectiveness implementation trial.

Background: Depression and diabetes cause significant burden for patients and the healthcare system and, when co-occurring, result in poorer self-care behaviors and worse glycemic control than for either condition alone. However, the clinical management of these comorbid conditions is complicated by a host of patient, provider, and system-level barriers that are especially problematic for patients in rural locations. Patient-centered medical homes provide an opportunity to integrate mental and physical health care to address the multifaceted needs of complex comorbid conditions.

Predicting survival in cancer patients: the role of cachexia and hormonal, nutritional and inflammatory markers.

Background: Cancer can lead to weight loss, anorexia, and poor nutritional status, which are associated with decreased survival in cancer patients.

Methods: Male cancer patients (n = 136) were followed for a mean time of 4.5 years.

Adipokines in patients with cancer anorexia and cachexia.

Background: Anorexia, cachexia, and insulin resistance are commonly seen in patients with cancer. Adipocyte-derived hormones or adipokines play a role in the regulation of appetite, body weight, and insulin sensitivity. However, their role in cancer-induced cachexia has not been well-established.

Child control of food choices in Head Start families.

Objective: To describe parents' perceived feeding practices of their Head Start children as related to 6 feeding constructs based on the literature about the division of mealtime responsibilities.

Design: A qualitative study involving 45-minute audiotaped and transcribed discussion groups with items that probed constructs of interest.

Setting: Five discussion groups were conducted in local, urban Head Start sites in a north central state.