Hospital Food Research Articles

UV-curable enzymatic antibacterial waterborne polyurethane coating

Novel ultraviolet (UV)-curable enzymatic antibacterial coatings were designed and fabricated. The coatings were prepared by simply mixture of castor oil-based cationic waterborne polyurethane-acrylate dispersion (WPUA) and acryloyl chloride modified lysozyme followed by UV curing. The covalent incorporation of lysozyme into the coatings was proved by enzyme leakage and IR analysis of the coatings. As the lysozyme content increased from 0 to 2.5% (w/w), the tensile strength of the coating enhanced by 37% (1.1MPa vs 0.8MPa), and the contact angle increased by 10% (73.1° vs 80.6°). Those changes are possibly due to enhancement of crosslinking degree and hydrogen bonding induced by modified lysozyme. Based on live/dead staining and colonies number assay, the coatings containing lysozyme (2.5%, w/w) were highly efficient in killing Staphylococcus aureus (91.3%) and Escherichia coil (62.9%) via degradation of cell wall within 2h, and the colonies number for both strains was significantly decreased to less than 1% after incubation for 24h. In addition, the killing efficiency of the coatings remained 68.3% after six continuous uses. Such UV-curable waterborne polyurethane coatings containing lysozyme (UWPU-L) may be useful in anti-bacterial stains on various common surfaces in hospital settings and food packaging.

Use of a catering staff development program to fight in-Hospital malnutrition by improving hospital food quality

Use of a catering staff development program to fight in-Hospital malnutrition by improving hospital food quality

Hospitality within hospital meals—Socio-material assemblages

ABSTRACTHospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host–guest interactions and creating temporary meal communities. However, asymmetrical host–guest relations bound to health and efficiency rationales typical for public meal production-systems contested the hospitality space. Findings indicate that hospitality thinking can be a valuable guiding principle to enable staff and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future.

Causes of inadequate intake of nutrients during the treatment of children with chemotherapy.

The purpose of the research was to explore nurses' perceptions of different causes of inadequate food intake in children treated with chemotherapy and to determine how often nurses identify these causes. Qualitative and quantitative approaches were used. Qualitative data were first gathered using semistructured interviews in a sample of six nurses and analysed by conventional content analysis. Based on the results of qualitative data and literature analysis, a 28-item questionnaire was developed and evaluated for its face validity in a sample of fifteen nurses. Questionnaires were then administered to twenty-seven nurses working at one pediatric oncology ward. Quantitative data were analysed using descriptive statistic. The major themes that emerge from the content analysis, describing nurses' perceptions of causes of inadequate food intake in children undergoing chemotherapy, were as follows: physiological causes of eating problems, psychological causes of eating problems, change in food selection, hospital food and individual counselling. 13 causes of inadequate food intake were identified from the questionnaire data. Pain due to mucositis was the most commonly identified cause of inadequate food intake in children, followed by nausea and vomiting, altered taste, loss of appetite and an altered smell. Psychological causes of eating problems are rarely identified. Nurses identify most of the physiological and psychological causes of inadequate food intake in children treated with chemotherapy. The early identification and management by nurses of inadequate food intakes should be part of the curriculum for nurse education as well as part of treatment planning in clinical environment.

Hospital nurses survive on diet of fast food

Poor quality hospital food risks the health of NHS workers, a survey from Unison and the Campaign for Better Hospital Food warns.

Patient perceptions on hospital food service at Teaching Hospital, Karapitiya

Background: Hospital diet is an integral part of the management of in-ward patients. The quality of hospital food plays a major role in determining the overall satisfaction of patients with regards to their hospital stay. Objective: To investigate the level of patient satisfaction with regards to the diet supplied at Teaching Hospital (TH), Karapitiya. Methods: A descriptive, cross sectional study was conducted among 316 patients who received inward treatment at TH Karapitiya and consumed hospital diet. Data were collected using an interview-administered questionnaire and analyzed using SPSS statistical software. Results : During the study period, only 27% of the in-ward patients consumed hospital diet. Of 316 included in the analysis, 13.6% rated hospital diet “good”, 59.7% “fair”, and 26.6% “unsatisfactory”. Patients were satisfied with the quantity of all types of food provided (above 85%), time of food distribution (90%), temperature of food (85%) and texture (86%). However, 31% of patients were unsatisfied with taste, 40% were unsatisfied with the smell of food and 29% were unsatisfied with the diversity of food provided. No significant association was found between overall satisfaction regarding food service and the patients' age, gender, ethnicity, educational level or length of hospital stay. Conclusions: Patient perception on hospital food service at TH, Karapitiya was mostly favourable although patients were less satisfied about the quality of food. The proportion who consumed hospital food was low. Attempts must be taken to enhance the taste, smell and the diversity of food provided.

Children, medical diets and hospital food services: Managing strict diets and patient safety in a process driven environment

Children, medical diets and hospital food services: Managing strict diets and patient safety in a process driven environment

The Medical Anthropologist as the Patient: Developing Research Questions on Hospital Food in Japan through Auto-Ethnography

I was an inpatient at a small maternity clinic in Japan in 2012–13 and found it impossible to separate the way I experienced medical care and my training as a medical anthropologist. As I was encouraged to eat and monitor my weight so that I would “grow” a healthy baby, I recalled how interviewees from my HIV/AIDS project described nourishing their bodies so they could fight disease. Because of my experience in the healthcare system in Japan, I ended up reframing my data to add questions about the role of hospital food in patient care. Meanwhile, I developed the social networks necessary to execute a new project, which I would later undertake. In this essay I argue that medical anthropologists working from a phenomenological perspective may regard their own bodies as assets rather than hindrances in research, and that because bodies are gendered, focusing on this facet of habitus can be particularly informative. I also illustrate how systematic reflection on personal experience in the field (autoethnography) aids in the development of research questions and reframing data. Finally, I discuss how highlighting these steps in research methods courses can demystify the research process for students.

Epidemiology of Clinical Oral Food Challenges (OFC) at Baylor College of Medicine/Texas Children's Hospital (TCH) Food Allergy Program: A Retrospective Chart Review

Epidemiology of Clinical Oral Food Challenges (OFC) at Baylor College of Medicine/Texas Children's Hospital (TCH) Food Allergy Program: A Retrospective Chart Review

“Man does not live by bread alone” : Feeding Confraternity in Early Modern Nuremberg Leprosaria

Looking beyond the history of food, feeding and nutrition, this article aims to capture the cultural history of food and feeding in Renaissance leper hospitals in Nuremberg. When attempting to understand the early modern hospital community and determining how hospital patients actually spent their time, one rapidly recognizes that such groups of patients spent most of their time praying and eating collectively. The article, therefore, focuses on the function of meals inside late medieval and early modern hospitals in generating a sense of community. The example of the Nuremberg hospitals, especially the four leprosaria around the imperial city, clearly indicates the way in which daily routine was structured by meals and prayers. Furthermore, the function of feeding within almsgiving is discussed using the example of a Nuremberg charity specifically for foreign lepers, which in the fifteenth and sixteenth centuries, fed hundreds and thousands of non-native lepers in the very centre of the imperial city dur...

Study of the effect of the new cooking system introduced to hospital diet and food service management

Study of the effect of the new cooking system introduced to hospital diet and food service management

Biofilm formation in <em>Hafnia alvei</em> HUMV-5920, a human isolate

Hafnia alvei is a Gram-negative, rodshaped, facultative anaerobic bacterium of the family Enterobacteriaceae that has been isolated from various mammals, fish, insects and birds. In humans, case reports of Hafnia-associated enteric infections have been chiefly reported in Spain. Although H. alvei shares some virulence mechanisms with other Gram-negative enteropathogens little is known about the factors that contribute to its pathogenesis or virulence factors and regulatory circuits that may enhance the establishment and survival of H. alvei in the environment. The goal of the present study was to analyze the capacity of a H. alvei clinical isolate (strain HUMV-5920) to form biofilms. Biofilm formation by this strain increases during growth at 28 °C compared to 37 °C. Investigation of multicellular behavior by confocal microscopy, crystal violet and calcofluor staining in this strain showed biofilm formation associated with the production of cellulose. Importantly, several genes related to cellulose production including bcsABZC and yhjQ are present in the H. alvei HUMV-5920 chromosome. The ability of H. alvei to adhere to abiotic surfaces and to form biofilms likely contributes to its persistence in the hospital environment or food processing environments, increasing the probability of causing infections. Therefore, a better understanding of the adherence properties of this species will provide greater insights into the diseases it causes.

Towards a History of Hospital Food

Towards a History of Hospital Food

The Role of Cooking for Hospital Food Service in Cancer Care-Units: Nutrition Is a Supportive Care While Cooking Appears to Be a Prescription

Cancer cachexia and treatment-induced side effects can contribute to deterioration in nutritional status in patients declining the quality of life and survival rates. Culinary practices may provide new strategies to minimize the symptoms. NEODIA (learning to live with a cancer on a day-to-day basis) is an observational program whose objective is to better understand the occurrence of treatment-related side effects as well as culinary and dietary habits in cancer patients followed in the Cancer Unit of the Beauvais City Hospital, France. First study step in 2010 has investigated culinary solutions to improve the quality of life of the patient at home. The present part tries in particular to answer the question if the culinary advising is transposable to the offer of restoration proposed by institutions of care in oncology. We first conducted an investigation on the determinants of quality of life in patients currently treated in a hospital service involving 41 people. In a second step, we are collecting information on the food supply itself, using advising of some patient’s specially prepared to test meals as a translational research expertise. The results of our survey show that patient’s remarks constitute real guidelines to adapt the practices in culinary production and healthy catering management. Based on these results, the consistency of frozen prepared meals has been analyzed regarding their potential to regulate the under nutrition-inducing treatment-related side effects. Conducted by the patient’s panel of the translational research group the study highlights the benefits of agro-food products and margins of progress.

Perceptions of Local Hospitals and Food Producers on Opportunities for and Barriers to Implementing Farm-to-Hospital Programs

The farm-to-table movement has significantly increased in the United States during the last decade. More locally sourced foods are being used in meal programs on a larger, institutional scale. Farm-to-hospital initiatives have been emerging as an effort to reestablish local, healthy diets into the health care model. As a result, barriers, opportunities, and capacity-building strategies specific to farm-to-hospital initiatives are being more closely explored. The purpose of this study is to investigate perceptions and attitudes of local food producers and hospital staff towards using locally sourced foods in hospital food service programs. To identify these perceptions, in-depth interviews were conducted with staff involved with food procurement and management at two Montana hospitals and with local food producers and distributors. Barriers for hospitals to use locally sourced foods included price, product availability, and quantity, while opportunities included positive relationships, product quality, and champion leaders of the local food system movement within the hospital setting. Furthermore, capacity-building strategies suggested by the interviews included development of cooperative distribution of local foods and formalized working-relationship contracts. Most significantly, collaborative dialogue was identified as a method to further support the extent of locally sourced foods being used in hospital food service programs.

Easy to open? Exploring the ‘openability’ of hospital food and beverage packaging by older adults

Food is increasingly a packaged commodity, both in the community and in institutionalised settings such as hospitals, where many older people are malnourished. Previous research with patients aged over 65 years in NSW public hospitals identified difficulties opening milk, water, juices, cereal and tetra packs. The aim of this paper was to assess the ability of well older people living in the community to open food and beverage items routinely used in NSW hospitals in order to gain further insights into the older person/pack interaction and the role of hand and finger strength in pack opening. A sample of 40 older people in good health aged over 65 years from 3 community settings participated in the study. The attempts at pack opening were observed, the time taken to open the pack was measured and the correlation between grip and pinch strengths with opening times was determined. Tetra packs, water bottles, cereal, fruit cups, desserts, biscuits and cheese portions appeared to be the most difficult food products to open. Ten percent of the sample could not open the water bottles and 39% could not open cheese portions. The results were consistent with the previous research involving hospitalised older adults, adding emphasis to the conclusion that food and beverage packaging can be a potential barrier to adequate nutrition when particular types of packaged products are used in hospitals or the community. The ageing population is rapidly becoming a larger and more important group to consider in the provision of goods and services. Designers, manufacturers and providers of food and beverage products need to consider the needs and abilities of these older consumers to ensure good ‘openability’ and promote adequate nutritional intakes.

Microsatellite Typing of Aspergillus flavus Strains in a Tunisian Onco-hematology Unit.

Aspergillus flavus is the most common species associated with invasive aspergillosis in Tunisia. The molecular epidemiology of the species is poorly documented. We used five highly discriminative microsatellite markers for the genotyping of clinical and hospital environmental A. flavus strains to assess whether IA could be hospital-acquired in the onco-hematology unit of the Farhat Hached teaching hospital of Sousse, Tunisia. The genotyping of 18 clinical isolates, collected from sputa of 17 acute leukemia patients, and 81 isolates, collected in these patients' hospital environment and food, identified 57 isolates that were grouped in 10 clones, each of them including 2-17 isolates. The remaining 42 isolates showed a unique genotype. Two main transmission scenarios were observed: (1) the same clone was isolated from different patients; (2) the same clone was isolated from a patient, its hospital environment and/or food. These findings strongly suggest the occurrence of hospital-acquired A. flavus infection/colonization in the investigated onco-hematology unit.

Cost of treatment for children with acute lymphoblastic leukemia in Bangladesh

BackgroundAcute lymphoblastic leukemia (ALL) is the most common childhood malignancy seen in Bangladesh and is potentially curable. However since parents currently have to pay for the full cost of therapy, high rates of treatment refusal and abandonment are observed, principally as a result of non-affordability. To date, no published data on the exact costs has existed for Bangladesh which makes clear parental counselling at diagnosis impossible. MethodsA cross-sectional study of the costs incurred by 50 families of children with ALL during therapy was conducted at the Pediatric Hematology & Oncology Department of the Bangabandhu Sheikh Mujib Medical University Hospital in Dhaka (BSMMU) from 2010 to 2011. The patients were all treated on a modified United Kingdom Medical Research Council ALL X1 protocol. Each family was asked to retain and submit all receipts for drugs bought from pharmacies, investigations and hospital procedures (LPs and Bone marrow sampling), transport, food and accommodation. Blood and blood products carried a standard hospital fee. ResultsThe basic cost of all treatment for each family was 3234 USD (local currency BDT 226,400) of which 48.6% was for essential and cytotoxic drugs (1571 USD); 9.3% for investigations(299 USD); 2.5% for procedures (79 USD); 0.6% for blood and blood products (20 USD); 12.9% for general treatment costs (416 USD) and 26% (848 USD) for other aspects of care including transport to and from hospital, food and parental lodging. However with an average of three episodes of febrile neutropenia/sepsis the mean overall cost rose to 4443 USD. Where there was refractory fever requiring changes in the antibiotic regimen, an additional average sum of 1740 USD was incurred. In such patients the total costs rose to 7672 USD. ConclusionThe mean treatment cost for Children with ALL in Bangladesh treated on this protocol was 4443 USD (BDT 311,028) with a range of 3234 USD (BDT 226,400) to 7672 USD (BDT 537,040). This data enables more realistic family counselling regarding the financial burden they face for their child's treatment. Although the costs are considerably lower than recorded in high income countries they remain prohibitively high for most parents in low-middle income countries like Bangladesh. During the period of this study treatment abandonment rates were 16%; 62% of which were reported to be due to families not being able to afford the costs. In a parallel project to our study family monthly incomes were recorded. 33% of families earned less than 5000 BDT/month (71 USD), 51% between 5000 and 20,000 (71–285 USD) and only16% more than 20,000 (greater than 285 USD). Solutions to reduce the cost to families in all low-middle income countries are urgently required. To achieve that requires a National and Global effort from medical professionals, the pharmaceutical industry, International agencies and individual Governments. In the long run only universal health coverage can significantly reduce the financial burden for families.

Improving Hospital Food: evaluating the impact of the UK Food for Life Partnership

The Food for Life Partnership (FFLP) is an initiative led by the Soil Association (SA), a non governmental organisation in the UK which aims to encourage a healthy, sustainable food culture in communities. The SA also runs a Catering Mark scheme that provides an independent endorsement that food providers are taking steps to improve the food they serve, using fresh ingredients which are free from undesirable additives and trans fats, are better for animal welfare, and comply with national nutrition standards. FFLP work in schools has already been shown a significant impact and FFLP has now been extended to hospitals, care homes, universities and early years settings.

Hospital food waste and environmental and economic indicators – A Portuguese case study

This study presents a comprehensive characterization of plate waste (food served but not eaten) at an acute care hospital in Portugal and elaborates on possible waste reduction measures. Even though waste prevention is a priority in Europe, large amounts of food are still being wasted every day, with hospitals giving rise to two to three times more food waste than other foodservice sectors.For this work the plate waste arising at the ward level was audited during 8weeks, covering almost 8000 meals, using a general hospital as case study. Weighing the food served to patients and that returned after the meal allowed calculating plate waste for the average meal, as well as for individual meal items. Comparison of food waste arising showed that differences exist among wards, with some generating more waste than others. On average each patient throws away 953g of food each day, representing 35% of the food served. This equates to 8.7 thousand tonnes of food waste being thrown away each year at hospitals across Portugal. These tonnes of food transformed into waste represent economic losses and environmental impacts, being estimated that 16.4 thousand tonnes of CO2 (equivalent) and 35.3 million euros are the annual national indicators in Portugal. This means that 0.5% of the Portuguese National Health budget gets thrown away as food waste. Given the magnitude of the food problem five measures were suggested to reduce food waste, and their potential impact and ease of implementation were discussed. Even though food waste is unavoidable the results obtained in this work highlight the potential financial and environmental savings for Portuguese hospitals, providing a basis to establish future strategies to tackle food waste.