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7400:328 NUTRITION IN MEDICAL SCIENCE I (4 credits) SPRING 2007 SCHOOL OF FAMILY AND CONSUMER SCIENCES THE UNIVERSITY OF AKRON

Instructors: Ms. Cinda Chima, MS, RD, LD

Office Hours: Before and after class or by appointment Call 330.972.6047 to schedule Office – SHS 215-G

E-mail: [email protected]

Home Page: http://www3.uakron.edu/chima/

Class Day & Time: Monday, Wednesday 11:30 AM -1:20 PM; lab Wednesday 1:20-2:20.

Required Course Materials: Mahan LK, Escott-Stump S. Krause’s Food, Nutrition, and Diet Therapy. 11th ed. Philadelphia:WB Saunders Co.; 2004. Access Student Study Guide for Krause at http://evolve.elsevier.com/productPages/s_228.html

Nelms MN, Anderson SL. Medical Nutrition Therapy: A Case Study Approach. 2nd Edition. Belmont, CA:Wadsworth/Thomson Learning; 2004.

Pronsky Z. Food-Medication Interactions, 14th Edition. Order from http://www.foodmedinteractions.com/

The American Dietetic Association Evidence Analysis Library. ADA members access online free of charge at www.eatright.org. Follow the Practice link and choose Evidence Analysis Library. Must sign in with ADA member number and password.

The American Dietetic Association. Nutrition diagnosis and intervention. (from Nutrition Assessment class) The American Dietetic Association. Nutrition Care Manual. Access online free of charge. http://nutritioncaremanual.org/universi13 (accessible from computers on campus only)

Recommended Resources: Fischbach F. Manual of Laboratory and Diagnostic Tests; 6th ed. Philadelphia:Lippincott; 2000.

Escott-Stump S. Nutrition and Diagnosis-Related Care. 5th ed. Baltimore: Lippincott Williams & Wilkins; 2002.

Course Objectives: At the completion of this course, the student will: 1. Use current information technologies. 2. Work effectively as a team member and recognize the role of the dietitian in the health care team. 3. Have knowledge of general health assessment, e.g. vital signs, blood pressure. 4. Have knowledge of physiology and nutrient metabolism. 2

5. Have knowledge of pathophysiology related to nutrition care. 6. Have knowledge of pharmacology, including nutrient-nutrient and drug-nutrient interactions. 7. Interpret laboratory parameters related to nutrition. 8. Interpret medical terminology. 9. Demonstrate the ability to interpret current research and apply it in clinical practice. 10. Have knowledge of the role of food in the promotion of a healthy lifestyle. 11. Calculate and interpret the nutrient composition of foods. 12. Have knowledge of evolving methods of assessing health status. 13. Have knowledge of nutrition and metabolism. 14. Have knowledge of medical nutrition therapy. 15. Have knowledge of strategies to assess need for adaptive feeding techniques and equipment. 16. Have knowledge of assessment and treatment of nutritional health risks. 17. Have knowledge of complementary and alternative nutrition and herbal therapies and dietary supplements. 18. Demonstrate the ability to calculate and/or define diets for health conditions addressed by health promotion/disease prevention activities or uncomplicated instances of chronic diseases of the general population, e.g. hypertension, obesity, diabetes. 19. Screen individuals for nutritional risk. 20. Collect pertinent information for comprehensive nutrition assessments. 21. Identify and describe the nutritional implications and dietary modifications dictated by various disease states or clinical conditions studied 22. Develop appropriate nutrition care plans while considering nutritional and medical requirements, laboratory findings, surgical procedures, medical therapies, individual preferences, and drug usage. 23. Recognize the impact of hospitalization and the disease process on the patient’s emotional and physical needs.

Course Policies:

1. Attendance at all classes for the full class time is expected. Attendance will be taken at every class. Your final grade will be affected by tardiness and absences.  If you must be late or absent due to an emergency, leave a message on the instructor’s voice mail (330.972.6047) as soon as possible.  Handouts, assignments, and tests will be distributed in class only once. After that, it is the student’s responsibility to determine what was missed and obtain copies from the instructor or a fellow student. 2. Guest speakers and off campus presentations are scheduled for several class sessions. Prompt attendance, your undivided attention, and professional dress are required/expected at these times. 3. Quizzes and exams are based on lecture material, class discussions and presentations, and assigned readings. No makeup quizzes will be given; however the lowest quiz grade will be dropped. No makeup exams will be given unless prior approval is arranged with the instructor. If you are ill on a test date, leave a message on the instructor’s voice mail (330.972.6047) by 8:45 AM. Makeup exams may be essay. 4. Assignments are due at the beginning of class. Late assignments will be penalized 10% for each late class session day. 5. All phones and beepers are to be turned off during class time. 3

6. Attendance at two single-session (e.g. GADA) or one multi-session professional meeting is required. Concise, complete, legible reports of these meetings are due one week after the meeting on the provided forms. Do not wait until the end of the semester to complete this assignment. 7. Academic Dishonesty: Any student found cheating on an exam or assignment will be given a zero and reported to the Academic Affairs Office. Documentation will also be placed in the student’s permanent file. There may be assignments that will involve handing in one paper from a group. Those assignments will be clearly delineated. For other assignments, each student must hand in work in his/her OWN WORDS. Any text directly quoted from a textbook or online source must be clearly delineated and limited to situations where quoting a well-known authority strengthens the work. Please reference the following University of Akron plagiarism policy and familiarize yourself with its contents. http://www.uakron.edu/ogc/PreventiveLaw/plagiarism.php 8. Adjustments will be made to the schedule and assignments as necessary. 9. Course-related documents (Powerpoints, handouts, forms, syllabi) are accessible at the professor’s home page at http://www3.uakron.edu/chima/. Posted information is updated frequently, so check back often. 10. Some information may be communicated to students via email. Students should check their email frequently and provide the professor an update if email changes 11. Labs are opportunities for enrichment of course content and application of techniques learned in class. Some lab sessions related to clinicals may be attended by CPs only but most labs will involve both CPs and DPDs

Course Grades: Course grades will be determined by the following:

Element Possible points Exams: 4 @ 100 points 400 Quizzes 80 Written assignments 120 Attendance and class participation 50 Attendance points: 0-1 absences=50 points 2=40, 3=30, 4=20, 5=10 6 or more = 0 points) Attendance at 2 professional meetings 40 Total points possible 690

Final Grade Percentage Final Percentage Grade A 93-100 C 73-76 A- 90-92 C- 70-72 B+ 87-89 D+ 67-69 B 83-86 D 63-66 B- 80-82 D- 60-62 C+ 77-79 F 59 & below 4

Date Topic Readings and Written Assignments 1/17 - Introduction to course Krause Chapter 21, 17; review Nutrition Diagnosis and Wednesday Nutrition Care Process Intervention book from ADA (NCP) Read JADA article on NCP at Nutrition Screening http://www.eatright.org/ada/files/Aug2003.pdf 5

Date Topic Readings and Written Assignments

1/22 – NCP: Nutrition Assessment and Weight Readings Monday Assessment In class: 24 hour intake Anthropometric Data Homework: analysis of intake by computer and food groups Clinical Data method Dietary Data

1/24- Laboratory Data in Krause, Chapter 18, 34 Wednesday Nutrition Assessment MNT in Nutritional Anemias

1/29 – Nutrition Care Krause Chapter 21 Monday Process: Diagnosis, Handouts: Diet Manual Example Intervention, Handout: JCAHO forbidden abbreviations Evaluation Handout: Nutrition Diagnostic Labels Standard Hospital NCP forms Diets Nutrition Care Documentation Charting formats Abbreviations

1/31 - Nutrition Care Process Written assignment: NCP forms and documentation formats Wednesday (continued) Use Nelms Case Study #6, p. 57 (do not complete rest of case study)

2/5 – Food-Drug Krause Chapter 19 Monday Interactions

2/7 - Integrative Medicine Krause Chapter 20 Wednesday and phytotherapy

2/12 - EXAM 1 Monday

2/14 - Diabetes Krause Chapter 33 Wednesday American Diabetes Association (ADA) Nutrition Principles and Recommendations in Diabetes http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s36 ADA Position Statement: Diagnosis and Classification of Diabetes Mellitus http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s5 6

Date Topic Readings and Written Assignments 2/19 - Diabetes Speaker: Kelly Dardinger Reed, RD, CDE, Akron General Monday Medical Center. MNT Considerations in Diabetes

2/21 - Diabetes Speaker: Kelly Dardinger Reed, RD, CDE, AGMC Wednesday Diabetes Medications, Diabetes Self Management Education, and Pattern Management in Diabetes ADA Position Statement: Diabetes Nutrition Recommendations for Health Care Facilities http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s55 MNT for Diabetes: considerations and calculations Homework: diabetes diet calculation exercise

2/26 - Diabetes Nelms Case Study #28: Diabetes Mellitus Type 2, p. 317 Monday PCOS/Diabetes ADA nutrition Care Manual, Disease and Nutrition Care sections Prevention for Metabolic Syndrome www.nutritioncaremanual.org

2/28 – Gestational Diabetes Speaker: Kelly Dardinger Reed, RD, CDE, Akron General Wednesday Diabetes in Pregnancy Medical Center ADA Position Paper: Gestational Diabetes Mellitus http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s88

ADA Position Statement: Prevention or Delay of Type 2 Diabetes http://care.diabetesjournals.org/cgi/content/full/27/suppl_1/s47

ADA Nutrition Care Manual www.nutritioncaremanual.org sections on Disease and Nutrition Care for Gestational Diabetes

3/5 - Weight Management Krause Chapter 24 Monday ADA Nutrition Care Manual sections on Disease and Nutrition Care for Weight Management ADA Evidence Analysis Library: Evidence Based Adult Weight Management Guideline (sign in at www.eatright.org)

3/7 - Weight Management Wednesday

3/12 - Weight Management Monday

3/14 - EXAM 2 Wednesday

3/19 - SPRING BREAK Monday 7

Date Topic Readings and Written Assignments

3/21 - SPRING BREAK Wednesday

3/26 – Eating Disorders Krause Chapter 25 Monday

3/28 – Cardiovascular Krause Chapter 35 Wednesday Disease

4/2 – Cardiovascular Nelms Case Study 7, Cardiovascular Disease, p. 71 Monday Disease ADA Evidence Analysis Library Disorders of Lipid Metabolism Guideline

4/4 - Hypertension Krause Chapter 36 Wednesday

4/9 - Heart Failure and Krause Chapter 37 Monday Transplant

4/11 – EXAM 3 Wednesday

4/16 - Normal Digestion Krause Chapter 1 Monday

4/18 - MNT in Oral and Krause Ch 28 Wednesday Dental Health Krause – Ch 29 MNT in Upper GI Krause Ch 43 – p 1087-1092 Disorders Appendix 55

4/23 - MNT in Celiac Krause Ch 30 pp 712-716 Monday Disease Speaker: Trisha Lyons MS RD on Celiac Disease Evidence Analysis Library – Gluten Intolerance/Celiac Disease Mrs. Chima at ODA

4/25 - MNT in Upper GI Krause Ch 29 Wednesday Disorders

4/30 – MNT in Lower GI Krause Ch 30 Monday Disorders Nelms Case #10: GERD, p. 107

5/2 - MNT in Lower GI Wednesday disorders (cont) 8

Date Topic Readings and Written Assignments

EXAM WEEK 5/7 – Exam per university schedule Friday 5/12 noon-1:55 p.m. may 5/11 reschedule