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Environment Conditions, circumstances and influences that… affect the development and behavior of humans as adaptive systems.
Scientific Assumptions Systems of matter and energy progress to higher levels of complex self-organization. Strengths: The theory suggests the influence of multiple causes in a situation, which is strength when dealing with multi-faceted human beings. As one of the weaknesses of the theory that application of it is time-consuming, application of the model to emergency situations requiring quick action is difficult to complete. Cognitive learning is a powerful mechanism that provides the means of knowledge, and goes well beyond simple imitation of others.
Cognitive theory is a learning theory of psychology that attempts to explain human behavior by understanding the thought processes. Pure cognitive theory largely rejects behaviorism on the basis that behaviorism reduces complex human behavior to simple cause and effect. Tip: To turn text into a link, highlight the text, then click on a page or file from the list above.
One of the goals of the Sackler Institute is to promote a global nutrition science community through public–private partnerships. On June 1, 2012, the Sackler Institute for Nutrition Science and the New York Academy of Sciences presented a conference titled Global Capacity Building in Nutrition Science: Training Future Practitioners, Empowering Future Leaders.
Capacity building aims to "[increase] the self-sustaining ability of people to recognize, analyze, and solve their problems by more effectively controlling and using their own and external resources" (deGraff, 1986). Although the perspectives shared ranged from the global to the local, one common theme united the presentations: the need for a holistic and sustained approach to capacity building that focuses on nutrition education.
Nutrition science research should adhere to international standards of academic inquiry and should be responsive to national and regional needs.
Leadership in nutrition should be promoted and should focus on team building and on enabling foreign-trained experts to become leaders in their home countries.
Partnerships should be created to promote interventions that utilize consortium-based models to combine the strengths of participating organizations.
Nutrition science graduate training in African countries should address the double burdens of malnutrition and over-nutrition. Emorn Wasantwisut, a Senior Advisor at the Institute of Nutrition at Mahidol University, drew on her experiences serving on numerous expert advisory groups for organizations like the World Health Organization to present the history of nutrition science education programs and highlight some of the problems encountered by these programs in the past.
Capacity building can be developed through different models: a top-down model, as practiced in China where the government handpicks and trains top scientists, or a collaborative model, as practiced in Singapore where world leaders in science and research are invited to collaborate with local scientists. Debra Wolgemuth, Associate Director for Research at the Institute of Human Nutrition (IHN) at Columbia University Medical Center, presented results from nutrition development programs in East Africa—The Consortium for Advanced Research Training in Africa (CARTA) and The African Economic Research Consortium (AERC), formed in 1995 and 1998, respectively. The Institute of Human Nutrition (IHN) is undertaking a similar project to advance nutrition science and education in Africa, building upon the collaborative model instituted by CARTA and AERC to identify and combine the strengths of different organizations. Like Wasantwisut, Wolgemuth underscored the idea that improvements in individual training should be combined with infrastructural, institutional, and systemic changes that will allow universities to buildup faculty in situ and ensure that the capacity building process is sustainable.
Nutrition education should be given a more prominent place in curricula and should be expanded to include experiential learning that focuses on case-based practice. Online learning platforms are ideal tools for connecting the global nutrition science community and addressing the needs of community-based practitioners.
An ecological approach to nutrition and public health should be implemented to account for multiple determinants of behavior.
This session featured presentations by Robert Karp, from SUNY-Downstate Medical Center, and Christina Stark, from Cornell NutritionWorks at the Division of Nutritional Sciences at Cornell University, who moved away from macro-level capacity building through organizational change to focus on individual-level capacity building through education and professional development. Karp gave a humorous yet frank presentation of how inadequately represented nutrition education is in medical school curricula: only 40 of 106 medical schools surveyed currently require the minimum 25 hours of nutrition instruction recommended by the National Academy of Sciences, while 88% of instructors at these schools think that more extensive nutrition education is greatly needed. A highlight of Stark's presentation was her emphasis on taking an ecological approach to nutrition and public health; she believes this is a powerful tool for addressing problems like childhood obesity and should be a focus of nutrition science education. The Socio-Ecological Model (SEM) encompasses multiple strata of determinants, ranging from those at the individual level to external drivers that influence and shape behavior. A multi-pronged approach to nutrition is needed to change perceptions among consumers and leaders: industry can promote change. Nutrition should not be evaluated in a vacuum, but instead, should be analyzed in the context of national and food security.
Nutrition practitioners and specialists should be trained to become leaders in their own organizations. Tailored international training programs should build networks of nutrition science leaders.
Gayle Binney, from the Dannon Institute, presented on international capacity building and education initiatives supported by The Dannon Company, Inc.
Alumni responses demonstrate the success of these programs, with 98% of participants remaining connected through an alumni network and some working together on RO1 funded projects.
The DESIGN Model for Planning Theory-based Nutrition Education provides a step-by-step guide to changing eating behaviors for curriculum developers in nutrition science and education. Dietary choice is influenced by multiple determinants that must all be addressed to effect change. Nutrition education in schools should focus on educating the school community and on targeted professional development. Informed advocacy should be at the forefront of nutrition interventions and should empower target audiences to effect change themselves. A multidisciplinary and multifocal approach to addressing nutrition issues is critical to effect broad-based policy changes. The third session focused heavily on theory-based tools and on the actual experiences of practitioners in the field. Influencers of Food Choices and Diet-Related Behavior: To effectively change nutrition patterns we must identify and address the determinants and mediators of change.
Any program aiming to influence dietary choice and behavior must take into account the different factors that influence our diet patterns. Koch explained the DESIGN model's components and how to translate theory into practice, elaborating on each step by introducing examples from the nutrition education programs she oversees. Koch stressed that it is essential to evaluate program outcomes to assess whether behavioral and environmental changes have occurred. Local outreach programs promoting nutrition education can build capacity from the ground up. Describing the barriers to providing healthy nutrition and adequate physical exercise in schools, Reed stressed the need to change students' behavior and to modify prevalent attitudes among parents, school cafeteria staff, teachers, principals, and policymakers. The conference concluded with a panel discussion moderated by Mandana Arabi, from the Sackler Institute of Nutrition Science, and featuring Nabeeha Kazi, from Humanitas Global Development, Glenn Denning, from Columbia University, Liesel Pritzker Simmons, from the IDP Foundation, and Pamela Koch, from the Center for Food & Environment at Teachers College Columbia University.
Kazi shared her perspective on the challenges involved in capacity building and in scaling-up nutrition interventions. Agriculture and nutrition seem to be disengaged from each other and the latter is often not at the top of the national agenda. To incorporate links and partnerships between agriculture and nutrition, who do we have to convince?
Can the new generation of international nutrition science professionals really help Africa? How do we create an argument for nutrition to become a priority vis-à-vis other sectors?
The person’s integrity, or wholeness, is behaviorally demonstrated when the person is able to meet the goals in terms of survival, growth, reproduction and mastery.
The individual might have completed the whole adaptation process without the benefit of having a complete assessment for thorough nursing interventions. The assumption is that humans are logical beings that make the choices that make the most sense to them.


However, the trend in past decades has been towards merging the two into a comprehensive cognitive-behavioral theory. Primarily focused on the ways in which we learn to model the behavior of others, social cognitive theory can be seen in advertising campaigns and peer pressure situations.
The conference had a multisectoral and international focus, and sought to address capacity building among all stakeholders—from students to educators, researchers to practitioners, and constituents to leaders.
At this innovative two-day conference uniting private industry and public organizations from fields as diverse as education and corporate business, participants and speakers came together to discuss some of the most pressing issues in capacity building in nutrition science. Capacity building and professional development must go beyond individual-level modifications to effect broad environmental and ecological changes. For example, the United Nations University's Food and Nutrition Programme, inaugurated in 1976, was intended to support fellowships and institutions that would produce high quality researchers and trainers, but, despite being perceived to be of the highest caliber, UNU research often fell short of international standards.
Undernutrition and overnutrition are both complex challenges that will only be solved with multi-pronged approaches.
These programs aim to re-structure and develop local educational institutions, creating internationally-competitive doctoral programs and strengthening laboratory and technical skills at the doctoral level. She also touched upon the need to engage local government to promote policy changes in education and nutrition science practice. Karp advocates focusing on experiential learning and evaluation to address some of the gaps in nutrition instruction. There is strong international representation in membership and in the content of online courses taught. The traditional approach focuses on effecting behavioral changes in diet and lifestyle at the individual level, but has had limited success because it only targets people who want to change; an ecological approach still involves individual modifiers, but shifts the focus to community-level changes in policy, structure, and environment. These platforms are ideal for addressing the needs of community-based practitioners, helping those who are unable to attend traditionally-structured courses to avoid isolation from professional peers. Yach acknowledged a growing global nutrition crisis, with rising health and economic costs associated with obesity in parallel to widespread food insecurity; obese and food insecure populations both number about one billion people each worldwide. The Nutrition Leadership Institute utilizes the expertise of nationally recognized nutrition specialists to impart capacity building and leadership skills to select group of PhD holders and physicians; the training incorporates self-assessment, effective leadership, professional network building, communication, and team building.
According to Binney, this program in North American has been so successful in cultivating and training nutrition science leaders that the Dannon Institute in the U.S.
Pamela Koch, Executive Director at the Center for Food & Environment at Teachers College Columbia University, spoke about drawing on psychosocial theories to motivate, teach, and change behavior in target communities. Koch explained that these factors are multi-layered and include biologically determined behavioral predispositions, prior experience with food, and individual and environmental determinants. The first component involves deciding which issue to focus on, identifying an intended audience, and targeting specific behaviors. This can be done by monitoring indicators of achievement; for instance, measuring Body Mass Indexes to evaluate obesity interventions, or surveying food sold in schools to evaluate environmental interventions.
Reed demonstrated how targeted professional development, combined with educating the school community, can promote significant improvements in nutrition and physical education. The discussion drew upon major themes raised at the conference and focused on current gaps in capacity building initiatives in the U.S. She thinks that transforming nutrition interventions from local-based programs into a broader movement requires a people-centered approach.
Nutrition science practitioners should be able to recognize, understand, and adapt to target audiences.
Learning would be extremely inefficient if we had to rely completely on conditioning for all our learning. This allows therapists to use techniques from both schools of thought to help clients achieve their goals.
Theory relied on the work of behavioral scientists in psychology, sociology and ethnology and system theory. Moreover, developing high-impact strategies to address the paradoxical twin burdens of undernutrition and overnutrition continues to be a struggle, both within the U.S. The conference had a decidedly multisectoral and international focus, mixing updates from academia from as far afield as Thailand with on-the-ground perspectives from an energetic local New York City non-profit organization. Leadership training and organizational capacity must be scaled up in a sustainable manner, in spite of funding inadequacies and the nutrition field's limited visibility. Wasantwisut used this example to demonstrate that research should adhere to the highest standards of academic inquiry and be responsive to national and regional needs. The CASNA project, which aimed to bring leaders, researchers, and technical experts together, found that it is important to nurture leadership and to focus on team building, and demonstrated that technical experts working alone find it difficult to implement policies in the field.
Undernutrition and stunting are often intra-country issues in developing nations that can be addressed by local, provincial, or national governments; over-nutrition and obesity are underpinned by global lifestyle and behavior changes and by emulation of Western diets (increased consumption of meat and obesogenic foods), and should be addressed through a concerted inter-government effort. Spanning 35 African countries, CARTA and AERC have the capacity to foster inter-country cooperation and to facilitate knowledge and resource transfers. This problem is exacerbated by an ongoing "brain-drain," as foreign-trained African academics seldom return to their home country as faculty, researchers, or leaders. Lab equipment donated from the European Union and the United States are readily available in many facilities, but are under utilized because of a dearth of technically trained staff and research-minded investigators; this all-too-common scenario must be remedied. To achieve this, Karp has produced A Teacher's Guide to Pediatric Nutrition, which utilizes case-based modules to promote active learning based on clinical practice and encourages students to understand nutrition experientially. NutritionWorks is a truly global platform, connecting practitioners worldwide to training courses that are often tailored for developing countries.
Cornell NutritionWorks uses a socio-ecological intervention model to educate practitioners to recognize both internal determinants of behavior (knowledge, attitudes, beliefs, and skills) and external determinants of behavior (interpersonal, organizational, community, and society), thus strengthening their ability to address nutrition, diet, and lifestyle changes in the local community.
Stark echoed concerns about funding: developing fellowships, strengthening institutions, and building education and online training platforms all require ongoing support and maintenance to succeed. Yach highlighted a large body of evidence that pinpoints nutrition as essential for growth and development, in terms of both individual achievement and health, and of the economic success of a generation. Danone, a multinational food and beverage giant, revamped its corporate portfolio several years ago with the goal of investing only in food brands that are healthy and nutritious.
To be effective, nutrition education must target all levels of influence and must focus on not only specific behaviors, actions, and practices, but also on identifying and addressing the determinants, or mediators, of change. The second component involves exploring determinants, or mediators, that could motivate, facilitate, and support positive change.
In designing and implementing these programs, nutrition practitioners and leaders must understand basic consumer behavior and be able to cultivate understanding, acceptance, and a desire to change. Simmons illustrated this point clearly with an example from IDP's partnership with microfinance institutions in Ghana, which aims to raise funds for nutritious private school lunches. Additionally, as living systems, persons are in constant interaction with their environments.
In the presentation of each of the key concepts there is the recurring idea of adaptation to maintain integrity. Human beings can learn efficiently by observation, taking instruction, and imitating the behavior of others. In cognitive learning, the individual learns by listening, watching, touching, reading, or experiencing and then processing and remembering the information.
Interestingly, the discussion of capacity building at this conference covered all of these approaches; for instance, Emorn Wasantwisut and Debra Wolgemuth presented on institutional and infrastructural change, while Robert Karp and Christina Stark discussed personal capacity building and professional development. Many fellowships, such as the Ellison Medical Foundation Fellowship, aim to address this need for macro-level changes by funding institutions rather than individuals.
In developing nations especially, a considerable knowledge gap often exists between foreign-trained scientists and incumbents in local institutions, yet the former are often restricted by institutional inertia and hierarchy based on tenure; these experts must be given the opportunity to grow and to assume true positions of leadership. Karp aims to outline essential vocabulary and to teach students how to assess diet and nutrition status so that they are better equipped to provide nutrition guidance. As part of its long-term capacity building and professional development initiative, Danone is considering global support for advanced nutrition science and leadership courses for mid-career professionals and international courses to address sustainability and multicultural challenges.


Successful strategies for changing behavior increase awareness and motivation (focusing on why people take action), facilitate action taking (focusing on how to take action), or provide environmental or policy-based support for action (focusing on where and when to take action). The model helped shape a philosophy self-agency within the program, which focuses on giving students tools to monitor and control their intake of sugary and obesogenic foods.
He emphasized that nearly all NYC schools currently fail to meet the minimum number of weekly physical education hours mandated by New York State.
NYC to develop empowered Parent Associations with basic nutrition education—schools have subsequently succeeded in reducing unhealthy food options. It is essential to speak to the target audience at a level they can understand and to eliminate unnecessary jargon that would obfuscate the message; furthermore, outreach should not take the form of a didactic translation of knowledge from practitioners to laypeople, but instead, should rally and empower the population to demand appropriate nutrition choices for themselves. Between the system and the environment occurs an exchange of information, matter, and energy.
Some coping mechanisms are inherited or genetic, such as white blood cell defense mechanism against bacteria that seek to invade the body. Thus, the span of control of nurses may be impeded by the time of the discharge of the patient.
Derek Yach and Gayle Binney presented on private-public partnerships and delineated how to facilitate knowledge transfers between industry and the public sector. It is important, however, that partnerships do not overshadow or crowd out the importance of nutrition itself. Participating institutions must demonstrate a track record of excellence and present a plan for improving nutrition science training.
Danone emphasizes affordable nutrition and sustainable production methods; for instance, it has committed to making yogurt products affordable in developing countries and to developing specific nutrient content so that twice weekly consumption of these, aptly named Shakti Doi ("energy" in Bengali), meets a child's minimum nutrient requirement for at least four vitamins and minerals including vitamin A, iron, zinc, and iodine.
Danone also supports early-career programs in the European Union and Africa, which have similar foci to their North American counterpart, aiming to create a network of future nutrition science leaders. Statistics showing correlations between nutrition, exercise, and test outcomes, among other targeted interventions, are demonstrably successful in appealing to school principals and similar stakeholders.
Koch underscored the need to encourage change on participants' terms, giving examples of how students in her program have altered their food choices based on education and peer influence. Kazi highlighted the utility of mapping out intervention strategies with a model that analyzes associated strengths, weaknesses, opportunities, and threats (SWOT): one should address both allies and detractors, garnering support from the former and taking corrective action to resolve misunderstandings with the latter. However, the learner is quite active, in a cognitive way, in processing and remembering newly incoming information.
Pamela Koch discussed community organization and community capacity building through targeted interventions. Public–private cooperation at all levels, from the field to the highest echelons of government and industry, is clearly essential to ensure that pressing issues in nutrition science are addressed effectively.
This type of institution-focused funding, with a mandatory stipulation of post-fellowship service in a developing nation, helps to encourage individuals to return home, and to ensure that knowledge and skills acquired at first-class universities are transferred back to developing countries.
The key question to address is whether our current agricultural system can deliver optimal nutritional, including a diverse set of nutritious foods like fruits, pulses, and leafy greens, for all? The European Nutrition Leadership Program (ENLP) was the first of its kind; Dannon shares funding responsibility for this program, which inspired many others around the world, including the North American program and similar leadership programs in Africa.
The final components of the model involve outlining objectives and creating specific activities and lesson plans. Reed strongly supports empowering teachers and school staff by using professional development interventions like teaching cafeteria staff how to calculate calories and how to plan healthy food choices; and giving teachers opportunities to obtain coaching certifications and to lead after-school programs in arts, dance and sports. Kazi reiterated the importance of taking a multi-sectorial approach to nutrition issues: although competition for visibility and resources between nutrition and other sectors (such as agriculture) can be intense, nutrition practitioners should be open to cooperative partnerships and dialogue.
Hunter Reed delved into community empowerment and provided strategies for educating diverse stakeholders. Denning also broached this point, arguing that a singular approach to capacity building in nutrition is deficient; rather, a multidisciplinary and multifocal approach is needed. In groups, this is the manner in which human systems manifest adaptation relative to basic operating resources. Each concept was linked with the coping mechanisms of every individual in the process of adapting. He argued that our current agricultural system has made dramatic improvements in health and development possible, but has “overshot the mark” by producing too many cheap calories and under-emphasizing food quality. Columbia University's program, where development practice is taught concurrently with nutrition, human ecology, food security, and economics, is a good example. The basic need of this mode is composed of the needs associated with oxygenation, nutrition, elimination, activity and rest, and protection. At the national level, a multifocal approach is equally crucial, and various ministries, including trade, finance, health and education, will need to work together to address the wide-ranging impacts of nutrition on health and economic productivity. The complex processes of this mode are associated with the senses, fluid and electrolytes, neurologic function, and endocrine function.
Regulator subsystem A basic type of adaptive process that responds automatically through neural, chemical, and endocrine coping channels. The main point of the concept was to promote adaptation but none were stated on how to prevent and resolve maladaptation. In a starker shift away from traditional agriculture, biotechnology methods are being applied by pharmaceutical companies like AcSentient, Inc.
Self-concept-group identity mode: focuses on psychological and spiritual integrity and a sense of unity, meaning, purposefulness in the universe.
Although processed healthy food may sound like an oxymoron, Yach emphasized that it can actually preserve nutrient quality, and could play a very important role in reducing food waste, which estimates put at 220 million metric tons each year.
Yach argued that we should be open to these new technologies, which could potentially reduce hunger and enhance human health.Yach discussed the need to shift the focus of nutrition science away from individual nutrition advice to effecting changes in the world agriculture system as a whole. In closing, Yach touched upon PepsiCo’s role in improving human and agricultural capacity, with initiatives like a program to help Ethiopian farmers with crop bio-fortification and irrigation and educational programs to teach techniques for producing nutrient-dense foods such as oilseeds, pulses, and chick peas.
Yach stressed the need for a multi-sectorial approach: nutrition science practitioners should work together with trade leaders and public health leaders to effect policy changes.
Interdependence mode: the close relationships of people and their purpose, structure and development individually and in groups and the adaptation potential of these relationships. They use the predicted outcome instrument developed by the author based on DJBSM and found out that by using a conceptual framework such that of DJBSM they increased the overall projected outcome by 80%. The nursing theoretical framework made it possible to prescribed nursing care as a distinction from medical care. Society - In Johnson ’ s theory, the environment consists of all the factors that are not part of the individual ’ s behavioral system, but that influence the system. Health - It is reflected by the organization, interaction, interdependence ,and integration of the subsystems of the behavioral system.
Nursing - An art and a science, nursing supplies external assistance both before and during system balance disturbance and therefore requires knowledge of order, disorder, and control article that demonstrates the nursing theory The four major conceptsPhilosophical basis: FLORENCE NIGHTINGALE ( NOTES IN NURSING ) Relationship between the ill person and his environment. Prevent disease or injury reducing stress support natural adaptive process Philosophical basisConceptual basis: a) Parsons social action theory(1951,1964) = 1) By functionalism it means that every observable social behavior has a function to perform 2) Structuralism it means social behaviors are expressions of deep underlying structures in the social system.
Conceptual basisConceptual basis: 1) Attachment or affilliative subsystem based on citation from the work of Ainsworth and Robson 2) Dependency subsystem Was based on the work of Heathers, Gerwitz, Rosenthal 3) Ingestive subsystem and Eliminative subsystem Supported by the work of Walile, Mead, and sears 4) Sexual subsystem Based on the work of Kagan, and resnik 5) Achievement subsystem Atkinson, Feather, Crandell in which they explained that physcial, creative, mechanical, and social skills are manifested by achievement behavior. 6) Aggressive subsystem Supported by Lorenz and Feshback Conceptual basisstrengths: strengths Theories Interrelate concepts to create a different way of viewing phenomenon- concepts in Johnson ’ s theory are consistently interrelated. Theories must be logical in nature - so is Johnson ’ s theory Theories must be simple yet generalized .



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