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ABSTRACT: BACKGROUND: Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country. METHODS: A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country. RESULTS: Emphasis of recommendations on whole‐grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days. CONCLUSIONS: The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe and compare the quality of recovery on discharge from hospital among patients undergoing elective hip or knee replacement. The study will also attempt to identify any predicting factors. Background. Arthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today's shorter hospital stay may be a challenge for the patients during the early period of recovery. It is therefore important to identify factors associated with quality of recovery at discharge from hospital. Design. A descriptive, comparative study including 12 hospitals in 5 European countries; Cyprus, Finland, Greece, Iceland and Sweden. Methods. Consecutively included patients responded on: health-related quality of life, and emotions before surgery and at hospital discharge; quality of recovery, patient satisfaction and fulfilment of knowledge expectations. Related factors and associations were analysed separately for each kind of arthroplasty. In total, 865 patients were included (hip n = 413, knee n = 452). Results. In the dimension of pain, patients undergoing hip replacement had significantly better quality of recovery compared to those undergoing knee replacement. Both patient groups experienced negative emotions before surgery that were related to poorer quality of recovery. Fulfilment of knowledge expectations has a limited effect on quality of recovery. Greater satisfaction with care predicted better quality of recovery. Conclusions. Negative preoperative emotions were related to poorer quality of recovery. For both kinds of arthroplasty, greater satisfaction with care was associated with better quality of recovery. Relevance to clinical practice. The result emphasises the need to detect patients in need of support in their preparation and recovery process, taking into account the perspective of their emotional state. [ABSTRACT FROM AUTHOR]

Background: Patient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled. Objectives: To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions. Design: A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery. Settings: Two Finnish, three Icelandic and two Swedish hospitals. Participants: The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women. Methods: Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations. Results: Patients expected more knowledge than they received (p < 0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge. Conclusions: In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery [ABSTRACT FROM AUTHOR]