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International Journal of Environmental... Jun 2022Many obesity and diet-related diseases have been observed in recent years. Insulin resistance (IR), a state of tissue resistance to insulin due to its impaired function,... (Review)
Review
Many obesity and diet-related diseases have been observed in recent years. Insulin resistance (IR), a state of tissue resistance to insulin due to its impaired function, is a common coexisting condition. The most important predisposing factors are excessive visceral fat and chronic low-grade inflammatory response. However, IR's pathogenesis is not fully understood. Hence, the diagnosis of IR should be carried out carefully because many different diagnostic paths do not always give equivalent results. An additional disease that is often associated with IR is urolithiasis. The common feature of these two conditions is metabolic acidosis and mild inflammation. A patient diagnosed with IR and urolithiasis is a big challenge for a dietitian. It is necessary to check a thorough dietary history, make an appropriate anthropometric measurement, plan a full-fledged diet, and carry out the correct nutritional treatment. It is also essential to conduct proper laboratory diagnostics to plan nutritional treatment, which is often a big challenge for dietitians. The diet's basic assumptions are based on the appropriate selection of carbohydrates, healthy fats, and wholesome protein sources. It is also essential to properly compose meals, prepare them, and plan physical activities tailored to the abilities. The study aims to summarise the necessary information on IR with concomitant urolithiasis, which may be helpful in dietary practice.
Topics: Diet; Humans; Inflammation; Insulin; Insulin Resistance; Nutritionists; Obesity; Urolithiasis
PubMed: 35742405
DOI: 10.3390/ijerph19127160 -
Canadian Journal of Dietetic Practice... Sep 2017
Topics: Canada; Dietetics; Food; Health Promotion; Humans; Nutritionists
PubMed: 28799797
DOI: 10.3148/cjdpr-2017-025 -
Nutrients Sep 2020Dietitian involvement has considerable benefits for hospitalized patients, resulting in better health outcomes and improved quality of life. However, dietitian referral...
Dietitian involvement has considerable benefits for hospitalized patients, resulting in better health outcomes and improved quality of life. However, dietitian referral routines are often inappropriate in hospitals. The aim of this study was to identify predictors for dietitian referrals in hospitalized patients. This study was performed on data collected in an annually conducted cross-sectional study (in the years 2017, 2018, 2019). A standardized questionnaire was used to collect data, and logistic regression and a generalized estimating equation (GEE) model were used to calculate the associations between the patient characteristics and dietitian referrals. In the final GEE model, the following predictors for dietitian referrals remained significant: diabetes diagnosis (OR 1.80), cancer diagnosis (OR 1.76), digestive disease diagnosis (OR 2.03), presence of a pressure injury (OR 1.58), risk of malnutrition based on body mass index (BMI) and weight loss (OR 1.72), risk of malnutrition based on the malnutrition universal screening tool (MUST) (2.55), and the application of any malnutrition screening at admission to hospital (2.20). Total dietitian referral rate was 16.8%. The highest rate of dietitian referrals was found in patients with a risk of malnutrition (37%). This study included a large sample of hospitalized adult patients and revealed a low dietitian referral rate among these patients. These results indicate that dietitian involvement in hospitalized patients with nutrition-related conditions urgently needs to be improved.
Topics: Aged; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Nutritionists; Referral and Consultation
PubMed: 32962105
DOI: 10.3390/nu12092863 -
Nutrition & Dietetics: the Journal of... Jul 2022Scientific evidence underpins dietetics practice; however, evidence of how the therapeutic relationship influences outcomes is limited. This integrative review aims to... (Review)
Review
AIM
Scientific evidence underpins dietetics practice; however, evidence of how the therapeutic relationship influences outcomes is limited. This integrative review aims to provide a comprehensive overview of the topic of the therapeutic relationship between clients and dietitians in the individual counselling context by summarising empirical literature into qualitative themes.
METHODS
An electronic literature search of the Cumulative Index of Nursing and Allied Health Literature, PsychInfo, Scopus and Web of Science databases was conducted in October 2018 and repeated in February 2021. Studies were included if they explicitly referred to the therapeutic relationship (or associated terms), were based on study data and available in full text. Extracted data were checked by a second researcher and the methodological quality was evaluated independently by two researchers using the Mixed Methods Appraisal Tool. An iterative process of qualitatively coding, categorising and comparing data to examine recurring themes was applied.
RESULTS
Seventy-six studies met the inclusion criteria. Five themes were identified which showed the extent and nature of research in this area. Studies revealed the therapeutic relationship: (i) is valued within clinical dietetic practice, (ii) involves complex and multifactorial interactions, (iii) is perceived as having a positive influence, (iv) requires skills training and (v) is embedded in practice models and tools.
CONCLUSION
Studies show the therapeutic relationship is a valued and multifactorial component of clinical dietetic practice and is perceived to positively influence the client and dietitian. Observational data are needed to assess the extent to which the strength of the therapeutic relationship might contribute to clients' health outcomes.
Topics: Counseling; Dietetics; Humans; Nutritionists; Referral and Consultation
PubMed: 35324041
DOI: 10.1111/1747-0080.12723 -
BMC Gastroenterology Jul 2023Gastroparesis is delayed gastric emptying in the absence of obstruction; dietary modifications are first-line treatment. However, we do not know the factors related to...
BACKGROUND
Gastroparesis is delayed gastric emptying in the absence of obstruction; dietary modifications are first-line treatment. However, we do not know the factors related to provision of dietary recommendations.
METHODS
We sought to determine how often pediatric patients with gastroparesis receive dietary education (from a gastroenterology provider vs dietitian), the recommendations given, and factors related to these outcomes. We performed a retrospective chart review of children 2- to 18-years-old managed by pediatric gastroenterology providers at our institution. Patient demographics and clinical data, dietary advice given (if any), and dietitian consultation (if any), practice location, and prokinetic use were captured. An adjusted binomial regression model identified factors associated with dietary education provision, dietitian consultation, and diet(s) recommended.
RESULTS
Of 161 patients who met criteria, 98 (60.8%) received dietary education and 42 (26.1%) met with a dietitian. The most common recommendation by gastroenterology providers and dietitians was diet composition adjustment (26.5% and 47.6%, respectively). Patients with nausea/vomiting were less likely to receive dietary education or be recommended to adjust diet composition. Patients with weight loss/failure to thrive were more likely to receive dietitian support. Patients seen in the community vs medical center outpatient setting were more likely to be recommended a low-fat diet.
CONCLUSIONS
Only a little over half of children with gastroparesis receive dietary education and use of a dietitian's expertise is much less frequent. Symptoms and clinical setting appear related to what, where, and by whom guidance is provided.
Topics: Humans; Child; Child, Preschool; Adolescent; Retrospective Studies; Gastroparesis; Diet; Vomiting; Nausea; Gastric Emptying
PubMed: 37460973
DOI: 10.1186/s12876-023-02865-6 -
Telemedicine Reports 2022Hospitals are constantly searching for opportunities to improve efficiency, and telehealth (TH) has recently emerged as a strategy to assist in patient flow. We...
BACKGROUND
Hospitals are constantly searching for opportunities to improve efficiency, and telehealth (TH) has recently emerged as a strategy to assist in patient flow. We evaluated two methods of dietary counseling offered to patients in the time period between the medical and final hospital discharge. Counseling was given either the TH group or the face to face (FTF) group to the patients and their respective impact was evaluated on the patients' satisfaction and on the hospital patient flow.
METHODS
This study was a prospective, randomized clinical trial where patients were randomized to receive dietary counseling TH (use of tablet) or FTF at the time of hospital discharge. We evaluate the duration of time between medical discharge and hospital discharge; between requesting dietary counseling and dietitian's arrival; and duration of dietary counseling. At the end of dietary counseling, both groups received a patient satisfaction questionnaire to answer.
RESULTS
A total of 159 patients were randomized to receive dietary counseling TH (TH, = 78) or FTF (FTF, = 81). The two groups TH and FTF did not differ in terms of the median time between (1) medical and hospital discharge; (2) requesting counseling and the dietitian's arrival; and (3) duration of dietary counseling. Both groups mostly reported being "satisfied" or "above expectations," and the FTF group scored "highest satisfaction" more often relative to the dietitian's work and interaction and on confidence in the dietitian's orientations. Finally, in the TH group, 90.7% graded likely-4 or very likely-5 when asked whether dietary counseling can be conducted entirely TH, and 92% answered "4" or "5" when asked whether they would recommend dietary counseling TH.
CONCLUSIONS
Although the FTF group had a greater overall satisfaction relative to the TH group, TH proved to be a useful tool for dietary counseling.The trial has only Institutional Review Board approval (protocol 2685-16).
PubMed: 35860304
DOI: 10.1089/tmr.2021.0054 -
Canadian Journal of Dietetic Practice... Dec 2019
Topics: Canada; Diet, Healthy; Humans; Nutritionists; Planets
PubMed: 31736395
DOI: 10.3148/cjdpr-2019-028 -
Hawai'i Journal of Health & Social... Apr 2022There is scant literature available on the Registered Dietitian Nutritionist (RDN) workforce in the United States, but a review of healthcare systems suggests that... (Review)
Review
There is scant literature available on the Registered Dietitian Nutritionist (RDN) workforce in the United States, but a review of healthcare systems suggests that implementation of RDNs in primary care settings may improve access to care, patient satisfaction, and quality of care. The Area Health Education Center (AHEC), in partnership with the Hawai'i Academy of Nutrition and Dietetics (HAND), investigated 395 providers to evaluate the status of Hawai'i's RDN workforce. The research team utilized all available provider information and direct calling methodology to collect data from August 2019 to February 2020. Microsoft Excel software allowed for data analysis and ArcGIS mapping software was used to visualize provider totals and Full-Time Equivalencies (FTEs) across the state. This study identifies trends in workforce demographics and provider supply. Researchers found 100 RDNs providing direct patient care for a total of 82.4 FTEs. Women account for 94% of survey respondents, and the average age of providers was 48. RDNs who self-identify as being Asian American (41%) or White (47%) were the largest ethnic groups providing direct patient care. Seventy percent of the RDN workforce was located on O'ahu, while RDN FTEs are concentrated in mainly 5 zip codes, 1 on each of O'ahu, Kaua'i, and Maui and 2 on Hawai'i Island. Provider demand trends, increased training and retention efforts, and integration of nutritional services in healthcare teams should be further investigated.
Topics: Academies and Institutes; Delivery of Health Care; Female; Hawaii; Humans; Nutritionists; United States; Workforce
PubMed: 35495070
DOI: No ID Found -
Journal of Renal Nutrition : the... Jan 2022This study described the job responsibilities and modalities of care among dialysis dietitians in the United States and their observations regarding the nutrition needs...
OBJECTIVE
This study described the job responsibilities and modalities of care among dialysis dietitians in the United States and their observations regarding the nutrition needs of their patients, during the COVID-19 pandemic.
DESIGN AND METHODS
Cross-sectional online survey captures dietitian characteristics and responsibilities, dialysis facility characteristics, and patient needs. We recruited US dialysis dietitians. We used chi-square tests to compare respondent stress and facility-level policies regarding eating/drinking and oral nutrition supplements based on facility ownership type.
RESULTS
We received 191 complete or partial survey responses. Sixty-three percent of respondents stated that their center banned eating/drinking during dialysis due to COVID-19 masking policies. DaVita and non-profit facilities were significantly more likely to still allow eating/drinking during dialysis (31% and 29%, respectively) compared to Fresenius facilities (7%). A common theme in open-ended responses regarding nutrition care for COVID-19-positive patients was providing less care to these patients. A majority of respondents admitted to stress from working in healthcare during COVID-19. The majority of respondents indicated that patients were taking precautions such as having a family member or friend grocery shop for them (69%) or going to the store less often (60%). Just over a quarter of respondents indicated that affordability of food was a concern among patients. Seventy-two percent reported that patients were cooking at home more often, 60% had observed an increase in serum phosphorus, and 72% an increase in interdialytic weight gain.
CONCLUSIONS
Due to the increased risk of malnutrition and symptoms that can affect dietary intake in COVID-positive patients, and the economic conditions leading to increased rates of food insecurity, dietitians must be proactive in preventing and/or treating malnutrition through adequate protein and energy intake. Eating/drinking bans should not become permanent and dialysis centers should take precautions to allow intradialytic meals and oral nutrition supplement protocols to continue during the pandemic.
Topics: COVID-19; Cross-Sectional Studies; Humans; Nutritionists; Pandemics; Renal Dialysis; SARS-CoV-2; United States
PubMed: 34465503
DOI: 10.1053/j.jrn.2021.07.006 -
Journal of Human Nutrition and... Feb 2022A suitably prepared and qualified nutrition and dietetics workforce is part of the solution to combating the burden of disease. Competency-based assessment is a key part... (Review)
Review
BACKGROUND
A suitably prepared and qualified nutrition and dietetics workforce is part of the solution to combating the burden of disease. Competency-based assessment is a key part of the education of future workforces. Although there has been recent attention on competency-based assessment in dietetics, there is little exploration of competency-based education for the preparation of nutritionists. The present study aimed to understand how competency-based assessment is implemented and evaluated in nutrition education.
METHODS
A systematic literature review was carried out according to PRISMA guidelines. Four databases were initially searched in February 2020 using key words related to competenc* in combination with nutrition or dietetic and their synonyms. An updated search was completed again in March 2021. Studies that met eligibility criteria where the focus was on nutrition and involved a method of competency-based assessment were synthesised narratively.
RESULTS
From a total of 6262 titles and abstracts, six studies on competency assessment in nutrition education were identified. The assessments focused on the development of key skills, including motivational interviewing and nutrition assessment, changes to knowledge and attitudes on food and culture, and self-perceived development of communication, collaboration, management, advocacy, scholarship and professional capabilities. No studies were found that assessed promotion of health and wellbeing or the food chain competencies.
CONCLUSIONS
The lack of research in competency-based assessment must be addressed to ensure we are effectively preparing future nutritionists for work such that they can impact health outcomes.
Topics: Counseling; Dietetics; Health Education; Humans; Nutrition Assessment; Nutritional Status; Nutritionists
PubMed: 34541713
DOI: 10.1111/jhn.12946