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Nutrients Oct 2021Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated... (Review)
Review
BACKGROUND
Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the "real-world" nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium.
METHODS
A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country.
RESULTS
Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs.
CONCLUSIONS
Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.
Topics: Cooperative Behavior; Diet; Health Personnel; Humans; Nutritional Status; Nutritionists; Oral Health
PubMed: 34684589
DOI: 10.3390/nu13103588 -
Nutrients Jan 2022The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the...
The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey ( = 35) or an in-depth interview ( = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation; while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Diet, Vegetarian; Health Plan Implementation; Humans; Nutritionists; Patient Acceptance of Health Care; Patient Education as Topic; Qualitative Research; Renal Insufficiency, Chronic; Surveys and Questionnaires
PubMed: 35011091
DOI: 10.3390/nu14010216 -
International Journal of Environmental... Jul 2016Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its... (Review)
Review
Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug's pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations.
Topics: Comorbidity; Diet; Humans; Nutritional Status; Nutritionists; Obesity; Psoriasis; Risk Factors
PubMed: 27455297
DOI: 10.3390/ijerph13070743 -
Osteoarthritis and Cartilage Apr 2021Explore patient and dietitian experiences with a multi-component dietary weight loss program for knee osteoarthritis to understand enablers and challenges to success at...
"It's the single best thing I've done in the last 10 years": a qualitative study exploring patient and dietitian experiences with, and perceptions of, a multi-component dietary weight loss program for knee osteoarthritis.
OBJECTIVE
Explore patient and dietitian experiences with a multi-component dietary weight loss program for knee osteoarthritis to understand enablers and challenges to success at 6-months.
DESIGN
Qualitative study embedded within a randomised controlled trial. Semi-structured individual interviews with 24 patients with knee osteoarthritis who undertook, and five dietitians who supervised, a weight management program (involving a ketogenic very low calorie diet (VLCD), video consultations, educational resources) over 6 months. Data were thematically analysed.
RESULTS
Five themes were developed: (1) ease and convenience of program facilitated adherence (structure and simplicity of the meal replacements; not feeling hungry on diet; convenience of consulting via video) (2) social and professional support crucial for success (encouragement from partner, family, and friends; guidance from, and accountability to, dietitian; anxiety around going at it alone) (3) program was engaging and motivating (determination to stick to program; rapid weight loss helped motivation) (4) holistic nature of program was important (suite of high-quality educational resources; exercise important to compliment weight loss) (5) rewarding experience and lifelong impact (improved knee pain and function; positive lifestyle change).
CONCLUSIONS
Patients and dietitians described positive experiences with the weight management program, valuing its simplicity, effectiveness, and convenience. Support from dietitians and a comprehensive suite of educational resources, incorporated with an exercise program, were considered crucial for success. Findings suggest this multi-component dietary program is an acceptable weight loss method in people with knee osteoarthritis that may benefit symptoms. Strategies for supporting long-term independent weight management should be a focus of future research.
Topics: Aged; Attitude of Health Personnel; Attitude to Health; Diet, Ketogenic; Diet, Reducing; Female; Humans; Male; Middle Aged; Nutritionists; Obesity; Osteoarthritis, Knee; Qualitative Research; Weight Reduction Programs
PubMed: 33434629
DOI: 10.1016/j.joca.2021.01.001 -
Healthcare (Basel, Switzerland) Apr 2021Approximately one-third of adult inpatients are malnourished with substantial associated healthcare burden. Delegation frameworks facilitate improved nutrition care...
Approximately one-third of adult inpatients are malnourished with substantial associated healthcare burden. Delegation frameworks facilitate improved nutrition care delivery and high-value healthcare. This study aimed to explore knowledge, attitudes, and practices of dietitians and dietitian assistants regarding delegation of malnutrition care activities. This multi-site study was nested within a nutrition care implementation program, conducted across Queensland (Australia) hospitals. A quantitative questionnaire was conducted across eight sites; 87 dietitians and 37 dietitian assistants responded and descriptive analyses completed. Dietitians felt guidelines to support delegation were inadequate (agreement: <50% for assessment/diagnosis, care coordination, education, and monitoring and evaluation); dietitian assistants perceived knowledge and guidelines to undertake delegated tasks were adequate (agreement: >50% food and nutrient delivery, education, and monitoring and evaluation). Dietitians and dietitian assistants reported confidence to delegate/receive delegation (dietitian agreement: >50% across all care components; dietitian assistant agreement: >50% for assessment/diagnosis, food and nutrient delivery, education, monitoring and evaluation). Practice of select nutrition care activities were routinely performed by dietitians, rather than assistants ( < 0.001 across all nutrition care components). The process for care delegation needs to be improved. Clarity around barriers and enablers to delegation of care prior to implementing reforms to the current models of care is key.
PubMed: 33920280
DOI: 10.3390/healthcare9040446 -
BMC Health Services Research Apr 2023Currently, many public health issues are directly related to malnutrition, and are made worse by social inequities. Nutrition professionals must be a key player in...
BACKGROUND
Currently, many public health issues are directly related to malnutrition, and are made worse by social inequities. Nutrition professionals must be a key player in improving epidemiological aspects of nutrition-related diseases and must be part of clinical teams to control nutritional concerns.
OBJECTIVE
To identify and analyze the nutritionists´ employment situation in Ecuador and areas of work covered and determine if type of university has an impact over work situation.
METHODOLOGY
A cross-sectional study was conducted, approved by the ethics committee of Universidad San Francisco de Quito. It included 442 nutritionists in Ecuador who graduated in 13 universities (5 private (PR) and 8 public (PU)) between 2008 and 2019. It implied an online survey that questioned their satisfaction with their education and current work situation. All the statistical analyses were performed using R version 4.0.3, two-sided weighted chi-square test was performed to estimate the difference between public and private university graduates, IC 95%, p between 0.01 and 0.05.
RESULTS
38,6% of participants are unemployed, 68,28% private university graduates (PR) are currently employed and 58.87% work as nutritionists, compared to 56,86% from a public university (PU) currently working and 44.69% working in the field. 76% have reported being unemployed at some point in their careers, being difficulty finding jobs the main reason. Regarding the professional field, most professionals have their own business, and the less common area of work was public and community nutrition. One third of the participants had another paid activity. The main salary is 800USD per month and graduated from PR perceived better salaries than from PU.
CONCLUSION
There is a lack of job opportunities for Ecuadorian nutritionists despite the high demand in every level of the health system. Most have been unemployed at some point in their careers due to difficulties finding jobs. There is a minimum nutrition staff working in community and public health nutrition.
Topics: Humans; Ecuador; Nutritionists; Cross-Sectional Studies; Nutritional Status; Government Programs
PubMed: 37101179
DOI: 10.1186/s12913-023-09340-8 -
Nutrition & Dietetics: the Journal of... Jul 2021Dietitians must be statistically literate to effectively interpret the scientific literature underpinning the discipline. Despite this, no study has been conducted that... (Review)
Review
AIM
Dietitians must be statistically literate to effectively interpret the scientific literature underpinning the discipline. Despite this, no study has been conducted that objectively identifies common statistical methods and packages specific to current nutrition and dietetics literature. This study aimed to identify statistical methods and software frequently used in nutrition and dietetics research.
METHODS
A text mining approach using the bag-of-words method was applied to a random sample of articles obtained from all journals in the 'Nutrition and Dietetics' subject category within the SCImago Journal and Country Rank portal and published in 2018. A list of 229 statistical terms and 19 statistical software packages was developed to define the search terms to be mined. Statistical information from the methods section of included articles was extracted into Microsoft Excel (2016) for data cleaning. Statistical analyses were conducted in R (Version 3.6.0) and Microsoft Excel (2016).
RESULTS
Seven hundred and fifty-seven journal articles were included. Numerical descriptive statistics were the most common statistical method group, appearing in 83.2% of articles (n = 630). This was followed by specific hypothesis tests (68.8%, n = 521), general hypothesis concepts (58.4%, n = 442), regression (44.4%, n = 336), and ANOVA (30.8%, n = 233). IBM SPSS statistics was the most common statistical software package, reported in 41.7% of included articles.
CONCLUSION
These findings provide useful information for educators to evaluate current statistics curricula and develop short courses for continuing education. They may also act as a starting point for dietitians to educate themselves on typical statistical methods they may encounter.
Topics: Curriculum; Data Mining; Dietetics; Humans; Nutritionists; Software
PubMed: 34155748
DOI: 10.1111/1747-0080.12678 -
Diabetes Therapy : Research, Treatment... Oct 2018This article has been co-authored by a patient with type 2 diabetes and a specialist dietitian. Here they discuss the patient's experience and difficulties with...
This article has been co-authored by a patient with type 2 diabetes and a specialist dietitian. Here they discuss the patient's experience and difficulties with controlling weight and strategies that can help a patient in this situation. The patient discusses how stress and her corresponding comfort eating dampened weight loss progress, and how adopting a lifestyle change aided through group support helped to deal with this. The physician discusses the importance of recognizing the mental and physical challenges faced by patients in this situation.
PubMed: 30218433
DOI: 10.1007/s13300-018-0500-7 -
Advances in Nutrition (Bethesda, Md.) Sep 2023In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This...
In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
Topics: Child; Humans; Female; Aged; Nutritionists; Food Supply; Nutritional Status; Income; Food Assistance; Europe
PubMed: 37543145
DOI: 10.1016/j.advnut.2023.07.008 -
Journal of the Academy of Nutrition and... Nov 2022Professionalism is a vital aspect of health care and multidisciplinary teamwork. Although there is substantive professionalism literature in medicine and an expanding...
BACKGROUND
Professionalism is a vital aspect of health care and multidisciplinary teamwork. Although there is substantive professionalism literature in medicine and an expanding health care professions literature, there is a significant gap in understanding professionalism in dietetics. There are very few research papers in the dietetics literature on this issue compared with other health professions. Given the multidisciplinary nature of health care, it is important to understand what professionalism means within each profession to develop shared understandings across health care teams.
OBJECTIVE
The study aim was to explore how dietetics professionalism is conceptualized by dietetic practitioners/preceptors, faculty, and new graduates.
DESIGN
A constructionist exploratory qualitative interview study was conducted.
PARTICIPANTS/SETTING
One hundred participants (dietetics graduates, faculty, and practitioners/preceptors), associated with 17 universities across Australia and New Zealand and from diverse geographical and work settings, participated in 27 group and 24 individual interviews from March 2018 to June 2019.
STATISTICAL ANALYSES PERFORMED
Thematic framework analysis was used to examine participants' understandings of professionalism.
RESULTS
Twenty-three dimensions of dietetics professionalism were identified, with the most common being communication and including four novel dimensions of professionalism (generational, emotion management, cultural capability, and advocacy) not previously described in other professions. Professionalism as emotion management and generational adds new insights to the professionalism literature, expanding understandings of this vital aspect of health care. Although high levels of consistency in professionalism understandings existed across the three stakeholder groups, some interesting differences were found. The profession of dietetics shares similarities with other professions in the ways professionalism is conceptualized.
CONCLUSIONS
Using these dimensions of professionalism as a framework for teaching and learning about professionalism will help in clarifying expectations and expand shared understandings about professionalism for dietitians, other health professions, and across multidisciplinary teams.
Topics: Humans; Dietetics; Professionalism; Nutritionists; Qualitative Research; Faculty
PubMed: 35202846
DOI: 10.1016/j.jand.2022.02.010