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Nutricion Hospitalaria Apr 2021The health industry has experienced great innovation and will continue to do so in the coming years. The term innovation comes from "outside to inside" driven by the...
The health industry has experienced great innovation and will continue to do so in the coming years. The term innovation comes from "outside to inside" driven by the need for knowledge and research to truly translate into effective improvements (hence the sequence from Research and Development to Innovation: R+D+I); but it also comes from "bottom up" as a drive of the health organization (based, as few others, on knowledge as a fundamental asset) to give way to their creativity and their ability to find new solutions to old and new problems. The current health system must advance in the development of a more global and integrated philosophy of care, which allows dealing with the consequences of aging and the increase in chronic diseases and dependence, which represent an increase in the demand for care. In the medium-long term, a care logic based on individual characteristics from the molecular perspective should be promoted, which is known as 5P medicine (personalized, preventive, predictive, participatory and population), also called personalized medicine, a paradigm that has already initiated its entry, slow and uneven, in health systems. And it must also adapt to a society with more informed and participatory people in the management of their own health, which increasingly use technologies whose development speed grows exponentially. Taking into account these characteristics and objectives, in this article we seek to define the fundamental features of the intersection between innovation and clinical nutrition.
Topics: Aging; Dietetics; Diffusion of Innovation; Humans; Mobile Applications; Nutritional Physiological Phenomena; Online Social Networking; Precision Medicine; Preventive Medicine; Self Care; Telemedicine
PubMed: 33525884
DOI: 10.20960/nh.03559 -
Nutrients Mar 2022This systematic literature review examined whole food or whole diet interventions to treat depression. The inclusion criteria encompassed adults, depression, a... (Review)
Review
This systematic literature review examined whole food or whole diet interventions to treat depression. The inclusion criteria encompassed adults, depression, a recognized depression scale and a whole food or diet intervention. APA PsychINFO, CINAHL, the Cochrance Central Register of Controlled Trails, MEDLINE and Scopus were searched for original research addressing diet as a treatment for depression in adult populations. The quality of the study was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Seven studies; with 49,156 participants; met the eligibility criteria. All these studies found positive outcomes with depression levels decreasing after dietary intervention. The calculated effect size varied from small (Cohen's = 0.32) to very large (Cohen's = 1.82). The inconsistent nature of the studies limited the synthesis of the data. Recommendations are provided to enhance future study design and measurement outcomes. Overall, the findings show a positive result for diets that promote an increased intake of fresh produce, wholegrains, low-fat dairy and lean protein sources, while also decreasing the intake of processed and high-fat foods. No funding was provided for this review. The protocol for this review is registered with PROSPERO (CRD42020210426).
Topics: Adult; Depression; Diet, Fat-Restricted; Dietetics; Humans; Nutritional Status
PubMed: 35406011
DOI: 10.3390/nu14071398 -
Cancers Jul 2022Malnutrition, intended as both overnutrition and undernutrition, is a common problem in children with cancer, impacting quality of life as well as survival. In addition,... (Review)
Review
Malnutrition, intended as both overnutrition and undernutrition, is a common problem in children with cancer, impacting quality of life as well as survival. In addition, nutritional imbalances during childhood can significantly affect proper growth. Nevertheless, there is currently a lack of a systematic approach to this issue in the pediatric oncology population. To fill this gap, we aimed to provide practice recommendations for the uniform management of nutritional needs in children with cancer. Twenty-one clinical questions addressing evaluation and treatment of nutritional problems in children with cancer were formulated by selected members from four Italian Association of Pediatric Hematology and Oncology (AIEOP) centers and from the Survivorship Care and Nutritional Support Working Group of Alliance Against Cancer. A literature search in PubMed was performed; during two consensus meetings, all recommendations were discussed and finalized using the nominal group technique. Members representing every institution voted on each recommendation. Finally, recommendations were approved by all authors.
PubMed: 35884438
DOI: 10.3390/cancers14143378 -
Nutricion Hospitalaria Aug 2020Chronic diseases and aging are placing an ever increasing burden on healthcare services worldwide. Nutritional counselling is a priority for primary care because it has... (Review)
Review
Chronic diseases and aging are placing an ever increasing burden on healthcare services worldwide. Nutritional counselling is a priority for primary care because it has shown substantial cost savings. This review aims to evaluate the evidence of the cost-effectiveness of nutritional care in primary care provided by health professionals. A literature search was conducted using PubMed/MEDLINE between January 2000 and February 2019. The review included thirty-six randomized controlled trials (RCTs) and systematic reviews conducted in healthy people and people with obesity, type-2 diabetes mellitus, cardiovascular risk or malnutrition. All the RCTs and reviews showed that nutritional intervention led by dietitians-nutritionists in people with obesity or cardiovascular risk factors was cost-effective. Dietary interventions led by nurses were cost-effective in people who needed to lose weight but not in people at high cardiovascular risk. Some dietary changes led by a primary care team in people with diabetes were cost-effective. Incorporating dietitians-nutritionists into primary care settings, or increasing their presence, would give people access to the healthcare professionals who are best qualified to carry out nutritional treatment, and may be the most cost-effective intervention in terms of health expenditure. Notwithstanding the limitations described, this review suggests that incorporating dietitians-nutritionists into primary health care as part of the multidisciplinary team could be regarded as an investment in health. Even so, more research is required to confirm the conclusions.
Topics: Cost-Benefit Analysis; Diabetes Mellitus, Type 2; Dietetics; Humans; Malnutrition; Nutrition Therapy; Obesity; Patient Care Team; Primary Health Care
PubMed: 32686448
DOI: 10.20960/nh.03025 -
Public Health Nutrition Apr 2021Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean.
OBJECTIVE
Identify and characterise the food industry's involvement in nutrition and dietetics national and regional events in Latin America and the Caribbean.
DESIGN
Between February and April 2020, we conducted desk-based searches for nutrition and dietetics events held in the region between January 2018 and December 2019. Online freely accessible, publicly available information was collected on the involvement of the food industry through: sponsorship of events; sponsorship of sessions; speakers from the food industry; scholarships, fellowship, grants, awards and other prizes and; exhibition space/booths.
SETTING
Nutrition and dietetics events in Latin America and the Caribbean.
RESULTS
Thirty-one events held in twenty countries of the region had information publicly available online at the period of data collection. There was a lack of transparency on the involvement of industry actors in these events. When information was publicly available, we found that a total of ninety-two food industry actors sponsored 88 % of these events.
CONCLUSIONS
There is a mostly unreported, but likely extensive, involvement of food industry actors in nutrition and dietetics events in Latin America and the Caribbean.
Topics: Caribbean Region; Food Industry; Food-Processing Industry; Humans; Latin America; Nutritional Status
PubMed: 33118920
DOI: 10.1017/S1368980020003870 -
Nutrients Jan 2023Breast cancer (BC) is the most common cancer worldwide. Chemotherapy (CT) is essential for the treatment of BC, but is often accompanied by several side effects,... (Review)
Review
Breast cancer (BC) is the most common cancer worldwide. Chemotherapy (CT) is essential for the treatment of BC, but is often accompanied by several side effects, including taste alterations, due to different mechanisms. Although dysgeusia is usually underestimated by clinicians, it is considered very worrying and disturbing by cancer patients undergoing CT, because it induces changes in dietary choices and social habits, affecting their physical and psychological health, with a profound impact on their quality of life. Several strategies and therapies have been proposed to prevent or alleviate CT-induced dysgeusia. This review aimed to evaluate the available evidence on prevalence, pathophysiological mechanisms, clinical consequences, and strategies for managing dysgeusia in BC patients receiving CT. We queried the National Library of Medicine, the Cochrane Library, Excerpta Medica dataBASE, and the Cumulative Index to Nursing and Allied Health Literature database, performing a search strategy using database-specific keywords. We found that the literature on this topic is scarce, methodologically limited, and highly heterogeneous in terms of study design and criteria for patient inclusion, making it difficult to obtain definitive results and make recommendations for clinical practice.
Topics: Humans; Female; Dysgeusia; Breast Neoplasms; Quality of Life; Diet
PubMed: 36615883
DOI: 10.3390/nu15010226 -
Australian Critical Care : Official... May 2024Recommendations to facilitate evidence-based nutrition provision for critically ill children exist and indicate the importance of nutrition in this population. Despite...
BACKGROUND
Recommendations to facilitate evidence-based nutrition provision for critically ill children exist and indicate the importance of nutrition in this population. Despite these recommendations, it is currently unknown how well Australian and New Zealand (ANZ) paediatric intensive care units (PICUs) are equipped to provide nutrition care.
OBJECTIVES
The objectives of this project were to describe the dietitian and nutrition-related practices and resources in ANZ PICUs.
METHODS
A clinician survey was completed as a component of an observational study across nine ANZ PICUs in June 2021. The online survey comprised 31 questions. Data points included reporting on dietetics resourcing, local feeding-related guidelines and algorithms, nutrition screening and assessment practices, anthropometry practices, and indirect calorimetry (IC) device availability and local technical expertise. Data are presented as frequency (%), mean (standard deviation), or median (interquartile range).
RESULTS
Survey responses were received from all nine participating sites. Dietetics staffing per available PICU bed ranged from 0.01 to 0.07 full-time equivalent (median: 0.03 [interquartile range: 0.02-0.04]). Nutrition screening was established in three (33%) units, all of which used the Paediatric Nutrition Screening Tool. Dietitians consulted all appropriate patients (or where capacity allowed) in six (66%) units and on a request or referral basis only in three (33%) units. All units possessed a local feeding guideline or algorithm. An IC device was available in two (22%) PICUs and was used in one of these units.
CONCLUSIONS
This is the first study to describe the dietitian and nutrition-related practices and resources of ANZ PICUs. Areas for potential improvement include dietetics full-time equivalent, routine nutrition assessment, and access to IC.
Topics: Child; Humans; Australia; Intensive Care Units, Pediatric; New Zealand; Nutritional Status; Nutritionists
PubMed: 37169654
DOI: 10.1016/j.aucc.2023.03.003 -
BMC Health Services Research Jan 2021Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems...
BACKGROUND
Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders' perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor's degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda.
METHODS
A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor's degrees in HN/HND obtained from the Makerere and Kyambogo Universities in 2005-2016; 14 academic staff that train HN/HND in the two universities; and 11 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey; data from other participants was through face to face interviews using researcher administered questionnaires.
RESULTS
Most HN/HND respondents (84.8%) obtained their Bachelor's degrees from Kyambogo University; 61.4% graduated in 2013-2016. Most (64.3%) academic staff respondents were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges cutting across different Sustainable Development Goals. The nutrition and dietetics interventions requested for, provided, and considered a priority for communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main competency domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research; and advocacy, communication, and awareness creation.
CONCLUSIONS
This study shows that nutrition and dietetics challenges in Uganda are multiple and multifaceted; HN/HND graduates are employed in different sectors, provide nutrition-specific and sensitive services in a multisectoral environment, and are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps in some of the areas they are expected to exhibit competency. We recommend using these findings as a basis for obtaining stakeholder consensus on the key competencies that should be exhibited by all HN/HND graduates in Uganda; developing a HN/HND competency-based education model and a national HN/HND training and practice standard; and undertaking further research to understand the quality and relevancy of HN/HND curricula to Uganda's job market requirements.
Topics: Cross-Sectional Studies; Dietetics; Female; Humans; Male; Perception; Professional Competence; Uganda
PubMed: 33504348
DOI: 10.1186/s12913-021-06090-3 -
Journal of the Academy of Nutrition and... Nov 2022The transition from student to dietitian is an implicit expectation of dietetic education. Although there has been an expanding literature around elements of...
BACKGROUND
The transition from student to dietitian is an implicit expectation of dietetic education. Although there has been an expanding literature around elements of competency-based education, little attention has focused on sociocultural aspects of learning and professional identity formation in dietetic education.
OBJECTIVE
The aim of this study was to explore sociocultural factors in dietetics education influencing the transition into the profession from the perspective of dietetics students and educators.
DESIGN
An exploratory qualitative study underpinned by social constructionism.
PARTICIPANTS/SETTING
From March 2018 until June 2019, interviews (individual and group) with final-year students (n = 22), dietetic preceptors (n = 27), and university faculty members (n = 51) from 17 of the 18 universities in Australia and New Zealand with accredited dietetic programs were undertaken and explored sociocultural factors in dietetic education.
ANALYSIS PERFORMED
Data were analyzed into key themes using framework analysis and applying the sociocultural theory of landscapes of practice.
RESULTS
Sociocultural factors are powerful influences on the student-professional transition. Dietetic cultures and minicultures of cohesion, conformity, competition, and conflict aversion exist. Boundaries exist within learning environments, which can limit or pose challenges to professional identity formation and transition into the profession.
CONCLUSION
Stakeholders involved in dietetics education play pivotal roles in shaping the microcultures students learn and work within, which influence and impact socialization and transition into the profession. Opportunities exist to re-vision curriculum and foster positive learning cultures with a focus on sociocultural learning, including supporting boundary crossing and professional identity development.
Topics: Humans; Dietetics; Nutritionists; Students; Competency-Based Education; Universities
PubMed: 35346871
DOI: 10.1016/j.jand.2022.03.015 -
The Ulster Medical Journal May 2022The translation of scientific evidence into guidelines and advice is a fundamental aspect of scientific communication within nutrition and dietetics. For communication... (Review)
Review
The translation of scientific evidence into guidelines and advice is a fundamental aspect of scientific communication within nutrition and dietetics. For communication to be effective for all patients, health literacy (HL) must be considered, i.e. an individual's capacity to obtain, comprehend and utilise information to empower decision-making and promote their own health. HL levels are varied and difficult to judge on an individual basis and have not been quantified, thus not giving a population mean HL competency indication. It has been evidenced that most of the working age population in England cannot comprehend healthcare materials due to complexity, thereby promoting a need for agreed readability thresholds for written healthcare information. A wide range of modalities within dietetics are used to communicate to a varied audience with the primary form written, e.g. journal articles, plain language summaries and leaflets. Audio/visual and digital communications are increasing in dietetic care and welcomed by patients; however, the effectiveness of such approaches has not been studied thoroughly and digital exclusion remains a concern. Communication considering a patient's HL level leads to empowerment which is key to effective management of chronic diseases with a high treatment burden. Therefore; this review will focus on the importance of modalities used to communicate science in nutrition to ensure they are appropriate in relation to Health Literacy.
Topics: Chronic Disease; Communication; Comprehension; Delivery of Health Care; Health Literacy; Humans
PubMed: 35722219
DOI: No ID Found