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Nutrients Feb 2022Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital...
Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital inpatients with or at risk of malnutrition remains primarily individually delivered by dietitians-an approach that is not considered sustainable. This study aimed to identify barriers and enablers to delegating malnutrition care activities to dietitian assistants. This qualitative descriptive study was nested within a broader quality assurance activity to scale and spread systematised and interdisciplinary malnutrition models of care. Twenty-three individual semi-structured interviews were completed with nutrition and dietetic team members across seven hospitals. Inductive thematic analysis was undertaken, and barriers and enablers to delegation of malnutrition care to dietitian assistants were grouped into four themes: working with the human factors; balancing value and risk of delegation; creating competence, capability, and capacity; and recognizing contextual factors. This study highlights novel insights into barriers and enablers to delegating malnutrition care to dietitian assistants. Successful delegation to dietitian assistants requires the unique perspectives of humans as individuals and in their collective healthcare roles, moving from words to actions that value delegation; engaging in processes to improve competency, capability, and capacity of all; and being responsive to climate and contextual factors.
Topics: Dietetics; Humans; Malnutrition; Nutritional Status; Nutritionists; Qualitative Research
PubMed: 35268008
DOI: 10.3390/nu14051037 -
Canadian Journal of Dietetic Practice... Dec 2023This scoping review mapped literature available on Canadian dietetics, nutrition, and foods students' and graduates' interaction(s) with simulation-based education (SBE)...
This scoping review mapped literature available on Canadian dietetics, nutrition, and foods students' and graduates' interaction(s) with simulation-based education (SBE) during undergraduate and/or practicum. One certified Librarian led the preliminary search (Summer, 2021), while three Joanna Briggs Institute-trained reviewers conducted the comprehensive search via MEDLINE (OVID), CINAHL (EBSCO), Academic Search Premier (EBSCO), Embase (Elsevier), Scopus (Elsevier), and Google (February 2022). A data extraction tool designed specifically for the study objectives and research inclusion criteria was used. We recorded 354 results and included 7. Seven types of SBE were recorded: () comprehensive care plan (n = 2); () nutritional diagnosis/assessment (n = 2); () body composition assessment (n = 1); () introducing patient to dysphagia care (n = 1); () nutrition counselling session (n = 1); () nutrition-focused physical examination (n = 1); and () professional communications via social media (n = 1). Results indicate that Canadian dietitian-led SBE includes the use of simulated patients, nutritional diagnosis/assessment, and the creation of comprehensive care plans, among others. Students have been assessed for performance of trained tasks through exams, self-awareness surveys, and interviews, and SBE activities have been evaluated for effectiveness through questionnaires and interviews with users/students. Canadian literature is limited, and more can be learned by exploring the global context within and outside the profession.
Topics: Humans; Canada; Dietetics; Educational Status; Learning; Students
PubMed: 37436143
DOI: 10.3148/cjdpr-2023-016 -
Journal of Human Nutrition and... Feb 2023One in seven couples are impacted by infertility in the UK, and female infertility is often associated with several health conditions impacted by nutrition. Despite many... (Review)
Review
BACKGROUND
One in seven couples are impacted by infertility in the UK, and female infertility is often associated with several health conditions impacted by nutrition. Despite many studies aimed at identifying the critical role of nutrition in infertility, there is currently no screening tool that identifies nutritional risk factors for infertility.
AIM
To propose a self-administered screening tool to identify women who would benefit from nutritional intervention to promote fertility.
METHODS
A narrative review was carried out to identify and summarise modifiable nutritional risk factors that can influence female fertility, including comorbidities that can influence nutrition intake, absorption, and metabolism.
KEY FINDINGS
A nutrition screening tool outlining modifiable nutrition risk factors potentially improving female fertility has been proposed, comprising of BMI, medical history and quality of diet and lifestyle which would aid in designing evidence based dietetic services for female infertility.
Topics: Humans; Female; Infertility, Female; Dietetics; Nutritional Status; Diet; Fertility
PubMed: 35762584
DOI: 10.1111/jhn.13055 -
Nutrition & Dietetics: the Journal of... Feb 2023This study aimed to explore dietitians' perspectives on the evidence surrounding the relationship between diet and 'gut health' and the current and emerging role of...
AIMS
This study aimed to explore dietitians' perspectives on the evidence surrounding the relationship between diet and 'gut health' and the current and emerging role of dietetics practice in this area.
METHODS
A qualitative descriptive methodology was used. Online semi-structured interviews were conducted with Australian dietitians, focused on the perspectives related to gut health management in dietetics practice. Inductive thematic analysis was employed, commencing with initial coding by two researchers, and further coding leading to development of emergent themes. Divergent data were discussed and considered in analysis.
RESULTS
Fourteen interviews were conducted (2 males, 12 females). An overarching theme identified that current evidence is insufficient to direct dietetics practice change regarding gut health. Six subthemes on dietetics practice in 'gut health' emerged including (a) practice is multifaceted, (b) current practice aligns with dietary guidelines, (c) symptom management remains the primary concern, (d) evidence-based information is sought, (e) translational evidence is required for practice change and (f) there is a role for dietetics in gut health research and translation.
CONCLUSIONS
Dietitians do not appear confident in their practice regarding gut microbiome-related management and recognise there is currently limited translatable research to inform practice. Evidence to date suggests that recommendations for positive gut health do not differ substantially from Australian Dietary Guidelines. Dietitians will need additional education if further evidence emerges, however they demonstrated a strong commitment to evidence-based practice.
Topics: Male; Female; Humans; Dietetics; Nutritionists; Australia; Diet
PubMed: 36217214
DOI: 10.1111/1747-0080.12778 -
The Journal of Nutrition Jan 2023Food and nutrition are popular topics in the media and on social media. The ubiquity of social media has created new opportunities for qualified or credentialed experts...
Food and nutrition are popular topics in the media and on social media. The ubiquity of social media has created new opportunities for qualified or credentialed experts in the scientific community to connect with clients and the public. It has also created challenges. Health and wellness gurus, or self-proclaimed experts, utilize social media platforms to garner attention through compelling narratives, build audience followings, and influence public opinion by sharing (often) misleading information about food and nutrition. The consequence of this can be the perpetuation of misinformation, which not only undermines a well-functioning democracy but also diminishes support for policies that are science or evidence based. Nutrition practitioners, clinician scientists, researchers, communicators, educators, and food experts need to encourage and model critical thinking (CT) to participate in our world of mass information and mitigate misinformation. These experts can play a vital role in the evaluation of information about food and nutrition against the body of evidence. This article explores the role of CT and ethics of practice in the context of misinformation and disinformation by providing a framework for engaging with clients and offering a checklist for ethical practice.
Topics: Humans; Dietetics; Disinformation; Food Technology; Communication; Nutritional Status
PubMed: 36913465
DOI: 10.1016/j.tjnut.2022.10.001 -
The American Journal of Gastroenterology Nov 2020Celiac disease (CeD) is a lifelong immune-mediated enteropathy in which dietary gluten triggers an inflammatory reaction in the small intestine. This retrospective...
INTRODUCTION
Celiac disease (CeD) is a lifelong immune-mediated enteropathy in which dietary gluten triggers an inflammatory reaction in the small intestine. This retrospective cohort study examines healthcare resource utilization (HRU) and costs between patients with CeD and matched controls.
METHODS
Patients with CeD (cases) with an endoscopic biopsy and ≥2 medical encounters with a CeD diagnosis between January 1, 2010, and October 1, 2015, were identified in the MarketScan databases. The date of the first claim with a CeD diagnosis on or after the endoscopic biopsy was the index date. Cases were matched 1:1 to patients without CeD (controls) on demographic characteristics and Deyo-Charlson Comorbidity Index score. Clinical characteristics, all-cause, and CeD-related HRU and costs (adjusted to 2017 US dollars) were compared between cases and controls during the 12 months before (baseline) and 24 months after (follow-up) the index date.
RESULTS
A total of 11,008 cases (mean age 40.6 years, 71.3% women) were matched to 11,008 controls. During the follow-up, a higher proportion of cases had all-cause and CeD-related HRU including inpatient admissions, emergency department visits, gastroenterologist visits, dietician visits, endoscopic biopsies, and gastroenterology imaging (all P ≤ 0.002). Incremental all-cause and CeD-related costs were in the first ($7,921 and $2,894) and second ($3,777 and $935) year of follow-up, driven by outpatient services costs.
DISCUSSION
In this US national claims database analysis, there was evidence of an increase in both all-cause and CeD-related HRU and related costs in patients with CeD compared with matched patients without CeD, suggesting a significant economic burden associated with CeD.
Topics: Adult; Ambulatory Care; Biopsy; Case-Control Studies; Celiac Disease; Dietetics; Emergency Service, Hospital; Endoscopy, Gastrointestinal; Female; Gastroenterology; Health Care Costs; Health Resources; Hospitalization; Humans; Male; Middle Aged; United States; Young Adult
PubMed: 33156101
DOI: 10.14309/ajg.0000000000000759 -
Poultry Science Apr 2021The aim of this study was to determine the effect of addition of alfalfa protein concentrate (APC) at the dose of 15 g or 30 g per 1 kg on the chemical composition,...
Effects of dietary alfalfa protein concentrate on lipid metabolism and antioxidative status of serum and composition and fatty acid profile and antioxidative status and dietetic value of muscles in broilers.
The aim of this study was to determine the effect of addition of alfalfa protein concentrate (APC) at the dose of 15 g or 30 g per 1 kg on the chemical composition, fatty acid profile, dietary value, and antioxidant status in muscles and serum of Ross 308 chickens. The experiment involved 150 1-day-old Ross 308 broiler chickens allocated into 3 groups in 5 replications (10 birds per pen). A 1-way system with 2 levels of APC, 15 g or 30 g per 1 kg of a complete diet, was used. Group C receiving a standard feed mixture without APC was the control. The addition of 15 and 30 g APC increased the CP content in the breast muscle and in the thigh muscle, and reduction in the cholesterol and fat level was noted. Higher content of polyunsaturated fatty acids from the n-6 group was noted in the breast muscles of the 30-g APC-supplemented chickens. The thigh muscles with APC were characterized by more favorable values of the atherogenic index, thrombotic index, and hypocholesterol-to-hypercholesterol ratio.The supplementation with 30 g APC reduced the cholesterol and triacylglycerol levels, increased the high-density lipoprotein level, and decreased the low-density lipoprotein level and improved the antioxidant parameters in plasma (increase in superoxide dismutase and in glutathione peroxidase and reduction of malondialdehyde), compared with group C. The results of this study indicate that the supplementation with 30 g APC improved the metabolic functions of the organism, meat resistance to oxidative processes, and the composition and profile of fatty acids. Therefore, APC can be a potential alternative to synthetic feed additives and soya protein in production of healthier poultry meat.
Topics: Animal Feed; Animals; Antioxidants; Chickens; Diet; Dietary Supplements; Dietetics; Fatty Acids; Lipid Metabolism; Meat; Medicago sativa
PubMed: 33588343
DOI: 10.1016/j.psj.2020.12.071 -
Journal of Medical Internet Research Feb 2018Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding... (Review)
Review
BACKGROUND
Social media platforms are increasingly used by registered dietitians (RDs) to improve knowledge translation and exchange in nutrition. However, a thorough understanding of social media in dietetic practice is lacking.
OBJECTIVE
The objective of this study was to map and summarize the evidence about the users, uses, and effects of social media in dietetic practice to identify gaps in the literature and inform future research by using a scoping review methodology.
METHODS
Stages for conducting the scoping review included the following: (1) identifying the research question; (2) identifying relevant studies through a comprehensive multidatabase and gray literature search strategy; (3) selecting eligible studies; (4) charting the data; and (5) collating, summarizing, and reporting results for dissemination. Finally, knowledge users (RDs working for dietetic professional associations and public health organizations) were involved in each review stage to generate practical findings.
RESULTS
Of the 47 included studies, 34 were intervention studies, 4 were descriptive studies, 2 were content analysis studies, and 7 were expert opinion papers in dietetic practice. Discussion forums were the most frequent social media platform evaluated (n=19), followed by blogs (n=13) and social networking sites (n=10). Most studies targeted overweight and obese or healthy users, with adult populations being most studied. Social media platforms were used to deliver content as part of larger multiple component interventions for weight management. Among intervention studies using a control group with no exposition to social media, we identified positive, neutral, and mixed effects of social media for outcomes related to users' health behaviors and status (eg, dietary intakes and body weight), participation rates, and professional knowledge. Factors associated with the characteristics of the specific social media, such as ease of use, a design for quick access to desired information, and concurrent reminders of use, were perceived as the main facilitators to the use of social media in dietetic practice, followed to a lesser extent by interactions with an RD and social support from fellow users. Barriers to social media use were mostly related to complicated access to the site and time issues.
CONCLUSIONS
Research on social media in dietetic practice is at its infancy, but it is growing fast. So far, this field of research has targeted few social media platforms, most of which were assessed in multiple-component interventions for weight management among overweight or obese adults. Trials isolating the effects and mechanisms of action of specific social media platforms are needed to draw conclusions regarding the effectiveness of those tools to support dietetic practice. Future studies should address barriers and facilitators related to the use of social media written by RDs and should explore how to make these tools useful for RDs to reach health consumers to improve health through diet.
Topics: Dietetics; Health Behavior; Humans; Social Media; Social Support
PubMed: 29463487
DOI: 10.2196/jmir.9230 -
The British Journal of Nutrition May 2022In May 2021, the Scientific Advisory Committee on Nutrition (SACN) published a risk assessment on lower carbohydrate diets for adults with type 2 diabetes (T2D). The...
In May 2021, the Scientific Advisory Committee on Nutrition (SACN) published a risk assessment on lower carbohydrate diets for adults with type 2 diabetes (T2D). The purpose of the report was to review the evidence on 'low'-carbohydrate diets compared with the current UK government advice on carbohydrate intake for adults with T2D. However, since there is no agreed and widely utilised definition of a 'low'-carbohydrate diet, comparisons in the report were between lower and higher carbohydrate diets. SACN's remit is to assess the risks and benefits of nutrients, dietary patterns, food or food components for health by evaluating scientific evidence and to make dietary recommendations for the UK based on its assessment. SACN has a public health focus and only considers evidence in healthy populations unless specifically requested to do otherwise. Since the Committee does not usually make recommendations relating to clinical conditions, a joint working group (WG) was established in 2017 to consider this issue. The WG comprised members of SACN and members nominated by Diabetes UK, the British Dietetic Association, Royal College of Physicians and Royal College of General Practitioners. Representatives from NHS England and NHS Health Improvement, the National Institute for Health and Care Excellence and devolved health departments were also invited to observe the WG. The WG was jointly chaired by SACN and Diabetes UK.
Topics: Adult; Humans; Diabetes Mellitus, Type 2; Diet, Carbohydrate-Restricted; Dietetics; Carbohydrates; England
PubMed: 34719409
DOI: 10.1017/S0007114521002373 -
Supportive Care in Cancer : Official... May 2023This study aimed to understand the experience of families caring for a child with cancer in New Zealand (NZ) who received nutrition and dietetic support during cancer...
PURPOSE
This study aimed to understand the experience of families caring for a child with cancer in New Zealand (NZ) who received nutrition and dietetic support during cancer treatment and their preferences for the delivery, format, and timing of nutrition information.
METHODS
Childhood cancer patients and their families (N = 21) participated in a mixed-methods study at a specialist paediatric oncology centre in Auckland, NZ. Before the semi-structured interview, participants completed a questionnaire capturing demographic, disease, and treatment characteristics of their child, their nutrition concerns, and their information needs. Quantitative data were described, and qualitative thematic analysis of the semi-structured interviews was performed using NVivo data analysis software.
RESULTS
Eighty-six percent of participants indicated they had concerns about their child's nutrition during treatment. The most common concerns were anorexia, vomiting, and weight loss. While many were happy with the quality of the nutrition support received, one-third of the patients wanted more support. Four key themes emerged from the interviews: (1) patients experience significant and distressing nutrition challenges; (2) patients and families have mixed perceptions of EN; (3) there are gaps in the current nutrition support system for inpatients; and (4) a desire for more accessible nutrition support.
CONCLUSION
Childhood cancer patients and families experience significant and distressing nutrition challenges during treatment. Standardising information given to patients and their families may optimise nutrition support for paediatric oncology patients and reduce the discordance between families and health professionals. Future implementation of a nutrition decision aid in this population is warranted.
Topics: Humans; Child; Dietetics; Neoplasms; Inpatients; Nutritional Status; Medical Oncology; Qualitative Research
PubMed: 37154869
DOI: 10.1007/s00520-023-07787-3