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Nutrition & Dietetics: the Journal of... Jul 2021The aim of this study was to explore the use and future potential of realist approaches to research in nutrition and dietetics. (Review)
Review
AIM
The aim of this study was to explore the use and future potential of realist approaches to research in nutrition and dietetics.
METHODS
A targeted literature review was used to search key journals (n = 7) in nutrition and dietetics to identify existing research using a realist approach. A narrative synthesis was conducted to explore findings in relation to the research aim.
RESULTS
Nine research papers (four realist evaluations, five realist reviews) describing seven nutrition interventions were found, which revealed the application of realist research in nutrition and dietetics has focused on public health interventions. Realist research provided a deeper, more nuanced understanding of varied outcomes including the role of context, and contributed to the development of theory about how and why interventions work. As a theory-driven research method, realist research was able to assist in overcoming methodological shortcomings to contribute to meaningful, transferable findings.
CONCLUSION
The results highlight the potential contribution of the realist research in nutrition and dietetics to evaluate interventions and inform future practice.
Topics: Dietetics; Humans; Nutritional Status; Public Health; Research Design
PubMed: 34155774
DOI: 10.1111/1747-0080.12675 -
Advances in Nutrition (Bethesda, Md.) Jan 2019Decision making in nutrition is based on current available scientific evidence. However, we are currently living in a time of highly accessible information, and with the... (Review)
Review
Decision making in nutrition is based on current available scientific evidence. However, we are currently living in a time of highly accessible information, and with the increase in accessibility has come a concomitant increase in misinformation and pseudoscience relating to nutrition. This presents a challenge to the nutrition research community, practitioners, and consumers, and highlights a need to critically examine the current evidence-based framework in nutrition, and identify strategies for future improvements. This narrative review outlines the current evidence-based framework and approaches to evidence-based practice in the nutrition field, focusing on policy and guideline development. Within the framework, systematic reviews are an important tool for evidence-based practice, underpinning translation guidelines and other implementation documents. Recommendations for consumption of nutrients, foods, and whole diets are required to guide consumers and practitioners; however, these resources must be updated regularly to remain timely and accurate. In turn, clinical practice guidelines guide practitioners in how to implement the evidence base for patients and clients, supporting practitioners to be positioned as a key conduit between scientific evidence and the public. In contrast, health claims may support marketing of food products, but require consideration of the strength and quality of the evidence to support health claims, with external oversight required to ensure claims are appropriate. Collecting, synthesizing, and translating the evidence base in nutrition remains an ongoing challenge, particularly in the current context of increased information availability. To address growing challenges in combating pseudoscience, nutrition researchers, policy makers, and practitioners must work together, and the role of practitioners in translating the evidence base and personalizing it to individual patients must be emphasized. Continuing to address current challenges, including increasing the timeliness and consistency of the approach to the evidence base, is required to ensure informed and robust nutrition policy, research, and practice into the future.
Topics: Dietetics; Evidence-Based Practice; Forecasting; Humans; Nutrition Policy
PubMed: 30649173
DOI: 10.1093/advances/nmy113 -
British Medical Journal May 1950
Topics: Dietetics; Food; Humans; Nutritional Sciences; Nutritional Status
PubMed: 15420406
DOI: 10.1136/bmj.1.4662.1101 -
Nutrition & Dietetics: the Journal of... Sep 2022We aimed to explore the future roles of nutrition and dietetics professionals, and what capabilities the workforce would need to fulfil these roles.
AIM
We aimed to explore the future roles of nutrition and dietetics professionals, and what capabilities the workforce would need to fulfil these roles.
METHOD
A qualitative interpretive approach was employed. We conducted individual interviews with nutrition and non-nutrition thought leaders external to the profession. In addition, we conducted focus groups with experts within the nutrition and dietetics profession, academic dietetics educators and students/recent nutrition and dietetics graduates (total sample n = 68). Key nutrition-related issues and challenges, drivers for change and potential future roles of the profession were explored. Data were analysed using a team-based thematic analysis approach.
RESULTS
Future roles of nutrition and dietetics professionals were described as food aficionados, diet optimisers, knowledge translators, equity champions, systems navigators and food systems activists, change makers, activists and disruptors. In addition, science was identified as a uniting framework underpinning the professions. An additional 16 critical capabilities were considered to underpin practice.
CONCLUSION
The results demonstrated that the current and future needs for workforce education and development need to address the impact of climate change, growing inequities, the democratisation of knowledge and the disruption of health and food systems. Education providers, regulators, professional associations and citizens need to work together to realise roles that will deliver on better health for all.
Topics: Dietetics; Forecasting; Humans; New Zealand; Nutritionists; Workforce
PubMed: 35355390
DOI: 10.1111/1747-0080.12734 -
The Impostor Phenomenon in the Nutrition and Dietetics Profession: An Online Cross-Sectional Survey.International Journal of Environmental... May 2022The impostor phenomenon (IP) (also known as impostor syndrome) describes high-achieving individuals who, despite their objective successes, fail to internalize their...
The impostor phenomenon (IP) (also known as impostor syndrome) describes high-achieving individuals who, despite their objective successes, fail to internalize their accomplishments and have persistent self-doubt and fear of being exposed as a fraud or impostor. This study aimed to assess the prevalence and predictors of IP within a sample of nutrition and dietetics students and practitioners. An online cross-sectional survey was conducted and utilized a non-random, convenience sampling approach. A total of 1015 students, dietetic interns, and currently practicing and retired registered dietitian nutritionists and nutrition and dietetic technicians registered provided complete responses. IP was assessed with the Clance Impostor Phenomenon Scale (CIPS). Self-reported job satisfaction and well-being were assessed using validated scales. Average CIPS score was 66.0 ± 16.3 (range 22−99), and higher scores indicate more frequent or severe IP experiences. Frequent or intense IP was reported by 64% of survey respondents (n = 655). Older age, greater educational attainment and professional level, and membership in Academy of Nutrition and Dietetics groups were associated with lower IP scores. Greater social media use was associated with higher IP scores. Job satisfaction and overall well-being were inversely correlated with IP (p < 0.001). Findings suggest that IP experiences were common among a majority of nutrition and dietetics students and practitioners surveyed. Additional research and development of preventative strategies and interventions is needed.
Topics: Anxiety Disorders; Cross-Sectional Studies; Dietetics; Humans; Nutritionists; Self Concept
PubMed: 35564953
DOI: 10.3390/ijerph19095558 -
Topics in Spinal Cord Injury... 2021Following spinal cord injury (SCI), individuals are at high risk for obesity and several chronic cardiometabolic disorders due to a deterioration in body composition,... (Review)
Review
Following spinal cord injury (SCI), individuals are at high risk for obesity and several chronic cardiometabolic disorders due to a deterioration in body composition, hypometabolic rate, and endometabolic dysregulation. Countermeasures to the consequences of an SCI include adopting a healthy diet that provides adequate nutrition to maintain good body habitus and cardiometabolic health. A proper diet for individuals with SCI should distribute carbohydrates, protein, and fat to optimize a lower energy intake requirement and should stress foods with low caloric yet high nutrient density. The purpose of this article is to present available evidence on how nutritional status after SCI should advance future research to further develop SCI-specific guidelines for total energy intake, as it relates to percent carbohydrates, protein, fat, and all vitamins and minerals, that take into consideration the adaptations after SCI.
Topics: Dietetics; Energy Intake; Humans; Nutritional Status; Obesity; Spinal Cord Injuries
PubMed: 33814888
DOI: 10.46292/sci20-00031 -
Nutrition & Dietetics: the Journal of... Sep 2022The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of... (Review)
Review
AIM
The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of dietetics practice in primary care.
METHODS
A scoping review synthesising peer-reviewed and other literature relevant to the development of Australian practice nurses was conducted. Structured searches using keywords 'general practice', 'nurse' and 'Australia' were conducted in PubMed and Google Scholar in June 2021. Key government websites, Department of Health and Services Australia, were searched to identify grey literature. One reviewer screened the titles and abstracts against inclusion criteria; two reviewers conducted full-text screening independently. Data on the evolution of practice nursing were extracted based on its interest and transferability to the dietetics workforce.
RESULTS
A total of 102 results (82 peer-reviewed and 20 other literature) were included in the review. Key drivers for practice nurse role development in Australia were government funding, practice nurse practice standards, cost-benefit analyses of practice nurses, career and education opportunities, general practitioner and patient perspectives of practice nurses and, individual, community and local needs.
CONCLUSIONS
The practice nurse role has grown and strengthened and there are three key learnings that could be translated to strengthen the dietetics workforce in primary care. (1) Use and expansion of government funding, (2) furthering post-tertiary education and career opportunities, including dietetic primary care practice standards and (3) targeting underserviced areas such as those that are rural and remote and building positive relationships with other stakeholders including practice nurses, general practitioners, patients and the broader primary care team.
Topics: Australia; Dietetics; Growth and Development; Humans; Nurse's Role; Workforce
PubMed: 35989542
DOI: 10.1111/1747-0080.12764 -
Asia Pacific Journal of Clinical... 2016Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the... (Review)
Review
Effective clinical nutrition practice depends on a sound knowledge of biomedical, societal and environmental science and the skills to diagnose, prevent and manage the health problems related to food patterns, energy equilibrium (mostly to do with physical activity) and nutrient metabolism. Its delivery needs to be accessible, equitable, affordable and sustainable. Ordinarily, this will require both local and widely distributed health services. In North-East (NE) Asia, these requisites are being met to an ever increasing extent. The roots of this progress are steeped in cultures which acknowledge the food-health connections and support education which pays regard to these connections. As elsewhere, however, the food and health systems, their safety and security are threatened by exploitative operatives. In China, a concerted effort was made in the mid-1980s to foster clinical nutrition in major hospitals throughout the country by programs directed at medical graduates, nursing and kitchen staff; dietetics has appeared much more recently. By contrast, Japan has had an extensive and well-trained dietetic workforce for much longer, alongside a vibrant basic nutrition science constituency in its universities and foodnutraceutical industry. South Korea and Taiwan have traversed a similar course to that in Japan. Now, all of these NE Asian economies have gathered rapid momentum in the publication of innovative approaches to public health and clinical nutrition which have the prospect of not only improving health outcomes, but also reducing the societal and financial burden of health care. This is particularly important in rapidly ageing societies, which they are. It is also a growing challenge where climate change threatens to engulf the lives and destinies of hundreds of millions of Asians on account of natural disasters, water and food insecurity.
Topics: Asia; China; Climate Change; Diet; Dietetics; Evidence-Based Practice; Food; Food Supply; Health Promotion; Health Services; Humans; Nutrition Disorders; Nutrition Policy; Nutritional Sciences; Republic of Korea; Taiwan
PubMed: 27440675
DOI: 10.6133/apjcn.072016.02 -
The Proceedings of the Nutrition Society Aug 2017Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its... (Review)
Review
Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes.
Topics: Biomedical Research; Congresses as Topic; Delayed Diagnosis; Dementia; Dietetics; Enteral Nutrition; Gastrostomy; Humans; Length of Stay; Malnutrition; Neurodegenerative Diseases; Nutrition Assessment; Nutritional Sciences; Oropharyngeal Neoplasms; Practice Guidelines as Topic; Prognosis; Societies, Scientific; Stroke
PubMed: 27916005
DOI: 10.1017/S0029665116002895 -
Nutrition & Dietetics: the Journal of... Jul 2021Internal coherence in research refers to the alignment between ontology (nature of reality), epistemology (nature of knowledge), axiology (values), methodology and... (Review)
Review
AIM
Internal coherence in research refers to the alignment between ontology (nature of reality), epistemology (nature of knowledge), axiology (values), methodology and methods and is an important but often overlooked element of research quality. We therefore aimed to illustrate the concept of internal coherence in nutrition and dietetics research, and its importance beyond individual elements of study quality.
METHOD
A targeted literature search in Nutrition and Dietetics was used to identify research illustrating one example of three main approaches to research (scientific, interpretive and critical inquiry) published between November 2017 and November 2020. Studies were included if they related to education research based on the expertise of the authors, and illustrated diverse points about internal coherence. The authors independently critiqued included studies for internal coherence and synthesised their findings.
RESULTS
From 76 manuscripts, 14 were identified as describing education research. Of the three selected studies that were critiqued, all had elements of internal coherence, in particular alignment between epistemology and methodology. However, each had elements of misalignment too, specifically between epistemology, axiology and method. The results point to the profession's historical groundings privileging the scientific approach, showing how this can yield misalignments, particularly when describing the limitations of interpretive and critical inquiry approaches.
CONCLUSION
This review demonstrates the importance of internal coherence as a marker of quality, over and above existing quality assessment checklists for qualitative and quantitative methodologies. As such, it can help authors, reviewers and editors to improve the quality of nutrition and dietetics research and its reporting.
Topics: Dietetics; Humans; Nutritional Status; Research Design
PubMed: 34151511
DOI: 10.1111/1747-0080.12680