Clinical Nutrition and Human Rights. An International Position Paper

Hungry for more: Australian medical students' competence, attitudes and preferences towards nutrition education

BACKGROUND

Inadequate nutrition education in medical training is a prevailing global challenge. This study assessed Australian medical students' self-perceived competencies in nutrition and preferences regarding nutrition education in medical training.

METHODS

We conducted a national cross-sectional online survey between September 2019 and January 2020. Our survey collected sociodemographic characteristics and assessed nutrition competency according to a validated assessment tool. All Australian medical students aged over 18 were eligible to participate.

RESULTS

One hundred ninety-five medical students representing 20 Australian medical schools completed the survey and reported moderate nutrition knowledge (17·6 ± 4.1 out of 35, 50%) and skills (29.8 ± 7.6 out of 55, 54%). Students demonstrated positive attitudes towards nutrition training/education (35·9 ± 4.0 out of 40, 90%). Most medical students (n = 148, 72%) reported they had sought some form of nutrition education outside of their degree. Students showed preference for practical, evidence-based nutrition education that is integrated in and prioritised throughout medical training.

CONCLUSIONS

Australian medical students express positive attitudes towards nutrition but report only low to moderate nutrition knowledge and skills. There is an opportunity to incorporate practical, regular nutrition learning activities into Australian medical curriculums to equip future doctors to adequately address non-communicable disease. Such initiatives are likely to be well received by students.

C-reactive protein and white blood cell count are adverse prognostic markers for patients with advanced cancer on parenteral nutrition in a palliative care unit setting: A retrospective cohort study

BACKGROUND

Parenteral nutrition is controversial in patients with advanced cancer. Nevertheless, this treatment is common practice near the end of life.

AIM

We aimed to identify factors which were associated with the outcome of patients on parenteral nutrition at an academic tertiary palliative care unit.

DESIGN

In this retrospective cohort study patients were assigned to two groups according to parenteral nutrition treatment. Inferential statistics were used to assess whether the dynamics of laboratory variables over 2 weeks of parenteral nutrition were associated with survival.

SETTING/PARTICIPANTS

Patients admitted to the Department of Palliative Medicine at the Medical University of Vienna between 2016 and 2018 were included in this study.

RESULTS

Of 443 patients, 113 patients received parenteral nutrition. Patients had a lower body mass index, lower levels of bilirubin, γ-glutamyltransferase, alkaline phosphatase, and were of younger age compared to patients which did not receive parenteral nutrition. No difference in survival as measured from admission to death was found when comparing the two groups. Levels for γ-glutamyltransferase, alkaline phosphatase, and C-reactive protein significantly increased during 2 weeks of parenteral nutrition. Among patients with parenteral nutrition, an increase in C-reactive protein or white blood cell count levels was associated with lower survival.

CONCLUSION

Patients who responded with an increase of C-reactive protein or white blood cell count during 2 weeks after reinitiation or start of parenteral nutrition had a worse survival. Our findings might support clinicians and patients in their decision to forgo parenteral nutrition in a palliative care setting.