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Pujia A, Montalcini T, Donini LM, Frittitta L, Galvano F, Natali A, Pironi L, Porrini M, Riso P, Rivellese AA, Russo D, Scapagnini G, Serafini M, Tagliabue A, De Lorenzo A. Roles and competencies in the nutritional domain for the management of the metabolic diseases and in the hospital setting: A position paper of the Italian College of Academic Nutritionists, MED-49 (ICAN-49). Nutr Metab Cardiovasc Dis 2021; 31:2993-3003. [PMID: 34518088 DOI: 10.1016/j.numecd.2021.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
Epidemiological evidence has confirmed the potential causal relationship between specific dietary factors and non-communicable diseases. However, currently nutrition was shown to be insufficiently integrated into medical education, regardless of the country. Without an adequate nutrition education, it is reasonable to assume that future physicians, as well as other health care professionals, will be not able to provide the highest quality care to patients in preventing and treating non-communicable diseases. Furthermore, the insufficient availability of physicians with specializations in nutrition has posed the basis for the development of non-medical careers in the field of nutrition. The present document was drafting by the Italian College of Academic Nutritionists, MED-49 (ICAN-49), with the aim to provide an overview on the nutritional competency standards covered by several health care professionals (Physicians Clinical Nutrition Specialists, Clinical Dietitians, Professional Clinical Nutrition Specialists, etc) for the prevention of diseases and/or support of pharmacological therapies. The aim of the ICAN 49 is to suggest a major shift in practice opportunities and roles for many nutritionists, especially for the management of the metabolic diseases, and promote a paradigm change: a clinical and educational leadership role for Physician Clinical Nutrition Specialists in the hospital setting.
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Affiliation(s)
- Arturo Pujia
- Department of Medical and Surgical Science, University of Catanzaro Magna Grecia, Viale Europa, Catanzaro, 88100, Italy.
| | - Tiziana Montalcini
- Department of Clinical and Experiment Medicine, University of Catanzaro Magna Grecia, Viale Europa, Catanzaro, 88100, Italy.
| | - Lorenzo M Donini
- Department of Experimental Medicine, University of La Sapienza, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Lucia Frittitta
- Department of Clinical and Experiment Medicine, University of Catania, Via Santa Sofia, 86-95123, Catania, Italy.
| | - Fabio Galvano
- Department of Biomedical and Biotechnology Science, University of Catania, Via Santa Sofia, 86-95123, Catania, Italy.
| | - Andrea Natali
- Department of Clinical and Experiment Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126, Pisa, Italy.
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria, 2, 20133, Milano, Italy.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria, 2, 20133, Milano, Italy.
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Corso Umberto I, 40, 80138, Napoli, Italy.
| | - Diego Russo
- Department of Health Science, University of Catanzaro Magna Grecia, Viale Europa, 88100, Catanzaro, Italy.
| | - Giovanni Scapagnini
- Department of Medicine and Health Science, University of Molise, Via F. De Sanctis, 86100, Campobasso, Italy.
| | - Mauro Serafini
- Faculty of Biosciences and Technologies for Agriculture, Food and Environment, University of Teramo, Via Renato Balzarini, 1, 64100, Teramo, Italy.
| | - Anna Tagliabue
- Department of Public Health, University of Pavia, Via Agostino Bassi, 21, 27100, Pavia, Italy.
| | - Antonino De Lorenzo
- Biomedicine and Prevention, University of Tor Vergata, Via Montpellier, 1, 00133, Roma, Italy.
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Shinozaki N, Wang HC, Yuan X, Li T, Asano K, Kobayashi S, Sasaki S. Current status of education and research on public health nutrition in Japan: comparison with South Korea, Taiwan, and mainland China. BMC Nutr 2020; 5:10. [PMID: 32153923 PMCID: PMC7050843 DOI: 10.1186/s40795-019-0275-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although the importance of capacity building for public health nutrition (PHN) has been increasing globally, reports on the current status of training programs for PHN in East-Asia including Japan are limited. The aim of this study was to compare the current status of education and research activities in the field of PHN in Japan with those in South Korea, Taiwan, and mainland China. Methods Necessary information was collected by internet search and telephone inquiry. Collection focused on the number of departments in colleges and universities with PHN as a compulsory subject in the 2016 academic year, and the number of articles and information related to these articles published in the journal Public Health Nutrition between 2007 and 2016. Results The number of departments with PHN as a compulsory subject was the highest in Japan (n = 137), followed by mainland China (n = 32), Taiwan (n = 18) and South Korea (n = 7). Using the classification list of education in each country and region, the majority of these departments were classified as home economics, natural science, health and welfare, and medical science in Japan, South Korea, Taiwan, and mainland China, respectively. Regarding publications, most of the articles were written in colleges and universities not having PHN as a compulsory subject in Japan, South Korea, and Taiwan. The number of articles per department among departments with compulsory PHN education was lowest in Japan (n = 0.3) compared to Taiwan, mainland China, and South Korea (n = 1.2, 2.7, and 3.7, respectively). Conclusions Japan has a much higher number of departments with PHN as a compulsory subject than neighboring East Asian states and relatively low research activities in the field of PHN. This suggests that current university education may not lead to active PHN research in Japan. Further studies are warranted to explore the reasons for this.
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Affiliation(s)
- Nana Shinozaki
- 1Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Han-Chieh Wang
- 1Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Xiaoyi Yuan
- 1Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tianyu Li
- 1Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kana Asano
- 2Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Satomi Kobayashi
- 3Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Satoshi Sasaki
- 1Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,3Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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Hughes R, Begley A, Yeatman H. Aspirational competency expectations for public health nutritionists in Australia: A consensus study. Nutr Diet 2013. [DOI: 10.1111/1747-0080.12098] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Roger Hughes
- School of Health Science; Bond University; Gold Coast Queensland Australia
| | - Andrea Begley
- School of Public Health; Curtin University; Perth Western Australia Australia
| | - Heather Yeatman
- School of Health Science; University of Wollongong; Wollongong New South Wales Australia
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Consensus on the competencies required for public health nutrition workforce development in Europe - the JobNut project. Public Health Nutr 2010; 14:1439-49. [PMID: 20353620 DOI: 10.1017/s1368980010000625] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess and develop consensus among a European panel of public health nutrition stakeholders regarding the competencies required for effective public health nutrition practice and the level of proficiency required in different practice contexts. DESIGN A modified Delphi study involving three rounds of questionnaires. SETTING European Union. SUBJECTS Public health nutrition workforce development stakeholders, including academics, practitioners and employers, from twenty European countries. RESULTS A total of fifty-two expert panellists (84 % of an initial panel of sixty-two Delphi participants) completed all three rounds of the Delphi study. The panellists rated the importance of fifty-seven competency units possibly required of a public health nutritionist to effectively practice (Essential competencies). Twenty-nine of the fifty-seven competency units (51 %) met the consensus criteria (≥66·7 % agreement) at the second round of the Delphi survey, with the highest agreement for competencies clustered within the Nutrition science, Professional, Analytical and Public health services competency domains. Ratings of the level of competencies required for different levels in the workforce indicated that for a public health nutrition specialist, advanced-level competency was required across almost all the twenty-nine competencies rated as essential. There were limited differences in rating responses between academics and employer panellists throughout the Delphi study. CONCLUSIONS Competencies identified as essential can be used to review current public health nutrition practices and provide the basis for curriculum design and re-development, continuing education and workforce quality assurance systems in Europe. These are all important tools for systematic and strategic workforce development.
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Abstract
AbstractObjectives:To assess the level of agreement amongst a panel of public health nutrition leaders regarding the key descriptors used to define the field of public health nutrition.Design:Cross-sectional survey requiring quantitative and qualitative responses representing the first round of a consensus development Delphi technique.Setting:International.Subjects:Expert panel of 24 public health nutrition leaders from nine countries in the European Union, the USA and Australia.Results:All but one of the panel agreed it was important to have a consensus definition for public health nutrition to describe the field consistently. Opinion about the length and complexity of this definition tended to vary depending on the intended use of the definition. The large majority (18/24) supported the inclusion of specific reference to physical activity in a definition of public health nutrition, although there was not consensus (>83% agreement as criterion) on this point. Consensus descriptors regarded as important in a definition of public health nutrition included: population-based, focus on health promotion, food and nutrition systems focus, wellness maintenance, primary prevention, applies public health principles, education, environmental and political descriptors. Treatment as a descriptor was rated as unimportant by a majority (14/24) of panellists, delineating public health nutrition from clinical practice.Conclusions:There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of descriptors that can be used to define public health nutrition. The limitations of using word-for-word definitions between and within countries may be overcome by explicit use of the consensus descriptors identified in this process.
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Affiliation(s)
- Roger Hughes
- Nutrition Unit, School of Health Science, Griffith University, Gold Coast, Queensland 4217, Australia.
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Hughes R. A conceptual framework for intelligence-based public health nutrition workforce development. Public Health Nutr 2007; 6:599-605. [PMID: 14690041 DOI: 10.1079/phn2003467] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjective:This paper describes a conceptual framework and associated intelligence requirements for problem-based workforce development for public health nutrition.Methods:A conceptual framework for public health nutrition workforce development was constructed based on a review of the literature and consideration of the intelligence needs to inform workforce development planning.Results:A cyclical conceptual framework including five intelligence-linked components including public health nutrition problems and priorities, solutions and best buys, work needed, capacity to do the work and workforce development needs. This framework applied to the Australian situation illustrates its applications in workforce development research and planning. Although the existing availability of workforce development intelligence in each of these components varies, the framework does provide a systematic approach for workforce development research and planning directly related to public health nutrition problem resolution.Conclusions:This framework highlights deficiencies in the existing public health nutrition workforce development intelligence and the need for further research to inform workforce development strategy planning.
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Affiliation(s)
- Roger Hughes
- Nutrition Unit, School of Health Science, Griffith University, Gold Coast, Queensland 4217, Australia.
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Hughes R. Public health nutrition workforce composition, core functions, competencies and capacity: perspectives of advanced-level practitioners in Australia. Public Health Nutr 2007; 6:607-13. [PMID: 14690042 DOI: 10.1079/phn2003465] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectives:To investigate the attitudes, experiences and beliefs of advanced-level public health nutritionists with respect to public health nutrition workforce composition, core functions, competency requirements and existing workforce capacity.Design:Qualitative study using structured interviews.Setting:Australia.Subjects:Forty-one advanced-level public health nutritionists employed in academic and senior technocratic positions in state health systems.Results:Advanced-level public health nutritionists recognise the diversity of the public health nutrition workforce but clearly identify the need for a specialist public health nutrition workforce tier to provide workforce leadership. Nominated core functions for public health nutrition reflect broader public health core functions but, in the context of nutrition, specific problem resolution. Opinions about competency needs were similar to many of the cross-cutting competencies identified in the public health field but with specific application to nutrition problems. Competency in the scientific underpinning of nutrition was considered particularly important and delineated this public health nutrition workforce from the broader public health workforce. Public health nutrition was identified as a specialisation within public health and dietetics. Workforce capacity assessments by this group indicate a need for workforce development.Conclusions:Qualitative data from a large proportion of the Australian public health nutrition leadership group have identified core functions, competencies and workforce development priorities that can be a basis for further systematic research and workforce strategy development.
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Affiliation(s)
- Roger Hughes
- Nutrition Unit, School of Health Science, Griffith University, Gold Coast, Queensland 4217, Australia.
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Hughes R. Competencies for effective public health nutrition practice: a developing consensus. Public Health Nutr 2005; 7:683-91. [PMID: 15251059 DOI: 10.1079/phn2003574] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To assess the level of consensus amongst an international panel of public health nutrition leaders regarding the essential competencies required for effective public health nutrition practice. DESIGN A modified Delphi study involving three rounds of questionnaires. SUBJECTS A panel of 20 public health nutrition experts from seven countries in the European Union, the USA and Australia. RESULTS Expert panellists completed three rounds of the study relating to competencies. A literature review conducted as a prelude to the expert panel survey identified common competency units from the fields of public health, health promotion, nutrition and dietetics, and health education. These were categorised into seven competency areas including analytical, socio-cultural and political, public health service, communication, management and leadership, nutrition science and professional competency categories. There was strong initial agreement (> or = 90% of panellists at Round 1) that developing internationally recognised competencies for public health nutrition specialists was a priority. Twenty-six of an initial listing of 52 competency units were rated as essential competencies by > or = 80% of the panellists after Round 1. Iteration rounds resulted in the addition of five extra competency units suggested by panellists after Round 1 and an increase by 13 in the number of competencies rated as essential to consensus levels. From a total of 57 competency units rated after the final survey round, 41 competency units were rated as essential competencies by > or = 80% of the panellists (consensus), with 21 of these unanimously rated as essential competencies. CONCLUSIONS There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of competencies required for effective public health nutrition practice. Essential competency units identified can be used to develop and review competency standards for public health nutrition.
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Affiliation(s)
- Roger Hughes
- Nutrition Unit, School of Health Science, Griffith University, Gold Coast, Queensland 4217, Australia.
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