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Wright L. Harnessing the Healing Power of Food: Why Registered Dietitian Nutritionists Must Lead the Food as Medicine Movement. J Acad Nutr Diet 2024; 124:557-558. [PMID: 38642954 DOI: 10.1016/j.jand.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 04/22/2024]
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Copley J, Martin R, Dix C, Forbes R, Hill A, Mandrusiak A, Penman A, Patterson F, Davies S, Jauncey-Cooke J, Mahendran N, Hooper K, Collins C. Fostering collaborative practice through interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students. J Interprof Care 2024; 38:534-543. [PMID: 38343271 DOI: 10.1080/13561820.2024.2303499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Literature regarding simulation for learning interprofessional collaborative practice (IPCP) indicates a need to include a range of health professions and to focus on students' development of team communication and conflict resolution skills in day-to-day healthcare delivery. This study evaluated the impact of interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students on interprofessional collaboration competencies, specifically collaborative communication and conflict resolution during day-to-day interactions, and their intention for IPCP during placement. A series of simulations featuring the potential for interprofessional conflict and involving explicit coaching on communication and conflict resolution were conducted. A single cohort pre-test post-test design included the Students' Perceptions of Interprofessional Clinical Education Revised (SPICE-R), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and an open response survey question on future intended practice. A total of 237 students participated in the simulation experience. Overall scores and scores on all IPCP competencies in the ICASS (n = 193) and SPICE-R (n = 226) improved for all professions post-simulation. The mean score of the ICCAS increased for 98% of the respondents and similarly the mean score of the SPICE-R increased for 71% of the respondents. Open-ended responses indicated students' intentions to pursue self-leadership in IPCP. Students who participated in an interprofessional simulation reported perceived improvements in IPCP competencies and were encouraged to initiate IPCP when on placement in the practice setting.
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Affiliation(s)
- Jodie Copley
- Occupational Therapy, The University of Queensland, ST LUCIA, Australia
| | - Romany Martin
- Physiotherapy, The University of Tasmania, Launceston, Newnham, Australia
| | - Clare Dix
- Nutrition and Dietetics, The University of Queensland, ST LUCIA, Australia
| | - Roma Forbes
- Physiotherapy, The University of Queensland, ST LUCIA, Australia
| | - Anne Hill
- Speech Pathology, The University of Queensland, ST LUCIA, Australia
| | | | - Adriana Penman
- Speech Pathology, The University of Queensland, ST LUCIA, Australia
| | - Freyr Patterson
- Occupational Therapy, The University of Queensland, ST LUCIA, Australia
| | - Sarah Davies
- Casual Academic, The University of Queensland, ST LUCIA, Australia
| | | | | | - Kelly Hooper
- School of Nursing, Midwifery and Social Work, The University of Queensland, ST LUCIA, Australia
| | - Cheryl Collins
- Nutrition and Dietetics, The University of Queensland, ST LUCIA, Australia
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Campbell A, Stirling M, Keele N, Larkin A, Crandall R, Wilcox AN, Adair M, Malan C, Thomson J, Bennett A, Jensen H, Flygare H, Peterson L, Hopkins H, Kendrick N, Givler M, Charlton R, Kraus KN. Fruit and Vegetable Intake, Food Security, Barriers to Healthy Eating, and Empowerment among Dietetic Interns and Physician Assistant Interns: A Cross-Sectional Pilot Study. Nutrients 2024; 16:1034. [PMID: 38613067 PMCID: PMC11013348 DOI: 10.3390/nu16071034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
Students are required to complete supervised practice hours prior to becoming Registered Dietitians and Physician Assistants. Research suggests that environmental and social factors affect dietetic interns' diets during their internship, although these factors have not been studied among physician assistant interns. This cross-sectional study utilized an online survey to compare dietetic interns' (n = 81) and physician assistant interns' (n = 79) fruit and vegetable intake, food security, barriers to healthy eating, and empowerment for making healthy dietary choices during an internship. Differences were assessed via independent t-tests and chi-square distributions. The significance was set at p < 0.05. Dietetic interns had a higher vegetable intake (p = 0.002) while physician assistant interns had higher rates of food insecurity (p = 0.040). Dietetic interns reported a greater impact on their dietary choices due to mental fatigue (p = 0.006), while physician assistant interns' dietary choices were more heavily impacted by peer influence, interactions with patients, and interactions with preceptors (p < 0.05). There was not a group difference in overall empowerment (p = 0.157), although both groups rated empowerment for asking for help with food and nutrition challenges the lowest of the empowerment sub-items. Addressing interns' unique needs may support students' educational success and wellbeing once they are professionals, promote a diverse workforce, and ensure optimal care for patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Katie N. Kraus
- Department of Nutrition, Dietetics & Food Sciences, College of Agricultural and Applied Sciences, Utah State University, Logan, UT 84322, USA; (A.C.); (M.S.); (N.K.); (A.L.); (R.C.); (A.N.W.); (M.A.); (C.M.); (J.T.); (A.B.); (H.J.); (H.F.); (L.P.); (H.H.); (N.K.); (M.G.); (R.C.)
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Aurélien C, Isabelle C, Ludivine S. Evaluation of the nutrition care process documentation in the patients' records using the Diet-NCP-Audit: experience in a medium-sized multi-site Swiss hospital. J Hum Nutr Diet 2024; 37:593-600. [PMID: 38268332 DOI: 10.1111/jhn.13283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/31/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The nutrition care process (NCP) is a four-step systematic approach to guide dietitians in providing high-quality nutrition care. It fosters critical thinking and enhances the consistency of dietitians' documentation. Following international recommendations, University Training Hospital of Fribourg (HFR) implemented it in 2013. This study aimed to evaluate the quality of NCP documentation in electronic patient records (EPRs) and to determine the nutrition problems dietitians most often identified while documenting their actions. METHODS The audit was performed on 92 EPRs using the Diet-NCP-Audit, which was translated into French for this study. RESULTS The documentation quality was assessed as high in 62% of the EPRs, and nutrition diagnoses were mostly documented. In half of the EPRs, nutrition assessment (step 1 of the NCP) was inconsistent with nutrition diagnosis (step 2). Dietitians often used the same nutrition problems: out of the 73 nutrition problems defined in NCP terminology, only 4 (5%) represented 58% of the 189 problems identified in the EPR audit. CONCLUSION EPRs were mostly assessed as high quality. However, the entire process requires improved consistency. The poorly documented link between the NCP steps and the restricted choices of nutrition problems dietitians identified should be addressed because they could reveal that dietitians have not fully adopted critical thinking, which the NCP stresses.
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Affiliation(s)
- Clerc Aurélien
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Department of Nutrition and Dietetics, University Training Hospital of Fribourg (HFR), Fribourg, Switzerland
| | - Carrard Isabelle
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
| | - Soguel Ludivine
- Department of Nutrition and Dietetics, School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
- Department of Teaching, University of Applied Sciences and Arts Western Switzerland (HES-SO), Geneva, Switzerland
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Meah S, Kidd C, Rothman B, Marino VL. Exploring paediatric dietetic resources available for critically ill children in the UK and Ireland: A multicentre survey. J Hum Nutr Diet 2024; 37:459-463. [PMID: 38009404 DOI: 10.1111/jhn.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND A dedicated intensive care dietitian, as part of the intensive care unit (ICU) multidisciplinary team, contributes to improved delivery of nutrition support. The Paediatric Critical Care Society recommends a minimum dietetic staffing to critical-care bed ratio of 1:10, led by an Agenda for Change (AfC) Band 7. METHODS A cross-sectional study was conducted using an electronic survey that was available for 12 weeks. The Paediatric Intensive Care Audit Network database was used to identify all hospitals with paediatric intensive care unit (PICU) beds (n = 28). RESULTS Only 14% (n = 4/28) of trusts met the recommended 1:10 dietitian to bed ratio. PICU dietetic whole time equivalent was 0.7 ± 0.4, with a staff to bed ratio of 1:23.7 ± 10.7, compared to adult staff to bed ratio of 1:24.7. Some 92.8% (n = 26/28) had a AfC Band 7 Lead and only 7% (n = 2/28) had an AfC Band 8a Lead compared to adult services where 12.5% (n = 15/122) had an AfC Band 8a (p < 0.05). CONCLUSIONS There is a significant disparity between adult versus paediatric services with regard to seniority of dietitians. Dietitians in well-resourced centres were more likely to review patients without the need for a referral, which may improve nutrition outcomes.
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Affiliation(s)
| | - Catherine Kidd
- Great Ormond Street Hospital for Children Foundation Trust, London, UK
| | - Brittany Rothman
- Great Ormond Street Hospital for Children Foundation Trust, London, UK
| | - V Luise Marino
- Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Swettenham M, Langley-Evans SC. Pragmatic patchwork ethnography, a call to action for health, nutrition and dietetic researchers. J Hum Nutr Diet 2024; 37:514-523. [PMID: 38185898 DOI: 10.1111/jhn.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/09/2023] [Indexed: 01/09/2024]
Abstract
Qualitative research methods are increasingly used in nutrition and dietetics research. Ethnography is an underexploited approach which seeks to explore the diversity of people and cultures in a given setting, providing a better understanding of the influences that determine their choices and behaviours. It is argued that traditional ethnography, that is, the methodology of living within participant communities, is a dated practice, with roots in colonialism, accessible to only researchers with the means, connections and status to conduct such research, typically white, privileged males. This paper proposes a formal interpretation of 'patchwork ethnography', whereby research is carried out in situ around existing modern-day commitments of the researcher, thus enabling more researchers within health, nutrition and dietetic practice to benefit from the rich data that can be discovered from communities. This review proposes the concept that pragmatic patchwork ethnography is required, proposing a framework for implementation, providing researchers, particularly within the fields of human nutrition, dietetics and health, the accessibility and means to deploy a meaningful client-centric methodology. We present pragmatic patchwork ethnography as a modern method for use within multiple healthcare settings, thus adding a progressive brick in the wall of qualitative research.
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Affiliation(s)
- Marie Swettenham
- School of Biosciences, University of Nottingham, Sutton Bonington, UK
- School of Allied and Public Health Professions, Faculty of Medicine, Health and Social Care Canterbury Christ Church University, Canterbury, UK
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Rothenberg E, Tsagari A, Erickson N, Katsagoni CN, Malone A, de van der Schueren M, Shaw C, Steiber A, Vranesic Bender D, Jager-Wittenaar H. Global Leadership Initiative on Malnutrition (GLIM) for the diagnosis of malnutrition - a framework for consistent dietetic practice. Clin Nutr ESPEN 2024; 60:261-265. [PMID: 38479920 DOI: 10.1016/j.clnesp.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 04/13/2024]
Abstract
Malnutrition is an alarming and ongoing healthcare problem globally. Malnutrition has a negative impact on the individual patient, leading to poorer clinical outcomes and increased mortality, but also poses an economic burden on society. Proper identification and diagnostics are prerequisites for initiation of treatment. In 2019, the Global Leadership Initiative on Malnutrition, a consensus-based global framework to uniformly diagnose malnutrition across populations, healthcare settings, and countries was published. Identifying and treating malnutrition is an interdisciplinary team effort. Nonetheless, the nutrition and dietetics profession is specifically trained for diagnosing and treating nutrition(-related) conditions, and therefore has a key role in the interdisciplinary team in implementing the GLIM framework in clinical practice. For the nutrition and dietetics profession, GLIM offers a great opportunity for moving both the scientific and clinical knowledge of malnutrition management forward. While the GLIM framework has been extensively studied since its launch, various knowledge gaps still remain. For the nutrition and dietetics profession, these knowledge gaps mainly relate to the GLIM implementation process, to the role of GLIM in relation to the nutrition care process, and to treatment strategies for various nutrition-related conditions. In this opinion paper, we aimed to describe the rationale for implementing the GLIM framework in clinical dietetic practice, and propose a research agenda based on knowledge gaps regarding GLIM in relation to nutrition care from a dietetic point of view.
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Affiliation(s)
- Elisabet Rothenberg
- Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Amalia Tsagari
- Department of Clinical Nutrition, "KAT'' Hospital, Athens, Greece; Healthcare Faculty, BSc Dietetics, Aegean College, Athens, Greece
| | - Nicole Erickson
- Comprehensive Cancer Center (CCC Munich LMU), Ludwig Maximilian University Hospital Munich, Munich, Germany
| | | | - Ainsley Malone
- American Society for Parenteral and Enteral Nutrition, Silver Springs, MD, United States
| | - Marian de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Clare Shaw
- The Royal Marsden NHS Foundation Trust, London and Sutton, United Kingdom
| | - Alison Steiber
- Research, International, and Scientific Affairs Team, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Darija Vranesic Bender
- Clinical Unit of Clinical Nutrition, Department of Internal Medicine, University Hospital Zagreb, Croatia
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands; Department of Gastroenterology and Hepatology, Dietetics, Radboud University Medical Center, Nijmegen, The Netherlands; Faculty of Physical Education and Physiotherapy, Department Physiotherapy and Human Anatomy, Research Unit Experimental Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
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8
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Steinberg FM. Advancing the Use of Evidence-Based Practice in Nutrition and Dietetics. J Nutr 2024; 154:1065-1066. [PMID: 38403252 DOI: 10.1016/j.tjnut.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Francene M Steinberg
- Department of Nutrition, Didactic Program in Dietetics, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, United States.
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Barker LA, Moore JD, Cook HA. Generative Artificial Intelligence as a Tool for Teaching Communication in Nutrition and Dietetics Education-A Novel Education Innovation. Nutrients 2024; 16:914. [PMID: 38612948 PMCID: PMC11013049 DOI: 10.3390/nu16070914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Although effective communication is fundamental to nutrition and dietetics practice, providing novice practitioners with efficacious training remains a challenge. Traditionally, human simulated patients have been utilised in health professions training, however their use and development can be cost and time prohibitive. Presented here is a platform the authors have created that allows students to interact with virtual simulated patients to practise and develop their communication skills. Leveraging the structured incorporation of large language models, it is designed by pedagogical content experts and comprises individual cases based on curricula and student needs. It is targeted towards the practice of rapport building, asking of difficult questions, paraphrasing and mistake making, all of which are essential to learning. Students appreciate the individualised and immediate feedback based on validated communication tools that encourage self-reflection and improvement. Early trials have shown students are enthusiastic about this platform, however further investigations are required to determine its impact as an experiential communication skills tool. This platform harnesses the power of artificial intelligence to bridge the gap between theory and practice in communication skills training, requiring significantly reduced costs and resources than traditional simulated patient encounters.
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Affiliation(s)
- Lisa A. Barker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC 3168, Australia
| | - Joel D. Moore
- School of Social Sciences, Monash University, Melbourne, VIC 3800, Australia;
| | - Helmy A. Cook
- School of Medicine, Monash University, Clayton, VIC 3800, Australia;
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Mueller KE, Bellini SG, Patten EV. Didactic program in dietetics (DPD) students' experiences with pandemic learning and expectations for their future education: a descriptive study through a systems lens. BMC Med Educ 2024; 24:244. [PMID: 38448906 PMCID: PMC10918922 DOI: 10.1186/s12909-024-05251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 03/01/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The systems approach has been used to evaluate higher education and explores inputs, transformation process, and outputs of a system that is also influenced by environmental factors such as COVID-19. The COVID-19 pandemic shifted many college students to different learning modes, changing their university experience. This study evaluated dietetics students' education experiences and characteristics in the latter period (spring 2022) of the COVID-19 pandemic using the systems approach. METHODS Researchers developed and distributed an electronic survey to all 215 US-based Didactic Program in Dietetics (DPD) directors during March to May 2022 to forward to their students. Researchers calculated descriptive statistics for variables related to inputs, transformation process, and outputs in the systems approach. RESULTS Respondents (n = 341) represented 51 DPDs in 31 states in the United States. Overall, DPD students (88.5%) were mostly or very satisfied with their choice of majoring in dietetics. Most (84.0%) planned to earn the RDN credential. Nearly half (46.9%) of DPD students were somewhat or extremely concerned about their readiness to continue their dietetics education path due to the pandemic-related learning conditions. Most students (43.6%) reported dissatisfaction with asynchronous remote instruction in laboratory courses. DPD students' GPAs remained consistent within the range of 3.75-4.0 from Fall 2019 (43.2%) to Spring 2022 (44.5%). The most important expectations of professors moving forward were to communicate effectively (97.3%), employ cultural humility (93.8%), eliminate discrimination in the classroom (93.6%), provide lecture slides (89.7%), and be flexible and accommodating (88.7%). CONCLUSIONS DPD students emerged from COVID-19 with new perspectives and expectations for their university learning experience. Future research should explore the perspectives of DI directors, preceptors, and employers of COVID-19 era DPD graduates.
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Affiliation(s)
- Kelsey E Mueller
- Department of Nutrition, Dietetics and Food Science, Brigham Young University (BYU), 1 Campus Dr, 84604, Provo, UT, USA
| | - Sarah G Bellini
- Department of Nutrition, Dietetics and Food Science, Brigham Young University (BYU), 1 Campus Dr, 84604, Provo, UT, USA
| | - Emily V Patten
- Department of Nutrition, Dietetics and Food Science, Brigham Young University (BYU), 1 Campus Dr, 84604, Provo, UT, USA.
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Ng SH, Babar MG, Ahmed SI, Hasan SS, Yang WY. Measuring empathic behaviour among undergraduate dietetics students. J Eval Clin Pract 2024; 30:153-161. [PMID: 37641432 DOI: 10.1111/jep.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
AIM Empathic behaviour has a direct link to the positive clinical outcomes. Health professionals, which include dietitians, are increasingly expected to demonstrate the impact of their care on patient outcomes. To date, there is limited research exploring the empathic behaviour of dietetics students. METHODS This cross-sectional study evaluated the psychometric properties of Jefferson Scale of Empathy-Healthcare Provider Student (JSE-HPS) and empathic behaviour of dietetics students. RESULTS Undergraduate dietetics students from one private and two public universities in Malaysia participated (n = 455). Item and scale psychometric properties were examined using principal component analysis and differences in mean empathy scores for students were assessed across years of study and types of universities. A 3-factor solution emerged in the results, accounting for 26.76%, 10.75% and 6.3% of the variance. The JSE-HPS demonstrated good internal consistency (α = 0.83). Despite students enroled at public universities scoring higher mean empathy scores than students enroled at the private university, the difference was not significant. The only significant difference was between the empathy level of first and third year students (p = 0.033). CONCLUSION As empathy underpins patient-centred management in the nutrition care process, it should be well integrated into curriculum delivery so that appropriate levels of empathy can be developed to prepare work-ready healthcare professionals.
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Affiliation(s)
- Shi Hui Ng
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Muneer Gohar Babar
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Syed Imran Ahmed
- School of Pharmacy, College of Health and Science, University of Lincoln, UK
| | | | - Wai Yew Yang
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
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Kistler B, Avesani CM, Burrowes JD, Chan M, Cuppari L, Hensley MK, Karupaiah T, Kilates MC, Mafra D, Manley K, Vennegoor M, Wang AYM, Lambert K, Sumida K, Moore LW, Kalantar-Zadeh K, Campbell KL. Dietitians Play a Crucial and Expanding Role in Renal Nutrition and Medical Nutrition Therapy. J Ren Nutr 2024; 34:91-94. [PMID: 38373524 DOI: 10.1053/j.jrn.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/21/2024] Open
Affiliation(s)
- Brandon Kistler
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
| | - Carla Maria Avesani
- Nephrology Division, Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolsinka Institutet, Stockholm, Sweden
| | | | - Maria Chan
- The St. George Hospital, Sydney, New South Wales, Australia
| | | | | | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health & Medical Science, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | | | - Denise Mafra
- Federal University Fluminense, UFF, Niterói, Brazil
| | | | - Marianne Vennegoor
- Retired, Department of Renal Medicine, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Angela Yee-Moon Wang
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Keiichi Sumida
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas
| | - Kamyar Kalantar-Zadeh
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California; Division of Nephrology, Hypertension, and Transplantation, Harbor-UCLA and the Lundquist Institute, Torrence, California
| | - Katrina L Campbell
- Metro North Hospital and Health Service, Brisbane, Queensland, Australia
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13
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Celebrating the Impact and Contribution of Dietitians. CAN J DIET PRACT RES 2024; 85:1. [PMID: 38516990 DOI: 10.3148/cjdpr-2024-006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
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Gilmore CJ, Coltman A, Ojeda T, Pertel D, Ashafa M, McCauley SM. Standards of Excellence in Nutrition and Dietetics Organization Criteria: An Update. J Acad Nutr Diet 2024; 124:397-407. [PMID: 37939846 DOI: 10.1016/j.jand.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Affiliation(s)
| | - Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois.
| | - Tamaire Ojeda
- Commission on Dietetic Registration, Chicago, Illinois
| | - Donna Pertel
- Commission on Dietetic Registration, Chicago, Illinois
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Buttriss J, Hickson M, Whelan K, Williams C. Navigating the complexity of applying nutrition evidence to individualised care: Summary of an Academy of Nutrition Sciences Position Paper. NUTR BULL 2024; 49:1-5. [PMID: 38372018 DOI: 10.1111/nbu.12660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 02/20/2024]
Affiliation(s)
| | | | - Kevin Whelan
- Academy of Nutrition Sciences, London, UK
- Department of Nutritional Sciences, King's College London, London, UK
| | - Christine Williams
- Academy of Nutrition Sciences, London, UK
- Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading, UK
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Moizé V, Fernando J, Martí R, Escarrabill J. Exploring Barriers in Integrating Patient Experience Evaluation and Improvement Within the Clinical Practice of Dietitians-Nutritionists in the Catalan Public Health System. Obes Surg 2024; 34:1033-1035. [PMID: 38278981 DOI: 10.1007/s11695-023-07046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/28/2024]
Affiliation(s)
- Violeta Moizé
- Endocrinology Department, Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
| | - Joan Fernando
- Patient Experience Observatory, Hospital Clínic Barcelona, Barcelona, Spain
| | - Roser Martí
- Professional College of Dietitians-Nutritionists of Catalonia (CODINUCAT), Barcelona, Spain
| | - Joan Escarrabill
- Patient Experience Observatory, Hospital Clínic Barcelona, Barcelona, Spain
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17
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Raynor HA, Morgan-Bathke M, Baxter SD, Halliday T, Lynch A, Malik N, Garay JL, Rozga M. Position of the Academy of Nutrition and Dietetics: Medical Nutrition Therapy Behavioral Interventions Provided by Dietitians for Adults With Overweight or Obesity, 2024. J Acad Nutr Diet 2024; 124:408-415. [PMID: 38040115 DOI: 10.1016/j.jand.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
Providing interventions that facilitate improvement of dietary intake and other health behaviors can improve nutrition-related outcomes in adults with overweight or obesity. Medical nutrition therapy (MNT) behavioral interventions require expertise from registered dietitian nutritionists or international equivalents (dietitians), which no other health care provider can provide for adults with obesity. Current evidence supports the role of MNT behavioral interventions for adults with overweight or obesity as an effective treatment option, when appropriate for and desired by the client. This Academy of Nutrition and Dietetics Position Paper describes potential benefits and concerns regarding dietitian-provided MNT behavioral interventions for adults with overweight and obesity and informs dietitians about implications for practice. This Position Paper is supported by a systematic review examining effectiveness of MNT interventions provided by dietitians and by an evidence-based practice guideline. It is the position of the Academy of Nutrition and Dietetics that MNT behavioral interventions for adults (aged 18 years and older) with overweight or obesity should be a treatment option, when appropriate and desired by the client, to improve cardiometabolic, quality of life, and anthropometric outcomes. Dietitians providing MNT recognize the complex contributors to overweight and obesity, and thus individualize interventions, based on a shared decision-making process, and deliver interventions in an inclusive, compassionate, and client-centered manner. Interventions should include collaboration with an interprofessional team when needed. Dietitians strive to increase health equity and reduce health disparities by advocating and providing opportunities for increased access to effective nutrition care services. This position remains in effect until December 31, 2031.
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Affiliation(s)
- Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee Knoxville, Knoxville, Tennessee
| | - Maria Morgan-Bathke
- Department of Nutrition and Dietetics, Viterbo University, La Crosse, Wisconsin
| | | | - Tanya Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, Michigan
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, California
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, New York
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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18
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Jimenez EY, Lamers-Johnson E, Long JM, McCabe G, Ma X, Woodcock L, Bliss C, Abram JK, Steiber AL. Predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition indicators to diagnose malnutrition tool in hospitalized adults: a cohort study. Am J Clin Nutr 2024; 119:779-787. [PMID: 38432715 DOI: 10.1016/j.ajcnut.2023.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The lack of a widely accepted, broadly validated tool for diagnosing malnutrition in hospitalized patients limits the ability to assess the integral role of nutrition as an input and outcome of health, disease, and treatment. OBJECTIVES This study aimed to evaluate the predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (ASPEN) indicators to diagnose malnutrition (AAIM) tool and determine if it can be simplified. METHODS A prospective cohort study was conducted from August 2019 to September 2022 with 32 hospitals in United States. At baseline, 290 adult patients were evaluated for a diagnosis of malnutrition using the AAIM tool, which assesses weight loss, inadequate energy intake, subcutaneous fat and muscle loss, edema, and hand grip strength. Healthcare outcomes were extracted from the medical record: composite incidence of emergency department (ED) visits and hospital readmissions within 90 d postdischarge; length of hospital stay (LOS); and Medicare Severity Disease Related Group (MS-DRG) relative weight (i.e., healthcare resource utilization). We used multilevel, multivariable negative binomial or generalized linear regression models to evaluate relationships between malnutrition diagnosis and healthcare outcomes. RESULTS After adjusting for disease severity and acuity and sociodemographic characteristics, individuals diagnosed with severe malnutrition had a higher incidence rate of ED visits and hospital readmissions (incidence rate ratio: 1.89; 95% CI: 1.14, 3.13; P = 0.01), and individuals diagnosed with moderate malnutrition had a 25.2% longer LOS (95% CI: 2.0%, 53.7%; P = 0.03) and 15.1% greater healthcare resource utilization (95% CI: 1.6%, 31.9%; P = 0.03) compared with individuals with no malnutrition diagnosis. Observed relationships remained consistent when only considering malnutrition diagnoses supported by at least 2 of these indicators: weight loss, subcutaneous fat loss, muscle wasting, and inadequate energy intake. CONCLUSIONS Findings from this multihospital study confirm the predictive validity of the original or simplified AAIM tool and support its routine use for hospitalized adult patients. This trial was registered at clinicaltrials.gov as NCT03928548 (https://classic. CLINICALTRIALS gov/ct2/show/NCT03928548).
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Affiliation(s)
- Elizabeth Yakes Jimenez
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States; Department of Pediatrics, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM, United States; Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM, United States; College of Population Health, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM, United States
| | - Erin Lamers-Johnson
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Julie M Long
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - George McCabe
- Department of Statistics, Purdue University, West Lafayette, IN, United States
| | - Xingya Ma
- Department of Pediatrics, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM, United States
| | - Lindsay Woodcock
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Courtney Bliss
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Jenica K Abram
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States
| | - Alison L Steiber
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL, United States.
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19
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Vaterlaus Patten E, Vaterlaus JM, Anderson C, Borden R. Opting In and Out: A Qualitative Study Exploring Career Break Experiences of Registered Dietitian Nutritionists. J Acad Nutr Diet 2024; 124:181-193. [PMID: 37690622 DOI: 10.1016/j.jand.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Since 2002, an average of 17.5% of registered dietitian nutritionists (RDNs) have reported being out of the paid dietetics workforce, and approximately half of those report intention to return. With the Academy of Nutrition and Dietetics' focus on expanding workforce demand and capacity, understanding why and how dietitians opt in and out of the dietetics workforce may provide insights into how to potentially reduce the number of career breaks or expedite and enhance the reentry process. OBJECTIVE To explore the lived experiences and perspectives of dietitians who were taking (with intention to return) or had taken a career break and returned to the paid dietetics' workforce. DESIGN A qualitative study with semistructured interviews was conducted. PARTICIPANTS/SETTING Participants (n = 22) were recruited through purposive sampling over social media. They were required to be credentialed as RDNs, reside in the United States, and have either previously or currently (with intent to return) taken a break from the dietetics workforce. Interviews were conducted using Zoom videoconferencing technology during September 2021. DATA ANALYSIS Data were analyzed using a Coding Reliability Thematic Analysis approach. RESULTS The data are summarized in four themes: (1) motivations to leave and return, (2) staying connected with dietetics, (3) preparing to return and returning to the dietetics workforce, and (4) desired resources for career breaks and reentry. CONCLUSIONS Understanding the experiences of dietitians who take career breaks may help inform career reentry and help the profession meet the current and future workforce demand.
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20
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Williams LT. What does your university degree do for you? The role of academic dietitians in the development of the dietetics profession. Nutr Diet 2024; 81:4-7. [PMID: 38311467 DOI: 10.1111/1747-0080.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Lauren T Williams
- School of Health Sciences and Social Work, Griffith University, Southport, Queensland, Australia
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21
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Ojeda T, Ashafa M, Pertel D, McCauley S, Coltman A. The Updated Global Malnutrition Composite Score Clinical Quality Measure: Its Relevance to Improving Inpatient Clinical Outcomes and Health Equity. J Acad Nutr Diet 2024; 124:249-256. [PMID: 37939845 DOI: 10.1016/j.jand.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
Quality improvement has existed in health care for centuries with a dramatic transformation over time, largely motivated by the academic health quality movement. Throughout this evolution, the Centers for Medicare and Medicaid Services have been at the forefront of the development and provision of quality measures for health care in a variety of settings, including acute care. Quality initiatives aid in the evaluation of patient care to encourage quality improvement efforts, determine pay-for-performance rates, and help patients and consumers evaluate their care providers. The addition of the Global Malnutrition Composite Score as an electronic Clinical Quality Measure in 2022 highlights the key role nutrition plays in outcomes and quality of hospitalized patients. With this, credentialed nutrition and dietetics practitioners lie front and center for the development of quality improvement processes to help promote high quality standards of nutrition care, improve length of stay, and reduce health care costs and readmissions while addressing malnutrition, health equity, and nutrition care as a human right. As the Global Malnutrition Composite Score steward, it is the obligation of the Academy of Nutrition and Dietetics and the Commission on Dietetic Registration to promote the measure and support credentialed nutrition and dietetics practitioners in advocating for the implementation of this measure. Therefore, the purpose of this practice update is to provide necessary information to credentialed nutrition and dietetics practitioners and other health care leaders related to the history and implementation of the Global Malnutrition Composite Score, along with relevant updates to the measure and practice implications.
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Affiliation(s)
- Tamaire Ojeda
- Commission on Dietetic Registration, Chicago, Illinois
| | | | - Donna Pertel
- Commission on Dietetic Registration, Chicago, Illinois
| | | | - Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois
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22
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Yoder AD, Proaño GV, Kelley K, Wu Y, Banna J. Perspectives of Food as Medicine Concept: Report of an Online Convenience Sample Survey of Registered Dietitian Nutritionists. J Acad Nutr Diet 2024; 124:257-267.e12. [PMID: 37179000 DOI: 10.1016/j.jand.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND In 2019, the Academy of Nutrition and Dietetics (Academy) Foundation launched a project to leverage registered dietitian nutritionists (RDNs) leading "food as medicine" (FAM) initiatives within food retail settings. Subsequently, a conceptual definition of FAM was created. OBJECTIVE This survey aimed to gauge RDNs' familiarity with FAM, assess RDNs' perceptions of the Academy's FAM definition, and prioritize program models for food retail implementation. DESIGN Development and testing of this cross-sectional survey involved expert content validation, cognitive interviews, and field testing. PARTICIPANTS One thousand five hundred fifty-two RDN Academy members completed the online survey. MAIN OUTCOME MEASURES Familiarity and perception of FAM was evaluated by asking participants about FAM focus areas, Academy definition, concept integration, and FAM program models within food retail settings. STATISTICAL ANALYSES PERFORMED Quantitative results were analyzed descriptively, using frequencies and proportions; content analysis was used on qualitative results to analyze open-ended responses. RESULTS Most respondents had heard the term FAM (94%) and were familiar with the concept (95%). Before learning the Academy's FAM definition, RDN views of the concept aligned with the definition's strategic focus areas (health and well-being, disease management and treatment, nutrition security, food safety). Overall, 77% of RDNs surveyed had a positive perception of the Academy's FAM definition. Sixty-nine percent also found food retail settings favorable for integrating FAM programming. Because of the limited number of RDNs identifying food retail as their primary practice setting (n = 12), data on prioritizing program models in these settings were not analyzed. CONCLUSIONS RDNs in all practice settings can incorporate strategic focus areas outlined in the Academy's FAM definition. Further research is needed, particularly around use of the term by the RDN profession. A follow-up survey targeting a larger sample size of RDNs who practice in food retail settings is also necessary to further prioritize FAM program models in these settings.
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23
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Bartrim K, Wright ORL, Moyle W, Ball L. Exploring Australian dietitians' experiences and preparedness for working in residential aged care facilities. J Hum Nutr Diet 2024; 37:111-125. [PMID: 37749863 DOI: 10.1111/jhn.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Dietitians are increasingly working in residential aged care facilities (RACF). As such, supporting the RACF dietetic workforce is imperative. This qualitative study explored dietitians' experiences and preparedness for working in RACFs. METHODS A qualitative descriptive approach from a non-singular reality relational position was used. Recruitment occurred through convenience and snowball sampling, including contacting a list of dietitians who had previously consented to be contacted for research. The interviews included a semi-structured approach. Data were analysed using constant comparison and reflexive thematic analysis. RESULTS Thirty-one dietitians (n = 29 female; median age, 39 years) with a range of career experience participated in an interview. Interviews ranged from 25 to 68 min (mean duration, 41 min). Five themes and 14 subthemes were identified. Themes were: (1) joining the aged care workforce was not initially considered a career option, (2) difficulty sustaining satisfaction working in aged care, (3) navigating practical challenges working with residents while prioritising quality care, (4) poor acknowledgement of the dietitian role by staff and (5) grappling with a moral desire to improve the aged care sector. CONCLUSION Dietitians face many challenges in fulfilling their role in RACFs, including RACF staff's poor understanding of dietitians' scope and a lack of procedural support for their daily activities. Dietitians report that genuine improvements in their job satisfaction and experiences of older adults require structural reform within the government, beyond their locus of control.
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Affiliation(s)
- Karly Bartrim
- Centre for Community Health and Wellbeing, The University of Queensland, Brisbane, Queensland, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - Lauren Ball
- Centre for Community Health and Wellbeing, The University of Queensland, Brisbane, Queensland, Australia
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24
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14th EFAD Congress: "Dietetic care, a human right: moving forward into a new era". Ann Nutr Metab 2024; 80:37-56. [PMID: 38246152 DOI: 10.1159/000535909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 01/23/2024]
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25
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Cuenca MH, Proaño GV, McDermid JM, Badreldin El Shikieri A, Steeves EA, Carrillo-Alvarez E, Fracassi P, Garelick DS, Brewer J, Kazimierczuk FK, Steiber A. Advancing Nutrition and Dietetics Research in Global Food and Nutrition Security: A Roundtable Meeting Report. J Acad Nutr Diet 2024; 124:102-122. [PMID: 37858674 DOI: 10.1016/j.jand.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
Food and nutrition security remains a relevant issue globally, impacting nutritional status and other health outcomes. This is further complicated by various environmental factors that impact stable access to, availability of, and utilization of nutritious foods. Nutrition and dietetics practitioners play an important role in the identification and treatment of food and nutrition security and are also well positioned to advance research that can support food and nutrition security solutions. To address this important issue, the Academy of Nutrition and Dietetics' Council on Research convened a Global Food and Nutrition Security Research Task Force (Task Force). To leverage existing information and expertise in this area and identify the need for future evidence, the Task Force hosted a virtual roundtable with key internal and external stakeholders. This 2-day event included discussions on research gaps, potential entry points for nutrition and dietetics practitioners, and important equity considerations in the area of food and nutrition security research. The identified research gaps included the need for standardized terminology for consistent data collection, the need for validated screening and assessment tools that can be used across settings and also assess diet quality, additional translational and implementation science research, multi-sectoral and multi-pronged approaches, interdisciplinary collaboration with community partners, incorporation of research into policy development, and additional evidence on food systems approaches to target food and nutrition security. To more clearly identify the entry points for practitioners, five examples from various countries were included to identify food and nutrition security issues and how nutrition and dietetics practitioners can be involved in research to address food and nutrition security. The Task Force would like this information to inform a research agenda and be leveraged by the larger scientific community to drive future funding and research opportunities for food and nutrition professionals on this topic.
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Shah RR, Dixon CC, Fowler MJ, Driesse TM, Liang X, Summerour CE, Gross DC, Spangler HB, Lynch DH, Batsis JA. Using Voice Assistant Systems to Improve Dietary Recall among Older Adults: Perspectives of Registered Dietitians. J Nutr Gerontol Geriatr 2024; 43:1-13. [PMID: 38287658 PMCID: PMC10922685 DOI: 10.1080/21551197.2024.2302619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Dietary assessments are important clinical tools used by Registered Dietitians (RDs). Current methods pose barriers to accurately assess the nutritional intake of older adults due to age-related increases in risk for cognitive decline and more complex health histories. Our qualitative study explored whether implementing Voice assistant systems (VAS) could improve current dietary recall from the perspective of 20 RDs. RDs believed the implementing VAS in dietary assessments of older adults could potentially improve patient accuracy in reporting food intake, recalling portion sizes, and increasing patient-provider efficiency during clinic visits. RDs reported that low technology literacy in older adults could be a barrier to implementation. Our study provides a better understanding of how VAS can better meet the needs of both older adults and RDs in managing and assessing dietary intake.
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Affiliation(s)
- Rahi R. Shah
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
| | - Claudia C. Dixon
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
| | - Michael J. Fowler
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
| | - Tiffany M. Driesse
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
| | - Xiaohui Liang
- Department of Computer Science, University of Massachusetts Boston, Boston, MA
| | - Caroline E. Summerour
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
| | - Danae C. Gross
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
| | - Hillary B. Spangler
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
| | - David H. Lynch
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
| | - John A. Batsis
- Division of Geriatric Medicine, University of North Carolina School of Medicine, Chapel Hill NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill NC
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Soguel L, Lapointe A, Burnand B, Desroches S. Descriptive and Content Analysis of Questionnaires Used to Assess Evidence-Based Practice Among Dietitians: A Systematic Review. J Acad Nutr Diet 2024; 124:80-101. [PMID: 37673334 DOI: 10.1016/j.jand.2023.08.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Evidence-based practice (EBP) is described as the integration of the following 3 main dimensions in health professionals' decision making: best currently available research evidence, professional expertise, and patient's values and circumstances. Barriers to EBP at an individual level have been assessed using questionnaires. Knowing which EBP dimensions are actually explored in these questionnaires is essential to promote EBP and its adoption. OBJECTIVE The aim of this review was to identify and describe questionnaires that have been used among dietitians to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP, and to perform a content analysis of these, drawn on the EBP dimensions explored. METHODS Questionnaires were identified through a systematic review in MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (last search was November 2022). Eligibility criteria were studies using, evaluating, or developing questionnaires meant to evaluate knowledge, skills, attitudes, and/or behaviors related to EBP among dietitians. The content analysis was conducted to identify the EBP dimensions explored (ie, research evidence, professional expertise, and/or patient's values and circumstances). Questionnaire items were categorized as follows: 1 sole EBP dimension, a combination of dimensions, or no identifiable dimension. RESULTS Thirty reports (25 studies) were included. The analysis of the 847 items extracted from the 25 questionnaires used showed that the main EBP dimension explored was the integration of research evidence into decision making, found in 75% of items, solely or in combination with another dimension. Professional expertise was explored in 18% of the items, patient's values and circumstances were found in 3%, and the combination of these 3 dimensions was found in <1%. CONCLUSIONS The important imbalance of explored EBP dimensions in the questionnaires used may lead to a partial and misleading evaluation that prevents efficient strategies to foster EBP. There is an important need to develop more integrative and accurate evaluations of EBP targeting dietitians to promote and develop high-quality dietetics practice.
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Affiliation(s)
- Ludivine Soguel
- School of Nutrition, Faculty of Agriculture and Food Sciences, Université Laval, Quebec City, Quebec, Canada; Nutrition and Dietetics Department, Geneva School of Health Sciences, University of Applied Sciences and Arts Western Switzerland HES-SO, Geneva, Switzerland.
| | - Annie Lapointe
- Centre Nutrition, Santé et Société, Faculty of Agriculture and Food Sciences, Université Laval, Quebec City, Quebec, Canada
| | - Bernard Burnand
- Department of Epidemiology and Health Systems, Unisanté and University of Lausanne, Lausanne, Switzerland
| | - Sophie Desroches
- School of Nutrition, Faculty of Agriculture and Food Sciences, Université Laval, Quebec City, Quebec, Canada; Centre Nutrition, Santé et Société, Faculty of Agriculture and Food Sciences, Université Laval, Quebec City, Quebec, Canada
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28
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Yeganehjoo M, Johanek J. Role of registered dietitians in nasoenteric feeding tube placement. Nutr Clin Pract 2023; 38:1225-1234. [PMID: 37725386 DOI: 10.1002/ncp.11071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/07/2023] [Accepted: 08/20/2023] [Indexed: 09/21/2023] Open
Abstract
Provision of enteral nutrition (EN) in hospitalized patients is an integral part of clinical care. For various reasons, including but not limited to delayed enteral access placement and EN initiation, it is becoming more prevalent for registered dietitians (RDs) to place feeding tubes in various clinical settings. Although numerous RDs have expanded their practice by learning this skill, many remain hesitant about adding feeding tube placement to their scope of responsibilities. Feeding tube placement is within RDs' scope of practice. The recently updated Accreditation Council for Education in Nutrition and Dietetics (ACEND) standards is requiring dietetic interns to learn the process and assist in placing feeding tubes. This will help promote the inclusion of this practice and open doors for future advancement in the scope of practice for RDs. This review will provide an overview of feeding tube placement methods, evidence-based techniques, training, competencies, and barriers to accepting this practice in dietetics.
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Affiliation(s)
- Maryam Yeganehjoo
- Nutrition Services Department, Baylor Scott & White Health, Grapevine, Texas, USA
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29
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Johnson SA, Kirkpatrick CF, Miller NH, Carson JAS, Handu D, Moloney L. Saturated Fat Intake and the Prevention and Management of Cardiovascular Disease in Adults: An Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2023; 123:1808-1830. [PMID: 37482268 DOI: 10.1016/j.jand.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the United States and globally and is largely attributable to atherosclerosis. Evidence indicates that multiple dietary components contribute to the complex causes of CVD and associated events and mortality. Public health authorities and scientific organizations have recommended reduced saturated fatty acid (SFA) intake for decades to promote cardiovascular health, which is linked to favorable impacts on established and emerging atherosclerotic CVD risk factors. Recently, a debate has emerged about whether SFA intake should be reduced for CVD prevention, which has contributed to confusion among health care professionals, including registered dietitian nutritionists (RDNs), and the general public, and necessitates the critical evaluation of the evidence. The objective of this evidence-based nutrition practice guideline is to provide health care and public health professionals, particularly RDNs, with evidence-based recommendations on how to address SFA intake in adults within an individualized healthy dietary pattern. Moderate evidence supports the reduction of SFA intake for CVD event reduction, low- to moderate-certainty evidence supports prioritization of replacement of SFAs with polyunsaturated fatty acids, and low-certainty evidence supports focusing on reducing the total amount of SFA rather than specific food sources of SFA. Guideline implementation should include consideration of individual preferences; principles of inclusion, diversity, equity, and access; and potential nutritional deficiencies that may occur with reduced SFA intake. Future research is needed to address gaps that were identified and provide high-quality evidence to support stronger future recommendations based on the relationship between SFA and CVD.
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Susan Caswell M, Lieffers JR, Wojcik J, Eisenbraun C, Buccino J, Hanning RM. COVID-19 Pandemic Effects on Job Search and Employment of Graduates (2015-2020) of Canadian Dietetic Programmes. CAN J DIET PRACT RES 2023; 84:200-210. [PMID: 37115016 DOI: 10.3148/cjdpr-2023-004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Purpose: Self-reported coronavirus 2019 (COVID-19) pandemic effects on dietetic job search, employment, and practice of recent graduates were explored within a national workforce survey.Methods: Graduates (2015-2020) who were registered/licensed dietitians or eligible to write the Canadian Dietetic Registration Exam were recruited through dietetic programmes, Dietitians of Canada's communication channels, and social media. The online survey, available in English and French from August through October 2020, included questions about pandemic experiences. Descriptive statistics and thematic analysis were applied to closed and open-ended responses, respectively.Results: Thirty-four percent of survey respondents (n = 524) indicated pandemic effects on job search and described delayed entry into dietetics, fewer job opportunities, and challenges including restricted work between sites. The pandemic affected employment for 44% of respondents; of these, 45% indicated working from home, 45% provided virtual counselling, 7% were redeployed within dietetics, 14% provided nondietetic COVID-19 support, and 6% were furloughed or laid off. Changed work hours, predominantly reduced, were identified by 29%. Changes in pay, identified by 12%, included loss (e.g., raises deferred) or gain (e.g., pandemic pay). Fear of infection and stress about careers and finances were expressed.Conclusion: The COVID-19 pandemic profoundly affected both acquiring positions and employment in 2020 for recent dietetic graduates.
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Affiliation(s)
- M Susan Caswell
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
| | - Jessica R Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | | | | | | | - Rhona M Hanning
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
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Silver HJ. The Design, Development, and Deployment of the Vanderbilt Diet, Body Composition, and Human Metabolism Core: How Dietitians Improved Clinical and Translational Research Practices in Academic Medicine. J Acad Nutr Diet 2023; 123:1701-1709. [PMID: 37611824 DOI: 10.1016/j.jand.2023.08.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/10/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Heidi J Silver
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee.
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McDermid JM, Almond MA, Roberts KM, Germer EM, Geller MG, Taylor TA, Sinley RC, Handu D. Celiac Disease: An Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2023; 123:1793-1807.e4. [PMID: 37499866 DOI: 10.1016/j.jand.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
Celiac disease is an autoimmune disorder in which the immune system of genetically susceptible individuals elicits a reaction to gluten causing small intestine damage. If left undiagnosed and untreated, the resulting nutrition malabsorption can lead to anemia, bone disease, growth faltering, or other consequences. The condition is lifelong and lacks a cure; the only treatment is lifelong adherence to a gluten-free diet (GFD). This diet is challenging to follow and adversely influences quality of life; however, it is essential to ensure intestinal recovery and prevent future negative health consequences. The Academy of Nutrition and Dietetics convened an expert panel complemented by a celiac disease patient advocate to evaluate evidence for six topics, including medical nutrition therapy; the GFD; oat consumption; micronutrients; pro-/prebiotics; and the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet. This publication outlines the Academy of Nutrition and Dietetics Evidence Analysis Library methods used to complete the systematic review and guideline development, and summarizes the recommendations and supporting evidence. The guidelines affirm that all individuals with celiac disease should follow a GFD (1C, Imperative) that may include gluten-free oats in adults (2D, Conditional). Children should follow a nutritionally adequate GFD that supports healthy growth and development (Consensus, Imperative) and does not unnecessarily restrict gluten-free oats (Consensus, Conditional). The guidelines indicate nutritional care should include routine nutritional assessment (Consensus, Imperative) and medical nutrition therapy (Consensus, Imperative). At this time, the guidelines do not support a recommendation for the addition of the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (2C, Conditional); prebiotic or probiotic supplementation (2D, Conditional); or micronutrient supplementation (in the absence of nutritional deficiency) (Consensus, Conditional). The 2021 Celiac Disease Evidence-Based Nutrition Guideline will assist registered dietitian nutritionists in providing appropriate evidence-based medical nutrition therapy to support people with celiac disease in achieving and maintaining nutritional health and avoiding adverse celiac disease consequences throughout their lives.
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Affiliation(s)
| | - M Angie Almond
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | | | - Emily M Germer
- Matthew Walker Comprehensive Health Center, Nashville, Tennessee
| | | | | | | | - Deepa Handu
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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Abstract
Many Canadian universities have committed to becoming more accountable to Indigenous Peoples by confronting the systemic, historical, and ongoing colonialism and anti-Indigenous racism that shape their campuses. In this Perspective in Practice piece, we invite the field of dietetics to consider how colonialism has shaped dietetics research, teaching, and practice. We also consider how we might transform the field of dietetics in ways that accept settler responsibility for interrupting racism and colonial harm; support the resurgence of Indigenous food and health practices; and recognise the connections between struggles to ensure that Indigenous Peoples can access culturally appropriate food and health care, and struggles for Indigenous sovereignty and self-determination. We do this by reviewing the history of the dietetics field, examining critical responses to existing Indigenisation and decolonisation efforts, and reflecting on recent changes to required dietetics competencies. We argue that curricula in dietetics programmes must teach the history of the colonial food system and equip students to identify and interrupt the individual and institutional colonial dynamics that contribute to the ongoing dispossession of Indigenous Peoples' lands and food sources and negatively impact Indigenous patients.
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Affiliation(s)
- Sharon Stein
- Department of Educational Studies, Faculty of Education, University of British Columbia, BC
| | - Tabitha Robin
- Applied Biology, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Michael Wesley
- Indigenous Health and Nutrition Consulting, Kelowna, BC
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Will Valley
- Centre for Sustainable Food Systems, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Daniel J Clegg
- Centre for Sustainable Food Systems, Faculty of Land and Food Systems, University of British Columbia, BC
| | - Cash Ahenakew
- Department of Educational Studies, Faculty of Education, University of British Columbia, BC
| | - Tamara R Cohen
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, BC
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Carlsson L, Poulia KA, Madden A. Sustainability in dietetics means embracing complexity, contributing and collaborating. J Hum Nutr Diet 2023; 36:2123-2126. [PMID: 37864405 DOI: 10.1111/jhn.13257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Liesel Carlsson
- School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada
| | - Kalliopi-Anna Poulia
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Angela Madden
- Nutrition and Dietetics, University of Hertfordshire, Hatfield, UK
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Carrad A, Smits R, Charlton K, Rose N, Reeve B. The role of Australian civil society organisations in food system governance: Opportunities for collaboration in dietetics practice. J Hum Nutr Diet 2023; 36:2336-2350. [PMID: 37335560 DOI: 10.1111/jhn.13195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Civil society organisations (CSOs) are increasingly participating in food system governance in ways that challenge the dominant industrialised profit-driven system. METHODS An online survey of Australian CSOs that self-identified as being involved in food system governance was conducted to identify their objectives and activities and the enablers of, and barriers to, their participation in food system governance. Respondents were nongovernment organisations/registered charities, social enterprises, businesses and collaborative research initiatives involved in food system governance in Australia (n = 43). RESULTS Organisations undertook activities across all dimensions of the food system (food growing/production, distribution, sale, marketing, access and consumption) and had diverse goals related to health, sustainability and social and economic development. They engaged in food system governance via activities such as advocacy and lobbying for policy and legislative change and guiding policy development. Key enablers of this engagement included funding, internal capacity, external supports and collaborations, and inclusive consultation processes and, when not present, were considered barriers. CONCLUSIONS CSOs play an important role in food system governance in Australia, including by influencing policy outcomes, contributing to more inclusive and democratic forms of governance and leading community-based food system policies. For CSOs to play a more central role, provision of longer-term funding; creation of dedicated food and nutrition policies at local, state and federal government levels; and governance processes that are inclusive, accessible and minimise power differentials are required. This study's findings can be used to identify many opportunities for dietitians to engage with CSOs in education, research and advocacy roles for food system transformation.
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Affiliation(s)
- Amy Carrad
- School of Medical, Indigenous and Health Sciences, Wollongong, New South Wales, Australia
- School of Regulation and Global Governance, College of Asia & the Pacific, Canberra, Auatralian Capital Territory, Australia
| | - Rebecca Smits
- School of Medical, Indigenous and Health Sciences, Wollongong, New South Wales, Australia
| | - Karen Charlton
- School of Medical, Indigenous and Health Sciences, Wollongong, New South Wales, Australia
| | - Nick Rose
- William Angliss Institute of TAFE, Melbourne, Victoria, Australia
| | - Belinda Reeve
- The University of Sydney Law School, Camperdown, New South Wales, Australia
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Everitt T, Carlsson L, Yantha B, Jean-Neilson M, MacIsaac S. Conceptualising sustainability in Canadian dietetic practice: A scoping review. J Hum Nutr Diet 2023; 36:2127-2146. [PMID: 37565587 DOI: 10.1111/jhn.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Dietitians (RDs) are well-positioned to promote sustainable food systems and diets. This research aims to review the literature for how RDs in Canada define sustainability and determine the types of relevant activities that exist in practice as described in published literature. METHODS Using standardised scoping review methods, researchers searched CINAHL, ACASP, PubMed and ENVCOM databases to identify peer-reviewed articles and conducted a grey literature search to locate other publications related to sustainability in Canadian dietetic practice. Qualitative, thematic coding methods were used to examine definitions and existing practice. The PRISMA extension for scoping reviews guided reporting. RESULTS The search resulted in 1059 documents and, after screening, 11 peer-reviewed and 16 grey literature documents remained. Ten unique definitions were used, the most common being Sustainable Diets. Definitions were multidimensional, including environmental, social, economic and health dimensions, and 31 unique subtopics. However, existing practice activities appear to reduce actions to one to two dimensions. Existing practice areas well-reflected include Food and Nutrition Expertise, Management and Leadership, Food Provision and Population Health Promotion. Notable gaps include action in Professionalism and Ethics and Nutrition Care. CONCLUSIONS No single definition supports all professional contexts, and agency in choice of language to define the work is helpful for contextual clarity. Strengthening practitioners' ability to analyse issues using systems thinking and applying this in practice will help to address challenges and reduce risks of trade-offs. Updates to competency standards that reflect the breadth of existing activities, as well as curricular supports or practice standards, are needed.
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Affiliation(s)
- Tracy Everitt
- Department of Human Nutrition, St Francis Xavier University, Antigonish, NS, Canada
| | - Liesel Carlsson
- School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada
| | - Brittany Yantha
- Department of Human Nutrition, St Francis Xavier University, Antigonish, NS, Canada
| | | | - Sarah MacIsaac
- Department of Human Nutrition, St Francis Xavier University, Antigonish, NS, Canada
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Zhang Y, Churchill M, Mannette J, Rothfus M, Mireault A, Harvey A, Lackie K, Hayward K, Fraser Arsenault J, Lordly D, Grant S. Identifying and Mapping Canadian Dietetic Students' Interaction(s) with Simulation-Based Education: A Scoping Review. CAN J DIET PRACT RES 2023; 84:233-241. [PMID: 37436143 DOI: 10.3148/cjdpr-2023-016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
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: (i) comprehensive care plan (n = 2); (ii) nutritional diagnosis/assessment (n = 2); (iii) body composition assessment (n = 1); (iv) introducing patient to dysphagia care (n = 1); (v) nutrition counselling session (n = 1); (vi) nutrition-focused physical examination (n = 1); and (vii) 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.
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Affiliation(s)
- Yingying Zhang
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Megan Churchill
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of Obstetrics and Gynecology and Pediatrics, IWK Health Centre, Halifax, NS
| | - Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Melissa Rothfus
- WK Kellogg Health Sciences Library, Dalhousie University; Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS
| | - Amy Mireault
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Antonia Harvey
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of General Medicine, Cardiology, Dartmouth General Hospital, Nova Scotia Health Authority, Dartmouth, NS
| | - Kelly Lackie
- School of Nursing, Dalhousie University, Halifax, NS
| | | | | | - Daphne Lordly
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
- Department of Obstetrics and Gynecology and Pediatrics, IWK Health Centre, Halifax, NS
- Department of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, NS
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Hoffmann L, Egert S, Allgaier J, Kohlenberg-Müller K. Review of Validated Methods to Evaluate Diet History in Diet Therapy and Counselling: An Overview and Analysis of Screeners Based on Food-Based Dietary Guidelines. Nutrients 2023; 15:4654. [PMID: 37960307 PMCID: PMC10647684 DOI: 10.3390/nu15214654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Evidence-based dietetic practice calls for systematically developed assessment methods for nutritional assessment in dietetic counselling and therapy (DCT). Screeners can provide a quick and easy way to determine a client's diet quality and contribute to quality assurance in DCT. The aim of this systematic review was to give a comparative overview of screeners based on national food-based dietary guidelines (FBDGs) and to derive recommendations for developing an FBDG-based screener for DCT. The literature search in PubMed (MEDLINE), embase and Web of Science was conducted between May and July 2022, and updated in March 2023, in accordance with the consensus-based standards for the selection of health measurement instruments (COSMIN). The analysis focused on characteristics of screener design and measurement properties for screener testing. In total, 13 studies on 11 screeners based on FBDGs were included; 7 screeners were targeted to DCT. The content and scoring of screeners were based on the corresponding national FBDGs. The validity and/or reliability of screeners were investigated in 11 studies; responsiveness was not tested for any screener and practicality was considered in all studies. Based on the screeners reviewed, a systematic rationale to develop, enhance and test screeners based on national FBDGs was established.
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Affiliation(s)
- Laura Hoffmann
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Sarah Egert
- Institute of Nutritional and Food Science, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany;
| | - Joachim Allgaier
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Kathrin Kohlenberg-Müller
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
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Miles A, Brady A, Friary P, Sekula J, Wallis C, Jackson B. Implementing an interprofessional palliative care education program to speech-language therapy and dietetic students. J Interprof Care 2023; 37:964-973. [PMID: 37161383 DOI: 10.1080/13561820.2023.2203731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/14/2023] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
Palliative care education for allied health professionals has received minimal research attention. This longitudinal study followed the development of an education program for speech-language therapy (SLT) and dietetic (DT) students. The project comprised three stages. In Stage I, consenting SLT and DT graduates (n = 9) were interviewed 6 months after graduation exploring preparedness for working in palliative care. Interviews were transcribed, and topics were extracted through content analysis. In Stage II, a new palliative care curriculum was developed using the extant literature and gaps reported in Stage I. In Stage III, we implemented and evaluated the new curriculum. Students were surveyed before (n = 68) and after (n = 42) the new program and at 6-month post-graduation (n = 15) to capture student-reported changes in knowledge and confidence in palliative care. In Stage I, 10 topics were developed covering knowledge, roles, team, family-focused care, and feelings. In Stage II, a hybrid program was developed including e-learning modules, didactic lectures, and a simulated learning experience. In Stage III, student feedback demonstrated positive shifts in knowledge and confidence ratings from medians 3-6 to 5-8 (1 = none; 10 = excellent) across all domains. Gains in knowledge and confidence were consistently higher at 6-month post-graduation for final survey respondents. Mixed modality interprofessional palliative care education for allied health professionals has merit in improving knowledge, confidence, and perceived preparedness for practice.
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Affiliation(s)
- Anna Miles
- Speech Science, School of Psychology, Grafton Campus, The University of Auckland, Auckland, New Zealand
| | - Alana Brady
- Speech Science, School of Psychology, Grafton Campus, The University of Auckland, Auckland, New Zealand
| | - Philippa Friary
- Speech Science, School of Psychology, Grafton Campus, The University of Auckland, Auckland, New Zealand
| | - Julia Sekula
- Nutrition and Dietetics, The University of Auckland, Auckland, New Zealand
| | - Clare Wallis
- Nutrition and Dietetics, The University of Auckland, Auckland, New Zealand
| | - Bianca Jackson
- Speech Science, School of Psychology, Grafton Campus, The University of Auckland, Auckland, New Zealand
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McCarthy NE, Schultz M, Wall CL. Current state of dietetic services for inflammatory bowel disease patients in New Zealand: an observational study. Nutr Diet 2023; 80:538-545. [PMID: 37056216 DOI: 10.1111/1747-0080.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/15/2023]
Abstract
AIM Nutritional therapies for inflammatory bowel disease are increasingly recommended. This study aimed to gain insight from patients, dietitians and gastroenterologists into inflammatory bowel disease dietetic care in New Zealand. METHODS Mixed-methods surveys were developed and then distributed online to patients with inflammatory bowel disease and dietitians and gastroenterologists that care for patients with inflammatory bowel disease. Quantitative survey data were analysed using nonparametric statistical tests. Qualitative survey data were analysed using thematic analysis. RESULTS Responses were received from 406 inflammatory bowel disease patients, 79 dietitians and 40 gastroenterologists. Half of the patients (52%) had seen a dietitian for nutrition advice. Patients more likely to have seen a dietitian were/had: Crohn's disease (p = 0.001), previous bowel surgery (p < 0.001), younger (p < 0.001) or receiving biologic therapy (p = 0.005). Two-thirds (66%) of patients found the dietitian advice at least moderately useful. A common theme from patient comments was that dietitians needed better knowledge of inflammatory bowel disease. Almost all (97%) gastroenterologists reported that their inflammatory bowel disease patients ask about nutrition; 57% reported that there were inadequate dietitians to meet patient needs. Over 50% of dietitians saw inflammatory bowel disease patients infrequently and 39% were not confident that their knowledge of the nutritional management of inflammatory bowel disease was current. Dietitians desired greater links with the inflammatory bowel disease multidisciplinary team. CONCLUSION Current inflammatory bowel disease dietetic services in New Zealand are inadequate. Standardised care, increased resourcing, dietitian training in inflammatory bowel disease, and stronger links with the multidisciplinary team are suggested to improve services.
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Affiliation(s)
- Nicky E McCarthy
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Michael Schultz
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Catherine L Wall
- Department of Medicine, University of Otago, Christchurch, New Zealand
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Kelly JT, Jegatheesan DK, Dawson J, Barnett A, Khor BH, Chang AR, Carrero JJ, Campbell KL. Are Digital Health Technologies and Models of Nutrition Care the Future of Chronic Kidney Disease Management? J Ren Nutr 2023; 33:S80-S87. [PMID: 36965753 DOI: 10.1053/j.jrn.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/11/2022] [Accepted: 02/27/2023] [Indexed: 03/27/2023] Open
Abstract
People living with chronic kidney disease (CKD) require long-term support at varying levels of individualization, intensity, and frequency. Mobile and digital models of nutrition care can facilitate long-term behavior change, address nutrition issues proactively, reduce travel burden, and reach people without access to health care more easily. However, while traditional health delivery continues to be digitally disrupted, there are many barriers to address before mobile and digitally supported models of nutrition care can become business as usual in nephrology and nutrition care practice. This paper overviews the current evidence base concerning the past and present mobile and digital health programs to improve nutrition in CKD and highlights the novel future trends in this field. The way nutrition and dietetic care can be feasible, safe, and potentially effective when delivered using various digital and virtual technologies, including consultations, assessments, establishment of diagnoses, formulation of plans, and monitoring/reviewing clinical progress is discussed. Of the available evidence to date, these modalities appear to improve dietary sodium intake and diet quality, self-efficacy, interdialytic weight gain, and body weight. Many barriers exist to sustaining the continued and widespread adoption of digital and mobile health-supported nutrition care in CKD. These include patient-, clinician-, and health system-specific and are discussed in detail. Mobile and digital-supported models of nutrition care present an exciting opportunity to assist kidney dietitians deliver patient-centred nutrition care in CKD.
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Affiliation(s)
- Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Dev K Jegatheesan
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Jessica Dawson
- Nutrition and Dietetics Department, St George Hospital, Sydney, New South Wales, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | - Amandine Barnett
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Alex R Chang
- Center for Kidney Health Research, Geisinger Health, Danville, PA
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Katrina L Campbell
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane, Australia
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Lee P, Kouba J, Jimenez EY, Kramer H. Medical Nutrition Therapy for Chronic Kidney Disease: Low Access and Utilization. Adv Kidney Dis Health 2023; 30:508-516. [PMID: 38453267 DOI: 10.1053/j.akdh.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 03/09/2024]
Abstract
CKD affects approximately half of US adults aged 65 years and older and accounts for almost 1 out of every 4 dollars of total Medicare fee-for-service spending. Efforts to prevent or slow CKD progression are urgently needed to reduce the incidence of kidney failure and reduce health care expenditures. Current CKD care guidelines recommend medical nutrition therapy (MNT), a personalized, evidence-based application of the Nutrition Care Process (assessment, intervention, diagnosis, and monitoring and evaluation) provided by registered dietitian nutritionists (RDNs) to help slow CKD progression, improve quality of life, and delay kidney failure. MNT is covered by Medicare Part B and most private insurances with no cost sharing. Despite recommendations that patients with CKD receive MNT and insurance coverage for MNT, utilization remains low. This article demonstrates low utilization of MNT and inadequate numbers of RDNs and RDNs who are board certified in renal nutrition relative to the estimated number of Medicare eligible adults with self-reported diagnosed CKD by state, with noted disparities across states. We discuss interventions to increase MNT utilization, such as improving MNT reimbursement, augmenting accessibility of RDNs via telenutrition services and increasing health care provider promotion of MNT and referral to MNT to optimize CKD outcomes.
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Affiliation(s)
- Promise Lee
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - Joanne Kouba
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Stritch School of Medicine, Maywood, IL
| | - Elizabeth Yakes Jimenez
- Departments of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM and Academy of Nutrition and Dietetics, Chicago, IL
| | - Holly Kramer
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Stritch School of Medicine, Maywood, IL.
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Chatelan A, Clerc A, Fonta PA. ChatGPT and Future Artificial Intelligence Chatbots: What may be the Influence on Credentialed Nutrition and Dietetics Practitioners? J Acad Nutr Diet 2023; 123:1525-1531. [PMID: 37544375 DOI: 10.1016/j.jand.2023.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/12/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Angeline Chatelan
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
| | - Aurélien Clerc
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland; HFR Fribourg University Training Hospital, Fribourg, Switzerland
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Owens C, Cook M, Goetz J, Marshburn L, Taylor K, Schmidt S, Bussey-Jones J, Chakkalakal RJ. Food is medicine intervention shows promise for engaging patients attending a safety-net hospital in the Southeast United States. Front Public Health 2023; 11:1251912. [PMID: 37905239 PMCID: PMC10613492 DOI: 10.3389/fpubh.2023.1251912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/15/2023] [Indexed: 11/02/2023] Open
Abstract
Public health organizations, including the Academy of Nutrition and Dietetics and the American Hospital Association, recognize the importance of achieving food and nutrition security to improve health outcomes, reduce healthcare costs, and advance health equity. In response, federal, state, and private agencies are increasingly seeking to fund healthcare-based interventions to address food insecurity among patients. Simultaneously, nutrition-based interventions targeting chronic diseases have grown across the United States as part of the broader "Food is Medicine" movement. Few studies have examined the successes, challenges, and limitations of such efforts. As Food is Medicine programs continue to expand, identifying common approaches, metrics, and outcomes will be imperative for ensuring program success, replicability, and sustainability. Beginning in 2020, the Food as Medicine (FAM) program, a multipronged, collaborative intervention at Grady Health System has sought to combat food insecurity and improve patient health by leveraging community resources, expertise, and existing partnerships. Using this program as a case study, we (1) outline the collaborative development of the FAM program; (2) describe and characterize patient engagement in the initial 2 years; and (3) summarize strengths and lessons learned for future hospital-based food and nutrition programming. As this case study illustrates, the Food as Medicine program provides a novel model for building health equity through food within healthcare organizations.
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Affiliation(s)
- Caroline Owens
- Department of Anthropology, College of Arts and Sciences, Emory University, Atlanta, GA, United States
- Department of Anthropology, College of Arts and Sciences, Washington State University, Pullman, WA, United States
| | | | - Joy Goetz
- Atlanta Community Food Bank, Atlanta, GA, United States
| | | | | | - Stacie Schmidt
- Grady Health System, Atlanta, GA, United States
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Jada Bussey-Jones
- Grady Health System, Atlanta, GA, United States
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Rosette J. Chakkalakal
- Grady Health System, Atlanta, GA, United States
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
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Alston L, Heaney S, Kent K, Godrich S, Kocanda L, Herbert J, Schumacher T, Brown LJ. Rural nutrition and dietetics research-Future directions. Aust J Rural Health 2023; 31:1027-1031. [PMID: 37723938 DOI: 10.1111/ajr.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023] Open
Abstract
AIM The aim of this study was to summarise key evidence from recent Australian rural nutrition research and provide recommendations for future nutrition and dietetics research with rural communities. CONTEXT Clear evidence demonstrates that diet plays a role in the health gap between rural and metropolitan Australia. Despite the opportunity to address the health of rural Australians through better nutrition, alarmingly low investment in nutrition and dietetics research has occurred historically, and over the past decade. APPROACH A review of the evidence was undertaken by rural nutrition and dietetics leaders to provide a commentary piece to inform future rural nutrition research efforts. CONCLUSION Establishing strong, collaborative place-based nutrition and dietetics research teams are necessary to combat the significant gaps in the scientific knowledge of solutions to improve nutrition in rural Australia. Further, dieticians and nutritionists who live in and understand the rural contexts are yet to be fully harnessed in research, and better engaging with these professionals will have the best chance of successfully addressing the nutrition-related disease disparity between rural and metropolitan Australia.
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Affiliation(s)
- Laura Alston
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Victoria, Warrnambool, Australia
- Research Unit, Colac Area Health, Victoria, Colac, Australia
| | - Susan Heaney
- Department of Rural Health, University of Newcastle, New South Wales, Port Macquarie, Australia
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
| | - Katherine Kent
- School of Health Science, Western Sydney University, New South Wales, Campbelltown, Australia
- School of Health Sciences, University of Tasmania, Tasmania, Launceston, Australia
| | - Stephanie Godrich
- Centre for People, Place and Planet, Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Bunbury, Australia
| | - Lucy Kocanda
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
- Dietetics Department, Tamworth Rural Referral Hospital, New South Wales, Tamworth, Australia
| | - Jaimee Herbert
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Victoria, Warrnambool, Australia
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
| | - Tracy Schumacher
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
| | - Leanne J Brown
- Hunter Medical Research Institute, New South Wales, New Lambton Heights, Australia
- Department of Rural Health, University of Newcastle, New South Wales, Tamworth, Australia
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Hickson M, Child J, Collinson A. A case study of the impact of a dietitian in the multi-disciplinary team within primary care: a service evaluation. J Hum Nutr Diet 2023; 36:1760-1770. [PMID: 37526210 DOI: 10.1111/jhn.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Expanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence suggests dietitians can improve patient outcomes and make cost savings. The present study aimed to evaluate a dietitian working as an expert generalist and first contact practitioner (FCP) in a general practice multi-disciplinary team (MDT) to provide appropriate care to patients and reduce GP workload. METHODS A dietitian was employed for 6 months at 0.6 full-time equivalents in a group of general practices in Devon, UK. Data were collected on the referral source, patient satisfaction, health outcomes and changes in prescribing data for all patients seen by the dietitian. Focus groups and interviews provided data to understand the experience of introducing a dietitian into the team. RESULTS This model of service delivery showed the dietitian acting as an expert generalist, a FCP and able to educate the MDT. A range of professionals within the MDT referred patients with a wide range of diagnoses (both paediatric and adults) and the dietitian acted as a FCP for 29% of patients. Saving were made for the optimisation of medicine management. CONCLUSIONS The dietitian can improve patient-centred care for several patient groups; enhance learning for staff around nutrition and dietary issues; and contribute to more efficient working and cost savings around prescription of nutritional products. This was an evaluation of one service and further research is needed to understand the value dietitians can contribute and the factors supporting effective and efficient working in this context.
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Affiliation(s)
- Mary Hickson
- School of Health Professions, University of Plymouth, Plymouth, UK
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Plymouth, Plymouth, UK
| | - Jenny Child
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Avril Collinson
- School of Health Professions, University of Plymouth, Plymouth, UK
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Phillips I, Allan L, Hug A, Westran N, Heinemann C, Hewish M, Mehta A, Saxby H, Ezhil V. Nutritional status and symptom burden in advanced non-small cell lung cancer: results of the dietetic assessment and intervention in lung cancer (DAIL) trial. BMJ Support Palliat Care 2023; 13:e213-e219. [PMID: 33563774 DOI: 10.1136/bmjspcare-2020-002838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION European Society for Clinical Nutrition and Metabolism guidelines recommend that patients with cancer should be screened for malnutrition at diagnosis. The dietetic assessment and intervention in lung cancer study investigated the nutritional status of patients with non-small cell lung cancer (NSCLC) and the need for dietetic intervention. METHODS In this observational cohort pilot study, patients with stage 3b and 4 NSCLC were assessed prior to starting first line systemic anticancer therapy (SACT) with a range of measurements and questionnaires. We report the outcomes related to the Patient Generated Subjective Global Assessment tool (PG-SGA), RESULTS: 96 patients were consented between April 2017 and August 2019. The PG-SGA identified that 78% of patients required specialist nutritional advice; with 52% patients having a critical need for dietetic input and symptom management. Results were dominated by symptom scores. As a screening test, one or more symptoms or recent weight loss history had a sensitivity of 88% (95% CI 78.44% to 94.36%) and specificity of 95.24% (95% CI 76.18% to 99.88%) for need for dietetic intervention. CONCLUSION A large proportion of patients with NSCLC have a high symptom burden and are at risk of malnutrition prior to starting SACT and would benefit from dietetic review. It is imperative that oncologists and healthcare professionals discuss weight loss history and symptoms with lung cancer patients to correct nutritional deficiencies and resolve symptoms prior to starting treatment.
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Affiliation(s)
- Iain Phillips
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Lindsey Allan
- Department of Nutrition and Dietetics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Adele Hug
- Department of Nutrition and Dietetics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Naomi Westran
- Department of Nutrition and Dietetics, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Claudia Heinemann
- Department of Nutrition and Dietetics, Frimley Park Hospital NHS Foundation Trust, Frimley, UK
| | - Madeleine Hewish
- St Lukes Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Ajay Mehta
- St Lukes Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Helen Saxby
- St Lukes Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
| | - Veni Ezhil
- St Lukes Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
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Le B, Flier S, Madill J, Joyes C, Dawson E, Wellington C, Adekunte S, Cheng D, John-Baptiste A. Malnutrition risk, outcomes, and costs among older adults undergoing elective surgical procedures: A retrospective cohort study. Nutr Clin Pract 2023; 38:1045-1062. [PMID: 37598397 DOI: 10.1002/ncp.11043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND We examine here the association between malnutrition risk and adverse health outcomes among older adult patients undergoing elective surgical procedures. METHODS We conducted a retrospective study using linked clinical and administrative databases. Malnutrition risk was assessed prior to surgery, defined by unintentional weight loss and decreased food intake. We performed a logistic regression analysis of the primary outcome, a composite adverse outcome measure, including death, bleeding, pneumonia, and other surgical complications. We conducted Fine-Gray proportional hazard regression analysis of hospital length of stay (LOS). We performed a generalized linear regression analysis of in-hospital cost data. All regression analyses controlled for frailty, age, sex, surgical category, and comorbidities. RESULTS Of a total of 3457 older adult elective surgical patients (65-102 years), 310 (9.0%) screened positive for malnutrition risk. In multivariable regression analyses, malnutrition risk was associated with an increased risk of the composite adverse outcome (odds ratio [OR] = 1.74; 95% CI = 1.25-2.39), higher hospitalization costs (relative cost = 1.84; 95% CI = 1.59-2.13), and a decreased risk of discharge from the hospital (hazard ratio = 0.67; 95% CI = 0.59-0.77) compared with those who screened negative. CONCLUSION Older adult patients with malnutrition risk were at an increased risk of adverse surgical outcomes, had longer LOS in the hospital, and incurred higher costs of care. It is important to screen for malnutrition risk and refer older adults for dietetic consults prior to elective surgery.
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Affiliation(s)
- Bill Le
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Suzanne Flier
- Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Lawson Health Sciences Research Institute, London, Ontario, Canada
| | - Janet Madill
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Catherine Joyes
- SouthWestern Academic Health Network, London, Ontario, Canada
| | - Emily Dawson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Chris Wellington
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Shadia Adekunte
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Davy Cheng
- Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China
- Centre for Medical Evidence, Decision Integrity and Clinical Impact, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Ava John-Baptiste
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Lawson Health Sciences Research Institute, London, Ontario, Canada
- Centre for Medical Evidence, Decision Integrity and Clinical Impact, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Schulich Interfaculty Program in Public Health, Western University, London, Ontario, Canada
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Ozcan T, Eroglu E. In vitro fermentation assay on the bifidogenic effect of steviol glycosides of Stevia rebaudiana plant for the development of dietetic novel products. Prep Biochem Biotechnol 2023; 53:1099-1108. [PMID: 36709420 DOI: 10.1080/10826068.2023.2169935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The relationship between excessive sugar consumption and many diseases such as dental caries, obesity, diabetes and coronary heart has been increasing in recent years. In this study, utilization of natural sugar replacer steviol glycosides and bifidogenic effect by Bifidobacterium animalis subsp. lactis was assayed in vitro model system. The basal medium (non-carbohydrate containing MRS, Man, Rogosa and Sharpe Agar) were supplemented with 0.025% and 1% stevia, 0.025% stevia + 1% inulin, %1 stevia + 1% inulin. The medium which contained no carbohydrate was designated as negative control, whereas the medium containing 1% glucose or inulin were evaluated as positive and evaluated on the 0, 12, 24, 36 and 48 h of fermentation. Steviol glycosides in both system significantly stimulated the growth of Bifidobacterium animalis subsp. lactis to varying degrees with highest prebiotic activity score, short chain fatty acid production and growth parameters as much as glucose and prebiotic inulin. The viability of the probiotic bacteria was determined within the bio-therapeutic level with potential prebiotic effects depending on the probiotic bacterial strain growing and the type of carbohydrate source utilized. In the study, stevia at lower concentration showed a higher growth rate of with inulin. In conclusion, stevia can be used as functional ingredients for the modulation of the gut microbiota and design of synbiotic systems as a prebiotic substrate and sugar substitute.
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Affiliation(s)
- Tulay Ozcan
- Faculty of Agriculture, Department of Food Engineering, Bursa Uludag University, Bursa, Turkey
| | - Ezgi Eroglu
- Republic of Turkey Ministry of Agriculture and Forestry, Hafik, Sivas, Turkey
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50
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Guenter P, Blackmer A, Malone A, Phillips W, Mogensen KM, Becker P. Current nutrition assessment practice: A 2022 survey. Nutr Clin Pract 2023; 38:998-1008. [PMID: 37060155 DOI: 10.1002/ncp.10998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/07/2023] [Accepted: 03/20/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Malnutrition remains a significant problem in patients with acute or chronic illnesses. Nutrition assessment is an important component in detecting malnutrition; but not always performed using a standardized tool. This survey on nutrition assessment evaluates current clinical practices on the assessment, diagnosis, and treatment of malnutrition. METHODS This 2022 survey of US-based nutrition clinicians collected data on assessment parameters used in hospitals, long-term care facilities, and the home care setting. RESULTS A total of 686 surveys were available for analysis. Ninety-seven percent of adult and 91% of pediatric responding clinicians indicated that a dietitian completed the assessment. Parameters used most frequently among adult clinician respondents included nutrient intake, current weight, and weight history, those used by pediatric clinician respondents included nutrient intake, weight-for-age z score, and weight-for-length/height z score. Eighty-nine percent of adult clinicians in all care settings and 85% of pediatric clinicians use the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Indicators of Malnutrition (AAIM). Respondents reported malnutrition rates of 32%-40% for adults and 4%-30% for pediatric patients, depending on the setting. Appropriate interventions for those with malnutrition (as perceived by the survey respondents) were ordered 70% of the time. CONCLUSION This survey demonstrated significant use of the AAIM by both adult and pediatric clinicians across care settings. Reported malnutrition rates are consistent with others published in the literature. The authors suggest that quality improvement efforts should focus on the 30% of patients with malnutrition but without a reported appropriate nutrition intervention.
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Affiliation(s)
- Peggi Guenter
- American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA
| | - Allison Blackmer
- American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA
| | - Ainsley Malone
- American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA
| | | | - Kris M Mogensen
- Department of Nutrition, Brigham and Women's Hospital, Boston, Massachusetts, USA
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