Nutrition & Dietetics最新文献

Aim: Caring for people with higher weight and complex health needs is increasingly common in hospitals. This study aimed to explore and compare inpatient and staff perspectives on the care of people with higher weight.

Methods: Cross-sectional study using purpose-designed surveys within Metropolitan Victoria, Australia. Inpatients (who weighed over 100 kg) and hospital staff who provide care across four hospitals were invited to complete an inpatient-specific or staff-specific survey, respectively. Surveys contained questions related to clinical care, environment and dignity/respect. Data was analysed using descriptive statistics of scale-based items, and textual synthesis of free-text responses.

Results: Thirty inpatients and 59 staff participated. Most inpatients reported their clinical care needs were met (73%-83%) and described appropriate equipment and staff support. However, 25% felt judged or emotionally unsupported, with some experiencing delays in care due to staffing or equipment availability. Staff were less positive, with 73% reporting difficulty accessing equipment, 71% citing inadequate staffing and only 39% agreeing that non-stigmatising care was provided. Differences in weight-related terminology preferences emerged: inpatients favoured the terms 'higher weight' (27%) or 'obese/overweight' (34%), while staff preferred 'bariatric' (71%). Three themes were identified: (1) Inappropriate equipment, delays to equipment-access can negatively impact on inpatient experience of care; (2) Processes of care and communication influence inpatient experience of care; and (3) Weight-related stigma.

Conclusions: Addressing gaps in care requires improved training, better resource access and alignment of language with consumer preferences to reduce stigma and deliver person-centred care.

Aims: To describe a Torres Strait (Melanesian) cultural immersion delivered to dietetics students at a large university in Australia and to understand whether cultural immersion supports the development of students' knowledge and skills in relation to specific Dietitians Australia performance criteria.

Methods: The cultural immersion was co-designed, analysed, and reported through an iterative process with a Torres Strait immersion educator from the Eastern Islands, a First Nations researcher, and a dietetics academic. The cultural immersion included an opening ceremony, four station rotations of creation stories through weaving; food preparation; artefacts and cultural dance; and yarning about health, as well as a closing ceremony. A mixed methods approach was used. Data from pre- and post-surveys were analysed with Wilcoxon Signed Rank Test or paired t-test, and integrated with the thematic analysis of focus group interviews to provide context, depth and perspectives.

Results: Forty-eight students completed pre- and post-surveys, and 25 participated in focus groups. Through working at the knowledge interface, students' general knowledge on Torres Strait Islander history, culture, diet and health increased (all p < 0.001). The cultural immersion supported the development of competence through reframing the narrative and experiential learning, impacted their journey as dietitians by promoting reflection, and increased their perceived confidence in working with Torres Strait Islander populations in a health setting.

Conclusions: This cultural immersion enriched dietetics students' understanding of Torres Strait Islander history, culture, diet, and health. Cultural immersion is one teaching method that can be used within an integrated suite of education strategies to support the development of Aboriginal and Torres Strait Islander health competencies.

Aims: To identify research priorities for ultra-processed foods in the context of the Australian food system.

Methods: Australian experts from academia, government and non-governmental organisations were invited to participate in an online survey in February-March 2024. Participants were asked about research priorities to advance the science, policy and practice and political commitment for ultra-processed foods in the context of the Australian food system. Responses posed by participants were categorised using the High Level Panel of Experts on food systems conceptual framework.

Results: A total of 27 participants contributed to the survey, most of whom worked in academia and had over 10 years' experience in the field. Research priorities to advance ultra-processed food science included evaluating systemic drivers, externalities and alternative systems; and developing tools to measure and monitor ultra-processed food systems and their impacts. Research priorities for policy and practice included ways to develop, implement and monitor synergistic actions to control ultra-processed food impacts, including in novel regulatory mechanisms and monitoring systems; translating ultra-processed foods evidence into dietary guidance; and quantifying healthcare system impacts. Research priorities to advance political commitment on ultra-processed foods included understanding how governance structures enable and sustain ultra-processed food dominance; mapping related lobbying and political donations; and countering industry rhetoric and misinformation.

Conclusions: A survey of Australian experts supported the development of a research roadmap for the concept of ultra-processed foods in the context of the Australian food system. This roadmap serves as a foundation for advancing future ultra-processed foods research, policy and practice in Australia.

Aims: This study investigates how sustainability competencies are integrated into educational interventions for dietitians and nutrition professionals and examines pedagogical approaches employed, offering insight into how well these professionals are prepared to support the transition towards a sustainable food system.

Methods: A systematic review was conducted using four electronic databases (PubMed, SCOPUS, Web of Science and ProQuest) and additional manual searches on 18 June 2024. Studies were included if they focused on educational interventions for dietitians and nutrition professionals that addressed sustainability competencies. Study quality was appraised using Johanna Briggs Institute critical appraisal tools and the Mixed Methods Appraisal Tool. Results were narratively synthesised and tabulated.

Results: Nineteen studies met the inclusion criteria. While certain sustainability competencies are addressed, competencies related to inter-personal, integration, intra-personal and futures-thinking remain underrepresented. Practical approaches with high potential for fostering sustainability competencies, such as project-/problem-based learning and place-based environmental education, were frequently implemented. These methods were often combined with less effective instructional strategies, such as traditional lecturing.

Conclusions: Education for dietitians and nutrition professionals should adopt a more comprehensive approach, integrating all sustainability competencies across the curriculum. Combining practical, experiential methods with traditional lecturing may enhance sustainability learning.

Aims: Red blood cell membrane fatty acids can be used alongside self-reported dietary assessment methods, such as food frequency questionnaires, to measure the validity of self-reported intakes. This study aimed to validate fatty acid intakes estimated from the Australian Eating Survey food frequency questionnaire against red blood cell profiles of healthy Australian adults.

Methods: Demographic data and dietary intakes of fatty acids were collected, and red blood cell membrane fatty acid composition was measured using gas chromatography. Bland-Altman plots and concordance correlation coefficients (ρ_c) examined levels of agreement between measures and were adjusted for confounders.

Results: A total of 58 participants (67% female, mean age 39.6 years) yielded 105 observations. Total saturated, total monounsaturated, total polyunsaturated fats including Eicosapentaenoic acid, Docosahexaenoic acid, Docosapentaenoic acid, and linoleic acid were within limits of agreement with moderate associations (ρ_c = 0.26-0.59). All adjusted models weakened associations; except total saturated fat retained moderate association in all models (ρ_c = 0.24-0.58). Omega-3 supplement use weakened associations for all fatty acids, except saturated and total omega-3 polyunsaturated fats. Carbohydrate intake had the least impact on associations.

Conclusion: Self-reported intakes from the Australian Eating Survey food frequency questionnaire were in moderate agreement (ρ_c = 0.20-0.60) with red blood cell membrane fatty acids. This questionnaire may be used as an indicator of self-reported long-term dietary fatty acid intake in Australian adults, with caveats for individuals reporting extreme intakes and consideration for evaluating the effects of endogenous synthesis of fatty acids. Future studies are warranted to replicate findings and strengthen translation to other sub-populations.

Aims: Concept-based approaches to curricula have been proposed as a solution to this issue, and 56 concepts have been proposed for dietetics curricula. This study aimed to develop a framework for a dietetic concept-based curriculum.

Methods: A pragmatic approach was employed by a team of nine experienced Australian dietetic educators. Iterative processes of idea generation, reflection, group discussion, and consensus formation were applied by seven of the academics in a two-day face-to-face workshop and four online meetings to further develop the 56 curriculum concepts previously identified for dietetics by Tweedie et al. The discussions were supported by document analysis and critical discussion with two other academics as a reference group. The finalised set of concepts were conceptualised into a curriculum framework.

Results: The original 56 concepts were expanded to 63, with seven concepts added in response to developing workforce demands. The 63 concepts were arranged into a framework of 19 core and 44 supporting concepts. Two exemplars were developed to show how five core concepts could be taught. The research team's processes and experiences provide a method for renewing curricula using concepts to guide others wishing to take this approach.

Conclusion: This study used an evidence-based approach to develop the first concept-based curriculum framework for dietetics. This paper provides a guide and practical tools for dietetics curriculum developers willing to apply a different approach. These findings have implications for curriculum renewal in other competency-based credentialing programs.

Aim: This cross-sectional study aimed to measure total polyphenols, total flavonoids, total anthocyanins, lutein and lycopene in Australian-grown horticultural commodities.

Methods: Primary samples (n = 822) of Australian-grown fruit, vegetables and nuts were purchased during peak growing season in Sydney, Melbourne and Perth between June 2021 and May 2022. Samples were prepared (e.g., peeled, trimmed, de-seeded) as they would usually be consumed. Raw, composite samples were analysed using spectrometry (polyphenols, flavonoids, anthocyanins), normal phase high-performance liquid chromatography with ultraviolet-visible detection (lutein) and reverse phase high-performance liquid chromatography with ultraviolet-visible detection (lycopene).

Results: A nationally representative dataset of two types of antioxidants (total polyphenols and flavonoids) in 86 types of fresh fruit (n = 38), dried fruit (n = 6), fresh vegetables (n = 38) and nuts (n = 4) was produced. Total anthocyanins, lutein and lycopene were measured in a subset of foods.

Conclusions: The new data reflect current growing practices, varieties, climate, and analytical methods and provide information that will assist consumer education on sources of dietary antioxidants.

Aim: This review aims to synthesise the evidence on supervision in dietetics and other health professions to (1) provide an evidence-based definition of supervision for dietetics and (2) translate this evidence to dietetics practice through developing a conceptualisation of the key components of supervision for dietitians.

Methods: A comprehensive narrative literature review was used to extract and synthesise supervision research data from (1) four bibliographic databases (Medline, CINAHL, ERIC, ProQuest), (2) two dietetic-specific journals, (3) the databases of two subject matter experts and (4) grey literature including position statements by Australian and international government health and professional governing bodies. The findings were synthesised by consensus between four authors, all supervision specialists.

Results: Fifty-one items of scholarship were reviewed and summarised as informing the evidence synthesis. A definition of supervision for dietetics is presented. The conceptualisation of the key elements of supervision includes (1) the supervisor, supervisee, supervisory alliance, and contracting; (2) supervision functions and outcomes; (3) frequency of supervision and (4) formats of supervision.

Conclusion: Supervision should form a regular part of all dietitians' practice and commitment to ongoing learning. It is a core component of contemporary dietetic practice and is recommended as a key part of professional development across the professional career trajectory.