Nutrition & Dietetics最新文献

Aims: Digital health transformation may enhance or impede person-centred care and interprofessional practice, and thus the provision of high-quality rehabilitation and nutrition services. We aimed to understand how different elements and factors within existing digital nutrition and health systems in subacute rehabilitation units influence person-centred and/or interprofessional nutrition and mealtime care practices through the lens of complexity science.

Methods: Our ethnographic study was completed through an interpretivist paradigm. Data were collected from observation and interviews with patients, support persons and staff. Overall, 58 h of ethnographic field work led to observing 125 participants and interviewing 77 participants, totalling 165 unique participants. We used reflexive thematic analysis to analyse the data with consideration of complexity science.

Results: We developed four themes: (1) the interplay of local context and technology use in nutrition care systems; (2) digitalisation affects staff participation in nutrition and mealtime care; (3) embracing technology to support nutrition and food service flexibility; and (4) the (in)visibility of digitally enabled nutrition care systems.

Conclusions: While digital systems enhance the visibility and flexibility of nutrition care systems in some instances, they may also reduce the ability to customise nutrition and mealtime care and lead to siloing of nutrition-related activities. Our findings highlight that the introduction of digital systems alone may be insufficient to enable interprofessional practice and person-centred care within nutrition and mealtime care and thus should be accompanied by local processes and workflows to maximise digital potential.

Aim: To develop and pilot a tool to evaluate Australian dietitians' and student dietitians' ethical and professional practice using social media.

Methods: A Social Media Evaluation Checklist was developed based on checklist development literature with a four-staged process. Stage one included a literature review and input from an expert panel to ensure content validity. Stages two and three were to ensure face validity by categorising the checklist and pilot testing the tool. Instagram profiles and posts were audited by two authors using the checklist in the final stage to analyse ethical and professional use. An account purposely created for this study was used, and the first 25 dietitian and first 25 student dietitian profiles identified using the key words 'dietitian', 'student dietitian' and 'dietitian student' and the hashtag '#australiandietitian' were reviewed.

Results: A total of 50 Instagram profiles and 250 posts were audited based on seven categories; (1) financial disclosure, (2) cultural awareness, (3) evidence-based information, (4) transparency, (5) privacy/confidentiality, (6) professionalism and (7) justifiability. Areas for improvement included advertising transparency which was met in only 12% of dietitian posts, and the provision of evidence-based information, which was met in 56% of dietitian posts and 72% of student dietitian posts.

Conclusions: This study provides insight into the ethical and professional use of social media by Australian dietitians and dietetics students. With the evolving nature of social media, guidance is required. This will ensure dietitians remain, now and in the future, the credible source of nutrition information for the public.

Aims: Major trauma patients need adequate nutrition for recovery. This study aimed to evaluate the adequacy of nutritional supply and the correlation between nutritional supply and clinical outcome.

Methods: A single-centre retrospective observational study was undertaken, describing the amounts of energy and proteins provided to 320 critically ill trauma patients during the first 10 days after admission. The data were collected from the electronic medical records of patients admitted to the trauma intensive care unit during the study period and descriptive statistical analyses were performed with the SPSS software.

Results: The mean proportion of supplied energy to recommended energy during the first 10 days after admission was 57.5%, and the mean percentage of supplied protein to recommended protein intake was 51.3%. The patients were divided into those who received ≥70% (isocaloric nutrition group) and those who received <70% (hypocaloric nutrition group) of their estimated requirements. Both the duration of ventilator use (12.7 ± 10.5 vs. 16.0 ± 15.8 days, respectively, p = 0.009) and duration of parenteral nutrition (1.1 ± 1.4 vs. 2.0 ± 2.0 days, respectively, p = 0.001) were shorter in the isocaloric nutrition group (n = 83) than in the hypocaloric nutrition group (n = 237).

Conclusion: Total energy and the amount of protein supplied were insufficient compared to the recommended amount. The duration of ventilator use was shorter in the isocaloric nutrition group than in the hypocaloric nutrition group. The association between shortened ventilator use and isocaloric nutrition requires further investigation as a potential intervention to reduce the risk of complications such as ventilator-related pneumonia.

Aim: Regulation on food marketing to children is a recommended response to childhood obesity rates. Policy requires country-relevant criteria to determine which foods are eligible to be advertised. This study aims to compare six nutrition profiling models for use in food marketing regulation in Australia.

Methods: Advertisements on the outside of buses in five suburban Sydney transport hubs were photographed. Food and beverages advertised were analysed using the Health Star Rating; three models developed for food marketing regulation: the Australian Health Council guide and two World Health Organization models; the NOVA system; and the Nutrient Profiling Scoring Criterion used in Australian advertising industry codes. The proportion and types of products advertised on the buses that would be permitted by each of the six models were then analysed.

Results: A total of 603 advertisements were identified. Of those, over a quarter of the advertisements were for foods and beverages (n = 157, 26%) and 2.3% (n = 14) for alcohol. Among the food and non-alcoholic beverage advertisements, 84% were for unhealthy foods according to the Health Council guide. The Health Council guide would permit 31% unique foods to be advertised. The NOVA system would permit the least proportion of foods to be advertised (16%), while the Health Star Rating (40%), and Nutrient Profiling Scoring Criterion (38%) would permit the most.

Conclusion: The Australian Health Council guide is the recommended model for food marketing regulation because it aligns with dietary guidelines by excluding discretionary foods from advertising. Australian governments can use the Health Council guide to develop policy in the National Obesity Strategy to protect children from marketing of unhealthy food.

Aims: Improving hospital nutrition and mealtime care is complex and often requires multifaceted interventions and implementation strategies to change how staff, wards and systems operate. This study aimed to develop and validate a staff questionnaire to identify multilevel barriers and enablers to optimal nutrition and mealtime care on hospital wards, to inform and evaluate local quality improvement.

Methods: Literature review, multidisciplinary focus groups and end-user testing informed questionnaire development and establishment of content and face validity. To determine the construct validity, the questionnaire was administered to ward staff working in five wards across two facilities (acute hospital, rehabilitation unit). Exploratory factor analysis was used to estimate the number of factors and to guide decisions about whether to retain or reject individual items. Scale reliability was assessed using Cronbach's alpha.

Results: The questionnaire was completed by 138 staff, with most respondents being nurses (57%) and working in the acute care facility (76%). Exploratory factor analysis supported construct validity of four of the original seven subscales. The final questionnaire consisted of 17 items and 4 sub sub-scales related to (1) Personal Staff Role; (2) Food Service; (3) Organisational Support, and (4) Family Involvement; each sub-scale demonstrated good reliability with Cronbach's alpha values all >0.70.

Conclusion: This novel and brief questionnaire shows good reliability and preliminary evidence of construct validity in this small sample. It provides a potentially useful instrument to identify barriers and enablers to nutrition and mealtime care from the staff perspective and inform where improvement efforts should be focused.

Aims: Diet-related chronic disease contributes significantly to the global burden of disease. Dietitians are best placed to address this disease burden, yet graduate dietitians may struggle to find employment. This study aimed to explore dietetics graduates' experiences of employment and employability, up to 6-month post-degree completion.

Methods: Secondary data analysis of in-depth qualitative interview data and longitudinal audio-diaries was undertaken. An interpretivist approach was employed whereby knowledge was viewed as subjective and multiple realities exist. A total of five entrance interviews, 31 audio-diaries and three exit interviews, from nine graduates were included in the analysis. This comprised 12 h of longitudinal audio data. Thematic analysis was undertaken using a framework analysis method.

Results: Four key themes were identified: (1) The tumultuous process of applying for jobs demonstrated that graduates struggled with repeated rejections. (2) The uncertain journey to employment indicated that job-seeking was a limbo stage marked by uncertainty. (3) Feeling the pressure showed that graduates experienced pressure from multiple sources. (4) Enhancing employability explained that graduates were not prepared for available employment opportunities, but utilised resources to increase their employability.

Conclusion: Diverse placement experiences may better prepare graduates for available employment opportunities. To enhance employability, it may be beneficial to assist students to develop job-seeking skills, and to engage in networking and volunteering experiences during their education.

Aims: To investigate whether members of the public read blogs for the purpose of accessing healthy eating information; examine demographic predictors of healthy eating blog readership, specifically education, gender, age, body mass index, and residential location; and explore the reasons for reading, and not reading, healthy eating blogs.

Methods: This study used a cross-sectional online self-reported survey design collected over three time points (round 1: December 2017-March 2018, round 2: August 2018-December 2018, round 3: December 2021-March 2022). The total sample of participants comprised of 238 respondents with a mean age of 46 years old, who mostly reported gender as female (82%), being educated with a university degree (69%), and predominantly resided in urban and city areas (84%).

Results: Fifty-one percent of respondents reported reading healthy eating blogs, suggesting that consumers were proactively seeking healthy eating information through this avenue. Participants who identified as female were 3.2 times more likely to read healthy eating blogs. Commonly, healthy eating blogs were read to receive practical information that aligned with current food choices. The main reason participants reported not reading healthy eating blogs was not thinking about using them (29%).

Conclusions: Understanding who is seeking healthy eating information through blogs, and their reasons doing so, is important to continue research into the potential effectiveness of blogs as a platform to communicate healthy eating and nutrition messages. This study provides direction for further investigation into how dietetics professionals could effectively use blogs to disseminate healthy eating information and positively influence consumer food choices and dietary intake.