Nutrition & Dietetics最新文献

{"title":"Exploring the relationship between vitamin C deficiency and protein-energy malnutrition in adult hospitalised patients: A cross-sectional study.","authors":"Janet E Golder, Judy D Bauer, Lisa A Barker, Christopher N Lemoh, Simone J Gibson, Zoe E Davidson","doi":"10.1111/1747-0080.12918","DOIUrl":"10.1111/1747-0080.12918","url":null,"abstract":"<p><strong>Aims: </strong>To explore the prevalence of vitamin C deficiency, 'undetectable' vitamin C status, and scurvy features, in adult hospitalised patients with protein-energy malnutrition diagnosed using validated malnutrition screening and assessment tools commonly used in clinical practice.</p><p><strong>Methods: </strong>This study included adult inpatients from four acute hospitals within a single Australian tertiary health service, over a 3.5-year period. A medical file review activity retrospectively determined malnutrition risk and diagnosis, via Malnutrition Screening Tool, Malnutrition Universal Screening Tool, Subjective Global Assessment and Global Leadership Initiative on Malnutrition criteria. Prevalence of vitamin C deficiency and scurvy features was examined in adult patients with plasma vitamin C levels <11.4 μmol/L and <5 μmol/L ('undetectable'), respectively.</p><p><strong>Results: </strong>In the final cohort (n = 364), prevalence of vitamin C deficiency was 30.2%. Malnutrition was present in 76.1% and 79.8% of patients via Subjective Global Assessment (n = 310) and Global Leadership Initiative on Malnutrition criteria (n = 342) respectively. Patients with high nutrition risk and those diagnosed with severe malnutrition had the highest prevalence of vitamin C deficiency, reported as 32.8% for malnutrition detected via Malnutrition Screening Tool (n = 244), 32.9% via Malnutrition Universal Screening Tool (n = 222), 35.8% via Subjective Global Assessment (n = 106), and 34.2% via Global Leadership Initiative on Malnutrition (n = 152). Scurvy features were associated with severe malnutrition in patients with 'undetectable' vitamin C status.</p><p><strong>Conclusions: </strong>Severely malnourished adult hospital patients have a high prevalence of vitamin C deficiency, and scurvy features in those with 'undetectable' vitamin C status. Leveraging existing malnutrition screening and assessment practices may support early identification of patients with vitamin C deficiency during hospitalisation.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"152-162"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting the needs of the nutritionally vulnerable in our population.","authors":"Jane Kellett","doi":"10.1111/1747-0080.70012","DOIUrl":"https://doi.org/10.1111/1747-0080.70012","url":null,"abstract":"","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":"82 2","pages":"126-127"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of professional practices, attitudes and barriers to blended tube feeding in Australia and New Zealand.","authors":"Claire Reilly, Nicole Ross, Stacey Watene, Rachel Lindeback, Tanya Coelho, Usha Krishnan, William Pinzon Perez, Neha Chandrasekar, Jason Yap, Lina Breik, Fiona Arrowsmith","doi":"10.1111/1747-0080.12909","DOIUrl":"10.1111/1747-0080.12909","url":null,"abstract":"<p><strong>Aims: </strong>This study investigates the utilisation of blended tube feeding by health professionals in Australia and New Zealand, assessing factors influencing its implementation following the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding consensus statement.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted targeting health professionals across Australia and New Zealand. The survey comprised 35-questions including multiple choice, Likert scales and open-ended responses, to gain insights into blended tube feeding practices and perspectives. The effect of the health professional factors on outcomes was explored in pairs with a series of Chi-squared tests. Odds ratios (ORs) were calculated using standard univariate logistic regression. An exploratory content analysis was used to code the open-ended text responses to the survey questions which were then categorised and further synthesised into overarching themes.</p><p><strong>Results: </strong>Out of 89 health professionals who completed the survey, the majority were dietitians, 63% reported managing fewer than five patients using blended tube feeding within their services. Parental request was the leading reason for adoption. Notable barriers included clinician time constraints, resource limitations and a lack of formal guidelines. Some health professionals considered the primary risk associated with blended tube feeding to be poor growth and/or weight loss. Professional development was pivotal in increasing confidence and advocating for blended tube feeding, with significant correlations observed between blended tube feeding training and clinical practice.</p><p><strong>Conclusions: </strong>This study emphasises the essential role of education, resource availability and institutional policy in promoting blended tube feeding practices for health professionals. Findings suggest that focusing on professional development and standardised resources could significantly enhance knowledge, confidence and competence of health professionals in blended tube feeding application. The outcomes point towards the need for a coordinated approach to support evidence-based blended tube feeding practices, aligning with the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding resources and recommendations.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"143-151"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of Australian healthcare professionals towards gamification in practice.","authors":"Anita Stefoska-Needham, Allegra Leah Goldman","doi":"10.1111/1747-0080.12911","DOIUrl":"10.1111/1747-0080.12911","url":null,"abstract":"<p><strong>Aim: </strong>Gamification may be an effective tool in motivating sustained behaviour change. This study aimed to explore perspectives of Australian-based healthcare professionals, including dietitians, towards gamification in their practice when assisting patients/clients to achieve health-related goals.</p><p><strong>Methods: </strong>Semi-structured online interviews were conducted with healthcare professionals. Data was audio-recorded, transcribed verbatim, de-identified and thematically analysed to identify key themes and inform the creation of personas.</p><p><strong>Results: </strong>Six dietitians, two psychologists, two exercise physiologists, one medical specialist, with 1-24 years of work experience, participated. Most participants (n = 7, 64%) were unable to articulate a definition of gamification, however, when offered more context, they could identify examples. Overall, participants were positive towards gamification, regardless of prior experience/exposure. Three themes emerged; (1) Variable familiarity with gamification, (2) Context matters, (3) Barriers hinder engagement/adoption. Stage of career rather than profession influenced participants' views of gamification, as reflected in three characterising personas; 'Joel: Early-Career, Progressive', 'Bella: Mid-Career, Stable' and 'Sam: Advanced-Career, Expert'.</p><p><strong>Conclusions: </strong>Findings suggest that gamification is not widely used in health practice in Australia. Concerns about participation costs and data privacy are adoption barriers. Promotion of the effectiveness of gamification as a valuable adjunct tool to encourage behaviour change needs support from peak bodies. Embedding gamification in university curricula could better prepare graduates to engage with gamification in future practice. Further research capturing more diverse healthcare professionals' perspectives is required to fully understand the potential of gamification to change health behaviours, and to design feasible gamified solutions.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":"206-217"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home parenteral nutrition under an activity based funding model-An Australian costing study.","authors":"Sharon Carey, Rena H M Cao, Dayna Moore, Michelle Cunich","doi":"10.1111/1747-0080.70010","DOIUrl":"https://doi.org/10.1111/1747-0080.70010","url":null,"abstract":"<p><strong>Aim: </strong>There is limited understanding about the cost of managing individuals requiring home parenteral nutrition within an outpatient setting. This study aimed to quantify healthcare costs of managing home parenteral nutrition (at-home and within the multidisciplinary outpatient clinic setting) and compare incurred costs against an activity-based funding model.</p><p><strong>Methods: </strong>A 12-month retrospective study compared parenteral nutrition at-home costs and outpatient clinic costs to funding reimbursement. Costing data were retrieved from electronic medical records and monthly hospital finance reports for 28 individuals that required home parenteral nutrition at a quaternary hospital in Sydney, Australia. Hospital remuneration was calculated. Data are presented as median and range.</p><p><strong>Results: </strong>Individuals on home parenteral nutrition attended a median (range) of 4 (3-7) multidisciplinary outpatient appointments over the year, where one outpatient appointment cost AU$294.51, less than the reimbursement of AU$366.37 based on the funding model allowing for medical billing; and AU$560.55 for activity-based funding where additional loading was added for multidisciplinary input. The median at-home costs per individual per month were AU$6949.86 (AU$2951.64 to AU$15015.77), compared to the funding model reimbursement of AU$7374.64 per individual per month.</p><p><strong>Conclusions: </strong>The current healthcare funding model sufficiently covers home parenteral nutrition multidisciplinary outpatient service costs as well as at-home costs within this single-site study. This is likely due to the routine use of ready-to-hang 3-in-1 parenteral nutrition solutions. Further multicentre research is needed to better understand funding, corroborate the findings of this study, and inform future funding revisions.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the incorporation of Entrustable Professional Activities into assessment in nutrition and dietetics education: A systematic review.","authors":"Ryan Surace, Claire Palermo, Judi Porter","doi":"10.1111/1747-0080.70004","DOIUrl":"https://doi.org/10.1111/1747-0080.70004","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to identify and synthesise the evidence on factors influencing the incorporation of Entrustable Professional Activities into assessment in nutrition and dietetics education.</p><p><strong>Methods: </strong>A systematic review was conducted with a narrative synthesis and was undertaken and reported in accordance with the PRISMA guidelines. Six electronic databases were searched (MEDLINE, CINAHL, SCOPUS, PsycINFO, Web of Science, and EMBASE) on 9 September 2024. Methodological quality was assessed using the Critical Appraisal Skills Program checklists. Key patterns identified from the narrative synthesis of the included manuscripts were labelled as themes and represented in a figure.</p><p><strong>Results: </strong>Across the international literature, six articles were identified revealing six main and interconnected themes related to factors influencing the incorporation of Entrustable Professional Activities in nutrition and dietetics. In summary, development and review processes for Entrustable Professional Activities require key stakeholder engagement in addition to ensuring they are linked to assessment structures and existing frameworks. Furthermore, technology platforms and applications appeared to support Entrustable Professional Activity incorporation, and training is an important part of integration.</p><p><strong>Conclusions: </strong>Further research on factors influencing incorporation is occurring and is suggested to continue, especially given Entrustable Professional Activities seemingly offer a tangible option to simplify the intricacy of competency-based assessment in work-based practice. However, further research to enhance understanding of whether Entrustable Professional Activities support nutrition and dietetics learners and assessors in undertaking high-quality assessment with utility is warranted.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrient intake in adult haemodialysis patients and influence of dialysis treatment day and patient age.","authors":"Shatha S Hammad, Dima Farrah, Randa I Farah, Aya Awwad","doi":"10.1111/1747-0080.70006","DOIUrl":"https://doi.org/10.1111/1747-0080.70006","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the variation in food intake during dialysis and non-dialysis days and to assess the nutritional status of elderly haemodialysis patients.</p><p><strong>Methods: </strong>An observational multicentre cross-sectional study was conducted. A total of 311 patients aged ≥18 years were recruited. Multiple 24-h recalls were collected, appetite levels were assessed through self-reporting, and biochemical and anthropometric data were obtained. Data were collected via a face-to-face interview during haemodialysis sessions at four major dialysis centres.</p><p><strong>Results: </strong>The findings of this study revealed higher consumption of sodium (2570.25 ± 74.15 vs. 2106.25 ± 77.39, p-value < 0.001) and potassium (1456.59 ± 47.42 vs. 1137.41 ± 35.40, p-value < 0.001) on dialysis days compared to non-dialysis days. Superior appetite levels were significantly associated with higher protein and energy intake and better serum albumin levels on days with versus without dialysis. Patients who reported a better understanding of the importance of their dietary recommendations had lower consumption of sodium, phosphorus, and potassium. Further, patients aged ≥60 years had significantly lower albumin levels and consumed considerably lower levels of protein and sodium but had higher body mass index and waist circumference compared to young patients.</p><p><strong>Conclusions: </strong>Dialysis treatment schedules could affect nutrient intake and compliance rates with renal guidelines; thus, nutritional education must be performed individually to eliminate barriers to adherence. Elderly haemodialysis patients might be prone to a high risk of nutritional deficiencies and require special continuous and in-depth dietary provisions.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative nutritional practices and associations with delayed gastric emptying in patients undergoing a pancreaticoduodenectomy: A retrospective observational study.","authors":"Mikeeley Hoch, Ingrid Hickman, Thomas O'Rourke, Nick Butler, Ra'eesa Doola","doi":"10.1111/1747-0080.70008","DOIUrl":"https://doi.org/10.1111/1747-0080.70008","url":null,"abstract":"<p><strong>Aims: </strong>Delayed gastric emptying is a common complication of a pancreaticoduodenectomy and can adversely impact nutritional status, and potentially clinical outcomes due to delays in nutrition initiation post-operatively. The aim of this study was to explore associations between delayed gastric emptying and patient baseline characteristics, early post-operative nutritional status, post-operative nutritional practices and clinical outcomes in a tertiary Australian hospital.</p><p><strong>Methods: </strong>This was a retrospective, observational study of 80 consecutive patients who underwent a pancreaticoduodenectomy between January 2019 and June 2022. Delayed gastric emptying was classified according to the International Study Group of Pancreatic Surgery definition. Continuous variables were compared using the independent t test, and categorical variables were compared using chi-squared or Fisher's exact test. Significant variables were included in a multivariable model.</p><p><strong>Results: </strong>The incidence of delayed gastric emptying within this cohort was 45% (36/80) and was higher in males compared to females (p = 0.025). Early post-operative nutritional status was not significantly associated with delayed gastric emptying (p = 0.124). Patients with delayed gastric emptying had a higher incidence of post-operative pancreatic fistula (p = 0.03) and Clavien-Dindo complications ≥3 (p = 0.011). Delayed gastric emptying was associated with greater usage of enteral (p < 0.001) and parenteral nutrition (p < 0.001), a longer length of stay (p < 0.001) and increased re-admissions (p = 0.014). Male sex remained significantly associated with delayed gastric emptying following regression analysis.</p><p><strong>Conclusions: </strong>Delayed gastric emptying rates were high, associated with greater use of artificial nutrition and worse outcomes in our patient population post-operatively. Early post-operative malnutrition was not significantly associated with delayed gastric emptying.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy and protein intake threshold modelling using nutrition dashboard technology and sensitivity of hospital malnutrition identification.","authors":"Erin Fisher, Leanne Brown, Kerith Duncanson","doi":"10.1111/1747-0080.70007","DOIUrl":"https://doi.org/10.1111/1747-0080.70007","url":null,"abstract":"<p><strong>Aims: </strong>Hospital food provision/intake dashboards may improve malnutrition screening. The aim of this study was to use Nutrition Dashboard data to determine the optimal threshold for screening for malnutrition risk, and compare the accuracy of this method with estimated dietary requirements.</p><p><strong>Methods: </strong>Observational data were extracted from medical files and food service records of 267 patients for a 4-month period in a 99-bed hospital. Energy (2500-8000 kJ) and protein (30-90 g) thresholds were applied for Nutrition Dashboard categorisation by supply and intake of food. Deficits in estimated requirements (105 kJ/kg/day and 0.75 g/kg/day) were also applied as a comparative method. The association between Nutrition Dashboard categories and the Malnutrition Screening Tool was explored using generalised estimating equations.</p><p><strong>Results: </strong>A total of 267 patients and 1908 days of data were analysed. The use of estimated requirements for Nutrition Dashboard categorisation was not a statistically significant predictor of malnutrition risk. Application of energy (≤6000 kJ) and protein (≤65 g) thresholds for categorisation was significant (χ² = 9.50, df = 3, p = 0.023). When 5000 kJ and 55 g of protein were used for categorisation, patients were more likely to be at malnutrition risk when within low supply (odds ratio = 2.11, p = 0.002) and low intake (odds ratio 2.23, p < 0.001) categories.</p><p><strong>Conclusions: </strong>Nutrition Dashboard categories are associated with an increased risk of malnutrition when categorised using thresholds of up to 6000 kJ and 65 g protein. Technologies like the Nutrition Dashboard present innovative opportunities for dietitians to utilise nutrition informatics to enhance and optimise nutrition care.</p>","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing landscape of dietetic education in Australia.","authors":"Fiona Pelly, Hattie Wright, Libby Swanepoel, Anthony Villani","doi":"10.1111/1747-0080.70009","DOIUrl":"https://doi.org/10.1111/1747-0080.70009","url":null,"abstract":"","PeriodicalId":19368,"journal":{"name":"Nutrition & Dietetics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}