1
|
Merlino Barr S, Hand RK, Fenton TR, Groh-Wargo S. Role of the neonatal registered dietitian nutritionist in Canada: A description of staffing and a comparison to practices in the United States. Nutr Clin Pract 2024; 39:1212-1226. [PMID: 39010702 DOI: 10.1002/ncp.11182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/15/2024] [Accepted: 06/07/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Neonatal registered dietitian nutritionists (RDNs) are critical members of the neonatal intensive care unit (NICU) team. Ideal RDN staffing levels are unknown. Current staffing levels of neonatal RDNs in Canadian NICUs have not been recently reported. The objective of this study was to describe neonatal RDN staffing and responsibilities in Canada and contrast these findings with those of neonatal RDNs in the United States. METHODS An online cross-sectional neonatal RDN survey was performed in the Fall of 2021 to collect hospital-level and individual-RDN-level data. Descriptive statistics were performed to summarize Canadian neonatal RDN staffing levels and responsibilities and compared with US findings. RESULTS Canadian RDNs reported a median staffing ratio of 25.3 NICU beds per RDN full-time equivalent, with neonatal RDNs reporting a desired 31% increase in staffing. The majority of Canadian NICUs (n = 20/24) reported having a dedicated space to prepare infant feeds away from bedside. Canadian neonatal RDNs reported wanting to expand their responsibilities in research, administration, and education. Canadian neonatal RDNs reported a higher rate of order writing privileges as compared with that of US neonatal RDNs. CONCLUSION Canadian neonatal RDNs reported a desired increase in their staffing levels. Neonatal RDNs have the potential to expand their professional role but require additional staffing, dedicated time, and compensation to support this. Further research determining the optimal neonatal RDN staffing ratio to maximize patient outcomes is required.
Collapse
Affiliation(s)
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Tanis R Fenton
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center, Cleveland, Ohio, USA
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
2
|
Gholami Z, Maracy MR, Paknahad Z. The effects of MIND diet and propolis supplementation on metabolic syndrome: A randomized controlled clinical trial. Heliyon 2024; 10:e34493. [PMID: 39220895 PMCID: PMC11363718 DOI: 10.1016/j.heliyon.2024.e34493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 09/04/2024] Open
Abstract
The MIND is a novel eating plan preserves cognitive function. Propolis is a resinous substance that has several biological and medicinal properties. This study examines the effect of the MIND diet and propolis supplementation on MetS indices among metabolic syndrome subjects. This RCT study, was conducted on adults with metabolic syndrome who were referred to the Hazrat Ali Health Center in Isfahan. 84 eligible subjects were divided into 3 groups. Including MIND diet + Propolis supplement, MIND diet + placebo, and control group. The data obtained from the subjects was analyzed in two descriptive and analytic levels. The Shapiro-Wilk test and examination of skewness were conducted to assess the normality of the distribution of quantitative variables. Quantitative variables were reported using either the mean (SD). SPSS Statistics software version 26 was used for statistical analysis of data. In this study the MIND + Propolis group compared to the control group after adjusting variables showed a significant decrease (p-value < 0.05) in weight, BMI, WC, SBP, DBP, and TG by 0.97 times (3%), 0.97 times (3%), 0.98 times (2%), 0.93 times (7%), 0.94 times (6%), and 0.75 times (25%), respectively; this significant change was also observed in FBS (p-value < 0.001) by 0.85 times (15%), and HDL-C (mg/dl) has shown a significant increase (p-value < 0.05) by 1.17 times (17%). MIND group compared to the control group after adjusting variables showed a significant decrease (p-value < 0.05) in BMI, WC, and SBP by 0.98 times (2%), 0.98 times (2%), and 0.95 times (5%), respectively; this significant change (p-value < 0.001) was also observed in DBP, FBS, and TG by 0.92 times (8%), 0.83 times (17%), and 0.71 times (29%), respectively; HDL-C has shown a significant increase (p-value < 0.001) by 1.21 times (21%), and weight has shown a non-significant decrease (p-value = 0.055) by 0.98 times (2%). This study indicated that the MIND diet + Propolis supplement and MIND diet compared to the control group can significantly decrease BMI, WC, SBP, DBP, FBS, TG, and weight (non-significant for the MIND group), and also increase HDL-C.
Collapse
Affiliation(s)
- Zainab Gholami
- School of Nutrition and Food Science, Students' Research Committee, Department of Clinical Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zamzam Paknahad
- Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
3
|
Jordan R, Watowicz RP, King C, Phillips C, Obeid R, Hand RK. Preliminary content and construct validity of a new model to differentiate research skills from evidence-based practice skills: Core, Evidence Application, Research (CEAR) Model. J Hum Nutr Diet 2024; 37:440-458. [PMID: 38014585 DOI: 10.1111/jhn.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Research is the scientific basis for the profession of dietetics, as it must be located and applied in evidence-based practice (EBP). EBP is often presented as a foundational skill for research. CEAR - Core, Evidence Application, Research - is a newly proposed model that separates Research and Evidence Application skills into distinct domains, jointly supported by a set of Core skills, thus acknowledging that education and advancement in one domain neither requires nor precipitates education and advancement in the other. The goal was to investigate the content and construct validity of the new CEAR Model. METHODS A cross-sectional online survey of randomly selected dietitians in the United States was used to collect CEAR domain scores, validated measures of research or EBP skills and self-reported characteristics. Exploratory factor analysis, Cronbach's α and Pearson correlation between various tools and CEAR domains were used to assess validity and reliability. Analysis of variance (ANOVA) and multiple linear regression between CEAR domains and participant characteristics were used to assess convergent and divergent validity. RESULTS One hundred and fifty-four responses with a valid CEAR score were received and led to a three-factor solution, supporting the theorised differentiation of research from evidence application skills (content validity). Internal reliability for the CEAR Model overall and for each domain was high. The hypothesised correlations between existing research or EBP measurement tools and the relevant CEAR domains were found (construct validity). Known groups analysis demonstrated the expected differences in CEAR domain scores based on participant characteristics. CONCLUSIONS The CEAR Model demonstrates preliminary validity and internal reliability. It adds to the current literature by acknowledging the separateness of evidence application skills from research skills.
Collapse
Affiliation(s)
- Raeanne Jordan
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rosanna P Watowicz
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Carrie King
- Dietetics and Nutrition Department, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Catherine Phillips
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rita Obeid
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
4
|
Merlino Barr S, Hand RK, Fenton TR, Groh-Wargo S. The Role of the Neonatal Registered Dietitian Nutritionist: Past, Present, and Future. Clin Perinatol 2023; 50:743-762. [PMID: 37536776 DOI: 10.1016/j.clp.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Neonatal registered dietitian nutritionists (RDNs) are critical members of the neonatal intensive care unit (NICU) team due to their unique skillset of growth assessment, nutrition evaluation, and implementation of nutrition best practices. There is a paucity of data on appropriate staffing of neonatal RDNs in NICUs to promote improved patient outcomes. Here, the authors describe current neonatal RDN staffing and responsibilities in the US NICUs.
Collapse
Affiliation(s)
- Stephanie Merlino Barr
- Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44102, USA.
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Tanis R Fenton
- Cumming School of Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, Alberta T2N 4Z6, Canada
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44102, USA; Department of Nutrition, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| |
Collapse
|
5
|
Malik N, Paalani M, Becerra B. Nutrition Professionals' Confidence Recommending Integrative Medicine Modalities. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
|
6
|
May R, Sehgal AR, Hand RK. Changes in US Dialysis Dietitian Responsibilities and Patient Needs During the COVID-19 Pandemic. J Ren Nutr 2021; 32:112-119. [PMID: 34465503 PMCID: PMC8313484 DOI: 10.1053/j.jrn.2021.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/01/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study described the job responsibilities and modalities of care among dialysis dietitians in the United States and their observations regarding the nutrition needs of their patients, during the COVID-19 pandemic. DESIGN AND METHODS Cross-sectional online survey captures dietitian characteristics and responsibilities, dialysis facility characteristics, and patient needs. We recruited US dialysis dietitians. We used chi-square tests to compare respondent stress and facility-level policies regarding eating/drinking and oral nutrition supplements based on facility ownership type. RESULTS We received 191 complete or partial survey responses. Sixty-three percent of respondents stated that their center banned eating/drinking during dialysis due to COVID-19 masking policies. DaVita and non-profit facilities were significantly more likely to still allow eating/drinking during dialysis (31% and 29%, respectively) compared to Fresenius facilities (7%). A common theme in open-ended responses regarding nutrition care for COVID-19-positive patients was providing less care to these patients. A majority of respondents admitted to stress from working in healthcare during COVID-19. The majority of respondents indicated that patients were taking precautions such as having a family member or friend grocery shop for them (69%) or going to the store less often (60%). Just over a quarter of respondents indicated that affordability of food was a concern among patients. Seventy-two percent reported that patients were cooking at home more often, 60% had observed an increase in serum phosphorus, and 72% an increase in interdialytic weight gain. CONCLUSIONS Due to the increased risk of malnutrition and symptoms that can affect dietary intake in COVID-positive patients, and the economic conditions leading to increased rates of food insecurity, dietitians must be proactive in preventing and/or treating malnutrition through adequate protein and energy intake. Eating/drinking bans should not become permanent and dialysis centers should take precautions to allow intradialytic meals and oral nutrition supplement protocols to continue during the pandemic.
Collapse
Affiliation(s)
- Rachael May
- At the time of submission, Department of Nutrition, Case Western Reserve University, Cleveland, Ohio; At the time of publication, Clinical Dietitian, Banner Health, Phoenix, Arizona
| | - Ashwini R Sehgal
- Department of Medicine and Institute for H.O.P.E, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio
| | - Rosa K Hand
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio.
| |
Collapse
|
7
|
Noland D, Raj S. Academy of Nutrition and Dietetics: Revised 2019 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition in Integrative and Functional Medicine. J Acad Nutr Diet 2019; 119:1019-1036.e47. [DOI: 10.1016/j.jand.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Indexed: 02/07/2023]
|
8
|
Practice Roles and Characteristics of Integrative and Functional Nutrition Registered Dietitian Nutritionists. J Acad Nutr Diet 2018; 118:2356-2368.e1. [DOI: 10.1016/j.jand.2018.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/29/2018] [Indexed: 01/23/2023]
|
9
|
Buttenshaw K, Shakespeare-Finch J, Ash S. A Methodological Review of Confidence Measurement Scales for Dietitians Working with Individuals. J Acad Nutr Diet 2017; 117:1396-1412. [PMID: 28606555 DOI: 10.1016/j.jand.2017.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 04/12/2017] [Indexed: 11/27/2022]
Abstract
Confidence is frequently used to assess practitioner effectiveness, and its evaluation requires valid and reliable domain-specific tools. However, the quality of existing measures is unknown. This review identifies studies measuring dietitians' confidence in working with individuals; assesses psychometric (measurement) qualities of relevant tools; and identifies areas for future research. Seven electronic databases, the internet, and reference lists were searched to identify the development or use of relevant confidence measurement scales. A quality assessment of psychometric properties was conducted using guidelines developed by Terwee and colleagues. Of the 15 measures reviewed, 4 were subject to factor analysis. Overall, content validity was strong. However, many measures rated poorly due to lack of factor analysis, inadequate sampling, or poor reporting. Of the dietetics-specific instruments, the Dietetic Confidence Scale and Nutrition Counselling Self-Efficacy Scale received the best ratings. The General Self-Efficacy Subscale also rated highly due to validation with the general population. This article highlights the need for dietitians to incorporate evidence-based methods into practice evaluation and instrument development. Dietitians need an awareness of the terminology and key criteria used to evaluate instrument quality to effectively collaborate with statisticians and scale development experts, and critically evaluate the quality of existing measures. Future scale development and reporting must incorporate psychometric evaluation, such as factor analysis, which should be used to explore and/or confirm scale dimensionality. There is broad scope for future methodological research with existing and new measures for nutrition and dietetics practitioners.
Collapse
|