Nutrition Services Research Articles

An Analysis of the Social Impacts of a Health System Strengthening Program Based on Purchasing Health Services

Access to universal health coverage is a fundamental right that ensures that even the most disadvantaged receive health services without financial hardship. The Democratic Republic of Congo is among the poorest countries in the world, yet healthcare is primarily made by direct payment which renders care inaccessible for most Congolese. Between 2017 and 2021 a purchasing of health services initiative (Le Programme de Renforcement de l’Offre et Développement de l’accès aux Soins de Santé or PRO DS), was implemented in Kongo Central and Ituri with the assistance of the non-governmental organization Memisa Belgium. The program provided funding for health system strengthening that included health service delivery, workforce development, improved infrastructure, access to medicines and support for leadership and governance. This study assessed the social and health impacts of the PRO DS Memisa program using a health impact assessment focus. A documentary review was performed to ascertain relevant indicators of program effect. Supervision and management of health zones and health centers, use of health and nutritional services, the population’s nutritional health, immunization levels, reproductive and maternal health, and newborn and child health were measured using a controlled longitudinal model. Positive results were found in almost all indicators across both provinces, with a mean proportion of positive effect of 60.8% for Kongo Central, and 70.8% in Ituri. Barriers to the program’s success included the arrival of COVID-19, internal displacement of the population and resistance to change from the community. The measurable positive impacts from the PRO DS Memisa program reveal that an adequately funded multi-faceted health system strengthening program can improve access to healthcare in a low-income country such as the Democratic Republic of Congo.

Evaluation of impact of engaging federations of women groups to improve women's nutrition interventions- before, during and after pregnancy in social and economically backward geographies: Evidence from three eastern Indian States.

Undernutrition-before, during and after pregnancy endangers the health and well-being of the mother and contributes to sub-optimal fetal development and growth. A non-randomized controlled evaluation was undertaken to assess the impact of engaging federations of women's group on coverage of nutrition interventions and on nutrition status of women in the designated poverty pockets of three Indian states-Bihar, Chhattisgarh, and Odisha. The impact evaluation is based on two rounds of cross-sectional data from 5 resource poor blocks across 3 States, assigning 162 villages to the intervention arm and 151 villages to the control arm. The cross-sectional baseline (2016-17) and endline survey (2021-22) covered a total of 10491 adolescent girls (10-19 years), 4271 pregnant women (15-49 years) and 13521 mothers of children under age two years (15-49 years). Exposure was defined based on participation in the participatory learning and action meetings, and fixed monthly health camps (Adolescent Health Days (AHDs) and Village Health Sanitation and Nutrition Days (VHSNDs)). Logistic regression models were applied to establish the association between exposure to programme activities and improvement in coverage of nutrition interventions and outcomes. In the intervention area at endline, 27-38% of women participated in the participatory learning and action meetings organized by women's groups. Pregnant women participating in programme activities were two times more likely to receive an antenatal care visit in the first trimester of pregnancy (Odds ratio: 2.55 95% CI-1.68-3.88), while mothers of children under 2 were 60% more likely to receive 4 ANC visits (Odds ratio: 1.61, 95% CI- 1.30-2.02). Odds of consuming a diversified diet was higher among both pregnant women (Odds ratio: 2.05, 95% CI- 1.41-2.99) and mother of children under 2 years of age (Odds ratio: 1.38, 95% CI- 1.08-1.77) among those participating in programme activities in the intervention arm. Access to commodities for WASH including safe sanitation services (Odds ratio: 1.80, 95% CI- 1.38-2.36) and sanitary pads (Odds ratio: 1.64, 95% CI- 1.20-2.22) was higher among adolescent girls participating in programme activities. Women's groups led participatory learning and action approaches coupled with strengthening of the supply side delivery mechanisms resulted in higher coverage of health and nutrition services. However, we found that frequency of participation was low and there was limited impact on the nutritional outcomes. Therefore, higher frequency of participation in programme activities is recommended to modify behaviour and achieve quick gains in nutritional outcomes.

Design Analysis Achievement Target Database Information System at SEAMEO RECFON

SEAMEO Regional Center for Food and Nutrition (RECFON), is an organization of Southeast Asian Ministers of Education in the field of food and nutrition. The activities carried out by SEAMEO RECFON already have a fairly good system, but there are several problems SEAMEO RECFON actively conducts education, research, training, and community empowerment activities so the need for up-to-date information on food and nutrition topics and services and facilities support all these activities is very important. This important task must be supported by adequate facilities, including the procurement of data processing and communication devices capable of supporting RECFON's activities. For this reason, the author takes the title "Analysis and Design of the Target Achievement Database Information System System at SEAMEO RECFON " This SI / IT strategic planning is made using the Ward and Peppard framework with several analysis methods, namely value chain analysis, by mapping what are the main and supporter activities at SEAMEO RECFON and analyzing the problems of each activity. To see the strengths, weaknesses, opportunities, and threats, a SWOT (Strength, Weakness, Opportunity, Thread) analysis is used. Factors that are successful and can solve problems and needs are used in CSFs (Critical Success Factors) analysis. McFarlan Strategic Grid analysis is used to map existing applications in DPPKA Kampar based on categories, namely support, Key Operational, Strategic, and High Potential. The results achieved through this analysis method are recommendations in the form of 19 information systems, 10 information technologies, and 4 SI and IT management. The information system and information technology are made in the form of a roadmap that will be implemented over the next 3 years by SEAMEO RECFON

Systematic review on school health program and health-promoting schools in Southeast Asian region countries

Introduction: Studying the process and impact of interventions like Health Promoting Schools (HPS) is important for sustenance and policy changes. This calls for gathering evidence on the current status of school health programs at a larger level so as to identify barriers and opportunities to strengthen their implementation. Methodology: Systematic research using selected databases led to identification of 18 eligible studies (from 1979 to 2019). Results: The studies were from India (n = 12), Indonesia (n = 3), Thailand (n = 2), and Nepal (n = 1). Collectively, studies have assessed health services under domains of health education (n = 2), health services (n = 3), nutrition services (n = 6), healthy school environment (n = 4), disease control and prevention (n = 6), school and community collaboration (n = 5), risk factor management (n = 6), life skills education, mental health and well-being (n = 7), and health promotion for school staff (n = 1). Health promotion services provided under similar domains were not similar kind in all studies. Five studies reported student, teacher, administration, and parental level facilitators and barriers to service provision under school health/health-promoting interventions/programs. Lack of time, overburdening, poor support by parents, unhealthy behavior in schools, etc., were some of the barriers. Cooperation by stakeholders and behavior reinforcement and parental trust in school activities reflected potential facilitators. Conclusion: Implementation of global standards of health-promoting schools (HPSs) is variable. Service provision is not essentially under the school health program and is mostly restricted to school children only. The study can serve as baseline for the implementation of standards in Southeast Asian Region countries. Countries should build on this information. Recommendations: Policies may be framed to include global standards of HPSs, understanding that little change can bring about a larger impact.

Ketepatan Pemberian Diet dengan Pengetahuan Pramusaji terhadap Mutu Pelayanan Instalasi Gizi RSUD Leuwiliang

Background : RSUD Leuwiliang has 391 inpatient beds that servers must feed. The results of the accuracy of data on the accuracy of patient feeding at the Nutrition Installation of Leuwiliang Hospital in 2018 were 98.25%, 98.45% in 2019, 98.42% in 2020, and 98.80% in 2021. The indicators show that An error has occurred in administering the patient's diet. RSUD Leuwiliang has not yet achieved a minimum service standard of 100% for indicators of the accuracy of patient feeding. Based on the background above, the researcher will know more about the results of "Accuracy in providing a diet with the knowledge of the waiter on the quality of nutrition service at Leuwiliang Hospital." Objective : I am measuring the knowledge and thoroughness of the waiter in providing food according to the patient's diet on the quality of nutrition installation services. Methods : This descriptive-analytic study uses a cross-sectional study design and a closed quantitative approach. Primary data was taken using a questionnaire with the total sample method used to test the knowledge of servers with the accuracy of giving a diet—quantitative approach using univariate analysis and bivariate analysis. Results : The accuracy of giving the diet at Leuwiliang Hospital is based on the questionnaire results in table 3. Poor knowledge is 36%, those who do the diet incorrectly are 12%, and those who carry out the diet properly are 24%, while 64% with good knowledge, there is no frequency of dietary values. Inappropriate, and 64% carry out the diet correctly. Compared with the Minimum Service Standards, where the indicator for the accuracy of the diet must be 100%, the results showed that the minimum service standard assessment had not been met, so the conclusion of the final statistical analysis using the Chi-Square test (X2) resulted in a P-Value = 0.014

Perceived Quality of Health Care Provided to Mothers during Immediate Postpartum Period at Health Facilities in Kakamega County, Kenya

Health care workers are essential in averting the high infant and mortality rates in Kenya. The immediate postpartum period is a delicate period when the mother and infant's health is in danger with evidence indicating the majority of deaths occurring during this period. The aim of the study was to assess mothers' perception of quality of care during the immediate postpartum period in selected facilities in Kakamega County in Kenya. Socio-demographic factors, knowledge and health services provided during the immediate postpartum period were evaluated. A cross-sectional descriptive study design to collect quantitative data was adopted. Self-administered questionnaires were utilized to collect data. The study participants were 257 postnatal mothers who were systematically sampled from facilities within Kakamega County. Quantitative data was analyzed using SPSS version 21.0. Descriptive statistics were used to present quantitative data in frequency tables, charts, and graphs. Inferential statics were done using Chi-Square tests at a 95% confidence interval (p<0.05). The results revealed majority of the women perceived the quality of postpartum care as slightly above average at 3.18(63.6%). 58.1% of participants had high knowledge on immediate postpartum care. Knowledge level (p = 0.018) had a significant association with the perceived postpartum care quality. Socio-demographic factors such as age (p=0.014), education (p=0.001), and parity (p=0.029) were associated with the perceived quality of postpartum care. Availability of family planning (p=0.050), immunization (p=0.001), and nutritional counseling services (p=0.012) was associated with the perceived quality of postpartum care. In conclusion the perceived quality of postpartum care was slightly above average with availability of health services positively influencing perception. Keywords: Perception, Quality, and Immediate postpartum care.

Assessment of the Impact of Caregivers Complementary Feeding Knowledge on Undernutrition among Children 6 to 36 Months in Borno State, Nigeria

This paper is an assessment of the impact of Caregivers complementary feeding Knowledge on undernutrition among children 6-36 Months in Borno state. Large-scale renewables raise new challenges and provide new opportunities across Health systems. The paper considers the barriers faced by health workers and caregivers in Maiduguri Metropolitan Council in providing nutritional services to infants. We review the current state of knowledge in relation to nutrition. This paper then explores key issues in health and nutrition system structure, the main challenges to the uptake of renewables, and the various existing fiscal and policy approaches to encouraging health services. We also highlight possible ways of moving forward to ensure more widespread health management systems. Keywords: Caregivers, Feed Knowledge. Maiduguri Metropolitan Council, Undernutrition.

The effects of COVID-19 on African American communities in Baltimore’s health enterprise zones: a mixed-methods examination

BackgroundThe CoVID-19 pandemic underscored effects of community resources on the built environment, health and health outcomes. The purpose of this study was to conduct community-engaged research and examine aspects of health, and access to healthcare from the voices of community members, as a foundation for improving health equity through the built environment.MethodsThis study utilized a convergent mixed methods design that included surveys and semi-structured interviews conducted from July 2021 to August 2022 to examine the impact of limited community resources, such as community health clinics on participants during the CoVID-19 pandemic. A convenient sample of 345 male and female African American participants represented five zip codes (21215, 21216, 21217, 21223, and 21229) in with the highest impact from CoVID 19, in Baltimore, Maryland. Quantitative and qualitative data were integrated to describe how the two types supported one another in health, healthcare and healthcare access.ResultsMore than half of all participants reported satisfaction with overall health, quality of healthcare provided and access to health care services. However, results indicated extreme differences in factors related to health and wellness after, as comparted to before the onset of the pandemic, Semi-structured interviews, expanded on overall community health, highlighting that overall satisfaction with health does not equal satisfaction with health-related resources and suggested participants felt frustrated and left out of much-needed community health resources to improve health and mental health services for all ages, nutrition services and community activities that make communities thrive. Data integration provided a more realistic view of what participants really experience, due to the expanded analysis of semi-structured interviews, and indicated quantitative and qualitative data did not always support each other.ConclusionsFuture research to improve the built environment, and to address historic health inequities, will require ongoing community engagement to better understand community needs. This study results encourage ongoing research to expand resources for community-engaged research and interventions. Researchers must remain cognoscente of changing needs, and persistent disparities that can only be addressed if policies, supported by these results, are introduced to make equitable investments to forge an environment where healthy communities thrive.

An ethnographic study exploring person-centred nutrition care in rehabilitation units

Purpose Person-centred care (PCC) is an essential component of high-quality healthcare across professions and care settings. While research is emerging in subacute nutrition services more broadly, there is limited literature exploring the person-centredness of nutrition care in rehabilitation. This study aimed to explore person-centred nutrition care (PCNC) in rehabilitation units, as described and actioned by patients, support persons and staff. Key factors influencing PCNC were also explored. Materials and methods An ethnographic study was undertaken across three rehabilitation units. Fifty-eight hours of field work were completed with 165 unique participants to explore PCNC. Field work consisted of observations and interviews with patients, support persons and staff. Data were analysed through the approach of reflexive thematic analysis, informed by PCC theory. Results Themes generated were: (1) tensions between patient and staff goals; (2) disconnected moments of PCNC; (3) the necessity of interprofessional communication for PCNC; and (4) the opportunity for PCNC to enable the achievement of rehabilitation goals. Conclusions PCNC was deemed important to different stakeholders but was at times hindered by a focus on profession-specific objectives. Opportunities exist to enhance interprofessional practice to support PCNC in rehabilitation. Future research should consider the system-level factors influencing PCNC in rehabilitation settings.

Dialysis capacity and nutrition care across Bangladesh: A situational assessment.

Hemodialysis (HD) is a treatment for ensuring the survival of end-stage kidney disease (ESKD) patients, and nutrition care is integral to their management. We sent questionnaires to evaluate the total dialysis service capacity and nutrition services across all dialysis facilities (DF) in Bangladesh, with responses from 149 out of 166 active DFs. Survey results revealed that 49.7% of DFs operated two shifts, and 42.3% operated three shifts daily, with 74.5% holding between one and ten dialysis machines. Sixty-three percent of DFs served between one and 25 patients per week, and 77% of patients received twice-weekly dialysis. The average cost for first-time dialysis was 2800 BDT per session (range: 2500-3000 BDT), but it was lower if reused dialyzers were used (2100 BDT, range: 1700-2800 BDT). Nutritionists were available in only 21% of the DFs. Parameters related to nutritional health screening (serum albumin, BMI, MIS-malnutrition inflammation assessment, and dietary intakes) were carried out in 37.6%, 23.5%, 2%, and 2% of the DFs, respectively, only if recommended by physicians. Nutrition education, if recommended, was provided in 68.5% of DFs, but only in 17.6% of them were these delivered by nutritionists. The recommendation for using renal-specific oral nutrition supplements (ONS) is not a familiar practice in Bangladeshi DFs and, therefore, was scarcely recommended. Dialysis capacity across Bangladesh is inadequate to meet current or projected needs and nutrition education and support across the DFs to benefit improving patients' quality of life is also inadequate.

Empathy through Data? Student Exploration of Elements of Diversity through Projects in an Introductory Statistics Course

A project involving data related to socioeconomic indicators was administered in an introductory statistics course. As part of this project, student groups investigated a data set from the United States Department of Agriculture Food and Nutrition Service website with information on recipients of Supplemental Nutrition Assistance Program (SNAP) benefits. Pre/post data from the Miville-Guzman Universality-Diversity Scale (M-GUDS) short form were collected to measure changes in diversity awareness. The survey administered also included demographic information and open-ended questions. Based on study results (n = 48), there was moderate evidence of a change in the diversity of contact subscale of the M-GUDS short form. Written feedback indicated that students demonstrated empathy for individuals with potentially different lived experiences. The focus of this paper is to describe the study results and provide information on the importance of incorporating elements of diversity into curriculum.

Analysis of the evaluation performance of cadres care stunting in efforts to prevent stunting

Stunting is a condition in which a child experiences growth disturbances so that the child's height is lower or shorter than the standard age. One of the efforts to prevent stunting is by providing assistance to pregnant women. Cadres as the spearhead of health workers who are near pregnant women and mothers with toddlers are expected to be able to monitor pregnant women and mothers with toddlers in efforts to prevent stunting. This study aims to analyze the evaluation of the performance of cadres in efforts to prevent stunting. The study used qualitative methods with in-depth interviews with four key informants and focus group discussions . In-depth interviews were conducted with 4 health cadres, and a Focus Group Discussion involving the Leaders of Organization of regional apparatus for family planning affairs , District Bappeda, Village Government, Health Center and Nutrition service staff. The data is then processed through the content analysis method. The data is then reduced through a coding process, summarized and drilled into partitions or sections that focus on questions. The results of the study show that, until now there has been no specific program in the context of efforts to prevent stunting to be carried out by cadres, even though there are currently various types of cadres besides health cadres who are known to be at posyandu, there are also other cadres who formed for the prevention of stunting, however, the implementation of the tasks has not been maximized because there is no specific program that is used as a reference in carrying out the tasks. In conclusion, that the performance of cadres is currently not optimal and focused on efforts to prevent stunting.

Utilization and Satisfaction of Services Provided for Children under the Integrated Child Development Services Scheme in a Block of West Bengal, India

Background: The Integrated Child Development Services (ICDS) scheme is a community-based program in India for the betterment of health and nutrition of children aged 0-6, pregnant and lactating mothers, and women aged 15-44 years. This study aimed to investigate the pattern of the utilization of services and the level of satisfaction of mothers regarding the services provided to their children in a block of West Bengal, India.
 Methods: This descriptive cross-sectional study was conducted from August 2016 to November 2018, and simple random sampling was used to select ICDS centres. The centres’ were evaluated for determining the rate of utilization of the services. For evaluating satisfaction, a face and content-validated, pre-tested questionnaire was used. The first part of questionnaire was for collecting the socio-demographic profile of mothers. The second part was concerned about determining satisfaction regarding various services provided by centers to children below 6 years of age on a 5-point Likert scale. About 10% of children enrolled in each ICDS centre were selected, and their mothers were surveyed for satisfaction regarding supplementary nutrition services, informal education, immunization, and other health-related services and infrastructures. The data were expressed in number and percentages and the test of association between categorical variables was done using a chi-square test. The GraphPad Prism 6.01 (GraphPad Software, USA) was used for statistical test.
 Results: Among the surveyed 62 ICDS centres, service utilization rates were 98.04% for immunization, 90.56% for supplementary nutrition, 82.52% for informal education, 40.27% for health check-ups, and 13.32% for referral services regarding different health problems. A total of 89.63% of the mothers were satisfied with the supplementary nutrition, 83.46% with immunization and health-related services, 77.42% with informal education, and 56.5% with infrastructures.
 Conclusion: Using supplementary nutrition and informal education exceeded expectations, but immunization, other health-related services, and referral services need improvement to achieve the program's goal. ICDS center infrastructure needs improvement, and a holistic approach is necessary to meet the satisfaction of mothers regarding different services.

The Gluten-Free Diet for Celiac Disease: Critical Insights to Better Understand Clinical Outcomes.

The gluten-free diet (GFD) remains a complex paradigm in managing celiac disease (CeD) in children and adults, and there are many reasons why GFD adherence should be strict to improve outcomes. However, this is a challenging task for patients, since they need to have access to quality healthcare resources that facilitate optimal GFD adherence. Understanding the strengths and weaknesses of the GFD, tackling coexisting nutritional deficiencies, and dealing with complex situations, such as seronegative CeD or non-responsive CeD, all require the involvement of a multidisciplinary team. The short- and long-term follow-up of CeD patients should preferably be performed by a combined Gastroenterology and Nutrition service with well-defined quality standards and the multidisciplinary involvement of physicians, nurses, dietitians, and psychologists. Nutritional advice and counseling by an experienced dietitian can reduce the costs associated with long-term follow-up of CeD patients. Likewise, psychological interventions may be essential in specific scenarios where implementing and sustaining a lifelong GFD can cause a significant psychological burden for patients. This manuscript aims to provide guidelines to improve clinical practice in the follow-up and monitoring of CeD patients and provide information on the nutritional risks of an ill-advised GFD. Clinicians, biochemists, food technologists, dietitians, and psychologists with a global view of the disease have been involved in its writing.

311 Nutrition and dietetics on a Frailty at the Front Door Team, what does it look like?

Abstract Background A dietitian was introduced to the Frailty at the Front Door team (FFDT) in January 2022. The introduction of the Malnutrition Screening Tool (MST) to the Comprehensive Geriatric Assessment (CGA) resulted in a 47% increase in dietetic referrals. The aim of this study was to understand the characteristics of this population and how intervention was initiated. Methods Over a five month period, data was collected from the CGAs administered. Gender, Clinical Frailty Score (CFS), MST score (high risk of malnutrition is defined as MST ≥2), method of referral, patients admitted under a specialty, referrals to Community Nutrition and Dietetics Services (CNDS) and those discharged from dietetics. The data was prospectively entered into an excel spreadsheet and analysed using descriptive statistics. Results 206 frail older adults (≥ 75 yrs) were referred and seen for dietetic intervention. Male to female ratio was 1: 1.75.The mean CFS was 5.8. 89% (n = 183) had MST ≥2. 83% (n = 171) of referrals were made by FFDT, 6% (n = 12) were referred via the hospitals’ electronic referral system. 64% (n = 132) were admitted to the acute hospital while a further 20% (n = 41) were referred to CNDS. The remaining 16% were either transferred to a different hospital or discharged from the dietetics service. Of those admitted, the data was broken down into the top 5 specialities; Geriatrics: 18% (n = 37), Acute Medicine: 16.5% (n = 34), Endocrinology: 12% (n = 25), General Medicine: 10% (n = 20) and Respiratory: 8.2% (n = 17). Conclusion High risk of malnutrition is highly prevalent in frail older adults presenting to the ED and through a number of medical specialties. Increased awareness identifies these patients so that targeted interventions early can reduce adverse outcomes in hospital or the community. Screening for malnutrition with a dietitian embedded in the FFDT identifies a much bigger proportion of those who need intervention than the traditional referral method.

Evaluation of the Implementation of Healthy Food Provision for Early Childhood at Muslimat Nu Puton Kindergarten in Pekalongan

Early Childhood Education in addition to providing educational services as well in the form of early childhood nutritional health services implemented through provision of a healthy and nutritionally balanced diet to help growth and support physical and spiritual development, as well as to help develop the potential for spiritual, intellectual, emotional and social intelligence in early childhood through the Provision of Healthy Food. The aims of this study were 1) to find out the mechanism for implementing healthy food at the Muslimat NU Puton Kindergarten in Pekalongan. 2) To find out the criteria for providing healthy food at the Muslimat NU Puton Kindergarten in Pekalongan. 3) To find out the extent of achievement in implementing healthy food at the Muslimat NU Puton Kindergarten in Pekalongan. The method used in this research is descriptive qualitative. Data collection techniques using interview techniques, observation, and documentation.
 The results showed that 1) The implementation of healthy food for young children in Muslimat Kindergarten NU Puton Pekalongan is given once a week which is held every Thursday at 10.00 WIB for lunch for children after carrying out learning and playing activities, the menu given every week is different Different, namely in the form of healthy snacks/snacks and main meals so that children don't get bored of receiving healthy food at school. 2) The criteria for providing healthy food to children at the Muslimat NU Puton Pekalongan Kindergarten have not been fully implemented in accordance with the existing criteria, the criteria that have not been implemented are that in the process of making food for cooks they have not used personal protective equipment (PPE) and the food ingredients used have not been fully using local ingredients. 3) The achievement of implementing healthy food at the Muslimat NU Puton Kindergarten in Pekalongan seen from the aspect of increasing children's development according to their age stages, increasing children's weight and height, as well as parental involvement in parenting activities can be said to be successful.

Differential use of postoperative psychosocial and physical services among older adults with head and neck cancer

IntroductionOlder adults undergoing head and neck cancer (HNC) surgery often have significant functional and mental health impairments. We examined use of postoperative physical, nutritional, and psychosocial services among a cohort of older adults with HNC comanaged by geriatricians and surgeons. Materials and MethodsOur sample consisted of older adults who were referred to the Geriatrics Service at Memorial Sloan Kettering Cancer Center between 2015 and 2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional, and psychosocial service utilization was assessed. Physical services included a physical, occupational, or rehabilitation consult during the patient's stay. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of psychiatry, psychology, or a social work consult. Relationships between each service use, geriatric deficits, demographic, and surgical characteristics were assessed using Wilcoxon rank-sum test or Chi-square test. ResultsIn total, 157 patients were included, with median age of 80 and length of stay of six days. The most common GA impairments were major distress (61%), depression (59%), social activity limitation (SAL) (54%), and deficits in activities of daily living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (80% and 85% vs 31%, respectively). Receipt of services was associated with longer median length of hospital stay, operation time, and greater deficits in ADLs. SAL was associated with physical and psychosocial consult and lower Timed Up and Go (TUG) score; instrumental ADL (iADL) deficits were associated with physical services; and depression and distress were associated with psychosocial services. DiscussionThe burden of psychosocial deficits is high among older adults with HNC. Future work is needed to understand the limited utilization of psychosocial services in this population as well as whether referral to psychosocial services can reduce the burden of these deficits.

REKAM MEDIS ELEKTRONIK (RME) UNTUK PELAYANAN GIZI RUMAH SAKIT

Background: Electronic Medical Record (EMR) is mandatory for the healthcare provider in Indonesia. EMR were also developed for medical support services such as nutrition services. EMR application for nutrition services consists of nutrition assessment forms and patient-integrated clinical development records.Objective: To determine factors that influence the implementation of EMR for hospital nutrition services.Methods: This research is qualitative research with a single-case holistic design. The research location was in Instalasi Gizi RSUD Dr. Soetomo, from May to June 2023. The data collecting method was using in depth-interview and focus group discussions. Participants were selected using purposive sampling. Data was analyzed based on the Human, Organization, and Technology (HOT)–Fit Framework.Results: This research showed that the main factor influencing the success of EMR implementation for hospital nutrition is the digital competencies of the staff. These competencies could be increased by giving some training to the staff. Another essential factor is that organization should support by providing Standard Operating Procedures (SOPs) for EMR implementation and technical support from the Information Technology (IT) team. IT team has the responsibility to handle complaints and problems about EMR. Facilities such as computers and Local Area Networks (LAN) should be sufficient to make EMR implementation run well. The interface and features of EMR should answer the needs of the staff. So, staff would feel EMR is beneficial to help them finish their work, and they would show their acceptance toward this EMR.Conclusions: The success of EMR implementation for hospital nutrition services is determined by several factors like staff digital competencies, organizational support, and provision of computers and LAN for implementing EMR. Positive perception about the benefit of EMR encouraged the increase of EMR utilization in hospitals.

Food insecurity and social capital during COVID-19: A cross-national qualitative study of communities from South Africa and the United States

This study investigates the evolving ways in which social workers helped provide food assistance during the first months of the COVID-19 pandemic in communities in South Africa and the United States. A cross-national qualitative methodology was used to collect data about the nutritional services social workers delivered, the types of social capital used to assist in these efforts, and the challenges they experienced. This study not only highlights differences in the approaches of these two countries but also how these different communities might be able to learn from one another in delivering food relief during times of emergency.

Opportunity, hierarchy, and awareness: an ethnographic exploration across rehabilitation units of interprofessional practice in nutrition and mealtime care

ABSTRACT Interprofessional practice is increasingly cited as necessary in the delivery of high-quality nutrition and rehabilitation services. However, there is limited evidence available exploring the factors which influence interprofessional practice in subacute rehabilitation nutrition services. Our ethnographic study explored collaborative activities, influential factors and staff attitudes related to interprofessional practice in nutrition care. Fifty-eight hours of ethnographic field work were undertaken from September 2021—April 2022, across three subacute rehabilitation units, with a total of 165 patients, support persons and staff participating. Overall, 125 unique participants were observed and 77 were interviewed. We generated three themes through reflexive thematic analysis. First, the potential opportunities for interprofessional practice at mealtimes, as influenced by communication, role clarity and reciprocity. Second, hierarchy of nutrition roles and tasks impedes interprofessional practice, where the perceived lower importance of nutrition care to other clinical roles and physical therapies influences staff practice. Third, the mystery of nutrition care roles and systems in rehabilitation, which exposes gaps in the awareness of different team members regarding nutrition care roles and systems, hindering interprofessional practice. Our findings highlight the opportunity for embedded, innovative models of care and staff education to enhance interprofessional practice in nutrition and mealtimes.