Nutrition Training Research Articles

Nursing Home Organization Mealtimes and Staff Attitude Toward Nutritional Care: A Multicenter Observational Study

ObjectivesThe aims of this study were to investigate the practices of registered nurses and nurse aides at mealtimes in nursing homes (NHs) and to evaluate the attitudes of health care staff toward the nutritional care of older people. DesignThis is a multicenter cross-sectional study. Setting and ParticipantsThe study involved a convenience sample of NH health care staff: physicians, registered nurses, and nurse aides. MethodsData were collected on characteristics of the dining environment, organizational and nutritional care practices, staff-resident ratio, and staff activities during meals, using 2 questionnaires and staff attitudes were assessed with Staff Attitudes to Nutritional Nursing Care Geriatric Scale (SANN-G). Total score ranges from 18 to 90 points, with the following cutoffs: ≥72, positive attitude; ≤54, negative; and 55-71 points, neutral attitude. ResultsA total of 1267 workers from 29 NHs in northern Italy participated in the study. The most common nutritional assessment tool used by nurses was the Malnutrition Universal Screening Tool. A median of 4.0 and 4.2 people (family caregivers, volunteers and staff) were present for feeding support, respectively, at lunch and dinner. A median of 2.5 and 2.0 staff members at lunch and at dinner, respectively, fed residents. Overall, 1024 health care workers responded to SANN-G of which 21.9% showed a negative attitude, 57.2% neutral, and 20.9% a positive attitude. Nurse aides (190/714) showed worse attitudes compared with registered nurses (20/204) and physicians (2/36); differences were statistically significant. Overall, the best attitudes were toward “habits,” “interventions,” and “individualization” of nutritional care. Staff who had received nutritional training (29.2%) had best attitudes. Conclusions and ImplicationsThe results suggest that NHs should ensure adequate staff-resident ratio during meals, involving trained volunteers and relatives. Moreover, health professionals' knowledge and attitude toward nutritional care should be improved through continuous training.

Bridging knowledge gaps in fish health management through education, research, and biosecurity

Education, research, and biosecurity have global recognition as strong pillars of sustainable aquaculture development. In many developing countries, insufficient knowledge and awareness among stakeholders regarding the relevance of education, research, and biosecurity have influenced aquaculture sustainability negatively. To uncover the gaps in education, research, and biosecurity practices in aquatic animal health management, we conducted a questionnaire-based study in various East and West African countries. By adopting the methodology of self-reporting data, we invited a significant number of individuals to participate in the study. In the end, 88 respondents contributed, with the majority from Ghana (47) and Kenya (20), and 21 respondents from five other East and West African nations. The results revealed substantial educational gaps, including the need for practical training in aquatic animal health management, nutrition, and genetics. Respondents also emphasized the importance of creating additional national aquaculture research institutions and augmented funding to enable them to address industry needs. Governments of the represented nations should actively intervene by providing the essential logistics and capacity to support aquaculture research and development. Informed government involvement is paramount for bridging the disconnection among all stakeholders, as revealed in the results. Furthermore, the lack of biosecurity measures and the understanding of the importance of biosecurity measures in the industry addressed through awareness creation. Creating awareness on biosecurity underpinned with national aquaculture biosecurity policies can prevent disease incidences in the industry. The outcomes of this study can serve as a vital working document to enhance aquatic animal health management in East and West Africa, thereby fostering sustainable and resilient aquaculture.

The Eating and Food Literacy Behaviors Questionnaire Has the Capacity to Distinguish Between Food Literacy Scores of Students Enrolled in Senior-Level Nutrition Classes Compared With Those Students Registered in Other Academic Courses Attending a University in the Southeastern United States

BackgroundThe Eating and Food Literacy Behaviors Questionnaire (EFLBQ) is an instrument that has not been tested for its capacity to distinguish among individuals assumed to have higher and lower food literacy. ObjectiveThe aim of this study was to examine and compare EFLBQ scores among university students with and without formal nutrition-related training. DesignThis study had a cross-sectional design. Participants and SettingsTwo hundred twenty-seven young adult university students enrolled in non–nutrition-related classes (n = 76), introductory nutrition classes (n = 98), and senior-level nutrition classes (n = 53) were recruited from a large university in the southeastern United States during the spring and fall semesters of 2022. The students ranged in age from 18 to 30 years. Main Outcome MeasuresMean EFLBQ total scores and factor scores of health and nutrition, taste, food preparation, planning and decision making, and convenience were compared among the three groups. Statistical AnalysesLinear regression backward method examined whether level of training, age, sex, race and ethnicity, and BMI were independent variables associated with total EFLBQ mean scores. Analysis of variance (ANOVA) compared normally distributed data and Kruskal-Wallis and Mann-Whitney U tests compared non-normally distributed data. ResultsLinear regression testing found that the level of nutrition training was significantly associated with total EFLBQ scores. Students in senior-level nutrition classes had higher total EFLBQ mean scores (M = 3.1 ± 0.2) than students in non–nutrition-related classes (M = 2.9 ± 0.3) (P = 0.002; 95% CI = 0.055, 0.280) and introductory nutrition classes (M = 2.9 ± 0.3) (P = 0.001; 95% CI = 0.275, 0.061). Total EFLBQ mean scores were not different among the students in non–nutritional-related classes and introductory nutrition classes (P = 1.000; 95% CI = −0.096, 0.096). Scores differed by training level for items measuring EFLBQ Factor 1: Health and Nutrition. Factor 1 mean scores were higher in students in senior-level classes (M = 3.1 ± 0.4) than for those in non-nutrition classes (M = 2.7 ± 0.5) (P < 0.001; 95% CI = 0.294, 0.670) and introductory nutrition classes (M = 2.8 ± 0.5) (P < 0.001; 95% CI = 0.228, 0.553). The other EFLBQ factor mean scores were not different among the three groups (all P-values > 0.12). ConclusionThe EFLBQ demonstrated the capacity to distinguish food literacy scores between students expected to have higher as compared with lower food literacy.

How Competent are Health Professionals in Delivering Nutrition Education? A Cross-Sectional Study in Ebonyi State, Nigeria

BACKGROUND: The World Health Organization recognises nutrition as the basis for good health and the leading edge of disease prevention. Nutrition education is also key in facilitating healthy habits in all spheres of life. Health professionals are central to informing good dietary habits through nutrition education since they are seen as reliable sources for nutritional information. This study assessed health professionals’ competencies in nutrition education in Ebonyi State, Nigeria. METHODOLOGY: A health facility-based cross-sectional study among health professionals was conducted in three selected hospitals from three Local Government Areas in Ebonyi State, Nigeria. A total of 421 health professionals selected by multistage sampling were surveyed. Data analysis was done using IBM SPSS version 25. Chi-square test and multivariate analysis using binary logistic regression were used in the analysis, and the level of statistical significance was determined by a p-value of &lt;0.05. Overall adequate competence of health professionals on nutrition education was derived by the proportion of respondents who had good knowledge, good perception, and good practice of nutrition education. RESULTS: The mean age of the respondents was 32.4 ± 8.9 years, and the majority, 67.5% (283), were females. The highest proportion of respondents, 59.4% (249), were nurses. Less than one-tenth of respondents, 7.4%, had good knowledge of nutrition. A higher proportion of respondents, 85.9% (360), had good practice of nutrition education while less than half, 42.5% (178), had a good perception of nutrition education. A minor proportion of respondents, 43.0% (180), had adequate competency in nutrition education. Predictors of health professionals’ competencies included having postgraduate level of training (AOR= 0.4; 95% CI = 0.2 - 0.8), being a physiotherapist (AOR = 17.2; 95% CI = 1.1 - 267.5), being &lt; 39 years (AOR = 5.8; 95% CI = 2.1 – 16.3) and 40 - 49 years (AOR = 4.8; 95% CI = 1.6 – 14.6). CONCLUSIONS: A minor proportion of respondents had adequate competency in nutrition education. The knowledge of nutrition among health professionals is also poor. The health professionals may require nutrition training for proper delivery of nutrition education. There is a need to incorporate regular in-service training as a strategy for improving health professionals’ nutritional competency.

Application of an Interactive, Hands-On Nutritional Curriculum for Pediatric Residents.

Currently, there exists a scarcity of suitable nutrition training resources for the primary care physician (PCP) and a paucity of educational materials for pediatric residency programs. Barriers to nutritional education include: a lack of well-defined competencies, a dearth of centralized resources for nutritional education, and a reliance on didactic teaching methodology. Because PCPs often cite a lack of confidence as a primary reason for not providing nutritional counseling, we created an interactive 3-pronged nutritional curriculum for pediatric residents with the aim of increasing their confidence to provide nutritional counseling to patients. This curriculum included an in-person visit to a local supermarket, an online, interactive case during the resident's continuity clinic, and an interactive lecture. There was a statistically significant change in pediatric residents' confidence to manage issues of outpatient nutrition management. We find this particularly relevant as increasing physician confidence is key to increasing nutritional counseling in a clinical setting.

Assessment of General and Sports Nutrition Knowledge, Dietary Habits, and Nutrient Intake of Physical Activity Practitioners and Athletes in Riyadh, Saudi Arabia.

Physical performance and overall health are crucial in the athletic population, and their improvement relies on specific dietary guidelines and practices. Athletes and physical activity practitioners who participate in physical activity for specific health reasons need nutritional knowledge to improve physical performance. This study aimed to understand nutrient intake and nutritional knowledge among physical activity practitioners and athletes in Riyadh, Saudi Arabia. This cross-sectional study sampled 263 individuals divided into two groups: athletes (n = 121) and practitioners (n = 142). Their nutritional knowledge and dietary intake were measured with validated questionnaires: the Arabic Abridged Nutrition for Sport Knowledge Questionnaire and the Saudi Food Frequency Questionnaire. The majority of the sample (77.2%) had poor nutritional knowledge. Highest scoring domains for the dietary intake were protein from meat, fish, chicken (65.6%), vegetarian protein (62.4%), grains (51.0%), and the lowest were vegetables (41.1%), dairy (36.3%), and fruits (27.9%). In conclusion, athletes and practitioners in Riyadh, Saudi Arabia, have poor nutritional knowledge and dietary intake and may benefit from nutritional education and training to improve their knowledge, dietary intake, and performance.

Transfers, nutrition programming, and economic well-being: Experimental evidence from Bangladesh

Many cash transfer programs include complementary nutrition training, with the aim of encouraging households to use transfer resources toward improving child nutrition. Evidence indicates that these bundled programs, if intensive and well-implemented, can be effective in improving child nutritional status. However, little is known about how adding nutrition training to transfer programs affects their economic impacts. In particular, few studies have assessed whether nutrition programming may induce reallocation of transfer resources from physical capital to human capital. Scarce evidence also exists as to whether these tradeoffs depend on the transfer modality. We study a pilot program called the Transfer Modality Research Initiative in Bangladesh (TMRI), designed as a randomized controlled trial. TMRI provided cash or food transfers, with or without intensive group-based nutrition behavior change communication (BCC), to mothers of young children in poor rural households. We find that adding nutrition BCC to cash or food transfers leads to larger impacts on both consumption and assets – potentially surprising, given that the transfer value is unchanged. Analysis of mechanisms suggests that these effects occur through the BCC inducing increases in income generation, through investments in livelihoods. Suggestive evidence indicates that the effects of TMRI’s BCC are plausibly due to the intensive group-based format, which increased social capital for participant women and their household members, as well as improved participant women’s agency and self-confidence, knowledge, and input into household decisions. Results indicate that adding nutrition BCC to cash or food transfer programs do not necessarily induce a tradeoff between investing in human capital versus physical capital, but can rather strengthen impacts on both if appropriately designed.

Urban nutrition situation in the slums of three cities in Asia during the COVID-19 pandemic.

Urban-poor households are disproportionately food insecure. The Status and Determinants of Food Insecurity and Undernutrition in Poor Urban Settings (SDFU)cross-sectional surveys were conducted in 2020-2021 to assess the impacts of COVID-19on food security and diet quality among urban poor women of reproductive age (WRA)and children under 5 (CU5)in Jakarta, Quezon City, and Yangon. Data, collected on food insecurity and child and maternal diet quality using Computer Assisted Telephone Interviewing (CATI),were compared with prepandemic surveys. Prevalence for food insecurity and diet quality indicators were computed. Eight in 10 households in all three cities reported reduced incomes, with 6 in 10 worried about food the previous year. Over 10% of households in all cities substituted nutrient-dense (ND)foods with cheaper alternatives; yet less than 50% of children 6-59 months ate sugar-sweetened beverages or sweet and savoury snacks. Compared with baseline, women's minimum dietary diversity (MDD)in the three cities was significantly lower (up to 30% lower in Yangon and Jakarta), while the prevalence of children (6-23 months) meeting MDD was lower by 17.4%-42.5% in all cities. MDD was attained by >40% of children (24-59 months) in Yangon and Jakarta but only 12.6% in Quezon City. To improve food security and diet quality, multi-sectoral interventions are needed, including distributing ND foods and cash assistance to vulnerable households with CU5 and WRA and delivering targeted nutrition training to encourage appropriate complementary feeding practices and purchasing and consumption of ND foods.

Factors Influencing the Management of Musculoskeletal Pain among Children with Sickle Cell Disease in Western Kenya

Musculoskeletal pain (MSK) is a common and often distressing symptom among children diagnosed with sickle cell disease (SCD). Despite the recurrent and often severe pain episodes these children endure, there has been limited research into the factors that influence the management of this pain. This study sought to delve into the various factors that impact the management of MSK pain in children with SCD in Western Kenya. It took a comprehensive approach, considering psychological, economic, sociocultural, individual, nutritional, environmental, and hospital-related factors. To gather insights, caregivers of 176 children with musculoskeletal pain associated with SCD were interviewed using semi-structured questionnaires. Thematic analysis was employed to identify recurring themes, and a codebook was developed based on findings from the literature and emerging themes. The interviews continued until theoretical saturation was achieved, ensuring that all necessary data was collected. The results of the study revealed seven key themes that significantly influenced the management of musculoskeletal pain in these children. These themes included psychological factors, economic constraints, sociocultural beliefs, individual health status, nutritional challenges, environmental triggers, and healthcare system-related factors. Caregivers often grappled with psychological distress, financial strain, and social stigmatization. Individual factors, such as compromised immune status, played a crucial role in the frequency and severity of pain episodes. Furthermore, inadequate access to nutritious food exacerbated musculoskeletal pain. Additionally, changing weather conditions and previous negative experiences with healthcare facilities hindered effective pain management. In light of these findings, the study underscores the urgent need for a holistic approach to address these challenges. This includes providing psychosocial support, financial assistance, community awareness campaigns, improved healthcare services, education on proper nutrition, climate-related support, and healthcare worker training to better manage MSK pain in children with SCD.

An innovative state-of-the-art health storytelling technique for better management of type 2 diabetes.

Type 2 diabetes (T2D) is a chronic lifelong disease that requires long-term prevention and management strategies in a community setting. A health story is a novel technique that may be used as an effective tool for better prevention and management of T2D. The main objective of this study is to develop a story to be used as a social health technique based on contemporary scientific knowledge that may be used at a community level for better communication and management of T2D. A community-academic partnership was formed with a not-for-profit Nutrition Education, Awareness, and Training (NEAT) organization in Khyber Pakhtunkhwa, Pakistan. We agreed to develop a story that may be used as a health and nutrition education communication tool for better management of patients with T2D. The following phases were followed during the story creation process: (1) the theory phase, (2) the modeling phase, and (3) the evaluation phase. Raters evaluated the story to determine its literary and scientific quality, comprehensiveness, and T2D specificity. The title of the story translated into English is "The Story of Diabetes-The Story of Success." It is text based and contains 86 pages in the local language, "Pashto," with an English translation. The story is divided into five chapters and describes the initial diagnosis, fear associated with the disease, issues related to referral to certified practitioners, the importance of a balanced diet, and related lifestyle habits. After story evaluation, the raters suggested its literary and scientific quality, comprehensiveness, and T2D specificity (Pearson correlation scores of >0.8). This unique story was created for T2D and found to be of significant quality in terms of its literary and scientific quality, as well as its comprehensiveness and diabetes specificity. As a result, it may be suggested that it can be used in subsequent studies to improve T2D management among adult patients.

Integrative medical group visits for patients with chronic pain: results of a pilot single-site hybrid implementation-effectiveness feasibility study.

Approximately 20% of adults in the United States experience chronic pain. Integrative Medical Group Visit (IMGV) offers an innovative approach to chronic pain management through training in mindfulness, nutrition, and other mind-body techniques combined with peer support. To date, there are no studies on IMGV implementation, despite its promise as a feasible non-pharmacological intervention for chronic pain management. In this study, we assessed the feasibility of implementing IMGV and assessing its effectiveness for chronic pain. Implementation Mapping was used to develop and evaluate implementation strategies for IMGV. Strategies included disseminating educational materials, conducting ongoing training, and conducting educational meetings. IMGV was delivered by three healthcare providers: an allopathic physician, registered yoga teacher, and naturopathic physician. The effectiveness of IMGV on patient health outcomes was assessed through qualitative interviews and a Patient-Reported Outcomes Scale (PROMIS-29). Provider perspectives of acceptability, appropriateness, and feasibility were assessed through periodic reflections (group interviews reflecting on the process of implementation) and field notes. Paired t-tests were used to assess changes between scores at baseline and post intervention. Qualitative data were coded by three experienced qualitative researchers using thematic content analysis. Of the initial 16 patients enrolled in research, 12 completed at least two sessions of the IMGV. Other than fatigue, there was no statistically significant difference between the pre- and post-scores. Patients reported high satisfaction with IMGV, noting the development of new skills for self-care and the supportive community of peers. Themes from patient interviews and periodic reflections included the feasibility of virtual delivery, patient perspectives on acceptability, provider perspectives of feasibility and acceptability, ease of recruitment, complexity of referral and scheduling process, balancing medical check-in with group engagement, and nursing staff availability. IMGV was feasible, acceptable, and effective from the perspectives of patients and providers. Although statistically significant differences were not observed for most PROMIS measures, qualitative results suggested that participants experienced increased social support and increased pain coping skills. Providers found implementation strategies effective, except for engaging nurses, due to staff being overwhelmed from the pandemic. Lessons learned from this pilot study can inform future research on implementation of IMGV.

Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy.

Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated the impact of an interprofessional CM course for medical and health professional students who experienced the hands-on cooking component in person or a in mixed-mode format (in-person and via Zoom) at the University of Utah from 2019-2023 (n = 84). A factorial ANOVA assessed differences between educational environment and changes between pre- and post-course survey responses related to diet and lifestyle counseling, interprofessional communication, and health behaviors and advocacy. Qualitative comments from post-course surveys were analyzed on a thematic level. Students rated themselves as having greater confidence and competence in diet and lifestyle counseling (p < 0.05) and increased ability to prepare eight healthy meals (p < 0.05). Additionally, a Mann-Whitney two-sample rank-sum test was used to compare data from exit survey responses from medical students who took the CM course (n = 48) and did not take the CM course (n = 297). Medical students who took CM were significantly more likely to agree that they could counsel patients about nutrition (p < 0.05) and physical activity (p < 0.05). CM courses may improve students' confidence to provide diet and lifestyle counseling.

Increasing Production Diversity and Diet Quality: Evidence from Bangladesh.

In the context of rural Bangladesh, we assess whether agriculture training alone, nutrition Behavior Communication Change (BCC) alone, combined agriculture training and nutrition BCC, or agriculture training and nutrition BCC combined with gender sensitization improve: (a) production diversity, either on household fields or through crop, livestock or aquaculture activities carried out near the family homestead and (b) diet diversity and the quality of household diets. All treatment arms were implemented by government employees. Implementation quality was high. No treatment increased production diversification of crops grown on fields. Treatment arms with agricultural training did increase the number of different crops grown in homestead gardens and the likelihood of any egg, dairy, or fish production but the magnitudes of these effect sizes were small. All agricultural treatment arms had, in percentage terms, large effects on measures of levels of homestead production. However, because baseline levels of production were low, the magnitude of these changes in absolute terms was modest. Nearly all treatment arms improved measures of food consumption and diet with the largest effects found when nutrition and agriculture training were combined. Relative to treatments combining agriculture and nutrition training, we find no significant impact of adding the gender sensitization on our measures of production diversity or diet quality. Interventions that combine agricultural training and nutrition BCC can improve both production diversity and diet quality, but they are not a panacea. They can, however, contribute towards better diets of rural households.

Culinary medicine and healthy ageing: a comprehensive review.

Culinary medicine (CM) represents a novel strategy to promote healthy ageing, as it improves adherence to healthy dietary patterns by providing nutritional education and training in cooking skills. We conducted a comprehensive review of the current scientific literature (2011-2022) concerning CM programmes implemented among participants over the age of 40. This review includes fourteen culinary-nutritional interventions. Each CM programme was analysed according to seven variables: health goal, study design, theoretical basis of the intervention, intervention duration, main outcomes, culinary intervention and the effectiveness of intervention. Although CM programmes showed low effectiveness in achieving positive results on psychosocial outcomes, they were successful in improving dietary intake and health-related outcomes. The interventions lasting for at least 5 months and employing study designs with two or more groups seemed to be important factors associated with achieving significant results. Significant results were observed regardless of the prevention phase defined as the health objective of the CM programme. The use of theoretical frameworks as an educational resource did not influence the effectiveness of the interventions. Other variables such as the inclusion of culinary outcomes, the optimisation of the culinary curriculum taught to the participants and the participation of a chef in the intervention are factors that should be taken into account. In addition, several educational components (cooking classes, hands-on cooking, free food delivery, individualized counselling) were promising for achieving health outcomes in ageing people. Our review has shown that CM programmes can be a powerful tool to improve the health status of ageing people.

Emergency nurse and physician perceptions of barriers and facilitators to optimal nutrition in the emergency department: A national cross-sectional survey

IntroductionOptimal nutritional support is becoming increasingly important in Emergency Departments (EDs) as over half of patients presenting to ED are reported to be malnourished or at risk of malnutrition. Few studies have examined the barriers and facilitators to nutritional support in ED. AimTo identify barriers and facilitators to providing optimal nutritional support in the ED from nurse and physician perspectives. MethodsA cross-sectional 31-item electronic survey was developed, validated, and distributed nationally in August 2021 in China. ResultsA total of 1766 eligible respondents completed the survey, including 846 ED nurses and 920 ED physicians from 155 hospitals. Barriers to optimal nutrition were moderate (2.72/5 ± 0.88); the most common barrier was lack of multidisciplinary team-work support. Facilitators to support optimal nutrition were moderately high (3.58/5 ± 1.08); the most common facilitator was technical/professional support and organizational management. Respondents who received recent nutrition training and those with higher levels of nutrition knowledge (self-rated) perceived fewer barriers overall to optimal nutrition in ED (P < 0.01). ConclusionContext specific barriers and facilitators both hinder and support optimal nutrition in ED. Further research is required to develop tailored interventions to address specific barriers to optimal nutrition and enhance facilitators in the ED context.

Protocol to evaluate the effectiveness and cost-effectiveness of an environmental nutrition and physical activity intervention in nurseries (Nutrition and Physical Activity Self Assessment for Child Care - NAP SACC UK): a multicentre cluster randomised controlled trial

BackgroundOne in seven UK children have obesity when starting school, with higher prevalence associated with deprivation. Most pre-school children do not meet UK recommendations for physical activity and nutrition. Formal childcare settings provide opportunities to deliver interventions to improve nutritional quality and physical activity to the majority of 3–4-year-olds. The nutrition and physical activity self-assessment for childcare (NAP SACC) intervention has demonstrated effectiveness in the USA with high acceptability in the UK. The study aims to evaluate the effectiveness and cost-effectiveness of the NAP SACC UK intervention to increase physical activity, reduce sedentary time and improve nutritional intake.MethodsMulti-centre cluster RCT with process and economic evaluation. Participants are children aged 2 years or over, attending UK early years settings (nurseries) for ≥ 12 h/week or ≥ 15 h/week during term time and their parents, and staff at participating nurseries. The 12-month intervention involves nursery managers working with a Partner (public health practitioner) to self-assess policies and practices relating to physical activity and nutrition; nursery staff attending one physical activity and one nutrition training workshop and setting goals to be achieved within 6 months. The Partner provides support and reviews progress. Nursery staff receive a further workshop and new goals are set, with Partner support for a further 6 months. The comparator is usual practice. Up to 56 nurseries will be stratified by area and randomly allocated to intervention or comparator arm with minimisation of differences in level of deprivation. Primary outcomes: accelerometer-assessed mean total activity time on nursery days and average total energy (kcal) intake per eating occasion of lunch and morning/afternoon snacks consumed within nurseries. Secondary outcomes: accelerometer-assessed mean daily minutes of moderate-to-vigorous physical activity and sedentary time per nursery day, total physical activity on nursery days compared to non-nursery days, average serving size of lunch and morning/afternoon snacks in nursery per day, average percentage of core and non-core food in lunch and morning/afternoon snacks, zBMI, proportion of children who are overweight/obese and child quality-of-life. A process evaluation will examine fidelity, acceptability, sustainability and context. An economic evaluation will compare costs and consequences from the perspective of the local government, nursery and parents.Trial registrationISRCTN33134697, 31/10/2019.

Balanced Nutrition Training for Adolescent Girls as Peer Educators on Improving Behavior among Senior High School Students for Stunting Prevention

Remaja Indonesia banyak yang tidak menyadari bahwa mereka memiliki tinggi badan yang pendek atau disebut stunting. Data Riskesdas tahun 2017, diketahui persentase remaja putri dengan kondisi pendek dan sangat pendek meningkat dari tahun sebelumnya, yaitu 7,9% sangat pendek dan 27,6% pendek. Salah satu pendekatan pendidikan kesehatan yang efektif pada remaja untuk mencegah stunting yaitu dengan metode Peer Education (pendidikan sebaya) tentang gizi seimbang. Tujuan penelitian ini adalah pengaruh Pelatihan Gizi Seimbang Bagi Remaja Putri Sebagai Peer Education Terhadap Peningkatkan Perilaku Pada Pencegahan Stunting Di Sekolah Menengah Atas Kec. SoropiaJenis penelitian ini survey analitik dengan rancangan kuasi eksperimen dengan model pre test post test control group desain yaitu kelompok perlakuan metode peer education sebanyak 40 siswi dan kelompok kontrol metode penyuluhan sebanyak 32 siswi diukur tingkat pengetahuan, sikap dan praktik tentang gizi seimbang melalui pre test dan post test. Untuk mengetahui ada perbedaan dilakukan uji Mann Whitney dengan taraf signifikan 0,05. Hasil uji statistik ada perbedaan bermakna antara tingkat pengetahuan, sikap dan praktik remaja putri kelompok perlakuan metode peer education dan kelompok kontrol metode penyuluhan yaitu p= 0,046 (p&lt;0,05), p= 0,034 (p&lt;0,05) dan p= 0,000 (p&lt;0,05).

Hospital management of the patient with dysphagia. Survey and recommendations of SEEN nutrition area

IntroductionThe prevalence of dysphagia in hospitalized patients is extraordinarily high and little known. The goal of care should be to assess the efficacy and safety of swallowing, to indicate personalized nutritional therapy. The development of Dysphagia Units, as a multidisciplinary team, facilitates comprehensive care for this type of patient. Material and methodsA observational, cross-sectional, web-based survey-type study, focused on Spanish Society of Endocrinology and Nutrition department heads, was conducted in September-October 2021. The following data were analyzed: size and type of center, existence of a dysphagia unit, dysphagia screening, dietary and nutritional therapy, education and training of professionals and patients, codification, and quality of life evaluation. Results65 responses (39% of the total Endocrinology and Nutrition departments). 37% of hospitals have a Dysphagia Unit and 25% are developing it. 75.4% perform screening, with MECV-V in 80.6%, and VED (61.4%) and VFS (54.4%) are performed as main complementary tests. The centers have different models of oral diet, thickeners and nutritional oral supplements adapted to dysphagia. In 40% of the centers, no information is offered on dysphagia, nor on the use of thickeners, dysphagia is coded in 81%, 52.3% have specific nursing protocols and only 8% have scales for quality-of-life evaluation. ConclusionsThe high prevalence and the risk of serious complications require early and multidisciplinary management at the hospital level. The information received by the patient and caregiver about the dietary adaptations they need, is essential to minimize risks and improve quality of life.

A framework to assess the role of social cash transfers in building adaptive capacity for climate resilience

ABSTRACT Climate change is increasingly affecting vulnerable groups and resulting in dire social and economic consequences, especially for those in the Global South. Managing current and emerging climate-related risks will require increasing individual’s and communities’ resilience, including enhancing absorptive, adaptive, and transformative capacities. Policymakers are now considering the role that social protection policies and programmes can play in building climate resilience by contributing to these capacities. However, there is a limited understanding of the extent to which social protection instruments can influence these three resilience-related capacities. Lack of assessment tools or frameworks might contribute to limited evidence of social protection’s ability to increase climate resilience. In particular, there appear to be no frameworks or tools that help assess the role of social cash transfers (SCT) in building adaptive capacity. Based on a multi-staged literature review, we develop an adaptive capacity outcomes framework (ACOF) that can help assess SCT’s contribution to building adaptive capacity, and, consequently, resilience. The framework is then tested using impact evaluation and assessment reports from SCT programmes in Indonesia, Zambia, Ethiopia, Bangladesh, and Tanzania. The exercise finds that SCTs alone have a limited contribution to adaptive capacity outcomes, but interventions that combine cash transfers with other components such as nutrition or livelihood training show positive impacts. We find that the ACOF can support assessments of SCT’s contribution towards adaptive capacity. It can help build evidence, evaluate impacts, and through further research, can facilitate learning on SCTs' role in increasing climate resilience.

Fostering Nourished Families: Outcomes Research on Nutrition Training for Foster Parents

Fostering Nourished Families: Outcomes Research on Nutrition Training for Foster Parents