Perceptions of Nut Consumption amongst Australian Nutrition and Health Professionals: An Online Survey

Habitual nut consumption is associated with reduced risk of chronic diseases; however, consumption levels in Australia are below recommendations. This study examined perceptions and knowledge regarding nut consumption among Australian healthcare professionals and their provision of nut consumption recommendations. A cross-sectional online survey of Australian health professionals was conducted in February–April 2020. Questions in the survey included demographic details, participants’ perceptions of nut consumption, and nut consumption recommendations they may make to clients and patients. A total of 204 health professionals completed the survey, of which 84% were dietitians or nutritionists. Health professionals demonstrated basic nutritional knowledge regarding nut consumption; however, non-dietitians/nutritionists lacked knowledge of long-term benefits of nut consumption. Dietitians/nutritionists were more likely to agree that nuts are healthy and do not cause weight gain when compared to non-dietitians/nutritionists (p = 0.021). A total of 63% of health professionals advised at least some of their clients to eat more nuts, and this was higher among dietitians/nutritionists (68%) than non-dietitians/nutritionists (31%). While basic nutritional knowledge regarding nut consumption was observed among all health professionals, there is scope for further education, particularly for non-dietitians/nutritionists, to ensure that nutrition information provided to patients and clients is accurate and reflects the current evidence base.     

Assessment of Community Development and Leadership Skills Required by Caribbean Nutritionists and Dietitians: Research and International Collaboration in Action

As part of a collaborative project between the Canadian Dietetic Association and the Caribbean Association of Nutritionists and Dietitians, Caribbean nutritionists and dietitians (N = 61) were surveyed via a mailed questionnaire to determine their self-perceived needs with respect to community development and leadership skills. Factors that would support or deter participation in a professional development program aimed at enhancing those skills were identified. The response rate to the questionnaire was 67.8%, representing nutritionists and dietitians from all but one Caribbean territory included in the survey. Analysis of the data revealed that respondents do perceive the need for professional development. This paper describes the specific needs identified and provides recommendations for addressing those needs through further collaboration between the two professional groups. It also calls for revisions to university curricula and practicum training programs so that new graduates will be better prepared to meet the challenges of future dietetic practice.     

Dietitians' and nutritionists' knowledge and views on aspects of health claims regulation in the UK: Do we inadvertently shoot the messenger?

Article 12(c) of the Nutrition and Health Claims Regulation (NHCR) prohibits authorised health claims in consumer-facing commercial communications which make reference to the recommendations of individual doctors or health professionals. However, this has been controversial amongst dietitians and nutritionists who work in commercial settings. Given the lack of empirical data, a survey was conducted amongst UK-based nutrition professionals to assess their knowledge of, and attitudes to, Article 12(c). The findings revealed confusion about the scope of the regulation and how it applies to working practices, with a considerable proportion of respondents being unable to recognise examples of commercial communications or health claims, indicating a need for additional training. There was also a broad interpretation of what nutrition professionals could, and could not, say about a hypothetical food product. This paper explores current guidance in Great Britain and debates the proportionality and fairness of Article 12(c), which, at present, does not regulate authorised health claims made by influencers or celebrities in commercial communications to consumers. It could be argued that consumers are better protected by the articulation of health claims by nutrition professionals who are guided by codes of practice rather than by unqualified, unregulated individuals. Hence, it is essential to level the regulatory playing field either by revising the NHCR to amend Article 12(c) or by updating the guidance to apply an interpretation of the Article's intention which enables a broader role for nutrition professionals in commercial communications. Such action would also be consistent with the UK's better regulation agenda to ensure evidence-based, proportionate regulation for industry.     

Public nutrition: Why,What, How?

Public Nutrition is a field of professional study and practice that has existed for many years without being named as such. It encompasses the disciplines that deal with factors affecting the food consumption and nutritional outcomes of populations, and goes beyond the definition of Public Health Nutrition by including the study of public policy in areas outside of health and nutrition as traditionally defined, that nonetheless can have profound effects on nutrition. Career paths in Public Nutrition exist at a variety of professional levels, including practitioners and direct service providers; administrators and planners; policy makers; and researchers and educators. The professional preparation of those working in Public Nutrition typically combines education and experience in nutritional science, social science, and sometimes management and planning. The field of Public Nutrition is important in providing a critical link between advances in understanding biomedical determinants of nutrition and the application of such understanding in programs and policies. However, the study of Public Nutrition goes beyond this: it represents an agenda of research and practice in its own right. Public Nutrition includes the study of how specific policies, in varying contexts, affect food consumption and nutrition outcomes; it includes the study of determinants of program effectiveness in improving these outcomes. Specific training programs in Public Nutrition do exist; the elements of a curriculum in Public Nutrition include social science research skills (data collection, management, analysis and interpretation), an understanding of economic, social, political, and behavioral determinants of food consumption, health and nutrition; a grounding in nutritional science. Field experience is an essential part of the preparation of Public Nutrition professionals.     

A demographic profile of Canadian public health nutritionists

The purpose of this study was to obtain a comprehensive demographic profile of public health nutritionists employed in provincial and municipal/regional departments of health in Canada in 1988. One hundred and fifty three (78%) of all eligible Canadian public health nutritionists responded to a mailed questionnaire. Almost all (98%) respondents were female, with a mean age of 35.8 +/- 7.2 years. Most nutritionists (83%) worked full time, and had been employed in public health for a mean of six years and nine months. Seventy percent of respondents had worked in another profession(s) or other area(s) of nutrition prior to entering public health. Although 65% were members of the management team or represented by a nutritionist on the management team, 25% of nutritionists were not regarded as members of senior management in their health agency. While the majority of nutritionists in Ontario (84%) had completed a graduate degree, this was the case for the minority of respondents from British Columbia (35%), the Prairies (32%), Quebec (33%), and Atlantic Canada (27%).     

Academy of Nutrition and Dietetics and National Kidney Foundation: Revised 2014 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent,Proficient, and Expert) in Nephrology Nutrition

Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition.     

7th International Food Data Conference: Food composition and biodiversity

The 7th International Food Data Conference “Food Composition and Biodiversity”, from 21–24 October 2007, was organized and convened by the University of Sao Paulo (USP), Department of Food Science and Experimental Nutrition of Pharmaceutical Science School of USP, the Brazilian Network of Food Data Systems (BRASILFOODS), and FAO, in conjunction with the FAO International Expert Consultation “Nutrition Indicators for Biodiversity” and the 9th National Congress of the Brazilian Society for Food and Nutrition. The scientific program had 55 oral presentations in the plenary sessions and 87 abstracts presented as posters. The complete articles (18) related to some of the presentations are being published in this issue. This conference was a unique opportunity for interaction between renowned researchers and participants from several countries, several international organs, Brazilian regulatory organs and government agencies, industries, nutritionists and other health professionals. This conference allowed us to exchange experiences and knowledge, structure new partnerships and discuss aspects that may improve the food composition area.     

Bioethics and biosafety: the use of biomaterials in dental practice

OBJECTIVE: To analyze the use of biomaterials in surgical procedures carried out by specialist dental surgeons, in light of the Principalist Bioethics Theory and the Individual and Collective Ethics of Responsibility. METHODS: Dental surgeons (n=95), who were registered as specialists at the Regional Dentistry Council of Brasilia as of 2002, completed questionnaires regarding the use of biomaterials in their work. Data relating to sanitary control were collated, based on these dental surgeons' responses and research at relevant organizations. RESULTS: All of the professionals in the survey used biomaterials on a regular basis; 45% believed their use to be risk-free for patients, and 48% did not classify biomaterials as drugs. About 70% of professionals trust the source of the biomaterials even though membranes and bones are the items most commonly bought from individual suppliers. Nonetheless, 96% of interviewees believed that government sanitation agencies should regulate more. More than half of the professionals (51%) pointed to little or no participation by the patient in the process of therapeutic choice. A copy of the informed consent form was provided by 12% of the dental surgeons interviewed produced. CONCLUSIONS: The results showed that the professionals use biomaterials without knowing about related risks and adverse side effects, contrary to the principle of beneficence. Government agencies and professional bodies alike do not show evidence of observing public responsibility ethics. Informed consent is not yet integrated fully into professional practice and the doctor-patient relationship in dentistry remains markedly vertical.     

Professional risk, knowledge, attitudes and practice of health care personnel in Serbia with regard to HIV and AIDS

The aim of our investigation was to assess HIV/AIDS-related professional risk, knowledge, attitude and practice of health care workers in Nis. A cross-sectional study of health personnel from Primary Health Centre, Clinical Medical Centre and Dental Clinic in Nis was performed. The data were collected by an anonymous questionnaire. Mantel-Haenszel X2 testing and multiple logistic regression analysis were applied. Results show that 89% of health personnel perceived high professional risk of acquiring HIV infection. The risk perception of acquiring HIV infections was higher among those who were frequently exposed to patients' blood and other body fluids (OR = 10.1 95% CI = 3.1-32.5), and those who had treated HIV-positive patients (OR = 3.0 95% CI = 1.0-8.8). The majority of respondents had insufficient knowledge about the modes of HIV transmission. Nearly two thirds of health personnel agreed that every hospitalized patient should be tested for HIV, and more than four fifths of them agreed that their personal protection was more important than the confidentiality of patient's HIV/AIDS status. Twenty nine percent of health personnel use adequate protection during their daily work with patients. These findings indicated a need for urgent educational and training initiatives of HIV and AIDS for all categories of health care workers.     

The professional self-evaluation of immigrant physicians from the former Soviet Union in Israel

This study tests the hypothesis that the personal construction of a positive professional identity is central to immigrant physicians' psychosocial well-being. Data are derived from responses to structured questionnaires from the first and third stages of a 5-year, three-stage cohort study of physicians who immigrated to Israel from the former Soviet Union in 1990. At the third stage of the study, in 1995, 387 physicians were working as physicians of a total of 519 respondents. Previous analyses of this research population showed that the immigrants who obtained work in their profession had significantly higher scores on a variety of indicators of psychosocial well-being than those who did not. In this paper, which narrows its focus to those who were working as physicians in 1995, significant positive relationships were found among three measures of self-evaluation, and between professional self-esteem, global self-esteem, and work satisfaction, and adaptation to life in Israel. General practitioners and specialists scored higher on professional self-evaluation than residents. Women scored higher than men, and older respondents (age's 36–45) scored higher than younger respondents (ages 25–35). The immigrant physicians viewed themselves as similar to their Israeli-trained colleagues in terms of their professional role behavior and were particularly positive about their diagnostic skills and the quality of their relationships with their patients. These findings are discussed in terms of role theory, which suggests that the work role of professionals is the most salient component of their self-identify.     

Public health nutrition practices to prevent low birth weight in eight southeastern states.

This study was conducted to identify current public health nutrition practices for the prevention and treatment of low-birth-weight (LBW) infants in eight southeastern states. Nutrition personnel (n = 1,054) were mailed a 51-item questionnaire with three parts that sought information on the respondents' professional backgrounds and employment status and on practice and standards of care for women before and during pregnancy and of LBW infants. Results based on a 62% response rate indicated 73% had worked in public health nutrition for 2 to 9 years, 56% were direct care providers, and 51% had bachelor's degrees. Only 40% of respondents indicated that their agencies had prepregnancy nutrition intervention protocols, whereas 89% indicated that they had high-risk pregnancy screening protocols and 91% indicated that they had high-risk treatment protocols. More than 91% indicated that their treatment protocols included guidelines for weight gain, preparation of nutrition care plans, and assessment of dietary and biochemical factors, health behavior, and obstetric history. Only 73% indicated inclusion of assessment of educational level. Nutritionists saw high-risk pregnant women (or those at risk for preterm labor) slightly more frequently during pregnancy than they saw low-risk women; however, the range (0.9 to 3.8 vs 0.5 to 2.3) and average (2.0 vs 1.2) number of visits for both groups differed only slightly. Nutritionists counseled women and charted in the medical record more frequently than they used nutrition care plans. To reduce LBW, nutritionists should implement treatment protocols and monitor high-risk women closely. The relationship between pre-pregnancy nutrition interventions and birth weight should be investigated.     

Strategic planning: public health nutritionists strengthen their capacity to function in a changing environment

In 1987, the public health nutritionists who work in Ontario's 42 health units and the Ministry of Health, initiated a province-wide strategic planning process. That same year, three major reports received by the Ontario Ministry of Health proposed new directions for health services. This article briefly describes the strategic planning process used by the nutritionists and presents the resulting "Strategic Plan for Nutrition in Public Health." It also reviews the three reports and illustrates how they support the priorities established by the nutritionists under four major themes: data needs and data collection; economic/environmental issues; program/service issues; and professional issues. The relevance and significance of the parallels among the reports and strategic plan are explored.     

Satisfaction of recent University of British Columbia dietetics graduates with undergraduate education and current job

This study was designed to investigate the career status of recent University of British Columbia (UBC) dietetics graduates and their satisfaction with undergraduate education and current job. All graduates from the UBC Dietetics Program between 1978-1987, inclusive (n = 238), were mailed questionnaires. Information was sought regarding success in obtaining a dietetic internship, current employment status, job satisfaction, and satisfaction with undergraduate education. Questionnaires were returned by 67% (n = 130) of those who received them. Approximately 83% were eventually successful in obtaining an internship. Most respondents (68.5%) were employed as dietitian/nutritionists, and 69% of those who were employed worked full-time. Those who interned had significantly higher salaries than those who did not. A measure of overall job satisfaction revealed that 89.6% were satisfied to very satisfied with their present job, and scores on the Brayfield-Rothe Index of Job Satisfaction revealed no differences between those who did and did not intern. With regard to undergraduate education, respondents were most satisfied with library resources, class size and quality of teaching, and least satisfied with internship opportunities. Those who had interned were significantly more satisfied with their undergraduate education than were those who had not. We conclude that success in obtaining a dietetic internship affects salary and satisfaction with undergraduate education, but does not affect job satisfaction.     

公共卫生专业人员参与健康科普现状及需求调查分析

目的 了解我国公共卫生专业人员参与健康科普活动现状及其健康科普能力培训需求。方法 选取2017年11月参加中华预防医学会第五届学术交流会的全国公共卫生专业人员进行问卷调查，分析健康科普活动参与率及其影响因素、健康科普能力建设需求以及面临的主要问题。结果 本研究共纳入499名调查对象，314名（62.9%）参与过健康科普活动；女性、中级以及副高及以上职称（OR = 2.086，95%CI:1.362～6.879，P = 0.001；OR = 0.514，95%CI:0.290～0.908，P = 0.022；OR = 0.325 95%CI:0.145～0.729，P = 0.006）是影响公共卫生专业人员参与健康科普活动的影响因素。在479名调查对象中希望获得“综合性专业科普知识”“专业表达、沟通和演讲技巧”“多媒体应用技能”分别占66.2%、51.8%、37.4%。在476名调查对象中认为开展健康科普活动面临策划、资金、组织、实施困难分别占56.9%、46.8%、28.4%、25.6%。结论 我国半数以上公共卫生专业人员参与过健康科普活动，公共卫生专业人员尤其是30岁以下或职称较低者的健康科普活动参与率较低。开展健康科普的主要动因与工作岗位相关，因兴趣爱好参与健康科普活动的比例低于科技工作者的整体水平。需健全公共卫生专业人员参与健康科普的激励机制，加大培训力度，加强专业人员健康科普能力建设。     

Report on Clinical Nutrition Research Units

The National Institutes of Health support seven Clinical Nutrition Research Units, which are designed to create or strengthen nutrition research, training, and education through coordinated effort, intellectual stimulation, and use of shared resources. Research at the participating institutions focuses on the role of nutrition in cancer, cardiovascular disease, renal disease, digestive diseases, cystic fibrosis, diabetes, and other illnesses. Contributing substantially to the development of this nutrition research base have been Clinical Nutrition Research Unit-supported pilot studies, core laboratories, and new investigators. In the clinical setting, Clinical Nutrition Research Unit Nutritional Support Services assist in the care of patients receiving total parenteral nutrition and those with anorexia nervosa, burns, cancer, and a spectrum of nutrition-related problems. Participation of Clinical Nutrition Research Unit staff in training activities range from undergraduate, graduate, and postgraduate education courses for medical students and other health professionals to continuing education workshops, lecture series, and information programs for professional and lay audiences.     

Organisation,niveaux de prise en charge de la dénutrition et place des acteurs de santé dans les parcours de soins en nutrition à l’hôpital et en ville

This paper describes the role of actors in the coordinated healthcare circuit in hospital and ambulatory. At the hospital, the respective roles of each intervener depend on their organization. The transversal organization and the creation of dietetics-nutrition unit could improve the efficiency of the management. This organization sets the level of intervention of each professional involved. Dieticians and nutritionists are central to the management but teaching in adapted physical activity must find its place in the coordinated healthcare circuit of malnourished patients in the hospital and in ambulatory. The role of liberal nutritionist currently very limited has to be discussed. Finally, the general practitioner has a central role in the coordinated healthcare circuit and should have access to coordination platforms allowing patients to access to dieticians and to teachers in adapted physical activity, currently unsupported. This article largely repeats the teaching synthesis on coordinated healthcare circuit in health facilities, incorporates proposals made by the French Society of Clinical Nutrition and Metabolism (SFNEP) for actions in the “Plan National Nutrition Santé” 2011–2015 and proposes changes in the organization in the coordinated healthcare circuit and in the role of actors.     

Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent,Proficient, and Expert) in Pediatric Nutrition

Pediatrics spans the first 2 decades of life and is a dynamic period with rapid changes in size and physical ability, cognitive development, behavior, and nutrient needs. Registered dietitian nutritionists (RDNs) who work with the pediatric population provide the nutrition knowledge and support needed to promote optimal health and nutrition during this time across a variety of settings. The Pediatric Nutrition Practice Group, along with the Academy of Nutrition and Dietetics Quality Management Committee, have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs working with pediatric populations. The SOP and SOPP for RDNs in Pediatric Nutrition provide indicators that describe 3 levels of practice: competent, proficient, and expert. The SOP uses the Nutrition Care Process and clinical workflow elements for delivering patient/client care. The SOPP describes the 6 domains that focus on professional performance. Specific indicators outlined in the SOP and SOPP illustrate how these standards apply to practice. The SOP and SOPP are intended to be used as a self-evaluation tool for assuring competent practice in pediatric nutrition and for determining potential education and training needs for advancement to a higher practice level in a variety of settings.     

The Next Generation of Dietitians: Implementing Dietetics Education and Practice in Integrative Medicine

Integrative medicine is a quickly expanding field of health care that emphasizes nutrition as a key component. Dietitians and nutritionists have an opportunity to meet workforce demands by practicing dietetics and integrative medicine (DIM). The purpose of this article is to describe a DIM education program and practicum. We report the results of an interprofessional nutrition education and practicum program between the University of Kansas Medical Center (KUMC) Department of Dietetics and Nutrition and KU Integrative Medicine. This partnered program provides training that builds on the strong foundation of the Nutrition Care Process and adds graduate-level educational and practicum experiences in foundational integrative medicine knowledge, including nutritional approaches from a systems biology perspective, nutrigenomics, and biochemistry as the core knowledge to understand the root cause of a chronic disorder and to choose appropriate nutritional tools for interventions. This interprofessional KUMC program provides a dietetic internship, master's degree, and graduate certificate in DIM and fulfills a need for dietitians and nutritionists who seek careers practicing in an integrative medicine setting. The program fulfills expanding workforce needs to provide quality health care for patients with chronic illnesses.     

The field of Food and Nutrition from the perspective of comprehensive theories

The present article is a brief reflection on the field of Food and Nutrition as it interconnects with the humanities. Relevant theorists' thinking as well as the experience of the authors were used as references. The main purpose is to stimulate the discussion on the food-and-nutrition issue, taking into account the complexities involved in the relations between food consumption and dietetics. Also it is expected to motivate nutritionists to reflect upon their professional practice. Incorporating the use of hermeneutics for the comprehension of the subject is justified in terms of its methodological significance. The importance of taking action in guiding food consumption through the association of the technical knowledge of the field with various perspectives of comprehensive theories is also discussed.