OBJECTIVES: To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education.DESIGN: Cross-sectional and longitudinal research (2004-2010).SETTING: Data collection by 7 d dietary record and questionnaire.SUBJECTS: Dutch nutrition and dietetics students.RESULTS: Three hundred and fifty-two first-year and 216 fourth-year students were included. One hundred and thirty-three students in three cohorts were assessed twice. Of first-year students, >80 % met the RDA for all macronutrients. Of these students only 37 % met the RDA for fibre and in 43 % intake of saturated fat was too high. Fourth-year students more often met the RDA for fruits (55 %) and vegetables (74 %) compared with first-year students (32 % and 40 %, respectively). Intake of fruits and vegetables of both first- and fourth-year students was much higher than that of DNFCS participants (where 2 % and 7 %, respectively, met the corresponding RDA). Only <25 % of fourth-year students met the RDA for Fe, Se and vitamin D. In the cohorts, dietary intake for all macronutrients stabilised from the first to the fourth year (>80 %). Intakes of dietary fibre, Ca, Mg, Se, riboflavin, niacin, fruits, vegetables and fish improved significantly during education.CONCLUSIONS: Dietary intake of nutrition and dietetics students is much better than that of DNFCS participants and improved during education. However, there is still a gap between actual dietary intake and the RDA, especially for Fe, Se and vitamin D.
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BACKGROUND & AIMS: Dietetic interventions contribute to certain health objectives and other outcomes, but are mostly part of a multimodal and multidisciplinary approach what makes evaluating the actual effects of dietitians' involvement rather complex. Although monitoring and outcome evaluation (M&OE) can provide routine data to prove the effectiveness of dietetic interventions, this has not been established yet in different dietetic settings.METHODS: A comprehensive framework for M&OE in dietetics was developed by dietetic experts from five European higher education institutes for dietetics in the course of the EU sponsored project "Improvement of Education and Competences in Dietetics (IMPECD)".RESULTS: Firstly, clear definitions on M&OE are proposed to facilitate the use of consistent terminology, with a specific emphasis on the term "impact" covering macro-level outcomes such as cost-effectiveness. Secondly, the Dietetic Care Process (DCP) was merged into a logic model to demonstrate the position of M&OE in relation to intervention planning and implementation, in both group and individual settings. Thirdly, selecting the appropriate indicators is indispensable to monitor and evaluate outcomes, and requires a high level of dietitians' critical reasoning. A categorized overview of indicators is provided to support this process. Lastly, the consortium developed a checklist to give dietitians a handle on what elements could be included in their M&OE plan and trigger them to perform M&OE in practice.CONCLUSIONS: Innovative M&OE models may help dietitians to demonstrate their effectiveness in improving clinical outcomes and justify their role in health care.
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Using a Dietetic Care Process (DCP) can lead to improved application of evidence-based guidelines and critical thinking in dietetics. One aim of the project Improvement of Education and Competences in Dietetics (IMPECD) is to develop a unified DCP for international educational purposes. Therefore, a comparison of European DCPs was needed.A concise literature search and semi-structured interviews with experts representing the full EFAD (European Federation of the Associations of Dietitians) member states were conducted from June to October 2017.16 out of 23 EFAD member states responded (70%) from which 13 indicated to use a DCP. Eight different DCPs were found, with four to six core steps and three graphical representations. In one country the use of a dietetic process is indicated by law. The DCPs have more similarities than differences as they follow the same principles. Differences in language or form may not limit the improvement in collaboration and international exchange in dietetic practice. These results provide a good basis for the development of a unified DCP for educational purposes.
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Interprofessional Education (IPE) as a preparatory stage for Interprofessional collaboration (IPC) is overlooked in some low-and middle-income countries, including Indonesia. One of the driving forces behind IPC is the development of Interprofessional Identity (IPI), which has yet to be assessed in the Indonesian context. Our study aims were translating and culturally adapting the Extended Professional Identity Scale (EPIS) and confirming its construct validity. We invited third-year students from three programs (medicine, nursing, and dietetics) without previous IPE experience to participate in the study. Using Confirmatory Factor Analysis (CFA), we examined the construct validity, analyzed internal consistency, and conducted a Kruskal–Wallis test to identify variations across professions. Of 513 students approached, 335 participated (response rate 65.3%). The CFA showed factor loadings ranging between.59 and.86, while correlations among subscales varied from.55 to.86. All five goodness-of-fit indices were sufficient. The internal consistency of subscales interprofessional belonging, commitment, and beliefs was.82,.84 and.87, respectively, and.90 for the overall scale. Interprofessional belonging and commitment were different among various students (p-value =.009 and.004) and the dietetics students had lower scores than other students. The Indonesian EPIS (EPIS-RI) demonstrated reliability and construct validity.
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Increasing flexibilisation and personalisation of education creates challenges in terms ofstudents’ social connectedness with each other, with the programme and with lecturers.For this reason, a team of researchers and professors from four universities of applied sciences in the Netherlands carried out research into how a sense of community can be created in learning communities. On the basis of a literature review and design-oriented research, we conducted experiments aimed at fostering social connectedness in eight learning communities. These learning communities were in the domains of Nursing, Healthcare and Welfare Teacher Training, Management in Care, Teacher Training, and Nutrition and Dietetics (part-time, full-time and dual programme variants).
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BACKGROUND & AIMS: Although up-to-date definitions for nutrition assessment integrate behavioural components, it is not clear what behavioural components are to be assessed. Since behavioural modification is linked to effective therapeutic dietetic interventions, assessing behaviour and factors influencing behaviour might be beneficial to improve personalized dietetic outcome. The aim of the following report is to emphasize the role of behavioural components and factors affecting behaviour at baseline nutrition assessment in personalized dietetic intervention.METHODS: The present work is part of the EU-funded project IMPECD ("Improvement of Education and Competences in Dietetics", www.impecd.eu). The project aims to improve the clarity and consistency of national dietetic process models to unify education and training of future dietitians. Experts from five European Universities of Applied Sciences (UAS) in Antwerp (BE), Fulda (DE), Groningen (NL), Neubrandenburg (DE) and St. Pölten (AT) developed a Massive Open Online Course (MOOC) consisting of several clinical cases. It warranted a detailed evaluation of all dietetic care process steps, starting with nutrition assessment.RESULTS: Results for motivation assessed during nutrition assessment are not consistently positively associated with outcome and the added value of assessing them at baseline is still unclear. However, depressive symptoms, emotional distress, and anxiety negatively affect eating and physical activity and therefore limit the efficacy of the dietetic intervention. Assessing behavioural components including nutrition literacy is an important precondition for influence on behavioural modification.CONCLUSION: Indisputably, baseline assessment of behavioural components and factors influencing behaviour are important to increase the therapeutic efficacy of personalized dietetic interventions.
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The aim of this research was to gain evidence based arguments for the use of the scoring rubric for performance assessment of information literacy [1] in Dutch Universities of Applied Sciences. Faculty members from four different departments of The Hague University were interviewed on the ways in which they use the scoring rubric and their arguments for it. A fifth lecturer answered the main question by email. The topic list, which has been used as a guide for the interviews, was based on subject analysis of scholar literature on rubric use. Four of the five respondents used (parts of) the rubric for the measurement of students’ performances in information use but none of them used the rubric as it is. What the faculty staff told the researcher is that the rubric helped them to improve the grading criteria for existing assignments. Only one respondent used the rubric itself, but this lecturer extended it with some new criteria on writing skills. It was also discovered that the rubric is not only used for grading but also for the development of new learning content on research skills. [De hier gepubliceerde versie is het 'accepted paper' van het origineel dat is gepubliceerd op www.springerlink.com . De officiële publicatie kan worden gedownload op http://link.springer.com/chapter/10.1007/978-3-319-03919-0_58]
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Cliënten, hun naasten en voedingsprofessionals (diëtisten en voedingskundigen) worden geconfronteerd met technologieën gericht op het verbeteren of behouden van gezondheid en/of kwaliteit van leven. Technologieën worden tevens ingezet om de efficiëntie en/of kosteneffectiviteit van zorg te verbeteren. Voorbeelden hiervan zijn beeldschermzorg en ziekte specifieke apps voor de smartphone. De perspectieven van alle betrokkenen in een praktijksituatie in de gezondheidszorg bepalen hoe technologieën gebruikt worden. In dit hoofdstuk worden verschillende perspectieven op technologie, gezondheid en zorg bediscussieerd en worden dilemma’s beschreven die hieruit kunnen ontstaan. Theorie en praktijk tonen het belang van bewust nadenken over de eigen, persoonlijke perspectieven op technologie, gezondheid, voeding en zorg en over perspectieven van anderen. Conclusie: diëtisten en voedingskundigen hebben de verantwoordelijkheid om sensitiviteit te ontwikkelen voor potentiële dilemma’s bij het gebruik van technologieën om daar in de praktijk zorgvuldig mee om te gaan.
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Malnutrition, especially among the elderly in the healthcare environment, is a prevalent problem in The Netherlands, affecting both patients and the healthcare budget. Although oral nutritional supplements (ONS) are often used to restore the nutritional status of a patient, the evaluated current available literature failed to show a coherent picture of the effectiveness of ONS in malnourished patients. In the present study, we used a qualitative research approach to gain insight in the treatment of malnutrition via ONS and food snacks in a single non-academic teaching hospital. Twelve semi-structured interviews with stakeholders (such as dieticians, nurses, care-assistants, physician) were held. Results indicated opportunities for further improvement, for example through the introduction of a screening tool for malnutrition in cognitive impaired patients, better timing for handing out the daily meal plan forms, and improved range and provision of snacks. The stakeholders indicated that taste and physical properties of ONS, but also social environment as well as the physical/mental state and motivation of a patient are important facilitators which should be considered during the prescription. In conclusion, to optimize treatment of malnutrition using ONS and food snacks, the above mentioned opportunities to better match the needs of malnourished patients have to be tackled. Involvement of the different stakeholders within the healthcare facility will be important to implement required changes in nutritional practice.
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Background Physical activity after bariatric surgery is associated with sustained weight loss and improved quality of life. Some bariatric patients engage insufficiently in physical activity. The aim of this study was to examine whether and to what extent both physical activity and exercise cognitions have changed at one and two years post-surgery, and whether exercise cognitions predict physical activity. Methods Forty-two bariatric patients (38 women, 4 men; mean age 38 ± 8 years, mean body mass index prior to surgery 47 ± 6 kg/m²), filled out self-report instruments to examine physical activity and exercise cognitions pre- and post surgery. Results Moderate to large healthy changes in physical activity and exercise cognitions were observed after surgery. Perceiving less exercise benefits and having less confidence in exercising before surgery predicted less physical activity two years after surgery. High fear of injury one year after surgery predicted less physical activity two years after surgery. Conclusion After bariatric surgery, favorable changes in physical activity and exercise cognitions are observed. Our results suggest that targeting exercise cognitions before and after surgery might be relevant to improve physical activity.
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