Closing the Gap in Nutrition Care at Outpatient Cancer Centers: Ongoing Initiatives of the Oncology Nutrition Dietetic Practice Group

Abstract Objectives Nutritional services are a critical component of cancer care, yet Registered Dietitian Nutritionist (RDN) staffing patterns in outpatient cancer centers are poorly documented. The objective of this study was to inform availability of nutrition services by examining RDN staffing and utilization in outpatient cancer centers nationwide. Methods An online questionnaire was developed and approved by the Oncology Nutrition Dietetic Practice Group (a practice group of the Academy of Nutrition and Dietetics) and The Ohio State University Institutional Review Board. The deidentified survey was intended for RDNs who practice at outpatient oncology centers and distributed via Academy email in fall 2017. To avoid duplication, each respondent was prompted to submit one survey per center. Annual analytic cases, representing unique new patients diagnosed and treated at each center, were collected. Data on RDN staffing patterns, reimbursement for services, and malnutrition screening practices were analyzed. Results Over one year, 310 surveys were submitted and 206 provided usable data. Of those, 82% of the centers reported at least one dedicated RDN on staff with an average of 1.7 RDN full-time equivalents. The mean annual analytic cases reported were 2043, representing a RDN-to-patient ratio of 1:1202. During this time, RDNs evaluated an average of 7.5 patients per day, yet 48% of centers did not bill for nutrition services. Over half (54%) of the participating facilities screened for malnutrition using a validated or adapted screening tool, such as the Malnutrition Screening Tool. Conclusions This is the first comprehensive, national study to inform nutrition care provider-to-patient ratio in cancer centers which have at least one dedicated RDN. Screening for malnutrition and billing for nutritional evaluations were not widely practiced in the participating facilities. Our findings indicate that the majority of cancer centers nationally are providing inadequate RDN coverage and have low utilization of nutrition services. Funding Sources N/A.

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Improving services for those who serve: A private practice initiative to improve psychiatric care for first responder and military patients

Australasian Psychiatry ◽

10.1177/10398562211057873 ◽

2021 ◽

pp. 103985622110578

Author(s):

Jamalulhak Amir Izzat ◽

Galletly Cherrie ◽

Ford Nick

Keyword(s):

Private Practice ◽

Psychiatric Care ◽

Interdisciplinary Communication ◽

South Australia ◽

Practice Group ◽

Referral Service ◽

Timely Access ◽

Professional Isolation ◽

Closing The Gap ◽

Military Patients

Objectives Professional isolation and limited opportunities for multidisciplinary collaborations are well-recognised challenges for psychiatrists in private practice. This narrative paper describes the development of a private practice group to assist first responders (FRs) and military patients located in Adelaide, South Australia. The aims included both peer review, and interdisciplinary communication and collaboration. Relevant personnel in the ambulance, police and fire services, military and veterans’ groups, and the compensation system, participated in monthly meetings. Lack of timely access to psychiatric care for FR and military patients was identified as a problem and an expedited referral service was established. Conclusions The Closing the Gap Group was established in 2017. The terminology refers to the gap between treating psychiatrists and the complex organisations that manage the workplace context for FR/military patients. This initiative provides a template for private practice innovations to improve psychiatrists’ skills and knowledge, along with better engagement and understanding between private psychiatrists and relevant community organisations.

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Examining Access to Nutrition Care in Outpatient Cancer Centers

10.17226/23579 ◽

2016 ◽

Cited By ~ 2

Author(s):

◽

Keyword(s):

Cancer Centers ◽

Nutrition Care

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Knowledge, Perceptions and Practices of Registered Dietitians in the Dietetic Practice Group, Consultant Dietitians in Health Care Facilities, Regarding the American Dietetic Association's Standardized Language to Document the Nutrition Care Process

Journal of the American Dietetic Association ◽

10.1016/j.jada.2009.06.010 ◽

2009 ◽

Vol 109 (9) ◽

pp. A10 ◽

Cited By ~ 1

Author(s):

T. Regan ◽

J. O'Sullivan Maillet ◽

R. Touger-Decker ◽

H. Khan ◽

L. Byham-Gray ◽

...

Keyword(s):

Health Care ◽

Health Care Facilities ◽

Care Process ◽

Registered Dietitians ◽

Practice Group ◽

Nutrition Care ◽

Care Facilities ◽

Nutrition Care Process

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Closing the GAP—A 5Å Scanning Microscope

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100061938 ◽

1969 ◽

Vol 27 ◽

pp. 6-7

Author(s):

A. V. Crewe

Keyword(s):

Normal Form ◽

The Other ◽

Resolving Power ◽

Scanning Microscope ◽

Conventional Microscope ◽

Other Hand ◽

Closing The Gap ◽

Thermal Sources ◽

Better Than ◽

Transmission Microscope

We have become accustomed to differentiating between the scanning microscope and the conventional transmission microscope according to the resolving power which the two instruments offer. The conventional microscope is capable of a point resolution of a few angstroms and line resolutions of periodic objects of about 1Å. On the other hand, the scanning microscope, in its normal form, is not ordinarily capable of a point resolution better than 100Å. Upon examining reasons for the 100Å limitation, it becomes clear that this is based more on tradition than reason, and in particular, it is a condition imposed upon the microscope by adherence to thermal sources of electrons.

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