A realist review of educational interventions to improve the delivery of nutrition care by doctors and future doctors

Malnutrition results in increased duration of patient stay and increases hospital costs. However, few studies address this issue in the Indian context. A recent UK study showed that intensive nutrition training was effective in increasing awareness of health professionals. In order to inform such educational interventions in India, a needs assessment was conducted in Kolkata by measuring doctors’ and dietitians’ attitudes and confidence regarding nutrition care, advocacy, and leadership. A total of 123 doctors (including general medicine, endocrinology, and critical care) and 56 dietitians completed a questionnaire. Doctors displayed moderate confidence in providing nutrition care but were less confident in their skills relating to advocacy and leadership. Dietitians displayed greater confidence than doctors in providing nutrition care but similarly lacked confidence in skills relating to advocacy and leadership. Overall, doctors and dietitians displayed equally positive attitudes towards nutrition in patient care. The greater confidence of dietitians compared to doctors in providing nutrition care may be the result of specialised training. Despite the limitations of this study, this paper provides a first glance at the gaps in nutritional practice within the doctors and dietitians community of Kolkata such that targeted future studies can now be planned.

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Enhancing health care professionals’ knowledge of childhood sexual abuse through self-assessment: A realist review

10.21203/rs.3.rs-127743/v1 ◽

2020 ◽

Author(s):

Olumide Adisa ◽

Katherine Allen ◽

Katie Tyrrell

Keyword(s):

Sexual Abuse ◽

Health Care Professionals ◽

Good Practice ◽

Realist Review ◽

Adult Survivors ◽

Educational Interventions ◽

Assessment Tools ◽

Future Research ◽

Programme Theory ◽

Self Assessment

Abstract Background Healthcare professionals (HCPs) are well-placed to facilitate disclosures by child sexual abuse/exploitation (CSA/E) survivors and promote timely access to specialist support. However, research with HCPs shows that many are reluctant to enquire about abuse and feel underprepared to deal with disclosures. Self-assessment offers a participatory approach that may be employed as part of a suite of educational interventions to increase HCP knowledge and confidence. As a complex intervention involving multiple steps and actors, its effectiveness is contingent on organisational contexts. Realist reviews offer a theory-driven and contextually sensitive approach for understanding the mechanisms of change that generate specific outcomes, enabling reviewers to identify generalisable insights on how and why programmes work. Methods We adopted a realist approach to answer the following questions: how are CSA/E self-assessment tools currently being used by HCPs, what does ‘good practice’ in the use of such tools look like, under what circumstances are existing tools effective, and why? Guided by Pawson’s 5 stages, we conducted a realist review of abuse-related self-assessment tools for HCPs. Following preliminary scoping of the literature, we developed an initial programme theory which informed our search strategy and theoretical framework. Results 25 items met criteria for data extraction, and relevant contexts (C), mechanisms (M) and outcomes (O) were identified and mapped. Eight of these were included in the final synthesis. We identified two key ‘families’ of abuse-related self-assessment for healthcare contexts: PREMIS, a validated survey instrument to assess HCP knowledge, confidence and practice in relation to domestic violence and abuse (DVA); Trauma-informed practice/care (TIP/C) organisational self-assessment protocols. Two revised programme theories were formulated: 1. Individual self-assessment can promote organisational accountability 2. Organisational self-assessment can increase the coherence and sustainability of changes in practice. Conclusions Our review contributes to the evidence base on improving healthcare responses to CSA/E survivors, illustrating that self-assessment tools or protocols specifically designed to improve HCP responses to adult survivors of CSA/E remain under-developed and under-studied. Refined programme theories developed during synthesis regarding DVA and TIP/C related tools or protocols suggest areas for CSA/E-specific future research with stakeholders and service users.

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Why we need to seek the perspectives of young people with SEBD about the effectiveness of educational interventions made with them

PsycEXTRA Dataset ◽

10.1037/e739422011-051 ◽

2007 ◽

Author(s):

Frances Toynbee

Keyword(s):

Young People ◽

Educational Interventions

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Naming Nutrition Injustice: How Might Dietitians Articulate a Socially Just Dietetic Practice?

Critical Dietetics ◽

10.32920/cd.v4i2.1321 ◽

2019 ◽

Vol 4 (2) ◽

pp. 6-17

Author(s):

Jennifer Brady

Keyword(s):

Conceptual Framework ◽

Food Justice ◽

Care Process ◽

Nutrition And Health ◽

Nutrition Care ◽

The Everyday ◽

Willingness To Change ◽

Paper Work ◽

Nutrition Care Process ◽

Primary Care Institutions

This paper invites readers to consider how the ideals, concepts, and language of nutrition justice may be incorporated into the everyday practice of clinical dietitians whose work is often carried out within large, conservative, primary care institutions. How might clinical dietitians address the nutritional injustices that bring people to their practice, when practitioners are constrained by the limits of current diagnostic language, as well as the exigencies of their workplaces. In the first part of this paper, I draw on Cadieux and Slocum’s work on food justice to develop a conceptual framework for nutrition justice. I assert that a justice-oriented understanding of nutrition redresses inequities built in to the biomedicalization of nutrition and health, and seeks to trouble by whom and how these are defined. In the second part of this paper, I draw on the conceptual framework of nutrition justice to develop a politicized language framework that articulates nutrition problems as the outcome of nutritional injustices rather than individuals’ deficits of knowledge, willingness to change, or available resources. This language framework serves as a counterpoint to the current and widely accepted clinical language tool, the Nutrition Care Process Terminology, that exemplifies biomedicalized understandings of nutrition and health. Together, I propose that the conceptual and language frameworks I develop in this paper work together to foster what Croom and Kortegast (2018) call “critical professional praxis” within dietetics.

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Incidence of nonaccidental head trauma in infants: a call to revisit prevention strategies

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.7.peds195 ◽

2019 ◽

Vol 24 (6) ◽

pp. 689-696 ◽

Cited By ~ 1

Author(s):

LaVerne W. Thompson ◽

Kathryn D. Bass ◽

Justice O. Agyei ◽

Hibbut-Ur-Rauf Naseem ◽

Elizabeth Borngraber ◽

...

Keyword(s):

New York ◽

Parent Education ◽

Shaken Baby Syndrome ◽

Retrospective Chart Review ◽

Educational Interventions ◽

Significant Rise ◽

Significant Incidence ◽

Significant Difference ◽

Icd 10 ◽

Parent Education Programs

OBJECTIVETraumatic brain injury is a major sequela of nonaccidental trauma (NAT) that disproportionately affects young children and can have lasting sequelae. Considering the potentially devastating effects, many hospitals develop parent education programs to prevent NAT. Despite these efforts, NAT is still common in Western New York. The authors studied the incidence of NAT following the implementation of the Western New York Shaken Baby Syndrome Education Program in 1998.METHODSThe authors performed a retrospective chart review of children admitted to our pediatric hospital between 1999 and 2016 with ICD-9-CM and ICD-10-CM codes for types of child abuse and intracranial hemorrhage. Data were also provided by the Safe Babies New York program, which tracks NAT in Western New York. Children with a diagnosis of abuse at 0–24 months old were included in the study. Children who suffered a genuine accidental trauma or those with insufficient corroborating evidence to support the NAT diagnosis were excluded.RESULTSA total of 107 children were included in the study. There was a statistically significant rise in both the incidence of NAT (p = 0.0086) and the incidence rate of NAT (p = 0.0235) during the study period. There was no significant difference in trendlines for annual NAT incidence between sexes (y-intercept p = 0.5270, slope p = 0.5263). When stratified by age and sex, each age group had a distinct and statistically significant incidence of NAT (y-intercept p = 0.0069, slope p = 0.0374).CONCLUSIONSDespite educational interventions targeted at preventing NAT, there is a significant rise in the trend of newly reported cases of NAT, indicating a great need for better injury prevention programming.

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