Exploring the views of young women and their healthcare professionals on dietary habits and supplementation practices in adolescent pregnancy: a qualitative study

Background: Nutrition is a modifiable factor affecting foetal growth and pregnancy outcomes. Inadequate nutrition is of particular concern in adolescent pregnancies with poor quality diet and competing demands for nutrients. The aim of this study was to explore knowledge and understanding of nutrition advice during adolescent pregnancy,and identify barriers and facilitators to dietary change and supplementation use in this vulnerable population. Methods: Semi-structured interviews were conducted with young women and key antenatal healthcare providers: midwives, family nurses and obstetricians. Doncaster, Manchester and London were chosen as sites offering different models of midwifery care alongside referral to the Family Nurse Partnership programme. Results: A total of 34 young women (adolescents aged 16–19 years) and 20 health professionals were interviewed. Young women made small changes to their dietary intake despite limited knowledge and social constraints. Supplementation use varied; the tablet format was identified by few participants as a barrier but forgetting to take them was the main reason for poor adherence. Health professionals provided nutrition information but often lack the time and resources to tailor this appropriately. Young women’s prime motivator was a desire to have a healthy baby; they wanted to understand the benefits of supplementation and dietary change in those terms. Conclusion: Pregnancy is a window of opportunity for improving nutrition but often constrained by social circumstances. Health professionals should be supported in their role to access education, training and resources which build their self-efficacy to facilitate change in this vulnerable population group beyond the routine care they provide

The effects of an enhanced simulation programme on medical students' confidence responding to clinical deterioration

BACKGROUND: Clinical deterioration in adult hospital patients is an identified issue in healthcare practice globally. Teaching medical students to recognise and respond to the deteriorating patient is crucial if we are to address the issue in an effective way. The aim of this study was to evaluate the effects of an enhanced simulation exercise known as RADAR (Recognising Acute Deterioration: Active Response), on medical students’ confidence. METHODS: A questionnaire survey was conducted; the instrument contained three sections. Section 1 focused on students’ perceptions of the learning experience; section 2 investigated confidence. Both sections employed Likert-type scales. A third section invited open responses. Questionnaires were distributed to a cohort of third-year medical students (n = 158) in the North East of Scotland 130 (82 %) were returned for analysis, employing IBM SPSS v18 and ANOVA techniques. RESULTS: Students’ responses pointed to many benefits of the sessions. In the first section, students responded positively to the educational underpinning of the sessions, with all scores above 4.00 on a 5-point scale. There were clear learning outcomes; the sessions were active and engaging for students with an appropriate level of challenge and stress; they helped to integrate theory and practice; and effective feedback on their performance allowed students to reflect and learn from the experience. In section 2, the key finding was that scores for students’ confidence to recognise deterioration increased significantly (p. < .001) as a result of the sessions. Effect sizes (Eta(2)) were high, (0.68–0.75). In the open-ended questions, students pointed to many benefits of the RADAR course, including the opportunity to employ learned procedures in realistic scenarios. CONCLUSIONS: The use of this enhanced form of simulation with simulated patients and the judicious use of moulage is an effective method of increasing realism for medical students. Importantly, it gives them greater confidence in recognising and responding to clinical deterioration in adult patients. We recommend the use of RADAR as a safe and cost-effective approach in the area of clinical deterioration and suggest that there is a need to investigate its use with different patient groups

Associations of body mass index and waist circumference with: energy intake and percentage energy from macronutrients, in a cohort of australian children

Background: It is evident from previous research that the role of dietary composition in relation to the development of childhood obesity remains inconclusive. Several studies investigating the relationship between body mass index (BMI), waist circumference (WC) and/or skin fold measurements with energy intake have suggested that the macronutrient composition of the diet (protein, carbohydrate, fat) may play an important contributing role to obesity in childhood as it does in adults. This study investigated the possible relationship between BMI and WC with energy intake and percentage energy intake from macronutrients in Australian children and adolescents

Weight Care Project: Health professionals' attitudes and ability to assess body weight status - Study protocol

<p>Abstract</p> <p>Background</p> <p>Health professionals working in primary care and public health have opportunities to address body weight status issues with their patients through face-to-face contact. The objectives of this all-Ireland project are: 1. to assess the attitudes, current practices/behaviours and knowledge of key health professional groups on body weight status; 2. to assess the health professional groups' ability to identify body weight status in both adults and children. The health professional groups are: (a) community related public health nurses; (b) school public health nurses; (c) GPs and practice nurses (primary care); and (d) occupational health nurses (workplace) from both Northern Ireland and the Republic of Ireland.</p> <p>Methods/Design</p> <p>This all-Ireland multi-disciplinary project follows a mixed methods approach using both quantitative and qualitative methodologies, and consists of four components:</p> <p>1. Literature review - to explore the role of health professionals in managing obesity through spontaneous intervention in a variety of health promotion settings.</p> <p>2. Telephone interviews and focus groups - to gain an in-depth insight into the views of health professionals in assessing body weight status.</p> <p>3. Survey (primarily online but also paper-based) - to determine the attitudes, current practices/behaviours and knowledge of health professionals in assessing body weight status.</p> <p>4. Online evaluation study - an online interactive programme will be developed to assess health professionals' ability to identify the body weight status of adults and children.</p> <p>Discussion</p> <p>This project will assess and report the attitudes, current practices/behaviours and knowledge of key health professional groups within Northern Ireland and the Republic of Ireland on body weight status, and their ability to identify body weight status in both adults and children. The results of this project will generate recommendations for clinical practice in managing obesity, which may inform policy guidelines.</p

Hábitos alimentares de crianças eutróficas e com sobrepeso em Viçosa, Minas Gerais, Brasil Food habits of well nourished and overweight children in Viçosa, Minas Gerais state, Brazil

OBJETIVO: Comparar os hábitos alimentares entre crianças eutróficas e com sobrepeso. MÉTODOS: Estudo caso-controle com 50 crianças eutróficas e 50 com sobrepeso, pareadas de acordo com o sexo, idade e condição socioeconômica, selecionadas a partir da avaliação nutricional de 2.074 crianças, entre 6 e 8 anos, de escolas públicas e privadas da área urbana de Viçosa, Minas Gerais. O estado nutricional foi classificado pelo Índice de Massa Corporal, segundo o Centers for Disease Control and Prevention. Um questionário de freqüência alimentar seletivo de alimentos que contribuem para o sobrepeso, bem como recordatórios alimentares habituais relativos aos dias de semana e finais de semana foram aplicados, sendo, nestes últimos, avaliada a ingestão de energia, carboidrato, lipídio, proteína, vitamina C, vitamina A, ferro, cálcio e fibras. Um quarto questionário foi aplicado, a fim de analisar a prática de realizar dietas pelas crianças. RESULTADOS: Destaca-se a excessiva ingestão de alimentos pelo grupo com sobrepeso, evidenciando um maior consumo de energia, lipídio, carboidrato, proteína, vitamina C e vitamina A (p<0,05). Entretanto, os hábitos alimentares foram semelhantes em ambos os grupos. Um maior percentual de crianças com sobrepeso tinha hábito, passado e/ou atual, de realizar dietas (p<0,05). CONCLUSÃO: Este estudo confirma a importância do trabalho de reeducação nutricional, tanto em crianças eutróficas quanto naquelas com sobrepeso, ressaltando a necessidade de uma alimentação mais saudável e variada nesta faixa etária, bem como a conscientização quanto ao tamanho das porções ingeridas pelas crianças com sobrepeso.<br>OBJECTIVE: To compare the food habits between well nourished and overweight children. METHODS: Case-control study with 50 well nourished children and 50 overweight children, paired by gender, age and socioeconomic conditions. They were selected from the nutritional assessment of 2074 children aging from 6 to 8 years, enrolled in public and private schools of the urban area of Viçosa, Minas Gerais State. Nutritional status was classified according to the Body Mass Index criteria of the Center for Disease Control and Prevention. A food frequency questionnaire with the foods that contribute to overweight as well as the usual food recalls regarding week and weekend days were applied. The food recalls were also used to determine intake of energy, carbohydrates, lipids, proteins, vitamin C, vitamin A, iron, calcium and fibers. A fourth questionnaire was applied in order to determine if the children had the habit of going on diets. RESULTS: Food intake among overweight children was excessive. They had a higher intake of energy, lipids, carbohydrates, proteins, vitamin C and vitamin A (p<0.05). However, the food habits were similar in both groups. A high percentage of overweight children had the habit or have the habit of dieting (p<0.05). CONCLUSION: This study confirms the importance of educating both well nourished and overweight children with respect to diet. They need a healthier and more varied diet, especially at this age, and the overweight children need to make smaller meals