A case study of the impact of a dietitian in the multi‐disciplinary team within primary care: a service evaluation

AbstractBackgroundExpanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence suggests dietitians can improve patient outcomes and make cost savings. The present study aimed to evaluate a dietitian working as an expert generalist and first contact practitioner (FCP) in a general practice multi‐disciplinary team (MDT) to provide appropriate care to patients and reduce GP workload.MethodsA dietitian was employed for 6 months at 0.6 full‐time equivalents in a group of general practices in Devon, UK. Data were collected on the referral source, patient satisfaction, health outcomes and changes in prescribing data for all patients seen by the dietitian. Focus groups and interviews provided data to understand the experience of introducing a dietitian into the team.ResultsThis model of service delivery showed the dietitian acting as an expert generalist, a FCP and able to educate the MDT. A range of professionals within the MDT referred patients with a wide range of diagnoses (both paediatric and adults) and the dietitian acted as a FCP for 29% of patients. Saving were made for the optimisation of medicine management.ConclusionsThe dietitian can improve patient‐centred care for several patient groups; enhance learning for staff around nutrition and dietary issues; and contribute to more efficient working and cost savings around prescription of nutritional products. This was an evaluation of one service and further research is needed to understand the value dietitians can contribute and the factors supporting effective and efficient working in this context.</jats:sec

Efficacy of non-pharmacological interventions to treat malnutrition in older persons : A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL Knowledge Hub project

The preparation of this paper was supported by the MalNutrition in the ELderly (MaNuEL) knowledge hub. MaNuEL is supported by the Joint Programming Initiative ‘Healthy Diet for a Healthy Life’. The MaNuEL funding agencies supporting this paper are (in alphabetical order of participating Member State): France: Ecole Supérieure d’Agricultires (ESA); Germany: Federal Ministry of Food and Agriculture (BMEL) represented by Federal Office for Agriculture and Food (BLE); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw). This work was also supported by the SENATOR trial (FP7-HEALTH-2012-305930).Peer reviewedPostprin

A breath of fresh air : breathing stories of the lived experiences of asthma and sporting embodiment

The purpose of this study is to conduct an investigation of the lived experiences of asthma and sporting embodiment in non-elite sportspeople of different ages and levels of ability, involved in a range of sports. Asthma is characterised as a breathing disorder and the aim of this research is to add to embodied literature by providing ‘fleshy’ realities of the moving, sweating, sensuous sporting body, which holds meanings, purposes and interests for people who experience sport with asthma. Breathing is not only a physiological process, but it is also cultural and people may deal with their asthma symptoms in ways that reflect cultural attitudes embedded in sport. This qualitative study addresses five exploratory questions: 1) How do sportspeople experience asthma? 2) How do sportspeople negotiate their asthma and sporting identities? 3) How do emotional dimensions play a role in sportspeople’s asthma and sporting experiences? 4) How do perceptions of environment and illness shape one another by examining the relationship between the body, the self and environment? 5) What is the role of trauma in sportspeople with asthma? 6) How do key senses (sound) play a role in sportspeople’s asthma and embodied sporting experiences? Through a symbolic-interactionsist and phenomenological-inspired approach, this research places emphasis on the mind-body-self nexus in relation to sensory experiences with a focus upon the centrality of the ‘visceral’ body in the relationship between self-consciousness and the self. A bodily disruption (e.g., asthmatic attack) is likely to heighten awareness of the body-self and contingency and may amplify how sportspeople listen to their own embodied selves when engaged in sporting action. Therefore, sportspeople may become even more acutely aware of, and attuned to, their breathing in ways that link the physiological, the psychological, the social and the environment. This may lead to a permanent re-ordering/negotiation of identities (e.g., athletic identity - asthma identity) through ‘emotion work’ and ‘somatic (auditory) work’ in which a concern with the body is central. The findings are represented as a typology consisting of Conformers, Contesters and Creators, which may be used as a framework to assist health care and sporting professionals in developing more appropriate and effective rehabilitation regimes for sportspeople, in order to improve the quality of treatment and outcomes.EThOS - Electronic Theses Online ServiceGBUnited Kingdo