Identification of Multicultural Nutrition Counseling Competencies for Registered Dietitians

Objective: Research was conducted to develop a model and identify multicultural nutrition counseling competencies for Registered Dietitians Design: A mail survey was administered followed by a post card reminder and a follow-up survey to non-respondents. The survey consisted of 46 competency items that subjects rated on a Likert scale of 1 to 7 (1=Unessential to 7 -Essential). Subjects: A stratified random sample was taken from 1300 members of the American Dietetic Association\u27s Public Health Nutrition Practice Group and directors of the Didactic Programs in Dietetics (DPD) and Dietetic Internship (DI) Programs. A total of 604 subjects were selected and mailed surveys. Surveys completed by Registered Dietitians who were members of the practice group or directors of a DPD or DI program were used for data analysis. Statistical Analysis: Descriptive statistics were used to calculate frequency of response. Exploratory principal component analysis was used to analyze the dimensionality of the multicultural nutrition counseling competencies. MANOVA was used to determine if dimensions extracted differed among respondents who provided nutrition counseling or education to culturally different clients and those who did not. Results: Of the 604 subjects surveyed, 60% responded (n=363) and of the respondents, 94.4% (n=343) met the selection criteria. Most respondents were Caucasian (86%), spoke English as their primary language (97%), and had Master\u27s degrees (82%). Many (38.2%) worked in a community/public health facility or organization and 50% provided nutrition counseling or education to culturally different clients. Three dimensions were extracted with 28 competencies loading on them: Multicultural Nutrition Counseling Skills, Multicultural Awareness, and Multicultural Food and Nutrition Knowledge. Subjects responded similarly for the extracted dimensions regardless of whether or not they provided nutrition counseling to culturally different clients. Application: It is imperative for Registered Dietitians who work with various cultural groups to be multi-culturally competent, given the changing and dynamic nature of our society. The resulting multicultural nutrition counseling model is a guideline, which can be applied to many aspects of the dietetic profession. The American Dietetic Association\u27s Diversity Committee should review the model to determine how the competencies fit into the committee\u27s objectives. Directors of Didactic Programs in Dietetics and Dietetic Internship Programs may want to focus on some of the competencies to enhance dietetic education and training. Public health nutritionists may use them as a basis for selecting continuing education opportunities to enhance their multicultural nutrition counseling competence. Additional research is recommended to further develop and define multicultural nutrition counseling competencies for Registered Dietitians

It\u27s a Simple Idea, But It\u27s Not Easy To Do: Practical Lessons in Telementoring

There are now more than 42 million people worldwide with access to global electronic mail. Many of these millions are subject matter specialists whose knowledge encompasses a wide spectrum of expertise. What if “matches” could be made so that volunteers from among this group could communicate directly with K-12 students and teachers who are studying about these experts\u27specialties? This article discusses lessons learned from The Electronic Emissary Project, an internet-based interpersonal resource that matches teachers to experts in different disciplines

HIFs, angiogenesis, and metabolism:elusive enemies in breast cancer

Hypoxia-inducible factors (HIFs) and the HIF-dependent cancer hallmarks angiogenesis and metabolic rewiring are well-established drivers of breast cancer aggressiveness, therapy resistance, and poor prognosis. Targeting of HIF and its downstream targets in angiogenesis and metabolism has been unsuccessful so far in the breast cancer clinical setting, with major unresolved challenges residing in target selection, development of robust biomarkers for response prediction, and understanding and harnessing of escape mechanisms. This Review discusses the pathophysiological role of HIFs, angiogenesis, and metabolism in breast cancer and the challenges of targeting these features in patients with breast cancer. Rational therapeutic combinations, especially with immunotherapy and endocrine therapy, seem most promising in the clinical exploitation of the intricate interplay of HIFs, angiogenesis, and metabolism in breast cancer cells and the tumor microenvironment