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PubMed2000

Nutrition and dietetics--neglected subjects in medical education.

A brief historical review of the development of nutrition and dietetics in the world is followed by concise description of the history of the discipline in Croatia after the foundation of the School of Medicine in Zagreb in 1919. As differentiated from the Schools of Medicine in Zagreb, Rijeka, Osijek and Split, the third, nutritional curriculum at the School of Food Science and Biotechnology has allocated as many as 280 theoretical and 110 practical periods in the form of seminars (15 periods) and practical exercise (95 periods) to nutrition and dietetics. The curriculum includes special course of lectures in dietetics, delivered by a physician specialized in the field. This is followed by the observation that none of the four Croatian Schools of Medicine in Zagreb, Rijeka, Osijek and Split has introduced systematic education in the field in either undergraduate or postgraduate curricula. There are only some sporadic related topics included in undergraduate and postgraduate studies. Thus, the paper points to the serious neglect of this important subject in the curricula of our medical schools, and present some ideas how to solve the problem in the nearest future. The possible organization of a special postgraduate study in nutrition and dietetics for physicians willing to devote themselves professionally to this field of medicine is strongly advocated, because modern nutritional practices and dietetics are likely to soon impose the need of such experts in every large hospital and clinical department.

Croatia↗
PubMed1991

Position of the American Dietetic Association: nutrition education of health professionals.

The American Dietetic Association supports nutrition education for the health professions and considers didactic, clinical and continuing education top priorities for the next decade. The future of health care will require adequate numbers of qualified professionals. Dietetics practitioners/nutritionists should teach health care providers the importance of nutrition in health promotion and disease prevention and take leading roles in coordinating nutrition education efforts. Expanded nutrition services will enhance the health care system and be an integral part of the health services necessary to meet the public's needs.

Dietary Services↗
PubMed2004

On the front line: practice satisfactions and challenges experienced by dietetics and nutrition professionals working in community settings in New York State.

The goal of this study was to understand dietetics and nutrition professionals' experiences of their practice roles. Qualitative interviews using a grounded theory design covered practitioners' perceptions of their professional roles, role enactment, and practice context. Twenty-four dietetics and nutrition practitioners varying in their work settings, length of professional experience, education, and community type were recruited through professional contacts in New York State. Interview transcripts were analyzed using the constant comparative method of qualitative data analysis. An ecological model of practice in context emerged in which participants described daily practice satisfactions and challenges arising out of interactions among their personal characteristics, client characteristics, the work setting, and the food and nutrition and health care systems. Practice satisfactions related to positive interactions and measurable outcomes of work with clients and coworkers, recognition for expert and helper roles, and involvement in disease prevention. Practice challenges centered on others' misunderstandings of the dietary change process, assessment of practice outcomes, others' respect for expertise, keeping up-to-date, client and coworker expectations, isolation from peers, and the food environment. An ecological model of dietetics and nutrition practice as experienced in community settings draws attention to the need to address challenges in the multiple contexts that frame that practice.

Adult↗
PubMed1992

[Economic aspects of therapy for lipid metabolism disorders].

The primary and secondary prevention of cardiovascular diseases and, therefore, the therapy of hyperlipidemia is essential in strategies to lower morbidity and mortality from coronary heart disease (CHD), the most relevant atherosclerosis-associated disease. These programs imply not only a medical but also an economic challenge to our health system. That is why all therapeutic measures have to be evaluated regarding their cost-effectiveness. A cost-effectiveness profile was calculated for all the therapies of hyperlipidemia (nutritional therapy, dietetic nutritionals, drugs and LDL-apheresis) with respect to the following parameters: total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides. The daily costs of all interventional measures are compared to the success rate, whereby an index of daily therapy costs and 1% change per lipid parameter was calculated. Nutritional therapy is by far the cheapest, and LDL-apheresis the most expensive but also the most effective and reliable therapeutic measure. It has to be considered, however, that dietary intervention can be very successful in overnutrition while in rare cases of severe homozygous familial hypercholesterolemia there is no therapeutic alternative to LDL-apheresis. Life-style modifications, such as changing nutritional habits, may contribute towards reducing or removing one or more risk factor(s) (e.g. malnutrition is associated with overweight, hyperlipoproteinemia (HLP), hyperinsulinemia (syndrome X), hyperfibrinogenemia and hypertension). But neither health politicians nor the population seem to be conscious of the fact that life-style changes help to reduce medical expenditure. Considering the fact that nearly every medical service is getting more and more expensive, the need to introduce financial regulations is evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesterol↗