Kentucky has a health crisis and most of the causes can be linked to diet, smoking and physical activity. Vegetarian and vegan diets have numerous benefits for many diet related health problems such as obesity, heart disease, Type 2 diabetes and certain cancers. There has been limited research on vegetarians and vegans in the United States and none in Kentucky. This study used an anonymous electronic survey to examine the different characteristics, behaviors, experiences and opinions of adult vegetarians and vegans in Kentucky. Results were compared to statistical data reported on the general population of Kentucky. Calculated body mass index (BMI) from self-reported height and weight showed 36% of vegetarians and 21% of vegans to be overweight or obese compared to 67% of the general Kentucky population being overweight or obese. The impact on BMI due to type of plant based diet (vegetarian or vegan) was found to be of greater significance (p=0.0030) than that of exercise. Reports from both groups indicated that they may be underserved by health care professionals. These findings have important implications for dietitians, dietetics education programs and health care providers concerned with high rates of obesity and chronic diseases.

Malnutrition is a significant issue affecting the health of many adults over the age of 65. Screening for malnutrition in this population can help identify those in need of a complete nutritional assessment. Many screening tools have been developed to aid healthcare team members in identifying those at risk for malnutrition. A population of dietitians with a focus in older adult nutrition was surveyed to determine dietitians’ perceptions and use of screening tools for the older adult. The results of the study showed many dietitians did not use validated screening tools at their place of work and were not confident in their knowledge regarding the topic. Despite dietitians’ having the expertise in nutrition, other interdisciplinary team members are performing the screening in many settings in the United States and some dietitians’ feel this is an obstacle in identifying older adults at risk.

The media has highlighted a proposed link between a gluten free diet (GFD) and weight loss. However, research related to weight gain and a GFD for persons with celiac disease (CD) has shown the opposite effect. A GFD is the only known treatment for persons with CD. If a patient with CD consumes a diet high in GF processed foods, weight management may be difficult to achieve. Participants with self-reported CD completed a modified GF food frequency questionnaire (FFQ) to assess typical dietary consumption of whole grains, sweets, fruits, vegetables and regular soda. Additionally, body mass index (BMI) and exercise were assessed. The results of this study found that whole grain, fruit and vegetable intakes were low among celiac patients. Additionally, BMI was on the high end of the normal weight range. The results of this study indicate that a greater emphasis should be placed on nutritional quality when counseling patients with CD. Registered dietitians should focus their diet counseling sessions with CD patients on a nutritious naturally GF diet in order to better manage weight.

Minimal educational requirements for Registered Dietitians (RDs) include a bachelor’s degree and practice program. Recently, a master’s degree was recommended. Studies have not established whether education affects employment. A secondary analysis of 2005 Dietetics Practice Audit data determined whether job responsibility, individuals supervised, and activities differed between 1,626 bachelor’s RDs (B-RDs) and 767 master’s (M-RDs) RDs, registered ≤5 years. Chi-square and ANOVA analyzed differences between B-RDs and M-RDs, at entry-level (0-3 years experience) and beyond-entry-level (3+-5 years experience). Beyond-entry-level B-RDs (31.8%) and entry-level M-RDs (31.9%) reported “supervisor/executive” responsibility more than entry-level B-RDs (26.5%; p=0.01). A higher percentage of M-RDs supervised (29.2%) than B-RDs (24.7%; p=0.02); however, B-RDs supervised more individuals (7.38 ± 4.89) than M-RDs (6.25 ± 4.87; t=2.32; p=0.021). A master’s degree has limited benefits; experience may affect responsibility, individuals supervised, and activities more than education.

Eating Disorder-Diabetes Mellitus Type 1 (ED-DMT1) refers to individuals who have type 1 diabetes and a co-occurring eating disorder. The aim of this study was to identify current treatment practices for individuals with ED-DMT1 in a residential eating disorder treatment setting. Clinical nutrition managers (CNMs) at 18 residential eating disorder treatment facilities were interviewed about treatment practices for patients with type 1 diabetes. Four themes were identified through qualitative case study analysis: 1) nutrition interventions for patients with diabetes, 2) medical diabetes management, 3) interdisciplinary diabetes team, and 4) CNM's assessment of diabetes care. The majority of CNMs interviewed reported utilizing an exchange- based meal plan, which is well suited for patients with type 1 diabetes. Dietitians described the use of diabetes technology (e.g., insulin pumps and continuous glucose monitors) and described a gradual advancement of responsibility and autonomy with portioning food at meals and snacks and managing diabetes care. The dietitian is heavily involved in providing diabetes education along with the medical and/or nursing team. The majority of CNMs interviewed demonstrated knowledge deficits related to diabetes management and expressed the need and desire for increased education for themselves and other staff members in order to provide the highest quality of care.

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There are low retention rates of dietitians and this impacts quality of care. Emotional intelligence (EI) may be the missing component to improve retention, due to EI increasing job satisfaction and decreasing burnout for other health providers. The purpose of this study was to examine the relationship between EI, job satisfaction, and burnout for dietitians. The theoretical framework utilized was the 4-branch model of EI. Method of inquiry was convenience, quantitative non-experimental design. Registered dietitians (N = 84,173) living in the United States were contacted via e-mail. Approximately 9.5% of dietitians (n = 8,038) completed the Wong and Law EI Scale, Job Diagnostic Survey, Copenhagen Burnout Inventory, and a demographic survey. Frequency was calculated based on coded data that 89.38% of dietitians indicated high level of EI (score -?¥ 4.5). Levels of EI and burnout for dietitians were examined with a Chi2 (p = 0.000), Pearson r correlation (r = 0.28, p = 0.000), and positive linear regression (r2 = 0.075, p = 0.000). Levels of EI and job satisfaction for dietitians were examined with a Chi2 (p = 0.000), Pearson r correlation (r = 0.271, p = 0.000), and positive linear regression (r2 = 0.070, p = 0.000). Significant findings reveal that dietitians possess increased levels of EI, a positive correlation exists between EI and burnout, and a positive correlation exists between EI and job satisfaction. Results may contribute to social change by highlighting the importance of EI in the field of dietetics to integrate EI in curriculum, encourage professional growth, and improve client outcomes.

Literature Review Undernutrition in the hospital setting has been shown to cause adverse outcomes. Screening for nutritional risk assists in the detection of undernutrition with subsequent early intervention to prevent further decline. While many nutrition screening tools exist, none are proven to detect undernutrition. Furthermore, many barriers exist for utilizing nurses as primarily responsible for screening patients for nutritional risk. Background A hospital reviewed the nutrition screening process and found that the form used and screening factors were insufficient to adequately detect undernutrition and appropriate referrals for dietitians. Objectives 1) Determine if nursing compliance improved when the nutrition screening form was integrated with the Interdisciplinary Care Plan form. 2) Improve the relevance of the nutrition screening risk factors used and the overall screening tool. Methods The Interdisciplinary Plan of Care form was updated to include the nutrition screening tool and used on the Medical /Surgical unit. Data was also collected on the Intensive Care Unit which continued to use the original screening tool. Results Screening completion did not improve with the implementation of the new screening process, however the quality and quantity of referrals from the new screening form did improve. Total compliance for nurses responsibility also improved with the new form. Conclusion Integrating nutrition screening factors into an interdisciplinary plan of care can improve the rate of dietitian referrals. Nutritional screening procedures must be continually reevaluated for effectiveness in detecting undernutrition in the hospitalized patient. Further studies must be conducted to evaluate the validity and specificity of all nutrition screening tools.

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The purpose of this study was to determine if patients with cancer receiving radiation therapy were satisfied with the nutrition counseling they were receiving and if they obtained any benefit. Radiation increases the risk for side effects such as taste changes, chewing/swallowing problems, constipation, diarrhea, nausea, and vomiting. When these side effects are present, a decrease in food and fluid intake occurs, which leads to weight loss, increased risk of morbidity and mortality, as well as decreased quality of life. Subjects were recruited from a regional cancer treatment facility and a survey was administered to those who met criteria. Subjects were found to manage some of their side effects better after counseling from the registered dietitian. A minimal amount of weight loss was observed. Therefore, registered dietitians, when effectively incorporated into a radiation treatment facility, can provide a nutrition program targeted at reducing weight loss and improving quality of life.