A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Public health, Johannesburg September, 2013 / Background: Human resources in health has been identified as one of the current challenges facing health systems in South Africa. Dietitians in South Africa are a reflection of this. There is limited research on South Africa dietitians about their experiences and what motivates or encourages them to stay in the public sector. Aim: The main aim of the study is to understand the current challenges faced by dietitians working in the public sector with the view to formulate recommendations for the retention of this workforce. Method: The study used a qualitative method of in-depth interviews with dietitians and policy makers. A thematic content analysis was used to identify key themes. Results: Dietitians pointed out that they experience challenges in the work settings. These challenges which impacts on their motivation included; the lack of understanding of the role of a dietitian by other health professional, low salary levels, limited opportunities to further their careers in the field, inadequate infrastructure and limited availability of tools required in the work place, high patient loads, and limited supervision and support. Despite the expressed constraints the perspective from the policymakers was positive. They highlighted that recognition of the profession has improved. However, they reported dissatisfaction with the current caliber of dietitians. Conclusion: Although, there are positive aspects reported about the work experiences of dietitians in hospitals in Gauteng, there remains a range of factors which contribute negatively to their motivation and retention in the public service. The study indicates that these factors need to be addressed to maintain and increase the positive gains seen by the profession.

Thesis (MEd (Human Resources Studies))--University of South Australia

Dietitians and nutritionists today realise the importance of knowing about peoples' food habits and patterns to be able to understand their dietary and medical problems more readily. It is my intention to study the current and traditional food habits and patterns of the various population groups by interviewing as many members of each group as possible on: - daily eating patterns - cooking methods - traditional foods - taboos, feasts and fasts In the introduction the discussion will focus on the origin of food habits and patterns and the influencing factors in a wider context.

The purpose of this study was to examine the availability, credentials, and qualifications of nutrition providers for Division IA intercollegiate athletic programs that have competitive women's gymnastics, women's swimming and women's cross country, or a combination of two of these sports. It was also the purpose of the study to identify if relationships exists between demographic factors and 1). The employer of the nutrition provider, 2) the title of the nutrition provider and 3) the availability of nutrition education.Surveys were sent to 161 Division IA Athletic Directors. The institutions selected in the study have competitive women's gymnastics, women's swimming and women's cross country, or a combination of tow of these sports. The National Directory of College Athletics was used for selection of the universities participating in this study. A 69% return rate was achieved and all surveys were deemed useable. / Department of Family and Consumer Sciences

Thesis (M.S.)--Brigham Young University. Dept. of Nutrition, Dietetics, and Food Science, 2005. / Includes bibliographical references (p. 83-86).

Dietetic professionals integrate knowledge and expertise in food, nutrition, management and people and apply their skills in a variety of settings. As the changing scene in health care has necessitated enhanced management of resources, the clinical nutrition manager (CNM) has emerged as a dietetic professional in hospitals applying sound management practices to the area of clinical nutrition services. The purpose of this study was to provide information about the position of clinical nutrition manager and about the professional development strategies used by incumbents. The research design had two phases. The purpose of the first phase was to develop a job description for the position of clinical nutrition manager, including duties/activities and job specifications for education, experience and professional credentialing. The purpose of the second phase was to verify the accuracy of the job description, determine educational and experiential resources used to develop the required skills and knowledge for performing the duties/activities, and collect other descriptive data about the position. The result was a job description for a Clinical Nutrition Manager with 46 duties/activities assigned to the position and job specifications for work experience and academic preparation. Chi square analysis was used to test the association of the performance of a duty/activity with amount of time allotted to the position; number of personnel supervised; and type of personnel supervised. Results indicated that type of personnel supervised had the most significant association. One sample chi square analysis indicated that entry-level education and entry-level experience were the less likely resources to be used for development of skills and knowledge. For more than 50% of the duties/activities, the number of resources used was significantly related to the perceived level of importance. There was no significant finding for an association between timing of career decision to become a CNM and career development strategies intentionally selected. Findings also indicated that perceived competence improves with increasing number of years in the position and is not affected by having an advanced degree. / Graduation date: 1992

Introdução - Dentre as consequências da obesidade, estão questões psicológicas e sociais como o preconceito e a discriminação social, que trazem implicações negativas para a saúde do indivíduo obeso. As atitudes de profissionais da saúde em relação à obesidade podem ser influenciadas por visões negativas sobre os indivíduos obesos e as causas que o levaram a obesidade e podem influenciar a conduta profissional. Objetivo - Avaliar a existência de atitudes negativas em relação aos indivíduos obesos entre estudantes universitários de nutrição. Métodos - Estudo transversal descritivo, no qual estudantes de nutrição responderam instrumentos on-line no site do projeto Estudo de Saúde de Nutricionistas (NutriHS): a) avaliação sociodemográfica e do estado nutricional; b) escala de silhuetas brasileiras para avaliação de satisfação e percepção corporal; c) fatores de desenvolvimento da obesidade; d) Antifat Attitudes Test (AFAT) - adaptado transculturalmente para este estudo; e) avaliação da conduta terapêutica em relação ao paciente obeso. A frequência de resposta para os fatores de desenvolvimento da obesidade foi analisada, e seu escore comparado com a pontuação na AFAT total e subescalas, percepção e insatisfação corporal e Índice de Massa Corpórea (IMC) utilizando o coeficiente de correlação de Pearson. Escores na AFAT (total e subescalas) foram comparados entre os sexos, e associações entre os mesmos foram avaliadas com relação às variáveis sociodemográficas e de caracterização da amostra. Análises de regressão linear simples e múltipla foram utilizadas para avaliar a relação entre as características da amostra e as atitudes dos estudantes de nutrição. A comparação das respostas dos estudantes com relação à conduta terapêutica em relação ao paciente obeso foi conduzida por meio do Teste de Kruskal Wallis, seguido de Teste de Comparações Múltiplas das Médias 3 das Ordens. Resultados Participaram do estudo 335 alunos de nutrição (idade média 23 anos) de universidade/faculdades diversas, principalmente do 1º ano de graduação (40 por cento ), sexo feminino (94 por cento ), solteiros (87 por cento ), e com renda familiar entre 1 e 5 salários mínimos (62 por cento ). Houve elevado índice de insatisfação corporal - 54 por cento das mulheres 58 por cento dos homens - e percepção corporal alterada especialmente entre as mulheres (71 por cento ). Os principais fatores determinantes da obesidade listados foram: 1) Inatividade física; 2) Comer uma quantidade maior do que a necessária; 3) Alterações metabólico-hormonais; 4) Vício/dependência em comida; 5) Comer alimentos inadequados. A pontuação na AFAT total foi associada positivamente a idade e ao sexo masculino e negativamente ao IMC e o ano de graduação. As condutas terapêuticas dos estudantes foram influenciadas pelo peso do paciente hipotético e revelaram a presença de preconceito. Conclusões A respostas aos determinantes da obesidade demonstraram que os estudantes possuem crenças em fatores estigmatizadores do indivíduo obeso. As atitudes mais negativas em relação à obesidade foram encontradas para os homens e os estudantes mais velhos. E pode-se confirmar que o peso de um paciente hipotético influencia a conduta terapêutica sugerida pelo estudante, com atitudes negativas para com o indivíduo obeso. Os resultados indicam, portanto, que estes estudantes de nutrição atribuem causas comportamentais para a obesidade, pautam possível conduta terapêutica pelo peso do indivíduo (mesmo que a questão de saúde colocada não tenha relação direta com estado nutricional) e apresentam atitudes negativas e preconceito em relação aos indivíduos obesos. / Introduction - Among the consequences of obesity, there are psychological and social issues as prejudice and social discrimination, which have negative implications for the health of obese person. The health professional attitudes towards obesity can be influenced by negative views of obese people and the causes that led to obesity can influence the professional conduct. Aim To evaluate the existence of negative attitudes toward obese people among dietetic undergraduate students. Methods - Descriptive cross-sectional study in which nutrition students answered online tools on the project site \'Health Study Nutritionists \"(NutriHS): a) sociodemographic evaluation and nutritional status; b) scale of Brazilian silhouettes to evaluate patients satisfaction and body awareness; c) the obesity development factors; d) Antifat Attitudes Test (AFAT) - culturally adapted for this study; e) evaluation of the therapeutic approach toward obese patient. The frequency of responses to the obesity development factors was analysed, and its score compared to the overall score and subscales AFAT, perception and body dissatisfaction and body mass index (BMI) using the Pearson correlation coefficient. Scores in AFAT (total and subscales) were compared between the genres, and associations between them were evaluated toward sociodemographic variables and characteristics of the sample. Analysis of simple linear and multiple regression were used to evaluate the relationship between the sample characteristics and attitudes of nutrition students. The comparison of students\' responses regarding the therapeutic approach toward obese person was conducted using Kruskal Wallis test, followed Test of Multiple Comparisons of Order Averages. Results 335 students from several nutrition university courses (mean age 23 years) participated during this research, mainly the 1st graduation year students (40 per cent ), being women 5 (94 per cent ), single (87 per cent ), and family income between 1 and 5 minimum wages (62 per cent ). There was high body dissatisfaction index - 54 per cent women 58 per cent men - and altered body perception especially among women (71 per cent ). The main determinants of obesity were: 1) Physical inactivity; 2) Eating an amount greater than needed; 3) Metabolic and hormonal changes; 4) Addiction / dependence on food; 5) Eating inadequate food. The score in the total AFAT was positively associated with age and male and negatively with BMI and the year of graduation. The therapeutic procedures of the students were influenced by hypothetical patient\'s weight and they revealed the presence of prejudice. Conclusions The answers to obesity determinants have shown that students have stigmatizing factors beliefs about obese person. The most negative attitudes toward obesity were found among men and older students. It is possible to confirm that the weight of a hypothetical patient influences the therapeutic approach suggested by the student, who has negative attitudes towards obese person. Therefore, the results indicate that these nutrition students attribute behavioural causes to obesity. They also use possible therapeutic approach guided by the individual\'s weight (even if the health question has not connected to nutritional status) and have negative attitudes and prejudice against obese people.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-07-28T14:07:54Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Mestrado Priscilla Alves Santos.pdf: 1293471 bytes, checksum: 3b49693740c5dee22a179a5e2defbd37 (MD5) / Made available in DSpace on 2016-07-28T14:07:54Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Mestrado Priscilla Alves Santos.pdf: 1293471 bytes, checksum: 3b49693740c5dee22a179a5e2defbd37 (MD5) Previous issue date: 2016-02-16 / Com o objetivo de avaliar a qualidade da dieta e seus fatores associados em nutricionistas do sexo feminino do estado de Pernambuco, foi realizado um estudo observacional, com uma amostra de 135 nutricionistas com idade média de 33,210,0 anos. As informações foram obtidas através do preenchimento de questionário online, de onde foram coletados dados demográficos, de estilo de vida, antropométricos e autopercepção do peso corporal. O excesso de peso foi definido pelo índice de massa corporal (IMC) ≥ 25kg/m2 e a obesidade abdominal foi determinada pela circunferência abdominal (CA) ≥80cm e pela razão cintura-estatura (RCE) >0,5. Dados sobre o consumo alimentar foram coletados através de dois recordatórios de 24h. O consumo calórico foi dicotomizado em acima e abaixo da Necessidade de Energia Estimada (Estimated Energy Requirement - EER), sendo observada a proporção de indivíduos em cada caso. A qualidade da dieta foi avaliada através do Índice de Qualidade da Dieta Revisado (IQD-R), sendo categorizadas em dieta adequada as nutricionistas que apresentaram valores acima do terceiro tercil (IQD-R>78,3 pontos). Para identificar as variáveis associadas à dieta inadequada foi realizada a Regressão de Poisson. A média do IQD-R encontrada foi de 71,612,6 pontos, sendo que, do total de mulheres envolvidas neste estudo, 66,7% apresentaram dieta inadequada. Quanto ao estado nutricional, o excesso de peso e a obesidade abdominal foram encontrados em 23,0% e 50,4% das mulheres, respectivamente. Após ajuste, as variáveis autopercepção de magreza (RP ajustada=0,31 IC95% 0,12-0,63), número de filhos ≥2 (RP ajustada=0,53 IC95% 0,25-0,78) e não fazer exercícios físicos (RP ajustada=1,26 IC95% 1,06-1,43) permaneceram independentemente associadas à dieta inadequada. Dos componentes do IQD-R, os que apresentaram os consumos mais inadequados foram cereais integrais e óleos. Além disso, sete componentes (frutas totais; frutas integrais; vegetais totais; vegetais verdes escuros e alaranjados; cereais totais; carnes, ovos e leguminosas; e sódio) apresentaram pontuação máxima, demonstrando que as mulheres alcançaram as recomendações para esses componentes dietéticos. Observou-se que o percentual de dieta inadequada é alto para este tipo de público, detentor do conhecimento da Nutrição, que o fato de não praticar exercício físico é fator de risco para a má qualidade da dieta, bem como se achar magro e ter mais de dois filhos é fator protetor contra a mesma. / Aiming to assess the quality of diet and its associated factors in female nutritionists from the State of Pernambuco, we conducted an observational study with a sample of 135 nutritionists with mean age of 33.2±10.0 years. By means of an online questionnaire, demographic, lifestyle, anthropometric and self-perception of body weight data were collected. Overweight was determined by the body mass index (BMI) ≥25kg/m2 and abdominal obesity was determined by abdominal circumference (WC) ≥80cm and by the waist-to-height ratio (WHR) > 0,5. Data on food consumption were collected using two 24-hour dietary recalls. The caloric consumption was dichotomized into above and below the Estimated Energy Requirement (EER), and it was observed the proportion of individuals in each case. The quality of diet was assessed using the Brazilian Healthy Eating Index Revised (BHEI-R). Subjects who presented a BHEI-R above the third tercil (>78.3 points) were categorized into proper diet. To identify the variables associated with inadequate diet was performed Poisson regression analysis. The BHEI-R average found was 71.6±12.6 points, and, of all women involved in this study, 66.7% showed inadequate diet. Regarding nutritional status, overweight and abdominal obesity were found in 23.0% and 50.4% of women, respectively. After adjustment, self-perception of thinness (adjusted PR=0.31 95%CI 0.12-0.63), number of children ≥2 (adjusted PR = 0.53 95%CI 0.25-0.78), and physical inactivity (adjusted PR=1.26 95%CI 1.06-1.43) remained independently associated with inadequate diet. Of the BHEI-R components, whole grain cereals and oils were among the most inadequate intakes. In addition, seven components (total fruits; whole fruits; total vegetables; dark green and orange vegetables; total cereals; meat, eggs and legumes; and sodium) presented maximum score, demonstrating that women achieved the recommendations for these dietary components. We found that the percentage of inadequate diet is high for this public, who has knowledge of nutrition, and that physical inactivity is a risk factor for poor diet. On the other hand, finding themselves thin and having more than two children is a protective factor against this problem.

Introdução - Dentre as consequências da obesidade, estão questões psicológicas e sociais como o preconceito e a discriminação social, que trazem implicações negativas para a saúde do indivíduo obeso. As atitudes de profissionais da saúde em relação à obesidade podem ser influenciadas por visões negativas sobre os indivíduos obesos e as causas que o levaram a obesidade e podem influenciar a conduta profissional. Objetivo - Avaliar a existência de atitudes negativas em relação aos indivíduos obesos entre estudantes universitários de nutrição. Métodos - Estudo transversal descritivo, no qual estudantes de nutrição responderam instrumentos on-line no site do projeto Estudo de Saúde de Nutricionistas (NutriHS): a) avaliação sociodemográfica e do estado nutricional; b) escala de silhuetas brasileiras para avaliação de satisfação e percepção corporal; c) fatores de desenvolvimento da obesidade; d) Antifat Attitudes Test (AFAT) - adaptado transculturalmente para este estudo; e) avaliação da conduta terapêutica em relação ao paciente obeso. A frequência de resposta para os fatores de desenvolvimento da obesidade foi analisada, e seu escore comparado com a pontuação na AFAT total e subescalas, percepção e insatisfação corporal e Índice de Massa Corpórea (IMC) utilizando o coeficiente de correlação de Pearson. Escores na AFAT (total e subescalas) foram comparados entre os sexos, e associações entre os mesmos foram avaliadas com relação às variáveis sociodemográficas e de caracterização da amostra. Análises de regressão linear simples e múltipla foram utilizadas para avaliar a relação entre as características da amostra e as atitudes dos estudantes de nutrição. A comparação das respostas dos estudantes com relação à conduta terapêutica em relação ao paciente obeso foi conduzida por meio do Teste de Kruskal Wallis, seguido de Teste de Comparações Múltiplas das Médias 3 das Ordens. Resultados Participaram do estudo 335 alunos de nutrição (idade média 23 anos) de universidade/faculdades diversas, principalmente do 1º ano de graduação (40 por cento ), sexo feminino (94 por cento ), solteiros (87 por cento ), e com renda familiar entre 1 e 5 salários mínimos (62 por cento ). Houve elevado índice de insatisfação corporal - 54 por cento das mulheres 58 por cento dos homens - e percepção corporal alterada especialmente entre as mulheres (71 por cento ). Os principais fatores determinantes da obesidade listados foram: 1) Inatividade física; 2) Comer uma quantidade maior do que a necessária; 3) Alterações metabólico-hormonais; 4) Vício/dependência em comida; 5) Comer alimentos inadequados. A pontuação na AFAT total foi associada positivamente a idade e ao sexo masculino e negativamente ao IMC e o ano de graduação. As condutas terapêuticas dos estudantes foram influenciadas pelo peso do paciente hipotético e revelaram a presença de preconceito. Conclusões A respostas aos determinantes da obesidade demonstraram que os estudantes possuem crenças em fatores estigmatizadores do indivíduo obeso. As atitudes mais negativas em relação à obesidade foram encontradas para os homens e os estudantes mais velhos. E pode-se confirmar que o peso de um paciente hipotético influencia a conduta terapêutica sugerida pelo estudante, com atitudes negativas para com o indivíduo obeso. Os resultados indicam, portanto, que estes estudantes de nutrição atribuem causas comportamentais para a obesidade, pautam possível conduta terapêutica pelo peso do indivíduo (mesmo que a questão de saúde colocada não tenha relação direta com estado nutricional) e apresentam atitudes negativas e preconceito em relação aos indivíduos obesos. / Introduction - Among the consequences of obesity, there are psychological and social issues as prejudice and social discrimination, which have negative implications for the health of obese person. The health professional attitudes towards obesity can be influenced by negative views of obese people and the causes that led to obesity can influence the professional conduct. Aim To evaluate the existence of negative attitudes toward obese people among dietetic undergraduate students. Methods - Descriptive cross-sectional study in which nutrition students answered online tools on the project site \'Health Study Nutritionists \"(NutriHS): a) sociodemographic evaluation and nutritional status; b) scale of Brazilian silhouettes to evaluate patients satisfaction and body awareness; c) the obesity development factors; d) Antifat Attitudes Test (AFAT) - culturally adapted for this study; e) evaluation of the therapeutic approach toward obese patient. The frequency of responses to the obesity development factors was analysed, and its score compared to the overall score and subscales AFAT, perception and body dissatisfaction and body mass index (BMI) using the Pearson correlation coefficient. Scores in AFAT (total and subscales) were compared between the genres, and associations between them were evaluated toward sociodemographic variables and characteristics of the sample. Analysis of simple linear and multiple regression were used to evaluate the relationship between the sample characteristics and attitudes of nutrition students. The comparison of students\' responses regarding the therapeutic approach toward obese person was conducted using Kruskal Wallis test, followed Test of Multiple Comparisons of Order Averages. Results 335 students from several nutrition university courses (mean age 23 years) participated during this research, mainly the 1st graduation year students (40 per cent ), being women 5 (94 per cent ), single (87 per cent ), and family income between 1 and 5 minimum wages (62 per cent ). There was high body dissatisfaction index - 54 per cent women 58 per cent men - and altered body perception especially among women (71 per cent ). The main determinants of obesity were: 1) Physical inactivity; 2) Eating an amount greater than needed; 3) Metabolic and hormonal changes; 4) Addiction / dependence on food; 5) Eating inadequate food. The score in the total AFAT was positively associated with age and male and negatively with BMI and the year of graduation. The therapeutic procedures of the students were influenced by hypothetical patient\'s weight and they revealed the presence of prejudice. Conclusions The answers to obesity determinants have shown that students have stigmatizing factors beliefs about obese person. The most negative attitudes toward obesity were found among men and older students. It is possible to confirm that the weight of a hypothetical patient influences the therapeutic approach suggested by the student, who has negative attitudes towards obese person. Therefore, the results indicate that these nutrition students attribute behavioural causes to obesity. They also use possible therapeutic approach guided by the individual\'s weight (even if the health question has not connected to nutritional status) and have negative attitudes and prejudice against obese people.

Despite a shortage of Registered Dietitian Nutritionists (RDNs), only half of applicants currently match with a dietetic internship. A key reason is a shortage of preceptors. The purpose of this cross-sectional study was to better understand RDNs’ views of the preceptor role. An online survey was sent to a randomly selected sample of 10% of RDNs. A total of 1,170 RDNs completed the survey. The survey collected data on reasons dietitians precept, training received, and incentives. Five scales measured supports, benefits, satisfaction, commitment, and barriers to the preceptor role. Three groups of RDNs—current (37.1%), former (33.6%), and never preceptors (29.3%)—were compared and a regression analysis used to determine factors associated with precepting. The main reason RDNs precept was to help the field. Two-thirds of respondents would precept if it were their choice, yet only 37% were current preceptors. RDNs were somewhat dissatisfied with incentives. Continuing Professional Education Units (CPEUs) for precepting was the most common incentive (9.3%), while 35.6% received no incentives. The benefits scale mean scores were similar across the three groups, while current and former preceptors scored significantly higher (p < .001) than the never precepted group on the commitment, satisfaction, and support scales. The never group had significantly higher barriers (p < .001). The top barriers were increased stress from having interns, time-consuming/increased workload, and lack of incentives. Most (69%) RDNs received no preceptor training. Several factors were associated with being a current preceptor: fewer years as an RDN, Bachelor’s degree as the highest degree, holding a specialization credential, working full-time, working/residing in urban areas, working for a DI program, being on a DI advisory committee, and higher commitment scale scores. This study provides valuable insights for increasing RDNs who become preceptors, especially as the field transitions to the competency-based Future Education Model, which combines a graduate degree and supervised experiential learning. RDNs can be recruited as preceptors early in their career and encouraged to become members of advisory committees to connect them more to the preceptor role. Training for precepting can be widely provided, incentives improved, and barriers addressed to reduce stress for RDNs to precept.