Dual RN-RDN program: Training for the future of health and nutrition.

PURPOSE: Explore the benefits and feasibility of a dual training program for dietetics and nursing to increase nutrition in clinical practice. METHODS: A professional interest survey on the perceived value of a dual program with 222 registered nurses (RN) and registered dietitian nutritionists (RDN) and an in-depth literature review were completed. RESULTS: A majority of RNs indicated the addition of the RDN would be beneficial for supporting patients with diet-related chronic diseases and performing nutritional assessments and interventions. The RDN respondents indicated a dual program approach would also improve the ability to serve a small community or place of employment that is limited in having both a full-time RDN and RN, and rated benefits for performing more medical and laboratory procedures. The RDNs also indicated the dual program could help increase their income potential. Both dual Master's and dual Bachelor's programs were rated as valuable. Of the 18 (8%) of respondents who had both RDN and RN credentials, half indicated personal growth and interest was the incentive for pursuing the dual training; whereas half indicated professional incentives (e.g., no RDN in the area, improving specialty care, job security, lack of opportunities), The literature review indicated no studies on the efficacy of a dual RDN-RN program on health outcomes; however, studies have shown that individualized counseling from RDNs is more beneficial than general nutritional counselling from other health care providers not specifically trained in dietary assessments. Noted barriers to pursuing dual training included time and cost, and some respondents in both specialties were not interested in a dual program. DISCUSSION: These results support providing students with dual program options, although further exploration of the specific approach is warranted, particularly decreasing time-to-degree while not affecting efficacy.

Involvement of interleukin-1 genotypes in the association of coronary heart disease with periodontitis.

BACKGROUND: Epidemiologic studies demonstrated an association between periodontitis (PE) and coronary heart disease (CHD). The coexistence of the two disease entities could be dependent on mutual risk factors, and polymorphism of the interleukin (IL)-1 gene cluster associated with the severity of PE might also be involved in the pathogenesis of CHD. METHODS: The study consisted of 225 dentate white subjects, including 97 patients with CHD and 128 controls. Patients with confirmed diagnoses of CHD were recruited after being discharged from a cardiology department, and controls without CHD were recruited consecutively from the Copenhagen City Heart Study. Mean alveolar bone level (ABL) was measured on radiographs. ABL was stratified into ABL1 (ABL < or = 2 mm), ABL2 (2 mm 4 mm). Genotypes were analyzed by amplifying the polymorphic regions of the IL-1 gene cluster using polymerase chain reaction, followed by restriction digestion and gel electrophoresis. RESULTS: In the univariate analysis, allele 2 of IL-1B+3954 and IL-1B-511 was associated with ABL (P = 0.040 and P = 0.039, respectively), whereas no association was found with allele 2 of IL-1A+4845 or IL-1RN variable number tandem repeat (VNTR) (P = 0.445 and P = 0.375, respectively). A lower ABL was associated with the occurrence of allele 2 of IL-1B-511. The multiple logistic regression analysis also showed a significant association of allele 1 of IL-1B-511 with high ABL (P = 0.049) and of allele 2 of IL-1A+4845 with high ABL among individuals with CHD (P = 0.050). There was no association between any of the polymorphisms of IL-1 and CHD in the univariate or multiple analyses. However, in a binary multiple logistic regression model, carriage of allele 1 of IL-1RN VNTR was found to be associated with the occurrence of both CHD and ABL3 (P = 0.016). CONCLUSION: Allele 1 of IL-1RN VNTR may be associated with the coexistence of CHD and PE in a multiple regression model.

Periodontal disease and coronary heart disease.

BACKGROUND: Several epidemiological studies have demonstrated an association between periodontal disease and coronary heart disease (CHD). The association could be a result of confounding by mutual risk factors. The present study was undertaken in a Danish population to reveal the significance of common risk factors. METHODS: The investigation was conducted as a case-control study comprising 250 individuals: 110 individuals with verified CHD from a Department of Cardiovascular Medicine and 140 control individuals without CHD from the Copenhagen City Heart Study. Information on diabetic status, smoking habits, alcohol consumption, physical activity, school attendance, household income, body weight and height, triglyceride, and serum cholesterol was obtained. Full-mouth probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and alveolar bone level (ABL) on radiographs were registered. ABL was stratified into ABL1=ABL2 to 4 mm. Multiple logistic regression models with stepwise backward elimination were used allowing variables with P<0.15 to enter the multivariate analysis. RESULTS: The CHD group had a significantly lower outcome with respect to PD, BOP, CAL, and ABL. For participants<60 years old, only risk factors such as smoking and diabetic status entered the multivariate analysis. For the ABL3 group, there was a significant association with CHD for participants<60 years old, the odds ratio being 6.6 (1.69 to 25.6). For participants>or=60 years old, there was no association. CONCLUSIONS: The present study showed a positive association between periodontal disease and CHD in agreement with several other studies. The association was highly age dependent and could only be attributed to diabetes and smoking to some extent.