An exploration of Irish nutrition educators' experiences of competency-based assessment in nutrition science education.

BACKGROUND: Competency-based assessment (CBA) supports the development and attainment of skills required for the workforce. Little is known about educators' experience in developing or implementing CBA in nutrition science education or their opinions on how well it captures a student's preparedness for the workforce. The objective of this study was to explore educators' experience of CBA in nutrition education in Ireland. METHOD: Grounded in interpretivism, in-depth, semi-structured, audio-recorded interviews were conducted with 13 educators from five of the ten undergraduate honours degree nutrition programmes across Ireland. Interviews explored experiences of CBA and perception of students training to prepare for the workforce. A reflexive thematic analysis approach was implemented whereby the data were transcribed, inductively coded, and themes identified. RESULTS: A clear divide was evident between participants who were confident in their understanding of CBA and those who were unsure or had no knowledge of the term. Those with a clear understanding were more involved in programme development and evaluation. Three themes were identified: 'Assessment process' including intended learning outcomes, assessment design, and grading systems, 'Student-centred approach to assessment' focusing on work-based assessment and preparation for the workforce, and 'Upskilling educators' to equip educators with the skills and knowledge for professional development and to foster student success. CONCLUSION: The importance of CBA as a student-centred approach, supporting them to meet standards expected to practice as a nutrition professional, was the key experience of educators. Training in CBA and inclusion of more authentic assessment may better prepare students for the workforce.

Competency-based assessment in nutrition education: A systematic literature review.

BACKGROUND: A suitably prepared and qualified nutrition and dietetics workforce is part of the solution to combating the burden of disease. Competency-based assessment is a key part of the education of future workforces. Although there has been recent attention on competency-based assessment in dietetics, there is little exploration of competency-based education for the preparation of nutritionists. The present study aimed to understand how competency-based assessment is implemented and evaluated in nutrition education. METHODS: A systematic literature review was carried out according to PRISMA guidelines. Four databases were initially searched in February 2020 using key words related to competenc* in combination with nutrition or dietetic and their synonyms. An updated search was completed again in March 2021. Studies that met eligibility criteria where the focus was on nutrition and involved a method of competency-based assessment were synthesised narratively. RESULTS: From a total of 6262 titles and abstracts, six studies on competency assessment in nutrition education were identified. The assessments focused on the development of key skills, including motivational interviewing and nutrition assessment, changes to knowledge and attitudes on food and culture, and self-perceived development of communication, collaboration, management, advocacy, scholarship and professional capabilities. No studies were found that assessed promotion of health and wellbeing or the food chain competencies. CONCLUSIONS: The lack of research in competency-based assessment must be addressed to ensure we are effectively preparing future nutritionists for work such that they can impact health outcomes.

Identifying a biological signature of prenatal maternal stress.

Psychological stress affects maternal gastrointestinal (GI) permeability, leading to low-grade inflammation, which can negatively affect fetal development. We investigated a panel of circulating markers as a biological signature of this stress exposure in pregnant women with and without the stress-related GI disorder irritable bowel syndrome (IBS). Markers of GI permeability and inflammation were measured in plasma from healthy and IBS cohorts of women at 15 and 20 weeks' gestation. Biomarkers were evaluated with respect to their degree of association to levels of stress, anxiety, and depression as indicated by responses from the Perceived Stress Scale, State-Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale. High levels of stress were associated with elevations of soluble CD14, lipopolysaccharide binding protein (LBP), and tumor necrosis factor-α, while anxiety was associated with elevated concentrations of C-reactive protein (CRP) in otherwise healthy pregnancies. Prenatal depression was associated with higher levels of soluble CD14, LBP, and CRP in the healthy cohort. High levels of prenatal anxiety and depression were also associated with lower concentrations of tryptophan and kynurenine, respectively, in the IBS cohort. These markers may represent a core maternal biological signature of active prenatal stress, which can be used to inform intervention strategies via stress reduction techniques or other lifestyle approaches. Such interventions may need to be tailored to reflect underlying GI conditions, such as IBS.

Nigral overexpression of α-synuclein in a rat Parkinson's disease model indicates alterations in the enteric nervous system and the gut microbiome.

BACKGROUND: A hallmark feature of Parkinson's disease (PD) is the build-up of α-synuclein protein aggregates throughout the brain; however α-synuclein is also expressed in enteric neurons. Gastrointestinal (GI) symptoms and pathology are frequently reported in PD, including constipation, increased intestinal permeability, glial pathology, and alterations to gut microbiota composition. α-synuclein can propagate through neuronal systems but the site of origin of α-synuclein pathology, whether it be the gut or the brain, is still unknown. Physical exercise is associated with alleviating symptoms of PD and with altering the composition of the gut microbiota. METHODS: This study investigated the effects of bilateral nigral injection of adeno-associated virus (AAV)-α-synuclein on enteric neurons, glia and neurochemistry, the gut microbiome, and bile acid metabolism in rats, some of whom were exposed to voluntary exercise. KEY RESULTS: Nigral overexpression of α-synuclein resulted in significant neuronal loss in the ileal submucosal plexus with no change in enteric glia. In contrast, the myenteric plexus showed a significant increase in glial expression, while neuronal numbers were maintained. Concomitant alterations were observed in the gut microbiome and related bile acid metabolism. Voluntary running protected against neuronal loss, increased enteric glial expression, and modified gut microbiome composition in the brain-injected AAV-α-synuclein PD model. CONCLUSIONS AND INFERENCES: These results show that developing nigral α-synuclein pathology in this PD model exerts significant alterations on the enteric nervous system (ENS) and gut microbiome that are receptive to modification by exercise. This highlights brain to gut communication as an important mechanism in PD pathology.