Examining dietitians' knowledge, skills and attitudes regarding working with older adults in residential aged care facilities and home care services: An integrative review.

BACKGROUND: The Australian 2021 Royal Commission identified that the dietetic workforce needs to grow in size and capacity to support nutrition care in older adults. However, little is known about dietitians' knowledge, skills and attitudes (KSA) regarding working with older adults in residential aged care facilities (RACFs) or their homes. This review describes dietitians' KSA regarding older adults in RACFs and home care services. METHODS: A systematic literature search was conducted in August 2021 to identify studies examining any aspect of dietitians or student dietitians' KSA working in RACFs and home care services. No restrictions were applied to methodological design, language, location or publication year. Studies were assessed for quality using the Johanna Briggs Institute Quality Appraisal Tools. Study findings were analysed thematically using meta-synthesis. RESULTS: All 17 studies that met the inclusion criteria explored dietitians' attitudes towards their role, three studies examined perceived knowledge, although no studies objectively explored dietitians' skill levels. Five themes were developed inductively: (1) recognising their contribution as dietitians; (2) lacking clarity about the boundaries of their role; (3) all team members have a role to play in nutrition care; (4) assumptions and biases about working with older people; and (5) needing to build capacity in the workforce. DISCUSSION: Dietitians have mixed attitudes about working in RACFs and home care services. Future directions include evaluating dietitians' role in RACFs, reviewing education and training and practical opportunities for student dietitians, and assessing the impact of more dietitian support on an older person's dietary intake and nutrition.

Effects of Different Sources of Low-Dose Caffeine on Mood/Arousal and Cognitive Performance.

In this study we investigated the effects of variously derived sources of low-dose caffeine on mood/arousal and cognitive performance. Twenty-two participants (15 men, 7 women; M age: 28.2, SD = 9.0 years) undertook five randomized, crossover trials in which they consumed either a water control (CON) or 80 mg of caffeine from one of four sources (coffee [COF], energy drink [END], capsule [CAP], and dissolvable mouth strip [STR]). We measured the participants' perceived efficacy of these varied caffeine sources pre-treatment; and we measured mood/arousal at pre-treatment, and again at 15 and 45 minutes post-treatment. We also measured choice reaction-time at 15 and 45 minutes post-treatment, and participants completed the psychomotor vigilance task (PVT) 45 minutes post-treatment. Caffeine increased participant ratings of alertness and decreased their ratings of tiredness irrespective of source (p's < .05), and all sources of caffeine decreased reaction time on the PVT (p's < .05), with ex-Gaussian distributional analysis localizing this to the tau-parameter, indicating lower variability. However, only the COF source was associated with improved 'overall mood' (p's < .05). Participants expected to perform better on the PVT with COF compared to CON, but there were no other significant associations between source expectancy and performance. In sum, a modest dose of caffeine, regardless of source, positively impacted mood/arousal and cognitive performance, and these effects did not appear to be influenced by expectations.