The holistic maternity care needs of women with Gestational Diabetes Mellitus: A systematic review with thematic synthesis.

PROBLEM: Models of care for women with gestational diabetes mellitus (GDM) have evolved in an ad hoc way and do not meet women's needs. BACKGROUND: GDM affects 50,000 Australian women per annum with prevalence quadrupling in the last ten years. Many health services are struggling to provide a quality service. People with diabetes are calling for care that focuses on their wellbeing more broadly. AIM: To examine the holistic (emotional, social, economic, and spiritual) care needs of women with GDM. METHODS: Qualitative and mixed-methods studies capturing the healthcare experiences of women with GDM were searched for in CINAHL, Medline, Web of Science and Scopus. English-language studies published between 2011 and 2023 were included. Quality of studies was assessed using Crowe Critical Appraisal Tool and NVIVO was used to identify key themes and synthesise data. FINDINGS: Twenty-eight studies were included, representing the experiences of 958 women. Five themes reflect women's holistic needs through their journey from initial diagnosis to postpartum: psychological impact, information and education, making change for better health, support, and care transition. DISCUSSION: The biomedical, fetal-centric model of care neglects the woman's holistic wellbeing resulting in high levels of unmet need. Discontinuity between tertiary and primary services results in a missed opportunity to assist women to make longer term changes that would benefit themselves (and their families) into the future. CONCLUSIONS: The provision of holistic models of care for this cohort is pivotal to improving clinical outcomes and the experiences of women with GDM.

#Healthpromotion: A qualitative exploration of how dietitians can use social media to positively influence women aged 18-35 years.

AIMS: To understand how young adult women use social media, including which nutrition and health-related content they prefer to view and why. Findings are intended to support dietitians to use social media more effectively for health promotion to reach, educate and positively influence young adult women. METHODS: Qualitative research was conducted through semi-structured interviews involving 10 women aged 18-35 years via Zoom videoconferencing. The interviews were recorded, transcribed verbatim and analysed using an interpretative phenomenological approach. RESULTS: Young adult women use social media daily to view a wide variety of content, including nutrition and health-related content. Three themes were identified: authenticity, engaging content, and affecting trust through selling products. CONCLUSION: To effectively use social media for health promotion, dietitians need to share their authentic voice while maintaining professional standards. Recommendations for effective social media engagement include using engaging content, infographics, and videos with closed captions. More research is needed to assess whether health promotion deployed via social media is effective at increasing nutrition knowledge, improving health literacy, and producing behaviour change.

Associations between appetitive traits, dietary patterns and weight status of children attending the School Kids Intervention Program.

BACKGROUND: The nexus between appetitive traits, dietary patterns and weight status has predominantly been studied in a mixed sample (healthy weight, overweight and obese sample). AIM: This cross-sectional study examined associations between overweight/obese children's appetitive traits, dietary patterns and weight status. METHODS: We studied children (N = 58, body mass index z-score: 2.25±0.46), 4-12 years attending the School Kids Intervention Program. Children's appetitive traits and dietary patterns were measured with the Child Eating Behaviour Questionnaire and Children's Dietary Questionnaire, respectively. Children's height and weight were used to compute body mass index z-score; waist circumference was also measured and waist-to-height ratio was calculated. RESULTS: After controlling for children's age and gender, hierarchical linear regression analyses showed that lower scores for slowness in eating were associated with higher body mass index z-scores in children (ß = -0.31, p = 0.01). Higher scores for emotional overeating were associated with higher waist-to-height ratio in children (ß = 0.48, p = 0.01). Higher scores for fussiness were correlated with lower scores for fruits and vegetables (ß = -0.59, p < 0.001) and higher scores for non-core foods (ß = 0.26, p = 0.04). CONCLUSION: Results observed in the current sample of overweight and obese children are consistent with previous studies examining healthy-weight children. Slowness in eating may foster an obesity 'protective' effect, whereas emotional overeating may promote susceptibility to weight gain. Fussy eating may impair diet quality by lower consumption of vegetables and fruits and higher intake of non-core foods. This evidence will support dietitians to consider children's appetitive traits when providing dietary consultation to support obesity management among overweight/obese children.

The Environmental and Bitter Taste Endophenotype Determinants of Picky Eating in Australian School-Aged Children 7-12 years-A Cross-Sectional Pilot Study Protocol.

Caregivers' perceptions of children's pickiness are relatively scarce in relation to the five core food groups and their importance in providing a nutritionally balanced diet. Furthermore, there is no validated questionnaire that examines child-reported food preferences in an age-appropriate manner, and the use of terms such as a "picky eater" can be attributed to environmental and genetic factors. Despite potential links between children's food preferences and endophenotype bitter taste, associations between bitter taste sensitivity and picky eating is relatively unexplored. The proposed cross-sectional study aims to develop and validate a parent-reported core-food Picky Eating Questionnaire (PEQ) and child-reported Food Preference Questionnaire (C-FPQ) and simultaneously investigate environmental and phenotype determinants of picky eating. The study will be conducted in three stages: Phase 1, piloting PEQ and C-FPQ questionnaires (15-20 primary caregivers and their children aged 7-12 years); Phase 2 and 3, validating the revised questionnaires and evaluating the 6-n-propylthiouracil (PROP) bitter taste sensitivity to examine perception to bitter taste (369 primary caregivers and their children). Study findings will generate new validated tools (PEQ, C-FPQ) for use in evidence-based practice and research and explore picky eating as a behavioural issue via the potential genetic-phenotype basis of bitter taste sensitivity.

A Consensus Model: Shifting assessment practices in dietetics tertiary education.

AIM: The aim of this research was to evaluate a Consensus Model for competency-based assessment. METHODS: An evaluative case study was used to allow a holistic examination of a constructivist-interpretivist programmatic model of assessment. Using a modified Delphi process, the competence of all 29 students enrolled in their final year of a Master of Nutrition and Dietetics course was assessed by a panel (with expertise in competency-based assessment; industry and academic representation) from a course e-portfolio (that included the judgements of student performance made by worksite educators) and a panel interview. Data were triangulated with assessments from a capstone internship. Qualitative descriptive studies with worksite educators (focus groups n = 4, n = 5, n = 8) and students (personal interviews n = 29) explored stakeholder experiences analysed using thematic analysis. RESULTS: Panel consensus was achieved for all cases by the third-round and corroborated by internship outcomes. For 34% of students this differed to the 'interpretations' of their performance made by their worksite educator/s. Emerging qualitative themes from stakeholder data found the model: (i) supported sustainable assessment practices; (ii) shifted the power relationship between students and worksite educators and (iii) provided a fair method to assess competence. To maximise benefits, more refinement, resources and training are required. CONCLUSIONS: This research questions competency-based assessment practices based on discrete placement units and supports a constructivist-interpretivist programmatic approach where evidence across a whole course of study is considered by a panel of assessors.