Exploring the role of dietitians in mental health services and the perceived barriers and enablers to service delivery: A cross-sectional study.

BACKGROUND: Mental health is a rapidly evolving area of practice for dietitians. The role of dietitians in supporting the physical health of consumers experiencing mental illness is becoming more widely recognised given the importance of lifestyle interventions for physical health. The present study aimed to explore the dietitian role in mental health services as well as identify barriers and enablers to service delivery. METHODS: This was a cross-sectional survey of dietitians currently employed in any capacity in public and private mental health services. An online survey comprised of questions pertaining to four domains, including demographics, role and service provision, experience and supervision, barriers/challenges and drivers/enablers was completed and included closed and open-ended responses. RESULTS: In total, 48 responses were included. The mean ± SD age of respondents was 36.1 ± 10.9 years (range 23-67 years) with the majority working in inpatient settings. The top three tasks respondents reported conducting were individual consultations (n = 47; 98%), group programs (n = 23; 48%) and multidisciplinary team meetings. Barriers included a lack of awareness from others regarding a dietitian's role in mental health, and a lack of specific tools for nutrition screening. More training, resources and increased evidence base to guide practice would enable better service provision. CONCLUSIONS: The present study provides insights regarding the possible drivers and barriers to effective service provision for dietitians working in mental health services focusing on the local contexts of respondents. The findings highlight the importance and value of working collaboratively within a multidisciplinary team.

Current practice in the introduction of solid foods for preterm infants.

OBJECTIVE: The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction. DESIGN: Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12 months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed. SETTING: This prospective longitudinal study recruited primary carers of preterm and term infants from a regional metropolitan referral hospital in eastern Australia. PARTICIPANTS: One hundred and fifty infants (preterm, n 85; term, n 65). RESULTS: When corrected for prematurity, preterm infants received solid foods before the recommended age for the introduction of solid foods for term infants. Median introduction of solid foods for preterm infants was 14 weeks corrected age (range 12-17 weeks). This was significantly less than 19 weeks (range 17-21 weeks) for term infants (P < 0·001). Lower maternal education and male gender were associated with earlier introduction of solid foods among preterm infants. CONCLUSIONS: Preterm infants are introduced to solid foods earlier than recommended for term infants, taking account of their corrected age. Further research is needed to assess any risk or benefit associated with this pattern and thus to develop clear evidence-based feeding guidelines for preterm infants.

The prevalence of diabetes after gestational diabetes - An Australian perspective.

BACKGROUND: Women with gestational diabetes mellitus (GDM) are likely to develop diabetes in later life. International reports and reviews indicate a variable but generally high rate of conversion. However, data from international reports are difficult to apply to an Australian population. AIM: To investigate in Australia, in a representative population, the prevalence of diabetes developing in women who have been diagnosed with one criteria and who have had uniform standards of clinical care. MATERIAL AND METHODS: This study considered women referred with a diagnosis of GDM according to the Australasian Diabetes in Pregnancy Society criteria and seen by one practitioner over a 20 year period, from 1991 to 2010. The area of referral had an ethnic distribution similar to the overall Australian demography. RESULTS: Despite, in some cases, being more than 25 years since the pregnancy, more than half the women were contactable and the majority agreed to have their diabetes status declared or determined. The overall prevalence was 10.3%. The prevalence at each 10 year age increment was more than twice the figure reported from the AusDiab study. A higher maternal body mass index and a positive family history of diabetes were the strongest predictive factors. The prevalence of undiagnosed diabetes was 0.9%. CONCLUSION: In a representative population, after GDM, the prevalence of diabetes of 10.3% was far lower than that reported internationally but was still about twice the rate for the overall Australian population.