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Background: For children with cystic fibrosis (CF), achieving and maintaining optimal growth by the age of 2 years is critical for future health outcomes. A standardized nutrition screening is needed to identify growth problems, enable timely interventions, and improve nutritional outcomes for children (0 to 2 years) with CF. The purpose of this study was to develop a nutrition screening tool for children (0 to 2 years) with CF to identify nutrition risk at every clinical encounter., Methods: A retrospective cross-sectional study was used to develop a nutrition screening tool to determine if nutrition interventions needed to change (at-risk) or continue (not at-risk). Retrospective data for pertinent nutrition factors were collected for 99 children attending an accredited CF clinic. The nutrition factors were compared to a dietitian assessment. A stepwise discriminant analysis determined weight-for-age (WFA) and weight-for-length (WFL) z-scores were significant. Then anthropometric data and corresponding dietitian assessment results were collected for children with CF attending two other accredited CF clinics (n = 29, n = 30). Discriminant analysis was used to determine sensitivity and specificity of the nutrition factors and to create a nutrition screening tool equation., Results: The nutrition screening model that included WFA z-score, LFA z-score, WFL z-score, and weight change velocity adequacy determined nutrition risk the best. The sensitivity was 89.7 %, specificity 83.2 %, NPV 93.3 %, and PPV 75.4 % for this model., Conclusion: The nutrition screening tool equation developed in this study standardizes the process to identify children (0 to 2 years) with CF at nutrition risk. Further validation is needed., Competing Interests: Declaration of Competing Interest None of the authors have conflicts of interest to declare., (Copyright © 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.)

Background: Members of the dietetics profession have been discussing and confronting the lack of diversity within the profession. The Academy of Nutrition and Dietetics is committed to diversity and inclusion efforts., Objective: Our aim was to determine current admission criteria and practices used by Dietetic Internships (DIs) across the United States., Design: This was a cross-sectional study using electronic survey with open and close-ended items conducted in the fall of 2020., Participants: The electronic survey was distributed to 261 DI directors. Statistical analysis performed Descriptive statistics were calculated for each variable using SPSS software. Six topically related open-ended items were analyzed through a qualitative thematic approach., Results: DI directors (n = 89) were primarily female (n = 76) and White (n = 77). Most admissions process and criteria decisions were made by committees. Directors (n = 79) reported using a predefined rubric/scoring system for candidate evaluation. Many (n = 60) indicated not using Graduate Record Examination scores. All reported considering Didactic Program in Dietetics' grade point average; personal statement quality; professional interests and goals; and type and quantity of previous dietetics-related work and volunteer experience. The admission factors rated (on a 7-point scale) most important were quality of interview (mean = 6.03), Didactic Program in Dietetics' grade point average (mean = 5.67), type of work and volunteer experience (mean = 5.62), quality of personal statement (mean = 5.5), recommender comments (mean = 5.41), and quantity of work and volunteer experience (mean = 5.40). Most (n = 80) indicated that they were satisfied with their selection processes., Conclusions: Educators should continue refining admissions processes as professional gatekeepers, consider reducing application fees, diversifying and training selection committees, re-evaluating admission criteria, and assessing how criteria weights., (Copyright © 2023 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Objective: To examine websites of didactic programs in dietetics (DPD) for diversity, equity, and inclusion (DEI)-related language and to assess perceived gender and ethnic/racial representation in images., Methods: We conducted a content analysis on the first 6 website images and 3-elements of DPD (n = 212) websites (mission statement, goals and objectives, and the immediate landing page). Descriptive statistics and a website DEI score were calculated., Results: Equity and inclusion-related terms appeared on < 5% of websites. Diversity and culture-related terms appeared on about one-third of websites. On average, researchers perceived 28.45% of people in website images as non-White, and 20.11% as non-female. Most websites received low DEI scores., Conclusions and Implications: The DPD websites had a limited representation of DEI-related terms and image representation of individuals perceived to be non-female and non-White. Leaders of DPDs may consider displaying and describing the program's commitment to DEI on the website for potential students., (Copyright © 2022 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To (1) explore RDNs' descriptions of patient-centered care (PCC), (2) measure Registered Dietitian Nutritionists' (RDNs) preferences for PCC and (3) identify factors that affect RDNs' PCC preferences., Methods: A survey instrument including two open-ended items exploring RDN descriptions of and experiences with PCC, the Patient-Practitioner Orientation Scale (PPOS), and various factors that could influence PCC (e.g., work intensification, work engagement, and work/demographic characteristics) was expert reviewed, pilot tested, and distributed electronically to 4697 RDNs. A regression analysis was conducted, and two open-ended items were qualitatively analyzed., Results: Three themes emerged when RDNs described PCC (n = 375): dietitian/patient relationship (95.7%), organizational influence (64.4%), and interprofessional teams (26.3%). RDNs (n = 318) scored 4.60/6 on the PPOS. Higher levels of work engagement were predictive of higher PPOS scores, and heavier workloads were predictive of lower PPOS scores (p < 0.05). Primary work position also influenced PPOS scores (p<0.05)., Conclusion: RDNs have varying personal definitions of and experiences with PCC, however there are common themes. RDNs generally prefer PCC and score moderately high on the PPOS., Practice Implications: To strengthen preferences for PCC, managers should create manageable workloads and prioritize work engagement. Continued emphasis on interprofessional collaboration with and organizational promotion of RDNs could improve PCC., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Both food insecurity and malnutrition are associated with adverse health outcomes in the pediatric population. However, the research on the relationship between these factors has been inconsistent, leading to uncertainty regarding whether or how evaluation of food insecurity should be incorporated into nutrition screening or the nutrition care process. The objective of this systematic review was to determine the association between food insecurity and malnutrition related to undernutrition or overnutrition (defined by anthropometrics) in the pediatric population in the United States. A literature search was conducted using Medline, Embase, and CINAHL databases for studies published from January 2002 through November 2017. A total of 23 studies (19 cross-sectional and 4 prospective cohort studies) met inclusion criteria and were included in qualitative analysis. In 6 studies, there was no overall relationship between food insecurity and underweight. All included studies examined the relationship between food insecurity status and overweight/obesity and results were mixed, with large cross-sectional studies demonstrating a positive relationship between food insecurity and overweight/obesity. There were no clear patterns according to subpopulation. Evidence quality was graded as fair due to heterogeneity in how food insecurity was measured and populations included as well as inconsistency in results. Use of a 2-item food insecurity screening tool may allow for efficient, effective screening of food insecurity in order to identify potential contributors overweight and obesity., (Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Nutrition screening tools are used to identify risk of malnutrition or change in risk of malnutrition. However, it is unclear which tools have demonstrated high validity, reliability, and agreement., Objective: Our aim was to conduct a systematic review of valid and reliable pediatric nutrition screening tools for identifying malnutrition risk (under- or overnutrition), and to determine whether there are differences in validity and reliability according to users of the tools., Methods: A literature search using Medline, Embase, and CINAHL databases was conducted to identify relevant research published between 1995 and May 2017 examining validity and reliability of nutrition screening tools in the pediatric population. A multidisciplinary workgroup developed eligibility criteria, data were extracted and summarized, risk of bias was assessed, and evidence strength was graded, according to a standard process., Results: Twenty-nine studies met inclusion criteria. Thirteen pediatric nutrition screening tools designed for various settings were included in the review (seven inpatient/hospital, three outpatient or specialty setting, and three community). The most frequently examined tools were the Screening Tool for the Assessment of Malnutrition in Pediatrics, Screening Tool for Risk on Nutritional Status and Growth (13 studies each), and Paediatric Yorkhill Malnutrition Score (nine studies). No tools demonstrated high validity. Reliability and agreement were reported infrequently., Conclusions: Nutrition screening tools with good/strong or fair evidence and moderate validity included the Screening Tool for the Assessment of Malnutrition in Pediatrics, Screening Tool for Risk on Nutritional Status and Growth, and Paediatric Yorkhill Malnutrition Score in the inpatient setting and Nutrition Risk Screening Tool for Children and Adolescents with Cystic Fibrosis in the specialty setting. No tools in the community setting met these criteria. While differences in validity and reliability measures among tool users were found, the significance of these findings is unclear. Limitations included few studies examining each tool, heterogeneity between studies examining a common tool, and lack of tools that included currently recommended indicators to identify pediatric malnutrition., (Copyright © 2020 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments., Methods: In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as <600 kcal, <700 mg sodium, and <30% fat. Signage with nutrition information and health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase., Results: Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; P<0.001)., Conclusions: Promoting healthy entrées with nutrition information and branding has a positive influence on the nutrition environment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors., (Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)