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BACKGROUND: Integrating nutrition care into physiotherapy can address modifiable risk factors contributing to chronic diseases, providing comprehensive and effective patient care, and supporting a wellness-oriented approach to healthcare. OBJECTIVE: To investigate physiotherapists' self-perceived confidence in their competence in nutrition care in Ireland. METHODS: Cross-sectional study using data from a validated online survey tool. Four constructs of competence in nutrition care were assessed: knowledge, skill, communication and counseling, and attitude. Open-ended responses were collected to gather opinions on nutrition knowledge requirements. Participants were chartered physiotherapists representing public and private workplaces across geographical settings in Ireland. RESULTS: 447 physiotherapists completed the survey. Most were female (n = 364, 81%), in private practice (n = 136, 31%), and located in a city (n = 215, 48%) with a mean 17 years post-qualification experience. Participants' self-perceived confidence in nutrition care competence was positive (mean score of 107.2/175). However, knowledge (mean score of 18.5/35) and skills (mean score of 27.2/55) related to nutrition care received lower ratings. Age and years of practice were positively associated with higher confidence in providing nutrition care. Most participants (n = 314, 71%) agreed that additional nutrition education is needed. Three overarching themes were identified regarding nutrition knowledge requirements: importance of providing nutrition advice, stated knowledge needs for nutrition education and training, and feasibility of nutrition care within physiotherapy practice. CONCLUSIONS: Physiotherapists in Ireland have confidence in provision of nutrition care but rated their knowledge and skills in nutrition as relatively low. Nutrition knowledge and skill are essential for physiotherapist practice as they can significantly impact patients' outcomes.
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Background: Pharmacists are integral members of healthcare teams, providing accessible nutrition care to patients, carers and health professionals. However, little is known about nutrition competence among pharmacists. Objective: The aim of the study is to determine the self-perceived competence in providing nutrition care among pharmacists in Ireland. Methods: This cross-sectional study used a mixed methods design consisting of an online survey delivered to pharmacists in Ireland. The pharmacists' self-perceived competencies according to confidence in knowledge, skills, communication and counselling, and attitudes in nutrition care were assessed using the validated NUTCOMP questionnaire. Qualitative responses in relation to nutrition knowledge were also gathered. Questionnaire responses were analysed using descriptive statistics and free text narratives were coded into themes and subthemes. Results: A total of n = 557 (74% (n = 413) female; 24.1% (n = 134) male) respondents completed the questionnaire providing a 14.9% response rate. Confidence in nutrition knowledge (mean score (SD) 21.6 (±4.31) out of a maximum of 35 points), nutrition skills (mean score (SD) 31.8 (±7.74) out of a maximum count of 55) and nutrition related counselling and communication (mean score (SD) 29.8 (±6.35) out of a maximum of 45 points) were limited. Most respondents had completed a programme with some nutrition content (60.8%) either formally or informally. Previous nutrition education was positively associated with greater scores in knowledge, skills, communication/counselling and attitudes towards nutrition care (p = ≤0.001). Over three-quarters of respondents (78.1%) agreed that they would like further nutrition education to support themselves in their roles as pharmacists. Thematic analysis highlights the role of interprofessional nutrition care, barriers to providing nutritional care in practice and opportunities for improving nutrition training. Conclusions: Most pharmacists reported being somewhat confident in their nutrition knowledge, skills and attitudes and are willing to participate in further nutrition education to support their patients. The findings suggest that there are other barriers to providing nutrition care in the pharmacy setting such as time, renumeration and lack of community dietitians.
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UNLABELLED: The marked deficiency of peroxisomal organelle assembly in the PEX2(-/-) mouse model for Zellweger syndrome provides a unique opportunity to developmentally and biochemically characterize hepatic disease progression and bile acid products. The postnatal survival of homozygous mutants enabled us to evaluate the response to bile acid replenishment in this disease state. PEX2 mutant liver has severe but transient intrahepatic cholestasis that abates in the early postnatal period and progresses to steatohepatitis by postnatal day 36. We confirmed the expected reduction of mature C24 bile acids, accumulation of C27-bile acid intermediates, and low total bile acid level in liver and bile from these mutant mice. Treating the PEX2(-/-) mice with bile acids prolonged postnatal survival, alleviated intrahepatic cholestasis and intestinal malabsorption, reduced C27-bile acid intermediate production, and prevented older mutants from developing severe steatohepatitis. However, this therapy exacerbated the degree of hepatic steatosis and worsened the already severe mitochondrial and cellular damage in peroxisome-deficient liver. Both untreated and bile acid-fed PEX2(-/-) mice accumulated high levels of predominantly unconjugated bile acids in plasma because of altered expression of hepatocyte bile acid transporters. Significant amounts of unconjugated bile acids were also found in the liver and bile of PEX2 mutants, indicating a generalized defect in bile acid conjugation. CONCLUSION: Peroxisome deficiency widely disturbs bile acid homeostasis and hepatic functioning in mice, and the high sensitivity of the peroxisome-deficient liver to bile acid toxicity limits the effectiveness of bile acid therapy for preventing hepatic disease.