Efad newsletter september 2015

The Voice of

European Dietitians President's Message:

Welcome back from your summer break! As my picture shows taken about 10 days ago I still want to be on holiday! But our Newsletter brings me back to reality and shows how hard dietitians have been working in many diverse and significant ways.

Firstly, many congratulations to our co-­‐chairs of the European Network of Dietetic Students on winning the Complete Nutrition ‘Student of the Year Competition’ – read more on page 12. What a wonderful and well-­‐ deserved honour and recognition for European students.

Other members have also been in the news: in particular, the Portuguese nutritionists came up with a novel way of directly influencing their politicians in parliament -­‐ see page 9. Also, the irrepressible Arnt Steffensen from the Norwegian Dietetic Association launched a campaign to bring to the attention of public and politicians the situation regarding food and nutrition, and especially malnutrition, in care homes. Arnt took a ‘pressure’ point of public concern and showed how dietitians can make a difference through carefully timed and coordinated media events. These can have a real impact and may become a political issue in Norwegian local/national elections.

Arnt highlighted two objectives from the European Dietetic Action Plan (EuDAP; 2015-­‐ 2020) and I hope that more readers will tell us how they are meeting the EuDAP actions in future issues of the Newsletter.

It is conference season and the EFAD conference programme is ready and I hope to see many of you in Amsterdam – see the next two pages for the finalised programme. We will be welcoming our newest European Specialist Dietetic Network (ESDN) in Oncology and showcasing our other ESDNs as dietitians share their expertise and interests. Once again we will be attracting dietitians from across the world to our conference and seeing that students are also on exchange visits (Germany / Canada page 6) makes me wonder how much else is going on in Europe to share and develop the profession. Please keep those inspiring updates coming into the Editor – it is all abut communication!

Anne

Anne de Looy, President, EFAD Professor of Dietetics, Plymouth University, England

B o o

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Now Finalised

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Norway

'Appetite for Life': Challenging the Politicians

Randi Flesland (left), Director of the Norwegian Consumer Council, with me at the annual Arendalsuka Political Festival in the city of Arendal in August

The Norwegian Consumer Council is a government watchdog that looks after the rights of consumers. One of their sections works with food-­‐related issues. This spring they decided to have a closer look at care homes for the elderly, after alarming reports in the press about malnutrition.

The Norwegian Dietetic Association has been debating the question in the media for some time, which had caught the Consumer Council’s attention. Therefore they wanted us to join them in a partnership. The Council wanted to write and publish a report about malnutrition and meals for the elderly, addressing the politicians in charge, as the local elections were coming up in September. Appetite for Life became the name of the project. Early in the process, the project group decided to have a positive angle to the project. We set out to find best practice in care facility homes, and visited a dozen homes throughout the country. We then selected three of them, the best examples, and described in the report what they were doing and what criteria they used to measure success. We also hired a professional film crew to make three short films from the places, to be shared in social media when the project was to be launched. http://youtu.be/Cxx5P5dJMKU

At the same time we conducted a national survey, which showed that 80 % of respondents thought this was an important issue that should have a high profile in the upcoming local elections. Only 20 % believed that the local politicians were concerned at all about meal quality in care homes. Based on this research, we challenged the politicians. Inspired by similar activity in 'Appetite for Life' is all about Copenhagen, Denmark, we strongly encouraged making politicians aware of every county in Norway to adopt an active policy for food and public meals, in order to ensure that the their responsibilities elderly get good nutritious care. This initiative is all about making the politicians aware of their responsibilities: demonstrating respect for the elderly, the dietetic work and the food quality. Giving care homes enough resources to do their work properly is not just about throwing money at the problem, but also about the organization of the work and having a civilised ratio of catering staff to the number being served.

We also conducted a survey among our members in the hospital and facility care catering services, which showed that over 80 % of the kitchens would like more freedom to choose good quality food when catering for the elderly. Too often, the kitchen has to buy the cheapest, and therefore the most tasteless food available, because the framework agreement says that it has to. For example, we visited a care home in the north of Norway, only 50 metres from the sea, with lots of fishing boats in the area. The sea in this area is rich in fish and I actually saw three whales when we were visiting the place. While politicians pay lip-­‐service to the benefits of ________________________________________________________________________________________________ EFAD Newsletter September 2015 www.efad.org 4

using local food and fresh products, the chef in this particular facility told me that the framework agreement forces her to buy frozen fish from a grocer 120 km away! The need to source fresh food locally has been one of the issues raised in our report.

The report was launched during a press conference on 2 July, which received a lot of media coverage. There were more than 60 reports and interviews on national tv, radio and newspapers over two days, which was more media coverage for us than the whole of the previous two years.

The films were shared on social media and the issue was soon followed up by other organizations, local politicians and activists, who started to debate the matter. The message soon spread widely in newspapers and magazines, and was a huge success.

This was followed up in August. There is an annual political festival week in the city of Arendal, a very prestigious event. All the political parties are present, all the political journalists, all the important organizations, and an armada of lobbyists. During this week, there are hundreds of political debate meetings, from morning till late evening. Again, the Consumer Council and The Norwegian Dietetic Association joined forces, and arranged a debate meeting, among them participants from some of the political parties. The meeting was well attended, and the message was again widely spread on the social media.

The Appetite for Life project continues. At the time of writing, there are still four weeks until the local elections, so it is too early to say if this will be a major topic for the politicians to debate on a larger scale. However, the topic is on the agenda in local societies, the local newspapers are debating it, and we are planning other debate meetings in some other cities during the autumn.

Appetite for Life is a good example of work within the European Dietetic Action Plan (EuDAP). In particular, it meets two objectives of the Plan:

Objective 2: Promote the gains of a healthy diet throughout the life course, especially for the most vulnerable groups in the community and in clinical settings

Objective 5: Strengthen governance, alliances and networks for a health-­‐in-­‐all-­‐ policies approach

Arnt Steffensen President of the Norwegian Dietetic Association

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Germany

Dietitians Explore!

An Exchange Across the Atlantic

Recently three Canadian dietetic students came to Germany for a one-­‐week internship. The major topics covered during the week were the differences between the two countries in:

• education and training of dietitians • the work of dietitians • the eating habits of Canadians and Germans

The story began In March this year, Dietitians Explore!

Education Exchange offered the International Committee of the German Dietitian Association (VDD) the opportunity to be involved with an international experience for future dietetic professionals. Dietitians Explore! (DE!) is a non-­‐profit organization that facilitates international professional development trips for Canadian dietetics students. The trips create leadership opportunities for international dietitians and host and foster connections with Canadian Registered Dietitians http://dietitiansexplore.ca

In consultation with the Canadians, my fellow committee member Ursula Lukas and I developed a varied program for the students. This included:

• a presentation by the VDD President Ina Lauer on the work of the Association • visits to two hospitals to see the work of German dietitians, visit wards and get an idea of the initial patient contact with a dietitian • a presentation from me on the eating habits and nutritional status of Germans • visit to a food market where the Canadians found redcurrants and gooseberries that they had not seen before • a discussion on the recent change to the Canadian guideline on daily fluid intake: from 43.7 litres per day to 'drink by thirst' • a workshop on enteral nutrition and screening for malnutrition • a presentation in hospital of sous-­‐vide (under vacuum) cooking whereby food is sealed in airtight plastic bags then placed in a water or steam bath In the cooler of SANA Hospital in Remscheid

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The feedback from the Canadian students is shown below, together with some of their favourite German dishes that were new to them.

I have seen the many responsibilities of hospital dietitians, learned about the education and training of students and the German food culture. I would like to thank all our hosts who welcomed us and showed us around. I appreciate their time and effort very much. Danke schön!

Knödel (potato

dumplings) Photo © Kobako from

Bonnie Huang Commons.Wikimedia

I am so grateful for this opportunity to visit Germany and learn more about German dietetics. It was incredibly interesting to observe various dietetic practices, especially clinical nutrition in Krefeld. I loved my time here and hope to visit Blaukraut (spicy red cabbage) Jennifer Villalta again soon! Danke!

Photo © Frank Steiner

Our week in Germany was such a wonderful unique learning

experience. All of our hosts at the VDD were warm and welcoming and able to guide u s through the dietetic profession

It here. was so wonderful to see that our passion for dietetics is Matjes Hausfrauenart (herring with shared across the world. I will a sour cream sauce, apple & onions) definitely build on this Photo © Jessica Spengler

experience in my career as a

future dietitian. Thank you!

Katey Davidson

Next year’s DE! trip is already in planning and will go to our Slovenian colleges.

Manuela Thul Dietitian, VDD International Committee

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Austria

Dietetics & Physiotherapy Students Create Teaching Videos

Alexandra Schweiger, Linda-­‐Maria Herb, Alexandra Illy, Karin Oberreiter, Martina Ritt, Lisa Schedlberger, Anita Kiselka, Alexandra Kolm

Recently, the University of Applied Sciences in St.Pölten created the project X-­‐SITE (Student Interprofessional Teaching Experience), where we were able to create teaching videos for use in an inverted classroom model (ICM). ICM involves a pre-­‐class digital phase of learning, eg watching videos, as in this example. www.youtube.com/channel/UCRoRb7yMzwAdSzh0oEP43SA

ICM is already used in the training of medical students, where significant pre-­‐class preparation is necessary and ...in the USA ...dietetic time in class is used for discussion and/or problem-­‐ students preferred ICM the solving of relevant case studies1. The use of ICM in the over traditional in-­‐class training of dietitians in the USA showed that dietetic students preferred ICM to traditional in-­‐class teaching teaching settings settings2.

A combination of online and traditional face-­‐to-­‐face teaching can be a successful teaching strategy. A meta-­‐analysis from 20103 shows significantly better learning results when blended learning such as ICM has been used, compared to either exclusively face-­‐to-­‐face teaching or exclusively online learning methods.

Our team of seven students from dietetics and physiotherapy created four teaching videos on:

• stigma and obesity • weight reduction in focus: nutrition and sports • arthrosis (osteoarthritis) and bone metabolism • type 2 diabetes mellitus

Over two terms we did research for our videos and focused on interdisciplinary areas between physiotherapists and dietitians. We wrote movie scripts, got didactic advice from the teaching team SKILL (http://skill.fhstp.ac.at) and were supported by media students from the university.

We gained a deeper understanding through collaboration with other health professionals and improved our project management and media skills.

Contact: Alexandra Kolm, Lecturer (alexandra.kolm@fhstp.ac.at

1 Tune JD et al (2013) Flipped classroom model improves graduate student performance in cardiovascular, respiratory, and renal physiology Advances in Physiology Education Bd 37 4 316-­‐320 2 Gilboy MB et al (2014) Enhancing student engagement using the flipped classroom www.ncbi.nlm.nih.gov/pubmed?term=25262529 3 Means B et al (2010) Evaluation of Evidence-­‐Based Practices in Online Learning: A Meta-­‐Analysis and Review of Online Learning Studies Washington DC, US Department of Education, Office of Planning, Evaluation, and Policy Development ________________________________________________________________________________________________ EFAD Newsletter September 2015 www.efad.org 8

Portugal

14th Congress of Nutrition and Food: 'Nutrition: Knowledge to Act' Lisbon 21-­‐22 May

The Congress of Nutrition and Food, organized by the Association of Portuguese Nutritionists (APN), is one of the oldest and largest conferences in the field of nutrition and food in Portugal. This year it attracted more than 1200 nutritionists, registered dietitians, scientists and other professionals interested in acting as agents of change in healthcare. Also present from the Portuguese government were several senior figures with responsibilities for food, agri-­‐research and education.

Key topics from the congress included: • food waste • new techniques in catering • sports nutrition • marketing the 'healthy eating' message Later in the month, as part of the 6th annual 'Health in Parliament' project, the APN provided a nutritional check-­‐up for all Parliament employees of Parliament; ran a healthy eating workshop and provided a Mediterranean breakfast for all Parliament employees. This is an interesting way to influence political decision-­‐makers.

Miguel Yeep

EFAD General Meeting and Conference Amsterdam, The Netherlands, 21-­‐25 October 2015 Dietitians Meeting the Food and Nutrition Action Plan

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European Specialist Dietetic Network for Oncology

During recent years the importance of nutrition in cancer prevention and therapy has increased. The latest scientific evidence suggests that about 30 % of all cancers may be prevented by a combination of appropriate nutrition and physical exercise.

...30% of all cancers may For patients who are already diagnosed with cancer, an appropriate diet is an important part of the overall therapy be prevented by plan. In particular, it is vital that any malnutrition related to the illness is recognized and prevented. Early intervention appropriate diet and with nutritional support has been shown to be cost-­‐ physical exercise.... effective in this patient group.

The knowledge that poor nutritional status can affect outcomes for cancer patients has led to more dietitians working in oncology. However, there continues to be a lack of consensus in the diagnosis of malnutrition and the best ways of providing nutritional support in such cases.

However, recently EFAD convened a European Specialist Dietetic Network for Oncology (ESDNO).

At the moment the committee comprises three dietitians with expertise in oncology: • Carolina Bento (Portugal) • Julia Lobenwein (Austria) • Clare Shaw (UK)

For us in the European Network it is important to strengthen the position of dietitians in this area of responsibility and find new members to join this expert group. International exchange among the dietitians should take place in order to care for oncological patients in a standardized way according to the latest science. Our hope is to connect with other European oncology dietitians in order to discuss evidence, compare practice and share information through the EFAD website. One aim will also be to write and publish a position paper on nutrition and oncology.

In the EFAD Conference in Amsterdam next month there will be a roundtable on oncology, where committee members will introduce themselves and give presentations on some topical issues.

Clare Shaw Consultant Dietitian The Royal Marsden NHS Foundation Trust England

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Professional Practice Committee (PPC) From the PPC Desktop

Electronic Nutrition Care Process Terminology (eNCPT) and Standardized Language

The American Academy of Nutrition and Dietetics has recently updated 15 video modules that explain the Nutrition Care Process and the layout and organization of the eNCPT. Each module is approximately 10 minutes long. The modules are free to everyone. To access the modules, click on this link: https://ncpt.webauthor.com/encpt-­‐tutorials. The modules are great to use as an inspiration for both educators, students and at workshops for dietitians. At the moment the electronic version is available in English, Swedish, Swiss German and Canadian French).

Additional languages will become available in electronic form (eNCPT). https://ncpt.webauthor.com/modules/portal/publications.cfm

Research Dietitians in Europe

Research and Evidence Based Practice Committee

At the request of European dietitians, the committee has established a database of dietitians involved in dietetic research. This will help dietitians to find their colleagues in Europe and will facilitate European dietetic research.

In 2014, the REBPC invited research dietitians in Europe to complete an online questionnaire on their work. The questionnaire asked for information about research areas, research projects and activities, working areas and affiliations. Results were published on the EFAD extranet.

In April 2015, EFAD and National Dietetic Associations put out a call for new registrations and gave those already registered the opportunity to change their details. Once again, registrants completed an online questionnaire and the results were published on the EFAD extranet.

After these two calls, the database contains research information on 154 dietitians from 13 countries. Most of these 154 research dietitians worked in hospitals and higher education. As their main dietitians in 13 research area, most dietitians mentioned obesity, weight management, diabetes and childhood& countries adolescents.

In 2016, the REBPC will evaluate how dietitians acountries re using the research database. To view the database and the database report, go to www.efad.org/iextranet/4738/5/0/70

Elke Naumann, Chair EFAD Research and Evidence Based Practice Committee e.naumann@han.nl

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Complete Nutrition Magazine:

Two Dietetics Students a re J oint

Winners of Student of the Year!

Ann-­‐Christin Lindenau (left) and Amelie Kahl just after they heard the news

Two dietetics students from Neubrandenburg, Germany have won the prestigious Student of the Year Award run by Complete Nutrition magazine and sponsored by the British clinical nutrition supply company Nutrinovo. Readers of the magazine (nutrition professionals) voted for Ann-­‐ Christin and Amelie, and both have been invited to the CN Award Winners Afternoon Tea in London on 25 September for the awards ceremony.

Ann-­‐Christin and Amelie were nominated for this award by Anne de Looy (EFAD President) and Koen Vanherle, (EFAD anchor of ENDietS). Part of their written nomination was:

Amélie and Ann-­‐Christin have played a major role in establishing the ENDietS network: • Preparing and leading frequent virtual meetings • Making promotional material, such as a video and other information (see http://www.efad.org/everyone/4803/5/0/32) • Working on mission & vision statements, work plans & a strategy for the future • Representing the network at national conferences and promoting the profession • Organising the first European student webinar • Coached and motivated other students within the network More is still planned and all on a voluntary basis! I am convinced that in future years, many dietetic students will look back with gratitude to their vision and commitment.

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This is how Ann-­‐Christin reacted when she heard the news:

It was Wednesday afternoon and Amelie and I were sitting in my garden having a barbecue together. I was checking my emails when suddenly I found the one from CN Magazine and I read it out loud: Congratulations you are the winners of this year's student of the year award.

We looked at each other, jumped immediately out of our seats, hugged each other laughing and screaming due to the happiness we felt in this moment.

We smiled at each other the whole evening. It was such a great moment that we were sitting together and could share this special moment. Since the start of the ENDietS network last year, the time has passed so fast. It is a really great experience for us to work in this network and we are every day overwhelmed by how many interested students we can reach all over the world.

We really would like to thank Prof Anne de Looy and Koen Vanherle for their nomination. We never expected that we would be nominated for such an award, especially as this is a British magazine a different country. Therefore we felt very pleased and honoured to win such an award. We really want to thank you all readers, friends and members who support us and gave us their votes. Especially we would like say thank you to our fantastic ENDietS anchor team for their great work and enthusiasm. The network is still in the beginning of its development and we are looking forward to what will happen in the future.

More Information on the European Network of Dietetic Students (ENDietS)

ENDietS is a network of dietetic students established in 2014 in the students workshop of the 8th EFAD Conference in Athens.

Who can be a Member?

Membership of ENDietS is open to any student of dietetics in Europe. Membership is free.

To join, click here: www.efad.org/survey/index.php?sid=47181&lang=en How is ENDietS Organised?

A voluntary executive team of students lead EnDietS. EFAD representatives provide coaching and to ensure the network’s sustainability. We hold regular virtual meetings and attend the annual EFAD conference. ENDietS is embedded within EFAD, which represents the interests of all European dietitians and dietetic students and promotes the development of the dietetic profession.

What is the vision of ENDietS? ENDietS aims to develop activities for dietetic students and by dietetic students. The network also offers us the opportunity to speak as the one voice of European dietetic students when dealing with student associations in different health fields and policy makers.

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Save the Dates

www.efadconference.com Deadline for Submissions for the Winter Newsletter: 30 November 2015 to: editor@efad.org See Guidelines for Authors on the next page

www.efad.org European Dietitians ________________________________________________________________________________________________ EFAD Newsletter September 2015 www.efad.org 14

Guidelines for Submitting Articles to the EFAD Newsletter • • • • • •

Please read previous editions of the Newsletter available here: www.efad.org/everyone/3147/5/0/32 Your article should be in English and emailed to me Terry Hyde: editor@efad.org Your article should be about 500 words (2,500 characters with spaces), but can be up to 1000 words if it is particularly important.

Please send your own photographs or ones that are licensed as free-­‐to-­‐use for non-­‐ commercial purposes If your article does not include the words 'dietitian' or 'dietetics', then it is unlikely to be published.

I will edit all articles to meet the needs of a very wide audience: from undergraduate students to Ministers of Health and senior figures at WHO.

The first language of most of our readers and authors will not be English. Therefore, I will also edit to ensure that the writing is concise; the meaning is clear and the language is free of bias. I will use plain English, modern English usage & open punctuation.

What is plain English?

Some of the principles of plain English are: • use short words rather than long words • write in short sentences rather than long ones • use the active verb rather than the passive, eg 'I edit the Newsletter” not “The Newsletter is edited by me' • use lists where possible • avoid jargon, acronyms and abbreviations

In science and education, the last point is probably the most difficult to follow. All of our readers will know what EFAD and EU and UN refer to (and probably WHO), but how many will know what FNAP refers to? For more information on plain English, go to www.plainenglish.co.uk

What is modern English usage?

English is a living language in constant change; in particular it absorbs words from other languages and treats them as its own. New words arrive every day and others drop out of use. Existing words change their meanings or develop extra meanings. A few years ago, the only thing that could be stored in a cloud was water vapour, but now…. Spellings and constructions also change.

So, in modern English usage the word ‘lifelong’ is written as one word (no space, no hyphen); similarly with the words ‘online’ and ‘website’. A date such as '24th March', is now more commonly written as '24 March'. Part of my job is to reflect these changes in usage and spelling etc. For more information on modern English usage, see Burchfield RW (2004) Fowler's Modern English Usage 3rd Ed Re-­‐revised OUP Oxford.

What is Open Punctuation?

Open punctuation seeks to reduce the number of keystrokes needed to type a document. It does this by removing unnecessary punctuation and capital letters. So:

Ph.D. → PhD B.Sc. → BSc e.g. → eg Dr. → Dr

..Doctors, Dietitians and Physiotherapists... → ...doctors, dietitians and physiotherapists... ________________________________________________________________________________________________ EFAD Newsletter September 2015 www.efad.org 15