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With the focus of care shifting from the hospital to the community, supportive nutritional care to old people is to become an important issue to address in the community, since undernutrition has serious consequences, both for the quality of life and for the health care costs. Several modifiable nutritional risk factors relate to undernutrition. Unfortunately, the problem with (risk of) undernutrition is aggravated due to a lack of alertness among e.g. health care staff, leading to insufficient attention for systemic screening and nutritional care. Only a few of the existing screening tools have been validated among old people receiving support at home. Few studies have assessed the beneficial effect of nutritional support among old people in their own home, and recently, it was concluded that such have shown limited effects. One reason may be that the nutritional interventions performed have not taken the multiple nutritional risk factors afore-mentioned into consideration when formulating the action/treatment plan and hence not used a multidisciplinary approach. Another reason may be that the intervention studies have not used validated screening tools to identify those old people most likely to benefit from the nutritional support. However, three recent studies have used a multidisciplinary approach and two have proven a beneficial effect on the quality of life of the old people and the health care costs. These findings suggest that when planning nutritional intervention studies for old people receiving support at home, modifiable nutritional risk factors should be taken into consideration, and a multidisciplinary approach considered.

Cancer cachexia is a complex syndrome. Its defining feature is involuntary weight loss, which arises, in part, because of muscle atrophy and is accompanied by functional decline. International expert consensus recommends that nutritional support and counselling is a component of multimodal therapy for cancer cachexia, as poor nutritional intake can contribute to progression of the syndrome. The present paper focuses on what is presently known about the nursing contribution to nutritional care in cancer cachexia. There is potential for nurses to play an important role. However, obstacles to this include lack of a robust evidence base to support their nutritional care practices and unmet need for education about nutrition in cancer. The nursing role's boundaries and the outcomes of nurse-delivered nutritional care in cancer cachexia are both uncertain and should be investigated.

Treatable malnutrition may occur in up to 25% of hospital patients, depending on the specialty concerned. Nutritional status may also deteriorate during a prolonged hospital stay. The management and prevention of malnutrition requires a climate in which hospital managers have a positive policy towards nutritional care, a screening system to identify the patients at risk, and appropriate protocols for action. Catering services need to be reorganized to address the problems of the sick, so that appropriate food is not only prepared but delivered in a way which makes it likely to be consumed. For the optimal management of artificial nutrition by the enteral or parenteral route, a skilled nutrition team is both necessary and cost-effective.

NNEdPro aimed to conduct an educational needs analysis and pilot a non-vertical curriculum intervention through aninnovatively developed educational package in a national sample of tomorrow’s doctors.An intervention group of 100 senior/clinical medical students from 15 medical schools were recruited. A non-vertical educationalpackage was delivered over 2d, incorporating interactive lectures, role-play, simulated consultations, small group work and mini-PBL. Aspiral learning approach revisited topics in order to build upon consolidated basic concepts. Clinical nutrition knowledge, attitudes andpractices (KAP) were assessed before and after intervention, and at 3 months, using a construct-validated questionnaire. Questionnaireitems were randomised before and after intervention, to minimise recall bias. A student-reported evaluation of the educational interventionwas also conducted and yielded favourable results.

The aim of this study was to evaluate the Integrated Care Plan (ICP) used for the Malnutrition Universal Screening Tool (MUST), in alarge teaching hospital, involving ward staff in a developmental project to improve the delivery of basic nutritional care initiated afterscreening.An audit of 100 patients was conducted to determine if MUST was completed correctly and if basic nutritional support actions werecompleted as a result of screening. Data were collected from the MUST ICP, nursing, medical and dietetic records. Eight focus groupswere conducted, 6 involving 22 nurses and another 2 involving 10 dietitians and patients. Qualitative data from the focus groups weretranscribed verbatim and analysed using thematic analysis in NVivo8.Screening tools were completed correctly for height in 93 cases, for weight in 69 cases and for usual body weight in 83 cases. Wardstaff and dietitians scores were compared and scores were the same for 92 patients (level of agreement Kappa = 0.82). The ICP was re-designed and qualitative data from the focus groups were substantiated by discussing the new care plan with ward staff.