Understanding the knowledge, attitudes, and practices (KAP) of hospital staff is needed to improve care activities that support the detection/prevention/treatment of malnutrition, yet quality measures are lacking. The purpose was to develop (study 1) and assess the administration and discriminative potential (study 2) of using such a KAP measure in acute care. In study 1, a 27-question KAP questionnaire was developed, face validated (n = 5), and tested for reliability (n = 35). Kappa and Intraclass Correlation (ICC) were determined. In study 2, the questionnaire was sent to staff at five diverse hospitals (n = 189). Administration challenges were noted and analyses completed to determine differences across sites, professions, and years of practice. Study 1 results demonstrate that the knowledge/attitude (KA) and the practice (P) subscales are reliable (KA: ICC = 0.69 95% CI 0.45–0.84, F = 5.54, p < 0.0001; P: ICC = 0.84 95% CI 0.68−0.92, F = 11.12, p < 0.0001). Completion rate of individual questions in study 2 was high and suggestions to improve administration were identified. The KAP mean score was 93.6/128 (range 51–124) with higher scores indicating more knowledge, better attitudes and positive practices. Profession and years of practice were associated with KAP scores. The KAP questionnaire is a valid and reliable measure that can be used in needs assessments to inform improvements to nutrition care in hospital.

MAT is sufficiently reliable when used by auditors with minimal training. Routinely auditing mealtimes with MAT could be useful in identifying and removing barriers to food intake for older hospitalized patients.

Background: Anemia is highly prevalent particularly in low- and middle-income countries. Iron deficiency contributes to an estimated 50% of anemia cases. Iron interventions have become central to global anemia treatment and prevention; however, few iron interventions have been scaled up to the national level, despite their proven effectiveness. While both cross-sectional and interventional studies on the effect of anemia and iron supplementation on worker productivity have been conducted, there have been few systematic reviews conducted. As such, a synthesis of previously conducted primary research is warranted and may provide a more comprehensive overview of the strength of currently available evidence, potentially helping to inform national policy on matters relating to funding and legislation for population-level iron interventions. Objectives: The objective of this study was to synthesize available evidence on the effect of both anemia and therapeutic iron interventions on productivity in working adults. Methods: All relevant English language studies were systematically obtained from both MEDLINE and EMBASE and assessed for evidence of differing productivity levels across groups stratified by iron intervention or anemia status. Potential mediating variables were reported, and the results were narratively summarized. Results: The available data from 12 included studies provide strong evidence that anemia negatively impacts occupational performance and that therapeutic iron interventions can yield substantial productivity gains. Conclusions: Despite their limitations, these findings make an important contribution to the literature highlighting the impact of iron deficiency and population-wide iron interventions on work productivity and occupational performance.

PurposeTo uncover the major government constraints to enactment and implementation of public health-targeted climate change adaptation (CCA) strategies in order to equip public health stakeholders and health advocates with the knowledge resources necessary to more effectively mobilize and support CCA for public health responses at the national level.Design/methodology/approachA mixed-methods online survey was distributed to the representatives of national public health associations and societies of 82 countries. The survey comprised 15 questions assessing national progress on CCA for public health and the effects of various institutional, economic/financial, technical and sociopolitical barriers on national adaptive capacity.FindingsSurvey responses from 11 countries indicated that national commitments to CCA for public health have increased markedly since prior assessments but significant shortcomings remain. The largest apparent barriers to progress in this domain were poor government coordination, lack of political will and inadequate adaptation finances.Originality/valueThis study is unique in relation to the prior literature on the topic in that it effectively captures an array of country-specific yet cross-cutting adaptation constraints across diverse national contexts. With a deepened understanding of the major determinants of national adaptive capacity, international actors can devise more effective, evidence-informed strategies to support national governments in responding to the health impacts of climate change.

Rome has long been central to the story of Galileo's life and scientific work. Through an analysis of the metadata of Galileo's surviving letters, combined with a close reading of the letters themselves, we discuss how Galileo used correspondence to build a Roman network. Galileo initially assembled this network around the members of the Lincean Academy, a few carefully nurtured relationships with important ecclesiastics, and the expertise of well positioned Tuscan diplomats in the Eternal City. However, an analysis of Galileo's correspondence in the aftermath of the trial of 1633 provides us with a unique opportunity to interrogate how his altered circumstances transformed his social relations. Forced to confront the limitations on his activities imposed by Catholic censure and house arrest, Galileo experienced the effects of these restrictions in his relationships with others and especially in his plans for publication. In the years following 1633, Galileo turned his epistolary attention north to the Veneto and to Paris in order to publish his Two New Sciences. While Galileo's Lincean network and papal contacts in Rome were defunct after 1633, we see how Rome remained important to him as the site of a number of Roman disciples who would continue his intellectual project long after his own death.