Nutritional Assessment Programmes for Public Health Situations

Case Study A - Rural Australia

Two OSCE summary reports (maximum 800 words each), each detailing:

(Case study A) Rural Australia:

Working in a remote community in Australia, life can be challenging, boring and frustrating; but it can also be rewarding, exciting, and fulfilling!  The technology and facilities we are trained with are not always accessible, and harsh environmental conditions can impact day to day working lives significantly.  Health clinics are always available, however, like in local community stores, supplies of even basic needs can be affected by seasonal factors such as heavy rain wiping out the roads and distances to supply chains.  

Based on age-standardised rates, the rate of non-Indigenous Australians self-reporting ‘excellent’ or ‘very good’ health status was 1.4 times the rate for Indigenous Australians (ABS 2019).  The burden of disease was 2.3 times greater for Indigenous Australians, leading to 284 years lost due to premature death or living with illness per 1,000 Indigenous people in Australia, a figure equivalent to 190,227 DALYs (AIHW 2016).

Q) Design a nutritional assessment programme to inform planning/ implementation of a “Health and wellbeing strategy” to improve health in a Torres Straits Islanders community.

(Case study B)             Adopted child:

A 4-year-old male child (from Tanzania) has been adopted by a UK couple.  Although apparently healthy, abdominal discomfort was suspected, and routine checks conducted prior to immigration highlighted low iron levels and hookworm ova in stool samples collected. The adoptive parents have requested information on diagnostic results, treatment requirements and longer-term implications.

Q)  Explore how nutritional assessment tools could benefit understanding/ management of this public health situation.

Submission requirements

1. Assessment of the problem.  Could focus on an individual (e.g., patient/ athlete history) and/ or population (e.g., situation you are tasked with resolving). Students should aim to demonstrate broad, evidence-informed understanding of factors they consider relevant to each scenario.  This section should be inspired by details included in the OSCE scenario(s) and insight(s) gained from literature and should inform their proposed actions.
   
   
2. Planning.  Reactive to their appraisal of the problem outlined, the demographic of the affected individual/ group, cost and resource implications imposed (and any other factors deemed relevant) students should plan a tailored response to their selected scenario(s).  Consideration of ‘ideal’ vs. ‘feasible within constraints outlined’ options may be included.
   
   
3. Implementation. To collect data necessary to inform planning and/ or facilitate appraisal of interventions proposed, various anthropometric, biochemical, clinical and/ or dietary/ nutritional intake information (and potentially other) nutritional assessment techniques will be required.  Methods proposed for use in your scenario should be outlined here.
   
   
4. Evaluation. Demonstrates understanding of how (and why) follow up is necessitated, including consideration of how inaccuracies identified and/ or difficulties experienced could be managed for example.

Understanding the baseline details provided

1: Imagine the details in the outline about are the only aspects you are told: do you know how Indigenous/ non-indigenous Australians differ? What do you understand by the terms ‘self-assessed health status’, Age-standardised, DALY’s or burden of disease?

2: Subjective global assessment:

- What are the most pertinent details you would need to know to enable a comprehensive address of the intervention needed here?

3. Monitoring and Evaluation:

- With your subjective assessment done, what would you include in your plans?  Consider (a) environmental constraints impacting this community; (b) capacity to determine health status using biochemical measures; (c) consideration of potential mental health concerns/ cultural identity; (d) education plans/ long term intervention?

4. CPD/ Development needs:

- Reflection: What would you ideally need to develop to become more proficient leading a team working on this scenario. Consider use of a “3+3 format” (three things you’ve learnt from considering this scenario, three things you need to develop further to increase your capacity addressing a scenario like this.  

Marking Criteria

The following module learning outcomes (LO’s) are assessed in this piece of work:

LO1. Critically justify the appropriate choice of functional status, dietary intake and body composition techniques for a range of scenarios.

LO2. Describe professional conduct and accurate appraisal of nutritional status using nutritional assessment indices (for low, middle, and high-income contexts) including global assessment methods.

LO3. Design and defend strategies used to plan and conduct analysis of raw data on nutritional status within topics relevant to degree pathway.

LO4. Justify scientific interpretation of nutritional assessment data using appropriate reference values in a range of scenarios relevant to the degree pathway.

LO5. Apply transferable skills in laboratory techniques and scientific data interpretation to communicate nutritional assessment results to a defined audience.