A notable difference between the Irish and US cohorts is the significant dietetic resource limitation in the Irish cohort.
The low levels of dietitian-led carbohydrate teaching are due to significant dietetic resource limitations at UHL prior to this study.
For example, whether there is under or over-use of dietetic care resources and unnecessary health care costs.
Correct identification of these patients, who are at most need of nutritional intervention, allows appropriate targeting of scarce dietetic expertise and resources.
" (Urban midwife 10)" One midwife felt that the limited dietetic and physiotherapy resources available to them in the public health system has resulted in a redefinition of "at risk" or "healthy" pregnancy weight because only those women with BMIs > 35/kg/m were chosen for interventions and education.
Contributing factors included: practices, policies and views limiting the weighing of women and provision of GWG guidelines; perceptions regarding pregnant women's low levels of interest in weight; limited education of midwives regarding GWG; time limitations for education of pregnant women; and perceptions of limited allied health services, such as Dietetic and Physiotherapy resources.
(Urban midwife 1)" As noted, the limited resources for dietetic and physiotherapy services were seen to constrain interventions for healthy GWG and lifestyle issues, reducing the ability for antenatal services to intervene even if a need was identified.
In addition, the registered dietitian and dietetic technician, registered, are responsible for serving as a nutrition resource to all groups and individuals providing services to children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits.
According to the participants, upper management, when allocating financial resources, prioritized the hospital's other services to the detriment of the dietetic service, which resulted in resentment.
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