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Integrated Advanced Education Supports Future Registered Dietitian Nutritionists’ Breastfeeding Self-Efficacy In Practice, Crystal C. Douglas, Simone Camel

Journal of Dietetic Education

Objective: Evaluate the effectiveness of graduate-level breastfeeding and lactation management education that includes didactive and active learning components on future RDNs’ knowledge, attitudes, and self-efficacy. Design: A pre-and post-test design, utilizing a 41-item pre-intervention survey, learning modules, and a 35-item post-intervention survey. Setting: Three U.S. public universities located in Texas, Louisiana, and Arkansas. Participants: Graduate-level dietetic internship students. Intervention: Four advanced education modules (2 didactive; 2 active learning) developed by Registered Dietitian Nutritionists. Main outcome measures: Gains in breastfeeding knowledge, attitudes, and self-efficacy to assist with breastfeeding education and problem-solving using validated and newly developed survey items. Analysis: Descriptive statistics, …

Sense Of Belonging In The Profession And Program Of Study Among Nutrition And Dietetics Students, Jessica Torro, Melissa Masters, Rachel C. Sinley, Jesse Lunsford, Heidi Masching, Miranda Chen Musgrove

Journal of Dietetic Education

Sense of belonging may positively impact student performance, especially in marginalized groups. This study aimed to examine sense of belonging among a diverse group of nutrition and dietetics students. An online survey investigated students’ feelings of belonging, isolation, and connection to the field of nutrition and dietetics and department of study. The survey was distributed through email to the nutrition and dietetics student body in the Department of Nutrition at Metropolitan State University of Denver. Quantitative data were analyzed as count and percentage. Overall sense of belonging scores were calculated as an average on a 5-point scale (1-strongly disagree to …

Cover, Table Of Contents, About The Journal, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

No abstract provided.

Editors' Message, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

No abstract provided.

Thick-Billed Murres Uria Lomvia At Cape Parry, Northwest Territories: Core-Use Areas, Morphometrics And Chick Diets, Rosana Paredes, Stephen, J. Insley, Sebastian Luque, Piia Kortsalo

Marine Ornithology

Cape Parry is home to the only colony of Thick-billed Murres Uria lomvia in the western Canadian Arctic, but ecological information for this small, isolated population is lacking. To address this information gap, we investigated the spatial distribution, diving behaviour, diet, and morphometrics of male and female Cape Parry Thick-billed Murres during the breeding season. We tracked 23 chick-rearing adults (seven females and 16 males) using Global Positioning System (GPS) tags with depth sensors (2021) and collected chick diet data (2021, 2022) using observations and photos. Cape Parry murres foraged relatively close to the colony (4.5 ± 3.3 km) and …

Comparison Of Offspring Growth Models In Atlantic Puffins Fratercula Arctica , Katja H. Kochvar, Raul Zabala Belenguer, Pierre-Paul Bitton

Marine Ornithology

Growth of morphological traits in the offspring of many seabirds, including Atlantic Puffins Fratercula arctica, has typically been characterized by linear models despite displaying nonlinear patterns. We assessed the fit of six typical avian growth models to measurements of puffling mass, wing length, and tenth primary length. Across all three biometrics, the first- and second-best performing models were nonlinear (i.e., quadratic, logistic, extreme value function); these models were then used to generate separate growth curves for individual pufflings and extract easily interpretable and comparable parameter estimates. We recommend the reported models in future studies incorporating metrics of puffling growth and …

Ocular Pathology In The Flightless Cormorant Nannopterum Harrisi, Gustavo Jiménez-Uzcátegui

Marine Ornithology

Ocular pathological conditions affecting the cornea, iris, conjunctiva, and third eyelid in each of four Flightless Cormorants Nannopterum harrisi were observed on Fernandina Island, Galápagos, in September 2014. Observations over many years, 2009–2023 (n = 313 cormorants inspected), suggest that the infection noted in 2014 was rare.

Long-Term Outcomes Of A Laysan Albatross Phoebastria Immutabilis Foster Egg Translocation Program, Eric A. Vanderwerf, Lindsay C. Young, C. Robert Kohley, Jessica Behnke, Brooke Mcfarland, Katherine Finney, Hob Osterlund, Julie Murphy, Angela Serota, Louise Barnfield, Yuka Green, Kim S. Rogers, Cathy Granholm

Marine Ornithology

In the 1960s and 1970s, Laysan Albatrosses Phoebastria immutabilis colonized several sites in the Pacific from which they had been extirpated or had not been known to nest previously, including the US Navy’s Pacific Missile Range Facility (PMRF) on Kaua‘i, Hawai‘i, USA, where they increased to become a bird aircraft strike hazard (BASH). To reduce their population at PMRF, albatross eggs were destroyed or removed as part of a BASH reduction program until 2005, when an alternate plan was devised by the Navy, US Fish and Wildlife Service, and US Department of Agriculture Wildlife Services, in which eggs from PMRF …

Assessment Of Tufted Puffin Fratercula Cirrhata Diet Using Dna Metabarcoding, Thomas P. Good, Andrew O. Shelton, Abigail H. Wells, Ana Ramón-Laca, Ramon Gallego, Peter J. Hodum, Scott F. Pearson

Marine Ornithology

Investigating trophic relationships can be critical for understanding relationships between marine predators and their prey. DNA analysis of feces is used increasingly as a non-invasive method to uncover seabird dietary patterns across space and time. Tufted Puffins Fratercula cirrhata are listed as Endangered in the state of Washington (WA), USA, and reduced prey availability is thought to be a key factor in the species’ decline. Recent information on Tufted Puffin diet is lacking, and present opportunities for direct diet observation are limited. We conducted a pilot study to characterize Tufted Puffin diet on Destruction Island, WA, in 2019 using DNA …

Life-History Traits And Divergence In Population Trends Of Two North Pacific Auks: Rhinoceros Auklet Cerorhinca Monocerata And Tufted Puffin Fratercula Cirrhata, J. Mark Hipfner

Marine Ornithology

Population trends in two closely related and ecologically similar North Pacific auks, the Rhinoceros Auklet Cerorhinca monocerata and Tufted Puffin Fratercula cirrhata, have diverged over recent decades: stable in the former, declining in the latter. I propose that differences between the two species in a broad suite of interrelated morphological, demographic, behavioral, and physiological life-history traits could explain their differing responses to recent environmental conditions.

Environmental Advocacy As An Occupation: Perceived Self-Efficacy And Occupational Justice In Community Programming, Emma Sims, Laura H. Vanpuymbrouck

The Open Journal of Occupational Therapy

Background: Current occupational therapy literature demonstrates a gap in knowledge of environmental advocacy as an occupation, which directly impacts occupational justice in those experiencing environmental racism or discrimination. This study’s purpose was to provide foundational information on the importance of advocacy work in the sphere of environmental and occupational justice through the lived experiences of those directly involved in community environmental advocacy.

Method: Qualitative data was collected via three focus groups using semi-structured interviews focused on perceptions of participant experiences in environmental advocacy occupations. Thematic analysis was used to identify themes relating to research questions.

Results: When …

Breastfeeding Interventions For Dyads With Medical Complexity: A Mixed Methods Study, Jairrah L. Godsil, Julia R. Farrell, Julia Shin, Cary C. Moore, Yongyue Qi, Vanessa D. Jewell

The Open Journal of Occupational Therapy

Background: Breastfeeding dyads with medical complexity have lower success with direct breastfeeding. Evidence to support occupational therapists working with this population is limited. This study explored occupational therapists' experiences, training, and interventions for breastfeeding dyads with medical complexity.

Method: Occupational therapists providing clinical breastfeeding services for parents and or children with medically complex conditions participated in this study. The study employed an explanatory, sequential mixed-methods design, consisting of an online survey (N = 102) followed by two 75-min semi-structured focus groups (N = 7).

Results: Occupational therapists with more clinical breastfeeding experience (p = .003) and …

Exploring Due Process Rights And Litigation Strategies For Homeless Youth Under Federal Law, John A. Salois, Liz Harding Chao

Maine Law Review

Over fifty years after the Runaway and Homeless Youth Act, this Article explores the due process rights youth have in shelter and other transitional housing covered under the Act. Further, this Article explores whether youth have a property interest under the Act’s recent reauthorization under the Reconnecting Homeless Youth Act of 2008. This Article also discusses the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act and the due process rights youth have in shelter and other housing options covered under the HEARTH Act’s extensive funding of homeless programs. Additionally, this Article explores litigation strategies that youth and advocates …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Improving Hpv Vaccination Decision-Making For Adolescents And Their Caregiver, Mary E. Hohman

Dissertations

Abstract

Problem: Human papillomavirus (HPV) is a viral infection associated with the development of certain cancers and is the most common sexually transmitted infection in the United States (U.S.) (Centers for Disease Control and Prevention [CDC], 2023). The CDC (2021) asserts that more than 90% of cancers caused by HPV infections could be prevented through the HPV vaccination. The CDC recommends the HPV vaccine series for children ages 11 or 12 years; however, this organization further submits that the HPV series could be initiated as early as 9 years of age through 26 years of age (CDC, 2024). Despite CDC …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

Modulatory Effects Of Flavonoids On Il- 4/Il-13 In Atopic Dermatitis And Their Structure-Activity Relationships, Yueyuan Wang, Jing Liu, Chen Li, Fengfeng Chen, Cheng Yang, Bingtian Zhao

Journal of Food Science and Biotechnology

[Objective ] This study aims to explore the ameliorating effects of flavonoids on atopic dermatitis (AD) and their structure-activity relationships.[Method ] Flavonoids were selected through network pharmacology with interleukin- 4 (IL-4) and interleukin- 13 (IL-13) as key targets.The immunoglobulin E (IgE)-induced RBL- 2H3 cell model was employed to evaluate the effects of flavonoids on inflammatory factors,degranulation activities,and calcium ion influx,and the structure-activity relationships were analyzed.Finally,molecular docking was utilized to assist in exploring the action mechanism.[Result ] All of the six flavonoids (luteolin,apigenin,chrysin,quercetin,kaempferol,and fisetin ) screened by network pharmacology had significant inhibitory effects on the expression of IL- 4,IL- 13,tumor necrosis …

Structural And Solution Property Characterization Of Oat Β-Glucans, Hongli Zhang, Yaning Shi, Ming Miao

Journal of Food Science and Biotechnology

[Objective ] This study aims to characterize the structure and investigate the solution properties of oat β-glucan (OBG ).[Method ] Two soluble OBGs with different weigh-average molecular weights (Mw),number-average molar weights (Mn),and peak molecular weights (Mp) were prepared by hot water extraction and ethanol classification.The structures and solution properties were characterized by Fourier-transform infrared spectroscopy (FT-IR ),nuclear magnetic resonance (NMR ),X-ray diffraction (XRD ),scanning electron microscopy (SEM ),high performance size exclusion chromatography coupled with multi-angle laser light scattering (HPSEC-MALLS ),and rheology.[Result ] OBG- 1 and OBG- 2 showed the Mw of 80.73×104 g/mol and 8.05×104 g/mol,the yields of (4.86±0.55)% and …

Priority Ir: Protocol For Implementation Research On Single-Dose Postpartum Iv Iron To Treat Iron-Deficiency Anemia Among Women In India And Pakistan, Valerie L. Flax, Narjis Rizvi, Umesh Charantimath, Saleem Jessani, Avinash Kavi, Sarah Saleem, Manjunath Somannavar, Shivaprasad S. Goudar, Anika Hannan, Elizabeth M. Mcclure, Simal Thind, Rosemary Frasso, Richard Derman

Global Health Articles

BACKGROUND: Anemia among women of reproductive age has remained highly prevalent globally. Intravenous (IV) iron is well tolerated and proven effective for treating postpartum iron deficiency anemia in high-income countries, but evidence from LMICs, where oral iron is standard treatment, is limited. The PRIORITY trial will test the effectiveness of IV iron compared to oral iron for postpartum women with moderate anemia in eight LMIC sites. An implementation research (IR) study will be conducted alongside the PRIORITY trial in India and Pakistan to gather information on the intervention characteristics and the implementation process, and to assess feasibility, acceptability, fidelity, and …

Research Progress In Thermo-Reversible Polysaccharide Gels, Dongxin Zhou, Ziao Zhang, Su Chen, Weimin Yang, Jiajun Sun, Shengzu Han, Anning Xie, Xiaoxiao Li, Yuxiang Bai

Journal of Food Science and Biotechnology

Thermo-reversible gels are widely applied in the processing of baking,meat,and snack products including cakes,candies,jelly,aspic,and steamed custard buns.Currently,the most effective thermo-reversible gel is gelatin,which can combine with water to form a transparent gel that melts when it is close to the temperature of the human oral cavity.However,gelatin is expensive.Therefore,researchers have turned their attention to polysaccharide gels,hoping to obtain more thermo-reversible food raw materials with different properties.The author reviews thermo-reversible polysaccharide gels from natural sources such as plants,algae,and microorganisms and those modified by physical,chemical,and enzymatic methods and summarizes the sources,structures,gelatinization mechanisms,and product applications of polysaccharide gels.It is expected to provide a reference …

Mechanisms Of Antioxidant Activity Of Lactic Acid Bacteria And Its Application In Oxidative Stress-Related Diseases, Yixiao Shao, Chuang Huang, Chenjian Liu, Xiaoran Li

Journal of Food Science and Biotechnology

The antioxidant properties of lactic acid bacteria are related to various probiotic activities,which can prevent and alleviate a variety of chronic diseases caused by oxidation in the host.The antioxidant mechanisms of lactic acid bacteria,including the action mechanisms of antioxidant enzymes and non-enzymatic antioxidants and regulation of host signaling pathways,were expounded.Furthermore,the application status of antioxidant properties of lactic acid bacteria in diseases of the nervous system,digestive system,and skin system were summarized.The aim is to explore how to enhance the antioxidant activity of lactic acid bacteria in oxidative stress-related diseases and give new insights into the development of related treatment strategies.

Zeaxanthin Encapsulated With High Internal Phase Emulsions And Its Stability, Ya Li, Ying Ou, Jie Lu, Shuo Meng, Shoushuai Feng, Hailin Yang

Journal of Food Science and Biotechnology

[Objective ] This study prepared highly stable high internal phase emulsions (HIPEs ) to encapsulate zeaxanthin,thereby improving the stability and expanding the food and pharmaceutical applications of zeaxanthin.[Method ] HIPEs were prepared with the gelatin-chitosan suspension for encapsulation of zeaxanthin extracted from goji berries.Ultra-performance convergence chromatography (UPCC ) was employed to separate zeaxanthin.Confocal laser scanning microscopy (CLSM ) was employed to observe the emulsion structure.The rheological analysis was performed to characterize the emulsion,which was combined with the hydrogen peroxide and storage stability tests to evaluate the performance of encapsulation with HIPEs in improving the stability of zeaxanthin.[Result ] The separation …

Identification And Spoilage Capacity Analysis Of Main Spoilage Bacteria In Pickles, Li Zhu, Huimin Li, Liejiang Yuan, Cancan Peng, Bo Zhou, Sheng Song, Haizhi Wu, Mingyang Zhu, Fangmei Wang, Yu Liu, Yuqian Hu, Ge Li, Yiqing Sun, Yi Zhou

Journal of Food Science and Biotechnology

[Objective ] This study aims to identify the main spoilage bacteria and evaluate their spoilage capacity in the spoilage process of pickles.[Method ] High-throughput sequencing was employed to analyze the microbial community dynamics in the samples of pickles at the early,middle,and late stages of spoilage.The key spoilage bacteria were isolated,purified,and then identified through a combination of colony morphology observation,biochemical analysis,and 16S rDNA/ITS sequencing.Re-inoculation experiments were carried out for further validation of the primary spoilage bacteria in pickles.[Result ] Acinetobacter and Bacillus were the dominant spoilage bacterial genera across the three spoilage stages.Notably,Bacillus exhibited rapid growth over time,with the relative abundance …

Lichen Planopilaris With Pili Torti And Ectodermal Dysplasia: A Hair Curling Case Report, Collins Langley, Elena Plakotaris, Nicole E. Rogers

School of Medicine Faculty Publications

Introduction: Lichen planopilaris (LPP) is a well-known cicatricial alopecia with a frontal fibrosing variant. LPP has a prevalence rate of 13.4 per 100,000 persons. It is understood that LPP favors the female populations. What is not commonly known is that LPP can be preceded by other signs and symptoms such as pili torti. Case Report: We present a case report of a 70-year-old female whose initial flare of LPP was preceded by a flare of pili torti. This patient's case is also complicated by her history of ectodermal dysplasia. She experienced progressive itching, shedding, and mid-scalp hair loss along with …

Effect Of Vitamin  C As An Iron-Supporting Supplement In Adolescents With Suspected Iron Deficiency Anemia: Is It Effective For Increasing Hemoglobin Levels?, Ryan Pramana Putra, Nany Hairunisa, Refia Putri Restiana, Husnun Amalia, Emad Yousif

Iraqi National Journal of Medicine

Background: Anemia is a global health problem that affects adolescents, adults, and children in both developed and developing countries. Anemia in adolescent girls (10–19 years of age) is defined as a hemoglobin level in the blood of <12 g/dL. In Indonesia, the prevalence of iron deficiency anemia in adolescent girls reaches 48.9%. Iron supplementation can be enhanced with vitamin C as a companion supplement. Vitamin C increases iron absorption in the body by reducing Fe3+ to Fe2+, which requires an acidic environment for optimal dissolution and absorption. Aim: This study aims to assess the comparative effectiveness of iron supplementation with or without vitamin C in increasing hemoglobin levels. Methodology: An experimental design with consecutive sampling was conducted in September 2023 at Junior High School 1 Prambon, Nganjuk, East Java. The total sample consisted of 52 girls aged 12–13 years with anemia. The first group received iron and vitamin C, while the second group received iron only. Hemoglobin levels were  by the fingerstick method. Results: There were 32 samples (53.33%) aged 13 years. The average change in hemoglobin levels before and after intervention in group 1 was 2.238 g/dL with < 0.05, while in group 2 it was 0.661 g/dL with <0.05. The average difference in changes in hemoglobin levels between groups 1 and 2 after intervention was 1.303 g/dL with <0.05. Conclusion: Iron supplementation with vitamin C results in more significant increases in hemoglobin levels.

Patients Journey To Hemodialysis Centers: Multi-Center Study, Ali Al Saedi, Dalia Ali, Anas Aljboori, Anas Mansour, Zahraa Mahdi

Iraqi National Journal of Medicine

Background: Hemodialysis is used to restore electrolyte balance (sodium levels, potassium in the body, bicarbonate, chloride, as well as magnesium, calcium, and phosphate) and filters the waste products and excess fluid. Unfortunately, developing nations continue to have a severe shortage of resources, which makes it difficult to provide highly technical and costly care like dialysis. Aim: The study's objective is to reveal and trace the journey of patients with end stage kidney disease who are on regular hemodialysis program and how they reach to dialysis centers. Methods: the study was to be conducted in many dialysis centers in different regions …

Knowledge And Practice Of Undergraduate Medical Students Regarding Self-Medication: A Cross-Sectional Survey In Baghdad, Iraq, Samer Shukur Mohammed, Wael Waleed Mustafa

Iraqi National Journal of Medicine

Background: The global trend of self-medication is rising, making it a priority to investigate associated risks that could lead to life-threatening complications. Aim: To assess self-medication practices among undergraduate medical students and evaluate their knowledge and the factors influencing their use of self-medication Methods: A cross-sectional questionnaire-based study was conducted among 234 medical students from various medical colleges in Baghdad between November 2023 and March 2024. Participants were selected randomly. Data were collected and analyzed using SPSS version 23. The chi-square significance test was performed, and P-values ≤ 0.05 were considered statistically significant. Results: The study found that 72% of …

Barriers To Diet And Exercise Among Patients With Type 2 Diabetes Mellitus In Basrah Hospitals, Jhood Abdul Samad Molan, Fatima K. Hassan, Miaad K. Khaddam, Zainab A.R. Antesh, Hudaa S. Karim

Iraqi National Journal of Medicine

Background: Type 2 diabetes mellitus (T2DM) is growing health concern globally, particularly in the Middle East. To encourage individuals to adopt a healthy lifestyle essential for managing diabetes, it is imperative to thoroughly understand the barriers, especially those that can be modified, encountered by patients following nutritional and exercise medical advice. Aim: The primary objective of this study was to investigate the barriers related to nutrition and exercise among patients with T2DM in hospitals located in Basrah. Methods: This cross-sectional study included 194 adults with history of T2DM who were visiting the outpatient departments of internal medicine in four selected …

Alternate Day Oral Iron Replacement Versus Daily Intake In Women With Iron-Deficiency Anemia In Basrah, Muntadar Jafar Mawla, Mohammed A. Al-Anssari, Qutaiba M. Dawood, Murtadha A. Jeber, Asaad A. Khalaf

Iraqi National Journal of Medicine

Background: Iron-deficiency anemia (IDA) remains a major global health concern, disproportionately affecting women of reproductive age. Conventional daily iron supplementation, though effective, is often associated with poor adherence due to gastrointestinal side effects. Emerging evidence suggests that alternate-day dosing may enhance iron absorption and tolerability, but comparative efficacy data in clinical settings remain limited. Aim: This study aimed to compare the hematological and iron store responses of women with IDA in Basrah, Iraq, between alternate-day and daily oral iron supplementation regimens. Methods: A total of 97 women with confirmed IDA (hemoglobin [Hb] < 12 g/dL, serum ferritin < 15 ng/mL) were enrolled in a prospective follow-up cohort study. The participants were divided into two groups: Group B (n = 48) received 100 mg of elemental iron daily, while Group A (n = 49) received the same dose every other day. Serum ferritin and hematological parameters (Hb, red blood cell [RBC] count, hematocrit) were assessed at baseline, three weeks, six weeks, and three months. ANOVA and paired t-tests were used for statistical analysis, with a significance level of P < 0.05. Results: Compared to the daily group, the alternate-day group exhibited a significantly higher mean increase in serum ferritin (28.6 ± 4.2 ng/mL vs. 22.3 ± 3.8 ng/mL, P = 0.001) and hemoglobin (2.8 ± 0.5 g/dL vs. 2.1 ± 0.4 g/dL, P = 0.001) at three months. The alternate-day group demonstrated earlier and more sustained improvements in iron reserves (P < 0.01 at all follow-ups), but both regimens increased RBC counts. Conclusion: In women with IDA, alternate-day iron supplementation is more effective in restoring hemoglobin and iron stores than daily dosing, possibly due to improved absorption and reduced hepcidin inhibition. These findings suggest potential benefits for patient adherence and clinical outcomes, supporting the use of alternate-day regimens as a superior therapeutic approach. To validate these results, further randomized controlled trials are necessary.

Role Of Nurses And Allied Health Professionals In Hepatology And The Challenges Faced When Navigating A Career Pathway, Lynsey Spillman, Dianne Backhouse, Leah Cox, Katie Ballesteros, Katie Ramos, Felicity Williams

School of Health Professions

Hepatology specialist nurses and allied health professionals (AHPs), including dietitians and physiotherapists, are essential members of the multidisciplinary team, delivering person-centred care from prevention through to advanced disease. Their contributions support lifestyle intervention, symptom management and care coordination, improving patient outcomes and service efficiency. Despite this, roles remain underfunded, inconsistently embedded and often overlooked in workforce planning. This article outlines the impact and challenges facing hepatology nurses and AHPs, drawing on UK service examples that demonstrate improved quality of life, reduced admissions, recompensation and cost savings. Barriers include limited access to structured training, protected time and clearly defined career pathways. …