ORCID Profile
0000-0003-2086-9590
Current Organisations
Princess Alexandra Hospital
,
University of Queensland
,
Royal Brisbane and Women's Hospital
,
Queensland University of Technology
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Publications
Associations between diet composition, dietary pattern, and weight outcomes after bariatric surgery: a systematic review
Publisher: Springer Science and Business Media LLC
Date: 06-07-2023
DOI: 10.1038/S41366-023-01333-1
Abstract: Literature describing the impact of dietary intake on weight outcomes after bariatric surgery has not been synthesized. This study aimed to synthesize the evidence regarding any association between diet composition and weight outcomes post-bariatric surgery. CINAHL, Cochrane, Embase, MEDLINE and Scopus were searched for adult studies up to June 2021 that assessed any association between dietary intakes (≥1-macronutrient, food group, or dietary pattern) and weight outcomes at 12-months or longer after bariatric surgery. Risk of bias and quality assessments were conducted using the Scottish Intercollegiate Guidelines Network checklists and the NHMRC’s Level of Evidence and Grades for Recommendations. Study findings were presented according to the time of post-surgery dietary intake assessment (≤12months, between 12 and 24 months, ≥24months). 5923 articles were identified, 260 were retrieved for full text screening, and 36 were eligible for inclusion (9 interventional including five randomized-controlled trials, and 27 observational cohort studies s le sizes: 20–1610 total s le: 5065 follow-up periods: 1 year–12 years level of evidence: II to IV, risk of bias: low to high). Findings on the association between long-term weight outcomes and dietary composition up to 24-months were mixed. After 24-months, studies consistently suggested no significant associations between weight loss and macronutrient composition or core food group patterns, or between carbohydrate, protein or food group patterns and weight recurrence. A single cohort study reported a weak association between diet quality score and weight-recurrence after 24-months. There was no strong evidence to support significant associations between diet composition and weight outcomes post-bariatric surgery. The heterogeneity in study design and quality may reduce generalizability to external populations. In idualized dietary recommendations may be useful to support long-term post-surgery weight outcomes. More studies are needed to define and measure diet quality in this patient cohort. PROSPERO (CRD42021264120)
Implementation and evaluation of a university–hospital partnership program for Type 2 diabetes
Publisher: CSIRO Publishing
Date: 16-11-2021
DOI: 10.1071/AH21173
Abstract: Objective The aims of this study were to determine whether a university–hospital partnership program for Type 2 diabetes (T2D) would: be well attended reduce the number of patients on the diabetes out-patient waiting list who have been waiting longer than the recommended increase discharge from the hospital clinic increase university health clinic (UHC) occasions of service be sustainable and be acceptable to participants. Method A prospective observational study was conducted between 2016 and 2019. Participants with T2D were referred to a UHC, initially from a hospital diabetes wait list. The final program consisted of 10 weeks: before and after in idual assessments, as well as 8 weeks of exercise and education facilitated by health professionals and students. Participant demographic characteristics and data on attendance, discharge and follow-up requirements, the percentage of patients waiting longer than the recommended for a new hospital out-patient appointment, university activity and patient satisfaction were collected. Results In all, 130 participants commenced the program, 80% completed at least six of eight group sessions and 80% attended the final assessment. The percentage of people waiting longer than recommended decreased from 63% to 16%. The hospital discharged 87% and 59% of participants from the dietitian and endocrinologist respectively. The UHC recorded 2056 occasions of service and 2056 student experiences including dietetics, exercise physiology, psychology, nursing, optometry, social work and podiatry students relating to the program. Satisfaction was high, as measured by the Short Assessment of Patient Satisfaction, with a mean score of 23.9 from a possible score of 28.0 (n = 93). Conclusion The partnership resulted in a new model of care for patients with T2D and increased learning experiences for students. What is known about the topic? Diabetes is the fastest growing disease in Australia, placing unsustainable demands on the health system. Access to patient-centred care and self-management education is essential to optimise glycaemic control, prevent or delay complications and maintain quality of life. The increasing demand of diabetes on the health system affects access to timely care, with unacceptably long wait times reported, resulting in an increase in morbidity and mortality and poor patient satisfaction. A potential solution is the use of clinical students to contribute to service delivery. Student-assisted and student-led health clinics have increased access to care across the globe for many years. What does the paper add? Although group education has the potential to reduce the burden on clinical service delivery, it was unclear whether a partnership program using students and university and hospital resources would be acceptable to people with T2D and whether this model delivered at a UHC would be sustainable and of benefit to both the health service and university. The results of the evaluation suggest that a university–hospital partnership program is well accepted by participants, well attended, reduces the number of patients waiting for a hospital appointment longer than the acceptable waiting times, increases UHC activity and provides interdisciplinary student experiences. As such, this paper provides evidence that this model of care offers a potential solution to increasing demands for health services for diabetes and student clinical experience. What are the implications for practitioners? Partnerships between UHCs and hospitals offer a sustainable solution to increasing demand for diabetes services and student training requirements. The description of the development, implementation and evaluation processes can be used by practitioners and educators as a framework for the translation of similar models of care to meet demands in other areas where demand for health services exceeds capacity.
A mixed‐method study to inform the development and implementation of eHealth in a bariatric surgery service in an Australian public hospital
Publisher: Wiley
Date: 24-04-2023
Abstract: This study aimed to explore patient barriers to accessing services, current technology ownership/use and digital device preferences for accessing health information/health service delivery. Additionally, it aimed to explore the Theoretical Domains Framework and the acceptability of future eHealth solutions in bariatric surgery. This mixed‐method study (survey and semi‐structured interviews) was conducted in a bariatric surgery service in an Australian public hospital. Quantitative data were analysed descriptively, and the qualitative data were deductively and inductively analysed. This study included 117 participants ( n = 102 surveyed and n = 15 interviewed). Most participants were aged ≥51 years ( n = 70, 60%), and two‐thirds were female ( n = 76, 65%). One in three participants reported barriers to accessing services ( n = 38, 37%), including parking, travel time, and taking time off work. Most participants preferred to receive or access additional health information via email ( n = 84, 82%) and were willing to engage with health professionals via email ( n = 92, 90%), text messages ( n = 87, 85%), and telephone ( n = 85, 83%). Deductive analysis of interviews generated three themes: ‘Knowledge’, ‘Social influence’ and ‘Behavioural regulation, goals and environmental resources’. The inductive analysis generated one theme: ‘Seeing a place for eHealth in service delivery’. This study's findings can potentially influence the development of future eHealth solutions. Text message, email, and online approaches may be suitable for delivering further information and resources to patients, particularly regarding diet and physical activity. Online health communities are being used by patients for social support and may be worth further investigation. In addition, developing a bariatric surgery mobile application may be beneficial.
Related Organisations
Related Funding Activities
No related grants have been discovered for Jane Musial.