ORCID Profile
0000-0002-9993-8239
Current Organisation
Bond University
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Publisher: Cambridge University Press (CUP)
Date: 2013
Publisher: Wiley
Date: 20-12-2023
DOI: 10.1002/BIOF.1928
Abstract: Traditionally cardiovascular disease (CVD) risk has been assessed through blood lipids and inflammatory marker C‐reactive protein (hsCRP). Recent clinical interest in novel pro‐inflammatory markers platelet‐activating factor (PAF) and lipoprotein‐associated phospholipase A 2 (Lp‐PLA 2 ) recognizes that vascular damage can exist in the absence of traditional risk factors. This cross‐sectional study investigated the potential relationship between circulating PAF, Lp‐PLA 2 , hsCRP, and traditional risk factors for CVD. One hundred adults (49 ± 13 years, 31% male) with variable CVD risk were recruited. Fasting inflammatory markers PAF, Lp‐PLA 2 and hsCRP and total, high‐density lipoprotein (HDL), low‐density lipoprotein (LDL) cholesterol, and triglycerides were measured. Blood pressure, body mass index, and waist circumference were measured. Medical and physical activity data were self‐reported. Linear and multiple regressions were performed. PAF, Lp‐PLA 2 , and hsCRP independently correlated with several CVD risk factors. PAF was correlated significantly with risk factors in an unexpected way there was a medium positive correlation between PAF and HDL cholesterol ( r = 0.394, p 0.001) and medium negative correlations with Total:HDL cholesterol ( r = −0.436, p 0.001) systolic blood pressure ( r = −0.307, p = 0.001) BMI ( r = −0.381, p 0.001) and waist circumference ( r = −0.404, p 0.001). There were large positive correlations between Lp‐PLA 2 and LDL ( r = 0.525, p 0.001) and non‐HDL cholesterol ( r = 0.508, p 0.001). There were large positive correlations between hsCRP and Total:HDL cholesterol ( r = 0.524, p 0.001) BMI ( r = 0.668, p 0.001) and waist circumference ( r = 0.676, p 0.001). PAF, Lp‐PLA 2 , and hsCRP are implicated in the pathophysiology of inflammation in CVD however, the relationships between each marker and traditional risk factors were different suggesting they may be involved in different atherogenic pathways.
Publisher: Elsevier BV
Date: 06-2017
Abstract: To explore obesity policy options recommended by stakeholders and identify their impact on in idual autotomy. Qualitative and quantitative methods were used. A content analysis of submissions to the Australian Government's Inquiry into Obesity was conducted. Each recommendation was categorised by its impact on autonomy, according to existing frameworks. Chi-square test for independence was used to explore the association between autonomy and stakeholder support defined as frequency of recommendation. The extent of support for a policy option was significantly associated with impact on autonomy (p<0.001). Options that reduce autonomy were least frequently recommended in every setting but more likely in schools (27%) than other settings (<1%). Recommendations to provide incentives (9%) were more common than disincentives (2%) or restrictions (3%), and those that enhance autonomy were most widely recommended (46%). Stakeholders advocated policy options that enhance in idual autonomy to a greater extent than those that diminish autonomy. Implications for public health: Targeting obesity policy options that enhance rather than diminish autonomy may be more politically acceptable across most settings, with the exception of schools where more restrictive policy options are appropriate. Re-framing options accordingly may improve leadership by government in obesity policy.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2019
DOI: 10.1186/S12909-019-1825-2
Abstract: Behaviour can be defined as the internally coordinated responses (actions or inactions) of whole living organisms (in iduals or groups) to internal and/or external stimuli, excluding responses more easily understood as developmental changes. Unlike personality traits, that are thought to be biologically consistent, behaviour, through the application of cognition and reasoning is open to change across time and circumstance, although most humans will display preferred ways of behaving. The objective of this study was to: i) identify the behaviour styles of physiotherapy students and investigate if there is a relationship (predictive or otherwise) between students’ unique behaviour patterns and their clinical placement grades and ii) examine if this relationship differs when student’s in a Master’s level program as well as student’s in a Bachelor’s level program are explored separately. This cross-sectional study with 132 (F = 78, M = 54) physiotherapy students was conducted across two Australian university settings. Measures included Everything DiSC Workplace profile, Assessment of Physiotherapy Practice (APP). Physiotherapy students ( n = 133) profiled the following ways: Dominance (D) style n = 20 (15%), Influence (i) style n = 33 (25%), Steadiness (S) style n = 36 (27%) and Conscientiousness (C) n = 44 (33%). Students with the in idual DiSC styles of i and Conscientiousness / Steadiness (CS) were in the lowest APP quartile for clinical grades and the D style was in the highest quartile. Binary logistic regressions revealed students with an i DiSC style had 3.96 times higher odds, and students with a CS DiSC style had 4.34 times higher odds, of failing a clinical placement. When explored independently, the same trend remained for Master’s level students. Bachelor’s level students with DiSC styles of S and C had failed placements, however these styles were not significantly associated with failure (DiSC S Style: Exp(B) 1.667, p = 0.713 (CI: 0.109 to 25.433), DiSC C Style: Exp(B) 11.00, p = 0.097 (CI: 0.646 to 187.166)). Physiotherapy students with DiSC styles i and CS appear to be more likely to fail physiotherapy clinical placements. Further research with larger undergraduate s les is required to establish if relations differ for undergraduate versus postgraduate students.
Publisher: Wiley
Date: 20-03-2023
Abstract: Foodservices are a strong contributor to global environmental impact. Systemic change is required to lead the transformation towards environmentally sustainable foodservices. However, guidance to support foodservices to be more environmentally sustainable is lacking. The aim was to explore food‐related environmentally sustainable strategies and their transferability to foodservices in a range of settings, to inform a framework for future application and research. A constructivist grounded theory study design was used. Semi‐structured interviews with foodservice sustainability consultants, who support foodservice organisations to improve environmental sustainability, were conducted. Interviews were recorded, transcribed, and coded line‐by‐line. Ten consultants were purposively s led for ersity in location, organisation type, funding model, and services provided. Codes were collapsed into categories, to inform the development of themes and a framework for the implementation of strategies. Four sub‐themes were created under an overarching theme of ‘Transforming the Foodservice System’: embedding leadership, shifting perspective, constructing collaborative networks, and fostering momentum. A range of implementation strategies were captured within the sub‐themes. These themes informed the development of a practical application framework for implementing sustainable strategies in foodservices that is useful for practice and future research in the area.
Publisher: Elsevier BV
Date: 12-2016
Abstract: The long-term management of chronic disease requires the adoption of complex dietary recommendations, which can be facilitated by regular coaching to support behavioral changes. Telehealth interventions can overcome patient-centered barriers to accessing face-to-face programs and provide feasible delivery methods, accessible regardless of geographic location. This systematic review assessed the effectiveness of telehealth dietary interventions at facilitating dietary change in chronic disease. A structured systematic search was conducted for all randomized controlled trials evaluating multifactorial dietary interventions in adults with chronic disease that provided diet education in an intervention longer than 4 wk. Meta-analyses that used the random-effects model were performed on diet quality, dietary adherence, fruit and vegetables, sodium intake, energy, and dietary fat intake. A total of 25 studies were included, involving 7384 participants. The telehealth dietary intervention was effective at improving diet quality [standardized mean difference (SMD): 0.22 (95% CI: 0.09, 0.34), P = 0.0007], fruit and vegetable intake [mean difference (MD) 1.04 servings/d (95% CI: 0.46, 1.62 servings/d), P = 0.0004], and dietary sodium intake [SMD: -0.39 (-0.58, -0.20), P = 0.0001]. Single nutrients (total fat and energy consumption) were not improved by telehealth intervention however, after a telehealth intervention, important clinical outcomes were improved, such as systolic blood pressure [MD: -2.97 mm Hg (95% CI: -5.72, -0.22 mm Hg), P = 0.05], total cholesterol [MD: -0.08 mmol/L (95% CI: -0.16, -0.00 mmol/L), P = 0.04], triglycerides [MD: -0.10 mmol/L (95% CI: -0.19, -0.01 mmol/L), P = 0.04], weight [MD: -0.80 kg (95% CI: -1.61, 0 kg), P = 0.05], and waist circumference [MD: -2.08 cm (95% CI: -3.97, -0.20 cm), P = 0.03]. Telehealth-delivered dietary interventions targeting whole foods and/or dietary patterns can improve diet quality, fruit and vegetable intake, and dietary sodium intake. When applicable, they should be incorporated into health care services for people with chronic conditions. This review was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015026398.
Publisher: Wiley
Date: 20-03-2017
DOI: 10.1111/DME.13340
Abstract: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with in idual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA Group-based education interventions are more effective than usual care, waiting list control and in idual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
Publisher: Wiley
Date: 10-10-2017
Abstract: The present study developed and evaluated a patient-centred, patient-directed, group-based education program for the management of type 2 diabetes mellitus. Two frameworks, the Medical Research Council (MRC) framework for developing and evaluating complex interventions and the RE-AIM framework were followed. Data to develop the intervention were sourced from scoping of the literature and formative evaluation. Program evaluation comprised analysis of primary recruitment of participants through general practitioners, baseline and end-point measures of anthropometry, four validated questionnaires, contemporaneous facilitator notes and telephone interviews with participants. A total of 16 participants enrolled in the intervention. Post-intervention results were obtained from 13 participants, with an estimated mean change from baseline in weight of -0.72 kg (95%CI -1.44 to -0.01), body mass index of -0.25 kg/m This patient-centred, patient-directed, group-based intervention for the management of type 2 diabetes mellitus was both feasible and acceptable to patients. Health professionals should consider the combined use of the MRC and RE-AIM frameworks in the development of interventions to ensure a rigorous design process and to enable the evaluation of all phases of the intervention, which will facilitate translation to other settings. Further research with a larger s le trialling additional recruitment strategies, evaluating further measures of effectiveness and utilising lengthier follow-up periods is required.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1053/J.JRN.2017.07.008
Abstract: People with chronic kidney disease (CKD) contend with complex dietary recommendations. The challenge in practice is for clinicians to provide in idualized support with the frequency and consistency required to sustain dietary changes. This study aimed to describe the experiences of patients with managing dietary recommendations, including their perspectives on the potential to use telehealth to support dietary management in CKD. Focus group study. Twenty-one adult patients with CKD (nondialysis) and 3 caregivers (total N = 24) purposively s led to achieve erse demographic and clinical characteristics, from two nephrology units in Queensland, Australia. Five focus groups were conducted, audio recorded, and transcribed. Transcripts were analyzed using thematic analysis drawing on the principles of grounded theory. Themes aligned with the research question. We identified five themes: exasperating stagnancy (patronized by redundant advice, confused and unprepared for dietary change, inevitability of failure, and barriers to accessing dietetic services) supporting and sustaining change (receiving regular feedback, incremental and comprehendible modification, practical guidance on food, flexibility in monitoring schedule, and valuing peer advice) fostering ownership (seeking kidney diet information, enacting behavior change, making reminders, and tracking progress against targets) motivators and positive learning instruction (relying on reassurance, positive reinforcement, focusing on allowable foods, and involving family) threats and ambiguities of risk (sugar as the culprit, ubiquity of salt, illegible food labeling, avoiding processed foods, and questioning credibility of sources). Patients with CKD desire a preventative approach to CKD progression and maintaining their health, however, are stymied by dietary restrictions and a lack of reliable dietetic advice. Easy-to-use telehealth options have the potential to overcome the shortcomings in current health service delivery which may be limiting factors to providing these approaches. They provide patients with pragmatic tools, comprehensible and consistent information which fosters ownership and self-monitoring.
Publisher: Wiley
Date: 21-08-2022
Abstract: The aim of this scoping review was to provide an overview of the development of practice nurses, and the learnings that could be applied to improve the profile of dietetics practice in primary care. A scoping review synthesising peer-reviewed and other literature relevant to the development of Australian practice nurses was conducted. Structured searches using keywords 'general practice', 'nurse' and 'Australia' were conducted in PubMed and Google Scholar in June 2021. Key government websites, Department of Health and Services Australia, were searched to identify grey literature. One reviewer screened the titles and abstracts against inclusion criteria two reviewers conducted full-text screening independently. Data on the evolution of practice nursing were extracted based on its interest and transferability to the dietetics workforce. A total of 102 results (82 peer-reviewed and 20 other literature) were included in the review. Key drivers for practice nurse role development in Australia were government funding, practice nurse practice standards, cost-benefit analyses of practice nurses, career and education opportunities, general practitioner and patient perspectives of practice nurses and, in idual, community and local needs. The practice nurse role has grown and strengthened and there are three key learnings that could be translated to strengthen the dietetics workforce in primary care. (1) Use and expansion of government funding, (2) furthering post-tertiary education and career opportunities, including dietetic primary care practice standards and (3) targeting underserviced areas such as those that are rural and remote and building positive relationships with other stakeholders including practice nurses, general practitioners, patients and the broader primary care team.
Publisher: Wiley
Date: 15-07-2019
Abstract: The present study aimed to systematically map and summarise existing research regarding dietetics workforce preparation and preparedness that has been conducted in Australia. The secondary aim was to then identify gaps in the literature to inform future priority areas in Australian dietetics education research. The databases MEDLINE, CINAHL, Embase, ERIC, Informit and PsycINFO were systematically searched from inception until July 2017 using key search terms to identify eligible studies. Extracted data were independently reviewed, and study quality was appraised by multiple researchers. Results were categorised by setting and primary focus/foci and then narratively summarised. Sixty-eight studies were included from 3779 records identified. Dietetics education research in Australia has spanned almost 30 years with more than half of studies (51% 35/68) published in the last five years. The greatest proportion of research was conducted in the university setting (43% 29/68), with students as participants (48% 43/90) and was focused on the medical nutrition therapy area of dietetics practice (43% 29/68). Published studies involving graduates (14% 13/90) conducted in the workplace (12% 8/68) and regarding emerging areas of dietetics practice (0% 0/90) are lacking. Employment outcomes of dietetics graduates across Australia were last published over 25 years ago. This review provides a map for dietetics educators and researchers in Australia to guide future research regarding the preparation and preparedness of dietitians. Advancing the Australian dietetics workforce of the future will require a strategic, coordinated and collaborative approach to address the research gaps identified in this review.
Publisher: Wiley
Date: 29-06-2016
Abstract: Peer-assisted learning (PAL) has been positively evaluated during practice placements for medical, nursing and some allied health professional students. The aim of this study was to evaluate a PAL and small-group teaching model of dietetic practice placement education implemented in the UK setting as part of a quality improvement process. A PAL placement model was adapted from a previously published Australian model, implemented and evaluated among dietetic students at King's College London and with their practice educators. Process evaluation with students and practice educators from PAL practice placements at two sites and traditional 1:1 practice placements at six sites consisted of weekly questionnaires and end-of-placement focus groups with 16 students and 35 practice educators. Perceptions of the barriers, concerns and strengths of the novel model were identified. Implementing the PAL placement model at just two sites increased placement capacity by 12 students, a 1.3-fold increase across London. Students on PAL placements reported a good learning experience (89.3 vs 67.7% P < 0.001) and a satisfactory workload (83.1 vs 61.3%, P = 0.005) more frequently than those on a traditional 1:1 placement. Practice educators reported significantly less time undertaking direct student supervision on PAL practice placements compared to 1:1 placements (153 minutes/week 95% confidence interval (CI) 124-183 vs 264 minutes/week 95% CI 204-324 P = 0.001). PAL practice placements offer potential benefits to placement capacity and possibly quality. The detailed evaluation will enable others to implement similar novel models of dietetics placements.
Publisher: Wiley
Date: 21-01-2019
DOI: 10.1111/JHN.12620
Abstract: Dietetics practice educators are instrumental in the development of future dietitians. The present study aimed to explore dietetics practice educators' experiences of, and challenges faced in, dietetics workforce preparation. This study was guided by interpretive description methodology. Purposive and maximum variation s ling were used to recruit 18 dietetics practice educators from a variety of practice areas and locations across Australia. In-depth, semi-structured interviews were digitally recorded then transcribed verbatim and inductive coding of data was managed with nvivo (QSR International Pty Ltd, Doncaster, VIC, Australia). Multiple researchers analysed the data to develop preliminary themes using template analysis before final themes were identified. Three main themes were developed: nurturing others seeing the flaws and soldiering on. Practice educators take great satisfaction in witnessing students develop and are focused on cultivating future practitioners with authentic learning activities. However, they are impacted by perceived shortcomings of the systems in which they operate and consider that broadening the scope of dietetics placements to better align with contemporary practice could benefit graduates and the profession. Despite these challenges, practice educators are pragmatic in getting on with their roles and recognise the advantages gained from student placements. Despite facing numerous challenges, practice educators derive benefits from their role in workforce preparation. Evidence is required on how students can demonstrate competence in contemporary areas of practice and on how to enable the scope of student placements to be broadened. Such strategies could support practice educators to overcome challenges and help ensure the dietetics profession of tomorrow is relevant and responsive.
Publisher: Wiley
Date: 16-10-2018
DOI: 10.1111/JHN.12600
Abstract: Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation. MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines. From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9-year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles reconciling expectations transforming self and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies. Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in erse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating ersity in academic lacement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition-related health of those they will serve.
Publisher: Wiley
Date: 28-05-2020
DOI: 10.1111/JHN.12743
Publisher: Cambridge University Press (CUP)
Date: 2013
Publisher: Hindawi Limited
Date: 22-09-2022
DOI: 10.1111/HSC.14009
Abstract: Interprofessional collaborative practice has been shown to be an appropriate model of care for chronic disease management in primary care. However, how patients play a role in this model is relatively unknown. The aim of this constructivist grounded theory focus group study was to explore the perceptions of patient advocates regarding the role of patients in interprofessional collaborative practice for chronic conditions in primary care. Primary data were collected from patient advocates, from public and private Australian organisations and who represent patients with chronic disease in primary care, through focus groups in July-August 2020. Videoconference focus groups were recorded, transcribed verbatim and inductively, thematically analysed using the five-step approach by Charmaz: (1) initial line-by-line coding, (2) focused coding, (3) memo writing, (4) categorisation and (5) theme and sub-theme development. Three focus groups comprising 17 patient advocates with erse cultural and professional backgrounds participated. Two themes and five sub-themes relating to interprofessional collaborative practice teams were constructed from the data. In theme 1, patients 'shifted across the spectrum of roles' from 'relinquishing control to the team', 'joining the team' to 'disengaging from the team'. The second theme was the need for 'juggling roles' by 'integrating patient role with life roles', and 'learning about the patient role'. The ersity and variability of patient roles as described by patient advocates highlight the challenges of working with people with chronic conditions. The erse patient roles described by advocates are an important finding that may better inform communication between patients and health professionals when managing chronic conditions. From the health professional perspective, identification of the role of a patient may be challenging. Therefore, future research should explore the development of a tool to assist both patients and health professionals to identify patient roles as they move across the spectrum, with the support of policy makers. This tool should aim to identify and promote patient engagement in interprofessional collaborative practice in primary care settings.
Publisher: JMIR Publications Inc.
Date: 11-12-2017
DOI: 10.2196/JMIR.8193
Publisher: Cambridge University Press (CUP)
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: BMJ
Date: 09-2016
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.JNEB.2022.08.008
Abstract: Intuitive eating interventions aim to improve in idual health and promote sustainable changes to one's relationship with food. However, there is no evidence-based consensus on the impact of intuitive eating interventions on diet quality. This systematic review aimed to investigate intuitive eating interventions and their impact on diet quality. PubMed, Embase, CINAHL, PsycInfo, and Cochrane databases were systematically searched to October 2021 for studies reporting interventions that encompassed the principles of intuitive eating and measured diet quality. Other health outcomes were used for secondary analysis. Findings were synthesized narratively. Seventeen papers reporting 14 intervention studies (n = 3,960) were included in the review. All studies found a positive or neutral effect on diet quality following an intuitive eating intervention. A favorable change in eating behavior following these interventions was also observed. Intuitive eating promotes an attunement to the body, which aids in improving diet quality because of increased awareness of physiological cues. The reduction of emotional and binge eating may also increase diet quality. Findings from the current review suggest that intuitive eating interventions are most effective face-to-face, in a group setting, and sustained for at least 3 months.
Publisher: Springer Science and Business Media LLC
Date: 05-08-2020
DOI: 10.1007/S10459-019-09904-6
Abstract: Effective health workforce preparation is critical to the health of those who stand to benefit from its services. Emerging dietitians can provide important insights on an evolving workforce that is well-placed to advance future global health. This study aimed to explore a national s le of dietetics graduates' experiences of, and challenges faced in, dietetics workforce preparation and preparedness in Australia. An interpretive description methodology guided this study whereby researchers interpreted the meanings that participants attributed to their experiences. Twenty dietitians (graduated within the last 2 years) were purposively s led from across Australia and detailed insights were obtained through semi-structured interviews. A multi-analyst approach employing thematic and template analysis, enabled five themes to be identified across the data set. These included: (1) being held back (2) chasing the prize (3) valuing real learning (4) easing the transition and (5) encountering influencers. While graduates appreciated their preparation, they were not empowered or equipped to embrace opportunities in erse and emerging areas of dietetics practice. Graduates were challenged by the competitive landscape of securing obvious job opportunities and by a lack of support in transitioning into the workforce. Practice exposures and encounters with influential dietitians were highly valued. Research on role-emerging dietetics placements along with enhanced support mechanisms for novice dietitians is urgently required to ensure appropriate alignment between future dietetics preparation and practice. Obtaining insights into health professional graduates' experiences of their education can be used to ensure that emerging health workforces are relevant and responsive to future market needs.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16156
Abstract: Group-based education has the potential to substantially improve the outcomes of in iduals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a s le of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians’ preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3–6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.
Publisher: Wiley
Date: 13-06-2018
Abstract: Dietetics educators represent a small but influential workforce group that has experienced significant change in recent years. The workforce development challenges faced by this group have been largely unexplored. The present study aimed to explore the experiences of, and challenges faced by, academic dietetics educators in preparing dietitians for the workforce. The approach taken in the present study was informed by qualitative description. Fifteen dietetics educators employed by 13 universities across Australia were purposively s led. In-depth, semi-structured interviews conducted via telephone (n = 12) or face-to-face (n = 3) were digitally recorded then transcribed verbatim. Data were managed with NVivo and inductively analysed using open coding. Codes were condensed into themes through an iterative process involving multiple researchers. The overarching theme of 'aiming for a moving target' was underpinned by the themes of: (i) striving for betterment (ii) bridging dissonance and (iii) distressing impossibilities. Interviewees described how they were driven to enhance the preparation of dietitians but acknowledged disparity between what graduates are being prepared for and what they need to be prepared for. Heightened expectations of others, professional constraints and a lack of collegiality among the profession were among the challenges that manifested in a sense of frustration, concern and isolation. Dietetics educators are motivated to shape and enhance the future profession. However, they face numerous challenges in their efforts to prepare graduates who are well-equipped for increasingly erse dietetics practice. Strong leadership, academic collaboration and greater engagement of the broader workforce are required for the benefit of the entire profession.
Publisher: Cambridge University Press (CUP)
Date: 17-12-2018
DOI: 10.1017/S0007114518003409
Abstract: Adherence to dietary guidelines (DG) may result in higher intake of polyphenols via increased consumption of fruits, vegetables and whole grains. We compared polyphenol dietary intake and urinary excretion between two intervention groups in the Cardiovascular risk REduction Study: Supported by an Integrated Dietary Approach study: a 12-week parallel-arm, randomised controlled trial ( n 161 sixty-four males, ninety-seven females aged 40–70 years). One group adhered to UK DG, whereas the other group consumed a representative UK diet (control). We estimated polyphenol dietary intake, using a 4-d food diary (4-DFD) and FFQ, and analysed 24-h polyphenol urinary excretion by liquid chromatography-tandem MS on a subset of participants ( n 46 control n 45 DG). A polyphenol food composition database for 4-DFD analysis was generated using Phenol-Explorer and USDA databases. Total polyphenol intake by 4-DFD at endpoint (geometric means with 95 % CI, adjusted for baseline and sex) was significantly higher in the DG group (1279 mg/d per 10 MJ 1158, 1412) compared with the control group (1084 mg/d per 10 MJ 980, 1197). The greater total polyphenol intake in the DG group was attributed to higher intake of anthocyanins, proanthocyanidins and hydroxycinnamic acids, with the primary food sources being fruits, cereal products, nuts and seeds. FFQ estimates of flavonoid intake also detected greater intake in DG compared with the control group. 24-h urinary excretion showed consistency with 4-DFD in their ability to discriminate between dietary intervention groups for six out of ten selected, in idual polyphenols. In conclusion, following UK DG increased total polyphenol intake by approximately 20 %, but not all polyphenol subclasses corresponded with this finding.
Publisher: Oxford University Press (OUP)
Date: 06-2022
Abstract: While the non-profit sector has an integral role in health promotion, it is unclear whether these organisations have the capacity for health promotion activities. This study aims to explore and describe capacity changes of a non-profit organisation during a 3-year community-based nutrition intervention. The non-profit organisation, with 3800 members throughout the state of Queensland, Australia, implemented a 3-year food literacy community-based intervention. A team of qualified nutritionists delivered the program in partnership with community-based volunteers. A separate aim of the intervention was to build capacity of the non-profit organisation for health promotion. A qualitative study was undertaken, using a social constructivist approach to explore organisational capacity changes longitudinally. All relevant participants including non-profit executive managers and nutritionists were included in the study (100% response rate). Data collection included semi-structured interviews (n = 17) at multiple intervention time points and document analysis of program newsletters (n = 21). Interview transcripts and documents were analysed separately using thematic and content analysis. Codes and categories between the two data sources were then compared and contrasted to build themes. Organisational capacity was predominantly influenced by four themes ‘communicating’, ‘changing relationships’, ‘limited organisational learning’ and ‘adaptability and resistance to change’. Developing non-profit organisational health promotion capacity appears to require focusing on fostering communication processes and building positive relationships over time. Capacity changes of the non-profit organisation were not linear, fluctuating across various levels over time. Assessing non-profit organisational capacity to implement community interventions by describing adaptive capacity, may help researchers focus on the processes that influence capacity development.
Publisher: BMJ
Date: 2013
Publisher: Elsevier BV
Date: 10-2011
Publisher: Cambridge University Press (CUP)
Date: 18-01-2017
DOI: 10.1017/S1368980016003529
Abstract: To determine whether a cardioprotective dietary intervention based on UK dietary guidelines was more expensive than a conventional UK diet. Cost analysis of food records collected at baseline and after a 12-week dietary intervention of a cardioprotective diet v . conventional UK diet. A randomized controlled dietary intervention study (CRESSIDA ISRCTN 92382106) investigating the impact of following a diet consistent with UK dietary guidelines on CVD risk. Participants were healthy UK residents aged 40–70 years. A sub-s le of participants was randomly selected from those who completed the cardioprotective dietary intervention ( n 20) or the conventional UK dietary intervention ( n 20). Baseline diet costs did not differ between groups mean daily food cost for all participants was £6·12 ( sd £1·83). The intervention diets were not more expensive: at end point the mean daily cost of the cardioprotective diet was £6·43 ( sd £2·05) v . the control diet which was £6·53 ( sd £1·53 P =0·86). There was no evidence that consumption of a cardioprotective diet was more expensive than a conventional dietary pattern. Despite the perception that healthier foods are less affordable, these results suggest that cost may not be a barrier when modifying habitual intake and under tightly controlled trial conditions. The identification of specific food groups that may be a cost concern for in iduals may be useful for tailoring interventions for CVD prevention for in iduals and populations.
Publisher: Wiley
Date: 14-07-2017
DOI: 10.1111/JHN.12397
Abstract: To improve perceived value of nutrition support and patient outcomes, the present study aimed to determine the nutrition and food-related roles, experiences and support needs of female family carers of community-dwelling malnourished older adults admitted to rehabilitation units in rural New South Wales, Australia, both during admission and following discharge. Four female family carers of malnourished rehabilitation patients aged ≥65 years were interviewed during their care-recipients' rehabilitation admission and again at 2 weeks post-discharge. The semi-structured interviews were audiotaped, transcribed and analysed reflecting an interpretative phenomenological approach by three researchers. A series of 'drivers' relevant to the research question were agreed upon and discussed. Three drivers were identified. 'Responsibility' was related to the agency who assumed responsibility for providing nutrition support and understanding family carer obligation to provide nutrition support. 'Family carer nutrition ethos' was related to how carer nutrition beliefs, knowledge and values impacted the nutrition support they provided, the high self-efficacy of family carers and an incongruence with an evidence-based approach for treating malnutrition. 'Quality of life' was related to the carers' focus upon quality of life as a nutrition strategy and outcome for their care-recipients, as well as how nutrition support impacted upon carer burden. Rehabilitation units and rehabilitation dietitians should recognise and support family carers of malnourished patients, which may ultimately lead to an improved perceived benefit of care and patient outcomes. Intervention research is required to make strong recommendations for practice.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2021
Publisher: Elsevier BV
Date: 05-2015
Abstract: Controversy surrounds the effectiveness of dietary guidelines for cardiovascular disease (CVD) prevention in healthy middle-aged and older men and women. The objective was to compare effects on vascular and lipid CVD risk factors of following the United Kingdom dietary guidelines with a traditional British diet (control). With the use of a parallel-designed randomized controlled trial in 165 healthy nonsmoking men and women (aged 40-70 y), we measured ambulatory blood pressure (BP) on 5 occasions, vascular function, and CVD risk factors at baseline and during 12 wk after random assignment to treatment. The primary outcomes were differences between treatments in daytime ambulatory systolic BP, flow-mediated dilation, and total cholesterol/HDL cholesterol. Secondary outcomes were differences between treatment in carotid-to-femoral pulse wave velocity, high-sensitivity C-reactive protein, and a measure of insulin sensitivity (Revised Quantitative Insulin Sensitivity Check Index). Data were available on 162 participants, and adherence to the dietary advice was confirmed from dietary records and biomarkers of compliance. In the dietary guidelines group (n = 80) compared with control (n = 82), daytime systolic BP was 4.2 mm Hg (95% CI: 1.7, 6.6 mm Hg P < 0.001) lower, the treatment effect on flow-mediated dilation [-0.62% (95% CI: -1.48%, 0.24%)] was not significant, the total cholesterol:HDL cholesterol ratio was 0.13 (95% CI: 0, 0.26 P = 0.044) lower, pulse wave velocity was 0.29 m/s (95% CI: 0.07, 0.52 m/s P = 0.011) lower, high-sensitivity C-reactive protein was 36% (95% CI: 7%, 48% P = 0.017) lower, the treatment effect on the Revised Quantitative Insulin Sensitivity Check Index [2% (95% CI: -2%, 5%)] was not significant, and body weight was 1.9 kg (95% CI: 1.3, 2.5 kg P < 0.001) lower. Causal mediated effects analysis based on urinary sodium excretion indicated that sodium reduction explained 2.4 mm Hg (95% CI: 1.0, 3.9 mm Hg) of the fall in blood pressure. Selecting a diet consistent with current dietary guidelines lowers BP and lipids, which would be expected to reduce the risk of CVD by one-third in healthy middle-aged and older men and women. This study is registered at www.isrctn.com as 92382106.
Publisher: Wiley
Date: 17-06-2014
DOI: 10.1111/HEX.12219
Publisher: Cambridge University Press (CUP)
Date: 2015
Publisher: Wiley
Date: 14-02-2014
DOI: 10.1111/JHN.12215
Abstract: Accurate assessment of energy expenditure and anthropometry in older people is important for targeted nutritional support. The present study aimed to compare measured and calculated resting metabolic rate (m-RMR and c-RMR) and measured, calculated and estimated weight and height in older people aged ≥70 years. Participants were healthy older people aged ≥70 years. Indirect calorimetry using a ventilated hood calorimeter was performed for 30 min on fasted participants, and was compared with c-RMR, as calculated using six commonly used equations. Measured, calculated and estimated height and weight were compared. Subjects comprised 14 males and 20 females and mean (SD) m-RMR was 5243 (845) kJ day(-1) [1253 (202) kcal day(-1) ]. The Mifflin St-Jeor equation was the most consistently accurate, with the smallest mean difference between m-RMR and c-RMR of 58 (553) kJ day(-1) [14 (132) kcal day(-1) ] and c-RMR was within 10% of m-RMR in the greatest number of participants (n = 24 70%). The Schofield equation was among the least accurate in this age group. In older males, self-reported height and weight were accurate, whereas, in females or those unable to self-report height, ulna length was the most accurate alternative to measured height. Current equations used to calculate RMR in older people have inaccuracies, although the Mifflin St-Jeor equation was most accurate. Future studies should investigate the validity, reliability, cost and practicality of using fat free mass as an item in novel equations to calculate RMR in this age group. Self-reported height and weight in males, and height calculated from ulna length in females, were the most accurate alternatives to measured values in the present study.
Publisher: Wiley
Date: 20-06-2021
Abstract: Internal coherence in research refers to the alignment between ontology (nature of reality), epistemology (nature of knowledge), axiology (values), methodology and methods and is an important but often overlooked element of research quality. We therefore aimed to illustrate the concept of internal coherence in nutrition and dietetics research, and its importance beyond in idual elements of study quality. A targeted literature search in Nutrition and Dietetics was used to identify research illustrating one ex le of three main approaches to research (scientific, interpretive and critical inquiry) published between November 2017 and November 2020. Studies were included if they related to education research based on the expertise of the authors, and illustrated erse points about internal coherence. The authors independently critiqued included studies for internal coherence and synthesised their findings. From 76 manuscripts, 14 were identified as describing education research. Of the three selected studies that were critiqued, all had elements of internal coherence, in particular alignment between epistemology and methodology. However, each had elements of misalignment too, specifically between epistemology, axiology and method. The results point to the profession's historical groundings privileging the scientific approach, showing how this can yield misalignments, particularly when describing the limitations of interpretive and critical inquiry approaches. This review demonstrates the importance of internal coherence as a marker of quality, over and above existing quality assessment checklists for qualitative and quantitative methodologies. As such, it can help authors, reviewers and editors to improve the quality of nutrition and dietetics research and its reporting.
Publisher: Public Library of Science (PLoS)
Date: 16-05-2017
Publisher: JMIR Publications Inc.
Date: 15-06-2017
Abstract: elehealth-delivered dietary interventions are effective for chronic disease management and are an emerging area of clinical practice. However, to apply interventions from the research setting in clinical practice, health professionals need details of each intervention component. he aim of this study was to evaluate the completeness of intervention reporting in published dietary chronic disease management trials that used telehealth delivery methods. ligible randomized controlled trial publications were identified through a systematic review. The completeness of reporting of experimental and comparison interventions was assessed by two independent assessors using the Template for Intervention Description and Replication (TIDieR) checklist that consists of 12 items including intervention rationale, materials used, procedures, providers, delivery mode, location, when and how much intervention delivered, intervention tailoring, intervention modifications, and fidelity. Where reporting was incomplete, further information was sought from additional published material and through email correspondence with trial authors. ithin the 37 eligible trials, there were 49 experimental interventions and 37 comparison interventions. One trial reported every TIDieR item for their experimental intervention. No publications reported every item for the comparison intervention. For the experimental interventions, the most commonly reported items were location (96%), mode of delivery (98%), and rationale for the essential intervention elements (96%). Least reported items for experimental interventions were modifications (2%) and intervention material descriptions (39%) and where to access them (20%). Of the 37 authors, 14 responded with further information, and 8 could not be contacted. any details of the experimental and comparison interventions in telehealth-delivered dietary chronic disease management trials are incompletely reported. This prevents accurate interpretation of trial results and implementation of effective interventions in clinical practice.
Publisher: Wiley
Date: 09-2016
DOI: 10.1111/NEP.12888
Publisher: Springer Science and Business Media LLC
Date: 08-01-2016
Publisher: Oxford University Press (OUP)
Date: 10-2011
DOI: 10.1016/J.CROHNS.2011.04.016
Abstract: Background and aims: Crohn's Disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases (IBD), which may result in nutrition problems that impact on patient health, nutritional status and quality of life. Subjective reports of how IBD patients experience these problems as part of their disease process, including comparisons between patient groups, or the need for tailored nutrition advice as perceived by these patients, have not been widely studied. This survey aimed to identify and explore nutritional problems that are important to CD and UC patients and to investigate their views on the IBD health services provided to help them with these. Methods: Eighty-seven IBD patients were invited to take part in a nutrition survey using face-to-face questionnaire interviews. The survey asked about food and nutrition problems that patients have experienced, identifying which were most significant and the extent to which they had been addressed by the clinical service. Results: Seventy-two IBD patients completed the evaluation (47 CD, 25 UC). Of these, 45 (62.5%) felt that food and nutrition were either ‘important’ or ‘extremely important’ in their experience of IBD, and 59 (82%) reported problems with food and nutrition. Patients with CD and UC reported similar frequencies of most nutritional problems. However, 44 (94%) CD vs. 16 (64%) UC patients reported problems with weight (p = 0.002). Less than half of patients had seen a dietitian for tailored nutritional advice to address these problems. Conclusions: Nutritional problems experienced and reported by IBD patients are numerous and varied. They are considered important by patients with CD and UC, both of whom would generally value specific dietary counselling, highlighting a need for further research in this area and adequate and equal provision of services for both groups.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2022
DOI: 10.1186/S12875-021-01595-6
Abstract: Improving the patient experience is one of the quadruple aims of healthcare. Therefore, understanding patient experiences and perceptions of healthcare interactions is paramount to quality improvement. This integrative review aimed to explore how patients with chronic conditions experience Interprofessional Collaborative Practice in primary care. An integrative review was conducted to comprehensively synthesize primary studies that used qualitative, quantitative, and mixed methods. Databases searched were Medline, Embase, CINAHL and Web of Science on June 1st, 2021. Eligible studies were empirical full-text studies in primary care that reported experiences or perceptions of Interprofessional Collaborative Practice by adult patients with a chronic condition, in any language published in any year. Quality appraisal was conducted on included studies using the Mixed Method Appraisal Tool. Data on patients’ experiences and perceptions of Interprofessional Collaborative Practice in primary care were extracted, and findings were thematically analyzed through a meta-synthesis. Forty-eight ( n = 48) studies met the inclusion criteria with a total of n = 3803 participants. Study quality of in idual studies was limited by study design, incomplete reporting, and the potential for positive publication bias. Three themes and their sub-themes were developed inductively: (1) Interacting with Healthcare Teams, subthemes: widening the network, connecting with professionals, looking beyond the condition, and overcoming chronic condition collectively (2) Valuing Convenient Healthcare, subthemes: sharing space and time, care planning creates structure, coordinating care, valuing the general practitioner role, and affording healthcare (3) Engaging Self-care, subthemes: engaging passively is circumstantial, and, engaging actively and leading care. Patients overwhelmingly had positive experiences of Interprofessional Collaborative Practice, signaling it is appropriate for chronic condition management in primary care. The patient role in managing their chronic condition was closely linked to their experience. Future studies should investigate how the patient role impacts the experience of patients, carers, and health professionals in this context. PROSPERO: CRD42020156536.
Publisher: Wiley
Date: 29-07-2023
DOI: 10.1111/HEX.13828
Abstract: Chronic conditions can lead to physical, cognitive and social decline thus, increasing an in idual's dependence on family who assist with activities of daily living. Interprofessional collaborative practice (IPCP), involving two or more health professionals working with the patient and their family, is one model of care for the high‐quality management of in iduals with chronic conditions in primary care. Nevertheless, family carers have reported a disconnect between themselves and healthcare providers in previous research. This study aimed to explore the experiences and perspectives of family carers for in iduals with chronic conditions, regarding their involvement in IPCP. Aspects of constructivist grounded theory methodology were used. Family carers of in iduals with chronic conditions were invited to participate in a one‐on‐one, semistructured interview about their experiences with IPCP in the care of their loved one. Interview transcripts were analysed using Charmaz's four‐step iterative process: (1) line‐by‐line coding, (2) focused coding, (3) categorisation of codes and (4) potential theme and subtheme development with memo writing to support each phase of analysis. The research team collaborated on reflexivity exercises, the conceptualisation of categories and the development of themes. Constructivist data analysis of interviews (average 40 min) with 10 family carers resulted in two themes. (1) Stepping in for my loved one represents the notion that carers take on external roles on behalf of their loved ones (subthemes: working with interprofessional teams, supporting independence and learning as I go). (2) Taking on the carer role, represents the internal factors that influence the external roles described in theme 1 (subthemes: feeling obligated to be involved and changing relationship dynamics). This study outlines the external actions and internal influences on family carer involvement in an interprofessional team. The required knowledge and support to care for their loved ones is currently learned in an ad hoc manner, and carers' resources should be better promoted by health professionals. Additionally, the relationship dynamics between a carer and their loved one change as the carer becomes more involved in IPCP and influences how and the extent health professionals involve family carers. Carers were the study population involved in this qualitative study. Patient advocates who have chronic conditions, and are informal family carers, were involved in the creation and design of this study, including a review of the research question, participant information sheet and the interview guide.
No related grants have been discovered for Dianne Reidlinger.