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ABSTRACT: BACKGROUND: Radiotherapy-induced damage to noncancerous gastrointestinal mucosa has effects on secretory and absorptive functions and can interfere with normal gastrointestinal physiology. Nutrient absorption and digestion may be compromised. Dietary manipulation is an attractive option for the prevention and management of symptoms. AIM: To synthesise the evidence for the use of elemental formula low- or modified-fat diets, fibre, lactose restriction and probiotics, prebiotics and synbiotics to protect the gastrointestinal tract during pelvic radiotherapy. METHODS: Four electronic databases were searched. Randomised controlled trials (RCT), controlled trials (CT) and case series in adult patients receiving radiotherapy for pelvic cancers employing nutritional interventions to reduce gastrointestinal toxicity were included. Methodological quality was assessed using a bespoke tool. RESULTS: Twenty-two original studies (2446 patients) were identified. Study quality was highly variable with only 37% scoring ≥10 points (maximum 17: bespoke scale). Few studies assessed compliance with the intervention. End-points varied and included symptom scales (IBDQ, CTC, Bristol Stool and RTOG). Evidence from RCTs was weak for elemental, low- or modified-fat, fibre and low-lactose interventions with 1/4, 3/4, 1/2, 0/1 trials respectively reporting favourable outcomes. Evidence for probiotics as prophylactic interventions was more promising (4/5 favourable), but dose, strains and methodologies varied. CONCLUSIONS: There is insufficient high-grade evidence to recommend nutritional intervention during pelvic radiotherapy. Total replacement of diet with elemental formula may be appropriate in severe toxicity. Probiotics offer promise, but cannot be introduced into clinical practice without rigorous safety analysis, not least in immunocompromised patients. The methodological quality of nutritional intervention studies needs to be improved.
Alimentary Pharmacology & Therapeutics 04/2013; · 3.77 Impact Factor
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Journal of Human Nutrition and Dietetics 08/2012; 25(4):406-7. · 1.74 Impact Factor
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ABSTRACT: The intestinal microbiota is involved in the pathogenesis of inflammatory bowel disease (IBD). Faecal microbiota transplantation (FMT) has been used for the management of IBD as well as infectious diarrhoea.
To undertake a systematic review of FMT in patients with IBD.
The systematic review followed Cochrane and PRISMA recommendations. Nine electronic databases were searched in addition to hand searching and contacting experts. Inclusion criteria were reports (RCT, nonrandomised trials, case series and case reports) of FMT in patients with IBD.
Of the 5320 articles identified, 17 fulfilled the inclusion criteria, none of which were controlled trials. There were nine case series/case reports of patients receiving FMT for management of their IBD, and eight where FMT was for the treatment of infectious diarrhoea in IBD. These 17 articles reported on 41 patients with IBD (27 UC, 12 Crohn's, 2 unclassified) with a follow-up period of between 2 weeks and 13 years. Where reported, FMT was administered via colonoscopy/enema (26/33) or via enteral tube (7/33). In patients treated for their IBD, the majority experienced a reduction of symptoms (19/25), cessation of IBD medications (13/17) and disease remission (15/24). There was resolution of C. difficile infection in all those treated for such (15/15).
Whilst the available evidence is limited and weak, it suggests that faecal microbiota transplantation has the potential to be an effective and safe treatment for IBD, at least when standard treatments have failed. Well-designed randomised controlled trials are required to investigate these findings.
Alimentary Pharmacology & Therapeutics 07/2012; 36(6):503-16. · 3.77 Impact Factor
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ABSTRACT: There is increasing evidence to support a role for the gastrointestinal microbiota in the etiology of irritable bowel syndrome (IBS). Given the evidence of an inflammatory component to IBS, the mucosa-associated microbiota potentially play a key role in its pathogenesis. The objectives were to compare the mucosa-associated microbiota between patients with diarrhea predominant IBS (IBS-D), constipation predominant IBS (IBS-C) and controls using fluorescent in situ hybridization and to correlate specific bacteria groups with individual IBS symptoms.
Forty-seven patients with IBS (27 IBS-D and 20 IBS-C) and 26 healthy controls were recruited to the study. Snap-frozen rectal biopsies were taken at colonoscopy and bacterial quantification performed by hybridizing frozen sections with bacterial-group specific oligonucleotide probes.
Patients with IBS had significantly greater numbers of total mucosa-associated bacteria per mm of rectal epithelium than controls [median 218 (IQR - 209) vs 128 (121) P = 0.007], and this was chiefly comprised of bacteroides IBS [69 (67) vs 14 (41) P = 0.001] and Eubacterium rectale-Clostridium coccoides [52 (58) vs 25 (35) P = 0.03]. Analysis of IBS sub-groups demonstrated that bifidobacteria were lower in the IBS-D group than in the IBS-C group and controls [24 (32) vs 54 (88) vs 32 (35) P = 0.011]. Finally, amongst patients with IBS, the maximum number of stools per day negatively correlated with the number of mucosa-associated bifidobacteria (P < 0.001) and lactobacilli (P = 0.002).
The mucosa-associated microbiota in patients with IBS is significantly different from healthy controls with increases in bacteroides and clostridia and a reduction in bifidobacteria in patients with IBS-D.
Neurogastroenterology and Motility 11/2011; 24(1):31-9. · 3.41 Impact Factor
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ABSTRACT: Emerging evidence indicates that the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may result in symptoms in some patients with irritable bowel syndrome (IBS). The present study aimed to determine whether a low FODMAP diet is effective for symptom control in patients with IBS and to compare its effects with those of standard dietary advice based on the UK National Institute for Health and Clinical Excellence (NICE) guidelines.
Consecutive patients with IBS who attended a follow-up dietetic outpatient visit for dietary management of their symptoms were included. Questionnaires were completed for patients who received standard (n = 39) or low FODMAP dietary advice (n = 43). Data were recorded on symptom change and comparisons were made between groups.
In total, more patients in the low FODMAP group reported satisfaction with their symptom response (76%) compared to the standard group (54%, P = 0.038). Composite symptom score data showed better overall symptom response in the low FODMAP group (86%) compared to the standard group (49%, P < 0.001). Significantly more patients in the low FODMAP group compared to the standard group reported improvements in bloating (low FODMAP 82% versus standard 49%, P = 0.002), abdominal pain (low FODMAP 85% versus standard 61%, P = 0.023) and flatulence (low FODMAP 87% versus standard 50%, P = 0.001).
A low FODMAP diet appears to be more effective than standard dietary advice for symptom control in IBS.
Journal of Human Nutrition and Dietetics 05/2011; 24(5):487-95. · 1.74 Impact Factor
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ABSTRACT: A gluten-free diet is the only treatment for patients with coeliac disease, although it can be burdensome to follow and result in inadequate nutrient intake. The cost and availability of a gluten-free diet has been cited as a cause of incomplete dietary compliance; however, this has not been extensively investigated. The aim was to investigate the availability and cost of gluten-free foods across a wide range of stores.
The availability and cost of 20 foods (both wheat-based and everyday foods) was surveyed at 30 different stores across five different store categories. For each of the 20 foods, four products were selected (branded gluten-free, cheapest gluten-free, branded standard, cheapest standard) resulting in sampling of up to 80 products in each of the 30 stores.
In general, there was limited availability of gluten-free foods, with an average of 8.2 of the 20 (41%) foods being available in a gluten-free version per store. Regular supermarkets had a greater availability (18.0/20, 90%), whereas budget supermarkets (1.8/20, 9%) and corner shops (1.8/20, 9%) had almost no gluten-free versions (P < 0.001). All 10 gluten-free versions of wheat-based foods were more costly than their standard counterparts (76-518% more expensive; P < 0.001). Some gluten-free versions of everyday foods were also more costly than standard counterparts (2-124%).
There is limited availability of gluten-free foods and they are generally more expensive than their standard counterparts. This may impact on compliance to a gluten-free diet, with potential nutritional and clinical consequences, together with an increased risk of complications.
Journal of Human Nutrition and Dietetics 05/2011; 24(5):479-86. · 1.74 Impact Factor
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ABSTRACT: Malnutrition is a common problem in hospitalised inpatients, resulting in a range of negative clinical, patient-centred and economic sequelae. Protected mealtimes (PM) aim to enhance the quality of the mealtime experience and maximise nutrient intake in hospitalised patients. The present study aimed to measure mealtime environment, patient experience and nutrient intake before and after the implementation of PM.
PM were implemented in a large teaching hospital through a range of different approaches. Direct observations were used to assess ward-level mealtime environment (e.g. dining room use, removal of distractions) (40 versus 34 wards) and individual patient experience (e.g. assistance with eating, visitors present) (253 versus 237 patients), and nutrient intake was assessed with a weighed food intake at lunch (39 versus 60 patients) at baseline and after the implementation of PM, respectively.
Mealtime experience showed improvements in three objectives: more patients were monitored using food/fluid charts (32% versus 43%, P = 0.02), more were offered the opportunity to wash hands (30% versus 40%, P = 0.03) and more were served meals at uncluttered tables (54% versus 64%, P = 0.04). There was no difference in the number of patients experiencing mealtime interruptions (32% versus 25%, P = 0.14). There was no difference in energy intake (1088 versus 837 kJ, P = 0.25) and a decrease in protein intake (14.0 versus 7.5 g, P = 0.04) after PM.
Only minor improvements in mealtime experience were made after the implementation of PM and so it is not unexpected that macronutrient intake did not improve. The implementation of PM needs to be evaluated to ensure improvements in mealtime experience are made such that measurable improvements in nutritional and clinical outcomes ensue.
Journal of Human Nutrition and Dietetics 05/2011; 24(4):370-4. · 1.74 Impact Factor
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ABSTRACT: Prebiotics potentially increase the growth of bifidobacteria, which may minimise the risk of diarrhoea in patients receiving enteral nutrition (EN). The present study aimed to compare the concentrations of faecal microbiota and short-chain fatty acids (SCFA) in patients receiving EN with either a standard formula or one enriched with fructo-oligosaccharides (FOS) and fibre.
Forty-one hospitalised adult patients (25 males, 16 females) who were on exclusive EN for at least 12 days were recruited to a cross-sectional study. Faecal samples were collected and analysed for major groups of microbiota using fluorescent in situ hybridisation and SCFA concentrations were analysed using gas liquid chromatography.
There were generally low concentrations of the major bacterial groups, including bifidobacteria, in all patients receiving either standard or FOS/fibre-enriched formula [bifidobacteria: 6.6 (1.3) versus 7.0 (2.0) log(10) cells g(-1) dry faecal, P=0.199]. However, faecal butyrate concentrations were higher in patients receiving the FOS/fibre-enriched formula compared to standard formula [20.5 (21.6) versus 4.6 (6.7) μmol g(-1) dry faecal, P=0.006].
Low concentrations of faecal bifidobacteria were identified in these patients, which potentially increases their risk of diarrhoea. Other microbiota groups may utilise FOS/fibre, leading to different butyrate concentrations between the two cohorts.
Journal of Human Nutrition and Dietetics 03/2011; 24(3):260-8. · 1.74 Impact Factor
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ABSTRACT: Background: Problems of undernutrition are common in hospital in-patients. Multiple morbidity increases with age and may contribute to nutritional risks. This research aimed to determine whether increased burden of long-term conditions is associated with patients' difficulties gaining access to food in hospital. Methods: A survey was implemented in 29 wards at four hospitals using a questionnaire measure of patients' experiences of food access and the Cumulative Illness Rating Scale (CIRS) to evaluate the burden of long-term illness in each patient. Experiences of food access were evaluated in relation to CIRS score category using random effects logistic regression to adjust for age group, sex and clustering by ward. Results: Data were analysed for 764/1154 (66%) eligible participants, including 384 women. The median age was 60 years (range 18-96 years). CIRS scores were analysed using the categories 0 (104 patients), 1-3 (197), 4-6 (285), 7-9 (144) and ≥10 (34). When the CIRS was zero, 10% of patients experienced physical problems with food access, whereas, when the CIRS was ≥10, 41% experienced physical barriers to food access, adjusted odds ratio 3.65 (1.14-11.7, P = 0.029). Problems with food quality were experienced by 13% with CIRS = 0 and 32% with CIRS ≥ 10 (adjusted odds ratio 3.97, 1.35-11.6, P = 0.012). Participants with greater morbidity were more likely to report that depression, breathing difficulties or chewing and swallowing difficulties affected the amount of food that they ate at mealtimes. Conclusions: Patients with multiple morbidities are more vulnerable to experiencing physical barriers to accessing food and increased concerns with food quality. Assessing barriers to food access is particularly important in multiple morbidity.
Journal of Human Nutrition and Dietetics 12/2010; 23(6):575-82. · 1.74 Impact Factor
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ABSTRACT: Inulin and oligofructose are prebiotic carbohydrates associated with numerous health benefits. The aim of this study was to accurately measure inulin and oligofructose intakes and to develop and validate a food frequency questionnaire (FFQ).
A 7-d semi-weighed food diary (FD) was used to measure intakes in 66 healthy subjects. A 23-item FFQ was developed to measure short-term inulin and oligofructose intakes over the same 7 days and was completed twice on 2 separate days.
There were no significant differences in inulin intake (4.0 ± 1.3 vs 4.0 ± 1.4 g/d, P = 0.646) or oligofructose intake (3.8 ± 1.2 vs 3.8 ± 1.3 g/d, P = 0.864) when measured using the 7-d FD or the FFQ. Bland-Altman analysis demonstrated low mean differences between the FD and FFQ in measuring intakes of inulin (-0.09 g/d) and oligofructose (-0.03 g/d). The FFQ categorised 89% of subjects into the same or adjacent tertiles of intakes as the 7-d FD. For the majority of food items, kappa values indicated 'substantial' or 'almost perfect' agreement for assignment of 'portion size' and 'frequency of consumption' between the FFQs completed on separate days.
The FFQ is a valid and reliable method for measuring short-term inulin and oligofructose intakes for use in dietary surveys and clinical trials.
European journal of clinical nutrition 12/2010; 65(3):402-8. · 3.07 Impact Factor
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ABSTRACT: Irritable bowel syndrome (IBS) is a disorder of chronic abdominal pain, altered bowel habit and abdominal distension. It is the commonest cause of referral to gastroenterologists in the developed world and yet current therapeutic strategies are often unsatisfactory. There is now increasing evidence linking alterations in the gastrointestinal (GI) microbiota and IBS. Changes in faecal and mucosa-associated microbiota, post-infectious IBS, a link with small intestinal bacterial overgrowth and an up-regulation of the GI mucosal immune system all suggest a role for the GI microbiota in the pathogenesis of IBS. Given this evidence, therapeutic alteration of the GI microbiota by probiotic bacteria could be beneficial. The present paper establishes an aetiological framework for the use of probiotics in IBS and comprehensively reviews randomised placebo-controlled trials of probiotics in IBS using multiple electronic databases. It highlights safety concerns over the use of probiotics and attempts to establish guidelines for their use in IBS in both primary and secondary care.
Proceedings of The Nutrition Society 03/2010; 69(2):187-94. · 2.77 Impact Factor
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ABSTRACT: The association between malnutrition and poor clinical outcome is well-established, yet most research has focussed on the role of artificial nutritional support in its management. More recently, emphasis has been placed on the provision of adequate nutritional care, including nutritional screening and the routine provision of food and drink. The aim of this literature review is to establish the evidence for the efficacy of interventions that might result in improvements in nutritional and clinical outcomes and costs.
A structured literature review was conducted investigating the role of nutritional care interventions in adults, and their effects on nutritional and clinical outcomes and costs, in all healthcare settings. Ten databases were searched electronically using keywords relating to nutritional care, patient outcomes and healthcare costs. High quality trials were included where available.
Two hundred and ninety-seven papers were identified and reviewed. Of these, only two randomised, controlled trials and six other trials were identified that addressed the major issues. A further 99 addressed some aspects of the provision of nutritional care, although very few formally evaluated nutritional or clinical outcomes and costs.
This review reveals a serious lack of evidence to support interventions designed to improve nutritional care, in particular with reference to their effects on nutritional and clinical outcomes and costs. The review suggests that screening alone may be insufficient to achieve beneficial effects and thus more research is required to determine the most cost-effective interventions in each part of the nutritional care pathway, in a variety of healthcare settings and across all age ranges, to impact upon nutritional and clinical outcomes.
Journal of Human Nutrition and Dietetics 09/2009; 22(4):324-35. · 1.74 Impact Factor
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ABSTRACT: There is a lack of dedicated resources for adolescent and adult patients with phenylketonuria (PKU) and few studies have examined dietary practices within this group.
One hundred and seventy-seven PKU patients were sent questionnaires to assess dietary compliance and the preferred format for an educational resource. Seventy-one patients responded; 32 following diet were recruited to assess the resource's impact on test variables. The results were compared for the intervention group (n = 22) and control group (n = 10) at baseline, and 1 and 6 months after resource intervention.
Most patients were aware of dietary recommendations, although this did not always result in compliance. The preferred resource format was a filofax-style folder with inserts (P < 0.05). There was a significant difference in the extent of change in knowledge score between baseline and 1 month in favour of the intervention group (P < 0.05). The improvement in knowledge was not accompanied by a significant improvement in measures of compliance.
These findings add to the knowledge base about this patient group and support the use of patient involvement in resource development. It is likely that the test parameters used were not sensitive enough to pick up subtle and longer-term effects on compliance.
Journal of Human Nutrition and Dietetics 10/2008; 21(5):474-85. · 1.74 Impact Factor
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ABSTRACT: Background: The reported incidence of refeeding syndrome is highly variable due to the heterogeneity of its definition, the electrolyte reference ranges used, patient populations investigated and the treatment protocols implemented (Marik & Bedigian, 1996; Fan et al., 2004). Recent guidelines have been published by the National Institute of Clinical Excellence on the identification and management of patients at risk of refeeding syndrome (NICE, 2006). The aim of this prospective observational study was to determine the incidence of refeeding syndrome in hospital patients referred for artificial nutrition and hydration (ANH) via the enteral or parenteral route, where national practice guidelines exist to prevent its occurrence. Methods: Data was collected as part of a larger, ongoing study at a London hospital. All patients referred to the Department of Nutrition and Dietetics for ANH had their feeding regimen and their risk of refeeding syndrome determined based upon the clinical decision of their dietitian and local guidelines. An independent researcher screened patients for inclusion into the study and then categorised their risk of refeeding syndrome based upon criteria from national guidelines (NICE, 2006). Patient characteristics, diet history, anthropometry, feed prescription and baseline serum phosphate, potassium and magnesium were recorded. Electrolytes were recorded every 3 days, up to 15 days, to determine clinical signs consistent with refeeding syndrome. Patients 'at risk' of refeeding syndrome were compared with those categorised as 'not at risk'. Statistical analysis was conducted using SPSS version 15 and included descriptive statistics, McNemar's test and independent t-tests for continuous data. Ethical approval was obtained from the appropriate committee. Results: Of the 24 patients recruited, only three (13%) were judged to be 'at-risk' of refeeding syndrome by the patient's dietitian, compared with 18 (75%) who were identified as 'at-risk' based upon criteria from national guidelines (P < 0.001). There were no significant differences in energy prescription (P = 0.836), energy delivery on the first day of feeding (P = 0.814) or serum electrolyte concentrations at any time point during feeding, when comparing patients identified as 'at-risk' or 'not at-risk' by national guidelines. Refeeding syndrome was not observed. Discussion: Adherence to the NICE guidelines (2006) for preventing refeeding syndrome was variable in these patients. However, patients identified as being 'at-risk' according to these guidelines did not develop refeeding syndrome, despite frequently receiving energy prescriptions in excess of the recommendations. Conclusions: Patients who were categorised as 'at risk' of refeeding syndrome according to national guidelines did not always go on to develop the syndrome. The role of dietetic assessment of risk of refeeding syndrome warrants further investigation. References Fan, C., Ren, J., Wang, X. & Li, J. (2004) Refeeding syndrome in patients with gastrointestinal fistula. Nutrition 20, 346-350. Marik, P.E. & Bedigian, M.K. (1996) Refeeding hypophosphatemia in critically ill patients in an intensive care unit. Arch. Surg. 131, 1043-1047. National Institute for Clinical Excellence/National Collaborating Centre for Acute Care, February 2006. Nutrition support in adults. Oral nutrition support, enteral tube feeding and parenteral nutrition. London: National Collaborating Centre for Acute Care.
Journal of Human Nutrition and Dietetics 08/2008; 21(4):387-388. · 1.74 Impact Factor
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ABSTRACT: Background: Diarrhoea is a common complication during enteral tube feeding (ETF) and, despite little empirical evidence, is said to be unpleasant for both patients and nurses (Whelan et al., 2007). The aspects of diarrhoea considered to be unpleasant among patients receiving ETF or among nurses caring for these patients has not previously been investigated. Therefore, the aim of the study was to investigate patients’ and nurses’ attitudes towards diarrhoea during ETF.Methods: A questionnaire was developed following an extensive literature review and was pre-tested for clarity. An interviewer-administered questionnaire survey was then conducted by the same interviewer, in patients receiving ETF and in nurses caring for patients receiving ETF. Seven different characteristics of diarrhoea (faecal colour, consistency, frequency, quantity, incontinence, odour, need to change underwear) were rated for their unpleasantness using a four-point Likert scale. Ratings were then ranked and a mean rank calculated for each group to determine the most and least unpleasant characteristic. Ranks were then compared within patients and within nurses using a Friedman test. Ethical approval was obtained from an NHS Research Ethics Committee.Results: In total, 22 patients (16 male, six female; mean age 58.5 ± 15.2 years) receiving ETF due to dysphagia, post-surgery, tracheostomy and inadequate nutritional intake and 57 nurses (16 male, 41 female) from respiratory, intensive therapy, elderly care and renal units were interviewed. There were differences in the rankings of the seven characteristics among patients (P < 0.001) and among nurses (P < 0.001). Patients rated incontinence and frequency as the most unpleasant characteristic of diarrhoea, whereas nurses rated odour and changing underwear as the most unpleasant characteristic of caring for patients with diarrhoea during ETF (Table 1).Table 1. Mean ranking of attitude towards diarrhoea during ETF within nurses and patients (Rank 1 = least unpleasant, 7 = most unpleasant) CharacteristicsPatient (n = 22)Nurses (n = 57)Incontinence5.54.0Frequency4.84.0Consistency4.44.1Odour4.25.3Quantity3.83.7Colour2.82.4Changing underwear2.54.5P-value (Friedman test)<0.001<0.001Discussion: The characteristics of diarrhoea considered to be unpleasant by patients are not the same as for nurses. The importance of understanding the patient perspective of symptoms is increasingly recognised in practice and research.Conclusion: Faecal incontinence and frequency are considered to be the most unpleasant characteristics of diarrhoea by patients. These characteristics should be monitored by healthcare professionals and strategies developed to minimize their occurrence in hospitalised patients receiving ETF.Reference Whelan, K. (2007) Enteral-tube-feeding diarrhoea: manipulating the colonic microbiota with probiotics and prebiotics. Proc. Nutr Soc. 66, 299–306.
Journal of Human Nutrition and Dietetics 07/2008; 21(4):395 - 395. · 1.74 Impact Factor
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Proceedings of The Nutrition Society 06/2008; 67(OCE):E141. · 2.77 Impact Factor
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Proceedings of The Nutrition Society 06/2008; 67(OCE):E144. · 2.77 Impact Factor
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ABSTRACT: Estimation of resting energy expenditure (REE) involves predicting basal metabolic rate (BMR) plus adjustment for metabolic stress. The aim of this study was to investigate the methods used to estimate REE and to identify the impact of the patient's clinical condition and the dietitians' work profile on the stress factor assigned. A random sample of 115 dietitians from the United Kingdom with an interest in nutritional support completed a postal questionnaire regarding the estimation of REE for 37 clinical conditions. The Schofield equation was used by the majority (99%) of dietitians to calculate BMR; however, the stress factors assigned varied considerably with coefficients of variation ranging from 18.5 (cancer with cachexia) to 133.9 (HIV). Dietitians specializing in gastroenterology assigned a higher stress factor to decompensated liver disease than those not specializing in gastroenterology (19.3 vs 10.7, P=0.004). The results of this investigation strongly suggest that there is wide inconsistency in the assignment of stress factors within specific conditions and gives rise to concern over the potential consequences in terms of under- or overfeeding that may ensue.
European Journal of Clinical Nutrition 02/2008; 62(1):150-3. · 2.46 Impact Factor
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ABSTRACT: Student dietitians' attitudes towards research and audit are important as they are likely to influence their subsequent involvement in such activities once qualified. The aim of this study was to investigate the attitudes of student dietitians towards research and audit and to compare them with those of registered dietitians previously reported.
A questionnaire survey of final-year student dietitians' attitudes towards research and audit was conducted. Students indicated their agreement with 12 statements relating to research and audit and the results were compared with those from an identical survey of registered dietitians.
A total of 110 questionnaires were completed (87% response rate). In general, students had positive attitudes towards research and audit. The majority (91%) agreed that 'all dietitians should be able to act on research', whilst only a small minority agreed that research (6%) and audit (4%) was 'not part of a dietitian's role'. In general, students had more positive attitudes towards research, and less positive attitudes towards audit, than dietitians from a previously published survey.
Final year student dietitians have positive attitudes towards research and audit. These should be nurtured throughout the early years of their career in order to maximize on their research potential.
Journal of Human Nutrition and Dietetics 05/2007; 20(2):121-5. · 1.74 Impact Factor
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ABSTRACT: Interprofessional education (IPE) is a novel teaching and learning initiative where students of more than one health profession learn interactively together. However, despite its potential for improving interprofessional relationships, there is little information regarding the participation of student dietitians in IPE. The aim of this paper was to consider the reaction of student dietitians to an IPE course in order to stimulate debate between dietitians regarding the issues relating to IPE.
Student dietitians participated in an IPE course consisting of seven sessions on communication and ethics in health care together with students of medicine and nursing. Student dietitians completed an evaluation questionnaire following each session that surveyed their reaction to the session using both a Likert scale and free-text comments.
Twenty-six student dietitians completed the IPE course. All sessions were rated positively for interest value (P < or = 0.14), learning experience (P < or = 0.036) and value for clinical practice (P < or = 0.05). The limited number of free-text comments indicated some positive experiences regarding interprofessional learning, teaching content and teaching strategy.
This is one of very few evaluations to describe the reaction of student dietitians to IPE. Student dietitians had largely positive reactions to the IPE course. Further research is required to evaluate whether these positive reactions were a direct consequence of the inclusion of students from other health professions and whether these translate into positive effects on learning, behaviour and results. The opportunities for the dietetic profession posed by students' involvement in IPE are discussed.
Journal of Human Nutrition and Dietetics 12/2005; 18(6):461-6. · 1.74 Impact Factor
