This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

Protecting the health of the athlete is a goal of the International Olympic Committee (IOC). The IOC convened an expert panel to update the 2005 IOC Consensus Statement on the Female Athlete Triad. This Consensus Statement replaces the previous and provides guidelines to guide risk assessment, treatment and return-to-play decisions. The IOC expert working group introduces a broader, more comprehensive term for the condition previously known as ‘Female Athlete Triad’. The term ‘Relative Energy Deficiency in Sport’ (RED-S), points to the complexity involved and the fact that male athletes are also affected. The syndrome of RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a ‘triad’ of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. This Consensus Statement also recommends practical clinical models for the management of affected athletes. The ‘Sport Risk Assessment and Return to Play Model’ categorises the syndrome into three groups and translates these classifications into clinical recommendations.

https://bjsm.bmj.com/content/bjsports/48/7/491.full.pdf

The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S)

The medical effects of modest weight reduction (approximately 10% or less) in patients with obesity-associated medical complications were reviewed. The National Library of Medicine MEDLINE database and the Derwent RINGDOC database were searched to identify English language studies that examined the effects of weight loss in obese patients with serious medical complications commonly associated with obesity (non-insulin dependent diabetes mellitus (NIDDM or type II), hypertension, hyperlipidemia, hypercholesterolemia, and cardiovascular disease). Studies in which patients experienced approximately 10% or less weight reduction were selected for review. Studies indicated that, for obese patients with NIDDM, hypertension or hyperlipidemia, modest weight reduction appeared to improve glycemic control, reduce blood pressure, and reduce cholesterol levels, respectively. Modest weight reduction also appeared to increase longevity in obese individuals. In conclusion, a large proportion of obese individuals with NIDDM, hypertension, and hyperlipidemia experienced positive health benefits with modest weight loss. For patients who are unable to attain and maintain substantial weight reduction, modest weight loss should be recommended; even a small amount of weight loss appears to benefit a substantial subset of obese patients.

Beneficial health effects of modest weight loss.

The role of social media in higher education classes (real and virtual) – A literature review

The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity. We explore sex-specific hormonal changes, inflammatory pathways and myocellular mechanisms leading to the development of sarcopenic obesity. We discuss the evolution, controversies and challenges in defining sarcopenic obesity and present current body composition modalities used to assess this condition. Epidemiological surveys form the basis of defining its prevalence and consequences beyond comorbidity and mortality. Current treatment strategies, and the evidence supporting them, are outlined, with a focus on calorie restriction, protein supplementation and aerobic and resistance exercises. We also describe weight loss-induced complications in patients with sarcopenic obesity that are relevant to clinical management. Finally, we review novel and potential future therapies including testosterone, selective androgen receptor modulators, myostatin inhibitors, ghrelin analogues, vitamin K and mesenchymal stem cell therapy.

Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies.

This study investigated the effects of aerobic exercise, fluid loss and rehydration on cognitive performance in well-trained athletes. Ten endurance-trained males (25 ± 5 years; 175 ± 5 cm; 70.35 ± 5.46 kg; VO2max, 62.95 ± 7.20 ml · kg.min−1) lost ~2.5 ± 0.6% body mass via continuous cycling exercise at ~65% peak sustainable power output (60 min duration) before consuming different beverages (Water = W1 and W2, Sustagen Sport = SS, Powerade = PD) and food ad libitum on four separate occasions. Cognitive function using a four-choice reaction time task (CRT), body mass, fluid consumption volumes, urine samples and subjective ratings (alertness, concentration, energy) were obtained before and after exercise, and hourly during recovery (for 4 h). CRT latency was significantly reduced immediately after exercise compared to pre-exercise measures for all trials (W1 = −16 ± 18 ms, W2 = −22 ± 21 ms, PD = −22 ± 22 ms, SS = −19 ± 26 ms). However, this effect was short-lived with subsequent measures not diffe...

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Effects of acute exercise, dehydration and rehydration on cognitive function in well-trained athletes

Adolescence (ages 13–18 years) is a period of significant growth and physical development that includes changes in body composition, metabolic and hormonal fluctuations, maturation of organ systems, and establishment of nutrient deposits, which all may affect future health. In terms of nutrition, adolescence is also an important time in establishing an individual’s lifelong relationship with food, which is particularly important in terms of the connection between diet, exercise, and body image. The challenges of time management (e.g., school, training, work and social commitments) and periods of fluctuating emotions are also features of this period. In addition, an adolescent’s peers become increasingly powerful moderators of all behaviours, including eating. Adolescence is also a period of natural experimentation and this can extend to food choice. Adolescent experiences are not the same and individuals vary considerably in their behaviours. To ensure an adolescent athlete fulfils his/her potential, it is important that stakeholders involved in managing youth athletes emphasize eating patterns that align with and support sound physical, physiological and psychosocial development and are consistent with proven principles of sport nutrition.

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Youth Athlete Development and Nutrition

/pdf/a-descriptive-partial-economic-evaluation-of-clinical-5dxvwn2lik.pdf

A descriptive partial economic evaluation of clinical dietetic student professional placements

Personal trainers are well placed to provide basic nutrition care in line with national dietary guidelines. However, many personal trainers provide nutrition care beyond their scope of practice and this has been identified as a major industry risk due to a perceived lack of competence in nutrition. This paper explores the context in which personal trainers provide nutrition care, by understanding personal trainers' perceptions of nutrition care in relation to their role and scope of practice. Semistructured telephone interviews were conducted with 15 personal trainers working within Australia. Thematic analysis was used to identify key themes. All personal trainers reported to provide nutrition care and reported that nutrition care was an important component of their role. Despite this, many were unaware or uncertain of the scope of practice for personal trainers. Some personal trainers reported a gap between the nutrition knowledge they received in their formal education, and the knowledge they needed to optimally support their clients to adopt healthy dietary behaviors. Overall, the personal training context is likely to be conducive to providing nutrition care. Despite concerns about competence personal trainers have not modified their nutrition care practices. To ensure personal trainers provide nutrition care in a safe and effective manner, greater enforcement of the scope of practice is required as well as clear nutrition competencies or standards to be developed during training.

Personal Trainer Perceptions of Providing Nutrition Care to Clients: A Qualitative Exploration

Aim: To qualitatively evaluate a learning and teaching intervention for developing research and evaluation competencies, structured around the experience of having to conduct a significant research project. Methods: A qualitative study utilising semi-structured interviews among a sample of 25 recent graduates from Griffith University's Master of Nutrition and Dietetics Program. Interviews explored student motivations for doing the research major, the student's experience of the full-time semester long research project, and the actual and perceived outcomes of this experience. Interviews were audiotaped, transcribed verbatim, and thematically analysed via open coding and triangular analysis by three of the authors. Results: All of the graduates interviewed had conducted research projects across a range of practice settings. Motivations for electing to do the research major varied from disinterest in other options to an opportunity to 'taste-test' research, to develop research competencies and secure pathways to later research studies. The student learning experience was described as intense, stressful but rewarding and a steep learning curve. Graduates reported that they learned much more than research competencies during this process and many converted this research activity into a research output (journal article or conference abstract). Students reflected on the strong sense of achievement associated with research outputs and the competitive advantage it had provided on seeking graduate employment. Conclusions: It is possible to develop graduate dietitians' research and evaluation competencies using curriculum initiatives that exploit experiential learning. Exposing students to the research practice cycle culminating in peer-reviewed publication builds research self-efficacy and positions students for good employment outcomes.

Ben Desbrow

Papers

Effects of acute exercise, dehydration and rehydration on cognitive function in well-trained athletes

Youth Athlete Development and Nutrition

A descriptive partial economic evaluation of clinical dietetic student professional placements

Personal Trainer Perceptions of Providing Nutrition Care to Clients: A Qualitative Exploration

Evaluation of a curriculum initiative designed to enhance the research training of dietetics graduates