Nutrition Disciplines Research Articles

Foundational and Clinical Science Integration in a Team-Based Learning Module Modeling Care of a Patient With Dyslipidemia.

Foundational and clinical science integration, a long-standing goal of undergraduate medical education, benefits learners by promoting retention of critical knowledge and skills as well as their transfer to the clinical setting. We implemented a team-based learning (TBL) module in which foundational knowledge and skills from the disciplines of biochemistry, nutrition, and genetics were leveraged in a simulated patient encounter for diagnosis and management of a patient with dyslipidemia. The TBL was deployed in a first-year medical student cardiovascular system course with 125 students over three academic years. Following individual and team readiness assurance tests (iRAT and tRAT, respectively), teams participated in an initial application exercise requiring consideration of clinical and laboratory data and other risk factors to engage the patient in a shared decision-making process. Using dietary and family history narratives in subsequent application exercises, teams completed recommendations for an individualized diet plan and an assessment of potential disease inheritance patterns to formulate appropriate patient care management strategies. Student engagement with prelearning materials and session team activities was high as judged by RAT performance and application exercise outcomes: iRAT question performance ranged from 89% to 99% for individual items, and tRAT performance was routinely 100%. Learners reported that the exercises were impactful and believed the learned foundational knowledge and skills were transferable to future patient care. The dyslipidemia TBL module provides an illustration for early clinical learners of how foundational knowledge and skills can be operationalized and transferred for optimal patient care.

Identification of tax options for high fat, sugar, salt foods for the HEALTHEI Project: a mixed-methods study

BackgroundThe health economic analysis incorporating effects on labour outcomes, households, environment, and inequalities (HEALTHEI) explores which food taxes would have greatest benefits to health, labour, and work outcomes; household expenditure; environmental sustainability; and inequalities within the UK food system. Work package 1 includes a rapid review and workshops, aiming to explore the effects of price increases in food and non-alcoholic beverages to facilitate the specification of food taxes and research design. MethodsIn this mixed-methods study, we first did a rapid review to examine relevant published evidence. A preplanned framework ensured a systematic approach, in which we searched PubMed, HMIC, Scopus, Google, Mintel/Mintel Food and Drink, and Business Source Ultimate for papers published in English from Jan 1, 2010, to Nov 2, 2022. This review was followed by three online workshops (in March, 2023), which used interactive padlets to explore food systems, food taxation policy, tax rationales, and a rapid review infographic. 14 stakeholders from non-governmental organisations (n=10), academia (n=2), the Civil Service (n=1), and a local authority (n=1) took part (gender or ethnicity were not recorded). A stakeholder recruitment grid was developed to ensure representation across public sectors and disciplines of public health, nutrition, environment, and economics. FindingsThe rapid review identified six tax options with a broadly positive impact on consumption and health (high fat, high sugar, high salt, “junk food”, sugar-sweetened-beverages, and meats plus sugar-sweetened beverages). It generated five core rationales for a food tax: change consumption, reduce or prevent harm, change product affordability, raise revenue, and industry impact. Using the workshop feedback, health inequalities, economics, ease of implementation and animal welfare were additional key areas for a so-called real-world application of tax. Stakeholders questioned the taxes in the current economic and political climate. InterpretationThe work highlights the need to develop an impactful food tax option that encompasses the five core rationales identified in the findings. The workshops identified key areas to explore further to understand the feasibility, impact, and logistics of implementing future food taxes. Being unable to deliver workshops in person due to difficulties of participants travelling to London was a limitation. However, switching online allowed for varied and well attended workshops. FundingNational Institute of Health Research (Ref: NIHR133927).

Pandemic nutrition: Does the COVID-19 necessitate the emergence of an independent discipline of nutrition?

As we contend with the global effects of the COVID-19 pandemic, nutrition has received a growing amount of attention. The relationship between our diet and immune response has become apparent

Clinical study of lurasidone combined with nutritional intervention strategy in the treatment of chronic schizophrenia

BackgroundSchizophrenia is a complex mental disorder with a chronic course. The atypical antipsychotics represented by lurasidone are commonly used in chronic schizophrenia, and its mechanism of action determines the superiority of efficacy and safety. However so far, there are still some adverse reactions, of which the more significant are lethargy, nausea, and sedentary inability. In view of these situations, we will combine nutrition intervention with the use of lurasidone to eliminate adverse reactions and provide help for the formulation of treatment plans.Subjects and MethodsThe study will be based on whether to add nutrition intervention as a difference set up control experiment, the experimental group using lurasidone combined nutrition intervention, the control group using lurasidone single factor intervention. The patients who received treatment in the psychiatric department of our hospital from March 2021 to March 2022 were selected as the research objects, and the efficacy and adverse reactions of the patients were monitored during the treatment. The efficacy will be judged by the medical scale of symptom severity of patients with schizophrenia (Positive and Negative Syndrome Scale, PANSS) and the monitoring data will be statistically analyzed by SPSS.ResultsWith the treatment, the results of the Experimental group and the control group are shown in Table 1. The PANSS scores of the two groups finally reached a range of 30-40, with a difference of 4. The incidence of nausea, lethargy and sedentary disorder in adverse symptoms was higher in the control group, and the difference was statistically significant (P < 0.05). It shows that nutritional intervention cannot affect the efficacy of psychosis itself, yet can alleviate the adverse symptoms after medication.Table 1.Efficacy and adverse reactions of the two groupsGroupPANSSNauseaSomnolenceSedentary disorderExperimental group (n=46)32.3±4.13(6.5%)4(8.7%)2(4.3%)Control group (n=41)36.3±5.28(19.5%)6(14.6%)5(12.2%)P>0.05<0.05<0.05<0.05ConclusionsThe group of schizophrenics is not limited to a certain age. Therefore, adverse symptoms caused by psychotropic drugs need to be considered in the practice. Symptoms in the course of the patient’s disease can be used as a treatment optimization path. Although the nutrition intervention strategy has no direct impact on the indicators of mental illness, the prevention of adverse symptoms during treatment can improve the actual experience of patients. In the future, the nutrition strategy will be adaptively optimized to improve the rehabilitation effect of chronic schizophrenia.AcknowledgementsThe research is supported by: Key Discipline of Nutrition and Food Hygiene of Changsha Medical university Quality Engineering Construction Project+2016; Study on Intervention Effect of Mindfulness Acceptance Stress Project on Nurses Aid to COVID-19+Outstanding Youth Project of Scientific Research of Hunan Education Department +2020(264)20B070.

Assessment of Knowledge and Attitudes on Genetically Modified Foods Among Students Studying Life Sciences.

Genetic engineering has stimulated interest in a range of fields, including agribusiness, food technology, food product development, and nutrition. Even though the public opinion on genetically modified (GM) goods is polarizing, the majority of experts believe that the advantages outweigh any potential risks, if at all there are any. As a result, the role of science education is to prepare students to be citizens who have a fundamental understanding of genetic engineering. As the students of life sciences are the future scientific experts and scholars who progress in the subject of genetically modified organisms (GMOs), they need to have correct knowledge of GMOs, GMfoods, and appropriate attitudes regarding the same. To investigate the knowledge and attitudes of life-sciences university students (n= 203)concerning GM foods, a cross-sectional observational survey-based study was carried out by administering a structured questionnaire across three disciplines of life sciences - Biotechnology, Food Technology, and Nutrition for undergraduates, postgraduates, and post-graduate diploma students. The scores for knowledge and attitudes were divided into tertiles as high, moderate, and low scores. 88.2% of the participants agreed to have read about GMOs in their curriculum and76.8%had defined GM foods correctly. When the participants were categorized into tertiles, it was observed that out of all the high scorers,45.5% were food technology majors and 43% were biotechnologymajors and only 11.3% were nutrition majors.63.1% of students were found to be in favor of GMOs and GM foods and had a positive attitude toward them. There was a moderately positive association of knowledge levels with attitudes toward GMOs and GM foods (p< 0.05). Although in general, the life-sciences students had the basic knowledge of GMOs and GM foods, the food technology, and biotechnology majors had better knowledge about GMOs and GM foods as compared to nutrition majors. The attitude scores were directly proportional to knowledge scores which emphasizes the need for robust science education on comprehending the topic better. Incorporating a GM-related curriculum for nutrition discipline can help students learn better about the issues surrounding transgenic technology, food safety, and nutrition.

Exercise-Induced Muscle Damage and Protein Intake: A Bibliometric and Visual Analysis.

Numerous studies have covered exercise-induced muscle damage (EIMD) topics, ranging from nutritional strategies to recovery methods, but few attempts have adequately explored and analyzed large volumes of scientific output. The purpose of this study was to assess the scientific output and research activity regarding EIMD and protein intake by conducting a bibliometric and visual analysis. Relevant publications from 1975–2022 were retrieved from the Web of Science Core Collection database. Quantitative and qualitative variables were collected, including the number of publications and citations, H-indexes, journals of citation reports, co-authorship, co-citation, and the co-occurrence of keywords. There were 351 total publications, with the number of annual publications steadily increasing. The United States has the highest total number of publications (26.21% of total publications, centrality 0.44). Institutional cooperation is mostly geographically limited, with few transnational cooperation links. EIMD and protein intake research is concentrated in high-quality journals in the disciplines of Sport Science, Physiology, Nutrition, and Biochemistry & Molecular Biology. The top ten journals in the number of publications are mostly high-quality printed journals, and the top ten journals in centrality have an average impact factor of 13.845. The findings of the co-citation clusters and major keyword co-occurrence reveal that the most discussed research topics are “exercise mode”, “nutritional strategies”, “beneficial outcomes”, and “proposed mechanisms”. Finally, we identified the following research frontiers and research directions: developing a comprehensive understanding of new exercise or training models, nutritional strategies, and recovery techniques to alleviate EIMD symptoms and accelerate recovery; applying the concept of hormesis in EIMD to induce muscle hypertrophy; and investigating the underlying mechanisms of muscle fiber and membrane damage.

Predictors of Tri-council Funding Among Nutrition Researchers in Canada.

Purpose: Barriers in research for women and dietitians have been documented. We sought to describe tri-council funding awarded within the nutrition discipline according to institution type, academic rank, gender, dietitian status, and primary research methods used.Methods: Using an online search methodology, faculty members with research appointments were identified from nutrition departments offering accredited dietetic programs and/or at Canada's collective of research-intensive universities known as U15. All data regarding faculty members, their institutions, and funding were collected through publicly available websites and Scopus. Tri-council funding associated with the nominated principal investigator, from a 5-year period, 2013-2014 to 2017-2018, was extracted. Binary logistic regression was used to test for predictors of receiving any tri-council operating funds within the 5-year period.Results: Faculty members (n = 237) from 21 institutions were identified for inclusion. Those from U15 institutions, at the full professor rank, nondietitians, men, and those who engaged in primarily quantitative research methods (vs. qualitative or mixed-methods) were significantly more likely to hold any tri-council funding during the eligible period. Dietitians (n = 76) were significantly less likely to hold tri-council funding, independent of institution, rank, gender, and primary research methods utilized.Conclusions: The apparent under-funding of academic dietitians from federal tri-council sources requires exploration.

Physicians' Knowledge of Clinical Nutrition Discipline in Riyadh Saudi Arabia.

Background: Nutrition plays a major role in the prevention and management of diet-related disease. With the absence of clinical nutrition dietitians, physicians are considered responsible for prescribing nutritional support. Identifying weaknesses in nutritional knowledge among Saudi physicians may provide guidance to improve their nutritional knowledge. Methods: A cross-sectional study that used an anonymous electronic questionnaire to investigate physicians’ knowledge of the clinical nutrition discipline. In addition to demographics, the questionnaire consisted of 15 questions covering six areas in the clinical nutrition discipline (macro- and micronutrients, nutrition and chronic diseases, nutrition and metabolic diseases, nutrition care process, nutrition support therapy, and research). For continuous variables, independent t-tests and one-way ANOVA were used. Results: A total of 332 had completed the questionnaire and were included in the study. Most of the physicians were Saudi (87%), male (73.5%), aged between 26 and 35 years (63.3%), and without health problems (56.3%). The mean score of the physicians’ knowledge was 5.3 ± 1.97 out of 15. Physicians who reported that they received some sort of nutritional training or course (M = 5.57, SD = 2.08) scored significantly more than physicians who did not (M = 5.10, SD = 1.86); t(330) = −2.174, p = 0.30. Conclusions: Nutrition should be reinforced as an important component of continuing medical education. There is a need for hiring more dietitians in health care settings in Saudi Arabia as an integral part of a multidisciplinary team delivering medical care services.

Meanings and mechanisms of One Health partnerships: insights from a critical review of literature on cross-government collaborations.

Complex health policy challenges such as antimicrobial resistance and other emerging infections are driven by activities in multiple sectors. Therefore, addressing these also requires joint efforts from multiple sectors as exemplified in the One Health approach. We undertake a critical review to examine the different ways in which multisector partnerships have been conceptualized across multiple disciplines and thematic areas. We started with a set of six articles from the disciplines of health, nutrition and public administration that reviewed conceptual frameworks within their respective fields. We conducted backward citation tracing using the bibliography of the six articles to identify other articles in the same and related fields that conceptualized multisector partnerships. We identified 58 articles published from 1967 to 2018 from the fields of global health, infectious diseases, management, nutrition and sustainability sciences indicating that multisector partnerships have been a topic of study across different fields for several decades. A thematic analysis of the 58 articles revealed that multisector partnerships assume a variety of forms and have been described in different ways. Partnerships can be categorized by scope, scale, formality and strength. Multisector partnerships emerge in conditions of dynamic uncertainty and sector failure when the information and resources required are beyond the capacities of any individual sector. Such partnerships are inherently political in nature and subsume multiple competing agendas of collaborating actors. Sustaining collaborations over a long period of time will require collaborative approaches like One Health to accommodate competing political perspectives and include flexibility to allow multisector partnerships to respond to changing external dynamics.

John W. Suttie (1934–2020)

John W. Suttie (1934–2020)

Ensino de Nutrição Esportiva no Brasil: Proposta de curso de extensão

As análises das lacunas envolvendo a disciplina de nutrição esportiva nos 50 melhores cursos de graduação em Nutrição no Brasil, informação que foi divulgada através de ranking pelo INEP em 2016, culminaram em uma proposta de curso de extensão. Podemos observar que nas diretrizes curriculares nacionais do curso de graduação em nutrição, instituídas pelo Conselho Nacional de Educação, a disciplina de nutrição esportiva não é considerada como obrigatória. Tal fato nos permite supor que, embora o número de nutricionistas seja expressivo no Brasil, há pouca atuação dos profissionais na área esportiva, como um reflexo de uma deficiência do ensino nessa área. Diante deste cenário, o curso de extensão criado seria um facilitador no processo de formação dos discentes, permitindo a abordagem de temas relacionados a nutrição esportiva. O curso ainda visa discutir atuais mitos envolvendo suplementação, preparar os profissionais para atendimento de atletas de alta performance, indivíduos praticantes de exercícios físicos e o desenvolvimento de censo crítico dos discentes durante a avaliação nutricional.

Technology offers sustainable nutrition solutions

Technology offers sustainable nutrition solutions

CHARACTERISTICS OF ENERGY AND PROTEIN FOODS. A REPORT

The feed formulation is a tool of great importance for technicians and producers of domestic animals, since the nutritional requirements of animals must be met, so that they can present a good productive and reproductive performance, directly related to viability, technical and economic value of the animal production system. Veterinary medicine students, during the animal nutrition discipline, had the opportunity to study concentrates, which is reported in this article.

Social media analytics in nutrition research: a rapid review of current usage in investigation of dietary behaviours.

Social media analytics (SMA) has a track record in business research. The utilisation in nutrition research is unknown, despite social media being populated with real-time eating behaviours. This rapid review aimed to explore the use of SMA in nutrition research with the investigation of dietary behaviours. The review was conducted according to rapid review guidelines by WHO and the National Collaborating Centre for Methods and Tools. Five databases of peer-reviewed, English language studies were searched using the keywords 'social media' in combination with 'data analytics' and 'food' or 'nutrition' and screened for those with general population health using SMA on public domain, social media data between 2014 and 2020. The review identified 34 studies involving SMA in the investigation of dietary behaviours. Nutrition topics included population nutrition health investigations, alcohol consumption, dieting and eating out of the home behaviours. All studies involved content analysis with evidence of surveillance and engagement. Twitter was predominant with data sets in tens of millions. SMA tools were observed in data discovery, collection and preparation, but less so in data analysis. Approximately, a third of the studies involved interdisciplinary collaborations with health representation and only two studies involved nutrition disciplines. Less than a quarter of studies obtained formal human ethics approval. SMA in nutrition research with the investigation of dietary behaviours is emerging, nevertheless, if consideration is taken with technological capabilities and ethical integrity, the future shows promise at a broad population census level and as a scoping tool or complementary, triangulation instrument.

8 How to drive efficiencies in pork production: What are the gaps in knowledge and obstacles?

Abstract Swine nutrition and production has been the cornerstone scientific discipline of the Midwest Section ASAS meeting for decades. During this time, the impact of scientists’ work and the scientific application by swine professionals has been profound. However, if we are to double our food supply by 2050, we have much to do. This presentation will attempt to illustrate contrasting examples of production efficiencies associated with differing production goals, and highlight examples of processes that lead to improved pork production efficiency within the discipline of swine nutrition. This presentation will also cover obstacles and gaps in knowledge that practicing nutritionists, pork producers, and other professionals regularly encounter. Some knowledge gaps are within a single scientific discipline and if resources were put towards the problem would be relatively easily solved. Examples include: development of an inexpensive in vitro assay to assess DDGS amino acid digestibility, re-defining the upper and lower critical effective temperature for modern pigs, defining the minimum and best equipment for growing pigs, identifying additivity effects of various dietary compounds, scientifically sound method(s) to understand and resolve mycotoxin contamination of grains. Other gaps in knowledge are more complex and require multi-disciplinary scientific approach. Examples include: defining root causes of sow mortality, defining factors influencing pig and piglet mortality especially during health challenges, developing models to assist optimization of litter size and post-wean performance, determining best practices of cross-fostering. Pork production will continue to be a viable yet challenging endeavor. It will require persistence, collaboration, and ingenuity from our scientific and pork production community in order to adequately feed the growing population’s demand for protein.

Physiotherapeutic and dietetic parameters in burns patients modelling a multidisciplinary approach to burns practice: A bi-disciplinary illustration of interrelated factors

ObjectiveEarly mobilisation and early enteral feeding after burn injury are two of the most important treatment therapies for optimal recovery. These factors form a part of a team approach, but research has historically focused on one discipline at a time and its effects in isolation; integrated inter-disciplinary influences are not typically studied. This observational study combines strategies and outcomes from the disciplines of nutrition and physiotherapy in an attempt to part-way exemplify the team approach. MethodsPatients were recruited through the Burns Unit records and divided into two groups: Group 1 constituted burn patients who were mobilised before surgery and Group 2 constituted burn patients who were mobilised after surgery. ResultsPatients mobilised after surgery had significantly greater burn surface area, significantly fewer days to wait for surgery (3.4 vs 6.9 days, p < 0.01), significantly more days to mobilise after burn injury (13 vs 2.3 days, p < 0.05), and significantly more time to achieve independent mobilization (42 vs 19.5 days, p < 0.05); they had a significantly longer stay in intensive care (10.8 vs 4.1 days, p < 0.05), and a longer hospital stay (p < 0.05). These patients also had significantly greater episodes of diarrhoea (11.6 vs 4.1 episodes, p < 0.05), significantly lower albumin levels and more days on antibiotics compared with the group of patients who were mobilised before surgery (p < 0.05). Patients mobilised after surgery waited longer to be enterally fed (89 days vs 62.5 days), and although this was not statistically significant, it may be clinically significant. There were significant correlations between independent mobilisation and diarrhoea, independent mobilisation and albumin, length of stay and diarrhoea (p < 0.05). Regression analysis showed hours taken to commence enteral feeding and days in ICU predicted diarrhoea (p < 0.05). ConclusionsThis study illustrates the combined approach of two disciplines and their interrelated factors. Mobilisation appears to interrelate with nutrition factors, and this includes diarrhoea (which is likely a manifestation of gut effects due to the nature and timing of substrate delivery). A few factors were revealed in this interrelation that have not been documented previously in burns, namely the associations between mobilisation, diarrhoea, and serum albumin. Team members need to ensure inclusion of key recommendations from other disciplines when a particular, crucial factor from one discipline cannot be applied. Results in this study need to be interpreted with caution due to the small sample size, the use of statistical applications with sample size, and the retrospective nature of the study. A larger, more rigorous prospective research study is required to confirm these results.

Nutrition in New Zealand: Can the Past Offer Lessons for the Present and Guidance for the Future?

Over the last century, nutrition research and public health in New Zealand have been inspired by Dr Muriel Bell, the first and only state nutritionist. Some of her nutritional concerns remain pertinent today. However, the nutritional landscape is transforming with extraordinary changes in the production and consumption of food, increasing demand for sustainable and healthy food to meet the requirements of the growing global population and unprecedented increases in the prevalence of both malnutrition and noncommunicable diseases. New Zealand’s economy is heavily dependent on agrifoods, but there is a need to integrate interactions between nutrition and food-related disciplines to promote national food and nutrition security and to enhance health and well-being. The lack of integration between food product development and health is evident in the lack of investigation into possible pathological effects of food additives. A national coherent food strategy would ensure all components of the food system are optimised and that strategies to address the global syndemic of malnutrition and climate change are prioritised. A state nutritionist or independent national nutrition advocacy organisation would provide the channel to communicate nutrition science and compete with social media, lead education priorities and policy development, engage with the food industry, facilitate collaboration between the extraordinary range of disciplines associated with food production and optimal health and lead development of a national food strategy.

Pharmacological activities of differential parts of selected Essential Indian Spices

The role of plants in human health has extensively revealed due to the emergence of numerous advancements in the medicine and nutrition disciplines. The awareness of the benefits of plants in food as wealthy additives poses researchers to pursue for discovering the influence of such ingredients to the health of the human beings. Spices and herbs are well known food ingredients, which enhances the flavour and aroma of the supplemented foods. Botanically, spices are one class of the aromatic plants; they are mainly present in the tropical provinces. Spices play an important role as flavouring agents in the diet and are used throughout the world. Spices refers to dried part of plant that contains volatiles oils or aromatic flavours such as buds (cloves), bark (cinnamon), root (ginger), berries (black pepper), seeds (cumin, coriander). Spices can be used as medicine because they are natural products easily absorbed by our bodies and generally do not have any adverse effects. Herbal remedies are an important source for the discovery of new antibiotics. Highest phenolic content was observed for ethanol extract of Bunium bulbocastanum (374.28±0.22 µg/mg GAE) and highest flavonoid content was observed for ethanol extract of Piper nigrum (123.58±0.32 µg/mg QE). Cuminum cyminum possessed effective inhibition against gram negative bacteria (Escherichia coli and Proteus vulgaris) and the zone of inhibition were found to be 23 mm at 100 µg/mL concentration respectively. The DPPH˙ radical scavenging activity was found to be higher for Syzygium aromaticum among the tested spices with 75.37±0.48% at 120 µg/mL concentration and the IC50 value was 53.54 µg/mL concentration respectively. The Fe3+ reduction was found to be higher for Syzygium aromaticum among the tested spices with 99.14±0.26% at 120 µg/mL concentration and the RC50 value was 12.81 µg/mL concentration respectively. The α-amylase enzyme inhibition was found to be higher for Piper nigrum among the tested spices with 67.47±0.40% at 120 µg/mL concentration and the IC50 value was 44.69 µg/mL concentration respectively.

Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme.

Australia's National Disability Insurance Scheme (NDIS) is the catalyst for a significant shift in the delivery of disability services to people with a disability and their families, including those residing in rural and remote parts of Australia. Allied health services in rural areas of Australia are often limited, existing services are characterised as being of a generalist nature and demand for services often exceeds service capacity. This shift in the delivery of disability services with the rollout of NDIS could have a poignant impact on the rurally based allied health providers delivering these services. The aim of this study was to explore in depth the experiences of providing clinical services under the NDIS in a rural area. Accessing the publicly available NDIS register, the authors purposively sampled service providers delivering services in rural or remote areas of the state of New South Wales (NSW). Participants consented by email to participate in a semi-structured interview during which they were asked about their lived experience providing services under the NDIS in rural NSW. Data collection and analysis were guided by phenomenology of practice. Interviews were audio-recorded and transcribed verbatim, and data were then thematically analysed. Eight service providers were interviewed, representing the disciplines of occupational therapy, nutrition and dietetics, speech pathology and physiotherapy. The locations of their service delivery varied across a range of rural and remote areas of NSW. Data analysis yielded three themes: (1) 'Beyond my depth', which described service providers' limited influence on the funding process their clients were now required to navigate as participants of the NDIS; (2) 'A sea of uncertainty', which described the inconsistencies demonstrated by the NDIS and its impact on service providers; and (3) 'Drowning in the wave', which described increases in service demand and changes to case mix as experienced by service providers. Additionally, the essence of providing services within the NDIS in a rural area was identified as 'Powerless facing the wave of change'. These findings offer insights into the particular challenges for rural clinicians in providing services under the NDIS. While there is improved funding support for people with a disability, this places additional pressure on rural clinicians who are already likely to be working at or beyond their workload capacity. Issues with recruitment and retention of new clinicians into rural and remote areas appear to be ongoing, which was identified as compounding the impact of the NDIS on existing service providers. Supporting the rural and remote workforce appears critical to avoid de-registration of existing NDIS service providers.

Decolonizing Nutrition Science

ABSTRACT Colonization and decolonization are common concepts within the discourse of Indigenous scholars and show significance within the recently emerging Native Nutrition conferences. Yet these words and the meanings they convey rarely appear within scholarly literature of nutrition professionals. To what extent are the concepts of colonization and decolonization relevant to the scope of nutrition education, practice, and research? If they are relevant, why are they not more common within professional discourse? Here we briefly describe these concepts and address these questions. We report findings from a study designed to examine barriers to Indigenous scholar participation within nutrition professions. Our results suggest that greater awareness and more fully understanding the dynamics of colonization hold potential to improve nutrition research, education, and practice. Not only is colonization woven into the tapestry of North American history, but our results support assertions of Indigenous scholars that its deeply embedded patterns still echo through our food, education, and health professions and systems. We identify several barriers and colonizing patterns and 2 interrelated lines of decolonizing work, and present a cross-cultural engagement protocol for pursuing decolonizing work. Exploring the complexities and nuances of these ideas more thoroughly is both a developmental process and a collective responsibility that we see as deserving more attention within food and nutrition disciplines. If implemented, we suggest that decolonizing practice holds potential for advancing nutrition science while also creating a more welcoming environment for future Indigenous scholars.