Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 2021
BACKGROUND Dietitians are recognised as experts in nutrition care and essential members of multid... more BACKGROUND Dietitians are recognised as experts in nutrition care and essential members of multidisciplinary health care teams. However, dietitians' role in caring for people with eating disorders is not well understood. This review aimed to identify, critically appraise and synthesise the current evidence exploring the views and experiences of dietitians, other health professionals, patients and carers regarding the role of dietitians in the treatment of eating disorders. METHODOLOGY CINAHL, MEDLINE, Embase, Scopus and PsycINFO were searched in April 2020 and again in February 2021. Studies were included if they were original research; explored views and experiences of the role of dietitians in the treatment of eating disorders, including perceptions of patients, carers, and other health professionals regarding nutrition care for eating disorders; and the full text article was available in English. Title and abstract screening, full text screening, quality assessment and data e...
The practicum is one of the most important components in health professional education. It is als... more The practicum is one of the most important components in health professional education. It is also one of the most challenging. The hospital setting offers situations that may be physically, mentally and emotionally demanding on students. Under the pressure of being assessed, students may be reluctant to reflect on their challenges with placement supervisors, which may leave difficult experiences unprocessed. A university-based reflection and debrief following hospital placement has the advantage of avoiding this student-supervisor dynamic and embedding the evaluation of placement clearly in the university curriculum. This format was chosen for a formal reflection and debrief session that formed part of a week-long post-placement workshop held upon return to the university for nutrition and dietetic students at Griffith University at the end of their credentialing programme. The aim of the reflective debrief was to provide a staff-facilitated opportunity for students to reflect form...
In light of the changing landscape of workforce demand, digital technologies are becoming increas... more In light of the changing landscape of workforce demand, digital technologies are becoming increasingly important to support students with their studies and professional preparation. As such, tertiary institutions are embedding curriculum approaches focused on the development of employability skills and drawing upon technology in order to prepare students for the real world of work in a manner that is scalable and transferable. Digital technologies such as ePortfolios have become an increasingly utilized platform for reflection, evidencing professional competencies and professional branding. Within this chapter, the authors discuss the benefits and limitations of these platforms from the perspectives of students, staff, professional, and institutional contexts. Case studies are utilzsed to demonstrate ePortfolios in practice across the allied health disciplines and key research questions and solutions for the future are discussed. Use of E-Portfolios in Health Professions Education
1. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Improving the delivery of nutrition a... more 1. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Improving the delivery of nutrition advice in General Practice. Nutrition & Dietetics, 67(1), S9 (Abstract from 2010 DAA National Conference). 2. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Increasing referrals through enhanced relationships. Nutrition & Dietetics, 67(1), S49 (Abstract from 2010 DAA National Conference). 3. Mitchell, L. J., Capra, S., & MacDonald-Wicks, L. (2007). Structural change in Medicare funding – what does it mean for dietetics? Nutrition & Dietetics, 64(Supp 1), S28. (Abstract from 2007 DAA National Conference)
AIM The application of behaviour change science is fundamental to the role of dietitians. This st... more AIM The application of behaviour change science is fundamental to the role of dietitians. This study aimed to describe how behaviour change science is embedded within the curricula of accredited/registered dietetics programs in Australia and New Zealand. METHODS A descriptive study triangulated quantitative document analysis of curricula content from university websites (Part 1) with qualitative, structured interviews with dietetics academics (Part 2). Part 2 verified and advanced upon information captured in Part 1 and was analysed using thematic content analysis. RESULTS Twenty-five courses from 18 university programs (15 Australia and 3 New Zealand) were synthesised. Fifteen interviews (12 Australia, 3 New Zealand) were conducted. Behaviour change science was taught and assessed at varying levels across all programs. It was taught primarily within lectures or workshops where students apply skills learnt in practical case-based activities, and assessed through small group educatio...
Background: Childhood obesity has an uneven socioeconomic distribution. In health interventions, ... more Background: Childhood obesity has an uneven socioeconomic distribution. In health interventions, equity aspects are crucial. In 2007–2008, the IDEFICS/Sweden health survey (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) was performed in children aged 2–9 years, followed by a health promoting community intervention.Aims: To assess if families with disadvantageous socioeconomic and -demographic backgrounds and children with obesity were underrepresented.Methods: IDEFICS participants (N = 1,825) were compared with a referent child matched for age, gender and municipality (N = 1,825) by using registers from Statistics Sweden. Longitudinal growth data from birth to 8 years was collected from local health services (n = 3,650) to compare children's BMI standard deviation score (SDS) at age of inclusion in the IDEFICS study (BMI SDS-index) and the children's BMI-categories during the age-span between the groups.Results: The re...
Context Issues related to nutrition and health are prominent, yet it is unclear if the dietetics ... more Context Issues related to nutrition and health are prominent, yet it is unclear if the dietetics workforce is being used optimally. Objective Trends, challenges, opportunities, and future needs of the international dietetic workforce are investigated in this review, which was registered with Open Science Framework (10.17605/OSF.IO/DXNWE). Data sources Eight academic and 5 grey-literature databases and the Google search engine were searched from 2010 onward according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Of 2050 articles screened, 184 were eligible for inclusion. Data extraction To chart data, a directed content analysis and a constant comparison technique were used. Data analysis The following 13 themes were identified: 1) emerging or expanding areas of practice; 2) skill development; 3) economic considerations; 4) nutrition informatics; 5) diversity within the workforce; 6) specific areas of prac...
Objective:To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s diet... more Objective:To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s dietary diversity and its impact pathway components of children’s food knowledge and healthy food preferences.Design:A 6-week cluster randomised controlled trial with a MCI consisting of child nutrition education plus family engagement through parental nutrition education, meal preparation and tasting was compared with two groups: single component intervention (SCI) of child nutrition education, and control, conducted during February to July 2018. Preschool centres were randomly assigned to one of the three arms. Children’s food knowledge, healthy food preferences and dietary diversity scores were collected. Intervention effects were analysed using a pre-post analysis and a difference-in-difference model.Setting:Fourteen preschool centres in an urban area of Kurunegala, Sri Lanka.Participants:Child–parent dyads of children aged 4–6 years. Final analyses included 306 (for food knowledge and p...
Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitia... more Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitians have provided individualized weight management counselling for decades, yet evidence of the effectiveness of this intervention has never been synthesized. The aim of this study was to examine the effectiveness of individualized nutrition care for weight management provided by dietitians to adults in comparison to minimal or no intervention. Databases (Cochrane, CINAHL plus, MedLine ovid, ProQuest family health, PubMed, Scopus) were searched for terms analogous with patient, dietetics and consultation with no date restrictions. The search yielded 5796 unique articles, with 14 randomized controlled trials meeting inclusion criteria. The risk of bias for the included studies ranged from unclear to high. Six studies found a significant intervention effect for the dietitian consultation, and a further four found significant positive change for both the intervention and control groups. Data...
Aim: Evidence of the effectiveness of dietetic consultation for the management of cardiovascular ... more Aim: Evidence of the effectiveness of dietetic consultation for the management of cardiovascular disease (CVD) risk factors has not been previously synthesised. A systematic review and four meta-analyses evaluated the effectiveness of dietetic consultation for lowering blood lipid levels in high-risk individuals in primary health-care settings. Methods: Of the 4860 records identified, 10 eligible randomised controlled trials (RCTs, n = 1530) were evaluated for reporting blood lipid outcomes following dietetic consultation (DN)-defined as at least one exclusive individual face-to-face consultation with a dietitian and comparators (C)-defined as no nutrition intervention or usual or minimal care provided by physicians and/or nurses. Results: DN groups were effective for lowering blood lipid levels across nine studies reporting total cholesterol (TC) and LDL; and across five of six studies reporting triglycerides (TG). Between-group differences were not consistently assessed, with significance levels reported in four studies all in favour of DN, P < 0.05. Meta-analyses for TC and LDL (seven studies) confirmed DN and C groups were equally effective, P > 0.05; and for TG (six studies) DN groups were significantly more effective than C groups, P < 0.05). Conclusions: This review provides RCT evidence that dietetic counselling is effective for lowering TG levels and at least as effective as usual and minimal care for improving cholesterol levels in high-risk individuals in primary health care. However, more adequate reporting of methods and greater consistency in timing interventions and data collection will enhance the quality of the evidence and increase confidence in the health benefits of dietetic counselling for the management of CVD risk.
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 2021
BACKGROUND Dietitians are recognised as experts in nutrition care and essential members of multid... more BACKGROUND Dietitians are recognised as experts in nutrition care and essential members of multidisciplinary health care teams. However, dietitians' role in caring for people with eating disorders is not well understood. This review aimed to identify, critically appraise and synthesise the current evidence exploring the views and experiences of dietitians, other health professionals, patients and carers regarding the role of dietitians in the treatment of eating disorders. METHODOLOGY CINAHL, MEDLINE, Embase, Scopus and PsycINFO were searched in April 2020 and again in February 2021. Studies were included if they were original research; explored views and experiences of the role of dietitians in the treatment of eating disorders, including perceptions of patients, carers, and other health professionals regarding nutrition care for eating disorders; and the full text article was available in English. Title and abstract screening, full text screening, quality assessment and data e...
The practicum is one of the most important components in health professional education. It is als... more The practicum is one of the most important components in health professional education. It is also one of the most challenging. The hospital setting offers situations that may be physically, mentally and emotionally demanding on students. Under the pressure of being assessed, students may be reluctant to reflect on their challenges with placement supervisors, which may leave difficult experiences unprocessed. A university-based reflection and debrief following hospital placement has the advantage of avoiding this student-supervisor dynamic and embedding the evaluation of placement clearly in the university curriculum. This format was chosen for a formal reflection and debrief session that formed part of a week-long post-placement workshop held upon return to the university for nutrition and dietetic students at Griffith University at the end of their credentialing programme. The aim of the reflective debrief was to provide a staff-facilitated opportunity for students to reflect form...
In light of the changing landscape of workforce demand, digital technologies are becoming increas... more In light of the changing landscape of workforce demand, digital technologies are becoming increasingly important to support students with their studies and professional preparation. As such, tertiary institutions are embedding curriculum approaches focused on the development of employability skills and drawing upon technology in order to prepare students for the real world of work in a manner that is scalable and transferable. Digital technologies such as ePortfolios have become an increasingly utilized platform for reflection, evidencing professional competencies and professional branding. Within this chapter, the authors discuss the benefits and limitations of these platforms from the perspectives of students, staff, professional, and institutional contexts. Case studies are utilzsed to demonstrate ePortfolios in practice across the allied health disciplines and key research questions and solutions for the future are discussed. Use of E-Portfolios in Health Professions Education
1. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Improving the delivery of nutrition a... more 1. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Improving the delivery of nutrition advice in General Practice. Nutrition & Dietetics, 67(1), S9 (Abstract from 2010 DAA National Conference). 2. Mitchell, L.J., MacDonald-Wicks, L., & Capra, S. (2010). Increasing referrals through enhanced relationships. Nutrition & Dietetics, 67(1), S49 (Abstract from 2010 DAA National Conference). 3. Mitchell, L. J., Capra, S., & MacDonald-Wicks, L. (2007). Structural change in Medicare funding – what does it mean for dietetics? Nutrition & Dietetics, 64(Supp 1), S28. (Abstract from 2007 DAA National Conference)
AIM The application of behaviour change science is fundamental to the role of dietitians. This st... more AIM The application of behaviour change science is fundamental to the role of dietitians. This study aimed to describe how behaviour change science is embedded within the curricula of accredited/registered dietetics programs in Australia and New Zealand. METHODS A descriptive study triangulated quantitative document analysis of curricula content from university websites (Part 1) with qualitative, structured interviews with dietetics academics (Part 2). Part 2 verified and advanced upon information captured in Part 1 and was analysed using thematic content analysis. RESULTS Twenty-five courses from 18 university programs (15 Australia and 3 New Zealand) were synthesised. Fifteen interviews (12 Australia, 3 New Zealand) were conducted. Behaviour change science was taught and assessed at varying levels across all programs. It was taught primarily within lectures or workshops where students apply skills learnt in practical case-based activities, and assessed through small group educatio...
Background: Childhood obesity has an uneven socioeconomic distribution. In health interventions, ... more Background: Childhood obesity has an uneven socioeconomic distribution. In health interventions, equity aspects are crucial. In 2007–2008, the IDEFICS/Sweden health survey (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) was performed in children aged 2–9 years, followed by a health promoting community intervention.Aims: To assess if families with disadvantageous socioeconomic and -demographic backgrounds and children with obesity were underrepresented.Methods: IDEFICS participants (N = 1,825) were compared with a referent child matched for age, gender and municipality (N = 1,825) by using registers from Statistics Sweden. Longitudinal growth data from birth to 8 years was collected from local health services (n = 3,650) to compare children's BMI standard deviation score (SDS) at age of inclusion in the IDEFICS study (BMI SDS-index) and the children's BMI-categories during the age-span between the groups.Results: The re...
Context Issues related to nutrition and health are prominent, yet it is unclear if the dietetics ... more Context Issues related to nutrition and health are prominent, yet it is unclear if the dietetics workforce is being used optimally. Objective Trends, challenges, opportunities, and future needs of the international dietetic workforce are investigated in this review, which was registered with Open Science Framework (10.17605/OSF.IO/DXNWE). Data sources Eight academic and 5 grey-literature databases and the Google search engine were searched from 2010 onward according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Of 2050 articles screened, 184 were eligible for inclusion. Data extraction To chart data, a directed content analysis and a constant comparison technique were used. Data analysis The following 13 themes were identified: 1) emerging or expanding areas of practice; 2) skill development; 3) economic considerations; 4) nutrition informatics; 5) diversity within the workforce; 6) specific areas of prac...
Objective:To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s diet... more Objective:To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s dietary diversity and its impact pathway components of children’s food knowledge and healthy food preferences.Design:A 6-week cluster randomised controlled trial with a MCI consisting of child nutrition education plus family engagement through parental nutrition education, meal preparation and tasting was compared with two groups: single component intervention (SCI) of child nutrition education, and control, conducted during February to July 2018. Preschool centres were randomly assigned to one of the three arms. Children’s food knowledge, healthy food preferences and dietary diversity scores were collected. Intervention effects were analysed using a pre-post analysis and a difference-in-difference model.Setting:Fourteen preschool centres in an urban area of Kurunegala, Sri Lanka.Participants:Child–parent dyads of children aged 4–6 years. Final analyses included 306 (for food knowledge and p...
Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitia... more Effective, evidence-based strategies to prevent and treat obesity are urgently required. Dietitians have provided individualized weight management counselling for decades, yet evidence of the effectiveness of this intervention has never been synthesized. The aim of this study was to examine the effectiveness of individualized nutrition care for weight management provided by dietitians to adults in comparison to minimal or no intervention. Databases (Cochrane, CINAHL plus, MedLine ovid, ProQuest family health, PubMed, Scopus) were searched for terms analogous with patient, dietetics and consultation with no date restrictions. The search yielded 5796 unique articles, with 14 randomized controlled trials meeting inclusion criteria. The risk of bias for the included studies ranged from unclear to high. Six studies found a significant intervention effect for the dietitian consultation, and a further four found significant positive change for both the intervention and control groups. Data...
Aim: Evidence of the effectiveness of dietetic consultation for the management of cardiovascular ... more Aim: Evidence of the effectiveness of dietetic consultation for the management of cardiovascular disease (CVD) risk factors has not been previously synthesised. A systematic review and four meta-analyses evaluated the effectiveness of dietetic consultation for lowering blood lipid levels in high-risk individuals in primary health-care settings. Methods: Of the 4860 records identified, 10 eligible randomised controlled trials (RCTs, n = 1530) were evaluated for reporting blood lipid outcomes following dietetic consultation (DN)-defined as at least one exclusive individual face-to-face consultation with a dietitian and comparators (C)-defined as no nutrition intervention or usual or minimal care provided by physicians and/or nurses. Results: DN groups were effective for lowering blood lipid levels across nine studies reporting total cholesterol (TC) and LDL; and across five of six studies reporting triglycerides (TG). Between-group differences were not consistently assessed, with significance levels reported in four studies all in favour of DN, P < 0.05. Meta-analyses for TC and LDL (seven studies) confirmed DN and C groups were equally effective, P > 0.05; and for TG (six studies) DN groups were significantly more effective than C groups, P < 0.05). Conclusions: This review provides RCT evidence that dietetic counselling is effective for lowering TG levels and at least as effective as usual and minimal care for improving cholesterol levels in high-risk individuals in primary health care. However, more adequate reporting of methods and greater consistency in timing interventions and data collection will enhance the quality of the evidence and increase confidence in the health benefits of dietetic counselling for the management of CVD risk.
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Papers by Lana Mitchell