A prospective investigation of swallowing, nutrition, and patient-rated functional impact following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer

Altered fractionation radiotherapy for head and neck cancer has been associated with improved locoregional control, overall survival, and heightened toxicity compared with conventional treatment. Swallowing, nutrition, and patient-perceived function for altered fractionation radiotherapy with concomitant boost (AFRT-CB) for T1–T3 oropharyngeal squamous cell carcinoma (SCC) have not been previously reported. Fourteen consecutive patients treated with AFRT-CB for oropharyngeal SCC were recruited from November 2006 to August 2009 in a tertiary hospital in Brisbane, Australia. Swallowing, nutrition, and patient-perceived functional impact assessments were conducted pretreatment, at 4–6 weeks post-treatment, and at 6 months post-treatment. Deterioration from pretreatment to 4–6 weeks post-treatment in swallowing, nutrition, and functional impact was evident, likely due to the heightened toxicity associated with AFRT-CB. There was significant improvement at 6 months post-treatment in functional swallowing, nutritional status, patient-perceived swallowing, and overall function, consistent with recovery from acute toxicity. However, weight and patient perception of physical function and side effects remained significantly worse than pretreatment scores. The ongoing deficits related to weight and patient-perceived outcomes at 6 months revealed that this treatment has a long-term impact on function possibly related to the chronic effects of AFRT-CB

New to Indigenous health? Dietetics and nutrition with Indigenous communities: a starting point

Introduction This resource is intended for dietitians and nutritionists who are new to the area of Indigenous health in Australia and would like to learn more about working with this diverse cultural group. The resource is not just for students or new graduates; it is applicable to dietitians and nutritionists with any level of experience who are looking to learn more about working with Indigenous Australians. This resource has been written with the intention of providing a starting point for your continuing professional development (CPD) and reflective practice in this area. You can use this as a framework for your CPD over time. There are seven topics which have been designed to flow in order. Each topic is briefly outlined along with suggested readings and practical activities. Indigenous communities are complex and heterogeneous, and so the practical activities included ask you to reflect on your own background and beliefs, deepen your understanding about the communities that you are working with, and identify their specific needs. Working with Indigenous people and communities can be a challenge but it can also be incredibly rewarding. Indigenous culture in Australia is rich and has a long history. The opportunity to experience this first hand is a privilege that few Australians are afforded and your role can contribute to the improvement of health for Aboriginal and Torres Strait Islander people. Basic structure of the resource: Overview of the topic Readings Practical activities for you to complete