ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Integrating methods for ecosystem service assessment: Experiences from real world situations

The Ecosystem Services (ES) concept highlights the varied contributions the environment provides to humans and there are a wide range of methods/tools available to assess ES. However, in real-world decision contexts a single tool is rarely sufficient and methods must be combined to meet practitioner needs. Here, results from the OpenNESS project are presented to illustrate the methods selected to meet the needs of 24 real-world case studies and better understand why and how methods are combined to meet practical needs. Results showed that within the cases methods were combined to: i) address a range of ES; ii) assess both supply and demand of ES; iii) assess a range of value types; iv) reach different stakeholder groups v) cover weaknesses in other methods used and vi) to meet specific decision context needs. Methods were linked in a variety of ways: i) as input–output chains of methods; ii) through learning; iii) through method development and iv) through comparison/triangulation of results. The paper synthesises these case study-based experiences to provide insight to others working in practical contexts as to where, and in what contexts, different methods can be combined and how this can add value to case study analyses

Integrating methods for ecosystem service assessment: Experiences from real world situations

The Ecosystem Services (ES) concept highlights the varied contributions the environment provides to humans and there are a wide range of methods/tools available to assess ES. However, in real-world decision contexts a single tool is rarely sufficient and methods must be combined to meet practitioner needs. Here, results from the OpenNESS project are presented to illustrate the methods selected to meet the needs of 24 real-world case studies and better understand why and how methods are combined to meet practical needs. Results showed that within the cases methods were combined to: i) address a range of ES; ii) assess both supply and demand of ES; iii) assess a range of value types; iv) reach different stakeholder groups v) cover weaknesses in other methods used and vi) to meet specific decision context needs. Methods were linked in a variety of ways: i) as input–output chains of methods; ii) through learning; iii) through method development and iv) through comparison/triangulation of results. The paper synthesises these case study-based experiences to provide insight to others working in practical contexts as to where, and in what contexts, different methods can be combined and how this can add value to case study analyses