A problem-based approach to clinical education in dietetics

Developing the clinical skills and knowledge of dietetic students provides a challenge for both universities and health care agencies. Deakin University has recently adopted a group learning model using problem-based learning to deliver the clinical component of the Master of Nutrition and Dietetics course. This approach was designed to enhance integration of clinical theory and practice, develop closer links between on-campus and off-campus learning environments and provide students with more active learning experiences. The impact of the new approach was evaluated using student questionnaires, academic and competency outcomes, and a focus group convened with hospital supervisors. The evaluation indicated that students generally thought that this method of learning had helped to integrate their basic knowledge with dietetic case management. There was no difference in academic scores from the previous year and an apparent reduction in the number of students requiring additional placement time to mee t competency standards. Hospital supervisors were supportive of the changes, although they had some reservations regarding the time and structure of clinical placements. As a result of this evaluation, recommendations for future development of the program include introducing problem-based learning to students earlier in their course, providing additional placement days during the block and increasing the amount of time dedicated to more complex topics. Based on the evaluation results obtained, this collaborative learning using a problem-based approach will continue to be used in the clinical education program at Deakin University. <br /

Direct patient contacts of dietetic students during their final clinical placement

Direct student-patient contacts, during the professional clinical placement of a Master of Nutrition and Dietetics course, were collected and analysed for the first time using a computerised method. In the final eight-week hospital placement, 26 dietetic students submitted data on direct patient contacts which included: dietetic activities (e.g. assessing, counselling and reviewing); the primary nutritional condition of the patient (e.g. type 2 diabetes and liver disease); and the time spent in contact with patients. The most common dietetic activities were reviews, followed by collection of dietary information and counselling. The most common nutritional condition encountered by students was an inadequate nutrient intake, followed by patients receiving enteral nutrition. Contact time with patients increased over the placement, with proportionately more time spent by students seeing patients independently than when being observed by supervising dietitians. The data collected provided valuable informa tion on the amount of time spent by students in direct patient contacts, the range of dietetic activities undertaken and the amount of time student activities were directly observed. This information will be useful in the development of benchmarks for clinical skill development, hospital and university staff planning and the assessment of the impact of any changes to the format of student placement experience in the clinical setting.<br /

Evaluation of an interactive, internet-based weight loss program : a pilot study

The Internet can access a large number of consumers in a more cost-effective manner than other information delivery channels. In this pilot study, we assessed whether an online weight reduction program including dietary advice plus exercise (ED) was more effective in reducing weight than an exercise-only program (EX) &gt;12 weeks. Participants were randomized to either the ED or EX group and attended a center for anthropometric measurements and dietary assessment. Both groups wore a pedometer and set weekly goals to increase daily steps through an interactive Web site. The ED group set weekly dietary goals via the Web site and received tailored e-mail assistance. Seventy-three participants commenced and 53 (73%) completed the study [EX n = 26; ED n = 27; body mass index&mdash;mean (standard deviation): 29.7 (2.5) kg m&ndash;2, age 46.3 (10.8); 21% male]. Percent weight changes were EX, 2.1 (0.6)% and ED, 0.9 (0.6)% (P = 0.15). Both groups increased their daily steps with no difference between groups. Only the ED group significantly reduced their energy intake. Despite a greater fall in energy intake reported by the ED group and a similar increase in physical activity in both groups, setting individual dietary goals did not enhance weight loss.<br /

Modification of tyrosine residues in lysozyme by electrochemical, sonochemical and sonoelectrochemical nitration

Póster presentado en el 10th Meeting of European Society of Sonochemistry, ESS 10, Hamburg, June 4-8, 2006

Mass spectrometry in demonstrating the site-specific nitration of hen egg white lysozyme by an improved electrochemical method

In producing a method for selective protein nitration, we previously demonstrated the electrochemical nitration of hen egg white lysozyme to be at Tyr23 initially, followed by bisnitration at Tyr20, but with no trisnitration at Tyr53. The nitration site was determined by sequencing a tryptic peptide that included Tyr23 and Tyr20, but possible effects on other regions of the protein were not determined. Moreover, the electrooxidation conditions were harsh, involving an oxidation potential of +1.2 V (vs. saturated calomel electrode [SCE]), no added nitrogen source except the lysozyme itself, and long reaction periods with copper flag electrodes. Here we report a gentler procedure using much shorter reaction times with nitrite as the nitration source, a lower potential (+0.85 V vs. SCE), and a platinum basket electrode. Intact protein analysis by electrospray Fourier transform ion cyclotron resonance mass spectrometry identified mono- and bisnitration products with mass increases of +45 and +90 Da, respectively, consistent with the substitution of NO2 for H. In addition, the results revealed that no other covalent change in the protein occurred following electrooxidation. Nozzle skimmer dissociation of the intact mononitrated species localized the modification site to Tyr20 or Tyr23. Matrix-assisted laser desorption/ ionization time-of-flight and electrospray ionization time-of-flight analysis of the tryptic peptides of mononitrated lysozyme identified the site of nitration as Tyr23. (c) 2006 Elsevier Inc. All rights reserved

Retention of enzyme activity with a boron-doped diamond electrode in the electro-oxidative nitration of lysozyme

In this paper we report the successful use of a non-metallic electrode material, boron-doped diamond (BDD), for the anodic electro-oxidative modification of hen egg white lysozyme (HEWL). Platinum electrodes can give rise to loss of activity of HEWL in electrosynthetic studies, whereas activity is retained on boron-doped diamond which is proposed as an effective substitute material for this purpose. We also compare literature methods of electrode pre-treatment to determine the most effective in electrosynthesis. Our findings show a decrease in total nitroprotein yield with decreasing nitrite concentration and an increase with increasing solution pH, confirming that, at a BDD electrode, the controlling factor remains the concentration of tyrosine phenolate anion. Purification of mono- and bis-nitrated HEWL and assay of enzymic activity showed better retention of activity at BDD electrode surfaces when compared to platinum. The products from electro-oxidation of HEWL at BDD were confirmed by electrospray ionization Fourier transform ion cyclotron resonance (ESI-FT-ICR) mass spectrometry, which revealed unique mass increases of +45 and +90 Da for the mono- and bis-nitrated lysozyme, respectively, corresponding to nitration at tyrosine residues. The nitration sites were confirmed as Tyr23 and Tyr20