The incidence of personal importation of prescription medicines among Australians 45 and older: a cross-sectional survey.

Objective This study is the first to investigate the incidence of personal importation of prescription medicines among Australians aged 45 years or older, and the reasons driving this behaviour. Methods An online survey was distributed to Australians, aged 45 years or older, who were taking prescription medicines. Recruitment was conducted via Qualtrics. The survey was completed by 1180 respondents. Results In our sample, 1.8% of respondents had imported prescription medicines in the previous 12 months, 21.9% had not taken, or had delayed taking, a prescribed medicine due to cost, 21.9% described medicines as unaffordable/very unaffordable, and 17.7% took some budgetary measure to pay for their medicines. The most significant predictors (P < 0.001) of importation were doctors raising it as an option (1.0% vs 42.9%), awareness of the Personal Importation Scheme (0.8% vs 22.6%), believing that importing was safe (1.6% vs 20.9%), paying more than the maximum PBS co-payment for any individual medicine (0.4% vs 8.1%), higher monthly spend on medicines (1.0% vs 6%), and delaying or not taking a medicine due to cost (0.9% vs 5.0%). Almost half (44.4%) would consider importing medicines to save money. Conclusions Potentially hundreds of thousands of Australians are importing prescription medicines from abroad, and many Australians indicate they are willing to import medicines to save money.

Validation of a sports nutrition knowledge questionnaire for athletes in the United Kingdom and Ireland.

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports - Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92⋅3 (9⋅3) v. EA (n 154): 71⋅4 (10⋅0)%; P < 0⋅001] and individual section scores (P < 0⋅001) except Section B, Identification of Food Groups (P = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) v. EA: 56⋅7 (14⋅5)%; P < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach's alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes.

Cryobiopsy with radial-endobronchial ultrasound (Cryo-Radial) has comparable diagnostic yield with higher safety in comparison to computed tomography-guided transthoracic biopsy for peripheral pulmonary lesions: An exploratory randomised study.

BACKGROUND: Computed tomography-guided transthoracic biopsy (CT-TTB) is the 'gold standard' biopsy for lung nodules. Radial-endobronchial ultrasound (R-EBUS) bronchoscopy is another recommended biopsy but carries a lower diagnostic yield. Addition of cryobiopsy with R-EBUS (Cryo-Radial) has shown promising results. There are no studies comparing CT-TTB with Cryo-Radial biopsy. AIM: The co-primary aims were the diagnostic yeild and safety. The secondary aim: ability to test epidermal growth factor receptor (EGFR). METHODS: A randomised controlled, multicentre exploratory study was conducted at three tertiary hospitals. Patients with nodules >1 cm on CT of the chest were randomised to CT-TTB or Cryo-Radial. With Cryo-Radial, patients had 1-3 cryo-biopsies in addition to at least one R-EBUS biopsy through the 2.6 mm guide sheath. RESULTS: Forty-eight patients were randomised: 22 to CT-TTB and 26 to Cryo-Radial. Sixteen in the CT-TTB and 20 in the Cryo-Radial received the allocated biopsy. The diagnostic yield was CT-TTB 93.8% (15/16) versus Cryo-Radial 85% (17/20) P = 0.61 and the odds ratio was 0.37. For 5/13 (38%), a diagnosis was solely made on cryobiopsy. Eleven (78%) of 14 in CT-TTB versus 7/10 (70%) Cryo-Radial were suitable for EGFR testing P = 0.66, with odds ratio 0.63. Pneumothorax occurrence was 44% (7/16) in CT-TTB versus 4.2% (1/24) in Cryo-Radial. Two (12.5%) of 16 CT-TTB required chest drain insertion. CONCLUSION: Cryo-Radial is comparable in diagnostic yield and ability to perform EGFR testing with a significantly lower risk of pneumothorax, compared with CT-TTB. Cryo-Radial has the additional advantage of mediastinal staging during the same procedure with Linear-EBUS and is a promising first-line tool in the diagnostic method of lung cancer.

Musculoskeletal anatomy core syllabus for Australian chiropractic programs: A pilot study.

OBJECTIVE: The aim of this study is to conduct a pilot survey to determine core anatomy content for chiropractic curriculum based on the perception of chiropractors and anatomy educators involved in teaching in an Australian chiropractic program. METHODS: A survey of anatomical structures previously used in a medical survey, with similar criteria for synthesizing responses, was used and classified according to whether the respondents rated an item as essential, important, acceptable, or not required in a chiropractic program. The item was scored as core if ≥60% of respondents rated it essential, recommended if 30%-59% rated it essential, not recommended if 20%-29% rated it essential, or not core if <20% rated it essential. RESULTS: The respondents rated 81.6% of all musculoskeletal concepts as core and 18.4% as recommended, 88.8% of the vertebral column items as core, and 11.2% of the items as recommended, 69.4% upper limb and pectoral girdle items as core, 23.7% of items as recommended, 5.5% as not recommended and 1.3% as not core items for inclusion, 85.3% of all lower limb and pelvic girdle items as core, 14.4% as recommended and 0.3% not recommended. CONCLUSION: Chiropractors and anatomists involved in teaching in an Australian chiropractic program rated most musculoskeletal items as essential for inclusion in a chiropractic teaching program to ensure adequate preparation for safe practice and to promote alignment with the standards of anatomy education delivered into the clinical professions.

Musculoskeletal anatomy knowledge in Australian chiropractors.

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors' self-rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple-choice test was utilized to measure retention of limb musculoskeletal (MSK) knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors' self-rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self-assessing their anatomy knowledge. This study found that Australian chiropractors' knowledge of MSK anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective.

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

The Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire: a reliable and valid electronic sports nutrition knowledge questionnaire for athletes.

Reliable and valid assessment of sports nutrition knowledge can inform athlete nutrition education to address knowledge gaps. This study aimed to test the reliability and validity of an electronically administered sports nutrition knowledge tool - Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire (PEAKS-NQ). A 94-item PEAKS-NQ was piloted to 149 developmental athletes (DA) in New Zealand, with a subset invited to complete the PEAKS-NQ again to assess reliability. Reliability was evaluated using sign test, intraclass correlation and Cronbach's α. Accredited sports dietitians (ASD; n 255) completed the PEAKS-NQ to establish construct validity via known-groups methodology and provided relevance scores to determine the scale content validity index (S-CVI). Rasch analysis was conducted to identify potentially problematic items and test reliability. Score differences between DA and ASD were analysed using independent t or non-parametric tests. DA (n 88) were 17·8 (sd 1·4) years, 61·4 % female and mostly in high school (94·3 %). ASD (n 45) were 37·8 (sd 7·6) years, 82·2 % female, with >5 years of dietetic experience (59·1 %). ASD scored higher than DA in all sections and overall (91·5 (sd 3·4) v. 67·1 (sd 10·5) %) (P < 0·001). There were no differences between retests (n 18; P = 0·14). Cronbach's α was 0·86. S-CVI indicated good content validity (0·88). Rasch analysis resulted in a fifty-item PEAKS-NQ with high item (0·91) and person (0·92) reliability. The PEAKS-NQ is reliable and valid for assessing sports nutrition knowledge which could assist practitioners effectively tailor and evaluate nutrition education.

Client experiences and confidence in nutrition advice delivered by registered exercise professionals.

OBJECTIVES: The aims of this cross-sectional study were to describe the client experiences of registered exercise professionals (REP) in regard to nutrition advice, and to identify factors considered important when selecting a REP. DESIGN: A convenience sample of fitness facility-users were recruited. Participants completed a 46 item online questionnaire. METHOD: Frequency distributions were calculated for nutrition advice received from a REP, confidence in the nutrition advice received, and factors considered when selecting a REP. The effect of sex and level of education on participant responses were investigated. RESULTS: A total of 455 individuals participated, of which 55.6% had worked with a REP. Participants working with a REP had received nutrition advice on body fat loss (77.4%), muscle gain (78.7%), and clinical nutrition (51.9%). Sex and level of education did not influence confidence in nutrition advice, with 60.7% of participants reporting being 'very or extremely confident' in the nutrition advice. Over half of participants (58.3%) prefer to work with a REP who offers nutrition advice. Basic and personal professional conduct were identified as 'very or extremely important' by >70% of participants when selecting a REP. CONCLUSION: Clients of REP prefer to work with a REP who provides nutrition advice and are generally confident in this advice. Educating fitness facility-users on the nutrition scope of practice of REP and promoting the role of accredited nutrition professionals should be advocated. Encouraging REP to work collaboratively with nutrition professionals will help ensure clients receive appropriate nutrition care, while better allowing REP to remain within their scope of practice.

Australian chiropractors' perception of the clinical relevance of anatomical sciences and adequacy of teaching in chiropractic curricula.

BACKGROUND: Human anatomy education is compulsory in the undergraduate curriculum in all Australian chiropractic education programs. There is very little data on clinicians' perceptions of the adequacy of their anatomy training and its relevance to practice. The aims of this study were to evaluate Australian registered chiropractors' perceptions on the relevance and adequacy of anatomy training for clinical practice and analyse their opinion on the usefulness of the teaching resources utilized during their preprofessional training. METHODS: A questionnaire-based survey was conducted on a sample of Australian registered chiropractors focussing on the adequacy of their anatomical science (gross anatomy, histology, neuroanatomy and embryology) training and the clinical relevance of each individual sub-discipline, and the perceived value of each of the different anatomy teaching resources utilized. RESULTS: A total of 128 completed surveys were returned from an estimated 387 attendees at two national chiropractic conferences (estimated 33% response rate). The respondents represent 2.6% of registered chiropractors in Australia in 2016 and were representative in terms of gender (66.4% male) but not age, with older generations being over-represented (peak age group 35-44 vs. 25-34). The majority of the survey respondents obtained their chiropractic qualification in Australia (89.1%) and graduated after 1990 with an average of 21.7 years (SD = 11.3, range = 1-44) in practice. Respondents were equally likely to have undertaken anatomy training in Medicine, Science, Health Science, or other faculties. The disciplines perceived most relevant for clinical practice were neuroanatomy (100% of respondents agreeing) and gross anatomy (99.2%), followed by histology (86.0%) and embryology (81.1%). Respondents also perceived their training to be most adequate in neuroanatomy (99.3%) and gross anatomy (99.2%) followed by histology (91.4%) and embryology (85%). Respondents confirmed exposure to a varied suite of anatomy teaching tools utilized during their pre-professional training and highly valued access to cadavers and prosected specimens. CONCLUSIONS: The majority of respondents perceived anatomy as highly relevant to their clinical practice and noted that it was adequately taught within a wide range of educational approaches. These results will assist educators to refine content and delivery of anatomy course offerings to maximize relevance in chiropractic clinical practice.

Validation of the e-NutLit, an Electronic Tool to Assess Nutrition Literacy.

OBJECTIVE: To validate an electronic nutrition literacy assessment tool (e-NutLit). DESIGN: Cross-sectional. SETTING: An Australian teaching hospital obesity clinic (clinical cohort) and university (dietetic cohort). PARTICIPANTS: A convenience sample of patients with obesity (body mass index > 35 kg m-2) (obese participants [OP]) and dietetic interns (DI). INTERVENTIONS: The e-NutLit was administered to OP and scores were compared with performance on the Newest Vital Sign and e-NutLit scores of the DI to establish construct validity. A subset of OP completed the e-NutLit again to examine instrument temporal stability. Internal consistency was assessed using Cronbach α. MAIN OUTCOME MEASURES: Construct validity, temporal stability, and internal consistency. ANALYSIS: Parametric and nonparametric tests and general linear modeling were used as appropriate. RESULTS: A total of 103 participants completed the study (OP: n = 59; 64.4% female; DI: n = 44; 86.4% female). Newest Vital Sign and e-NutLit scores were significantly and positively associated (rs = 0.66; P <.001). The DI performed significantly better than the OP (OP: 59.7 ± 13.1 percentage points; DI: 83.9 ±â€¯5.5 percentage points; P <.001), further supporting construct validity. The e-NutLit Cronbach α was >0.9 indicating a good level of internal consistency. The OP test and retest scores were not significantly different, supporting instrument temporal stability. CONCLUSION AND IMPLICATIONS: The results support the validity of the e-NutLit, for both clinicians and researchers.

The Role of Music in Families of Children With Hearing Loss and Normal Hearing in Australia, Finland, and the UK.

The primary aim of this current study was to compare the role, importance and value placed on music by families with normally hearing (NH) children, to those who had a child with a hearing loss (HL) who wore either hearing aids and/or cochlear implants. A secondary aim was to see whether this differed between the countries. Parents of children aged 2-6 years living in Australia, Finland, and the United Kingdom were invited to complete the Role of Music in Families Questionnaire (RMFQ). Two groups of participants were recruited from each country: (i) parents of NH children, and (ii) parents of children with a HL. The RMFQ had seven subsections covering topics such as music participation, attitudes to music, importance of music in the family, and future perspectives on music. Three hundred and twenty-two families of NH children, and 56 families of children with HL completed the questionnaire (Australia: 50 NH, 25 HL; Finland: 242 NH, 21 HL; United Kingdom: 30 NH, 10 HL). Analyses compared between NH and HL groups within each country, and between the three countries for the NH group, and the HL group, independently. Overall, there were few significant differences between the participation levels, role, or importance of music in families with NH children compared to those with a child who had a HL, regardless of whether the families lived in Australia, Finland or the United Kingdom. Children first started to respond to music at similar ages, and overall music participation frequency, and music enjoyment were relatively similar. The importance of music in the family was also similar between the NH and HL groups. In comparing between the countries, Finnish children had a tendency to have higher participation rates in musical activities, with few other differences noted. Overall, the results of this study indicate that children, regardless of hearing levels or country of residence, have similar levels of music engagement and enjoyment, and HL is not seen as a contraindication to music participation and involvement by the parents involved in this study.

Music Appreciation of Adult Hearing Aid Users and the Impact of Different Levels of Hearing Loss.

OBJECTIVES: The main aim of this study was to collect information on music listening and music appreciation from postlingually deafened adults who use hearing aids (HAs). It also sought to investigate whether there were any differences in music ratings from HA users with different levels of hearing loss (HL; mild, versus moderate to moderately-severe, versus severe or worse. DESIGN: An existing published questionnaire developed for cochlear implant recipients was modified for this study. It had 51 questions divided into seven sections: (1) music listening and music background; (2) sound quality; (3) musical styles; (4) music preferences; (5) music recognition; (6) factors affecting music listening enjoyment; and (7) music training program. The questionnaire was posted out to adult HA users, who were subsequently divided into three groups: (i) HA users with a mild HL (Mild group); (ii) HA users with a moderate to moderately-severe HL (Moderate group); and (iii) HA users with a severe or worse (Severe group) HL. RESULTS: One hundred eleven questionnaires were completed; of these, 51 participants had a mild HL, 42 had a moderate to moderately-severe loss, and 18 a severe or worse loss. Overall, there were some significant differences noted, predominantly between the Mild and Severe groups, with fewer differences between the Mild and Moderate groups. The respondents with the greater levels of HL reported a greater reduction in their music enjoyment as a result of their HL and that HAs made music sound significantly less melodic for them. It was also observed that the Severe group's mean scores for both the pleasant rating as well as the combined rating for the six different musical styles were lower than both the Mild and Moderate groups' ratings for every style, with just one exception (pop/rock pleasantness rating). There were significant differences between the three groups for the styles of music that were reported to sound the best with HA(s), as well as differences between the ratings on more specific timbre rating scales used to rate different elements of each style. In rating the pleasantness and naturalness of different musical instruments or instrumental groups, there was no difference between the groups. There were also significant differences between the Mild and Severe groups in relation to musical preferences for the pitch range of music, with the Severe group significantly preferring male singers and lower pitched instruments. CONCLUSIONS: The overall results indicated little difference in music appreciation between those with a mild versus moderate loss. However, poorer appreciation scores were given by those with a severe or worse HL. This would suggest that HAs or HL have a negative impact on music listening, particularly when the HL becomes more significant. There was a large degree of variability in ratings, though, with music listening being satisfactory for some listeners and largely unsatisfactory for others, in all three groups. Music listening preferences also varied significantly, and the reported benefit (or otherwise) provided by the HA for music was also mixed. The overriding variability in listening preferences and ratings leads to the question as to the benefit and effectiveness of generic, manufacturer-derived music programs on HAs. Despite the heterogeneity in the listening habits, preferences, and ratings, it is clear that music appreciation and enjoyment is still challenging for many HA users and that level of HL is one, but not the only factor that impacts on music appreciation.

Are exercise professionals fit to provide nutrition advice? An evaluation of general nutrition knowledge.

OBJECTIVES: Registered exercise professionals (REP) are trained to provide structured exercise recommendations and general nutrition advice to healthy clients. However REP provide specific nutrition advice beyond their scope of practice, including diet-disease advice. The present study aims to investigate the level of general nutrition knowledge of REP, and compare this to a sample of community members (CTM), and university trained dietitians (DN). DESIGN: Age-matched REP, CTM and DN were recruited to complete the previously validated revised-general nutrition knowledge questionnaire. METHODS: Total nutrition knowledge score and section scores were compared between REP, CTM and DN. The impact of sex, age, level of education, and years' experience on nutrition knowledge was investigated. RESULTS: A total of 554 participants completed the questionnaire (REP, n=161; CTM, n=357; DN, n=36). The DN group performed significantly better overall (DN, 91.2±4.6; REP, 78.4±9.6; CTM, 75.4±11.3) and for knowledge of dietary guidelines (DN, 82.3±20.7; REP, 80.5±15.5; CTM, 80.0±14.1), nutrient content of foods (DN, 92.6±4.4; REP, 80.9±9.9; CTM, 75.7±12.0), and diet-disease relationships (DN, 91.4±9.7; REP, 65.4±18.0; CTM, 68.6±11.1) compared to the REP and CTM groups (p<0.001). Sex, education and age were all significant predictors of total nutrition knowledge (p<0.0005). CONCLUSIONS: Total nutrition knowledge and knowledge of diet-disease relationships is limited in REP. Encouraging REP to work collaboratively with a multidisciplinary team, including DN, will assist in providing optimal client care in achieving health and body composition related goals.

Dietary Supplement Use in Australian Army Personnel.

INTRODUCTION: Military personnel are reported to use more dietary supplements (DS) than the general population. However, a comprehensive investigation of DS use in Australian Army personnel has not been conducted. This study investigated the prevalence and types of DS used by Australian Army personnel and examined the underpinning reasons and demographic factors influencing this use. MATERIALS AND METHODS: A Convenience sample of Australian Army personnel from both Headquarter (desk-based) and Brigade (field-based) environments completed a researcher-designed DS questionnaire. The questionnaire examined 19 types of DS (including sports foods) and reasons for use. Logistic regression, adjusting for age, sex, education, physical activity, BMI, and occupational group were performed. RESULTS: A total of 667 personnel completed the questionnaire. Overall, 74.5% of personnel reported using ≥1 DS/day, with ~26% reporting use of ≥5 types of DS at least once/week. The most common DS used daily were caffeine (48.4%), vitamin and mineral supplements (34.8%), protein powders (27.9%), creatine (13.3%), and amino acids (13.2%). Reasons for use in descending order were "to provide energy," "performance," "general health," "I like it," "muscle gain," "hydration," "endurance," "convenience," and "weight loss." Using ≥5 DS/week was associated with a higher level of education (p = 0.034), physical activity >10 h/week (p < 0.0005) and having an occupation as a physical training instructor (p = 0.040). CONCLUSION: If military personnel choose to utilize DS, it is important they are used in a safe, legal and effective manner. Education and up to date guidance on the rapidly evolving range of DS available are therefore necessary.

Association between Haem and Non-Haem Iron Intake and Serum Ferritin in Healthy Young Women.

Iron is an essential micronutrient for human health and inadequate intake may result in iron deficiency (ID) or iron deficiency anaemia (IDA). Unlike other recent studies investigating iron status in young women, this cross-sectional study analysed dietary intake and biochemical data from healthy young (18-35 years) women (n = 299) to determine the association between both haem iron (HI) and non-haem iron (NHI) intakes and serum ferritin (SF). Dietary restraint and possible inflammation secondary to obesity were also measured and accounted for, and energy intake was adjusted for using the residuals method. Independent samples t-tests and chi-squared tests were performed, and factors found to be significantly different between iron replete (IR) and ID/IDA participants were analysed using general linear modelling. ID/IDA participants consumed significantly lower total energy than iron replete (IR) (p = 0.003). Lower energy intake was also associated with higher levels of dietary restraint (p = 0.001). Both HI and NHI were positively associated with SF with HI was found to be a stronger predictor (ß = 0.128, p = 0.009) than NHI (ß = 0.037, p = 0.028). The study demonstrates that intake of both HI and NHI, as well as adequate dietary energy, are associated with normal iron status levels in young women, and that restrained eaters may be at greater risk of low iron status.

Correlates of muscle dysmorphia symptomatology in natural bodybuilders: Distinguishing factors in the pursuit of hyper-muscularity.

Muscle dysmorphia (MD) is characterized by the pathological pursuit of muscularity and leanness, which includes eating- and exercise-related practices. The aim of this cross-sectional study was to identify correlations of MD symptomatology in natural bodybuilders. An online survey assessing diet, supplementation and training practices, and MD and eating disorder symptoms was completed by male bodybuilders with recent experience competing in a drug-tested competition. Sixty participants (age 29.6±7.1 years) completed the survey. Eating disorder scores (ß=.298), rate of pre-competition weight loss (ß=.307) and number of competitions (ß=-.257) were significant predictors of MD. The association between the EAT-26 and MDDI underscores the salience of disordered eating pathology in presentations of MD. Supporting this, greater rate of pre-competition weight loss, which may reflect disordered eating practices, is also associated with MD symptomatology. The inverse association of competition experience suggests novice bodybuilders may display increased MD symptomatology.

Relationship between general nutrition knowledge and diet quality in Australian military personnel.

A balanced diet informed by sound nutrition knowledge is key for operational readiness and the health of military personnel. Unfortunately, research suggests that military personnel have inadequate dietary intakes. This study assessed general nutrition knowledge, diet quality and their association in Australian military personnel. A convenience sample of male military personnel (n 211) including Army soldiers and officers completed a validated general nutrition knowledge questionnaire (GNKQ) and FFQ. The GNKQ assessed knowledge of dietary guidelines (Section A), sources of nutrients (Section B), choosing everyday foods (Section C) and diet-disease relationships (Section D). The Australian Recommended Food Score (ARFS) was used to assess diet quality from FFQ data. Statistical analyses included the χ 2 test, Spearman's correlation test, t test, median test, ANCOVA and ordinal logistic regression. The mean total GNKQ score was 52·7 %. Participants performed best on Section A (58·5 %) followed by Sections B (57·3 %) and C (57·0 %) and worst on Section D (31·0 %). Overall, officers scored significantly higher than soldiers (58·7 v. 51·9 %, P=0·001). Age was weakly but positively correlated with GNKQ total scores (r 0·307; P<0·0005), with no significant effects seen for level of education (P=0·463) or living arrangement (P=0·167). Overall ARFS was 37·6 (sd 7·7) (50·8 %) with officers scoring significantly higher than soldiers (54·7 v. 50·3 %, P=0·040). No demographic variables influenced total ARFS. The total GNKQ score had a significant, positive but weak relationship with total ARFS (r 0·179; P=0·009). Given the importance of nutrition to personnel health and operational readiness, initiatives to improve nutrition knowledge and diet quality are recommended in this population, especially in soldiers.

A systematic review and metaanalysis of energy intake and weight gain in pregnancy.

BACKGROUND: Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase energy intake by ∼ 1000 kJ/day in pregnancy may be excessive. OBJECTIVE: To determine by metaanalysis of relevant studies whether greater increments in energy intake from early to late pregnancy corresponded to greater or excessive gestational weight gain. DATA SOURCES: We systematically searched electronic databases for observational and intervention studies published from 1990 to the present. The databases included Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct. In addition we hand-searched reference lists of all identified articles. STUDY ELIGIBILITY CRITERIA: Studies were included if they reported gestational weight gain and energy intake in early and late gestation in women of any age with a singleton pregnancy. Search also encompassed journals emerging from both developed and developing countries. STUDY APPRAISAL AND SYNTHESIS METHODS: Studies were individually assessed for quality based on the Quality Criteria Checklist obtained from the Evidence Analysis Manual: Steps in the academy evidence analysis process. Publication bias was plotted by the use of a funnel plot with standard mean difference against standard error. Identified studies were meta-analyzed and stratified by body mass index, study design, dietary methodology, and country status (developed/developing) by the use of a random-effects model. RESULTS: Of 2487 articles screened, 18 studies met inclusion criteria. On average, women gained 12.0 (2.8) kg (standardized mean difference = 1.306, P < .0005) yet reported only a small increment in energy intake that did not reach statistical significance (∼475 kJ/day, standard mean difference = 0.266, P = .016). Irrespective of baseline body mass index, study design, dietary methodology, or country status, changes in energy intake were not significantly correlated to the amount of gestational weight gain (r = 0.321, P = .11). CONCLUSION: Despite rapid physiologic weight gain, women report little or no change in energy intake during pregnancy. Current recommendations to increase energy intake by ∼ 1000 kJ/day may, therefore, encourage excessive weight gain and adverse pregnancy outcomes.

Evaluation of General Nutrition Knowledge in Australian Military Personnel.

BACKGROUND: Sound nutrition knowledge and a balanced diet are essential for operational readiness and optimal health of military personnel. Few studies have examined nutrition knowledge in this population. OBJECTIVE: To assess the level of general nutrition knowledge across military occupations (ie, officers [OFFRs], physical training instructors [PTIs], cooks [CKs], and soldiers [SOLs]) compared with a civilian, community (C) sample. DESIGN: Cross-sectional study. PARTICIPANTS/SETTING: Convenience sample of Australian military (M) and C participants. MAIN OUTCOME MEASURES: General nutrition knowledge measured using the validated General Nutrition Knowledge Questionnaire (GNKQ). Knowledge scores and the influence of demographic characteristics (eg, age, sex, level of education, and living arrangement) within and between M and C groups were evaluated. STATISTICAL ANALYSES: Analysis of variance, general linear models, independent-samples median test, t tests, χ(2) test, and Spearman's correlation. RESULTS: A sample of 1,295 participants were recruited with 622 (48%) from C. The M sample (n=673) consisted of SOLs 62.1%, OFFRs 9.1%, PTIs 12.8%, and CKs 16.0%. Mean age was higher for C than M (35.5±14 y vs 29.7±9.2 y; P<0.001). However, SOLs were younger and OFFRs older than other groups (P<0.001). The M sample had more men (91.1% vs 39.4%; P<0.001). The OFFRs, PTIs, and C members had similar total GNKQ scores (62.8%, 61.9%, and 64.7%, respectively) with these groups higher (P<0.001) than CKs and SOLs (56.4% and 50.6%, respectively). Across all participants, there was a positive relationship between total GNKQ score and age, female sex, and tertiary education (all P values <0.001). Significant differences identified in total GNKQ score between groups remained after adjusting for demographic factors. Young men (M or C) without tertiary education had the lowest GNKQ scores. CONCLUSIONS: Because low general nutrition knowledge may be detrimental to dietary intake, health, and operational readiness in military personnel, nutrition education programs particularly targeted at SOLs and CKs seem warranted.