Attitudes, behaviours, and self-reported confidence of Australian pharmacy students and interns towards nutritional counselling.

INTRODUCTION: Pharmacists play a prominent role in the counselling and education of patients complementary to provision of medicines. The increase in non-communicable diseases associated with poor quality diets has placed a greater demand on pharmacists to play a role in the provision of nutritional education to patients. This study aimed to investigate pharmacy students' and interns' attitudes, behaviours, and self-reported confidence towards nutritional counselling and to examine factors associated with their intention to counsel patients in nutrition. METHODS: An online survey was designed using the theory of planned behaviour and was distributed to final-year pharmacy students and interns enrolled at the University of Sydney. Data analysis was conducted to test for correlations between behavioural intentions, attitudes, confidence, subjective norms, and perceived behavioural control. RESULTS: Sixty-six surveys were completed, representing an average response rate of 19.6%. Half of all participants reportedly were providing nutritional advice to patients at least once per week or more often when working in a pharmacy. Participants' intention to counsel patients about nutrition was influenced by preceptors' encouragement. The participants' average level of confidence in having the knowledge and skills to provide nutritional counselling, reported over 13 medical conditions, showed that they were on average "somewhat confident" in providing nutritional counselling, with the level of confidence differing depending upon the specific topic areas. CONCLUSIONS: Participants acknowledged the role of pharmacists in the provision of nutritional counselling, but a more comprehensive nutrition curriculum integrated within existing pharmacy curricula is warranted to increase pharmacy students' and interns' confidence.

A review of primary healthcare practitioners' views about nutrition: implications for medical education.

Objectives: This study aimed to review literature that reports on the perspectives and opinions of Australian and New Zealand primary healthcare practitioners on their role in nutrition counselling of their patients. Methods: A systematic search of relevant articles reporting on attitudes towards nutrition counselling by Australian and New Zealand doctors/physicians, nurses including midwives, pharmacists and dentists was conducted. The search included literature from the past ten years until March 2021 and identified 21 relevant papers, with most of the studies including medical practitioners and nurses. Results: Three main themes were identified from qualitative and quantitative data, which included education and training, practitioner experiences and challenges. Consistent with previous literature, health care practitioners acknowledged their important role in the provision of dietary advice to patients. Challenges that influenced the provision of this advice included insufficient education and training, time constraints and limited knowledge and confidence. Time constraints during normal consultations led to a low priority of nutrition counselling. An absence of assessment opportunities to demonstrate nutrition competence and limited coverage of specific nutrition-related advice during training were also reported. Conclusions: Primary healthcare practitioners acknowledge the importance of playing a role in the provision of nutrition advice but require education and access to evidence-based information that can be utilised effectively within the time constraints of standard consultations. Medical education curricula can be improved to provide more emphasis on nutrition education, including relevant assessment opportunities.

Widespread contribution of methane-cycle bacteria to the diets of lake profundal chironomid larvae.

Reports of unexpectedly 13C-depleted chironomid larvae in lakes have led to an hypothesis that significant transfer of detrital organic matter to chironomid larvae may occur via methane-cycle bacteria. However, to date little is known of how such transfer might vary across species and lakes. We gathered data from 87 lakes to determine how widespread this phenomenon might be and to define boundaries for its likely magnitude. Carbon stable isotope values of chironomid larvae varied greatly between taxa. Very marked 13C-depletion was evident only in certain taxa, especially Chironomus plumosus, C. anthracinus, and C. tenuistylus, all characteristic of eutrophic or dystrophic lakes and known to be tolerant of low oxygen conditions. Furthermore, marked 13C-depletion was only found in larvae from lakes in which late-summer hypolimnetic oxygen depletion near the sediment surface was below an apparent threshold concentration of 2-4 mg O2/L. Similarly, application of a two-source mixing model suggested that methanotrophic bacteria made the greatest contribution to profundal chironomid growth (0-70% of larval carbon) when the late-summer oxygen concentration dropped below approximately 2 mg O2/L. Our study demonstrates that methane-derived carbon is an important, but often neglected, contribution to the flux of carbon through the food webs of many productive or dystrophic lakes.

Miniaturized receptor binding assays: complications arising from ligand depletion.

The advent of miniaturized assay formats has made possible the screening of large numbers of compounds against a single target, known as high-throughput screening. Despite this clear advantage, assay miniaturization also increases the risk of ligand depletion, where the actual concentration of free ligand is significantly lower than that added. This, in turn, complicates the interpretation of data from such assays, potentially introducing significant error if not recognized. In this study, the effects of reducing assay volume on radioligand Kd and competitor Ki values have been investigated, using the muscarinic M(3) receptor as a model system. It was found that assay miniaturization caused dramatic effects, with up to a 30-fold underestimation of ligand affinity. A theoretical model was developed and shown to accurately predict both the degree of ligand depletion in any given assay volume and the effect of this depletion on affinity estimates for competing ligands. Importantly, it was found that in most cases, errors introduced by ligand depletion could be largely corrected for by the use of appropriate analysis methods. In addition to those previously described by others, the authors propose a simple method capable of correcting errors in competition binding experiments performed in conditions of ligand depletion.