Susan Ash - Academia.edu (original) (raw)

Papers by Susan Ash

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, Sep 5, 2012

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences School of Public Health Social Work, Sep 22, 2013

This study aimed to demonstrate how supervisors and students use their time during the three doma... more This study aimed to demonstrate how supervisors and students use their time during the three domains of nutrition and dietetic clinical placement and to what extent patient-care and non-patient activities change during placement compared with pre-and post-placement. Methods: A cohort survey design was used with students from two Queensland universities, and their supervisors in 2010. Participants recorded their time use in either a paper-based or an electronic survey. Supervisors' and students' time use was calculated as independent daily means according to time-use categories reported over the length of the placement. Mean daily number of occasions of service, length of occasions of service, project activities and other time use in minutes was reported as productivity output indicators and the data imputed. A linear mixed modelling approach was used to describe the relationship between the stage of placement and time use in minutes. Results: Combined students' (n = 21) and supervisors' (n = 29) time use as occasions of service or length of occasions of service in patient-care activities were significantly different pre, during and post placement. On project-based placements in food-service management and community public health nutrition, supervisors' project activity time significantly decreased during placements with students undertaking more time in project activities. Conclusions: This study showed students do not reduce occasions of service in patient care, and they enhance project activities in food service and community public health nutrition while on placement. A larger study is required to confirm these results.

Faculty of Health Institute of Health and Biomedical Innovation, Jul 1, 2003

American Journal of Clinical Nutrition, 2002

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences School of Psychology Counselling, Sep 5, 2012

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, May 1, 2011

Review in Clinical Oncology, 2003

Faculty of Health Institute of Health and Biomedical Innovation School of Public Health Social Work, Aug 1, 2009

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, May 1, 2013

Human nutrition. Applied nutrition

ABSTRACT

Nutrition & Dietetics, 2015

ABSTRACT AimAssessment of entry-level health professionals is complex, especially in the work-bas... more ABSTRACT AimAssessment of entry-level health professionals is complex, especially in the work-based setting, placing additional pressures on these learning environments. The present study aims to gain understanding and ideally consensus regarding the setting for assessment of all elements of competence for entry-level dietitians across Australia.Methods Seventy-five experienced academic and practitioner assessors were invited to participate in an online Delphi survey. The 166 entry-level performance criteria of the competency standards for dietitians formed the basis of the questions in the survey, with rating on which ones could be assessed in the practice setting, those which could be assessed in a classroom/university setting and which could be assessed in either setting. Forty-three of 75 invited assessors responded to the first round of the Delphi. A second modified survey was sent to the 43 participants with 34 responding.ResultsConsensus was achieved for the assessment setting for 86 (52%) of the performance criteria after two rounds of surveying. The majority of these performance criteria achieved consensus at round one (n = 44) and were deemed to be best assessed in the practice setting (n = 55). This study highlighted the perspectives of assessors and their preference for the work-based setting for assessment.Conclusions To reduce the focus on work-based settings as the only place for competence-based assessment of health professionals, there is a need to support individual and organisational change through challenging existing norms around assessment.

International Journal of Obesity

Objective: To investigate the effect of an 8 week group based cognitive behaviour therapy interve... more Objective: To investigate the effect of an 8 week group based cognitive behaviour therapy intervention on change in weight and other weight related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving information only Design: A randomised control trial with an 8-week intervention period – two intervention groups, a group based cognitive behaviour therapy intervention, Fat Booters Inc – (FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). Intervention for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting. Subjects: A total of 176 adults with body mass index (BMI) > 27kg/m2, mean (+/-SD) age 48+/-13 years, mean BMI 34+/-5.5 kg/m2. Main Outcome Measures: Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measur...

Nutrients, 2015

Image-based dietary records have limited evidence evaluating their performance and use among adul... more Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77-0.99) was lower when compared with the 3-day WFR (ICC = 0.82-0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

International Journal of Evidence-Based Healthcare, 2015

The requirement for an allied health workforce is expanding as the global burden of disease incre... more The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

doses. However, the current methods for predicting LBW are inconsistent at extremes of size and c... more doses. However, the current methods for predicting LBW are inconsistent at extremes of size and could be misleading with respect to interpreting weight-based regimens. Objective: The objective of the present study was to develop a semi-mechanistic model to predict fat-free mass (FFM) from subject characteristics in a population that includes extremes of size. FFM is considered to closely approximate LBW. There are several reference methods for assessing FFM, whereas there are no reference standards for LBW. Patients and methods: A total of 373 patients (168 male, 205 female) were included in the study. These data arose from two populations. Population A (index dataset) contained anthropometric characteristics, FFM estimated by dual-energy x-ray absorptiometry (DXA -a reference method) and bioelectrical impedance analysis (BIA) data. Population B (test dataset) contained the same anthropometric measures and FFM data as population A, but excluded BIA data. The patients in population A had a wide range of age (18-82 years), bodyweight (40.7-216.5kg) and BMI values (17.1-69.9 kg/m 2 ). Patients in population B had BMI values of 18.7-38.4 kg/m 2 . A two-stage semi-mechanistic model to predict FFM was developed from the demographics from population A. For stage 1 a model was developed to predict impedance and for stage 2 a model that incorporated predicted impedance was used to predict FFM. These two models were combined to provide an overall model to predict FFM from patient characteristics. The developed model for FFM was externally evaluated by predicting into population B.

Human nutrition. Applied nutrition, 1984

The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney w... more The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney were collected and analysed. Participants in the study (n = 124) had their midday meal at either an Activity Centre or at home (Meals-on-Wheels Organization). The dietary data was collected over 4 days. Heights and weights and some sociological data were also obtained. The study indicated that a significant proportion of this population may be at nutritional risk, and that this was particularly so for males receiving Meals-on-Wheels.

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, Sep 5, 2012

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences School of Public Health Social Work, Sep 22, 2013

This study aimed to demonstrate how supervisors and students use their time during the three doma... more This study aimed to demonstrate how supervisors and students use their time during the three domains of nutrition and dietetic clinical placement and to what extent patient-care and non-patient activities change during placement compared with pre-and post-placement. Methods: A cohort survey design was used with students from two Queensland universities, and their supervisors in 2010. Participants recorded their time use in either a paper-based or an electronic survey. Supervisors' and students' time use was calculated as independent daily means according to time-use categories reported over the length of the placement. Mean daily number of occasions of service, length of occasions of service, project activities and other time use in minutes was reported as productivity output indicators and the data imputed. A linear mixed modelling approach was used to describe the relationship between the stage of placement and time use in minutes. Results: Combined students' (n = 21) and supervisors' (n = 29) time use as occasions of service or length of occasions of service in patient-care activities were significantly different pre, during and post placement. On project-based placements in food-service management and community public health nutrition, supervisors' project activity time significantly decreased during placements with students undertaking more time in project activities. Conclusions: This study showed students do not reduce occasions of service in patient care, and they enhance project activities in food service and community public health nutrition while on placement. A larger study is required to confirm these results.

Faculty of Health Institute of Health and Biomedical Innovation, Jul 1, 2003

American Journal of Clinical Nutrition, 2002

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences School of Psychology Counselling, Sep 5, 2012

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, May 1, 2011

Review in Clinical Oncology, 2003

Faculty of Health Institute of Health and Biomedical Innovation School of Public Health Social Work, Aug 1, 2009

Faculty of Health Institute of Health and Biomedical Innovation School of Exercise Nutrition Sciences, May 1, 2013

Human nutrition. Applied nutrition

ABSTRACT

Nutrition & Dietetics, 2015

ABSTRACT AimAssessment of entry-level health professionals is complex, especially in the work-bas... more ABSTRACT AimAssessment of entry-level health professionals is complex, especially in the work-based setting, placing additional pressures on these learning environments. The present study aims to gain understanding and ideally consensus regarding the setting for assessment of all elements of competence for entry-level dietitians across Australia.Methods Seventy-five experienced academic and practitioner assessors were invited to participate in an online Delphi survey. The 166 entry-level performance criteria of the competency standards for dietitians formed the basis of the questions in the survey, with rating on which ones could be assessed in the practice setting, those which could be assessed in a classroom/university setting and which could be assessed in either setting. Forty-three of 75 invited assessors responded to the first round of the Delphi. A second modified survey was sent to the 43 participants with 34 responding.ResultsConsensus was achieved for the assessment setting for 86 (52%) of the performance criteria after two rounds of surveying. The majority of these performance criteria achieved consensus at round one (n = 44) and were deemed to be best assessed in the practice setting (n = 55). This study highlighted the perspectives of assessors and their preference for the work-based setting for assessment.Conclusions To reduce the focus on work-based settings as the only place for competence-based assessment of health professionals, there is a need to support individual and organisational change through challenging existing norms around assessment.

International Journal of Obesity

Objective: To investigate the effect of an 8 week group based cognitive behaviour therapy interve... more Objective: To investigate the effect of an 8 week group based cognitive behaviour therapy intervention on change in weight and other weight related variables, change in physical activity and change in health and well being compared to individualised dietetic treatment or giving information only Design: A randomised control trial with an 8-week intervention period – two intervention groups, a group based cognitive behaviour therapy intervention, Fat Booters Inc – (FBI) and individualised dietetic treatment (IDT) and control group receiving an information booklet only (BO). Intervention for 8 weeks with monthly follow-up to 6 months and further follow-up at 12 months, conducted in real practice setting. Subjects: A total of 176 adults with body mass index (BMI) > 27kg/m2, mean (+/-SD) age 48+/-13 years, mean BMI 34+/-5.5 kg/m2. Main Outcome Measures: Weight, percent body fat, waist circumference, physical activity, health status, self-efficacy and satisfaction with life were measur...

Nutrients, 2015

Image-based dietary records have limited evidence evaluating their performance and use among adul... more Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77-0.99) was lower when compared with the 3-day WFR (ICC = 0.82-0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

International Journal of Evidence-Based Healthcare, 2015

The requirement for an allied health workforce is expanding as the global burden of disease incre... more The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

doses. However, the current methods for predicting LBW are inconsistent at extremes of size and c... more doses. However, the current methods for predicting LBW are inconsistent at extremes of size and could be misleading with respect to interpreting weight-based regimens. Objective: The objective of the present study was to develop a semi-mechanistic model to predict fat-free mass (FFM) from subject characteristics in a population that includes extremes of size. FFM is considered to closely approximate LBW. There are several reference methods for assessing FFM, whereas there are no reference standards for LBW. Patients and methods: A total of 373 patients (168 male, 205 female) were included in the study. These data arose from two populations. Population A (index dataset) contained anthropometric characteristics, FFM estimated by dual-energy x-ray absorptiometry (DXA -a reference method) and bioelectrical impedance analysis (BIA) data. Population B (test dataset) contained the same anthropometric measures and FFM data as population A, but excluded BIA data. The patients in population A had a wide range of age (18-82 years), bodyweight (40.7-216.5kg) and BMI values (17.1-69.9 kg/m 2 ). Patients in population B had BMI values of 18.7-38.4 kg/m 2 . A two-stage semi-mechanistic model to predict FFM was developed from the demographics from population A. For stage 1 a model was developed to predict impedance and for stage 2 a model that incorporated predicted impedance was used to predict FFM. These two models were combined to provide an overall model to predict FFM from patient characteristics. The developed model for FFM was externally evaluated by predicting into population B.

Human nutrition. Applied nutrition, 1984

The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney w... more The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney were collected and analysed. Participants in the study (n = 124) had their midday meal at either an Activity Centre or at home (Meals-on-Wheels Organization). The dietary data was collected over 4 days. Heights and weights and some sociological data were also obtained. The study indicated that a significant proportion of this population may be at nutritional risk, and that this was particularly so for males receiving Meals-on-Wheels.