Preparing our future workforce: a qualitative exploration of dietetics practice educators' experiences.

BACKGROUND: Dietetics practice educators are instrumental in the development of future dietitians. The present study aimed to explore dietetics practice educators' experiences of, and challenges faced in, dietetics workforce preparation. METHODS: This study was guided by interpretive description methodology. Purposive and maximum variation sampling were used to recruit 18 dietetics practice educators from a variety of practice areas and locations across Australia. In-depth, semi-structured interviews were digitally recorded then transcribed verbatim and inductive coding of data was managed with nvivo (QSR International Pty Ltd, Doncaster, VIC, Australia). Multiple researchers analysed the data to develop preliminary themes using template analysis before final themes were identified. RESULTS: Three main themes were developed: nurturing others; seeing the flaws; and soldiering on. Practice educators take great satisfaction in witnessing students develop and are focused on cultivating future practitioners with authentic learning activities. However, they are impacted by perceived shortcomings of the systems in which they operate and consider that broadening the scope of dietetics placements to better align with contemporary practice could benefit graduates and the profession. Despite these challenges, practice educators are pragmatic in getting on with their roles and recognise the advantages gained from student placements. CONCLUSIONS: Despite facing numerous challenges, practice educators derive benefits from their role in workforce preparation. Evidence is required on how students can demonstrate competence in contemporary areas of practice and on how to enable the scope of student placements to be broadened. Such strategies could support practice educators to overcome challenges and help ensure the dietetics profession of tomorrow is relevant and responsive.

Endocervical mucus pH is inversely related to serum androgen levels and waist to hip ratio.

OBJECTIVE: To determine whether an inter-relationship exists between endocervical mucus pH, serum androgen levels, and waist to hip (W:H) ratio. SETTING: Donor insemination clinic, University of Sheffield, Jessop Hospital, Sheffield, United Kingdom. PATIENTS: One hundred patients receiving donor insemination. INTERVENTIONS: Waist, hip, height, and weight measurements were recorded for 100 patients receiving donor insemination. At the onset of the LH surge when patients attended for their first insemination, a sample of endocervical mucus and blood was taken. The Insler score of the mucus was recorded and the pH was measured with multirange pH paper. Of the 100 patients studied, 10 cases had an endocervical mucus pH < 6 despite Insler scores of > 10. Serum T, DHEAS, and androstenedione levels were measured in the 10 patients with pH < 6 and in 26 patients selected at random from the 90 patients with pH > or = 6. RESULTS: The W:H ratio was significantly higher in the patients with pH < 6 than pH > or = 6. No significant difference was seen in body mass index between the latter groups. All serum androgen levels were significantly higher in the patients with pH < 6 than pH > or = 7. CONCLUSION: A potential link (serum androgen levels) between a powerful predictive factor of fertility (W:H ratio) and a potential mechanism of subfertility (low endocervical mucus pH) has been demonstrated. This observation warrants further detailed evaluation particularly as it has been shown that a low endocervical mucus pH may be corrected by simple inexpensive treatment.

Oral health assessment and mouth care for children and young people receiving palliative care. Part two.

This is the second part of a two-part article on oral health assessment and mouth care for children and young people receiving palliative care. This article covers basic oral hygiene and management of oral health problems: oral candidiasis, coated tongue/dirty mouth, dry mouth, hypersalivation, ulceration, painful mouth, stomatitis and mucositis. The article also covers treating patients who are immunocompromised and the need to educate families and carers in the basic principles of oral care, including the importance of preventing cross-infection. Part one outlined oral assessment and discussed the adaptation of the Nottingham Oral Health Assessment Tool (Freer 2000).

A prospective, randomised, cross-over study comparing the effects of clomiphene citrate and cyclofenil on endometrial morphology in the luteal phase of normal, fertile women.

OBJECTIVE: To examine the effect of two anti-oestrogens, clomiphene citrate and cyclofenil, on endometrial morphology in the luteal phase. DESIGN: A prospective, randomised, cross-over study. SETTING: Jessop Hospital for Women, Sheffield, UK. SUBJECTS: 10 women who were previously fertile and regularly cycling. INTERVENTION: The administration of clomiphene citrate or cyclofenil in the treatment cycles. A LH timed endometrial biopsy was taken on day LH + 6. MAIN OUTCOME MEASURES: Histological dating and morphometric analysis of the endometrial sample. RESULTS: Only one out of 10 subjects had abnormal endometrium. There was no difference in the results between cycles treated with clomiphene citrate and cyclofenil. CONCLUSIONS: Clomiphene citrate or cyclofenil does not have a major adverse effect on endometrial morphology in the luteal phase of normal fertile subjects. The possible adverse effects of anti-oestrogens on endometrium may have been previously overestimated.