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Aim: This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specific EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy., Methods: Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy. Standardized Response Mean and Effect Size were calculated to assess responsiveness. Ceiling effects for each dimension were calculated as the proportion of the best level responses for that dimension at follow-up/post-operatively. Convergent validity was assessed using Spearman's correlation and the level of agreement was explored using Bland-Altman plots., Results: Data from 164 respondents (mean age: 63 years, 81% male) were analysed. HRQoL significantly reduced on both measures with large effect sizes (> 0.80), and a greater mean difference (0.29 compared to 0.16) on QLU-C10D. Both measures had ceiling effects (> 15%) on all dimensions at baseline. Following esophagectomy, ceiling effects were observed with self-care (86%), mobility (67%), anxiety/depression (55%) and pain/discomfort (19%) dimensions on EQ-5D-3L. For QLU-C10D ceiling effects were observed with emotional function (53%), physical function (16%), nausea (35%), sleep (31%), bowel problems (21%) and pain (20%). A strong correlation (r = 0.71) was observed between EQ-5D-3L anxiety and QLU-C10D emotional function dimensions. Good agreement (3.7% observations outside the limits of agreement) was observed between the utility scores., Conclusion: The QLU-C10D is comparable to the more widely applied generic EQ-5D-3L, however, QLU-C10D was more sensitive to short-term utility changes following esophagectomy. Cognisant of requirements by policy makers to apply generic utility measures in cost effectiveness studies, the disease-specific QLU-C10D should be used alongside the generic measures like EQ-5D-3L., Trial Registration: The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12611000178943) on the 15th of February 2011., (© 2021. The Author(s).)

Background and Objectives: Vitamin D plays an important role in bone and muscle function, and cell prolifera-tion. The impact of chemotherapy and associated behavioural changes such as fatigue and sun avoidance on vit-amin D (25(OH) D) is unknown. This study aims to evaluate variations in serum vitamin D during chemotherapy and the predictive value of latitude, season and pre-existing vitamin D deficiency., Methods and Study Design: A 12-week prospective cohort study was conducted in chemotherapy-naïve patients in two Australian locations with different sun exposure. Vitamin D deficiency was defined as ≤25 nmol/L and insufficiency 26-50 nmol/L 25(OH) D. Demographics, chemotherapy regimen, nutritional status, sun exposure, geographic location, and sea-son were collected at baseline, 6 and 12 weeks after commencing chemotherapy., Results: Eighty-five patients (μ55.3±13.4 years of age; 49% female) were recruited, 96% Caucasian. Fifty-four patients were treated with cura-tive intent (mostly for breast [n=29] or colorectal [n=12] cancers). At baseline, 10 patients were vitamin D defi-cient and 33 were insufficient. Mean serum 25(OH) D (nmol/L) was higher at latitude -27.5o (Brisbane) than lati-tude -34.9o (Adelaide) (μ61.9±22.1 vs μ42.2±19.2, p<0.001) and varied according to season (spring: μ46.9±20.3, summer: μ50.8±18.2, autumn: μ76.4±25.2, winter: μ36.5±15.7, p<0.001). Serum 25(OH) D decreased with chemotherapy (baseline: μ49.2±22.3, 6-weeks: μ40.9±19.0, 12-weeks: μ45.9±19.7, p=0.05), with a significant and more rapid decline in winter and autumn (p=0.03)., Conclusions: Chemotherapy is associated with a decrease in serum vitamin D, particularly during winter and autumn. Investigations into the underlying mechanism and as-sociated potential outcomes with this decrease requires further investigation.

Group-based education has the potential to substantially improve the outcomes of individuals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a sample of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians' preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3-6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.

Background: The Malnutrition Screening Tool (MST) is a valid nutrition screening tool in the acute hospital setting but has not been assessed in residential aged care facilities. The aim of this secondary analysis was to determine whether the MST could be a useful nutrition screening tool when compared with a full nutrition assessment by Subjective Global Assessment (SGA) in the residential aged care setting., Methods: Two hundred and eighty-five residents (29% male; mean age 84 +/- 9 years) from eight residential aged care facilities in Australia participated in the study. A secondary analysis of data collected during a nutrition intervention study was conducted. The MST consists of two questions related to recent weight loss and appetite. Although the MST was not specifically applied, weight loss and appetite information was available and an estimated MST score (0-5) was calculated. Nutritional status was assessed by a research assistant trained in using the SGA., Results: Malnutrition prevalence was 42.8% (122 malnourished out of 285 residents). Compared to the SGA, the MST was an effective predictor of nutritional risk (sensitivity = 83.6%, specificity = 65.6%, positive predictive value = 0.65, negative predictive value = 0.84)., Conclusions: The components of the MST have acceptable sensitivity and specificity, suggesting that it can play a valuable role in quickly identifying the risk of malnutrition in the residential aged care setting. Further prospective research using the MST tool against a broader array of objective and subjective nutritional parameters is required to confirm its validity as a screening tool in aged care settings.