Biomedical subjects

Laura D Byham-Gray

Publications and source records attributed to Laura D Byham-Gray.

5 recordsLinked to original sources

PubMed2006

Predictors for research involvement among registered dietitians.

OBJECTIVE: The primary aim of this study was to measure registered dietitians' (RDs') research involvement (by creating a research score) and to determine whether their perceptions, attitudes, and knowledge of evidence-based practice and key antecedent factors (eg, sociodemographic characteristics, education and training, professional experiences, and employment setting) predicted their research involvement. DESIGN: This cross-sectional, descriptive study used the Dietitian Research Involvement Survey and followed the Tailored Design Method. SUBJECTS/SETTING: This study surveyed 258 randomly selected RDs from seven dietetic practice groups of the American Dietetic Association. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, bivariate relationships, and multiple linear regression analyses were conducted to test whether perceptions, attitudes, and knowledge of evidence-based practice score and antecedent factors predicted the research score of dietitians. RESULTS: Perceptions, attitudes, and knowledge of evidence-based practice score (r = 0.59, P < 0.0005), level of education (r = 0.53, P < 0.0005), taking a research course (r = 0.40, P < 0.0005), last time read research (r = 0.35, P < 0.0005), frequency of professional reading (r = 0.32, P < 0.0005), primary area of practice (r = 0.14, P = 0.02), association memberships (r = 0.14, P = 0.02), and dietetic practice group affiliation (r = 0.14, P = 0.02) were significantly correlated with research score. Using multivariate linear regression, the perceptions, attitudes, and knowledge of evidence-based practice score (beta = 0.48, P < 0.0005) and level of education (beta = 0.39, P < 0.0005) were identified as the strongest predictors of research score. CONCLUSIONS: Involvement in research by RDs is largely determined by their perceptions, attitudes, and knowledge of evidence-based practice and their level of education. Additional education and training related to research methodology and design, and evidence-based practice, is essential for greater participation in research activities by RDs.

Adult↗

PubMed2006

Weighing the evidence: energy determinations across the spectrum of kidney disease.

Evidence based guidelines for medical nutrition therapy (MNT) in chronic kidney disease (CKD) recommend a range of caloric levels, dependent on age and level of kidney function. Recent literature has explored whether current research findings still support these earlier conclusions, and if new energy determinations for CKD are warranted. This review will take a brief look at the history of the controversy, examine the research evidence at the time of practice guideline development, investigate emerging research, and discuss implications for additional scientific inquiry.

Energy Intake↗

PubMed2006

Scope of practice in renal nutrition.

Clinical standards for practice in renal nutrition can vary dramatically from region to region, state to state, and clinic to clinic, and are greatly affected by the policies of several governing bodies. This review explores the factors that influence practice patterns among renal dietitians and examines the current American Dietetic Association's Scope of Dietetics Practice Framework for its applicability to kidney disease. Lastly, this article discusses current strategies for establishing a scope of practice in renal nutrition and evaluates licensure and credentialing issues that impact standards for practice across the various regions of the United States.

Credentialing↗

PubMed2005

Evidence-based practice: what are dietitians' perceptions, attitudes, and knowledge?

OBJECTIVE: The objective of this study was to measure dietitians' perceptions, attitudes, and knowledge of evidence-based practice (PAK score), and to determine whether antecedent factors (eg, sociodemographic characteristics, education and training, professional experiences, and employment setting) predicted PAK score. DESIGN: This cross-sectional, descriptive study used the Dietitian Research Involvement Survey following the Tailored Design Method. SUBJECTS/SETTING: This study surveyed 500 randomly selected registered dietitians from seven dietetic practice groups of the American Dietetic Association. STATISTICAL ANALYSES PERFORMED: Bivariate relationships were examined between antecedent factors and PAK score. Multiple linear regression analyses were conducted to test whether these factors predicted PAK score. RESULTS: Higher PAK scores were associated with registered dietitians who completed more years of education (r=0.28, P<.0005), had taken a research course (r=0.28, P<.0005), frequently read research articles (r=0.41, P<.0005), earned an advanced-level board certification (r=0.18, P=.004), worked full-time (r=0.26, P<.0005), or belonged to professional organizations (r=0.18, P=.003). The strongest predictors for PAK score were "last time read research" (beta=.33, P<.0005), work status (beta=.20, P<.0005), level of education (beta=.19, P=.001), and association memberships (beta=.14, P=.01). CONCLUSIONS: Results indicated that dietitians' ability to incorporate an evidence-based approach is largely determined by their education and training, work experience, and professional association involvement. This study identified a need to integrate concepts and principles of evidence-based practice into dietetics curriculums so that practitioners are able to routinely apply research findings to clinical practice.

Adult↗

PubMed2005

Outcomes research in nutrition and chronic kidney disease: perspectives, issues in practice, and processes for improvement.

Despite greater access to health care and advances in medicine and technology, the morbidity and mortality among patients diagnosed with chronic kidney disease (CKD) remain unacceptably high. Discrepancies in patient care outcomes exist between the United States and other industrialized countries and are partly explained by variances reported in clinical practice. Outcomes research (OR) has been the primary methodology used to more fully explore the root causes for the practice variation and to uncover which indicators have the greatest impact. Research has established the relationships between early diagnosis and treatment, cardiovascular disease, quality of life, and malnutrition with morbidity and mortality rates among patients with kidney disease. Although nutrition parameters are predictive of mortality, they are complex to understand and even more difficult to improve, largely because of the effects of the inflammatory process and the lack of a direct measure that defines nutritional status. Future OR projects must focus on specific nutrition-related outcomes and the effectiveness of intervention, as these outcomes can establish clinical guidelines, lead to changes in practice, and create more controlled clinical trials that continue to search for answers to questions on the impact of nutrition and others.

Biomedical Research↗