Micronutrients: dietary intake v. supplement use

Whilst clinical deficiency of micronutrients is uncommon in the developed world, a suboptimal intake of certain micronutrients has been linked with an increased risk of chronic diseases such as CVD and cancer. Attention has therefore focused on increasing micronutrient status in order to theoretically reduce chronic disease risk. Increasing micronutrient status can involve a number of approaches: increasing dietary intake of micronutrient-rich foods; food fortification; use of supplements. Observational cohort studies have demonstrated an association between high intakes of micronutrients such as vitamin E, vitamin C, folic acid and beta-carotene, and lower risk of CHD, stroke and cancer at various sites. However, randomised intervention trials of micronutrient supplements have, to date, largely failed to show an improvement in clinical end points. The discordance between data from cohort studies and the results so far available from clinical trials remains to be explained. One reason may be that the complex mixture of micronutrients found, for example, in a diet high in fruit and vegetables may be more effective than large doses of a small number of micronutrients, and therefore that intervention studies that use single micronutrient supplements are unlikely to produce a lowering of disease risk. Studies concentrating on whole foods (e.g. fruit and vegetables) or diet pattern (e.g. Mediterranean diet pattern) may be more effective in demonstrating an effect on clinical end points. The present review will consider the clinical trial evidence for a beneficial effect of micronutrient supplements on health, and review the alternative approaches to the study of dietary intake of micronutrients.

Designing and evaluating an instructional exercise as a supplement to the Fluids & Electrolytes lecture

First year nursing students repeatedly have difficulty recalling, understanding, and applying knowledge from the Fluids & Electrolytes (F&E) class. Although the traditional teaching method of lecturing is appropriate in a situation of knowledge acquisition, this situation refers to a broader context. An alternate teaching method is needed to increase students' understanding of the previously acquired knowledge and its application. This research concerns gaming as a tool for teaching with the focus on process as well as product. An instructional exercise, in the Jeopardy format, is designed to incorporate understanding (through problem-solving), group collaboration, and metacognition. Constructivist philosophy is combined with Instructional Design to construct an exercise that focuses not only on knowledge recall, but also emphasizes thinking, understanding, and the reflective nature of the exercise. The focus of this research is to design and evaluate an exercise as a supplemental teaching method to the lecture presentation of the F&E class.