STUDY UNIT 1: RESEARCH METHODOLOGY

OUTCOMES:
✓ Motivate the necessity of knowledge of research methods for all members of the health profession
✓ Explain the concept evidence-based/informed nutrition and to motivate same in the context of the health
profession
✓ Implement the various steps that must be taken in order to base nutrition scientifically and to apply these to a
practical case in point

Term Definition
Science of nutrition The study of nutrients & other substances in foods and the body’s handling
of them
Research Systematic search that leads to new knowledge; open for inputs/criticism by
others.
Nutritional The science of how nutrients affect the activities of genes and how genes
genomics affect the interactions between diet and disease
Anecdote A personal account of an experience or event; not reliable scientific info
Blind experiment an experiment in which the subjects do not know whether they are
members of the experimental group of the control group
Control group Group of individuals similar in all possible respects to the experimental group
except for the treatment. Control group receives placebo: experimental
group receives a real treatment.
Correlation The simultaneous increase, decreases or change in two variables. E.g. if A
increases as B increases or if A decreases as B decreases, the correlation is
positive (doesn’t mean that A causes B) or vice versa) If A increases.
Double blind An experiment in which neither the subjects nor the researcher know which
experiment subjects are members of the experimental group and which are serving as
control subjects, until after the experiment is over.
Experimental A group of individuals similar in all possible respects to the control group
group except for the treatment
Hypothesis An unproven statement that tentatively explains the relationships between
2< variables

Peer review A process in which a panel of scientists rigorously evaluates a research study
to ensure that the scientific method was followed
Placebo An inert, harmless medication given to provide comfort and hope; a sham
treatment used in controlled research studies
A change that occurs in response to expectations about the effectiveness
Placebo effect of a treatment that actually has no pharmaceutical effects

Randomization The process of choosing members of the experimental & control groups
without bias
Replication Repeating an experiment and getting the same results
Subjects The people or animals participating in research project
Theory A tentative explanation that integrates many and diverse findings to further
the understanding of a defined topic
Validity having the quality of being founded on fact of evidence
Variables Factors that change. A variable may depend on a second variable.
Sometimes both variables correlate with a third variable
Research methods: The systematic procedures, techniques, and approaches used to conduct
research, gather data, and analyze information in order to answer research questions and
achieve research objectives.

Valid conclusions: Conclusions that are logically and factually supported by evidence
obtained through rigorous research methods. Valid conclusions are reliable, accurate, and
based on sound reasoning.

Scientific method: A systematic approach to conducting scientific research, involving

observation, formulation of hypotheses, experimentation, data collection, analysis, and
drawing conclusions. It is a structured and logical process used to investigate phenomena and
discover new knowledge.

Research paradigm: A framework or perspective that guides the researcher's approach to

conducting research, including their beliefs, assumptions, and methodologies. It sets the
overall direction and principles that shape the research design and data collection methods.

Biomedical research: Research that focuses on studying health and diseases in relation to
human biology and medical interventions. It involves investigating biological, physiological,
and clinical aspects to understand, prevent, diagnose, and treat diseases.

Ethical guidelines: Principles and standards that provide guidance on conducting research in
an ethical manner, ensuring the protection of participants' rights, privacy, and well-being.
Ethical guidelines promote integrity, fairness, and respect in research involving human subjects.

Translational research: Research that aims to bridge the gap between scientific discoveries
(basic research) and their practical application in improving health outcomes. It involves
transferring knowledge from the laboratory or clinical setting to real-world settings and
population-based interventions.

Basic research: Research conducted to expand knowledge, understand fundamental

concepts, and explore theories without immediate practical application. It aims to increase
scientific understanding and often takes place in controlled laboratory settings.

Applied research: Research focused on addressing specific practical problems, developing

solutions, and providing practical applications in real-world settings. Applied research aims to
solve practical challenges and directly impact practices, policies, or interventions.

Research continuum: The spectrum or range of research activities, from basic research to
applied research. It represents the various stages and approaches within the research process,
allowing for the integration of knowledge from different research types.

Systematic process: A well-structured and organized approach to conducting research,

following a series of steps or stages in a logical and sequential manner. It ensures consistency,
accuracy, and reliability in research activities.

Research question: A clear and concise question that defines the objective of a research study
and guides the research process. It focuses on the specific aspect to be investigated and
provides a framework for data collection and analysis.

Feasible: Refers to the practicality and achievability of a research study or project. Feasibility
considers factors such as available resources, time constraints, ethical considerations, and the
likelihood of successfully completing the research within given constraints.

Preparatory phase: The initial stage of the research process, where the research problem is
identified and defined, literature is reviewed, and the research question is formulated. It
involves planning, organizing, and setting the foundation for the research study.
Research problem: A specific issue, challenge, or gap in knowledge that motivates the
research study. The research problem provides the focus and context for the research question
and guides the overall research process.

Literature study: A comprehensive review and analysis of existing published literature and
research studies related to the research topic. It provides an overview of the current
knowledge, identifies gaps, and informs the theoretical framework and research design.

Planning phase: The stage of research where the study design, methodology, and data
collection procedures are determined. It involves making decisions on sampling, data
collection tools, and data analysis techniques.

Research proposal or protocol: A detailed document outlining the objectives, methods, and
plan for conducting a research study. It describes the research question, study design,
participant selection, data collection methods, and ethical considerations.

Execution phase: The stage of research where the research plan is implemented, data is
collected, and interventions or experiments are carried out. It involves following the research
protocol and ensuring adherence to ethical guidelines.

Data collection: The process of gathering information and data relevant to the research study.
It can involve surveys, interviews, observations, measurements, or experiments, depending on
the research design and objectives.

Analytical phase: The stage of research where collected data is analyzed, interpreted, and
evaluated using appropriate statistical or qualitative analysis methods. It involves drawing
conclusions and making inferences based on the data.

Reporting phase: The final stage of the research process, where the findings, conclusions, and
implications of the study are communicated. This can include writing research reports,
publishing scientific papers, presenting at conferences, or sharing information with relevant
stakeholders

Scientific journals: Periodicals or publications that disseminate research findings and scholarly
articles in various fields of study. They undergo a peer-review process to ensure the quality and
validity of the research presented.

Evidence-based practice: The integration of the best available research evidence, clinical
expertise, and patient values and preferences in making informed decisions about healthcare
or professional practice. It emphasizes the use of research findings to guide decision-making
and improve outcomes.

Supervisor: A knowledgeable and experienced individual who provides guidance,

mentorship, and support to researchers or students throughout their research projects.
Supervisors play a crucial role in ensuring research projects are conducted effectively and
ethically.

Ethical approval: The formal approval obtained from an ethical review board or committee
before commencing a research study involving human subjects. Ethical approval ensures that
the research adheres to ethical guidelines and protects the rights and well-being of
participants.

Literature review: A critical and systematic evaluation of existing literature and research studies
on a specific topic. It provides an overview of the current knowledge, identifies research gaps,
and informs the research question and methodology.
 What is research and what does it actually mean?

Re-search: to search again

Research= systematic search that leads to new knowledge; open for inputs/criticism by
others. The systematic investigation into and study of materials and sources in order to
establish facts and reach conclusions.

❖ Synonyms: investigation, experimentation, testing, analysis, fact-finding, fieldwork,

examination, scrutiny, experiment(s), experimentation, test(s), testing, inquiry/inquiries,
study/studies
❖ Verb: research; to investigate systematically
❖ Synonyms: investigate, study, inquire into, look into, probe, explore, analyze, examine,
scrutinize, review

“Research is formalized curiosity. It is poking and prying with a purpose.” (Zora Neale Hurston)
“A systematic means of problem solving” (Tuckman 1978)

What the experts say research is

➔ The term "research" refers to a class of activity designed to develop or contribute to
generalizable knowledge.
➔ Generalizable knowledge consists of theories, principles or relationships, or the
accumulation of information on which they are based, that can be corroborated by
accepted scientific methods of observation and inference.
➔ In the present context "research" includes both medical and behavioural studies
pertaining to human health.
➔ Usually "research" is modified by the adjective "biomedical" to indicate its relation to
health.
-CIOMS, International Ethical Guidelines for Biomedical Research Involving Human
Subjects, Geneva 2002, Preamble

What is medical/biomedical research’s goal?

➔ The primary purpose of medical research involving human subjects is to understand the
causes, development and effects of diseases and improve preventive, diagnostic and
therapeutic interventions (methods, procedures and treatments).

➔ Even the best current interventions must be evaluated continually through research for
their safety, effectiveness, efficiency, accessibility and quality.
- Declaration of Helsinki, 2008 par. 7

Nutrition research: From past to present

❖ Nutrition research has shifted focus from addressing micronutrient deficiencies to
addressing overnutrition.
❖ This shift is driven by changing dietary patterns, lifestyle changes, and the rise of diet-
related non-communicable diseases.
❖ Previous research focused on identifying and combating deficiencies in essential
micronutrients.
❖ Current research focuses on the excessive intake of nutrients and the associated health
risks of overnutrition.
❖ Modern nutrition research explores the complex relationship between diet, lifestyle,
genetics, and health outcomes
❖ It investigates the impact of various dietary factors, such as calorie intake, macronutrient
composition, and food quality.
❖ Researchers study the mechanisms through which overnutrition contributes to chronic
diseases.
❖ The emphasis is on a balanced diet, portion control, and the quality of food consumed.
 ❖ Factors like food marketing, accessibility to healthy options, and socio-economic factors
are considered.
❖ Personalized nutrition, individual variations, and gut microbiota are also areas of interest.
❖ The goal is to promote healthier dietary habits, prevent chronic diseases, and improve
overall well-being.

Reasons for diverse ideas / perceptions about research

Usually arises from the research paradigm shift phases, that there is a research continuum
and that research has certain phases

➔ Research has shown definite paradigm shifts from research should unlock the world of
ideas to research is done for the sake of research itself
➔ To research should have social/societal relevance/significance (current)
➔ It should have potential to generate or refine knowledge to influence the profession
➔ Solve a problem

Research Continuum
Research continuum: The spectrum or range of research activities, from basic research to
applied research. It represents the various stages and approaches within the research
process, allowing for the integration of knowledge from different research types.

Basic research and applied research can be thought of as two ends of a continuum

➔ Basic research = type of research that a have limited direct application, but in which the
researcher has careful control of the conditions
➔ Applied research = type of research that has direct value to practitioners, but in which
the researcher has limited control over the research setting
➔

Research continuum

BASIC APPLIED

1) Theoretical 1) Real life

2) More invasive 2) Less invasive
3) Laboratory based 3) Field based
4) Tightly controlled 4) Loosely controlled
5) Lacks external validity 5) Externally valid
6) Focus on mechanism 6) Focus on effect
7) More reductionist 7) Less reductionist
 Translation of research

Translational research: Research that aims to bridge the gap between scientific discoveries
(basic research) and their practical application in improving health outcomes. It involves
transferring knowledge from the laboratory or clinical setting to real-world settings and
population-based interventions.

Translational research aims= to translate (convert) results in basic research into results that
directly benefit humans.
• Bench to bed
• Molecules to society

Translational research Is separated into four segments:

1. T1 is the translation of basic science into clinical research (phase 1 and 2 clinical trials)
2. T2 the further research that establishes relevance to patients(phase 3 trials)
3. T3 is translation into clinical practice
4. T4 is the movement of scientific knowledge into the public sector.
 The scientific method/process
Scientific method: A systematic approach to conducting scientific research, involving
observation, formulation of hypotheses, experimentation, data collection, analysis, and
drawing conclusions. It is a structured and logical process used to investigate phenomena
and discover new knowledge.

✓ Research is different than other forms of discovering knowledge (like reading a book)
because it uses a systematic process called the Scientific Method
✓ Many research process models – same basic principles
✓ Hypothesis = the anticipated outcome of a study or experiment

Scientific method of problem solving = method of solving problems that uses the following steps:

1. Defining and delimiting the problem

2. Forming a hypothesis
3. Gathering data
4. Analysing data
5. Interpreting the results

FINER = feasible, interesting, novel, ethical, and relevant

The FINER* mnemonic is a framework used for formulating research questions.

FINER allows researchers to ponder the philosophical, logical, and scientific implications
of writing research questions
 The research process: (15 marks)
1. Preparation
2. Planning
3. Execution
4. Analysis
5. Reporting

1. Preparatory phase:
1) The initial stage of the research process, where the research problem is identified and
defined, literature is reviewed, and the research question is formulated.
2) It involves planning, organizing, and setting the foundation for the research study.
3) Problem/research question
1. Identification and delimination of a problem
2. Research problem = “situation in need of a solution, improvement or alteration”
3. Major source of research problem is practice/real world situation.
4. Other sources are literature study, theory, research priorities or a broad problem area of interest.
5. The research problem should be integrated within the existing theoretical framework
6. Research question should initiate and give direction to the research process
4) Assemble research team
5) Do a thorough literature search, review, and write about relevant literature

2. Planning phase:
1) The stage of research where the study design, methodology, and data collection
procedures are determined.
2) It involves making decisions on sampling, data collection tools, and data analysis
techniques.
3) Design research to answer research question and to test the hypotheses
4) Develop a research proposal or protocol (“recipe”): What, how, who, when, with what?

3. Execution phase:
1) The stage of research where the research plan is implemented, data is collected, and
interventions or experiments are carried out.
2) It involves following the research protocol and ensuring adherence to ethical
guidelines.
3) Selecting, describing, testing, and treating/observing the participants

4. Analytical phase:
1) The stage of research where collected data is analyzed, interpreted, and evaluated
using appropriate statistical or qualitative analysis methods.
2) It involves drawing conclusions and making inferences based on the data.
3) Analyze results using statistics

5. Reporting phase:
1) The final stage of the research process, where the findings, conclusions, and
implications of the study are communicated.
2) This can include writing research reports, publishing scientific papers, presenting at
conferences, or sharing information with relevant stakeholders
3) Discussing the meaning and implication of the findings
4) Congress presentations and publications to other researchers, health profession, government,
providers of funding, media, industry, public.
Preparational phase Problem/research question
7. Identification and delimination of a problem
8. Research problem = “situation in need of a solution, improvement or alteration”
9. Major source of research problem is practice/real world situation.
10. Other sources are literature study, theory, research priorities or a broad problem
area of interest.
11. The research problem should be integrated within the existing theoretical
framework
12. Research question should initiate and give direction to the research process
Assemble research team
Do a thorough literature search, review, and write about relevant literature

Planning phase ➔ Design research to answer research question and to test the hypotheses
➔ Develop a research proposal or protocol (“recipe”): What, how, who, when, with
what? (Ehrlich & Joubert, 2014 Tabel 4.1)

Execution phase: Selecting, describing, testing, and

collect treating/observing the participants
information (data)
Analytical phase Analyse results using statistics

Reporting phase ➔ Discussing the meaning and implication of the findings

➔ Congress presentations and publications to other researchers, health profession,
government, providers of funding, media, industry, public.
➔ Research publications – “peer reviewed”
6) Research publications – “peer reviewed
7) This can include writing research reports, publishing scientific papers, presenting at
conferences, or sharing information with relevant stakeholders
8) Discussing the meaning and implication of the findings
9) Congress presentations and publications to other researchers, health profession, government,
providers of funding, media, industry, public.
10) Research publications – “peer reviewed”

Characteristics of research process

5 key characteristics
1. Systematic – research process
2. Logical – induction/deduction
3. Empirical – evidence based
4. Reductive – generalisation
5. Replicable – methodology

Why the fuss about research?

Research is a knowledge creator

1. Without research there will be no new knowledge to develop societies, to expand the
economy and to improve people’s daily lives including health
Research is a problem solver
2. In a complex society with daring challenges research can solve problems and provide
solutions to challenges
Research is a skills developer
3. Through research people can get hands-on (acquired) skills that can enable them to
address challenges associated with the quality of life

Why is knowledge and insight regarding research methods for members of the
health profession, public health and legislature essential?
✓ Research can solve health/nutrition problems
✓ So that existing research can be interpreted
✓ New good quality research can be done
Transcript of session 1
Slide 1:
Welcome to NUTR321, where you will learn how to critically evaluate information and make the best
recommendations based on available evidence. To draw valid conclusions and provide the best
recommendations on nutrition-related matters, it is essential to understand research methods. This
module will prepare you for nutrition and dietetic practice.
Slide 2:
In this introduction to the module, I will begin by introducing myself as the module owner and the
assistant of NUTR321. I will then provide an overview of the world of research, defining what research is
and addressing common perceptions surrounding it. We will explore the scientific method and its
processes. Additionally, we will discuss why research matters in general, as well as its significance for
dietitians. Finally, I will conclude the module introduction by outlining what you can expect from
NUTR321 and sharing other important information about the module.
Slide 3:
I am Prof. C Nienaber-Rousseau, the module owner and presenter of NUTR321. The module's assistant is
Marlize Erasmus, a post-graduate student who is well-versed in the module's content and will handle
administrative tasks. We are also eager to get to know you better, so please upload a face and shoulder
photo of yourself to your eFundi profile.
Slide 4:
To foster further engagement, I would like you to form groups of three. Each group will have six minutes
to write down three synonyms on three red sticky notes respectively, and three perceptions (positive or
negative) you have for/of research on three blue sticky notes respectively. Make sure to write clearly
and prominently.
Slide 5:
I am going to give two groups the opportunity to share three synonyms of research to test prior
knowledge of the definition of research.
In a previous group, I provided two groups with the opportunity to share the synonyms they had come
up with to test their prior knowledge of the definition of research. The assistant then recorded the red
sticky notes with the synonyms, eliminated repetitions, and displayed them on the whiteboard. In the
next slide, you will see the photograph we took of the synonyms.
Slide 6:
Here are some noun synonyms: investigation, testing, analysis, fact-finding, fieldwork, examination,
scrutiny, experiment(s), experimentation, test(s), testing, inquiry/inquiries, study/studies and some
verb synonyms: investigate (knowledge investigation), study, (critical) inquire into, look into, probe,
explore, analyse (analysis of facts and data), examine, scrutinise, review
Slide 7:
According to some humorous interpretations, research is often depicted as "searching" again. On a
more serious note, research can be defined as formalised curiosity—an organised method of problem-
solving that leads to new knowledge open to input and criticism from others. Online dictionaries define
research as the systematic investigation and study of materials and sources to establish facts and draw
conclusions.
Slide 8:
Referring to the CIOMS International Ethical Guidelines for Biomedical Research involving Humans,
research refers to a class of activities designed to contribute to generalisable knowledge. Generalisable
knowledge encompasses theories, principles, relationships, or the accumulation of information that can
be confirmed through accepted scientific methods of observation and conclusion.
Slide 9:
We have now defined research in its broad features, but let's look at medical or biomedical research
related to health.
According to CIOMS, medical or biomedical "research" includes both medical and behavioural studies
related to human health.
Slide 10:
Medical or biomedical research related to health, as defined by CIOMS, includes both medical and
behavioural studies pertaining to human health. The primary purpose of medical research involving
people, according to the Declaration of Helsinki, is to understand the causes, development, and
consequences of illness, as well as to improve preventive, diagnostic, and therapeutic interventions.
Continuous evaluation of existing interventions is essential in terms of safety, efficiency, effectiveness,
accessibility, and quality.
Slide 11:
Some important examples of medical epidemiological research throughout history include:

In 1747, James Lind, a British surgeon, demonstrated the effectiveness of citrus in treating sailors with
scurvy.
In 1854, John Snow, a British doctor, identified that most cases of cholera occurred in London among
people who drank water from a pump in Broad Street. He persuaded authorities to remove the pump's
handle, effectively stopping the epidemic.
Florence Nightingale contributed to the importance of hygiene in hospitals by utilising statistical data.
Slide 12 and 13:
Nutrition research: From past to present
Early Focus: Micronutrient Deficiencies

Historically, nutrition research primarily focused on identifying and addressing micronutrient deficiencies.
Efforts were aimed at combating deficiencies in essential vitamins, minerals, and other nutrients.
Key areas of research included understanding nutrient requirements, identifying deficiency diseases,
and developing interventions.

Expansion of Research Scope

Over time, the scope of nutrition research expanded to include broader aspects of diet and health.
Researchers began investigating the impact of macronutrients (carbohydrates, proteins, and fats) on
health outcomes.
The relationship between dietary patterns, lifestyle factors, and chronic diseases started gaining
attention.

Shifting Priorities: Overnutrition and Chronic Diseases

In recent decades, there has been a significant shift towards addressing the rise of overnutrition and
associated chronic diseases.
Overnutrition refers to excessive intake of calories and imbalanced diets leading to obesity and related
health issues.
Research now focuses on understanding the causes, mechanisms, and prevention of obesity and diet-
related diseases.

Holistic Approach: Diet, Lifestyle, and Genetics

Modern nutrition research takes a holistic approach, considering the interplay between diet, lifestyle
factors, and genetic factors.
It investigates the influence of genetics, gut microbiota, and individual variations on nutrient metabolism
and health outcomes.
Personalised nutrition, tailored to individual needs and characteristics, is an emerging field of research.

Prevention and Health Promotion

Nutrition research now places greater emphasis on disease prevention and health promotion.
The focus is on identifying dietary patterns, specific foods, and nutrients that can reduce the risk of
chronic diseases.
Research explores the benefits of functional foods, plant-based diets, and other approaches for
promoting overall well-being.
Integration of Technology and Data Analysis

Advanced technology and data analysis methods are revolutionising nutrition research.
Techniques such as nutrigenomics, metabolomics, and wearable devices are used to gather precise
data and personalise recommendations.
Big data analytics and artificial intelligence are employed to analyse large datasets and uncover
complex associations.

Global and Environmental Perspectives

Nutrition research increasingly recognises the global and environmental aspects of food systems and
sustainability.
Studies explore the impact of food production, distribution, and consumption on environmental
resources and climate change.
The importance of addressing malnutrition and food insecurity in various regions and populations is a
prominent research focus.
In summary, nutrition research has evolved from addressing micronutrient deficiencies to encompassing
a wide range of factors influencing diet, health, and disease. The current focus is on combating
overnutrition, promoting preventive approaches, and embracing personalised nutrition, while
considering genetic, environmental, and societal influences.
Slide 14:
As with group discussion A (definitions), last year I also gave two groups the opportunity for discussion B
(perceptions) to share their perceptions of research with the rest of the class.
The assistant then recorded the blue sticky notes with the perceptions written on them, removed the
repetitions and grouped the notes pasted on the whiteboard according to positive, neutral and
negative perceptions. In the next 3 slide you can see the photos we took of the perceptions.
Slide 15:
In 2019, 36% of the perceptions of research were positive.
Slide 16:
In 2019, 9% of the perceptions of research were neutral.
Slide 17:
In 2019, 55% of the perceptions of research were negative.
Slide 18:
People's perceptions regarding research can differ due to several factors. Here are a few reasons for the
variation in perceptions:
Background and Education: People with different educational backgrounds may have varying levels of
exposure to research methodologies and scientific principles. Those with a strong research background
may have a more positive perception and understanding of the value of research, while others may
have limited exposure or may hold misconceptions.
Personal Beliefs and Values: Personal beliefs and values can shape one's perception of research.
Individuals with strong convictions or preconceived notions may approach research findings with
scepticism or bias, especially if they contradict their existing beliefs. Confirmation bias, the tendency to
favour information that aligns with pre-existing beliefs, can influence how research is interpreted and
accepted.
Media Influence: Media plays a significant role in shaping public perception of research. Depending on
the media source and its biases, research findings can be presented with varying degrees of accuracy,
sensationalism, or oversimplification. Misinterpretation or misrepresentation of research in the media can
lead to confusion and conflicting perceptions.
Trust in Science and Institutions: Trust in the scientific community and research institutions can impact
how research is perceived. Individuals who have trust in the integrity and transparency of the research
process are more likely to view research findings positively. On the other hand, distrust or scepticism
towards scientific institutions can lead to questioning or dismissing research findings.
Cultural and Societal Factors: Cultural and societal factors can influence how research is perceived
within a community or society. Cultural norms, traditions, and values can shape attitudes towards
research. Additionally, societal factors such as political climate, economic interests, or prevailing
ideologies can impact how research findings are received and accepted.
Complexity and Accessibility of Research: Research findings can be complex and technical, making
them challenging for the general public to understand fully. The accessibility of research information,
including open access to publications and clear dissemination of findings, can affect perceptions. Lack
of access or difficulties in comprehending research may lead to limited engagement or scepticism.
It's important to recognise that differing perceptions of research are natural and can contribute to
constructive dialogue and critical thinking. Promoting science communication, improving accessibility to
research information, and fostering a culture of open-mindedness and evidence-based decision-making
can help bridge the gaps in perceptions and promote a more informed understanding of research.

Diverse ideas and perceptions about research often arise due to the different phases of the research
paradigm shift and the understanding that research operates along a continuum. Research also follows
specific phases, which can influence perceptions.
Slide 19:
In the past, research was believed to be an open exploration of ideas. Later, it was seen as an end in
itself, to be done purely for the sake of research. However, current understanding emphasises that
research should have a purpose. It should be relevant and generate knowledge that is useful in
professions or addresses real-world problems. Many negative perceptions about research stem from the
early phases of the research paradigm.
Slide 20:
Research typically occurs along a continuum, with basic research and applied research representing
two ends of this spectrum. Basic research has limited direct application but provides researchers with
control over the conditions. Applied research, on the other hand, has direct value for practitioners but
researchers have limited control over the research environment.
Slide 21:
In this slide, I highlighted the differences between basic and applied research in a table format. Basic
research addresses theoretical problems, often in laboratory conditions. Applied research, on the other
hand, focuses on immediate problems in real-world conditions and is closely linked to practical
applications. It is important to recognise that both types of research have their place and can
complement each other, shaping perceptions about research.
Slide 22:
Lab bench to the patient bed
Molecules to society
Translational research aims to convert the findings of basic research into results that directly benefit
people. It involves translating knowledge from one end of the continuum (basic research) to the other.
Translational research is divided into four segments: T1, T2, T3, and T4. T1 involves the translation of basic
science into clinical research (phase 1 and 2 clinical trials). T2 focuses on further research to determine
relevance for patients (phase 3 trials). T3 centers around translation into clinical practice, while T4
involves the movement of scientific knowledge into the public sector.
Slide 23:
Research is distinct from other forms of knowledge discovery, such as reading a book, because it follows
a systematic process called the scientific method. There are various research process models with similar
fundamentals. These processes, also known as phases, can be influenced by individual researchers'
talents or skill levels. The knowledge of different research phases can shape outsiders' perceptions of
research.
Slide 24:
The scientific method typically involves defining a problem and forming a hypothesis after studying
existing evidence. This is followed by data collection, analysis, and interpretation. The process can be
divided into five main phases.
Slide 25:
These phases include preparation, planning, execution, analysis, and reporting.
Slide 26:
During the preparatory phase, it is crucial to identify and demarcate the research problem or question.
A research problem represents a situation that requires a solution, improvement, or change. Research
problems can emerge from real-world situations, literature study, theory, research priorities, or broad
problem areas. It is essential to integrate the research problem within the existing theoretical framework
and ensure the research question provides direction for the entire research process.
Slide 27:
The research question should be feasible, interesting, novel, ethical, and relevant. The acronym "Finer"
can be used as a framework to formulate questions, helping researchers consider the philosophical,
logical, and scientific implications of their research questions or evaluate existing research. In Study Unit
2, we will divide you into groups and provide research questions to choose from, which you can then
further refine.
Slide 28:
While defining the research question, it is beneficial to assemble a research team and conduct a
thorough literature search. The research team can aid in demarcating the question or problem,
conducting the literature review, and writing the literature study during the preparatory phase. In Study
Unit 2, we will learn how to conduct a literature study and begin writing it in groups.
Slide 29:
After adequate preparation, the planning phase of the study can commence. The study should be
designed to answer the research question and test hypotheses. This planning process can precede the
writing of the protocol or occur simultaneously with the development of the research proposal. In Study
Unit 8, we will delve into the protocol in detail and begin compiling one that provides the recipe of
what, how, who, when, and with what of a study aimed at answering our research question.
Slide 30:
The table on this slide, taken from Ehrlich & Joubert's "Epidemiology: a research manual for South Africa,"
presents the main headings of a protocol or proposal.

Slide 31:
After thorough preparation and planning, the execution phase of the study can commence. This phase
involves selecting participants, conducting tests and/or treatments, and collecting data through
observation. Once the execution phase is completed, the analytical phase begins, wherein data is
processed and analysed using statistical methods. In Study Unit 6, we will master basic statistical tests
that will enable us to analyse our own data in NUTR471.
Slide 32:
Research and breakthrough discoveries need to be communicated to the world. During the reporting
phase, we discuss the meaning and implications of our findings. Research results can be disseminated
through conference presentations and publications. Research articles are often published in peer-
reviewed scientific journals to reach other researchers, but sometimes they can also be shared through
mainstream media or social media to reach a wider audience.
Slide 33:
From these processes or phases, it becomes clear that research possesses five key characteristics:
systematic, logical, empirical, reductive, and replicable.
Slide 34:
Now, let's discuss in your groups of three why research is important in general and why it holds particular
significance for dietitians. Write down three reasons why you believe research is important and evaluate
them based on the aspects that I will discuss in the following slides.
Slide 35:
Research is a knowledge creator. Without research, there would be no new knowledge to advance
societies, expand the economy, and improve people's daily lives, including their health.
Slide 36:
Research is a problem solver. In our complex society with various challenges, research has the capacity
to solve problems and provide solutions to these challenges.
Research is a skills developer
through research people can get hands-on (acquired) skills that can enable them to address
challenges associated with the quality of life
Slide 37:
Research is central to dietetics training because it underpins the growth of the profession, supports
evidence-based dietetic practice, and helps maintain our credibility. Research is essential for evidence-
based medical care and nutrition. In Study Unit 2, I will provide more insights into evidence-based
medicine.
Slide 38:
Now, engage in group discussions to explore why knowledge and insight into research methods are
crucial for members of the health profession, public health, and legislators.
Slide 39:
Here are some reasons mentioned by students in the previous year.
Research is essential in various fields, including nutrition and dietetics, due to its overarching importance
in generating new knowledge, solving problems, and improving practices. Here are some reasons why
research is important in general and why it holds particular significance for dietitians:

Advancing knowledge: Research contributes to the expansion of knowledge in various areas. It helps us
understand the underlying mechanisms, causes, and effects related to nutrition and dietetics. Through
research, new discoveries and insights emerge, allowing professionals to stay updated with the latest
information and make evidence-based decisions.

Evidence-based practice: Research plays a vital role in establishing evidence-based practices. It

provides dietitians with the scientific foundation necessary to make informed decisions when designing
nutrition interventions, developing dietary guidelines, or providing recommendations to patients.
Evidence-based practice ensures that dietitians are utilising the most effective and reliable methods to
promote health and manage nutrition-related conditions.

Improving patient outcomes: By conducting research, dietitians can identify the most effective
approaches to improve patient outcomes. They can evaluate the efficacy of specific dietary
interventions, explore the impact of nutritional factors on various health conditions, and determine the
best strategies for disease prevention and management. Research allows dietitians to provide tailored
and evidence-based recommendations to optimise patient health and well-being.

Addressing nutritional challenges: Research helps dietitians tackle the complex challenges associated
with nutrition. It enables them to investigate the relationship between diet and health outcomes, identify
nutritional deficiencies or excesses in certain populations, and develop strategies to address these issues.
Research also plays a role in exploring the social, economic, and cultural factors that influence dietary
behaviors, allowing dietitians to design interventions that are effective and culturally sensitive.

Enhancing professional credibility: Engaging in research enhances the credibility and professional
standing of dietitians. Being knowledgeable about research methods and staying up-to-date with
current scientific literature allows dietitians to critically evaluate research studies and apply the findings
to their practice. By actively participating in research activities, dietitians contribute to the
advancement of the field and establish themselves as trusted professionals who are committed to
evidence-based practice.

Guiding policy and practice: Research provides the foundation for developing dietary guidelines, health
policies, and public health initiatives. Dietitians who are actively involved in research can contribute
valuable insights and data-driven recommendations to guide policy decisions. Their expertise and
research findings can influence public health strategies, nutritional guidelines, and regulations, ultimately
shaping the larger landscape of nutrition and dietetics.

In summary, research is crucial in general for expanding knowledge, promoting evidence-based

practice, and improving outcomes across various fields. For dietitians specifically, research plays a vital
role in informing their practice, improving patient outcomes, addressing nutritional challenges,
enhancing professional credibility, and guiding policy and practice. By actively engaging in research,
dietitians can contribute to the advancement of their field and make meaningful contributions to the
health and well-being of individuals and communities.

Slide 40:
With our improved understanding of what research is, its different aspects, and why it is important for
dietitians, we can better appreciate the presence of two research modules in your curriculum. Take a
moment to review the infographic of NUTR321 and NUTR471 to gain an understanding of what these
modules entail.
Slide 41:
In NUTR321, you will be taught the theory of research and begin applying it practically in preparation for
NUTR471. By the end of NUTR321 and 471, you will need to apply the different steps of the research
process. In NUTR471, you will write a protocol, orally present it, conduct your own study within the
NutritionStat study, and write up the study as a research report.
Slide 42:
To successfully complete these modules, you will need a skilled supervisor to guide you. The supervisor
will help you identify a line of inquiry, define the scope of your project, and provide guidance for its
successful completion. You will be divided into groups of three and assigned a topic and study leader.
Communication with the supervisor will primarily be conducted electronically.
Slide 43:
Here are some important details about NUTR321:

An interactive study guide is available on eFundi, providing the study material accompanying the
prescribed textbook.
All contact sessions per week are set for online learning activities, and you may require additional time
to successfully complete these activities.
Study Unit 7 includes an online internationally recognised TRREE course. Completing this course
successfully will earn you certificates that you must keep safe, as they will be needed in NUTR471 when
applying for ethical approval for your projects. The marks obtained in this course will also contribute to
your participation mark.
Appointments with your supervisors, not listed on the program or schedule, will be arranged to suit the
group and the supervisor. The same supervisor will guide you as far as possible in both NUTR321 and
NUTR471, assisting with writing literature reviews and completing the protocol assignment.
Slide 44:
To summarise what we have covered in this session:

We have defined research and explored perceptions about it, considering the research paradigm,
continuum, and process.
We have discussed the importance of research in general and specifically for dietitians.
Lastly, we have provided an overview of the expectations for NUTR321 and NUTR471, allowing you to
gain insights into the study units through the provided infographic. Take a few minutes to reflect on
whether the lecture has influenced or deepened your perception of research. Remember to complete
the reflection exercise at the end of the study unit on eFundi and evaluate your attainment of the study
unit's outcomes.
Slide 45:
Now, it's time to dive into NUTR and begin your learning journey. Please ensure you upload a face and
shoulder photo of yourself to your eFundi profile. Revise Chapter 1, Section 1.3, "The Science of Nutrition,"
from the W&R textbook that you covered in NUTB112. Study the IFIC report available on the eFundi
interactive guide. Evaluate the extent to which you have achieved the outcomes for Study Unit 1. When
you feel ready, you can proceed with the assessment for Study Unit 1. Good luck!
Controls
In studies, researchers divide the subjects into 2 groups:
1) Experimental group
2) Control group

➢ This is done by randomization, which Helps to:

1. Eliminate bias
2. Ensures that the 2 groups are equal and that
3. Observed differences reflect the treatment and no other factors

➢ The 2 groups of people must be similar

Sample size
Groups must be large to make sure the chance in variation between the groups doesn’t
influence the results

Placebos
➔ Taking pills to be beneficial may shorten the duration and lessen the severity of illness
regardless of whether the pills contain active ingredients
➔ This mind-body effect must be rigorously controlled
➔ People who believe they are receiving treatment may report less severe symptoms
➔ to control the placebo effect each participant receives a pills, a group receives the pills
with the active ingredient and the other receives palcebos, so that the expectation of
both groups are equal
➔ A study conducted under these conditions = blind experiment

Double blind
➔ Subjects and researcher don’t know which subjects are in which group
➔ This prevents researcher from recording and interpreting results with a bias in a expected
direction
➔ Pills are therefore coded by a third party

Analyzing research findings

Correlation and Causes:

➔ Researches must be able to observe, measure or verify the variable selected
➔ Examine the relationship between 2 variables:
1. No correlation
2. Positive correlation
3. Negative correlation
➔ Correlation evidence proves only that variable are associated, not that one is the cause
of another

Cautious Conclusions:
➔ Caution in interpretation of the findings
➔ Caution in applying animal finding to human beings
 Parts of a research article

1. Abstract: provides a brief overview of the article

2. Introduction: clearly states the purpose of the current study & provides a comprehensive review
of the relevant literature
3. Methodology: defines key terms & describes the study design, subjects and procedures used in
conducting the study
4. Results: report finding and may include tables & figures that summarize the information
5. Discussion: draws tentative conclusions that are supported by the data and reflect original
purpose as stated in the introduction. It answers a few questions and raises several more
6. References: reflect the investigator’s knowledge of the subject and should include an extensive
list of relevant studies

Publishing Research
➔ The findings of a study are peer reviewed
➔ Reviewers critique the study’s hypothesis, methodology, statistical significance and
conclusions
➔ They also note the funding source; financial support my bias scientific conclusions
➔ If research has validity it is endorsed for publication in a scientific journal
➔ when a new finding is published it is still only preliminary
➔ Other scientists need to confirm or disprove the findings through replication
➔ To be accepted, a finding must stand up to rigorous testing in experiments performed by
several different researchers

Research process
Preparational phase Problem/research question
13. Identification and delimination of a problem
14. Research problem = “situation in need of a solution, improvement or alteration”
15. Major source of research problem is practice/real world situation.
16. Other sources are literature study, theory, research priorities or a broad problem
area of interest.
17. The research problem should be integrated within the existing theoretical
framework
18. Research question should initiate and give direction to the research process
Assemble research team
Do a thorough literature search, review, and write about relevant literature

Planning phase ➔ Design research to answer research question and to test the hypotheses
➔ Develop a research proposal or protocol (“recipe”): What, how, who, when, with
what? (Ehrlich & Joubert, 2014 Tabel 4.1)

Execution phase: Selecting, describing, testing, and

collect treating/observing the participants
information (data)
Analytical phase Analyse results using statistics

Reporting phase ➔ Discussing the meaning and implication of the findings

➔ Congress presentations and publications to other researchers, health profession,
government, providers of funding, media, industry, public.
➔ Research publications – “peer reviewed”
 2.1 Evidence based or informed nutrition
Introduction:
➔ Nutrition – science that is growing at an enormous rate
➔ Members of the health profession confronted with new and old diets (e.g. Atkins diet),
dietary supplements, foods with health claims, new diseases
➔ As a result of internet, public better informed
➔ Nutrition in the News:
-Can be misleading and contradictory – read IFIC
-May report scientific findings prematurely before enough research was conducted
➔ How do we provide the public and clients with the correct information?
➔ Stay up to date with the latest information/ research by acquiring scientific literature, to
read, to critically evaluate
➔ Knowledge regarding research methods is therefore essential
➔ “Evidence-based/informed nutrition” – Scientifically based nutrition

What is evidence?
Evidence=“ findings from research and other knowledge that may serve as a useful basis for
decision making in public health and health care. ”

Evidence

Scientific Colloquial or
indigenous

Context-free: Context-specific:
Universal truth of What works and how
what works in specific
circumstances

Level of evidence pyramid

The strongest type of evidence:

1. Meta-analyses
2. Systematic reviews
3. Randomised, placebo- controlled studies

Weaker type of evidence:

4. Case-control studies
“Level of evidence”
▪ Cochrane library
▪ Cochrane collaboration is the best- known organisation that conducts systematic
reviews/meta-analysis
▪ Named in honor of Prof Archibald Cochrane, a British researcher who wrote in 1979: “It is
surely a great criticism of our profession that we have not organised critical summaries, by
specialty or subspecialty, adapted periodically, of all relevant randomised controlled
trials”

Introduction to evidence/science based/informed medical care

➔ Only reading evidence such as research articles is not enough

➔ We must apply the evidence and translate it

Evidence based medicine is:

1. The conscientious, explicit and judicious use of current best evidence in making decisions
about the care of individual patients – David Sackett et al. (1996)
2. A set of principles and methods intended to ensure that to the greatest extent possible,
medical decisions, guidelines and other types of policies are based on and consistent
with good evidence of effectiveness and benefit - Eddy (2005)
3. The gold standard of clinical practice, but also of giving advice to individuals and
communities

What is evidence- based/informed nutrition?

The improvement/optimisation of the traditional skills of a nutrition scientist in the prevention

and treatment of nutrition-related conditions by the systematic use of the best available
scientific evidence, including the application of mathematic estimations of probability and
risk, in decision making about the treatment of individual patients, communities and
populations
Steps in the “evidence- based/informed” approach

1. Frame a clear, focused, answerable question

➢ translation of uncertainty to an answerable question and includes critical

questioning, study design and levels of evidence
➢ Define population, intervention, comparison intervention, outcomes, time and/or
setting in the question (PICOT)

2. Collect all relevant scientific evidence – systematically structured search strategy

3. Critically evaluate literature and appraise evidence for internal validity that can be
broken down into aspects regarding:

➢ Systematic errors as a result of selection bias, information bias and confounding

➢ Quantitative aspects of diagnosis and treatment
➢ The effect size and aspects regarding its precision
➢ Clinical importance of results
➢ External validity or generalisability

4. Interpret results – draw a conclusion, what does it mean and what is the impact thereof?
➢ Summarise the evidence in “evidence tables” to make conclusion from
➢ Categorise treatment as (1) likely to be beneficial, (2) likely to be harmful, or (3)
evidence did not support either benefit or harm
➢ OR recommended further research
➢ Write a narrative review and systematic review /meta-analyses

5. Action: implement findings in nutritional care

6. Evaluate to determine effectiveness

Steps in evidence-based/informed decision making

1. Question
2. Search
3. Appraise
4. Combine
5. Contextualise
6. Recommend
7. Share
8. Decide
Exam question: class group activity !!
Compare the scientific method to the evidence based/informed medicine/nutrition process.

Why is it essential for members of the health profession, public health and legislature to
understand and apply the evidence-based/informed approach?

1. Through the four years student study dietetics, it is impossible to learn about all the
diseases/conditions/new diets or products
2. Moreover, nutrition is a science growing at a tremendous rate
3. Textbooks can be out-of-date
4. Therefore, when faced with new disease states or products/diets that were not included
in the curricula, students should be able to apply their research skills to digest existing
knowledge and use it to give advice or to make a stand or to treat their patients based
on evidence
5. Lifelong, self-directed learning
6. Monitor and evaluate established treatments to determine their effectiveness
7. Search for new (better more effective; less negative side effects) treatments
8. Also to treat the new diseases and conditions that emerge
9. Many dietary supplements and foods on the market and all kinds of claims are made;
new developments about which there is not always consensus
10. Research will help to know what to prescribe/use/ingest
11. To ensure always giving correct information and the best treatment to the public/our
clients/patients
12. Optimises the quality of care
13. Minimises the errors in patient care
14. Limits the use of ineffective treatment
15. Saves money
16. Basing care on evidence improves the credibility of the dietician and profession because
it is objective and less bias than opinions/beliefs
17. The lay public has access to the very same medical literature as medical practitioners –
we must protect our reputations
18. It is unethical not to use existing evidence

Who benefits by the implementation of evidence-based medicine?

1. Patients: get the best treatment
2. Health workers including: current knowledge to assist with decision making
3. Researchers: reduced duplication therefore research waste, identify research gaps
4. Community: recipients of evidence-based interventions
5. Funders: identify research gaps/priorities
6. Policy makers: current knowledge to assist with policy formulation
Policy makers and evidence-based care
Policy = a specific decision or set of decisions designed to carry out a course of action, a
national, regional, local or institutional project, law, regulation or rule.

Policymakers must determine whether existing policy is justified by the evidence and should
base new policy on evidence.

Political
judgement

Resources
scientific Values
evidence

Lobbyists

Problems that hinder evidence- based/informed medicine

“Publication bias” = bias that occurs in published academic research when the outcome of
an experiment or study influences the decision whether to publish or distribute it.

➔ Among studies with the same quality of execution and design those with statistically
significant results are three times more likely to be published than papers with null results
➔ Publication bias is a problem for evidence based/informed medicine
➔ literature/systematic reviews regarding support for a hypothesis can be biased if the
original literature is contaminated by publication bias and disguises the truth

Exam question: class group activity !!

Analyse how the phenomenon of publication bias in research could lead to the undermining
of the evidence based / informed process.
Possible solution to publication bias: pre- register research before execution

➔ Depositing study design in a repository holds you to the highest standards of research
integrity while ensuring that your work will be reproducible.
➔ Other benefits:

• Expert peer feedback BEFORE you conduct your research

• An editorial decision based only on the quality of the research and importance of
the research question

➔ “Registered reports give me the unique opportunity to describe in detail the statistical-
methodological approach prior to having seen the data, and to get credit for it. When
we submitted our registered report we received very detailed reviewer comments, and
we could improve our study design and analysis, as well as reporting.”
➔ “Registered reports...offer incentives for good practices by promising to publish rigorous
scientific work, regardless of the results. And the results themselves are likely to be more
robust because the method undergoes peer review before data are collected.”

Problems that hinder evidence- based/informed medicine

➔ The theoretical ideal that every narrow clinical question, would be answered by meta-
analysis and systematic reviews of multiple randomised clinical trails (RCTs) faces the
limitation that research is expensive; thus, there will always be much more research in
demand than supply.
➔ Research can be influenced by conflict of interest when studies with industry funding are
more likely to favour their product.
➔ There is a lag between when the RCT is conducted and when its results are published.
➔ There is a lag between when results are published and when these are properly applied.
➔ While patient values are considered in the original definition of EBM, the importance of
values is not commonly emphasised in training and application
➔ Access to research - partly solved by "open access", but created other problems
➔ ‘predatory’ journals = journals that ‘prey’ on (often unsuspecting and young) scholars to
submit their manuscripts for the sole purpose of making money with no regard for the
scientific value of research
➔ In this process of publishing fraud, normal good editorial and review processes are
violated or suspended.
➔ Absence of evidence isn’t necessarily evidence of absence
➔ Absence of Evidence ≠ Evidence of
➔ Absence: Exploring the Complexity
- Impact on Evidence-Based/Informed Medicine
- Necessity for Comprehensive Research
- Pitfalls of Misinterpreting Absence of Evidence
Evidence based nutrition advice for consumers in SA and international
➔ In SA FACS (food advisory consumer service) has a free website with scientifically
accurate info on a host of food and nutrition topics specially prepared and selected by
food and nutrition science professionals
➔ www.foodfacts.org.za
➔ Internationally you can check out examine.com and metafact.io

Critics of evidence-based process

➔ Critics of the evidence-based process see this as an effort of arrogant young scientists to
question existing practices.
➔ Arrogance vs confidence
➔ Dr RC Sproul: “Arrogance is a false confidence”

What evidence- based/informed nutrition is not

To decide based on:

1. An anecdote
2. Newspaper clippings, popular magazines
3. Expert opinion-especially when there are stronger evidence
4. Cost minimisation
Non-scientific methods to decide on patient care
1. Anecdotal approach
➢ The treatment is based on one or more single cases of successful treatment.
➢ Anecdotal cases may be useful in practice, but should not be the base for decision
making.

2. Press cuttings and the internet

➢ Newsworthy articles draw a lot of attention in the press and on the internet, but do
not always provide details on study designs and type of patients.

➢ Popular journals publish exceptional cases and serious side-effects and the journalists
very seldom have the necessary background to interpret the results.

➢ Pamphlets and free promotional are funded by industry or pharmaceutical

companies and the articles are written to promote specific products.

3. The expert opinion

➢ Older specialists and well-known scientists sometimes express their own opinion and
may not necessarily consider all the available evidence.

➢ Expert opinion does not belong in the rankings of the quality of empirical evidence,
because it does not represent a form of empirical evidence and have little value
because of the placebo effect, the biases inherent in observation and reporting of
cases, difficulties in ascertaining who is an expert and more.

4. Patient testimonials
5. Decision making by cost minimisation

➢ Health care functions on limited budgets and sometimes decisions must be made to
save money.

➢ The result is a protocol for treatment with cost minimisation, but not necessarily the
best available option.

Exam question: class activity !!

Compare the evidence based/informed medicine process with non-scientific methods.

Conclusions

By adopting the principles of Evidence based medicine to nutrition, it will be possible to

maximise the benefits of scientific research for patient care to increase probability of success
of nutrition interventions.
Case study 1

Approximately five years ago a dietician read in a newspaper clipping that, according to a
very well-known professor in paediatrics, sugar intake relates to behaviour difficulties in
children. She then started to prescribe sugar-free diets for her child patients with behavioural
difficulties. It is her experience that behavioural difficulties improved considerably with this
diet.

1.Identify the various approaches that were used by the dietician in order to make decisions
regarding the health care of her patients. (3)

Answer:

This dietitian currently uses scientifically unfounded methods to treat her patients.

The two methods she used to use newspaper clippings / media clippings and rely on expert
opinion . Furthermore, her experience that her patients respond well to is only anecdotal (1).
(any 3)

2.Which approach would you recommend to the dietician that will be better than the ones
she is currently using? Motivate your answer to her. (3)

Answer:

Recommend the evidence based / informed method to take care of patient care.

The reason for this recommendation is that her decisions about nutrition will then be based on
the best relevant scientific evidence collected and critically evaluated in a systematic (1)
objective manner. (any 2 for motivation)

Case study 2

One of your patients wants to start following the Atkins diet (high protein, low carbohydrates)
to lose weight and asks your opinion about it.

3.Write down the steps you will follow to give science-based advice to this patient. (Note, the
question demands the discussion of the steps. Thus, do not try to give a detailed evaluation of
the research methodology – this will follow in time). (5)

Answer:

1. Formulate the question

2. Seek the best available evidence to answer the question
3. Critically evaluate the evidence, determine the validity and usefulness
4. Implement the results in practice
5. Evaluate the implementation

Total [11]
Narration

Slide 1:

In the first part of Study Unit 2, we will explore the significance of nutrition research for evidence-based
also called scientifically based or informed nutrition (EBN) intervention or care.

Slide 2:

The information I will share is based on NUTB112 Study Section 1.2 and NUTR321 Study Unit 1. In Study Unit 1,
we learned that research plays a vital role in healthcare professions, including dieticians, as it enables us
to provide patients with the best available information for their care.

Slide 3:

By the end of this session, you should be able to:

Understand the concept of evidence and its relevance to nutrition.

Explain evidence-based/informed nutrition (EBN) and its importance in the context of healthcare
professions.

Implement the steps involved in scientifically based nutrition and apply them to practical cases.

Recognize the necessity of research knowledge for all members of the healthcare profession.

Identify challenges encountered in practicing evidence-based nutrition.

Be aware of non-scientific methods of decision-making.

Slide 4:

Nutrition is a rapidly growing science, and healthcare professionals continually encounter new diets,
dietary supplements, and food products in the market, each making various health claims. Additionally,
the internet and social media have made the public more knowledgeable about nutrition-related topics
and expect healthcare professionals to be well-informed about the scientific basis behind these claims.
However, nutrition-related news can be misleading, contradictory, and sometimes report scientific
findings prematurely before sufficient research has been conducted.

Slide 5:

To ensure that we provide accurate information and the best treatment to the public and our patients, it
is essential to stay updated with the most reliable information obtained from research. This requires the
ability to obtain, read, and critically evaluate evidence from scientific literature. Therefore, knowledge of
research methods is crucial in the field of nutrition.

Slide 6:

I will provide you with three minutes to read an excerpt from the 2014 Braintainment, now known as Very
Interesting magazine. It is important to remember that not all information is reliable, so we should not
believe everything we read or hear. It is crucial to develop skills in obtaining and evaluating information or
evidence.

Slide 7:

Evidence refers to findings from research and other knowledge that can serve as a useful basis for
decision-making in public health and healthcare. Scientific evidence can be categorized into context-
free and context-specific evidence. Context-free evidence produces universal truths and is often derived
from experimental studies like randomized controlled trials (RCTs). Context-specific evidence focuses on
what works in specific circumstances and populations, often obtained from epidemiological and
observational studies. In some cases, limited evidence may be present, requiring the use of colloquial
evidence, which includes grey literature and expert opinions, until further research can fill the gaps.

Colloquial evidence (conventional wisdom) focuses on “other knowledge” that takes into account the
relevance of the research, which is in the form of grey literature and expert opinion.

Colloquial/informal Evidence is ‘anything that establishes a fact or gives reason for believing something’
and it goes beyond the research evidence that is obtained from rigorous experimental or epidemiological
studies.

Colloquial knowledge and indigenous knowledge differ in their origin, context, and transmission. Here are
some key distinctions between the two:

Origin and Cultural Context: Colloquial knowledge typically emerges from everyday experiences and
interactions within a specific language or cultural group. It is the informal, common knowledge that
people acquire through their social environment and personal experiences. On the other hand,
indigenous knowledge is deeply rooted in the specific cultural, social, and ecological context of
indigenous communities. It encompasses the unique knowledge, practices, and beliefs that have been
developed and passed down through generations within indigenous cultures.

Transmission and Traditional Practices: Colloquial knowledge is often transmitted through informal
communication channels, such as conversations, storytelling, and personal observations. It is shared within
a community and may vary across different regions or social groups. Indigenous knowledge, however, is
typically transmitted through traditional and formal means, such as oral traditions, ceremonies,
apprenticeships, and intergenerational learning. It is passed down from elders and respected community
members to younger generations as a means of preserving cultural heritage and ensuring the continuity
of indigenous practices.

Scope and Depth: Colloquial knowledge tends to have a narrower scope and may be more focused on
everyday topics, local customs, and informal insights. It may include knowledge about local slang,
common practices, practical tips, or popular beliefs. Indigenous knowledge, on the other hand, often has
a broader scope and encompasses a wide range of areas, including traditional ecological knowledge,
medicinal practices, agriculture, resource management, spirituality, and cultural traditions. It is often
deeply interconnected with the natural environment and reflects the holistic worldview of indigenous
cultures.

Relationship with Formal Knowledge Systems: Colloquial knowledge is distinct from formal knowledge
systems, such as academic disciplines or scientific knowledge. It is often not systematically documented
or subjected to rigorous scientific validation. In contrast, indigenous knowledge has its own unique
knowledge systems that have developed alongside or independently of formal knowledge systems.
Indigenous knowledge may complement, challenge, or provide alternative perspectives to Western
scientific knowledge, offering valuable insights into sustainable practices, environmental management,
and community well-being.

It's important to note that both colloquial knowledge and indigenous knowledge hold significance within
their respective cultural contexts. Colloquial knowledge reflects the everyday wisdom and shared
experiences of a community, while indigenous knowledge represents the rich cultural heritage and
accumulated wisdom of indigenous peoples. Both forms of knowledge contribute to the diversity of
human understanding and can provide valuable insights for various aspects of life, community
development, and decision-making processes.

Slide 8:

The central idea is that evidence should be classified based on the rigor of its study design and
epistemological strength, and the strength of a recommendation should depend on the strength of the
evidence. In evidence-based medicine, different types of evidence are categorised according to their
freedom from biases. The strongest evidence comes from meta-analyses or systematic reviews of
randomised, placebo-controlled trials, while conventional wisdom or expert opinions are considered
weaker evidence. https://en.wikipedia.org/wiki/Evidence-based_medicine

Slide 9:

When time is limited and decisions need to be made, it is crucial to search for quality evidence. The
Cochrane Library is an extremely helpful resource for this purpose. The Cochrane Collaboration conducts
systematic reviews and meta-analyses, providing reliable evidence for decision-making.

• Named in honour of Prof Archibald Cochrane, a British researcher who wrote in 1979: “It is surely a
great criticism of our profession that we have not organised on critical summary, by specialty or
subspecialty, adapted periodically, of all relevant randomised controlled trials”

Slide 10:

In groups of three students, each group will receive a systematic review/meta-analysis, an original
research report, and a narrative review. Take 10 minutes to skim through the articles and identify the
differences and similarities between them. Use sticky notes to write down the differences, using different
colours for each type of article.

Slide 11:

Two groups will share what they have noticed and provide reasons why systematic reviews/meta-analyses
are considered the best evidence. In the following slides, I will present what students have identified in
previous years.

Slide 12:

Here is a photo we took of the yellow sticky notes representing the systematic review/meta-analysis.

Slide 13:

Here is a photo we took of the green sticky notes representing the original research report.

Slide 14:

Here is a photo we took of the pink sticky notes representing the narrative review.

Slide 15:

Merely reading evidence, such as research articles, is not sufficient. We must apply the evidence and
translate it into practice. By utilising research to guide our practice, we move towards evidence-
based/informed nutrition and ensure the best possible care.

Let's define evidence-based medicine or care.

It is the conscientious, explicit and judicious use of current best evidence in making decisions about the
care of individual patients – David Sackett et al. (1996)

It is a set of principles and methods intended to ensure that to the greatest extent possible, medical
decisions, guidelines and other types of policies are based on and consistent with good evidence of
effectiveness and benefit - Eddy (2005).

It is the gold standard of clinical practice, but also of giving advice to individuals and communities.

Slide 16:

Let's adapt the definition of evidence-based medicine for nutrition. Evidence-based/informed nutrition
(EBN) involves improving and optimising the traditional skills of a nutrition scientist in preventing and
treating nutrition-related conditions. This is achieved by systematically using the best available scientific
evidence, including mathematical estimations of probability and risk, to make decisions regarding the
treatment of individuals, communities, and populations.

Slide 17:

With NUTR321, we aim to equip you with the skills to apply the scientifically based approach to nutrition.
Let's explore the steps involved in scientifically based medicine and nutrition. The first step is framing a
clear, focused, answerable question. This step includes translating uncertainty into a question, critical
questioning, study design, and levels of evidence. We also define the population, intervention,
comparison intervention, outcomes, time, and setting in the question using the PICOT framework.

Slide 18:

The second step is gathering all relevant scientific evidence through a systematic and structured search
strategy. In Study Unit 2, we will also learn how to design and apply the best search strategy.

Slide 19:

The third step involves critically evaluating the obtained literature and appraising evidence for internal
validity. This evaluation includes aspects related to systematic errors, quantitative aspects of diagnosis
and treatment, effect size and precision, clinical importance of results, and external validity or
generalisability.

Slide 20:

In the fourth step, we interpret the results of the best evidence we gathered and draw conclusions.
Summarising the evidence in data extraction tables can aid in this process. We categorise treatments as
likely to be beneficial, harmful, or inconclusive. We evaluate consistency among studies, assess the size of
the effect, and recommend further research when necessary.

Slide 21:

The fifth step is to act by implementing the findings in nutritional care, while the sixth step involves
evaluating the effectiveness of the implemented care.

Slide 22:

The steps of scientifically based decision-making are cyclical and continuous. It is important to consider
new developments and constantly seek opportunities to improve and optimise treatment and advice.

Slide 23:

In groups of three, take three minutes to refer to Study Unit 1, where we studied the scientific
method/process, and compare it with the scientifically based decision-making process. Highlight the
similarities and differences. This exercise will help you understand how the evidence-based process
summarises findings gathered through the scientific method. Note that the evidence-based process may
indicate the need for further scientific research.

Here's a comparison between the scientific method/process and the scientifically based decision-making
process:

Feedback: The EB process is followed by health professionals and sometimes also researchers, while the
scientific method is mainly implemented by researchers. The EB process summarises findings gathered
through the scientific method. Sometimes when there is not enough evidence, it can be concluded from
the EB process that a study must be done, therefore that the scientific method must be applied.
Scientific Method/Process:

Objective: The scientific method is a systematic and objective approach used by researchers to acquire
knowledge and understand the natural world.

Research Question: It begins with formulating a research question or hypothesis to be tested.

Design and Conduct Research: Researchers design and conduct experiments or studies to gather data
and evidence.

Data Collection and Analysis: Data is collected through observations, measurements, and experiments.
The data is then analysed using statistical methods to draw conclusions.

Peer Review and Publication: The research findings are subjected to peer review by experts in the field
and published in scientific journals.

Replication and Verification: Other researchers replicate the study to verify the results and ensure the
reliability of the findings.

Iterative Process: The scientific method is an iterative process, with new questions arising from the findings,
leading to further research and refinement of knowledge.

Scientifically Based Decision-Making Process:

Objective: The scientifically based decision-making process aims to make informed decisions by
integrating the best available scientific evidence with professional expertise and patient values.

Framing the Question: The process begins by framing a clear and answerable question, specifying the
population, intervention, comparison, outcomes, and setting (PICOS).

Gathering Evidence: Relevant scientific evidence is collected through a systematic search strategy,
including studies, systematic reviews, and meta-analyses.

Critical Appraisal: The gathered evidence is critically appraised to assess its internal validity, including
potential biases, study design, and statistical analysis.

Evidence Synthesis: The results of the appraised evidence are synthesised to draw conclusions and
determine the strength of the evidence.

Application and Implementation: The evidence is applied in clinical or practical settings to guide
decision-making and inform patient care.

Evaluation: The effectiveness and outcomes of the implemented decisions are evaluated and monitored.

Continuous Improvement: The process is cyclical, and new evidence and developments are continuously
considered to refine and optimise treatment decisions.

Key Differences:

Scope: The scientific method focuses on the generation of new knowledge through research, while
scientifically based decision-making applies existing scientific evidence to guide decision-making in
practice.

Iterative Process: The scientific method involves a continuous cycle of hypothesis formulation,
experimentation, and refinement of knowledge, whereas the decision-making process may involve a
shorter cycle of gathering, appraising, and applying evidence for specific decisions.
Research vs. Application: The scientific method primarily aims to advance scientific knowledge, while
scientifically based decision-making focuses on applying scientific evidence to inform decision-making in
healthcare or other fields.

Peer Review: The scientific method emphasises the importance of peer review and publication in
validating research findings, while the decision-making process relies on critical appraisal and synthesis of
existing evidence.

Replication: Replication of research studies is a crucial aspect of the scientific method to ensure the
reliability of findings, whereas the decision-making process relies on the existing body of evidence for
decision-making rather than replicating specific studies.

Overall, while both processes share the goal of informed decision-making, the scientific method focuses
on generating new knowledge through research, while the scientifically based decision-making process
applies existing scientific evidence to guide decision-making in practice.

This is a typical exam question.

Slide 24:

Take three minutes in groups of three to discuss why knowledge and insight into the evidence-based
approach to decision-making are essential for members of the health profession, public health, and
legislature.

Slide 25:

In the following slides, we will explore possible answers to the importance of evidence-based decision-
making for various stakeholders.

Through the four years student study dietetics, it is impossible to learn about all the
diseases/conditions/new diets or products

Moreover, nutrition is a science growing at a tremendous rate and Textbooks can be out-of-date

Therefore, when faced with new disease states or products/diets that were not included in the curricula,
students should be able to apply their research skills to digest existing knowledge and use it to give advice
or to make a stand or to treat their patients based on evidence

Slide 26:

It is important to monitor and evaluate established treatments to determine their effectiveness. We should
continuously search for new treatments that are more effective and have fewer adverse side effects.
Evidence-based decision-making is crucial for treating new diseases and conditions and making informed
decisions about dietary supplements and food products.

Slide 27:

Adopting evidence-based decision-making ensures that we provide the correct information and best
treatment to the public, clients, and patients. This approach optimises the quality of care, minimises errors,
avoids ineffective treatments, and saves money.

Slide 28:

Basing care on evidence enhances the credibility of dieticians and the profession as a whole, as it relies
on objective information rather than personal opinions or biases. In today's information age, where the
public has access to the same medical literature as healthcare practitioners, it is essential to uphold our
reputations by providing evidence-based care. It is considered unethical not to use existing evidence in
decision-making.

Slide 29:
Scientific decision-making benefits various stakeholders, including health workers, researchers,
communities, funders, and policymakers.

Slide 30:

Policymakers and lawmakers should also utilise scientific evidence in their decision-making processes.
Existing policies should be justified by evidence, and new policies or laws should be based on sound
scientific evidence.

Slide 31:

Unfortunately, there are certain problems that lead to the fact that scientifically based medical care is
not always possible. The biggest problem is publication bias. This is bias that occurs in published academic
research when the outcome of an experiment or study influences the decision whether to publish or
distribute it.

Among studies with the same quality of execution and design those with statistically significant results are
three times more likely to be published than papers with null results (insert ref)

Publication bias is a problem for evidence based/informed medicine

literature/systematic reviews regarding support for a hypothesis can be biased if the original literature is
contaminated by publication bias and disguises the truth.

Slide 32:

A typical exam question is to analyse how the phenomenon of publication bias in research could lead to
the undermining of the evidence based / informed process. Students must indicate here how publication
bias can lead to the truth about the effect of a treatment not coming to the fore. E.g. if a person were to
consult the literature and only find the articles where it is reported that the treatment is effective because
the studies in which the treatment has been reported to have no effect were never published, then one
can come to the wrong conclusion the treatment's effectiveness etc. In particular, students must refer
here to the effect that publication bias has on systematic reviews and meta-analysis that is used
especially in Scientifically Grounded / Informed Nutrition.

Slide 33:

The slide highlights the benefits of depositing study designs in a research repository, emphasising on
research integrity and reproducibility. This approach demands researchers to define their research
question, hypothesis, and methodology in advance, reducing the chance for selective reporting or post-
hoc adjustments. Moreover, it provides an opportunity for peer feedback before conducting the
research, allowing for improvements in the study design. An important aspect of registered reports is that
editorial decisions are based on the quality and significance of the research question, not on the study's
outcomes. This approach encourages rigorous research practices and promotes reliable evidence.
Testimonials from researchers underline these advantages and emphasise the role of registered reports in
improving study design, analysis, reporting, and promoting robust outcomes.

Slide 34:

Other problems hindering evidence-based care include limited research resources, potential conflicts of
interest, delays in publishing research results, and the challenges of applying published results in practice.
Additionally, the importance of patient values and involvement may be overlooked in the training and
application of evidence-based medicine.

The theoretical ideal that every narrow clinical question, would be answered by meta-analysis and
systematic reviews of multiple randomised clinical trials (RCTs) faces the limitation that research is
expensive; thus, there will always be much more research in demand than supply.
Research can be influenced by conflict of interest when studies with industry funding are more likely to
favour their product.

There is a lag between when the RCT is conducted and when its results are published.

There is a lag between when results are published and when these are properly applied.

While patient values are considered in the original definition of EBM, the importance of values is not
commonly emphasised in training and application.

Slide 35:

Open access to research publications has partially addressed the issue of access, but it has also led to the
emergence of predatory journals that prioritise profit over scientific value. These journals violate standard
editorial and review processes, compromising the quality and reliability of published research.

Slide 36:

As we delve deeper into the realm of evidence-based and informed medicine, we come across several
challenges. One such challenge, and perhaps a complex one, is understanding the concept that the
'Absence of Evidence isn’t necessarily Evidence of Absence'.

This concept is vital to grasp, especially in the field of medicine and nutrition, where research studies
might not yet have explored certain aspects or been able to conclusively prove a particular hypothesis.
It's essential to understand that a lack of current evidence does not confirm the non-existence of an
effect or a relationship. Rather, it underscores the need for further comprehensive research in that area.

Misinterpretation of the absence of evidence can lead to critical errors in decision-making, resulting in
potential missed opportunities for novel treatments or interventions. So, as we navigate through evidence-
based and informed medicine, it's crucial to keep in mind that the absence of evidence isn't evidence of
absence. This understanding can significantly influence our approach towards conducting further
research and making evidence-based decisions in medical and nutritional practices.

Slide 37:

In South Africa, resources like the SA FACS (Food Advisory Consumer Service) provide free scientifically
accurate information on various food and nutrition topics, specifically prepared and screened by food
and nutrition scientists. Similarly, international organizations like examine.com and metafact.io.

Slide 38:

Critics of the evidence-based process sometimes view it as an attempt by young scientists to challenge
established practices. Despite the challenges it faces, evidence-based decision-making remains the best
approach available. There are ongoing efforts to improve and refine the process.

Slide 39:

In the following slides, we will explore other non-scientific methods used in decision-making, such as relying
on anecdotes, newspaper/magazine clippings, expert opinions, and cost minimisation.

Slide 40:

The anecdotal approach bases treatment decisions on single cases of successful treatment. While
anecdotes may have some value in practice, they should not serve as the sole basis for decision-making,
as they can overlook broader evidence and potential benefits.

Slide 41:
Using a few articles in the news, magazines, free medical journals, information sheets funded by industry or
the internet to decide on patient care is non-scientific. Newsworthy articles draw a lot of attention in the
press and on the internet, but do not always provide details on study designs and type of patients.

Popular journals publish exceptional cases and serious side-effects and the journalists very seldom have
the necessary background to interpret the results.

Pamphlets and free promotional are funded by industry or pharmaceutical companies and the articles
are written to promote specific products.

Slide 42:

To customise practices or policies according to expert opinion, reviews, invited reviews (main article of a
magazine), consensus statements from experts is non-scientific. Older specialists and well-known scientists
sometimes express their own opinion and may not necessarily consider all the available evidence.

Expert opinion does not belong in the rankings of the quality of empirical evidence, because it does not
represent a form of empirical evidence and have little value because of the placebo effect, the biases
inherent in observation and reporting of cases, difficulties in ascertaining who is an expert and more.

Slide 43:

Decisions are often made, or policies made owing to economic cost of treatment. Health care functions
on limited budgets and sometimes decisions must be made to save money.

The result is a protocol for treatment with cost minimisation, but not necessarily the best available option.
The best treatment may not be used because it is too expensive.

Also consider that the most expensive treatment may not always be the best. This is unfortunately ironic
because costs are saved by giving the most effective treatment according to scientific evidence from
the beginning of treatment.

Slide 44:

A typical exam question is to compare the evidence based/informed medicine process with non-
scientific methods. Therefore, I suggest that you prepare such a table for the continuous assessment
opportunity.

Evidence-based or informed medicine (EBM) and non-scientific methods are two distinct approaches to
medical decision-making. They differ in multiple ways:

Process & Approach:

EBM follows a rigorous process, using research data from systematic reviews, meta-analyses, and
randomised controlled trials (RCTs) to form a basis for clinical decisions. This method is analytical,
systematic, and transparent.

Non-scientific methods rely on anecdotal evidence, expert opinions, economic costs, and other non-
empirical factors. This approach is typically less systematic, less transparent, and more subject to bias and
variability.

Quality of Evidence:

EBM emphasises high-quality evidence, ideally from RCTs, systematic reviews, and meta-analyses. The
evidence is typically graded, with higher levels attributed to more rigorous research designs.

Non-scientific methods may consider a broader range of evidence types, including individual case
studies, anecdotal reports, and expert opinions. The quality and reliability of such evidence can vary
greatly.
Outcomes and Effectiveness:

EBM aims to ensure the best patient outcomes based on the most current and rigorous scientific
evidence. It incorporates the values and preferences of the patient along with clinical expertise.

Non-scientific methods might work in certain cases due to the placebo effect or individual differences,
but they are less predictable and reliable for a larger population. These methods might not always
account for patient values and preferences.

Bias and Conflicts:

EBM strives to minimise bias by promoting transparency, methodological rigor, and reproducibility.
However, it can be influenced by factors like publication bias or industry-sponsored research.

Non-scientific methods are often more prone to bias, as they can be heavily influenced by personal
beliefs, experiences, and financial or industry interests.

In essence, while EBM provides a structured, reproducible, and transparent method for decision-making
based on high-quality evidence, non-scientific methods are generally more flexible but less reliable due to
their reliance on lower-quality evidence and greater susceptibility to bias. It's important to note, however,
that an integrated approach, utilizing the strengths of both methods, might sometimes be necessary in
practice, especially in areas where high-quality scientific evidence is scarce or non-existent.

Slide 45:

To summarise what we've learned:

We explored the definition and importance of evidence.

We discussed evidence-based medicine and applied its principles to nutrition.

We examined the steps involved in scientifically based decision-making.

We identified challenges that hinder evidence-based care.

We recognised non-scientific methods of decision-making and their limitations.

Reflection Group Discussion:

• Divide students into small groups and assign each group a specific challenge or limitation
discussed in the lecture, such as publication bias or conflicts of interest. Ask them to discuss the
implications of the challenge on evidence-based decision-making and brainstorm strategies to
overcome or minimise these limitations. Encourage groups to share their insights and solutions with
the rest of the class.

• Discuss the ethical implications of evidence-based decision-making in nutrition. Encourage them

to reflect on the potential consequences of basing decisions solely on personal beliefs or
anecdotal evidence, the responsibility to provide accurate information to clients/patients, and the
importance of continuously updating knowledge to ensure the best care. This exercise fosters
ethical awareness and the understanding of the impact of decision-making on individuals and
communities.

Slide 46:

Study Greenhalgh and complete the case studies in the interactive study guide, comparing your answers
to the provided memo. Evaluate your achievement of the learning outcomes for Study Unit 2 and prepare
for the assessment for Study section 2.1.

Slide 47:
Lastly, prepare for the next session by skim reading Brusco, Jones, and Smyth. Good luck!
The scientific evidence can be divided into: context free and context specific evidence:
1. Context free evidence produces universal truths of what works and is usually available
from randomised control trials (RCT) (evidence-based medicine).
2. Context specific evidence is more about what works in specific circumstances and for
specific populations which is usually available from epidemiological studies and
observational studies (validity of science is context dependent).

➔ We are very commonly faced with issues of limited evidence and a need for filling gaps
in the evidence. Hence the proposed use of colloquial evidence.
➔ Colloquial evidence focuses on “other knowledge” that takes into account the
relevance of the research, which is in the form of grey literature and expert opinion.
➔ Colloquial Evidence = ‘anything that establishes a fact or gives reason for believing
something’ and it goes beyond the research evidence that is obtained from rigorous
RCTs or epidemiological studies.
 Level of evidence pyramid

Steps in the “evidence-based” approach

1. Clearly answerable question
2. Collect all relevant scientific evidence – systematically structured search strategy
3. Type of literature: original research, systematic overviews of original research
4. Critically evaluate literature
5. Interpret results– come to a conclusion, what does it mean and what is the impact
thereof?
6. Action: implement nutritional care
7. Evaluate

What is evidence based/informed nutrition?

❖ Use of the best scientific evidence in order to take decisions on nutritional care of
patients/communities.
❖ The best scientific information must be used when treating patients and giving them
advice.
❖ Evidence based/informed nutrition definition in SG.
❖ Definition: p. 40, Addendum D

What evidence-based/informed nutrition isn’t:

To make a decision based on:
1) an anecdote
2) Newspaper clippings, popular magazines
3) Expert opinion
-especially when there are more stronger evidence
4) Cost minimisation
5) Policy = a specific decision or set of decisions designed to carry out a course of action, a
national, regional, local or institutional project, law, regulation or rule.
 Political
judgement

Resources
scientific Values
evidence

Lobbyists

Publication bias

A type of bias that occurs in published academic research. It occurs when the outcome of
an experiment or research study influences the decision whether to publish or otherwise
distribute it.

Case studies
->Identify the various approaches that were used by the following dietician to make
decisions
regarding the health care of her patients:
->Which approaches would you recommend and motivate?

Approximately five years ago the dietician read in a newspaper clipping that, according to
a very well-known professor in paediatrics, sugar intake relates to behaviour difficulties in
children. She then started to prescribe sugar-free diets for her child patients with behavioural
difficulties. It is her experience that behavioural difficulties improved considerably with this
diet.

One of your patients wants to start following the Atkins diet (high protein, low carbohydrates)
to lose weight and asks your opinion about it. Write down the steps you will follow to give
science-based advice to this patient. (Note, the question demands the discussion of the
steps. Thus, do not try to give a detailed evaluation of the research methodology – this will
follow in time).

A local general practitioner advises the use of beetroot to treat iron-deficiency anaemia.
Describe the steps you will follow in making a recommendation to him on this aspect. (Note,
the question requires the discussion of the steps. Thus, do not try giving a detailed evaluation
of the research methodology– this will follow in time).
 SU 1.2

OUTCOMES
✓ motivate why we should read articles
✓ Possess knowledge of and insights into the various elements of a research publication
with other words how to read a research publication

Hierarchy of evidence in order

1. meta-analysis
2. review
3. original research publication
4. paper clipping
5. E-mail

Why read papers?

➔ Journal papers are current
-Textbooks are often years out of date
➔ You get enough details to replicate the
research you read about
-Adapt cutting edge ideas and
techniques to your own research
➔ Training of critical faculties
-You can see whether you agree with
conclusions
➔ Because one day soon you could be
writing papers too!

How to take effective notes?

Good note-taking saves time and helps clarify
your thoughts
Suggested template for note taking
 What are the different structural components/sections of an original research paper?
1) Title, (Authors)
2) Abstract, (Keywords)
3) Introduction
4) Methods
5) Results
6) Discussion (Conclusion)
7) Acknowledgements
8) References

What is the purpose of an abstract?

1) To provide an overview (summary) and clear preview of the paper
2) A reader uses the abstract to quickly understand the purpose, methods, results and
significance of the work and will only read further if the reader’s interest is captivated by the
abstract
3) Editor’s first impression of the research
 SU 2.2 iterature search and referencing for evidence-based care
and research
Search Strategy: A method used to organize your search and locate relevant information
sources for a particular research topic.

Boolean logic: A form of algebra in which all values are reduced to either TRUE or FALSE. It is
named after George Boole, an English mathematician and philosopher.

Boolean Operators: Words used as conjunctions to combine or exclude keywords in a search,

resulting in more focused and productive results. Common operators are AND, OR, and NOT.

PICO Framework: A mnemonic acronym used in evidence-based practice to frame and

answer a clinical or health-related question. The acronym stands for Patient/Problem,
Intervention, Comparison, and Outcome.

Primary Sources: These are original, uninterpreted information or first-hand testimonies about
the subject of interest. They are created by witnesses or participants who directly experienced
the events or conditions being documented. These sources are often produced at the time
the events occurred but can also include autobiographies, memoirs, or oral histories recorded
later. Examples include research articles reporting original findings (such as experiments,
clinical trials, and observational studies), historical documents (like letters, speeches, diaries),
raw data, creative works (like art, literature, music), and legal documents (laws, court cases).

Secondary Sources: These sources interpret, analyze, or summarize information from primary
sources. They are one step removed from the original event or phenomenon under study. They
provide commentary, interpretation, analysis, or a second-hand account of a primary source's
information. Examples include review articles (like systematic reviews and meta-analyses),
textbooks, articles that interpret or review research works, and histories. They are useful for
getting a comprehensive overview of a topic or for understanding different interpretations or
analyses of a set of primary data.

PubMed: A free search engine accessing primarily the MEDLINE database of references and
abstracts on life sciences and biomedical topics.

Google Scholar: A freely accessible web search engine that indexes the full text or metadata
of scholarly literature across various formats and disciplines.
Citation or reference: A citation is a reference to a published or unpublished source that you
consulted and obtained information from while writing your research paper. The way in
which you document your sources depends on the writing style manual your professor wants
you to use for the class (e.g., APA, MLA, Chicago, Harvard, etc.). Citations consist of standard
elements, including:

Author's Name: The author’s name is the first element of a citation.

Title: This is the name of the source. If no name exists, some citations require a description.

Source: Where you found the work (book, magazine, journal, website, etc.)

Publication Information: Specifics vary depending on what type of source it is (book, journal
article, web page, etc.). It could include publisher name, journal name, date of publication,
page numbers, etc.

Citation Tracking: A process of identifying articles or other materials that have cited a
previously published work.

MeSH Terms: Medical Subject Headings (MeSH) are standardized terms used for searching in
PubMed. They enhance the effectiveness of keyword-based searches.

Narrative Review: A summary of the medical literature that attempts to survey the literature
and describe the topic.

Systematic Review: A type of literature review that uses systematic methods to collect
secondary data, critically appraise research studies, and synthesize findings qualitatively or
quantitatively.

Filters: Tools used in databases to refine search results based on specific criteria.

EndNote: A commercial reference management software package, used to manage

bibliographies and references when writing essays and articles.

Verwysingslys: 'n Lys van al die bronne wat direk in 'n stuk akademiese geskrif aangehaal
word.

Reference list: A list of all the sources cited directly in a piece of academic writing.

Abstracts: Brief summaries of academic articles or reports, providing a snapshot of the study's
purpose, methodology, and findings.

Keywords: Significant or descriptive words used for searching information in databases or

search engines.
 What is research evidence?

Systematic
revies or
meta-
analysis
Intervention
studies such
Qualitative as
research randomised
control trials
(RCT)
Research
evidense
Observation
al studies
Process
(longitudinal
evaluations
, case
control etc.)
Policy,
documents
and
guidance

Define what is meant by literature

1. A collection of all the scholarly writings on a topic
2. Scientific peer reviewed journal articles, dissertations and theses
• Recent (last 5 years) preferable to old
• Seminal work/major works/older, classic/”golden oldie” sources used for origin of
theory – state that it was original work and what the development was and current
status
• Grey literature

Background...
➔ “Most clinicians are unaware of the extent of the clinical literature and of how to go
about accessing it” Greenhalgh (2001)
➔ “Effectively using an Internet search engine to perform a literature search is one of the
quickest ways to find information” Brusco (2010)
• Handsearching
• Another is to go to the library

The internet computer literature search (1)

➔ Computer searching involves entering subjects or keywords into the search field of a
search engine/database and selecting search
➔ Database = an electronic collection of data that can be accessed and manipulated by a
data processing system such as PubMed
➔ Research articles can be traced/accessed in two ways with internet computer searches
➔ By any word listed on the database including words in the title, abstract, authors’ names,
and the institution where the research was done
➔ By a restricted thesaurus of medical titles, known as medical subject heading (MeSH)
terms
Stages in the literature search process (computerised search)
1. Locate dependable & relevant research literature/evidence through a systematic search
2. “...you will waste time and miss many valuable articles if you simply search at random”
Greenhalgh (2001)

Stages in the literature search process (computerised search)

1. Focus and write your question or problem statement

➢ Titles or research question for intervention trails can be formulated by using
PICO(T)(S) = population, intervention, comparison, outcome, (time (duration)), (study
design)
➢ For qualitative questions, the acronym SPICE can be used to search for qualitative
evidence
➢ ECLIPSE - to search for health policy/management information

2. Decide on the most appropriate evidence/sources/databases (more on databases

follow)
➢ Primary sources vs secondary sources
➢ Primary sources = first-hand source of data in research; the original study
➢ Secondary sources = source of data in research in which an author has evaluated
and summarized research; narrative reviews; topic updates
➢ Even though systematic reviews summarises the literature these articles are consider
to be primary sources.

Various databases and their advantages and limitations Different database sources

Medicine MEDLINE,
specific EMBASE,
databases CINAHL,
PubMed
Google
Reference Trials scholar, Cochrane
repositories registers Mendeley, Library
Citulike

Research Research
evidense evidence

General Evidensed Web of

topic based TRIP
science
databases databases
Policy and
profession WHO web
al web site
sites
Medicine specific databases
Examples:
• MEDLINE – Medicine and Health (access via PubMed)
• EMBASE – Clinical Medicine
• CINAHL – Nursing and Allied Health
• PSYCINFO – Psychology and Psychiatry

Medicine specific databases...

➢ PubMed is a free search engine accessing primarily the MEDLINE database of references
and abstracts on life sciences and biomedical topics.
➢ The United States National Library of Medicine (NLM) at the National Institutes of Health
maintains the database as part of the Entrez system of information retrieval

Advantages
• Enhanced relevance via focus

Limitations
• Poor low middle income country (LMIC) coverage

Evidence Based databases

Examples:
• Cochrane Library
• NHS CRD Databases
• TRIP –turning research into practice database (http://www.tripdatabase.co m)
• Health Systems Evidence
• Epistemonikos
• PDQ-Evidence

Advantages
1. Prefiltered or selected
2. Higher quality evidence

Limitations
1. Limited coverage
2. Favour clinical areas
3. Narrow definitions of what evidence is

General topic databases

Examples:
• Web of Science
• Scopus
• Scirus

Advantages
1. Broad topic coverage
2.Strong on multidisciplinary topics

Limitations
1. words with multiple meanings can increase the number of search results that can be
considered “false drops/hits.”
2. Indexing not as specific as medical databases
Reference repositories (1)
Examples:
1. Google Scholar– scholarly research across many disciplines and sources: articles, theses,
books, and abstracts, from academic publishers, professional societies, online
repositories, universities and other web sites;
2. Mendeley – world’s largest crowd sourced research catalogues;
3. Citeulike - web service for users to save and share citations to academic papers.

Advantages
1. May link to full text
2. Extensive coverage
3. Allows basic “reference management”
4. Can link to newer sources by easily finding other articles that referred to the original
articles as opposed to just looking at the references (older) used in the original article

Limitations
1. “Dirty” references
2. Duplicates
3. No definition of scope

Stages in the literature search process continue…

3. Construct search by:

a) Dividing your search into a series of ‘concepts’/descriptors
➢ The more you read the better keywords you will select
➢ Consider using the most important inclusion and exclusion criteria of your own
research question or study as some of the keywords
➢ e.g. children; diabetes
➢ Truncation (use asterisk after text string e.g. child* to retrieve child, children,
childhood etc)
➢ Wildcard (use a question mark in a word to denote possible variation in spelling
e.g.p?ediatric to retrieve paediatric and pediatric)
➢ Use quotation marks to retrieve phrases
b) Thinking of alternative terms for each concept
c) Searching for each concept separately at first (pilot search)
d) Combining concepts using Boolean logic (=putting in particular words linked by
operators)
➢ Most common Boolean operators or connectors and “AND” and “OR”
➢ The scope of your search can be narrowed (“AND”) or broadened (“OR”) by using
this
➢ “NOT” is beneficial when you want to filter out a certain word or phrase
e) Broaden or limit your search after the pilot search
f) Compile final search string
NOTE! Developing your search is an iterative process. You usually have to modify your original
search several times.
 Example of a search string
• ((((((((((homocysteine) OR "Homocysteine"[Mesh]) OR hyperhomocysteinemia) OR
"Hyperhomocysteinemia"[Mesh]) OR Hyperhomocysteinaemia) OR total homocysteine) OR
homocysteinylation) OR thiolactone) OR "homocysteine thiolactone"[Supplementary
Concept])) AND ((((((((((((((((("Fibrin Clot Lysis Time"[Mesh]) OR Fibrin clot lysis time) OR
clotting time) OR lateral aggregation) OR maximum absorbance) OR slope) OR clot Fibre
thickness) OR Fibre thickness) OR clot ly?ability) OR Blood clot propert*) OR
"Fibrinolysis"[Mesh]) OR fibrinolysis) OR lysis time) OR clot lysis time) OR blood clot architecture)
OR blood clot structure) OR blood clot properties)

Step 4: Consult complementary Sources

➢ Is it sufficient to just search electronic sources? – Alas, no... (See: Papaioannou et al.
(2011))
➢ Try reference tracking (locate sources in reference list of good articles – back in time)
➢ citation tracking (using Google scholar and see who cited an article – more recent)
➢ hand-searching journals
➢ Recent textbooks in field

Step 5: Processing the literature after the search

➢ Scan through literature
➢ Read for relevance (direct or indirect) to your problem or study (next class will be on
how to read a paper)
➢ Read wide, work narrow
➢ Keep rest for later use
➢ Organise your literature
➢ Keep reference list up to date! • EndNote
➢ Evaluate the quality of sources you site – critical assessment
➢ Write the literature review

Stages in the literature search process

Focus your question or problem statement
1. Decide on • Primary sources vs secondary sources
the most • Primary sources = first-hand source of data in research; the original study
appropriate • Secondary sources = source of data in research in which an author has evaluated
sources and summarized precious research
• Keep in mind that (a) the previous author may have been careless and cited the
source or sources incorrectly and (b) the previous author may have taken the
results of a study out of context or from a point of view different from the original
author’s or your own.

2. Construct • Dividing your search into a series of ‘concepts’/descriptors

search by: • Thinking of alternative terms for each concept
• Searching for each concept separately at first
• Combining concepts using Boolean logic
• -Most common Boolean operators or connectors are AND and OR
• Limiting your search

3. Revise your As necessary, and replicate in other sources, then search citations and references
search
Example of a search strategy on the PubMed and Google Scholar databases
1. Focus Your Question

Divide your question into concepts:

➢ Are multiple micronutrients more effective than supplements of iron + folic acid (IFA) in
pregnant women?

➢ Population = Pregnant Women

➢ Intervention = Multiple Micronutrients

➢ Comparison(s) = Supplements of iron + folic acid

➢ Outcome(s) = ????

2. Decide on most Appropriate Sources to search

INTERVENTION OUTCOMES
POPULATION -micronutrients Reduction in neonatal mortality
-pregnant women •Reduction in low birthweight
COMPARISON •Reduction in premature delivery
-Iron and folic acid •Cost effectiveness

3. Think of alternative terms for each concept

➔ HINT: Look at terms used in Clinical Studies on PubMed Clinical Queries (particularly
look at their MeSH terms) http://www.ncbi.nlm.nih.gov/pubmed/clinical

➔ HINT: Use PubMed Reminer to generate alternative terms http://hgserver2.amc.nl/cgi-

bin/miner/miner2.cgi

3a Search for each Concept separately

POPULATION INTERVENTION OUTCOMES

•Pregnant Women •Micronutrients •Reduce, Reducing,
•Female Reduction •neonatal
•Pregnancy COMPARISON mortality
•Folic Acid Deficiency •Iron and Folic Acid •Newborn
•Infant, Low Birth Weight •Iron, Dietary •Death
•Prenatal Nutritional •Dietary Supplements •Low birthweight
Physiological Phenomena •Supplementation •Premature delivery
•Maternal Nutritional ...etc •Cost effectiveness
Physiological •Costs; Economic
Phenomena…etc
3d Combine Concepts
INTERVENTION
• Micronutrients OUTCOMES
POPULATION • Reduction in neonatal mortality
Pregnant AND OR
Women • Reduction in low birthweight OR
COMPARISON • Reduction in premature delivery
AND AND
•Iron AND/OR Folic OR
Acid • Cost effectiveness

Sample Search Strategy

[POPULATION:] ("Mothers"[Mesh] OR "Pregnancy"[Mesh] OR mother* OR maternal OR

pregnancy) AND

[INTERVENTION:] ("Micronutrients"[Mesh] OR "multiple micronutrient*" OR multivitamin OR

(micronutrient* AND supplement*)

3e Limit your search

PubMed: The Filters Sidebar https://www.youtube.com/watch?v=696 R9GbOyvA (2 min.,

YouTube video, December 2012

Additional filters:

1) Article types

2) Text availability

3) PubMed

4) Commons

5) Publication

6) dates

7) Species

8) Languages

9) Sex

10) Subjects

11) Journal

12) Categories

13) Ages Search fields

4. Revise search as necessary, replicate in other sources, search citing articles and
references
Tips for search strategies
Look at systematic reviews or meta-analyses method sections where the search strategy is
given

Evaluating the credibility of information on websites is essential, especially in the era of

widespread misinformation. Here are some tips to help you ascertain the reliability of online
information:

1. Check the Domain:

➢ .gov, .edu, and .org are typically more reliable than .com or .net.

➢ However, be cautious with .org sites as they can be created by both reputable
organizations and biased groups.

2. Authorship:

➢ Check for an author or organization responsible for the content.

➢ Research the author's credentials or background to see if they're an expert in the

subject.

3. Sources and Citations:

➢ Reliable articles often cite their sources.

➢ Check these citations to see if they come from reputable sources.

4. Publication Date:

➢ Information, especially in fields like science and medicine, can change over time.
Check the date to ensure the content is current.

5. Bias and Objectivity:

➢ Be wary of sites that display overt biases or those that present opinions as facts.

➢ Look for balanced viewpoints or acknowledgment of opposing arguments.

6. Check the "About Us" Section:

➢ Reliable websites often have an "About Us" page where they describe their mission,
values, and organizational or corporate backgrounds.

7. Professional Design and Functionality:

➢ While a professional look isn't a guarantee of credibility, a poorly designed site with
many pop-ups or broken links can be a red flag.

8. Review Contact Information:

➢ Reliable websites typically have contact details, such as an email address, phone
number, or physical address. A lack of contact information can be a warning sign.

9. Cross-check Information:

➢ Verify the website's information with other trusted sources or publications to ensure
consistency.

10. Avoid Websites Relying Heavily on Anecdotes:

➢ Personal stories can be misleading. Reliable information should be based on
comprehensive research or established facts.

11. Check for Peer Reviews or Endorsements:

➢ In academic or scientific contexts, see if the information has been peer-reviewed.

➢ Endorsements by recognized experts or institutions in the field can also add credibility.

12. Beware of "Too Good to Be True" Claims:

➢ If a website makes sensational claims without solid evidence, it's a good reason to be
skeptical.

13. Utilize Fact-checking Sites:

➢ Websites like Snopes, FactCheck.org, or PolitiFact can help verify the truthfulness of claims
or news stories.

14. Use Common Sense and Intuition:

➢ If something feels off or too biased, it's worth digging deeper or seeking out additional
sources.

By keeping these tips in mind, you'll be better equipped to navigate the vast digital landscape
and discern reliable information from misinformation.
Various databases and their advantages and limitations Different database sources

Medicine MEDLINE,
specific EMBASE,
databases CINAHL,
PubMed
Reference Google
Trials scholar, Cochrane
repositorie
registers Mendeley, Library
s Citulike

Research Research
evidense evidence

General Evidensed Web of

topic based TRIP
science
databases databases
Policy and
profession WHO web
al web site
sites

Medicine specific databases

Examples:
• MEDLINE – Medicine and Health Advantages: Enhanced relevance via focus
• EMBASE – Clinical Medicine
• CINAHL – Nursing and Allied Health Limitations: Poor LMIC coverage
• PSYCINFO – Psychology and Psychiatry

PubMed is a free search engine accessing primarily the MEDLINE database of references
and abstracts on life sciences and biomedical topics. The United States National Library of
Medicine (NLM) at the National Institutes of Health maintains the database as part of the
Entrez system of information retrieval.
Advantages:
-Prefiltered or selected
Evidence Based databases -Higher quality evidence
Examples:
• Cochrane Library
• NHS CRD Databases Limitations:
• TRIP -Limited coverage
• Health Systems Evidence -Favour clinical areas
• Epistemonikos -Narrow definitions of evidence
• PDQ-Evidence

General topic databases Advantages:

Examples: -Broad topic coverage
• Web of Science -Strong on multidisciplinary topics
• Scopus
• Scirus Limitations :
-Words may have multiple meanings
increasing “false drops”
-Indexing not as specific as medical
databases
Reference repositories
Examples:
Advantages:
• Google Scholar –scholarly research across many disciplines
✓ May link to full text
and sources: articles, theses, books, abstracts and court
✓ Extensive coverage
opinions, from academic publishers, professional societies,
✓ Allows basic
online repositories, universities and other web sites;
“reference
• Mendeley – (one of) world’s largest crowd sourced
management”
research catalogues;
• Citeulike - web service for users to save and share citations
Limitations:
to academic papers. Based on the principle of social
➔ “Dirty” references
bookmarking, site works to promote and develop sharing
➔ Duplicates
of scientific references among researchers
➔ No definition of
scope

Bare essentials
According to Cochrane Handbook Guidance bare minimum of sources for an effectiveness
review in a non-resource constrained context:
• MEDLINE
• EMBASE
• Cochrane Library
But EMBASE is expensive subscription-based database - for low middle income countries
(LMICs) we suggest MEDLINE, Cochrane Library, Google Scholar plus free Evidence-Based
and LMIC sources

Complementary Sources
Is it sufficient to just search electronic sources? – Alas, no… (See: Papaioannou et al., 2011)
Try
▪ reference tracking,
▪ citation tracking
▪ hand-searching journals

Introduction on how to use PubMed

Searching PubMed https://www.youtube.com/watch?v=iTW9Gboters

PubMed Simple Subject Search

https://www.nlm.nih.gov/bsd/viewlet/search/subject/subject.html (1 min., Dec 2014)

PubMed Simple Subject Search: How It Works

https://www.nlm.nih.gov/bsd/viewlet/search/subject2/subject2.ht ml (1 min., Dec 2014)

Use MeSH to Build a Better PubMed Query:

https://www.youtube.com/watch?v=uyF8uQY9wys (3 min., YouTube video, February 2013)

Advanced Search Builder: https://www.youtube.com/watch?v=dncRQ1cobdc (2 min.,

YouTube video, December 2011)

Saving Searches (My NCBI)

Save Searches and Set E-mail Alerts https://www.nlm.nih.gov/bsd/viewlet/myncbi/saving/ (2
min., YouTube video, May 2013)
 CONDUCTING A SEARCH
5. Focus Your Question
Divide your question into concepts:
➢ Are multiple micronutrients more effective than supplements of iron + folic acid (IFA) in
pregnant women?
➢ Population = Pregnant Women
➢ Intervention = Multiple Micronutrients
➢ Comparison(s) = Supplements of iron + folic acid
➢ Outcome(s) = ????

6. Decide on most Appropriate Sources to search

POPULATION INTERVENTION OUTCOMES

-pregnant women -micronutrients Reduction in neonatal mortality
•Reduction in low birthweight
COMPARISON •Reduction in premature delivery
-Iron and folic acid •Cost effectiveness

7. Think of alternative terms for each concept

➔ HINT: Look at terms used in Clinical Studies on PubMed Clinical Queries (particularly
look at their MeSH terms) http://www.ncbi.nlm.nih.gov/pubmed/clinical

➔ HINT: Use PubMed Reminer to generate alternative terms http://hgserver2.amc.nl/cgi-

bin/miner/miner2.cgi

8. Search for each Concept separately

POPULATION INTERVENTION OUTCOMES

•Pregnant Women •Micronutrients •Reduce, Reducing,
•Female Reduction •neonatal
•Pregnancy COMPARISON mortality
•Folic Acid Deficiency •Iron and Folic Acid •Newborn
•Infant, Low Birth Weight •Iron, Dietary •Death
•Prenatal Nutritional •Dietary Supplements •Low birthweight
Physiological Phenomena •Supplementation •Premature delivery
•Maternal Nutritional ...etc •Cost effectiveness
Physiological •Costs; Economic
Phenomena…etc

9. Combine Concepts
INTERVENTION
OUTCOMES
• Micronutrients
POPULATION • Reduction in neonatal mortality
Pregnant OR
AND
Women AND AND • Reduction in low birthweight OR
• Reduction in premature delivery
COMPARISON OR
•Iron AND/OR Folic • Cost effectiveness
Acid
Sample Search Strategy

[POPULATION:] ("Mothers"[Mesh] OR "Pregnancy"[Mesh] OR mother* OR maternal OR

pregnancy) AND

[INTERVENTION:] ("Micronutrients"[Mesh] OR "multiple micronutrient*" OR multivitamin OR

(micronutrient* AND supplement*)

10. Limit your search

PubMed: The Filters Sidebar https://www.youtube.com/watch?v=696 R9GbOyvA (2 min.,
YouTube video, December 2012

Additional filters:
14) Article types
15) Text availability
16) PubMed
17) Commons
18) Publication
19) dates
20) Species
21) Languages
22) Sex
23) Subjects
24) Journal
25) Categories
26) Ages Search fields

11. Revise search as necessary, replicate in other sources, search citing articles and
references
 SU 2.3: How to read a scientific paper

➔ Abstract= A succinct summary at the beginning of a scientific paper that provides an

overview of the study's objectives, methods, key findings, and primary conclusions.

➔ Discussion Section: A segment of the paper where authors contextualise their findings,
compare them with existing literature, and discuss implications and future research
directions.

➔ Title: The heading of the paper which often encapsulates the primary focus or outcome
of the research.

➔ Conclusions: The main findings or outcomes derived from the research presented in the
paper.

➔ General Relevance: The potential impact of the paper's conclusions on a broader

scientific domain or society.

➔ Scope: The extent or range of view, outlook, application, operation, and effectiveness of
the presented research.

➔ Results Section: Part of the paper where the evidence or data is provided, usually
accompanied by statistical analyses to substantiate the paper's claims.

➔ Tables and Figures: Graphical representations in a paper that provide a snapshot of key
findings and help in understanding complex datasets.

➔ Methods: Details about the techniques, equipment, and procedures used to conduct the
research.

➔ Controls: Benchmarks used in experimental design to decipher between actual effects

and coincidental observations.

➔ Gold Standard: An accepted benchmark or standard in a field against which new

methods or findings are compared.

➔ Data: Raw facts and statistics collected together for reference or analysis in the paper.

➔ Logical Connection: The bridge of reasoning that exists between raw data and the
interpretations derived from it.

➔ Peer Review: A rigorous process where other experts in the field evaluate a scientific
paper before it's published.

➔ Credible Science: Research that sincerely addresses significant queries with meticulous
data collection and analysis.

➔ Funding Source: The entity or organisation that provides monetary support for the
research.
➔ Conflict of Interest: A situation where a person or organisation may have multiple
interests, one of which could possibly corrupt the motivation for an act in another.

➔ Replication Studies: Research projects conducted by independent groups to confirm the

findings of a previous study.

➔ Ethical Guidelines: Rules or principles designed to ensure research remains as objective

and reliable as possible.

➔ Assumptions: Foundational beliefs or principles that underlie the study's design,

methodology, or interpretation.

➔ Half-life =the time required for any specified property (e.g. the concentration of a
substance in the body) to decrease by half.

➔ Flunky = a person who performs relatively menial tasks for someone else, especially
obsequiously

➔ Pilot study = a small scale preliminary study conducted in order to evaluate feasibility,
time, cost, adverse events, and effect size (statistical variability) in an attempt to predict
an appropriate sample size and improve upon the study design prior to performance of a
full-scale study.

➔ Longitudinal cohort study = A longitudinal study is an observational research method in

which data is gathered for the same subjects repeatedly over a period of time.

➔ Errant = travelling in search of adventure

➔ Resistentialism is a jocular theory to describe "seemingly spiteful behaviour manifested by

inanimate objects", where objects that cause problems (like lost keys or a runaway
bouncy ball) are said to exhibit a high degree of malice toward humans.
Outcomes
Apply knowledge in order to read the identified literature, to interpret, to critically evaluate
and to integrate and then to convey this information in a systematic, logical, clear and
critically reasoned manner in a neat, technical and language edited scientific report
(literature review) that can be used practically for the nutrition education of individuals, groups
or communities;

Group activity (revision)

Arrange: best evidence (information source) above and unreliable on

• A = E-mail
• B = original research publication • C = meta analysis
• D = paper clipping
• E = review

Answer= C, B, E, D, A

Why read papers?

1. Provides current information
- Generally journal papers are current on the date of publication
- Textbooks are often years out of date
2. Fosters evidence-based practice
3. Allows replicability and innovation
- You can get enough details to replicate the research you read about
- Adapt cutting edge ideas and techniques to your own research
4. Enhance critical thinking and analysis
- You can see whether you agree with conclusions
5. Aids in patient education
6. Facillitates professional development and preparation

What kind of papers should I read?

1. Original research or review, opinion, Hypothesis?
2. Peer-reviewed or inivation only?
3. Published in a high-impact journal
4. Consider the authors reputation
5. Papers and journals are judged by their impact factors
6. Also need to ask if this a specialist journal or general journal
7. Specialist journals in nutrition include:
- American journal of clinical nutrition
- Frontiers in Nutrition
- Molecular nutrition and food research
- South African Journal of clinical nutrition

How to Select a Suitable Scientific Paper

1. Define your Purpose
2. Consider Time Constraints
3. Determine Desired Level of Detail
4. Assess Reliability: Peer Review, Journal Reputation, Author Expertise
5. Check Recency
6. Evaluate Relevance to Your Field and Interests
7. Look at Citations and Impact
Organisation of a paper
1. IMRAD
- Introduction
- Methods
- Results and
- Discussion
2. Plus
- Title
- Abstract
- Authors
- Acknowledgements
- Declarations
- references
- Tables and figures
- legends (an explanatory list of the abbreviations or symbols etc)

3. Variations
- Pressures on length versus
- accessibility to non-expert
- Combined Results and Discussion
- Methods at end
- Science and Nature
- On-line supplements

Reading a scientific paper

➢ This is not a novel
➢ No need for a linear approach
➢ Look at
1. Title
2. Abstract
3. Figures, tables
4. Introduction, results, discussion
5. Then methods

Struggle with the paper

➢ Active not passive reading
➢ Use highlighter, underline text, scribble comments or questions on it, make notes
➢ If at first you don’t understand, read and re-read, spiralling in on central points

How to take effective notes?

• Good note-taking saves time and helps clarify
your thoughts
• Suggested template for note taking
Reading a scientific paper
➢ Get into question-asking mode
- doubt everything
- nit-pick
- find fault
- just because it’s published, doesn’t mean it’s right
- get used to doing peer review

➢ Move beyond the text of the paper

- talk to other people about it
- read commentaries
- consult, dictionaries, textbooks, online links to references, figure legends to clarify things
you don’t understand

Evaluating a paper
1) What questions does the paper address?
2) What are the main conclusions of the paper?
3) What evidence supports those conclusions?
4) Do the data actually support the conclusions?
5) What is the quality of the evidence?
6) Why are the conclusions important?

What questions does the paper address?

➢ Descriptive research
- often in early stages of our understanding can't formulate hypotheses until we know what
is there.
- e.g. DNA sequencing and microarray
➢ Comparative research
- Ask how general or specific a phenomenon is
- e.g. homology searches, comparative genomics
➢ Analytical or hypothesis-driven research
- test hypotheses
- e.g. amino-acid composition can be used to predict thermophily
➢ Methodological research
- Find out new and better ways of doing things
- Describe new resources
- e.g. description of new homology search method, genome database
➢ Many papers combine all of the above

What are the main conclusions?

➢ Look at Title and Abstract, then Discussion
➢ Do they matter?
➢ Of general relevance?
➢ Broad in scope?
➢ Detailed but with far-reaching conclusions?
➢ Accessible to general audience?
What evidence supports them?
➢ Look at Results section and relevant tables and figures.
- May be one primary experiment to support a point.
- More often several different experiments or approaches combine to support a
particular conclusion.
- First experiment might have several possible interpretations, and the later ones are
designed to distinguish among these.
➢ In the ideal case, the Discussion begins with a section of the form "Three lines of evidence
provide support for the conclusion that...."

Judging the quality of the evidence

➢ You need to understand the methods thoroughly
- May need to consult textbooks
➢ You need to know the limits of the methods
- e.g. an assignment of distant homology has to be treated as working hypothesis
rather than fact
➢ Separate fact from interpretation
➢ Are the results expected?
- Extraordinary claims require extraordinary evidence
➢ Look at details, assess them for plausibility
- The veracity of whole depends on the veracity of its parts!
- e.g. look at gene lists, what is missing but expected, what is present, but
unexpected?
➢ Where are the controls?
➢ What is the gold standard?
- e.g. when predicting protein-coding genes, when evaluating annotation, how can
you assess accuracy?

Do the data support the conclusions?

➢ Data may be believable but not support the conclusion the authors wish to reach
➢ logical connection between the data and the interpretation is not sound (often hidden
by bad writing)
➢ might be other interpretations that are consistent with the data

Rule of thumb
• If multiple approaches, multiple lines of evidence, from different directions, supporting the
conclusions, then more credible.
Question assumptions!
• Identify any implicit or hidden assumptions used by the authors in interpreting their data?
Importance of Funding Source in Evaluating a Study

➔ Funding can introduce potential biases.

➔ Studies funded by vested interests may lean towards positive results.
➔ However, transparent declaration of funding and conflicts of interest is crucial.
➔ Ethical guidelines are in place to handle potential biases.
➔ Peer review and replication studies serve as checks and balances.

Conclusion. Peer review: you are the judge!

❖ Medical journals prioritize “important” science, but author background can influence
reviewer decisions.
❖ Double-blinded review isn’t entirely blind.
❖ Credibility assessment is vital.
❖ Credible science is a reflection of genuine effort in research and communication.
❖ No system is foolproof; "buyer beware" applies to interpreting published science.
❖ Always engage critically with scientific content.
 SU 2.4.1: Nutrition Research Methodology

Meta-analysis: A statistical technique used to combine results from multiple studies to identify
a common effect.

Systematic Review: A research method that answers a defined question by collecting and
summarising all empirical evidence fitting specific eligibility criteria.

Literature Review: A qualitative method that provides an overview of a topic based on the
author's knowledge, experience, and interpretation of the available literature.

PICO Method: A technique used to formulate research questions; it stands for Population,
Intervention, Comparator, and Outcome.

Randomised Controlled Studies (RCTs): Experiments that randomly assign participants to

either the treatment or the control group to determine the effect of the intervention.

Cohort Studies: A type of observational study where a group of people is followed over time
to see if they develop a particular outcome.

Case Control Studies: Observational studies where two groups differing in outcome are
identified and compared to find a causal factor.

Bibliographic databases: Digital databases that catalog published academic research.

Examples include Medline/Pubmed, EMBASE, Cochrane Library, and CINAHL.

GradePro (Grade Profiler): A software used in determining the quality of studies.

Forest Plot: A graphical representation of individual study results and the combined meta-
analysis result.

Rapid Reviews: Accelerated systematic reviews undertaken when decisions need to be

made urgently.

Grey Literature: Material that has not been formally published, such as reports, conference
proceedings, or academic theses.

Downs and Black checklist: A checklist used for the assessment of the methodological
quality of both randomized and non-randomized studies.
Introduction
Reviews usually form part of a research protocol, dissertation/thesis, grant application or
research publication, but may be a standalone publication

What is involved in reviewing the literature to give a review

1. Collect and read relevant literature
2. Provide an overview of significant literature
3. Highlight key concepts and papers

Functions of reviews (1)

1. Summarise existing literature
2. Provide not merely a summary of previous findings, but also a critical examination,
appraisal and synthesis of existing reports
3. Gives the reader the current state of knowledge about a subject
- Include all results/the most important results, also negative results
- Gives strengths and limitations of the underlying research
- What is known and what is not known
- Need for further research?
4. Identify key themes and trends
5. Make sense of research
- Highlight significant studies
- Extract the essence from existing information
- Interpret research results
- Put new results in context
6. Coping with information overload
- We do not have time to read and digest all the relevant primary research material in
fields of interest, therefore we rely on literature review to keep up to date

7. Systematic reviews and meta- analyses are essential for evidence- based or informed
health care

8. Provide a reference point for researchers, students, and professionals

Reviews upon which we will focus for NUTR321

Systematic reviews:
1. Narrative or Literature Review:
➢ A qualitative technique that provides an overview of a particular topic based on the
author's knowledge, experience, and interpretation of the available literature. Unlike
systematic reviews, it doesn't follow a strict protocol, making it more prone to biases
and subjective interpretations.
2. Meta-analysis:
➢ Quantitative technique, results of various individual studies (e.g. means and standard
deviation) thrown together, processed statistically in order to reach an all-round
conclusion.
3. Systematic review:
➢ Results not statistically processed. Complete summary of all the studies and their
results – critical deductions are made.
4. Pooled analysis - not a real review, but rather original research (primary source):
➢ Like meta-analysis, but pool raw data from various studies.
➢ By amalgamating primary data, it allows for a more in-depth analysis, often yielding
insights not evident in the individual studies.

Reviews of evidence and our confidence in the reliability

Shortcomings of reviews (1)
Shortcomings of traditional (narrative) literature reviews excluding systematic and meta-
analyses:

1. Potential for bias due to:

➢ Incomplete search, e.g. only in English or one database, e.g. Medline
➢ Selective inclusion to fit in with a preconceived idea
➢ “Cherry picking”
2. Insufficient attention given to quality of studies included
➢ Studies with poor study design are included
➢ Inadequate attention to sample size – size matters!
3. Publication Bias
4. Outdated Information
5. Difficulty in Identifying All Relevant Studies
6. Time-Consuming Process
7. Lack of Consensus on Quality Assessment
8. Narrative Reviews Lack Transparency

Better reviews with less shortcomings: systematic reviews or meta-analyses (1)

Here's how they can address these limitations:

1. Bias Mitigation: Systematic reviews and meta- analyses adopt a structured protocol,
setting clear inclusion/exclusion standards, which curbs selection bias. Additionally,
individual studies are scrutinized for risk of bias.
2. Rigorous Evaluation: These reviews employ robust tools to assess the calibre of
encompassed studies, ensuring reliance on top- tier evidence.
3. Countering Publication Bias: Comprehensive search methodologies capture both
published and unpublished works, mitigating publication bias. For a visual check, meta-
analyses might incorporate a funnel plot.
4. Relevance and Timeliness: Regular updates keep systematic reviews current, reflecting
the latest research trends.
5. Managing Methodological Variability: A systematic approach considers study
heterogeneity. Meta-analyses use specific statistical techniques to amalgamate results,
alongside tests to gauge data pooling viability.
6. Exhaustive Research: These search strategies are far-reaching, tapping into multiple
databases and manual exploration, ensuring all pertinent studies are flagged.
7. Time and Quality Balance: While time- intensive, the richness of insights from systematic
reviews and meta-analyses often justifies the effort.
8. Heightened Transparency: Contrary to narrative reviews, these reviews abide by a
transparent, stipulated protocol, bolstering the process's clarity and reproducibility
 Components of a review paper
-Structure varies according to the type of review
-Main structure for reviews excluding systematic reviews and meta-analyses
1) Title (+authors & addresses)
2) Abstract (+key words)
3) Introduction (issue/need? What does your paper contribute? What is its purpose?
Background/context as needed?)
4) Discussion (how are you evaluating the field/literature etc.? What kind of analysis are you
contributing and why? What sub-headings will best “tell the story” and clarify your
argument/structure? What is the value of this review of the literature?)
5) Conclusions (overall conclusions? So what? Contribution made? Way forward – new
research should investigate…?)
6) Literature citations (whose work are you covering?)
7) Tables and figures if needed

Components of a published systematic review/meta- analyses

1. Title (+authors & addresses)
2. Abstract (+key words)
3. Introduction
4. Methods (search strategy, data extraction, statistical analysis (in meta-analysis))
5. Results
6. Discussion
7. Acknowledgements
8. References
9. Tables and figures prominent

Comparison between a systematic overview or meta-analysis and narrative

overview

Systematic review or meta-analyses Narrative review

1. Detailed, systematic search strategy. 1. No search strategy, publications not collected

2. ALL the studies on the subject. in systematic manner.
3. Quality appraisal of studies. 2. Selective inclusion of publications may occur.
4. “Bias” limited. 3. Often no quality appraisal of studies.
5. Deductions reliable and accurate 4. Bias may occur.
5. Deductions not necessarily reliable and/or
accurate.

Comparison between a systematic overview and meta-analysis

• A systematic review
answers a defined research question by collecting and summarising all empirical
evidence that fits pre-specified eligibility criteria.
• A meta-analysis
Takes the systematic review one step further by using statistical methods to summarise
the results of these studies. Meta-analysis is the statistical procedure for combining data
from multiple studies.
Steps of compiling a systematic review or meta-analysis

Steps
1) Formulate an objective or research question.
2) Define criteria for inclusion in studies.
3) Identify all studies that comply with this.
4) Determine quality of studies.
5) Compile the available data.
6) Analyse the data statistically if possible (meta-analysis) or in the form of a table.
7) Write a research article on the results

1. Formulate a research question:The PICO method

➢ Experimental participants/population
➢ Indicator/intervention • Control/ comparator
➢ Outcome = result
➢ Application of PICO method p 71 of textbook Ehrlich and Joubert

2.Define criteria for inclusion in studies

➢ Which type of study will best answer the question?
➢ Randomised controlled studies (RCTs) – mostly used in meta- analysis
- Golden standard
➢ Case control studies
➢ Cohort studies

3.Identify all studies that comply with this

➢ Bibliographic databases:
➢ Medline/Pubmed: 1966 + selected
➢ Publications
➢ EMBASE: Pharmaceutical studies
➢ Cochrane Library: clinical trials
➢ CINAHL: Nursing and other health care

4.Determine quality of studies

➢ GradePro (Grade Profiler) 3.2.2 software
➢ Downs and Black checklist for non- randomized studies
➢ Critical reading of subject of study, number of trial participants, duration of intervention,
control group.

5.Compile the available data

➢ Summarise in table format:
➢ How many studies found positive results, how many negative and how many no effect.
➢ Meta-analysis: statistical processing, Forest plot

6.Write a research article on the results

➢ Structure:
- Introduction, methods, results, conclusion
➢ Reference list
Rapid reviews
Rapid reviews (also rapid evidence reviews or rapid evidence assessments) = an
accelerated systematic review that forms part of methodologies in assessing evidence

➢ Expert searching and the use of extended search techniques such as locating the grey
literature are used.
➢ undertaken when
- When decision should be made urgently
- Central to evidence-based decision-making for public health policy experts and
medical officials who must use the evidence to make decisions
 Shortcomings of reviews
-Shortcomings of traditional (narrative) literature reviews excluding systematic and
metaanalyses:
1. Incomplete search, e.g. only in English or one database, e.g. Medline
2. Selective inclusion to fit in with a preconceived idea
-“Cherry picking”
3. Insufficient attention given to quality of studies included
▪ Studies with poor study design are included
▪ Inadequate attention to sample size

Better reviews with less shortcomings

✓ systematic reviews or meta-analyses
✓ There is also some other kinds of reviews

Systematic reviews:
Meta-analysis:
• Quantitative technique, results of various individual studies (e.g. means and standard
deviation) thrown together, processed statistically in order to reach an all-round
conclusion.

Systematic review:
• Resultate nie statisties verwerk nie. Volledige opsomming van al die studies en hul
resultate – kritiese afleidings word gemaak./ Results not statistically processed. Complete
summary of all the studies and their results – critical deductions are made.

Pooled analysis - not a real review, but rather original research:

• Like meta-analysis, but pool raw data from various studies.

Steps
8) Formulate an objective or research question.
9) Define criteria for inclusion in studies.
10) Identify all studies that comply with this.
11) Determine quality of studies.
12) Compile the available data.
13) Analyse the data statistically if possible (meta-analysis) or in the form of a table.
14) Write a research article on the results.

Comparison between a systematic overview or meta-analysis and narrative overview

Systematic review or meta-analyses Narrative review

6. Detailed, systematic search strategy. 6. No search strategy, publications not collected

7. ALL the studies on the subject. in systematic manner.
8. Quality appraisal of studies. 7. Selective inclusion of publications may occur.
9. “Bias” limited. 8. Often no quality appraisal of studies.
10. Deductions reliable and accurate 9. Bias may occur.
10. Deductions not necessarily reliable and/or
accurate.

->Table 6,8 p 76 Ehrlich and Joubert: Contrasting traditional and systematic reviews
Comparison between a systematic overview and meta-analysis
• A systematic review answers a defined research question by collecting and summarising
all empirical evidence that fits pre-specified eligibility criteria.
• A meta-analysis takes the systematic review one step further by using statistical methods
to summarise the results of these studies. Meta-analysis is the statistical procedure for
combining data from multiple studies.

Steps of compiling a systematic review or meta-analysis

1. Formulate a research question: The PICO method
2. Experimental participants/population
3. Indicator/intervention
4. Control/ comparator
5. Outcome = result
->Application of PICO method p 71 of textbook Ehrlich and Joubert

Define criteria for inclusion in studies

• Which type of study will best answer the question?
• Randomised controlled studies (RCTs) – mostly used in metaanalysis
• Case control studies
• Cohort studies

Identify all studies that comply with this

▪ Bibliographic databases:
▪ Medline/Pubmed: 1966 + selected publications
▪ EMBASE: Pharmaceutical studies
▪ Cochrane Library: clinical tests
▪ CINAHL: Nursing and other health care

Determine quality of studies

▪ GradePro (Grade Profiler) 3.2.2 software
▪ Downs and Black checklist for non-randomized studies
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756728/p df/v052p00377.pdf
▪ Critical reading of subject of study, number of trial participants, duration of intervention,
control group.

Compile the available data

->Summarise in table format:
▪ How many studies found positive results, how many negative and how many no effect.
▪ Metaanalysis: statistical processing, Forest plot
https://en.wikipedia.org/wiki/Forest_plot
https://www.youtube.com/watch?v=py-L8DvJmDc
Figure 3. Forest plot of low carbohydrate versus balanced diets in overweight and obese
adults for weight loss (kg) at 3–6 months.

Write a research article on the results

Structure:
1. Introduction, methods, results, conclusion.
2. Do not commit plagiarism.
3. Reference list.

Rapid reviews
▪ Rapid reviews (also rapid evidence reviews or rapid evidence assessments) = a kind of
accelerated systematic review that forms part of methodologies in assessing evidence.
-Expert searching and the use of extended search techniques such as locating the
grey literature are used.
▪ undertaken when:
-when decision should be made urgently (i.e., policy or clinical urgency), new
medical devices and policy.
-central to evidence-based decision-making for public health policy experts and
medical officials who must use the evidence to make decisions
▪ Rapid review - Source: http://hlwiki.slais.ubc.ca/index.php/Rapid_reviews

The literature study/review of the dissertation or thesis

▪ The literature review/study comes after the introduction and before the methods/first
article in the dissertation/thesis
▪ Some similarities to reviews that are published
▪ It is a review of works previously published by other scholars
-it is critical and factual overview
 Tips for literature review writing…
1. The literature review is only as good as the literature search that preceded it
➔ Use your new search skills to locate related literature
➔ The completeness of the literature review refers not to the length of the review, but
rather the completeness of the reference list
2. The literature review has four basic parts :
(1) Introduction
(2) Body
(3) Summary/ recommendations and/or conclusions and
(4) Reference list
▪ Introduction – explain the purpose of the review and the how and why of its
organization
▪ Body – is organized around important topics that serve as subheadings; requires
considerable attention
▪ Summary – summarize important implications and suggest directions for future
research

3. Best way to organise the topics and the info within topics is to develop an outline
▪ Select a published review paper from a journal on a topic as closely related to
yours/similar to yours and reconstruct the outline the author(s) used and adapt as
needed

4. Use the funnel/top-down method of structuring the literature review

▪ Structured from broad (pertaining to topic) to subtopics to specific
(pertaining to your specific research question)
▪ First, outline what you propose to write, then write it and then
rewrite as needed
▪ Framework can change when as one writes

5. Critically evaluate reference material

➔ Identify the seminal works and those that are directly related to
your topic
➔ More relevant and important studies can be presented in greater
detail
➔ Studies with the same outcome can be covered in one sentence
➔ Synthesise the facts
➔ Cite primary sources and if secondary sources are cited they are systematic reviews
or meta-analyses
➔ Theoretical, methodological and interpretative aspects of research should be
critically evaluated not study by study, but rather across studies
• Explain how each work is similar to and how it varies from others
▪ -Problems identified by criticism provide opportunities for future research
▪ -If you point out flaws without appreciating the good you imply that your
research is going to be far superior to all the work you’ve trashed and your
going to have to live up to that
 ➔ Reporting verbs:
Argue; assert; assume; challenge; claim; contend; contradict; describe; dispute;
emphasise; establish; examine; find; maintain; note; object; observe; persuade;
propose; prove; purport; recommend; refute; reject; remark; suggest; support
➔ Making links between studies that agree
▪ Similarly, author A point to…
▪ Likewise, author B makes the case that…
▪ Author C also makes this point…
▪ Making links between studies that disagree
▪ However, author D points to…
▪ Conversely, author E argues…

6. Write the introduction for your literature review last

• In it you comment on the scope of your lit rev (comment on what you included and
why) and how you structured it (briefly discuss the order of the categories)
7. When you are convinced the review represents your best effort
▪ have an outside graduate student read it and welcome suggestions to improve the
review before presenting it to your supervisor
▪ Mark your own review using the evaluation sheet

8. Neat, technically polished unit

▪ Spell-check
▪ Check for errors of style and grammar
▪ Are sentences short, to the point, and stripped of redundant words
▪ Is the point that you are making clear to the reader in every paragraph
▪ Are paragraphs logical units of thought, argument or description
▪ Check text for relevance, redundancy and repetition
▪ Check for flow; does everything move logically into what follows

The purpose of the literature review in the dissertation or thesis

A good literature review shows:
1. That you (the student) are aware of what is going on in the field
2. That there is a theory base for the research you are going to do in NUTR471
3. How your NUTR471 research fits in with what has already been done
4. That the proposed NUTR471 research has significance
5. That your NUTR471 research will lead to new knowledge

Rules to avoid plagiarism

1. Keep track of all source materials
2. Use quotation marks when directly quoting words of others
3. Use own words when paraphrasing ideas of others instead o simply changing word order
or substituting words
4. Cite the original source of info or ideas you express in the review
5. Synthesise the facts