{"version":"1.0.0","segments":[{"speaker":"Kylie Matthews","startTime":2.399,"endTime":4.439,"body":"refeeding"},{"speaker":"Kylie Matthews","startTime":2.399,"endTime":4.439,"body":"syndrome really interested me"},{"speaker":"Kylie Matthews","startTime":4.439,"endTime":7.409,"body":"because as you mentioned before,"},{"speaker":"Kylie Matthews","startTime":4.439,"endTime":7.409,"body":"there's not a great deal of"},{"speaker":"Kylie Matthews","startTime":7.409,"endTime":10.499,"body":"evidence, no one really knows"},{"speaker":"Kylie Matthews","startTime":7.409,"endTime":10.499,"body":"what they're doing. It's all"},{"speaker":"Kylie Matthews","startTime":10.499,"endTime":14.129,"body":"it's very confusing. I sometimes"},{"speaker":"Kylie Matthews","startTime":10.499,"endTime":14.129,"body":"I don't know where anyone's"},{"speaker":"Kylie Matthews","startTime":14.159,"endTime":17.579,"body":"pitch their numbers from I don't"},{"speaker":"Kylie Matthews","startTime":14.159,"endTime":17.579,"body":"even know where Australia has"},{"speaker":"Kylie Matthews","startTime":17.579,"endTime":21.539,"body":"picked their numbers from. We've"},{"speaker":"Kylie Matthews","startTime":17.579,"endTime":21.539,"body":"got a conservative bunch of"},{"speaker":"Kylie Matthews","startTime":21.569,"endTime":25.019,"body":"clinicians. And then the"},{"speaker":"Kylie Matthews","startTime":21.569,"endTime":25.019,"body":"guidelines aren't made up on"},{"speaker":"Kylie Matthews","startTime":25.019,"endTime":27.959,"body":"research. Most of them are based"},{"speaker":"Kylie Matthews","startTime":25.019,"endTime":27.959,"body":"on expert opinions. So if you've"},{"speaker":"Kylie Matthews","startTime":27.959,"endTime":30.479,"body":"got experts that are cautious,"},{"speaker":"Kylie Matthews","startTime":27.959,"endTime":30.479,"body":"then of course, they're going to"},{"speaker":"Kylie Matthews","startTime":30.479,"endTime":33.899,"body":"recommend cautious"},{"speaker":"Kylie Matthews","startTime":30.479,"endTime":33.899,"body":"recommendations. When I was a"},{"speaker":"Kylie Matthews","startTime":33.899,"endTime":37.829,"body":"student, the number of times I"},{"speaker":"Kylie Matthews","startTime":33.899,"endTime":37.829,"body":"had to pay the doctor to tell"},{"speaker":"Kylie Matthews","startTime":37.829,"endTime":40.109,"body":"them that I thought a patient"},{"speaker":"Kylie Matthews","startTime":37.829,"endTime":40.109,"body":"was at risk of refeeding"},{"speaker":"Kylie Matthews","startTime":40.109,"endTime":43.979,"body":"syndrome was borderline"},{"speaker":"Kylie Matthews","startTime":40.109,"endTime":43.979,"body":"ridiculous, like I can't believe"},{"speaker":"Kylie Matthews","startTime":44.009,"endTime":49.199,"body":"I used to harass the medics so"},{"speaker":"Kylie Matthews","startTime":44.009,"endTime":49.199,"body":"much, Dr. Kelly Matthews, she's"},{"speaker":"Kylie Matthews","startTime":49.199,"endTime":52.229,"body":"a dietitian. She's also a"},{"speaker":"Kylie Matthews","startTime":49.199,"endTime":52.229,"body":"researcher. And it all started"},{"speaker":"Kylie Matthews","startTime":52.229,"endTime":54.869,"body":"when she disagreed with the"},{"speaker":"Kylie Matthews","startTime":52.229,"endTime":54.869,"body":"placement supervisor so much"},{"speaker":"Kylie Matthews","startTime":54.899,"endTime":58.169,"body":"about if a patient had refeeding"},{"speaker":"Kylie Matthews","startTime":54.899,"endTime":58.169,"body":"syndrome and she decided to go"},{"speaker":"Kylie Matthews","startTime":58.169,"endTime":61.739,"body":"ahead and get a PhD in the"},{"speaker":"Kylie Matthews","startTime":58.169,"endTime":61.739,"body":"topic. Kelly is a dietitian"},{"speaker":"Kylie Matthews","startTime":61.739,"endTime":64.739,"body":"based in Queensland, Australia,"},{"speaker":"Kylie Matthews","startTime":61.739,"endTime":64.739,"body":"who graduated from Griffith"},{"speaker":"Kylie Matthews","startTime":64.739,"endTime":69.329,"body":"University in 2014 and completed"},{"speaker":"Kylie Matthews","startTime":64.739,"endTime":69.329,"body":"her PhD in refeeding syndrome in"},{"speaker":"Kylie Matthews","startTime":69.329,"endTime":72.899,"body":"2018. 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I"},{"speaker":"Aaron Boysen","startTime":154.32,"endTime":157.95,"body":"thought about doing veterinary"},{"speaker":"Aaron Boysen","startTime":157.95,"endTime":161.64,"body":"science. And then all of a"},{"speaker":"Aaron Boysen","startTime":157.95,"endTime":161.64,"body":"sudden one day I woke up and"},{"speaker":"Aaron Boysen","startTime":161.76,"endTime":165.93,"body":"realised I love food. And I love"},{"speaker":"Aaron Boysen","startTime":161.76,"endTime":165.93,"body":"science and why don't I put"},{"speaker":"Aaron Boysen","startTime":165.93,"endTime":170.49,"body":"those two together? 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Why"},{"speaker":"Aaron Boysen","startTime":210.69,"endTime":213.72,"body":"didn't you just go straight into"},{"speaker":"Aaron Boysen","startTime":210.69,"endTime":213.72,"body":"work and actually working with"},{"speaker":"Aaron Boysen","startTime":213.72,"endTime":217.17,"body":"people and food I never planned"},{"speaker":"Aaron Boysen","startTime":213.72,"endTime":217.17,"body":"to it's actually funny, I get a"},{"speaker":"Aaron Boysen","startTime":217.17,"endTime":221.34,"body":"yearly reminder on Facebook that"},{"speaker":"Aaron Boysen","startTime":217.17,"endTime":221.34,"body":"I posted that I would never do a"},{"speaker":"Aaron Boysen","startTime":221.34,"endTime":223.92,"body":"PhD when I was in the middle of"},{"speaker":"Aaron Boysen","startTime":221.34,"endTime":223.92,"body":"my master's research."},{"speaker":"Kylie Matthews","startTime":225.15,"endTime":227.19,"body":"I did my"},{"speaker":"Kylie Matthews","startTime":225.15,"endTime":227.19,"body":"master's research because I"},{"speaker":"Kylie Matthews","startTime":227.19,"endTime":230.88,"body":"didn't like the other streams"},{"speaker":"Kylie Matthews","startTime":227.19,"endTime":230.88,"body":"through uni through the Master's"},{"speaker":"Kylie Matthews","startTime":230.88,"endTime":233.37,"body":"course, I think there was a"},{"speaker":"Kylie Matthews","startTime":230.88,"endTime":233.37,"body":"business stream and there was a"},{"speaker":"Kylie Matthews","startTime":233.37,"endTime":236.04,"body":"community stream and I thought,"},{"speaker":"Kylie Matthews","startTime":233.37,"endTime":236.04,"body":"Oh, no research would be really"},{"speaker":"Kylie Matthews","startTime":236.04,"endTime":240.36,"body":"nice. And then in our programme,"},{"speaker":"Kylie Matthews","startTime":236.04,"endTime":240.36,"body":"we were offered a variety of"},{"speaker":"Kylie Matthews","startTime":240.36,"endTime":242.52,"body":"different topics. And someone"},{"speaker":"Kylie Matthews","startTime":240.36,"endTime":242.52,"body":"said,"},{"speaker":"Kylie Matthews","startTime":243.66,"endTime":245.46,"body":"you don't want to go with"},{"speaker":"Kylie Matthews","startTime":243.66,"endTime":245.46,"body":"Michelle Palmer unless you're"},{"speaker":"Kylie Matthews","startTime":245.46,"endTime":248.67,"body":"going to really put in 100%. 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So I thought it would be"},{"speaker":"Kylie Matthews","startTime":259.14,"endTime":263.13,"body":"really great to just go into"},{"speaker":"Kylie Matthews","startTime":259.14,"endTime":263.13,"body":"that and have a look."},{"speaker":"Aaron Boysen","startTime":264.24,"endTime":268.14,"body":"Michelle was a"},{"speaker":"Aaron Boysen","startTime":264.24,"endTime":268.14,"body":"hard worker. She was a hard"},{"speaker":"Aaron Boysen","startTime":268.14,"endTime":270.93,"body":"supervisor. And I can say that"},{"speaker":"Aaron Boysen","startTime":268.14,"endTime":270.93,"body":"because she went on to be my PhD"},{"speaker":"Aaron Boysen","startTime":270.93,"endTime":274.11,"body":"advisor and I love it a bit. And"},{"speaker":"Aaron Boysen","startTime":270.93,"endTime":274.11,"body":"she knows I say this sort of"},{"speaker":"Aaron Boysen","startTime":274.11,"endTime":278.91,"body":"stuff. But she originally while"},{"speaker":"Aaron Boysen","startTime":274.11,"endTime":278.91,"body":"I was going through that"},{"speaker":"Aaron Boysen","startTime":278.94,"endTime":284.97,"body":"suggested that I would be good"},{"speaker":"Aaron Boysen","startTime":278.94,"endTime":284.97,"body":"for a PhD candidate. And that"},{"speaker":"Aaron Boysen","startTime":284.97,"endTime":288.78,"body":"stuck with me and then it's"},{"speaker":"Aaron Boysen","startTime":284.97,"endTime":288.78,"body":"really quite difficult to get"},{"speaker":"Aaron Boysen","startTime":288.78,"endTime":291.78,"body":"into the workforce here. I"},{"speaker":"Aaron Boysen","startTime":288.78,"endTime":291.78,"body":"always knew I wanted to be a"},{"speaker":"Aaron Boysen","startTime":291.78,"endTime":297.54,"body":"hospital clinician. I think a"},{"speaker":"Aaron Boysen","startTime":291.78,"endTime":297.54,"body":"lot of students do. And then it"},{"speaker":"Aaron Boysen","startTime":297.54,"endTime":300.6,"body":"just seemed like a really good"},{"speaker":"Aaron Boysen","startTime":297.54,"endTime":300.6,"body":"option and I could work one day"},{"speaker":"Aaron Boysen","startTime":300.6,"endTime":304.38,"body":"a week while I was doing my PhD"},{"speaker":"Aaron Boysen","startTime":300.6,"endTime":304.38,"body":"at the hospital that Michelle"},{"speaker":"Aaron Boysen","startTime":304.38,"endTime":308.01,"body":"works at. So I got a nice"},{"speaker":"Aaron Boysen","startTime":304.38,"endTime":308.01,"body":"balance, having some clinical"},{"speaker":"Aaron Boysen","startTime":308.01,"endTime":309.27,"body":"work while doing my PhD."},{"speaker":"Aaron Boysen","startTime":309.509,"endTime":311.849,"body":"Sounds like someone always bet"},{"speaker":"Aaron Boysen","startTime":309.509,"endTime":311.849,"body":"you to do wondering that you"},{"speaker":"Aaron Boysen","startTime":312.179,"endTime":314.819,"body":"shouldn't go, Michelle, unless"},{"speaker":"Aaron Boysen","startTime":312.179,"endTime":314.819,"body":"you're gonna work hard. And"},{"speaker":"Aaron Boysen","startTime":314.819,"endTime":318.899,"body":"you're just like, I can work"},{"speaker":"Aaron Boysen","startTime":314.819,"endTime":318.899,"body":"right? I can do that. 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So I would do work for a"},{"speaker":"Aaron Boysen","startTime":345.3,"endTime":347.91,"body":"few hours every day, and then"},{"speaker":"Aaron Boysen","startTime":347.91,"endTime":351.27,"body":"really have to stop myself from"},{"speaker":"Aaron Boysen","startTime":347.91,"endTime":351.27,"body":"having an app and keep working."},{"speaker":"Aaron Boysen","startTime":351.84,"endTime":354.84,"body":"And then you get to the last"},{"speaker":"Aaron Boysen","startTime":351.84,"endTime":354.84,"body":"year of it, and you're like not,"},{"speaker":"Aaron Boysen","startTime":354.84,"endTime":358.53,"body":"I gotta punch it out. So I"},{"speaker":"Aaron Boysen","startTime":354.84,"endTime":358.53,"body":"actually started, I did it. The"},{"speaker":"Aaron Boysen","startTime":358.53,"endTime":361.11,"body":"opposite way to most people"},{"speaker":"Aaron Boysen","startTime":358.53,"endTime":361.11,"body":"actually started working full"},{"speaker":"Aaron Boysen","startTime":361.11,"endTime":366.09,"body":"time in the last six months of"},{"speaker":"Aaron Boysen","startTime":361.11,"endTime":366.09,"body":"my PhD. So I really had to work"},{"speaker":"Aaron Boysen","startTime":366.09,"endTime":368.88,"body":"extremely hard to get it over"},{"speaker":"Aaron Boysen","startTime":366.09,"endTime":368.88,"body":"the line and finish the writing"},{"speaker":"Aaron Boysen","startTime":368.88,"endTime":371.34,"body":"part of it. 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So my PhD"},{"speaker":"Aaron Boysen","startTime":398.82,"endTime":402.96,"body":"has opened a lot of doors for"},{"speaker":"Aaron Boysen","startTime":402.96,"endTime":407.46,"body":"me, I've been asked to present"},{"speaker":"Aaron Boysen","startTime":402.96,"endTime":407.46,"body":"internationally, like at Aspen"},{"speaker":"Aaron Boysen","startTime":407.46,"endTime":411.42,"body":"last year, which was really"},{"speaker":"Aaron Boysen","startTime":407.46,"endTime":411.42,"body":"lovely. I've been able to act up"},{"speaker":"Aaron Boysen","startTime":411.42,"endTime":414.51,"body":"at work in the research"},{"speaker":"Aaron Boysen","startTime":411.42,"endTime":414.51,"body":"coordinator roles and that sort"},{"speaker":"Aaron Boysen","startTime":414.51,"endTime":419.7,"body":"of thing. But I also work in a"},{"speaker":"Aaron Boysen","startTime":414.51,"endTime":419.7,"body":"department that has a lot of"},{"speaker":"Aaron Boysen","startTime":419.73,"endTime":423.15,"body":"dieticians with PhDs. And"},{"speaker":"Aaron Boysen","startTime":419.73,"endTime":423.15,"body":"because we all want to do"},{"speaker":"Aaron Boysen","startTime":423.15,"endTime":426.78,"body":"research, we also really need"},{"speaker":"Aaron Boysen","startTime":423.15,"endTime":426.78,"body":"those people that just love to"},{"speaker":"Aaron Boysen","startTime":426.78,"endTime":429.78,"body":"do clinical work, because"},{"speaker":"Aaron Boysen","startTime":426.78,"endTime":429.78,"body":"researchers are always going to"},{"speaker":"Aaron Boysen","startTime":429.78,"endTime":433.14,"body":"want to do research, I love a"},{"speaker":"Aaron Boysen","startTime":429.78,"endTime":433.14,"body":"bit of a mix of clinical work"},{"speaker":"Aaron Boysen","startTime":433.14,"endTime":435.66,"body":"and research work. But I know"},{"speaker":"Aaron Boysen","startTime":433.14,"endTime":435.66,"body":"not all researchers are like"},{"speaker":"Aaron Boysen","startTime":435.66,"endTime":439.32,"body":"that. So I think it's important"},{"speaker":"Aaron Boysen","startTime":435.66,"endTime":439.32,"body":"to just focus on what you really"},{"speaker":"Aaron Boysen","startTime":439.32,"endTime":444.33,"body":"want to do. And don't just do a"},{"speaker":"Aaron Boysen","startTime":439.32,"endTime":444.33,"body":"PhD because someone looks"},{"speaker":"Aaron Boysen","startTime":444.33,"endTime":445.62,"body":"impressive, because they've done"},{"speaker":"Aaron Boysen","startTime":444.33,"endTime":445.62,"body":"it."},{"speaker":"Aaron Boysen","startTime":446.94,"endTime":448.71,"body":"I've actually really, to be"},{"speaker":"Aaron Boysen","startTime":446.94,"endTime":448.71,"body":"honest, that's a really"},{"speaker":"Aaron Boysen","startTime":448.71,"endTime":451.62,"body":"interesting response. Because I"},{"speaker":"Aaron Boysen","startTime":448.71,"endTime":451.62,"body":"feel like sometimes a lot of"},{"speaker":"Aaron Boysen","startTime":451.62,"endTime":455.07,"body":"people who from the PhD"},{"speaker":"Aaron Boysen","startTime":451.62,"endTime":455.07,"body":"background are very encouraging."},{"speaker":"Aaron Boysen","startTime":455.07,"endTime":457.5,"body":"And I don't know a little bit"},{"speaker":"Aaron Boysen","startTime":455.07,"endTime":457.5,"body":"like they, they really want"},{"speaker":"Aaron Boysen","startTime":457.5,"endTime":459.81,"body":"everyone to do PhDs and they"},{"speaker":"Aaron Boysen","startTime":457.5,"endTime":459.81,"body":"think it's for everybody,"},{"speaker":"Aaron Boysen","startTime":459.84,"endTime":461.79,"body":"however, but when I talk to"},{"speaker":"Aaron Boysen","startTime":459.84,"endTime":461.79,"body":"people on the ground, there's"},{"speaker":"Aaron Boysen","startTime":461.79,"endTime":465.63,"body":"loads of dieticians who are"},{"speaker":"Aaron Boysen","startTime":461.79,"endTime":465.63,"body":"amazing clinicians, amazing for"},{"speaker":"Aaron Boysen","startTime":465.63,"endTime":470.22,"body":"patients really just fantastic"},{"speaker":"Aaron Boysen","startTime":465.63,"endTime":470.22,"body":"people. But they really don't"},{"speaker":"Aaron Boysen","startTime":470.22,"endTime":473.88,"body":"enjoy the research side. And I"},{"speaker":"Aaron Boysen","startTime":470.22,"endTime":473.88,"body":"think even some of them have"},{"speaker":"Aaron Boysen","startTime":473.88,"endTime":479.04,"body":"been pushed to do masters"},{"speaker":"Aaron Boysen","startTime":473.88,"endTime":479.04,"body":"because of pressures at work or"},{"speaker":"Aaron Boysen","startTime":479.07,"endTime":482.94,"body":"having a certain role. And that"},{"speaker":"Aaron Boysen","startTime":479.07,"endTime":482.94,"body":"being a requirement and just not"},{"speaker":"Aaron Boysen","startTime":482.94,"endTime":485.28,"body":"enjoying that side of the role"},{"speaker":"Aaron Boysen","startTime":482.94,"endTime":485.28,"body":"and actually just really"},{"speaker":"Aaron Boysen","startTime":485.28,"endTime":488.55,"body":"enjoying the patient work. And"},{"speaker":"Aaron Boysen","startTime":485.28,"endTime":488.55,"body":"they sometimes feel a little bit"},{"speaker":"Aaron Boysen","startTime":488.58,"endTime":491.76,"body":"frustrated by the constant"},{"speaker":"Aaron Boysen","startTime":488.58,"endTime":491.76,"body":"feeling they need to do more"},{"speaker":"Aaron Boysen","startTime":491.76,"endTime":494.73,"body":"research, get more"},{"speaker":"Aaron Boysen","startTime":491.76,"endTime":494.73,"body":"qualifications, and it feels a"},{"speaker":"Aaron Boysen","startTime":494.73,"endTime":497.43,"body":"bit. I don't know, it feels a"},{"speaker":"Aaron Boysen","startTime":494.73,"endTime":497.43,"body":"little bit uncomfortable for"},{"speaker":"Aaron Boysen","startTime":497.43,"endTime":497.61,"body":"them"},{"speaker":"Aaron Boysen","startTime":497.639,"endTime":502.589,"body":"PhDs a long time. And if you're"},{"speaker":"Aaron Boysen","startTime":497.639,"endTime":502.589,"body":"not enjoying it, then life is so"},{"speaker":"Aaron Boysen","startTime":502.589,"endTime":505.259,"body":"short, is just look around with"},{"speaker":"Aaron Boysen","startTime":502.589,"endTime":505.259,"body":"COVID and everything. If you're"},{"speaker":"Aaron Boysen","startTime":505.259,"endTime":507.419,"body":"not doing something that you"},{"speaker":"Aaron Boysen","startTime":505.259,"endTime":507.419,"body":"aren't, there's no point I've"},{"speaker":"Aaron Boysen","startTime":507.419,"endTime":510.869,"body":"watched people do their PhDs"},{"speaker":"Aaron Boysen","startTime":507.419,"endTime":510.869,"body":"that haven't really wanted to do"},{"speaker":"Aaron Boysen","startTime":510.869,"endTime":515.039,"body":"it and they've come so close,"},{"speaker":"Aaron Boysen","startTime":510.869,"endTime":515.039,"body":"they've either dropped out or"},{"speaker":"Aaron Boysen","startTime":515.039,"endTime":517.559,"body":"they've come so close to"},{"speaker":"Aaron Boysen","startTime":515.039,"endTime":517.559,"body":"dropping out, they've had to"},{"speaker":"Aaron Boysen","startTime":517.559,"endTime":521.219,"body":"take a lot of time off and then"},{"speaker":"Aaron Boysen","startTime":517.559,"endTime":521.219,"body":"really push themselves to finish"},{"speaker":"Aaron Boysen","startTime":521.219,"endTime":523.919,"body":"it. And they're not going to do"},{"speaker":"Aaron Boysen","startTime":521.219,"endTime":523.919,"body":"research again after it's done."},{"speaker":"Aaron Boysen","startTime":523.949,"endTime":528.929,"body":"Because they just it's tainted"},{"speaker":"Aaron Boysen","startTime":523.949,"endTime":528.929,"body":"now. So I think it's Yeah, I"},{"speaker":"Aaron Boysen","startTime":529.169,"endTime":532.379,"body":"think it's important to really"},{"speaker":"Aaron Boysen","startTime":529.169,"endTime":532.379,"body":"think about what you want out of"},{"speaker":"Aaron Boysen","startTime":532.379,"endTime":535.739,"body":"your career. Yeah, there's some"},{"speaker":"Aaron Boysen","startTime":532.379,"endTime":535.739,"body":"amazing clinicians out there"},{"speaker":"Aaron Boysen","startTime":535.739,"endTime":537.989,"body":"that just don't want to borrow"},{"speaker":"Aaron Boysen","startTime":535.739,"endTime":537.989,"body":"research and I have a lot of"},{"speaker":"Aaron Boysen","startTime":537.989,"endTime":541.559,"body":"respect for them that they're"},{"speaker":"Aaron Boysen","startTime":537.989,"endTime":541.559,"body":"sticking to their guns and doing"},{"speaker":"Aaron Boysen","startTime":541.559,"endTime":542.159,"body":"what they love."},{"speaker":"Aaron Boysen","startTime":543.03,"endTime":547.2,"body":"And they're fantastic in that"},{"speaker":"Aaron Boysen","startTime":543.03,"endTime":547.2,"body":"way. And I think, yeah, I think"},{"speaker":"Aaron Boysen","startTime":547.23,"endTime":549.45,"body":"we're gonna get better"},{"speaker":"Aaron Boysen","startTime":547.23,"endTime":549.45,"body":"clinicians and better dieticians"},{"speaker":"Aaron Boysen","startTime":549.45,"endTime":553.35,"body":"and happier dietitians if we"},{"speaker":"Aaron Boysen","startTime":549.45,"endTime":553.35,"body":"just let people work to their"},{"speaker":"Aaron Boysen","startTime":553.35,"endTime":556.74,"body":"skill set, instead of just"},{"speaker":"Aaron Boysen","startTime":553.35,"endTime":556.74,"body":"making everyone fit in a in a"},{"speaker":"Aaron Boysen","startTime":556.77,"endTime":560.04,"body":"square hole. So what made you go"},{"speaker":"Aaron Boysen","startTime":556.77,"endTime":560.04,"body":"into refeeding syndrome? What"},{"speaker":"Aaron Boysen","startTime":560.04,"endTime":564.09,"body":"made you focus in on that area"},{"speaker":"Aaron Boysen","startTime":560.04,"endTime":564.09,"body":"in particular dietetic practice,"},{"speaker":"Aaron Boysen","startTime":564.12,"endTime":568.71,"body":"so I remember when I was on my"},{"speaker":"Aaron Boysen","startTime":564.12,"endTime":568.71,"body":"placement for Masters, this was"},{"speaker":"Aaron Boysen","startTime":568.71,"endTime":572.67,"body":"after I'd done my research"},{"speaker":"Aaron Boysen","startTime":568.71,"endTime":572.67,"body":"project, I was on my emplacement"},{"speaker":"Aaron Boysen","startTime":572.67,"endTime":578.16,"body":"and I was seeing a patient with"},{"speaker":"Aaron Boysen","startTime":572.67,"endTime":578.16,"body":"my supervisor, and I recommended"},{"speaker":"Aaron Boysen","startTime":578.19,"endTime":580.59,"body":"one sausages in a day to this"},{"speaker":"Aaron Boysen","startTime":578.19,"endTime":580.59,"body":"patient because she was"},{"speaker":"Aaron Boysen","startTime":580.59,"endTime":584.25,"body":"struggling to eat. I didn't"},{"speaker":"Aaron Boysen","startTime":580.59,"endTime":584.25,"body":"think she was at risk of"},{"speaker":"Aaron Boysen","startTime":584.25,"endTime":589.23,"body":"refeeding syndrome. But my"},{"speaker":"Aaron Boysen","startTime":584.25,"endTime":589.23,"body":"supervisor did and I got a fair"},{"speaker":"Aaron Boysen","startTime":589.26,"endTime":592.47,"body":"amount of trouble for"},{"speaker":"Aaron Boysen","startTime":589.26,"endTime":592.47,"body":"recommending the surgeon daily."},{"speaker":"Aaron Boysen","startTime":592.98,"endTime":597.12,"body":"And I found that really"},{"speaker":"Aaron Boysen","startTime":592.98,"endTime":597.12,"body":"frustrating because it's very"},{"speaker":"Aaron Boysen","startTime":597.12,"endTime":601.8,"body":"different now with Oral"},{"speaker":"Aaron Boysen","startTime":597.12,"endTime":601.8,"body":"nutrition compared to when we"},{"speaker":"Aaron Boysen","startTime":601.8,"endTime":604.47,"body":"think of like the prisoners of"},{"speaker":"Aaron Boysen","startTime":601.8,"endTime":604.47,"body":"war, who were suddenly given"},{"speaker":"Aaron Boysen","startTime":604.47,"endTime":607.35,"body":"something when they hadn't had"},{"speaker":"Aaron Boysen","startTime":604.47,"endTime":607.35,"body":"anything for a very long time."},{"speaker":"Aaron Boysen","startTime":607.71,"endTime":610.8,"body":"Most people that come into our"},{"speaker":"Aaron Boysen","startTime":607.71,"endTime":610.8,"body":"hospitals here in Australia now,"},{"speaker":"Aaron Boysen","startTime":611.73,"endTime":616.11,"body":"they haven't been starved. For"},{"speaker":"Aaron Boysen","startTime":611.73,"endTime":616.11,"body":"months or years, they've maybe"},{"speaker":"Aaron Boysen","startTime":616.11,"endTime":620.43,"body":"had two weeks of slightly poor"},{"speaker":"Aaron Boysen","startTime":616.11,"endTime":620.43,"body":"oral intake, and then someone's"},{"speaker":"Aaron Boysen","startTime":620.46,"endTime":622.86,"body":"realised and walk them to"},{"speaker":"Aaron Boysen","startTime":620.46,"endTime":622.86,"body":"hospital if they haven't bought"},{"speaker":"Aaron Boysen","startTime":622.86,"endTime":627.75,"body":"themselves in. So I thought,"},{"speaker":"Aaron Boysen","startTime":622.86,"endTime":627.75,"body":"because I was so frustrated, I"},{"speaker":"Aaron Boysen","startTime":627.75,"endTime":631.77,"body":"am a complainer, I will admit"},{"speaker":"Aaron Boysen","startTime":627.75,"endTime":631.77,"body":"that I complain to my fellow"},{"speaker":"Aaron Boysen","startTime":631.77,"endTime":636.69,"body":"students on placement. And er, I"},{"speaker":"Aaron Boysen","startTime":631.77,"endTime":636.69,"body":"just realised refeeding syndrome"},{"speaker":"Aaron Boysen","startTime":636.69,"endTime":641.13,"body":"really needs a lot of research"},{"speaker":"Aaron Boysen","startTime":636.69,"endTime":641.13,"body":"done in it. And I felt really"},{"speaker":"Aaron Boysen","startTime":641.13,"endTime":643.38,"body":"passionate that day, like I felt"},{"speaker":"Aaron Boysen","startTime":641.13,"endTime":643.38,"body":"range and"},{"speaker":"Aaron Boysen","startTime":644.19,"endTime":646.41,"body":"felt we did a PhD to prove her"},{"speaker":"Aaron Boysen","startTime":644.19,"endTime":646.41,"body":"wrong."},{"speaker":"Aaron Boysen","startTime":647.7,"endTime":653.64,"body":"Yeah, pretty much that and"},{"speaker":"Aaron Boysen","startTime":647.7,"endTime":653.64,"body":"Michelle Obama loves it. And my"},{"speaker":"Aaron Boysen","startTime":653.64,"endTime":657.42,"body":"other primary advisor, she hates"},{"speaker":"Aaron Boysen","startTime":653.64,"endTime":657.42,"body":"it, I'm just really pushing them"},{"speaker":"Aaron Boysen","startTime":657.42,"endTime":660.84,"body":"with Sandra Capra. Because she"},{"speaker":"Aaron Boysen","startTime":657.42,"endTime":660.84,"body":"never wanted to look at"},{"speaker":"Aaron Boysen","startTime":660.84,"endTime":661.86,"body":"refeeding syndrome,"},{"speaker":"Aaron Boysen","startTime":662.07,"endTime":665.4,"body":"it probably helped in the"},{"speaker":"Aaron Boysen","startTime":662.07,"endTime":665.4,"body":"development of the PhD and the"},{"speaker":"Aaron Boysen","startTime":665.4,"endTime":668.16,"body":"research, if you have that sort"},{"speaker":"Aaron Boysen","startTime":665.4,"endTime":668.16,"body":"of back and forth between"},{"speaker":"Aaron Boysen","startTime":668.37,"endTime":670.02,"body":"different individuals that are"},{"speaker":"Aaron Boysen","startTime":668.37,"endTime":670.02,"body":"there to support you."},{"speaker":"Aaron Boysen","startTime":670.77,"endTime":673.74,"body":"Yeah, it was really wonderful,"},{"speaker":"Aaron Boysen","startTime":670.77,"endTime":673.74,"body":"actually. Because I will admit,"},{"speaker":"Aaron Boysen","startTime":673.74,"endTime":678.75,"body":"when I started my PhD, I thought"},{"speaker":"Aaron Boysen","startTime":673.74,"endTime":678.75,"body":"refeeding syndrome was a lot"},{"speaker":"Aaron Boysen","startTime":678.75,"endTime":683.64,"body":"more common than I do now. So it"},{"speaker":"Aaron Boysen","startTime":678.75,"endTime":683.64,"body":"was nice to see that. Also,"},{"speaker":"Aaron Boysen","startTime":683.67,"endTime":686.34,"body":"because I am also stubborn, I"},{"speaker":"Aaron Boysen","startTime":683.67,"endTime":686.34,"body":"will admit that I'm mentioning"},{"speaker":"Aaron Boysen","startTime":686.34,"endTime":690.78,"body":"all my faults to you today"},{"speaker":"Aaron Boysen","startTime":686.34,"endTime":690.78,"body":"aren't that changing my own mind"},{"speaker":"Aaron Boysen","startTime":690.78,"endTime":695.58,"body":"over that course was really nice"},{"speaker":"Aaron Boysen","startTime":690.78,"endTime":695.58,"body":"as well. And I think having two"},{"speaker":"Aaron Boysen","startTime":695.61,"endTime":700.05,"body":"very different opinions in my"},{"speaker":"Aaron Boysen","startTime":695.61,"endTime":700.05,"body":"advisors was helpful for that"},{"speaker":"Aaron Boysen","startTime":700.05,"endTime":700.38,"body":"too."},{"speaker":"Aaron Boysen","startTime":700.739,"endTime":705.479,"body":"Definitely. So just so we can"},{"speaker":"Aaron Boysen","startTime":700.739,"endTime":705.479,"body":"get a little bit of a set the"},{"speaker":"Aaron Boysen","startTime":705.479,"endTime":707.519,"body":"scene, could you explain a"},{"speaker":"Aaron Boysen","startTime":705.479,"endTime":707.519,"body":"little bit about what is"},{"speaker":"Aaron Boysen","startTime":707.519,"endTime":710.729,"body":"refeeding syndrome? Or how would"},{"speaker":"Aaron Boysen","startTime":707.519,"endTime":710.729,"body":"you explain what refeeding"},{"speaker":"Aaron Boysen","startTime":710.729,"endTime":711.509,"body":"syndrome is."},{"speaker":"Aaron Boysen","startTime":712.74,"endTime":717.33,"body":"So in simplest terms, I like to"},{"speaker":"Aaron Boysen","startTime":712.74,"endTime":717.33,"body":"say that refeeding syndrome"},{"speaker":"Aaron Boysen","startTime":717.33,"endTime":719.82,"body":"comes about because we have a"},{"speaker":"Aaron Boysen","startTime":717.33,"endTime":719.82,"body":"patient that comes into"},{"speaker":"Aaron Boysen","startTime":719.82,"endTime":724.02,"body":"hospital, who is severely"},{"speaker":"Aaron Boysen","startTime":719.82,"endTime":724.02,"body":"malnourished, and their body is"},{"speaker":"Aaron Boysen","startTime":724.02,"endTime":729.27,"body":"in a state of catabolism. When"},{"speaker":"Aaron Boysen","startTime":724.02,"endTime":729.27,"body":"we start giving them nutrition,"},{"speaker":"Aaron Boysen","startTime":729.3,"endTime":732.6,"body":"any type of nutrition, oral"},{"speaker":"Aaron Boysen","startTime":729.3,"endTime":732.6,"body":"enteral, or parenteral, the body"},{"speaker":"Aaron Boysen","startTime":732.6,"endTime":736.95,"body":"brief kicks back into what it"},{"speaker":"Aaron Boysen","startTime":732.6,"endTime":736.95,"body":"should be doing. And that means"},{"speaker":"Aaron Boysen","startTime":736.98,"endTime":740.01,"body":"because our body stores have our"},{"speaker":"Aaron Boysen","startTime":736.98,"endTime":740.01,"body":"electrolytes our time and"},{"speaker":"Aaron Boysen","startTime":740.73,"endTime":743.94,"body":"everything is so low from being"},{"speaker":"Aaron Boysen","startTime":740.73,"endTime":743.94,"body":"severely malnourished, those"},{"speaker":"Aaron Boysen","startTime":743.94,"endTime":747.48,"body":"levels plummet even further,"},{"speaker":"Aaron Boysen","startTime":743.94,"endTime":747.48,"body":"because our bodies using them to"},{"speaker":"Aaron Boysen","startTime":747.66,"endTime":751.62,"body":"work through that food. So using"},{"speaker":"Aaron Boysen","startTime":747.66,"endTime":751.62,"body":"glucose in particular, which is"},{"speaker":"Aaron Boysen","startTime":751.62,"endTime":755.91,"body":"why people talk about monitoring"},{"speaker":"Aaron Boysen","startTime":751.62,"endTime":755.91,"body":"how much carbohydrate you're"},{"speaker":"Aaron Boysen","startTime":755.91,"endTime":759.66,"body":"giving these patients who are at"},{"speaker":"Aaron Boysen","startTime":755.91,"endTime":759.66,"body":"risk. So refeeding syndrome is I"},{"speaker":"Aaron Boysen","startTime":759.66,"endTime":764.31,"body":"like to always remind people,"},{"speaker":"Aaron Boysen","startTime":759.66,"endTime":764.31,"body":"it's a combination of signs and"},{"speaker":"Aaron Boysen","startTime":764.31,"endTime":767.07,"body":"symptoms. It's not just"},{"speaker":"Aaron Boysen","startTime":764.31,"endTime":767.07,"body":"hypophosphatemia, which a lot of"},{"speaker":"Aaron Boysen","startTime":767.07,"endTime":771.15,"body":"people will Bandy about. It's"},{"speaker":"Aaron Boysen","startTime":767.07,"endTime":771.15,"body":"also hypokalemia,"},{"speaker":"Aaron Boysen","startTime":771.15,"endTime":775.29,"body":"hypomagnesemia, FireMon"},{"speaker":"Aaron Boysen","startTime":771.15,"endTime":775.29,"body":"deficiency and all the symptoms"},{"speaker":"Aaron Boysen","startTime":775.29,"endTime":778.32,"body":"that come along with that it can"},{"speaker":"Aaron Boysen","startTime":775.29,"endTime":778.32,"body":"be edoema, as well. And it"},{"speaker":"Aaron Boysen","startTime":778.32,"endTime":780.06,"body":"doesn't have to be all of those"},{"speaker":"Aaron Boysen","startTime":778.32,"endTime":780.06,"body":"together."},{"speaker":"Aaron Boysen","startTime":780.09,"endTime":783.24,"body":"Is it easy to diagnose refeeding"},{"speaker":"Aaron Boysen","startTime":780.09,"endTime":783.24,"body":"syndrome? Would you be able to"},{"speaker":"Aaron Boysen","startTime":783.27,"endTime":786.09,"body":"see it on someone? Or do you"},{"speaker":"Aaron Boysen","startTime":783.27,"endTime":786.09,"body":"just make a sort of educated"},{"speaker":"Aaron Boysen","startTime":786.09,"endTime":788.85,"body":"guess based on the symptoms?"},{"speaker":"Aaron Boysen","startTime":786.09,"endTime":788.85,"body":"They're presenting with a"},{"speaker":"Aaron Boysen","startTime":788.85,"endTime":791.49,"body":"collection of symptoms? You've"},{"speaker":"Aaron Boysen","startTime":788.85,"endTime":791.49,"body":"just started feeding after a"},{"speaker":"Aaron Boysen","startTime":791.49,"endTime":794.79,"body":"period of starvation? Is that"},{"speaker":"Aaron Boysen","startTime":791.49,"endTime":794.79,"body":"how you deduce if it's refeeding"},{"speaker":"Aaron Boysen","startTime":794.79,"endTime":798.21,"body":"syndrome or not? Or is there"},{"speaker":"Aaron Boysen","startTime":794.79,"endTime":798.21,"body":"anything you can say for sure?"},{"speaker":"Aaron Boysen","startTime":798.48,"endTime":801.27,"body":"Is refeeding syndrome? Or is it"},{"speaker":"Aaron Boysen","startTime":798.48,"endTime":801.27,"body":"just really just an educated"},{"speaker":"Aaron Boysen","startTime":801.27,"endTime":803.4,"body":"guess a set of signs and"},{"speaker":"Aaron Boysen","startTime":801.27,"endTime":803.4,"body":"symptoms?"},{"speaker":"Aaron Boysen","startTime":804.51,"endTime":808.59,"body":"In my mind, it's an educated"},{"speaker":"Aaron Boysen","startTime":804.51,"endTime":808.59,"body":"guess there's no consensus on"},{"speaker":"Aaron Boysen","startTime":808.59,"endTime":812.1,"body":"definitions anywhere. When I"},{"speaker":"Aaron Boysen","startTime":808.59,"endTime":812.1,"body":"talked to doctors in the"},{"speaker":"Aaron Boysen","startTime":812.1,"endTime":814.65,"body":"hospital, they just named the"},{"speaker":"Aaron Boysen","startTime":812.1,"endTime":814.65,"body":"three electrolytes and they say"},{"speaker":"Aaron Boysen","startTime":814.65,"endTime":817.41,"body":"if it's low, that's refeeding"},{"speaker":"Aaron Boysen","startTime":814.65,"endTime":817.41,"body":"syndrome. And I really do"},{"speaker":"Aaron Boysen","startTime":817.41,"endTime":822.69,"body":"disagree with that train of"},{"speaker":"Aaron Boysen","startTime":817.41,"endTime":822.69,"body":"thought, I think that sometimes"},{"speaker":"Aaron Boysen","startTime":822.9,"endTime":826.86,"body":"your electrolytes are going to"},{"speaker":"Aaron Boysen","startTime":822.9,"endTime":826.86,"body":"drop. And because we'll never"},{"speaker":"Aaron Boysen","startTime":826.86,"endTime":829.35,"body":"get through ethics, you're never"},{"speaker":"Aaron Boysen","startTime":826.86,"endTime":829.35,"body":"going to know how if they'll"},{"speaker":"Aaron Boysen","startTime":829.38,"endTime":832.89,"body":"like drop and naturally lift"},{"speaker":"Aaron Boysen","startTime":829.38,"endTime":832.89,"body":"back up as nutrition increases."},{"speaker":"Aaron Boysen","startTime":833.67,"endTime":837.66,"body":"But I think it's a natural part"},{"speaker":"Aaron Boysen","startTime":833.67,"endTime":837.66,"body":"of restarting nutrition, that"},{"speaker":"Aaron Boysen","startTime":837.66,"endTime":840.21,"body":"doesn't mean that you're going"},{"speaker":"Aaron Boysen","startTime":837.66,"endTime":840.21,"body":"to the full blown refeeding"},{"speaker":"Aaron Boysen","startTime":840.21,"endTime":847.86,"body":"syndrome. When I did my, I did a"},{"speaker":"Aaron Boysen","startTime":840.21,"endTime":847.86,"body":"case study. For my PhD, I looked"},{"speaker":"Aaron Boysen","startTime":847.86,"endTime":850.62,"body":"back at the case histories of"},{"speaker":"Aaron Boysen","startTime":847.86,"endTime":850.62,"body":"patients that have died in"},{"speaker":"Aaron Boysen","startTime":850.62,"endTime":854.19,"body":"Queensland with refeeding"},{"speaker":"Aaron Boysen","startTime":850.62,"endTime":854.19,"body":"syndrome listed on their death"},{"speaker":"Aaron Boysen","startTime":854.19,"endTime":858.78,"body":"certificate. And we only found"},{"speaker":"Aaron Boysen","startTime":854.19,"endTime":858.78,"body":"five across 20 years. And when I"},{"speaker":"Aaron Boysen","startTime":858.78,"endTime":861.78,"body":"read through the case notes,"},{"speaker":"Aaron Boysen","startTime":858.78,"endTime":861.78,"body":"there was only one of those"},{"speaker":"Aaron Boysen","startTime":861.78,"endTime":865.08,"body":"patients that I actually was"},{"speaker":"Aaron Boysen","startTime":861.78,"endTime":865.08,"body":"like, Oh my God, that person"},{"speaker":"Aaron Boysen","startTime":865.08,"endTime":868.98,"body":"actually did die with refeeding"},{"speaker":"Aaron Boysen","startTime":865.08,"endTime":868.98,"body":"syndrome. They had a lot of"},{"speaker":"Aaron Boysen","startTime":868.98,"endTime":871.74,"body":"other issues going on as well."},{"speaker":"Aaron Boysen","startTime":868.98,"endTime":871.74,"body":"So it's hard to say whether"},{"speaker":"Aaron Boysen","startTime":871.74,"endTime":877.14,"body":"refeeding syndrome with the"},{"speaker":"Aaron Boysen","startTime":871.74,"endTime":877.14,"body":"primary cause but yeah, that one"},{"speaker":"Aaron Boysen","startTime":877.14,"endTime":879.69,"body":"was really obvious to me,"},{"speaker":"Aaron Boysen","startTime":877.14,"endTime":879.69,"body":"whereas the others, I was just"},{"speaker":"Aaron Boysen","startTime":879.69,"endTime":882.57,"body":"like, I don't think this is it"},{"speaker":"Aaron Boysen","startTime":879.69,"endTime":882.57,"body":"at all. And I got really"},{"speaker":"Aaron Boysen","startTime":882.57,"endTime":885.78,"body":"excited. It sounds bad, but I"},{"speaker":"Aaron Boysen","startTime":882.57,"endTime":885.78,"body":"got really excited when I was"},{"speaker":"Aaron Boysen","startTime":885.78,"endTime":889.89,"body":"reading that case. Because like"},{"speaker":"Aaron Boysen","startTime":885.78,"endTime":889.89,"body":"that, that is what I've been"},{"speaker":"Aaron Boysen","startTime":889.89,"endTime":893.94,"body":"looking for. And I don't see it"},{"speaker":"Aaron Boysen","startTime":889.89,"endTime":893.94,"body":"and I obviously feel really"},{"speaker":"Aaron Boysen","startTime":893.94,"endTime":896.97,"body":"horrible for that patient and"},{"speaker":"Aaron Boysen","startTime":893.94,"endTime":896.97,"body":"the patient's family that I"},{"speaker":"Aaron Boysen","startTime":896.97,"endTime":902.19,"body":"would get excitement out of"},{"speaker":"Aaron Boysen","startTime":896.97,"endTime":902.19,"body":"reading that case but is so rare"},{"speaker":"Aaron Boysen","startTime":902.67,"endTime":907.26,"body":"in a hospital system that has so"},{"speaker":"Aaron Boysen","startTime":902.67,"endTime":907.26,"body":"much support that can do daily"},{"speaker":"Aaron Boysen","startTime":907.26,"endTime":909.48,"body":"bloods that can give"},{"speaker":"Aaron Boysen","startTime":907.26,"endTime":909.48,"body":"supplementation to patients"},{"speaker":"Aaron Boysen","startTime":909.48,"endTime":910.59,"body":"easily and that sort of thing."},{"speaker":"Aaron Boysen","startTime":912.21,"endTime":914.64,"body":"What do you think about the"},{"speaker":"Aaron Boysen","startTime":912.21,"endTime":914.64,"body":"term? I've heard it described as"},{"speaker":"Aaron Boysen","startTime":914.64,"endTime":917.97,"body":"biochemical refeeding syndrome?"},{"speaker":"Aaron Boysen","startTime":914.64,"endTime":917.97,"body":"Is that even a thing? Or is that"},{"speaker":"Aaron Boysen","startTime":917.97,"endTime":921.48,"body":"just made up being that I've"},{"speaker":"Aaron Boysen","startTime":917.97,"endTime":921.48,"body":"heard that term bandied around"},{"speaker":"Aaron Boysen","startTime":921.48,"endTime":924.72,"body":"quite a bit for disturbances and"},{"speaker":"Aaron Boysen","startTime":921.48,"endTime":924.72,"body":"electrolytes and just calling it"},{"speaker":"Aaron Boysen","startTime":924.72,"endTime":926.7,"body":"biochemical refeeding? syndrome?"},{"speaker":"Aaron Boysen","startTime":924.72,"endTime":926.7,"body":"Yeah,"},{"speaker":"Aaron Boysen","startTime":926.73,"endTime":930.45,"body":"yeah, I look, I don't mind the"},{"speaker":"Aaron Boysen","startTime":926.73,"endTime":930.45,"body":"term, I just find that most"},{"speaker":"Aaron Boysen","startTime":930.45,"endTime":933.96,"body":"people just hear the refeeding"},{"speaker":"Aaron Boysen","startTime":930.45,"endTime":933.96,"body":"syndrome part and just roll with"},{"speaker":"Aaron Boysen","startTime":933.96,"endTime":938.55,"body":"it. So I'm always very cautious"},{"speaker":"Aaron Boysen","startTime":933.96,"endTime":938.55,"body":"of using too many times for one,"},{"speaker":"Aaron Boysen","startTime":938.94,"endTime":942.72,"body":"one issue. So because, you know,"},{"speaker":"Aaron Boysen","startTime":938.94,"endTime":942.72,"body":"we've got refeeding,"},{"speaker":"Aaron Boysen","startTime":942.72,"endTime":946.83,"body":"hypervelocity. Sorry, refeeding,"},{"speaker":"Aaron Boysen","startTime":942.72,"endTime":946.83,"body":"hyperphosphatemia, and then"},{"speaker":"Aaron Boysen","startTime":946.83,"endTime":949.41,"body":"we've got refeeding syndrome and"},{"speaker":"Aaron Boysen","startTime":946.83,"endTime":949.41,"body":"biochemical refeeding syndrome."},{"speaker":"Aaron Boysen","startTime":949.41,"endTime":953.13,"body":"And we've got general refeeding,"},{"speaker":"Aaron Boysen","startTime":949.41,"endTime":953.13,"body":"like as in refeeding, our"},{"speaker":"Aaron Boysen","startTime":953.13,"endTime":955.65,"body":"patients, but some people when"},{"speaker":"Aaron Boysen","startTime":953.13,"endTime":955.65,"body":"they see refeeding, they think"},{"speaker":"Aaron Boysen","startTime":955.65,"endTime":960.69,"body":"it's refeeding syndrome. And it"},{"speaker":"Aaron Boysen","startTime":955.65,"endTime":960.69,"body":"just gets very messy. I think."},{"speaker":"Aaron Boysen","startTime":960.87,"endTime":963.84,"body":"So. But I do agree with the"},{"speaker":"Aaron Boysen","startTime":960.87,"endTime":963.84,"body":"premise of the biochemical"},{"speaker":"Aaron Boysen","startTime":963.84,"endTime":964.41,"body":"refeeding."},{"speaker":"Aaron Boysen","startTime":965.01,"endTime":968.64,"body":"And, obviously, based on what"},{"speaker":"Aaron Boysen","startTime":965.01,"endTime":968.64,"body":"you're saying, is very different"},{"speaker":"Aaron Boysen","startTime":968.64,"endTime":970.62,"body":"than a lot of the guidance"},{"speaker":"Aaron Boysen","startTime":968.64,"endTime":970.62,"body":"around the world. I'm quite"},{"speaker":"Aaron Boysen","startTime":970.62,"endTime":973.86,"body":"familiar with nice guidance, and"},{"speaker":"Aaron Boysen","startTime":970.62,"endTime":973.86,"body":"we've got other guidance for"},{"speaker":"Aaron Boysen","startTime":973.86,"endTime":976.41,"body":"different conditions such as"},{"speaker":"Aaron Boysen","startTime":973.86,"endTime":976.41,"body":"eating disorders, where do you"},{"speaker":"Aaron Boysen","startTime":976.41,"endTime":980.1,"body":"think this this sort of caution"},{"speaker":"Aaron Boysen","startTime":976.41,"endTime":980.1,"body":"comes from? Well, why are we so"},{"speaker":"Aaron Boysen","startTime":980.1,"endTime":984.03,"body":"cautious? In such a way we know"},{"speaker":"Aaron Boysen","startTime":980.1,"endTime":984.03,"body":"malnutrition is probably way"},{"speaker":"Aaron Boysen","startTime":984.03,"endTime":987.06,"body":"more prevalent than refeeding"},{"speaker":"Aaron Boysen","startTime":984.03,"endTime":987.06,"body":"syndrome? Why are we so cautious"},{"speaker":"Aaron Boysen","startTime":987.06,"endTime":988.77,"body":"when we're refilling our"},{"speaker":"Aaron Boysen","startTime":987.06,"endTime":988.77,"body":"patients? Where does that"},{"speaker":"Aaron Boysen","startTime":989.07,"endTime":990.51,"body":"caution come from? Do you think?"},{"speaker":"Aaron Boysen","startTime":991.17,"endTime":997.5,"body":"I think, for one, no one wants"},{"speaker":"Aaron Boysen","startTime":991.17,"endTime":997.5,"body":"to be the dietician that killed"},{"speaker":"Aaron Boysen","startTime":997.5,"endTime":1000.83,"body":"someone with refeeding, because"},{"speaker":"Aaron Boysen","startTime":997.5,"endTime":1000.83,"body":"they let them go into refeeding"},{"speaker":"Aaron Boysen","startTime":1000.83,"endTime":1006.53,"body":"syndrome. The second is that a"},{"speaker":"Aaron Boysen","startTime":1000.83,"endTime":1006.53,"body":"lot of the cases, I think that"},{"speaker":"Aaron Boysen","startTime":1006.53,"endTime":1012.38,"body":"people will refer back to cases"},{"speaker":"Aaron Boysen","startTime":1006.53,"endTime":1012.38,"body":"that weren't managed well, and"},{"speaker":"Aaron Boysen","startTime":1012.38,"endTime":1014.72,"body":"they weren't managed well,"},{"speaker":"Aaron Boysen","startTime":1012.38,"endTime":1014.72,"body":"because we didn't have the"},{"speaker":"Aaron Boysen","startTime":1014.72,"endTime":1019.43,"body":"research to show us what to do."},{"speaker":"Aaron Boysen","startTime":1014.72,"endTime":1019.43,"body":"So there were the two cases in"},{"speaker":"Aaron Boysen","startTime":1019.97,"endTime":1022.28,"body":"the very early 80s, with the"},{"speaker":"Aaron Boysen","startTime":1019.97,"endTime":1022.28,"body":"parenteral nutrition and"},{"speaker":"Aaron Boysen","startTime":1022.28,"endTime":1028.52,"body":"everyone references those. But"},{"speaker":"Aaron Boysen","startTime":1022.28,"endTime":1028.52,"body":"the latest, the RCT that was"},{"speaker":"Aaron Boysen","startTime":1028.52,"endTime":1032.42,"body":"recently published in November"},{"speaker":"Aaron Boysen","startTime":1028.52,"endTime":1032.42,"body":"shows us that no, we don't need"},{"speaker":"Aaron Boysen","startTime":1032.42,"endTime":1035.06,"body":"to be that scared of parenteral"},{"speaker":"Aaron Boysen","startTime":1032.42,"endTime":1035.06,"body":"nutrition provided we are giving"},{"speaker":"Aaron Boysen","startTime":1035.21,"endTime":1038.18,"body":"supplementation and that sort of"},{"speaker":"Aaron Boysen","startTime":1035.21,"endTime":1038.18,"body":"thing. And when I talk about"},{"speaker":"Aaron Boysen","startTime":1038.18,"endTime":1041.48,"body":"refeeding syndrome, and I'm"},{"speaker":"Aaron Boysen","startTime":1038.18,"endTime":1041.48,"body":"explaining how bad it can be to"},{"speaker":"Aaron Boysen","startTime":1041.48,"endTime":1044.66,"body":"people that haven't heard of it"},{"speaker":"Aaron Boysen","startTime":1041.48,"endTime":1044.66,"body":"before, I always refer back to"},{"speaker":"Aaron Boysen","startTime":1044.66,"endTime":1047.36,"body":"the prisoners of war, because"},{"speaker":"Aaron Boysen","startTime":1044.66,"endTime":1047.36,"body":"they're actual, those were"},{"speaker":"Aaron Boysen","startTime":1047.36,"endTime":1050.39,"body":"actual cases, like when you're"},{"speaker":"Aaron Boysen","startTime":1047.36,"endTime":1050.39,"body":"reading the literature, you're"},{"speaker":"Aaron Boysen","startTime":1050.39,"endTime":1054.92,"body":"like, Oh, yes, that is legit."},{"speaker":"Aaron Boysen","startTime":1050.39,"endTime":1054.92,"body":"That prisoner of war was in a"},{"speaker":"Aaron Boysen","startTime":1054.92,"endTime":1058.04,"body":"concentration camp for years,"},{"speaker":"Aaron Boysen","startTime":1054.92,"endTime":1058.04,"body":"and then they were let out and"},{"speaker":"Aaron Boysen","startTime":1058.04,"endTime":1061.94,"body":"someone very kindly fed them."},{"speaker":"Aaron Boysen","startTime":1058.04,"endTime":1061.94,"body":"And that was it. And I think as"},{"speaker":"Aaron Boysen","startTime":1061.94,"endTime":1065.66,"body":"a profession as well, we are"},{"speaker":"Aaron Boysen","startTime":1061.94,"endTime":1065.66,"body":"cautious bunch, like, we're"},{"speaker":"Aaron Boysen","startTime":1065.93,"endTime":1069.08,"body":"basically all type A, we like to"},{"speaker":"Aaron Boysen","startTime":1065.93,"endTime":1069.08,"body":"follow rules, we've got a"},{"speaker":"Aaron Boysen","startTime":1069.08,"endTime":1074.12,"body":"conservative bunch of"},{"speaker":"Aaron Boysen","startTime":1069.08,"endTime":1074.12,"body":"clinicians, and then the"},{"speaker":"Aaron Boysen","startTime":1074.12,"endTime":1077.09,"body":"guidelines aren't made up on"},{"speaker":"Aaron Boysen","startTime":1074.12,"endTime":1077.09,"body":"research. Most of them are based"},{"speaker":"Aaron Boysen","startTime":1077.09,"endTime":1080.24,"body":"on expert opinion. So if you've"},{"speaker":"Aaron Boysen","startTime":1077.09,"endTime":1080.24,"body":"got experts that are cautious,"},{"speaker":"Aaron Boysen","startTime":1080.24,"endTime":1082.34,"body":"then of course, they're going to"},{"speaker":"Aaron Boysen","startTime":1080.24,"endTime":1082.34,"body":"recommend cautious"},{"speaker":"Aaron Boysen","startTime":1083.33,"endTime":1084.29,"body":"recommendations."},{"speaker":"Aaron Boysen","startTime":1085.46,"endTime":1088.19,"body":"Definitely, I remember I had a"},{"speaker":"Aaron Boysen","startTime":1085.46,"endTime":1088.19,"body":"student on placement with me,"},{"speaker":"Aaron Boysen","startTime":1088.19,"endTime":1090.23,"body":"and we're going through a"},{"speaker":"Aaron Boysen","startTime":1088.19,"endTime":1090.23,"body":"patient and she was quite"},{"speaker":"Aaron Boysen","startTime":1090.23,"endTime":1093.53,"body":"concerned about this patient was"},{"speaker":"Aaron Boysen","startTime":1090.23,"endTime":1093.53,"body":"a risk of refeeding syndrome."},{"speaker":"Aaron Boysen","startTime":1093.92,"endTime":1097.22,"body":"And our trust guidance were"},{"speaker":"Aaron Boysen","startTime":1093.92,"endTime":1097.22,"body":"based, similar to nice guidance,"},{"speaker":"Aaron Boysen","startTime":1097.22,"endTime":1099.38,"body":"just so everyone can get an"},{"speaker":"Aaron Boysen","startTime":1097.22,"endTime":1099.38,"body":"example that were going through"},{"speaker":"Aaron Boysen","startTime":1099.74,"endTime":1103.1,"body":"the guidelines. And she felt"},{"speaker":"Aaron Boysen","startTime":1099.74,"endTime":1103.1,"body":"that because the patient was at"},{"speaker":"Aaron Boysen","startTime":1103.1,"endTime":1106.28,"body":"risk of refeeding syndrome, she"},{"speaker":"Aaron Boysen","startTime":1103.1,"endTime":1106.28,"body":"thought maybe I should be even"},{"speaker":"Aaron Boysen","startTime":1106.28,"endTime":1109.07,"body":"more cautious than Nice."},{"speaker":"Aaron Boysen","startTime":1106.28,"endTime":1109.07,"body":"However, thanks to your"},{"speaker":"Aaron Boysen","startTime":1109.07,"endTime":1113.57,"body":"presentation, I was able to"},{"speaker":"Aaron Boysen","startTime":1109.07,"endTime":1113.57,"body":"explain a little bit around kind"},{"speaker":"Aaron Boysen","startTime":1113.57,"endTime":1115.49,"body":"of like the evidence and things"},{"speaker":"Aaron Boysen","startTime":1113.57,"endTime":1115.49,"body":"like that she was able to"},{"speaker":"Aaron Boysen","startTime":1115.49,"endTime":1118.76,"body":"understand, maybe I shouldn't be"},{"speaker":"Aaron Boysen","startTime":1115.49,"endTime":1118.76,"body":"more cautious than Nice."},{"speaker":"Aaron Boysen","startTime":1118.819,"endTime":1122.299,"body":"Yeah, long. Stories like that"},{"speaker":"Aaron Boysen","startTime":1118.819,"endTime":1122.299,"body":"make me really sad for our"},{"speaker":"Aaron Boysen","startTime":1122.299,"endTime":1125.719,"body":"patients, because you know that"},{"speaker":"Aaron Boysen","startTime":1122.299,"endTime":1125.719,"body":"if they're underpaid, they're"},{"speaker":"Aaron Boysen","startTime":1125.719,"endTime":1128.899,"body":"generally in hospital for a lot"},{"speaker":"Aaron Boysen","startTime":1125.719,"endTime":1128.899,"body":"longer, and we're exacerbating"},{"speaker":"Aaron Boysen","startTime":1128.959,"endTime":1132.409,"body":"their malnutrition. So, always"},{"speaker":"Aaron Boysen","startTime":1128.959,"endTime":1132.409,"body":"trying to remind people of that,"},{"speaker":"Aaron Boysen","startTime":1132.409,"endTime":1135.679,"body":"like, you're probably doing more"},{"speaker":"Aaron Boysen","startTime":1132.409,"endTime":1135.679,"body":"harm than good. By sitting back"},{"speaker":"Aaron Boysen","startTime":1135.679,"endTime":1139.639,"body":"and panicking about that we can"},{"speaker":"Aaron Boysen","startTime":1135.679,"endTime":1139.639,"body":"generally fix so if the"},{"speaker":"Aaron Boysen","startTime":1139.639,"endTime":1143.419,"body":"electrolytes start dropping, we"},{"speaker":"Aaron Boysen","startTime":1139.639,"endTime":1143.419,"body":"can give something"},{"speaker":"Aaron Boysen","startTime":1144.77,"endTime":1148.1,"body":"definitely. And that study your"},{"speaker":"Aaron Boysen","startTime":1144.77,"endTime":1148.1,"body":"reference previously, I will"},{"speaker":"Aaron Boysen","startTime":1148.1,"endTime":1151.1,"body":"have that study in the show"},{"speaker":"Aaron Boysen","startTime":1148.1,"endTime":1151.1,"body":"notes and it's a study it's a"},{"speaker":"Aaron Boysen","startTime":1151.16,"endTime":1153.02,"body":"randomised control trial,"},{"speaker":"Aaron Boysen","startTime":1151.16,"endTime":1153.02,"body":"correct me if I'm wrong, a"},{"speaker":"Aaron Boysen","startTime":1153.02,"endTime":1155.72,"body":"randomised control trial,"},{"speaker":"Aaron Boysen","startTime":1153.02,"endTime":1155.72,"body":"looking at parenteral nutrition,"},{"speaker":"Aaron Boysen","startTime":1155.72,"endTime":1158.78,"body":"high and low feeding. I'm not"},{"speaker":"Aaron Boysen","startTime":1155.72,"endTime":1158.78,"body":"sure how they defined it. And"},{"speaker":"Aaron Boysen","startTime":1158.84,"endTime":1162.14,"body":"looking at markers for refeeding"},{"speaker":"Aaron Boysen","startTime":1158.84,"endTime":1162.14,"body":"syndrome. Yes, that's the one."},{"speaker":"Aaron Boysen","startTime":1162.86,"endTime":1165.23,"body":"Yeah, so I'll share that in the"},{"speaker":"Aaron Boysen","startTime":1162.86,"endTime":1165.23,"body":"show notes. So that brings us on"},{"speaker":"Aaron Boysen","startTime":1165.23,"endTime":1168.5,"body":"to guidelines and the variation"},{"speaker":"Aaron Boysen","startTime":1165.23,"endTime":1168.5,"body":"in guidelines around the world."},{"speaker":"Aaron Boysen","startTime":1168.53,"endTime":1171.74,"body":"However, there's one variation"},{"speaker":"Aaron Boysen","startTime":1168.53,"endTime":1171.74,"body":"that sort of brings my attention"},{"speaker":"Aaron Boysen","startTime":1171.8,"endTime":1174.71,"body":"every single time and I've"},{"speaker":"Aaron Boysen","startTime":1171.8,"endTime":1174.71,"body":"always wondered about it, is the"},{"speaker":"Aaron Boysen","startTime":1174.71,"endTime":1178.67,"body":"variation between nice and"},{"speaker":"Aaron Boysen","startTime":1174.71,"endTime":1178.67,"body":"marzipan. And they seem to move"},{"speaker":"Aaron Boysen","startTime":1178.67,"endTime":1181.19,"body":"around back and forth playing"},{"speaker":"Aaron Boysen","startTime":1178.67,"endTime":1181.19,"body":"with each other on two opposite"},{"speaker":"Aaron Boysen","startTime":1181.19,"endTime":1184.31,"body":"ends of the spectrum. They move"},{"speaker":"Aaron Boysen","startTime":1181.19,"endTime":1184.31,"body":"back and forth all the time. And"},{"speaker":"Aaron Boysen","startTime":1184.31,"endTime":1187.04,"body":"I know that I think they're"},{"speaker":"Aaron Boysen","startTime":1184.31,"endTime":1187.04,"body":"working on another revision of"},{"speaker":"Aaron Boysen","startTime":1187.07,"endTime":1190.52,"body":"marzipan coming up in the summer"},{"speaker":"Aaron Boysen","startTime":1187.07,"endTime":1190.52,"body":"this year. They're probably"},{"speaker":"Aaron Boysen","startTime":1190.52,"endTime":1193.52,"body":"sitting around discussing at the"},{"speaker":"Aaron Boysen","startTime":1190.52,"endTime":1193.52,"body":"moment they're probably wanting"},{"speaker":"Aaron Boysen","startTime":1193.52,"endTime":1197.15,"body":"to move in another direction or"},{"speaker":"Aaron Boysen","startTime":1193.52,"endTime":1197.15,"body":"move back and forth. Why is"},{"speaker":"Aaron Boysen","startTime":1197.15,"endTime":1199.55,"body":"this? Why is they're just paying"},{"speaker":"Aaron Boysen","startTime":1197.15,"endTime":1199.55,"body":"a little bit of almost playing"},{"speaker":"Aaron Boysen","startTime":1199.55,"endTime":1201.5,"body":"like a game with each other"},{"speaker":"Aaron Boysen","startTime":1199.55,"endTime":1201.5,"body":"until the opposite ends of the"},{"speaker":"Aaron Boysen","startTime":1201.5,"endTime":1204.26,"body":"spectrum, why are they doing"},{"speaker":"Aaron Boysen","startTime":1201.5,"endTime":1204.26,"body":"this? From your assessment?"},{"speaker":"Aaron Boysen","startTime":1204.29,"endTime":1208.97,"body":"I wish I knew. So I sometimes I"},{"speaker":"Aaron Boysen","startTime":1204.29,"endTime":1208.97,"body":"just I don't understand why"},{"speaker":"Aaron Boysen","startTime":1209.0,"endTime":1212.09,"body":"patients with eating disorders"},{"speaker":"Aaron Boysen","startTime":1209.0,"endTime":1212.09,"body":"can generally be fed higher"},{"speaker":"Aaron Boysen","startTime":1213.59,"endTime":1217.67,"body":"calories when they've probably"},{"speaker":"Aaron Boysen","startTime":1213.59,"endTime":1217.67,"body":"been starving for longer than"},{"speaker":"Aaron Boysen","startTime":1217.7,"endTime":1220.85,"body":"the nice criteria, which is"},{"speaker":"Aaron Boysen","startTime":1217.7,"endTime":1220.85,"body":"little or no intake for five"},{"speaker":"Aaron Boysen","startTime":1220.85,"endTime":1224.0,"body":"days. Yeah, it still blows my"},{"speaker":"Aaron Boysen","startTime":1220.85,"endTime":1224.0,"body":"mind, we can double the intake"},{"speaker":"Aaron Boysen","startTime":1224.0,"endTime":1226.7,"body":"for these patients that have"},{"speaker":"Aaron Boysen","startTime":1224.0,"endTime":1226.7,"body":"been starving themselves for"},{"speaker":"Aaron Boysen","startTime":1227.09,"endTime":1231.32,"body":"potentially years. But we have"},{"speaker":"Aaron Boysen","startTime":1227.09,"endTime":1231.32,"body":"to be really cautious with our"},{"speaker":"Aaron Boysen","startTime":1231.32,"endTime":1236.45,"body":"88 year old who hasn't eaten"},{"speaker":"Aaron Boysen","startTime":1231.32,"endTime":1236.45,"body":"properly for five days. So who's"},{"speaker":"Aaron Boysen","startTime":1236.45,"endTime":1241.49,"body":"had a low BMI for her entire"},{"speaker":"Aaron Boysen","startTime":1236.45,"endTime":1241.49,"body":"life? And it's not because she"},{"speaker":"Aaron Boysen","startTime":1241.49,"endTime":1243.68,"body":"stabbed herself. It's just"},{"speaker":"Aaron Boysen","startTime":1241.49,"endTime":1243.68,"body":"because she's a tiny little"},{"speaker":"Aaron Boysen","startTime":1243.68,"endTime":1250.76,"body":"lady. So yeah, it's frustrating."},{"speaker":"Aaron Boysen","startTime":1243.68,"endTime":1250.76,"body":"And I get why clinicians will"},{"speaker":"Aaron Boysen","startTime":1250.76,"endTime":1254.15,"body":"then default to the more"},{"speaker":"Aaron Boysen","startTime":1250.76,"endTime":1254.15,"body":"conservative option. So if they"},{"speaker":"Aaron Boysen","startTime":1254.15,"endTime":1256.94,"body":"say this, these guidelines say"},{"speaker":"Aaron Boysen","startTime":1254.15,"endTime":1256.94,"body":"this, and these guidelines say"},{"speaker":"Aaron Boysen","startTime":1256.94,"endTime":1260.03,"body":"this, and the second set of"},{"speaker":"Aaron Boysen","startTime":1256.94,"endTime":1260.03,"body":"guidelines say something a bit"},{"speaker":"Aaron Boysen","startTime":1260.03,"endTime":1264.65,"body":"more conservative, they seem"},{"speaker":"Aaron Boysen","startTime":1260.03,"endTime":1264.65,"body":"safer. So why not default to"},{"speaker":"Aaron Boysen","startTime":1264.68,"endTime":1269.18,"body":"five calories per day to start"},{"speaker":"Aaron Boysen","startTime":1264.68,"endTime":1269.18,"body":"feeding? Yeah,"},{"speaker":"Aaron Boysen","startTime":1269.21,"endTime":1272.78,"body":"I think probably also nice makes"},{"speaker":"Aaron Boysen","startTime":1269.21,"endTime":1272.78,"body":"it a little bit more confusing"},{"speaker":"Aaron Boysen","startTime":1272.78,"endTime":1275.15,"body":"with little to no intake, what"},{"speaker":"Aaron Boysen","startTime":1272.78,"endTime":1275.15,"body":"does that actually mean?"},{"speaker":"Aaron Boysen","startTime":1275.72,"endTime":1282.32,"body":"Or more expert opinion. It is"},{"speaker":"Aaron Boysen","startTime":1275.72,"endTime":1282.32,"body":"funny, though, because I read"},{"speaker":"Aaron Boysen","startTime":1282.32,"endTime":1287.24,"body":"them. And I think our Australian"},{"speaker":"Aaron Boysen","startTime":1282.32,"endTime":1287.24,"body":"New Zealand guidelines are"},{"speaker":"Aaron Boysen","startTime":1287.24,"endTime":1291.23,"body":"quite, they're a bit more"},{"speaker":"Aaron Boysen","startTime":1287.24,"endTime":1291.23,"body":"assertive than both of marzipan"},{"speaker":"Aaron Boysen","startTime":1291.23,"endTime":1295.07,"body":"and nice. So we actually start"},{"speaker":"Aaron Boysen","startTime":1291.23,"endTime":1295.07,"body":"for our patients with medically"},{"speaker":"Aaron Boysen","startTime":1295.07,"endTime":1298.85,"body":"compromised eating sores, we"},{"speaker":"Aaron Boysen","startTime":1295.07,"endTime":1298.85,"body":"actually start feeds it just"},{"speaker":"Aaron Boysen","startTime":1298.85,"endTime":1304.67,"body":"over 6000 kilojoules per day. So"},{"speaker":"Aaron Boysen","startTime":1298.85,"endTime":1304.67,"body":"no matter what their BMI is, and"},{"speaker":"Aaron Boysen","startTime":1304.67,"endTime":1307.34,"body":"that sort of thing, and then"},{"speaker":"Aaron Boysen","startTime":1304.67,"endTime":1307.34,"body":"advanced up to 12,000"},{"speaker":"Aaron Boysen","startTime":1307.67,"endTime":1312.35,"body":"kilojoules. So yeah, there is"},{"speaker":"Aaron Boysen","startTime":1307.67,"endTime":1312.35,"body":"variation everywhere."},{"speaker":"Aaron Boysen","startTime":1313.04,"endTime":1315.83,"body":"6000 kilojoules and calories is"},{"speaker":"Aaron Boysen","startTime":1313.04,"endTime":1315.83,"body":"that."},{"speaker":"Aaron Boysen","startTime":1316.43,"endTime":1319.88,"body":"So that's a sorry, I can't I go"},{"speaker":"Aaron Boysen","startTime":1316.43,"endTime":1319.88,"body":"back and forth. And it's very"},{"speaker":"Aaron Boysen","startTime":1319.88,"endTime":1325.16,"body":"confusing. So about 1500"},{"speaker":"Aaron Boysen","startTime":1319.88,"endTime":1325.16,"body":"calories per day. 100. Yeah, and"},{"speaker":"Aaron Boysen","startTime":1325.16,"endTime":1328.19,"body":"then the new aspirin"},{"speaker":"Aaron Boysen","startTime":1325.16,"endTime":1328.19,"body":"recommendations that came out."},{"speaker":"Aaron Boysen","startTime":1328.22,"endTime":1332.21,"body":"They also they're quite similar"},{"speaker":"Aaron Boysen","startTime":1328.22,"endTime":1332.21,"body":"to nice and they're starting"},{"speaker":"Aaron Boysen","startTime":1332.33,"endTime":1336.71,"body":"rate. So they say start between"},{"speaker":"Aaron Boysen","startTime":1332.33,"endTime":1336.71,"body":"10 and 20 calories per kilo. But"},{"speaker":"Aaron Boysen","startTime":1336.71,"endTime":1339.86,"body":"then they say you can advance up"},{"speaker":"Aaron Boysen","startTime":1336.71,"endTime":1339.86,"body":"a bit faster as you can go up"},{"speaker":"Aaron Boysen","startTime":1339.95,"endTime":1344.45,"body":"33% towards go right every day"},{"speaker":"Aaron Boysen","startTime":1339.95,"endTime":1344.45,"body":"or two. It's all it's very"},{"speaker":"Aaron Boysen","startTime":1344.45,"endTime":1348.05,"body":"confusing. I sometimes I don't"},{"speaker":"Aaron Boysen","startTime":1344.45,"endTime":1348.05,"body":"know where anyone's pitch their"},{"speaker":"Aaron Boysen","startTime":1348.05,"endTime":1351.5,"body":"numbers from I don't even know"},{"speaker":"Aaron Boysen","startTime":1348.05,"endTime":1351.5,"body":"where Australia has picked their"},{"speaker":"Aaron Boysen","startTime":1351.5,"endTime":1354.77,"body":"numbers from I just know that I"},{"speaker":"Aaron Boysen","startTime":1351.5,"endTime":1354.77,"body":"like it, because it's a little"},{"speaker":"Aaron Boysen","startTime":1354.77,"endTime":1358.61,"body":"bit more assertive than some of"},{"speaker":"Aaron Boysen","startTime":1354.77,"endTime":1358.61,"body":"the other countries. But yeah,"},{"speaker":"Aaron Boysen","startTime":1358.64,"endTime":1361.16,"body":"they're all they are all"},{"speaker":"Aaron Boysen","startTime":1358.64,"endTime":1361.16,"body":"different, which is"},{"speaker":"Aaron Boysen","startTime":1361.19,"endTime":1364.52,"body":"disappointing, because you'd"},{"speaker":"Aaron Boysen","startTime":1361.19,"endTime":1364.52,"body":"like to think that we can all"},{"speaker":"Aaron Boysen","startTime":1364.52,"endTime":1368.3,"body":"practice the same way."},{"speaker":"Aaron Boysen","startTime":1364.52,"endTime":1368.3,"body":"Especially in Australia, Europe,"},{"speaker":"Aaron Boysen","startTime":1368.3,"endTime":1372.26,"body":"UK, Australia. So did I say"},{"speaker":"Aaron Boysen","startTime":1368.3,"endTime":1372.26,"body":"America was the first time in"},{"speaker":"Aaron Boysen","startTime":1372.26,"endTime":1373.52,"body":"Australia? I can't remember."},{"speaker":"Aaron Boysen","startTime":1372.26,"endTime":1373.52,"body":"Sorry. I"},{"speaker":"Aaron Boysen","startTime":1373.52,"endTime":1376.37,"body":"remember. I was first a"},{"speaker":"Aaron Boysen","startTime":1373.52,"endTime":1376.37,"body":"dietitian and I was handing over"},{"speaker":"Aaron Boysen","startTime":1376.37,"endTime":1379.46,"body":"my plan to one of the doctors I"},{"speaker":"Aaron Boysen","startTime":1376.37,"endTime":1379.46,"body":"mentioned refeeding syndrome and"},{"speaker":"Aaron Boysen","startTime":1379.46,"endTime":1382.31,"body":"Arendt mentioned about"},{"speaker":"Aaron Boysen","startTime":1379.46,"endTime":1382.31,"body":"supplementing time in and stuff"},{"speaker":"Aaron Boysen","startTime":1382.31,"endTime":1385.49,"body":"like that. And he says to me,"},{"speaker":"Aaron Boysen","startTime":1382.31,"endTime":1385.49,"body":"refeeding syndrome doesn't"},{"speaker":"Aaron Boysen","startTime":1385.49,"endTime":1387.77,"body":"exist. Do you think that has"},{"speaker":"Aaron Boysen","startTime":1385.49,"endTime":1387.77,"body":"any? Where do you think that"},{"speaker":"Aaron Boysen","startTime":1387.77,"endTime":1390.11,"body":"comes from? I've heard it from a"},{"speaker":"Aaron Boysen","startTime":1387.77,"endTime":1390.11,"body":"few other sort of doctors,"},{"speaker":"Aaron Boysen","startTime":1390.11,"endTime":1392.75,"body":"usually doctors, and usually"},{"speaker":"Aaron Boysen","startTime":1390.11,"endTime":1392.75,"body":"probably even more senior"},{"speaker":"Aaron Boysen","startTime":1392.75,"endTime":1395.57,"body":"doctors say it occasionally."},{"speaker":"Aaron Boysen","startTime":1392.75,"endTime":1395.57,"body":"Where do you think that comes"},{"speaker":"Aaron Boysen","startTime":1395.57,"endTime":1397.49,"body":"from? And is there we know"},{"speaker":"Aaron Boysen","startTime":1395.57,"endTime":1397.49,"body":"they're wrong? Obviously,"},{"speaker":"Aaron Boysen","startTime":1397.49,"endTime":1400.7,"body":"because we're discussing"},{"speaker":"Aaron Boysen","startTime":1397.49,"endTime":1400.7,"body":"refeeding syndrome. And however,"},{"speaker":"Aaron Boysen","startTime":1400.73,"endTime":1402.83,"body":"where do you think that probably"},{"speaker":"Aaron Boysen","startTime":1400.73,"endTime":1402.83,"body":"comes from? Do you think it"},{"speaker":"Aaron Boysen","startTime":1402.83,"endTime":1406.13,"body":"could come from a lot of"},{"speaker":"Aaron Boysen","startTime":1402.83,"endTime":1406.13,"body":"clinicians being overly cautious"},{"speaker":"Aaron Boysen","startTime":1406.13,"endTime":1409.94,"body":"and being warned about it about"},{"speaker":"Aaron Boysen","startTime":1406.13,"endTime":1409.94,"body":"100 times and never seeing it"},{"speaker":"Aaron Boysen","startTime":1409.97,"endTime":1413.84,"body":"in better bias? I think for a"},{"speaker":"Aaron Boysen","startTime":1409.97,"endTime":1413.84,"body":"lot of these doctors have been"},{"speaker":"Aaron Boysen","startTime":1413.84,"endTime":1417.14,"body":"very lucky that either their"},{"speaker":"Aaron Boysen","startTime":1413.84,"endTime":1417.14,"body":"dieticians have been on top of"},{"speaker":"Aaron Boysen","startTime":1417.14,"endTime":1420.44,"body":"it. And if the patients on feeds"},{"speaker":"Aaron Boysen","startTime":1417.14,"endTime":1420.44,"body":"have started quite slowly and"},{"speaker":"Aaron Boysen","startTime":1420.44,"endTime":1424.52,"body":"built up, or they're lucky if"},{"speaker":"Aaron Boysen","startTime":1420.44,"endTime":1424.52,"body":"the patient's on oral nutrition"},{"speaker":"Aaron Boysen","startTime":1424.52,"endTime":1428.78,"body":"and just gradually started"},{"speaker":"Aaron Boysen","startTime":1424.52,"endTime":1428.78,"body":"eating more on their own without"},{"speaker":"Aaron Boysen","startTime":1428.81,"endTime":1432.32,"body":"sometimes you do see patients"},{"speaker":"Aaron Boysen","startTime":1428.81,"endTime":1432.32,"body":"that go from zero to 100 when"},{"speaker":"Aaron Boysen","startTime":1432.32,"endTime":1435.05,"body":"they're on oral nutrition, but I"},{"speaker":"Aaron Boysen","startTime":1432.32,"endTime":1435.05,"body":"do in my opinion, it's quite"},{"speaker":"Aaron Boysen","startTime":1435.05,"endTime":1440.63,"body":"rare, not as rare as some of the"},{"speaker":"Aaron Boysen","startTime":1435.05,"endTime":1440.63,"body":"stuff we're talking about. But I"},{"speaker":"Aaron Boysen","startTime":1440.63,"endTime":1444.62,"body":"also think there is an aspect of"},{"speaker":"Aaron Boysen","startTime":1440.63,"endTime":1444.62,"body":"the boy that cried wolf, when I"},{"speaker":"Aaron Boysen","startTime":1444.62,"endTime":1448.64,"body":"was a student, the number of"},{"speaker":"Aaron Boysen","startTime":1444.62,"endTime":1448.64,"body":"times I had to pay the doctor to"},{"speaker":"Aaron Boysen","startTime":1448.64,"endTime":1450.89,"body":"tell them that I thought a"},{"speaker":"Aaron Boysen","startTime":1448.64,"endTime":1450.89,"body":"patient was at risk of refeeding"},{"speaker":"Aaron Boysen","startTime":1450.89,"endTime":1454.85,"body":"syndrome was borderline"},{"speaker":"Aaron Boysen","startTime":1450.89,"endTime":1454.85,"body":"ridiculous. Like, I can't"},{"speaker":"Aaron Boysen","startTime":1454.85,"endTime":1462.38,"body":"believe I used to harass the"},{"speaker":"Aaron Boysen","startTime":1454.85,"endTime":1462.38,"body":"medics so much. Whereas now I"},{"speaker":"Aaron Boysen","startTime":1462.38,"endTime":1466.01,"body":"would barely page so generally,"},{"speaker":"Aaron Boysen","startTime":1462.38,"endTime":1466.01,"body":"we're actually very lucky in the"},{"speaker":"Aaron Boysen","startTime":1466.01,"endTime":1468.83,"body":"health service that I'm in and"},{"speaker":"Aaron Boysen","startTime":1466.01,"endTime":1468.83,"body":"our doctors are very aware of"},{"speaker":"Aaron Boysen","startTime":1468.83,"endTime":1472.88,"body":"refeeding syndrome. Our patients"},{"speaker":"Aaron Boysen","startTime":1468.83,"endTime":1472.88,"body":"that are have eating disorders"},{"speaker":"Aaron Boysen","startTime":1473.06,"endTime":1477.62,"body":"or automatically started on"},{"speaker":"Aaron Boysen","startTime":1473.06,"endTime":1477.62,"body":"supplementation. And I think"},{"speaker":"Aaron Boysen","startTime":1477.62,"endTime":1480.8,"body":"it's I think it's a good thing"},{"speaker":"Aaron Boysen","startTime":1477.62,"endTime":1480.8,"body":"that they're obviously I think"},{"speaker":"Aaron Boysen","startTime":1480.8,"endTime":1482.6,"body":"it's a good thing that they're"},{"speaker":"Aaron Boysen","startTime":1480.8,"endTime":1482.6,"body":"very aware of it so I don't have"},{"speaker":"Aaron Boysen","startTime":1482.6,"endTime":1487.1,"body":"to page them but it's also come"},{"speaker":"Aaron Boysen","startTime":1482.6,"endTime":1487.1,"body":"with experience that not"},{"speaker":"Aaron Boysen","startTime":1487.1,"endTime":1491.51,"body":"everyone is at risk just because"},{"speaker":"Aaron Boysen","startTime":1487.1,"endTime":1491.51,"body":"they meet that nice criteria"},{"speaker":"Aaron Boysen","startTime":1491.72,"endTime":1498.2,"body":"that I've Yeah, I think it does"},{"speaker":"Aaron Boysen","startTime":1491.72,"endTime":1498.2,"body":"come with clinical practice. It"},{"speaker":"Aaron Boysen","startTime":1498.2,"endTime":1501.65,"body":"comes from having good supervise"},{"speaker":"Aaron Boysen","startTime":1498.2,"endTime":1501.65,"body":"arises it comes with thinking"},{"speaker":"Aaron Boysen","startTime":1501.65,"endTime":1505.4,"body":"really objectively about where"},{"speaker":"Aaron Boysen","startTime":1501.65,"endTime":1505.4,"body":"these where the criteria have"},{"speaker":"Aaron Boysen","startTime":1505.4,"endTime":1509.39,"body":"actually come from and what"},{"speaker":"Aaron Boysen","startTime":1505.4,"endTime":1509.39,"body":"supporting Yeah, I think for the"},{"speaker":"Aaron Boysen","startTime":1509.39,"endTime":1513.29,"body":"people that say it's not real, I"},{"speaker":"Aaron Boysen","startTime":1509.39,"endTime":1513.29,"body":"always argue, tell me, how come"},{"speaker":"Aaron Boysen","startTime":1513.29,"endTime":1516.62,"body":"the prisoners of war dropped"},{"speaker":"Aaron Boysen","startTime":1513.29,"endTime":1516.62,"body":"dead? But there is also an"},{"speaker":"Aaron Boysen","startTime":1516.62,"endTime":1522.05,"body":"aspect of, yes, we do, yell and"},{"speaker":"Aaron Boysen","startTime":1516.62,"endTime":1522.05,"body":"shout about it a lot, which"},{"speaker":"Aaron Boysen","startTime":1522.08,"endTime":1525.68,"body":"would get on their nerves. And I"},{"speaker":"Aaron Boysen","startTime":1522.08,"endTime":1525.68,"body":"don't blame them to some degree."},{"speaker":"Aaron Boysen","startTime":1527.15,"endTime":1529.76,"body":"Definitely. So you mentioned a"},{"speaker":"Aaron Boysen","startTime":1527.15,"endTime":1529.76,"body":"little bit around refeeding"},{"speaker":"Aaron Boysen","startTime":1530.0,"endTime":1534.08,"body":"syndrome was definitely common"},{"speaker":"Aaron Boysen","startTime":1530.0,"endTime":1534.08,"body":"common in prisoners of war when"},{"speaker":"Aaron Boysen","startTime":1534.08,"endTime":1537.44,"body":"they started eating, and it was"},{"speaker":"Aaron Boysen","startTime":1534.08,"endTime":1537.44,"body":"well done. It was documented and"},{"speaker":"Aaron Boysen","startTime":1537.44,"endTime":1541.16,"body":"it was seen, but we don't see it"},{"speaker":"Aaron Boysen","startTime":1537.44,"endTime":1541.16,"body":"as much today in our modern"},{"speaker":"Aaron Boysen","startTime":1541.31,"endTime":1543.74,"body":"medical systems with the"},{"speaker":"Aaron Boysen","startTime":1541.31,"endTime":1543.74,"body":"monitoring and the"},{"speaker":"Aaron Boysen","startTime":1543.74,"endTime":1545.93,"body":"supplementation and things like"},{"speaker":"Aaron Boysen","startTime":1543.74,"endTime":1545.93,"body":"that. What do you think makes"},{"speaker":"Aaron Boysen","startTime":1545.93,"endTime":1549.77,"body":"the biggest impact from those"},{"speaker":"Aaron Boysen","startTime":1545.93,"endTime":1549.77,"body":"two different settings? Is there"},{"speaker":"Aaron Boysen","startTime":1549.77,"endTime":1552.17,"body":"anything that makes the biggest"},{"speaker":"Aaron Boysen","startTime":1549.77,"endTime":1552.17,"body":"impact? Or what would you say"},{"speaker":"Aaron Boysen","startTime":1552.17,"endTime":1554.42,"body":"makes the biggest impact when"},{"speaker":"Aaron Boysen","startTime":1552.17,"endTime":1554.42,"body":"trying to manage refeeding"},{"speaker":"Aaron Boysen","startTime":1554.42,"endTime":1554.84,"body":"syndrome?"},{"speaker":"Aaron Boysen","startTime":1554.9,"endTime":1558.8,"body":"So primarily, biggest impact is,"},{"speaker":"Aaron Boysen","startTime":1554.9,"endTime":1558.8,"body":"before we even get into the"},{"speaker":"Aaron Boysen","startTime":1558.8,"endTime":1563.42,"body":"hospital system, there's a"},{"speaker":"Aaron Boysen","startTime":1558.8,"endTime":1563.42,"body":"support most people like they"},{"speaker":"Aaron Boysen","startTime":1563.42,"endTime":1566.24,"body":"have family or they have friends"},{"speaker":"Aaron Boysen","startTime":1563.42,"endTime":1566.24,"body":"checking in on them, they have a"},{"speaker":"Aaron Boysen","startTime":1566.24,"endTime":1568.61,"body":"neighbour that's aware that"},{"speaker":"Aaron Boysen","startTime":1566.24,"endTime":1568.61,"body":"there's that there could be"},{"speaker":"Aaron Boysen","startTime":1568.61,"endTime":1572.9,"body":"something wrong and that sort of"},{"speaker":"Aaron Boysen","startTime":1568.61,"endTime":1572.9,"body":"thing. So I find that don't see"},{"speaker":"Aaron Boysen","startTime":1572.9,"endTime":1575.96,"body":"that many patients come through"},{"speaker":"Aaron Boysen","startTime":1572.9,"endTime":1575.96,"body":"the health care service that"},{"speaker":"Aaron Boysen","startTime":1575.96,"endTime":1582.05,"body":"have been neglected and staffed"},{"speaker":"Aaron Boysen","startTime":1575.96,"endTime":1582.05,"body":"for months and months on end,"},{"speaker":"Aaron Boysen","startTime":1582.14,"endTime":1584.54,"body":"which is what our prisons have"},{"speaker":"Aaron Boysen","startTime":1582.14,"endTime":1584.54,"body":"what went through in the"},{"speaker":"Aaron Boysen","startTime":1584.54,"endTime":1588.35,"body":"hospital, I actually think it"},{"speaker":"Aaron Boysen","startTime":1584.54,"endTime":1588.35,"body":"comes down to the fact that we"},{"speaker":"Aaron Boysen","startTime":1588.35,"endTime":1592.64,"body":"can get blood results within a"},{"speaker":"Aaron Boysen","startTime":1588.35,"endTime":1592.64,"body":"couple of hours. And we can give"},{"speaker":"Aaron Boysen","startTime":1592.64,"endTime":1596.45,"body":"some electrolyte supplementation"},{"speaker":"Aaron Boysen","startTime":1592.64,"endTime":1596.45,"body":"very quickly. I think that's"},{"speaker":"Aaron Boysen","startTime":1596.45,"endTime":1602.69,"body":"our, like our biggest tool in"},{"speaker":"Aaron Boysen","startTime":1596.45,"endTime":1602.69,"body":"our toolbox like diamond"},{"speaker":"Aaron Boysen","startTime":1602.69,"endTime":1605.18,"body":"supplementation, multivitamin"},{"speaker":"Aaron Boysen","startTime":1602.69,"endTime":1605.18,"body":"supplementation is important."},{"speaker":"Aaron Boysen","startTime":1605.18,"endTime":1609.23,"body":"But I really do think it's"},{"speaker":"Aaron Boysen","startTime":1605.18,"endTime":1609.23,"body":"monitoring what's actually"},{"speaker":"Aaron Boysen","startTime":1609.23,"endTime":1611.66,"body":"happening in this person's body"},{"speaker":"Aaron Boysen","startTime":1609.23,"endTime":1611.66,"body":"and being able to fix it"},{"speaker":"Aaron Boysen","startTime":1611.66,"endTime":1612.08,"body":"quickly."},{"speaker":"Aaron Boysen","startTime":1613.49,"endTime":1616.28,"body":"So that's the monitoring the"},{"speaker":"Aaron Boysen","startTime":1613.49,"endTime":1616.28,"body":"electrolytes and those sorts of"},{"speaker":"Aaron Boysen","startTime":1616.28,"endTime":1619.55,"body":"things actually made the biggest"},{"speaker":"Aaron Boysen","startTime":1616.28,"endTime":1619.55,"body":"difference over all the other"},{"speaker":"Aaron Boysen","startTime":1619.55,"endTime":1620.36,"body":"things. Yeah."},{"speaker":"Aaron Boysen","startTime":1621.98,"endTime":1626.87,"body":"Yeah, we looked at in our health"},{"speaker":"Aaron Boysen","startTime":1621.98,"endTime":1626.87,"body":"service, once I finished my PhD,"},{"speaker":"Aaron Boysen","startTime":1626.87,"endTime":1629.15,"body":"we changed our refeeding"},{"speaker":"Aaron Boysen","startTime":1626.87,"endTime":1629.15,"body":"syndrome guidelines quite"},{"speaker":"Aaron Boysen","startTime":1629.15,"endTime":1633.77,"body":"drastically. And it didn't make"},{"speaker":"Aaron Boysen","startTime":1629.15,"endTime":1633.77,"body":"a difference if we fared really"},{"speaker":"Aaron Boysen","startTime":1633.77,"endTime":1638.24,"body":"fast. And I think that come it's"},{"speaker":"Aaron Boysen","startTime":1633.77,"endTime":1638.24,"body":"so it's not, I don't think it"},{"speaker":"Aaron Boysen","startTime":1638.24,"endTime":1641.42,"body":"comes down to what we're what"},{"speaker":"Aaron Boysen","startTime":1638.24,"endTime":1641.42,"body":"Nutrition has provided. I think"},{"speaker":"Aaron Boysen","startTime":1641.42,"endTime":1645.23,"body":"it's all the other things that"},{"speaker":"Aaron Boysen","startTime":1641.42,"endTime":1645.23,"body":"come into it. Yeah, I always"},{"speaker":"Aaron Boysen","startTime":1645.23,"endTime":1649.16,"body":"preach that. If you think"},{"speaker":"Aaron Boysen","startTime":1645.23,"endTime":1649.16,"body":"someone's at risk, make sure"},{"speaker":"Aaron Boysen","startTime":1649.16,"endTime":1653.24,"body":"there's daily blobs, like"},{"speaker":"Aaron Boysen","startTime":1649.16,"endTime":1653.24,"body":"minimum for four days, and most"},{"speaker":"Aaron Boysen","startTime":1653.24,"endTime":1658.34,"body":"of the guidelines, say 10 to 14,"},{"speaker":"Aaron Boysen","startTime":1653.24,"endTime":1658.34,"body":"which I think is difficult in"},{"speaker":"Aaron Boysen","startTime":1658.34,"endTime":1660.89,"body":"clinical practice. Because, you"},{"speaker":"Aaron Boysen","startTime":1658.34,"endTime":1660.89,"body":"know, most of our patients,"},{"speaker":"Aaron Boysen","startTime":1660.89,"endTime":1662.87,"body":"unless they're quite sick,"},{"speaker":"Aaron Boysen","startTime":1660.89,"endTime":1662.87,"body":"aren't staying in the healthcare"},{"speaker":"Aaron Boysen","startTime":1662.87,"endTime":1665.72,"body":"service for that. aren't staying"},{"speaker":"Aaron Boysen","startTime":1662.87,"endTime":1665.72,"body":"in hospital for that long"},{"speaker":"Aaron Boysen","startTime":1665.72,"endTime":1668.6,"body":"anymore. We're trying to reduce"},{"speaker":"Aaron Boysen","startTime":1665.72,"endTime":1668.6,"body":"length of stay. So I think being"},{"speaker":"Aaron Boysen","startTime":1668.6,"endTime":1672.95,"body":"realistic about what you can"},{"speaker":"Aaron Boysen","startTime":1668.6,"endTime":1672.95,"body":"manage is important, too. So"},{"speaker":"Aaron Boysen","startTime":1673.04,"endTime":1677.3,"body":"yeah, I do think it's all those"},{"speaker":"Aaron Boysen","startTime":1673.04,"endTime":1677.3,"body":"medical, like, we need our"},{"speaker":"Aaron Boysen","startTime":1677.3,"endTime":1679.64,"body":"medics to do blood tests. Yeah,"},{"speaker":"Aaron Boysen","startTime":1680.51,"endTime":1682.52,"body":"definitely. Yeah. So"},{"speaker":"Aaron Boysen","startTime":1680.51,"endTime":1682.52,"body":"carbohydrate is one of the"},{"speaker":"Aaron Boysen","startTime":1682.52,"endTime":1686.03,"body":"biggest triggers of refeeding"},{"speaker":"Aaron Boysen","startTime":1682.52,"endTime":1686.03,"body":"syndrome, is there any benefit"},{"speaker":"Aaron Boysen","startTime":1686.03,"endTime":1689.48,"body":"to manipulating macronutrient"},{"speaker":"Aaron Boysen","startTime":1686.03,"endTime":1689.48,"body":"composition. So for example,"},{"speaker":"Aaron Boysen","startTime":1689.81,"endTime":1691.97,"body":"giving the patient a higher Fat"},{"speaker":"Aaron Boysen","startTime":1689.81,"endTime":1691.97,"body":"Feed instead of a higher"},{"speaker":"Aaron Boysen","startTime":1691.97,"endTime":1693.35,"body":"carbohydrate feed. Yeah,"},{"speaker":"Aaron Boysen","startTime":1693.38,"endTime":1697.94,"body":"the research is quite limited in"},{"speaker":"Aaron Boysen","startTime":1693.38,"endTime":1697.94,"body":"it in this sort of field. For"},{"speaker":"Aaron Boysen","startTime":1697.94,"endTime":1700.43,"body":"me, I always say as long as it's"},{"speaker":"Aaron Boysen","startTime":1697.94,"endTime":1700.43,"body":"balanced, so as long as you're"},{"speaker":"Aaron Boysen","startTime":1700.43,"endTime":1704.75,"body":"not giving a patient, straight,"},{"speaker":"Aaron Boysen","startTime":1700.43,"endTime":1704.75,"body":"glucose drinks all day, every"},{"speaker":"Aaron Boysen","startTime":1704.75,"endTime":1708.05,"body":"day when they're at risk, then"},{"speaker":"Aaron Boysen","startTime":1704.75,"endTime":1708.05,"body":"you shouldn't have a problem."},{"speaker":"Aaron Boysen","startTime":1709.4,"endTime":1712.49,"body":"There is definitely discussion"},{"speaker":"Aaron Boysen","startTime":1709.4,"endTime":1712.49,"body":"in the eating disorder"},{"speaker":"Aaron Boysen","startTime":1712.49,"endTime":1716.45,"body":"literature, that limiting"},{"speaker":"Aaron Boysen","startTime":1712.49,"endTime":1716.45,"body":"carbohydrate to 40% is"},{"speaker":"Aaron Boysen","startTime":1716.45,"endTime":1720.32,"body":"beneficial, especially when your"},{"speaker":"Aaron Boysen","startTime":1716.45,"endTime":1720.32,"body":"intro during enteral feeds. We"},{"speaker":"Aaron Boysen","startTime":1720.32,"endTime":1725.45,"body":"did our study a few years ago"},{"speaker":"Aaron Boysen","startTime":1720.32,"endTime":1725.45,"body":"and carbohydrates 50%. And we"},{"speaker":"Aaron Boysen","startTime":1725.45,"endTime":1731.51,"body":"had no cases of refeeding"},{"speaker":"Aaron Boysen","startTime":1725.45,"endTime":1731.51,"body":"syndrome. So I think as long as"},{"speaker":"Aaron Boysen","startTime":1731.81,"endTime":1734.21,"body":"there's a little bit of common"},{"speaker":"Aaron Boysen","startTime":1731.81,"endTime":1734.21,"body":"sense there, like as long as"},{"speaker":"Aaron Boysen","startTime":1734.21,"endTime":1737.33,"body":"it's not 100% carbohydrate load,"},{"speaker":"Aaron Boysen","startTime":1734.21,"endTime":1737.33,"body":"and there's a bit of other stuff"},{"speaker":"Aaron Boysen","startTime":1737.33,"endTime":1738.98,"body":"going on in there, then I think"},{"speaker":"Aaron Boysen","startTime":1740.48,"endTime":1743.18,"body":"it's fine. And is there any"},{"speaker":"Aaron Boysen","startTime":1740.48,"endTime":1743.18,"body":"difference between parenteral"},{"speaker":"Aaron Boysen","startTime":1743.18,"endTime":1746.33,"body":"and enteral nutrition? I think"},{"speaker":"Aaron Boysen","startTime":1743.18,"endTime":1746.33,"body":"my brain thinks that there's"},{"speaker":"Aaron Boysen","startTime":1746.33,"endTime":1749.03,"body":"less risk of say enteral"},{"speaker":"Aaron Boysen","startTime":1746.33,"endTime":1749.03,"body":"nutrition compared to"},{"speaker":"Aaron Boysen","startTime":1749.03,"endTime":1749.57,"body":"parenteral."},{"speaker":"Aaron Boysen","startTime":1749.599,"endTime":1754.819,"body":"When we when I did my systematic"},{"speaker":"Aaron Boysen","startTime":1749.599,"endTime":1754.819,"body":"review from my PhD, we actually"},{"speaker":"Aaron Boysen","startTime":1754.819,"endTime":1758.779,"body":"found that the patients"},{"speaker":"Aaron Boysen","startTime":1754.819,"endTime":1758.779,"body":"receiving enteral nutrition were"},{"speaker":"Aaron Boysen","startTime":1758.809,"endTime":1763.459,"body":"getting most of the symptoms"},{"speaker":"Aaron Boysen","startTime":1758.809,"endTime":1763.459,"body":"that sent a lot of the papers"},{"speaker":"Aaron Boysen","startTime":1763.459,"endTime":1766.279,"body":"that we looked at because the"},{"speaker":"Aaron Boysen","startTime":1763.459,"endTime":1766.279,"body":"definitions for refeeding"},{"speaker":"Aaron Boysen","startTime":1766.279,"endTime":1769.969,"body":"syndrome are all over the shop,"},{"speaker":"Aaron Boysen","startTime":1766.279,"endTime":1769.969,"body":"some of them were counting"},{"speaker":"Aaron Boysen","startTime":1769.969,"endTime":1773.629,"body":"things like diarrhoea and that"},{"speaker":"Aaron Boysen","startTime":1769.969,"endTime":1773.629,"body":"sort of thing, which when you're"},{"speaker":"Aaron Boysen","startTime":1773.629,"endTime":1778.669,"body":"using enteral nutrition, I think"},{"speaker":"Aaron Boysen","startTime":1773.629,"endTime":1778.669,"body":"is sometimes inevitable. So I do"},{"speaker":"Aaron Boysen","startTime":1778.669,"endTime":1785.149,"body":"take that with a grain of salt."},{"speaker":"Aaron Boysen","startTime":1778.669,"endTime":1785.149,"body":"I think parenteral nutrition can"},{"speaker":"Aaron Boysen","startTime":1785.149,"endTime":1790.129,"body":"be more I want to say harsh or"},{"speaker":"Aaron Boysen","startTime":1785.149,"endTime":1790.129,"body":"are patients at risk of"},{"speaker":"Aaron Boysen","startTime":1790.129,"endTime":1793.459,"body":"refeeding syndrome. So because"},{"speaker":"Aaron Boysen","startTime":1790.129,"endTime":1793.459,"body":"it's it's straight in rather"},{"speaker":"Aaron Boysen","startTime":1793.459,"endTime":1796.429,"body":"than going through the digestive"},{"speaker":"Aaron Boysen","startTime":1793.459,"endTime":1796.429,"body":"system, but the literature"},{"speaker":"Aaron Boysen","startTime":1796.429,"endTime":1800.449,"body":"doesn't support my thinking on"},{"speaker":"Aaron Boysen","startTime":1796.429,"endTime":1800.449,"body":"that. So I wouldn't take All of"},{"speaker":"Aaron Boysen","startTime":1800.449,"endTime":1802.909,"body":"what I just said with a grain of"},{"speaker":"Aaron Boysen","startTime":1800.449,"endTime":1802.909,"body":"salt. Yeah, unfortunately, I"},{"speaker":"Aaron Boysen","startTime":1802.909,"endTime":1804.919,"body":"don't think there's a clear cut"},{"speaker":"Aaron Boysen","startTime":1802.909,"endTime":1804.919,"body":"answer on that one hour. And I'm"},{"speaker":"Aaron Boysen","startTime":1804.919,"endTime":1808.969,"body":"sorry. So the literature is so"},{"speaker":"Aaron Boysen","startTime":1804.919,"endTime":1808.969,"body":"all over the shop too, because"},{"speaker":"Aaron Boysen","startTime":1808.969,"endTime":1811.069,"body":"you know, a lot of these studies"},{"speaker":"Aaron Boysen","startTime":1808.969,"endTime":1811.069,"body":"are done in ICU where"},{"speaker":"Aaron Boysen","startTime":1811.069,"endTime":1813.709,"body":"everything's protocolized, which"},{"speaker":"Aaron Boysen","startTime":1811.069,"endTime":1813.709,"body":"is very different to being on a"},{"speaker":"Aaron Boysen","startTime":1813.709,"endTime":1814.309,"body":"general ward"},{"speaker":"Aaron Boysen","startTime":1814.4,"endTime":1816.86,"body":"is very different than being on"},{"speaker":"Aaron Boysen","startTime":1814.4,"endTime":1816.86,"body":"a general ward. So yeah,"},{"speaker":"Aaron Boysen","startTime":1816.89,"endTime":1819.92,"body":"definitely, there's a"},{"speaker":"Aaron Boysen","startTime":1816.89,"endTime":1819.92,"body":"understanding the context of"},{"speaker":"Aaron Boysen","startTime":1819.92,"endTime":1822.98,"body":"where you work in stuff, but it"},{"speaker":"Aaron Boysen","startTime":1819.92,"endTime":1822.98,"body":"might be an area for research"},{"speaker":"Aaron Boysen","startTime":1823.01,"endTime":1825.2,"body":"that obviously, as we're"},{"speaker":"Aaron Boysen","startTime":1823.01,"endTime":1825.2,"body":"discussing all these gaps, I"},{"speaker":"Aaron Boysen","startTime":1825.2,"endTime":1829.49,"body":"hope everyone's thinking there's"},{"speaker":"Aaron Boysen","startTime":1825.2,"endTime":1829.49,"body":"an opportunity there, or there's"},{"speaker":"Aaron Boysen","startTime":1829.49,"endTime":1832.22,"body":"an opportunity there and just"},{"speaker":"Aaron Boysen","startTime":1829.49,"endTime":1832.22,"body":"always be looking for that"},{"speaker":"Aaron Boysen","startTime":1832.22,"endTime":1833.09,"body":"opportunity thing."},{"speaker":"Aaron Boysen","startTime":1833.119,"endTime":1836.629,"body":"Yes, yeah, I always remind"},{"speaker":"Aaron Boysen","startTime":1833.119,"endTime":1836.629,"body":"people that have a bit of a"},{"speaker":"Aaron Boysen","startTime":1836.629,"endTime":1840.259,"body":"competitive nature with"},{"speaker":"Aaron Boysen","startTime":1836.629,"endTime":1840.259,"body":"research. There's always so many"},{"speaker":"Aaron Boysen","startTime":1840.259,"endTime":1842.779,"body":"topics. So if someone's nabbed"},{"speaker":"Aaron Boysen","startTime":1840.259,"endTime":1842.779,"body":"something, there's always"},{"speaker":"Aaron Boysen","startTime":1842.779,"endTime":1845.209,"body":"something else, especially in"},{"speaker":"Aaron Boysen","startTime":1842.779,"endTime":1845.209,"body":"refeeding syndrome,"},{"speaker":"Aaron Boysen","startTime":1845.24,"endTime":1848.75,"body":"exactly. From Carly's"},{"speaker":"Aaron Boysen","startTime":1845.24,"endTime":1848.75,"body":"experience, I dare a dietetic"},{"speaker":"Aaron Boysen","startTime":1848.75,"endTime":1851.21,"body":"student or a dietitian to do"},{"speaker":"Aaron Boysen","startTime":1848.75,"endTime":1851.21,"body":"research in some of the areas"},{"speaker":"Aaron Boysen","startTime":1851.21,"endTime":1854.21,"body":"that we'll discuss today, I dare"},{"speaker":"Aaron Boysen","startTime":1851.21,"endTime":1854.21,"body":"you. And we'll see if they do"},{"speaker":"Aaron Boysen","startTime":1854.21,"endTime":1857.48,"body":"it, because I want to get more"},{"speaker":"Aaron Boysen","startTime":1854.21,"endTime":1857.48,"body":"people doing doing research to"},{"speaker":"Aaron Boysen","startTime":1857.48,"endTime":1861.38,"body":"just prove people wrong and set"},{"speaker":"Aaron Boysen","startTime":1857.48,"endTime":1861.38,"body":"the record straight. I think"},{"speaker":"Aaron Boysen","startTime":1861.38,"endTime":1866.12,"body":"that's definitely a competitive"},{"speaker":"Aaron Boysen","startTime":1861.38,"endTime":1866.12,"body":"nature. So I think a lot of the"},{"speaker":"Aaron Boysen","startTime":1866.12,"endTime":1869.18,"body":"information discussed here for"},{"speaker":"Aaron Boysen","startTime":1866.12,"endTime":1869.18,"body":"even when I was a new dietitian"},{"speaker":"Aaron Boysen","startTime":1869.18,"endTime":1873.08,"body":"will be quite sort of earth"},{"speaker":"Aaron Boysen","startTime":1869.18,"endTime":1873.08,"body":"shattering. Or what do I do now?"},{"speaker":"Aaron Boysen","startTime":1873.08,"endTime":1875.15,"body":"How do I actually do this?"},{"speaker":"Aaron Boysen","startTime":1873.08,"endTime":1875.15,"body":"Should I just feed everyone"},{"speaker":"Aaron Boysen","startTime":1875.15,"endTime":1878.27,"body":"loads of calories? Am I just"},{"speaker":"Aaron Boysen","startTime":1875.15,"endTime":1878.27,"body":"purposely not feeding them? How"},{"speaker":"Aaron Boysen","startTime":1878.27,"endTime":1880.37,"body":"does this actually translate"},{"speaker":"Aaron Boysen","startTime":1878.27,"endTime":1880.37,"body":"into practice? So when we go"},{"speaker":"Aaron Boysen","startTime":1880.37,"endTime":1883.31,"body":"into managing Reif possible"},{"speaker":"Aaron Boysen","startTime":1880.37,"endTime":1883.31,"body":"refeeding syndrome and our"},{"speaker":"Aaron Boysen","startTime":1883.31,"endTime":1886.64,"body":"patients, how does that actually"},{"speaker":"Aaron Boysen","startTime":1883.31,"endTime":1886.64,"body":"translate? What would you what"},{"speaker":"Aaron Boysen","startTime":1886.64,"endTime":1889.88,"body":"do you think is a sensible way"},{"speaker":"Aaron Boysen","startTime":1886.64,"endTime":1889.88,"body":"to approach practice?"},{"speaker":"Aaron Boysen","startTime":1890.66,"endTime":1895.85,"body":"sensible ways, being sure if"},{"speaker":"Aaron Boysen","startTime":1890.66,"endTime":1895.85,"body":"your medics, so being sure that"},{"speaker":"Aaron Boysen","startTime":1895.88,"endTime":1899.24,"body":"they will supplement what's"},{"speaker":"Aaron Boysen","startTime":1895.88,"endTime":1899.24,"body":"needed, they will do blood"},{"speaker":"Aaron Boysen","startTime":1899.24,"endTime":1902.33,"body":"tests, there'll be all the"},{"speaker":"Aaron Boysen","startTime":1899.24,"endTime":1902.33,"body":"monitoring that's recommended."},{"speaker":"Aaron Boysen","startTime":1902.33,"endTime":1908.27,"body":"So I think that sets the system"},{"speaker":"Aaron Boysen","startTime":1902.33,"endTime":1908.27,"body":"up and allows the dietician to"},{"speaker":"Aaron Boysen","startTime":1908.27,"endTime":1913.7,"body":"be a bit more, I want to say"},{"speaker":"Aaron Boysen","startTime":1908.27,"endTime":1913.7,"body":"assertive or aggressive. When"},{"speaker":"Aaron Boysen","startTime":1913.7,"endTime":1918.2,"body":"because the research is so poor,"},{"speaker":"Aaron Boysen","startTime":1913.7,"endTime":1918.2,"body":"the study that we've done on our"},{"speaker":"Aaron Boysen","startTime":1918.2,"endTime":1922.49,"body":"service is one of the more"},{"speaker":"Aaron Boysen","startTime":1918.2,"endTime":1922.49,"body":"assertive types that are out"},{"speaker":"Aaron Boysen","startTime":1922.49,"endTime":1924.77,"body":"there. And it's not with"},{"speaker":"Aaron Boysen","startTime":1922.49,"endTime":1924.77,"body":"patients with eating disorders,"},{"speaker":"Aaron Boysen","startTime":1924.77,"endTime":1927.5,"body":"it's just our patient that on"},{"speaker":"Aaron Boysen","startTime":1924.77,"endTime":1927.5,"body":"the general ward, and we start"},{"speaker":"Aaron Boysen","startTime":1927.5,"endTime":1932.06,"body":"at 50%. And if there's only mild"},{"speaker":"Aaron Boysen","startTime":1927.5,"endTime":1932.06,"body":"or there's no electrolyte"},{"speaker":"Aaron Boysen","startTime":1932.06,"endTime":1935.9,"body":"decreases, we actually go to"},{"speaker":"Aaron Boysen","startTime":1932.06,"endTime":1935.9,"body":"gold within 24 hours. And we"},{"speaker":"Aaron Boysen","startTime":1935.9,"endTime":1939.23,"body":"didn't have any adverse"},{"speaker":"Aaron Boysen","startTime":1935.9,"endTime":1939.23,"body":"outcomes. With that, I will"},{"speaker":"Aaron Boysen","startTime":1939.23,"endTime":1942.47,"body":"highlight that this was a three"},{"speaker":"Aaron Boysen","startTime":1939.23,"endTime":1942.47,"body":"month audit. And we I think it"},{"speaker":"Aaron Boysen","startTime":1942.47,"endTime":1946.07,"body":"was about, I want to say 90"},{"speaker":"Aaron Boysen","startTime":1942.47,"endTime":1946.07,"body":"patients in the end, so it's not"},{"speaker":"Aaron Boysen","startTime":1946.07,"endTime":1949.88,"body":"huge. But we've had good"},{"speaker":"Aaron Boysen","startTime":1946.07,"endTime":1949.88,"body":"outcomes from that. So I think"},{"speaker":"Aaron Boysen","startTime":1949.88,"endTime":1955.34,"body":"it's, I'm not saying go in and"},{"speaker":"Aaron Boysen","startTime":1949.88,"endTime":1955.34,"body":"do that exactly. Because that"},{"speaker":"Aaron Boysen","startTime":1955.34,"endTime":1958.34,"body":"would just be adding my own got"},{"speaker":"Aaron Boysen","startTime":1955.34,"endTime":1958.34,"body":"my Kiley guidelines out there"},{"speaker":"Aaron Boysen","startTime":1958.34,"endTime":1961.07,"body":"with the 50,000 other guidelines"},{"speaker":"Aaron Boysen","startTime":1958.34,"endTime":1961.07,"body":"that have different numbers and"},{"speaker":"Aaron Boysen","startTime":1961.07,"endTime":1965.6,"body":"recommendations. But finding"},{"speaker":"Aaron Boysen","startTime":1961.07,"endTime":1965.6,"body":"something that you're"},{"speaker":"Aaron Boysen","startTime":1965.6,"endTime":1970.19,"body":"comfortable with. So when we"},{"speaker":"Aaron Boysen","startTime":1965.6,"endTime":1970.19,"body":"were updating the refeeding"},{"speaker":"Aaron Boysen","startTime":1970.19,"endTime":1973.28,"body":"syndrome guidelines for our"},{"speaker":"Aaron Boysen","startTime":1970.19,"endTime":1973.28,"body":"health service as a department,"},{"speaker":"Aaron Boysen","startTime":1973.28,"endTime":1975.83,"body":"we got together and we all"},{"speaker":"Aaron Boysen","startTime":1973.28,"endTime":1975.83,"body":"talked about what we all"},{"speaker":"Aaron Boysen","startTime":1975.83,"endTime":1978.02,"body":"individually do, because none of"},{"speaker":"Aaron Boysen","startTime":1975.83,"endTime":1978.02,"body":"us were following the"},{"speaker":"Aaron Boysen","startTime":1978.02,"endTime":1980.81,"body":"recommendations because we all"},{"speaker":"Aaron Boysen","startTime":1978.02,"endTime":1980.81,"body":"felt that was so conservative."},{"speaker":"Aaron Boysen","startTime":1981.35,"endTime":1984.38,"body":"And then once we've been told"},{"speaker":"Aaron Boysen","startTime":1981.35,"endTime":1984.38,"body":"did a poll on what everyone is"},{"speaker":"Aaron Boysen","startTime":1984.38,"endTime":1988.34,"body":"doing, really kicks that around,"},{"speaker":"Aaron Boysen","startTime":1984.38,"endTime":1988.34,"body":"we looked at what the evidence"},{"speaker":"Aaron Boysen","startTime":1988.34,"endTime":1991.28,"body":"shows compared to what everyone"},{"speaker":"Aaron Boysen","startTime":1988.34,"endTime":1991.28,"body":"else was doing. And that's how"},{"speaker":"Aaron Boysen","startTime":1991.28,"endTime":1994.73,"body":"we came up with that cut what we"},{"speaker":"Aaron Boysen","startTime":1991.28,"endTime":1994.73,"body":"were comfortable with as a"},{"speaker":"Aaron Boysen","startTime":1994.73,"endTime":1999.11,"body":"service providing to our"},{"speaker":"Aaron Boysen","startTime":1994.73,"endTime":1999.11,"body":"patients. So you can't do it"},{"speaker":"Aaron Boysen","startTime":1999.11,"endTime":2003.07,"body":"alone. I don't think so. If you"},{"speaker":"Aaron Boysen","startTime":1999.11,"endTime":2003.07,"body":"go rogue, someone's gonna read"},{"speaker":"Aaron Boysen","startTime":2003.07,"endTime":2007.03,"body":"the chat entry and wonder why"},{"speaker":"Aaron Boysen","startTime":2003.07,"endTime":2007.03,"body":"you're starting and doing"},{"speaker":"Aaron Boysen","startTime":2007.03,"endTime":2010.0,"body":"something so assertive compared"},{"speaker":"Aaron Boysen","startTime":2007.03,"endTime":2010.0,"body":"to the rest of the service. So I"},{"speaker":"Aaron Boysen","startTime":2010.0,"endTime":2012.19,"body":"think it's important to have"},{"speaker":"Aaron Boysen","startTime":2010.0,"endTime":2012.19,"body":"those discussions as a team."},{"speaker":"Aaron Boysen","startTime":2013.24,"endTime":2016.57,"body":"Definitely, I think, yeah, a"},{"speaker":"Aaron Boysen","startTime":2013.24,"endTime":2016.57,"body":"team approach and then building"},{"speaker":"Aaron Boysen","startTime":2016.57,"endTime":2018.91,"body":"the guidelines together, and"},{"speaker":"Aaron Boysen","startTime":2016.57,"endTime":2018.91,"body":"basically what you all feel"},{"speaker":"Aaron Boysen","startTime":2018.91,"endTime":2021.91,"body":"comfortable with. And just so"},{"speaker":"Aaron Boysen","startTime":2018.91,"endTime":2021.91,"body":"there's uniformity. So when"},{"speaker":"Aaron Boysen","startTime":2021.91,"endTime":2024.46,"body":"you're actually going when"},{"speaker":"Aaron Boysen","startTime":2021.91,"endTime":2024.46,"body":"different dieticians cover, or"},{"speaker":"Aaron Boysen","startTime":2024.64,"endTime":2027.31,"body":"different dietitians cover"},{"speaker":"Aaron Boysen","startTime":2024.64,"endTime":2027.31,"body":"different services, there's not"},{"speaker":"Aaron Boysen","startTime":2027.31,"endTime":2032.23,"body":"confusion or there's not. Yeah,"},{"speaker":"Aaron Boysen","startTime":2027.31,"endTime":2032.23,"body":"it just helps with continuity"},{"speaker":"Aaron Boysen","startTime":2032.23,"endTime":2035.35,"body":"and things like that, also, I"},{"speaker":"Aaron Boysen","startTime":2032.23,"endTime":2035.35,"body":"think probably translate it is"},{"speaker":"Aaron Boysen","startTime":2035.56,"endTime":2037.96,"body":"this is a massive area for"},{"speaker":"Aaron Boysen","startTime":2035.56,"endTime":2037.96,"body":"research a massive area of"},{"speaker":"Aaron Boysen","startTime":2037.99,"endTime":2042.1,"body":"development. And the only way we"},{"speaker":"Aaron Boysen","startTime":2037.99,"endTime":2042.1,"body":"can alarm has to say, improve"},{"speaker":"Aaron Boysen","startTime":2042.1,"endTime":2045.91,"body":"the guidelines. And the evidence"},{"speaker":"Aaron Boysen","startTime":2042.1,"endTime":2045.91,"body":"behind them is by create getting"},{"speaker":"Aaron Boysen","startTime":2045.91,"endTime":2050.23,"body":"more evidence getting more even"},{"speaker":"Aaron Boysen","startTime":2045.91,"endTime":2050.23,"body":"audits or actual practice of"},{"speaker":"Aaron Boysen","startTime":2050.23,"endTime":2052.99,"body":"what dietitians are doing in"},{"speaker":"Aaron Boysen","startTime":2050.23,"endTime":2052.99,"body":"practice and how it impacts"},{"speaker":"Aaron Boysen","startTime":2052.99,"endTime":2056.62,"body":"patients. So that's obviously an"},{"speaker":"Aaron Boysen","startTime":2052.99,"endTime":2056.62,"body":"area where we can collect data"},{"speaker":"Aaron Boysen","startTime":2056.62,"endTime":2061.12,"body":"and and I know Allison from the"},{"speaker":"Aaron Boysen","startTime":2056.62,"endTime":2061.12,"body":"UK is very bullish on this and"},{"speaker":"Aaron Boysen","startTime":2061.12,"endTime":2063.49,"body":"patients at risk of refeeding"},{"speaker":"Aaron Boysen","startTime":2061.12,"endTime":2063.49,"body":"syndrome. She's particularly"},{"speaker":"Aaron Boysen","startTime":2063.49,"endTime":2066.55,"body":"bullish, and she keeps on"},{"speaker":"Aaron Boysen","startTime":2063.49,"endTime":2066.55,"body":"saying, Let's collect evidence,"},{"speaker":"Aaron Boysen","startTime":2066.55,"endTime":2070.06,"body":"keep on collecting evidence, the"},{"speaker":"Aaron Boysen","startTime":2066.55,"endTime":2070.06,"body":"more we have, the better and"},{"speaker":"Aaron Boysen","startTime":2070.06,"endTime":2074.23,"body":"obviously you might think I"},{"speaker":"Aaron Boysen","startTime":2070.06,"endTime":2074.23,"body":"don't have the capacity to do X"},{"speaker":"Aaron Boysen","startTime":2074.23,"endTime":2078.13,"body":"type of study or the dream study"},{"speaker":"Aaron Boysen","startTime":2074.23,"endTime":2078.13,"body":"or whatever. But I think with"},{"speaker":"Aaron Boysen","startTime":2078.13,"endTime":2081.19,"body":"everything, it's just collecting"},{"speaker":"Aaron Boysen","startTime":2078.13,"endTime":2081.19,"body":"as much evidence as possible"},{"speaker":"Aaron Boysen","startTime":2081.19,"endTime":2081.4,"body":"because"},{"speaker":"Aaron Boysen","startTime":2081.4,"endTime":2085.24,"body":"I love Allison, I've talked to"},{"speaker":"Aaron Boysen","startTime":2081.4,"endTime":2085.24,"body":"her about this before, like, I"},{"speaker":"Aaron Boysen","startTime":2085.42,"endTime":2091.06,"body":"really want to do an RCT but in"},{"speaker":"Aaron Boysen","startTime":2085.42,"endTime":2091.06,"body":"our service here, it's just it's"},{"speaker":"Aaron Boysen","startTime":2091.06,"endTime":2093.91,"body":"impossible and she's always"},{"speaker":"Aaron Boysen","startTime":2091.06,"endTime":2093.91,"body":"turned around and said it's not"},{"speaker":"Aaron Boysen","startTime":2093.91,"endTime":2096.64,"body":"impossible. There's a study"},{"speaker":"Aaron Boysen","startTime":2093.91,"endTime":2096.64,"body":"published you can totally do it."},{"speaker":"Aaron Boysen","startTime":2097.0,"endTime":2101.59,"body":"So like to tell people that like"},{"speaker":"Aaron Boysen","startTime":2097.0,"endTime":2101.59,"body":"Don't ever think it's impossible"},{"speaker":"Aaron Boysen","startTime":2101.59,"endTime":2104.95,"body":"because someone has just done"},{"speaker":"Aaron Boysen","startTime":2101.59,"endTime":2104.95,"body":"it. And it needs to be"},{"speaker":"Aaron Boysen","startTime":2104.95,"endTime":2108.37,"body":"replicated. And the poor things"},{"speaker":"Aaron Boysen","startTime":2104.95,"endTime":2108.37,"body":"have so many problems with their"},{"speaker":"Aaron Boysen","startTime":2108.37,"endTime":2110.8,"body":"study as well, just with delays"},{"speaker":"Aaron Boysen","startTime":2108.37,"endTime":2110.8,"body":"and that sort of thing,"},{"speaker":"Aaron Boysen","startTime":2110.8,"endTime":2112.78,"body":"definitely need some more work"},{"speaker":"Aaron Boysen","startTime":2110.8,"endTime":2112.78,"body":"out there as well."},{"speaker":"Aaron Boysen","startTime":2114.519,"endTime":2118.359,"body":"Definitely, I'm so grateful that"},{"speaker":"Aaron Boysen","startTime":2114.519,"endTime":2118.359,"body":"you obviously did your PhD in"},{"speaker":"Aaron Boysen","startTime":2118.359,"endTime":2121.749,"body":"this topic. And hopefully, it's"},{"speaker":"Aaron Boysen","startTime":2118.359,"endTime":2121.749,"body":"been really informative to those"},{"speaker":"Aaron Boysen","startTime":2121.749,"endTime":2125.049,"body":"who are dieticians and student"},{"speaker":"Aaron Boysen","startTime":2121.749,"endTime":2125.049,"body":"dieticians out there to really"},{"speaker":"Aaron Boysen","startTime":2125.049,"endTime":2127.509,"body":"understand a little bit more"},{"speaker":"Aaron Boysen","startTime":2125.049,"endTime":2127.509,"body":"about refeeding syndrome. And I"},{"speaker":"Aaron Boysen","startTime":2127.509,"endTime":2129.729,"body":"think that's the push going"},{"speaker":"Aaron Boysen","startTime":2127.509,"endTime":2129.729,"body":"forward. I think, as we can see"},{"speaker":"Aaron Boysen","startTime":2129.729,"endTime":2132.999,"body":"from I mentioned the beginning"},{"speaker":"Aaron Boysen","startTime":2129.729,"endTime":2132.999,"body":"of the pench handbook, from"},{"speaker":"Aaron Boysen","startTime":2132.999,"endTime":2136.989,"body":"quite prescriptive guidelines to"},{"speaker":"Aaron Boysen","startTime":2132.999,"endTime":2136.989,"body":"displaying the evidence and you"},{"speaker":"Aaron Boysen","startTime":2136.989,"endTime":2139.389,"body":"pick for yourself and looking"},{"speaker":"Aaron Boysen","startTime":2136.989,"endTime":2139.389,"body":"actually reading the studies."},{"speaker":"Aaron Boysen","startTime":2139.389,"endTime":2141.159,"body":"And that was very much"},{"speaker":"Aaron Boysen","startTime":2139.389,"endTime":2141.159,"body":"encouraged when we went through"},{"speaker":"Aaron Boysen","startTime":2141.189,"endTime":2144.669,"body":"collating requirements, which is"},{"speaker":"Aaron Boysen","startTime":2141.189,"endTime":2144.669,"body":"a story for another day, around"},{"speaker":"Aaron Boysen","startTime":2145.029,"endTime":2150.099,"body":"evidence and gaps in evidence."},{"speaker":"Aaron Boysen","startTime":2145.029,"endTime":2150.099,"body":"But definitely the opening sort"},{"speaker":"Aaron Boysen","startTime":2150.099,"endTime":2154.749,"body":"of accident. To be honest, a lot"},{"speaker":"Aaron Boysen","startTime":2150.099,"endTime":2154.749,"body":"of dietitians that I talked to"},{"speaker":"Aaron Boysen","startTime":2154.749,"endTime":2156.879,"body":"at the time, were quite"},{"speaker":"Aaron Boysen","startTime":2154.749,"endTime":2156.879,"body":"frustrated with actually they"},{"speaker":"Aaron Boysen","startTime":2156.879,"endTime":2159.819,"body":"were like, how is this clear to"},{"speaker":"Aaron Boysen","startTime":2156.879,"endTime":2159.819,"body":"read? How do we tell people what"},{"speaker":"Aaron Boysen","startTime":2159.819,"endTime":2163.449,"body":"to do? This is going to be"},{"speaker":"Aaron Boysen","startTime":2159.819,"endTime":2163.449,"body":"really problematic for students."},{"speaker":"Aaron Boysen","startTime":2163.449,"endTime":2165.309,"body":"And it's not prescriptive, and"},{"speaker":"Aaron Boysen","startTime":2163.449,"endTime":2165.309,"body":"it's quite difficult to"},{"speaker":"Aaron Boysen","startTime":2165.309,"endTime":2168.489,"body":"understand. But I think moving"},{"speaker":"Aaron Boysen","startTime":2165.309,"endTime":2168.489,"body":"more towards that actually"},{"speaker":"Aaron Boysen","startTime":2168.489,"endTime":2172.449,"body":"understanding what's behind the"},{"speaker":"Aaron Boysen","startTime":2168.489,"endTime":2172.449,"body":"guidelines, actually helps"},{"speaker":"Aaron Boysen","startTime":2172.449,"endTime":2176.319,"body":"people to be more informed"},{"speaker":"Aaron Boysen","startTime":2172.449,"endTime":2176.319,"body":"practitioners. I think it's so"},{"speaker":"Aaron Boysen","startTime":2176.319,"endTime":2179.049,"body":"important to understand what is"},{"speaker":"Aaron Boysen","startTime":2176.319,"endTime":2179.049,"body":"actually behind certain"},{"speaker":"Aaron Boysen","startTime":2179.049,"endTime":2181.659,"body":"guidelines. And I think what"},{"speaker":"Aaron Boysen","startTime":2179.049,"endTime":2181.659,"body":"your talk did originally, and"},{"speaker":"Aaron Boysen","startTime":2181.659,"endTime":2184.929,"body":"what some of this podcast has"},{"speaker":"Aaron Boysen","startTime":2181.659,"endTime":2184.929,"body":"done is help inform me"},{"speaker":"Aaron Boysen","startTime":2184.929,"endTime":2188.199,"body":"personally, around what's"},{"speaker":"Aaron Boysen","startTime":2184.929,"endTime":2188.199,"body":"actually behind the refeeding"},{"speaker":"Aaron Boysen","startTime":2188.199,"endTime":2191.739,"body":"guidelines. So when I'm"},{"speaker":"Aaron Boysen","startTime":2188.199,"endTime":2191.739,"body":"implementing it, or actually"},{"speaker":"Aaron Boysen","startTime":2191.769,"endTime":2195.159,"body":"using the guidelines, I"},{"speaker":"Aaron Boysen","startTime":2191.769,"endTime":2195.159,"body":"understand the evidence and how"},{"speaker":"Aaron Boysen","startTime":2195.159,"endTime":2196.299,"body":"much evidence is behind it."},{"speaker":"Aaron Boysen","startTime":2196.809,"endTime":2200.109,"body":"Thanks. Yeah, look, it was a"},{"speaker":"Aaron Boysen","startTime":2196.809,"endTime":2200.109,"body":"learning curve for me too. I"},{"speaker":"Aaron Boysen","startTime":2200.139,"endTime":2203.049,"body":"remember reading our level C"},{"speaker":"Aaron Boysen","startTime":2200.139,"endTime":2203.049,"body":"level D evidence. Okay. So that"},{"speaker":"Aaron Boysen","startTime":2203.049,"endTime":2205.449,"body":"means it's pretty rubbish. But"},{"speaker":"Aaron Boysen","startTime":2203.049,"endTime":2205.449,"body":"then when you dig down deep into"},{"speaker":"Aaron Boysen","startTime":2205.449,"endTime":2207.729,"body":"it, you're like, Oh, okay."},{"speaker":"Aaron Boysen","startTime":2205.449,"endTime":2207.729,"body":"There's really no studies. It's"},{"speaker":"Aaron Boysen","startTime":2207.729,"endTime":2211.359,"body":"it is expert opinions. Yeah, I"},{"speaker":"Aaron Boysen","startTime":2207.729,"endTime":2211.359,"body":"do think it's important. We do"},{"speaker":"Aaron Boysen","startTime":2211.359,"endTime":2213.729,"body":"journal club at work quite"},{"speaker":"Aaron Boysen","startTime":2211.359,"endTime":2213.729,"body":"regularly, and we rip apart"},{"speaker":"Aaron Boysen","startTime":2213.729,"endTime":2217.329,"body":"guidelines all the time. It's"},{"speaker":"Aaron Boysen","startTime":2213.729,"endTime":2217.329,"body":"fun. Just rip them apart,"},{"speaker":"Aaron Boysen","startTime":2217.329,"endTime":2219.999,"body":"looking at what's supporting"},{"speaker":"Aaron Boysen","startTime":2217.329,"endTime":2219.999,"body":"them. Yeah. And I highly"},{"speaker":"Aaron Boysen","startTime":2219.999,"endTime":2221.109,"body":"recommend so."},{"speaker":"Aaron Boysen","startTime":2222.82,"endTime":2225.31,"body":"I mean, yeah, it's a really good"},{"speaker":"Aaron Boysen","startTime":2222.82,"endTime":2225.31,"body":"practice to do rip apart"},{"speaker":"Aaron Boysen","startTime":2225.31,"endTime":2227.98,"body":"guidelines and look at what's"},{"speaker":"Aaron Boysen","startTime":2225.31,"endTime":2227.98,"body":"actually behind them. I think"},{"speaker":"Aaron Boysen","startTime":2227.98,"endTime":2231.22,"body":"it's it just Yeah, it is really"},{"speaker":"Aaron Boysen","startTime":2227.98,"endTime":2231.22,"body":"important. I think that's vital."},{"speaker":"Aaron Boysen","startTime":2231.43,"endTime":2233.26,"body":"But thank you so much for coming"},{"speaker":"Aaron Boysen","startTime":2231.43,"endTime":2233.26,"body":"on the podcast."},{"speaker":"Kylie Matthews","startTime":2233.65,"endTime":2235.21,"body":"Thank you for"},{"speaker":"Kylie Matthews","startTime":2233.65,"endTime":2235.21,"body":"having me on. It was fun."}]}