Sample records for adult care food

  1. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Child and Adult Care Food Program (CACFP). 250.61... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... CACFP to distributing agencies, which provide them to child care and adult care institutions...

  2. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Child and Adult Care Food Program (CACFP). 250.61... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... CACFP to distributing agencies, which provide them to child care and adult care institutions...

  3. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Child and Adult Care Food Program (CACFP). 250.61... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... CACFP to distributing agencies, which provide them to child care and adult care institutions...

  4. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Child and Adult Care Food Program (CACFP). 250.61... National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.61 Child and Adult Care Food... CACFP to distributing agencies, which provide them to child care and adult care institutions...

  5. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  6. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

  7. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

  8. Food insecurity in Canadian adults receiving diabetes care.

    PubMed

    Galesloot, Suzanne; McIntyre, Lynn; Fenton, Tanis; Tyminski, Sheila

    2012-01-01

    The prevalence of adult-level household food insecurity was examined among clients receiving outpatient diabetes health care services. Participants were adults diagnosed with diabetes mellitus, who attended individual counselling sessions at Calgary's main clinic from January to April 2010. Clinicians were trained to administer the Household Food Security Survey Module (HFSSM), and did so with clients' assent during their scheduled sessions. The prevalence of adult-level household food insecurity among 314 respondents was 15.0% (95% confidence interval [CI], 11.2 to 19.4); 6.7% (95% CI, 4.2 to 10.0) of clinic attendees were categorized as severely food insecure. The comparable rates obtained in Alberta in 2007 using the same instrument (HFSSM) were 5.6% and 1.2%, respectively. Household food insecurity rates among individuals with diabetes in active care are higher than rates reported in Canadian population surveys. Severe food insecurity, indicating reduced food intake and disrupted eating patterns, may affect this population's ability to follow a pattern of healthy eating necessary for effective diabetes management. This study reinforces the importance of assessing clients' inability to access food because of financial constraints, and indicates that screening with a validated measure may facilitate identification of clients at risk.

  9. 7 CFR 250.61 - Child and Adult Care Food Program (CACFP).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... a contract with a food service management company. A child care or adult care institution may use donated foods in a contract with a food service management company to conduct its food service. The... considered a food service management company. ...

  10. 7 CFR 240.4 - Cash in lieu of donated foods for nonresidential child and adult care institutions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... and adult care institutions. 240.4 Section 240.4 Agriculture Regulations of the Department of... LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult care... or adult care institutions participating in the Child and Adult Care Food Program. FNS shall pay each...

  11. 7 CFR 240.4 - Cash in lieu of donated foods for nonresidential child and adult care institutions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... and adult care institutions. 240.4 Section 240.4 Agriculture Regulations of the Department of... LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult care... or adult care institutions participating in the Child and Adult Care Food Program. FNS shall pay each...

  12. 7 CFR 240.4 - Cash in lieu of donated foods for nonresidential child and adult care institutions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and adult care institutions. 240.4 Section 240.4 Agriculture Regulations of the Department of... LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult care... or adult care institutions participating in the Child and Adult Care Food Program. FNS shall pay each...

  13. 7 CFR 240.4 - Cash in lieu of donated foods for nonresidential child and adult care institutions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and adult care institutions. 240.4 Section 240.4 Agriculture Regulations of the Department of... LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult care... or adult care institutions participating in the Child and Adult Care Food Program. FNS shall pay each...

  14. Supporting Nutrition in Early Care and Education Settings: The Child and Adult Care Food Program (CACFP)

    ERIC Educational Resources Information Center

    Stephens, Samuel A.

    2016-01-01

    Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…

  15. 7 CFR 240.4 - Cash in lieu of donated foods for nonresidential child and adult care institutions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and adult care institutions. 240.4 Section 240.4 Agriculture Regulations of the Department of... LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult care... the school year, elect to receive cash in lieu of donated foods for use in nonresidential child care...

  16. Is Food Insufficiency Associated with Health Status and Health Care Utilization Among Adults with Diabetes?

    PubMed Central

    Nelson, Karin; Cunningham, William; Andersen, Ron; Harrison, Gail; Gelberg, Lillian

    2001-01-01

    OBJECTIVES Preliminary studies have shown that among adults with diabetes, food insufficiency has adverse health consequences, including hypoglycemic episodes and increased need for health care services. The purpose of this study was to determine the prevalence of food insufficiency and to describe the association of food insufficiency with health status and health care utilization in a national sample of adults with diabetes. METHODS We analyzed data from adults with diabetes (n = 1,503) interviewed in the Third National Health and Nutrition Examination Survey. Bivariate and multivariate analyses were used to examine the relationship of food insufficiency to self-reported health status and health care utilization. RESULTS Six percent of adults with diabetes reported food insufficiency, representing more than 568,600 persons nationally (95% confidence interval, 368,400 to 768,800). Food insufficiency was more common among those with incomes below the federal poverty level (17% vs 4%, P≤.001). Adults with diabetes who were food insufficient were more likely to report fair or poor health status than those who were not (63% vs 43%; odds ratio, 2.2; P =.05). In a multivariate analysis, fair or poor health status was independently associated with poverty, nonwhite race, low educational achievement, and number of chronic diseases, but not with food insufficiency. Diabetic adults who were food insufficient reported more physician encounters, either in clinic or by phone, than those who were food secure (12 vs 7, P <.05). In a multivariate linear regression, food insufficiency remained independently associated with increased physician utilization among adults with diabetes. There was no association between food insufficiency and hospitalization in bivariate analysis. CONCLUSIONS Food insufficiency is relatively common among low-income adults with diabetes and was associated with higher physician utilization. PMID:11422638

  17. The Child and Adult Care Food Program and the Nutrition of Preschoolers

    ERIC Educational Resources Information Center

    Korenman, Sanders; Abner, Kristin S.; Kaestner, Robert; Gordon, Rachel A.

    2013-01-01

    Children spend a considerable amount of time in preschools and child care centers. As a result, these settings may have an influence on their diet, weight, and food security, and are potentially important contexts for interventions to address nutritional health. The Child and Adult Care Food Program (CACFP) is one such intervention. No national…

  18. Participation in the child and adult care food program is associated with more nutritious foods and beverages in child care.

    PubMed

    Ritchie, Lorrene D; Boyle, Maria; Chandran, Kumar; Spector, Phil; Whaley, Shannon E; James, Paula; Samuels, Sarah; Hecht, Ken; Crawford, Patricia

    2012-06-01

    Nearly two million California children regularly spend time in child care. Surprisingly little is known about the nutrition environments of these settings. The aim of this study was to compare foods and beverages served to 2- to 5-year-olds by type of child care and participation in the federally funded Child and Adult Care Food Program (CACFP). A statewide survey of child care providers (n = 429) was administered. Licensed child care was divided into six categories: Head Start centers, state preschools, centers that participate in CACFP, non-CACFP centers, homes that participate in CACFP, and non-CACFP homes. CACFP sites in general, and Head Start centers in particular, served more fruits, vegetables, milk, and meat/meat alternatives, and fewer sweetened beverages and other sweets and snack-type items than non-CACFP sites. Reported barriers to providing nutritious foods included high food costs and lack of training. CACFP participation may be one means by which reimbursement for food can be increased and food offerings improved. Further research should investigate whether promoting CACFP participation can be used to provide healthier nutrition environments in child care and prevent obesity in young children.

  19. Creditable Foods Guide for Child Care Centers on the Child Care Food Program.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    This manual provides information on creditable and noncreditable foods in child care centers, before-and-after-school centers, family day care homes, and adult day care centers. Creditable foods are foods that may be counted toward meeting the requirements for a reimbursable meal. Foods are determined to be creditable according to guidelines…

  20. Simplified Buying Guide, 1992 Edition. California Child and Adult Care Food Program.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    This guidebook provides a combination of guidance and policy information that will help California sponsors to plan, purchase, prepare, and serve nutritious meals and snacks that comply with the Child and Adult Care Food Program (CACFP) meal pattern requirements. Sections 1 through 4 list foods that may be used for the meat/meat alternate,…

  1. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-13

    ... Vol. 76 Monday, No. 113 June 13, 2011 Part IV Department of Agriculture Food and Nutrition Service 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program... Regulations#0;#0; [[Page 34542

  2. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    ERIC Educational Resources Information Center

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  3. Practitioners' opinions on Food and Nutrition Care Indicators in assisted living facilities for older adults.

    PubMed

    Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Tennstedt, Sharon; Jacques, Paul

    2008-09-01

    This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.

  4. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    ERIC Educational Resources Information Center

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  5. Foods served in child care facilities participating in the Child and Adult Care Food Program: Menu match and agreement with the new meal patterns and best practices

    USDA-ARS?s Scientific Manuscript database

    Our objective was to assess the agreement of posted menus with foods served to 3- to 5-year-old children attending federal Child and Adult Care Food Program (CACFP)-enrolled facilities, and the degree to which the facilities met the new meal patterns and best practices. On-site observations and menu...

  6. Food Assistance: Efforts To Control Fraud and Abuse in the Child and Adult Care Food Program Should Be Strengthened. United States General Accounting Office Report to Congressional Committees.

    ERIC Educational Resources Information Center

    Robertson, Robert E.

    The Child and Adult Care Food Program provides over $1.5 billion in benefits annually to children and adults in day care. In order to address the longstanding problems of fraud and abuse present in the program, state agencies have been charged with the responsibility for implementing Food and Nutrition Service's (FNS) regulations to prevent and…

  7. Diarrhea - what to ask your health care provider - adult

    MedlinePlus

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health care provider - adult ... you should ask: Can I eat dairy foods? What foods can make my problem worse? Can I ...

  8. Healthful Menus and Recipes for Children Over Two Years of Age in the Child and Adult Care Food Program.

    ERIC Educational Resources Information Center

    Haines, Julie A.; Sigman-Grant, Madeleine; Brown, J. Lynne

    Noting that children will adjust their food intake to their energy needs, and that offering a variety of foods often will increase their acceptance of new foods, this guide offers instruction on the proper feeding of children ages 3 to 5 in Pennsylvania's Child and Adult Care Food Program (CACFP). The menus presented in the guide follow the…

  9. Food Insecurity in Older Adults in an Integrated Health Care System.

    PubMed

    Steiner, John F; Stenmark, Sandra H; Sterrett, Andrew T; Paolino, Andrea R; Stiefel, Matthew; Gozansky, Wendolyn S; Zeng, Chan

    2018-05-01

    To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. Retrospective cohort study. Kaiser Permanente Colorado. Adult members who completed a pre-Medicare Annual Wellness Visit survey. Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self-reported characteristics from the survey were used to develop the prediction model. Of 130,208 older adult members between January 2012 and December 2015, 50,097 (38.5%) completed food insecurity screening, 2,859 of whom (5.7% of respondents) reported food insecurity. The prevalence of food insecurity was 10.0% or greater among individuals who were black or Hispanic, had less than high school education, had Medicaid insurance, were extremely obese, had poor health status or quality of life, had depression or anxiety, had impairments in specific activities of daily living, had other nutritional risk factors, or were socially isolated (all p<.001). A multivariable model based on these and other characteristics showed moderate discrimination (c-statistic = 0.74) between individuals with food insecurity and those without and 14.3% of individuals in the highest quintile of risk reported food insecurity. Food insecurity is prevalent even in older adults with private-sector healthcare coverage. Specific individual characteristics, and a model based on those characteristics, can identify older adults at higher risk of food insecurity. System-level interventions will be necessary to connect older adults with community-based food resources. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  10. Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings.

    PubMed

    van der Meij, Barbara S; Wijnhoven, Hanneke A H; Finlayson, Graham S; Oosten, Babette S H; Visser, Marjolein

    2015-07-01

    A poor appetite in older adults is an important determinant of reduced food intake and undernutrition. Food preferences may influence food intake. The aim of this study was to investigate food preferences of older adults with a poor appetite and compare these with preferences of older adults with a good appetite. Older adults (n = 349, aged 65-101 years) in nursing/residential care homes, hospitals or at home receiving home care participated in a computer-based forced-choice food preference assessment. Self-reported appetite in the past week was classified as 'good' or 'poor' using a validated instrument. Food preferences were determined by counting the relative frequency of choices for food images according to 11 dichotomous categories: high/low 1) protein; 2) fat; 3) carbohydrates; 4) fiber; 5) variation; and 6) animal/vegetarian proteins; 7) sweet/savory taste; 8) solid/liquid texture; 9) dairy/non-dairy; with/without 10) sauce or 11) color variation. Specific food preferences in participants with a poor appetite were identified by one-sample t-tests comparing frequencies to the expected value of 48. Preference differences between those with a good and a poor appetite were analyzed using GLM adjusting for confounders. The results showed that older adults with a poor appetite (n = 113; 32.4%) preferred variation (51.6 vs. 48, P < 0.001), color variation (55.9 vs. 48, P < 0.01), non-dairy (53.0 vs. 48, P < 0.001), high-fiber (51.8 vs. 48, P < 0.05), and solid texture (53.5 vs. 48, P < 0.05). Participants with a poor appetite had a higher frequency score for variation than participants with a good appetite (51.6 vs. 48.5, P < 0.001). In conclusion, older adults with a poor appetite may have specific food preferences. Their preference for variation differs from those with a good appetite. These results may be used to develop meals that are preferred by older adults with poor appetite in order to increase food intake and prevent

  11. Improving food and fluid intake for older adults living in long-term care: a research agenda.

    PubMed

    Keller, Heather; Beck, Anne Marie; Namasivayam, Ashwini

    2015-02-01

    Poor food and fluid intake and malnutrition are endemic among older adults in long-term care (LTC), yet feasible and sustainable interventions that target key determinants and improve person-centered outcomes remain elusive. Without a comprehensive study addressing a range of determinants to identify those that are of greatest importance for targeting with interventions, expert consensus can be used to develop a research agenda. International experts and stakeholders convened for a 2-day meeting to participate in a nominal group process to identify and prioritize determinants of food and fluid intake for persons living in LTC. Top determinants to address with intervention research included social interactions of residents at mealtime; self-feeding ability; the dining environment; the attitudes, knowledge, and skills of staff; adequate time to eat/availability of staff to provide assistance; sensory properties of the food; hospitality and mealtime logistics; choice and variety in the dining experience; and nutrient density of food. Multimodal interventions that could target these prioritized determinants were also suggested. This consensus process has resulted in a prioritized research agenda for the development and testing of interventions to improve food and fluid intake of older adults living in LTC. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  12. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  13. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  14. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  15. Obesity Prevention Practices and Policies in Child Care Settings Enrolled and Not Enrolled in the Child and Adult Care Food Program.

    PubMed

    Liu, Sherry T; Graffagino, Cheryl L; Leser, Kendall A; Trombetta, Autumn L; Pirie, Phyllis L

    2016-09-01

    Objectives The United States Department of Agriculture's Child and Adult Care Food Program (CACFP) provides meals and snacks to low-income children in child care. This study compared nutrition and physical activity practices and policies as well as the overall nutrition and physical activity environments in a sample of CACFP and non-CACFP child care settings. Methods A random stratified sample of 350 child care settings in a large Midwestern city and its suburbs, was mailed a survey on obesity prevention practices and policies concerning menu offerings, feeding practices, nutrition and physical activity education, activity levels, training, and screen time. Completed surveys were obtained from 229 of 309 eligible child care settings (74.1 % response rate). Chi square tests were used to compare practices and policies in CACFP and non-CACFP sites. Poisson and negative binomial regression were used to examine associations between CACFP and total number of practices and policies. Results Sixty-nine percent of child care settings reported CACFP participation. A significantly higher proportion of CACFP sites reported offering whole grain foods daily and that providers always eat the same foods that are offered to the children. CACFP sites had 1.1 times as many supportive nutrition practices as non-CACFP sites. CACFP participation was not associated with written policies or physical activity practices. Conclusions for Practice There is room for improvement across nutrition and physical activity practices and policies. In addition to food reimbursement, CACFP participation may help promote child care environments that support healthy nutrition; however, additional training and education outreach activities may be needed.

  16. Participation in the Child and Adult Care Food Program Is Associated with Healthier Nutrition Environments at Family Child Care Homes in Mississippi.

    PubMed

    Erinosho, Temitope; Vaughn, Amber; Hales, Derek; Mazzucca, Stephanie; Gizlice, Ziya; Ward, Dianne

    2018-05-01

    Describe foods and beverages offered, nutrition practices, and nutrition policies of family child care homes in Mississippi and differences by participation in the Child and Adult Care Food Program (CACFP). Cross-sectional study conducted between fall, 2015 and spring, 2016. Mississippi. Random, stratified sample of 134 family child care homes that enroll 3- to 5-year-olds. Providers completed a modified version of the Environment and Policy Assessment and Observation-self-report tool. Foods and beverages offered at lunch, provider practices regarding nutrition, and presence or absence of written nutrition policies. Descriptive statistics, likelihood ratio chi-square, and t tests. Most homes (>75%) provided components from the fruit, vegetable, grain/bread, meat/meat alternative, and milk food groups at lunch. At some homes, the food and beverage selections offered were high in fat, sugar, and refined grains. Providers at CACFP-participating homes (P < .05) reported healthier beverage selections, more healthful nutrition practices, and more written nutrition policies compared with providers at non-CACFP homes. Interventions and regulatory standards are needed, particularly in non-CACFP homes, to ensure that food and beverage offerings, provider practices, and policies regarding nutrition support the development of healthful dietary behaviors in early childhood. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  17. The association of food insecurity with health outcomes for adults with disabilities.

    PubMed

    Brucker, Debra L

    2017-04-01

    Adults with disabilities are more likely to live in households that are food insecure and are more likely to experience health disparities than adults without disabilities. Research examining the intersection of food insecurity and health outcomes for adults with disabilities has so far been lacking, however. The research presented here tests whether living in a food insecure household is associated with poorer self-reported health and mental health and different health care utilization, controlling for disability status and other sociodemographic characteristics. Multivariate regression analyses are conducted using linked data from the 2011 National Health Interview Survey and the 2012 Medical Expenditures Panel Survey. Adults with and without disabilities who live in food insecure households have higher odds of reporting fair or poor health or mental health in either the current year or the subsequent year. Health care utilization patterns differ for adults who are food insecure as well, both within and across years. Efforts to address health disparities among adults with disabilities should consider the possible additional impact of food insecurity on health outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Exploring implementation of the 2010 Institute of Medicine’s Child and Adult Food Care Program recommendations for after-school snacks

    PubMed Central

    Nanney, Marilyn S; Glatt, Carissa

    2012-01-01

    Objective The aim of the present study was to explore the implementation of nutrition recommendations made in the 2010 Institute of Medicine (IOM) report, Child and Adult Care Food Program: Aligning Dietary Guidance for All, in school-based after-school snack programmes. Design A descriptive study. Setting One large suburban school district in Minneapolis, Minnesota, USA. Subjects None. Results Major challenges to implementation included limited access to product labelling and specifications inconsistent with the IOM’s Child and Adult Care Food Program (CACFP) recommendations, limited access to healthier foods due to current school district buying consortium agreement, and increased costs of wholegrain and lower-sodium foods and pre-packaged fruits and vegetables. Conclusions Opportunities for government and industry policy development and partnerships to support schools in their efforts to promote healthy after-school food environments remain. Several federal, state and industry leadership opportunities are proposed: provide product labelling that makes identifying snacks which comply with the 2010 IOM CACFP recommended standards easy; encourage compliance with recommendations by providing incentives to programmes; prioritize the implementation of paperwork and technology that simplifies enrolment and accountability systems; and provide support for food safety training and/or certification for non-food service personnel. PMID:22050891

  19. Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients.

    PubMed

    Cheung, Grace; Pizzola, Lisa; Keller, Heather

    2013-01-01

    Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.

  20. Chronic disease burden predicts food insecurity among older adults.

    PubMed

    Jih, Jane; Stijacic-Cenzer, Irena; Seligman, Hilary K; Boscardin, W John; Nguyen, Tung T; Ritchie, Christine S

    2018-06-01

    Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity. Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS. USA. Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0-1, 2-4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions. The prevalence of food insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37). A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

  1. Foods Served in Child Care Facilities Participating in the Child and Adult Care Food Program: Menu Match and Agreement with the New Meal Patterns and Best Practices.

    PubMed

    Dave, Jayna M; Cullen, Karen W

    2018-06-01

    To assess the agreement of posted menus with foods served to 3- to 5-year-old children attending federal Child and Adult Care Food Program (CACFP)-enrolled facilities, and the degree to which the facilities met the new meal patterns and best practices. On-site observations and menu coding. Nine early care and education centers. Agreement of posted menus with foods served, and comparison of foods served and consumed with the new CACFP meal guidelines and best practices. Data were compiled for each meal (breakfast, lunch, and snacks). Frequencies and percentages of agreement with the posted menu (coded matches, substitutions, additions, and omissions) were calculated for each food component in the CACFP menu guidelines. Menu total match was created by summing the menu match plus acceptable substitutions. Menus were compared with the new CACFP meal guidelines and best practices. The match between the posted menus and foods actually served to children at breakfast, lunch, and snack was high when the acceptable menu substitutions were considered (approximately 94% to 100% total match). Comparing the menus with the new meal guidelines and best practices, the 1 guideline that was fully implemented was serving only unflavored, low-fat, or 1% milk; fruit and vegetable guidelines were partially met; fruit juice was not served often, nor were legumes; the guideline for 1 whole grain-rich serving/d was not met; and regular beef and full-fat cheese products were commonly served. Early care and education centers enrolled in CACFP provided meals that met the current CACFP guidelines. Some menu improvements are needed for the centers to meet the new guidelines and best practices. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  2. Food expectations-long term care Spanish questionnaire.

    PubMed

    Crogan, Neva L; Evans, Bronwynne C

    2010-10-01

    Although little is known about nutrition care for Hispanic older adults in nursing homes, soon at least 4.5 million will reside there because of chronic disease. The purpose of this pilot study was to test the internal consistency reliability of a food and food service satisfaction instrument, the Food Expectations-Long Term Care Spanish (FoodEx-LTCSp) questionnaire with nursing home residents and to examine relationships between satisfaction and food intake, serum prealbumin, and functional status. Only two FoodEx-LTCSp subscales, Cooking Good Food and Providing Food Service, were significantly correlated with one another (r = 0.624, p = 0.002). No significant correlations were found between prealbumin and food intake (perhaps related to the small sample and the short duration of food weight measurement) or between prealbumin and functional status, and no significant difference was found in the subscales of Enjoying Food and Food Service and Exercising Choice. Additional qualitative work may be needed with Hispanic residents to examine items that evolved from interview data obtained from an Anglo population. Copyright 2010, SLACK Incorporated.

  3. Child Care Recipes: Food for Health and Fun. From USDA's Child and Adult Care Food Program.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    Intended to help child care providers show young children how to make healthy food choices, this collection contains standardized recipes and kitchen tips to help providers put together great tasting, nutritious meals that will appeal to young children. The recipe instructions are geared for groups of 25 and 50, and have been tested for product…

  4. Food choice patterns among frail older adults: The associations between social network, food choice values, and diet quality.

    PubMed

    Kim, Chang-O

    2016-01-01

    Social network type might affect an individual's food choice because these decisions are often made as a group rather than individually. In this study, the associations between social network type, food choice value, and diet quality in frail older adults with low socioeconomic status were investigated. For this cross-sectional study, 87 frail older adults were recruited from the National Home Healthcare Services in Seoul, South Korea. Social network types, food choice values, and diet quality were assessed using The Practitioner Assessment of Network Type Instrument, The Food Choice Questionnaire, and mean adequacy ratio, respectively. Results showed that frail older adults with close relationships with local family and/or friends and neighbors were less likely to follow their own preferences, such as taste, price, and beliefs regarding food health values. In contrast, frail older adults with a small social network and few community contacts were more likely to be influenced by their food choice values, such as price or healthiness of food. Frail older adults who tend to choose familiar foods were associated with low-quality dietary intake, while older adults who valued healthiness or use of natural ingredients were associated with a high-quality diet. The strength and direction of these associations were dependent on social network type of frail older adults. This study explored the hypothesis that food choice values are associated with a certain type of social network and consequently affect diet quality. While additional research needs to be conducted, community-based intervention intended to improve diet quality of frail older adults must carefully consider individual food choice values as well as social network types. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Food Insecurity and Depression Among Adults With Diabetes

    PubMed Central

    Montgomery, Joshua; Lu, Juan; Ratliff, Scott; Mezuk, Briana

    2017-01-01

    Purpose While both food insecurity and depression have been linked to risk of type 2 diabetes, little is known about the relationship between food insecurity and depression among adults with diabetes. Research Design and Methods Cross-sectional analyses of the National Health and Nutrition Examination Survey (2011–2014), a nationally representative, population-based survey. Analytic sample was limited to adults aged ≥20 with diabetes determined by either fasting plasma glucose (≥126 mg/dL) or self-report (n = 1724) and adults age ≥20 with prediabetes determined by fasting plasma glucose (100–125 mg/dL) or self-report (n = 2004). Food insecurity was measured using the US Food Security Survey Module. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to assess the relationship between food insecurity and depression while accounting for sociodemographic characteristics and health behaviors. Results Approximately 10% of individuals with diabetes and 8.5% of individuals with prediabetes had severe food insecurity in the past year; an additional 20.3% of individuals with diabetes and 14.3% of those with prediabetes had mild food insecurity. Among individuals with diabetes, both mild and severe food insecurity were associated with elevated odds of depression These relationships were similar in magnitude among individuals with prediabetes. Conclusions Food insecurity is significantly associated with depressive symptoms in people with diabetes and prediabetes. Results point to the need to address economic issues in conjunction with psychosocial issues for comprehensive diabetes care. PMID:28436293

  6. Adult Day Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Adult Day Care Adult Day Care Centers are designed to provide care and ... adults who need assistance or supervision during the day. Programs offer relief to family members and caregivers, ...

  7. Food Insecurity among Homeless Adults with Mental Illness

    PubMed Central

    Parpouchi, Milad; Moniruzzaman, Akm; Russolillo, Angela; Somers, Julian M.

    2016-01-01

    Background The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada. Methods Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture’s Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity. Results The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95–0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35–0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00–2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96–0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16–4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36–12.96), heart disease (aOR = 0.39; 95% CI: 0.16–0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01–2.68). Conclusions The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed. PMID:27437937

  8. A review of the role of food insecurity in adherence to care and treatment among adult and pediatric populations living with HIV and AIDS

    PubMed Central

    Young, Sera; Wheeler, Amanda; McCoy, Sandi; Weiser, Sheri D.

    2013-01-01

    Adherence to antiretroviral therapy (ART) is critical for reducing HIV/AIDS morbidity and mortality. Food insecurity (FI) is emerging as an important barrier to adherence to care and treatment recommendations for people living with HIV (PLHIV), but this relationship has not been comprehensively examined. Therefore, we reviewed the literature to explore how FI may impact ART adherence, retention in medical care, and adherence to health care recommendations among PLHIV. We found data to support FI as a critical barrier to adherence to ART and to other health care recommendations among HIV-infected adults, HIV-infected pregnant women and their HIV-exposed infants, and child and adolescent populations of PLHIV. Associations between FI and ART non-adherence were seen in qualitative and quantitative studies. We identified a number of mechanisms to explain how food insecurity and ART non-adherence may be causally linked, including the exacerbation of hunger or ART side effects in the absence of adequate food and competing resource demands. Interventions that address FI may improve adherence to care and treatment recommendations for PLHIV. PMID:23842717

  9. Food Insecurity and Health Care Expenditures in the United States, 2011-2013.

    PubMed

    Berkowitz, Seth A; Basu, Sanjay; Meigs, James B; Seligman, Hilary K

    2018-06-01

    To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). Longitudinal retrospective cohort. A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. Fourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p < .0001), an extra $1,863 in health care expenditure per year, or $77.5 billion in additional health care expenditure annually. Food insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs. © Health Research and Educational Trust.

  10. Food Insecurity and Metabolic Control Among U.S. Adults With Diabetes

    PubMed Central

    Berkowitz, Seth A.; Baggett, Travis P.; Wexler, Deborah J.; Huskey, Karen W.; Wee, Christina C.

    2013-01-01

    OBJECTIVE We sought to determine whether food insecurity is associated with worse glycemic, cholesterol, and blood pressure control in adults with diabetes. RESEARCH DESIGN AND METHODS We conducted a cross-sectional analysis of data from participants of the 1999–2008 National Health and Nutrition Examination Survey. All adults with diabetes (type 1 or type 2) by self-report or diabetes medication use were included. Food insecurity was measured by the Adult Food Security Survey Module. The outcomes of interest were proportion of patients with HbA1c >9.0% (75 mmol/mol), LDL cholesterol >100 mg/dL, and systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg. We used multivariable logistic regression for analysis. RESULTS Among the 2,557 adults with diabetes in our sample, a higher proportion of those with food insecurity (27.0 vs. 13.3%, P < 0.001) had an HbA1c >9.0% (75 mmol/mol). After adjustment for age, sex, educational attainment, household income, insurance status and type, smoking status, BMI, duration of diabetes, diabetes medication use and type, and presence of a usual source of care, food insecurity remained significantly associated with poor glycemic control (odds ratio [OR] 1.53 [95% CI 1.07–2.19]). Food insecurity was also associated with poor LDL control before (68.8 vs. 49.8, P = 0.002) and after (1.86 [1.01–3.44]) adjustment. Food insecurity was not associated with blood pressure control. CONCLUSIONS Food insecurity is significantly associated with poor metabolic control in adults with diabetes. Interventions that address food security as well as clinical factors may be needed to successfully manage chronic disease in vulnerable adults. PMID:23757436

  11. The association between housing instability, food insecurity, and diabetes self-efficacy in low-income adults.

    PubMed

    Vijayaraghavan, Maya; Jacobs, Elizabeth A; Seligman, Hilary; Fernandez, Alicia

    2011-11-01

    Limited data exist on whether structural factors associated with poverty such as inadequate housing and food insecurity affect diabetes care. In a sample of low-income participants with diabetes (N=711), we sought to determine if housing instability was associated with lower diabetes self-efficacy, and whether this relationship was mediated by food insecurity. We ordered housing from most to least stable. We observed a linear decrease in diabetes self-efficacy as housing instability increased (p<.01). After adjusting for age, sex, race/ethnicity, and alcohol or substance use, adults lacking a usual place to stay had lower self-efficacy than those who owned their own home (ß-coefficient -0.94, 95% CI -1.88, -0.01). Food insecurity mediated the association between housing instability and diabetes self-efficacy (ß-coefficient -0.64, 95% CI -1.57, 0.31). Our findings suggest that inadequate access to food lowers self-efficacy among adults with diabetes, and supports provision of food to unstably housed adults as part of diabetes care.

  12. The Relation between Food Insecurity and Mental Health Care Service Utilization in Ontario.

    PubMed

    Tarasuk, Valerie; Cheng, Joyce; Gundersen, Craig; de Oliveira, Claire; Kurdyak, Paul

    2018-01-01

    To determine the relationship between household food insecurity status over a 12-month period and adults' use of publicly funded health care services in Ontario for mental health reasons during this period. Data for 80,942 Ontario residents, 18 to 64 years old, who participated in the Canadian Community Health Survey in 2005, 2007-2008, 2009-2010, or 2011-2012 were linked to administrative health care data to determine individuals' hospitalizations, emergency department visits, and visits to psychiatrists and primary care physicians for mental health reasons. Household food insecurity over the past 12 months was assessed using the Household Food Security Survey Module. Logistic regression models were used to estimate the odds of mental health service utilization in the past 12 months by household food insecurity status, adjusting for sociodemographic factors and prior use of mental health services. In our fully adjusted models, in comparison to food-secure individuals, the odds of any mental health care service utilization over the past 12 months were 1.15 (95% confidence interval [CI], 1.04 to 1.29) for marginally food-insecure individuals, 1.39 (95% CI, 1.19 to 1.42) for moderately food-insecure individuals, and 1.50 (95% CI, 1.35 to 1.68) for severely food-insecure individuals. A similar pattern persisted across individual types of services, with odds of utilization highest with severe food insecurity. Household food insecurity status is a robust predictor of mental health service utilization among working-age adults in Ontario. Policy interventions are required to address the underlying causes of food insecurity and the particular vulnerability of individuals with mental illness.

  13. Development of a food allergy education resource for primary care physicians

    PubMed Central

    Yu, Joyce E; Kumar, Arvind; Bruhn, Christine; Teuber, Suzanne S; Sicherer, Scott H

    2008-01-01

    Background Food allergy is estimated to affect 3–4% of adults in the US, but there are limited educational resources for primary care physicians. The goal of this study was to develop and pilot a food allergy educational resource based upon a needs survey of non-allergist healthcare providers. Methods A survey was undertaken to identify educational needs and preferences for providers, with a focus on physicians caring for adults and teenagers, including emergency medicine providers. The results of the survey were used to develop a teaching program that was subsequently piloted on primary care and emergency medicine physicians. Knowledge base tests and satisfaction surveys were administered to determine the effectiveness of the educational program. Results Eighty-two physicians (response rate, 65%) completed the needs assessment survey. Areas of deficiency and educational needs identified included: identification of potentially life-threatening food allergies, food allergy diagnosis, and education of patients about treatment (food avoidance and epinephrine use). Small group, on-site training was the most requested mode of education. A slide set and narrative were developed to address the identified needs. Twenty-six separately enrolled participants were administered the teaching set. Pre-post knowledge base scores increased from a mean of 38% correct to 64% correct (p < 0.001). Ability to correctly demonstrate the use of epinephrine self injectors increased significantly. Nearly all participants (>95%) indicated that the teaching module increased their comfort with recognition and management of food allergy. Conclusion Our pilot food allergy program, developed based upon needs assessments, showed strong participant satisfaction and educational value. PMID:18826650

  14. Improving nutrition in home child care: are food costs a barrier?

    PubMed Central

    Monsivais, Pablo; Johnson, Donna B

    2015-01-01

    Objective Child-care providers have a key role to play in promoting child nutrition, but the higher cost of nutritious foods may pose a barrier. The present study tested the hypothesis that higher nutritional quality of foods served was associated with higher food expenditures in child care homes participating in the Child and Adult Care Food Program (CACFP). Design In this cross-sectional study, nutritional quality of foods served to children and food expenditures were analysed based on 5 d menus and food shopping receipts. Nutritional quality was based on servings of whole grains, fresh whole fruits and vegetables, energy density (kJ/g) and mean nutrient adequacy (mean percentage of dietary reference intake) for seven nutrients of concern for child health. Food expenditures were calculated by linking receipt and menu data. Associations between food expenditures and menu quality were examined using bivariate statistics and multiple linear regression models. Setting USA in 2008–2009. Subjects Sixty child-care providers participating in CACFP in King County, Washington State. Results In bivariate analyses, higher daily food expenditures were associated with higher total food energy and higher nutritional quality of menus. Controlling for energy and other covariates, higher food expenditures were strongly and positively associated with number of portions of whole grains and fresh produce served (P = 0·001 and 0·005, respectively), with lower energy density and with higher mean nutrient adequacy of menus overall (P = 0·003 and 0·032, respectively). Conclusions The results indicate that improving the nutritional quality of foods in child care may require higher food spending. PMID:22014448

  15. Frailty and food insecurity in older adults.

    PubMed

    Pérez-Zepeda, Mario Ulises; Castrejón-Pérez, Roberto Carlos; Wynne-Bannister, Emma; García-Peña, Carmen

    2016-10-01

    The objective of the current work was to determine the association between food insecurity and frailty in older adults, within the context of a country with accelerated ageing and nutritional problems. Cross-sectional analysis of a representative nationwide survey on health and nutrition. Mexican nationwide survey. A sample of 7108 adults aged 60 years or older living in communities, representative of Mexican older adults. Multivariate regression and descriptive analyses of food insecurity and frailty were performed. From a total of 7108 adults aged 60 years or older, with a mean age of 70·7 years, most (54·7 %) were women. Food security categories were: 26·3 % had food security, 40·3 % had mild food insecurity, 20·5 % had moderate food insecurity and 12·9 % had severe food insecurity. Food insecurity categories were associated with frailty, with the severe category having the highest odds ratio of 2·41 (95 % CI 2·03, 2·86; P<0·001) after adjustment for confounding factors. According to our results, food insecurity is associated to frailty, which in turn is a condition that renders the older adult at a higher risk of developing adverse outcomes. Targeted food programmes for older adults with a high risk of having food insecurity or of being frail may improve health in this population group.

  16. Food insecurity is associated with poor sleep outcomes among US adults.

    PubMed

    Ding, Meng; Keiley, Margaret K; Garza, Kimberly B; Duffy, Patricia A; Zizza, Claire A

    2015-03-01

    Although food insecure (FI) adults are at risk of chronic conditions, little research attention is given to their health behaviors, such as sleep. We examined the associations between adult food security status and sleep duration, sleep latency, and sleep complaints reported to a health care professional. Our population-based sample included 5637 men and 5264 women (≥22 y) who participated in the NHANES 2005-2010. Food security status was assessed with USDA's 10-item adult Food Security Survey Module. Self-reported information about sleep duration, sleep latency, and sleep complaints to a health care professional were used as sleep outcomes. Multiple linear, stratified by sex, and logistic regression models were used to estimate the association between food security status and the 3 sleep outcomes. Very low food secure (FS) women reported significantly shorter sleep duration than fully FS women (difference: -30 ± 5.2 min; P < 0.01); however, no relation to sleep duration was observed among men. Among men, participants who were marginally FS (4 ± 1.1 min), low FS (4 ± 1.7 min), and very low FS (5 ± 1.8 min) reported significantly longer sleep latency than fully FS men (P < 0.05), but no association with sleep latency was observed among women. The divergent patterns in sleep duration and latency were likely because of our reference groups reporting undesirable sleep outcomes; fully FS men reported inadequate sleep and fully FS women reported long sleep latency. Among both men and women, marginally FS (OR: 1.64; 95% CI: 1.24, 2.16), low FS (OR: 1.63; 95% CI: 1.16, 2.30), and very low FS (OR: 1.99; 95% CI: 1.36, 2.92) participants were more likely to report sleep complaints than their fully FS counterparts (P < 0.05). Poor sleep quantity and quality may predispose FI adults to adverse health outcomes. © 2015 American Society for Nutrition.

  17. Food insecurity is associated with diabetes self-care behaviours and glycaemic control.

    PubMed

    Heerman, W J; Wallston, K A; Osborn, C Y; Bian, A; Schlundt, D G; Barto, S D; Rothman, R L

    2016-06-01

    Food insecurity is the 'limited or uncertain availability of nutritionally adequate and safe foods'. Our objective was to examine the association between food insecurity, diabetes self-care and glycaemic control. We conducted a cross-sectional analysis of baseline data from adult patients with Type 2 diabetes who were enrolled in a randomized trial evaluating a health literacy-focused diabetes intervention in safety net primary care clinics in middle Tennessee. Food insecurity was assessed with three items from the U.S. Household Food Security Survey. Diabetes self-care behaviours were assessed with the Summary of Diabetes Self-Care Activities Scale, Personal Diabetes Questionnaire and Adherence to Refills and Medication Scale. Glycaemic control was assessed with HbA1c . The sample consisted of 401 participants, 73% of whom reported some level of food insecurity. Food insecurity was significantly associated with self-care behaviours including less adherence to a general diet [Adjusted Odds Ratio (AOR) 0.9, P = 0.02], less physical activity (AOR 0.9, P = 0.04) and with a greater occurrence of medication non-adherence (AOR 1.2, P = 0.002) and calorie restriction (AOR 1.1, P = 0.02). Food insecurity was also associated with worse glycaemic control (adjusted β = 0.1, P = 0.03). None of the self-care behaviours were significantly associated with HbA1c , limiting the ability to test for self-care as a mechanism linking food insecurity to glycaemic control. There was a high rate of food insecurity in a sample of patients with Type 2 diabetes who were of low socio-economic status. Food insecurity was associated with less adherence to recommended self-care behaviours and worse glycaemic control. © 2015 Diabetes UK.

  18. School's Out, Let's Eat: FRAC's Guide to Using the Child and Adult Care Food Program (CACFP) to Expand Afterschool Opportunities for Children. The Building Blocks Project. Promoting Education and Child Development with Nutrition Resources.

    ERIC Educational Resources Information Center

    Wierwille, Jennifer; Parker, Lynn; Henchy, Geraldine; Driscoll, Christin M.; Tingling-Clemmons, Michele

    The provision of quality before- and after-school child care is a major challenge facing educators. This guide from the Food Research and Action Center's Building Blocks Project provides information to providers of before and after school programs on using the federal Child and Adult Care Food Program (CACFP) to provide snacks and meals. Following…

  19. Knowledge Belongs to Everyone: The Challenge for Adult Education and Primary Health Care.

    ERIC Educational Resources Information Center

    Barrow, Nita

    1981-01-01

    Gives examples of health care areas that are the responsibility of individuals and the community: water and sanitation, nutrition and food habits, and family planning. Stresses the role of adult education in changing people's attitudes toward their own health care. (CT)

  20. Effect of Micronutrient Powder Addition on Sensory Properties of Foods for Older Adults.

    PubMed

    Field, Katherine M; Duncan, Alison M; Keller, Heather H; Stark, Ken D; Duizer, Lisa M

    2017-10-01

    Micronutrient fortification can improve nutrient intake of older adults in long-term care. However, previous studies indicate that micronutrient fortification can alter food sensory attributes and, potentially, consumer liking. Others have found no effect of fortification on liking. This research investigates the effect of micronutrient powder addition on the sensory properties of selected foods commonly served in long-term care. A micronutrient powder containing 9 vitamins and 3 minerals was added to tomato soup and oatmeal at different levels. Using projective mapping, changes in sensory properties were observed with powder addition. Descriptive analysis, used to quantify these changes, showed that both the tomato soup and oatmeal had reduced flavor as the amount of added micronutrient powder increased. Oatmeal also showed changes in texture with fortification. Consumer liking scores for tomato soup showed that micronutrient addition affected liking when 100% of a daily dose was added into the soup. Addition of 50% of the daily dose did not affect liking. Oatmeal liking did not differ between fortified and unfortified samples. Results from this research can be used to decide whether a micronutrient powder of selected vitamins and minerals can be added to foods served to older adults in long-term care. Although sensory properties of the foods will be altered, fortification of both tomato soup and oatmeal with the developed powder is possible without reducing consumer liking to the point where it is disliked. © 2017 Institute of Food Technologists®.

  1. The Unmet Health Care Needs of Homeless Adults: A National Study

    PubMed Central

    O'Connell, James J.; Singer, Daniel E.; Rigotti, Nancy A.

    2010-01-01

    Objectives. We assessed the prevalence and predictors of past-year unmet needs for 5 types of health care services in a national sample of homeless adults. Methods. We analyzed data from 966 adult respondents to the 2003 Health Care for the Homeless User Survey, a sample representing more than 436 000 individuals nationally. Using multivariable logistic regression, we determined the independent predictors of each type of unmet need. Results. Seventy-three percent of the respondents reported at least one unmet health need, including an inability to obtain needed medical or surgical care (32%), prescription medications (36%), mental health care (21%), eyeglasses (41%), and dental care (41%). In multivariable analyses, significant predictors of unmet needs included food insufficiency, out-of-home placement as a minor, vision impairment, and lack of health insurance. Individuals who had been employed in the past year were more likely than those who had not to be uninsured and to have unmet needs for medical care and prescription medications. Conclusions. This national sample of homeless adults reported substantial unmet needs for multiple types of health care. Expansion of health insurance may improve health care access for homeless adults, but addressing the unique challenges inherent to homelessness will also be required. PMID:20466953

  2. Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents.

    PubMed

    Machado, Tania Diniz; Dalle Molle, Roberta; Reis, Roberta Sena; Rodrigues, Danitsa Marcos; Mucellini, Amanda Brondani; Minuzzi, Luciano; Franco, Alexandre Rosa; Buchweitz, Augusto; Toazza, Rudineia; Ergang, Bárbara Cristina; Cunha, Ana Carla de Araújo; Salum, Giovanni Abrahão; Manfro, Gisele Gus; Silveira, Patrícia Pelufo

    2016-05-01

    Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.

  3. Transient, but not persistent, adult food insecurity influences toddler development.

    PubMed

    Hernandez, Daphne C; Jacknowitz, Alison

    2009-08-01

    In this study, we examined characteristics associated with experiencing persistent and transitional adult food insecurity and how persistent and transitional adult food insecurity influences toddler cognitive and motor development, along with toddler's weight and health status. Using the first 2 waves of the Early Childhood Longitudinal Study-Birth Cohort, 4 mutually exclusive variables capturing persistent and transitional adult food insecurity were created to capture those adults that experience adult food insecurity in the following: both waves, in 1 wave (at 9 or 24 mo after birth), and never experience food insecurity. We used logistic regression models to estimate characteristics associated with the likelihood of experiencing persistent and transitional adult food insecurity. Ordinary least squares regression models were used to estimate how persistent and transitional adult food insecurity influences toddler development. Similar factors influenced one's likelihood of experiencing adult transitional and persistent food insecurity; individuals who experienced any food insecurity were more economically disadvantaged. Thus, outreach efforts do not need to vary by duration of food insecurity. Whereas negative effects of food insecurity on school-aged children are found in the literature, it appears toddlers are buffered from the effects of persistent adult food insecurity. Our findings suggest that toddlers residing with a temporarily food-insecure adult compared with a never food-insecure adult experienced immediate, but small, negative effects on their development. Hence, outreach and assistance may lessen immediate impacts of food insecurity on toddler development.

  4. Dietary Intake Contributions of Food and Beverages by Source and Food Security Status in US Adults.

    PubMed

    Spees, Colleen K; Clark, Jill E; Hooker, Neal H; Watowicz, Rosanna P; Taylor, Christopher A

    2017-09-01

    To compare the consumption patterns and diet quality of foods and beverages obtained from various sources by food security status. Cross-sectional analysis of 2011-2012 National Health and Nutrition Examination Survey data. A total of 4,789 adults (aged >19 years) with dietary intake and food security data. The contribution of foods and beverages to energy, nutrients, and diet quality by locations where food was obtained was compared across food security status. Descriptive analysis and logistic regression. Almost all US adults consumed food and beverages obtained from grocery stores, regardless of food security status (about 95%), which accounted for one half to two thirds of total macronutrient intakes. The diet quality of foods from grocery stores was better in highly food-secure adults. Convenience stores are used most by very low food-secure adults; those foods had the poorest diet quality profile. Dietary patterns of marginally food-secure adults more closely resembled sources and intakes of low and very low food-secure adults. Food-insecure adults use food sources differently, resulting in diet quality differences of foods and beverages obtained. Place-based interventions in the food environment may have differential effects by food security status. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  5. Adult care providers' perspectives on the transition to adult care for emerging adults with Type 1 diabetes: a cross-sectional survey.

    PubMed

    Michaud, S; Dasgupta, K; Bell, L; Yale, J-F; Anjachak, N; Wafa, S; Nakhla, M

    2018-03-25

    To assess adult diabetes care providers' current transition practices, knowledge about transition care, and perceived barriers to implementation of best practices in transition care for emerging adults with Type 1 diabetes mellitus. We administered a 38-item web-based survey to adult diabetes care providers identified through the Québec Endocrinologist Medical Association and Diabetes Québec. Fifty-three physicians responded (35%). Fewer than half of all respondents (46%) were familiar with the American Diabetes Association's transition care position statement. Approximately one-third of respondents reported a gap of >6 months between paediatric and adult diabetes care. Most (83%) believed communication with the paediatric team was adequate; however, only 56% reported receiving a medical summary and 2% a psychosocial summary from the paediatric provider. Respondents believed that the paediatric team should improve emerging adults' preparation for transition care by developing their self-management skills and improve teaching about the differences between paediatric and adult-oriented care. Only 31% had a system for identifying emerging adults lost to follow-up in adult care. Perceived barriers included difficulty accessing psychosocial services, emerging adults' lack of motivation, and inadequate transition preparation. Most (87%) were interested in having additional resources, including a self-care management tool and a registry to track those lost to follow-up. Our findings highlight the need to better engage adult care providers into transition care practices. Despite adult physicians' interest in transition care, implementation of transition care recommendations and resources in clinical care remains limited. Enhanced efforts are needed to improve access to mental health services within the adult healthcare setting. © 2018 Diabetes UK.

  6. Material Resources and Population Health: Disadvantages in Health Care, Housing, and Food Among Adults Over 50 Years of Age

    PubMed Central

    Soldo, Beth J.; Pagán, José A.; McCabe, John; deBlois, Madeleine; Field, Samuel H.; Asch, David A.; Cannuscio, Carolyn

    2009-01-01

    Objectives. We examined associations between material resources and late-life declines in health. Methods. We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15 441). Results. Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage. Conclusions. Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone. PMID:19890175

  7. Characteristics of fast-food/takeaway-food and restaurant/café-food consumers among New Zealand adults.

    PubMed

    Smith, Claire; Gray, Andrew Robert; Fleming, Elizabeth Ann; Parnell, Winsome Ruth

    2014-10-01

    To investigate: (i) the percentage of the New Zealand (NZ) population reporting fast food/takeaway food and restaurant/café food per day; (ii) examine demographic factors associated with their use; (iii) quantify their contribution to energy intake; and (iv) describe the specific types of foods reported from both sources. Twenty-four hour diet recalls from the cross-sectional 2008/09 NZ Adult Nutrition Survey were used to identify fast-food and restaurant-food consumers. NZ households. Adults aged 15 years and older (n 4721). Overall 28 % reported consuming at least one fast food and 14 % a restaurant food within the 24 h diet recall. Fast-food consumption was not associated with level of education or an area-based measure of socio-economic status, but a higher education was positively associated with restaurant-food consumption. Individual factors such as ethnicity, household size, age, sex and marital status were found to be important influences on the use of fast food and restaurant food. Fast-food consumption was more prevalent among participants living in urban areas, young adults (19-30 years) and Māori compared with NZ European and Others. The most frequently reported fast foods were bread-based dishes, potatoes (including fries) and non-alcoholic beverages. Given the high reported consumption of fast food by young adults, health promotion initiatives both to improve the nutritional quality of fast-food menus and to encourage healthier food choices would likely make a large impact on the overall diet quality of this group.

  8. Food insecurity and obesity in New York City primary care clinics.

    PubMed

    Karnik, Arati; Foster, Byron Alexander; Mayer, Victoria; Pratomo, Vanessa; McKee, Diane; Maher, Stacia; Campos, Giselle; Anderson, Matthew

    2011-07-01

    Hunger continues to be a problem in New York City; paradoxically, the city also has disproportionally high rates of diabetes and obesity. Some research suggests that food insecurity leads to obesity. We undertook a cross-sectional "card study" in which doctors working at 8 New York City area primary care practices administered a brief, anonymous survey to patients they saw during clinic sessions. The survey included a 2-question food insecurity screen and questions about enrollment in nutrition assistance programs. Height and weight were also measured at the visit. Cards were completed for 558 patients (65.1% female; 74.7% adults; 78.5% conducted in English). Fifty-five percent of patients were receiving some form of food assistance. More than half of patients (51.7%) reported some degree of food insecurity. Of adult participants, 21.8% had normal weight, 29.1% were overweight, and 48.2% were obese. Food insecurity was significantly associated with increasing body mass index in women not receiving food assistance. There was no significant association between body mass index and food insecurity in children. In an urban population, overweight and obesity are very common as is food insecurity. We found an association between food insecurity and obesity only among women not receiving food assistance suggesting a possible protective role for food assistance. Providers should consider food insecurity in similar populations when trying to address obesity.

  9. Longitudinal Examination of Homebound Older Adults Who Experience Heightened Food Insufficiency: Effect of Diabetes Status and Implications for Service Provision

    ERIC Educational Resources Information Center

    Sharkey, Joseph R.

    2005-01-01

    Purpose: Healthful eating is important for optimal diabetes self-care. However, the level of food sufficiency may influence the degree of adherence to dietary self-care behaviors through the affordability of nutritionally appropriate food. This study examines whether homebound older adults with diabetes were at greater risk for heightened food…

  10. Adults' food skills and use of gardens are not associated with household food insecurity in Canada.

    PubMed

    Huisken, Anne; Orr, Sarah K; Tarasuk, Valerie

    2017-03-01

    To determine the extent to which Canadian adults' food preparation and cooking skills and use of home or community gardens relate to their household food insecurity status; and to compare the food shopping and cooking behaviours of adults in food-secure and food-insecure households. Data were drawn from two Rapid Response Modules appended to the Canadian Community Health Survey in 2012 and 2013. The analytic sample comprised 16,496 respondents 18 years and older. Multivariable logistic regression analyses were conducted to determine the association between food insecurity and adults' self-rated cooking abilities, food preparation skills score, use of gardens, food shopping behaviours, and cooking behaviours, while adjusting for socio-demographic characteristics. Adults in food-insecure households did not differ significantly from others with respect to their food preparation skills or cooking ability, and neither variable predicted the odds of household food insecurity when socio-demographic characteristics were taken into account. Adults in food-insecure households were less likely to use a garden for food, but gardening was unrelated to the odds of food insecurity. Shopping with a budget was more common among adults in food-insecure households, but no other differences in food shopping behaviours were observed after adjustment for socio-demographic characteristics. Adults in food-insecure households were as likely as others to adjust recipes to make them healthier, but they had higher odds of adjusting recipes to reduce their fat content. Our findings suggest that household food insecurity in Canada is not a problem of insufficient food skills.

  11. A review of food allergy and nutritional considerations in the food-allergic adult

    USDA-ARS?s Scientific Manuscript database

    In the United States, the prevalence of adults with food allergies is approximately 2 percent to 3 percent. Theoretically, any food can cause an allergic reaction; however, some foods are clearly more allergenic than others are. In adults, peanuts, tree nuts, finned fish, crustaceans, fruit, and veg...

  12. Making the Most of Mealtimes (M3): protocol of a multi-centre cross-sectional study of food intake and its determinants in older adults living in long term care homes.

    PubMed

    Keller, Heather H; Carrier, Natalie; Slaughter, Susan; Lengyel, Christina; Steele, Catriona M; Duizer, Lisa; Brown, K Steve; Chaudhury, Habib; Yoon, Minn N; Duncan, Alison M; Boscart, Veronique M; Heckman, George; Villalon, Lita

    2017-01-13

    Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study. A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for

  13. Fast-food consumption and obesity among Michigan adults.

    PubMed

    Anderson, Beth; Rafferty, Ann P; Lyon-Callo, Sarah; Fussman, Christopher; Imes, Gwendoline

    2011-07-01

    Consumption of meals eaten away from home, especially from fast-food restaurants, has increased in the United States since the 1970s. The main objective of this study was to examine the frequency and characteristics of fast-food consumption among adults in Michigan and obesity prevalence. We analyzed data from 12 questions about fast-food consumption that were included on the 2005 Michigan Behavioral Risk Factor Survey, a population-based telephone survey of Michigan adults, using univariate and bivariate analyses and multivariate logistic regression, and compared these data with data on Michigan obesity prevalence. Approximately 80% of Michigan adults went to fast-food restaurants at least once per month and 28% went regularly (≥2 times/wk). Regular fast-food consumption was higher among younger adults (mostly men) but was not significantly associated with household income, education, race, or urbanicity (in a multivariate framework). The prevalence of obesity increased consistently with frequenting fast-food restaurants, from 24% of those going less than once a week to 33% of those going 3 or more times per week. The predominant reason for choosing fast food was convenience. Although hypothetically 68% of adults who go to fast-food restaurants would choose healthier fast-food items when available, only 16% said they ever use nutritional information when ordering. The prevalence of fast-food consumption is high in Michigan across education, income, and racial groups and is strongly associated with obesity. Making nutritional information at fast-food restaurants more readily available and easier to use may help consumers to order more healthful or lower-calorie items.

  14. Supplemental Nutrition Assistance Program (SNAP) Participation and Health Care Expenditures Among Low-Income Adults.

    PubMed

    Berkowitz, Seth A; Seligman, Hilary K; Rigdon, Joseph; Meigs, James B; Basu, Sanjay

    2017-11-01

    Food insecurity is associated with high health care expenditures, but the effectiveness of food insecurity interventions on health care costs is unknown. To determine whether the Supplemental Nutrition Assistance Program (SNAP), which addresses food insecurity, can reduce health care expenditures. This is a retrospective cohort study of 4447 noninstitutionalized adults with income below 200% of the federal poverty threshold who participated in the 2011 National Health Interview Survey (NHIS) and the 2012-2013 Medical Expenditure Panel Survey (MEPS). Self-reported SNAP participation in 2011. Total health care expenditures (all paid claims and out-of-pocket costs) in the 2012-2013 period. To test whether SNAP participation was associated with lower subsequent health care expenditures, we used generalized linear modeling (gamma distribution, log link, with survey design information), adjusting for demographics (age, gender, race/ethnicity), socioeconomic factors (income, education, Social Security Disability Insurance disability, urban/rural), census region, health insurance, and self-reported medical conditions. We also conducted sensitivity analyses as a robustness check for these modeling assumptions. A total of 4447 participants (2567 women and 1880 men) were enrolled in the study, mean (SE) age, 42.7 (0.5) years; 1889 were SNAP participants, and 2558 were not. Compared with other low-income adults, SNAP participants were younger (mean [SE] age, 40.3 [0.6] vs 44.1 [0.7] years), more likely to have public insurance or be uninsured (84.9% vs 67.7%), and more likely to be disabled (24.2% vs 10.6%) (P < .001 for all). In age- and gender-adjusted models, health care expenditures between those who did and did not participate in SNAP were similar (difference, $34; 95% CI, -$1097 to $1165). In fully adjusted models, SNAP was associated with lower estimated annual health care expenditures (-$1409; 95% CI, -$2694 to -$125). Sensitivity analyses were consistent with

  15. Housing instability and food insecurity as barriers to health care among low-income Americans.

    PubMed

    Kushel, Margot B; Gupta, Reena; Gee, Lauren; Haas, Jennifer S

    2006-01-01

    Homelessness and hunger are associated with poor health outcomes. Housing instability and food insecurity describe less severe problems securing housing and food. To determine the association between housing instability and food insecurity and access to ambulatory health care and rates of acute health care utilization. Secondary data analysis of the National Survey of American Families. 16,651 low-income adults. Self-reported measures of past-year access: (1) not having a usual source of care, (2) postponing needed medical care, or (3) postponing medication; and past-year utilization: (1) not having an ambulatory care visit, (2) having emergency department (ED) visits, or (3) inpatient hospitalization. 23.6% of subjects had housing instability and 42.7% had food insecurity. In multivariate logistic regression models, housing instability was independently associated with not having a usual source of care (adjusted odds ratio [AOR] 1.31, 95% confidence interval [CI] 1.08 to 1.59), postponing needed medical care (AOR 1.84, 95% CI 1.46 to 2.31) and postponing medications (AOR 2.16, 95% CI 1.70 to 2.74), increased ED use (AOR: 1.43, 95% CI 1.20 to 1.70), and hospitalizations (AOR 1.30, 95% CI 1.01 to 1.67). Food insecurity was independently associated with postponing needed medical care (AOR 1.74, 95% CI 1.38 to 2.21) and postponing medications (AOR 2.15, 95% CI 1.62 to 2.85), increased ED use (AOR 1.39, 95% CI 1.17 to 1.66), and hospitalizations (AOR 1.42, 95% CI 1.09 to 1.85). Housing instability and food insecurity are associated with poor access to ambulatory care and high rates of acute care. These competing life demands may lead to delays in seeking care and predispose to acute care.

  16. Food Insecurity, CKD, and Subsequent ESRD in US Adults.

    PubMed

    Banerjee, Tanushree; Crews, Deidra C; Wesson, Donald E; Dharmarajan, Sai; Saran, Rajiv; Ríos Burrows, Nilka; Saydah, Sharon; Powe, Neil R

    2017-07-01

    Poor access to food among low-income adults has been recognized as a risk factor for chronic kidney disease (CKD), but there are no data for the impact of food insecurity on progression to end-stage renal disease (ESRD). We hypothesized that food insecurity would be independently associated with risk for ESRD among persons with and without earlier stages of CKD. Longitudinal cohort study. 2,320 adults (aged ≥ 20 years) with CKD and 10,448 adults with no CKD enrolled in NHANES III (1988-1994) with household income ≤ 400% of the federal poverty level linked to the Medicare ESRD Registry for a median follow-up of 12 years. Food insecurity, defined as an affirmative response to the food-insecurity screening question. Development of ESRD. Demographics, income, diabetes, hypertension, estimated glomerular filtration rate, and albuminuria. Dietary acid load was estimated from 24-hour dietary recall. We used a Fine-Gray competing-risk model to estimate the relative hazard (RH) for ESRD associated with food insecurity after adjusting for covariates. 4.5% of adults with CKD were food insecure. Food-insecure individuals were more likely to be younger and have diabetes (29.9%), hypertension (73.9%), or albuminuria (90.4%) as compared with their counterparts (P<0.05). Median dietary acid load in the food-secure versus food-insecure group was 51.2 mEq/d versus 55.6 mEq/d, respectively (P=0.05). Food-insecure adults were more likely to develop ESRD (RH, 1.38; 95% CI, 1.08-3.10) compared with food-secure adults after adjustment for demographics, income, diabetes, hypertension, estimated glomerular filtration rate, and albuminuria. In the non-CKD group, 5.7% were food insecure. We did not find a significant association between food insecurity and ESRD (RH, 0.77; 95% CI, 0.40-1.49). Use of single 24-hour diet recall; lack of laboratory follow-up data and measure of changes in food insecurity over time; follow-up of cohort ended 10 years ago. Among adults with CKD, food

  17. Comparison of food safety cognitions and self-reported food-handling behaviors with observed food safety behaviors of young adults.

    PubMed

    Abbot, J M; Byrd-Bredbenner, C; Schaffner, D; Bruhn, C M; Blalock, L

    2009-04-01

    Developing tailored and effective food safety education for young adults is critical given their future roles as caregivers likely to be preparing food for populations who may be at greater risk for foodborne disease (FBD). The objective of this study was to examine the relationship between food safety self-reported food-handling behaviors and cognitions of young adults to observed food-handling behaviors. Participants were 153 young adults (mean age 20.74+/-1.30 s.d.) attending a major American university. Each prepared a meal under observation in a controlled laboratory setting, permitted researchers to observe their home kitchen and completed an online survey assessing food safety knowledge, behavior and psychosocial measures. Descriptive statistics were generated for participants' self-reported food-handling behaviors, psychosocial characteristics, knowledge, food preparation observations and home kitchen observations. Determinants of compliance with safe food-handling procedures while preparing a meal and home food storage/rotation practices were identified using backward regression models. Participants engaged in less than half of the recommended safe food-handling practices evaluated and correctly answered only two-thirds of the food safety knowledge items. They reported positive food safety beliefs and high food safety self-efficacy. Self-reported compliance with cross-contamination prevention, disinfection procedures and knowledge of groups at greatest risk for FBD were the best measures for predicting compliance with established safe food-handling practices. Food safety education directed toward young adults should focus on increasing awareness of FBD and knowledge of proper cross-contamination prevention procedures to help promote better compliance with actual safe food handling.

  18. Food insecurity is associated with obesity among US adults in 12 states.

    PubMed

    Pan, Liping; Sherry, Bettylou; Njai, Rashid; Blanck, Heidi M

    2012-09-01

    A redesigned food insecurity question that measured food stress was included in the 2009 Behavioral Risk Factor Surveillance System in the Social Context optional module. The objective of our study was to examine the association between food stress and obesity using this question as a surrogate for food insecurity. Our analytic sample included 66,553 adults from 12 states. Food insecurity was determined by response (always/usually/sometimes) to the question, "How often in the past 12 months would you say you were worried or stressed about having enough money to buy nutritious meals?" T tests were used to compare prevalence differences between groups, and logistic regression was used to examine the association between food insecurity and obesity. Among the 12 states, the prevalence of obesity was 27.1% overall, 25.2% among food secure adults, and 35.1% among food insecure adults. Food insecure adults had 32% increased odds of being obese compared to food secure adults. Compared with food secure adults, food insecure adults had significantly higher prevalence of obesity in the following population subgroups: adults ages ≥30 years, women, non-Hispanic whites, non-Hispanic blacks, adults with some college education or a college degree, a household income of <$25,000 or $50,000 to $74,999, and adults with none or two children in their households. One in three food insecure adults were obese. Food insecurity was associated with obesity in the overall population and most population subgroups. These findings are consistent with previous research and highlight the importance of increasing access to affordable healthy foods for all adults. Published by Elsevier Inc.

  19. Food Insecurity and Peripheral Arterial Disease in Older Adult Populations.

    PubMed

    Redmond, M L; Dong, F; Goetz, J; Jacobson, L T; Collins, T C

    2016-01-01

    Food insecurity, defined as the limited or uncertain availability of nutritious and safe foods, is a complex phenomenon and is linked to poor nutrition and diet-sensitive chronic diseases. Dietary patterns that include saturated fats and meat products are potential risk factors for the progression of peripheral arterial disease (PAD). This study explored whether there is a relationship between food insecurity and PAD among a national sample of older adults. We conducted a cross-sectional data analysis using data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Food security was assessed using the US Household Food Security Survey Module. Bivariate analyses were conducted using the Rao-Scott Chi-square test to examine associations between PAD and sociodemographic variables. Multivariable generalized logistic regression was employed to assess the effect of food security on the presence of PAD, with adjustment for respondent's socio demographic characteristics. A total of 2,027 adults with PAD were included (Ankle Brachial Index (ABI) score ≤ 0.90).We excluded participants less than 60 years of age. Compared to older adults who are food secure, those who are food insecure have an increased risk for PAD. Food insecurity is associated with peripheral arterial disease among older adults (adults adjusted odds ratio, 1.50 [95% CI 1.11-2.03). Older adults with peripheral arterial disease are experiencing food insecurity. While nutrition and PAD are not well-defined, previous literature indicates there is a connection between food insecurity and diet-sensitive chronic diseases (diabetes and hypertension) which are risk factors for PAD. Food insecurity should be taken into consideration when treating older adults with PAD to help decrease poor health outcomes that are linked to an insufficient amount of nutritious foods.

  20. Adult Learning in Alternative Food Networks

    ERIC Educational Resources Information Center

    Etmanski, Catherine; Kajzer Mitchell, Ingrid

    2017-01-01

    This chapter describes the role small-scale organic farmers are playing as adult educators in alternative food networks and as leaders for food systems transformation. Findings are drawn from a survey of organic farmers in British Columbia, Western Canada.

  1. Blue Ribbon Child Care Food and Nutrition Skill Series: Idaho Child Nutrition Programs. Second Edition.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise.

    Noting that children have different appetites and adjust their food intake on a meal by meal basis, this self study guide presents ideas to help home child care providers meet the nutritional needs of the children in their care. The guide is to be used by individuals and small groups of adults working with infants and children. The guide's eight…

  2. Food acquisition habits, nutrient intakes, and anthropometric data of Havasupai adults.

    PubMed

    Vaughan, L A; Benyshek, D C; Martin, J F

    1997-11-01

    To describe the dietary patterns, anthropometric data, and food sources of Havasupai adults (> or = 18 years old) and determine the effect of age and gender. Dietary intakes (one 24-hour recall), anthropometric measures (body mass index [BMI], waist-to-hip ratio [WHR]) and demographic data, including sites of food purchases, were obtained. Food sources of selected nutrients were calculated from diet recalls. 92 adults (60 women, 32 men) from the Havasupai Reservation, Supai, Ariz. Descriptive statistics were generated for demographic data. Nutrient intakes, BMI, and WHR were compared across gender and age groups ("Younger" [18 to 59 years old] vs "older" [> or = 60 years old]) by one-way analysis of variance. Two-tailed t tests identified significant differences in selected food practices by age group. Diets were moderately high in fat (35% of energy), saturated fat (12%), and sugar (14%); intakes of zinc, calcium, vitamin A, vitamin B-6, and folate were frequently inadequate (less than two thirds of the Recommended Dietary Allowance). Of the 92 subjects, 76 (83%) were obese (BMI > or = 27). Fifty-four of the 60 women (90%) and 24 of the 32 men (75%) exhibited abdominal obesity (no age effect). Thirty-nine of the subjects (42%) consumed at least one food item purchased off the reservation on the day of the recall; the remaining 53 subjects (58%) consumed only food purchased or acquired on the reservation. Older Havasupai were significantly more dependent on the tribal store and other village food sources than were younger adults. Food sources of key nutrients did not differ by age or gender. The dietary patterns of isolated populations may be shaped by the unique limitations of their food sources as well as by factors such as age and gender. Individual and community-wide efforts to improve nutrient intakes and food patterns must recognize these geographic limitations. For populations such as the Havasupai, cooperative marketing and health promotion efforts between

  3. Cognitive-behavioral treatment of food neophobia in adults.

    PubMed

    Marcontell, Deborah K; Laster, Alison E; Johnson, Jan

    2003-01-01

    Food neophobia is an eating disturbance defined as the fear of trying new foods. In its extreme, the disorder can lead to malnutrition, limited social functioning, and psychological difficulties. Successful treatment of food neophobia in children has been reported, but if those children are not provided with treatment, it stands to reason that the disorder may follow them into adulthood. To date, adult cases have not been described in the literature and the prevalence in adults is unknown. Our paper will review the methods used to treat children with the disorder then delineate how the procedures were modified for an adult population, giving two case examples.

  4. Cognitive-behavioral treatment of food neophobia in adults.

    PubMed

    Marcontel, Deborah K; Laster, Alison E; Johnson, Jan

    2002-01-01

    Food neophobia is an eating disturbance defined as the fear of trying new foods. In its extreme, the disorder can lead to malnutrition, limited social functioning, and psycholo gical difficulties. Successful treatment of food neophobia in children has been reported, but if those children are not provided with treatment, it stands to reason that the disorder may follow them into adulthood. To date, adult cases have not been described in the literature and the prevalence in adults is unknown. Our paper will review the methods used to treat children with the disorder, then delineate how the procedures were modified for an adult population, giving two case examples.

  5. [Food allergy to wheat flour in adults].

    PubMed

    Guénard-Bilbault, L; Kanny, G; Moneret-Vautrin, D

    1999-01-01

    Wheat flour is a basic foodstuff. Food allergy has been especially described in children, in the form of atopic dermatitis. Food allergy in adults is rare and especially described in the form of anaphylactic shock sometimes induced by effort. Four observations of adult food allergy are presented. The IgE dependent mechanism is documented. The positive oral provocation tests needed doses of 17 to 30 grams. One crossed sensitivity between rye and barley was seen. The major allergen was probably gluten, particularly gliadines. Sensitization was probably due to prolonged inhalation of wheat flour. The authors stress the possibility of food allergy to wheat flour by other mechanisms, the difficulty of diagnosis, needed for a diet without cereal and gluten that is now non reimbursable.

  6. Transition from Pediatric to Adult OI Care

    MedlinePlus

    Moving from Pediatric to Adult Care Introduction Teen and young adult years are a critical time for major life changes. An ... for youth who have OI is moving from pediatric care into the adult care system. Children’s hospitals ...

  7. Drosophila adult and larval pheromones modulate larval food choice

    PubMed Central

    Farine, Jean-Pierre; Cortot, Jérôme; Ferveur, Jean-François

    2014-01-01

    Insects use chemosensory cues to feed and mate. In Drosophila, the effect of pheromones has been extensively investigated in adults, but rarely in larvae. The colonization of natural food sources by Drosophila buzzatii and Drosophila simulans species may depend on species-specific chemical cues left in the food by larvae and adults. We identified such chemicals in both species and measured their influence on larval food preference and puparation behaviour. We also tested compounds that varied between these species: (i) two larval volatile compounds: hydroxy-3-butanone-2 and phenol (predominant in D. simulans and D. buzzatii, respectively), and (ii) adult cuticular hydrocarbons (CHs). Drosophila buzzatii larvae were rapidly attracted to non-CH adult conspecific cues, whereas D. simulans larvae were strongly repulsed by CHs of the two species and also by phenol. Larval cues from both species generally reduced larval attraction and pupariation on food, which was generally—but not always—low, and rarely reflected larval response. As these larval and adult pheromones specifically influence larval food search and the choice of a pupariation site, they may greatly affect the dispersion and survival of Drosophila species in nature. PMID:24741012

  8. Food preparation by young adults is associated with better diet quality.

    PubMed

    Larson, Nicole I; Perry, Cheryl L; Story, Mary; Neumark-Sztainer, Dianne

    2006-12-01

    To describe food-preparation behaviors, cooking skills, resources for preparing food, and associations with diet quality among young adults. Cross-sectional analyses were performed in a sample of young adults who responded to the second wave of a population-based longitudinal study. Measures pertaining to food preparation were self-reported and dietary intake was assessed by a food frequency questionnaire, both by a mailed survey. Males (n = 764) and females (n = 946) ages 18 to 23 years. Cross-tabulations and chi2 tests were used to examine associations between food preparation, skills/resources for preparing foods, and characteristics of young adults. Mixed regression models were used to generate expected probabilities of meeting the Healthy People 2010 dietary objectives according to reported behaviors and skills/resources. Food-preparation behaviors were not performed by the majority of young adults even weekly. Sex (male), race (African American), and living situation (campus housing) were significantly related to less frequent food preparation. Lower perceived adequacy of skills and resources for food preparation was related to reported race (African American or Hispanic) and student status (part-time or not in school). The most common barrier to food preparation was lack of time, reported by 36% of young adults. Young adults who reported frequent food preparation reported less frequent fast-food use and were more likely to meet dietary objectives for fat (P < 0.001), calcium (P < 0.001), fruit (P < 0.001), vegetable (P < 0.001), and whole-grain (P = 0.003) consumption. To improve dietary intake, interventions among young adults should teach skills for preparing quick and healthful meals.

  9. HEALTH CARE TRANSITION IN YOUNG ADULTS WITH TYPE 1 DIABETES: BARRIERS TO TIMELY ESTABLISHMENT OF ADULT DIABETES CARE

    PubMed Central

    Garvey, Katharine C.; Wolpert, Howard A.; Laffel, Lori M.; Rhodes, Erinn T.; Wolfsdorf, Joseph I.; Finkelstein, Jonathan A.

    2014-01-01

    Objective To examine barriers to health care transition reported by young adults with type 1 diabetes and associations between barriers and prolonged gaps between pediatric and adult diabetes care. Methods We surveyed young adults aged 22 to 30 years with type 1 diabetes about their transition experiences, including barriers to timely establishment of adult diabetes care. We evaluated relationships between barriers and gaps in care using multivariate logistic regression. Results The response rate was 53% (258 of 484 eligible subjects). Respondents (62% female) were 26.7 ± 2.4 years old and transitioned to adult diabetes care at 19.5 ± 2.9 years. Reported barriers included lack of specific adult provider referral name (47%) or contact information (27%), competing life priorities (43%), difficulty getting an appointment (41%), feeling upset about leaving pediatrics (24%), and insurance problems (10%). In multivariate analysis, barriers most strongly associated with gaps in care >6 months were lack of adult provider name (odds ratio [OR], 6.1; 95% confidence interval [CI], 3.0–12.7) or contact information (OR, 5.3; 95% CI, 2.0–13.9), competing life priorities (OR, 5.2; 95% CI, 2.7–10.3), and insurance problems (OR, 3.5; 95% CI, 1.2–10.3). Overall, respondents reporting ≥1 moderate/major barrier (48%) had 4.7-fold greater adjusted odds of a gap in care >6 months (95% CI, 2.8–8.7). Conclusion Significant barriers to transition, such as a lack of specific adult provider referrals, may be addressed with more robust preparation by pediatric providers and care coordination. Further study is needed to evaluate strategies to improve young adult self-care in the setting of competing life priorities. PMID:23807526

  10. Factors Associated with Consuming Junk Food among Saudi Adults in Jeddah City.

    PubMed

    Mandoura, Najlaa; Al-Raddadi, Rajaa; Abdulrashid, Ola; Shah, Hassan Bin Usman; Kassar, Sulaiman M; Adel Hawari, Abdul Rehman; Jahhaf, Jana M

    2017-12-31

    Introduction Junk food (JF) consumption trend is increasing in all parts of the world. The transition in lifestyle and dietary habits is leading to many non-communicable diseases. The objectives of this study are twofold: (1) To examine the prevalence of junk food consumption and factors associated with consuming junk food among Saudi adults in Jeddah; and (2) to compare the trends of junk food consumption among males and females in Jeddah. Methodology This cross-sectional study was conducted in five different Primary Health Care centers (PHCCs) of Jeddah working under Ministry of Health. The subjects were men (n = 146) and women (n = 254) aged 18-67 years visiting these centers. Structured validated close ended questionnaire was filled by all the participants. Data analysis was done using SPSS. Chi-square was applied to analyze the difference between male and female JF consumption and multivariate logistic regression analysis was done to examine the risk factors. Results Overall the JF consumption in subjects with mean age 33.69 ± 12.29 years was highly prevalent in both genders (86.5%); (men = 85.6% and women = 87.4%). Controlling for some demographic and socioeconomic variables, increased junk food consumption was independently associated with education (OR = 2.47, 95% CI: 1.088-5.605, p = 0.031), individuals who had limited time (OR = 3.82, 95% CI: 1.690-8.642, p < 0.001), for the change of routine and taste (OR = 7.64, 95% CI: 3.145-18.563, p < 0.001 and OR = 11.031, 95% CI: 4.219-28.843, p < 0.001, respectively). Conclusion The study findings provide evidence on the high prevalence of junk food consumption among Saudi adults. Junk food has influence in the dietary patterns of Saudi adults and this trend is likely to rise. This growing widespread use of junk food is of concern which may cause obesity-related non-communicable diseases.

  11. Factors Associated with Consuming Junk Food among Saudi Adults in Jeddah City

    PubMed Central

    Mandoura, Najlaa; Al-Raddadi, Rajaa; Abdulrashid, Ola; Kassar, Sulaiman M; Adel Hawari, Abdul Rehman; Jahhaf, Jana M

    2017-01-01

    Introduction Junk food (JF) consumption trend is increasing in all parts of the world. The transition in lifestyle and dietary habits is leading to many non-communicable diseases. The objectives of this study are twofold: (1) To examine the prevalence of junk food consumption and factors associated with consuming junk food among Saudi adults in Jeddah; and (2) to compare the trends of junk food consumption among males and females in Jeddah. Methodology This cross-sectional study was conducted in five different Primary Health Care centers (PHCCs) of Jeddah working under Ministry of Health. The subjects were men (n = 146) and women (n = 254) aged 18-67 years visiting these centers. Structured validated close ended questionnaire was filled by all the participants. Data analysis was done using SPSS. Chi-square was applied to analyze the difference between male and female JF consumption and multivariate logistic regression analysis was done to examine the risk factors. Results Overall the JF consumption in subjects with mean age 33.69 ± 12.29 years was highly prevalent in both genders (86.5%); (men = 85.6% and women = 87.4%). Controlling for some demographic and socioeconomic variables, increased junk food consumption was independently associated with education (OR = 2.47, 95% CI: 1.088-5.605, p = 0.031), individuals who had limited time (OR = 3.82, 95% CI: 1.690-8.642, p < 0.001), for the change of routine and taste (OR = 7.64, 95% CI: 3.145-18.563, p < 0.001 and OR = 11.031, 95% CI: 4.219-28.843, p < 0.001, respectively). Conclusion The study findings provide evidence on the high prevalence of junk food consumption among Saudi adults. Junk food has influence in the dietary patterns of Saudi adults and this trend is likely to rise. This growing widespread use of junk food is of concern which may cause obesity-related non-communicable diseases. PMID:29507856

  12. The meaning of food and eating among home parenteral nutrition-dependent adults with intestinal failure: a qualitative inquiry.

    PubMed

    Winkler, Marion F; Wetle, Terrie; Smith, Carol; Hagan, Elizabeth; O'Sullivan Maillet, Julie; Touger-Decker, Riva

    2010-11-01

    Using content and interpretative phenomenological analysis, we explored the meaning of food and eating from the perspective of adults receiving home parenteral nutrition (PN). The aim of this research was to obtain a deeper understanding of how issues related to food and eating influence quality of life (QOL). Semistructured telephone interviews were conducted between May 2006 and January 2007 with 24 adults with intestinal failure and home PN dependency. The analysis revealed themes relevant to eating behaviors, hunger and thirst, strategies for dining in restaurants, and a perception of wasting money because of malabsorbed food. Three patterns of eating emerged: eating for survival, eating for health benefits, and eating for socialization. A proposed model illustrates how these eating patterns are linked to QOL. Being able to eat and enjoy food is an important ingredient for good self-reported QOL. Measurements of QOL for this population may be enhanced with inclusion of a food and eating domain. The social and emotional context of food and mealtimes is an important component to address in the nutrition care plan for PN-dependent adults. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  13. Lifetime Increased Risk of Adult Onset Atopic Dermatitis in Adolescent and Adult Patients with Food Allergy.

    PubMed

    Yu, Hsu-Sheng; Tu, Hung-Pin; Hong, Chien-Hui; Lee, Chih-Hung

    2016-12-27

    Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD) causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years) for 14 years and compared them with 11,404 matched controls. While 2.8% (81) of the 2851 food allergy patients developed AD, only 2.0% (227) of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001). Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively) of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD.

  14. 25 CFR 20.331 - What is Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is Adult Care Assistance? 20.331 Section 20.331... SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.331 What is Adult Care Assistance? Adult care assistance provides non-medical care for eligible adult Indians who: (a) Have needs that...

  15. 25 CFR 20.331 - What is Adult Care Assistance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What is Adult Care Assistance? 20.331 Section 20.331... SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.331 What is Adult Care Assistance? Adult care assistance provides non-medical care for eligible adult Indians who: (a) Have needs that...

  16. 25 CFR 20.331 - What is Adult Care Assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is Adult Care Assistance? 20.331 Section 20.331... SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.331 What is Adult Care Assistance? Adult care assistance provides non-medical care for eligible adult Indians who: (a) Have needs that...

  17. 25 CFR 20.331 - What is Adult Care Assistance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is Adult Care Assistance? 20.331 Section 20.331... SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.331 What is Adult Care Assistance? Adult care assistance provides non-medical care for eligible adult Indians who: (a) Have needs that...

  18. 25 CFR 20.331 - What is Adult Care Assistance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is Adult Care Assistance? 20.331 Section 20.331... SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.331 What is Adult Care Assistance? Adult care assistance provides non-medical care for eligible adult Indians who: (a) Have needs that...

  19. Consumption of added sugars among US children and adults by food purchase location and food source.

    PubMed

    Drewnowski, Adam; Rehm, Colin D

    2014-09-01

    The proposed changes to the Nutrition Facts Label by the US Food and Drug Administration will include information on added sugars for the first time. The objective was to evaluate the sources of added sugars in the diets of a representative sample of US children and adults by food purchase location and food source (eg, food group). This cross-sectional study among 31,035 children, adolescents, and adults aged ≥6 y from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 NHANES used data from a 24-h dietary recall to evaluate consumption of added sugars. Food locations of origin were identified as stores (supermarket or grocery store), quick-service restaurants/pizza (QSRs), full-service restaurants (FSRs), schools, and others (eg, vending machines or gifts). Added sugars consumption by food purchase location was evaluated by age, family income-to-poverty ratio, and race-ethnicity. Food group sources of added sugars were identified by using the National Cancer Institute food categories. Added sugars accounted for ∼14.1% of total dietary energy. Between 65% and 76% of added sugars came from stores, 6% and 12% from QSRs, and 4% and 6% from FSRs, depending on age. Older adults (aged ≥51 y) obtained a significantly greater proportion of added sugars from stores than did younger adults. Lower-income adults obtained a significantly greater proportion of added sugars from stores than did higher-income adults. Intake of added sugars did not vary by family income among children/adolescents. Soda and energy and sports drinks were the largest food group sources of added sugars (34.4%), followed by grain desserts (12.7%), fruit drinks (8.0%), candy (6.7%), and dairy desserts (5.6%). Most added sugars came from foods obtained from stores. The proposed changes to the Nutrition Facts Label should capture the bulk of added sugars in the US food supply, which suggests that the recommended changes have the potential to reduce added sugars consumption. © 2014 American Society

  20. Exploration of functional food consumption in older adults in relation to food matrices, bioactive ingredients, and health.

    PubMed

    Vella, Meagan N; Stratton, Laura M; Sheeshka, Judy; Duncan, Alison M

    2013-01-01

    The functional food industry is expanding, yet research into consumer perceptions of functional foods is limited. Older adults could benefit from functional foods due to age-related food and health issues. This research gathered information about functional foods from community-dwelling older adults (n = 200) who completed a researcher-administered questionnaire about consumption, food matrices, bioactive ingredients, and health areas addressed through functional foods. Overall prevalence of functional food consumption was found to be 93.0%. Commonly consumed foods included yogurt with probiotics (56.0%), eggs with omega-3 fatty acids (37.0%), and bread with fiber (35.5%). Functional food matrices primarily consumed were yogurt (51.5%), bread (44.0%), and cereal (40.0%). The primary functional food bioactive consumed was dietary fiber (79.5%). Most participants (86.2%) indicated that they consume functional foods to improve health, and the major areas specified were osteoporosis/bone health (67.5%), heart disease (61.0%), and arthritis (55.0%). These results inform health professionals regarding the potential of functional foods to support health among older adults.

  1. Factors Influencing Food Choices Among Older Adults in the Rural Western USA.

    PubMed

    Byker Shanks, Carmen; Haack, Sarah; Tarabochia, Dawn; Bates, Kate; Christenson, Lori

    2017-06-01

    Nutrition is an essential component in promoting health and quality of life into the older adults years. The purpose of this qualitative research is to explore how the rural food environment influences food choices of older adults. Four focus groups were conducted with 33 older adults (50 years of age and older) residing in rural Montana communities. Four major themes related to factors influencing food choices among rural older adults emerged from this study: perception of the rural community environment, support as a means of increasing food access, personal access to food sources, and dietary factors. The findings from this current study warrant further research and promotion of specifically tailored approaches that influence the food choices of older adults in the rural western USA, including the developing and expanding public transportation systems, increasing availability of local grocers with quality and affordable food options, increasing awareness and decreasing stigma surrounding community food programs, and increasing nutrition education targeting senior health issues.

  2. Foods and dietary profiles associated with 'food addiction' in young adults.

    PubMed

    Pursey, Kirrilly M; Collins, Clare E; Stanwell, Peter; Burrows, Tracy L

    2015-12-01

    It has been suggested that addictive behaviors related to consumption of specific foods could contribute to overeating and obesity. Although energy-dense, hyper-palatable foods are hypothesized to be associated with addictive-like eating behaviors, few studies have assessed this in humans. To evaluate in young adults whether intakes of specific foods are associated with 'food addiction', as assessed by the Yale Food Addiction Scale (YFAS), and to describe the associated nutrient intake profiles. Australian adults aged 18-35 years were invited to complete an online cross-sectional survey including demographics, the YFAS and usual dietary intake. Participants were classified as food addicted (FAD) or non-addicted (NFA) according to the YFAS predefined scoring criteria. A total 462 participants (86% female, 73% normal weight) completed the survey, with 14.7% ( n  = 68) classified as FAD. The FAD group had a higher proportion of females ( p  = .01) and higher body mass index ( p  < .001) compared to NFA. Higher YFAS symptom scores were associated with higher percentage energy intake (%E) from energy-dense, nutrient-poor foods including candy, take out and baked sweet products, as well as lower %E from nutrient-dense core foods including whole-grain products and breakfast cereals. These remained statistically significant when adjusted for age, sex and BMI category ( p  = .001). Statistically significant associations were identified between YFAS assessed food addiction and dietary intake, specifically intakes of energy-dense, nutrient-poor foods. However, the effect sizes were small limiting clinical applications. Further examination of the relationship between addictive-like eating and intake of specific foods in a nationally representative sample is warranted.

  3. Primary care management of food allergy and food intolerance.

    PubMed

    Garzon, Dawn Lee; Kempker, Tara; Piel, Pamela

    2011-12-16

    The incidence of food allergies is steadily increasing. Due to potentially life-threatening complications, it is important that primary care providers recognize and appropriately manage these disorders. This article includes a discussion of the current evidence-based guidelines for the diagnosis, screening, and management of food allergies.

  4. Food Insecurity Among Young Adults With Intellectual and Developmental Disabilities in the United States: Evidence From the National Health Interview Survey.

    PubMed

    Brucker, Debra L; Nord, Derek

    2016-11-01

    People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may be particularly vulnerable. Using pooled data from the 2011-2014 National Health Interview Survey, we find that young adults with IDD have significantly higher levels of food insecurity than young adults without disabilities, even when controlling for poverty. Young adults with IDD who are living in low-income households are not significantly more likely to participate in the Supplemental Nutrition Assistance Program (SNAP) than young adults without disabilities who are also living in low-income households. Although our results suggest that SNAP is effectively reaching many young adults with IDD in need of nutrition assistance, further research is needed to determine the specific effects of food insecurity and SNAP participation on overall economic and health outcomes for this population.

  5. Gauging food and nutritional care quality in hospitals

    PubMed Central

    2012-01-01

    Background Food and nutritional care quality must be assessed and scored, so as to improve health institution efficacy. This study aimed to detect and compare actions related to food and nutritional care quality in public and private hospitals. Methods Investigation of the Hospital Food and Nutrition Service (HFNS) of 37 hospitals by means of structured interviews assessing two quality control corpora, namely nutritional care quality (NCQ) and hospital food service quality (FSQ). HFNS was also evaluated with respect to human resources per hospital bed and per produced meal. Results Comparison between public and private institutions revealed that there was a statistically significant difference between the number of hospital beds per HFNS staff member (p = 0.02) and per dietitian (p < 0.01). The mean compliance with NCQ criteria in public and private institutions was 51.8% and 41.6%, respectively. The percentage of public and private health institutions in conformity with FSQ criteria was 42.4% and 49.1%, respectively. Most of the actions comprising each corpus, NCQ and FSQ, varied considerably between the two types of institution. NCQ was positively influenced by hospital type (general) and presence of a clinical dietitian. FSQ was affected by institution size: large and medium-sized hospitals were significantly better than small ones. Conclusions Food and nutritional care in hospital is still incipient, and actions concerning both nutritional care and food service take place on an irregular basis. It is clear that the design of food and nutritional care in hospital indicators is mandatory, and that guidelines for the development of actions as well as qualification and assessment of nutritional care are urgent. PMID:22954229

  6. Consumption of added sugars among US children and adults by food purchase location and food source123

    PubMed Central

    Drewnowski, Adam; Rehm, Colin D

    2014-01-01

    Background: The proposed changes to the Nutrition Facts Label by the US Food and Drug Administration will include information on added sugars for the first time. Objective: The objective was to evaluate the sources of added sugars in the diets of a representative sample of US children and adults by food purchase location and food source (eg, food group). Design: This cross-sectional study among 31,035 children, adolescents, and adults aged ≥6 y from the 2003–2004, 2005–2006, 2007–2008, and 2009–2010 NHANES used data from a 24-h dietary recall to evaluate consumption of added sugars. Food locations of origin were identified as stores (supermarket or grocery store), quick-service restaurants/pizza (QSRs), full-service restaurants (FSRs), schools, and others (eg, vending machines or gifts). Added sugars consumption by food purchase location was evaluated by age, family income-to-poverty ratio, and race-ethnicity. Food group sources of added sugars were identified by using the National Cancer Institute food categories. Results: Added sugars accounted for ∼14.1% of total dietary energy. Between 65% and 76% of added sugars came from stores, 6% and 12% from QSRs, and 4% and 6% from FSRs, depending on age. Older adults (aged ≥51 y) obtained a significantly greater proportion of added sugars from stores than did younger adults. Lower-income adults obtained a significantly greater proportion of added sugars from stores than did higher-income adults. Intake of added sugars did not vary by family income among children/adolescents. Soda and energy and sports drinks were the largest food group sources of added sugars (34.4%), followed by grain desserts (12.7%), fruit drinks (8.0%), candy (6.7%), and dairy desserts (5.6%). Conclusions: Most added sugars came from foods obtained from stores. The proposed changes to the Nutrition Facts Label should capture the bulk of added sugars in the US food supply, which suggests that the recommended changes have the potential to

  7. Primary care of adults with developmental disabilities

    PubMed Central

    Sullivan, William F.; Berg, Joseph M.; Bradley, Elspeth; Cheetham, Tom; Denton, Richard; Heng, John; Hennen, Brian; Joyce, David; Kelly, Maureen; Korossy, Marika; Lunsky, Yona; McMillan, Shirley

    2011-01-01

    Abstract Objective To update the 2006 Canadian guidelines for primary care of adults with developmental disabilities (DD) and to make practical recommendations based on current knowledge to address the particular health issues of adults with DD. Quality of evidence Knowledgeable health care providers participating in a colloquium and a subsequent working group discussed and agreed on revisions to the 2006 guidelines based on a comprehensive review of publications, feedback gained from users of the guidelines, and personal clinical experiences. Most of the available evidence in this area of care is from expert opinion or published consensus statements (level III). Main message Adults with DD have complex health issues, many of them differing from those of the general population. Good primary care identifies the particular health issues faced by adults with DD to improve their quality of life, to improve their access to health care, and to prevent suffering, morbidity, and premature death. These guidelines synthesize general, physical, behavioural, and mental health issues of adults with DD that primary care providers should be aware of, and they present recommendations for screening and management based on current knowledge that practitioners can apply. Because of interacting biologic, psychoaffective, and social factors that contribute to the health and well-being of adults with DD, these guidelines emphasize involving caregivers, adapting procedures when appropriate, and seeking input from a range of health professionals when available. Ethical care is also emphasized. The guidelines are formulated within an ethical framework that pays attention to issues such as informed consent and the assessment of health benefits in relation to risks of harm. Conclusion Implementation of the guidelines proposed here would improve the health of adults with DD and would minimize disparities in health and health care between adults with DD and those in the general population

  8. Palliative care - fluid, food, and digestion

    MedlinePlus

    ... gov/ency/patientinstructions/000531.htm Palliative care - fluid, food, and digestion To use the sharing features on ... When Your Body Has Problems Handling Fluids and Food It is normal for a person who has ...

  9. Food Insecurity and Depression Among Adults With Diabetes: Results From the National Health and Nutrition Examination Survey (NHANES).

    PubMed

    Montgomery, Joshua; Lu, Juan; Ratliff, Scott; Mezuk, Briana

    2017-06-01

    Purpose While both food insecurity and depression have been linked to risk of type 2 diabetes, little is known about the relationship between food insecurity and depression among adults with diabetes. Research Design and Methods Cross-sectional analyses of the National Health and Nutrition Examination Survey (2011-2014), a nationally representative, population-based survey. Analytic sample was limited to adults aged ≥20 with diabetes determined by either fasting plasma glucose (≥126 mg/dL) or self-report (n = 1724) and adults age ≥20 with prediabetes determined by fasting plasma glucose (100-125 mg/dL) or self-report (n = 2004). Food insecurity was measured using the US Food Security Survey Module. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression was used to assess the relationship between food insecurity and depression while accounting for sociodemographic characteristics and health behaviors. Results Approximately 10% of individuals with diabetes and 8.5% of individuals with prediabetes had severe food insecurity in the past year; an additional 20.3% of individuals with diabetes and 14.3% of those with prediabetes had mild food insecurity. Among individuals with diabetes, both mild and severe food insecurity were associated with elevated odds of depression These relationships were similar in magnitude among individuals with prediabetes. Conclusions Food insecurity is significantly associated with depressive symptoms in people with diabetes and prediabetes. Results point to the need to address economic issues in conjunction with psychosocial issues for comprehensive diabetes care.

  10. Relation between local food environments and obesity among adults

    PubMed Central

    Spence, John C; Cutumisu, Nicoleta; Edwards, Joy; Raine, Kim D; Smoyer-Tomic, Karen

    2009-01-01

    Background Outside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes. Methods Data from a population health survey of 2900 adults (18 years or older) conducted in 2002 was linked with geographic measures of access to food retailers. Based upon a ratio of the number of fast-food restaurants and convenience stores to supermarkets and specialty food stores, a Retail Food Environment Index (RFEI) was calculated for 800 m and 1600 m buffers around people's homes. In a series of logistic regressions, associations between the RFEI and the level of obesity among adults were examined. Results The median RFEI for adults in Edmonton was 4.00 within an 800 m buffer around their residence and 6.46 within a 1600 m buffer around their residence. Approximately 14% of the respondents were classified as being obese. The odds of a resident being obese were significantly lower (OR = 0.75, 95%CI 0.59 – 0.95) if they lived in an area with the lowest RFEI (below 3.0) in comparison to the highest RFEI (5.0 and above). These associations existed regardless of the covariates included in the model. No significant associations were observed between RFEI within a 1600 m buffer of the home and obesity. Conclusion The lower the ratio of fast-food restaurants and convenience stores to grocery stores and produce vendors near people's homes, the lower the odds of being obese. Thus the proximity of the obesogenic environment to individuals appears to be an important factor in their risk for obesity. PMID:19538709

  11. Food Insecurity among Young Adults with Intellectual and Developmental Disabilities in the United States: Evidence from the National Health Interview Survey

    ERIC Educational Resources Information Center

    Brucker, Debra L.; Nord, Derek

    2016-01-01

    People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may…

  12. [Macronutrient food sources in a probabilistic sample of Brazilian adults].

    PubMed

    de Souza, Danielle Ribeiro; Ados njos, Luiz Antonio; Wahrlich, Vivian; de Vasconcellos, Mauricio Teixeira Leite

    2015-05-01

    Once it is available, the information on food intake (FI) may enable the development of strategies to intervene, monitor and explore dietary patterns with more sophisticated statistical methods. Thus, the purpose of this study was to document the quantitative dietary characteristics in a probabilistic sample of adults in Niterói in the State of Rio de Janeiro. A 24-hour dietary recall of a typical day was conducted. The food eaten by most adults (> 50%) was white rice, coffee, black beans, refined sugar and French bread. Whole milk was ingested by more adults than skimmed or semi-skimmed milk. Beef was ingested by more adults than chicken, fish or pork. More adults ingested sodas than fruit juices and fruits were eaten by a relatively high percentage of adults (63.3%). The combination of white rice, black beans, beef and French bread was responsible for at least 25% of energy, protein and carbohydrate and 17% of lipids. A total of 65 food items accounted for approximately 90% of energy and macronutrients. The list generated is somewhat similar to the one used in a similar survey conducted in São Paulo. The list can serve as the basis for a single food frequency questionnaire to be used for the southeastern Brazilian urban population.

  13. Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

    PubMed

    Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

    2017-07-01

    Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

  14. Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

    PubMed

    Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

    2010-03-01

    Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

  15. UnAdulterated - children and adults' visual attention to healthy and unhealthy food.

    PubMed

    Junghans, Astrid F; Hooge, Ignace T C; Maas, Josje; Evers, Catharine; De Ridder, Denise T D

    2015-04-01

    Visually attending to unhealthy food creates a desire to consume the food. To resist the temptation people have to employ self-regulation strategies, such as visual avoidance. Past research has shown that self-regulatory skills develop throughout childhood and adolescence, suggesting adults' superior self-regulation skills compared to children. This study employed a novel method to investigate self-regulatory skills. Children and adults' initial (bottom-up) and maintained (top-down) visual attention to simultaneously presented healthy and unhealthy food were examined in an eye-tracking paradigm. Results showed that both children and adults initially attended most to the unhealthy food. Subsequently, adults self-regulated their visual attention away from the unhealthy food. Despite the children's high self-reported attempts to eat healthily and importance of eating healthily, children did not self-regulate visual attention away from unhealthy food. Children remained influenced by the attention-driven desire to consume the unhealthy food whereas adults visually attended more strongly to the healthy food thereby avoiding the desire to consume the unhealthy option. The findings emphasize the necessity of improving children's self-regulatory skills to support their desire to remain healthy and to protect children from the influences of the obesogenic environment. Copyright © 2015. Published by Elsevier Ltd.

  16. Elicitors and co-factors in food-induced anaphylaxis in adults

    PubMed Central

    2013-01-01

    Food-induced anaphylaxis (FIA) in adults is often insufficiently diagnosed. One reason is related to the presence of co-factors like exercise, alcohol, additives and non-steroidal anti-inflammatory drugs. The objective of this analysis was to retrospectively investigate the role of co-factors in patients with FIA. 93 adult patients with suspected FIA underwent double-blind, placebo-controlled food challenges with suspected allergens and co-factors. The elicitors of anaphylaxis were identified in 44/93 patients. 27 patients reacted to food allergens upon challenge, 15 patients reacted only when a co-factor was co-exposed with the allergen. The most common identified allergens were celery (n = 7), soy, wheat (n = 4 each) and lupine (n = 3). Among the co-factors food additives (n = 8) and physical exercise (n = 6) were most frequent. In 10 patients more than one co-factor and/or more than one food allergen was necessary to elicit a positive reaction. The implementation of co-factors into the challenge protocol increases the identification rate of elicitors in adult food anaphylactic patients. PMID:24262093

  17. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if he/she...

  18. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if he/she...

  19. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if he/she...

  20. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if he/she...

  1. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Who can receive Adult Care Assistance? 20.332 Section 20... AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.332 Who can receive Adult Care Assistance? An adult Indian is eligible to receive adult care assistance under this part if he/she...

  2. Functional food awareness and perceptions in relation to information sources in older adults.

    PubMed

    Vella, Meagan N; Stratton, Laura M; Sheeshka, Judy; Duncan, Alison M

    2014-05-17

    The functional food industry has experienced innovative and economic expansion, yet research into consumer perceptions of functional foods and their associated health claims is limited. Among consumers, older adults could benefit from functional foods due to age-related issues pertaining to food and health. The purpose of this research was to identify the need for information related to functional foods among older adults (≥60 years old) and to assess awareness and perceptions of health claims on functional food packages. Community-dwelling older adults (n = 200) completed a researcher administered questionnaire designed to collect information about functional foods including current consumption, motivating factors for consumption, perceived need for information, sources of information for functional foods and awareness of health claims. Prevalence of functional food consumption among participants was 93.0%. Increased awareness and knowledge was the most commonly reported factor that would promote functional food consumption (85.5%) and 63.5% of participants wanted more information about functional foods with preferred sources being newspapers/magazines/books (68.5%) and food labels (66.1%). Participants were predominately (93.5%) aware of health claims on functional foods and those with more education were more likely to report being aware of health claims (p = 0.045). Although functional food consumption among older adults in this sample is high, there is a need for further information regarding functional foods. These results inform stakeholders regarding the potential for information to influence functional food acceptance among older adult consumers.

  3. Dental Care Utilization among North Carolina Rural Older Adults

    PubMed Central

    Arcury, Thomas A.; Savoca, Margaret R.; Anderson, Andrea M.; Chen, Haiying; Gilbert, Gregg H.; Bell, Ronny A.; Leng, Xiaoyan; Reynolds, Teresa; Quandt, Sara A.

    2012-01-01

    Objectives This analysis delineates the predisposing, need, and enabling factors that are significantly associated with regular and recent dental care in a multi-ethnic sample of rural older adults. Methods A cross-sectional comprehensive oral health survey conducted with a random, multi-ethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Results Almost no edentulous rural older adults received dental care. Slightly more than one-quarter (27.1%) of dentate rural older adults received regular dental care and slightly more than one-third (36.7%) received recent dental care. Predisposing (education) and enabling (regular place for dental care) factors associated with receiving regular and recent dental care among dentate participants point to greater resources being the driving force in receiving dental care. Contrary to expectations of the Behavioral Model of Health Services, those with the least need (e.g., better self-rated oral health) received regular dental care; this has been referred to as the Paradox of Dental Need. Conclusions Regular and recent dental care are infrequent among rural older adults. Those not receiving dental care are those who most need care. Community access to dental care and the ability of older adults to pay for dental care must be addressed by public health policy to improve the health and quality of life of older adults in rural communities. PMID:22536828

  4. Current Status and Issues Regarding Transitional Health Care for Adults and Young Adults with Special Health Care Needs in Japan.

    PubMed

    Ariyasu, Hiroyuki; Akamizu, Takashi

    2018-05-15

    With the progress of medical care in recent years, the prognosis of intractable diseases of childhood onset has markedly improved. Young adults with special health care needs require continuous medical support throughout their lifetimes. To provide them with optimal health care services, a smooth transition from the pediatric medical system to the adult one is essential. However, in Japan many adult health providers are not sufficiently prepared to care for these patients, due both to limited opportunities to gain up-to-date medical knowledge on transitional health care and a lack of familiarity with the medical treatment of childhood-onset chronic diseases. In this review, we discuss current issues in transitional health care in Japan from an internist's viewpoint.

  5. Titanium Dioxide Nanoparticles in Food and Personal Care Products

    PubMed Central

    Weir, Alex; Westerhoff, Paul; Fabricius, Lars

    2012-01-01

    Titanium dioxide is a common additive in many food, personal care, and other consumer products used by people, which after use can enter the sewage system, and subsequently enter the environment as treated effluent discharged to surface waters or biosolids applied to agricultural land, incinerated wastes, or landfill solids. This study quantifies the amount of titanium in common food products, derives estimates of human exposure to dietary (nano-) TiO2, and discusses the impact of the nanoscale fraction of TiO2 entering the environment. The foods with the highest content of TiO2 included candies, sweets and chewing gums. Among personal care products, toothpastes and select sunscreens contained 1% to >10% titanium by weight. While some other crèmes contained titanium, despite being colored white, most shampoos, deodorants, and shaving creams contained the lowest levels of titanium (<0.01 μg/mg). For several high-consumption pharmaceuticals, the titanium content ranged from below the instrument detection limit (0.0001 μg Ti/mg) to a high of 0.014 μg Ti/mg. Electron microscopy and stability testing of food-grade TiO2 (E171) suggests that approximately 36% of the particles are less than 100 nm in at least one dimension and that it readily disperses in water as fairly stable colloids. However, filtration of water solubilized consumer products and personal care products indicated that less than 5% of the titanium was able to pass through 0.45 or 0.7 μm pores. Two white paints contained 110 μg Ti/mg while three sealants (i.e., prime coat paint) contained less titanium (25 to 40 μg Ti/mg). This research showed that while many white-colored products contained titanium, it was not a prerequisite. Although several of these product classes contained low amounts of titanium, their widespread use and disposal down the drain and eventually to WWTPs deserves attention. A Monte Carlo human exposure analysis to TiO2 through foods identified children as having the highest

  6. Functional food awareness and perceptions in relation to information sources in older adults

    PubMed Central

    2014-01-01

    Background The functional food industry has experienced innovative and economic expansion, yet research into consumer perceptions of functional foods and their associated health claims is limited. Among consumers, older adults could benefit from functional foods due to age-related issues pertaining to food and health. The purpose of this research was to identify the need for information related to functional foods among older adults (≥60 years old) and to assess awareness and perceptions of health claims on functional food packages. Methods Community-dwelling older adults (n = 200) completed a researcher administered questionnaire designed to collect information about functional foods including current consumption, motivating factors for consumption, perceived need for information, sources of information for functional foods and awareness of health claims. Results Prevalence of functional food consumption among participants was 93.0%. Increased awareness and knowledge was the most commonly reported factor that would promote functional food consumption (85.5%) and 63.5% of participants wanted more information about functional foods with preferred sources being newspapers/magazines/books (68.5%) and food labels (66.1%). Participants were predominately (93.5%) aware of health claims on functional foods and those with more education were more likely to report being aware of health claims (p = 0.045). Conclusions Although functional food consumption among older adults in this sample is high, there is a need for further information regarding functional foods. These results inform stakeholders regarding the potential for information to influence functional food acceptance among older adult consumers. PMID:24886306

  7. Food Buying Guide for Family Day Care Homes.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Chicago, IL. Midwest Regional Office.

    Offered in this guide are facts enabling family day care providers in Michigan to serve meals meeting meal pattern requirements of the state's Child Care Food Program. Adapted from the "Food Buying Guide for Child Nutrition Programs," contents are based on the latest Federal regulations and meal pattern requirements, current food…

  8. The Impact of a Community-Based Intervention Including a Monthly Food Ration on Food Insecurity Among HIV-Positive Adults During the First Year of Antiretroviral Therapy.

    PubMed

    Rothman, Jessica; Kayigamba, Felix; Hills, Victoria; Gupta, Neil; Machara, Faustin; Niyigena, Peter; Franke, Molly F

    2018-01-01

    The objective of this study was to examine how food insecurity changed among HIV-positive adults during the first 12 months of combination antiretroviral therapy (cART) and whether any change differed according to the receipt of food support, which was provided in the context of a comprehensive community-based intervention. We conducted secondary data analyses of data from a prospective cohort study of the effectiveness of a community-based cART delivery model when added to clinic-based cART delivery in Rwanda. We included patients from four health centers that implemented a clinic-based cART delivery model alone and five health centers that additionally implemented the intervention, which included 10 months of food support. We compared food insecurity at 3, 6, and 12 months, relative to baseline, and stratified by receipt of the intervention. Relative to baseline, median food insecurity score decreased after 3, 6, and 12 months (p value <0.0001 for all) for patients receiving a food ration through the community-based model for cART delivery. Among patients receiving care under the clinic-based cART model, food insecurity scores remained unchanged at 3 and 12 months and were significantly higher after 6 months. In adjusted analyses, participants enrolled in the community-based intervention with a food ration had a lower risk of severe food insecurity and a lower risk of moderate or severe food insecurity after 12 months. A comprehensive community-based HIV program including a food ration likely contributes to an alleviation of food insecurity among adults newly initiating cART.

  9. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

    PubMed

    Tan, Ming Yeong; Magarey, Judy

    2008-08-01

    To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

  10. Development of a food frequency questionnaire for Sri Lankan adults

    PubMed Central

    2012-01-01

    Background Food Frequency Questionnaires (FFQs) are commonly used in epidemiologic studies to assess long-term nutritional exposure. Because of wide variations in dietary habits in different countries, a FFQ must be developed to suit the specific population. Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no FFQ has been developed for Sri Lankan adults. In this study, we developed a FFQ to assess the regular dietary intake of Sri Lankan adults. Methods A nationally representative sample of 600 adults was selected by a multi-stage random cluster sampling technique and dietary intake was assessed by random 24-h dietary recall. Nutrient analysis of the FFQ required the selection of foods, development of recipes and application of these to cooked foods to develop a nutrient database. We constructed a comprehensive food list with the units of measurement. A stepwise regression method was used to identify foods contributing to a cumulative 90% of variance to total energy and macronutrients. In addition, a series of photographs were included. Results We obtained dietary data from 482 participants and 312 different food items were recorded. Nutritionists grouped similar food items which resulted in a total of 178 items. After performing step-wise multiple regression, 93 foods explained 90% of the variance for total energy intake, carbohydrates, protein, total fat and dietary fibre. Finally, 90 food items and 12 photographs were selected. Conclusion We developed a FFQ and the related nutrient composition database for Sri Lankan adults. Culturally specific dietary tools are central to capturing the role of diet in risk for chronic disease in Sri Lanka. The next step will involve the verification of FFQ reproducibility and validity. PMID:22937734

  11. Young adults' health care utilization and expenditures prior to the Affordable Care Act.

    PubMed

    Lau, Josephine S; Adams, Sally H; Boscardin, W John; Irwin, Charles E

    2014-06-01

    To examine young adults' health care utilization and expenditures prior to the Affordable Care Act. We used 2009 Medical Expenditure Panel Survey to (1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and (2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other sociodemographic factors, including race/ethnicity and income. Young adults had (1) significantly lower rates of overall utilization (72%) than other age groups (83%-88%, p < .001), (2) the lowest rate of office-based utilization (55% vs. 67%-77%, p < .001) and (3) higher rate of emergency room visits compared with adolescents (15% vs. 12%, p < .01). Uninsured young adults had high out-of-pocket expenses. Compared with the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/person, p < .001) but essentially the same out-of-pocket expenses ($403 vs. $380/person, p = .57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language, and sex. Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of emergency room visits. The Affordable Care Act provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address noninsurance barriers and ensure equal access to health services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Self-Control and Impulsiveness in Nondieting Adult Human Females: Effects of Visual Food Cues and Food Deprivation

    ERIC Educational Resources Information Center

    Forzano, Lori-Ann B.; Chelonis, John J.; Casey, Caitlin; Forward, Marion; Stachowiak, Jacqueline A.; Wood, Jennifer

    2010-01-01

    Self-control can be defined as the choice of a larger, more delayed reinforcer over a smaller, less delayed reinforcer, and impulsiveness as the opposite. Previous research suggests that exposure to visual food cues affects adult humans' self-control. Previous research also suggests that food deprivation decreases adult humans' self-control. The…

  13. Food safety hazards lurk in the kitchens of young adults.

    PubMed

    Byrd-Bredbenner, Carol; Maurer, Jaclyn; Wheatley, Virginia; Cottone, Ellen; Clancy, Michele

    2007-04-01

    Food mishandling in home kitchens likely causes a significant amount of foodborne disease; however, little is known about the food safety hazards lurking in home kitchens. The purposes of this study were to audit the kitchens of young adults with education beyond high school to identify food safety problems and develop recommendations for education efforts. Researchers developed a criterion-referenced home kitchen observation instrument to assess compliance of home food storage and rotation practices (e.g., temperature), sanitation and chemical storage, and general kitchen condition (e.g., infestation) with recommended practices. The instrument contained seven scales: Kitchen Cleanliness (eight items), Appliance Cleanliness (three items), Cleaning Supplies Availability (eight items), Temperatures (Food Thermometer Access & Refrigerator/Freezer Temperatures) (five items), Cold Food Storage (seven items), Dry Food Storage (eight items), and Poisons Storage (two items). Descriptive statistics were conducted to describe the study population, as a whole, and by gender. A total of 154 young adults (mean age, 20.7+/- 1.3 SD) enrolled in a northeastern university participated. Participants scored 70% or higher on Poisons Storage, Dry Food Storage, Kitchen Cleanliness, and Cleaning Supplies Availability scales but less than 60% on the Appliance Cleanliness and Cold Food Storage scales. Performance was lowest on the Temperatures scale. Females scored significantly higher than males on the Kitchen Cleanliness and Cleaning Supply Availability scales. Average refrigerator and freezer temperatures were higher than recommendations. Food safety education targeted at this young adult population needs to evolve into focused messages pertaining to the key food safety violations in this population.

  14. Sex differences in young adults' snack food intake after food commercial exposure.

    PubMed

    Anschutz, Doeschka J; Engels, Rutger C M E; van der Zwaluw, Carmen S; Van Strien, Tatjana

    2011-04-01

    Exposure to food commercials on television is considered to be related to elevated snack food intake in front of the television. However, this assumed relation has as yet not been fully established. The present study, therefore examined the direct effects of watching television food commercials on concurrent non-advertised snack food intake in young adults. In addition, possible sex differences were investigated. Participants (N=82, 50% male) watched a movie interrupted by two commercial breaks that contained either food commercials or neutral commercials. While watching, they could freely eat crisps and chocolate coated peanuts. Afterwards, participants filled out questionnaires and were weighed and measured. Regression analyses showed that men and women were differently affected by the food commercials. Food intake in women was higher when they watched the food commercials than when they watched the neutral commercials, whereas food intake in men was lower when they watched the food commercials than when they watched the neutral commercials. The results suggest that especially women are vulnerable for eating more snack food when exposed to food commercials. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Immunoglobulin E-mediated food allergies among adults with allergic rhinitis.

    PubMed

    Sahin-Yilmaz, Asli; Nocon, Cheryl C; Corey, Jacquelynne P

    2010-09-01

    To compare the prevalence of food allergy for peanut, shrimp, and milk in adults with allergic rhinitis and to determine predictive values of these allergens and total immunoglobulin E (IgE) to detect food allergies. Cross-sectional study. University of Chicago Medical Center, Chicago, Illinois. We retrospectively analyzed in vitro enzyme-linked immunosorbent assays of adults with rhinitis. Subjects were tested for nine inhalants and three foods (peanut, shrimp, milk) and total IgE. Subjects with food allergy history were tested with additional foods. The sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) of the allergens and total IgE to detect food allergies were calculated. A total of 283 subjects received in vitro tests. Forty-one percent tested negative and 59 percent tested positive for inhalants. The prevalence of subjects with a positive peanut or shrimp allergy in the inhalant-positive population was significantly greater than subjects with milk allergy (23.4% peanut [P = 0.008], 22.2% shrimp [P = 0.001], and 13.2% milk [P = 0.008], P = 0.001). For subjects with food allergy history, peanut had the best SP (100.0%), SE (28.1%), PPV (100.0%), and NPV (64.6%) in detecting allergies to other foods. In patients positive for the initial panel (inhalants and peanut), the SP, SE, PPV, and NPV of elevated total IgE was 71.4, 72.4, 77.8, and 65.2 percent, respectively. Peanut and shrimp were the most common foods encountered in adults with allergic rhinitis. Peanut was best in predicting other food allergies. Total IgE levels with inhalants plus peanut provided the optimal combination of SE, SP, PPV, and NPV. In vitro testing may be important to identify and prevent anaphylaxis to foods in adults. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  16. Food allergy knowledge, attitudes, and beliefs of primary care physicians.

    PubMed

    Gupta, Ruchi S; Springston, Elizabeth E; Kim, Jennifer S; Smith, Bridget; Pongracic, Jacqueline A; Wang, Xiaobin; Holl, Jane

    2010-01-01

    To provide insight into food allergy knowledge and perceptions among pediatricians and family physicians in the United States. A national sample of pediatricians and family physicians was recruited between April and July 2008 to complete the validated, Web-based Chicago Food Allergy Research Survey for Primary Care Physicians. Findings were analyzed to provide composite/itemized knowledge scores, describe attitudes and beliefs, and examine the effects of participant characteristics on response. The sample included 407 primary care physicians; 99% of the respondents reported providing care for food-allergic patients. Participants answered 61% of knowledge-based items correctly. Strengths and weaknesses were identified in each content domain evaluated by the survey. For example, 80% of physicians surveyed knew that the flu vaccine is unsafe for egg-allergic children, 90% recognized that the number of food-allergic children is increasing in the United States, and 80% were aware that there is no cure for food allergy. However, only 24% knew that oral food challenges may be used in the diagnosis of food allergy, 12% correctly rejected that chronic nasal problems are not symptom of food allergy, and 23% recognized that yogurts/cheeses from milk are unsafe for children with immunoglobulin E-mediated milk allergies. Fewer than 30% of the participants felt comfortable interpreting laboratory tests to diagnose food allergy or felt adequately prepared by their medical training to care for food-allergic children. Knowledge of food allergy among primary care physicians was fair. Opportunities for improvement exist, as acknowledged by participants' own perceptions of their clinical abilities in the management of food allergy.

  17. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa.

    PubMed

    Benzekri, Noelle A; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Guèye, Ndèye Fatou; Diallo, Mouhamadou Baïla; Hawes, Stephen E; Seydi, Moussa; Gottlieb, Geoffrey S

    2015-01-01

    Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes. We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01). Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population.

  18. Does school health and home economics education influence adults' food knowledge?

    PubMed

    Worsley, A; Wang, W C; Yeatman, H; Byrne, S; Wijayaratne, P

    2016-12-01

    Home economics and health teachers are to be found in many parts of the world. They teach students about food in relation to its nutritional, safety and environmental properties. The effects of such teaching might be expected to be reflected in the food knowledge of adults who have undertaken school education in these areas. This study examined the food knowledge associations of school home economics and health education among Australian adults. Two separate online surveys were conducted nationwide among 2022 (November 2011) and 2146 Australian adults (November-December 2012). True/false and multiple choice questions in both surveys were used to assess nutrition, food safety and environmental knowledge. Knowledge scores were constructed and compared against respondents' experience of school health or home economics education via multiple regression analyses. The results from both studies showed that home economics (and similar) education was associated with higher levels of food knowledge among several age groups. The associations of home economics education with food knowledge differed across several Australian states and recall of home economics themes differed across the age groups. These findings suggest that home economics education may bring about long-lasting learning of food knowledge. Further research is required, however, to confirm the findings and to test the causal influence of home economics education on adults' food knowledge. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Food and Drug Labeling and the Adult Reader.

    ERIC Educational Resources Information Center

    McKenna, Michael C.; Aker, Richard

    1978-01-01

    Full disclosure of ingredients on food, drugs, and cosmetic labels is really non-disclosure where the chemical formulation has no common name or where one generic name covers a variety of formations. The Food and Drug Administration offers suggestions for adult education programs in consumer awareness, understanding compound nomenclature, and…

  20. Effect of food prices on the prevalence of obesity among young adults.

    PubMed

    Han, E; Powell, L M

    2011-03-01

    To examine the extent to which various food prices were associated with the obesity status of young adults. Retrospective cohort study of 6537 men and 5324 women in the USA using panel data from the Monitoring the Future Surveys (1992-2003), which were merged with two food-at-home and one food-away-from-home price measures from the American Chamber of Commerce Researchers Association. Longitudinal individual random effect and fixed effect models were estimated. This study found that food prices did not have a significant effect on the prevalence of obesity among young female adults. For young adult men, an individual random effect estimator suggested that a 10% increase in the price of fast food was associated with a 13.2% decrease in the probability of obesity, but this effect lost its economic and statistical significance once individual fixed effects were controlled for in the estimation. Overall, the results imply that observed time-varying individual characteristics, such as working status, marital status and school enrolment status, may over-ride the effect of changes in food prices for young adults. More research employing longitudinal data is necessary to determine if food subsidies or taxes, particularly soft drink and fast food taxes or subsidies for fruit and vegetables, could be effective policy measures to curtail the increasing prevalence of obesity among young adults. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Prevalence of self reported food allergy in US adults: 2001, 2006, and 2010.

    PubMed

    Verrill, L; Bruns, R; Luccioli, S

    2015-10-08

    Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. To report the prevalence of srFA and compare differences at three time points over a decade. We analyzed srFA and reported physician-diagnosed food allergy in 4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p less than 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group.

  2. Clinical-Community Partnerships to Identify Patients With Food Insecurity and Address Food Needs

    PubMed Central

    Siegel, Karen R.; Calhoun, Holly; Kim, Sonia A.; Garcia, Sandra P.; Hoeting, Natalie M.; Harris, Diane M.; Khan, Laura Kettel; Smith, Bryce; Blanck, Heidi M.; Barnett, Kevin; Haddix, Anne C.

    2017-01-01

    Introduction More than 42 million people in the United States are food insecure. Although some health care entities are addressing food insecurity among patients because of associations with disease risk and management, little is known about the components of these initiatives. Methods The Systematic Screening and Assessment Method was used to conduct a landscape assessment of US health care entity–based programs that screen patients for food insecurity and connect them with food resources. A network of food insecurity researchers, experts, and practitioners identified 57 programs, 22 of which met the inclusion criteria of being health care entities that 1) screen patients for food insecurity, 2) link patients to food resources, and 3) target patients including adults aged 50 years or older (a focus of this assessment). Data on key features of each program were abstracted from documentation and telephone interviews. Results Most programs (n = 13) focus on patients with chronic disease, and most (n = 12) partner with food banks. Common interventions include referrals to or a list of food resources (n = 19), case managers who navigate patients to resources (n = 15), assistance with federal benefit applications (n = 14), patient education and skill building (n = 13), and distribution of fruit and vegetable vouchers redeemable at farmers markets (n = 8). Most programs (n = 14) routinely screen all patients. Conclusion The programs reviewed use various strategies to screen patients, including older adults, for food insecurity and to connect them to food resources. Research is needed on program effectiveness in improving patient outcomes. Such evidence can be used to inform the investments of potential stakeholders, including health care entities, community organizations, and insurers. PMID:29144894

  3. A Planning Guide for Food Service in Child Care Centers.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    This publication is designed to help child care center directors and other personnel in programs receiving funding through the Child Care Food Program plan their food service. Included are sections on: (1) planning food for a day; (2) meal patterns (information on the necessary food groups, a chart of vegetables and fruits containing vitamin A, C…

  4. Development of Food Safety Psychosocial Questionnaires for Young Adults

    ERIC Educational Resources Information Center

    Byrd-Bredbenner, C.; Wheatley, V.; Schaffner, D.; Bruhn, C.; Blalock, L.; Maurer, J.

    2007-01-01

    Food mishandling is thought to be more acute among young adults; yet little is known about why they may engage in risky food handling behaviors. The purpose of this study was to create valid, reliable instruments for assessing key food safety psychosocial measures. Development of the measures began by examining published studies and behavior…

  5. 7 CFR Appendix A to Part 226 - Alternate Foods for Meals

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... used in the Child and Adult Care Food Program? 1. An alternate protein product used in meals planned..., manufacturers should provide information on: (1) The amount by weight of dry alternate protein product in the... meat alternates. B. How are alternate protein products used in the Child and Adult Care Food Program? 1...

  6. 7 CFR Appendix A to Part 226 - Alternate Foods for Meals

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... used in the Child and Adult Care Food Program? 1. An alternate protein product used in meals planned..., manufacturers should provide information on: (1) The amount by weight of dry alternate protein product in the... meat alternates. B. How are alternate protein products used in the Child and Adult Care Food Program? 1...

  7. 7 CFR Appendix A to Part 226 - Alternate Foods for Meals

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... used in the Child and Adult Care Food Program? 1. An alternate protein product used in meals planned..., manufacturers should provide information on: (1) The amount by weight of dry alternate protein product in the... meat alternates. B. How are alternate protein products used in the Child and Adult Care Food Program? 1...

  8. 7 CFR Appendix A to Part 226 - Alternate Foods for Meals

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... used in the Child and Adult Care Food Program? 1. An alternate protein product used in meals planned..., manufacturers should provide information on: (1) The amount by weight of dry alternate protein product in the... meat alternates. B. How are alternate protein products used in the Child and Adult Care Food Program? 1...

  9. 7 CFR Appendix A to Part 226 - Alternate Foods for Meals

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... used in the Child and Adult Care Food Program? 1. An alternate protein product used in meals planned..., manufacturers should provide information on: (1) The amount by weight of dry alternate protein product in the... meat alternates. B. How are alternate protein products used in the Child and Adult Care Food Program? 1...

  10. Dental care among young adults with intellectual disability

    PubMed Central

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2015-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer young adults with ID (45%) visited a dentist at least once per year, compared with those without ID (58%). ID severity and the presence of co-occurring developmental disabilities predicted dental care use. Sociodemographics, daily functioning, societal participation, dental services, and dental health factors were examined as predictors of dental care frequency. Our findings can help focus efforts toward improving the frequency of dental care visits among young adults with ID. PMID:23501584

  11. Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study.

    PubMed

    Mahesh, P A; Wong, Gary W K; Ogorodova, L; Potts, J; Leung, T F; Fedorova, O; Holla, Amrutha D; Fernandez-Rivas, M; Clare Mills, E N; Kummeling, I; Versteeg, S A; van Ree, R; Yazdanbakhsh, M; Burney, P

    2016-07-01

    Data are lacking regarding the prevalence of food sensitization and probable food allergy among general population in India. We report the prevalence of sensitization and probable food allergy to 24 common foods among adults from general population in Karnataka, South India. The study was conducted in two stages: a screening study and a case-control study. A total of 11 791 adults in age group 20-54 were randomly sampled from general population in South India and answered a screening questionnaire. A total of 588 subjects (236 cases and 352 controls) participated in the case-control study involving a detailed questionnaire and specific IgE estimation for 24 common foods. A high level of sensitization (26.5%) was observed for most of the foods in the general population, higher than that observed among adults in Europe, except for those foods that cross-react with birch pollen. Most of the sensitization was observed in subjects who had total IgE above the median IgE level. A high level of cross-reactivity was observed among different pollens and foods and among foods. The prevalence of probable food allergy (self-reports of adverse symptoms after the consumption of food and specific IgE to the same food) was 1.2%, which was mainly accounted for cow's milk (0.5%) and apple (0.5%). Very high levels of sensitization were observed for most foods, including those not commonly consumed in the general population. For the levels of sensitization, the prevalence of probable food allergy was low. This disassociation needs to be further explored in future studies. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. [Food insecurity is associated with obesity in adult women of Mexico].

    PubMed

    Morales-Ruán, Ma Del Carmen; Méndez-Gómez Humarán, Ignacio; Shamah-Levy, Teresa; Valderrama-Álvarez, Zaira; Melgar-Quiñónez, Hugo

    2014-01-01

    To describe the association of food insecurity (FI) and obesity in adults in Mexico. Cross-sectional design. We included adults' data from the health and nutrition national survey 2012 (Ensanut 2012). Measures of weight and height were obtained and BMI was calculated. The level of household food insecurity was measured through the Latin American Scale of Food Security (ELCSA). Linear and logistic regression models were adjusted. 70.6% of the population had some level of food insecurity, 42.6% mild insecurity, 17.7% moderate insecurity and 10.3% severe insecurity. Adults with mild FI had higher probability of obesity (OR: 1.66; 95%CI 1.11-2.50). Women were slightly more likely to be obese (OR: 1.78; 95%CI 1.01-3.12). Mild FI is associated with obesity, particularly among women.

  13. It helps me live, sends my children to school, and feeds me: a qualitative study of how food and cash incentives may improve adherence to treatment and care among adults living with HIV in Tanzania.

    PubMed

    Czaicki, Nancy L; Mnyippembe, Agatha; Blodgett, Madeline; Njau, Prosper; McCoy, Sandra I

    2017-07-01

    Financial and in-kind incentives have been shown to improve outcomes along the HIV care cascade, however the potential mechanismsthrough which they work remain unclear. To identify the pathways through which incentives improve retention in care and adherence to antiretroviral therapy (ART), we conducted a qualitative study with participants in a trial evaluating conditional food and cash incentives for HIV-positive food insecure adults in Shinyanga, Tanzania. We found that the incentives acted through three pathways to potentially increase retention in care and adherence to ART: (1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, (2) alleviating stress associated with attending clinic and meeting basic needs, and (3) by potentially increasing motivation. Participants did not report any harmful events associated with the incentives, but reported myriad beneficial effects on household welfare. Understanding how incentives are used and how they impact outcomes can improve the design of future interventions.

  14. Experimental scarcity increases the relative reinforcing value of food in food insecure adults.

    PubMed

    Crandall, Amanda K; Temple, Jennifer L

    2018-05-29

    People with fewer financial resources are at greater risk for obesity, but the mechanisms of this relationship are not fully understood. One factor that is related, both cross-sectionally and prospectively, to obesity is the relative reinforcing value of food. It is possible that the experience of scarcity increases this reinforcing value. To date, no studies have examined this potential relationship experimentally in humans. The purpose of the studies presented here was to test the hypothesis that experimental manipulations of perceived scarcity would impact the relative reinforcing value of food. A secondary hypothesis was that individuals who report experiencing food insecurity would be more sensitive to these experimental manipulations. In order to test these hypotheses, we investigated the effects of experimentally manipulated scarcity on the relative reinforcing value of food in a laboratory setting. Study 1 had a within-subjects design and included 25 adults. Scarcity was manipulated by placing time and resource limits on the relative reinforcing value task and examining responding for a high calorie snack food versus that of an alternative reinforcer. Study 1 showed a tendency for food insecure participants to respond more for all reinforcers across conditions and have a higher proportional response for food when resources were limited. Study 2 also made use of a within-subjects design with 30 adults and primed scarcity by creating financial gains and losses on the Iowa Gambling Task. We observed higher relative reinforcing values of food among food insecure participants in the control condition, which decreased in the financial gain condition. When taken together, these two studies suggest that individuals who report experiencing food insecurity respond to acute manipulations of scarcity by increasing their reinforcing value of snack food. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Promoting Food Safety Awareness for Older Adults by Using Online Education Modules

    ERIC Educational Resources Information Center

    Roy, Amber; Francis, Sarah L.; Shaw, Angela; Rajagopal, Lakshman

    2016-01-01

    Older adults are susceptible to and at greater risk for food-borne illness in comparison to those in other adult age groups. Online education is an underused method for the delivery of food safety information to this population. Three online mini-modules, based on social marketing theory (SMT), were created for and pilot-tested with older adults.…

  16. Diabetes Self-Care and the Older Adult

    PubMed Central

    Weinger, Katie; Beverly, Elizabeth A.; Smaldone, Arlene

    2014-01-01

    The prevalence of diabetes is highest in older adults, a population that is increasing. Diabetes self-care is complex with important recommendations for nutrition, physical activity, checking glucose levels, and taking medication. Older adults with diabetes have unique issues which impact self-care. As people age, their health status, support systems, physical and mental abilities, and nutritional requirements change. Furthermore, comorbidities, complications, and polypharmacy complicate diabetes self-care. Depression is also more common among the elderly and may lead to deterioration in self-care behaviors. Because of concerns about cognitive deficits and multiple comorbidities, adults older than 65 years are often excluded from research trials. Thus, little clinical evidence is available and the most appropriate treatment approaches and how to best support older patients’ self-care efforts are unclear. This review summarizes the current literature, research findings, and expert and consensus recommendations with their rationales. PMID:24510969

  17. Food Consumption Patterns: Findings from the Malaysian Adult Nutrition Survey (MANS).

    PubMed

    Norimah, A K; Safiah, M; Jamal, K; Haslinda, Siti; Zuhaida, H; Rohida, S; Fatimah, S; Norazlin, Siti; Poh, B K; Kandiah, M; Zalilah, M S; Wan Manan, W M; Fatimah, S; Azmi, M Y

    2008-03-01

    This study reports the food consumption patterns of adults aged 18 to 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. A total of 6,742 subjects comprising 3,274 men and 3,468 women representing the northern, central , southern and east coast of Peninsular Malaysia as well as Sabah and Sarawak were interviewed. A semiquantitative food frequency questionnaire (FFQ) which consisted of 126 food items was used to evaluate the food consumption pattern (habitual food intake) of the respondents during the previous one- year period. The results demonstrate that nasi putih (cooked rice) was consumed by 97% of the population twice daily (average 2½ plates per day). Other food items consumed daily were marine fish, (one medium fish per day), green leafy vegetables (one cup per day) and sweetened condensed milk (three teaspoons per day. The mean frequencies for daily intake of rice, leafy vegetables, marine fish, local kuih, anchovy (ikan bilis) and biscuits were significantly higher among the rural compared to the urban adults. In contrast, more urban dwellers consumed chicken and eggs more frequently than their rural counterparts. More men than women consumed chicken and eggs more frequently. Malaysian adults showed a satisfactory habit of drinking plain water, with 99% drinking at least six glasses of plain water daily. Other beverages such as tea (47%), coffee (28%), chocolate-based drinks (23%) and cordial syrup (11%) were also consumed on daily basis, however, in a smaller proportion of the population. There were differences in the prevalence of daily consumption of foods when comparing urban and rural population, and also between men and women. The prevalence of daily consumption of marine fish among rural and urban adults was 51% and 34% respectively. For sweetened condensed milk, men and women consumed 43% and 28% respectively; however, more women drank full cream milk than men. Between the age groups, 21

  18. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health care...

  19. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health care...

  20. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health care...

  1. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Adult day health care... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care requirements. As a condition for receiving a grant and grant funds under this part for an adult day health care...

  2. 77 FR 43229 - Food and Nutrition Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National... AGENCY: Food and Nutrition Service, USDA. ACTION: Notice. SUMMARY: This notice announces the annual... Namian, Section Head, Policy and Program Development Branch, Child Nutrition Division, Food and Nutrition...

  3. Language use affects food behaviours and food values among Mexican-origin adults in the USA.

    PubMed

    Langellier, Brent A; Brookmeyer, Ron; Wang, May C; Glik, Deborah

    2015-02-01

    Previous studies have established that acculturation is associated with dietary intake among Mexican immigrants and their offspring, but few studies have investigated whether food purchasing, food preparation or food-related values act as mechanisms of dietary acculturation. We examine the relationship between language use and a wide range of food behaviours and food-related values among Mexican-American adults. Nationally representative probability sample of the US population. 2005-2010 National Health and Nutrition Examination Survey. Mexican-American adults (n 2792) at least 20 years of age. Mexican Americans who speak only or mostly English consume more energy from fast-food and sit-down restaurants and report increased consumption of non-homemade meals, fast-food and pizza meals, frozen meals and ready-to-eat meals relative to Spanish speakers. English speakers prepare one fewer homemade dinner per week and spend less time on meal preparation. English speakers are more likely than Spanish speakers to cite convenience as an important reason why they prefer fast food over cooking at home. There is no relationship between language use and the perceived importance of the nutritional quality, price or taste of fast food. Our results provide evidence that the well-documented relationship between acculturation and diet among Mexican Americans may be just one indicator of a broader pattern characterized by decreased home meal preparation and increased reliance on convenience foods.

  4. Caring for adults with thalassemia in a pediatric world.

    PubMed

    Compagno, Laurice M

    2005-01-01

    Improved technology and medical advances have increased the life span for patients with thalassemia. Therefore, serious consideration must now be given to adult issues such as fertility, employment opportunities, medical insurance, and long-term coping with chronic illness. Since thalassemia is a childhood illness, most adults are seen in pediatric hospitals-often, in centers with a specialty for thalassemia. Compared to a decade ago, many more patients in thalassemia centers are adolescents or older. Unfortunately, pediatric hospitals are not fully equipped to meet the changing and complex needs of adults. Emergency room care, hospital admissions, decentralized care, comprehensive care, and psychosocial issues are current challenges that must be addressed. In this study, six adult patients were asked to keep track of their care for one month to further examine self-care for thalassemia, a high-maintenance disease. From a qualitative perspective, the issues and challenges that adults face are examined and solutions for improved care are discussed.

  5. Young Adults' Health Care Utilization and Expenditures Prior to the Affordable Care Act

    PubMed Central

    Lau, Josephine S.; Adams, Sally H.; Boscardin, W. John; Irwin, Charles E.

    2014-01-01

    Purpose Examine young adults' health care utilization and expenditures prior to the ACA. Methods We used 2009 Medical Expenditure Panel Survey (MEPS) to 1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and 2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other socio-demographic factors, including race/ethnicity and income. Results Young adults had: 1) significantly lower rates of overall utilization (72%) than other age groups (83-88%, P<.001) and 2), the lowest rate of office-based utilization (55% vs. 67-77%, P<.001) and higher rate of ER visits compared to adolescents (15% v. 12%, P<.01). Uninsured young adults had high out-of-pocket expenses. Compared to the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/ person, P<.001), but essentially the same out-of-pocket expenses ($403 vs. $380/person, p =.57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language and sex. Conclusions Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of ER visits. The ACA provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address non-insurance barriers and ensure equal access to health services. PMID:24702839

  6. Mindful eating reduces impulsive food choice in adolescents and adults.

    PubMed

    Hendrickson, Kelsie L; Rasmussen, Erin B

    2017-03-01

    The present study tested the extent to which age and obesity predicted impulsive choices for food and monetary outcomes and tested how a brief mindful-eating training would alter delay discounting for food and money choices compared with control groups. First, 172 adolescents (M age = 13.13 years) and 176 (M age = 23.33 years) adults completed the Food Choice Questionnaire (FCQ) and Monetary Choice Questionnaire (MCQ) as measures of food and money delay discounting, respectively. Then, participants returned to the lab and were randomly assigned to complete a brief mindful-eating training, watch a DVD on nutrition, or serve as a control. Participants completed the FCQ and MCQ again as a postmanipulation measure. Participants with high percent body fat (PBF) were more impulsive for food than those with low PBF. Adults with high PBF were also more impulsive for money compared with adults with low PBF; no PBF-related differences were found for adolescents. Participants in the mindful-eating group exhibited more self-controlled choices for food, but not for money. The control conditions did not exhibit changes. The study suggests that individuals with high PBF make more impulsive food choices relative to those with low PBF, which could increase the risk of obesity over time. It also is the first to demonstrate shifts in choice patterns for food and money using a brief mindful-eating training with adolescents. Mindful eating is a beneficial strategy to reduce impulsive food choice, at least temporarily, that may impede weight gain. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. How Television Fast Food Marketing Aimed at Children Compares with Adult Advertisements

    PubMed Central

    Bernhardt, Amy M.; Wilking, Cara; Adachi-Mejia, Anna M.; Bergamini, Elaina; Marijnissen, Jill; Sargent, James D.

    2013-01-01

    Objectives Quick service restaurant (QSR) television advertisements for children’s meals were compared with adult advertisements from the same companies to assess whether self-regulatory pledges for food advertisements to children had been implemented. Methods All nationally televised advertisements for the top 25 US QSR restaurants from July 1, 2009 to June 30, 2010 were obtained and viewed to identify those advertising meals for children and these advertisements were compared with adult advertisements from the same companies. Content coding included visual and audio assessment of branding, toy premiums, movie tie-ins, and depictions of food. For image size comparisons, the diagonal length of the advertisement was compared with the diagonal length of salient food and drink images. Results Almost all of the 92 QSR children’s meal advertisements that aired during the study period were attributable to McDonald’s (70%) or Burger King (29%); 79% of 25,000 television placements aired on just four channels (Cartoon Network, Nickelodeon, Disney XD, and Nicktoons). Visual branding was more common in children’s advertisements vs. adult advertisements, with food packaging present in 88% vs. 23%, and street view of the QSR restaurant present in 41% vs. 12%. Toy premiums or giveaways were present in 69% vs. 1%, and movie tie-ins present in 55% vs. 14% of children’s vs. adult advertisements. Median food image diagonal length was 20% of the advertisement diagonal for children’s and 45% for adult advertisements. The audio script for children’s advertisements emphasized giveaways and movie tie-ins whereas adult advertisements emphasized food taste, price and portion size. Conclusions Children’s QSR advertisements emphasized toy giveaways and movie tie-ins rather than food products. Self-regulatory pledges to focus on actual food products instead of toy premiums were not supported by this analysis. PMID:24015250

  8. How television fast food marketing aimed at children compares with adult advertisements.

    PubMed

    Bernhardt, Amy M; Wilking, Cara; Adachi-Mejia, Anna M; Bergamini, Elaina; Marijnissen, Jill; Sargent, James D

    2013-01-01

    Quick service restaurant (QSR) television advertisements for children's meals were compared with adult advertisements from the same companies to assess whether self-regulatory pledges for food advertisements to children had been implemented. All nationally televised advertisements for the top 25 US QSR restaurants from July 1, 2009 to June 30, 2010 were obtained and viewed to identify those advertising meals for children and these advertisements were compared with adult advertisements from the same companies. Content coding included visual and audio assessment of branding, toy premiums, movie tie-ins, and depictions of food. For image size comparisons, the diagonal length of the advertisement was compared with the diagonal length of salient food and drink images. Almost all of the 92 QSR children's meal advertisements that aired during the study period were attributable to McDonald's (70%) or Burger King (29%); 79% of 25,000 television placements aired on just four channels (Cartoon Network, Nickelodeon, Disney XD, and Nicktoons). Visual branding was more common in children's advertisements vs. adult advertisements, with food packaging present in 88% vs. 23%, and street view of the QSR restaurant present in 41% vs. 12%. Toy premiums or giveaways were present in 69% vs. 1%, and movie tie-ins present in 55% vs. 14% of children's vs. adult advertisements. Median food image diagonal length was 20% of the advertisement diagonal for children's and 45% for adult advertisements. The audio script for children's advertisements emphasized giveaways and movie tie-ins whereas adult advertisements emphasized food taste, price and portion size. Children's QSR advertisements emphasized toy giveaways and movie tie-ins rather than food products. Self-regulatory pledges to focus on actual food products instead of toy premiums were not supported by this analysis.

  9. Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: food and nutrition programs for community-residing older adults.

    PubMed

    Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

    2010-01-01

    Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services. Copyright 2010 The American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  10. Self-perceived met and unmet care needs of frail older adults in primary care.

    PubMed

    Hoogendijk, Emiel O; Muntinga, Maaike E; van Leeuwen, Karen M; van der Horst, Henriëtte E; Deeg, Dorly J H; Frijters, Dinnus H M; Hermsen, Lotte A H; Jansen, Aaltje P D; Nijpels, Giel; van Hout, Hein P J

    2014-01-01

    In order to provide adequate care for frail older adults in primary care it is essential to have insight into their care needs. Our aim was to describe the met and unmet care needs as perceived by frail older adults using a multi-dimensional needs assessment, and to explore their associations with socio-demographic and health-related characteristics. Cross-sectional baseline data were used from the Frail older Adults: Care in Transition (ACT) study in the Netherlands, consisting of 1137 community dwelling frail older adults aged 65 and above. Patients were recruited through 35 primary care practices. Self-perceived care needs were assessed using the Camberwell Assessment of Need for the Elderly (CANE). Socio-demographic characteristics included age, sex, partner status and educational level. Health-related characteristics included functional capacity, hospital admissions, chronic diseases and the degree of frailty. Frail older adults reported on average 4.2 care needs out of 13 CANE topics, of which 0.5 were unmet. The physical and environmental domain constituted the highest number of needs, but these were mostly met. Unmet needs were mainly found in the psychosocial domain. Regression analyses revealed that Activities of Daily Living (ADL) limitations and a higher frailty score were the most important determinants of both met and unmet care needs. A younger age and a higher educational level were associated with the presence of unmet care needs. In conclusion, most frail older adults in primary care report to receive sufficient help for their physical needs. More attention should be paid to their psychosocial needs. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Food provision for older people receiving home care from the perspectives of home-care workers.

    PubMed

    Watkinson-Powell, Anna; Barnes, Sarah; Lovatt, Melanie; Wasielewska, Anna; Drummond, Barbara

    2014-09-01

    Malnutrition is a significant cause of morbidity and mortality, particularly among older people. Attention has focused on the inadequacies of food provision in institutions, yet the majority suffering from malnutrition live in the community. The aim of this study was to explore barriers and facilitators to food provision for older people receiving home care. It was a qualitative exploratory study using semi-structured interviews with nine home-care workers in June 2013 employed by independent agencies in a large city in northern England. Data were analysed thematically, based on the principles of grounded theory. Findings showed that significant time pressures limited home-care workers in their ability to socially engage with service users at mealtimes, or provide them with anything other than ready meals. Enabling choice was considered more important than providing a healthy diet, but choice was limited by food availability and reliance on families for shopping. Despite their knowledge of service users and their central role in providing food, home-care workers received little nutritional training and were not involved by healthcare professionals in the management of malnutrition. Despite the rhetoric of individual choice and importance of social engagement and nutrition for health and well-being, nutritional care has been significantly compromised by cuts to social care budgets. The potential role for home-care workers in promoting good nutrition in older people is undervalued and undermined by the lack of recognition, training and time dedicated to food-related care. This has led to a situation whereby good quality food and enjoyable mealtimes are denied to many older people on the basis that they are unaffordable luxuries rather than an integral component of fundamental care. © 2014 John Wiley & Sons Ltd.

  12. Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

    PubMed

    Tanner, Amanda E; Philbin, Morgan M; Ma, Alice; Chambers, Brittany D; Nichols, Sharon; Lee, Sonia; Fortenberry, J Dennis

    2017-10-01

    The HIV Care Continuum highlights the need for HIV-infected youth to be tested, linked, and maintained in lifelong care. Care engagement is important for HIV-infected youth in order for them to stay healthy, maintain a low viral load, and reduce further transmission. One point of potential interruption in the care continuum is during health care transition from adolescent- to adult-centered HIV care. HIV-related health care transition research focuses mainly on youth and on adolescent clinic providers; missing is adult clinic providers' perspectives. We examined health care transition processes through semi-structured interviews with 28 adult clinic staff across Adolescent Trials Network sites. We also collected quantitative data related to clinical characteristics and transition-specific strategies. Overall, participants described health care transition as a "warm handoff" and a collaborative effort across adolescent and adult clinics. Emergent transition themes included adult clinical care culture (e.g., patient responsibility), strategies for connecting youth to adult care (e.g., adolescent clinic staff attending youth's first appointment at adult clinic), and approaches to evaluating transition outcomes (e.g., data sharing). Participants provided transition improvement recommendations (e.g., formalized protocols). Using evidence-based research and a quality improvement framework to inform comprehensive and streamlined transition protocols can help enhance the capacity of adult clinics to collaborate with adolescent clinics to provide coordinated and uninterrupted HIV-related care and to improve continuum of care outcomes. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

  13. Self-care in older adults with heart failure: an integrative review.

    PubMed

    Zavertnik, Jean Ellen

    2014-01-01

    The aims of this integrative review were to examine the evidence specific to self-care in older adults, 65 years or older, with heart failure and to indicate best nursing practice interventions for use in this population. Self-care is a complex set of activities involving self-care maintenance and self-care management. Age-related and psychosocial factors impact older patients' ability to engage effectively in self-care practices. Although self-care processes are the focus of the investigation, few studies provide implications specific for the older adult population. Limited research on heart failure self-care in the older adult meets the age criterion of 65 years or older. A comprehensive search of the literature was performed using Medline, CINAHL, and the Cochrane Library, as well as an ancestry approach of reference lists of selected studies. Eligible studies were randomized controlled trial, qualitative, quantitative, and mixed-method design studies on older adults with heart failure related to self-care for the years 2002-2012. Three themes of self-care were noted in the selected studies: patient-related factors, patient education, and telemonitoring. The patient-related factors identified were barriers to self-care such as age-related symptoms, cognitive factors, and social issues. The interventions promoting self-care were patient education (self-care knowledge) and telemonitoring (augmenting symptom recognition). Patient education tailored to older adults may be beneficial. Telemonitoring is an appropriate self-care enhancement tool for selected older adults. More emphasis needs to be placed on interventions to assist older adults with heart failure in symptom recognition and early notification of healthcare providers. As the population ages, a need for evidence-based care for older adults with heart failure is warranted. Heart failure self-care interventions do not address the special considerations of the older heart failure patient. To determine the

  14. Food safety self-reported behaviors and cognitions of young adults: results of a national study.

    PubMed

    Byrd-Bredbenner, Carol; Maurer, Jaclyn; Wheatley, Virginia; Schaffner, Donald; Bruhn, Christine; Blalock, Lydia

    2007-08-01

    With limited opportunities to learn safe food handling via observation, many young adults lack the knowledge needed to keep them safe from foodborne disease. It is important to reach young adults with food safety education because of their current and future roles as caregivers. With a nationwide online survey, the demographic characteristics, self-reported food handling and consumption behaviors, food safety beliefs, locus of control, self-efficacy, stage of change, and knowledge of young adults with education beyond high school (n = 4,343) were assessed. Young adults (mean age, 19.92 +/- 1.67 SD) who participated were mainly female, white, never married, and freshmen or sophomores. Participants correctly answered 60% of the knowledge questions and were most knowledgeable about groups at greatest risk for foodborne disease and least knowledgeable about common food sources of foodborne disease pathogens. They reported less than optimal levels of safe food handling practices. Young adults generally had a limited intake of foods that increase the risk of foodborne disease, positive food safety beliefs, an internal food safety locus of control, and confidence in their ability to handle food safely, and they were contemplating an improvement in, or preparing to improve, their food handling practices. Females significantly outperformed males on nearly all study measures. Future food safety educational efforts should focus on increasing knowledge and propelling young adults into the action stage of safe food handling, especially males. Efforts to improve knowledge and, ultimately, food safety behaviors are essential to safeguard the health of these young adults and enable them to fulfill the role of protecting the health of their future families.

  15. High Prevalence of Severe Food Insecurity and Malnutrition among HIV-Infected Adults in Senegal, West Africa

    PubMed Central

    Benzekri, Noelle A.; Sambou, Jacques; Diaw, Binetou; Sall, El Hadji Ibrahima; Sall, Fatima; Niang, Alassane; Ba, Selly; Ngom Guèye, Ndèye Fatou; Diallo, Mouhamadou Baïla; Hawes, Stephen E.; Seydi, Moussa; Gottlieb, Geoffrey S.

    2015-01-01

    Background Malnutrition and food insecurity are associated with increased mortality and poor clinical outcomes among people living with HIV/AIDS; however, the prevalence of malnutrition and food insecurity among people living with HIV/AIDS in Senegal, West Africa is unknown. The objective of this study was to determine the prevalence and severity of food insecurity and malnutrition among HIV-infected adults in Senegal, and to identify associations between food insecurity, malnutrition, and HIV outcomes. Methods We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review. Results One hundred and nine HIV-1 and/or HIV-2 participants were enrolled. The prevalence of food insecurity was 84.6% in Dakar and 89.5% in Ziguinchor. The prevalence of severe food insecurity was 59.6% in Dakar and 75.4% in Ziguinchor. The prevalence of malnutrition (BMI <18.5) was 19.2% in Dakar and 26.3% in Ziguinchor. Severe food insecurity was associated with missing clinic appointments (p = 0.01) and not taking antiretroviral therapy due to hunger (p = 0.02). Malnutrition was associated with lower CD4 cell counts (p = 0.01). Conclusions Severe food insecurity and malnutrition are highly prevalent among HIV-infected adults in both Dakar and Ziguinchor, and are associated with poor HIV outcomes. Our findings warrant further studies to determine the root causes of malnutrition and food insecurity in Senegal, and the short- and long-term impacts of malnutrition and food insecurity on HIV care. Urgent interventions are needed to address the unacceptably high rates of malnutrition and food insecurity in this population. PMID:26529509

  16. Kansas Adult Care Home Aide Curriculum. Revised.

    ERIC Educational Resources Information Center

    Fornelli, Linda K.; Bartel, Myrna J.

    This curriculum guide is designed for use by instructors whose responsibility it is to prepare persons to provide basic direct care for residents living in adult care homes. Addressed in the individual units of part I (which contains information to be covered in the first 40 hours of training) are the following topics: working in an adult care…

  17. Comparison of nutrient intake in adolescents and adults with and without food allergies.

    PubMed

    Maslin, K; Venter, C; MacKenzie, H; Vlieg-Boerstra, B; Dean, T; Sommer, I

    2018-04-01

    Exclusion diets for the management of food allergy pose a risk of nutritional deficiencies and inadequate growth in children, yet less is known about their effect in adolescents and adults. The present study aimed to compare the dietary intake of adolescents and adults with food allergies with that of a control group. A food allergic and a control group were recruited from Portsmouth and the Isle of Wight in the UK. Participants were recruited from a food allergy charity, allergy clinics, a local school and university, and previous research studies. Macro and micronutrient intake data were obtained using a 4-day estimated food diary. Sociodemographic and anthropometric data was collected via a constructed questionnaire. This cross-sectional study included 81 adolescents (48 food allergic and 33 controls) aged 11-18 years and 70 adults aged 19-65 years (23 food allergic and 47 controls). Overall, 19 (22.8%) adolescents and 19 (27.1%) adults took dietary supplements, with no difference according to food allergic status. Adolescents with food allergy had higher intakes of niacin and selenium than adolescents without (P < 0.05). This difference persisted when dietary supplements were removed from the analysis. Adults with food allergies had higher intakes of folate and zinc than those without (P < 0.05); however, this difference did not persist when dietary supplements were removed from the analysis. Across all participants, the intake of several micronutrients was suboptimal. There was no difference in protein or energy intake, or body mass index, according to food allergic status. The dietary intake of food allergic participants was broadly similar and, in some cases, better than that of control participants. However, suboptimal intakes of several micronutrients were observed across all participants, suggesting poor food choices. © 2017 The British Dietetic Association Ltd.

  18. Association of food environment and food retailers with obesity in US adults.

    PubMed

    Yan, Renfei; Bastian, Nathaniel D; Griffin, Paul M

    2015-05-01

    The food environment has been shown to be a factor affecting the obesity rate. We studied the association of density of food retailer type with obesity rate in U.S. adults in local regions controlling for socioeconomic factors. Parametric nonlinear regression was used on publically available data (year=2009) at the county level. We used the results of this association to estimate the impact of the addition of a new food retailer type in a geographic region. Obesity rate increased in supercenters (0.25-0.28%) and convenience stores (0.05%) and decreased in grocery stores (0.08%) and specialized food stores (0.27-0.36%). The marginal measures estimated in this work could be useful in identifying regions where interventions based on food retailer type would be most effective. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Language use affects food behaviours and food values among Mexican-origin adults in the USA

    PubMed Central

    Langellier, Brent A; Brookmeyer, Ron; Wang, May C; Glik, Deborah

    2015-01-01

    Objectives Previous studies have established that acculturation is associated with dietary intake among Mexican immigrants and their offspring, but few studies have investigated whether food purchasing, food preparation, or food-related values act as mechanisms of dietary acculturation. We examine the relationship between language use and a wide range of food behaviors and food-related values among Mexican American adults. Design Nationally-representative probability sample of the U.S. population. Setting 2005–2010 National Health and Nutrition Examination Survey. Subjects 2,792 Mexican American adults at least 20 years of age. Results Mexican Americans who speak only or mostly English consume more energy from fast food and sit-down restaurants and report increased consumption of non-homemade meals, fast food and pizza meals, frozen meals, and ready-to-eat meals relative to Spanish speakers. English speakers prepare one fewer homemade dinner per week and spend less time on meal preparation. English speakers are more likely than Spanish speakers to cite convenience as an important reason why they prefer fast food over cooking at home. There is no relationship between language use and the perceived importance of the nutritional quality, price, or taste of fast food. Conclusions Our results provide evidence that the well-documented relationship between acculturation and diet among Mexican Americans may be just one indicator of a broader pattern characterized by decreased home meal preparation and increased reliance on convenience foods. PMID:24698136

  20. Development and evaluation of a university campus-based food safety media campaign for young adults.

    PubMed

    Abbot, Jaclyn Maurer; Policastro, Peggy; Bruhn, Christine; Schaffner, Donald W; Byrd-Bredbenner, Carol

    2012-06-01

    Food safety information campaigns are more likely to be most effective if the messages are tailored to the needs of a specific audience. Designing effective campaigns involves careful study of the target population and working with them using a community-based participatory research model. Thus, the development of the campaign materials for a university campus-based food safety media campaign for young adults followed intense efforts of working with the target audience to gather the baseline data needed to characterize this audience, to identify the most salient messages for college students, and to create materials and events that would resonate with them. This campaign was implemented and evaluated on eight university campuses in the United States. The results indicate that the campaign significantly increased self-ratings of food safety knowledge and skill, actual food safety knowledge, food safety self-efficacy, stage of change for safe food handling, and reported hand washing behaviors of a geographically and racially diverse group of college students. The positive study outcomes support the value of engaging in these research and development efforts and reflect the usefulness of the audience-specific materials and activities developed for the campaign. The findings also demonstrate the versatility and utility of the materials on different campuses. Developing health media campaigns specifically for unique populations is key to ensuring health messages reach the target audience and, even more importantly, appeal to them. The detailed overview of the development of a food safety media campaign aimed at young adults presented in this article illustrates how health professionals can work with their target population to develop a focused, effective health promotion campaign.

  1. Residents' choice of and control over food in care homes.

    PubMed

    Winterburn, Susan

    2009-04-01

    This study aimed to map food pathways in care homes to identify how residents exercised choice and control over their food intake and any associated or influencing factors. Four homes were visited, interviews were conducted with chefs and nursing staff and the dining facilities were noted. It was found that residents were dependent on the care home for the provision of food. There was almost no direct contact between residents and external food retailers. A food map was constructed, which identified three routes for potential improvements in practice: supply and delivery of food; serving of food; and consumption of food. Residents' choice and control over food could be improved through the design of new products for serving and consumption of food and eating aids, access to local food retailers and nutritional training.

  2. Care of adults with developmental disabilities: Effects of a continuing education course for primary care providers.

    PubMed

    Balogh, Robert; Wood, Jessica; Lunsky, Yona; Isaacs, Barry; Ouellette-Kuntz, Hélène; Sullivan, William

    2015-07-01

    To evaluate the effects of an interdisciplinary, guideline-based continuing education course on measures related to the care of adults with developmental disabilities (DD). Before-and-after study with a control group. Ontario. Forty-seven primary care providers (physicians, registered nurses, and nurse practitioners). Participants either only received reference material about primary care of people with DD (control group) or participated in a continuing education course on primary care of people with DD in addition to receiving the reference material (intervention group). Participants reported on 5 key measures related to care of adults with DD: frequency of using guidelines, frequency of performing periodic health examinations, frequency of assessing patients who present with behaviour changes, level of comfort while caring for adults with DD, and knowledge of primary care related to adults with DD. Over time, the intervention group showed significant increases in 4 of the 5 key measures of care compared with the control group: the frequency of guideline use (P < .001), frequency of assessment of patients' behaviour change (P = .03), comfort level in caring for people with DD (P = .01), and knowledge of primary care related to adults with DD (P = .01). A continuing education course on primary care of adults with DD is a useful interdisciplinary model to train health professionals who provide primary care services to these patients.

  3. Prevalence of self-reported food allergy in U.S. adults: 2001, 2006, and 2010

    PubMed Central

    Bruns, Richard; Luccioli, Stefano

    2015-01-01

    Background: Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. Objective: To report the prevalence of srFA and compare differences at three time points over a decade. Methods: We analyzed srFA and reported physician-diagnosed food allergy in >4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. Results: SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p < 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50–59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. Conclusions: Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group. PMID:26453524

  4. Prevalence of self-reported food allergy in U.S. adults: 2001, 2006, and 2010.

    PubMed

    Verrill, Linda; Bruns, Richard; Luccioli, Stefano

    2015-01-01

    Epidemiologic evidence indicates that food allergies are increasing in the population. Information on a change in self-reported food allergy (srFA) in adults over time is lacking. To report the prevalence of srFA and compare differences at three time points over a decade. We analyzed srFA and reported physician-diagnosed food allergy in >4000 U.S. adults who participated in the 2010 U.S. Food and Drug Administration Food Safety Survey. Information on causative food(s), reaction severity characteristics, and various diagnostic factors was also analyzed. We compared 2010 Food Safety Survey data with 2006 and 2001 data, and highlighted relevant differences. SrFA prevalence increased significantly, to 13% in 2010 and 14.9% in 2006 compared with 9.1% in 2001 (p < 0.001). Physician diagnosed food allergy was 6.5% in 2010, which was not significantly different compared with 7.6% in 2006 and 5.3% in 2001. SrFA increased in both men and women, non-Hispanic white and black adults, 50-59 year olds, and in adults with a high school or lower education. In 2010, milk, shellfish, and fruits were the most commonly reported food allergens, similar to 2001. Also, in 2010, 15% of reactions reportedly required a hospital visit and 8.4% were treated with epinephrine. Minor differences in reaction severity characteristics were noted among the surveys. Analysis of survey results indicates that the prevalence of srFA increased among U.S. adults from 2001 to 2010 and that adults are increasingly self-reporting FAs without obtaining medical diagnosis. Improved education about food allergies is needed for this risk group.

  5. Familism and Health Care Provision to Hispanic Older Adults.

    PubMed

    Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

    2016-01-01

    The Hispanic older adult population's rapid growth calls for an awareness of values that can affect the rendering and receipt of care. Familism, or familismo, a traditional Hispanic value, places importance of family over the self and can potentially affect health care perceptions and practices for Hispanic older adults. The current article discusses familism, which is upheld by some Hispanic older adults, and the potential for underuse of health care services. The traditional feminine role, marianismo, and masculine role, machismo, are considered, as well as implications for how decision making may be made by family members rather than the patient. Clinical implications for the provision of health care to Hispanic older adults are provided, along with the importance of considering acculturation and ethnic heterogeneity. Health care management strategies that reflect recognition and respect of familism, yet emphasize optimization of adherence and self-care, are described. Copyright 2016, SLACK Incorporated.

  6. Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

    PubMed

    Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

    2017-10-01

    Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

  7. Diabetes care and mental illness: the social organization of food in a residential care facility.

    PubMed

    Lowndes, Ruth H; Angus, Jan E; Peter, Elizabeth

    2013-06-21

    To explore the social organization of food provision and dietary intake in seriously mentally ill people with diabetes who reside in a for-profit group home. Institutional ethnography was used to explore diabetes-related care practices among 26 women in a rural residential care facility in southern Ontario. Semi-structured, in-depth interviews were conducted with residents with diabetes, care providers, field workers, and health professionals. Observations and document analysis were also used to understand the lack of congruence between diabetes guidelines and the possibilities for diabetes management within the confines of group home care. Although it was mandated in group home guidelines that "Health Canada's Eating Well with Canada's Food Guide" (2007) be followed, menus were planned within the context of a limited food budget of approximately $1.91 per day per resident. Group home policies regulated systems of safety, reporting, and financial accountability, but not health promotion. Inspections carried out by the Public Health Department focused primarily on food safety during handling, preparation, and storage, and compliance to regulations regarding environmental cleanliness and infection control. Resource rationing found in group home care exacerbates illness in an already marginalized group. Financial support is required to enable provision of healthy food choices, including dairy products, fresh fruits, and vegetables. Additional support is required for care of co-morbid conditions such as diabetes for associated food costs and education to improve outcomes. Group home policies must take into consideration health threats to this population and give primacy to health promotion and illness prevention.

  8. Young adults: beloved by food and drink marketers and forgotten by public health?

    PubMed

    Freeman, Becky; Kelly, Bridget; Vandevijvere, Stefanie; Baur, Louise

    2016-12-01

    Young adults are a highly desirable target population for energy-dense, nutrient-poor (EDNP) food and beverage marketing. But little research, resources, advocacy and policy action have been directed at this age group, despite the fact that young adults are gaining weight faster than previous generations and other population groups. Factors such as identity development and shifting interpersonal influences differentiate young adulthood from other life stages and influence the adoption of both healthy and unhealthy eating behaviours. EDNP food and beverage marketing campaigns use techniques to normalize brands within young adult culture, in particular through online social media. Young adults must be a priority population in future obesity prevention efforts. Stronger policies to protect young adults from EDNP food and beverage marketing may also increase the effectiveness of policies that are meant to protect younger children. Restrictions on EDNP food and beverage marketing should be extended to include Internet-based advertising and also aim to protect vulnerable young adults. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Food Shopping Venues, Neighborhood Food Environment, and Body Mass Index Among Guyanese, Black, and White Adults in an Urban Community in the US.

    PubMed

    Hosler, Akiko S; Michaels, Isaac H; Buckenmeyer, Erin M

    2016-06-01

    To investigate relationships among food shopping venues, food environment, and body mass index (BMI). Cross-sectional survey data and directly assessed food environment data were linked at the neighborhood level. Schenectady, NY. A sample of Guyanese, black, and white adults (n = 226, 485, and 908, respectively). BMI. Linear regression models were constructed with 10 food shopping venues and neighborhood food environment as explanatory variables, controlling for sociodemographics, dietary behavior, physical activity, and perception of healthy food access. On average, respondents used 3.5 different food shopping venues. Supermarkets and ethnic markets were associated with a lower BMI in Guyanese adults. Among black adults, farmers' markets were associated with a lower BMI, whereas supermarkets, wholesale clubs, and food pantries were associated with a higher BMI. Among white adults, food coops and supermarkets were associated with a lower BMI and wholesale clubs were associated with a higher BMI. Neighborhoods with less a favorable food environment (longer travel distance to a supermarket) were associated with a lower BMI in Guyanese adults. Both primary (ie, supermarkets) and secondary food shopping venues could be independent determinants of BMI. The observed variations by race and ethnicity provided insights into a culturally tailored approach to address obesity. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  10. The association between socioeconomic status and adult fast-food consumption in the U.S.

    PubMed

    Zagorsky, Jay L; Smith, Patricia K

    2017-11-01

    Health follows a socioeconomic status (SES) gradient in developed countries, with disease prevalence falling as SES rises. This pattern is partially attributed to differences in nutritional intake, with the poor eating the least healthy diets. This paper examines whether there is an SES gradient in one specific aspect of nutrition: fast-food consumption. Fast food is generally high in calories and low in nutrients. We use data from the 2008, 2010, and 2012 waves of the National Longitudinal Survey of Youth (NLSY79) to test whether adult fast-food consumption in the United States falls as monetary resources rise (n=8136). This research uses more recent data than previous fast-food studies and includes a comprehensive measure of wealth in addition to income to measure SES. We find little evidence of a gradient in adult fast-food consumption with respect to wealth. While adults in the highest quintile are 54.5% less likely to report fast-food consumption than those in the lowest quintile, adults in the second and third quintiles are no less likely to report fast food-food intake than the poorest. Contrary to popular belief, fast-food consumption rises as income rises from the lowest to middle quintiles. The variation in adult fast-food consumption across income and wealth groups is, however, small. Those in the wealthiest quintile ate about one less fast-food meal on average than those in the lowest quintile. Other factors play a bigger role in explaining fast-food consumption: reading ingredient labels is negatively associated while soda consumption and hours of work are positively associated with fast-food consumption. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Barriers to Care Among Transgender and Gender Nonconforming Adults.

    PubMed

    Gonzales, Gilbert; Henning-Smith, Carrie

    2017-12-01

    Policy Points: Transgender and gender nonconforming (GNC) adults may experience barriers to care for a variety of reasons, including discrimination and lack of awareness by providers in health care settings. In our analysis of a large, population-based sample, we found transgender and GNC adults were more likely to be uninsured and have unmet health care needs, and were less likely to have routine care, compared to cisgender (nontransgender) women. Our findings varied by gender identity. More research is needed on transgender and GNC populations, including on how public policy and provider awareness affects health care access and health outcomes differentially by gender identity. Very little population-based research has examined health and access to care among transgender populations. This study compared barriers to care between cisgender, transgender, and gender nonconforming (GNC) adults using data from a large, multistate sample. We used data from the 2014-2015 Behavioral Risk Factor Surveillance System to estimate the prevalence of having no health insurance, unmet medical care needs due to cost, no routine checkup, and no usual source of care for cisgender women (n = 183,370), cisgender men (n = 131,080), transgender women (n = 724), transgender men (n = 449), and GNC adults (n = 270). Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for each barrier to care while adjusting for sociodemographic characteristics. Transgender and GNC adults were more likely to be nonwhite, sexual minority, and socioeconomically disadvantaged compared to cisgender adults. After controlling for sociodemographic characteristics, transgender women were more likely to have no health insurance (OR = 1.60; 95% CI = 1.07-2.40) compared to cisgender women; transgender men were more likely to have no health insurance (OR = 2.02; 95% CI = 1.25-3.25) and no usual source of care (OR = 1.84; 95% CI = 1.18-2.88); and GNC

  12. Epidemiological investigation of a food-borne gastroenteritis outbreak caused by Norwalk-like virus in 30 day-care centres.

    PubMed

    Götz, Hannelore; de Jong, Birgitta; Lindbäck, Johan; Parment, Per Arne; Hedlund, Kjell Olof; Torvén, Maria; Ekdahl, Karl

    2002-01-01

    In March 1999, an outbreak of gastroenteritis occurred affecting 30 day-care centres served by the same caterer. A retrospective cohort study was performed in 13 randomly selected day-care centres to determine the source and mode of transmission. Electron microscopy and PCR were used to verify the diagnosis. The overall attack rate (AR) was 37% (195/524): 30% in children and 62% in adults. Modified by the age of the patient, eating pumpkin salad served on 1 March was associated with becoming an early case (odds ratio = 3.9; 95% confidence interval 1.8-8.8). No significant association was found between food consumption and becoming a late case. The primary food-borne AR was 27% and the secondary AR was 14%. The same genotype of Norwalk-like virus was found in 5 cases and in 1 ill and 1 asymptomatic food-handler. Contamination by 1 of the food-handlers seems the most likely route of spread of the virus and underlines the importance of strict hygienic routines.

  13. Staff awareness of food and fluid care needs for older people with dementia in residential care: A qualitative study.

    PubMed

    Lea, Emma J; Goldberg, Lynette R; Price, Andrea D; Tierney, Laura T; McInerney, Fran

    2017-12-01

    To examine awareness of aged care home staff regarding daily food and fluid care needs of older people with dementia. Older people in residential care frequently are malnourished, and many have dementia. Staff knowledge of the food and fluid needs of people with dementia is limited. Qualitative research on this topic is scarce but can provide insight into how nutrition and hydration care may be improved. Qualitative, interview-based study. Eleven staff in a range of positions at one care home were interviewed regarding their perceptions of current and potential food/fluid care practices. Transcripts were coded and analysed thematically. Key food and fluid issues reported by these staff members were weight loss and malnutrition, chewing and swallowing difficulties (dysphagia), and inadequate hydration. Staff identified a number of current care practices that they felt to be effective in facilitating older people's food and fluid intake, including responsiveness to their needs. Staff suggestions to facilitate food and fluid intake centred on improved composition and timing of meals, enhanced physical and social eating environment, and increased hydration opportunities. Staff commented on factors that may prevent changes to care practices, particularly the part-time workforce, and proposed changes to overcome such barriers. Staff were aware of key food and fluid issues experienced by the older people in their care and of a range of beneficial care practices, but lacked knowledge of many promising care practices and/or how to implement such practices. Staff need to be supported to build on their existing knowledge around effective food and fluid care practices. The numerous ideas staff expressed for changing care practices can be leveraged by facilitating staff networking to work and learn together to implement evidence-based change. © 2017 John Wiley & Sons Ltd.

  14. Mitigating Nutrition and Health Deficiencies in Older Adults: A Role for Food Innovation?

    PubMed

    Baugreet, Sephora; Hamill, Ruth M; Kerry, Joseph P; McCarthy, Sinéad N

    2017-04-01

    The aim of this review is to describe the factors contributing to diminished food intake, resulting in nutritional deficiencies and associated health conditions in older adults and proposes food innovation strategies to mitigate these. Research has provided convincing evidence of a link between healthy eating patterns and healthy aging. There is a need to target new food product development (NPD) with functional health benefits specifically designed to address the particular food-related needs of older consumers. When developing foods for older adults, consideration should be given to the increased requirements for specific macro- and micronutrients, especially protein, calcium, vitamin D, and vitamin B. Changes in chemosensory acuity, chewing difficulties, and reduced or poor swallowing ability should also be considered. To compensate for the diminished appetite and reduced intake, foods should be energy dense, nutritionally adequate, and, most importantly, palatable, when targeting this cohort. This paper describes the potential of new food product development to facilitate dietary modification and address health deficiencies in older adults. © 2017 Institute of Food Technologists®.

  15. Lead exposure and increased food allergic sensitization in U.S. children and adults.

    PubMed

    Mener, David J; Garcia-Esquinas, Esther; Navas-Acien, Ana; Dietert, Rodney R; Shargorodsky, Josef; Lin, Sandra Y

    2015-03-01

    Whether blood lead levels are associated with sensitization to food allergens in adults and children is unclear. Prior studies have shown that exposure to lead is associated with atopic sensitization and modulation of several cytokines (eg, interleukin [IL]-12, IL-10, interferon [IFN]-γ, and IL-4 production) and with T-cell dysregulation and bias toward T helper 2 (Th2) activity. The objective of this work was to assess whether exposure to lead is independently associated with allergic symptoms and sensitizations in a large nationally representative sample of children and adults. We studied 2712 children and 4333 adults enrolled in the 2005-2006 cycle of the National Health and Nutritional Examination Surveys (NHANES). Participants were tested for serum-specific immunoglobulin E (IgE) levels to food allergens as well as blood lead levels. Food allergens tested included shrimp, egg, peanut, and milk. Logistic regression models adjusted for demographic factors, body mass index, history of asthma, smoking, housing characteristics, and current exposure to animals in the home, to assess the association of blood lead levels with sensitization to food allergens. Median (interquartile range [IQR]) for serum blood was 0.87 μg/L (0.61 to 1.31) in children and 1.48 μg/L (0.92 to 2.34) in adults. At baseline, 672 (24.7%) of children participants and 719 (16.6%) of adult participants tested positive for increased sensitization to food allergens. A 2-fold increase in blood lead levels in adult participants was associated with increased sensitization to food allergens (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02 to 1.22). Blood lead was not associated with sensitization to food allergens among pediatric participants (OR, 0.95; 95% CI, 0.82 to 1.10). Exposure to lead was associated with increased odds of sensitization to food allergens in adult but not children participants. © 2014 ARS-AAOA, LLC.

  16. Survivorship Care for Older Adults with Cancer: U13 Conference Report

    PubMed Central

    Guerard, Emily J.; Nightingale, Ginah; Bellizzi, Keith; Burhenn, Peggy; Rosko, Ashley; Artz, Andrew S.; Korc-Grodzicki, Beatriz; Canin, Beverly; Dale, William; Ferrell, Betty

    2016-01-01

    Older adult cancer survivors currently account for almost 60% of all cancer survivors. The number of older cancer survivors will continue to increase as the population ages and as patients’ live longer after a cancer diagnosis. As part of cancer center accreditation, the American College of Surgeons Commission on Cancer® (CoC) has placed great importance on survivorship care planning. While the CoC has set standards for general survivorship care, there is sparse evidence on how to best care for older adult cancer survivors. Concern exists among the medical community that survivorship care plans could increase paperwork without improving outcomes. Given the diverse and unique needs of older adult cancer survivors, the inter-professional team provides a structure and process for survivorship care built around the particular needs of older adults. The Cancer and Aging Research Group (CARG), in partnership with the NIA/NCI, held a U13 conference in May 2015 in part to discuss survivorship care for older adults with cancer. This report discusses four themes that emerged from one section of the conference: (1) survivorship care is a process that continually evolves to meet the needs of older adults; (2) older adult cancer survivors have unique needs and care plans should be tailored to meet these needs; (3) the inter-professional team is ideally suited to structure survivorship care of older adults; (4) patient advocacy must be encouraged throughout the cancer care continuum. As evidence based survivorship practices develop, the unique needs of older adults need to be given substantial attention. PMID:27424802

  17. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  18. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  19. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  20. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  1. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  2. Functional limitation and chronic diseases are associated with food insecurity among U.S. adults.

    PubMed

    Venci, Brittany J; Lee, Seung-Yeon

    2018-03-01

    This study examined associations of functional limitation due to any health problems and six chronic diseases (arthritis, diabetes, coronary heart disease, heart attack, hypertension, and stroke) with food security among U.S. adults. The 2011 National Health Interview Survey data for 30,010 adults (≥18 years) were used. Adults were categorized into food secure, low food secure, or very low food secure. Multivariable logistic regressions were used to estimate adjusted odds ratio (OR) and 95% confidence interval (CI) for having functional limitation and chronic diseases while adjusting for sociodemographic and lifestyle factors. The prevalence of functional limitation and the chronic diseases were higher in low-food-secure and very low-food-secure than food-secure adults. The adjusted ORs were significant in both low food secure and very low food secure, respectively, for functional limitation (OR: 1.87; 95% CI: 1.63, 2.14), (OR: 2.20; 95% CI: 1.91, 2.52), inflammatory diseases or joint/muscular pain (OR: 1.42; 95% CI: 1.21, 1.68), (OR: 1.74; 95% CI: 1.49, 2.04), diabetes (OR: 1.26; 95% CI: 1.06, 1.51), (OR: 1.23; 95% CI: 1.02, 1.48), and hypertension (OR: 1.18; 95% CI: 1.04, 1.35), (OR: 1.42; 95% CI: 1.22, 1.65) when compared with food-secure adults. Findings indicate that food insecurity is associated with functional limitation and chronic diseases, whereas directionality is unknown. Besides the traditional food assistance program for food-insecure populations, interventions to prevent or manage chronic diseases may be necessary to help them reduce the risk of the diseases and manage their conditions. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Social Care in Adult Education: Resisting a Marketplace Agenda

    ERIC Educational Resources Information Center

    Taber, Nancy

    2011-01-01

    This article describes a research study about the experiences of adult educators in which the stories of three of the participants were central in exploring the issue of social care in adult education. It proposes that the adult educators with a social care orientation in this study acknowledge the importance of, and work to provide for, human…

  4. Associates of Engagement in Adult-Oriented Follow-Up Care for Childhood Cancer Survivors.

    PubMed

    Szalda, Dava; Piece, Lisa; Brumley, Lauren; Li, Yimei; Schapira, Marilyn M; Wasik, Monika; Hobbie, Wendy L; Ginsberg, Jill P; Schwartz, Lisa A

    2017-02-01

    Understanding how to predict appropriate uptake of adult-oriented medical care is important for adult patients with pediatric-onset chronic health conditions with continued health vulnerability. We examined associates of engagement in adult survivors of childhood cancer following transfer to adult-oriented care. Adult survivors of childhood cancer (N = 80), within 1-5 years post transfer from pediatric to adult-oriented follow-up care, completed assessments of engagement with recommended adult-oriented follow-up care and psychosocial and transition readiness measures. Measures were validated with adolescent and young adults and/or intended to measure readiness to transition to adult care. Earlier age at diagnosis, parental involvement in health care decision-making, higher motivation, and increased comfort speaking to providers about health concerns were significantly associated with attendance at adult-oriented follow-up care visits. Associates of engagement in adult care are complex, representing social-ecological variables. Current measures of transition readiness or adolescent and young adult health-related measures may not adequately capture the associates of engagement in care or identify targets of intervention to promote successful transfer of care. Identifying patients at risk for loss to follow-up will be useful to design interventions for young adult survivors of childhood cancer and other young adults with pediatric-onset chronic conditions who require ongoing adult-oriented care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Food security is related to adult type 2 diabetes control over time in a United States safety net primary care clinic population.

    PubMed

    Shalowitz, M U; Eng, J S; McKinney, C O; Krohn, J; Lapin, B; Wang, C-H; Nodine, E

    2017-05-15

    Successful Type 2 diabetes management requires adopting a high nutrient-density diet made up of food items that both meet dietary needs and preferences and can be feasibly obtained on a regular basis. However, access to affordable, nutrient-dense foods often is lacking in poorer neighbourhoods. Therefore, low food security should directly impair glucose control, even when patients have full access to and utilize comprehensive medical management. The present study sought to determine whether food security is related longitudinally to glucose control, over-and-above ongoing medication management, among Type 2 diabetes patients receiving comprehensive care at a Midwestern multi-site federally qualified health centre (FQHC). In this longitudinal observational study, we completed a baseline assessment of patients' food security (using the US Household Food Security Module), demographics (via Census items), and diabetes history/management (using a structured clinical encounter form) when patients began receiving diabetes care at the health centre. We then recorded those patients' A1C levels several times during a 24-month follow-up period. Three hundred and ninety-nine patients (56% with low food security) had a baseline A1c measurement; a subsample of 336 (median age=52 years; 56% female; 60% Hispanic, 27% African American, and 9% White) also had at least one follow-up A1c measurement. Patients with lower (vs higher) food security were more likely to be on insulin and have higher A1c levels at baseline. Moreover, the disparity in glucose control by food security status persisted throughout the next 2 years. Although results were based on one multi-site FQHC, potentially limiting their generalizability, they seem to suggest that among Type 2 diabetes patients, low food security directly impairs glucose control-even when patients receive full access to comprehensive medical management-thereby increasing their long-term risks of high morbidity, early mortality, and high

  6. Meeting the Hearing Health Care Needs of the Oldest Older Adult.

    PubMed

    Weinstein, Barbara E

    2015-06-01

    The purpose of this article is to provide an overview of the auditory needs of and approaches to management of the oldest older adult. This article is an overview of principles of geriatric care and implications of untreated hearing loss for function, management, and care of the oldest older adult. Person-centered care is at the heart of health care delivery to the oldest older adult, who typically suffers from multimorbidity. Given the high prevalence of moderate to severe hearing loss in this cohort and the functional limitations of untreated hearing loss, audiologists must become proactive in educating stakeholders on the importance of identifying and referring the oldest older adult for management of hearing health care needs. Audiologists have an integral role to play in collaborating with health care professionals in optimizing health care for the oldest older adult.

  7. Orchestrating care: nursing practice with hospitalised older adults.

    PubMed

    Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

    2015-12-01

    The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

  8. Staff Food-Related Behaviors and Children's Tastes of Food Groups during Lunch at Child Care in Oklahoma.

    PubMed

    Anundson, Katherine; Sisson, Susan B; Anderson, Michael; Horm, Diane; Soto, Jill; Hoffman, Leah

    2017-10-04

    Young children should consume a variety of nutrient-dense foods to support growth, while limiting added fat and sugar. A majority of children between the ages of 3 and 5 years attend child care in the United States, which makes this environment and the child-care staff influential at meals. The aim was to determine the association between best-practice food-related behaviors and young children's tastes of fruit, vegetable, low-fat dairy, and high-fat/high-sugar foods at child care. This was a cross-sectional study. A community-based study with 201 children ages 3 to 5 years from 25 early care and education centers, including 11 tribally affiliated centers and two Head Start programs across Oklahoma. Data collection occurred from fall 2011 to spring 2014. Classroom observations used the Environmental Policy Assessment Observation tool to measure the staff behaviors and environment. Staff behavior was compared at three different levels: the composite score of staff nutrition behavior, each constituent staff behavior, and staff behaviors grouped into broader feeding behaviors. Tasted food was measured through the Dietary Observation in Child Care method. The children's meals were categorized into the following food groups: fruit, vegetable, low-fat dairy, fried vegetable, fried meat, high-fat meat, and high-fat/high-sugar food. Descriptive statistics were calculated for relevant variables. Relationships between the constituent staff behaviors and food groups that children tasted were compared using multilevel mixed-model analysis. The mean number of tasted fruit or vegetable items was higher and the mean number of tasted high-fat/high-sugar food items was lower when staff: 1) determined fullness before plate removal when less than half of food was eaten, 2) ate with the children, 3) and talked about healthy food. The utilization of the three staff behaviors and their association with higher mean tastes of nutrient-dense items and lower mean tastes of high

  9. Evaluation of a Cooperative Extension Curriculum in Florida: Food Modification for Special Needs

    ERIC Educational Resources Information Center

    Dahl, Wendy J.; Ford, Amanda L.; Radford, Allyson; Gal, Nancy J.

    2016-01-01

    State and national surveys of adult family care homes identified a strong need for education on texture-modified food preparation and the nutritional needs of older adults. An Extension curriculum, Food Modification for Special Needs, was developed to provide an overview of chewing and swallowing problems, food texture, pureed food preparation,…

  10. Transitioning young adults from paediatric to adult care and the HIV care continuum in Atlanta, Georgia, USA: a retrospective cohort study.

    PubMed

    Hussen, Sophia A; Chakraborty, Rana; Knezevic, Andrea; Camacho-Gonzalez, Andres; Huang, Eugene; Stephenson, Rob; Del Rio, Carlos

    2017-09-01

    The transition from paediatric to adult HIV care is a particularly high-risk time for disengagement among young adults; however, empirical data are lacking. We reviewed medical records of 72 youth seen in both the paediatric and the adult clinics of the Grady Infectious Disease Program in Atlanta, Georgia, USA, from 2004 to 2014. We abstracted clinical data on linkage, retention and virologic suppression from the last two years in the paediatric clinic through the first two years in the adult clinic. Of patients with at least one visit scheduled in adult clinic, 97% were eventually seen by an adult provider (median time between last paediatric and first adult clinic visit = 10 months, interquartile range 2-18 months). Half of the patients were enrolled in paediatric care immediately prior to transition, while the other half experienced a gap in paediatric care and re-enrolled in the clinic as adults. A total of 89% of patients were retained (at least two visits at least three months apart) in the first year and 56% in the second year after transition. Patients who were seen in adult clinic within three months of their last paediatric visit were more likely to be virologically suppressed after transition than those who took longer (Relative risk (RR): 1.76; 95% confidence interval (CI): 1.07-2.9; p  = 0.03). Patients with virologic suppression (HIV-1 RNA below the level of detection of the assay) at the last paediatric visit were also more likely to be suppressed at the most recent adult visit (RR: 2.3; 95% CI: 1.34-3.9; p  = 0.002). Retention rates once in adult care, though high initially, declined significantly by the second year after transition. Pre-transition viral suppression and shorter linkage time between paediatric and adult clinic were associated with better outcomes post-transition. Optimizing transition will require intensive transition support for patients who are not virologically controlled, as well as support for youth beyond the first year

  11. Food Avoidance and Food Modification Practices of Older Rural Adults: Association with Oral Health Status and Implications for Service Provision

    ERIC Educational Resources Information Center

    Quandt, Sara A.; Chen, Haiying; Bell, Ronny A.; Savoca, Margaret R.; Anderson, Andrea M.; Leng, Xiaoyan; Kohrman, Teresa; Gilbert, Gregg H.; Arcury, Thomas A.

    2010-01-01

    Purpose: Dietary variation is important for health maintenance and disease prevention among older adults. However, oral health deficits impair ability to bite and chew foods. This study examines the association between oral health and foods avoided or modified in a multiethnic rural population of older adults. It considers implications for…

  12. Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults.

    PubMed

    Herbert, Linda J; Dahlquist, Lynnda M

    2008-12-01

    This study examined autonomy, anxiety, depression, and perceptions of parental behavior in 86 food allergic young adults and 344 healthy young adults between the ages of 18 and 22. Participants completed an online survey measuring self-reported autonomy, anxiety, depression, and perceptions of parental behavior. Results indicated that, as a group, food allergic young adults did not differ from healthy peers. However, food allergic young adults who reported having experienced an anaphylactic reaction described their disease as more severe, reported more worry about their disease, and rated their parents as more overprotective than food allergic young adults who reported never having experienced anaphylaxis. The experience of anaphylaxis may be a reliable indicator of food allergic individuals who are at risk for psychological distress.

  13. Food safety knowledge and practices of young adults.

    PubMed

    Green, Eric J; Knechtges, Paul L

    2015-06-01

    The objective of the study described in this article was to ascertain the food safety knowledge and practices of undergraduate students attending a major American university. The study participants were undergraduate college students (mean age 18.9 +/- 1.14 SD) enrolled in a required health course. The students were invited to take a validated food safety knowledge questionnaire as part of a health risk behavior online survey. The 786 respondents indicated their food is most often prepared at on-campus dining facilities and the majority of the students (72%) felt they were "unlikely or "very unlikely" at risk of foodborne disease. The mean food safety knowledge score of the participants was 10.23 (43%) +/- 4.13 SD (25%-60%), indicating the study population overall has poor knowledge of safe food practices. As a result, food safety educational initiatives and awareness campaigns should be developed to better inform young adults about safe food handling practices and habits.

  14. Systematic literature review of the effects of food and drink advertising on food and drink-related behaviour, attitudes and beliefs in adult populations.

    PubMed

    Mills, S D H; Tanner, L M; Adams, J

    2013-04-01

    A large body of research confirms that food advertising affects the food preferences and behaviour of children. The impact of food advertising on adults is less clear. We conducted a systematic review exploring the effects of advertising of food and non-alcoholic drinks (referred to as 'food' throughout) on food-related behaviour, attitudes and beliefs in adult populations. We searched seven electronic databases, grey literature sources, and references and citations of included material for experimental studies written in English investigating the effects of commercial food advertising on the food-related behaviours, attitudes and beliefs of adults aged 16 years and over. Nine studies, rated moderate to poor quality, were included in the review; all were from developed countries and explored the impact of televised food advertising. Overall, the results did not show conclusively whether or not food advertising affects food-related behaviour, attitudes or beliefs in adults, but suggest that the impact varies inconsistently within subgroups, including gender, weight and existing food psychology. The identification of a small number of relevant studies, none of which were high quality, and with substantial heterogeneity, highlights the need for further research. Future studies investigating longer term outcomes, diverse advertising formats, and in countries with different levels of economic development will be of particular value. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  15. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How do I apply for Adult Care Assistance? 20.333 Section... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for Adult Care Assistance? To apply for adult care assistance, you or someone acting on your behalf must...

  16. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false How do I apply for Adult Care Assistance? 20.333 Section... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for Adult Care Assistance? To apply for adult care assistance, you or someone acting on your behalf must...

  17. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true How do I apply for Adult Care Assistance? 20.333 Section... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for Adult Care Assistance? To apply for adult care assistance, you or someone acting on your behalf must...

  18. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false How do I apply for Adult Care Assistance? 20.333 Section... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for Adult Care Assistance? To apply for adult care assistance, you or someone acting on your behalf must...

  19. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false How do I apply for Adult Care Assistance? 20.333 Section... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for Adult Care Assistance? To apply for adult care assistance, you or someone acting on your behalf must...

  20. Food Insecurity and Food Choices in Rural Older Adults with Diabetes Receiving Nutrition Education via Telemedicine

    ERIC Educational Resources Information Center

    Homenko, Daria R.; Morin, Philip C.; Eimicke, Joseph P.; Teresi, Jeanne A.; Weinstock, Ruth S.

    2010-01-01

    Objective: To evaluate differences between rural older adults with diabetes reporting the presence or absence of food insecurity with respect to meal planning, preparation, shopping, obesity, and glycemic control after receiving nutrition counseling through telemedicine. Methods: Food insecurity data were obtained by telephone survey (n = 74).…

  1. Primary Care Providers' HIV Prevention Practices Among Older Adults

    PubMed Central

    Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika

    2016-01-01

    Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425

  2. Transitioning HIV-infected youth into adult health care.

    PubMed

    2013-07-01

    With advances in antiretroviral therapy, most HIV-infected children survive into adulthood. Optimal health care for these youth includes a formal plan for the transition of care from primary and/or subspecialty pediatric/adolescent/family medicine health care providers (medical home) to adult health care provider(s). Successful transition involves the early engagement and participation of the youth and his or her family with the pediatric medical home and adult health care teams in developing a formal plan. Referring providers should have a written policy for the transfer of HIV-infected youth to adult care, which will guide in the development of an individualized plan for each youth. The plan should be introduced to the youth in early adolescence and modified as the youth approaches transition. Assessment of developmental milestones is important to define the readiness of the youth in assuming responsibility for his or her own care before initiating the transfer. Communication among all providers is essential and should include both personal contact and a written medical summary. Progress toward the transition should be tracked and,once completed, should be documented and assessed.

  3. Perceptions of the food marketing environment among African American teen girls and adults.

    PubMed

    Bibeau, Wendy S; Saksvig, Brit I; Gittelsohn, Joel; Williams, Sonja; Jones, Lindsey; Young, Deborah Rohm

    2012-02-01

    Obesity disproportionately affects African American adolescents, particularly girls. While ethnically targeted marketing of unhealthful food products contributes to this disparity, it is not known how African Americans perceive the food marketing environment in their communities. Qualitative methods, specifically photovoice and group discussions, were used to understand perceptions of African American adults and teen girls regarding targeted food marketing to adolescent girls. An advisory committee of four students, two faculty, and two parents was formed, who recruited peers to photograph their environments and participate in group discussions to answer "what influences teen girls to eat what they do." Seven adults and nine teens (all female) participated in the study. Discussions were transcribed, coded, and analyzed with ATLAS.ti to identify common and disparate themes among participants. Results indicated that adults and teens perceived the type of food products, availability of foods, and price to influence the girls' choices. The girls spoke about products that were highly convenient and tasty as being particularly attractive. The adults reported that advertisements and insufficient nutrition education were also influencers. The teens discussed that the places in which food products were available influenced their choices. Results suggest that the marketing of highly available, convenient food at low prices sell products to teen girls. Future work is needed to better understand the consumer's perspective on the food and beverage marketing strategies used. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. The Chinese family-centered care survey for adult intensive care unit: A psychometric study.

    PubMed

    Wang, Wen-Ling; Feng, Jui-Ying; Wang, Chi-Jen; Chen, Jing-Huei

    2016-02-01

    This study aimed to develop a family-centered care survey for Chinese adult intensive care units and to establish the survey's psychometric properties. Family-centered care (FCC) is widely recognized as an ideal model of care. Few studies have explored FCC perceptions among family members of adult critical care patients in Asian countries, and no Chinese FCC measurement has been developed. An English version of the 3-factor family-centered care survey for adult intensive care units (FCCS-AICU) was translated into Chinese using a modified back translation procedure. Based on the literature review, two additional concepts, information and empowerment, were added to the Chinese FCCS-AICU. The psychometric properties of the Chinese FCCS-AICU were determined with 249 family members from a medical center in Taiwan and were tested for construct and convergent validity, and internal consistency. Both the monolingual and bilingual equivalence tests of the English and Chinese versions of the 3-factor FCCS-AICU were supported. Exploratory factor analysis supported the 5-factor structure of the Chinese FCCS-AICU with a total explained variance of 58.34%. The Chinese FCCS-AICU was correlated with the Chinese Critical Care Family Needs Inventory. Internal consistency, determined by Cronbach's α, for the overall scale was .94. The Chinese FCCS-AICU is a valid and reliable tool for measuring perceptions of FCC by family members of adult intensive care patients within Chinese-speaking communities. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Adult day health care evaluation study: methodology and implementation. Adult Day Health Care Evaluation Development Group.

    PubMed Central

    Hedrick, S C; Rothman, M L; Chapko, M; Inui, T S; Kelly, J R; Ehreth, J

    1991-01-01

    The Adult Day Health Care Evaluation Study was developed in response to a congressional mandate to study the medical efficacy and cost effectiveness of the Adult Day Health Care (ADHC) effort in the Department of Veterans Affairs (VA). Four sites providing ADHC in VA facilities are participating in an ongoing randomized controlled trial. Three years of developmental work prior to the study addressed methodological issues that were problematic in previous studies. This developmental work resulted in the methodological approaches described here: (1) a patient recruitment process that actively recruits and screens all potential candidates using empirically developed admission criteria based on predictors of nursing home placement in VA; (2) the selection and development of measures of medical efficacy that assess a wide range of patient and caregiver outcomes with sufficient sensitivity to detect small but clinically important changes; and (3) methods for detailed, accurate, and efficient measurement of utilization and costs of health care within and outside VA. These approaches may be helpful to other researchers and may advance the methodological sophistication of long-term care program evaluation. PMID:1991678

  6. Restraint Use in Older Adults Receiving Home Care.

    PubMed

    Scheepmans, Kristien; Dierckx de Casterlé, Bernadette; Paquay, Louis; Van Gansbeke, Hendrik; Milisen, Koen

    2017-08-01

    To determine the prevalence, types, frequency, and duration of restraint use in older adults receiving home nursing care and to determine factors involved in the decision-making process for restraint use and application. Cross-sectional survey of restraint use in older adults receiving home care completed by primary care nurses. Homes of older adults receiving care from a home nursing organization in Belgium. Randomized sample of older adults receiving home care (N = 6,397; mean age 80.6; 66.8% female). For each participant, nurses completed an investigator-constructed and -validated questionnaire collecting information demographic, clinical, and behavioral characteristics and aspects of restraint use. A broad definition of restraint was used that includes a range of restrictive actions. Restraints were used in 24.7% of the participants, mostly on a daily basis (85%) and often for a long period (54.5%, 24 h/d). The most common reason for restraint use was safety (50.2%). Other reasons were that the individual wanted to remain at home longer, which necessitated the use of restraints (18.2%) and to provide respite for the informal caregiver (8.6%). The latter played an important role in the decision and application process. The physician was less involved in the process. In 64.5% of cases, there was no evaluation after restraint use was initiated. Use of restraints is common in older adults receiving home care nursing in Belgium. These results contribute to a better understanding of the complexity of use of restraints in home care, a situation that may be even more complex than in nursing homes and acute hospital settings. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  7. 7 CFR 226.21 - Food service management companies.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Food service management companies. 226.21 Section 226.21 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions...

  8. 7 CFR 226.21 - Food service management companies.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Food service management companies. 226.21 Section 226.21 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions...

  9. 7 CFR 226.21 - Food service management companies.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Food service management companies. 226.21 Section 226.21 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions...

  10. Young adult eating and food-purchasing patterns food store location and residential proximity.

    PubMed

    Laska, Melissa Nelson; Graham, Dan J; Moe, Stacey G; Van Riper, David

    2010-11-01

    Young adulthood is a critical age for weight gain, yet scant research has examined modifiable contextual influences on weight that could inform age-appropriate interventions. The aims of this research included describing where young adults eat and purchase food, including distance from home, and estimating the percentage of eating/purchasing locations contained within GIS-generated buffers traditionally used in research. Forty-eight participants (aged 18-23 years, n=27 women) represented diverse lifestyle groups. Participants logged characteristics of all eating/drinking occasions (including location) occurring over 7 days (n=1237) using PDAs. In addition, they recorded addresses for stores where they purchased food to bring home. Using GIS, estimates were made of distances between participants' homes and eating/purchasing locations. Data collection occurred in 2008-2009 and data analysis occurred in 2010. Among participants living independently or with family (n=36), 59.1% of eating occasions were at home. Away-from-home eating locations averaged 6.7 miles from home; food-shopping locations averaged 3.1 miles from home. Only 12% of away-from-home eating occasions fell within -mile residential buffers, versus 17% within 1 mile and 34% within 2 miles. In addition, 12%, 19%, and 58% of shopping trips fell within these buffers, respectively. Results were similar for participants residing in dormitories. Young adults often purchase and eat food outside of commonly used GIS-generated buffers around their homes. This suggests the need for a broader understanding of their food environments. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Ingredients for Success: Strategies to Support Local Food Use in Health Care Institutions.

    PubMed

    Linton, Emily; Keller, Heather; Duizer, Lisa

    2018-06-12

    There is growing interest in use of local food within health care institutions such as hospitals and long-term care homes. This study explored stakeholder perspectives on (i) influences on local food use and (ii) strategies that support success and sustainability of use in health care institutions. Fifteen participants who were institutional leaders with experience in implementing or supporting local food use in health care institutions in Ontario were recruited through purposeful and snowball sampling. A semi-structured interview was conducted by telephone and audio-recorded. Qualitative content analysis identified that influences on local food use were: product availability, staff and management engagement, and legislation and resources (e.g., funding, labour). Several strategies were offered for building and sustaining success including: setting goals, requesting local food availability from suppliers, and more clearly identifying local foods in product lists. The influences and potential strategies highlighted in this paper provide a greater understanding for dietitians and food service managers on how local foods can be incorporated into health care institutions.

  12. Nursing Students' Willingness to Care for Older Adults in Taiwan.

    PubMed

    Chi, Mei-Ju; Shyu, Meei-Ling; Wang, Shou-Yu; Chuang, Hsiu-Ching; Chuang, Yeu-Hui

    2016-03-01

    The possibilities that nurses will take care of persons 65 years of age or older in hospitals and communities are increasing due to a growing aged population. Nursing students should be prepared to face the challenges of their future practice. Therefore, factors associated with nursing students' willingness to care for older adults need to be identified. This study aimed to explore Taiwanese nursing students' willingness to work with older persons and factors associated with this. A cross-sectional research design was used. Stratified sampling was applied to recruit participants from seven nursing schools in northern, central, southern, and eastern areas of Taiwan. There were 612 nursing students who successful completed the questionnaire including demographic data, the Attitudes Toward the Elderly Scale, and the Willingness Toward the Elderly Care Scale. Data were collected between November 2012 and January 2013. A stepwise regression analysis was conducted to identify predictors of nursing students' willingness to care for older adults. The mean score of nursing students' attitudes toward older people was 73.86 (SD = 8.9), with a range of 44-106. The mean score on the willingness to care for older adults was 55.01 (SD = 6.4), with a range of 36-75. The length of time with older adults per week (r = 0.12, p = .003) and grandparents having served as caregivers during the students' childhood (t = -2.147, β = .032) were both positively associated with the willingness to care for older adults. The best predictors of nursing students' willingness to care for older adults were students' attitudes toward older adults (β = 0.38, p < .001), paying attention to issues related to older adults (β = 0.24, p < .001), and having the experience of being a volunteer who served older people (β = 0.10, p = .005), which explained 26.8% of the total variance. Taiwanese undergraduate nursing students had neutral to slightly favorable attitudes toward working with older adults

  13. Young adult cancer survivors' follow-up care expectations of oncologists and primary care physicians.

    PubMed

    Hugh-Yeun, Kiara; Kumar, Divjot; Moghaddamjou, Ali; Ruan, Jenny Y; Cheung, Winson Y

    2017-06-01

    Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician's roles and responsibilities. A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations. Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient's most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001). Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults. Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can

  14. Older adults' influence in family care: how do daughters and aging parents navigate differences in care goals?

    PubMed

    Heid, Allison R; Zarit, Steven H; Van Haitsma, Kimberly

    2016-01-01

    This study seeks to address how older adults influence their daily care when their preferences conflict with those of their adult daughter caregivers. Using a sample of 10 dyads (N = 20) of an older adult and adult daughter, we utilize content analysis strategies to analyze in-depth, semi-structured interview data with QSR NVIVO to investigate how older adults influence their care, how daughters respond to such efforts of influence, and how dyads navigate differences in care goals. When there is agreement in goals, dyads report tasks going well and both individuals' requests are honored. When there are differences in care goals, daughters most frequently reason with their older parents, while parents walk away or 'let go' of their requests. Daughters report making decisions for their parents for health or safety-related needs. However, all dyads discuss differences in care goals, whereby parents are perceived as insisting, resisting, or persisting in care. Findings illustrate complex patterns of responses by families when navigating differences in daily care goals that carry important implications for research and the development of dyadic-based family interventions.

  15. Financial Care for Older Adults With Dementia.

    PubMed

    Pan, Xi; Lee, Yeonjung; Dye, Cheryl; Roley, Laurie Theriot

    2017-06-01

    This article describes an examination of the sociodemographic characteristics of adult children, particularly Baby Boomer caregivers, who provide financial care to older parents with dementia. The sample including 1,011adult children dementia caregivers aged 50 to 64 years is selected from a nationally representative sample in the 2010 Health and Retirement Study. Exact logistic regression revealed that race, provision of financial assistance to caregiver children, and the number of their children are significantly associated with financial caregiving of parents. Non-White caregivers are more likely to provide financial care to their parents or parents-in-law with dementia; those who have more children and provide financial assistance to their children are less likely to provide financial care to parents with dementia. The current findings present valuable new information on the sociodemographic characteristics of adult children who provide financial assistance to parents with dementia and inform research, programs, and services on dementia caregiving.

  16. Facilitating the transition of patients with special health care needs from pediatric to adult oral health care.

    PubMed

    Nowak, Arthur J; Casamassimo, Paul S; Slayton, Rebecca L

    2010-11-01

    Without guidelines or policies in dentistry for transitioning adolescents with special heath care needs from pediatric to adult oral health care, little is known about traditional support services. The authors surveyed pediatric dentists about their transition of adolescent patients with and without special health care needs (SHCNs) to adult care. In 2009, the authors e-mailed a pilot-tested survey modified from a survey used for U.S. pediatricians to 4,000 pediatric dentists. The survey included demographic questions and questions regarding services and barriers associated with the transition of patients to adult care. Responses were obtained from 1,686 (42.2 percent response) pediatric dentists who were mostly in group or solo private practices and were younger, in that most had completed their education in the preceding 15 years. More than one-half practiced in suburban settings, and most worked with both dental hygienists and dental assistants. Most assisted patients with SHCNs with their transitions to adult care, and the predominant barrier to transitioning to adult care was availability of general dentists and specialists who were willing to accept these new patients. Pediatric dentists' answers paralleled those of pediatricians for the most part in terms of services provided and barriers to transition. Most responding dentists helped adolescents with and without SHCNs make the transition into adult care, but the major barrier was the availability of general dentists and specialists. With an office protocol in place that includes trained staff members, transitioning patients (especially those with SHCNs) to adult care can be facilitated to provide the appropriate oral health and support services.

  17. You are what you choose to eat: factors influencing young adults' food selection behaviour.

    PubMed

    Hebden, L; Chan, H N; Louie, J C; Rangan, A; Allman-Farinelli, M

    2015-08-01

    Young or 'emerging' adulthood (ages 18-24 years) is a life-stage characterised by rapid weight gain, particularly among those born in recent decades, when environments have become saturated with cheap, highly palatable, processed foods. Although intervening in the immediate food environments of emerging adults is indicated, little is known about the factors influencing their food selection. The present study aimed to: (i) measure the relative importance of different influences on foods selected by emerging adults for consumption from a tertiary education setting and (ii) examine whether these influences differ according to gender, adiposity status, perceived stress and dieting or physical activity behaviours. An online survey was administered with 112 emerging adults aged 19-24 years assessing demographics, perceived stress, dieting, physical activity and influences on food selection. Adiposity indicators (body mass index and waist circumference) were measured. Analyses compared the importance of influences on food selection by gender, adiposity, perceived stress, dieting and physical activity. Taste was the most important influence on food selection, followed by convenience (availability), cost, nutrition/health value, smell and stimulatory properties (alertness). Participants with an elevated waist circumference selected foods to help them cope with stress and control their weight. Those reporting a higher level of physical activity placed greater importance on nutritional/health value of foods but less importance on taste. Female dieters also placed less importance on taste and value for money. Health promotion strategies addressing tertiary education food environments of emerging adults should ensure the ready availability of tasty and nutritious foods at a low cost. © 2015 The British Dietetic Association Ltd.

  18. Transitioning Adolescents and Young Adults With HIV Infection to Adult Care: Pilot Testing the "Movin' Out" Transitioning Protocol.

    PubMed

    Maturo, Donna; Powell, Alexis; Major-Wilson, Hannah; Sanchez, Kenia; De Santis, Joseph P; Friedman, Lawrence B

    2015-01-01

    Advances in care and treatment of adolescents/young adults with HIV infection have made survival into adulthood possible, requiring transition to adult care. Researchers have documented that the transition process is challenging for adolescents/young adults. To ensure successful transition, a formal transition protocol is needed. Despite existing research, little quantitative evaluation of the transition process has been conducted. The purpose of the study was to pilot test the "Movin' Out" Transitioning Protocol, a formalized protocol developed to assist transition to adult care. A retrospective medical/nursing record review was conducted with 38 clients enrolled in the "Movin' Out" Transitioning Protocol at a university-based adolescent medicine clinic providing care to adolescents/young adults with HIV infection. Almost half of the participants were able to successfully transition to adult care. Reasons for failure to transition included relocation, attrition, lost to follow-up, and transfer to another adult service. Failure to transition to adult care was not related to adherence issues, X(2) (1, N=38)=2.49, p=.288; substance use, X(2) (1, N=38)=1.71, p=.474; mental health issues, X(2) (1, N=38)=2.23, p=.322; or pregnancy/childrearing, X(2) (1, N=38)=0.00, p=.627). Despite the small sample size, the "Movin' Out" Transitioning Protocol appears to be useful in guiding the transition process of adolescents/young adults with HIV infection to adult care. More research is needed with a larger sample to fully evaluate the "Movin' Out" Transitioning Protocol. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Changes in Young Adult Primary Care Under the Affordable Care Act

    PubMed Central

    Ford, Carol A.; French, Benjamin; Rubin, David M.

    2015-01-01

    Objectives. We sought to describe changes in young adults’ routine care and usual sources of care (USCs), according to provider specialty, after implementation of extended dependent coverage under the Affordable Care Act (ACA) in 2010. Methods. We used Medical Expenditure Panel Survey data from 2006 to 2012 to examine young adults’ receipt of routine care in the preceding year, identification of a USC, and USC provider specialties (pediatrics, family medicine, internal medicine, and obstetrics and gynecology). Results. The percentage of young adults who sought routine care increased from 42.4% in 2006 to 49.5% in 2012 (P < .001). The percentage identifying a USC remained stable at approximately 60%. Among young adults with a USC, there was a trend between 2006 and 2012 toward increasing percentages with pediatric (7.6% vs 9.1%) and family medicine (75.9% vs 80.9%) providers and declining percentages with internal medicine (11.5% vs 7.6%) and obstetrics and gynecology (5.0% vs 2.5%) providers. Conclusions. Efforts under the ACA to increase health insurance coverage had favorable effects on young adults’ use of routine care. Monitoring routine care use and USC choices in this group can inform primary care workforce needs and graduate medical education priorities across specialties. PMID:26447914

  20. Optimizing health care for adults with spina bifida.

    PubMed

    Webb, Thomas S

    2010-01-01

    Survival into adulthood for individuals with spina bifida has significantly improved over the last 40 years with the majority of patients now living as adults. Despite this growing population of adult patients who have increased medical needs compared to the general population, including spina bifida (SB)-specific care, age-related secondary disabilities, and general adult medical needs, there is little published information about the natural history of SB in adulthood. There are few published studies of medical conditions, interventions, or long-term complications in this population. This article will provide a review of the medical issues of adults with SB, highlighting areas that are different than pediatric care, and areas of needed research.

  1. Parents Caring For Adult Children With Serious Mental Illness.

    PubMed

    Raymond, Kathryn Y; Willis, Danny G; Sullivan-Bolyai, Susan

    Parents often become the caregivers for their adult children with serious mental illness (SMI) due to the chronic and debilitating course of the illness and shortages in funding for community mental health services and residential placements. To examine parents' management styles when caring for adult children with SMI and parents' perspectives on what type of community-based mental health interventions would support and/or enhance overall family functioning. A qualitative descriptive study using semistructured interviews with parents caring for adult children with SMI. The study was undergirded by Knafl and Deatrick's Family Management Style Framework. Four major themes emerged from the data describing prolonged and difficult phases that parents and the family undergo in caring for an adult child with SMI. Successful management of these phases must include increasing access to mental health information, mental health screening, early interventions, and violence prevention for adult children and their families.

  2. 25 CFR 20.335 - What is the payment standard for Adult Care Assistance?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false What is the payment standard for Adult Care Assistance... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What is the payment standard for Adult Care Assistance? The approved payment for adult care assistance will...

  3. 25 CFR 20.335 - What is the payment standard for Adult Care Assistance?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is the payment standard for Adult Care Assistance... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What is the payment standard for Adult Care Assistance? The approved payment for adult care assistance will...

  4. 25 CFR 20.335 - What is the payment standard for Adult Care Assistance?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true What is the payment standard for Adult Care Assistance? 20... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What is the payment standard for Adult Care Assistance? The approved payment for adult care assistance will...

  5. 25 CFR 20.335 - What is the payment standard for Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is the payment standard for Adult Care Assistance... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What is the payment standard for Adult Care Assistance? The approved payment for adult care assistance will...

  6. 25 CFR 20.335 - What is the payment standard for Adult Care Assistance?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What is the payment standard for Adult Care Assistance... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What is the payment standard for Adult Care Assistance? The approved payment for adult care assistance will...

  7. Food security practice in Kansas schools and health care facilities.

    PubMed

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures.

  8. The emotional eating and negative food relationship experiences of obese and overweight adults.

    PubMed

    Ford, Tasha; Lee, HeeSoon; Jeon, MinJeong

    2017-07-01

    Overweight and obesity pose serious public health problems, affecting 68.8% of Americans. Previous research indicated that psychological factors played important roles in an individual's motivation to consume food. In particular, emotional eating, defined as overeating in response to negative affect, has received particular attention as a risk factor for obesity. This study explored and addressed the emotional factors involved in the development of emotional eating. A total of 10 Midwestern American male and female adults, previously diagnosed as medically overweight and obese, were recruited via online and print advertisement using maximum variation and snowball sampling methods. Using a semi-structured, face-to-face interview format, participants shared their perspectives about the development and persistence of emotional eating. The interviews were transcribed and Atlas.ti software was used to assist in thematic analysis of emotional eating. Study results yielded themes, such as emotional triggers, food cravings, comfort from foods, mindless eating, and childhood experiences. Findings indicated that participants generally lacked emotional self-care, but desired to decrease their emotional eating behaviors. Implications are discussed to construct creative, evidence-based treatments for the overweight and obese emotional eaters.

  9. Guidelines for the Productive Employment of Older Adults in Child Care.

    ERIC Educational Resources Information Center

    Newman, Sally M.; And Others

    This publication offers guidelines that policymakers, advocates of children and older adults, and child care practitioners can use to provide older adults with opportunities to work in the child care field. Guidelines that address developmental issues relating to older adults concern employers' sensitivity to older adults and staffing patterns in…

  10. Sodium intakes of US children and adults from foods and beverages by location of origin and by specific food source.

    PubMed

    Drewnowski, Adam; Rehm, Colin D

    2013-05-28

    Sodium intakes, from foods and beverages, of 22,852 persons in the National Health and Nutrition Examination Surveys (NHANES 2003-2008) were examined by specific food source and by food location of origin. Analyses were based on a single 24-h recall. Separate analyses were conducted for children (6-11 years of age), adolescents (12-19), and adults (20-50 and ≥51 years). Grouping of like foods (e.g., food sources) used a scheme proposed by the National Cancer Institute, which divides foods/beverages into 96 food subgroups (e.g., pizza, yeast breads or cold cuts). Food locations of origin were stores (e.g., grocery, convenience and specialty stores), quick-service restaurant/pizza (QSR), full-service restaurant (FSR), school, or other. Food locations of sodium were also evaluated by race/ethnicity amongst adults. Stores provided between 58.1% and 65.2% of dietary sodium, whereas QSR and FSR together provided between 18.9% and 31.8% depending on age. The proportion of sodium from QSR varied from 10.1% to 19.9%, whereas that from FSR varied from 3.4% to 13.3%. School meals provided 10.4% of sodium for 6-11 year olds and 6.0% for 12-19 year olds. Pizza from QSR, the top away from home food item, provided 5.4% of sodium in adolescents. QSR pizza, chicken, burgers and Mexican dishes combined provided 7.8% of total sodium in adult diets. Most sodium came from foods purchased in stores. Food manufacturers, restaurants, and grocery stores all have a role to play in reducing the amount of sodium in the American diet.

  11. Sodium Intakes of US Children and Adults from Foods and Beverages by Location of Origin and by Specific Food Source

    PubMed Central

    Drewnowski, Adam; Rehm, Colin D.

    2013-01-01

    Sodium intakes, from foods and beverages, of 22,852 persons in the National Health and Nutrition Examination Surveys (NHANES 2003–2008) were examined by specific food source and by food location of origin. Analyses were based on a single 24-h recall. Separate analyses were conducted for children (6–11 years of age), adolescents (12–19), and adults (20–50 and ≥51 years). Grouping of like foods (e.g., food sources) used a scheme proposed by the National Cancer Institute, which divides foods/beverages into 96 food subgroups (e.g., pizza, yeast breads or cold cuts). Food locations of origin were stores (e.g., grocery, convenience and specialty stores), quick-service restaurant/pizza (QSR), full-service restaurant (FSR), school, or other. Food locations of sodium were also evaluated by race/ethnicity amongst adults. Stores provided between 58.1% and 65.2% of dietary sodium, whereas QSR and FSR together provided between 18.9% and 31.8% depending on age. The proportion of sodium from QSR varied from 10.1% to 19.9%, whereas that from FSR varied from 3.4% to 13.3%. School meals provided 10.4% of sodium for 6–11 year olds and 6.0% for 12–19 year olds. Pizza from QSR, the top away from home food item, provided 5.4% of sodium in adolescents. QSR pizza, chicken, burgers and Mexican dishes combined provided 7.8% of total sodium in adult diets. Most sodium came from foods purchased in stores. Food manufacturers, restaurants, and grocery stores all have a role to play in reducing the amount of sodium in the American diet. PMID:23760055

  12. Assisting the Adult with a Respiratory Condition. Care of the Adult.

    ERIC Educational Resources Information Center

    Anoka-Hennepin Area Vocational Technical Inst., MN.

    These three units for students in a practical nursing program provide supplemental instruction in caring for adult patients with respiratory conditions. Unit titles are Introduction to Care of the Patient with a Respiratory Condition, Infectious Respiratory Conditions, and Chronic Lung Conditions. Each unit contains the following: objectives, an…

  13. Adult Patients' Experiences of Nursing Care Dependence.

    PubMed

    Piredda, Michela; Matarese, Maria; Mastroianni, Chiara; D'Angelo, Daniela; Hammer, Marilyn J; De Marinis, Maria Grazia

    2015-09-01

    Care dependence can be associated with suffering and humiliation. Nurses' awareness of patients' perception of care dependence is crucial to enable them in helping the dependent persons. This study aimed to describe adult patients' experience of nursing care dependence. A metasynthesis was conducted to integrate qualitative findings from 18 studies published through December 2014 on adult patients' experiences of care dependency. Procedures included the Johanna Briggs Institute approach for data extraction, quality appraisal, and integration of findings. The experience of dependence revealed the concept of the embodied person, particularly in relation to care of the physical body. The relationship between the individual and nurses within the context of care had a major impact for dependent patients. When the care relation was perceived as positive, the experience led to the development of the person in finding new balances in life, but when it was perceived as negative, it increased patient' suffering. Care dependence is manifested mostly as bodily dependence and is consistent with its relational nature. The nurse-patient relationship is important to the dependent patients' experience. A greater understanding of patients' experiences of dependence is crucial to enable nurses in improving care and decreasing patient suffering. © 2015 Sigma Theta Tau International.

  14. The food environment and adult obesity in US metropolitan areas.

    PubMed

    Michimi, Akihiko; Wimberly, Michael C

    2015-11-26

    This research examines the larger-scale associations between obesity and food environments in metropolitan areas in the United States (US). The US Census County Business Patterns dataset for 2011 was used to construct various indices of food environments for selected metropolitan areas. The numbers of employees engaged in supermarkets, convenience stores, full service restaurants, fast food restaurants, and snack/coffee shops were standardised using the location quotients, and factor analysis was used to produce two uncorrelated factors measuring food environments. Data on obesity were obtained from the 2011 Behavioral Risk Factor Surveillance System. Individual level obesity measures were linked to the metropolitan area level food environment factors. Models were fitted using generalised estimating equations to control for metropolitan area level intra-correlation and individual level sociodemographic characteristics. It was found that adults residing in cities with a large share of supermarket and full-service restaurant workers were less likely to be obese, while adults residing in cities with a large share of convenience store and fast food restaurant workers were more likely to be obese. Supermarkets and full-service restaurant workers are concentrated in the Northeast and West of the US, where obesity prevalence is relatively lower, while convenience stores and fast-food restaurant workers are concentrated in the South and Midwest, where obesity prevalence is relatively higher. The food environment landscapes measured at the metropolitan area level explain the continental-scale patterns of obesity prevalence. The types of food that are readily available and widely served may translate into obesity disparities across metropolitan areas.

  15. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors.

    PubMed

    Gonsalves, Nirmala; Yang, Guang-Yu; Doerfler, Bethany; Ritz, Sally; Ditto, Anne M; Hirano, Ikuo

    2012-06-01

    Adults with eosinophilic esophagitis (EoE) typically present with dysphagia and food impaction. A 6-food elimination diet (SFED) is effective in children with EoE. We assessed the effects of the SFED followed by food reintroduction on the histologic response, symptoms, and quality of life in adults with EoE. At the start of the study, 50 adults with EoE underwent esophagogastroduodenoscopies (EGDs), biopsies, and skin-prick tests for food and aeroallergens. After 6 weeks of SFED, patients underwent repeat EGD and biopsies. Histologic responders, defined by ≤ 5 eosinophils/high-power field (eos/hpf) (n = 32), underwent systematic reintroduction of foods followed by EGD and biopsies (n = 20). Symptom and quality of life scores were determined before and after SFED. Common symptoms of EoE included dysphagia (96%), food impaction (74%), and heartburn (94%). The mean peak eosinophil counts in the proximal esophagus were 34 eos/hpf and 8 eos/hpf, before and after the SFED, and 44 eos/hpf and 13 eos/hpf in the distal esophagus, respectively (P < .0001). After the SFED, 64% of patients had peak counts ≤ 5 eos/hpf and 70% had peak counts of ≤ 10 eos/hpf. Symptom scores decreased in 94% (P < .0001). After food reintroduction, esophageal eosinophil counts returned to pretreatment values (P < .0001). Based on reintroduction, the foods most frequently associated with EoE were wheat (60% of cases) and milk (50% of cases). Skin-prick testing predicted only 13% of foods associated with EoE. An elimination diet significantly improves symptoms and reduces endoscopic and histopathologic features of EoE in adults. Food reintroduction re-initiated features of EoE in patients, indicating a role for food allergens in its pathogenesis. Foods that activated EoE were identified by systematic reintroduction analysis but not by skin-prick tests. Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Food security in older adults: community service provider perceptions of their roles.

    PubMed

    Keller, Heather H; Dwyer, John J M; Edwards, Vicki; Senson, Christine; Gayle Edward, H

    2007-01-01

    Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food security, and (c) opinions about constraints that influenced these roles. A constant comparison analysis identified key themes. The formal caregivers reported six roles for improving food security: (a) monitoring, (b) coordination, and (c) promoting services, (d) education, (e) advocacy, and (f) providing a social environment. The final theme summarizes these roles as "the need for personalization of service". Social and community service providers are involved in roles that can promote the health of older adults by addressing their food insecurity. Social service providers need to be acknowledged and supported in this health promotion role.

  17. Food insecurity is associated with high risk glycemic control and higher health care utilization among youth and young adults with type 1 diabetes.

    PubMed

    Mendoza, Jason A; Haaland, Wren; D'Agostino, Ralph B; Martini, Lauren; Pihoker, Catherine; Frongillo, Edward A; Mayer-Davis, Elizabeth J; Liu, Lenna L; Dabelea, Dana; Lawrence, Jean M; Liese, Angela D

    2018-04-01

    Household food insecurity (FI), i.e., limited availability of nutritionally adequate foods, is associated with poor glycemic control among adults with type 2 diabetes. We evaluated the association of FI among youth and young adults (YYA) with type 1 diabetes to inform recent clinical recommendations from the American Diabetes Association for providers to screen all patients with diabetes for FI. Using data from the Washington and South Carolina SEARCH for Diabetes in Youth Study sites, we conducted an observational, cross-sectional evaluation of associations between FI and glycemic control, hospitalizations, and emergency department (ED) visits among YYA with type 1 diabetes. FI was assessed using the Household Food Security Survey Module, which queries conditions and behaviors typical of households unable to meet basic food needs. Participants' HbA 1c were measured from blood drawn at the research visit; socio-demographics and medical history were collected by survey. The prevalence of FI was 19.5%. In adjusted logistic regression analysis, YYAs from food-insecure households had 2.37 higher odds (95% CI: 1.10, 5.09) of high risk glycemic control, i.e., HbA 1c >9.0%, vs. peers from food-secure households. In adjusted binomial regression analysis for ED visits, YYAs from food-insecure households had an adjusted prevalence rate that was 2.95 times (95% CI [1.17, 7.45]) as great as those from food secure households. FI was associated with high risk glycemic control and more ED visits. Targeted efforts should be developed and tested to alleviate FI among YYA with type 1 diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Fast food restaurants and food stores: longitudinal associations with diet in young adults: The CARDIA Study

    PubMed Central

    Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I.; Shikany, James M.; Lewis, Cora E.; Popkin, Barry M.

    2011-01-01

    Background A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts – neighborhoods with little or no access to healthy foods – by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. Methods We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of U.S. young adults (n=5,115, 18–30 years at baseline), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from four examination periods (n=15,854 person-exam observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and meeting fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within 1 kilometer (km), 1–2.9km, 3–4.9km, and 5–8km of respondents’ homes. Models were sex-stratified, controlled for individual sociodemographics and neighborhood poverty, and tested for interaction by individual-level income. Results Fast food consumption was related to fast food availability in low-income respondents, particularly within 1–2.9km of homes among men [coefficient (95% CI) up to: 0.34 (0.16, 0.51)]. Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake and relationships between grocery store availability and diet outcomes were mixed. Conclusions Our findings provide some evidence for zoning restrictions on fast food restaurants within 3km of low-income residents, but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change. PMID:21747011

  19. Health care resource utilization in adults with congenital heart disease.

    PubMed

    Mackie, Andrew S; Pilote, Louise; Ionescu-Ittu, Raluca; Rahme, Elham; Marelli, Ariane J

    2007-03-15

    The number of adults with congenital heart disease (CHD) is increasing. However, rates of health care resource utilization in this population are unknown. The objectives of this study were to describe the use of general health care resources in adults with CHD and to examine the impact of CHD severity on resource utilization. The study consisted of adults alive in 1996 who had > or = 1 diagnosis of a CHD lesion conforming to the International Classification of Disease, Ninth Revision, in the physician's claims database of the province of Quebec from 1983 to 2000. From 1996 to 2000, rates of health care utilization were measured. The impact of the severity of CHD on the use of health care resources was determined using multivariate models to adjust for age, gender, Charlson co-morbidity score, and duration of follow-up. The study population consisted of 22,096 adults with CHD (42% men). From 1996 to 2000, 87% received outpatient care from specialists, 68% visited emergency rooms, 51% were hospitalized, and 16% were admitted to critical care units. Patients with severe CHD had higher adjusted rates of outpatient cardiologist care (rate ratio [RR] 2.24, 95% confidence interval [CI] 2.06 to 2.45), emergency department utilization (RR 1.09, 95% CI 1.03 to 1.17), hospitalization (RR 1.30, 95% CI 1.19 to 1.43), and days in critical care (RR 2.12, 95% CI 1.80 to 2.50) than patients with other congenital cardiac lesions. Hospitalization rates were higher than in the general Quebec adult population (RR 2.08, 95% CI 2.00 to 2.17). In conclusion, adults with CHD have high rates of health care resource utilization, particularly those with severe lesions. Appropriate resource allocation is required to serve this growing population.

  20. Fast food consumption in Iranian adults; dietary intake and cardiovascular risk factors: Tehran Lipid and Glucose Study.

    PubMed

    Bahadoran, Zahra; Mirmiran, Parvin; Golzarand, Mahdieh; Hosseini-Esfahani, Firoozeh; Azizi, Fereidoun

    2012-06-01

    Although fast food consumption has drastically increased in Iran in recent years; there is a paucity of data in relation to the association between fast food consumption, dietary intake, and cardiovascular risk factors. This study aims to determine fast food consumption status among young and middle-aged Iranian adults, and to assess its impact on dietary intake and cardiovascular disease (CVD) risk factors. This cross-sectional population-based study was conducted on 1944 young and middle-aged adults (840 men and 1104 women), who participated in the Tehran Lipid and Glucose Study (2006-2008). We collected dietary data by using a validated 168 item, semi-quantitative food frequency questionnaire. Total fast food consumption was calculated by summing up weekly consumption of the most commonly consumed fast foods in Iran. Mean consumption of fast food was 161g/week (95% CI: 147-175) for young adults and 108 g/week (95% CI: 101-115) for middle-aged adults. Mean dietary intakes of energy, fat, saturated fat, cholesterol, sodium, meat, and soft drinks increased significantly (P < 0.05), while carbohydrate and refined grain consumption decreased (P < 0.01) across tertiles of fast food in both age groups. In young adults, dietary energy density and protein intake increased significantly (P < 0.01) where as intake of non-starchy vegetables and carotenoids decreased (P < 0.05). In middle-aged adults dietary intakes of fiber, folate, calcium, and fruits significantly decreased across fast food tertiles (P < 0.05). After adjustment for confounders, there was an association between fast food consumption and body mass index (BMI; β = 0.104; P < 0.01) and waist circumference (WC; β= 0.083; P < 0.01) in young adults, and serum triglycerides (β = 0.072; P < 0.05), high density lipoprotein cholesterol (HDL-C; β = -0.051; P < 0.05), and atherogenic index of plasma (β = 0.056; P < 0.05) in middle-aged adults. The results show that increased consumption of fast foods is

  1. Developing and Implementing a Food Insecurity Screening Initiative for Adult Patients Living With Type 2 Diabetes.

    PubMed

    Thomas, Brittany; Fitzpatrick, Sandra; Sidani, Souraya; Gucciardi, Enza

    2018-06-01

    Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto. A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes. Interviews with 10 patients and a focus group with 15 care providers elicited feedback on the relevance and acceptance of the food insecurity screening questions and a care algorithm. Subsequently, 5 care providers at 4 sites implemented the screening initiative over 2 weeks, screening 33 patients. After implementation, 7 patients and 5 care providers were interviewed to assess the acceptability and feasibility of the screening initiative. Our findings demonstrate that patients are willing to share their experiences of food insecurity, despite the sensitivity of this topic. Screening elicited information about how patients cope with food insecurity and how this affects their ability to self-manage diabetes. Care providers found this information helpful in directing their care and support for patients. Using a standardized, respectful method of assessing food insecurity can better equip health-care providers to support food-insecure patients with diabetes self-management. Further evaluation of this initiative is needed to determine how food insecurity screening can affect patients' self-management and related health outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer.

    PubMed

    Soanes, Louise; Gibson, Faith

    2018-05-01

    For adolescents and young adults living in high-income countries cancer remains the most common disease-related death. Increasing survival rates and projected longevity are positive outcomes, although long-term consequences of cancer and/or its treatment will likely increase the global burden of cancer. In low and middle-income countries the impact and needs of young adults with cancer are largely unknown and require further attention. However, universal studies have revealed that cancer-related needs for this group are multifactorial, complex and largely unmet. In response to these findings, the body of work on supportive care for young adults with cancer is growing. Yet, there is no published research in the context of the United Kingdom, regarding the role young adults play in managing their supportive cancer care needs. To explore the experience, purpose and meaning of supportive cancer care to young adults recently diagnosed with cancer. Using constructivist grounded theory, data were collected in one to one interviews with eleven young adults (seven women and four men aged 19-24 years) being treated for cancer in two English hospitals. Data were analyzed using open and focused coding, constant comparison, theoretical coding and memoing, and this enabled construction of a subjective theory. Young adults in this study interpreted cancer as an interruption to the events, experiences and tasks forming the biographical work of their adult identity. Data analysis led to the construction of the theory, 'protecting an adult identity: self in relation to a diagnosis of cancer in young adulthood'. This theory arose from three categories: fragility of self, maintaining self in an altered reality and mobilizing external resources. Young adults faced the loss of their early adult identity. Interpreting cancer as a temporary interruption, they sought to re-establish their identity by directly and indirectly managing their supportive care needs. These findings contribute to

  3. Affective Pictures and the Open Library of Affective Foods (OLAF): Tools to Investigate Emotions toward Food in Adults.

    PubMed

    Miccoli, Laura; Delgado, Rafael; Guerra, Pedro; Versace, Francesco; Rodríguez-Ruiz, Sonia; Fernández-Santaella, M Carmen

    2016-01-01

    Recently, several sets of standardized food pictures have been created, supplying both food images and their subjective evaluations. However, to date only the OLAF (Open Library of Affective Foods), a set of food images and ratings we developed in adolescents, has the specific purpose of studying emotions toward food. Moreover, some researchers have argued that food evaluations are not valid across individuals and groups, unless feelings toward food cues are compared with feelings toward intense experiences unrelated to food, that serve as benchmarks. Therefore the OLAF presented here, comprising a set of original food images and a group of standardized highly emotional pictures, is intended to provide valid between-group judgments in adults. Emotional images (erotica, mutilations, and neutrals from the International Affective Picture System/IAPS) additionally ensure that the affective ratings are consistent with emotion research. The OLAF depicts high-calorie sweet and savory foods and low-calorie fruits and vegetables, portraying foods within natural scenes matching the IAPS features. An adult sample evaluated both food and affective pictures in terms of pleasure, arousal, dominance, and food craving, following standardized affective rating procedures. The affective ratings for the emotional pictures corroborated previous findings, thus confirming the reliability of evaluations for the food images. Among the OLAF images, high-calorie sweet and savory foods elicited the greatest pleasure, although they elicited, as expected, less arousal than erotica. The observed patterns were consistent with research on emotions and confirmed the reliability of OLAF evaluations. The OLAF and affective pictures constitute a sound methodology to investigate emotions toward food within a wider motivational framework. The OLAF is freely accessible at digibug.ugr.es.

  4. Affective Pictures and the Open Library of Affective Foods (OLAF): Tools to Investigate Emotions toward Food in Adults

    PubMed Central

    Guerra, Pedro; Versace, Francesco; Rodríguez-Ruiz, Sonia; Fernández-Santaella, M. Carmen

    2016-01-01

    Recently, several sets of standardized food pictures have been created, supplying both food images and their subjective evaluations. However, to date only the OLAF (Open Library of Affective Foods), a set of food images and ratings we developed in adolescents, has the specific purpose of studying emotions toward food. Moreover, some researchers have argued that food evaluations are not valid across individuals and groups, unless feelings toward food cues are compared with feelings toward intense experiences unrelated to food, that serve as benchmarks. Therefore the OLAF presented here, comprising a set of original food images and a group of standardized highly emotional pictures, is intended to provide valid between-group judgments in adults. Emotional images (erotica, mutilations, and neutrals from the International Affective Picture System/IAPS) additionally ensure that the affective ratings are consistent with emotion research. The OLAF depicts high-calorie sweet and savory foods and low-calorie fruits and vegetables, portraying foods within natural scenes matching the IAPS features. An adult sample evaluated both food and affective pictures in terms of pleasure, arousal, dominance, and food craving, following standardized affective rating procedures. The affective ratings for the emotional pictures corroborated previous findings, thus confirming the reliability of evaluations for the food images. Among the OLAF images, high-calorie sweet and savory foods elicited the greatest pleasure, although they elicited, as expected, less arousal than erotica. The observed patterns were consistent with research on emotions and confirmed the reliability of OLAF evaluations. The OLAF and affective pictures constitute a sound methodology to investigate emotions toward food within a wider motivational framework. The OLAF is freely accessible at digibug.ugr.es. PMID:27513636

  5. Food security: who is being excluded? A case of older people with dementia in long-term care homes.

    PubMed

    Vahabi, M; Schindel Martin, L

    2014-07-01

    To explore the extent of food security among older people, particularly those with cognitive impairments residing in Canadian long-term care homes (LTCHs) through a focused review of literature. Databases including Medline, Nursing and Health Sciences (SAGE), Psych Info, Social Sciences Abstract, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and HealthSTAR were searched for peer-reviewed articles related to food experiences of older individuals in industrialized countries including Canada. Only articles that were published in English between 1997-2012 were included. Sixty two studies met the inclusion criteria. Of those 17 focused on older adults in LTCHs. The review found that food security has rarely been examined among older persons living in LTCHs, and has never been examined within the context of cognitive impairment. While a few studies have focused on residents' satisfaction with foods that are provided to them in LTCHs, none have explored the extent of food security in this population. Furthermore, food satisfaction surveys in the LTCH are limited to the assessment of foods that are served to residents, and do not capture residents' food accessibility beyond the food dispensing routines of the organization. Thus, food quality, food preferences, and the traditional meanings and rituals associated with food consumption are not purposefully evaluated. In addition, LTCHs are not required to monitor residents' food satisfaction using a consistent, regular, and standardized approach and there is no regulation in the LTCH Act that requires LTCHs to assess their residents' food security. The findings highlight the need for: 1) expansion of food security research to non-community-based settings including LTCHs; 2) re-conceptualization of food security and modification of measurement tools to assess the extent and determinants of food security among older adults in LTCHs; 3) mandatory monitoring of food security via standardized and regular

  6. Which Food Patterns Are Predictors of Obesity in Tehranian Adults?

    ERIC Educational Resources Information Center

    Hosseini-Esfahani, Firoozeh; Djazaieri, Seyed-Abolghasem; Mirmiran, Parvin; Mehrabi, Yadollah; Azizi, Fereidoun

    2012-01-01

    Objectives: To determine whether changes in food patterns over a period of 6 years were related to obesity in Tehranian adults. Design: Data on dietary intake, using the food frequency questionnaire, and anthropometry were obtained in 2 periods of the survey (1999-2001 and 2005-2007). Setting: Participants of the Tehran Lipid and Glucose Study.…

  7. Primary care of adults with intellectual and developmental disabilities

    PubMed Central

    Sullivan, William F.; Diepstra, Heidi; Heng, John; Ally, Shara; Bradley, Elspeth; Casson, Ian; Hennen, Brian; Kelly, Maureen; Korossy, Marika; McNeil, Karen; Abells, Dara; Amaria, Khush; Boyd, Kerry; Gemmill, Meg; Grier, Elizabeth; Kennie-Kaulbach, Natalie; Ketchell, Mackenzie; Ladouceur, Jessica; Lepp, Amanda; Lunsky, Yona; McMillan, Shirley; Niel, Ullanda; Sacks, Samantha; Shea, Sarah; Stringer, Katherine; Sue, Kyle; Witherbee, Sandra

    2018-01-01

    Abstract Objective To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD). Methods Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations. Recommendations Adults with IDD are a heterogeneous group of patients and have health conditions and factors affecting their health that can vary in kind, manifestation, severity, or complexity from those of others in the community. They require approaches to care and interventions that are adapted to their needs. These guidelines provide advice regarding standards of care. References to clinical tools and other practical resources are incorporated. The approaches to care that are outlined here can be applied to other groups of patients that have impairments in cognitive, communicative, or other adaptive functioning. Conclusion As primary care providers, family physicians play a vital role in promoting the health and well-being of adults with IDD. These guidelines can aid their decision making with patients and caregivers. PMID:29650602

  8. Should frail older adults be in long-term care facilities?

    PubMed Central

    Sverdrup, Sidsel; Pay, Birgit Brunborg

    2018-01-01

    Aim Home-based nursing care is relatively easy to access in Norway compared to the rest of Europe, and the threshold for applying for assistance is relatively low. The aim of the present study was to analyze factors that enable frail older adults to live in their own homes, with a low level of care burden stress. Methodology In 2015 and 2016, eight municipalities from different parts of Norway participated in a cross-sectional study. The quantitative part of the project consisted of assessing care of 71 older adults, aged ≥80 years, using a geriatric comprehensive assessment. The qualitative part consisted of semistructured telephone interviews with 14 leaders of nursing homes and home-based nursing care and interviews with 26 close relatives. Results In this sample, 60% of the older adults were living alone, and 79% were at risk of permanent nursing home admission; 31% stated that they would be better-off at a higher caring level, mainly due to living alone. The relatives, their resources, and motivation to provide care seemed to be crucial for how long older adults with heavy care burden could stay at home. The municipalities offered a combination of comprehensive home care, day centers, and revolving short-term stays to enable them to live at home. Conclusion The results reveal that the need for home care services is steadily increasing. The relatives are coping with the physical care, far better than the uncertainties and worries about what could happen when the older adults stay alone. The number of beds in institutional care in each municipality depends on various factors, such as the inhabitants’ life expectancy, social aspects, geography, well-functioning eldercare pathways, competence of the health professionals, and a well-planned housing policy. PMID:29440911

  9. Development and Psychometric Testing of a Novel Food Service Satisfaction Questionnaire for Food Service Staff of Aged Care Homes.

    PubMed

    Miller, M; Hamilton, J; Scupham, R; Matwiejczyk, L; Prichard, I; Farrer, O; Yaxley, A

    2018-01-01

    Food service staff are integral to delivery of quality food in aged care homes yet measurement of their satisfaction is unable to be performed due to an absence of a valid and reliable questionnaire. The aim of this study was to develop and perform psychometric testing for a new Food Service Satisfaction Questionnaire developed in Australia specifically for use by food service staff working in residential aged care homes (Flinders FSSQFSAC). A mixed methods design utilizing both a qualitative (in-depth interviews, focus groups) and a quantitative approach (cross sectional survey) was used. Content validity was determined from focus groups and interviews with food service staff currently working in aged care homes, related questionnaires from the literature and consultation with an expert panel. The questionnaire was tested for construct validity and internal consistency using data from food service staff currently working in aged care homes that responded to an electronic invitation circulated to Australian aged care homes using a national database of email addresses. Construct validity was tested via principle components analysis and internal consistency through Cronbach's alpha. Temporal stability of the questionnaire was determined from food service staff undertaking the Flinders FSSQFSAC on two occasions, two weeks apart, and analysed using Pearson's correlations. Content validity for the Flinders FSSQFSAC was established from a panel of experts and stakeholders. Principle components analysis revealed food service staff satisfaction was represented by 61-items divided into eight domains: job satisfaction (α=0.832), food quality (α=0.871), staff training (α=0.922), consultation (α=0.840), eating environment (α=0.777), reliability (α=0.695), family expectations (α=0.781) and resident relationships (α=0.429), establishing construct validity in all domains, and internal consistency in all (α>0.5) except for "resident relationships" (α=0.429). Test

  10. Health care in adults with Down syndrome: a longitudinal cohort study.

    PubMed

    Jensen, K M; Davis, M M

    2013-10-01

    Individuals with Down syndrome increasingly survive into adulthood, yet little is known about their healthcare patterns as adults. Our study sought to characterise patterns of health care among adults with Down syndrome based on whether they had fully transitioned to adult-oriented providers by their inception in this cohort. In this retrospective observational cohort study, healthcare utilisation and annualised patient charges were evaluated in patients with Down syndrome aged 18-45 years who received care in a single academic health centre from 2000 to 2008. Comparisons were made based on patients' provider mix (only adult-focused or 'mixed' child- and adult-focused providers). The cohort included 205 patients with median index age = 28 years; 52% of these adult patients had incompletely transitioned to adult providers and received components of their care from child-focused providers. A higher proportion of these 'mixed' patients were seen exclusively by subspecialty providers (mixed = 81%, adult = 46%, P < 0.001), suggesting a need for higher intensity specialised services. Patients in the mixed provider group incurred higher annualised charges in analyses adjusted for age, mortality, total annualised encounters, and number of subspecialty disciplines accessed. These differences were most pronounced when stratified by whether patients were hospitalised during the study period (e.g., difference in adjusted means between mixed versus adult provider groups: $571 without hospitalisation, $19,061 with hospitalisation). In this unique longitudinal cohort of over 200 adults aged 18-45 years with Down syndrome, over half demonstrated incomplete transition to adult care. Persistent use of child-focused care, often with a subspecialty emphasis, has implications for healthcare charges. Future studies must identify reasons for distinct care patterns, examine their relationship with clinical outcomes, and evaluate which provider types deliver the highest

  11. Qualifying instrument for evaluation of food and nutritional care in hospital.

    PubMed

    Díez García, R W; Souza, A A; Proença, R P C

    2012-01-01

    Establishing criteria for hospital nutrition care ensures that quality care is delivered to patients. The responsibility of the Hospital Food and Nutrition Service (HFNS) is not always well defined, despite efforts to establish guidelines for patient clinical nutrition practice. This study describes the elaboration of an Instrument for Evaluation of Food and Nutritional Care (IEFNC) aimed at directing the actions of the Hospital Food and Nutrition Service. This instrument was qualified by means of a comparative analysis of the categories related to hospital food and nutritional care, published in the literature. Elaboration of the IEFNC comprised the following stages: (a) a survey of databases and documents for selection of the categories to be used in nutrition care evaluation, (b) a study of the institutional procedures for nutrition practice at two Brazilian hospitals, in order to provide a description of the sequence of actions that should be taken by the HFNS as well as other services participating in nutrition care, (c) design of the IEFNC based on the categories published in the literature, adapted to the sequence of actions observed in the routines of the hospitals under study, (d) application of the questionnaire at two different hospitals that was mentioned in the item (b), in order to assess the time spent on its application, the difficulties in phrasing the questions, and the coverage of the instrument, and (e) finalization of the instrument. The IEFNC consists of 50 open and closed questions on two areas of food and nutritional care in hospital: inpatient nutritional care and food service quality. It deals with the characterization and structure of hospitals and their HFNS, the actions concerning the patients' nutritional evaluation and monitoring, the meal production system, and the hospital diets. "This questionnaire is a tool that can be seen as a portrait of the structure and characteristics of the HFNS and its performance in clinical and meal

  12. Developmental differences in the brain response to unhealthy food cues: an fMRI study of children and adults.

    PubMed

    van Meer, Floor; van der Laan, Laura N; Charbonnier, Lisette; Viergever, Max A; Adan, Roger Ah; Smeets, Paul Am

    2016-12-01

    Food cues are omnipresent and may trigger overconsumption. In the past 2 decades, the prevalence of childhood obesity has increased dramatically. Because children's brains are still developing, especially in areas important for inhibition, children may be more susceptible than adults to tempting food cues. We examined potential developmental differences in children's and adults' responses to food cues to determine how these responses relate to weight status. We included 27 children aged 10-12 y and 32 adults aged 32-52 y. Functional magnetic resonance imaging data were acquired during a food-viewing task in which unhealthy and healthy food pictures were presented. Children had a stronger activation in the left precentral gyrus than did adults in response to unhealthy compared with healthy foods. In children, unhealthy foods elicited stronger activation in the right inferior temporal and middle occipital gyri, left precentral gyrus, bilateral opercular part of the inferior frontal gyrus, left hippocampus, and left middle frontal gyrus. Adults had stronger activation in the bilateral middle occipital gyrus and the right calcarine sulcus for unhealthy compared with healthy foods. Children with a higher body mass index (BMI) had lower activation in the bilateral dorsolateral prefrontal cortex while viewing unhealthy compared with healthy foods. In adults there was no correlation between BMI and neural response to unhealthy compared with healthy foods. Unhealthy foods might elicit more attention both in children and in adults. Children had stronger activation while viewing unhealthy compared with healthy foods in areas involved in reward, motivation, and memory. Furthermore, children activated a motivation and reward area located in the motor cortex more strongly than did adults in response to unhealthy foods. Finally, children with a higher BMI had less activation in inhibitory areas in response to unhealthy foods, which may mean they are more susceptible to tempting

  13. PHYSICIANS’ SELF-PERCEPTIONS OF CARE FOR EMERGING ADULTS WITH TYPE 1 DIABETES

    PubMed Central

    Lyons, Sarah K.; Helgeson, Vicki S.; Witchel, Selma F.; Becker, Dorothy J.; Korytkowski, Mary T.

    2015-01-01

    Objective Establishing care with adult providers is essential for emerging adults with type 1 diabetes (T1D) transitioning from pediatric care. Although research evaluating the transition from pediatric to adult care has been focused primarily on patients’ perceptions, little is known about the adult providers’ perspectives. We sought to ascertain adult providers’ perspectives of caring for the medical and psychosocial needs of this patient population. Methods We developed and mailed a survey to 79 regional adult endocrinologists and 186 primary care physicians (PCPs) identified through 2 regional insurance plans. Questions addressed perceived aptitude in clinical aspects of diabetes management, importance and availability of diabetes team members, and opinions regarding recommended transition methods. Results The response rate was 43% for endocrinologists and 13% for PCPs. Endocrinologists reported higher aptitude in insulin management (P<.01). PCPs reported greater aptitude in screening and treating depression (P<0.01). Although endocrinologists and PCPs did not differ in their views of the importance of care by a comprehensive team, endocrinologists reported better access to diabetes educators and dieticians than PCPs (P<.01). Recommended transition methods were described as useful. Conclusion These preliminary results suggest that endocrinologists are better prepared to assume diabetes care of emerging adults, whereas PCPs may be better prepared to screen and treat associated depression. Future studies are needed to determine if a medical home model with cooperative management improves care for emerging adults with T1D. PMID:26121463

  14. Residential Child Care Institutions (RCCI) Food Services Manual.

    ERIC Educational Resources Information Center

    Idaho State Dept. of Education, Boise.

    This food manual for small Idaho residential child care institutions with 10-15 students and no full-time cook, is designed to help directors serve meals that promote healthy eating behavior in their residents, serve meals that meet the USDA's Healthy School Meals Initiative, and manage the food service to assure the fiscal integrity of the…

  15. Food group and micronutrient intake adequacy among children, adults and elderly women in Greece.

    PubMed

    Manios, Yannis; Moschonis, George; Grammatikaki, Evangelia; Mavrogianni, Christina; van den Heuvel, Ellen G H M; Bos, Rolf; Singh-Povel, Cecile

    2015-03-11

    The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9-13-year-old children; 40-60-year-old adults; and 50-75-year-old women) were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05). Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor) was not always met. Indicatively, 18.2%-44.1% and 4.2%-7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients.

  16. Food Group and Micronutrient Intake Adequacy among Children, Adults and Elderly Women in Greece

    PubMed Central

    Manios, Yannis; Moschonis, George; Grammatikaki, Evangelia; Mavrogianni, Christina; van den Heuvel, Ellen GHM; Bos, Rolf; Singh-Povel, Cecile

    2015-01-01

    The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9–13-year-old children; 40–60-year-old adults; and 50–75-year-old women) were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05). Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor) was not always met. Indicatively, 18.2%–44.1% and 4.2%–7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients. PMID:25768954

  17. [Food and beverages available in automatic food dispensers in health care facilities of the Portugal North Health Region].

    PubMed

    Rodrigues, Filipa Gomes; Ramos, Elisabete; Freitas, Mário; Neto, Maria

    2010-01-01

    Patients and health staff frequently need to stay in health care facilities for quite a long time. Therefore, it's necessary to create the conditions that allow the ingestion of food during those periods, namely through the existence of automatic food dispensers. However, the available food and beverages might not always be compatible with a healthy diet. The aim of this work was to evaluate if the food and beverages available in automatic food dispensers in public Ambulatory Care Facilities (ACF) and Hospitals of the Portugal North Health Region were contributing to a healthy diet, during the year of 2007. A questionnaire was elaborated and sent to the Coordinators of the Health Sub-Regions and to the Hospital Administrators. The questionnaire requested information about the existence of automatic food dispensers in the several departments of each health care facility, as well as which food and beverages were available and most sold. Afterwards, the pre-processing of the results involved the classification of the food and beverages in three categories: recommended, sometimes recommended and not recommended. The questionnaire reply ratio was 71% in ACF and 83% in Hospitals. Automatic food dispensers were available in all the Hospitals and 86.5% of ACF. It wasn't possible to acquire food in 37% of the health facility departments. These departments were all located in ACF. The more frequently available beverages in departments with automatic food dispensers were coffee, still water, tea, juices and nectars and soft drinks. Still water, coffee, yogurt, juices and nectars and soft drinks were reported as the most sold. The more frequently avaliable food items were chocolate, recommended cookies, not recommended cakes, recommended sandwiches and sometimes recommended croissants. The food items reported as being the most sold were recommended sandwiches, chocolate, recommended cookies, sometimes recommended croissants and not recommended cookies. The beverages in the

  18. Transition of care for patients with type 1 diabetes mellitus from pediatric to adult health care systems

    PubMed Central

    Glick, Bethany; Kamboj, Manmohan K.

    2017-01-01

    Planning for the transition from pediatric to adult healthcare is broadly understood to be beneficial to the quality of care of patients with chronic illness. Due to the level of self-care that is necessary in the maintenance of most chronic diseases, it is important that pediatric settings can offer support during a time when adolescents are beginning to take more responsibility in all areas of their lives. Lack of supportive resources for adolescents with chronic conditions often results in both decreased access to care and impaired health and function likely leading to increased medical costs later. Additionally, fundamental differences in health care delivery exist between pediatric and adult care settings. There is limited empiric data and information on best practices in transition care. In this article we address the importance of bridging pediatric and adult care settings and highlight the challenges and successes of the implementation of the young adult transition clinic program for patients with type 1 diabetes at our facility. We provide recommendations for further research and program implementation with the transition population. PMID:29184818

  19. Self-care behaviors of Filipino-American adults with type 2 diabetes mellitus.

    PubMed

    Jordan, Deovina N; Jordan, James L

    2010-01-01

    To examine the diabetes self-care behaviors of Filipino-American (FA) adults with type 2 diabetes mellitus (DM). The Summary of Diabetes Self Care Activities-Revised and Expanded measure was administered to 192 (74 males and 118 females) FA adult immigrants with type 2 DM. Older FAs (> or =65 years), females, those who were older when they immigrated, and participants diagnosed with type 2 DM longer were more likely to follow recommended medication regimens. Younger FAs (<65 years) and participants diagnosed with type 2 DM for shorter duration of time were less likely to perform blood glucose testing. Most FAs reported following their eating plans; however, those who lived in the United States (US) longer followed healthful eating plans. Likewise, females reported eating five or more servings of fruits and/or vegetables daily. Moreover, older FAs reported evenly spacing carbohydrate intake everyday. Furthermore, older participants, those with less education, participants who were older when they immigrated, and those older when diagnosed with type 2 DM ate fewer foods high in fats. As to physical activity, FA males and participants with higher education exercised more frequently. Younger FAs were less likely to perform optimum type 2 DM self-care behaviors pertaining to diet, medication taking, and blood glucose testing compared to their older counterparts. This finding suggests an increased risk for type 2 DM comorbidities and/or complications in younger FAs, which may require more intensive treatments in later years. Copyright 2010. Published by Elsevier Inc.

  20. Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care.

    PubMed

    Niedert, Kathleen C

    2005-12-01

    It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by liberalization of the diet prescription. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person's individual medical condition, needs, desires, and rights. In 2003, ADA designated aging as its second "emerging" area. Nutrition care in long-term settings must meet two goals: maintenance of health and promotion of quality of life. The Nutrition Care Process includes assessment of nutritional status through development of an individualized nutrition intervention plan. Medical nutrition therapy must balance medical needs and individual desires and maintain quality of life. The recent paradigm shift from restrictive institutions to vibrant communities for older adults requires dietetics professionals to be open-minded when assessing risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss and undernutrition and a spiral of negative health effects. Facilities are adopting new attitudes toward providing care. "Person-centered" or "resident-centered care" involves residents in decisions about schedules, menus, and dining locations. Allowing residents to participate in diet-related decisions can provide nutrient needs, allow alterations contingent on medical conditions, and simultaneously increase the desire to eat and enjoyment of food, thus decreasing the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.

  1. Activity space-based measures of the food environment and their relationships to food purchasing behaviours for young urban adults in Canada.

    PubMed

    Widener, Michael J; Minaker, Leia M; Reid, Jessica L; Patterson, Zachary; Ahmadi, Tara Kamal; Hammond, David

    2018-03-16

    To examine the potential links between activity spaces, the food retail environment and food shopping behaviours for the population of young, urban adults. Participants took part in the Canada Food Study, which collected information on demographics, food behaviour, diet and health, as well as an additional smartphone study that included a seven-day period of logging GPS (global positioning system) location and food purchases. Using a time-weighted, continuous representation of participant activity spaces generated from GPS trajectory data, the locations of food purchases and a geocoded food retail data set, negative binomial regression models were used to explore what types of food retailers participants were exposed to and where food purchases were made. Toronto, Montreal, Vancouver, Edmonton and Halifax, Canada. Young adults aged 16-30 years (n 496). These participants were a subset of the larger Canada Food Study. Demographics, household food shopper status and city of residence were significantly associated with different levels of exposure to various types of food retailers. Food shopping behaviours were also statistically significantly associated with demographics, the activity space-based food environment, self-reported health and city of residence. The study confirms that food behaviours are related to activity space-based food environment measures, which provide a more comprehensive accounting of food retail exposure than home-based measures. In addition, exposure to food retail and food purchasing behaviours of an understudied population are described.

  2. Food Access Patterns and Barriers among Midlife and Older Adults with Mobility Disabilities

    PubMed Central

    Huang, Deborah L.; Rosenberg, Dori E.; Simonovich, Shannon D.; Belza, Basia

    2012-01-01

    We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility) were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants' ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home. PMID:23056944

  3. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy.

    PubMed

    Muraro, A; Werfel, T; Hoffmann-Sommergruber, K; Roberts, G; Beyer, K; Bindslev-Jensen, C; Cardona, V; Dubois, A; duToit, G; Eigenmann, P; Fernandez Rivas, M; Halken, S; Hickstein, L; Høst, A; Knol, E; Lack, G; Marchisotto, M J; Niggemann, B; Nwaru, B I; Papadopoulos, N G; Poulsen, L K; Santos, A F; Skypala, I; Schoepfer, A; Van Ree, R; Venter, C; Worm, M; Vlieg-Boerstra, B; Panesar, S; de Silva, D; Soares-Weiser, K; Sheikh, A; Ballmer-Weber, B K; Nilsson, C; de Jong, N W; Akdis, C A

    2014-08-01

    Food allergy can result in considerable morbidity, impact negatively on quality of life, and prove costly in terms of medical care. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group, building on previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence-based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists, this document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management of patients of all ages with food allergy is presented. The acute management of non-life-threatening reactions is covered in these guidelines, but for guidance on the emergency management of anaphylaxis, readers are referred to the related EAACI Anaphylaxis Guidelines. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Comparison of Menus to Actual Foods and Beverages Served in North Carolina Child-Care Centers

    PubMed Central

    BENJAMIN NEELON, SARA E.; COPELAND, KRISTEN A.; BALL, SARAH C.; BRADLEY, LAUREN; WARD, DIANNE S

    2011-01-01

    Menus from child-care centers are an important source of information for parents, researchers, and child-care regulators, but previous research suggests that menus do not accurately represent foods served. The purpose of this study was to compare menus with actual foods and beverages served to children in child-care centers. Menus were collected and a dietary observation was conducted to document all foods and beverages served to children during the course of 1 day in 84 child-care centers in North Carolina in the fall of 2005. Frequencies of foods and beverages on the menus vs those served were computed by eating occasion, food category, and individual foods and beverages. Of the 254 meals and snacks served, 131 (52%) meals and snacks matched entirely what was stated on the menu. Of the 820 individual foods and beverages served, 710 (86.6%) matched those listed on the menus. An additional 110 foods and beverages were served but not listed on the menus. Grains, juice, and vegetables were served less often than indicated on the menus, and milk, protein-rich foods, fruits, mixed dishes, and foods of low nutritional value were served more often than listed on the menus. Overall, just over half of all meals and snacks matched menus, and nearly 90% of individual foods and beverages served matched those stated on menus. Parents of children in child care and dietetics practitioners providing consultation to child-care centers can encourage not only provision of healthy foods and beverages, but also accurate menus in child care. PMID:21111096

  5. Factors Influencing the Food Purchases of Early Care and Education Providers.

    PubMed

    Otten, Jennifer J; Hirsch, Tad; Lim, Catherine

    2017-05-01

    With the majority of US children enrolled in some form of early care and education, the settings for early care and education represent a valuable opportunity to positively impact young children's diets and their interactions with food. Little evidence exists on how early care and education providers make food purchasing and service decisions for this population of young children. Our aim was to explore the factors that influence early care and education providers' food purchasing and service decisions. A qualitative design consisting of individual, in-person, and semi-structured interviews with providers and on-site observations was used. Sixteen early care and education providers-selected across a variety of characteristics that might affect food selection (eg, size of site, participation in reimbursement programs, presence of staff assigned to foodservice) using maximum variation purposive sampling-based in the Puget Sound region, Washington, were interviewed from June to September 2014. Provider perspectives on food purchasing and service decisions. Inductive analysis of transcribed interviews using TAMS Analyzer software (GPL version 2, 2012) to identify themes. Ten main influencers emerged from the data. These were grouped into four categories based on an ecological framework: macro-level environments (ie, regulations; suppliers and vendors, including stores); physical environment and settings (ie, organizational mission, budget, and structure; the facility itself); social environments (ie, professional networks; peers; the site-specific parent and child community); and individual factors at both a provider and child-level (ie, providers' skills, behaviors, motivations, attitudes, knowledge, and values; child food preferences; and, child allergies). A model was then developed to identify potential pathways of intervention and underscore the need for a comprehensive approach to improve early care and education nutrition. This study suggests that a more

  6. Correlates of Worry About Health Care Costs Among Older Adults.

    PubMed

    Choi, Namkee G; DiNitto, Diana M

    2018-06-01

    Although older adults in the United States incur more health care expenses than younger adults, little research has been done on their worry about health care costs. Using data from the 2013 National Health Interview Survey ( n = 7,253 for those 65+ years), we examined factors associated with older adults' health care cost worries, defined as at least a moderate level of worry, about ability to pay for normal health care and/or for health care due to a serious illness or accident. Bivariate analyses were used to compare worriers and nonworriers. Binary logistic regression analysis was used to examine the association of income, health status, health care service use, and insurance type with worry status. Older age and having Medicaid and Veterans Affairs (VA)/military health benefits were associated with lower odds of worry, while low income, chronic pain, functional limitations, psychological distress, and emergency department visits were associated with higher odds. Practice and policy implications for the findings are discussed.

  7. Transition to adult-oriented health care: perspectives of youth and adults with complex physical disabilities.

    PubMed

    Young, Nancy L; Barden, Wendy S; Mills, Wendy A; Burke, Tricia A; Law, Mary; Boydell, Katherine

    2009-01-01

    The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain injuries of childhood, and their parents (n = 30). Respondents discussed their health care services, their experience with clinical transition, and contributing factors. We analyzed the transcripts using qualitative methods. All participants identified challenges in transition, including: lack of access to health care; lack of professionals' knowledge; lack of information and uncertainty regarding the transition process. Two solutions were identified: early provision of detailed information and more extensive support throughout the clinical transition process. The challenges of clinical transition were universal. More extensive information and support is needed during transition to ensure an efficient move to appropriate adult-oriented health care.

  8. Association between fried food consumption and hypertension in Korean adults.

    PubMed

    Kang, Yunjin; Kim, Jihye

    2016-01-14

    The present study explored the relationships between fried food consumption and metabolic risk factors and hypertension in Korean adults. The study was based on the fifth Korean National Health and Nutrition Examination Survey between 2010 and 2011. A total of 9221 Korean adults aged ≥19 years were studied. Fried food consumption was assessed using a validated FFQ. Metabolic risk factors such as waist circumference, fasting plasma glucose (FPG), TAG, HDL-cholesterol and systolic and diastolic blood pressure (SBP and DBP) were measured. Hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg or current use of antihypertensive medication. Adjusted OR for elevated blood pressure significantly increased in men (OR 1·62; 95% CI 1·11, 2·37; P(trend)=0·0447) and women (OR 2·20; 95% CI 1·21, 4·00; P(trend)=0·0403) with a greater than twice a week consumption of fried food compared with those who rarely consumed fried food. However, fried food consumption was not associated with other metabolic risk factors (abdominal obesity, high FPG, hypertriacylglycerolaemia, low HDL-cholesterol and the metabolic syndrome). The adjusted OR for hypertension increased by 2·4-fold in women (OR 2·37; 95% CI 1·19, 4·72; P(trend)=0·0272) with a greater than twice a week fried food consumption compared with those who rarely consumed it. No significant association was found between fried food consumption and hypertension in men. This study suggests that frequent fried food consumption is associated with hypertension in Korean women. Further studies are needed to investigate the effect of different types of fried foods on hypertension.

  9. Natural history of perceived food hypersensitivity and IgE sensitisation to food allergens in a cohort of adults.

    PubMed

    Patelis, Antonios; Gunnbjörnsdottir, Maria; Borres, Magnus P; Burney, Peter; Gislason, Thorarinn; Torén, Kjell; Forsberg, Bertil; Alving, Kjell; Malinovschi, Andrei; Janson, Christer

    2014-01-01

    No longitudinal studies exist on the natural history of food hypersensitivity and IgE sensitisation to food allergens in adults. To examine the natural history of food hypersensitivity, the natural history of IgE sensitisation to food allergens and to investigate the risk factors for new onset food hypersensitivity. Food hypersensitivity was questionnaire-assessed in 2307 individuals (aged 20-45 years) from Iceland and Sweden during the European Community Respiratory Health Survey both at baseline and follow-up 9 years later. IgE food and aeroallergen sensitisation were assessed in a subgroup of these individuals (n = 807). Values of 0.35 kU/L and above were regarded as positive sensitisation. Food hypersensitivity was reported by 21% of the subjects and this proportion remained unchanged at follow-up (p = 0.58). Fruits, nuts and vegetables were the three most common causes of food hypersensitivity, with a similar prevalence at baseline and follow-up. The prevalence IgE sensitisation to food allergens decreased in general by 56% (p<0.001) and IgE sensitisation to peanut decreased in particular by 67% (p = 0.003). The prevalence of timothy grass IgE sensitisation decreased by 15% (p = 0.003) while cat, mite and birch IgE sensitisation did not decrease significantly. Female sex, rhinitis, eczema and presence of IgE sensitisation to aeroallergens were independently associated with new onset food hypersensitivity. The prevalence of food hypersensitivity remained unchanged while the prevalence of IgE sensitisation to food allergens decreased in adults over a 9-year follow-up period. The decrease in prevalence of IgE sensitisation to food allergens was considerably larger than the change in prevalence of IgE sensitisation to aeroallergens.

  10. Natural History of Perceived Food Hypersensitivity and IgE Sensitisation to Food Allergens in a Cohort of Adults

    PubMed Central

    Patelis, Antonios; Gunnbjörnsdottir, Maria; Borres, Magnus P.; Burney, Peter; Gislason, Thorarinn; Torén, Kjell; Forsberg, Bertil; Alving, Kjell

    2014-01-01

    Background No longitudinal studies exist on the natural history of food hypersensitivity and IgE sensitisation to food allergens in adults. Objective To examine the natural history of food hypersensitivity, the natural history of IgE sensitisation to food allergens and to investigate the risk factors for new onset food hypersensitivity. Methods Food hypersensitivity was questionnaire-assessed in 2307 individuals (aged 20–45 years) from Iceland and Sweden during the European Community Respiratory Health Survey both at baseline and follow-up 9 years later. IgE food and aeroallergen sensitisation were assessed in a subgroup of these individuals (n = 807). Values of 0.35 kU/L and above were regarded as positive sensitisation. Results Food hypersensitivity was reported by 21% of the subjects and this proportion remained unchanged at follow-up (p = 0.58). Fruits, nuts and vegetables were the three most common causes of food hypersensitivity, with a similar prevalence at baseline and follow-up. The prevalence IgE sensitisation to food allergens decreased in general by 56% (p<0.001) and IgE sensitisation to peanut decreased in particular by 67% (p = 0.003). The prevalence of timothy grass IgE sensitisation decreased by 15% (p = 0.003) while cat, mite and birch IgE sensitisation did not decrease significantly. Female sex, rhinitis, eczema and presence of IgE sensitisation to aeroallergens were independently associated with new onset food hypersensitivity. Conclusion The prevalence of food hypersensitivity remained unchanged while the prevalence of IgE sensitisation to food allergens decreased in adults over a 9-year follow-up period. The decrease in prevalence of IgE sensitisation to food allergens was considerably larger than the change in prevalence of IgE sensitisation to aeroallergens. PMID:24427301

  11. Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities.

    PubMed

    Hernandez, Daphne C; Reesor, Layton M; Murillo, Rosenda

    2017-10-01

    The majority of the food insecurity-obesity research has indicated a positive association among women, especially minority women. Less research has been conducted on men, and the findings are inconsistent. The aim was to assess whether gender and race/ethnic disparities exists between the food insecurity and overweight/obesity relationship among adults ages 18-59. We used the cross-sectional 2011 and 2012 National Health Interview Survey data (N = 19,990). Three or more affirmative responses on the 10-item USDA Food Security Scale indicated food insecure experiences. Self-reported height and weight were used to calculate body mass index according to the Centers for Disease Control and Prevention. Multivariate logistic regression models were stratified by gender and race/ethnicity to estimate the association between food insecurity and overweight/obesity controlling for several demographic characteristics. Adults on average were 36 years of age (51% female; 56% white, 27% Hispanic, and 17% black), 27% were food insecure, and 65% were overweight/obese. Food insecurity was most prevalent among blacks and Hispanics, regardless of gender. A greater percentage of food insecure women were overweight/obese compared to food secure women among all race/ethnicity groups; while similar proportions of white, black, and Hispanic men were overweight/obese irrespective of their food security status. In covariate-adjusted models, food insecurity was associated with a 41% and 29% higher odds of being overweight/obese among white and Hispanic women, respectively. Food insecurity was not related to overweight/obesity among black women nor among white, black, and Hispanic men. The complex relationship between food insecurity and obesity suggests a need to investigate potential behavioral and physiological mechanisms, and moderators of this relationship. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. [Food and nutrition in primary care in Brazil].

    PubMed

    Nunes Pereira, Tatiane; Alves Monteiro, Renata; Pacheco Santos, Leonor Maria

    To describe food and nutrition actions in primary health care in Brazil. Exploratory review of articles published between 2007 and 2016. Lilacs, PubMed, Scopus and Web of Science databases were consulted. 103 articles were included, mostly published between 2012 and 2016 and developed mainly in the Southeast region of Brazil. The most prevalent research topics were food behaviour or consumption, nutritional status and non-communicable diseases. Most research was led by universities and was focused on diagnosis. Few actions on health promotion, healthy eating, assistance, treatment, integral health care and prevention of diseases related to food and nutrition were found in the review. National interest in food and nutrition has increased, however academic production is still far from the actual needs for providing evidence that impacts health status. More research is needed to describe, propose and evaluate programmes and actions. Therefore, it is essential for closer relationships to be forged between universities, managers and health services in order to identify common interests and to develop research that meets the needs of the area and contribute to planning and improving programmes and actions. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Barriers to climate-friendly food choices among young adults in Finland.

    PubMed

    Mäkiniemi, Jaana-Piia; Vainio, Annukka

    2014-03-01

    The aim of the study was to examine how young adults in Finland perceive barriers to climate-friendly food choices and how these barriers are associated with their choices. The participants were 350 university students of the social and behavioral sciences who completed a questionnaire during class. The study found that the barriers the participants perceived as being the most relevant were different from those that were associated with the omission of climate-friendly food choices. High prices were perceived as the most relevant barrier, but were only weakly associated with the participants' food choices. Instead, habit and disbelief in the effects of food consumption on the climate were found to be the barriers that had the greatest association with climate-friendly choices. Moreover, women considered high prices and poor supply more important compared to men, whereas men considered disbelief and habit more important. In addition, vegetarians perceived fewer barriers than those who followed other diets. The findings increase our understanding of young adults' perceptions of barriers to climate-friendly food choices, as well as their effects. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Who is missing the message? Targeting strategies to increase food label use among US adults

    USDA-ARS?s Scientific Manuscript database

    Objective: To evaluate the associations between sociodemographic and psychosocial characteristics and food label (FL) use in US adults. Design: The 1994-1996 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey for 2,797 US adults were used. High socioeconomic st...

  15. Pediatric to Adult Care Transition: Perspectives of Young Adults With Sickle Cell Disease.

    PubMed

    Porter, Jerlym S; Wesley, Kimberly M; Zhao, Mimi S; Rupff, Rebecca J; Hankins, Jane S

    2017-10-01

    The aim of this study was to explore perspectives of transition and transition readiness of young adult patients (YAs) with sickle cell disease (SCD) who have transitioned to adult health care. In all, 19 YAs with SCD (ages 18-30 years) participated in one of three focus groups and completed a brief questionnaire about transition topics. Transcripts were coded and emergent themes were examined using the social-ecological model of adolescent and young adult readiness for transition (SMART). Themes were consistent with most SMART components. Adult provider relationships and negative medical experiences emerged as salient factors. YAs ranked choosing an adult provider, seeking emergency care, understanding medications/medication adherence, knowing SCD complications, and being aware of the impact of health behaviors as the most important topics to include in transition programming. The unique perspectives of YAs can inform the development and evaluation of SCD transition programming by incorporating the identified themes. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. Food insecurity and mental health problems among a community sample of young adults.

    PubMed

    Pryor, Laura; Lioret, Sandrine; van der Waerden, Judith; Fombonne, Éric; Falissard, Bruno; Melchior, Maria

    2016-08-01

    Food insecurity has been found to be related to anxiety and depression; however, the association with other psychiatric disorders, particularly among young adults, is not well known. We examined whether food insecurity is independently associated with four common mental health problems among a community sample of young adults in France. Data are from the TEMPO longitudinal cohort study. In 1991, participants' parents provided information on health and family socioeconomic characteristics. In 2011, participants' (18-35 years) reported food insecurity, mental health symptoms, and socioeconomic conditions (n = 1214). Mental health problems ascertained included major depressive episode, suicidal ideation, attention deficit and hyperactivity disorder, and substance abuse and/or dependence (nicotine, alcohol and cannabis). Cross-sectional associations between food insecurity and mental health problems were tested using modified Poisson regressions, weighted by inverse probability weights (IPW) of exposure. This makes food insecure and not food insecure participants comparable on all characteristics including socioeconomic factors and past mental health problems. 8.5 % of young adults were food insecure. In IPW-controlled analyses, food insecurity was associated with increased levels of depression (RR = 2.01, 95 % CI 1.01-4.02), suicidal ideation (RR = 3.23, 95 % CI 1.55-6.75) and substance use problems (RR = 1.68, 95 % CI 1.15-2.46). Food insecurity co-occurs with depression, suicidal ideation and substance use problems in young adulthood. Our findings suggest that reductions in food insecurity during this important life period may help prevent mental health problems. Policies aiming to alleviate food insecurity should also address individuals' psychiatric problems, to prevent a lifelong vicious circle of poor mental health and low socioeconomic attainment.

  17. Trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh

    PubMed Central

    ALFaris, Nora A.; Al-Tamimi, Jozaa Z.; Al-Jobair, Moneera O.; Al-Shwaiyat, Naseem M.

    2015-01-01

    Background Saudi Arabia has passed through lifestyle changes toward unhealthy dietary patterns such as high fast food consumption. Adolescents and young adults, particularly girls, are the main groups exposed to and affected by these adverse eating behaviors. Objective The aim of this study was to examine the trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh, and to compare between them. Design In a cross-sectional survey, 127 adolescent Saudi girls (13–18 years) and 69 young adult Saudi girls (19–29 years) were randomly recruited to participate in this study. Weight, height, waist circumference, and hip circumference were measured using standardized methods. Twenty-four-hour diet recall and a face-to-face interview food questionnaire were performed. Results Most of the participants had adequate intake of protein, riboflavin, iron, and sodium, but exhibited low intake for several other nutrients. Among study participants, 95.4% consume restaurants’ fast food and 79.1% eat fast food at least once weekly. Burgers and carbonated soft drinks were the main kinds of fast food meals and beverages usually eaten by girls. Adolescent girls who usually ate large portion sizes of fast food had significantly higher mean waist circumference and hip circumference. Participants eat fast food primarily for enjoying the delicious taste, followed by convenience. Restaurants’ hygiene and safety standards were the main concern regarding fast food for 62.2% of girls. Finally, international restaurants were preferable by participants to buy fast food compared with local restaurants (70.9% vs. 29.1%). Conclusion Our findings provide evidence on the high prevalence of fast food consumption among Saudi girls, suggesting an urgent need for community-based nutrition interventions that consider the trends of fast food consumption and targeted eating behaviors of adolescent and young adult girls. PMID:25792229

  18. Evolution of parental care driven by mutual reinforcement of parental food provisioning and sibling competition.

    PubMed

    Gardner, Andy; Smiseth, Per T

    2011-01-22

    In mammals, altricial birds and some invertebrates, parents care for their offspring by providing them with food and protection until independence. Although parental food provisioning is often essential for offspring survival and growth, very little is known about the conditions favouring the evolutionary innovation of this key component of care. Here, we develop a mathematical model for the evolution of parental food provisioning. We find that this evolutionary innovation is favoured when the efficiency of parental food provisioning is high relative to the efficiency of offspring self-feeding and/or parental guarding. We also explore the coevolution between food provisioning and other components of parental care, as well as offspring behaviour. We find that the evolution of food provisioning prompts evolutionary changes in other components of care by allowing parents to choose safer nest sites, and that it promotes the evolution of sibling competition, which in turn further drives the evolution of parental food provisioning. This mutual reinforcement of parental care and sibling competition suggests that evolution of parental food provisioning should show a unidirectional trend from no parental food provisioning to full parental food provisioning.

  19. A Decade in Dental Care Utilization among Adults and Children (2001–2010)

    PubMed Central

    Vujicic, Marko; Nasseh, Kamyar

    2014-01-01

    Objective To decompose the change in pediatric and adult dental care utilization over the last decade. Data 2001 through 2010 Medical Expenditure Panel Survey. Study Design The Blinder-Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year-specific logistic regression models. Outputs from these models were used to compute the Blinder-Oaxaca decomposition. Principal Findings Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p < .05). Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization (−0.018, p < .01). Among children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences. Conclusions Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care. PMID:24299620

  20. Adherence to HIV and TB care and treatment, the role of food security and nutrition.

    PubMed

    Claros, Joan M; de Pee, Saskia; Bloem, Martin W

    2014-10-01

    Food security and nutrition play an important role in HIV and TB care and treatment, including for improving treatment outcomes, adherence and uptake of HIV and TB care. This AIDS and behaviour supplement on "Adherence to HIV and TB care and treatment, the role of food security and nutrition" provides an overview of the current evidence and knowledge about the barriers to uptake and retention in HIV and TB treatment and care and on whether and how food and nutrition assistance can help overcome these barriers. It contains nine papers on three topic areas discussing: (a) adherence and food and nutrition security in context of HIV and TB, their definitions, measurement tools and the current situation; (b) food and nutrition insecurity as barriers to uptake and retention; and (c) food and nutrition assistance to increase uptake and retention in care and treatment. Future interventions in the areas of food security, nutrition and social protection for increasing access and adherence should be from an HIV sensitive lens, linking the continuum of care with health systems, food systems and the community, complementing existing platforms through partnerships and integrated services.

  1. Health and social care management for older adults with multimorbidity: a multiperspective approach.

    PubMed

    Meranius, Martina Summer; Josefsson, Karin

    2017-03-01

    Multimorbidity, a condition common among older adults, may be regarded as a failure of a complex system. The aim of this study was to describe the core components in health and social care management for older adults with multimorbidity. A cross-sectional design included two methods: individual interviews and group discussions. A total of 105 participants included older adults with multimorbidity and their relatives, care staff and healthcare policymakers. Data were analysed using content analysis. The results show that seven core components comprise a multiperspective view of health and social care management for older adults with multimorbidity: political steering, leadership, cooperation, competence, support for relatives, availability and continuity. Steps should be taken to ensure that every older adult with multimorbidity has a treatment plan according to a multiperspective view to prevent fragmentation of their health care. This study provides relevant evidence developing a multiperspective model of health and social care management for older adults with multimorbidity. © 2016 Nordic College of Caring Science.

  2. Care and support for older adults in The Netherlands living independently.

    PubMed

    Verver, Didi; Merten, Hanneke; Robben, Paul; Wagner, Cordula

    2018-05-01

    The growth in the numbers of older adults needing long-term care has resulted in rising costs which have forced the Dutch government to change its long-term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. However, it is unclear whether these older adults have such a network to rely upon. The objective of this study was to gain insight into the providers of formal and informal care to older adults, and to assess possible differences between older adults who are frail and those who are not. In addition, we investigated their care and support needs. We used data from a quantitative survey using a cross-sectional design in different regions of the Netherlands from July until September 2014 (n = 181). Frailty was measured using the Tilburg Frailty indicator. To analyse the data chi-square tests, crosstabs and odds ratios were used for dichotomous data and the Mann-Whitney U-Test for nominal data. The number of formal care providers involved was significantly higher (median = 2) for those deemed frail than for those not deemed frail (median = 1), U = 2,130, p < .005. However, more than one-third of the respondents deemed frail did not get the care or support they needed (33.7%). There was a significant positive association between being frail and having an informal care provider (χ 2  = 18.78, df = 1, p < .005). However, more than one-third of those deemed frail did not have an informal care provider (36.8%). One-third of older adults deemed to be frail did not have their needs sufficiently addressed by their care network. For a substantial part of this group of older adults, the informal network seems to be unable to support them sufficiently. Additional attention for their needs and wishes is required to implement the policy reforms successfully. © 2018 John Wiley & Sons Ltd.

  3. Caring for independent lives: geographies of caring for young adults with intellectual disabilities.

    PubMed

    Power, Andrew

    2008-09-01

    This paper engages with the emerging disciplinary clash between 'care' and 'independence' within disability studies by examining the geography of home care for young adults with intellectual disabilities. The care system as a whole is viewed as central to disablist structures within disability studies (see Thomas, C. (2007). Sociologies of disability and illness: Contested ideas in disability studies and medical sociology. Hampshire: Palgrave Macmillan.). However, despite the theorisation of dependency as being in antipathy to the goals of the disability movement, caregiving at home still continues to dominate community care. The paper attempts to address how family carers are 'caught-in-the-middle' between their 'duty' to care and at the same time, perpetuating dependency; the reality being that parents have to deal with issues of being overprotective and confronting various social assumptions about disability. It examines the narratives from 25 family caregivers in Ireland who provide personal assistance to young adults with intellectual disabilities.

  4. Volunteer home-based HIV/AIDS care and food crisis in Addis Ababa, Ethiopia: sustainability in the face of chronic food insecurity

    PubMed Central

    Maes, Kenneth C; Shifferaw, Selamawit; Hadley, Craig; Tesfaye, Fikru

    2011-01-01

    Low-income volunteers constitute a major part of AIDS care workforces in sub-Saharan Africa, yet little research has been conducted to determine how poverty and insecurity among volunteers impact their wellbeing and the sustainability of the AIDS treatment programmes they support. This paper presents longitudinal ethnographic and epidemiological research documenting how the 2008 food crisis in Addis Ababa affected AIDS care volunteers’ care relationships and motivations. Ethnographic results highlight the distress and demotivation that rising food costs created for caregivers by contributing to their own and their care recipients’ experiences of food insecurity and HIV-related stigmatization. Epidemiological results underscore a high prevalence of food insecurity (approximately 80%) even prior to the peak of food prices. Rising food prices over the 3 years prior to 2008, underemployment and household per capita incomes averaging less than US$1/day, likely contributed to the very high prevalence of food insecurity reported by caregivers in our sample. We also show that new volunteers recruited in early 2008 by one of the non-governmental organizations (NGOs) involved in this study were more likely to be dependants within their households, and that these participants reported lower rates of food insecurity and higher household income. While this shift in volunteer recruitment may help sustain volunteer care programmes in the face of widespread poverty and underemployment, food insecurity was still highly prevalent (58–71%) among this sub-group. Given the inability of the local NGOs that organize volunteers to address the challenge of food insecurity for programme sustainability, our results raise important policy questions regarding compensation for volunteers’ valuable labour and poverty reduction through public health sector job creation. PMID:20439347

  5. Exploring Baseline Food-Media Literacy of Adult Women

    ERIC Educational Resources Information Center

    Peterson, Tina L.

    2012-01-01

    Many media education researchers have identified the importance of adult media literacy but few have studied it. Such literacy is becoming increasingly important with regard to the growing category of food media--advertisements, television programs, and print media among them. Using two focus groups and guided by Primack and Hobbs' (2009) AA, RR,…

  6. Examining Diet-Related Care Practices Among Adults with Type 2 Diabetes: A Focus on Glycemic Index Choices.

    PubMed

    Avedzi, Hayford M; Mathe, Nonsikelelo; Bearman, Stephanie; Storey, Kate; Johnson, Jeffrey A; Johnson, Steven T

    2017-03-01

    We examined self-care dietary practices and usual intakes among adults with Type 2 diabetes in Alberta, Canada, using data from the Healthy Eating and Active Living for Diabetes study. Participants completed a modified Fat/Sugar/Fruit/Vegetable Screener and answered questions about the number of days per week they followed specific diabetes self-care dietary recommendations. Capillary blood samples were collected to assess glycemic control measured by hemoglobin A1c (HbA1c). ANOVA was used to examine differences in dietary self-care, intakes, and glycemic control across categories of days/week of practicing recommended dietary behaviour. Participants (n = 196) were 51% women, mean ± SD age 59.6 ± 8.5 years, with BMI 33.6 ± 6.5 kg/m 2 , and diabetes duration of 5.1 ± 6.3 years. Sixteen percent of participants were unfamiliar with low-GI eating and 28% did not include low-GI foods in their diet. Overall, lower mean intake of saturated fat, trans fat, added sugars, higher fibre, and greater GI were each associated with meeting diabetes-related dietary behaviours including: eating ≥5 servings of vegetables and fruit; avoiding processed high fat foods; and replacing high with low-GI foods (P < 0.05). No clear pattern was observed for low-GI eating and HbA1c.

  7. Bridging the gap: the role of Physiatrists in caring for adults with cerebral palsy.

    PubMed

    Cassidy, Caitlin; Campbell, Nerissa; Madady, Mona; Payne, Michael

    2016-01-01

    Individuals with cerebral palsy (CP) experience a significant gap in care as they move from interdisciplinary pediatric programs to limited or non-existent care in the adult sector. A lack of knowledgeable adult care providers has repeatedly been identified as a challenge in transitioning those with CP from pediatric to adult care. The objective of this study was to determine the extent to which Physiatrists provide care to adults with CP and to identify barriers to their engagement with this population. A survey was distributed to Physiatrists across Canada. Results were analyzed descriptively using SPSS software. Most Physiatrists provide care to very few adults with CP (10 or less), but over 80% feel that Physiatry is the most appropriate specialty to provide disability-related care to adults with CP following their pediatric discharge. Among the most frequently identified barriers to caring for this population were lack of accessible resources (i.e. social work, funded therapy, equipment) and lack of referrals. Physiatrists are willing and appropriate partners in transitioning patients with CP to adult care. Barriers to Physiatrists' engagement with this population appear to be amenable to change. A lack of knowledgeable and interested adult practitioners has repeatedly been identified as a challenge in transition planning for young adults with cerebral palsy (the vast majority of whom survive into adulthood). Physiatrists are ideally suited to manage adults with cerebral palsy, yet in this survey-based study, a majority of Canadian Physiatrists report caring for less than five adults with cerebral palsy on a regular basis. Barriers to further physiatric involvement in this population were reported to include lack of accessible resources and lack of referrals.

  8. Treatment issues for children with epilepsy transitioning to adult care.

    PubMed

    Nabbout, Rima; Camfield, Carol S; Andrade, Danielle M; Arzimanoglou, Alexis; Chiron, Catherine; Cramer, Joyce A; French, Jacqueline A; Kossoff, Eric; Mula, Marco; Camfield, Peter R

    2017-04-01

    This is the third of three papers that summarize the second symposium on Transition in Epilepsies held in Paris in June 2016. This paper focuses on treatment issues that arise during the course of childhood epilepsy and make the process of transition to adult care more complicated. Some AEDs used during childhood, such as stiripentol, vigabatrin, and cannabidiol, are unfamiliar to adult epilepsy specialists. In addition, new drugs are being developed for treatment of specific childhood onset epilepsy syndromes and have no indication yet for adults. The ketogenic diet may be effective during childhood but is difficult to continue in adult care. Regional adult epilepsy diet clinics could be helpful. Polytherapy is common for patients transitioning to adult care. Although these complex AED regimes are difficult, they are often possible to simplify. AEDs used in childhood may need to be reconsidered in adulthood. Rescue medications to stop prolonged seizures and clusters of seizures are in wide home use in children and can be continued in adulthood. Adherence/compliance is notoriously difficult for adolescents, but there are simple clinical approaches that should be helpful. Mental health issues including depression and anxiety are not always diagnosed and treated in children and young adults even though effective treatments are available. Attention deficit hyperactivity disorder and aggressive behavior disorders may interfere with transition and successful adulthood but these can be treated. For the majority, the adult social outcome of children with epilepsy is unsatisfactory with few proven interventions. The interface between pediatric and adult care for children with epilepsy is becoming increasingly complicated with a need for more comprehensive transition programs and adult epileptologists who are knowledgeable about special treatments that benefit this group of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The shortened food expectations--Long-term care questionnaire: Assessing nursing home residents' satisfaction with food and food service.

    PubMed

    Crogan, Neva L; Evans, Bronwynne C

    2006-11-01

    Lack of nursing home resident satisfaction with meals often results in reduced food intake, leading to poor nutritional status, weight loss, functional decline, and depression. The purpose of this article is to describe the development and initial testing of the 28-item revised Food Expectations-Long-Term Care (FoodEx-LTC) questionnaire with a convenience sample of nursing home residents (N = 61). Because of possible respondent burden, the original 44-item, five-domain FoodEx-LTC was revised, resulting in the deletion of 16 redundant items and those with inter-item correlations less than .25. Coefficient alpha scores ranged from .65 to .82, and test-retest correlations ranged from .79 to .88, dependent on domain. This revised instrument has good initial validity and reliability, resulting in a shorter instrument that accurately assesses nursing home resident satisfaction with food and food service.

  10. How emotions expressed by adults' faces affect the desire to eat liked and disliked foods in children compared to adults.

    PubMed

    Barthomeuf, Laetitia; Droit-Volet, Sylvie; Rousset, Sylvie

    2012-06-01

    The aim of this study was to determine whether or not pleasure, neutrality, and disgust expressed by eaters in photographs could affect the desire to eat food products to a greater extent in children than in adults. Children of 5 and 8 years of age, as well as adults, were presented with photographs of liked and disliked foods. These foods were presented either alone or with an eater who expressed three different emotions: pleasure, neutrality, or disgust. Results showed that, compared with food presented alone, food presented with a pleasant face increased the desire to eat disliked foods, particularly in children, and increased the desire to eat liked foods only in the 5-year-old children. In contrast, with a disgusted face, the desire to eat the liked foods decreased in all participants, although to a greater extent in children, while it had no effect on the desire to eat the disliked foods. Finally, food presented with a neutral face also increased and decreased the desire to eat disliked and liked foods, respectively, and in each case more for the 5-year-olds than for the older participants. In sum, the facial expressions of others influence the desire to eat liked and disliked foods and, to a greater extent, in younger children. ©2011 The British Psychological Society.

  11. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... adjustments to the national average payment rates for meals and snacks served in child care centers, outside... payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates...] Lunch and Centers Breakfast supper \\1\\ Snack Contingous States: Paid 0.26 0.26 0.06 Reduced Price 1.18 2...

  12. Food sources of energy and nutrients among adults in the US: NHANES 2003–2006.

    PubMed

    O'Neil, Carol E; Keast, Debra R; Fulgoni, Victor L; Nicklas, Theresa A

    2012-12-19

    Identification of current food sources of energy and nutrients among US adults is needed to help with public health efforts to implement feasible and appropriate dietary recommendations. To determine the food sources of energy and 26 nutrients consumed by US adults the 2003-2006 National Health and Nutrition Examination Survey (NHANES) 24-h recall (Day 1) dietary intake data from a nationally representative sample of adults 19+ years of age (y) (n = 9490) were analyzed. An updated USDA Dietary Source Nutrient Database was developed for NHANES 2003-2006 using current food composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from food sources were sample-weighted. Percentages of total dietary intake contributed from food sources were ranked. The highest ranked sources of energy and nutrients among adults more than 19 years old were: energy - yeast bread/rolls (7.2%) and cake/cookies/quick bread/pastry/pie (7.2%); protein-poultry (14.4%) and beef (14.0%); total fat - other fats and oils (9.8%); saturated fatty acids - cheese (16.5%) and beef (9.1%); carbohydrate - soft drinks/soda (11.4%) and yeast breads/rolls (10.9%); dietary fiber - yeast breads/rolls (10.9%) and fruit (10.2%); calcium - milk (22.5%) and cheese (21.6%); vitamin D - milk (45.1%) and fish/shellfish (14.4%); and potassium - milk (9.6%) and coffee/tea/other non-alcoholic beverages (8.4%). Knowledge of primary food sources of energy and nutrients can help health professionals design effective strategies to reduce excess energy consumed by US adults and increase the nutrient adequacy of their diets.

  13. Food Sources of Energy and Nutrients among Adults in the US: NHANES 2003–2006

    PubMed Central

    O’Neil, Carol E.; Keast, Debra R.; Fulgoni, Victor L.; Nicklas, Theresa A.

    2012-01-01

    Identification of current food sources of energy and nutrients among US adults is needed to help with public health efforts to implement feasible and appropriate dietary recommendations. To determine the food sources of energy and 26 nutrients consumed by US adults the 2003–2006 National Health and Nutrition Examination Survey (NHANES) 24-h recall (Day 1) dietary intake data from a nationally representative sample of adults 19+ years of age (y) (n = 9490) were analyzed. An updated USDA Dietary Source Nutrient Database was developed for NHANES 2003–2006 using current food composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from food sources were sample-weighted. Percentages of total dietary intake contributed from food sources were ranked. The highest ranked sources of energy and nutrients among adults more than 19 years old were: energy—yeast bread/rolls (7.2%) and cake/cookies/quick bread/pastry/pie (7.2%); protein—poultry (14.4%) and beef (14.0%); total fat—other fats and oils (9.8%); saturated fatty acids—cheese (16.5%) and beef (9.1%); carbohydrate—soft drinks/soda (11.4%) and yeast breads/rolls (10.9%); dietary fiber—yeast breads/rolls (10.9%) and fruit (10.2%); calcium—milk (22.5%) and cheese (21.6%); vitamin D—milk (45.1%) and fish/shellfish (14.4%); and potassium—milk (9.6%) and coffee/tea/other non-alcoholic beverages (8.4%). Knowledge of primary food sources of energy and nutrients can help health professionals design effective strategies to reduce excess energy consumed by US adults and increase the nutrient adequacy of their diets. PMID:23363999

  14. Novel technologies for assessing dietary intake: evaluating the usability of a mobile telephone food record among adults and adolescents.

    PubMed

    Daugherty, Bethany L; Schap, TusaRebecca E; Ettienne-Gittens, Reynolette; Zhu, Fengqing M; Bosch, Marc; Delp, Edward J; Ebert, David S; Kerr, Deborah A; Boushey, Carol J

    2012-04-13

    The development of a mobile telephone food record has the potential to ameliorate much of the burden associated with current methods of dietary assessment. When using the mobile telephone food record, respondents capture an image of their foods and beverages before and after eating. Methods of image analysis and volume estimation allow for automatic identification and volume estimation of foods. To obtain a suitable image, all foods and beverages and a fiducial marker must be included in the image. To evaluate a defined set of skills among adolescents and adults when using the mobile telephone food record to capture images and to compare the perceptions and preferences between adults and adolescents regarding their use of the mobile telephone food record. We recruited 135 volunteers (78 adolescents, 57 adults) to use the mobile telephone food record for one or two meals under controlled conditions. Volunteers received instruction for using the mobile telephone food record prior to their first meal, captured images of foods and beverages before and after eating, and participated in a feedback session. We used chi-square for comparisons of the set of skills, preferences, and perceptions between the adults and adolescents, and McNemar test for comparisons within the adolescents and adults. Adults were more likely than adolescents to include all foods and beverages in the before and after images, but both age groups had difficulty including the entire fiducial marker. Compared with adolescents, significantly more adults had to capture more than one image before (38% vs 58%, P = .03) and after (25% vs 50%, P = .008) meal session 1 to obtain a suitable image. Despite being less efficient when using the mobile telephone food record, adults were more likely than adolescents to perceive remembering to capture images as easy (P < .001). A majority of both age groups were able to follow the defined set of skills; however, adults were less efficient when using the mobile

  15. Transition to Adult Care for Youth with Type 1 Diabetes

    PubMed Central

    Garvey, Katharine C.; Markowitz, Jessica T.

    2014-01-01

    Emerging adults with type 1 diabetes are at risk for poor glycemic control, gaps in medical care, and adverse health outcomes. With the increasing incidence in type 1 diabetes in the pediatric population, there will be an increase in the numbers of teens and young adults transferring their care from pediatric providers to adult diabetes services in the future. In recent years, the topic of transitioning pediatric patients with type 1 diabetes to adult diabetes care has been discussed at length in the literature and there have been many observational studies. However, there are few interventional studies and, to date, no randomized clinical trials. This paper discusses the rationale for studying this important area. We review both observational and interventional literature over the past several years, with a focus on new research. In addition, important areas for future research are outlined. PMID:22922877

  16. Transitioning from pediatric to adult health care with familial hypercholesterolemia: Listening to young adult and parent voices.

    PubMed

    Sliwinski, Samantha K; Gooding, Holly; de Ferranti, Sarah; Mackie, Thomas I; Shah, Supriya; Saunders, Tully; Leslie, Laurel K

    Young adults with familial hypercholesterolemia (FH) are at a critical period for establishing behaviors to promote future cardiovascular health. To examine challenges transitioning to adult care for young adults with FH and parents of FH-affected young adults in the context of 2 developmental tasks, transitioning from childhood to early adulthood and assuming responsibility for self-management of a chronic disorder. Semistructured, qualitative interviews were conducted with 12 young adults with FH and 12 parents of affected young adults from a pediatric subspecialty preventive cardiology program in a northeastern academic medical center. Analyses were conducted using a modified grounded theory framework. Respondents identified 5 challenges: (1) recognizing oneself as a decision maker, (2) navigating emerging independence, (3) prioritizing treatment for a chronic disorder with limited signs and symptoms, (4) managing social implications of FH, and (5) finding credible resources for guidance. Both young adults and parents proposed similar recommendations for addressing these challenges, including the need for family and peer involvement to establish and maintain diet and exercise routines and to provide medication reminders. Systems-level recommendations included early engagement of adolescents in shared decision-making with health care team; providing credible, educational resources regarding FH; and using blood tests to track treatment efficacy. Young adults with FH transitioning to adult care may benefit from explicit interventions to address challenges to establishing healthy lifestyle behaviors and medication adherence as they move toward being responsible for their medical care. Further research should explore the efficacy of recommended interventions. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  17. A New Health Care Prevention Agenda: Sustainable Food Procurement and Agricultural Policy

    PubMed Central

    Harvie, Jamie; Mikkelsen, Leslie; Shak, Linda

    2009-01-01

    Health care leaders are broadening their awareness to include the need to address the food system as a means to individual, public, and global health, above and beyond basic nutritional factors. Key voices from the health care sector have begun to engage in market transformation and are aggregating to articulate the urgency for engagement in food and agricultural policy. Systemic transformation requires a range of policies that complement one another and address various aspects of the food system. Health care involvement in policy and advocacy is vital to solve the expanding ecological health crises facing our nation and globe and will require an urgency that may be unprecedented. PMID:23144678

  18. A New Health Care Prevention Agenda: Sustainable Food Procurement and Agricultural Policy.

    PubMed

    Harvie, Jamie; Mikkelsen, Leslie; Shak, Linda

    2009-07-01

    Health care leaders are broadening their awareness to include the need to address the food system as a means to individual, public, and global health, above and beyond basic nutritional factors. Key voices from the health care sector have begun to engage in market transformation and are aggregating to articulate the urgency for engagement in food and agricultural policy. Systemic transformation requires a range of policies that complement one another and address various aspects of the food system. Health care involvement in policy and advocacy is vital to solve the expanding ecological health crises facing our nation and globe and will require an urgency that may be unprecedented.

  19. Interviewing Baltimore Older Adults about Food System Change: Oral History as a Teaching Tool

    ERIC Educational Resources Information Center

    Neff, Roni A.; Laestadius, Linnea I.; DiMauro, Susan; Palmer, Anne M.

    2017-01-01

    Urban food systems have changed considerably over the past half century. Older adults' descriptions of place-based, personal food system history can help inform student learning and may contribute to expert understanding of food system change. Structural and social shifts in food purchasing and consumption contribute to diet-related disease and…

  20. Exposure assessment of adult intake of bisphenol A (BPA) with emphasis on canned food dietary exposures.

    PubMed

    Lorber, Matthew; Schecter, Arnold; Paepke, Olaf; Shropshire, William; Christensen, Krista; Birnbaum, Linda

    2015-04-01

    Bisphenol A (BPA) is a high-volume, synthetic compound found in epoxy resins and plastics used in food packaging. Food is believed to be a major source of BPA intake. In this study, we measured the concentration of BPA in convenience samplings of foodstuffs purchased in Dallas, Texas. Sampling entailed collection of 204 samples of fresh, frozen, and canned foods in two rounds in 2010. BPA was positive in 73% of the canned food samples, while it was found in only 7% of non-canned foods at low concentrations. The results of this food sampling program were used to calculate adult dietary intakes of BPA. A pathway approach combined food intakes, a "canned fraction" parameter which described what portion of total intake of that food came from canned products, and measured food concentrations. Dietary intakes were calculated as 12.6 ng/kg-day, of which 12.4 ng/kg-day was from canned foods. Canned vegetable intakes alone were 11.9 ng/kg-day. This dietary intake was compared to total intakes of BPA estimated from urine measurements of the National Health and Nutrition Examination Survey (NHANES). Total adult central tendency intakes ranged from 30 to 70 ng/kg-day for NHANES cycles between 2005 and 2010. Three possibilities were explored to explain the difference between these two approaches for intake estimation. Not all foods which may have been canned, particularly canned beverages such as soft drinks, were sampled in our food sampling program. Second, non-food pathways of exposure may be important for adults, including thermal paper exposures, and dust and air exposures. Finally, our canned food concentrations may not be adequately representative of canned foods in the United States; they were found to be generally lower compared to canned food concentrations measured in six other worldwide food surveys including three in North America. Our finding that canned food concentrations greatly exceeded non-canned concentrations was consistent with other studies, and

  1. Rural adults' perspectives on school food in a North Carolina county.

    PubMed

    Jeffries, Jayne K; Thayer, Linden M; Hennink-Kaminski, Heidi; Noar, Seth M

    2015-04-23

    To address alarming rates of youth obesity, multiple stakeholder perspectives must be understood and considered when developing nutrition interventions. The purpose of this qualitative study was to examine adults' perceptions of school food in rural North Carolina and their opinions about potential changes to encourage students to eat more fruits and vegetables in school meals. We conducted semistructured key informant interviews by telephone from February through March 2013 to determine adult opinions regarding elementary school food and child health. Participants included parents, teachers, school administrators, and a cafeteria staff member. Interview transcripts were thematically analyzed using Dedoose qualitative analysis software. Four themes emerged from key informant interviews regarding school meals and increasing fruit and vegetable consumption: 1) schools are an appropriate place for nutritious food, 2) current school food is bland and unappealing, 3) school cafeterias can use simple strategies to increase fruit and vegetable intake, and 4) federal school meal guidelines are perceived as barriers to increased fruit and vegetable intake during school meals. Study findings suggest that training and support for cafeteria staff on healthy food preparation and presentation are critical and that there should be a "meeting in the middle" between child appeal and health. Nutritious and appealing school food options may have the potential to greatly increase fruit and vegetable consumption in rural elementary schools in North Carolina.

  2. Regurgitative food transfer among wild wolves

    Treesearch

    L. David Mech; Paul C. Wolf; Jane M. Packard

    1999-01-01

    Few studies of monogamous canids have addressed regurgitation in the context of extended parental care and alloparental care within family groups. We studied food transfer by regurgitation in a pack of wolves on Ellesmere Island, North West Territories, Canada, during 6 summers from 1988 through 1996. All adult wolves, including yearlings and a post-reproductive female...

  3. Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review.

    PubMed

    Williamson, Heather J; Contreras, Graciela M; Rodriguez, Erica S; Smith, Jennifer M; Perkins, Elizabeth A

    2017-10-01

    Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study's purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.

  4. Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults.

    PubMed

    Beach, Scott R; Schulz, Richard

    2017-03-01

    To examine caregiver factors associated with unmet needs for care of older adults. Population-based surveys of caregivers and older adult care recipients in the United States in 2011. 2011 National Health and Aging Trends Study and National Study of Caregiving. Family caregivers (n = 1,996) of community-dwelling older adults with disabilities (n = 1,366). Disabled care recipient reports of unmet needs for care in the past month with activities of daily living (ADLs; e.g., wet or soiled clothing), mobility (e.g., have to stay inside), or instrumental activities of daily living (IADLs; e.g., medication errors). Caregiver reported sociodemographic characteristics, caregiving intensity and tasks performed, health, and psychosocial effects. Of the care recipients, 44.3% reported at least one unmet need for care in the past month (38.2% ADL related, 14.6% IADL related). Younger caregivers, caregiving sons, caregivers not living with care recipients, and having supplemental paid caregivers were associated with more unmet needs. Caregivers with recipients reporting two or more unmet needs were more likely to spend more than 100 hours per month caregiving, help with skin care and wounds, report caregiving as emotionally and physically difficult, and report restricted participation in valued activities (all P < .001). Unmet ADL needs are prevalent among older adults with family caregivers. Caregivers experiencing high levels of burden, stress, and negative physical and psychosocial impacts may provide substandard or poor care to older adults, which may be a risk factor for neglect. Clinicians caring for disabled older adults should assess their unmet needs and the capacity of caregivers to address them. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Secular trends in reported portion size of food and beverages consumed by Irish adults.

    PubMed

    O'Brien, Sinead A; Livingstone, M Barbara E; McNulty, Breige A; Lyons, Jacqueline; Walton, Janette; Flynn, Albert; Segurado, Ricardo; Dean, Moira; Spence, Michelle; McCaffrey, Tracy A; Pourshahidi, L Kirsty; Nugent, Anne P; Gibney, Eileen R

    2015-04-14

    The present analysis aimed to investigate the changes in the reported portion sizes (PS) of foods and beverages commonly consumed by Irish adults (18-64 years) from the North South Ireland Food Consumption Survey (NSIFCS) (1997-2001) and the National Adult Nutrition Survey (NANS) (2008-10). Food PS, which are defined as the weight of food (g) consumed per eating occasion, were calculated for comparable foods and beverages in two nationally representative cross-sectional Irish food consumption surveys and were published in NSIFCS and NANS. Repeated measure mixed model analysis compared reported food PS at the total population level as well as subdivided by sex, age, BMI and social class. A total of thirteen commonly consumed foods were examined. The analysis demonstrated that PS significantly increased for five foods ('white sliced bread', 'brown/wholemeal breads', 'all meat, cooked', 'poultry, roasted' and 'milk'), significantly decreased for three ('potatoes', 'chips/wedges' and 'ham, sliced') and did not significantly change for five foods ('processed potato products', 'bacon/ham', 'cheese', 'yogurt' and 'butter/spreads') between the NSIFCS and the NANS. The present study demonstrates that there was considerable variation in the trends in reported food PS over this period.

  6. Online version of the food allergy quality of life questionnaire-adult form: validity, feasibility and cross-cultural comparison.

    PubMed

    Goossens, N J; Flokstra-de Blok, B M J; Vlieg-Boerstra, B J; Duiverman, E J; Weiss, C C; Furlong, T J; Dubois, A E J

    2011-04-01

    Food-allergic reactions occur in 3-4% of the adult population in Western countries. It has been shown that food allergy may impair health-related quality of life (HRQL). Food allergy quality of life questionnaires (FAQLQs) have been developed and validated, including an adult form (FAQLQ-AF). These questionnaires may be particularly useful for cross-cultural comparisons. The aims of this study were to translate the FAQLQ-AF from Dutch into English and validate an online version in the United States. Additionally, HRQL of American and Dutch food-allergic adults was compared. The Dutch FAQLQ-AF was translated into English as set out by the World Health Organization and converted to an electronic online format. Participants (food allergic American adults) were recruited through the 'Food Allergy and Anaphylaxis Network' website and completed the questionnaire online. Construct validity, internal consistency, discriminative ability and feasibility were analysed. A cross-cultural comparison was made using the Dutch FAQLQ-AF scores. Data from 180 American participants were analysed. The online FAQLQ-AF had a good construct validity (correlation with FAIM: ρ=0.72; P<0.001), internal consistency (Cronbach's α=0.95) and was discriminative for 'anaphylaxis' vs. 'no anaphylaxis' and 'number of food allergies'. The most striking finding was a significantly greater impairment in HRQL in the American participants, as compared with their Dutch counterparts (the total FAQLQ-AF scores were 4.3 vs. 3.5, respectively; P<0.001, where 1 signifies no impairment and 7 signifies extreme impairment in HRQL). The online American FAQLQ-AF is a valid instrument to measure HRQL in food-allergic patients in the United States. Additionally, HRQL of American food-allergic adults may be more impaired than Dutch food-allergic adults. The FAQLQ-AF can now be used to determine the HRQL in American food-allergic adults and can assist clinicians in optimizing management strategies for food

  7. Lower nutritional status and higher food insufficiency in frail older US adults.

    PubMed

    Smit, Ellen; Winters-Stone, Kerrie M; Loprinzi, Paul D; Tang, Alice M; Crespo, Carlos J

    2013-07-14

    Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (n 4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as 'sometimes' or 'often' not having enough food to eat. Analyses were adjusted for sex, race, age, smoking, education, income, BMI, other co-morbid conditions and complex survey design. Prevalence of frailty was highest among people who were obese (20·8 %), followed by overweight (18·4 %), normal weight (16·1 %) and lowest among people who were underweight (13·8 %). Independent of BMI, daily energy intake was lowest in people who were frail, followed by pre-frail and highest in people who were not frail (6648 (se 130), 6966 (se 79) and 7280 (se 84) kJ, respectively, P< 0·01). Energy-adjusted macronutrient intakes were similar in people with and without frailty. Frail (adjusted OR (AOR) 4·7; 95 % CI 1·7, 12·7) and pre-frail (AOR 2·1; 95 % CI 0·8, 5·8) people were more likely to report being food insufficient than not frail people. Serum albumin, carotenoids and Se levels were lower in frail adults than not frail adults. Research is needed on targeted interventions to improve nutritional status and food insufficiency among frail older adults, while not necessarily increasing BMI.

  8. On Your Own: Older Adults' Food Choice and Dietary Habits.

    PubMed

    Whitelock, Emily; Ensaff, Hannah

    2018-03-27

    The United Kingdom, in common with many countries, has an ageing demographic. Changes accompanying ageing can influence food choice and dietary habits. This study explored older adults' perceptions and practices related to dietary behaviour and the factors influencing their food choice in later life. Semi-structured focus-group discussions were conducted with 30 individuals (aged 63-90 years) in a UK city. An inductive thematic approach was adopted for data analysis, and 4 themes and 12 sub-themes emerged: age-related changes (lower appetite, food changes, declining physical function); food access (food cost, support with food, maintaining independence); on your own (cooking for one, eating alone, shopping for one); and relationship with food (food variety, eating what you want, dieting). These influenced participants' food acquisition, food preparation and cooking, as well as eating habits. Living alone and its substantial influence, as well as associated social isolation and loneliness, were highlighted in many of the discussions. Given the possible implications for nutritional intake, further work is recommended in this area. Likewise, steps should be taken to improve food access, increase opportunities for commensal eating and, fundamentally, address social isolation and loneliness in the older population.

  9. Food security among young adults with disabilities in the United States: Findings from the National Health Interview Survey.

    PubMed

    Brucker, Debra L

    2016-04-01

    Prior research has suggested that young adults with disabilities face economic, health and social disadvantage. Food security, an area of disadvantage that can influence overall health, has not been fully explored for this population. To examine levels of food security between young adults with and without disabilities, controlling for individual characteristics. Logistic regression analysis of a nationally representative sample of young adults (age 18-25) (n = 32,795) with and without disabilities, using pooled data form the 2011-2013 National Health Interview Survey. Young adults with disabilities have significantly higher odds (OR: 2.58, p < 0.001) of living in a household that is food insecure than young adults without disabilities, even when controlling for individual characteristics. Odds of living in a household that is food insecure are particularly high (OR: 5.35, p < 0.001) among young adults with high levels of psychological distress, controlling for other factors. Young adults with disabilities have increased odds of living in a household that is food insecure. This study has important policy and community program implications. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Obese older adults report high satisfaction and positive experiences with care

    PubMed Central

    2014-01-01

    Background Obese, older adults often have multiple chronic conditions resulting in multiple health care encounters. However, their satisfaction and experiences with care are not well understood. The objective of this study was to examine the independent impact of obesity on patient satisfaction and experiences with care in adults 65 years of age and older with Medigap insurance. Methods Surveys were mailed to 53,286 randomly chosen adults with an AARP® Medicare Supplement Insurance Plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) in 10 states. Following adjustment for non-response bias, multivariate regression modeling was used to adjust for demographic, socioeconomic and health status differences to estimate the independent impact of weight on satisfaction and experiences with care. Outcome variables included four global and four composite measures of satisfaction and experiences with care. Results 21.4% of the respondents were obese. Relative to normal weight, obesity was significantly associated with higher patient satisfaction and better experiences with care in seven of the eight ratings measured. Conclusions Obese individuals were more satisfied and had better experiences with care. Obese individuals had more office visits and discussions about nutrition, exercise and medical checks. This may have led to increased attentiveness to care, explaining the increase in satisfaction and better experiences with care. Given the high level of satisfaction and experiences with care in older, obese adults, opportunities exist for clinicians to address weight concerns in this population. PMID:24885429

  11. "Not such a kid thing anymore": Young adults' perspectives on transfer from paediatric to adult cardiology care.

    PubMed

    Catena, G; Rempel, G R; Kovacs, A H; Rankin, K N; Muhll, I V; Mackie, A S

    2018-03-25

    Transfer of adolescents with congenital heart disease from paediatric cardiology providers to specialized adult congenital heart disease (ACHD) care providers is becoming a standard practice. However, some paediatric cardiologists continue to provide care for their patients into adult life. Little is known about the perspectives of young adult patients who have been transferred to ACHD clinics versus those who continue to receive their cardiology care in paediatric settings. Content and thematic analysis of structured telephone interviews with 21 young adults age 18-25 (13 transferred to ACHD clinic and 8 who had not transferred) was conducted to identify similarities and differences in patient characteristics of those in ACHD versus paediatric settings. There were no appreciable differences in gender, age, heart disease type, and independence between those transferred to ACHD care versus those not transferred. Participants in both groups were aware of differences between the paediatric and ACHD care settings and providers, with some favouring the familiarity offered by the paediatric setting and providers. Participants had varying views on parental involvement in their care; most of them had attended clinic appointments on their own. Those who had transferred to ACHD care acknowledged that it would take time to adjust to new relationships. Positive perspectives on actual or anticipated transfer to ACHD care included a growing sense of autonomy and responsibility, as well as access to reproductive information relevant to ACHD patients. The absence of patient characteristics distinguishing those in ACHD care versus those still followed in paediatric care suggests that system, provider, and parent factors, rather than patient factors, may account for patients' perspectives on transfer to ACHD care. © 2018 John Wiley & Sons Ltd.

  12. Reproductive Health-Care Utilization of Young Adults Insured as Dependents.

    PubMed

    Andrasfay, Theresa

    2018-05-01

    The common practice of sending an explanation of benefits to policyholders may inadvertently disclose sensitive services to the parents of dependents, making confidentiality a potential barrier to reproductive health care. This study compares the reproductive health-care utilization of young adult dependents and young adult policyholders using nationally representative data collected after full implementation of the Affordable Care Act. Data from 2,108 young adults aged 18-25 years in the 2015 National Health Interview Survey were analyzed. Logistic regressions predicted utilization of two preventive services (general doctor visit and flu vaccination) and four reproductive health services (HIV testing, obstetrician/gynecologist visit, hormonal contraceptive use, and Pap testing) from the insurance type of the young adult (dependent, privately insured policyholder, or Medicaid). In unadjusted analyses, young adult dependents had lower utilization of HIV tests than their peers who were privately insured or Medicaid policyholders. Young women dependents had lower utilization of Pap tests than young women on Medicaid. Once controls were included, young adult dependents did not have significantly lower odds of obtaining reproductive health care than privately insured policyholders. Dependent young men still had marginally lower odds of ever having an HIV test (adjusted odds ratio = .65, p = .08) and dependent young women still had marginally lower odds of ever having a Pap test (adjusted odds ratio = .58, p = .06) than comparable Medicaid policyholders. Despite confidentiality concerns, young adults insured as dependents have utilization of several reproductive health services similar to that of comparable young adult policyholders. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. The effects of a foot and toenail care protocol for older adults.

    PubMed

    Chan, Helen Y L; Lee, Diana T F; Leung, Edward M F; Man, Chui-Wah; Lai, Kwok-Man; Leung, Man-Wai; Wong, Irene K Y

    2012-01-01

    Foot and toenail problems are prevalent among older adults. The importance of foot care is often overlooked, however, because the associated problems are often considered to be minor. These "minor" problems often result in unnecessary distress and complications for older adults. This study aims to develop and examine the effects of a foot and toenail care protocol on promoting foot health in older adults. It includes a thorough assessment of foot health, footwear conditions, and specific self-care ability. On the basis of the assessment, an individualized nursing care plan was devised. It has been found that the implementation of the care protocol can help to increase the awareness of nurses and older adults with regard to foot health and that some foot and toenail problems can be identified earlier and better managed. Copyright © 2012 Mosby, Inc. All rights reserved.

  14. Psychological factors impacting transition from paediatric to adult care by childhood cancer survivors.

    PubMed

    Granek, Leeat; Nathan, Paul C; Rosenberg-Yunger, Zahava R S; D'Agostino, Norma; Amin, Leila; Barr, Ronald D; Greenberg, Mark L; Hodgson, David; Boydell, Katherine; Klassen, Anne F

    2012-09-01

    Childhood cancer survivors require life-long care focused on the specific late effects that may arise from their cancer and its treatment. In many centers, survivors are required to transition from follow-up care in a paediatric cancer center, to care provided in an adult care setting. The purpose of this study was to identify the psychological factors involved in this transition to adult care long-term follow-up clinics. Qualitative interviews were conducted with ten paediatric survivors still in paediatric care, as well as 28 adult survivors of whom 11 had transitioned successfully to adult care (attended three long-term follow-up (LTFU) appointments consecutively); ten who failed to transition (attended at least one LTFU appointment as an adult, but were inconsistent with subsequent attendance); and seven who had never transitioned (did not attend any LTFU care as an adult). Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Two overall categories and four subthemes were identified: (1) Identification with being a cancer survivor included the subthemes of 'cancer identity' and 'cancer a thing of the past' and; (2) Emotional components included the subthemes of 'fear and anxiety' and 'gratitude and gaining perspective'. The analysis revealed that the same factor could act as either a motivator or a hindrance to successful transition in different survivors (e.g., fear of recurrence of cancer might be a barrier or a facilitator depending on the survivor's life experience). Psychological factors are an important consideration when preparing cancer survivors for transition to adult long-term follow-up care. Identifying and addressing the individual psychological needs of childhood cancer survivors may improve the likelihood of their successful transition to adult care.

  15. Who Provides Care? A Prospective Study of Caregiving Among Adult Siblings

    PubMed Central

    Pillemer, Karl; Suitor, J. Jill

    2014-01-01

    Purpose: We use data from a longitudinal, within-family study to identify factors that predict which adult siblings assumed caregiving responsibilities to older mothers over a 7-year period. Design and Methods: Data for the study were collected from 139 older mothers at 2 points 7 years apart regarding their expectations and experiences of care from 537 adult children. Results: Children whom mothers identified at T1 as their expected future caregivers were much more likely to provide care when a serious illness occurred. Caregiving offspring were also more likely at T1 to have shared their mothers’ values, lived in proximity, and to be daughters. Implications: The findings indicate the degree to which a mother’s expectations for care predict actual caregiving by that child. Practitioners working with older adults should explore parents’ expectations for future care that involves their adult children. PMID:23840019

  16. Food insecurity and diabetes self-management among food pantry clients.

    PubMed

    Ippolito, Matthew M; Lyles, Courtney R; Prendergast, Kimberly; Marshall, Michelle Berger; Waxman, Elaine; Seligman, Hilary Kessler

    2017-01-01

    To examine the association between level of food security and diabetes self-management among food pantry clients, which is largely not possible using clinic-based sampling methods. Cross-sectional descriptive study. Community-based food pantries in California, Ohio and Texas, USA, from March 2012 through March 2014. Convenience sample of adults with diabetes queuing at pantries (n 1237; 83 % response). Sampled adults were stratified as food secure, low food secure or very low food secure. We used point-of-care glycated Hb (HbA1c) testing to determine glycaemic control and captured diabetes self-management using validated survey items. The sample was 70 % female, 55 % Latino/Hispanic, 25 % white and 10 % black/African American, with a mean age of 56 years. Eighty-four per cent were food insecure, one-half of whom had very low food security. Mean HbA1c was 8·1 % and did not vary significantly by food security status. In adjusted models, very-low-food-secure participants, compared with both low-food-secure and food-secure participants, had poorer diabetes self-efficacy, greater diabetes distress, greater medication non-adherence, higher prevalence of severe hypoglycaemic episodes, higher prevalence of depressive symptoms, more medication affordability challenges, and more food and medicine or health supply trade-offs. Few studies of the health impact of food security have been able to examine very low food security. In a food pantry sample with high rates of food insecurity, we found that diabetes self-management becomes increasingly difficult as food security worsens. The efficacy of interventions to improve diabetes self-management may increase if food security is simultaneously addressed.

  17. Health system strategies supporting transition to adult care.

    PubMed

    Hepburn, Charlotte Moore; Cohen, Eyal; Bhawra, Jasmin; Weiser, Natalie; Hayeems, Robin Z; Guttmann, Astrid

    2015-06-01

    The transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient and family satisfaction. However, little is known about health system strategies to streamline and safeguard care for youth transitioning to adult services. Moreover, the needs of children and youth are often excluded from broader health system reform discussions, leaving this population especially vulnerable to system 'disintegration'. (1) To explore the international policy profile of paediatric-to-adult care transitions, and (2) to document policy objectives, initiatives and outcomes for jurisdictions publicly committed to addressing transition issues. An international policy scoping review of all publicly available government documents detailing transition-related strategies was completed using a web-based search. Our analysis included a comparable cohort of nine wealthy Organisation for Economic Co-operation and Development (OECD) jurisdictions with Beveridge-style healthcare systems (deemed those most likely to benefit from system-level transition strategies). Few jurisdictions address transition of care issues in either health or broader social policy documents. While many jurisdictions refer to standardised practice guidelines, a few report the intention to use powerful policy levers (including physician remuneration and non-physician investments) to facilitate the uptake of best practice. Most jurisdictions do not address the policy infrastructure required to support successful transitions, and rigorous evaluations of transition strategies are rare. Despite the well-documented risks and costs associated with a poor transition from paediatric to adult care, little policy attention has been paid to this issue. We recommend that healthcare providers engage health system planners in the design and evaluation of system-level, policy-sensitive transition strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not

  18. Consumption of sugar-sweetened beverages and discretionary foods among US adults by purchase location.

    PubMed

    An, R; Maurer, G

    2016-12-01

    Excess calorie intake from sugar-sweetened beverages (SSBs) and energy-dense, nutrient-poor foods occupies a significant proportion of Western diet. The aim of this study was to examine consumption of SSBs and discretionary foods in US adults by purchase location. Nationally representative 24-h dietary recall data came from the 2011-2012 National Health and Nutrition Examination Survey. The discretionary food category identifies energy-dense, nutrient-poor foods that do not necessarily contain essential nutrients but may add variety and enjoyment. Linear regressions were performed to estimate daily calorie intake from SSBs and discretionary foods by purchase location (supermarket/grocery store, convenience store, vending machine, fast-food restaurant, full-service restaurant and other source), adjusting for individual characteristics and sampling design. During 2011-2012, 46.3% and 88.8% of US adults consumed SSBs and discretionary foods on any given day, respectively. SSB consumers on average consumed 213.0 kcal from SSBs daily, of which 111.6 kcal (52.4%) were purchased from supermarkets/grocery stores, 33.0 kcal (15.5%) from fast-food restaurants, 23.9 kcal (11.2%) from convenience stores, 17.1 kcal (8.0%) from full-service restaurants, 8.5 kcal (4.0%) from vending machines and 19.0 kcal (8.9%) from other sources. Discretionary food consumers on average consumed 439.0 kcal from discretionary foods daily, of which 280.1 kcal (63.8%) were purchased from supermarkets/grocery stores, 45.8 kcal (10.4%) from fast-food restaurants, 30.0 kcal (6.8%) from full-service restaurants, 21.1 kcal (4.8%) from convenience stores, 4.1 kcal (0.9%) from vending machines and 58.0 kcal (13.2%) from other sources. Supermarkets/grocery stores were by far the single largest source for SSB and discretionary food purchases in US adults.

  19. Food Security in Older Adults: Community Service Provider Perceptions of Their Roles

    ERIC Educational Resources Information Center

    Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle

    2007-01-01

    Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food…

  20. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... day care homes. 226.13 Section 226.13 Agriculture Regulations of the Department of Agriculture... CARE FOOD PROGRAM Payment Provisions § 226.13 Food service payments to sponsoring organizations for day care homes. (a) Payments shall be made only to sponsoring organizations operating under an agreement...

  1. Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana.

    PubMed

    Amegbor, Prince M; Kuuire, Vincent Z; Robertson, Hamish; Kuffuor, Oscar A

    2018-04-12

    The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Primary care for adults on the autism spectrum.

    PubMed

    Nicolaidis, Christina; Kripke, Clarissa Calliope; Raymaker, Dora

    2014-09-01

    Autism spectrum disorder (ASD) is defined by differences in social communication and restricted, repetitive patterns of behavior, interests, or activities. Skills and challenges can change depending on environmental stimuli, supports, and stressors. Quality of life can be improved by the use of accommodations, assistive technologies, therapies to improve adaptive function or communication, caregiver training, acceptance, access, and inclusion. This article focuses on the identification of ASD in adults, referrals for services, the recognition of associated conditions, strategies and accommodations to facilitate effective primary care services, and ethical issues related to caring for autistic adults. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Optimizing Health Care for Adults with Spina Bifida

    ERIC Educational Resources Information Center

    Webb, Thomas S.

    2010-01-01

    Survival into adulthood for individuals with spina bifida has significantly improved over the last 40 years with the majority of patients now living as adults. Despite this growing population of adult patients who have increased medical needs compared to the general population, including spina bifida (SB)-specific care, age-related secondary…

  4. Preventive-care practices among adults with diabetes--Puerto Rico, 2000-2002.

    PubMed

    2004-11-12

    Preventive-care practices among persons with diabetes can prevent or delay complications such as eye disease, kidney disease, or nerve damage that is a precursor to disabling foot disease. However, the level of diabetes-related preventive care is inadequate in the United States, and little has been reported about preventive care in Puerto Rico, where an estimated 10% of adults have diagnosed diabetes. CDC analyzed data from 2000, 2001, and 2002 Behavioral Risk Factor Surveillance System (BRFSS) surveys to assess the percentage of adults with diabetes in Puerto Rico who engaged in five selected preventive-care practices. This report summarizes the results of that analysis, which indicated that, with the exception of hemoglobin A1c testing, the percentages of adults engaging in preventive-care practices were lower than the target percentages set by U.S. national health objectives for 2010.

  5. Improving health care delivery to aging adults with disabilities: social work with dual eligibles in a climate of health care reform.

    PubMed

    Bachman, Sara S; Gonyea, Judith G

    2012-01-01

    Adults aging with disabilities comprise a diverse group. In this article, we identify the prevalence and characteristics of this target population, focusing on adults who are dually eligible for Medicare and Medicaid. We articulate challenges in the delivery of health, social, and support services to adults aging with disabilities, particularly how existing health care policy and financing contributes to fragmentation of care. Finally, we identify opportunities for social workers to advocate for and promote system improvements in the delivery of care for aging adults with disabilities in the current climate of health care reform.

  6. Neural processing of food and emotional stimuli in adolescent and adult anorexia nervosa patients.

    PubMed

    Horndasch, Stefanie; Roesch, Julie; Forster, Clemens; Dörfler, Arnd; Lindsiepe, Silja; Heinrich, Hartmut; Graap, Holmer; Moll, Gunther H; Kratz, Oliver

    2018-01-01

    A constant preoccupation with food and restrictive eating are main symptoms of anorexia nervosa (AN). Imaging studies revealed aberrant neural activation patterns in brain regions processing hedonic and reward reactions as well as-potentially aversive-emotions. An imbalance between so called "bottom-up" and "top-down" control areas is discussed. The present study is focusing on neural processing of disease-specific food stimuli and emotional stimuli and its developmental course in adolescent and adult AN patients and could offer new insight into differential mechanisms underlying shorter or more chronic disease. 33 adolescents aged 12-18 years (15 AN patients, 18 control participants) and 32 adult women (16 AN patients, 16 control participants) underwent functional magnetic resonance imaging (fMRI, 3T high-field scanner) while watching pictures of high and low-calorie food and affective stimuli. Afterwards, they rated subjective valence of each picture. FMRI data analysis was performed using a region of interest based approach. Pictures of high-calorie food items were rated more negatively by AN patients. Differences in activation between patients and controls were found in "bottom up" and "top down" control areas for food stimuli and in several emotion processing regions for affective stimuli which were more pronounced in adolescents than in adults. A differential pattern was seen for food stimuli compared to generally emotion eliciting stimuli. Adolescents with AN show reduced processing of affective stimuli and enhanced activation of regions involved in "bottom up" reward processing and "top down" control as well as the insula with regard to food stimuli with a focus on brain regions which underlie changes during adolescent development. In adults less clear and less specific activation differences were present, pointing towards a high impact that regions undergoing maturation might have on AN symptoms.

  7. Neural processing of food and emotional stimuli in adolescent and adult anorexia nervosa patients

    PubMed Central

    Forster, Clemens; Dörfler, Arnd; Lindsiepe, Silja; Heinrich, Hartmut; Graap, Holmer; Moll, Gunther H.; Kratz, Oliver

    2018-01-01

    Background A constant preoccupation with food and restrictive eating are main symptoms of anorexia nervosa (AN). Imaging studies revealed aberrant neural activation patterns in brain regions processing hedonic and reward reactions as well as–potentially aversive–emotions. An imbalance between so called “bottom-up” and “top-down” control areas is discussed. The present study is focusing on neural processing of disease-specific food stimuli and emotional stimuli and its developmental course in adolescent and adult AN patients and could offer new insight into differential mechanisms underlying shorter or more chronic disease. Methods 33 adolescents aged 12–18 years (15 AN patients, 18 control participants) and 32 adult women (16 AN patients, 16 control participants) underwent functional magnetic resonance imaging (fMRI, 3T high-field scanner) while watching pictures of high and low-calorie food and affective stimuli. Afterwards, they rated subjective valence of each picture. FMRI data analysis was performed using a region of interest based approach. Results Pictures of high-calorie food items were rated more negatively by AN patients. Differences in activation between patients and controls were found in “bottom up” and “top down” control areas for food stimuli and in several emotion processing regions for affective stimuli which were more pronounced in adolescents than in adults. Conclusion A differential pattern was seen for food stimuli compared to generally emotion eliciting stimuli. Adolescents with AN show reduced processing of affective stimuli and enhanced activation of regions involved in “bottom up” reward processing and “top down” control as well as the insula with regard to food stimuli with a focus on brain regions which underlie changes during adolescent development. In adults less clear and less specific activation differences were present, pointing towards a high impact that regions undergoing maturation might have on AN

  8. Dental Care among Young Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2013-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…

  9. Food Insecurity and Healthcare Costs: Research Strategies Using Local, State, and National Data Sources for Older Adults12

    PubMed Central

    Lee, Jung Sun

    2013-01-01

    Food insecurity in older adults is a clinically relevant problem with important implications for healthcare costs; however, few studies have examined the relationship between food insecurity and the healthcare cost burden in older adults. It may be due in part to lack of appropriate data and methods to examine these issues in the existing datasets. It is critical to identify and obtain the data necessary for estimating healthcare costs associated with food insecurity and to explore specific mechanisms by which food insecurity is related to adverse health outcomes and associated healthcare costs. This paper discusses how to best utilize and link available, nationally representative datasets and develop infrastructure and procedures to establish state and local datasets. As an example, an innovative approach tested in Georgia to establish a state-level dataset in a sample of low-income, older adults in need of food assistance is discussed. In this approach, data from the state aging services client database and the Centers for Medicare and Medicaid Services data were linked. Such efforts are essential to estimate the healthcare cost burden of food-insecure older adults who have a particularly higher burden of chronic diseases and direct future research, program, and policy decisions to improve the food and healthcare security of low-income, older adults. PMID:23319122

  10. Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity

    PubMed Central

    Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi

    2016-01-01

    Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen. PMID:27928456

  11. Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity.

    PubMed

    Al-Sobaihi, Saber; Nakamura, Keiko; Kizuki, Masashi

    2016-01-01

    Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption. Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth. Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038). Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.

  12. Food Insecurity and Behavioral Characteristics for Academic Success in Young Adults Attending an Appalachian University.

    PubMed

    Hagedorn, Rebecca L; Olfert, Melissa D

    2018-03-16

    In order to investigate the impact of food insecurity on college students in a highly health disparate region we (1) assessed the prevalence of food insecurity among young adults at a large, rural university in Appalachia, and (2) investigated the relationship between food insecurity and behavioral characteristics including academic performance, coping strategies, and money expenditure. A cross-sectional design was used to capture a representative sample of young adults attending a large, central Appalachian university in Fall 2016. The United States Department of Agriculture (USDA) Adult Food Security Survey was used to measure food insecurity. Independent variables include money expenditure (MES), coping strategies (CSS), academic performance (APS), and demographic, health, economic and culinary variables. Participant responses ( n = 692) showed one third (36.6%) of respondents were food-insecure. Students with higher scores for MES and CSS had significantly higher odds of being food-insecure (odds ratio (OR) = 2.07; 95% confidence interval (CI) 1.81 to 2.38 and OR = 1.20; 95% CI 1.16 to 1.23, respectively). The odds of high APS scores (OR = 0.79; 95% CI 0.73 to 0.86) were inversely related to food insecurity. Results of the logistic regression showed MES, CSS, health, and school year remained a significant predictor of food insecurity in college students. These findings suggest behavioral differences in terms of coping strategies, money expenditure, and academic progress among food-insecure students and can be used to identify and target at-risk students to promote student food security and well-being.

  13. Health Care Needs of Adults with Mental Retardation.

    ERIC Educational Resources Information Center

    Rubin, I. Leslie

    1987-01-01

    Experience with provision of optimal health services to mentally retarded individuals in institutional settings can be applied and adapted to design services for such adults living in the community. Coordination of health care by a team of nurses, primary care physicians, and special medical services is recommended. (Author/DB)

  14. Food Sanitation and Safety Self-assessment Instrument for Family Day-Care Homes.

    ERIC Educational Resources Information Center

    1990

    This self-assessment instrument for family day care providers is designed to help caregivers provide safe food to children. The eight sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing and inspecting of food; (3) food storage; (4) kitchen equipment; (5) food preparation; (6) infant food…

  15. Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

    PubMed

    Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

    2016-11-01

    A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care.

  16. Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

    PubMed

    Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

    2015-01-01

    Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

  17. Characteristics of Young Adults Enrolled Through the Affordable Care Act-Dependent Coverage Expansion.

    PubMed

    Han, Xuesong; Zhu, Shiyun; Jemal, Ahmedin

    2016-12-01

    The purpose of this study was to examine sociodemographic and health care-related characteristics of young adults covered through the Affordable Care Act (ACA)-dependent coverage expansion. Our sample consisted of 36,802 young adults aged 19-25 years from 2011 to 2014 National Health Interview Survey. Sociodemographic differences among young adults with the four insurance types were described: privately insured under parents, privately insured under self/spouse, publicly insured, and uninsured. Multivariable logistic models were fitted to compare those covered under parent with those covered through other traditional insurance types, in terms of the following outcomes: health status, health behaviors, insurance history and experience, access to care, care utilization, and receipt of preventive service, controlling for sociodemographic factors. Young adults who were covered under their parents' insurance were most likely to be college students and non-Hispanic whites. These young adults also had more stable insurance, better access to care, better care utilization patterns, and reported better health status, compared to their peers. The beneficiaries of the ACA-dependent coverage expansion were more likely to be college students from families with high socioeconomic status. Coverage under parents was associated with improved access to care and health outcomes among young adults. The enrollees through the ACA represent the healthiest subgroup of young adults and those with the best care utilization patterns, suggesting that the added cost relative to premium for insurers from this population will likely be minimal. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Food hygiene training in small to medium-sized care settings.

    PubMed

    Seaman, Phillip; Eves, Anita

    2008-10-01

    Adoption of safe food handling practices is essential to effectively manage food safety. This study explores the impact of basic or foundation level food hygiene training on the attitudes and intentions of food handlers in care settings, using questionnaires based on the Theory of Planned Behaviour. Interviews were also conducted with food handlers and their managers to ascertain beliefs about the efficacy of, perceived barriers to, and relevance of food hygiene training. Most food handlers had undertaken formal food hygiene training; however, many who had not yet received training were preparing food, including high risk foods. Appropriate pre-training support and on-going supervision appeared to be lacking, thus limiting the effectiveness of training. Findings showed Subjective Norm to be the most significant influence on food handlers' intention to perform safe food handling practices, irrespective of training status, emphasising the role of important others in determining desirable behaviours.

  19. Challenges of the Transition from Pediatric Care to Care of Adults: "Say Goodbye, Say Hello".

    PubMed

    Touraine, Philippe; Polak, Michel

    2018-01-01

    Transition has been defined as "the purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems." We will here describe the challenges of such a process: challenges coming from the pediatrician, from the adolescent, linked to the disease itself, and those from the parents. We will outline how to overcome those fears and challenges to provide a successful transition process. A key factor to underline that process is that a relationship based on confidence should be established between the pediatrician and the physician for adults, in order for that relationship, based on trust, to be the basis for the transfer of the adolescent from the pediatric system of care to the adult one. © 2018 S. Karger AG, Basel.

  20. The climatic impact of food consumption in a representative sample of Irish adults and implications for food and nutrition policy.

    PubMed

    Hyland, John J; Henchion, Maeve; McCarthy, Mary; McCarthy, Sinéad N

    2017-03-01

    To evaluate the greenhouse gas emissions (GHGE) associated with the diet of Irish adults. GHGE were estimated by applying conversion factors to habitual food consumption data taken from the National Adult Nutrition Survey, which was representative of the population. Descriptive analyses were undertaken for GHGE for the total population, as well as accounting for energy misreporting and across categories of sociodemographic and socio-economic factors and tertiles of emissions. Republic of Ireland. Adults aged 18-87 years (n 1500). The GHGE derived from daily dietary intakes was estimated as 6·5 kg of CO2 equivalents (CO2eq) per person. Males, younger consumers, those with secondary education and student employment status were associated with significantly higher GHGE. Red meat was the highest contributor to GHGE with 1646 g CO2eq arising from a mean intake of 47 g/d. Dairy and starchy staples were the next largest dietary GHGE sources, with mean daily emissions of 732 g CO2eq and 647 g CO2eq, respectively. The lowest emissions were associated with consumption of vegetables, fruits and legumes/pulses/nuts. Based on profiling using actual food consumption data, it is evident that one single measure is not sufficient and a range of evidence-based mitigation measures with potential to lower emissions throughout the food chain should be considered. The research contributes towards an improved understanding of the climatic impact of the dietary intakes of Irish adults and can serve to inform a sustainability framework to guide action in food and nutrition policy development.

  1. Cancer treatment, symptom monitoring, and self-care in adults: pilot study.

    PubMed

    Williams, Phoebe Dauz; Piamjariyakul, Ubolrat; Ducey, Kathleen; Badura, Jody; Boltz, Kristin D; Olberding, Karmen; Wingate, Anita; Williams, Arthur R

    2006-01-01

    A descriptive study was conducted on self-reported symptoms and self-care by 37 adults receiving chemotherapy primarily for leukemia, lymphomas, or breast cancer or radiation therapy for head and neck or lung cancers. The Therapy-Related Symptom Checklist and demographic and interview forms on self-care for identified symptoms were used. Severe symptoms on the Therapy-Related Symptom Checklist subscales fatigue, eating, nausea, pain, numbness in fingers/toes, hair loss, and constipation were reported by patients on chemotherapy. Those on radiation therapy reported severe symptoms on the eating, fatigue, skin changes, oropharynx, and constipation subscales.Self-care strategies were in the following categories, using complementary medicine as framework: diet/nutrition/lifestyle change (eg, use of nutritional supplements; modifications of food and of eating habits; naps, sleep, and rest); mind/body control (eg, relaxation methods, prayer, music, attending granddaughter's sports events); biologic treatments (vitamins); herbal treatments (green mint tea); and ethnomedicine (lime juice and garlic). The first category was predominantly used by patients in both treatment types. Medications were prescribed also to help control symptoms (eg, pain and nausea). Symptom monitoring and self-care for symptoms identified may be facilitated by the Therapy-Related Symptom Checklist; based on reported symptom severity, care providers may prioritize interventions. A larger study needs to be done on (a) the use of the Therapy-Related Symptom Checklist as a clinical tool to assess symptoms that oncology patients experience during therapy; (b) whether care providers, based on patient-reported symptom severity, can prioritize interventions--and how this influences the efficiency of care; (c) the self-care strategies used by patients on chemotherapy or radiation therapy or both; and (d) how useful these strategies are in alleviating symptoms.

  2. Food Security and Leukocyte Telomere Length in Adult Americans.

    PubMed

    Mazidi, Mohsen; Kengne, Andre Pascal; Vatanparast, Hassan

    2017-01-01

    Leukocyte telomere length (LTL) is a biomarker of biologic age. Whether food security status modulates LTL is still unknown. We investigated the association between food security and LTL in participants of the 1999-2002 US National Health and Nutrition Examination Survey (NHANES). Analysis of covariance (ANCOVA) was used to evaluate the association between food security categories and LTL controlling for sex, race, and education and accounting for the survey design and sample weights. We included 10,888 participants with 5228 (48.0%) being men. They were aged on average 44.1 years. In all, 2362 (21.7%) had less than high school, 2787 (25.6%) had achieved high school, while 5705 (52.5%) had done more than high school. In sex-, race-, and education-adjusted ANCOVA, average LTL (T/S ratio) for participants with high food security versus those with marginal, low, or very low food security was 1.32 versus 1.20 for the age group 25-35 years and 1.26 versus 1.11 for the 35-45 years, ( p < 0.001). The association between food insecurity and LTL shortening in young adults suggest that some of the future effects of food insecurity on chronic disease risk in this population could be mediated by telomere shortening.

  3. Barriers to ethical nursing practice for older adults in long-term care facilities.

    PubMed

    Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung

    2018-03-01

    To explore barriers to ethical nursing practice for older adults in long-term care facilities from the perspectives of nurses in South Korea. The number of older adults admitted to long-term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long-term care facilities have not been fully explored in previous literature. A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long-term care facilities in South Korea. Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long-term care facilities in South Korea. Data were analysed using qualitative content analysis. Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long-term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. This study has identified methods that could be used to improve ethical nursing practices for older adults in long-term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study. © 2017 John Wiley & Sons Ltd.

  4. Executive functions and consumption of fruits/ vegetables and high saturated fat foods in young adults.

    PubMed

    Limbers, Christine A; Young, Danielle

    2015-05-01

    Executive functions play a critical role in regulating eating behaviors and have been shown to be associated with overeating which over time can result in overweight and obesity. There has been a paucity of research examining the associations among healthy dietary behaviors and executive functions utilizing behavioral rating scales of executive functioning. The objective of the present cross-sectional study was to evaluate the associations among fruit and vegetable consumption, intake of foods high in saturated fat, and executive functions using the Behavioral Rating Inventory of Executive Functioning-Adult Version. A total of 240 university students completed the Behavioral Rating Inventory of Executive Functioning-Adult Version, the 26-Item Eating Attitudes Test, and the Diet subscale of the Summary of Diabetes Self-Care Activities Questionnaire. Multiple linear regression analysis was conducted with two separate models in which fruit and vegetable consumption and saturated fat intake were the outcomes. Demographic variables, body mass index, and eating styles were controlled for in the analysis. Better initiation skills were associated with greater intake of fruits and vegetables in the last 7 days (standardized beta = -0.17; p < 0.05). Stronger inhibitory control was associated with less consumption of high fat foods in the last 7 days (standardized beta = 0.20; p < 0.05) in the multiple linear regression analysis. Executive functions that predict fruit and vegetable consumption are distinct from those that predict avoidance of foods high in saturated fat. Future research should investigate whether continued skill enhancement in initiation and inhibition following standard behavioral interventions improves long-term maintenance of weight loss. © The Author(s) 2015.

  5. Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study.

    PubMed

    Boone-Heinonen, Janne; Gordon-Larsen, Penny; Kiefe, Catarina I; Shikany, James M; Lewis, Cora E; Popkin, Barry M

    2011-07-11

    A growing body of cross-sectional, small-sample research has led to policy strategies to reduce food deserts--neighborhoods with little or no access to healthy foods--by limiting fast food restaurants and small food stores and increasing access to supermarkets in low-income neighborhoods. We used 15 years of longitudinal data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of US young adults (aged 18-30 years at baseline) (n = 5115), with linked time-varying geographic information system-derived food resource measures. Using repeated measures from 4 examination periods (n = 15,854 person-examination observations) and conditional regression (conditioned on the individual), we modeled fast food consumption, diet quality, and adherence to fruit and vegetable recommendations as a function of fast food chain, supermarket, or grocery store availability (counts per population) within less than 1.00 km, 1.00 to 2.99 km, 3.00 to 4.99 km, and 5.00 to 8.05 km of respondents' homes. Models were sex stratified, controlled for individual sociodemographic characteristics and neighborhood poverty, and tested for interaction by individual-level income. Fast food consumption was related to fast food availability among low-income respondents, particularly within 1.00 to 2.99 km of home among men (coefficient, 0.34; 95% confidence interval, 0.16-0.51). Greater supermarket availability was generally unrelated to diet quality and fruit and vegetable intake, and relationships between grocery store availability and diet outcomes were mixed. Our findings provide some evidence for zoning restrictions on fast food restaurants within 3 km of low-income residents but suggest that increased access to food stores may require complementary or alternative strategies to promote dietary behavior change.

  6. Ask the Right Questions: What Do Non-Caregiving Adult Children Need From Health Care Providers?

    PubMed

    Wells, Munira; Kartoz, Connie

    2018-05-01

    Extended healthy life spans are a relatively recent phenomenon that increase the amount of time families spend with older adults in non-caregiving roles. As the emphasis of health care moves to population health and health prevention, nurses caring for older adults must be knowledgeable about this family life stage. To learn more about the lived experience of non-caregiving adult children, 16 non-caregiving adult children were interviewed. The purpose of the current article is to share what needs non-caregiving adult children have from the health care system as they obtain care for themselves and accompany their parent for health care visits. Content analysis of transcribed interviews revealed three main themes: Lack of Holistic Care, Lack of Effective Communication, and Fragmented Care and Need for Better Care Management. Participants suggested interventions that are patient- and family-centered and culturally safe. Nurses can use findings from the current study to research interventions using family-centered care strategies to improve health outcomes for older adults. [Journal of Gerontological Nursing, 44(5), 26-31.]. Copyright 2018, SLACK Incorporated.

  7. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as independent...

  8. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as independent...

  9. 7 CFR 226.17 - Child care center provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Child care center provisions. 226.17 Section 226.17... AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.17 Child care center provisions. (a) Child care centers may participate in the Program either as independent...

  10. Delirium in older adults attending adult day care and family caregiver distress.

    PubMed

    Bull, Margaret J

    2011-06-01

    BACKGROUND; Delirium is a critical, costly, frequently reversible problem in older adults. Findings of previous studies indicate that delirium occurs in up to 65% of hospitalised older adults and up to 80% of terminally ill patients. Few studies address the frequency of delirium in community dwelling older adults and the extent to which delirium symptoms create distress for their family caregivers. To determine the frequency of delirium in older people attending two adult day centers (ADC) in the United States and identify the extent to which delirium symptoms were associated with family caregivers' mental health symptoms, and ways of coping with the older adults' care. A descriptive, cross-sectional design was used. Thirty older adults and their family caregivers were randomly selected from the rosters of the ADC. Only 6.7% of the older adults had a positive screen for delirium. The majority of family caregivers (96.6%) stated that they had no knowledge of delirium prior to participating in this study. Both older adults and their family caregivers need education about delirium symptoms and risks. © 2010 Blackwell Publishing Ltd.

  11. Care Preferences Among Middle-Aged and Older Adults With Chronic Disease in Europe: Individual Health Care Needs and National Health Care Infrastructure.

    PubMed

    Mair, Christine A; Quiñones, Ana R; Pasha, Maha A

    2016-08-01

    The purpose of this study is to expand knowledge of care options for aging populations cross-nationally by examining key individual-level and nation-level predictors of European middle-aged and older adults' preferences for care. Drawing on data from the Survey of Health, Ageing and Retirement in Europe and the Organisation for Economic Co-operation and Development, we analyze old age care preferences of a sample of 6,469 adults aged 50 and older with chronic disease in 14 nations. Using multilevel modeling, we analyze associations between individual-level health care needs and nation-level health care infrastructure and preference for family-based (vs. state-based) personal care. We find that middle-aged and older adults with chronic disease whose health limits their ability to perform paid work, who did not receive personal care from informal sources, and who live in nations with generous long-term care funding are less likely to prefer family-based care and more likely to prefer state-based care. We discuss these findings in light of financial risks in later life and the future role of specialized health support programs, such as long-term care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Pediatric Heart Transplantation: Transitioning to Adult Care (TRANSIT): Baseline Findings.

    PubMed

    Grady, Kathleen L; Hof, Kathleen Van't; Andrei, Adin-Cristian; Shankel, Tamara; Chinnock, Richard; Miyamoto, Shelley; Ambardekar, Amrut V; Anderson, Allen; Addonizio, Linda; Latif, Farhana; Lefkowitz, Debra; Goldberg, Lee; Hollander, Seth A; Pham, Michael; Weissberg-Benchell, Jill; Cool, Nichole; Yancy, Clyde; Pahl, Elfriede

    2018-02-01

    Young adult solid organ transplant recipients who transfer from pediatric to adult care experience poor outcomes related to decreased adherence to the medical regimen. Our pilot trial for young adults who had heart transplant (HT) who transfer to adult care tests an intervention focused on increasing HT knowledge, self-management and self-advocacy skills, and enhancing support, as compared to usual care. We report baseline findings between groups regarding (1) patient-level outcomes and (2) components of the intervention. From 3/14 to 9/16, 88 subjects enrolled and randomized to intervention (n = 43) or usual care (n = 45) at six pediatric HT centers. Patient self-report questionnaires and medical records data were collected at baseline, and 3 and 6 months after transfer. For this report, baseline findings (at enrollment and prior to transfer to adult care) were analyzed using Chi-square and t-tests. Level of significance was p < 0.05. Baseline demographics were similar in the intervention and usual care arms: age 21.3 ± 3.2 vs 21.5 ± 3.3 years and female 44% vs 49%, respectively. At baseline, there were no differences between intervention and usual care for use of tacrolimus (70 vs 62%); tacrolimus level (mean ± SD = 6.5 ± 2.3 ng/ml vs 5.6 ± 2.3 ng/ml); average of the within patient standard deviation of the baseline mean tacrolimus levels (1.6 vs 1.3); and adherence to the medical regimen [3.6 ± 0.4 vs 3.5 ± 0.5 (1 = hardly ever to 4 = all of the time)], respectively. At baseline, both groups had a modest amount of HT knowledge, were learning self-management and self-advocacy, and perceived they were adequately supported. Baseline findings indicate that transitioning HT recipients lack essential knowledge about HT and have incomplete self-management and self-advocacy skills.

  13. Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study

    PubMed Central

    Spoorenberg, Sophie L. W.; Wynia, Klaske; Fokkens, Andrea S.; Slotman, Karin; Kremer, Hubertus P. H.; Reijneveld, Sijmen A.

    2015-01-01

    Background Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Methods Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through “Embrace,” an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Results Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”. The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants’ ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. Conclusion The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging. PMID:26489096

  14. Older Chinese people's views on food: implications for supportive cancer care.

    PubMed

    Payne, Sheila Alison; Seymour, Jane E; Chapman, Alice; Holloway, Margaret

    2008-11-01

    As people face cancer and the end of life, the social, cultural and therapeutic role of food takes on an increasing significance. As part of a larger study involving older Chinese people resident in the UK, we investigated their beliefs about the influence of food on cancer and its role in supportive cancer care. A two-phase qualitative research study involved older Chinese people identified via Chinese community groups. In phase one, 46 older Chinese people participated in seven focus group discussions. In phase two, semi-structured interviews were conducted in Cantonese or Mandarin with 46 different older Chinese people to elicit their understandings of the role of food in health and illness generally and specifically for those with cancer. The analyses revealed four main themes: (1) food as 'therapeutic'; (2) food as 'risky'; (3) food as supportive and comforting; and (4) beliefs about the lack of culturally appropriate and acceptable food in hospitals. Expectations about the lack of Chinese food and the poor quality and perceived unsuitability of 'western' food were regarded as major concerns in relation to hospital admission. Understanding the perceived cultural and therapeutic significance of food and its functions in social exchange is one important aspect of promoting supportive and end-of-life cancer care for minority communities. These views helped explain the diversity and salience of food use in illness for older Chinese people resident in the UK.

  15. The Child-care Food and Activity Practices Questionnaire (CFAPQ): development and first validation steps.

    PubMed

    Gubbels, Jessica S; Sleddens, Ester Fc; Raaijmakers, Lieke Ch; Gies, Judith M; Kremers, Stef Pj

    2016-08-01

    To develop and validate a questionnaire to measure food-related and activity-related practices of child-care staff, based on existing, validated parenting practices questionnaires. A selection of items from the Comprehensive Feeding Practices Questionnaire (CFPQ) and the Preschooler Physical Activity Parenting Practices (PPAPP) questionnaire was made to include items most suitable for the child-care setting. The converted questionnaire was pre-tested among child-care staff during cognitive interviews and pilot-tested among a larger sample of child-care staff. Factor analyses with Varimax rotation and internal consistencies were used to examine the scales. Spearman correlations, t tests and ANOVA were used to examine associations between the scales and staff's background characteristics (e.g. years of experience, gender). Child-care centres in the Netherlands. The qualitative pre-test included ten child-care staff members. The quantitative pilot test included 178 child-care staff members. The new questionnaire, the Child-care Food and Activity Practices Questionnaire (CFAPQ), consists of sixty-three items (forty food-related and twenty-three activity-related items), divided over twelve scales (seven food-related and five activity-related scales). The CFAPQ scales are to a large extent similar to the original CFPQ and PPAPP scales. The CFAPQ scales show sufficient internal consistency with Cronbach's α ranging between 0·53 and 0·96, and average corrected item-total correlations within acceptable ranges (0·30-0·89). Several of the scales were significantly associated with child-care staff's background characteristics. Scale psychometrics of the CFAPQ indicate it is a valid questionnaire that assesses child-care staff's practices related to both food and activities.

  16. Adults and children prefer a plate food guide relative to a pyramid.

    PubMed

    Talati, Zenobia; Pettigrew, Simone; Moore, Sarah; Pratt, Iain S

    2017-01-01

    This study explored attitudes toward two food guides currently being widely used in Australia: the Healthy Eating Pyramid and the Australian Guide to Healthy Eating Plate. Ten focus groups were conducted with adults (aged 18+ years) and children (aged 10-17 years) across various locations in Perth, Western Australia. The discussions focused on liked and disliked aspects of each food guide and the implications for participants' perceptions of their relative usefulness. When asked to state their preference, a large majority of participants nominated the plate as their preferred nutrition guide. The style of presentation used for the plate was reportedly clearer and more aesthetically pleasing. The plate was also perceived to be more complex while the pyramid was considered by adults to be more child-friendly. This study provides information on consumers' reactions to different food guides and the implications for perceived relevance and utility.

  17. Household food insecurity is associated with anemia in adult Mexican women of reproductive age.

    PubMed

    Fischer, Nils C; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael

    2014-12-01

    Anemia is a major cause of maternal mortality. Household food insecurity (HFI) may increase the risk of anemia among women of reproductive age although this hypothesis remains largely untested in representative samples from low- and middle-income countries. Our objective was to investigate the association of HFI with anemia in a nationally representative, cross-sectional sample of Mexican women of reproductive age (12-49 y old). We tested the association between HFI and anemia among 16,944 women of reproductive age using the multiple logistic regression among adolescent (12-20 y) and adult women (21-49 y). HFI was measured with the use of the Latin American and Caribbean Food Security Scale. Hemoglobin was measured with capillary hemoglobin with the use of HemoCue photometer (HemoCue, Inc.) and anemia was defined with the use of WHO standards. The association of HFI and anemia was not significant (P > 0.05) for adolescent women (12-20 y), whereas in adult women (21-49 y), the adjusted odds of having anemia were 31-43% higher among those living in mild to severely food insecure households than adult women residing in food secure households (P < 0.05). HFI is associated with anemia among adult Mexican women. Programs that reduce HFI may also be effective at reducing the risk of anemia among Mexican women. © 2014 American Society for Nutrition.

  18. The Obama health care plan: what it means for mental health care of older adults.

    PubMed

    Sorrell, Jeanne M

    2009-01-01

    Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.

  19. Food Group Intakes as Determinants of Iodine Status among US Adult Population.

    PubMed

    Lee, Kyung Won; Shin, Dayeon; Cho, Mi Sook; Song, Won O

    2016-05-26

    Adequate intake of iodine is essential for proper thyroid function. Although dietary reference intakes for iodine have been established, iodine intake cannot be estimated due to the lack of data on iodine contents in foods. We aimed to determine if food group intakes can predict iodine status assessed by urinary iodine concentration (UIC) from spot urine samples of 5967 US adults in the National Health and Nutrition Examination Survey (NHANES) 2007-2012. From an in-person 24-h dietary recall, all foods consumed were aggregated into 12 main food groups using the individual food code of the US Department of Agriculture (USDA); dairy products, meat/poultry, fish/seaweed, eggs, legumes/nuts/seeds, breads, other grain products, fruits, vegetables, fats/oils, sugars/sweets, and beverages. Chi-square test, Spearman correlation, and multiple linear regression analyses were conducted to investigate the predictability of food group intakes in iodine status assessed by UIC. From the multiple linear regressions, the consumption of dairy products, eggs, and breads, and iodine-containing supplement use were positively associated with UIC, whereas beverage consumption was negatively associated with UIC. Among various food group intakes, dairy product intake was the most important determinant of iodine status in both US men and women. Subpopulation groups with a high risk of iodine deficiency may need nutritional education regarding the consumption of dairy products, eggs, and breads to maintain an adequate iodine status. Efforts toward a better understanding of iodine content in each food and a continued monitoring of iodine status within US adults are both warranted.

  20. Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011

    PubMed Central

    Lightstone, Amy S.; Basurto-Davila, Ricardo; Morales, Douglas M.; Sturm, Roland

    2015-01-01

    Introduction The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. Methods We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents’ residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m2) or obese (BMI ≥30.0 kg/m2). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Results Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Discussion Little evidence was found for associations between proximity of respondents’ homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation. PMID:26334715

  1. Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011.

    PubMed

    Mejia, Nelly; Lightstone, Amy S; Basurto-Davila, Ricardo; Morales, Douglas M; Sturm, Roland

    2015-09-03

    The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents' residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m(2)) or obese (BMI ≥30.0 kg/m(2)). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Little evidence was found for associations between proximity of respondents' homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation.

  2. Fast-food and full-service restaurant consumption in relation to daily energy and nutrient intakes among US adult cancer survivors, 2003-2012.

    PubMed

    An, Ruopeng; Liu, Junyi

    2013-01-01

    Healthy diet is an essential component in cancer survivorship care planning. Cancer survivors should be particularly prudent regarding their daily food choices, with an aim of ensuring safe consumption, reducing risk of recurrence or other comorbidity, and improving quality of life. We aimed to examine the impacts of fast-food and full-service restaurant consumption on daily energy and nutrient intakes among US adult cancer survivors. Nationally representative data of 1308 adult cancer survivors came from the National Health and Nutrition Examination Survey 2003-2012 waves. First-difference estimator was adopted to address confounding bias from time-invariant unobservables like personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two non-consecutive 24-hour dietary recalls. Fast-food and full-service restaurant consumption, respectively, was associated with an increase in daily total energy intake by 125.97 and 152.26 kcal and sodium intake by 312.47 and 373.75 mg. Fast-food consumption was significantly associated with a decrease in daily vitamin A intake by 119.88 µg and vitamin K intake by 30.48 µg, whereas full-service restaurant consumption was associated with an increase in daily fat intake by 8.99 g and omega-6 fatty acid intake by 3.85 g, and a decrease in vitamin D intake by 0.93 µg. Compared with fast-food and full-service restaurant consumption at home, consumption away from home led to further reduced diet quality. Individualized nutrition counseling and food assistance programs should address cancer survivors' overall dining-out behavior rather than fast-food consumption alone. © The Author(s) 2015.

  3. Clinical care of adult Turner syndrome--new aspects.

    PubMed

    Trolle, Christian; Mortensen, Kristian Havmand; Hjerrild, Britta E; Cleemann, Line; Gravholt, Claus H

    2012-05-01

    Turner syndrome (TS) is characterized by numerous medical challenges during adolescence and adulthood. Puberty has to be induced in most cases, and female sex hormone replacement therapy (HRT) should continue during adult years. These issues are normally dealt with by the paediatrician, but once a TS female enters adulthood it is less clear who should be the primary care giver. Morbidity and mortality is increased, especially due to the risk of dissection of the aorta and other cardiovascular diseases, as well as the risk of type 2 diabetes, hypertension, osteoporosis, thyroid disease and other diseases. The proper dose of HRT with female sex steroids has not been established, and, likewise, benefits and/or drawbacks from HRT have not been thoroughly evaluated. The transition period from paediatric to adult care seems to be especially vulnerable and the proper framework for transition has not yet been established. Likewise, no framework is in place for continuous follow-up during adult years in many countries. Today, most treatment recommendations are based on expert opinion and are unfortunately not evidence based, although more areas, such as growth hormone and oxandrolone treatment for increasing height, are becoming well founded. Osteoporosis, diabetes, both type 1 and 2, hypothyroidism, obesity and a host of other endocrine diseases and conditions are seen more frequently in TS. Prevention, intervention and proper treatment is only just being recognized. Hypertension is frequent and can be a forerunner of cardiovascular disease. The description of adult life with TS has been broadened and medical, social and psychological aspects are being added at a compelling pace. Proper care during adulthood should be studied and a framework for care should be in place, since most morbidity potentially is amenable to intervention. In summary, TS is a condition associated with a number of diseases and conditions which need the attention of a multi-disciplinary team during

  4. Functional Limitations, Depression, and Cash Assistance are Associated with Food Insecurity among Older Urban Adults in Mexico City.

    PubMed

    Vilar-Compte, Mireya; Martínez-Martínez, Oscar; Orta-Alemán, Dania; Perez-Escamilla, Rafael

    2016-01-01

    To examine factors associated with food insecurity among urban older adults (65 years and older). Three hundred and fifty two older adults attending community centers in a neighborhood of Mexico City were surveyed for food insecurity, functional impairments, health and mental health status, cash-transfer assistance, socio-demographic characteristics, social isolation, and the built food environment. Having at least primary education and receiving cash-transfers were significantly associated with a lower probability of being moderately-severely food insecure (OR=0.478 and 0.597, respectively). The probability of moderate-severe food insecurity was significantly higher among elderly at risk of depression (OR=2.843), those with at least one activity of daily living impaired (OR=2.177) and those with at least one instrumental activity of daily living impaired (OR=1.785). Higher educational attainment and cash-transfers may have a positive influence on reducing food insecurity. Depression and functional limitations may increase the likelihood of food insecurity among older adults.

  5. Fast food: friendly?

    PubMed

    Rice, S; McAllister, E J; Dhurandhar, N V

    2007-06-01

    Fast food is routinely blamed for the obesity epidemic and consequentially excluded from professional dietary recommendations. However, several sections of society including senior citizens, low-income adult and children, minority and homeless children, or those pressed for time appear to rely on fast food as an important source of meals. Considering the dependence of these nutritionally vulnerable population groups on fast food, we examined the possibility of imaginative selection of fast food, which would attenuate the potentially unfavorable nutrient composition. We present a sample menu to demonstrate that it is possible to design a fast food menu that provides reasonable level of essential nutrients without exceeding the caloric recommendations. We would like to alert health-care professionals that fast food need not be forbidden under all circumstances, and that a fresh look at the role of fast food may enable its inclusion in meal planning for those who depend on it out of necessity, while adding flexibility.

  6. Transitions in Care from Pediatric to Adult Health Care Providers: Ongoing Challenges and Opportunities for Young Persons with Diabetes.

    PubMed

    Garvey, Katharine; Laffel, Lori

    2018-01-01

    Adolescence and young adulthood are times of multiple developmental changes, including physiological, social, emotional, cognitive, and behavioral transformations. The adolescent or young adult living with type 1 or type 2 diabetes must navigate the vicissitudes of these developmental stages while managing the rigors and self-care demands of these conditions. Diabetes in children is managed by adults, mainly by parents. As the child matures, diabetes management tasks transition from parents to the developing teen. This transition in care is a process that generally begins in early adolescence and culminates when the older teen successfully accepts and manages diabetes self-care tasks. Along with the transitions in diabetes management tasks, older teens and young adults must be prepared for transfer from the pediatric diabetes care team to an adult-focused health care team. Numerous publications have described the challenges associated with both the process of transition and the act of transfer. Lack of preparation during transition followed by unsuccessful transfer often results in gaps in diabetes care exceeding 6 months, deterioration in glycemic control, increase in emergency room use and hospitalization, and emergence of diabetes complications among older teens and young adults. There is need for ongoing research internationally to address these deficiencies in order to improve the short- and long-term health of young persons with diabetes. © 2018 S. Karger AG, Basel.

  7. Professional's Perspectives on Care Management of Young People with Perinatally Acquired HIV during Transition: A Qualitative Study in Adult Care Setting.

    PubMed

    Le Roux, Enora; Gottot, Serge; Aupiais, Camille; Girard, Thomas; Teixeira, Maria; Alberti, Corinne

    2017-01-01

    Increasing numbers of young people with perinatally acquired HIV are surviving to adulthood. When they come of age, they leave pediatric services in which they were followed and have to be transferred to the adult health care system. Difficulties in adaptation to adult care and the numbers of young people lost to follow up after transfer to adult care have been reported. This transition phase and their retention in adult care are crucial in maintaining the clinical status of these young with HIV in adulthood. Our study aimed to explore how HIV professionals working in adult care perceive and adapt their practices to young people in transition. Qualitative interviews were conducted with 18 health and social services professionals in hospitals or patient associations in France. A thematic analysis was conducted. Adult care professionals were found to be making a distinction between these young people and their patients who were infected during adulthood. On the basis of the healthcare teams' experience, a simplified categorization of these young people into four levels can be used: those "who have everything good"; those who have some deficiencies that must be addressed; those "who have everything bad"; and those lost to follow up. Professionals interviewed highlighted the difficulties they encountered with young people in transition. Three types of problematic situations were identified: problems of acceptance of the disease; communication problems; and problems of disorientation in the new care environment. Despite the lack of specific training or national policy recommendations for the integration of young people with perinatally acquired HIV into adult services, all the adult healthcare teams interviewed tried to adapt their practice to this population. The results suggested that professional involvement during transition should depend on the characteristics of the patient, not be limited to a single transition model and that a dedicated structure for transition

  8. Using the FoodEx-LTC to assess institutional food service practices through nursing home residents' perspectives on nutrition care.

    PubMed

    Evans, Bronwynne C; Crogan, Neva L

    2005-01-01

    Background. Undernutrition occurs in approximately 2 of every 5 nursing home residents, negatively influencing their health and quality of life. The purposes of this study were to collect data about institutional meal preparation and food service practices that promote or retard adequate nutritional intake and to evaluate residents' food and food service satisfaction. Methods. The FoodEx-LTC, a simple, 44-item, 5-subscale questionnaire that measures food and food service satisfaction, was administered to 61 residents. Serum albumin and body mass index gauged the nutritional status of each resident. SPSS for Windows, version 10, was used for analyses. Results. Overall, 89% of residents were satisfied or somewhat satisfied with the food service. Of those who ate in the dining room, 44% had to wait to go back to their rooms, presenting a quality of life issue. Fifty-two percent received food they hated, 56% often received the same food, and 59% received food always cooked the same way. Most residents (75%) felt comfortable refusing food they did not like, but 65% did not complain. Most (79%) wanted to choose what to eat, but only 54% believed that choosing when to eat was important. Conclusions. The FoodEx-LTC, used to monitor nutrition care in nursing homes, incorporates residents' views into service delivery and responds to the Health Care Finance Administration's Nutritional and Hydration Awareness Campaign, part of the federal Nursing Home Initiative. Using the FoodEx-LTC to identify residents' perspectives may promote resident satisfaction and dietary intake through adaptation of nursing home food and food service practices.

  9. Transitioning from pediatric care to adult care for adolescents with special health care needs: dentist perspectives (part 2)

    PubMed Central

    Bayarsaikhan, Zoljargal; Cruz, Stephanie; Neff, John; Chi, Donald L.

    2015-01-01

    Purpose To understand dental care transitions for adolescents with special health care needs (ASHCN) from the dentist perspective. Methods We conducted semi-structured interviews with 13 dentists (seven pediatric dentists and six general dentists) to learn about the dental transition process for ASHCN. Results Most dentists believed transitions from child-centered to adult-centered dental care were important for ASHCN. Dentists reported two main barriers to transitions: low dental reimbursements by Medicaid and a shortage of general dentists qualified or willing to treat ASHCN. Pediatric and general dentists reported playing complimentary roles in facilitating transitions for ASHCN and their families. Conclusions Dentists acknowledged the challenges that ASHCN and their families face in transitioning to adult-centered care and believed in the importance of ASHCN maintaining a dental home. Pediatric dentists and general dentists play a key role in working together to implement dental transition plans for the ASHCN and to ensure successful dental transitions. PMID:26531088

  10. Supportive care in older adults with cancer - An update of research in 2015.

    PubMed

    Steer, Christopher B

    2016-09-01

    The motto of the Multinational Association for Supportive Care in Cancer (MASCC) is "supportive care makes excellent cancer care possible". This is especially important in the care of older adults with cancer. The use of geriatric assessment in this patient population enables targeted supportive care interventions to work alongside appropriate anticancer therapy. It is the opinion of this author that geriatric oncology is mostly about the provision of streamlined, appropriate supportive care. There are many facets of supportive care of patients with cancer that are important regardless of age. These include issues such as the use of appropriate antiemetics, infection management, oral health, nutritional intervention, psychosocial care, and palliative care. This article provides an update on novel yet important supportive care research specifically in older adults with cancer published in peer-reviewed journals in 2015. This year saw important publications in geriatric assessment, psychosocial care, in the information and supportive care needs of older adults and the role of pharmacists and rehabilitation specialists in the geriatric oncology clinic. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Validity and test-retest reliability of the self-completion adult social care outcomes toolkit (ASCOT-SCT4) with adults with long-term physical, sensory and mental health conditions in England.

    PubMed

    Rand, Stacey; Malley, Juliette; Towers, Ann-Marie; Netten, Ann; Forder, Julien

    2017-08-18

    The Adult Social Care Outcomes Toolkit (ASCOT-SCT4) is a multi-attribute utility index designed for the evaluation of long-term social care services. The measure comprises eight attributes that capture aspects of social care-related quality of life. The instrument has previously been validated with a sample of older adults who used home care services in England. This paper aims to demonstrate the instrument's test-retest reliability and provide evidence for its validity in a diverse sample of adults who use publicly-funded, community-based social care in England. A survey of 770 social care service users was conducted in England. A subsample of 100 services users participated in a follow-up interview between 7 and 21 days after baseline. Spearman rank correlation coefficients between the ASCOT-SCT4 index score and the EQ-5D-3 L, the ICECAP-A or ICECAP-O and overall quality of life were used to assess convergent validity. Data on variables hypothesised to be related to the ASCOT-SCT4 index score, as well as rating of individual attributes, were also collected. Hypothesised relationships were tested using one-way ANOVA or Fisher's exact test. Test-retest reliability was assessed using the intra-class correlation coefficient for the ASCOT-SCT4 index score at baseline and follow-up. There were moderate to strong correlations between the ASCOT-SCT4 index and EQ-5D-3 L, the ICECAP-A or ICECAP-O, and overall quality of life (all correlations ≥ 0.3). The construct validity was further supported by statistically significant hypothesised relationships between the ASCOT-SCT4 index and individual characteristics in univariate and multivariate analysis. There was also further evidence for the construct validity for the revised Food and drink and Dignity items. The test-retest reliability was considered to be good (ICC = 0.783; 95% CI: 0.678-0.857). The ASCOT-SCT4 index has good test-retest reliability for adults with physical or sensory disabilities who use social care

  12. Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease.

    PubMed

    Lucendo, Alfredo J; Arias, Ángel; González-Cervera, Jesús; Yagüe-Compadre, José Luis; Guagnozzi, Danila; Angueira, Teresa; Jiménez-Contreras, Susana; González-Castillo, Sonia; Rodríguez-Domíngez, Benito; De Rezende, Livia C; Tenias, José M

    2013-03-01

    Although empiric exclusion from the diet of the 6 food groups most likely to trigger allergies achieves eosinophilic esophagitis (EoE) remission in children, data on its prolonged efficacy and effects on adults are lacking. We sought to evaluate the efficacy of a 6-food elimination diet in inducing and maintaining prolonged remission in patients with adult EoE. Sixty-seven consecutive patients with adult EoE were prospectively recruited and treated exclusively with a diet avoiding cereals, milk, eggs, fish/seafood, legumes/peanuts, and soy for 6 weeks. Subsequent challenge was undertaken by sequentially reintroducing all excluded single foods, followed by endoscopy and biopsies, which were developed every 6 weeks in case of response (eosinophil peak count reduction to <15/high-power field [hpf]). A food was considered a trigger for EoE and removed from the diet if pathologic eosinophilic infiltration (≥15 eosinophils/hpf) reappeared. Food-specific serum IgE measurements and skin prick tests were performed before initiating the diet. Forty-nine (73.1%) patients exhibited significantly reduced eosinophil peak counts (<15 eosinophils/hpf) before sequential single-food reintroduction. A single offending food antigen was identified in 35.71% of patients, 2 food triggers were identified in 30.95%, and 3 or more food triggers were identified in 33.3%. Cow's milk was the most common food antigen (61.9%), followed by wheat (28.6%), eggs (26.2%), and legumes (23.8%). Prior allergy tests showed no concordance with food-reintroduction challenge results. All patients who continued to avoid the offending foods maintained histopathologic and clinical EoE remission for up to 3 years. An empiric 6-food elimination diet effectively induced remission of active adult EoE, which was maintained for up to 3 years with individually tailored, limited exclusion diets. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  13. Validation of the ADAMO Care Watch for step counting in older adults.

    PubMed

    Magistro, Daniele; Brustio, Paolo Riccardo; Ivaldi, Marco; Esliger, Dale Winfield; Zecca, Massimiliano; Rainoldi, Alberto; Boccia, Gennaro

    2018-01-01

    Accurate measurement devices are required to objectively quantify physical activity. Wearable activity monitors, such as pedometers, may serve as affordable and feasible instruments for measuring physical activity levels in older adults during their normal activities of daily living. Currently few available accelerometer-based steps counting devices have been shown to be accurate at slow walking speeds, therefore there is still lacking appropriate devices tailored for slow speed ambulation, typical of older adults. This study aimed to assess the validity of step counting using the pedometer function of the ADAMO Care Watch, containing an embedded algorithm for measuring physical activity in older adults. Twenty older adults aged ≥ 65 years (mean ± SD, 75±7 years; range, 68-91) and 20 young adults (25±5 years, range 20-40), wore a care watch on each wrist and performed a number of randomly ordered tasks: walking at slow, normal and fast self-paced speeds; a Timed Up and Go test (TUG); a step test and ascending/descending stairs. The criterion measure was the actual number of steps observed, counted with a manual tally counter. Absolute percentage error scores, Intraclass Correlation Coefficients (ICC), and Bland-Altman plots were used to assess validity. ADAMO Care Watch demonstrated high validity during slow and normal speeds (range 0.5-1.5 m/s) showing an absolute error from 1.3% to 1.9% in the older adult group and from 0.7% to 2.7% in the young adult group. The percentage error for the 30-metre walking tasks increased with faster pace in both young adult (17%) and older adult groups (6%). In the TUG test, there was less error in the steps recorded for older adults (1.3% to 2.2%) than the young adults (6.6% to 7.2%). For the total sample, the ICCs for the ADAMO Care Watch for the 30-metre walking tasks at each speed and for the TUG test were ranged between 0.931 to 0.985. These findings provide evidence that the ADAMO Care Watch demonstrated highly accurate

  14. Barriers to Health Care Among Adults Identifying as Sexual Minorities: A US National Study.

    PubMed

    Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S; Ward, Brian W

    2016-06-01

    To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care. We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care). Relative to straight adults, gay or lesbian and bisexual adults had higher odds of delaying or not receiving care because of cost. Bisexual adults had higher odds of delaying care for noncost reasons, and gay men had higher odds than straight men of reporting trouble finding a provider. By contrast, gay or lesbian women had lower odds of delaying care for noncost reasons than straight women. Bisexual women had higher odds than gay or lesbian women of reporting 3 of the 5 barriers investigated. Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts.

  15. Evaluating family function in caring for a geriatric group: Family APGAR applied for older adults by home care nurses.

    PubMed

    Wang, Mei-Wen; Huang, Yi-Yu

    2016-06-01

    Family function is an essential factor affecting older adults' health. However, there has been no appropriate method to assess the family function of most older adults with fragility or poor health status. The present study aimed to explore the differences and relevance of family function estimated by home care nurses and the older adults, and to determine if nurses could represent older adults to provide the estimation. Study participants were 50 older adults who were aged older 65 years and were taken care of at home by well-trained nurses. The present study used the Family APGAR as the questionnaire. We compared the results evaluated by the older adults and their home care nurses. The results included the level of dysfunction and the total scores of the questionnaire. The paired t-test and McNemar-Bowker test were used for the analysis. Family function could be leveled as "good," "moderate dysfunction" and "severe dysfunction" according to the scores. The family function levels estimated by nurses showed no significant differences to the patients' condition (P = 0.123 > 0.05). Comparing the total scores of the older adults with those of their own home care nurses, the results showed a moderate to nearly high correlation (R = 0.689/P < 0.001). Caring time might be the factor affecting the result. The present study provides a way of helping physicians to ascertain older adults' family problems much earlier and to improve the their health status by enhancing family support. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  16. Older Adult Consumer Knowledge, Attitudes, and Self-Reported Storage Practices of Ready-to-Eat Food Products and Risks Associated with Listeriosis.

    PubMed

    Evans, Ellen W; Redmond, Elizabeth C

    2016-02-01

    Consumer implementation of recommended food safety practices, specifically relating to time and temperature control of ready-to-eat (RTE) food products associated with listeriosis are crucial. This is particularly the case for at-risk consumers such as older adults, given the increased listeriosis incidence reported internationally among adults aged ≥60 years. However, data detailing older adults' cognitive risk factors associated with listeriosis are lacking. Combining data about knowledge, self-reported practices, and attitudes can achieve a cumulative multilayered in-depth understanding of consumer food safety behavior and cognition. This study aims to ascertain older adults' cognition and behavior in relation to domestic food handling and storage practices that may increase the risks associated with L. monocytogenes. Older adults (≥60 years) (n = 100) participated in an interview and questionnaire to determine knowledge, self-reported practices, and attitudes toward recommended practices. Although the majority (79%) had positive attitudes toward refrigeration, 84% were unaware of recommended temperatures (5°C) and 65% self-reported "never" checking their refrigerator temperature. Although most (72%) knew that "use-by" dates indicate food safety and 62% reported "always" taking note, neutral attitudes were held, with 67% believing it was safe to eat food beyond use-by dates and 57% reporting doing so. Attitudes toward consuming foods within the recommended 2 days of opening were neutral, with 55% aware of recommendations and , 84% reporting that they consume RTE foods beyond recommendations. Although knowledgeable of some key practices, older adults self-reported potentially unsafe practices when storing RTE foods at home, which may increase risks associated with L. monocytogenes. This study has determined that older adults' food safety cognition may affect their behaviors; understanding consumer food safety cognition is essential for developing targeted

  17. Oxytocin is associated with infant-care behavior and motivation in cooperatively breeding marmoset monkeys.

    PubMed

    Finkenwirth, Christa; Martins, Eloisa; Deschner, Tobias; Burkart, Judith M

    2016-04-01

    The neurohormone oxytocin (OT) is positively involved in the regulation of parenting and social bonding in mammals, and may thus also be important for the mediation of alloparental care. In cooperatively breeding marmosets, infants are raised in teamwork by parents and adult and sub-adult non-reproductive helpers (usually older siblings). Despite high intrinsic motivation, which may be mediated by hormonal priming, not all individuals are always equally able to contribute to infant-care due to competition among care-takers. Among the various care-taking behaviors, proactive food sharing may reflect motivational levels best, since it can be performed ad libitum by several individuals even if competition among surplus care-takers constrains access to infants. Our aim was to study the link between urinary OT levels and care-taking behaviors in group-living marmosets, while taking affiliation with other adults and infant age into account. Over eight reproductive cycles, 26 individuals were monitored for urinary baseline OT, care-taking behaviors (baby-licking, -grooming, -carrying, and proactive food sharing), and adult-directed affiliation. Mean OT levels were generally highest in female breeders and OT increased significantly in all individuals after birth. During early infancy, high urinary OT levels were associated with increased infant-licking but low levels of adult-affiliation, and during late infancy, with increased proactive food sharing. Our results show that, in marmoset parents and alloparents, OT is positively involved in the regulation of care-taking, thereby reflecting the changing needs during infant development. This particularly included behaviors that are more likely to reflect intrinsic care motivation, suggesting a positive link between OT and motivational regulation of infant-care. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

    PubMed

    Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

    2016-11-01

    This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be

  19. Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care.

    PubMed

    Choi, Jin-Ho; Yoo, Han-Wook

    2017-02-01

    Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care.

  20. Up Close and Personal: Theorising Care Work in Adult Education

    ERIC Educational Resources Information Center

    John, Vaughn M.

    2016-01-01

    How do we account for the close personal bonds and deeply caring relationships forged by educators with learners in many adult educational encounters? The literature is relatively silent on the emotional and relational basis to adult educator work. This is a serious silence, given the stressful nature of adult education in developing contexts such…

  1. Considering quality of care for young adults with diabetes in Ireland

    PubMed Central

    2013-01-01

    Background Research on the quality of diabetes care provided to young adults with Type 1 diabetes is lacking. This study investigates perceptions of quality of care for young adults with Type 1 diabetes (23–30 years old) living in the Republic of Ireland. Methods Thirty-five young adults with Type 1 diabetes (twenty-nine women, six men) and thirteen healthcare professionals (ten diabetes nurse specialists, three consultant Endocrinologists) were recruited. All study participants completed semi-structured interviews that explored their perspectives on the quality of diabetes services in Ireland. Interviews were analyzed using standard qualitative thematic analysis techniques. Results Most interviewees identified problems with Irish diabetes services for young adults. Healthcare services were often characterised by long waiting times, inadequate continuity of care, overreliance on junior doctors and inadequate professional-patient interaction times. Many rural and non-specialist services lacked funding for diabetes education programmes, diabetes nurse specialists, insulin pumps or for psychological support, though these services are important components of quality Type 1 diabetes healthcare. Allied health services such as psychology, podiatry and dietician services appeared to be underfunded in many parts of the country. While Irish diabetes services lacked funding prior to the recession, the economic decline in Ireland, and the subsequent austerity imposed on the Irish health service as a result of that decline, appears to have additional negative consequences. Despite these difficulties, a number of specialist healthcare services for young adults with diabetes seemed to be providing excellent quality of care. Although young adults and professionals identified many of the same problems with Irish diabetes services, professionals appeared to be more critical of diabetes services than young adults. Young adults generally expressed high levels of satisfaction with

  2. Prevalence of intestinal parasites and bacteria among food handlers in a tertiary care hospital

    PubMed Central

    Zaglool, D. A.; Khodari, Y. A.; Othman, R. A. M.; Farooq, M. U.

    2011-01-01

    Objectives: The aim of this work is to determine the prevalence of intestinal parasites and bacteria among the food handlers. Materials and Methods: Two hundred food-handlers were subjected to a cross-sectional study working in the kitchen of a tertiary care hospital, i.e., Alnoor Specialist Hospital, Makkah, Saudi Arabia from February 2 to 27, 2009. The stool samples were examined for intestinal parasites following direct microscopic examination, formol ether concentration (Ritchie), and staining with modified acid fast staining techniques. For enteropathogenic bacteria samples were inoculated onto MacConkey's agar, deoxycholate citrate agar, xylose lysine deoxycholate agar as per the World Health Organization protocol. Fingernail materials were examined microscopically for enteropathogenic bacteria and parasites. Results: The majority (80%) of the food-handlers were young adults aged from 22 to 42 years. No intestinal parasites were detected from fingernail contents. Forty six (23%) stool specimens were positive for intestinal para¬sites. Giardia lamblia 18 (9%) was most frequent among the 10 different types of detected intestinal parasites followed by Entamoeba histolytica 9 (4.5%). No pathogenic bacteria were detected in all stool samples, whereas finger nails showed isolation of microorganisms as coagulase-negative staphylococci 79 (39.5%), followed by Staphylococcus aureus 35 (17.5%). Conclusion: The findings emphasized the importance of food handlers as potential sources of infections and suggested health institutions for appropriate hygienic and sanitary control measures. PMID:22529512

  3. Young Adult Outcomes of the Abecedarian and CARE Early Childhood Educational Interventions

    ERIC Educational Resources Information Center

    Campbell, Frances A.; Wasik, Barbara H.; Pungello, Elizabeth; Burchinal, Margaret; Barbarin, Oscar; Kainz, Kirsten; Sparling, Joseph J.; Ramey, Craig T.

    2008-01-01

    Adult benefits for participants in Project CARE were compared with those of the Abecedarian Project, a closely related randomized study of early childhood educational intervention for children from low-income families who were at risk of developmental delays and school failure. CARE replicated Abecedarian's young adult treatment-related…

  4. Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.

    PubMed

    Oketch, Jecinter Akinyi; Paterson, Marie; Maunder, Eleni Winfred; Rollins, Nigel Campbell

    2011-03-01

    Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Impact of the Oregon Health Plan on Access and Satisfaction of Adults with Low-income

    PubMed Central

    Mitchell, Janet B; Haber, Susan G; Khatutsky, Galina; Donoghue, Suzanne

    2002-01-01

    Objective To evaluate the effects of the Oregon Health Plan (OHP) on beneficiary access and satisfaction. Data Sources Telephone survey of nondisabled adults in 1998. Study Design Two groups of adults were surveyed: OHP enrollees and Food Stamp recipients not enrolled in OHP. The Food Stamp sample included both privately insured and uninsured recipients. This allowed us to disentangle the insurance effects of OHP from other effects such as its reliance on managed care and the priority list. OHP and Food Stamp adults were compared along the following measures: usual source of care, utilization of health care services, unmet need, and satisfaction with care. Data Collection The survey was conducted by telephone, using computer-assisted telephone interviewing techniques. Principal Findings Much of OHP's impact has been realized by its extension of health insurance coverage to Oregon's low-income residents. The availability of health insurance significantly increased the utilization of many health care services and reduced unmet need for care. OHP was associated within a higher percentage of enrollees having a usual source of care and higher rates of Pap test screening among women compared with Food Stamp recipients. OHP enrollees also reported significantly higher use of dental care and prescription drugs; use we attribute to the expanded benefit package under the priority list. At the same time, OHP enrollees reported a greater unmet need for prescription drugs. Drug treatment for below-the-line conditions was one reason for this unmet need, but often the specific drug simply was not in the plan's formulary. OHP enrollees were as satisfied with their health care as those Food Stamp recipients with private health insurance. Conclusions Despite the negative publicity prior to its implementation, there is no evidence that “rationing” under OHP's priority list has substantially restricted access to needed services. OHP adults appear to enjoy access equal to or better

  6. Comparison of major depressive disorder and subthreshold depression among older adults in community long-term care.

    PubMed

    Lee, Mi Jin; Hasche, Leslie K; Choi, Sunha; Proctor, Enola K; Morrow-Howell, Nancy

    2013-01-01

    This study extends existing knowledge regarding the continuum between major depression (MD) and subthreshold depression (SD) by examining differences in symptomology and associative factors for a subpopulation of older adults with functional disability. Our sample consisted of clients age 60 and above entering public community long term care derived from the baseline survey of a longitudinal study (315 non-depressed, 74 MD, and 221 SD). We used the Diagnostic Interview Schedule to establish diagnoses of MD, the Center for Epidemiological Studies Depression Scale (CES-D) to assess SD, and other self-report measures to explore potential associative factors of demographics, comorbidity, social support, and stressors. No differences in CES-D identified symptoms occurred between the two groups. MD and SD were both associated with lower education, poorer social support, more severe medical conditions, and higher stress when compared to non-depressed older adults. Younger age and being female were associated solely with MD; whereas, worse perceived health and more trouble affording food were associated solely with SD. The only associative factor significantly different between MD and SD was age. Those with MD were more likely to be younger than those with SD. Our findings of symptom profiles and associative factors lend support to the continuum notion of depression. Identification of only older adults within the community long-term care service system who meet criteria for MD would leave many older adults, who also face multiple comorbidities, high levels of stress and social isolation, and substantial depressive symptoms undiagnosed and untreated.

  7. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    PubMed

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  8. Foot care behaviors among adults with type 2 diabetes.

    PubMed

    D'Souza, Melba Sheila; Ruppert, Susan D; Parahoo, Kader; Karkada, Subrahmanya Nairy; Amirtharaj, Anandhi; Jacob, Devakirubai; Balachandran, Shreedevi; Al Salmi, Nasser Majid Dhabi

    2016-12-01

    The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes. A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014. Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management. Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  9. Reducing Young Adults' Health Care Spending through the ACA Expansion of Dependent Coverage.

    PubMed

    Chen, Jie; Vargas-Bustamante, Arturo; Novak, Priscilla

    2017-10-01

    To estimate health care expenditure trends among young adults ages 19-25 before and after the 2010 implementation of the Affordable Care Act (ACA) provision that extended eligibility for dependent private health insurance coverage. Nationally representative Medical Expenditure Panel Survey data from 2008 to 2012. We conducted repeated cross-sectional analyses and employed a difference-in-differences quantile regression model to estimate health care expenditure trends among young adults ages 19-25 (the treatment group) and ages 27-29 (the control group). Our results show that the treatment group had 14 percent lower overall health care expenditures and 21 percent lower out-of-pocket payments compared with the control group in 2011-2012. The overall reduction in health care expenditures among young adults ages 19-25 in years 2011-2012 was more significant at the higher end of the health care expenditure distribution. Young adults ages 19-25 had significantly higher emergency department costs at the 10th percentile in 2011-2012. Differences in the trends of costs of private health insurance and doctor visits are not statistically significant. Increased health insurance enrollment as a consequence of the ACA provision for dependent coverage has successfully reduced spending and catastrophic expenditures, providing financial protections for young adults. © Health Research and Educational Trust.

  10. Food allergy preceded by contact urticaria due to the same food: involvement of epicutaneous sensitization in food allergy.

    PubMed

    Inomata, Naoko; Nagashima, Mayumi; Hakuta, Amiko; Aihara, Michiko

    2015-01-01

    There have recently been reports suggesting that sensitization to food allergens may occur outside the intestinal tract, especially through the skin. To clarify the role of epicutaneous sensitization in food allergy, we investigated the clinical characteristics of adult patients with food allergies preceded by contact urticaria due to the same foods. We investigated clinical characteristics of 15 patients (20-51 years of age; 5 men and 10 women), who had food allergies preceded by contact urticaria. Fourteen patients were contact urticaria due to the causative foods during occupationally cooking, whereas 1 patient during face pack. In the occupational group, causative foods included rice, wheat, fruits, vegetables, fish, shrimp and cuttlefish; in the fresh cucumber paste case the cause was cucumber. In the 15 patients, the causative foods were fresh, not processed, and were tolerated by most (9/15, 60%) after heating. Regarding to symptoms after ingestion of the causative foods, the most frequently induced symptoms was oral symptoms (14/15, 93.3%), followed by urticaria (4/15, 26.7%), abdominal symptoms (3/15, 20%). The duration between the start of jobs or face pack, and the onset of contact urticaria was from 1 month to 19 years (mean, 8.7 years). The duration between the onset of contact urticaria and the onset of food allergy was from a few weeks to 6 years (mean, 11 months). One sushi cook experienced severe anaphylactic shock after ingestion of fish. In the occupational group, 13 of 15 patients (86.7%) had atopic dermatitis or hand eczema, indicating that the impaired skin barrier might be a risk for food allergies induced by epicutaneous sensitization. Epicutaneous sensitization of foods could induce food allergy under occupational cooking and skin-care treatment with foods in adults. Copyright © 2014 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  11. Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities

    ERIC Educational Resources Information Center

    Young, Nancy L.; Barden, Wendy S.; Mills, Wendy A.; Burke, Tricia A.; Law, Mary; Boydell, Katherine

    2009-01-01

    Introduction: The transition to adulthood is extremely difficult for individuals with disabilities. We sought to explore the specific issue of transition to adult-oriented health care in a Canadian context. Methods: We conducted semi-structured individual interviews with 15 youth and 15 adults with cerebral palsy, spina bifida, and acquired brain…

  12. Variable Food-Specific IgG Antibody Levels in Healthy and Symptomatic Chinese Adults

    PubMed Central

    Wu, Liu-Xin; Li, Hong; Sun, Zhi-Jian; Li, Jing-Bo; Jiang, Hong-Xia; Chen, Zhi-Heng; Wang, Qi-Bin; Chen, Wei-Wei

    2013-01-01

    Background The presence of food-specific IgG antibodies in human serum may be useful for diagnosis of adverse food reactions. However, the clinical utility of tesing for such antibodies remains very controversial. The aim of this study was to evaluate the serum levels and population distribution of food-specific IgGs and their association with chronic symptoms in a large-scale Chinese population. Methodology/Principal Findings A total of 21305 adult participants from different regions of China had 14 type of food-specific serum IgG antibodies that were measured by enzyme-linked immunosorbent assay. Amongthese, 5,394 participants were randomly chosen to complete follow-up questionnaire surveys on their dietary characteristics and chronic symptoms. The concentrations of food-specific IgGs against 14 foods ranged from a median (interquartile range) of 7.3 (3.8, 12.6) U/mL of pork-specfic IgG to 42.3 (28.8, 60.2) U/mL of crab-specific IgG. The concentration of food-specific IgGs was closely related to gender; after adjustment for region and age, women had higher concentrations of food-specific IgGs against all of the 14 foods except chicken (regression coefficient (95% CI): 0.01 (−0.003, 0.023); P = 0.129) and corn (0.002 (−0.013, 0.016); P = 0.825). Similar results were also found in the relationship of geographic region to the food-specific IgG concentrations for the 14 foods. Chronic symptoms were negatively associated with the concentrations of a few food-specific IgGs, and were positively associated with the concentrations of other food-specific IgGs. Conclusions The levels of food-specific IgGs were variable both in healthy and in symptomatic Chinese adults. These findings raise awareness that demographic factors, the type of food and specific chronic symptoms should be considered before food elimination treatment based on IgG testing in patients with chronic symptoms is used in clinical practice. PMID:23301096

  13. Healthy Choices for Every Body Adult Curriculum Improves Participants' Food Resource Management Skills and Food Safety Practices.

    PubMed

    Adedokun, Omolola A; Plonski, Paula; Jenkins-Howard, Brooke; Cotterill, Debra B; Vail, Ann

    2018-06-01

    To evaluate the impact of the University of Kentucky's Healthy Choices for Every Body (HCEB) adult nutrition education curriculum on participants' food resource management (FRM) skills and food safety practices. A quasi-experimental design was employed using propensity score matching to pair 8 intervention counties with 8 comparison counties. Independent-samples t tests and ANCOVA models compared gains in FRM skills and food safety practices between the intervention and comparison groups (n = 413 and 113, respectively). Propensity score matching analysis showed a statistical balance and similarities between the comparison and intervention groups. Food resource management and food safety gain scores were statistically significantly higher for the intervention group (P < .001), with large effect sizes (d = 0.9) for both variables. The group differences persisted even after controlling for race and age in the ANCOVA models. The HCEB curriculum was effective in improving the FRM skills and food safety practices of participants. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  14. Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States.

    PubMed

    Philbin, Morgan M; Tanner, Amanda E; Ma, Alice; Chambers, Brittany D; Ware, Samuella; Kinnard, Elizabeth N; Hussen, Sophia A; Lee, Sonia; Fortenberry, J Dennis

    2017-10-01

    It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28). We used the constant comparative method to examine how providers defined and approached youths' successful transition. Providers identified four components critical to successful transition: (1) clinical outcomes (e.g., medication adherence and viral suppression); (2) youth knowing how to complete treatment-related activities (e.g., refilling prescriptions and making appointments); (3) youth taking responsibility for treatment-related activities and their overall health (e.g., "when they stop reaching out to the adolescent [clinic] to solve all their problems."); and (4) youth feeling a connection and trust toward the adult clinic (e.g., "they feel safe here"), with some providers even prioritizing connectedness over clinical outcomes (e.g., "Even if they're not taking meds but are connected [to care], …that's a success."). The identification of key components of successful transition can guide focused interventions and resources to improve youth maintenance in the HIV Care Continuum as they transition to adult care. Identifying what facilitates successful transitions, and the gaps that interventions can target, will help to ensure HIV-infected youth remain healthy across their lifespan.

  15. Impact of a 12-week wellness coaching on self-care behaviors among primary care adult patients with prediabetes.

    PubMed

    DeJesus, Ramona S; Clark, Matthew M; Finney Rutten, Lila J; Jacobson, Robert M; Croghan, Ivana T; Wilson, Patrick M; Jacobson, Debra J; Link, Sara M; Fan, Chun; St Sauver, Jennifer L

    2018-06-01

    This single arm prospective study assessed the impact of individualized wellness coaching intervention for primary care patients with prediabetes on self-reported changes in physical activity level and food choices. Five hundred sixty adult patients 18 years and older with prediabetes, seen in primary care clinic, were invited to participate in 12 weeks wellness coaching sessions delivered by certified coaches. Responses from questionnaires at baseline, 6 and 12 weeks were analyzed. Of 168 consented patients, 99 completed at least one coaching session; majority was elderly, female, overweight or obese. At baseline, 50% had <60 min aerobic exercise/week. At 6 and 12 weeks, average aerobic exercise time significantly increased from 117 min to 166 and 199 min respectively. Effect was sustained at 24 weeks. Success in making healthy eating choices also statistically improved from baseline. Significant effects on both activity level and eating behavior persisted even after adjusting for age, sex and baseline glucose/A1c values. Secondary outcomes of self-efficacy and quality of life likewise showed significant improvement. Results suggest that integration of wellness coaching in primary care practice among individuals at high risk for diabetes is feasible and may be useful as part of diabetes prevention management strategies in target populations. Future randomized clinical trials are needed to further explore this issue.

  16. Household food diversity and nutritional status among adults in Brazil.

    PubMed

    Bezerra, Ilana N; Sichieri, Rosely

    2011-03-27

    The aims of this study were to evaluate whether a diversity of healthy foods in a household would decrease the availability of unhealthy foods and to evaluate the association between a healthy dietary diversity score (DDS) and nutritional status among adults. Data from the 2002-2003 Brazilian Household Budget Survey were used. This nationwide survey used a two-stage sampling technique: households were selected after selection of primary sample units (PSUs). Analyses were based on 3,393 PSUs, evaluating 659,816 records of food items purchased by 35,237 households. The DDS was based on the healthy food groups according to Brazilian food guidelines. Per capita acquisition of sugar, sweets, sugar-sweetened beverages and crackers, cookies and cakes (unhealthy food groups) in PSUs was also calculated. Individual weight and height were measured at household. Multivariate linear regression models estimated the association of underweight and overweight and obesity (excess weight) with the PSUs' DDS. Greater acquisition of unhealthy food groups was associated with higher DDS. A high PSU's DDS was negatively associated with underweight (β = -0.38; p-value = 0.04) and positively associated with excess weight (β = 0.98; p-value = 0.05) after adjustment for availability of unhealthy food groups and socioeconomic variables. Our data indicate that there was no replacement of unhealthy food groups by healthy food groups, therefore a healthy diet message for obesity prevention should be combined with a message focused on eating less.

  17. CoYoT1 Clinic: Home Telemedicine Increases Young Adult Engagement in Diabetes Care.

    PubMed

    Reid, Mark W; Krishnan, Subramanian; Berget, Cari; Cain, Cindy; Thomas, John Fred; Klingensmith, Georgeanna J; Raymond, Jennifer K

    2018-05-01

    Young adults with type 1 diabetes (T1D) experience poor glycemic control, disengagement in care, and are often lost to the medical system well into their adult years. Diabetes providers need a new approach to working with the population. The goal of this study was to determine whether an innovative shared telemedicine appointment care model (CoYoT1 Clinic [pronounced as "coyote"; Colorado Young Adults with T1D]) for young adults with T1D improves care engagement, satisfaction, and adherence to American Diabetes Association (ADA) guidelines regarding appointment frequency. CoYoT1 Clinic was designed to meet the diabetes care needs of young adults (18-25 years of age) with T1D through home telemedicine. Visits occurred every 3 months over the 1-year study (three times by home telemedicine and one time in-person). Outcomes were compared to patients receiving treatment as usual (control). Compared with controls, CoYoT1 patients attended significantly more clinic visits (P < 0.0001) and increased their number of clinic visits from the year before the intervention. Seventy-four percent of CoYoT1 patients were seen four times over the 12-month study period, meeting ADA guidelines, but none in the control group met the ADA recommendation. CoYoT1 patients used diabetes technologies more frequently and reported greater satisfaction with care compared with controls. Delivering diabetes care by home telemedicine increases young adults' adherence to ADA guidelines and usage of diabetes technologies, and improves retention in care when compared to controls. Home telemedicine may keep young adults engaged in their diabetes care during this challenging transition period.

  18. 77 FR 64390 - Agency Information Collection (Food Service and Nutritional Care Analysis) Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0227] Agency Information Collection (Food Service and Nutritional Care Analysis) Activities Under OMB Review AGENCY: Veterans Health Administration... ``OMB Control No. 2900-0227.'' SUPPLEMENTARY INFORMATION: Title: Food Service and Nutritional Care...

  19. Health Care Transition in Young Adults With Type 1 Diabetes: Perspectives of Adult Endocrinologists in the U.S.

    PubMed Central

    Telo, Gabriela H.; Needleman, Joseph S.; Forbes, Peter; Finkelstein, Jonathan A.; Laffel, Lori M.

    2016-01-01

    OBJECTIVE Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. Our objective was to describe experiences, resources, and barriers reported by a national sample of adult endocrinologists receiving and caring for young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS We fielded an electronic survey to adult endocrinologists with a valid e-mail address identified through the American Medical Association Physician Masterfile. RESULTS We received responses from 536 of 4,214 endocrinologists (response rate 13%); 418 surveys met the eligibility criteria. Respondents (57% male, 79% Caucasian) represented 47 states; 64% had been practicing >10 years and 42% worked at an academic center. Only 36% of respondents reported often/always reviewing pediatric records and 11% reported receiving summaries for transitioning young adults with type 1 diabetes, although >70% felt that these activities were important for patient care. While most respondents reported easy access to diabetes educators (94%) and dietitians (95%), fewer (42%) reported access to mental health professionals, especially in nonacademic settings. Controlling for practice setting and experience, endocrinologists without easy access to mental health professionals were more likely to report barriers to diabetes management for young adults with depression (odds ratio [OR] 5.3; 95% CI 3.4, 8.2), substance abuse (OR 3.5; 95% CI 2.2, 5.6), and eating disorders (OR 2.5; 95% CI 1.6, 3.8). CONCLUSIONS Our findings underscore the need for enhanced information transfer between pediatric and adult providers and increased mental health referral access for young adults with diabetes post-transition. PMID:26681724

  20. Psychologists and the Transition From Pediatrics to Adult Health Care.

    PubMed

    Gray, Wendy N; Monaghan, Maureen C; Gilleland Marchak, Jordan; Driscoll, Kimberly A; Hilliard, Marisa E

    2015-11-01

    Guidelines for optimal transition call for multidisciplinary teams, including psychologists, to address youth and young adults' multifactorial needs. This study aimed to characterize psychologists' roles in and barriers to involvement in transition from pediatric to adult health care. Psychologists were invited via professional listservs to complete an online survey about practice settings, roles in transition programming, barriers to involvement, and funding sources. Participants also responded to open-ended questions about their experiences in transition programs. One hundred participants responded to the survey. Involvement in transition was reported at multiple levels from individual patient care to institutional transition programming, and 65% reported more than one level of involvement. Direct clinical care (88%), transition-related research (50%), and/or leadership (44%) involvement were reported, with 59% reporting more than one role. Respondents often described advocating for their involvement on transition teams. Various sources of funding were reported, yet, 23% reported no funding for their work. Barriers to work in transition were common and included health care systems issues such as poor coordination among providers or lack of a clear transition plan within the clinic/institution. Psychologists assume numerous roles in the transition of adolescents from pediatric to adult health care. With training in health care transition-related issues, psychologists are ideally positioned to partner with other health professionals to develop and implement transition programs in multidisciplinary settings, provided health care system barriers can be overcome. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Health Care Reform and Young Adults' Access to Sexual Health Care: An Exploration of Potential Confidentiality Implications of the Affordable Care Act

    PubMed Central

    Garcia, Carolyn M.; Long, Sharon K.; Lechner, Kate E.; Lust, Katherine; Eisenberg, Marla E.

    2012-01-01

    One provision of the 2010 Affordable Care Act is extension of dependent coverage for young adults aged up to 26 years on their parent’s private insurance plan. This change, meant to increase insurance coverage for young adults, might yield unintended consequences. Confidentiality concerns may be triggered by coverage through parental insurance, particularly regarding sexual health. The existing literature and our original research suggest that actual or perceived limits to confidentiality could influence the decisions of young adults about whether, and where, to seek care for sexual health issues. Further research is needed on the scope and outcomes of these concerns. Possible remedial actions include enhanced policies to protect confidentiality in billing and mechanisms to communicate confidentiality protections to young adults. PMID:22897544

  2. IgE Sensitization Patterns to Commonly Consumed Foods Determined by Skin Prick Test in Korean Adults

    PubMed Central

    2016-01-01

    Offending food allergens can vary with regional preferences in food consumption. In this study, we analysed sensitization rates to commonly consumed foods in Korean adults suspected of having food allergy. One hundred and thirty four subjects underwent a skin prick test (SPT) with 55 food allergens, of which 13 were made by our laboratory and the rest were commercially purchased. Of the 134 patients, 73 (54.5%) were sensitized to one or more food allergens. Sensitization to chrysalis was detected most frequently, at a rate of 25.4%. Sensitization rates to other food allergens were as follows: maize grain (13.4%), shrimp (11.9%), almond (11.1%), wheat flour (8.2%), lobster (8.2%), buckwheat (8.2%), mackerel (5.2%), pollack (5.2%), halibut (4.5%), peanut (4.5%), anchovy (4.4%), squid (3.7%), saury (3.0%), common eel (3.0%), yellow corvina (3.0%), hairtail (2.2%), octopus (2.2%), and others. In addition to well-known food allergens, sensitivity to mackerel, chrysalis, pollack, and halibut, which are popular foods in Korea, was observed at high rates in Korean adults. We suggest that the SPT panel for food allergy in Korea should include these allergens. PMID:27478328

  3. Use of Color-Coded Food Photographs for Meal Planning by Adults with Mental Retardation.

    ERIC Educational Resources Information Center

    Gines, Deon J.; And Others

    1990-01-01

    Ten adults with mild mental retardation used color-coded food photographs and meal code cards to plan nutritionally balanced meals. Subjects spent an average of nine minutes to plan three meals. Errors, which were primarily omissions, occurred mostly in food groups requiring four servings daily. (JDD)

  4. Current practice and views of neurologists on the transition from pediatric to adult care.

    PubMed

    Oskoui, Maryam; Wolfson, Christina

    2012-12-01

    To describe the current practice and views of neurologists on transitioning patients from pediatric to adult care, a cross-sectional study of all pediatric and adult neurologists in the province of Quebec, Canada, was conducted. The response rate was 73% for pediatric and 49% for adult neurologists. Most pediatric neurologists do not have a patient transition program or policy in place. Although a transfer summary is commonly provided, critical information is often lacking. Nearly half of neurologists believed that patients experience a gap in care during the transition process, and most agreed that the transition process is often poorly coordinated, highlighting patient, family, and health care factors. Current practice does not follow existing consensus statements for transition of care with respect to timing, communication, and preparation, and many pediatric neurologists experience difficulty in finding an appropriate adult health care provider for their patients. Neurologists reported many challenges in the current transition of care process.

  5. Emotional and behavioral problems in adolescents and young adults with food allergy.

    PubMed

    Ferro, M A; Van Lieshout, R J; Ohayon, J; Scott, J G

    2016-04-01

    Adolescents with food allergy have poorer psychosocial outcomes compared with their nonallergic counterparts; however, few studies have prospectively examined the mental health of adolescents and young adults in this vulnerable population. Our objectives were to estimate the prevalence of emotional and behavioral problems in an epidemiological sample of adolescents and young adults with food allergy; determine whether food allergy is associated with adolescent and maternal reports of such problems; and examine the patterns of change in emotional and behavioral problems from adolescence to young adulthood among individuals with and without food allergy. Data came from 1303 participants at 14 and 21 years of age in the Mater University Study of Pregnancy. Emotional and behavioral problems were measured using self- and maternal-reported symptoms of depression, anxiety, attention/deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. Maternal, but not self-reports suggested that emotional and behavioral problems were higher among adolescents with food allergy. Food allergy was associated with increased odds of elevated levels of maternal-reported symptoms of depression [OR = 4.50 (1.83, 11.07)], anxiety [OR = 2.68 (1.12, 6.44)], and ADHD [OR = 3.14 (1.07, 9.19)] in adolescence. Food allergy was also associated with depressive symptoms that persisted from adolescence to young adulthood [OR = 2.05 (1.04, 4.03)]. Emotional and behavioral problems, particularly symptoms of depression, anxiety, and ADHD, are common among adolescents with food allergy in the general population and, in the case of elevated levels of depressive symptoms, persist into young adulthood. Healthcare professionals should seek adolescent and parental perspectives when assessing emotional and behavioral problems and monitor mental health during the transition to adulthood. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Seeing Health Insurance and HealthCare.gov Through the Eyes of Young Adults.

    PubMed

    Wong, Charlene A; Asch, David A; Vinoya, Cjloe M; Ford, Carol A; Baker, Tom; Town, Robert; Merchant, Raina M

    2015-08-01

    We describe young adults' perspectives on health insurance and HealthCare.gov, including their attitudes toward health insurance, health insurance literacy, and benefit and plan preferences. We observed young adults aged 19-30 years in Philadelphia from January to March 2014 as they shopped for health insurance on HealthCare.gov. Participants were then interviewed to elicit their perceived advantages and disadvantages of insurance and factors considered important for plan selection. A 1-month follow-up interview assessed participants' plan enrollment decisions and intended use of health insurance. Data were analyzed using qualitative methodology, and salience scores were calculated for free-listing responses. We enrolled 33 highly educated young adults; 27 completed the follow-up interview. The most salient advantages of health insurance for young adults were access to preventive or primary care (salience score .28) and peace of mind (.27). The most salient disadvantage was the financial strain of paying for health insurance (.72). Participants revealed poor health insurance literacy with 48% incorrectly defining deductible and 78% incorrectly defining coinsurance. The most salient factors reported to influence plan selection were deductible (.48) and premium (.45) amounts as well as preventive care (.21) coverage. The most common intended health insurance use was primary care. Eight participants enrolled in HealthCare.gov plans: six selected silver plans, and three qualified for tax credits. Young adults' perspective on health insurance and enrollment via HealthCare.gov can inform strategies to design health insurance plans and communication about these plans in a way that engages and meets the needs of young adult populations. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Exploring the factor structure of the Food Cravings Questionnaire-Trait in Cuban adults

    PubMed Central

    Rodríguez-Martín, Boris C.; Molerio-Pérez, Osana

    2014-01-01

    Food cravings refer to an intense desire to eat specific foods. The Food Cravings Questionnaire-Trait (FCQ-T) is the most commonly used instrument to assess food cravings as a multidimensional construct. Its 39 items have an underlying nine-factor structure for both the original English and Spanish version; but subsequent studies yielded fewer factors. As a result, a 15-item version of the FCQ-T with one-factor structure has been proposed (FCQ-T-reduced; see this Research Topic). The current study aimed to explore the factor structure of the Spanish version for both the FCQ-T and FCQ-T-reduced in a sample of 1241 Cuban adults. Results showed a four-factor structure for the FCQ-T, which explained 55% of the variance. Factors were highly correlated. Using the items of the FCQ-T-reduced only showed a one-factor structure, which explained 52% of the variance. Both versions of the FCQ-T were positively correlated with body mass index (BMI), scores on the Food Thoughts Suppression Inventory and weight cycling. In addition, women had higher scores than men and restrained eaters had higher scores than unrestrained eaters. To summarize, results showed that (1) the FCQ-T factor structure was significantly reduced in Cuban adults and (2) the FCQ-T-reduced may represent a good alternative to efficiently assess food craving on a trait level. PMID:24672503

  8. Validity of a food frequency questionnaire to assess food intake in Mexican adolescent and adult population.

    PubMed

    Denova-Gutiérrez, Edgar; Ramírez-Silva, Ivonne; Rodríguez-Ramírez, Sonia; Jiménez-Aguilar, Alejandra; Shamah-Levy, Teresa; Rivera-Dommarco, Juan A

    2016-01-01

    To assess the validity of a 140-item semiquantitative food frequency questionnaire (SFFQ), in Mexican adolescents and adults. Dietary intakes using a SFFQ and two 24-hour dietary recalls (24DRs), in nonconsecutive days during the same week were measured from 178 adolescents and 230 adults participating in the Mexican National Health and Nutrition Survey-2012.Validity was evaluated using correlation coefficients (CC),deattenuated CC, linear regression models, cross-classification analysis, and the Bland-Altman method. In adults, deattenuated correlation coefficients between the SFFQ and the 24DRs ranged from 0.30 for folate to 0.61 for saturated fat. In addition, 63% adults and 62% adolescents were classified in the same and adjacent quartile of nutrient intake when comparing data from SFFQ and 24DRs. The SFFQ had moderate validity for energy, macronutrients and micronutrients. It also had good validity to rank individuals according to their dietary intake of different nutrients.

  9. Standardizing communication from acute care providers to primary care providers on critically ill adults.

    PubMed

    Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

    2015-11-01

    To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P < .001) and the communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

  10. Intake of soy foods and soy isoflavones by rural adult women in China.

    PubMed

    Liu, Zhaoping; Li, Wenxian; Sun, Jing; Liu, Chenghong; Zeng, Qiang; Huang, Jian; Yu, Bo; Huo, Junsheng

    2004-01-01

    This study evaluated the intake of soy foods and soy isoflavones by rural adult women and potential determinant factors. Soy food consumption and information on age, education and medical history were collected on 1,188 subjects in Gansu Province and Hebei Province, China using a food frequency questionnaire to gather data on food intake over the past year. Weight and height were simultaneously measured. The results showed that 1139 (95.9%) rural women consumed soy foods in the past year. The average intake of soy foods and isoflavones was 38.7 +/- 58.2 (median = 23.5) g/d and 17.7 +/- 26.6 (median= 8.9) mg/d, respectively. Tofu accounted for the most contribution to their intake. The soy isoflavone intake ranged between 0-35 mg/day in 89.2% of subjects. Gansu women had higher intakes of soy foods and isoflavones than Henbei women (P< 0.05). Women aged 41-50 years consumed less soy foods and isoflavones than the 20-30-year olds and 31-40 year olds(P < 0.05). The intake of soy foods (P< 0.01) and isoflavones (P< 0.01) by women who experienced secondary education or above was significantly higher than illiterate women. Women without a medical history had a higher soy isoflavone intake than women with a medical history, but the difference was not statistically significant. These results suggest that the intake of soy isoflavones by Chinese rural adult women was much higher than women in Western countries. The distribution of intake was skewed to the right and varied among women in regard to region, age group and education level.

  11. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    PubMed

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Human rights dimensions of food, health and care in children's homes in Kampala, Uganda - a qualitative study.

    PubMed

    Vogt, Line Erikstad; Rukooko, Byaruhanga; Iversen, Per Ole; Eide, Wenche Barth

    2016-03-18

    More than 14 % of Ugandan children are orphaned and many live in children's homes. Ugandan authorities have targeted adolescent girls as a priority group for nutrition interventions as safeguarding nutritional health before pregnancy can reduce the chance of passing on malnutrition to the offspring and thus future generations. Ugandan authorities have obligations under international human rights law to progressively realise the rights to adequate food, health and care for all Ugandan children. Two objectives guided this study in children's homes: (a) To examine female adolescent residents' experiences, attitudes and views regarding: (i) eating patterns and food, (ii) health conditions, and (iii) care practices; and (b) to consider if the conditions in the homes comply with human rights standards and principles for the promotion of the rights to adequate food, health and care. A human rights-based approach guided the planning and conduct of this study. Five children's homes in Kampala were included where focus group discussions were held with girls aged 12-14 and 15-17 years. These discussions were analysed through a phenomenological approach. The conditions of food, health and care as experienced by the girls, were compared with international standards for the realisation of the human rights to adequate food, health and care. Food, health and care conditions varied greatly across the five homes. In some of these the girls consumed only one meal per day and had no access to clean drinking water, soap, toilet paper and sanitary napkins. The realisation of the right to adequate food for the girls was not met in three homes, the realisation of the right to health was not met in two homes, and the realisation of the right to care was not met in one home. In three of the selected children's homes human rights standards for food, health or care were not met. Care in the children's homes was an important contributing factor for whether standards for the rights to adequate

  13. Understanding Older Adult's Perceptions of Factors that Support Trust in Human and Robot Care Providers.

    PubMed

    Stuck, Rachel E; Rogers, Wendy A

    2017-06-01

    As the population of older adults increase so will the need for care providers, both human and robot. Trust is a key aspect to establish and maintain a successful older adult-care provider relationship. However, due to trust volatility it is essential to understand it within specific contexts. This proposed mixed methods study will explore what dimensions of trust emerge as important within the human-human and human-robot dyads in older adults and care providers. First, this study will help identify key qualities that support trust in a care provider relationship. By understanding what older adults perceive as needing to trust humans and robots for various care tasks, we can begin to provide recommendations based on user expectations for design to support trust.

  14. Adolescents' and young adults' transition experiences when transferring from paediatric to adult care: a qualitative metasynthesis.

    PubMed

    Fegran, Liv; Hall, Elisabeth O C; Uhrenfeldt, Lisbeth; Aagaard, Hanne; Ludvigsen, Mette Spliid

    2014-01-01

    The objective of this study was to synthesize qualitative studies of how adolescents and young adults with chronic diseases experience the transition from paediatric to adult hospital care. The review is designed as a qualitative metasynthesis and is following Sandelowski and Barroso's guidelines for synthesizing qualitative research. Literature searches were conducted in the databases PubMed, Ovid, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ISI Web of Science, and Nordic and German databases covering the period from 1999 to November 2010. In addition, forward citation snowball searching was conducted in the databases Ovid, CINAHL, ISI Web of Science, Scopus and Google Scholar. Of the 1143 records screened, 18 studies were included. Inclusion criteria were qualitative studies in English, German or Nordic languages on adolescents' and young adults' transition experiences when transferring from paediatric to adult care. There was no age limit, provided the focus was on the actual transfer process and participants had a chronic somatic disease. The studies were appraised as suitable for inclusion using a published appraisal tool. Data were analyzed into metasummaries and a metasynthesis according to established guidelines for synthesis of qualitative research. Four themes illustrating experiences of loss of familiar surroundings and relationships combined with insecurity and a feeling of being unprepared for what was ahead were identified: facing changes in significant relationships, moving from a familiar to an unknown ward culture, being prepared for transfer and achieving responsibility. Young adults' transition experiences seem to be comparable across diagnoses. Feelings of not belonging and of being redundant during the transfer process are striking. Health care professionals' appreciation of young adults' need to be acknowledged and valued as competent collaborators in their own transfer is crucial, and may protect them from

  15. Older adults challenged financially when adult children move home.

    PubMed

    Wallace, Steven P; Padilla-Frausto, D Imelda

    2014-02-01

    This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs.

  16. Promoting Wellness: A Nutrition, Health and Safety Manual for Family Child Care Providers.

    ERIC Educational Resources Information Center

    Tatum, Pam S.

    This manual provides a reference source for use by sponsor organizations of the Child and Adult Care Food Program (CACFP) in training family child care providers. The manual begins with separate introductory sections for trainers and for providers. The trainer's section includes materials on: how adults learn, strengths and limitations of various…

  17. Socio-economic differences in takeaway food consumption among adults.

    PubMed

    Miura, Kyoko; Giskes, Katrina; Turrell, Gavin

    2012-02-01

    To examine socio-economic differences in the frequency and types of takeaway foods consumed. A cross-sectional postal survey. Participants were asked about their usual consumption of overall takeaway food (<4 times/month or ≥4 times/month) and of twenty-two specific takeaway food items (<1 time/month or ≥1 time/month); these latter foods were grouped into 'healthy' and 'less healthy' choices. Socio-economic position was measured on the basis of educational level and equivalised household income, and differences in takeaway food consumption were assessed by calculating prevalence ratios using log binomial regression. Adults aged 25-64 years from Brisbane, Australia, were randomly selected from the electoral roll (n 903; 63·7 % response rate). Compared with their more educated counterparts, the least educated were more regular consumers of overall takeaway food and fruit or vegetable juice and less regular consumers of sushi. For the 'less healthy' items, the least educated more regularly consumed potato chips, savoury pies, fried chicken and non-diet soft drinks; however, the least educated were less likely to consume curry. Household income was not associated with overall takeaway consumption. The lowest-income group was a more regular consumer of fruit or vegetable juice compared with the highest-income group. Among the 'less healthy' items, the lowest-income group was a more regular consumer of fried fish, ice cream and milk shakes, whereas curry was consumed less regularly. The frequency and types of takeaway foods consumed by socio-economically disadvantaged groups may contribute to inequalities in overweight or obesity and to chronic disease.

  18. Participation of family members and quality of patient care - the perspective of adult surgical patients.

    PubMed

    Leino-Kilpi, Helena; Gröndahl, Weronica; Katajisto, Jouko; Nurminen, Matti; Suhonen, Riitta

    2016-08-01

    The aim of this study is to describe the participation of family members in the care of Finnish adult surgical patients and the connection of the participation with the quality of patient care as perceived by surgical patients. The family members of adult surgical patients are important. Earlier studies vary concerning the nature of participation, its meaning and the connection of participation with patient-centred quality of care. In this study, we aim to produce new knowledge about adult surgical patients whose family members have participated in their care. This was a cross-sectional descriptive survey study. The data were collected among adult surgical patients (N = 481) before being discharged home from hospital with two instruments: the Good Nursing Care scale and the Received Knowledge of Hospital Patients. Based on the results, most adult surgical patients report that family members participate in their care. Participation was connected with received knowledge and preconditions of care, which are components of the quality of patient care. In future, testing of different solutions for improving the participation of surgical patients' family members in patient care should be implemented. Furthermore, the preconditions of family members' participation in care and the concept of participation should be analysed to emphasise the active role of family members. The results emphasised the importance of family members for the patients in surgical care. Family members' participation is connected with the quality of patient care. © 2016 John Wiley & Sons Ltd.

  19. Ultra-processed food consumption and excess weight among US adults.

    PubMed

    Juul, Filippa; Martinez-Steele, Euridice; Parekh, Niyati; Monteiro, Carlos A; Chang, Virginia W

    2018-05-06

    Ultra-processed foods provide 58 % of energy intake and 89 % of added sugars in the American diet. Nevertheless, the association between ultra-processed foods and excess weight has not been investigated in a US sample. The present investigation therefore aims to examine the association between ultra-processed foods and excess weight in a nationally representative sample of US adults. We performed a cross-sectional analysis of anthropometric and dietary data from 15 977 adults (20-64 years) participating in the National Health and Nutrition Examination Survey 2005-2014. Dietary data were collected by 24-h recall. Height, weight and waist circumference (WC) were measured. Foods were classified as ultra-processed/non-ultra-processed according to the NOVA classification. Multivariable linear and logistic regression was used to evaluate the association between ultra-processed food consumption (% energy) and BMI, WC and odds of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity (men: WC≥102 cm, women: WC≥88 cm). Prevalence of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity was 69·2, 36·1 and 53·0 %, respectively. Consuming ≥74·2 v. ≤36·5 % of total energy from ultra-processed foods was associated with 1·61 units higher BMI (95 % CI 1·11, 2·10), 4·07 cm greater WC (95 % CI 2·94, 5·19) and 48, 53 and 62 % higher odds of BMI≥25 kg/m2, BMI≥30 kg/m2 and abdominal obesity, respectively (OR 1·48; 95 % CI 1·25, 1·76; OR 1·53; 95 % CI 1·29, 1·81; OR 1·62; 95 % CI 1·39, 1·89, respectively; P for trend<0·001 for all). A significant interaction between being female and ultra-processed food consumption was found for BMI (F 4,79=4·89, P=0·002), WC (F 4,79=3·71, P=0·008) and BMI≥25 kg/m2 (F 4,79=5·35, P<0·001). As the first study in a US population, our findings support that higher consumption of ultra-processed food is associated with excess weight, and that the association is more pronounced among women.

  20. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

    PubMed

    Bartels, Stephen J; Gill, Lydia; Naslund, John A

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

  1. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities

    PubMed Central

    Bartels, Stephen J.; Gill, Lydia; Naslund, John A.

    2015-01-01

    Abstract The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA. PMID:25811340

  2. Mothers' and Fathers' Roles in Caring for an Adult Child with an Intellectual Disability

    ERIC Educational Resources Information Center

    Rowbotham, Michelle; Carroll, Annemaree; Cuskelly, Monica

    2011-01-01

    To date, there have been few studies of mothers' and fathers' roles in caring for their adult children with intellectual disabilities. The present study investigated the care-giving roles of mother and father couples caring for their adult offspring with an intellectual disability, their psychological health, and the demands and satisfaction of…

  3. Basic need status and health-promoting self-care behavior in adults.

    PubMed

    Acton, G J; Malathum, P

    2000-11-01

    Health-promoting self-care behavior emphasizing positive lifestyle practices may improve the health and quality of life of adults. One variable that may influence health-related decisions is the status of basic needs as described by Maslow. The purpose of this study was to investigate the relationships among basic need satisfaction, health-promoting self-care behavior, and selected demographic variables in a sample of community-dwelling adults. A convenience sample of 84 community-dwelling adults was recruited to complete the Basic Need Satisfaction Inventory, the Health-Promoting Lifestyle Profile II, and demographic information. Results of the study indicated that self-actualization, physical, and love/belonging need satisfaction accounted for 64% of the variance in health-promoting self-care behavior. The findings of this study are consistent with Maslow's theory of human motivation and suggest that persons who are more fulfilled and content with themselves and their lives, have physical need satisfaction, and have positive connections with others may be able to make better decisions regarding positive health-promoting self-care behaviors.

  4. Nutrition outcomes of HIV-infected malnourished adults treated with ready-to-use therapeutic food in sub-Saharan Africa: a longitudinal study.

    PubMed

    Ahoua, Laurence; Umutoni, Chantal; Huerga, Helena; Minetti, Andrea; Szumilin, Elisabeth; Balkan, Suna; Olson, David M; Nicholas, Sarala; Pujades-Rodríguez, Mar

    2011-01-10

    Among people living with HIV/AIDS, nutritional support is increasingly recognized as a critical part of the essential package of care, especially for patients in sub-Saharan Africa. The objectives of the study were to evaluate the outcomes of HIV-positive malnourished adults treated with ready-to-use therapeutic food and to identify factors associated with nutrition programme failure. We present results from a retrospective cohort analysis of patients aged 15 years or older with a body mass index of less than 17 kg/m² enrolled in three HIV/AIDS care programmes in Africa between March 2006 and August 2008. Factors associated with nutrition programme failure (patients discharged uncured after six or more months of nutritional care, defaulting from nutritional care, remaining in nutritional care for six or more months, or dead) were investigated using multiple logistic regression. Overall, 1340 of 8685 (15.4%) HIV-positive adults were enrolled in the nutrition programme. At admission, median body mass index was 15.8 kg/m² (IQR 14.9-16.4) and 12% received combination antiretroviral therapy (ART). After a median of four months of follow up (IQR 2.2-6.1), 524 of 1106 (47.4%) patients were considered cured. An overall total of 531 of 1106 (48.0%) patients failed nutrition therapy, 132 (11.9%) of whom died and 250 (22.6%) defaulted from care. Men (OR = 1.5, 95% CI 1.2-2.0), patients with severe malnutrition at nutrition programme enrolment (OR = 2.2, 95% CI 1.7-2.8), and those never started on ART (OR = 4.5, 95% CI 2.7-7.7 for those eligible; OR = 1.6, 95% CI 1.0-2.5 for those ineligible for ART at enrolment) were at increased risk of nutrition programme failure. Diagnosed tuberculosis at nutrition programme admission or during follow up, and presence of diarrhoeal disease or extensive candidiasis at admission, were unrelated to nutrition programme failure. Concomitant administration of ART and ready-to-use therapeutic food increases the chances of nutritional recovery

  5. Hospitalization of older adults due to ambulatory care sensitive conditions

    PubMed Central

    Marques, Aline Pinto; Montilla, Dalia Elena Romero; de Almeida, Wanessa da Silva; de Andrade, Carla Lourenço Tavares

    2014-01-01

    OBJECTIVE To analyze the temporal evolution of the hospitalization of older adults due to ambulatory care sensitive conditions according to their structure, magnitude and causes. METHODS Cross-sectional study based on data from the Hospital Information System of the Brazilian Unified Health System and from the Primary Care Information System, referring to people aged 60 to 74 years living in the state of Rio de Janeiro, Souhteastern Brazil. The proportion and rate of hospitalizations due to ambulatory care sensitive conditions were calculated, both the global rate and, according to diagnoses, the most prevalent ones. The coverage of the Family Health Strategy and the number of medical consultations attended by older adults in primary care were estimated. To analyze the indicators’ impact on hospitalizations, a linear correlation test was used. RESULTS We found an intense reduction in hospitalizations due to ambulatory care sensitive conditions for all causes and age groups. Heart failure, cerebrovascular diseases and chronic obstructive pulmonary diseases concentrated 50.0% of the hospitalizations. Adults older than 69 years had a higher risk of hospitalization due to one of these causes. We observed a higher risk of hospitalization among men. A negative correlation was found between the hospitalizations and the indicators of access to primary care. CONCLUSIONS Primary healthcare in the state of Rio de Janeiro has been significantly impacting the hospital morbidity of the older population. Studies of hospitalizations due to ambulatory care sensitive conditions can aid the identification of the main causes that are sensitive to the intervention of the health services, in order to indicate which actions are more effective to reduce hospitalizations and to increase the population’s quality of life. PMID:25372173

  6. Transforming pedagogy in nursing education: a caring learning environment for adult students.

    PubMed

    Bankert, Esther G; Kozel, Victoria V

    2005-01-01

    This article is an account of a project involving nursing faculty and adult learners. Their purpose was to generate interactive and collaborative pedagogies. Reflection and dialogue were used to explore how the educational experience can be transformed into an engaging and caring learning environment for adult students. Principles derived from humanistic nursing and caring, reflection, and teaching and learning guided this project.

  7. Evaluation of the Child Care Class for Older Adults.

    ERIC Educational Resources Information Center

    Gallegos, Sandra

    In 1986, the Ability Based on Older Dependable Experience (ABODE) Program was developed at De Anza College to train older adults to serve as a temporary source of child care on an emergency basis. The program was sponsored by Tandem Computers, Incorporated, out of a desire to provide better employee benefits with respect to child care. The program…

  8. Folate intake in a Swedish adult population: Food sources and predictive factors.

    PubMed

    Monteagudo, Celia; Scander, Henrik; Nilsen, Bente; Yngve, Agneta

    2017-01-01

    Introduction : Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010-11 Riksmaten study. M ethods : The sample included a representative Swedish population aged 18-80 years ( n  = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis. Results : Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45-64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18-30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354-2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, non-smoking, and alcohol consumption within recommendations in the women. Conclusion : This study describes the folate intake per food group of Swedish adults according to the 2010-11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high-risk groups.

  9. Folate intake in a Swedish adult population: Food sources and predictive factors

    PubMed Central

    Monteagudo, Celia; Scander, Henrik; Nilsen, Bente; Yngve, Agneta

    2017-01-01

    ABSTRACT Introduction: Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010–11 Riksmaten study. Methods: The sample included a representative Swedish population aged 18–80 years (n = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis. Results: Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45–64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18–30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354–2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, non-smoking, and alcohol consumption within recommendations in the women. Conclusion: This study describes the folate intake per food group of Swedish adults according to the 2010–11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high

  10. Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults.

    PubMed

    Sommers, Benjamin D; Maylone, Bethany; Blendon, Robert J; Orav, E John; Epstein, Arnold M

    2017-06-01

    Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA's coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance. By the end of 2016 the uninsurance rate in the two expansion states had dropped by more than 20 percentage points relative to the nonexpansion state. For uninsured people gaining coverage, this change was associated with a 41-percentage-point increase in having a usual source of care, a $337 reduction in annual out-of-pocket spending, significant increases in preventive health visits and glucose testing, and a 23-percentage-point increase in "excellent" self-reported health. Among adults with chronic conditions, we found improvements in affordability of care, regular care for those conditions, medication adherence, and self-reported health. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Estimates of complications of medical care in the adult US population.

    PubMed

    Villanueva, E V; Anderson, J N

    2001-01-01

    Total US population estimates of complications of medical care have relied on extrapolations of state-specific estimates. Generalizability is suspect because findings are limited by geographical location or time. We describe the relationship between the annual prevalence of complications of medical care (CM) and socio-demographic characteristics in the adult US population. We used data from the National Health Interview Surveys, annual nationwide surveys of the resident, civilian, noninstitutionalized population of the United States. The main outcome of interest was self-reported conditions from CMs (ICD-9 996-999) and activity limitations that arise from such events. Univariate estimates and multivariably adjusted models accounting for selected socio-demographic characteristics and health status were derived. A total of 618,167 reports of conditions from 313,438 subjects 18 years and older from 1987 to 1994 were examined. In 1987, 830,386 adults reported complications of medical care, increasing by about 40% to 1,174,089 adults in 1994. Based on an extrapolation to the US adult population, rates increased by 25% from 558 to 678 per 100,000 during the same period. One-third reported onset a year prior to the interview; two-thirds visited a doctor six months prior; half experienced limitation in major activities; a quarter reported limitation in personal care activities. In the two weeks preceding the interview, complications of medical care caused an average of 1.72 days of restricted activity, 0.79 days spent in bed, and 0.58 days of work lost. Race modified the age-specific risk of these complications. Complications of medical care impose heavier morbidity than previously considered with some indication that socio-demographic variables modify the risk for injuries.

  12. Estimation of dietary flavonoid intake and major food sources of Korean adults.

    PubMed

    Jun, Shinyoung; Shin, Sangah; Joung, Hyojee

    2016-02-14

    Epidemiological studies have suggested that flavonoids exhibit preventive effects on degenerative diseases. However, lack of sufficient data on flavonoid intake has limited evaluating the proposed effects in populations. Therefore, we aimed to estimate the total and individual flavonoid intakes among Korean adults and determine the major dietary sources of these flavonoids. We constructed a flavonoid database of common Korean foods, based on the food list reported in the 24-h recall of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2012, using data from the Korea Functional Food Composition Table, US Department of Agriculture flavonoid database, Phenol-Explorer database and other analytical studies. This database, which covers 49 % of food items and 76 % of food intake, was linked with the 24-h recall data of 33 581 subjects aged ≥19 years in the KNHANES 2007-2012. The mean daily intake of total flavonoids in Korean adults was 318·0 mg/d, from proanthocyanidins (22·3%), flavonols (20·3%), isoflavones (18·1%), flavan-3-ols (16·2%), anthocyanidins (11·6%), flavanones (11·3%) and flavones (0·3%). The major contributing food groups to the flavonoid intake were fruits (54·4%), vegetables (20·5%), legumes and legume products (16·2%) and beverages and alcohols (3·1%), and the major contributing food items were apples (21·9%), mandarins (12·5%), tofu (11·5%), onions (9·6%) and grapes (9·0%). In the regression analysis, the consumption of legumes and legume products, vegetables and fruits predicted total flavonoid intake the most. The findings of this study could facilitate further investigation on the health benefits of flavonoids and provide the basic information for establishing recommended flavonoid intakes for Koreans.

  13. Professional’s Perspectives on Care Management of Young People with Perinatally Acquired HIV during Transition: A Qualitative Study in Adult Care Setting

    PubMed Central

    Le Roux, Enora; Gottot, Serge; Aupiais, Camille; Girard, Thomas; Teixeira, Maria; Alberti, Corinne

    2017-01-01

    Background Increasing numbers of young people with perinatally acquired HIV are surviving to adulthood. When they come of age, they leave pediatric services in which they were followed and have to be transferred to the adult health care system. Difficulties in adaptation to adult care and the numbers of young people lost to follow up after transfer to adult care have been reported. This transition phase and their retention in adult care are crucial in maintaining the clinical status of these young with HIV in adulthood. Our study aimed to explore how HIV professionals working in adult care perceive and adapt their practices to young people in transition. Methods Qualitative interviews were conducted with 18 health and social services professionals in hospitals or patient associations in France. A thematic analysis was conducted. Results Adult care professionals were found to be making a distinction between these young people and their patients who were infected during adulthood. On the basis of the healthcare teams’ experience, a simplified categorization of these young people into four levels can be used: those “who have everything good”; those who have some deficiencies that must be addressed; those “who have everything bad”; and those lost to follow up. Professionals interviewed highlighted the difficulties they encountered with young people in transition. Three types of problematic situations were identified: problems of acceptance of the disease; communication problems; and problems of disorientation in the new care environment. Conclusions Despite the lack of specific training or national policy recommendations for the integration of young people with perinatally acquired HIV into adult services, all the adult healthcare teams interviewed tried to adapt their practice to this population. The results suggested that professional involvement during transition should depend on the characteristics of the patient, not be limited to a single transition

  14. Caring for juveniles with mental disorders in adult corrections facilities.

    PubMed

    Wills, Cheryl D

    2017-02-01

    Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.

  15. Positive attitudes toward organic, local, and sustainable foods are associated with higher dietary quality among young adults

    PubMed Central

    Laska, Melissa N.; Neumark-Sztainer, Dianne; Story, Mary

    2012-01-01

    Scant evidence is available on the relationship between preferences for organic, local, sustainable, and non-processed foods (i.e., alternative food production practices) and dietary quality. This cross-sectional study examined the characteristics and dietary behaviors (e.g., consumption of fruit, vegetables, fast food, etc.) of young adults who reported placing low, moderate, or high importance on alternative food production practices. A diverse sample of 1,201 students at a two-year community college and a four-year public university in the Twin Cities, MN, completed the Student Health and Wellness Study survey in spring 2010. Chi-square tests examined differences in attitudes across demographic characteristics. Linear regression adjusted dietary intake across attitudes. About half (49%) of young adults placed moderate to high importance on alternative production practices, and few demographic differences across attitudes were found. Young adults who placed high importance on alternative production practices consumed 1.3 greater servings of fruits and vegetables (p<0.001), more dietary fiber (p<0.001), fewer added sugars (p<0.001) and less fat (p=0.025) than those who placed low importance on these practices. Young adults who placed high importance on alternative food production practices also consumed breakfast about one more day per week and fast food half as often as those who placed low importance on these practices (p<0.001). Study findings suggest that nutrition messaging around social and environmental implications of food production practices may be well received by this age group. Experimental studies are needed to investigate whether attitudes toward alternative production practices can be manipulated to improve dietary quality. PMID:23260729

  16. [Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

    PubMed

    Kim, Jiyeon; Kim, Hongsoo

    2016-12-01

    The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

  17. Brief Report: The Medical Care of Adults with Autism Spectrum Disorders--Identifying the Needs

    ERIC Educational Resources Information Center

    Bruder, Mary Beth; Kerins, Gerard; Mazzarella, Cynthia; Sims, Jessica; Stein, Neil

    2012-01-01

    There is a lack of information concerning adults with autism spectrum disorder (ASD), especially with regards to their access to health care. A paper and electronic survey was sent to 1,580 primary care physicians in Connecticut. 346 respondents returned a survey and provided care to adults with an ASD. This physician survey provides data on…

  18. Transitioning youth to adult healthcare: new tools from the Illinois Transition Care Project.

    PubMed

    Sanabria, K E; Ruch-Ross, H S; Bargeron, J L; Contri, D A; Kalichman, M A

    2015-01-01

    To improve youths' transition to adult healthcare, especially for youth with disabilities, The Illinois Transition Care Project created separate, yet complementary, curricula for pediatric and adult-oriented providers. Content from the curricula was tested by practicing physicians. The project created a library of skill worksheets with functional goals for patients. All methods included opportunities to teach life skills to patients to independently manage their conditions. The curricula used Maintenance of Certification (MOC) Part 4 credit as an incentive for physician participation. Pediatric pilot data indicate improvement across all sites and activities. Adult medicine results indicate increased perceived importance and feasibility of accepting young adult patients with childhood conditions. Patient/parent reviewers indicate the tools are understandable, interesting, and effective. Findings suggest the curricula, with MOC Part 4 credit for physicians, are effective in improving transition care. Project results provided new information on population management for transitioning youth and on the use of MOC Part 4 credit as an incentive. Findings have implications for primary care and specialty physicians, team-based care, teaching self-management skills to patients and methods for engaging adult-oriented physicians in the transition process.

  19. Older adult stereotypes among care providers in residential care facilities: examining the relationship between contact, eduaction, and ageism.

    PubMed

    Reyna, Christine; Goodwin, Eric J; Ferrari, Joseph R

    2007-02-01

    One barrier to quality elder care is ageism among care providers. In the present study, two models of stereotype reduction were tested with care providers at residential homes for older adults--the effects of contact and the effects of education on prejudice. Caregivers at five residential programs in Australia completed a survey assessing education, training, contact with older clients, prior experience, and stereotypes toward older adults. Results revealed that contact was not associated with fewer stereotypes but education (both specific and general) was associated with fewer stereotypes. Implications are discussed in terms of possible interventions and increasing optimal contact with older clients.

  20. What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey.

    PubMed

    van Leeuwen, K M; Malley, J; Bosmans, J E; Jansen, A P D; Ostelo, R W; van der Horst, H E; Netten, A

    2014-09-01

    Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Perceived adherence to prescribed or recommended standards of care among adults with diabetes.

    PubMed

    Jorgensen, Wendy A; Polivka, Barbara J; Lennie, Terry A

    2002-01-01

    Adults with diabetes were surveyed to determine the extent to which respondents perceived specific preventive regimens (diet, exercise, weight control, and education) had been prescribed or recommended, adhered to their prescribed regimens, and identified barriers to nonadherence. Surveys were mailed to 2 samples of adults diagnosed with diabetes. The clinic sample was from health department clinics (n = 264); the agency sample was from a nonprofit agency serving people with diabetes (n = 111). Of the 4 preventive measures under investigation, diet plans and weight reduction were perceived as most commonly recommended by health professionals; exercise schedules were the least commonly recommended. Diabetes self-management education was reportedly recommended more often among the agency sample. In terms of adherence, approximately half of both samples were able to lose weight. A smaller portion of the clinic sample was able to get needed foods and exercise, and maintain weight loss. The most frequently cited reasons for nonadherence were cost, transportation, and other health conditions. Improvement in the implementation of preventive behaviors is needed, particularly exercise schedules. Barriers to care, such as costs and transportation, may need special consideration.

  2. Local food environment interventions to improve healthy food choice in adults: a systematic review and realist synthesis protocol.

    PubMed

    Penney, Tarra L; Brown, Helen Elizabeth; Maguire, Eva R; Kuhn, Isla; Monsivais, Pablo

    2015-05-03

    Local food environments have been linked with dietary intake and obesity in adults. However, overall evidence remains mixed with calls for increased theoretical and conceptual clarity related to how availability of neighbourhood food outlets, and within-outlet food options, influence food purchasing and consumption. The purpose of this work is to develop a programme theory of food availability, supported by empirical evidence from a range of local food environment interventions. A systematic search of the literature will be followed by duplicate screening and quality assessment (using the Effective Public Health Practice Project tool). Realist synthesis will then be conducted according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards, including transparent appraisal, synthesis and drawing conclusions via consensus. The final synthesis will propose an evidence-based programme theory of food availability, including evidence mapping to demonstrate contextual factors, pathways of influence and potential mechanisms. With the paucity of empirically supported programme theories used in current local food environment interventions to improve food availability, this synthesis may be used to understand how and why interventions work, and thus inform the development of theory-driven, evidence-based interventions to improve healthy food choice and future empirical work. PROSPERO CRD42014009808. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Nutritional quality of foods and beverages on child-care centre menus in Mexico.

    PubMed

    Benjamin Neelon, Sara E; Reyes-Morales, Hortensia; Haines, Jess; Gillman, Matthew W; Taveras, Elsie M

    2013-11-01

    The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico. For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards. Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico. There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months. Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2?76 MJ for infants, 4.77 MJ for children aged 13–23 months, 5.36 MJ for children aged 24–47 months and 5.87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein. Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care.

  4. Meal-specific food patterns and the incidence of hyperglycemia in a Chinese adult population.

    PubMed

    Shi, Zumin; Riley, Malcolm; Taylor, Anne; Noakes, Manny

    2017-07-01

    This study aimed to examine the association between meal-specific food patterns and incident hyperglycaemia in a Chinese adult population. Adults aged 20 years and older (n 1056) were followed from 2002 to 2007. Dietary data were collected using a 3-d food record and meal-specific (breakfast, lunch and dinner) food patterns were independently described by factor analysis based on the consumption of thirty-five food groups at each eating occasion. Each food pattern score was recoded as quartiles. Hyperglycaemia was defined as fasting plasma glucose >5·6 mmol/l at baseline and follow-up. The associated between food patterns and incident hyperglycaemia was assessed by logistic regression. During the follow-up, 125 new cases of hyperglycaemia were identified. Traditional (wheat) breakfast was inversely associated with incident hyperglycaemia, whereas traditional (rice, vegetable and pork) lunch and dinner were positively associated with the risk of incident hyperglycaemia, even after adjustment for a number of covariates including glycaemic load, carbohydrate intake and BMI. Incident hyperglycaemia occurred in 15·9, 13·6, 11·7, 6·1 % across quartiles of traditional breakfast; and 5·3, 9·1, 15·9, 17·1 % of the quartiles of traditional lunch pattern. The adjusted OR for hyperglycaemia was 0·67 (95 % CI 0·48, 0·92), 1·83 (95 % CI 1·32, 2·53) and 1·39 (95 % CI 1·04, 1·86) for 1 sd increase of traditional breakfast, lunch and dinner pattern factor score, respectively. A traditional wheat-based breakfast is associated with a decreased risk of hyperglycaemia. A rice-based traditional lunch and dinner is associated with an increased risk of hyperglycaemia in Chinese adults.

  5. The Need for Comprehensive Health Care Quality Measures for Older Adults.

    PubMed

    MacLeod, Stephanie; Schwebke, Kay; Hawkins, Kevin; Ruiz, Joann; Hoo, Emma; Yeh, Charlotte S

    2017-10-24

    Research indicates that older adults receive only about half of their recommended care, with varying quality and limited attention to social issues impacting their health through the most commonly used quality measures. Additionally, many existing measures neglect to address nonclinical social determinants of health. Evidence of the need for more comprehensive measures for seniors is growing. The primary purpose of this article, which is supported by a limited review of literature, is to describe gaps among current quality measures in addressing certain nonclinical needs of older adults, including key social determinants of health. In doing so, the authors describe their position on the need for expanded measures to incorporate these factors to improve care and quality of life. The authors conducted a limited review of the literature to inform this article, focusing specifically on selected measures for older adults rather than a broader systematic review of all measures. Most research identified was related to clinical practice guidelines rather than quality measures of care as applied to older adults. Furthermore, the literature reviewed reflected limited evidence of efforts to tailor quality measures for the unique social needs of older adults, confirming a potential gap in this area. A growing need exists for improved quality measures specifically designed to help providers address the unique social needs of older adults. Filling this gap will improve overall understanding of seniors and help them to achieve optimal health and successful aging.

  6. Advance Care Planning Discussions with Adolescent and Young Adult Cancer Patients Admitted to a Community Palliative Care Service: A Retrospective Case-Note Audit.

    PubMed

    Fletcher, Sophie; Hughes, Rachel; Pickstock, Sarah; Auret, Kirsten

    2018-02-01

    Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015. Information was collected regarding end-of-life care discussions, documentation of agreed plan of care, and care received. Twenty-seven AYA and 37 adult medical records were reviewed. Eighteen (66.7%) AYA patients died at home, compared with 19 (51.4%) adults (p = 0.028). Desire to pursue all available oncological therapies, including clinical trials, was documented for 14 (51.9%) AYA patients compared with 9 (24.3%) of the adult group (p = 0.02). Eleven AYA patients (40.7%) received chemotherapy during the last month of life compared with two (5.4%) adults (p = 0.001). The results indicate that end-of-life care preferences for this unique cohort may differ from those of the adult population and need to be captured and understood. An ACP document incorporating a discussion regarding goals of care, preferred location of care, preference for place of death, and consent to future intervention, including cardiopulmonary resuscitation and prompts for review, could assist in pursuing this objective.

  7. The rural school meal as a site for learning about food.

    PubMed

    Torres, Irene; Benn, Jette

    2017-10-01

    The aim of the article is to contribute to the understanding of the school meal as a site for learning about food, nutrition and the wider determinants of health in three small rural schools of Ecuador. Based on a year-long qualitative fieldwork, the multiple case study associates Vygotsky's sociocultural theory of learning with Noddings' theory of care to analyze the findings. In the study, elements of care in the relationships between children and adults seemed to promote dialogue and, in this way, adults were able to model what is required to care for others and oneself. This entails that a focus solely on food or limitations on social interaction during the school meal may reduce its learning opportunities. The study concurs with the research that the food is better received when it is more aligned with the students' expectations. In addition, the findings support the view that rural school meal programs should address the views of parents and teachers because of their influence on how the meal is prepared and provided. The article proposes that schools work within a flexible framework emphasizing attention to the caring aspects of the meal, as a means to develop this dimension of the school meal. The study also contends that a collaborative reshaping of conditions formally set by school food policy is consistent with a critical approach to food and nutrition. In connection with this, the study concludes by highlighting the value of revisiting Noddings' perspective of care as deriving from the practice of opening up and meeting the other. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Health Care Transition in Young Adults With Type 1 Diabetes: Perspectives of Adult Endocrinologists in the U.S.

    PubMed

    Garvey, Katharine C; Telo, Gabriela H; Needleman, Joseph S; Forbes, Peter; Finkelstein, Jonathan A; Laffel, Lori M

    2016-02-01

    Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. Our objective was to describe experiences, resources, and barriers reported by a national sample of adult endocrinologists receiving and caring for young adults with type 1 diabetes. We fielded an electronic survey to adult endocrinologists with a valid e-mail address identified through the American Medical Association Physician Masterfile. We received responses from 536 of 4,214 endocrinologists (response rate 13%); 418 surveys met the eligibility criteria. Respondents (57% male, 79% Caucasian) represented 47 states; 64% had been practicing >10 years and 42% worked at an academic center. Only 36% of respondents reported often/always reviewing pediatric records and 11% reported receiving summaries for transitioning young adults with type 1 diabetes, although >70% felt that these activities were important for patient care. While most respondents reported easy access to diabetes educators (94%) and dietitians (95%), fewer (42%) reported access to mental health professionals, especially in nonacademic settings. Controlling for practice setting and experience, endocrinologists without easy access to mental health professionals were more likely to report barriers to diabetes management for young adults with depression (odds ratio [OR] 5.3; 95% CI 3.4, 8.2), substance abuse (OR 3.5; 95% CI 2.2, 5.6), and eating disorders (OR 2.5; 95% CI 1.6, 3.8). Our findings underscore the need for enhanced information transfer between pediatric and adult providers and increased mental health referral access for young adults with diabetes post-transition. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  9. Knowledge and attitudes of primary care physicians regarding food allergy and anaphylaxis in Turkey.

    PubMed

    Erkoçoğlu, M; Civelek, E; Azkur, D; Özcan, C; Öztürk, K; Kaya, A; Metin, A; Kocabaş, C N

    2013-01-01

    Food allergy, which becomes an important public health problem, can lead to important morbidity and mortality. Patients with food allergies are more likely to first present to their primary care physicians. We aimed to determine the knowledge of primary care physicians with regard to management of food allergies and anaphylaxis. Primary care physicians were surveyed via a questionnaire aimed to document their knowledge and attitudes about food allergy and anaphylaxis management. A total of 297 participants completed questionnaires, 55.6% of which were female. Participating physicians had a mean of 17.0 ± 6.1 years of experience. Participants answered 47.2% of knowledge-based items correctly. Overall, participants fared poorly with regard to their knowledge on the treatment of food allergies and anaphylaxis. For example while 60.7% knew that a child can die from the milk allergy reaction, only 37.5% were aware that a child with IgE mediated milk allergies cannot eat yoghourts/cheese with milk. Besides, 53.1% of them chose epinephrine as their first treatment of choice in case of anaphylaxis, yet only 16.6% gave the correct answer about its dosage. Nearly a third of participants (36.7%) felt they were knowledgeable enough regarding the management of patients with food allergies, while 98.2% extended their request for future periodic educational meetings on allergic disorders. Knowledge of food allergy and anaphylaxis among primary care physicians was unsatisfactory. Provision or periodic educational programmes should be aimed at improving the standard of practice as acknowledged by the participants. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

  10. Motivational interviewing for older adults in primary care: a systematic review.

    PubMed

    Purath, Janet; Keck, Annmarie; Fitzgerald, Cynthia E

    2014-01-01

    Chronic disease is now the leading cause of death and disability in United States. Many chronic illnesses experienced by older adults can be prevented or managed through behavior change, making patient counseling an essential component of disease prevention and management. Motivational Interviewing (MI), a type of conversational method, has been effective in eliciting health behavior changes in people in a variety of settings and may also be a useful tool to help older adults change. This review of the literature analyzes current research and describes potential biases of MI interventions that have been conducted in primary care settings with older adults. MI shows promise as a technique to elicit health behavior change among older adults. However, further study with this population is needed to evaluate efficacy of MI interventions in primary care settings. Copyright © 2014 Mosby, Inc. All rights reserved.

  11. Lack of access and continuity of adult health care: a national population-based survey

    PubMed Central

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2015-01-01

    OBJECTIVE To describe the lack of access and continuity of health care in adults. METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas. RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care. CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce. PMID:26061454

  12. Diet quality in young adults and its association with food-related behaviours.

    PubMed

    Thorpe, Maree G; Kestin, Mark; Riddell, Lynn J; Keast, Russell Sj; McNaughton, Sarah A

    2014-08-01

    To determine the diet quality of a group of young adults and explore its associations with two food-related behaviours (involvement in meal preparation and consumption of commercially prepared meals). Cross-sectional study of young adults. Sample characteristics, food-related behaviours and dietary intake were assessed using a self-administered questionnaire including an FFQ. Diet quality was measured using the fifteen-item Dietary Guideline Index (DGI) designed to assess adherence to Australian dietary guidelines. One-way ANOVA, t tests and multiple linear regression analyses were used to explore the relationships between DGI scores, sample characteristics and food-related behaviours. University students enrolled in an undergraduate nutrition class, Melbourne, Australia. Students (n 309) aged 18-36 years. The DGI score was normally distributed, with a mean score of 93·4 (sd 17·1) points (range 51·9-127·4 points), out of a possible score of 150 points. In multivariate analyses adjusted for age, sex, nationality, BMI and maternal education, cooking meals for oneself was positively associated with DGI score (β = 0·15; 95 % CI 1·15, 10·03; P = 0·01); frequency of takeaway and frequency of convenience meal consumption were inversely associated with DGI score (β = -0·21; 95 % CI -9·96, -2·32; P = 0·002 and β = -0·16; 95 % CI -7·40, -0·97; P < 0·01, respectively). Cooking meals for oneself was linked to higher diet quality among young adults, while consumption of commercially prepared meals was associated with poorer diet quality. Maintaining education programmes that promote cooking skills within young adults has the potential to improve DGI scores.

  13. Situational cues and momentary food environment predict everyday eating behavior in adults with overweight and obesity.

    PubMed

    Elliston, Katherine G; Ferguson, Stuart G; Schüz, Natalie; Schüz, Benjamin

    2017-04-01

    Individual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77; SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    PubMed

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  15. Association between time perspective and organic food consumption in a large sample of adults.

    PubMed

    Bénard, Marc; Baudry, Julia; Méjean, Caroline; Lairon, Denis; Giudici, Kelly Virecoulon; Etilé, Fabrice; Reach, Gérard; Hercberg, Serge; Kesse-Guyot, Emmanuelle; Péneau, Sandrine

    2018-01-05

    Organic food intake has risen in many countries during the past decades. Even though motivations associated with such choice have been studied, psychological traits preceding these motivations have rarely been explored. Consideration of future consequences (CFC) represents the extent to which individuals consider future versus immediate consequences of their current behaviors. Consequently, a future oriented personality may be an important characteristic of organic food consumers. The objective was to analyze the association between CFC and organic food consumption in a large sample of the adult general population. In 2014, a sample of 27,634 participants from the NutriNet-Santé cohort study completed the CFC questionnaire and an Organic-Food Frequency questionnaire. For each food group (17 groups), non-organic food consumers were compared to organic food consumers across quartiles of the CFC using multiple logistic regressions. Moreover, adjusted means of proportions of organic food intakes out of total food intakes were compared between quartiles of the CFC. Analyses were adjusted for socio-demographic, lifestyle and dietary characteristics. Participants with higher CFC were more likely to consume organic food (OR quartile 4 (Q4) vs. Q1 = 1.88, 95% CI: 1.62, 2.20). Overall, future oriented participants were more likely to consume 14 food groups. The strongest associations were observed for starchy refined foods (OR = 1.78, 95% CI: 1.63, 1.94), and fruits and vegetables (OR = 1.74, 95% CI: 1.58, 1.92). The contribution of organic food intake out of total food intake was 33% higher in the Q4 compared to Q1. More precisely, the contribution of organic food consumed was higher in the Q4 for 16 food groups. The highest relative differences between Q4 and Q1 were observed for starchy refined foods (22%) and non-alcoholic beverages (21%). Seafood was the only food group without a significant difference. This study provides information on the personality of

  16. Beverage Consumption in Relation to Discretionary Food Intake and Diet Quality among US Adults, 2003 to 2012.

    PubMed

    An, Ruopeng

    2016-01-01

    A majority of Americans consume beverages and discretionary foods-foods that are typically low in nutrient value but high in sugar, sodium, fats, and cholesterol-as part of their daily diet, which profoundly impacts their energy balance and nutritional status. This study examined consumption of different types of beverages in relation to discretionary food intake and diet quality among US adults. Nationally representative sample of 22,513 adults from the National Health and Nutrition Examination Survey 2003 to 2012 waves were analyzed. The discretionary food category identifies energy-dense, nutrient-poor food products that do not necessarily provide essential nutrients that the human body needs, but can add variety. First-difference estimator addressed confounding bias from time-invariant unobservables (eg, eating habits, taste preferences) by using within-individual variations in diet and beverage consumption between 2 nonconsecutive 24-hour dietary recalls. Approximately 21.7%, 42.9%, 52.8%, 26.3%, and 22.2% of study participants consumed diet beverage, sugar-sweetened beverage (SSB), coffee, tea, and alcohol, respectively, and 90.1% consumed discretionary foods on any given day. Across beverage types, alcohol (384.8 kcal) and SSB (226.2 kcal) consumption was associated with the largest increase in daily total calorie intake; coffee (60.7 kcal) and diet-beverage (48.8 kcal) consumption was associated with the largest increase in daily calorie intake from discretionary foods, and SSB consumption was associated with the largest reduction in daily overall diet quality measured by the Healthy Eating Index 2010. The impact of beverage consumption on daily calorie intake (overall and from discretionary foods) and diet quality differed across individual sociodemographics and body-weight status. The incremental daily calorie intake from discretionary foods associated with diet-beverage consumption was highest in obese adults, and that associated with SSB was highest in

  17. Patients' experiences of technology and care in adult intensive care.

    PubMed

    Stayt, Louise Caroline; Seers, Kate; Tutton, Elizabeth

    2015-09-01

    To investigate patients' experiences of technology in an adult intensive care unit. Technology is fundamental to support physical recovery from critical illness in Intensive Care Units. As well as physical corollaries, psychological disturbances are reported in critically ill patients at all stages of their illness and recovery. Nurses play a key role in the physical and psychological care of patients;, however, there is a suggestion in the literature that the presence of technology may dehumanise patient care and distract the nurse from attending to patients psychosocial needs. Little attention has been paid to patients' perceptions of receiving care in a technological environment. This study was informed by Heideggerian phenomenology. The research took place in 2009-2011 in a university hospital in England. Nineteen participants who had been patients in ICU were interviewed guided by an interview topic prompt list. Interviews were transcribed verbatim and analysed using Van Manen's framework. Participants described technology and care as inseparable and presented their experiences as a unified encounter. The theme 'Getting on with it' described how participants endured technology by 'Being Good' and 'Being Invisible'. 'Getting over it' described why participants endured technology by 'Bowing to Authority' and viewing invasive technologies as a 'Necessary Evil'. Patients experienced technology and care as a series of paradoxical relationships: alienating yet reassuring, uncomfortable yet comforting, impersonal yet personal. By maintaining a close and supportive presence and providing personal comfort and care nurses may minimize the invasive and isolating potential of technology. © 2015 John Wiley & Sons Ltd.

  18. 7 CFR 226.17a - At-risk afterschool care center provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 226.17a Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational... activities (i.e., in a structured and supervised environment); (iii) Include education or enrichment...

  19. Psychiatric disorders and treatment among newly homeless young adults with histories of foster care.

    PubMed

    Thompson, Ronald G; Hasin, Deborah

    2012-09-01

    Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.

  20. Nursing students' knowledge and beliefs about care of older adults in a shifting context of nursing education.

    PubMed

    Baumbusch, Jennifer; Dahlke, Sherry; Phinney, Alison

    2012-11-01

      To a report a study of improvements in students' knowledge and beliefs about nursing care of older adults following completion of an introductory course with integrated adult/older adult content. Background.  Nursing schools are under pressure to provide accelerated programmes to meet growing workforce demands and provide students with the knowledge they require to care for an ageing population. Thus, stand-alone courses in gerontological nursing are being eliminated and integrated with general adult content. The effect of this approach remains poorly understood.   A one-group pretest-post-test design was used.   Data were collected between September-December 2010. Students completed the Palmore Facts on Aging Quiz, the Perceptions of Caring for Older People Scale, and open-ended questions about their experiences before and after completing a course with integrated adult/older content.   Students' knowledge and beliefs about nursing care of older adults demonstrated an important improvement following completion of the course. Qualitative findings reflected three themes: relating to older people; neglect by the system; having time to learn.   Findings from this study suggest that even when integrated with general adult content, students' knowledge and beliefs about older adult care can be positively influenced. Furthermore research is needed to examine long-term integration of students' learning about older adult care. Nursing faculty with expertise in nursing care of older adults must develop resources and supports for their colleagues to build capacity among nurse educators and integrate older adult content throughout nursing programmes to enhance nursing practice with an ageing population. © 2012 Blackwell Publishing Ltd.

  1. Development and Testing of a Nutrition, Food Safety, and Physical Activity Checklist for EFNEP and FSNE Adult Programs

    ERIC Educational Resources Information Center

    Bradford, Traliece; Serrano, Elena L.; Cox, Ruby H.; Lambur, Michael

    2010-01-01

    Objective: To develop and assess reliability and validity of the Nutrition, Food Safety, and Physical Activity Checklist to measure nutrition, food safety, and physical activity practices among adult Expanded Food and Nutrition Education Program (EFNEP) and Food Stamp Nutrition Education program (FSNE) participants. Methods: Test-retest…

  2. Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

    PubMed

    Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

    2017-05-01

    To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p < .012) in young adulthood. Our findings highlight the importance of examining intragroup variability in culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Food in Foster Families: Care, Communication and Conflict

    ERIC Educational Resources Information Center

    Rees, Alyson; Holland, Sally; Pithouse, Andrew

    2012-01-01

    This study explores the significance of food and mealtimes in relation to the transition into foster care and the therapeutic settling of the child in a new family. In doing so, we draw upon an in-depth, qualitative case study of 10 experienced foster families in the UK focusing on what helped them to be successful. At the time of the study, there…

  4. The spiritual care meanings of adults residing in the midwest.

    PubMed

    Sellers, S C

    2001-07-01

    Only limited nursing knowledge exists as theoretical guidance for nurses in providing spiritual care. Using Leininger's theory of culture care diversity and universality, the purpose of this ethnonursing research study was to discover the embedded spiritual care meanings, expressions, lived experiences, and practices of adults residing in the Midwest and their perceptions of spiritual nursing care. Data were collected through interviews of 6 key and 12 general informants. Five universal spiritual themes were supported by the findings. Culture care modes were used to explicate spiritual knowledge that can be integrated into nursing practice.

  5. Food security and metabolic syndrome in U.S. adults and adolescents: findings from the National Health and Nutrition Examination Survey, 1999-2006.

    PubMed

    Parker, Emily D; Widome, Rachel; Nettleton, Jennifer A; Pereira, Mark A

    2010-05-01

    We sought to examine the association of food security and metabolic syndrome in a representative sample of U.S. adults and adolescents. We hypothesized that compared with those in food-secure households, adolescents and adults living in food-insecure households would have increased odds of (MetS). Data from the National Health and Nutrition Examination Surveys from 1999 to 2006 were combined and analyzed cross-sectionally. Logistic regression was used to compute odds ratios and 95% confidence intervals (95% CI) in the association of household food security (fully food secure, marginal, low, and very low food security) and MetS. Compared with those who were food secure, adults in households with marginal food security had 1.80-fold increased odds of MetS (95% CI, 1.30-2.49), and those with very low food security had a 1.65-fold increased odds of MetS (95% CI 1.12-2.42). There was no association with low food security. The association of marginal household food security and MetS was not significant in adolescents. In adults and adolescents, very low was food security not associated with increased odds of MetS compared with those who were food secure. Members of households with marginal and very low food security are at increased risk of MetS. A mechanism may be that foods that are inexpensive and easily accessible tend to be energy dense and nutrient poor. 2010 Elsevier Inc. All rights reserved.

  6. Do Carrots Make You See Better? A Guide to Food and Nutrition in Early Childhood Programs.

    ERIC Educational Resources Information Center

    Appleton, Julie; McCrea, Nadine; Patterson, Carla

    Noting that young children learn about food and nutrition through food preparation, eating together, play, science activities, and games, this resource guide addresses food learning and nutritional provisions in early childhood programs. The guide is designed to meet the needs of children and adults in child care centers, family child care…

  7. Household food insecurity, diabetes and hypertension among Mexican adults: results from Ensanut 2012.

    PubMed

    Pérez-Escamilla, Rafael; Villalpando, Salvador; Shamah-Levy, Teresa; Méndez-Gómez Humarán, Ignacio

    2014-01-01

    To examine the independent association of household food insecurity (HFI) with diabetes and hypertension in a nationally representative cross-sectional sample from Mexico. We assessed the association between HFI and self-reported doctor diagnosed diabetes and hypertension among 32 320 adult individuals using multiple logistic regression. HFI was measured using an adapted version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). HFI was a risk factor for diabetes among women but not men and for hypertension among both genders. Diabetes odds were higher by 31, 67 and 48%, among women living in mild, moderate, and severe food-insecure (vs. food-secure) households, respectively. Living in moderate to severe food-insecure (vs. food-secure) households was associated with hypertension odds that were 28 and 32% higher, respectively. Decreasing HFI may help improve public health and national development in Mexico.

  8. Adult obesity management in primary care, 2008-2013.

    PubMed

    Fitzpatrick, Stephanie L; Stevens, Victor J

    2017-06-01

    In the U.S., the occurrence of weight counseling in primary care for patients with obesity decreased by 10% between 1995-1996 and 2007-2008. There have been several national recommendations and policies to improve obesity management since 2008. The purpose of this study was to examine the rates of body mass index (BMI) screening, obesity diagnosis, and weight management counseling in the U.S. from 2008 to 2013. The National Ambulatory Medical Care Survey visit-level data for adults 18 and over with a primary care visit during survey years 2008-2009, 2010-2011, and 2012-2013 was included in the analyses using SAS v9.3. Study outcomes included percent of visits with: BMI screening; obesity diagnosis; and weight counseling. We compared survey years on these outcomes using 2008-2009 as the reference as well as examined patient and practice-level predictors. Analyses were conducted from 2015 to early 2017. Of the total 55,608 adult primary care visits sampled, 14,143 visits (25%) were with patients with obesity. BMI screening significantly increased between 2008-2009 and 2012-2013 from 54% to 73% (OR=1.75, 95% CI 1.28-2.41); however, percent of visits with an obesity diagnosis remained low at <30%. Weight management counseling during visits significantly declined from 33% to 21% between 2008-2009 and 2012-2013 (OR=0.62, 95% CI 0.41-0.92). Despite emerging recommendations and policies, from 2008 to 2013, obesity management in primary care remained suboptimal. Identifying practical strategies to enforce policies and implement evidence-based behavioral treatment in primary care should be a high priority in healthcare reform. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Transition of pediatric to adult care in inflammatory bowel disease: Is it as easy as 1, 2, 3?

    PubMed

    Afzali, Anita; Wahbeh, Ghassan

    2017-05-28

    Inflammatory bowel disease (IBD) is a heterogeneous group of chronic diseases with a rising prevalence in the pediatric population, and up to 25% of IBD patients are diagnosed before 18 years of age. Adolescents with IBD tend to have more severe and extensive disease and eventually require graduation from pediatric care toadult services. The transition of patients from pediatric to adult gastroenterologists requires careful preparation and coordination, with involvement of all key players to ensure proper collaboration of care and avoid interruption in care. This can be challenging and associated with gaps in delivery of care. The pediatric and adult health paradigms have inherent differences between health care models, as well as health care priorities in IBD. The readiness of the young adult also influences this transition of care, with often times other overlaps in life events, such as school, financial independence and moving away from home. These patients are therefore at higher risk for poorer clinical disease outcomes. The aim of this paper is to review concepts pertinent to transition of care of young adults with IBD to adult care, and provides resources appropriate for an IBD pediatric to adult transition of care model.

  10. Adult antisocial personality traits are associated with experiences of low parental care and maternal overprotection.

    PubMed

    Reti, I M; Samuels, J F; Eaton, W W; Bienvenu, O J; Costa, P T; Nestadt, G

    2002-08-01

    To investigate the role of parenting in the development of adult antisocial personality traits. A total of 742 community-based subjects were assessed for adult DSM-IV antisocial personality disorder traits and for measures of parental behavior experienced as children, including by the Parental Bonding Instrument (PBI). Three fundamental dimensions of parental behavior - care, behavioral restrictiveness and denial of psychological autonomy - were derived by factor analysis from the PBI. These dimensions significantly correlated with measures of parental behavior considered influential in later antisocial behavior. Adult antisocial traits in males were associated with low maternal care and high maternal behavioral restrictiveness, and in females, antisocial traits were associated with low paternal care and high maternal denial of psychological autonomy. These dimensions did not, however, explain all variance parental behavior has on adult antisocial personality traits. Adult antisocial personality traits are associated with experiences of low parental care and maternal overprotection.

  11. Is older adult care mediated by caregivers' cultural stereotypes? The role of competence and warmth attribution.

    PubMed

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care). In order to assess caregivers' cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers' cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences)-RS (staff functioning and residents' functioning) were applied. Caregivers' cultural views of older adults (compared to young people) are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research. Our results underline the influence of caregivers' cultural stereotypes on the type of care, as well as on their professional behaviors and on older adult functioning. Caregivers' cultural stereotypes could be considered as a central issue in older adult care since they mediate the triangle of care: caregivers/older adults/type of care; therefore, much more attention should be paid to this psychosocial care component.

  12. Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island

    PubMed Central

    Stopka, Thomas J.; Beckwith, Curt G.

    2018-01-01

    .29, 0.98) had a lower odds of being in a food insecure group. Food insecure participants resided in different neighborhoods than food secure participants. The highest density of food insecure participants resided in census tracts with the lowest median incomes for the general population. The areas of highest density for each level of food security for our participants were in the census tracts with the lowest levels of full-time employment for the general population. Conclusions The prevalence of food insecurity and very low food security were markedly higher in our probation population compared to the general RI population. These findings suggest that access to food on a regular basis is a challenge for adults on probation. Depression and being homeless were independently associated with a greater odds of being in a food insecure group. In addition to intervening directly on food insecurity, developing interventions and policies that address the contributing factors of food insecurity, such as safe housing and treatment for depression, are critical. PMID:29883491

  13. Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island.

    PubMed

    Dong, Kimberly R; Tang, Alice M; Stopka, Thomas J; Beckwith, Curt G; Must, Aviva

    2018-01-01

    being in a food insecure group. Food insecure participants resided in different neighborhoods than food secure participants. The highest density of food insecure participants resided in census tracts with the lowest median incomes for the general population. The areas of highest density for each level of food security for our participants were in the census tracts with the lowest levels of full-time employment for the general population. The prevalence of food insecurity and very low food security were markedly higher in our probation population compared to the general RI population. These findings suggest that access to food on a regular basis is a challenge for adults on probation. Depression and being homeless were independently associated with a greater odds of being in a food insecure group. In addition to intervening directly on food insecurity, developing interventions and policies that address the contributing factors of food insecurity, such as safe housing and treatment for depression, are critical.

  14. Mental health care Monitor Older adults (MEMO): monitoring patient characteristics and outcome in Dutch mental health services for older adults.

    PubMed

    Veerbeek, Marjolein; Oude Voshaar, Richard; Depla, Marja; Pot, Anne Margriet

    2013-06-01

    Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the "Mental health care Monitor Older adults" (MEMO) was developed in the Netherlands. The aim of this paper is to describe MEMO and the older adults who attend outpatient mental health care regarding their predisposing and enabling characteristics and need for care. In MEMO all patients referred to the division of old age psychiatry of the participating mental health care organisations are assessed at baseline and monitored at 4, 8 and 12-month follow-up. Primary outcomes are mental and social functioning, consumer satisfaction, and type of treatment provided (MEMO Basic). Over the years, MEMO Basic is repeated. In each cycle, additional information on specific patient groups is added (e.g. mood disorders). Data collection is supported by a web-based system for clinicians, including direct feedback to monitor patients throughout treatment. First results at baseline showed that the majority of patients that entered the division of old age psychiatry was female (69%), had low education (83%), lived alone (53%), was depressed (42%) and had a comorbid condition (82%). It seemed that older immigrants were not sufficiently reached. The current study is the first in the Netherlands to evaluate patient characteristics and outcome in mental health care provided for older adults in day-to-day practice. If MEMO works out successfully, the method should be extended to other target groups. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Trends in food and nutritional intakes of French adults from 1999 to 2007: results from the INCA surveys.

    PubMed

    Dubuisson, Carine; Lioret, Sandrine; Touvier, Mathilde; Dufour, Ariane; Calamassi-Tran, Gloria; Volatier, Jean-Luc; Lafay, Lionel

    2010-04-01

    Two independent cross-sectional dietary surveys (the Individual and National Food Consumption Surveys, INCA), performed in 1998-99 (INCA1) and in 2006-07 (INCA2) on nationally representative samples of French people, were used to analyse trends in the dietary habits and nutritional intake of French adults. Food consumption was recorded through 7-d dietary records, and nutritional intakes were assessed using the French food composition database. After exclusion of under-reporters, analyses were performed on 3267 adults, aged 18-79 years: 1345 from INCA1 and 1922 from INCA2. The trends highlighted over the 8-year period showed a decrease in consumption of dairy products, meat, bread, potatoes, pastries/croissant-like pastries/cakes/biscuits and sugar/confectionery. In contrast, the consumption of fruits and vegetables, rice, ice cream and chocolate increased. Other food groups, like fish and snacking foods, remained stable. Food choices were mostly age specific. These age differences remained consistent over the years and underlined two opposite dietary trends: a 'traditional' one mainly followed by the elderly, and a 'snacking and convenience' one mainly adopted by young adults. The overall trends in food consumption did not influence the mean energy intake, but did slightly modify the contribution of each macronutrient to energy intake. These repeated surveys highlighted the fact that trends in French food habits have moved towards an average European diet at the crossroads between Mediterranean and Northern diets, and that food consumption changes impacted, to a lesser extent, nutritional intake.

  16. Effectiveness of a Geriatric Care Model for frail older adults in primary care: Results from a stepped wedge cluster randomized trial.

    PubMed

    Hoogendijk, Emiel O; van der Horst, Henriëtte E; van de Ven, Peter M; Twisk, Jos W R; Deeg, Dorly J H; Frijters, Dinnus H M; van Leeuwen, Karen M; van Campen, Jos P C M; Nijpels, Giel; Jansen, Aaltje P D; van Hout, Hein P J

    2016-03-01

    Primary care-based comprehensive care programs have the potential to improve outcomes in frail older adults. We evaluated the impact of the Geriatric Care Model (GCM) on the quality of life of community-dwelling frail older adults. A 24-month stepped wedge cluster randomized controlled trial was conducted between May 2010 and March 2013 in 35 primary care practices in the Netherlands, and included 1147 frail older adults. The intervention consisted of a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Reassessment occurred every six months. Nurses worked together with primary care physicians and were supervised and trained by geriatric expert teams. Complex patients were reviewed in multidisciplinary consultations. The primary outcome was quality of life (SF-12). Secondary outcomes were health-related quality of life, functional limitations, self-rated health, psychological wellbeing, social functioning and hospitalizations. Intention-to-treat analyses based on multilevel modeling showed no significant differences between the intervention group and usual care regarding SF-12 and most secondary outcomes. Only for IADL limitations we found a small intervention effect in patients who received the intervention for 18months (B=-0.25, 95%CI=-0.43 to -0.06, p=0.007), but this effect was not statistically significant after correction for multiple comparisons. The GCM did not show beneficial effects on quality of life in frail older adults in primary care, compared to usual care. This study strengthens the idea that comprehensive care programs add very little to usual primary care for this population. The Netherlands National Trial Register NTR2160. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  17. Theme with Variations: Social Policy, Community Care and Adult Education.

    ERIC Educational Resources Information Center

    Lavender, Peter

    1990-01-01

    Changes in British social policy regarding community health care has implications for local education agency (LEA) providers of adult continuing education. LEAs will either have a role in providing staff training and other learning opportunities, will be forced to provide cheaper forms of community care, or will be ignored altogether. (SK)

  18. Staff Morale in Day Care Centres for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mascha, Katerina

    2007-01-01

    Background: Levels of burnout, job satisfaction and intended turnover of staff working in day care centres for adults with intellectual disabilities are investigated in relation to role clarity, staff support and supervision, and coping strategies used by staff. Materials and methods: Thirty six direct-care staff of four day care centres in the UK…

  19. The Supplemental Nutrition Assistance Program, Food Insecurity, Dietary Quality, and Obesity Among US Adults

    PubMed Central

    Shuval, Kerem; Bertmann, Farryl; Yaroch, Amy L.

    2015-01-01

    Objectives. We examined whether Supplemental Nutrition Assistance Program (SNAP) participation changes associations between food insecurity, dietary quality, and weight among US adults. Methods. We analyzed adult dietary intake data (n = 8333) from the 2003 to 2010 National Health and Nutrition Examination Survey. Bivariate and multivariable methods assessed associations of SNAP participation and 4 levels of food security with diet and weight. Measures of dietary quality were the Healthy Eating Index 2010, total caloric intake, empty calories, and solid fat; weight measures were body mass index (BMI), overweight, and obesity. Results. SNAP participants with marginal food security had lower BMI (1.83 kg/m2; P < .01) and lower probability of obesity (9 percentage points; P < .05). SNAP participants with marginal (3.46 points; P < .01), low (1.98 points; P < .05), and very low (3.84 points; P < .01) food security had better diets, as illustrated by the Healthy Eating Index. Associations between SNAP participation and improved diet and weight were stronger among Whites than Blacks and Hispanics. Conclusions. Our research highlights the role of SNAP in helping individuals who are at risk for food insecurity to obtain a healthier diet and better weight status. PMID:25973830

  20. Nutritional quality of foods and beverages on child-care centre menus in Mexico

    PubMed Central

    Benjamin Neelon, Sara E.; Reyes-Morales, Hortensia; Haines, Jess; Gillman, Matthew W.; Taveras, Elsie M.

    2013-01-01

    Objective The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico. Design For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards. Setting Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico. Subjects There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months. Results Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2·76 MJ for infants, 4·77 MJ for children aged 13–23 months, 5·36 MJ for children aged 24–47 months and 5·87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein. Conclusions Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care. PMID:23036360