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Sample records for adult care food

  1. 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

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  2. 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

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  3. 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

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2010 Through June 30, 2011 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  4. 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…

  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

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011... page 43255, the table labeled ``Administrative Reimbursement Rates for Sponsoring Organizations of...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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…

  14. 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…

  15. 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…

  16. Practitioners’ Opinions on Food and Nutrition Care Indicators (FANCI) in Assisted Living Facilities for Older Adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study assessed the utility of the 57 indicator FANCI checklist for assessing food and nutrition services in assisted living facilities (ALFs) for older adults among dietitians. They were members of two American Dietetic Association practice groups focusing on aging and long term care and were a...

  17. 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.

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

    PubMed

    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 study has compared nutrition-related outcomes of children in CACFP-participating centers to those of similar children in non-participating centers. We use a sample of four-year old children drawn from the Early Childhood Longitudinal Study, Birth Cohort to obtain estimates of associations between CACFP program participation and consumption of milk, fruits, vegetables, fast food, and sweets, and indicators of overweight, underweight status and food insecurity. We find that, among low-income children, CACFP participation moderately increases consumption of milk and vegetables, and may also reduce the prevalence of overweight and underweight. Effects on other outcomes are generally small and not statistically significant.

  19. 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…

  20. Early maternal care predicts reliance on social learning about food in adult rats.

    PubMed

    Lindeyer, Charlotte M; Meaney, Michael J; Reader, Simon M

    2013-03-01

    Many vertebrates rely extensively on social information, but the value of information produced by other individuals will vary across contexts and habitats. Social learning may thus be optimized by the use of developmental or current cues to determine its likely value. Here, we show that a developmental cue, early maternal care, correlates with social learning propensities in adult rodents. The maternal behavior of rats Rattus norvegicus with their litters was scored over the first 6 days postpartum. Rat dams show consistent individual differences in the rate they lick and groom (LG) pups, allowing them to be categorized as high, low, or mid-LG mothers. The 100-day old male offspring of high and low-LG mothers were given the opportunity to learn food preferences for novel diets from conspecifics that had previously eaten these diets ("demonstrators"). Offspring of high-LG mothers socially learned food preferences, but offspring of low-LG mothers did not. We administered oxytocin to subjects to address the hypothesis that it would increase the propensity for social learning, but there were no detectable effects. Our data raise the possibility that social learning propensities may be both relatively stable throughout life and part of a suite of traits "adaptively programmed" by early developmental experiences.

  1. 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

  2. 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, ...

  3. The Child and Adult Care Food Program: Who Is Served and What Are Their Nutritional Outcomes? NBER Working Paper No. 16148

    ERIC Educational Resources Information Center

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

    2010-01-01

    This paper addresses three basic questions about an under-studied food subsidy program, the Child and Adult Care Food Program (CACFP): (1) Does CACFP reach targeted low-income children? (2) How do eligible families and child care providers who participate differ from those who do not participate? (3) What is the association between attending…

  4. 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…

  5. 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.

  6. 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

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Cash in lieu of donated foods for nonresidential child... Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CASH IN LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult...

  7. 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

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Cash in lieu of donated foods for nonresidential child... Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CASH IN LIEU OF DONATED FOODS § 240.4 Cash in lieu of donated foods for nonresidential child and adult...

  8. Child and Adult Care Food Program: Meal Pattern Revisions Related to the Healthy, Hunger-Free Kids Act of 2010. Final rule.

    PubMed

    2016-04-25

    This final rule updates the meal pattern requirements for the Child and Adult Care Food Program to better align them with the Dietary Guidelines for Americans, as required by the Healthy, Hunger-Free Kids Act of 2010. This rule requires centers and day care homes participating in the Child and Adult Care Food Program to serve more whole grains and a greater variety of vegetables and fruit, and reduces the amount of added sugars and solid fats in meals. In addition, this final rule supports mothers who breastfeed and improves consistency with the Special Supplemental Nutrition Program for Women, Infants, and Children and with other Child Nutrition Programs. Several of the changes are extended to the National School Lunch Program, School Breakfast Program, and Special Milk Program. These changes are based on the Dietary Guidelines for Americans, science-based recommendations made by the National Academy of Medicine (formerly the Institute of Medicine of the National Academies), cost and practical considerations, and stakeholder's input. This is the first major revision of the Child and Adult Care Food Program meal patterns since the Program's inception in 1968. These improvements to the meals served in the Child and Adult Care Food Program are expected to safeguard the health of young children by ensuring healthy eating habits are developed early, and improve the wellness of adult participants.

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FOR USE IN THE UNITED STATES, ITS TERRITORIES AND POSSESSIONS AND AREAS UNDER ITS JURISDICTION... lieu of donated foods) multiplied by the number of reimbursable lunches and suppers served in the State... lunches and suppers are those meeting the nutritional standards established in 7 CFR part 226. The...

  10. Adult-onset food allergy.

    PubMed

    Kivity, Shmuel

    2012-01-01

    The prevalence of food allergy is increasing in both the pediatric and adult populations. While symptom onset occurs mostly during childhood, there are a considerable number of patients whose symptoms first begin to appear after the age of 18 years. The majority of patients with adult-onset food allergy suffer from the pollen-plant allergy syndromes. Many of them manifest their allergy after exercise and consuming food to which they are allergic. Eosinophilic esophagitis, an eosinophilic inflammation of the esophagus affecting individuals of all ages, recently emerged as another allergic manifestation, with both immediate and late response to the ingested food. This review provides a condensed update of the current data in the literature on adult-onset allergy.

  11. Crediting Foods in the Child Care Food Program. [Revised].

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Robbinsville, NJ. Mid-Atlantic Regional Office.

    This modified version of a previously published title provides additional information on foods for which reimbursement may be obtained from the United States Department of Agriculture (USDA) by child care centers and family day care homes participating in the Child Care Food Program. Such foods, called creditable foods, are those that may be…

  12. Association between household food insecurity and annual health care costs

    PubMed Central

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

    2015-01-01

    Background: Household food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs. Methods: We obtained data for 67 033 people aged 18–64 years in Ontario who participated in the Canadian Community Health Survey in 2005, 2007/08 or 2009/10 to assess their household food insecurity status in the 12 months before the survey interview. We linked these data with administrative health care data to determine individuals’ direct health care costs during the same 12-month period. Results: Total health care costs and mean costs for inpatient hospital care, emergency department visits, physician services, same-day surgeries, home care services and prescription drugs covered by the Ontario Drug Benefit Program rose systematically with increasing severity of household food insecurity. Compared with total annual health care costs in food-secure households, adjusted annual costs were 16% ($235) higher in households with marginal food insecurity (95% confidence interval [CI] 10%–23% [$141–$334]), 32% ($455) higher in households with moderate food insecurity (95% CI 25%–39% [$361–$553]) and 76% ($1092) higher in households with severe food insecurity (95% CI 65%–88% [$934–$1260]). When costs of prescription drugs covered by the Ontario Drug Benefit Program were included, the adjusted annual costs were 23% higher in households with marginal food insecurity (95% CI 16%–31%), 49% higher in those with moderate food insecurity (95% CI 41%–57%) and 121% higher in those with severe food insecurity (95% CI 107%–136%). Interpretation: Household food insecurity was a robust predictor of health care utilization and costs incurred by working-age adults, independent of other social determinants of health. Policy interventions at the provincial or federal level designed to reduce household food

  13. Update on food allergy in adults.

    PubMed

    Chaudhry, Rabia Quddus; Oppenheimer, John J

    2012-08-01

    Though much has been studied and written about food allergy, the majority of the available literature focuses on food allergies in the pediatric population. Unfortunately, it is likely that in regard to food allergies, adults are not just big children, and extrapolating findings from pediatric to adult patient populations might lead to erroneous assumptions. Thus, it is important to validate the correlation between pediatric and adult data, gather data regarding adult food allergy and understand the specific nuances of subsets of adults to better treat their food allergy. This review was conducted by identifying potentially relevant studies regarding food allergies in adults through electronic databases, including PubMed, Medline, and Google Scholar. The search terms included "allergy", "food" and "adults". Parameters of 19+ years of age were added to search terms and all journals were written in or translated to English. From these search results, focus was placed on studies from 2010 to 2012. This systematic update on food allergy in adults found that the evidence regarding prevalence, diagnosis and management of food allergies is very limited, with the majority of data derived from children and young adults.

  14. 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

    2017-04-11

    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.

  15. 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 ...

  16. Potential food-drug interactions in long-term care.

    PubMed

    Anderson, Judy K; Fox, Jodie R

    2012-04-01

    Medication administration at mealtimes may result in food-drug interactions. Older adults are especially at risk of food-drug interactions leading to adverse drug effects and subtherapeutic responses. Research on potential food-drug interactions is limited and dated. This study examined the frequency of potential food-drug interactions in long-term care. Forty-nine percent of drugs administered at mealtimes had potential for interaction, with cardiovascular medications given most frequently. The frequency of potential interactions makes this phenomenon critically important to review. Collaboration between nurses and pharmacists may identify optimal medication scheduling. Nurses can enhance care by identifying strategies to limit interactions through knowledge and creative, collaborative administration schedules.

  17. Counseling Services in Adult Day Care Centers.

    ERIC Educational Resources Information Center

    Zaki, Gamal; Zaki, Sylvia

    Federal support for adult day care centers began in the United States approximately 10 years ago. To examine the counseling practices in the adult day care centers across the country and to explore how the services are affected by the staffing patterns at these centers, 135 centers completed a questionnaire. The questionnaire addressed…

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. Young adult palliative care: challenges and opportunities.

    PubMed

    Clark, Jennifer K; Fasciano, Karen

    2015-02-01

    Young adulthood is a time of immense growth and possibilities. As a result, it is also a time when serious illness can have profound effects. This review examines the current data pertinent to young adult palliative care and discusses the challenges and opportunities where palliative medicine can enhance the care provided to this growing and vulnerable population. From the data, 2 primary themes emerged (1) ongoing young adult development not only generates unique biologic disease burdens and clinical treatment options but also requires frequent assessment and promotion and (2) binary health care systems often leave young adults without access to developmentally appropriate health care. Given its interdisciplinary approach, palliative care is uniquely poised to address the challenges known to caring for the seriously ill young adult.

  4. 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

  5. More nutritious food is served in child-care homes receiving higher federal food subsidies.

    PubMed

    Monsivais, Pablo; Kirkpatrick, Shannon; Johnson, Donna B

    2011-05-01

    The US Department of Agriculture's Child and Adult Care Food Program (CACFP) serves 2.3 million children by providing monetary subsidies for food to participating child-care providers. This cross-sectional study tested the hypothesis that higher reimbursement rates for food result in higher food expenditures and higher nutritional quality of foods served in family child-care homes participating in CACFP. Sixty family home child-care providers were recruited in 2008-2009 from King County, Washington. Half the sample received higher reimbursements and the other half received the lower rates. Participants provided a 5-day menu of meals/snacks served and food shopping receipts. The nutritional quality of foods served was assessed from portion-standardized menus. Nutritional quality was quantified as the mean adequacy (mean percent of dietary reference intake) for seven nutrients of concern for child health. Food expenditures were calculated by linking menus with receipts. Student's t tests for independent samples and general linear models were used to test for between-group differences. The two groups of providers were socioeconomically and demographically similar with comparable professional backgrounds. However, higher reimbursement providers had significantly greater menu expenditures than the lower reimbursement group ($2.36 vs $1.96/child/day; P=0.031). Reimbursement level was not associated with a difference in calories, but menus of higher reimbursement providers showed a significantly higher mean nutritional adequacy (64.5% vs 56.3%; P=0.033). The finding that reimbursement rates were positively associated with food expenditures and the nutritional quality of foods served suggests that raising CACFP reimbursements can improve child nutrition.

  6. 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

  7. 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.

  8. 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…

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

    PubMed Central

    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 nutrition and medical service provision to this population. Design and Methods: In-home interviews and oral examinations were conducted with 635 adults in rural North Carolina counties with substantial African American and American Indian populations. Avoidance and modification data were obtained for foods representing different dental challenges and dietary contributions. Data were weighted to census data for ethnicity and sex. Bivariate analyses of oral health measures and foods avoided used chi-square and logistic regression tests. Multivariable analyses used proportional odds or nominal regression models. Results: Whole fruits and raw vegetables were the most commonly avoided foods; substantial proportions of older adults also avoided meats, cooked vegetables, and other foods. Food avoidance was significantly associated with self-rated oral health, periodontal disease, bleeding gums, dry mouth, having dentures, and having fewer anterior and posterior occlusal contacts. Associations persisted when controlling for demographic and socioeconomic status indicators. From 24% to 68% of participants reported modifying specific fruits, vegetables, and meats. Modifying harder foods was related to location of teeth and periodontal disease and softer foods to oral pain and dry mouth. Implications: Food services for older adults should consider their oral health status. Policy changes are needed to provide oral health care in benefits for older adults. PMID:19574543

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  11. Food Safety Training Needs of Child Care Providers.

    ERIC Educational Resources Information Center

    Murphy, Anne S.; And Others

    1995-01-01

    A sample of child-care centers and family day-care homes in Michigan was used to identify what care providers need to know about safe food handling. Their primary concern was to become informed about what causes food to become unsafe and how to prevent foodborne illnesses. Providers preferred printed materials to tapes or workshops. (AA)

  12. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  13. 38 CFR 59.160 - Adult day health care requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... it is co-located in a nursing home, domiciliary, or other care facility, must have its own separate... (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.160 Adult day health care... necessary to accommodate an increased quality of care for patients, an adult day health care...

  14. How local and state regulations affect the child care food environment: A qualitative study of child care center directors’ perspectives

    PubMed Central

    Byrd-Williams, C. E.; Camp, E. J.; Mullen, P. D.; Briley, M. E.; Hoelscher, D. M.

    2015-01-01

    Almost one-third of preschoolers spend regular time in child care centers where they can consume the majority of their daily dietary intake. The child care setting influences children’s dietary intake. Thus, it is important to examine factors, such as local and state regulations, that influence the food environment at the center. This qualitative study explored directors’ perceptions of how regulations influence the foods available at child care centers. Ten directors of centers in Travis County, Texas completed semi-structured interviews. Directors reported that changes in local health department regulations (e.g., kitchen specifications) result in less-healthful foods being served (e.g., more prepackaged foods). Directors of centers that do not participate in the federal Child and Adult Care Food Program (CACFP) said the state licensing regulations clarify the portion size and nutritional requirements for preschoolers thereby improving the nutritional quality of the food served. Directors of centers participating in CACFP said they are not affected by state mandates, because the CACFP regulations are more stringent. These findings suggest that state regulations that specify and quantify nutritional standards may beneficially impact preschoolers’ diets. However, local health department regulations enacted to improve food safety may negatively influence the nutritional value of food served in centers. PMID:26251694

  15. 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…

  16. Access Barriers to Prenatal Care in Emerging Adult Latinas.

    PubMed

    Torres, Rosamar

    2016-03-01

    Despite efforts to improve access to prenatal care, emerging adult Latinas in the United States continue to enter care late in their pregnancies and/or underutilize these services. Since little is known about emerging adult Latinas and their prenatal care experiences, the purpose of this study was to identify actual and perceived prenatal care barriers in a sample of 54 emerging adult Latinas between 18 and 21 years of age. More than 95% of the sample experienced personal and institutional barriers when attempting to access prenatal care. Results from this study lend support for policy changes for time away from school or work to attend prenatal care and for group prenatal care.

  17. The thermic effect of food is reduced in older adults

    PubMed Central

    Du, Shichun; Rajjo, Tamim; Santosa, Sylvia; Jensen, Michael D.

    2015-01-01

    Background The thermic effect of food accounts for ~ 10% of daily energy expenditure. A reduction in the thermic effect of food, which has been variably observed in the older adults, could predispose to fat gain. We tested whether the thermic effect of food is reduced in older adults compared with young adults by analyzing our database of standardized studies conducted at the Mayo Clinic between 1999 and 2009. Methods Data was available from 136 older adults volunteers age 60 to 88 (56 females) and 141 young adults ages 18 to 35 years (67 female). Basal energy expenditure was measured by indirect calorimetry to assess basal metabolic rate. Body fat, fat free mass and visceral fat were measured using a combination of dual energy x-ray absorptiometry and an abdominal CT scan. We measured the thermic effect of food and postprandial insulinemia in 123 older adults (52 female) and 86 young (38 female) of these volunteers. Results Basal metabolic rate adjusted for fat free mass was less in older adults (P = 0.01) and the thermic effect of food was ~ 1% (P = 0.02) less in the older adults. After controlling for meal size and fat free mass, body fat and fat distribution did not predict the thermic effect of food. Conclusions Both basal metabolic rate and the thermic effect of food are less in older adults than young adults, even when they have similar amounts of lean tissue and consume a similar size meal. These factors contribute to lower daily energy expenditure in the older adults. PMID:24155251

  18. 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…

  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...

  20. 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...

  1. 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.

  2. 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…

  3. The Child Care Food Program and Family Day Care: A How-To Manual.

    ERIC Educational Resources Information Center

    Brock, Estelle; Travis, Nancy

    This manual explains what is involved in sponsoring a Child Care Food Program (CCFP) for family day care providers. It draws on the experience of Save the Children's Southern States Office in sponsoring the "Child Care Food Umbrella," a CCFP program serving over 1,000 providers, which Save the Children has operated for 6 years. Chapter 1…

  4. 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.

  5. 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.…

  6. 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…

  7. Dietary aspects of adverse reactions to foods in adults.

    PubMed Central

    Parker, S L; Sussman, G L; Krondl, M

    1988-01-01

    Dietary considerations play an important role in the diagnosis, treatment and management of immunologic and nonimmunologic reactions to foods. Food diaries and trial elimination diets may prove helpful in identifying the responsible foods. Elimination diets must be monitored carefully for nutritional adequacy and should be used no longer than absolutely necessary; in some instances appropriate vitamin and mineral supplementation may be necessary. Ideally the identification of foods that provoke symptoms should be confirmed by means of double-blind challenge testing. Avoidance of some problem foods is unlikely to cause nutritional problems, but the practical and nutritional implications of allergies to staple foods such as cow's milk, eggs and wheat are far greater. Nonimmunologic adverse reactions that may mimic food allergic reactions include gastrointestinal disorders, sensitivity to food additives and psychologically based adverse reactions. There may be some degree of tolerance in metabolic disorders, which makes dietary management easier. Sensitivity to food additives necessitates careful scrutiny of food labels. In psychologic adverse reactions to foods, several foods are often involved, which increases the risk of nutritional problems. PMID:3048623

  8. Titanium dioxide nanoparticles in food and personal care products.

    PubMed

    Weir, Alex; Westerhoff, Paul; Fabricius, Lars; Hristovski, Kiril; von Goetz, Natalie

    2012-02-21

    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-) TiO(2), and discusses the impact of the nanoscale fraction of TiO(2) entering the environment. The foods with the highest content of TiO(2) 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 TiO(2) (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 wastewater treatment plants (WWTPs) deserves attention. A Monte Carlo human exposure analysis to TiO(2) through foods

  9. 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

  10. 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.

  11. Food insecure families: description of access and barriers to food from one pediatric primary care center.

    PubMed

    DeMartini, Tori L; Beck, Andrew F; Kahn, Robert S; Klein, Melissa D

    2013-12-01

    Despite evidence that food insecurity negatively impacts child health, health care providers play little role in addressing the issue. To inform potential primary care interventions, we sought to assess a range of challenges faced by food insecure (FI) families coming to an urban, pediatric primary care setting. A cross-sectional study was performed at a hospital-based, urban, academic pediatric primary care clinic that serves as a medical home for approximately 15,000 patients with 35,000 annual visits. Subjects included a convenience sample of caregivers of children presenting for either well child or ill care over a 4 months period in 2012. A self-administered survey assessed household food security status, shopping habits, transportation access, budgeting priorities, and perceptions about nutrition access in one's community. Bivariate analyses between food security status and these characteristics were performed using Chi square statistics or Fisher's exact test. The survey was completed by 199 caregivers. Approximately 33% of families were FI; 93% received food-related governmental assistance. FI families were more likely to obtain food from a corner/convenience store, utilize food banks, require transportation other than a household car, and prioritize paying bills before purchasing food. FI families perceived less access to healthy, affordable foods within their community. Thus, FI families may face unique barriers to accessing food. Knowledge of these barriers could allow clinicians to tailor in-clinic screening and create family-centered interventions.

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

    PubMed Central

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

    2016-01-01

    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. PMID:28035995

  13. 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

  14. 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.

  15. [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.

  16. 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…

  17. 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).…

  18. Adult Day Care for Alzheimer's Patients and Their Families.

    ERIC Educational Resources Information Center

    Sands, Dan; Suzuki, Thelma

    1983-01-01

    Harbor Area Adult Day Care Center has operated for two years with a primary purpose of providing respite care to families caring for a relative with Alzheimer's disease or related disorders. The rationale, history, program, staffing, funding, and experience for the first two years of the project are provided. (Author/RC)

  19. In The Best Interest Of The (Adult) Child: Ideas About Kinship Care Of Older Adults

    PubMed Central

    Jennings, Tezra; Perry, Tam E.; Valeriani, Julia

    2014-01-01

    This article uses a qualitative, ethnographic approach to examine the experiences older adults and their kin, as the older adult engages in relocation. Studies looking at caregiving by kin for older adults highlight burdens for the adult child. This study offers a life course perspective on kinship care, analyzing older adults' decisions' to move. It was found that many older adults are strongly influenced by the desire to not be cared for by their kin as well as to select housing near their existing social network, which might exclude kin. In conclusion, policy implications are discussed. PMID:25278741

  20. 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

  1. Linkage to and retention in care following healthcare transition from pediatric to adult HIV care.

    PubMed

    Ryscavage, Patrick; Macharia, Thomas; Patel, Devang; Palmeiro, Robyn; Tepper, Vicki

    2016-01-01

    Outcomes following healthcare transition (HCT) from pediatric to adult HIV care are not well described. We sought to describe clinical outcomes following HCT within our institution among young adults with behavioral-acquired (N = 31) and perinatally-acquired (N = 19) HIV. We conducted a retrospective cohort study among HIV-infected adults who attempted transition from pediatric to adult HIV care within our institution. The primary end point was retention in care, defined as the completion of at least two visits over 12 months following linkage to adult care. Additional end points include time to linkage to adult care, and changes in CD4 + T cell count and HIV RNA across time. Outcomes were compared between perinatal and behavioral HIV cohorts. Binary data were analyzed using the Fisher exact test and continuous data were analyzed using the Mann-Whitney test. Forty-three (86%) of 50 patients were successfully linked to adult care. The median time to linkage was 98 days. Fifty percent of patients achieved full retention in care at 12 months post-linkage. Though those with behavioral-acquired HIV attempted transfer at an older age, the groups did not differ in rates of linkage and retention in adult care. CD4 + T cell counts and rates of viral suppression did not differ between pre- and post-HCT periods. Despite high rates of successful linkage to adult care in our study population, rates of retention in adult HIV care following HCT were low. These results imply that challenges remain in the adult HIV care setting toward improving the HCT process.

  2. Exploring Adult Care Experiences and Barriers to Transition in Adult Patients with Sickle Cell Disease

    PubMed Central

    Bemrich-Stolz, CJ; Halanych, JH; Howard, TH; Hilliard, LM; Lebensburger, JD

    2015-01-01

    Background Young adults with sickle cell anemia are at high risk for increased hospitalization and death at the time of transition to adult care. This may be related to failure of the transition system to prepare young adults for the adult healthcare system. This qualitative study was designed to identify factors related to transition that may affect the health of adults with sickle cell anemia. Procedure Ten patients currently treated in an adult hematology clinic participated in semi-structured qualitative interviews to describe their experience transitioning from pediatric to adult care and differences in adult and pediatric healthcare systems. Results Participants were generally unprepared for the adult healthcare system. Negative issues experienced by participants included physician mistrust, difficulty with employers, keeping insurance, and stress in personal relationships. Positive issues experienced by participants included improved self efficacy with improved self care and autonomy. Conclusions In the absence of a formalized transition program, adults with sickle cell anemia experience significant barriers to adult care. In addition to medical history review and identification of an adult provider, transition programs should incorporate strategies to navigate the adult medical system, insurance and relationships as well as encouraging self efficacy. PMID:26900602

  3. Classifying foods in contexts: How adults categorize foods for different eating settings

    PubMed Central

    Blake, C.E.; Bisogni, C.A.; Sobal, J.; Devine, C.M.; Jastran, M.

    2008-01-01

    This project examined adults' food cognitions by applying schema theory to explain how adults categorized foods for different contexts. Qualitative interviews and repeated card sort activities for different eating contexts were conducted to elicit as many food categories as possible from 42 US adults. Participants labeled card sort piles with their own words, providing 991 card sort labels. Qualitative analysis of the labels resulted in the emergence of 12 category types. Personal-experience-based types were specific to the individual (e.g. Preference). Context-based types were related to situational aspects of eating episodes (e.g. Location). Food-based types were related to intrinsic properties of the foods (e.g. Physical characteristics). Different combinations of the 12 category types were used for different eating contexts. Personal-experience and context-based types were used most frequently overall. Some category types were used more frequently for specific contexts (e.g. Convenience for work contexts). Food-based taxonomic category types were used most frequently when no context was defined. Script-oriented categories were more often used in response to specific eating contexts. These findings provide a framework to consider how individuals classify foods in real-life eating contexts. Attention to personal-experience and context-based category types may help improve understanding of relationships between knowledge and food choice behaviors. PMID:17512088

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. Caring for older adults: the parables in Confucian texts.

    PubMed

    Koh, Eun-Kang; Koh, Chin-Kang

    2008-10-01

    Confucianism is one of the frequently mentioned social factors in the research of care for the older adults in East Asian countries such as China, Taiwan, Japan, and Korea. Although Confucian philosophy functions as a powerful source of reference for care, the context of care in Confucian texts is not yet largely studied in nursing. This column focuses on the meaning of care in two key Confucian texts, the Analects and Mencius. The context of care in Confucian texts should provide a sound foundation and substantial understanding for researchers studying care in East Asian society.

  9. 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,…

  10. Factors Affecting Burnout when Caring for Older Adults Needing Long Term Care Services in Korea

    ERIC Educational Resources Information Center

    Won, Seojin; Song, Inuk

    2012-01-01

    The purpose of this study was to address factors related to caregiver burnout as a result of caring for an older adult with a chronic disease. Characteristics of care recipients and caregivers as well as social support were included to identify the relationships with caregiver burnout. The analysis was based on a sample of 334 older adults and…

  11. Foster Care Experiences and Educational Outcomes of Young Adults Formerly Placed in Foster Care

    ERIC Educational Resources Information Center

    Havalchak, Anne; White, Catherine Roller; O'Brien, Kirk; Pecora, Peter J.; Sepulveda, Martin

    2009-01-01

    This study contributes to the body of research on the educational outcomes of young adults who were formerly placed in foster care. Telephone interviews were conducted with 359 young adults (a 54.6% response rate). Participants must have been served for at least one year by one private foster care agency in one of its twenty-two offices. Results…

  12. Food Label Knowledge, Usage and Attitudes of Older Adults.

    PubMed

    Jackey, Beverly A; Cotugna, Nancy; Orsega-Smith, Elizabeth

    2017-01-01

    Few recent studies have investigated food label practices in older adults. This cross-sectional study surveyed adults, 60 years and older in Delaware (n = 100, 82% female, 74% between 60 and 79 years, 49% Caucasian, 45% African Americans) to examine associations between food label knowledge, attitudes, and usage patterns. A 28-item questionnaire assessed knowledge, attitudes, usage, and demographic information. Bivariate analysis results showed food label knowledge was associated with education and monthly income. Those reporting a high school education or less incorrectly identified calorie (P < 0.05) and carbohydrate information (P < 0.03). Monthly income ≤$2000 was associated with incorrectly interpreting carbohydrate information (P < 0.03). Label usage was associated with being female (P < 0.001), having a high school education or less (P < 0.000), being 70 years or older (P < 0.05), and having a monthly income ≤$2000 (P < 0.001). Respondent's usage and perceived label comprehension was high; however less than half could correctly interpret label information. When shown samples of the US Food and Drug Administration's proposed new labels, subjects had a very favorable attitude toward the new changes. Increasing nutrition knowledge through education interventions appropriate for older adult consumers may improve comprehension of information on the food labels.

  13. 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.

  14. 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.

  15. 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

  16. Middle-Aged and Older Adult Health Care Selection.

    PubMed

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L

    2017-04-01

    This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the "outshopping theory," where respondents select services in larger regional economic centers rather than local "mom and pop" providers, now extends to older adult health care selection.

  17. 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.

  18. 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.

  19. Health Care Transition Experiences of Young Adults With Cerebral Palsy.

    PubMed

    Carroll, Ellen McLaughlin

    2015-01-01

    Health care transition (HCT) describes the purposeful, planned movement of adolescents from child to adult-orientated care. The purpose of this qualitative study is to uncover the meaning of transition to adult-centered care as experienced by young adults with cerebral palsy (YA-CP) through the research question: What are the lived experiences of young adults with cerebral palsy transitioning from pediatric to adult healthcare? Six females and 3 males, aged 19-25 years of age, who identified as carrying the diagnosis of cerebral palsy without cognitive impairment, were interviewed. Giorgi's (1985) method for analysis of phenomenology was the framework for the study and guided the phenomenological reduction. The meaning of the lived experiences of YA-CPs transition to adult health care is expert novices with evidence and experience-based expectations, negotiating new systems interdependently and accepting less than was expected. More information and support is needed for the YA-CP during transition to ensure a well-organized move to appropriate adult-oriented health care that is considerate of the lifelong impact of the disorder. The nurses' role as advocate, mentor and guide can optimize the individual's response to the transition process.

  20. 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…

  1. 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…

  2. Adult beetles compensate for poor larval food conditions.

    PubMed

    Müller, Thorben; Müller, Caroline

    2016-05-01

    Life history traits of herbivores are highly influenced by the quality of their hosts, i.e., the composition of primary and secondary plant metabolites. In holometabolous insects, larvae and adults may face different host plants, which differ in quality. It has been hypothesised that adult fitness is either highest when larval and adult environmental conditions match (environmental matching) or it may be mainly determined by optimal larval conditions (silver spoon effect). Alternatively, the adult stage may be most decisive for the actual fitness, independent of larval food exposure, due to adult compensation ability. To determine the influence of constant versus changing larval and adult host plant experiences on growth performance, fitness and feeding preferences, we carried out a match-mismatch experiment using the mustard leaf beetle, Phaedon cochleariae. Larvae and adults were either constantly reared on watercress (natural host) or cabbage (crop plant) or were switched after metamorphosis to the other host. Growth, reproductive traits and feeding preferences were determined repeatedly over lifetime and host plant quality traits analysed. Differences in the host quality led to differences in the development time and female reproduction. Egg numbers were significantly influenced by the host plant species experienced by the adults. Thus, adults were able to compensate for poor larval conditions. Likewise, the current host experience was most decisive for feeding preferences; in adult beetles a feeding preference was shaped regardless of the larval host plant. Larvae or adults reared on the more nutritious host, cabbage, showed a higher preference for this host. Hence, beetles most likely develop a preference when gaining a direct positive feedback in terms of an improved performance, whereby the current experience matters the most. Highly nutritious crop plants may be, in consequence, all the more exploited by potential pests that may show a high plasticity in

  3. 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)

  4. Youth with special health care needs: transition to adult health care services.

    PubMed

    Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

    2013-12-01

    Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

  5. Food hypersensitivity among adult patients: epidemiological and clinical aspects.

    PubMed

    Castillo, R; Delgado, J; Quiralte, J; Blanco, C; Carrillo, T

    1996-01-01

    Food hypersensitivity (FH) is lesser frequent among adult patients than in childhood. Foods implicated in hypersensitivity reactions vary with sociocultural and diet habits from a geographic place to other. We studied 142 adult patients sensitized to foods, among 7698 patients visited at our Outpatient Clinic. Hundred and twenty patients referred clinical symptoms after consumption of one or more foods consistently. From the latest, 107 patients (89.2%) were atopics (92 of them sensitizes to dust mites) and 54 (45%) referred atopic familiar background. Most frequent recorded symptoms were: urticaria/angioedema 84 cases (70%), oral syndrome 65 (54%), asthma 48 (37%) and anaphylaxis 33 patients (27.5%). Shellfish sensitization occurred in 50 patients, fresh fruits in 33 and nuts in 29 cases. Shrimp (48 patients), squid (33), kiwi (14), papaya (14), avocado (13) and banana (12 cases) were the most frequent causes of FH. Significant statistical association between foods and inhalants was observed for fresh fruits and latex (p < 0.001), fresh fruits and pollens (p < 0.01), and shellfish and Blatta germanica (p < 0.001). Prevalence of FH among patients at our Area is around 1.6%. Tropical fruits, as other kind of fruits, seem to share common IgE-epitopes to pollens. High prevalence of shellfish and cockroach hypersensitivity could be more easily developed by previous domestic mites sensitization.

  6. Intensive care of the adult patient with congenital heart disease.

    PubMed

    Allan, Catherine K

    2011-01-01

    Prevalence of congenital heart disease in the adult population has increased out of proportion to that of the pediatric population as survival has improved, and adult congenital heart disease patients make up a growing percentage of pediatric and adult cardiac intensive care unit admissions. These patients often develop complex multiorgan system disease as a result of long-standing altered cardiac physiology, and many require reoperation during adulthood. Practitioners who care for these patients in the cardiac intensive care unit must have a strong working knowledge of the pathophysiology of complex congenital heart disease, and a full team of specialists must be available to assist in the care of these patients. This chapter will review some of the common multiorgan system effects of long-standing congenital heart disease (eg, renal and hepatic dysfunction, coagulation abnormalities, arrhythmias) as well as some of the unique cardiopulmonary physiology of this patient population.

  7. How Emotions Expressed by Adults' Faces Affect the Desire to Eat Liked and Disliked Foods in Children Compared to Adults

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  8. The role of chiropractic care in older adults

    PubMed Central

    2012-01-01

    There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults. PMID:22348431

  9. 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...

  10. 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... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  11. 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...

  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... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false Adult day care center provisions. 226.19a Section 226... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  14. 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...

  15. 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... § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program... auspices of a for-profit sponsoring organization. Adult day care centers participating as...

  16. 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...

  17. 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...

  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...

  19. 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...

  20. 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...

  1. 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...

  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...

  3. 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...

  4. 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...

  5. 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.

  6. Preventive Care Recommendations for Adults with MS

    MedlinePlus

    Preventive Care Recommendations THE BASIC FACTS MULTIPLE SCLEROSIS The Three Most Common Eye Disorders Carlos Healey, diagnosed in 2001 in Multiple Sclerosis Medical checklist: Recommendations: Dates of last & next test ...

  7. 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

    2017-02-07

    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.

  8. 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

  9. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52... knowledge and skills necessary to manage care requirements in the home. Adult day health care is...

  10. Integrating Adolescents and Young Adults into Adult-Centered Care for IBD.

    PubMed

    Trivedi, Itishree; Holl, Jane L; Hanauer, Stephen; Keefer, Laurie

    2016-05-01

    Planned healthcare transition, initiated in pediatric care, is a gradual process aimed at fostering the adolescent patient's disease knowledge and skills with the ultimate objective of preparing patients and families for adult-centered care. The process is critical in inflammatory bowel diseases (IBD) where there is an increased risk of non-adherence, hospitalizations, and emergency department use as young adult patients graduate from pediatric to adult-centered care. While evidence for healthcare transition in IBD is mounting, important gaps remain in the understanding of this process from the perspective of the adult gastroenterologist. This paper summarizes what is known about healthcare transition in IBD and explores the unanswered questions-a conceptual and methodological framework for transition interventions, relevant outcomes that define successful transition, and key stakeholder perspectives. For the adult gastroenterologist managing the young adult patient population, this paper presents the paradigm of "care integration"-a process of ongoing, multi-modality support for the patient, initiated in the adult care setting, with the goal of improving self-management skills and active participation in medical decision-making.

  11. Children, Food, and Family Day Care: A Manual for Sponsorship of the Child Care Food Program in Licensed Family Day Care.

    ERIC Educational Resources Information Center

    O'Konski, Gerry, Ed.

    This manual provides detailed information on how local non-profit organizations can sponsor licensed family day care homes for participation in the federally funded Child Care Food Program. This program subsidizes the provision of nutritious meals to children who are not in school. The introductory section of the manual answers basic questions…

  12. Adult Day Care--Extended Family.

    ERIC Educational Resources Information Center

    Smith, Bert Kruger

    This pamphlet describes a multi-purpose day-care center for the elderly in Abilene, Texas which is intended to fill the "extended family" role of offering companionship, medical attention, and other aspects of concern to older persons in the community. The goals of the program are as follows: (1) to keep individuals out of institutions…

  13. Adult Day Care--Extended Family.

    ERIC Educational Resources Information Center

    Smith, Bert K.

    This booklet reports on a community project in Texas involving a day care center for senior citizens. It contains an analysis of successes and failures in attempting to satisfy the project's goals of: (l) keeping individuals out of institutions as long as possible; (2) providing social contact and enrichment experiences; (3) making the burden…

  14. Transition to Adult-Oriented Health Care: Perspectives of Youth and Adults with Complex Physical Disabilities

    ERIC Educational Resources Information Center

    Gorter, Jan Willem

    2009-01-01

    In their qualitative study, Young and colleagues (2009) found that youth and adults with cerebral palsy (CP), spina bifida, and acquired brain injuries of childhood in the province of Ontario, Canada, perceive or have perceived their transfer from pediatric to adult-oriented health care services as a struggle. Although publications on transition…

  15. 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…

  16. Nursing care time and quality indicators for adult intensive care: correlation analysis.

    PubMed

    Garcia, Paulo Carlos; Fugulin, Fernanda Maria Togeiro

    2012-01-01

    The objective of this quantitative, correlational and descriptive study was to analyze the time the nursing staff spends to assist patients in Adult Intensive Care Units, as well as to verify its correlation with quality care indicators. The average length of time spent on care and the quality care indicators were identified by consulting management instruments the nursing head of the Unit employs. The average hours of nursing care delivered to patients remained stable, but lower than official Brazilian agencies' indications. The correlation between time of nursing care and the incidence of accidental extubation indicator indicated that it decreases with increasing nursing care delivered by nurses. The results of this investigation showed the influence of nursing care time, provided by nurses, in the outcome of care delivery.

  17. Associations between food insecurity and healthy behaviors among Korean adults

    PubMed Central

    Chun, In-Ae; Park, Jong; Ro, Hee-Kyung; Han, Mi-Ah

    2015-01-01

    BACKGROUND/OBJECTIVES Food insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults. SUBJECTS/METHODS The data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors. RESULTS The prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight. CONCLUSIONS Food insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population. PMID:26244083

  18. 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…

  19. 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.

  20. Adolescent and young adult cancer: principles of care

    PubMed Central

    Ramphal, R.; Aubin, S.; Czaykowski, P.; De Pauw, S.; Johnson, A.; McKillop, S.; Szwajcer, D.; Wilkins, K.; Rogers, P.

    2016-01-01

    Adolescents and young adults (ayas) with cancer in active treatment face a number of barriers to optimal care. In the present article, we focus on the 3 critical domains of care for ayas—medical, psychosocial, and research—and how changes to the system could overcome barriers. We summarize the current literature, outline recommended principles of care, raise awareness of barriers to optimal care, and suggest specific changes to the system to overcome those barriers in the Canadian context. Many of the recommendations can nevertheless be applied universally. These recommendations are endorsed by the Canadian Task Force on Adolescents and Young Adults with Cancer and build on outcomes from two international workshops held by that group. PMID:27330350

  1. Critical care issues in adult liver transplantation

    PubMed Central

    Gopal, Palepu B.; Kapoor, Dharmesh; Raya, Ravichandra; Subrahmanyam, M.; Juneja, Deven; Sukanya, B.

    2009-01-01

    Over the last decade, liver transplantation has become an operational reality in our part of the world. As a result, clinicians working in an intensive care unit are more likely to be exposed to these patients in the immediate postoperative period, and thus, it is important that they have a working knowledge of the common complications, when they are likely to occur, and how to deal with them. The main focus of this review is to address the variety of critical care issues in liver transplant recipients and to impress upon the need to provide favorable circumstances for the new liver to start functioning and maintain the function of other organs to aid in this process. PMID:20040807

  2. Mapping the literature: palliative care within adult and child neurology.

    PubMed

    Dallara, Alexis; Meret, Anca; Saroyan, John

    2014-12-01

    Objectives of this review were to examine definitions and background of palliative care, as well as address whether there is an increased need for palliative care education among neurologists. The review also explores what literature exists regarding palliative care within general neurology and child neurology. A literature review was conducted examining use of palliative care within child neurology. More than 100 articles and textbooks were retrieved and reviewed. Expert guidelines stress the importance of expertise in palliative care among neurologists. Subspecialties written about in child neurology include that of peripheral nervous system disorders, neurodegenerative diseases, and metabolic disorders. Adult and child neurology patients have a great need for improved palliative care services, as they frequently develop cumulative physical and cognitive disabilities over time and cope with decreasing quality of life before reaching the terminal stage of their illness.

  3. At-home oral care for adults with developmental disabilities

    PubMed Central

    Minihan, Paula M.; Morgan, John P.; Park, Angel; Yantsides, Konstantina E.; Nobles, Carrie J.; Finkelman, Matthew D.; Stark, Paul C.; Must, Aviva

    2015-01-01

    Background Little is known about effective at-home oral care methods for people with developmental disabilities (DDs) who are unable to perform personal preventive practices themselves and rely on caregivers for assistance. Methods A convenience sample of 808 caregivers (84.5 percent paid, 15.5 percent family members) who accompanied adults with DDs (20 years or older) to appointments at a specialized statewide dental care system completed computer-assisted personal interview surveys. The authors used these data to investigate caregivers’ at-home oral care experiences and to explore differences between caregivers who were paid and those who were family members. Results Caregivers reported that a high proportion (85 percent) of dentate adults with DDs received assistance with tooth cleaning. They also reported a high prevalence of dental problems, and low adherence to brushing (79 percent) and flossing (22 percent) recommendations. More caregivers reported that they felt confident assisting with brushing than with flossing (85 percent versus 54 percent). Family members and paid caregivers differed with respect to confidence and training. Conclusions At-home oral care, particularly flossing, presents substantial challenges for adults with DDs. Solutions must be tailored to address the different experiences and distinct needs of the family members and paid caregivers who assist these adults. Practical Implications Caregivers play an important role in providing at-home oral care, and they must be included in efforts to improve oral health outcomes for people with DDs. PMID:25270700

  4. 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…

  5. Transfer to Adult Care--Experiences of Young Adults with Congenital Heart Disease.

    PubMed

    Asp, Ann; Bratt, Ewa-Lena; Bramhagen, Ann-Cathrine

    2015-01-01

    More than 90% of children born with congenital heart disease survive into adulthood due to successes of cardiac surgery and medical management. Interviews with 16 young adults with congenital heart disease to explore their experiences of transfer from pediatric to adult care were performed. The analysis identified five themes; Feeling secure during the transfer process, Experiencing trust in the care, Expecting to be involved, Assuming responsibility for one's health is a process and Lack of knowledge leads to uncertainty. In conclusion; a structured and gradual transfer process was necessary to enable the informants to shoulder the responsibility for self-care.

  6. 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…

  7. 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…

  8. A simple dietary assessment tool to monitor food intake of hospitalized adult patients

    PubMed Central

    Budiningsari, Dwi; Shahar, Suzana; Manaf, Zahara Abdul; Susetyowati, Susetyowati

    2016-01-01

    Background/objectives Monitoring food intake of patients during hospitalization using simple methods and minimal training is an ongoing problem in hospitals. Therefore, there is a need to develop and validate a simple, easy to use, and quick tool that enables staff to estimate dietary intake. Thus, this study aimed to develop and validate the Pictorial Dietary Assessment Tool (PDAT). Subjects and methods A total of 37 health care staff members consisting of dietitians, nurses, and serving assistants estimated 130 breakfast and lunch meals consumed by 67 patients using PDAT. PDAT was developed based on the hospital menu that consists of staple food (rice or porridge), animal source protein (chicken, meat, eggs, and fish), and non-animal source protein (tau fu and tempeh), with a total of six pictorials of food at each meal time. Weighed food intake was used as a gold standard to validate PDAT. Agreement between methods was analyzed using correlations, paired t-test, Bland–Altman plots, kappa statistics, and McNemar’s test. Sensitivity, specificity, and area under the curve of receiver operating characteristic were calculated to identify whether patients who had an inadequate food intake were categorized as at risk by the PDAT, based on the food weighing method. Agreement between different backgrounds of health care staff was calculated by intraclass correlation coefficient and analysis of variance test. Results There was a significant correlation between the weighing food method and PDAT for energy (r=0.919, P<0.05), protein (r=0.843, P<0.05), carbohydrate (r=0.912, P<0.05), and fat (r=0.952; P<0.05). Nutrient intakes as assessed using PDAT and food weighing were rather similar (295±163 vs 292±158 kcal for energy; 13.9±7.8 vs 14.1±8.0 g for protein; 46.1±21.4 vs 46.7±22.3 g for carbohydrate; 7.4±3.1 vs 7.4±3.1 g for fat; P>0.05). The PDAT and food weighing method showed a satisfactory agreement beyond chance (k) (0.81 for staple food and animal source

  9. Food Insecurity Is Associated with Obesity among US Adults in 12 States

    PubMed Central

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

    2015-01-01

    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,“Howoften 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. PMID:22939441

  10. 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.

  11. Position of the Academy of Nutrition and Dietetics: food and nutrition for older adults: promoting health and wellness.

    PubMed

    Bernstein, Melissa; Munoz, Nancy

    2012-08-01

    It is the position of the Academy of Nutrition and Dietetics that all Americans aged 60 years and older receive appropriate nutrition care; have access to coordinated, comprehensive food and nutrition services; and receive the benefits of ongoing research to identify the most effective food and nutrition programs, interventions, and therapies. Health, physiologic, and functional changes associated with the aging process can influence nutrition needs and nutrient intake. The practice of nutrition for older adults is no longer limited to those who are frail, malnourished, and ill. The population of adults older than age 60 years includes many individuals who are living healthy, vital lives with a variety of nutrition-related circumstances and environments. Access and availability of wholesome, nutritious food is essential to ensure successful aging and well-being for the rapidly growing, heterogeneous, multiracial, and ethnic population of older adults. To ensure successful aging and minimize the effects of disease and disability, a wide range of flexible dietary recommendations, culturally sensitive food and nutrition services, physical activities, and supportive care tailored to older adults are necessary. National, state, and local strategies that promote access to coordinated food and nutrition services are essential to maintain independence, functional ability, disease management, and quality of life. Those working with older adults must be proactive in demonstrating the value of comprehensive food and nutrition services. To meet the needs of all older adults, registered dietitians and dietetic technicians, registered, must widen their scope of practice to include prevention, treatment, and maintenance of health and quality of life into old age.

  12. 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

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

    PubMed

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

    2016-10-21

    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.

  14. Energy intakes of US children and adults by food purchase location and by specific food source

    PubMed Central

    2013-01-01

    Background To our knowledge, no studies have examined energy intakes by food purchase location and food source using a representative sample of US children, adolescents and adults. Evaluations of purchase location and food sources of energy may inform public health policy. Methods Analyses were based on the first day of 24-hour recall for 22,852 persons in the 2003-4, 2005-6, and 2007-8 National Health and Nutrition Examination Surveys (NHANES). The most common food purchase locations were stores (grocery store, supermarket, convenience store, or specialty store), quick-service restaurants/pizza (QSR), full-service restaurants (FSR), school cafeterias, or food from someone else/gifts. Specific food sources of energy were identified using the National Cancer Institute aggregation scheme. Separate analyses were conducted for children ages 6-11y, adolescents ages 12-19y, and adults aged 20-50y and ≥51y. Results Stores (grocery, convenience, and specialty) were the food purchase locations for between 63.3% and 70.3% of dietary energy in the US diet. Restaurants provided between 16.9% and 26.3% of total energy. Depending on the respondents’ age, QSR provided between 12.5% and 17.5% of energy, whereas FSR provided between 4.7% and 10.4% of energy. School meals provided 9.8% of energy for children and 5.5% for adolescents. Vending machines provided <1% of energy. Pizza from QSR, the top food away from home (FAFH) item, provided 2.2% of energy in the diets of children and 3.4% in the diets of adolescents. Soda, energy, and sports drinks from QSR provided approximately 1.2% of dietary energy. Conclusions Refining dietary surveillance approaches by incorporating food purchase location may help inform public health policy. Characterizing the important sources of energy, in terms of both purchase location and source may be useful in anticipating the population-level impacts of proposed policy or educational interventions. These data show that stores provide a majority of

  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. 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... children and eligible enrolled children of day care home providers, at approved day care homes. (b)...

  17. 7 CFR 226.13 - Food service payments to sponsoring organizations for day care homes.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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... children and eligible enrolled children of day care home providers, at approved day care homes. (b)...

  18. 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.

  19. 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.

  20. 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

  1. Epilepsy: addressing the transition from pediatric to adult care

    PubMed Central

    Rajendran, Seetha; Iyer, Anand

    2016-01-01

    Adolescence is a period of rapid change, both physical and psychosocial for any young person. It can be challenging when they have ongoing health problems and when their care needs to be transitioned to the adult health care system. Transition should be a planned process of addressing the medical and associated comorbid conditions from pediatric to adult care in a coordinated manner. In most cases, the young person and their family are well known to the pediatrics services and have built a relationship based on trust and often friendship over many years. Understandably, there is significant apprehension about moving from this familiar setting to the unknown adult services. Apart from having a sound knowledge of specific childhood epileptic conditions and associated comorbid disorders, it is important that both the pediatric and adult epilepsy teams are motivated to provide a successful and safe transition for these patients. It is essential that transition is seen as a continual process and not as a single event, and good preparation is the key to its success. It is also important that general practitioners are closely engaged to ensure successful transition. An overview of how to effectively address transition in epilepsy, different models of transition, transition of relevant epilepsies, and their management is discussed. PMID:27390536

  2. Food Sanitation and Safety Self-assessment Instrument for Child Care Centers.

    ERIC Educational Resources Information Center

    1990

    This self-assessment instrument for day care center staff is designed to help caregivers provide safe food to children. The nine sections of the instrument, presented in checklist format, concern: (1) personal hygiene; (2) purchasing, receiving, and inspecting of food; (3) food storage; (4) food service equipment; (5) food preparation; (6) infant…

  3. Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.

    PubMed

    Duke, Naomi N; Scal, Peter B

    2011-01-01

    To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P < 0.001) and taking responsibility for their own care (79.3 vs. 64.4%, P < 0.001). Having a high level of family centered care (vs. low) was also associated with high rates of discussing future health needs (56.3 vs. 39.6%, P < 0.001) and encouragement to take responsibility for care (91.2 vs. 70.3%, P < 0.001). Family centered care mediated 39.1% of the effect of a usual source of care on discussion of future health needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues.

  4. Transition of care from paediatric to adult rheumatology

    PubMed Central

    McDonagh, Janet E

    2007-01-01

    The origin of paediatric rheumatology in the UK mainly lies in adult rheumatology and this has proved invaluable in terms of transition provision, education and training, and collaborative research. The last 5 years have seen adolescent rheumatology gather momentum with the creation of an objective evidence base, a sound foundation for future work addressing the many unanswered questions and hypotheses in the area of transitional care. The aim of this paper is to review the evidence supporting the recent developments in transitional care within rheumatology. Acknowledging the non‐categorical nature of transition, the author will also refer to evidence from other chronic illnesses which has informed these developments. PMID:17715444

  5. Transition of care from paediatric to adult rheumatology.

    PubMed

    McDonagh, Janet E

    2007-09-01

    The origin of paediatric rheumatology in the UK mainly lies in adult rheumatology and this has proved invaluable in terms of transition provision, education and training, and collaborative research. The last 5 years have seen adolescent rheumatology gather momentum with the creation of an objective evidence base, a sound foundation for future work addressing the many unanswered questions and hypotheses in the area of transitional care. The aim of this paper is to review the evidence supporting the recent developments in transitional care within rheumatology. Acknowledging the non-categorical nature of transition, the author will also refer to evidence from other chronic illnesses which has informed these developments.

  6. Fetal programming of adult disease: implications for prenatal care.

    PubMed

    Lau, Christopher; Rogers, John M; Desai, Mina; Ross, Michael G

    2011-04-01

    The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult health disorders, particularly metabolic syndrome, can be markedly influenced by prenatal and infant environmental exposures (ie, developmental programming). Low birth weight, together with infant catch-up growth, is associated with a significant risk of adult obesity and cardiovascular disease, as well as adverse effects on pulmonary, renal, and cerebral function. Conversely, exposure to maternal obesity or high birth weight also represents an increased risk for childhood and adult obesity. In addition, fetal exposure to select chemicals (eg, phytoestrogens) or environmental pollutants (eg, tobacco smoke) may affect the predisposition to adult disease. Animal models have confirmed human epidemiologic findings and provided insight into putative programming mechanisms, including altered organ development, cellular signaling responses, and epigenetic modifications (ie, control of gene expression without modification of DNA sequence). Prenatal care is transitioning to incorporate goals of optimizing maternal, fetal, and neonatal health to prevent or reduce adult-onset diseases. Guidelines regarding optimal pregnancy nutrition and weight gain, management of low- and high-fetal-weight pregnancies, use of maternal glucocorticoids, and newborn feeding strategies, among others, have yet to fully integrate long-term consequences on adult health.

  7. 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

  8. Older adult drivers living in residential care facilities

    PubMed Central

    Lum, Hillary D.; Ginde, Adit A.; Betz, Marian E.

    2015-01-01

    Residential care facilities (RCF) provide assistance to older adults who cannot live independently, but it is unclear whether these residents have retired from driving. Here, we characterize older adults living in RCFs who still drive from a national cross-sectional survey of residents (2010 National Survey of Residential Care Facilities), representing ~733,000 adults living in RCFs such as assisted living facilities and personal care homes. Key resident characteristics were health, function, mobility and community activity indicators, which could be associated with increased driving risk. Of 8,087 residents, 4.5% (95%CI=3.9-5.1) were current drivers. Many drivers were older than 80 years (74%, 95%CI=67-79), in very good health (31%, 95%CI=25-38) or good health (35%, 95%CI=29-42), and had a median of two medical conditions. Most were independent with activities of daily living, though some needed assistance with walking and used gait devices. Given these results, RCF staff and healthcare providers need a heightened awareness of factors associated with driving risk to promote safety of older drivers and provide resources for likely transition to other transportation. PMID:26366125

  9. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants.

  10. Child to adult: transitional care for young adults with cystic fibrosis.

    PubMed

    Al-Yateem, Nabeel

    Managing the transitional care needs of young adults with a complex chronic illness such as cystic fibrosis (CF) as they move from a child-orientated to adult setting has been reported in the literature as challenging and stressful, and may impart additional risks to the young person's health. However, in the Republic of Ireland, which has the highest incidence of CF in the world, the current services provided for children during this transitional period are still reported as underdeveloped. The aim of the author's research was to explore and understand the experience of young people before and after their transitional care, and the factors that both contribute to and hinder that experience. A qualitative approach guided by phenomenological tradition, and using in-depth interviews. The findings suggest that there are a range of needs required for patients during this transitional period, including the need for information, interventions that decrease the negative feelings associated with transition (e.g. distress, anxiety, uncertainty), structured service, and an approach to care that focuses on young adults. The author concludes that health professionals in the clinical setting who have responsibility for young adults in transitional care should focus on these needs to provide a more relevant and effective transition service.

  11. Assisting the Adult with a Respiratory Condition: Pharmacology. Care of the Adult.

    ERIC Educational Resources Information Center

    Anoka-Hennepin Area Vocational Technical Inst., MN.

    These two units for students in a practical nursing program provide supplemental instruction, with a focus on pharmacology, in caring for adult patients with a respiratory condition. Unit titles are Antibiotics, and Drugs that Affect the Respiratory System. Each unit contains the following: objectives, an introduction, and five to nine learning…

  12. 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

  13. Virtual Visits in Home Health Care for Older Adults

    PubMed Central

    Husebø, Anne Marie Lunde

    2014-01-01

    Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home. PMID:25506616

  14. Collaborative Care for Older Adults (COCOA), Palmer College of Chiropractic.

    PubMed

    Goertz, Christine; Lyons, Stacie Salsbury; Andresen, Andrew; Hondras, Maria; Jones, Mark; Killinger, Lisa Zaynab; Long, Cynthia; Lyons, Kevin; Mulhausen, Paul; Vining, Robert

    2010-01-01

    Integrative medicine (IM) is a subset of interprofessional health care that seeks to join the knowledge and practices of various allopathic and complementary and alternative medicine disciplines in an attempt to offer cost-effective and clinically significant healthcare options for persons with acute or chronic illnesses. Although touted as a means for improving health outcomes and patient satisfaction while possibly lowering costs, further scientific evidence regarding the utility of IM approaches to health services delivery is needed. Collaborative Care for Older Adults (COCOA) is a chiropractic demonstration project that brings together an interdisciplinary team of researchers and clinicians from the Palmer Center for Chiropractic Research, Genesis Quad Cities Family Practice Residency, The University of Iowa, and Thomas Jefferson University to study the impact of a model of interprofessional education on geriatric health care. The Health Resources and Services Administration funded COCOA in 2009 to further develop and assess a patient-centered care model for the treatment of low back pain in older adults that uses a team-based approach between medical doctors and doctors of chiropractic.

  15. Predicting Homelessness among Emerging Adults Aging Out of Foster Care.

    PubMed

    Shah, Melissa Ford; Liu, Qinghua; Mark Eddy, J; Barkan, Susan; Marshall, David; Mancuso, David; Lucenko, Barbara; Huber, Alice

    2016-11-10

    This study examines risk and protective factors associated with experiencing homelessness in the year after "aging out" of foster care. Using a state-level integrated administrative database, we identified 1,202 emerging adults in Washington State who exited foster care between July 2010 and June 2012. Initial bivariate analyses were conducted to assess the association between candidate predictive factors and an indicator of homelessness in a 12-month follow-up period. After deploying a stepwise regression process, the final logistic regression model included 15 predictive factors. Youth who were parents, who had recently experienced housing instability, or who were African American had approximately twice the odds of experiencing homelessness in the year after exiting foster care. In addition, youth who had experienced disrupted adoptions, had multiple foster care placements (especially in congregate care settings), or had been involved with the juvenile justice system were more likely to become homeless. In contrast, youth were less likely to experience homelessness if they had ever been placed with a relative while in foster care or had a high cumulative grade point average relative to their peers.

  16. Use of Adult Day Care Centers: Do They Offset Utilization of Health Care Services?

    ERIC Educational Resources Information Center

    Iecovich, Esther; Biderman, Aya

    2013-01-01

    Purpose: Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital admissions, length of hospitalizations, and visits to…

  17. The effects of larval nutrition on reproductive performance in a food-limited adult environment.

    PubMed

    Dmitriew, Caitlin; Rowe, Locke

    2011-03-30

    It is often assumed that larval food stress reduces lifetime fitness regardless of the conditions subsequently faced by adults. However, according to the environment-matching hypothesis, a plastic developmental response to poor nutrition results in an adult phenotype that is better adapted to restricted food conditions than one having developed in high food conditions. Such a strategy might evolve when current conditions are a reliable predictor of future conditions. To test this hypothesis, we assessed the effects of larval food conditions (low, improving and high food) on reproductive fitness in both low and high food adults environments. Contrary to this hypothesis, we found no evidence that food restriction in larval ladybird beetles produced adults that were better suited to continuing food stress. In fact, reproductive rate was invariably lower in females that were reared at low food, regardless of whether adults were well fed or food stressed. Juveniles that encountered improving conditions during the larval stage compensated for delayed growth by accelerating subsequent growth, and thus showed no evidence of a reduced reproductive rate. However, these same individuals lost more mass during the period of starvation in adults, which indicates that accelerated growth results in an increased risk of starvation during subsequent periods of food stress.

  18. Rehospitalization of Older Adults Discharged to Home Hospice Care

    PubMed Central

    Goldenheim, Anna; Oates, Daniel; Parker, Victoria; Russell, Matthew; Winter, Michael

    2014-01-01

    Abstract Background: Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals. Objective: To identify factors associated with 30-day readmission among older adults newly discharged to hospice. Design/Subjects: Medical record review of 59 patients, 19 readmitted within 30 days and 40 randomly selected controls not readmitted, from 206 patients newly discharged to home hospice care between February 1, 2005 and January 31, 2010. Measures/Analysis: Information was collected about hospital course, end-of-life planning, and posthospitalization follow-up. We calculated bivariate associations and developed a Cox Proportional Hazards model examining the relation between index admission characteristics and readmission. Results: Patients' mean age was 79.7±8.4; 74.6% were female; 52.5% were black. Among those readmitted, 25% had received a palliative care consultation, compared to 47.1% of those not readmitted (p=0.06). Patients without a participating decision-maker involved in their hospice decision had 3.5 times the risk of readmission within 30 days, compared to those with (hazard ratio [HR] 3.53, confidence interval [CI] 0.97, 12.82). Patients who had one or more telephone contacts with their primary care physician (PCP) during week 1 after discharge had 2.4 times the readmission risk within 30 days, compared to patients with no such contacts during this period (HR 2.35, CI 0.9, 6.1). Conclusions: Readmission within 30 days of initial discharge to hospice is associated with several measures of care and care planning. Further study of these measures may identify opportunities for interventions to improve the hospital-to-hospice transition and to decrease hospital readmissions. PMID:24708490

  19. Food Avoidance and Food Modification Practices due to Oral Health Problems Linked to the Dietary Quality of Older Adults

    PubMed Central

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

    2011-01-01

    OBJECTIVES 1) quantify the association between food avoidance and modification due to oral health problems; 2) quantify the relationship between these nutritional self-management strategies and dietary quality; and 3) determine foods associated with these self-management strategies. DESIGN Cross-sectional SETTING Rural North Carolina PARTICIPANTS Six hundred thirty-five community-dwelling adults aged 60 years and older. MEASUREMENTS Demographic and food frequency data and oral health assessments were obtained during home visits. Avoidance (none, 1–2 foods, 3–14 foods) and modification (0–3 foods, 4–5 foods) was assessed for foods representing oral health challenges. Food frequency data were converted into Healthy Eating Index-2005 (HEI-2005) scores. Linear regression models tested the significance of associations between HEI-2005 measures and food avoidance and modification. RESULTS Thirty-five percent of the sample avoided 3–14 foods and 28% modified 4–5 foods. After adjusting for age, sex, ethnicity, poverty, education, and tooth loss, the total HEI-2005 score was lower (P<0.001) for persons avoiding more foods and higher for persons modifying more foods (P<0.001). Those avoiding 3–14 foods consumed more saturated fat and energy from solid fat and added sugar and lower intake of non-hydrogenated fats than those avoiding <3 foods. Those who modified 4–5 foods consumed less saturated fat and solid fat and added sugar but more total grains than those modifying <4 foods. CONCLUSION Food avoidance and modification due to oral health problems are associated with significant differences in dietary quality. Approaches to minimize food avoidance and promote food modification by persons having eating difficulties due to oral health conditions are needed. PMID:20533966

  20. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

    PubMed Central

    Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M

    2015-01-01

    Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears. PMID:25750863

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  3. 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…

  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. 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.

  6. Disabled adults in adult care facilities facing disasters in New York City: an aggregate assessment.

    PubMed

    Maja-Schultz, Theresa; Swain, Bara

    2012-01-01

    Disabled adults who reside in adult care facilities (ACFs) are an at-risk population in the event of an emergency or disaster. This aggregate requires housing in congregate residential settings due to frailty, function, and/or cognitive impairments. All senior residents need long-term assistance to maintain maximum independence, including 24-hr on-site monitoring, case management, and personal care services such as eating, toileting, transferring, bathing, and dressing. Twenty-five percent of this special population of older adults has psychiatric disabilities and nonmental health comorbidities (Caron et al, 2008). Through a literature search, the challenges and risks of this aggregate in the event of a naturally occurring or manmade emergency, including epidemiological and environmental risks, are identified. Evidence-based literature reveals that the foundation of an effective emergency response and recovery is planning and preparation. Lessons learned from past disasters in the United States have brought attention to the needs of disabled and chronically ill older adults. Developing partnerships, improving communication systems, identifying emergency shelters for disabled adults, and empowering ACF residents and staff through education are recommended with the universal goal of reducing injury, preventing or controlling illness, and saving lives. An innovative educational program utilizing Hybrid Modality is outlined in this article including planning, coalition building, and the use of mapping systems as tools and strategies to improve outcomes. Resources such as local, state, and federal agencies; consumer groups; and trade associations are referenced for accessibility.

  7. 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.

  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.

  9. Nurses' and care workers' attitudes toward death and caring for dying older adults in Japan.

    PubMed

    Matsui, Miho; Braun, Kathryn

    2010-12-01

    Registered nurses (RNs) and care workers (CWs) have important roles in providing end-of-life care to older adults, but little is known about the attitudes of RNs and CWs in Japan. In this study, 464 RNs and CWs working in facilities in Japan were asked to complete a self-administered questionnaire that included the Frommelt Attitude Toward Care of the Dying Scale, Form B, Japanese version (FATCOD-Form B-J) and the Death Attitude Profile (DAP), Japanese version. A total of 388 (83.6%) questionnaires were returned, and 367 (79.1%) were fully completed. The final sample included 190 RNs and 177 CWs. Multiple regression analysis showed that better attitudes toward caring for the dying were positively associated with seminar attendance and negatively associated with fear of death.

  10. Food Safety Knowledge and Practices among Older Adults: Identifying Causes and Solutions for Risky Behaviors.

    PubMed

    Cates, Sheryl C; Kosa, Katherine M; Karns, Shawn; Godwin, Sandria L; Speller-Henderson, Leslie; Harrison, Robert; Ann Draughon, F

    2009-04-01

    Adults aged 60 years and older are more likely than younger adults to experience complications, hospitalization, and death because of food-borne infections. Recognizing this risk, we conducted a nationally representative survey (n = 1,140) to characterize older adults' food safety knowledge, attitudes, and practices as well as the demographic characteristics of older adults with risky food handling practices. The survey was conducted using a Web-enabled panel. We found that although older adults consider themselves to be knowledgeable about food safety, many are not following recommended food safety practices. Areas for improvement include the following: reheating deli meats to steaming hot, not eating store-bought deli salads, cooking eggs properly, monitoring refrigerator temperature using a thermometer, using a food thermometer to check doneness of meat/poultry/egg dishes, and storing leftovers properly. The survey results also suggest that food safety education targeting older adults is needed and that such initiatives should emphasize practices to prevent listeriosis, a potentially fatal illness among older adults. Our findings suggest that, in particular, men, individuals with higher incomes, and college-educated individuals would benefit from food safety education.

  11. Optimism and Planning for Future Care Needs among Older Adults

    PubMed Central

    Sörensen, Silvia; Hirsch, Jameson K.; Lyness, Jeffrey M.

    2015-01-01

    Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts. PMID:26045699

  12. Public mental health care utilization by older adults.

    PubMed

    Karlin, Bradley E; Norris, Margaret P

    2006-11-01

    The present study examined the extent to which older adults began public mental health treatment throughout Texas in 1999, the types of services they used, and how they compared on demographic and clinical variables to younger consumers. Notwithstanding recent policy and related developments, older adults were found to use public mental health services at substantially low rates, as in past decades. Significantly, older consumers tended to be relatively healthy and independent. Among younger and, even more so, older consumers, there were relatively high proportions of rural residents and minorities, groups previously found to be unlikely to utilize private mental health services. Overall, the findings urge that greater attention be devoted to public mental health outreach and service delivery with the elderly, and raise the question of what role the public mental health system should have in nursing homes and other long-term care settings.

  13. 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

  14. 77 FR 43229 - Food and Nutrition Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2012 Through June 30, 2013 AGENCY: Food and Nutrition Service... Program Development Branch, Child Nutrition Division, Food and Nutrition Service, U.S. Department...

  15. 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.

  16. Levels of maternal care in dogs affect adult offspring temperament

    PubMed Central

    Foyer, Pernilla; Wilsson, Erik; Jensen, Per

    2016-01-01

    Dog puppies are born in a state of large neural immaturity; therefore, the nervous system is sensitive to environmental influences early in life. In primates and rodents, early experiences, such as maternal care, have been shown to have profound and lasting effects on the later behaviour and physiology of offspring. We hypothesised that this would also be the case for dogs with important implications for the breeding of working dogs. In the present study, variation in the mother-offspring interactions of German Shepherd dogs within the Swedish breeding program for military working dogs was studied by video recording 22 mothers with their litters during the first three weeks postpartum. The aim was to classify mothers with respect to their level of maternal care and to investigate the effect of this care on pup behaviour in a standardised temperament test carried out at approximately 18 months of age. The results show that females differed consistently in their level of maternal care, which significantly affected the adult behaviour of the offspring, mainly with respect to behaviours classified as Physical and Social Engagement, as well as Aggression. Taking maternal quality into account in breeding programs may therefore improve the process of selecting working dogs. PMID:26758076

  17. Levels of maternal care in dogs affect adult offspring temperament.

    PubMed

    Foyer, Pernilla; Wilsson, Erik; Jensen, Per

    2016-01-13

    Dog puppies are born in a state of large neural immaturity; therefore, the nervous system is sensitive to environmental influences early in life. In primates and rodents, early experiences, such as maternal care, have been shown to have profound and lasting effects on the later behaviour and physiology of offspring. We hypothesised that this would also be the case for dogs with important implications for the breeding of working dogs. In the present study, variation in the mother-offspring interactions of German Shepherd dogs within the Swedish breeding program for military working dogs was studied by video recording 22 mothers with their litters during the first three weeks postpartum. The aim was to classify mothers with respect to their level of maternal care and to investigate the effect of this care on pup behaviour in a standardised temperament test carried out at approximately 18 months of age. The results show that females differed consistently in their level of maternal care, which significantly affected the adult behaviour of the offspring, mainly with respect to behaviours classified as Physical and Social Engagement, as well as Aggression. Taking maternal quality into account in breeding programs may therefore improve the process of selecting working dogs.

  18. Physical restraints practice in adult intensive care units in Egypt.

    PubMed

    Kandeel, Nahed Attia; Attia, Amal Kadry

    2013-03-01

    Physical restraints are commonly used in intensive care units to reduce the risk of injury and ensure patient safety. However, there is still controversy regarding the practice of physical restraints in such units. The purpose of this study was to investigate the practices of physical restraints among critical care nurses in El-Mansoura City, Egypt. The study involved a convenience sample of 275 critically ill adult patients, and 153 nurses. Data were collected from 11 intensive care units using a "physical restraint observation form" and a "structured questionnaire." The results revealed that physical restraint was commonly used to ensure patient safety. Assessment of physical restraint was mainly restricted to peripheral circulation. The most commonly reported physically restrained site complications included: redness, bruising, swelling, and edema. The results illustrated a lack of documentation on physical restraint and a lack of education of patients and their families about the rationale of physical restraint usage. The study shed light on the need for standard guidelines and policies for physical restraint practices in Egyptian intensive care units.

  19. Levels of maternal care in dogs affect adult offspring temperament

    NASA Astrophysics Data System (ADS)

    Foyer, Pernilla; Wilsson, Erik; Jensen, Per

    2016-01-01

    Dog puppies are born in a state of large neural immaturity; therefore, the nervous system is sensitive to environmental influences early in life. In primates and rodents, early experiences, such as maternal care, have been shown to have profound and lasting effects on the later behaviour and physiology of offspring. We hypothesised that this would also be the case for dogs with important implications for the breeding of working dogs. In the present study, variation in the mother-offspring interactions of German Shepherd dogs within the Swedish breeding program for military working dogs was studied by video recording 22 mothers with their litters during the first three weeks postpartum. The aim was to classify mothers with respect to their level of maternal care and to investigate the effect of this care on pup behaviour in a standardised temperament test carried out at approximately 18 months of age. The results show that females differed consistently in their level of maternal care, which significantly affected the adult behaviour of the offspring, mainly with respect to behaviours classified as Physical and Social Engagement, as well as Aggression. Taking maternal quality into account in breeding programs may therefore improve the process of selecting working dogs.

  20. Integration and continuity of Care in health care network models for frail older adults

    PubMed Central

    Veras, Renato Peixoto; Caldas, Célia Pereira; da Motta, Luciana Branco; de Lima, Kenio Costa; Siqueira, Ricardo Carreño; Rodrigues, Renata Teixeira da Silva Vendas; Santos, Luciana Maria Alves Martins; Guerra, Ana Carolina Lima Cavaletti

    2014-01-01

    A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change. PMID:24897058

  1. Integration and continuity of Care in health care network models for frail older adults.

    PubMed

    Veras, Renato Peixoto; Caldas, Célia Pereira; Motta, Luciana Branco da; Lima, Kenio Costa de; Siqueira, Ricardo Carreño; Rodrigues, Renata Teixeira da Silva Vendas; Santos, Luciana Maria Alves Martins; Guerra, Ana Carolina Lima Cavaletti

    2014-04-01

    A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change.

  2. 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.

  3. 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.

  4. Who Are the Clients?: Goal Displacement in an Adult Care Center for Elders with Dementia

    ERIC Educational Resources Information Center

    Abramson, Corey M.

    2009-01-01

    This ethnographic study of "goal displacement" in an adult day care center explains how and why certain goals come to surpass others in the organizational practices of elder day care settings. Adult day care is often oriented towards providing family caregivers with respite rather than attempting to directly improve the lives of the elders…

  5. 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…

  6. 25 CFR 20.332 - Who can receive Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... own resources; and (b) Does not require intermediate or skilled nursing care. ... 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...

  7. Prevalence of antibiotic resistant bacteria in healthy adults, foods, food animals, and the environment in selected areas in Thailand

    PubMed Central

    Boonyasiri, Adhiratha; Tangkoskul, Teerawit; Seenama, Chrakrapong; Saiyarin, Jatuporn; Tiengrim, Surapee; Thamlikitkul, Visanu

    2014-01-01

    Objectives: The aim of this study was to determine the prevalence of antibiotic-resistant bacteria, especially extended-spectrum beta-lactamase (ESBL) producing Escherichia coli, in samples from healthy adults, foods, food animals, and the environment in selected areas of Thailand. Methods: Samples were collected from stool specimens from adult food factory and food animal farm workers, fresh and cooked foods sold at markets, rectal swabs of healthy pigs and chickens, fresh pork meat from slaughterhouses, water samples from canals as well as fish and shrimp farm ponds, and stagnant water sources on pig farms. Antibiotic susceptibility was determined using the disk diffusion or agar dilution methods. Extended-spectrum beta-lactamase production was assayed using a double disk diffusion method. Results: Among 544 healthy adult food factory workers, 75.5% were positive for ESBL producing E. coli, while 77.3% of E. coli isolated from 30 healthy animal farm workers were positive. Amongst healthy food animals, ESBL producing status among E. coli isolates were more commonly detected in pigs (76.7%) than broilers (40%). Extended-spectrum beta-lactamase producing E. coli seemed to be more prevalent in fresh meat samples than in fresh vegetables, in fresh foods than in cooked foods, and in water samples collected from the animal farms than those from canals and fish and shrimp ponds. Conclusions: Extended-spectrum beta-lactamase producing E. coli isolates are prevalent amongst healthy individuals, foods along the food production chain from farms to consumers, and in the environment in selected areas in Thailand. PMID:25146935

  8. 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.

  9. Local cultural animal food contributes high levels of nutrients for Arctic Canadian Indigenous adults and children.

    PubMed

    Kuhnlein, Harriet V; Receveur, Olivier

    2007-04-01

    Food systems of Canadian Arctic Indigenous Peoples contain many species of traditional animal and plant food, but the extent of use today is limited because purchased food displaces much of the traditional species from the diet. Frequency and 24-h dietary interviews of Arctic adults and children were used to investigate these trends. The most frequently consumed Arctic foods were derived from animals and fish. In adults these foods contributed 6-40% of daily energy of adults. Children ate much less, 0.4-15% of energy, and >40% of their total energy was contributed by "sweet" and "fat" food sources. Nevertheless, for adults and children, even a single portion of local animal or fish food resulted in increased (P < 0.05) levels of energy, protein, vitamin D, vitamin E, riboflavin, vitamin B-6, iron, zinc, copper, magnesium, manganese, phosphorus, and potassium; although children had similar results for these nutrients, they did not reach significance for energy, vitamin D, or manganese. Because market foods are the major source of energy in the Arctic, traditional animal-source foods are extremely important to ensure high dietary quality of both adults and children.

  10. 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

    ... AFFAIRS Agency Information Collection (Food Service and Nutritional Care Analysis) Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Food Service and Nutritional Care Analysis, VA Form 10-5387. OMB Control... determine whether improvements are needed to enhance patient's nutritional therapy. An agency may...

  11. Food fears: a national survey on the attitudes of Australian adults about the safety and quality of food.

    PubMed

    Williams, Peter; Stirling, Emma; Keynes, Nick

    2004-01-01

    A national telephone survey of a representative sample of 1200 Australian adults was conducted in March 2002 in order to identify the factors of greatest concern to consumers in relation to the safety and quality of food, to measure recent trends in views about hazards in the food supply, to explore beliefs about the safety of additives and to discover whether consumers use food labels to check for ingredients of concern. Forty five percent of Australians responded that they were more concerned about the safety and quality of food than they were five years previously, while only 5% were less concerned. The most common potential hazards volunteered were additives and chemical residues (28%), followed by food processing/handling/freshness (21%), food hygiene or contamination (14%), and also genetic modification (14%). More than half of the respondents believe that additives and preservatives are harmful to your health and that many foods contain high levels of pesticides. A greater proportion of consumers claimed to be conscious of checking for additives, either general or specific, on food labels than for information on the salt or sugar content of products. Food regulators, journalists, the food industry and health professionals need to work together to correct misconceptions about the risks to health posed by common food additives and pesticide residues.

  12. 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

  13. Incentivizing health care behaviors in emerging adults: a systematic review

    PubMed Central

    Yu, Catherine H; Guarna, Giuliana; Tsao, Pamela; Jesuthasan, Jude R; Lau, Adrian NC; Siddiqi, Ferhan S; Gilmour, Julie Anne; Ladha, Danyal; Halapy, Henry; Advani, Andrew

    2016-01-01

    Purpose For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases. Methods The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years) with chronic medical conditions including addictions, were included. Results A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated. Conclusion While the majority of studies reported positive outcomes, these studies focused on promoting the cessation of adverse behaviors rather than promoting positive behaviors. In addition, conclusions were limited by the high risk of bias present in the majority of studies, as well as lack of follow-up after the incentive period. Whether behavioral incentives facilitate the adoption of positive health choices in this population remains to be determined. PMID:27069356

  14. Food insecurity and cognitive function in Puerto Rican adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Food insecurity is associated with nutrient inadequacy and a variety of unfavorable health outcomes. However, little is known about whether food security is associated with lower cognitive function in the elderly. We investigated the prevalence of food insecurity in a representative sample of 1358 P...

  15. Keeping Kids Safe: A Guide for Safe Food Handling & Sanitation for Child Care Providers.

    ERIC Educational Resources Information Center

    Food Safety and Inspection Service (USDA), Washington, DC.

    Because children under age 5 are susceptible to food-borne illnesses and children in diapers present special sanitation and health problems, food safety and sanitation are emerging as important issues for child care providers. This booklet is designed to give providers and parents a quick and easy reference for food safety and sanitation. The…

  16. 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

  17. Food prices and fruit and vegetable consumption among young American adults.

    PubMed

    Powell, Lisa M; Zhao, Zhenxiang; Wang, Youfa

    2009-12-01

    Multivariate negative binomial count models were estimated to examine associations between young adults' fruit and vegetable (FV) consumption and the prices of FV, other food at home grocery items, and fast food and the availability of restaurants and food stores. This study used the 2002 wave of data collected from US young adults aged 18-23 years in the 1997 National Longitudinal Survey of Youth merged by geocode identifiers with food prices and restaurant and food store availability. The results showed that higher levels of FV consumption were associated with lower FV prices (price elasticity of -0.32) and that this own-price effect was robust to the inclusion of other food prices and food outlet availability. Lower income and lower educated young adults and those with lower educated mothers and middle-income parents were found to be most price sensitive. No statistically significant cross-price effects on FV consumption were found with other grocery food (meat, dairy and bread) prices or fast food prices. Fiscal policy instruments such as FV subsidies may help to increase FV intake, particularly among young adults of lower socioeconomic status.

  18. [Factors associated with nursing workload in adult intensive care units].

    PubMed

    Gonçalves, Leilane Andrade; Padilha, Kátia Grillo

    2007-12-01

    This study was aimed both at analyzing the nursing workload on the first day of admission of patients in Intensive Care Units (ICUs) and the factors associated with it. This is a qualitative, retrospective, cross-section study that was carried out in April of 2002 and October of 2004. The data were taken from a database that gathered information from 5 ICUs from two private hospitals and the sample was comprised of 214 adult patients that remained in the ICU for at least 24 hours. The total Nursing Activities Score (NAS) average was 69.9%, and the median 68.0%. According to the median, it was verified that 109 (50.9%) individuals required heavy nursing attention and the remaining 105 (49.1%) required less attention. The severity of the illness, the patient's age and the kind of treatment were not factors associated with nursing workload in the first 24 hours at the ICU.

  19. 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.

  20. Food insecurity is inversely associated with diet quality of lower-income adults.

    PubMed

    Leung, Cindy W; Epel, Elissa S; Ritchie, Lorrene D; Crawford, Patricia B; Laraia, Barbara A

    2014-12-01

    Food insecurity acts as a chronic stressor independent of poverty. Food-insecure adults may consume more highly palatable foods as a coping mechanism, leading to poorer diet quality and increased risks of chronic disease over time. Using data from the 1999-2008 National Health and Nutrition Examination Surveys, this study aimed to examine the cross-sectional differences in dietary intake and diet quality by household food security among 8,129 lower-income adults (≤300% of the federal poverty level). Food insecurity was assessed using the 18-item US Household Food Security Survey Module. Dietary intake was assessed from 24-hour recalls and diet quality was measured using the Healthy Eating Index-2005 and the Alternate Healthy Eating Index-2010. Relative mean differences in dietary outcomes by household food security were estimated using linear regression models, adjusting for sociodemographic characteristics. Lower-income food-insecure adults reported higher consumption of some highly palatable foods, including high-fat dairy products (P trend<0.0001) and salty snacks (P trend=0.01) compared with lower-income food-secure adults. Food insecurity was also associated with more sugar-sweetened beverages (P trend=0.003); more red/processed meat (P trend=0.005); more nuts, seeds, and legumes (P trend=0.0006); fewer vegetables (P trend<0.0001); and fewer sweets and bakery desserts (P trend=0.0002). No differences were observed for intakes of total energy and macronutrients. Food insecurity was significantly associated with lower Healthy Eating Index-2005 (P trend<0.0001) and Alternate Healthy Eating Index-2010 scores (P trend<0.0001). Despite no macronutrient differences, food insecurity was associated with characteristics of poor diet quality known to increase chronic disease risk.

  1. Food insecurity and cognitive function in Puerto Rican adults123

    PubMed Central

    Gao, Xiang; Scott, Tammy; Falcon, Luis M; Wilde, Parke E; Tucker, Katherine L

    2009-01-01

    Background: Food insecurity is associated with nutrient inadequacy and a variety of unfavorable health outcomes. However, little is known about whether food security is associated with lower cognitive function in the elderly. Objective: We investigated the prevalence of food insecurity in a representative sample of 1358 Puerto Ricans aged 45–75 y living in Massachusetts in relation to cognitive function performances. Design: Food security was assessed with the US Household Food Security Scale. Cognitive function was measured to capture general cognition with a battery of 7 tests: Mini-Mental State Examination (MMSE), word list learning (verbal memory), digit span (attention), clock drawing and figure copying (visual-spatial ability), and Stroop and verbal fluency tests (fluency executive functioning). Results: The overall prevalence of food insecurity during the past 12 mo was 12.1%; 6.1% of the subjects reported very low food security. Food insecurity was inversely associated with global cognitive performance, as assessed by the MMSE score. The adjusted difference in the MMSE score was −0.90 (95% CI: −1.6, −0.19; P for trend = 0.003) for a comparison of participants with very low food security with those who were food secure, after adjustment for age, smoking, education, poverty status, income, acculturation, plasma homocysteine, alcohol, diabetes, and hypertension. Food insecurity was significantly associated with lower scores for word-list learning, percentage retention, letter fluency, and digit span backward tests. Conclusions: Very low food security was prevalent among the study subjects and was associated with lower cognitive performance. Further studies, both observational and experimental, are warranted to clarify the direction of causality in this association. PMID:19225117

  2. Fight Homemade Poisons: Home Food Care and Preservation.

    ERIC Educational Resources Information Center

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about food poisoning. Using a simplified vocabulary and shorter sentences, it explains the various kinds of food poisoning, how people get food poisoning, and how to prevent it. (FL)

  3. Food Allergies: Being Aware and Planning for Care

    ERIC Educational Resources Information Center

    Graville, Iris

    2010-01-01

    In recent years, parents and early childhood educators have become increasingly aware of food allergies in childhood. And since food allergies account for about 150 deaths a year, there is good reason to be concerned. The early childhood program can provide valuable learning for those without food allergies through explanations about why certain…

  4. 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.

  5. 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.

  6. 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…

  7. 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.

  8. Adolescents and young adults with life-threatening illness: special considerations, transitions in care, and the role of pediatric palliative care.

    PubMed

    Linebarger, Jennifer S; Ajayi, Toluwalase A; Jones, Barbara L

    2014-08-01

    This article will cover the special considerations, challenges, and opportunities presented by caring for adolescents and young adults with life-threatening illnesses when the possibility of transition to an adult care setting arises.

  9. Demographic differences and food patterns associated with metabolic syndrome in young adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Little is known about risk factors for metabolic syndrome (MS) in young adults. Intake was collected on 1,012 young adults (20-38 years) (61% female; 26% black) using a food-frequency questionnaire. Demographics, anthropometrics, blood pressure, insulin sensitivity, and lipid profiles were quantifi...

  10. Invisible Care: Friend and Partner Care Among Older Lesbian, Gay, Bisexual, and Transgender (LGBT) Adults

    PubMed Central

    Shiu, Chengshi; Muraco, Anna; Fredriksen-Goldsen, Karen

    2016-01-01

    Objective Lesbian, gay, bisexual, and transgender (LGBT) older adult caregivers may encounter obstacles in obtaining health and aging services due to discrimination in service and legal systems. The caregiving relationships in LGBT communities also differ from the general population in that friends are providing a large portion of informal care. This article examines how the relational context of caregiving relates to caregiving demands and resources, which in turn, influence perceived stress and depressive symptomatology among older LGBT caregivers. Method Using data from the National Health, Aging, and Sexuality Study: Caring and Aging with Pride, this study examines 451 participants who are providing caregiving to partners and friends. Structural equation modeling was applied to estimate the associations among the caregiver–care recipient relationship and caregiving demands, resources, perceived stress, and depressive symptomatology. Results On average, as compared with those caring for partners, those who provided care to friends reported experiencing lower levels of caregiving demands and lower levels of social support. The lower caregiving demands correlated positively with both lower perceived stress and less severe depressive symptomatology; however, the lower levels of social support were related to higher perceived stress and higher depressive symptomatology. Conclusions Caregiving provided by friends, which has long been under recognized, plays an important role in the LGBT community. Because lower levels of caregiving demands are offset by less social support, LGBT friend-caregivers experience similar levels of perceived stress and depressive symptomatology to those providing care to spouses and partners. Policy and service reforms are needed to better acknowledge the continuum of informal caregiving relationships. PMID:28367277

  11. Australian Adult Consumers' Beliefs about Plant Foods: A Qualitative Study

    ERIC Educational Resources Information Center

    Lea, Emma; Worsley, Anthony; Crawford, David

    2005-01-01

    This exploratory qualitative study examined consumers' perceived barriers and benefits of plant food (fruits, vegetables, grains, legumes, nuts, seeds) consumption and views on the promotion of these foods. Ten focus groups were conducted in Melbourne, Australia. Groups consisted of employees of various workplaces, community group members,…

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

    PubMed

    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.

  13. 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

  14. 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

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

    PubMed Central

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

    2015-01-01

    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

  16. 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.

  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. Effects of food restriction across stages of juvenile and early adult development on body weight, survival and adult life history.

    PubMed

    Wong, J W Y; Kölliker, M

    2014-11-01

    Organisms have to allocate limited resources among multiple life-history traits, which can result in physiological trade-offs, and variation in environmental conditions experienced during ontogeny can influence reproduction later in life. Food restriction may lead to an adaptive reallocation of the limited resources among traits as a phenotypically plastic adjustment, or it can act as an overall constraint with detrimental effects throughout reproductive life. In this study, we investigated experimentally the effects of food restriction during different stages of the juvenile and early adult development on body weight, survival and reproductive success in females and males of the European earwig Forficula auricularia. Individuals either received limited or unlimited access to food across three different stages of development (fully crossed) allowing us to identify sensitive periods during development and to test both additive and interactive effects of food limitation across stages on development and reproduction. Food restriction during the early and late juvenile stage had additive negative effects on juvenile survival and adult body weight. With regard to reproductive success of females which produce up to two clutches in their lifetime, restriction specifically in the late juvenile stage led to smaller first and second clutch size, lower probability of second clutch production and reduced hatching success in the second clutch. Reproductive success of females was not significantly affected when their male mates experienced food restriction during their development. Our findings in general support the 'silver-spoon' hypothesis in that food restriction during juvenile development poses constraints on development and reproduction throughout life.

  19. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  20. 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…

  1. 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.

  2. 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? 20.335 Section 20.335 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.335 What...

  3. In-house pureed food production in long-term care: perspectives of dietary staff and implications for improvement.

    PubMed

    Ilhamto, Nila; Anciado, Katrina; Keller, Heather H; Duizer, Lisa M

    2014-01-01

    Texture modification of foods to a pureed consistency is a common management approach for older adults with dysphagia. Long-term care (LTC) facilities commonly produce some pureed food in-house. This study investigated challenges and preferred practices associated with the production of pureed food in LTC facilities. Nutrition Managers (n = 27) and cooks (n = 26) from 25 Ontario LTC facilities were recruited for one-on-one, semistructured interviews. Interviews were digitally recorded, transcribed, and analyzed using inductive thematic analysis. Four themes arose from the data to exemplify challenges in production, including (a) difficulty in using standardized recipes, (b) varied interpretation of governmental guidelines, (c) lack of consistency in terminology and texture, and (d) wanting to improve the visual appeal. These challenges were reported to reduce the quality of in-house produced pureed food. Preferred practices to overcome these challenges were also provided by participants, such as involving cooks in pureed recipe improvements and tailoring to the specific needs of residents. Incorporation of these practices into pureed food production may help to shape and improve future practice and pureed food products.

  4. Impact of Denture Usage Patterns on Dietary Quality and Food Avoidance among Older Adults

    PubMed Central

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

    2011-01-01

    This study categorizes older adults living in rural areas by denture status, assesses the frequency of wearing dentures during meals, and determines whether denture status or use is associated with dietary quality or the number of foods avoided. A multi-ethnic population-based sample of adults ≥60 years (N=635) in the rural US was interviewed. Survey included denture use, removing dentures before eating, and foods avoided due to oral health problems. Dietary intakes were converted into Healthy Eating Index-2005 scores. Sixty percent wore removable dentures of some type; 55% never, 27% sometimes, and 18% always removed dentures when eating. More frequent removal was associated with lower dietary quality and more foods avoided. Those with severe tooth loss had the lowest dietary quality and avoided the most foods. Many rural older adults wear dentures. Learning how they adapt to denture use will offer insight into their nutritional self-management and help explain differences in dietary quality. PMID:23286643

  5. Congenital causes of neurogenic bladder and the transition to adult care

    PubMed Central

    Loftus, Christopher J.

    2016-01-01

    The population of patients with congenital genitourinary disorders has unique healthcare demands that require an additional interpersonal and medical skillset. Adults with congenital neurogenic bladder may have complex urinary anatomy, abnormal bladder function and atypical voiding mechanisms. While initial surgery and care of these patients is typically managed by a pediatric urologist, growth and development into adulthood necessitates transition of care to an adult care team. Failure of transition to adult care has been demonstrated to result in lower quality healthcare and increased risk of developing preventable complications. PMID:26904411

  6. 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

  7. 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.

  8. [Update on Current Care Guideline: Food allergy (children)].

    PubMed

    Mäkelä, Mika; Jartti, Tuomas; Kolho, Kaija-Leena; Poikonen, Sanna; Remes, Sami; Schwab, Ursula; Sipilä, Raija; Tulonen-Tapio, Johanna; Voutilainen, Helena

    2015-01-01

    This guideline, targeted to healthcare workers dealing with food-allergic children, provides a review on the clinical aspects of pediatric food allergy. The main updates include: elimination diets are not recommended for breast-feeding mothers; probiotics are not recommended for allergy prevention or treatment; food challenges are the basis of the diagnosis, but it can be improved by IgE component diagnostics. The treatment for severe symptoms is specific food avoidance, mildly symptomatic children should continue with versatile diet. Specific oral tolerance induction is a safe and effective treatment in most of the pediatric patients.

  9. Cigarette Smoking Among Socioeconomically Disadvantaged Young Adults in Association With Food Insecurity and Other Factors

    PubMed Central

    Tsoh, Janice Y.

    2016-01-01

    Introduction Low socioeconomic status is associated with high rates of cigarette smoking, and socioeconomic differences in cigarette smoking tend to emerge during young adulthood. To further our understanding of socioeconomic differences in smoking among young adults, we examined correlates of smoking, with attention to multiple socioeconomic indicators that have not been examined in this population. Methods We analyzed data from the 2011–2012 California Health Interview Survey. The analytic sample consisted of young adults aged 18–30 years who were considered socioeconomically disadvantaged as measured by education and poverty. Logistic regression analyses were conducted to examine factors associated with smoking status in this group, and multinomial logistic regression analyses were conducted to examine correlates of smoking frequency. Results In this sample (N = 1,511; 48% female, 66% Hispanic/Latino, 18% non-Hispanic white), 39.7% reported experiencing food insecurity in the past year. Smoking prevalence was significantly higher among young adults who reported being food insecure (26.9%) than among those who reported being food secure (16.4%). Past-year food insecurity was significantly associated with current smoking, independent of sociodemographic characteristics and alcohol use. Specifically, food insecurity was significantly associated with daily but not nondaily smoking. Conclusion Socioeconomically disadvantaged young adults with food insecurity may be considered a high-risk group with respect to cigarette smoking. Efforts to reduce tobacco-related health disparities should address diverse sources of socioeconomic influences, including experiences of food insecurity. PMID:26766849

  10. Basic Evaluation of Gelatinous Fat to Improve Properties of Nursing Care Food.

    PubMed

    Sano, Junya; Noda, Ryuji; Watanabe, Shinji; Aoyama, Toshiaki; Sato, Yukinori; Kayashita, Jun; Muto, Norio

    2015-01-01

    Nursing care food, made smooth and soft by adding a substantial amount of water, has been provided to elderly people who exhibit a decline in chewing and swallowing function. However, this is associated with problems such as an increase in the volume of meals and a decrease in the nutritional value per unit weight, causing malnutrition. To resolve these issues, we aimed to develop gelatinous fat suitable for processing nursing care food. We compared several types of oil and fat including this gelatinous fat using rheology measurement and sensory evaluation. In the measurement of fat alone using a dynamic viscoelastometer, the gelatinous fat had the highest values of storage elastic modulus (G') and loss elastic modulus (G") at the predetermined ranges of temperature and frequency. In the measurement of fat mixed with food using a creep meter, the gelatinous fat showed a significantly lower level of firmness and a higher level of cohesiveness than other types of fat. In the sensory evaluation, food processed with gelatinous fat was evaluated to be better than food processed with no addition or the addition of another type of fat in terms of softness, smoothness, low feeling of residual food, and palatability. These results suggest that the newly developed gelatinous fat is most suitable for nursing care food processing among the types of fat examined. It is expected that nursing care food processed with gelatinous fat can facilitate the consumption of food with high energy and reduce the risk of malnutrition in the elderly.

  11. The Association Between Urinary Benzophenone Concentrations and Personal Care Product Use in Korean Adults.

    PubMed

    Ko, Ahra; Kang, Hui-Seung; Park, Jae-Hong; Kwon, Ji-Eun; Moon, Gui Im; Hwang, Myung-Sil; Hwang, In Gyun

    2016-05-01

    Benzophenone (BP) derivatives are widely used in personal care products (PCPs) for protection from ultraviolet radiation. Because of their broad applications, BP derivatives have been found in various human bodily fluids. In the present study, we investigated the relationship between urinary concentrations of BP derivatives and PCP use in Korean adults. A urinary BP biomonitoring survey was conducted in Korea by the Ministry of Food and Drug Safety in 2014. BP derivatives (BP-1, BP-3, and 4-OH-BP) were measured in urine samples from 168 Korean adults (mean age, 43.2 ± 15.4 years) by high-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry. Information about the use of PCPs in the past 7 days was obtained by direct interviews. The mean levels of BP-1, BP-3, and 4-OH-BP were 0.87, 5.87, and 0.13 ng/g creatinine, respectively. The geometric mean levels of BP-1, BP-3, and 4-OH-BP were significantly higher in female than those in male. The medians of the urinary concentration of BP derivatives were significantly higher among users of the following PCPs than those in non-users; the PCPs included sunscreen, skin care products, functional cosmetics, makeup base, makeup, lip cosmetics, eye cosmetics, color cosmetics, perfume products, and nail products. A regression analysis revealed a significant linear association between urinary BP-3 concentrations and the number of additional cosmetic products used. These findings provide evidence of a positive association between exposure to PCPs and urinary BP derivative concentrations in Korean adults.

  12. Contributors to Adult Sibling Relationships and Intention to Care of Siblings of Individuals with Down Syndrome

    ERIC Educational Resources Information Center

    Cuskelly, Monica

    2016-01-01

    The contribution of childhood sibling relationships to adult sibling relationships and intention to provide care was investigated in a sample in which one member of each dyad had Down syndrome. Thirty-nine adult siblings of an adult with Down syndrome who had participated in a study of sibling relationships in childhood/adolescence provided data…

  13. 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

  14. Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011

    PubMed Central

    2013-01-01

    Objective The retail food environment may be one important determinant of dietary intake. However, limited research focuses on individuals’ food shopping behavior and activity within the retail food environment. This study’s aims were to determine the association between six various dietary indicators and 1) food venue availability; 2) food venue choice and frequency; and 3) availability of healthy food within food venue. Methods In Fall, 2011, a cross-sectional survey was conducted among adults (n=121) age 18 years and over in Lexington, Kentucky. Participants wore a global position system (GPS) data logger for 3-days (2 weekdays and 1 weekend day) to track their daily activity space, which was used to assess food activity space. They completed a survey to assess demographics, food shopping behaviors, and dietary outcomes. Food store audits were conducted using the Nutrition Environment Measurement Survey-Store Rudd (NEMS-S) in stores where respondents reported purchasing food (n=22). Multivariate logistic regression was used to examine associations between six dietary variables with food venue availability within activity space; food venue choice; frequency of shopping; and availability of food within food venue. Results 1) Food venue availability within activity space – no significant associations. 2) Food Venue Choice – Shopping at farmers’ markets or specialty grocery stores reported higher odds of consuming fruits and vegetables (OR 1.60 95% CI [1.21, 2.79]). Frequency of shopping - Shopping at a farmers’ markets and specialty stores at least once a week reported higher odds of consumption of fruits and vegetables (OR 1.55 95% CI [1.08, 2.23]). Yet, shopping frequently at a super market had higher odds of consuming sugar-sweetened beverages (OR 1.39 95% CI [1.03, 1.86]). 3) Availability of food within store – those who shop in supermarkets with high availability of healthy food has lower odds of consuming sugar-sweetened beverages (OR 0.65 95

  15. Household Food Insecurity and Sleep Patterns Among Mexican Adults: Results from ENSANUT-2012.

    PubMed

    Jordan, Monica L; Perez-Escamilla, Rafael; Desai, Mayur M; Shamah-Levy, Teresa

    2016-10-01

    To examine the independent association of household food insecurity with sleep duration and quality in a nationally representative survey of adults in Mexico. The Latin American and Caribbean Food Security Scale was used to categorize households as secure, mild (43.7 %), moderate (19.0 %), or severe (11.8 %). We assessed the association between household food insecurity and self-reported sleep duration and quality among 11,356 adults using weighted multinomial and binomial logistic regression. After adjusting for potential confounders, a significant association was found between severe household food insecurity and getting less than the recommended 7-8 h of sleep [adjusted odds ratio (AOR) =1.83, 95 % confidence interval (CI) =1.37-2.43]. Compared with food-secure households, odds of poor sleep quality increased with level of severity (AOR = 1.27, 95 % CI 1.04-1.56 for mild; AOR = 1.71, 95 % CI 1.36-2.14 for moderate; and AOR = 1.89, 95 % CI 1.45-2.45 for severe household food insecurity). Household food insecurity is associated with inadequate sleep duration and poor sleep quality among Mexican adults. This study underscores the adverse effects of household food insecurity on the well-being of vulnerable populations.

  16. Health reform in Massachusetts increased adult dental care use, particularly among the poor.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2013-09-01

    States frequently expand or limit dental benefits for adults covered by Medicaid. As part of statewide health reform in 2006, Massachusetts expanded dental benefits to all adults ages 19-64 whose annual income was at or below 100 percent of the federal poverty level. We examined the impact of this reform and found that it led to an increase in dental care use among the Massachusetts adult population, driven by gains among poor adults. Compared to the prereform period, dental care use increased by 2.9 percentage points among all nonelderly adults in Massachusetts, relative to all nonelderly adults in eight control states. For poor Massachusetts adults, the effect was larger-an eleven-percentage-point increase in dental care use above the increase among the state's nonpoor residents. The Massachusetts experience provides evidence that providing dental benefits to poor adults through Medicaid can improve dental care access and use. Our results imply that the lack of expanded dental coverage for low-income adults under the Affordable Care Act is a missed opportunity to improve access to oral care.

  17. 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

  18. Registered Nurse Care Coordination: Creating a Preferred Future for Older Adults with Multimorbidity.

    PubMed

    Scholz, Jean; Minaudo, Judith

    2015-09-30

    The concept of care coordination is often touted as the preferred way to streamline care for complex patients. Care coordination is even more popular with the mention of it in the Affordable Care Act of 2010 and with new Medicare payment models. The purpose of this article is to define care coordination, briefly describe trends for older adults and care coordination, and explore roles for registered nurses. We describe elder-appropriate models of care coordination useful for older adults with multimorbidity. A brief exemplar provides an example of evidence-based care coordination services provided by a nursing and social work team, a model supported by recent literature. As a result of this discussion, readers will become informed about possibilities for the future of care delivery and the future of professional nursing practice.

  19. 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.

  20. 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…

  1. Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women's Health.

    ERIC Educational Resources Information Center

    Crabtree, M. Katherine; Stanley, Joan; Werner, Kathryn E.; Schmid, Emily

    This document presents the nurse practitioner primary care competencies that a national panel of representatives of nine national organizations of the five primary care nurse practitioner specialties--adult, family, gerontological, pediatric, and women's health--identified as necessary for entry-level primary care nurse practitioners. Section 1…

  2. Physician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD)

    ERIC Educational Resources Information Center

    Warfield, Marji Erickson; Crossman, Morgan K.; Delahaye, Jennifer; Der Weerd, Emma; Kuhlthau, Karen A.

    2015-01-01

    We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this…

  3. Primary Care for Adults with Down Syndrome: Adherence to Preventive Healthcare Recommendations

    ERIC Educational Resources Information Center

    Jensen, K. M.; Taylor, L. C.; Davis, M. M.

    2013-01-01

    Background: Due to significant medical improvements, persons with Down syndrome now live well into adulthood. Consequently, primary care for adults with Down syndrome needs to incorporate routine care with screening for condition-specific comorbidities. This study seeks to evaluate the adherence of primary care physicians to age- and…

  4. Feeding Infants: A Guide for Use in the Child Care Food Program.

    ERIC Educational Resources Information Center

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

    Developed for use by staff participating in the Child Care Food Program (CCFP), this guide presents information on infant development, infant nutrition, safe food handling, and infant meal pattern requirements. The guide has an easy-to-read reference, covering general feeding issues as well as specifics of the CCFP infant meal pattern. All foods…

  5. Menu Planning, Food Consumption, and Sanitation Practices in Day Care Facilities.

    ERIC Educational Resources Information Center

    Kuratko, Connye N.; Martin, Ruth E.; Lan, William Y.; Chappell, James A.; Ahmad, Mahassen

    2000-01-01

    In 102 day care centers, data were collected on nutritional content of menus, compliance with guidelines, children's food consumption, and safety/sanitation. Although menus exceeded recommended daily allowances, quantities of food were below recommendations. No menu components were consumed by more than 65% of children. Sanitation problems were…

  6. Reconciliation of work and care among lone mothers of adults with intellectual disabilities: the role and limits of care capital.

    PubMed

    Chou, Yueh-Ching; Kröger, Teppo

    2014-07-01

    In this study, the concept of social capital is applied to an exploration of Guanxi (social networking to create good relationships) among working lone mothers of adults with intellectual disabilities (ID) in Taiwan. Using in-depth interviews, this study explores the role of social capital, here referred to as 'care capital', in making it possible for working lone mothers to combine their roles as family carers and workers. Eleven divorced or widowed mothers combining their paid work with long-term care responsibilities were recruited from a survey or through NGOs and were interviewed at their home between October 2008 and July 2010. An interpretative phenomenological approach was adopted for data analysis. The findings revealed that the mothers' care capital was extremely limited and was lost, gained and lost again during their life-cycles of long-term care-giving. Guanxi, especially in relation to their employers, proved to be the sole source of care capital for these mothers, making reconciliation between work and care responsibilities possible. In the absence of formal or informal support, religion and the mother-child relationship seemed also to become a kind of care capital for these lone mothers, helping them to get by with their life-long care responsibilities. For formal social and healthcare services, not just in Taiwan but in every country, it is important to develop support for lone mothers of adults with ID who have long-term care responsibilities and low levels of care capital and thus face care poverty.

  7. Knowledge of Food Production Methods Informs Attitudes toward Food but Not Food Choice in Adults Residing in Socioeconomically Deprived Rural Areas within the United Kingdom

    ERIC Educational Resources Information Center

    Barton, Maria; Kearney, John; Stewart-Knox, Barbara J.

    2011-01-01

    Objective: Understand food choice, from the perspective of people residing in socioeconomically deprived rural neighborhoods. Methods: Focus groups (n = 7) were undertaken within a community setting involving 42 adults (2 males and 40 females) recruited through voluntary action groups. Data were recorded, transcribed verbatim, and content…

  8. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition)

    PubMed Central

    2012-01-01

    Background Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care professionals. We aim to address these challenges by introducing the geriatric care model, based on the chronic care model, and to evaluate its effects on the quality of life of community-dwelling frail older adults. Methods/design In a 2-year stepped-wedge cluster randomised clinical trial with 6-monthly measurements, the chronic care model will be compared with usual care. The trial will be carried out among 35 primary care practices in two regions in the Netherlands. Per region, practices will be randomly allocated to four allocation arms designating the starting point of the intervention. Participants: 1200 community-dwelling older adults aged 65 or over and their primary informal caregivers. Primary care physicians will identify frail individuals based on a composite definition of frailty and a polypharmacy criterion. Final inclusion criterion: scoring 3 or more on a disability case-finding tool. Intervention: Every 6 months patients will receive a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Expert teams will manage and train practice nurses. Patients with complex care needs will be reviewed in interdisciplinary consultations. Evaluation: We will perform an effect evaluation, an economic evaluation, and a process evaluation. Primary outcome is quality of life as measured with the Short Form-12 questionnaire. Effect analyses will be based on the “intention-to-treat” principle, using multilevel regression analysis. Cost measurements will be administered continually during the study period. A cost-effectiveness analysis and cost-utility analysis will be conducted comparing mean total costs to functional status, care needs and QALYs

  9. Transition From Pediatric to Adult Epilepsy Care: A Difficult Process Marked by Medical and Social Crisis

    PubMed Central

    Camfield, Peter; Camfield, Carol; Pohlmann-Eden, Bernd

    2012-01-01

    When epilepsy does not remit in childhood, transition and transfer to adult care is eventually required. Youth must leave the family-centered approach of pediatric care for the individual focus of adult medicine. Evidence from population-based studies indicates that many of those with childhood-onset epilepsy have major social difficulties in adulthood even if their epilepsy has resolved. Epilepsy may have major effects on normal adolescent development, and societal attitudes confound this difficult period in the lives of young people with epilepsy. Very little objective data are available to assist in the designing of models of care for youth with epilepsy; however, based on our clinical experience and the limited available literature, it appears that a transition program to prepare children for adult care is best started during childhood and adolescence. The formal transfer to adult services may be assisted by a transition clinic jointly attended by pediatric and adult epilepsy specialists. PMID:23476118

  10. Food-related advertisements and food intake among adult men and women.

    PubMed

    Wonderlich-Tierney, Anna L; Wenzel, Kevin R; Vander Wal, Jillon S; Wang-Hall, Jennifer

    2013-12-01

    Television viewing may contribute to obesity via promotion of sedentary behavior and exposure to food-related commercials. However, the mechanisms by which food-related commercials promote food intake are not well understood. Therefore, the purpose of the present study was to examine the impact of television advertisements on food intake according to sex and transportability, or the tendency to become engrossed in what one is viewing. Eighty-three undergraduate students, free of disordered eating symptoms, were stratified by sex and randomly assigned to one of three conditions (food-related advertisements, neutral advertisements, or no advertisements). They were then identified as high or low in transportability according to a median split. A significant interaction was found between advertisement condition and transportability such that those high in transportability ate more in the food than other advertisement conditions. A second interaction was found between sex and transportability with women high in transportability eating more food than women low in transportability irrespective of advertisement condition. No significant main effects of advertisement condition, sex, or transportability were found. Results suggest the importance of studying the impact of individual difference variables on the relationship between food-related advertising and food intake.

  11. 77 FR 45717 - Proposed Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... Information Collection (Food Service and Nutritional Care Analysis) Activity; Comment Request AGENCY: Veterans... Service and Nutritional Care Analysis, VA Form 10-5387. OMB Control Number: 2900-0227. Type of Review... improvements are needed to enhance patient's nutritional therapy. Affected Public: Individuals and...

  12. 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.

  13. Transitioning Adolescents and Young Adults With Sickle Cell Disease From Pediatric to Adult Health Care: Provider Perspectives.

    PubMed

    Stollon, Natalie B; Paine, Christine W; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Bonafide, Christopher P; Schwartz, Lisa A

    2015-11-01

    The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method. Our results showed that transition success was measured by health care utilization, quality of life, and continuation on a stable disease trajectory. We also found that barriers to transition include negative experiences in the emergency department, sociodemographic factors, and adolescent skills. Facilitators include a positive relationship with the provider, family support, and developmental maturity. Success in SCD transition is primarily determined by the patients' quality of relationships with their parents and providers and their developmental maturity and skills. Understanding these concepts will aid in the development of future evidence-based transition care models.

  14. Nutrition Education for Preschoolers: A Resource Guide for Use in the Child Care Food Program.

    ERIC Educational Resources Information Center

    Batko, Margaret W.; And Others

    Developed to assist child care providers in starting or maintaining a nutrition education program, this guide lists resources primarily directed toward adults who care for young children (2 to 5 years of age) and toward the children themselves. Over 90 entries concerning nutrition education materials have been included. Each resource has been…

  15. Priorities for young adults when accessing UK primary care: literature review.

    PubMed

    Davey, Antoinette; Carter, Mary; Campbell, John L

    2013-10-01

    This literature review focuses on what matters to young adults when they access primary care services in the United Kingdom. Patients' access to and experience of primary care services differs across age groups. Existing research has largely focused on the needs and experiences of children, adolescents, and adults. There is some evidence to suggest the views of young adults (aged 18-25 years) that may differ from the views of other age groups, and research has not previously reported specifically on the views of this group of the population. The literature was reviewed to identify the views and priorities of young UK adults regarding primary healthcare provision, and furthermore, to identify those related topics that would benefit from further research. Relevant academic publications and grey literature published from 2000 onwards was reviewed and synthesised. We identified and reported emerging themes that were of importance to young adults in respect of the UK primary care provision. A total of 19 papers met our inclusion criteria. Young adults access primary care services less frequently than other age groups; this may be because of their experience of primary care throughout childhood and adolescence. Five aspects of primary care provision emerged as being of importance to young adults--the accessibility and availability of services, the confidentiality of health-related information, issues relating to communication with healthcare professionals, continuity of care, and behaviours and attitudes expressed towards young adults by healthcare professionals. There is a lack of focus of current research on the expectations, needs, and primary healthcare experiences of young adults. Young adults may hold views that are distinct from other age groups. Further research is needed to better understand the needs of a young adult population as their needs may impact the future use of services.

  16. Smaller food item sizes of snack foods influence reduced portions and caloric intake in young adults.

    PubMed

    Marchiori, David; Waroquier, Laurent; Klein, Olivier

    2011-05-01

    Studies considering the impact of food-size variations on consumption have predominantly focused on portion size, whereas very little research has investigated variations in food-item size, especially at snacking occasions, and results have been contradictory. This study evaluated the effect of altering the size of food items (ie, small vs large candies) of equal-size food portions on short-term energy intake while snacking. The study used a between-subjects design (n=33) in a randomized experiment conducted in spring 2008. In a psychology laboratory (separate cubicles), participants (undergraduate psychology students, 29 of 33 female, mean age 20.3±2 years, mean body mass index 21.7±3.7) were offered unlimited consumption of candies while participating in an unrelated computerized experiment. For half of the subjects, items were cut in two to make the small food-item size. Food intake (weight in grams, kilocalories, and number of food items) was examined using analysis of variance. Results showed that decreasing the item size of candies led participants to decrease by half their gram weight intake, resulting in an energy intake decrease of 60 kcal compared to the other group. Appetite ratings and subject and food characteristics had no moderating effect. A cognitive bias could explain why people tend to consider that one unit of food (eg, 10 candies) is the appropriate amount to consume, regardless of the size of the food items in the unit. This study suggests a simple dietary strategy, decreasing food-item size without having to alter the portion size offered, may reduce energy intake at snacking occasions.

  17. Association Between Food Insecurity and Serious Psychological Distress Among Hispanic Adults Living in Poverty

    PubMed Central

    Sis-Medina, Reacheal Connie; Reyes, Alexa; Becerra, Monideepa B.

    2015-01-01

    Introduction Food insecurity has been associated with negative health outcomes, but the relationship between psychological distress and food insecurity among ethnic minorities has not been extensively examined in the literature. The goal of this study was to evaluate whether low food security and very low food security were significantly associated with past month serious psychological distress (SPD) among Hispanic adults living in poverty. Methods We studied 10,966 Hispanic respondents to the California Health Interview Survey for 2007, 2009, and 2011–2012 whose income was below 200% of the federal poverty level. The relationship between food insecurity and SPD was evaluated by using survey-weighted univariate and logistic regression analyses. Results Nearly 30% of the study population had low food security and 13% had very low food security. Low food security and very low food security were associated with 1.99 and 4.43 odds of past month SPD, respectively, and perceived low neighborhood safety was related to 1.47 odds of past month SPD. Conclusions We found that food insecurity was prevalent among Hispanic people living in poverty and was significantly associated with past month SPD. These results demonstrate the need for further targeted public health efforts, such as community gardens led by promotores, faith-based initiatives, and initiatives to reduce barriers to participation in food-assistance programs. PMID:26605706

  18. 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…

  19. Confidentiality Protections for Adolescents and Young Adults in the Health Care Billing and Insurance Claims Process.

    PubMed

    2016-03-01

    The importance of protecting confidential health care for adolescents and young adults is well documented. State and federal confidentiality protections exist for both minors and young adults, although the laws vary among states, particularly for minors. However, such confidentiality is potentially violated by billing practices and in the processing of health insurance claims. To address this problem, policies and procedures should be established so that health care billing and insurance claims processes do not impede the ability of providers to deliver essential health care services on a confidential basis to adolescents and young adults covered as dependents on a family's health insurance plan.

  20. "Quien Sabe Mas Lucha Mejor": Adult Educators' Care of the Self Practices within Social Movements in Buenos Aires, Argentina

    ERIC Educational Resources Information Center

    O'Donnell, Jennifer Lee

    2014-01-01

    This article looks at popular adult educators' care of the self practices within social movements in Buenos Aires, Argentina. It answers the following questions: How is popular adult education practiced amongst educators in social movements? What can studying popular adult educators' care of the self practices offer the field of adult education?…

  1. 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.

  2. 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

  3. 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.

  4. Parental attachment insecurity predicts child and adult high-caloric food consumption.

    PubMed

    Faber, Aida; Dubé, Laurette

    2015-05-01

    Eating habits are established early and are difficult to change once formed. This study investigated the role of caregiver-child attachment quality and its associations with high-caloric food consumption in a sample of middle socio-economic status children and adults, respectively. Survey data were collected from an online questionnaire administered separately to 213 (143 girls) children and 216 parents (adult sample; 180 women). Two studies showed that an insecure parental attachment, whether actual (Study 1; children) or recalled (Study 2; adults), significantly and positively predicted high-caloric food consumption in both samples. The present findings highlight the importance of parental attachment and its association with unhealthy eating patterns in children and adults.

  5. Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

    PubMed

    Jurewicz, Izabela

    2015-04-01

    In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults.

  6. Disposable adult breathing circuits for use with critical care ventilators.

    PubMed

    1994-04-01

    In this issue, we evaluate seven models of disposable breathing circuits from seven manufacturers; the evaluated circuits are intended to be used for adult patients on critical care ventilators. This study is a follow-up to our earlier Evaluation of disposable breathing circuits for use with portable ventilators, published in Health Devices 22(7), July 1993. We based our ratings on the breathing circuits' ability to function properly with minimal intervention from the healthcare provider. We rated only one of the evaluated units Acceptable; this circuit was not likely to interrupt ventilation during normal use (provided that its operation was verified before use). Three of the evaluated breathing circuits were rated Unacceptable because they had disadvantages that were likely to interrupt ventilation during normal use (e.g., a component could accidentally disconnect, the tubing could become kinked or crushed). When such a disadvantage could be compensated for by the healthcare provider, we rated the circuit Conditionally Acceptable: one circuit was rated Conditionally Acceptable; two circuits that had other significant disadvantages were rated Conditionally Acceptable--Not Recommended. We caution readers not to base purchasing decisions on our ratings alone, but on a thorough understanding of the issues surrounding our conclusions, which can be gained by reading this study in its entirety. We offer additional guidance and discuss important selection factors and usage issues in the Selection and Use Guide for Disposable Breathing Circuits included at the end of the Evaluation. Also see "Pre-use Verification of Breathing Circuits" in this issue for step-by-step guidelines to help healthcare providers and caregivers verify proper performance and identify the defective circuits that inevitably reach the clinical setting.

  7. 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

  8. Redesigning Systems of Care for Older Adults with Alzheimer' Disease

    PubMed Central

    Callahan, Christopher M.; Sachs, Greg A.; LaMantia, Michael A.; Unroe, Kathleen T.; Arling, Greg A.; Boustani, Malaz A.

    2017-01-01

    The basic principle of care for patients with Alzheimer's disease is support for a patient-caregiver dyad. Any model of care seeking to improve the quality, efficiency, or cost of care for persons with Alzheimer's disease must attend to this principle. Models of care seeking to support this dyad began with strategies focusing mainly on the family caregiver. These models have grown in complexity to encompass team-based care that seeks to coordinate care across settings and providers of care for a defined population of patients. Most Americans in most communities, however, do not have access to these best practices models. While the effectiveness of new models of care is evidence-based, there are multiple barriers to widespread adoption including workforce limitations and the cost of practice redesign. We review the origins and content of current models and describe early efforts to improve their implementation on a broader scale. PMID:24711324

  9. Food Hypersensitivity in Mexican Adults at 18 to 50 Years of Age: A Questionnaire Survey

    PubMed Central

    Bedolla-Pulido, Tonatiuh Ramses; Camacho-Peña, Alan Salvador; González-García, Estefanía; Morales-Romero, Jaime

    2014-01-01

    Purpose There is limited epidemiological evidence of food hypersensitivity (FH) in the adult population. We aimed to determine the prevalence of FH in Mexican adults, their clinical features and to establish common food involved in its appearance. Methods We designed a cross-sectional study using a fixed quota sampling; 1,126 subjects answered a structured survey to gather information related to FH. Results The prevalence of FH in adults was 16.7% (95% CI, 14.5% to 18.8%), without statistical significant differences related to gender (women, 17.5% and men, 15.9%) or residential location. The most common clinical manifestations in adults with FH were oral allergy syndrome (70 of 1,126) and urticaria (55 of 1,126). According to category, fruits and vegetables were the most frequent foods to trigger FH (6.12%) and were individually related to shrimp (4.0%), and cow milk (1.5%). Adults under age 25 had a higher frequency of FH (OR, 1.39; 95% CI, 1.01 to 1.91, P <0.001). Personal history of any atopic disease was significantly associated with FH (P <0.0001). Conclusions The prevalence of FH is relatively high in Mexican adults, and FH is significantly associated with atopic diseases. PMID:25374750

  10. 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

  11. The Effects of Various Comfort Food on Heart Coherence in Adults

    PubMed Central

    Joseph, Madeline Matar; McIntosh, Mark S.; Joseph, Christine Marie

    2014-01-01

    Background: Some of the nutrients in food are precursors to neurotransmitters, accounting for its effects on mood. Heart coherence (HC), which relates to the optimal psycho-physiological conditions for human body functions, is affected by a person's emotional status. Objectives: (1) To determine the effects of various comfort food on HC and heart rate (HR) in adult females 20 to 50 years of age and (2) to evaluate if body mass index (BMI) has an effect on HC and HR when eating various comfort foods. Methods: The researcher obtained consent from participants after explaining the project. The subjects' height and weight were measured using standardized methods to calculate their BMI. Participants sat in a comfortable chair in a quiet area with a clipped earpiece to measure their heart rate variability (HRV), HR, and HC. Each participant was asked about their favorite comfort food (sweet vs salty). First, the participant imagined eating her favorite comfort food (IFCF) and then was asked to imagine her non-favorite comfort food (INFCF). Finally, the participant ate her favorite comfort food (EFCF) and then ate her non-favorite comfort food (ENFCF). HC scores were recorded in three categories (low, medium, and high) in these four settings. Results: A total of 20 participants completed the study. Paired student's t-tests were used to assess whether the means of the compared groups were statistically different. The data demonstrated that there was a higher HC when participants ate their favorite comfort food than when they ate the non-favorite comfort food (t=−2.912, P<.01) and a higher HC when eating a favorite comfort food than when imaging eating a favorite comfort food (t=−.2408, P<.01). The participants' BMI had a positive correlation between the BMI and low HC (when one increases, the other increases as well) when imagining eating a favorite comfort food (r =.475, P<.05). There was a negative correlation between BMI and medium HC (when one increases, the other

  12. Semantic Provisioning of Children's Food: Commerce, Care and Maternal Practice

    ERIC Educational Resources Information Center

    Cook, Daniel Thomas

    2009-01-01

    Drawing upon in-depth interviews with mothers in the US about feeding their young children, this article examines how consumer culture--broadly construed--constitutes part of the indispensable context of mothering practices. The argument put forward is that mothers not only provide food and sustenance for their children, but necessarily encounter,…

  13. Improving nutritional support for adults in primary and secondary care.

    PubMed

    Cartwright, Andrea

    There has been serious concern about the nutritional care provided in some secondary and primary care settings. As a result, best practice, benchmarking initiatives and nutritional guidance have been issued by government and non-government agencies. This article helps nurses to synthesise these initiatives and improve their knowledge of nutritional care.

  14. Improving supportive and palliative care for adults with cancer.

    PubMed

    Richardson, Alison

    Although many patients with cancer report positively on their experience of care, others claim they are not receiving the information and support they need at different stages of their care pathway. The national cancer patient survey (Department of Health, 2002), for example, showed wide variations in the quality of care delivered across the country.

  15. Contributors to Adult Sibling Relationships and Intention to Care of Siblings of Individuals With Down Syndrome.

    PubMed

    Cuskelly, Monica

    2016-05-01

    The contribution of childhood sibling relationships to adult sibling relationships and intention to provide care was investigated in a sample in which one member of each dyad had Down syndrome. Thirty-nine adult siblings of an adult with Down syndrome who had participated in a study of sibling relationships in childhood/adolescence provided data about the quality of current relationships and of their intention to provide care for their brother/sister with Down syndrome in the future. Only behavior problems in the child with Down syndrome predicted warmth of the current adult relationship. Although adult sibling relationships were reported to be warm, the quality of neither the current nor the past relationship was associated with the reported intention to provide care.

  16. CYCLES OF POVERTY, FOOD INSECURITY, AND PSYCHOSOCIAL STRESS AMONG AIDS CARE VOLUNTEERS IN URBAN ETHIOPIA

    PubMed Central

    Maes, Kenneth; Shifferaw, Selamawit

    2013-01-01

    With the rollout of AIDS therapies, volunteer AIDS care has been promoted across Africa under the assumption that volunteerism is economically imperative in settings of health professional and resource scarcity. As low-income volunteers have become a major part of HIV/AIDS prevention and treatment workforces, it is imperative to question how poverty impacts their well-being. This chapter presents epidemiologic data collected during the 2008 food crisis from a sample of 110 AIDS care volunteers in Addis Ababa, Ethiopia, as well as narratives offered by HIV-positive volunteers, highlighting a widely overlooked way in which food insecurity and mental distress impact efforts to treat AIDS in sub-Saharan Africa. Food insecurity and elevated common mental disorder (CMD) symptom loads were common and tightly linked among the volunteers in the sample. Volunteers who were HIV-positive (17 percent) fared slightly worse in terms of food insecurity and psychosocial well-being. However, positive HIV serostatus was not associated with CMD in multivariate analyses accounting for food insecurity. Narratives illustrate how being HIV-positive shaped experiences of psychosocial stress, which involved unemployment and lack of prospects for marital relationships or strife within them. Our focus demonstrates the potential for mixing ethnographic and epidemiological methods to inform policy questions regarding poverty-reduction through compensation for volunteers’ valuable labor, as well as AIDS care program sustainability. [volunteerism, AIDS care, food insecurity, livelihoods, HIV, psychosocial health] PMID:24077603

  17. 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.

  18. Is older adult care mediated by caregivers’ cultural stereotypes? The role of competence and warmth attribution

    PubMed Central

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    Purpose 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. Methods 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. Results 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. Conclusion 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. PMID:27217736

  19. Does the U.S. Food Stamp Program contribute to adult weight gain?

    PubMed

    Zagorsky, Jay L; Smith, Patricia K

    2009-07-01

    Obesity poses substantial costs both to the individual and society, mainly through its impact on health and labor productivity. Because obesity is more prevalent among the poor some have raised concerns that food assistance programs may encourage excess weight. This paper investigates whether the U.S. Food Stamp Program contributes to adult participants' weight as measured by body mass index (BMI). Results suggest that the typical female food stamp participant's BMI is indeed more than 1 unit higher than someone with the same socioeconomic characteristics who is not in the program. For the average American woman, who is 5 ft 4 in. (1.63 m) tall, this means an increase in weight of 5.8 pounds (2.6 kg). While this association does not prove that the Food Stamp Program causes weight gain, it does suggest that program changes to encourage the consumption of high-nutrient, low-calorie foods should be considered.

  20. Content Analysis of Food and Beverages Advertisements Targeting Children and Adults on Television in Sri Lanka

    PubMed Central

    Prathapan, Shamini; Wijewardena, Kumudu; Low, Wah Yun

    2016-01-01

    Introduction Food marketing is one of the main factors in the increase in childhood obesity. The objective is to compare the strategies used for promotion of food and beverages advertisements on Sri Lankan television for children and adults. Method Among 16 analog television channels in Sri Lanka, 50% of the channels were selected randomly after stratifying according to language. Recording was during weekdays and weekends. In total, 95 different food and beverages advertisements were analyzed irrespective of the channel. Results Among all food and beverages–related advertisements, 78% were child focused, and among these 74% claimed health benefits. A statistically significant difference was found in terms of implications related to nutrition or health (P < .05). None of the advertisements contained disclaimers. Conclusion and recommendations The Ministry of Health needs to pursue all food and beverages–focused advertisements for policy formulation and implementation. PMID:26658325

  1. 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.

  2. A Preliminary Study of Self-Reported Food Selectivity in Adolescents and Young Adults with Autism Spectrum Disorder

    PubMed Central

    Kuschner, Emily S.; Eisenberg, Ian W.; Orionzi, Bako; Simmons, W. Kyle; Kenworthy, Lauren; Martin, Alex; Wallace, Gregory L.

    2015-01-01

    Although it is well-established that picky eating is a common feature of early development in autism spectrum disorder (ASD), far less is known about food selectivity during adolescence and adulthood. Using portions of the Adult/Adolescent Sensory Profile, food selectivity self-ratings were obtained from 65 high-functioning adolescents/young adults with ASD and compared to those of 59 typically developing controls matched on age, IQ, and sex ratio. Individuals with ASD reported preferring familiar foods (food neophobia) and disliking foods with particular textures and strong flavors. Providing linkage to everyday behavior, parent ratings of daily living skills were lower among individuals with ASD and food neophobia than among those without food neophobia. Food selectivity continues to be an important issue for adolescents/young adults with ASD. PMID:26309446

  3. Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care

    PubMed Central

    Yoo, Han-Wook

    2017-01-01

    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. PMID:28289431

  4. Differences in Dietary Preferences, Personality and Mental Health in Australian Adults with and without Food Addiction

    PubMed Central

    Burrows, Tracy; Hides, Leanne; Brown, Robyn; Dayas, Christopher V; Kay-Lambkin, Frances

    2017-01-01

    Increased obesity rates, an evolving food supply and the overconsumption of energy dense foods has led to an increase in research exploring addictive eating behaviours. This study aimed to investigate food addiction in a sample of Australian adults using the revised Yale Food Addiction Survey (YFAS) 2.0 tool and how it is associated with dietary intake, personality traits and mental health issues. Australian adults were invited to complete an online survey that collected information including: demographics, dietary intake, depression, anxiety, stress and personality dimensions including impulsivity, sensation seeking, hopelessness and anxiety sensitivity. A total of 1344 individuals were recruited with the samples comprising 75.7% female, mean age 39.8 ± 13.1 years (range 18–91 years) and body mass index BMI 27.7 ± 9.5. Food addiction was identified in 22.2% of participants using the YFAS 2.0 tool, which classified the severity of food addiction as “mild” in 0.7% of cases, “moderate” in 2.6% and “severe” in 18.9% of cases. Predictors of severe food addiction were female gender (odds ratio (OR) 3.65 95% CI 1.86–7.11) and higher levels of soft drink OR 1.36 (1.07–1.72), confectionary consumption and anxiety sensitivity 1.16 (1.07–1.26). Overall people with “severe” (OR 13.2, 5.8–29.8) or extremely severe depressive symptoms (OR 15.6, range 7.1–34.3) had the highest odds of having severe food addiction. The only variable that reduced the odds of having severe food addiction was vegetable intake. The current study highlights that addictive food behaviours are associated with a complex pattern of poor dietary choices and a clustering with mental health issues, particularly depression. PMID:28294965

  5. ABUSE VICTIMIZATION IN CHILDHOOD OR ADOLESCENCE AND RISK OF FOOD ADDICTION IN ADULT WOMEN

    PubMed Central

    Flint, Alan J.; Field, Alison E.; Austin, S. Bryn; Rich-Edwards, Janet W.

    2013-01-01

    Objective Child abuse appears to increase obesity risk in adulthood, but the mechanisms are unclear. This study examined the association between child abuse victimization and food addiction, a measure of stress-related overeating, in 57,321 adult participants in the Nurses’ Health Study II (NHSII). Design and Methods The NHSII ascertained physical and sexual child abuse histories in 2001 and current food addiction in 2009. Food addiction was defined as ≥3 clinically significant symptoms on a modified version of the Yale Food Addiction Scale. Confounder-adjusted risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression. Results Over eight percent of the sample reported severe physical abuse in childhood, while 5.3% reported severe sexual abuse. Eight percent met the criteria for food addiction. Women with food addiction were 6 units of BMI heavier than women without food addiction. Severe physical and severe sexual abuse were associated with roughly 90% increases in food addiction risk (physical abuse RR=1.92; 95% CI: 1.76, 2.09; sexual abuse RR=1.87; 95% CI: 1.69, 2.05). The RR for combined severe physical abuse and sexual abuse was 2.40 (95% CI: 2.16, 2.67). Conclusions A history of child abuse is strongly associated with food addiction in this population. PMID:23637085

  6. Pathways of Adult Children Providing Care to Older Parents

    ERIC Educational Resources Information Center

    Barnett, Amanda E.

    2013-01-01

    Guided by life course and stress process theory, this study investigated pathways of adult child caregivers' family (caregiving, marital, parenting) and nonfamily (employment) roles. Eight waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers. Latent class analysis provided strong evidence for a 4-class…

  7. Making Work Fit Care: Reconciliation Strategies Used by Working Mothers of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Fu, Li-yeh; Chang, Heng-Hao

    2013-01-01

    Background: This study explored the experiences of working mothers with an adult child with intellectual disabilities to understand how they reconcile paid work and care responsibilities. Methods: Fifteen working mothers in Taiwan with an adult child with intellectual disabilities were interviewed, and an interpretative phenomenological approach…

  8. The Productive Employment of Older Adults in Child Care. Practitioner's Manual.

    ERIC Educational Resources Information Center

    Newman, Sally M.; Vander Ven, Karen; Ward, Christopher R.

    As the American population ages, society has grown more concerned about using older adults' skills and experience so they remain active, contributing members. Noting that work in child care for appropriate older adults is both natural and timely, this manual provides practical, concrete steps for implementing the guidelines of the Productive…

  9. Literacy Conversations between Adults and Children at Child Care: Descriptive Observations and Hypotheses.

    ERIC Educational Resources Information Center

    Rosemary, Catherine A.; Roskos, Kathleen A.

    2002-01-01

    Examined the nature of literacy-related, teacher-child talk in the daily routines of three child care centers. Found that adults talked about reading and writing to a modest degree, compared to total talk with children. Incidence of adults' literacy talk, aside from book talk, was primarily intermittent and spontaneous. Discourse features of…

  10. Quality Outcomes in Group Home Dementia Care for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Janicki, M. P.

    2011-01-01

    Background: Dementia, as a public health challenge, is a phenomenon vexing many care organisations providing specialised residential and family supports for older adults with intellectual disabilities. With increasing survivorship to ages when risk is greatest, expectations are that many more adults in service will present with cognitive decline…

  11. The plastic fly: the effect of sustained fluctuations in adult food supply on life-history traits.

    PubMed

    van den Heuvel, J; Zandveld, J; Mulder, M; Brakefield, P M; Kirkwood, T B L; Shanley, D P; Zwaan, B J

    2014-11-01

    Many adult traits in Drosophila melanogaster show phenotypic plasticity, and the effects of diet on traits such as lifespan and reproduction are well explored. Although plasticity in response to food is still present in older flies, it is unknown how sustained environmental variation affects life-history traits. Here, we explore how such life-long fluctuations of food supply affect weight and survival in groups of flies and affect weight, survival and reproduction in individual flies. In both experiments, we kept adults on constant high or low food and compared these to flies that experienced fluctuations of food either once or twice a week. For these 'yoyo' groups, the initial food level and the duration of the dietary variation differed during adulthood, creating four 'yoyo' fly groups. In groups of flies, survival and weight were affected by adult food. However, for individuals, survival and reproduction, but not weight, were affected by adult food, indicating that single and group housing of female flies affects life-history trajectories. Remarkably, both the manner and extent to which life-history traits varied in relation to food depended on whether flies initially experienced high or low food after eclosion. We therefore conclude that the expression of life-history traits in adult life is affected not only by adult plasticity, but also by early adult life experiences. This is an important but often overlooked factor in studies of life-history evolution and may explain variation in life-history experiments.

  12. Adult Education and Palliative Care: The Last Journey of Life and Two Main Kinds of Adult Learning.

    ERIC Educational Resources Information Center

    Elsey, Barry

    1996-01-01

    As a voluntary learning movement, adult education finds expression through a search for values. Continuing and community education provide support for both hospice and palliative care workers as well as families and friends of terminally ill persons in dealing with death and dying. (SK)

  13. A Reason, a Season, or a Lifetime: "Relational Permanence among Young Adults with Foster Care Backgrounds"

    ERIC Educational Resources Information Center

    Samuels, Gina Miranda

    2008-01-01

    The phenomenon called "aging out" includes approximately 20,000 young people who enter adulthood directly from foster care each year (U.S. Department of Health and Human Services, 2005). The number of youth and young adults who aged out of care in the U.S. in 2005, the year for which the most current statistics are available, increased 48 percent…

  14. Pilot Investigation of the Effectiveness of Respite Care for Carers of an Adult with Mental Illness

    ERIC Educational Resources Information Center

    Jardim, Claudia; Pakenham, Kenneth I.

    2009-01-01

    Informal carers of an adult with mental illness have asked that respite care be an integral component of mental health service provision. The present study involved a pilot investigation of the effectiveness of accessing respite care for carers of individuals with a mental illness. It was hypothesised that compared to carers who have not accessed…

  15. Older Parents Providing Child Care for Adult Children: Does It Pay Off?

    ERIC Educational Resources Information Center

    Geurts, Teun; Poortman, Anne-Rigt; van Tilburg, Theo G.

    2012-01-01

    This study examined whether past grandparental child care is related to present support from adult children. On the basis of social exchange theory, the authors expected that grandparental child care creates a debt that is repaid in the form of receiving support later in life. Using data from the Longitudinal Aging Study Amsterdam (N = 349…

  16. Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

    ERIC Educational Resources Information Center

    Tucker, Larry A.; Clegg, Alan G.

    2002-01-01

    Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

  17. "Our" food versus "my" food. Investigating the relation between childhood shared food practices and adult prosocial behavior in Belgium.

    PubMed

    De Backer, Charlotte J S; Fisher, Maryanne L; Poels, Karolien; Ponnet, Koen

    2015-01-01

    This study focuses on the connection between prosocial behavior, defined as acting in ways that benefit others, and shared meals, defined as meals that consist of food(s) shared with others. In contrast to individual meals, where consumers eat their own food and perhaps take a sample of someone else's dish as a taste, shared meals are essentially about sharing all the food with all individuals. Consequently, these meals create situations where consumers are confronted with issues of fairness and respect. One should not be greedy and consume most of a dish; instead, rules of polite food sharing need to be obeyed. It is therefore proposed that those who have often engaged in shared meals during childhood will have a more prosocial personality, as compared to those who less often took part in shared meals during childhood. To test this hypothesis, data about frequency of shared meals during childhood and altruistic personality in early adulthood were collected using a cross-sectional survey in Belgium (n = 487). Results confirm that higher levels of shared meal consumption correspond to higher scores on the self-report altruism scale among students.

  18. 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

  19. Exploring the factor structure of the Food Cravings Questionnaire-Trait in Cuban adults.

    PubMed

    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.

  20. 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

  1. Enhancing Primary Health Care Services for Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Melville, C. A.; Finlayson, J.; Cooper, S.-A.; Allan, L.; Robinson, N.; Burns, E.; Martin, G.; Morrison, J.

    2005-01-01

    Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training…

  2. Environmental factors associated with primary care access among urban older adults.

    PubMed

    Ryvicker, Miriam; Gallo, William T; Fahs, Marianne C

    2012-09-01

    Disparities in primary care access and quality impede optimal chronic illness prevention and management for older adults. Although research has shown associations between neighborhood attributes and health, little is known about how these factors - in particular, the primary care infrastructure - inform older adults' primary care use. Using geographic data on primary care physician supply and surveys from 1260 senior center attendees in New York City, we examined factors that facilitate and hinder primary care use for individuals living in service areas with different supply levels. Supply quartiles varied in primary care use (visit within the past 12 months), racial and socio-economic composition, and perceived neighborhood safety and social cohesion. Primary care use did not differ significantly after controlling for compositional factors. Individuals who used a community clinic or hospital outpatient department for most of their care were less likely to have had a primary care visit than those who used a private doctor's office. Stratified multivariate models showed that within the lowest-supply quartile, public transit users had a higher odds of primary care use than non-transit users. Moreover, a higher score on the perceived neighborhood social cohesion scale was associated with a higher odds of primary care use. Within the second-lowest quartile, nonwhites had a lower odds of primary care use compared to whites. Different patterns of disadvantage in primary care access exist that may be associated with - but not fully explained by - local primary care supply. In lower-supply areas, racial disparities and inadequate primary care infrastructure hinder access to care. However, accessibility and elder-friendliness of public transit, as well as efforts to improve social cohesion and support, may facilitate primary care access for individuals living in low-supply areas.

  3. Guideline for primary care management of headache in adults

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. Quality of evidence A comprehensive search was conducted for relevant guidelines and systematic reviews published between January 2000 and May 2011. The guidelines were critically appraised using the AGREE (Appraisal of Guidelines for Research and Evaluation) tool, and the 6 highest-quality guidelines were used as seed guidelines for the guideline adaptation process. Main message A multidisciplinary guideline development group of primary care providers and other specialists crafted 91 specific recommendations using a consensus process. The recommendations cover diagnosis, investigation, and management of migraine, tension-type, medication-overuse, and cluster headache. Conclusion A clinical practice guideline for the Canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidence-informed care for patients with headache. PMID:26273080

  4. The evolving paradigm of adult cancer survivor care.

    PubMed

    Grant, Marcia; Economou, Denice

    2008-04-01

    As a result of earlier diagnosis and improved treatment, the number of cancer survivors is steadily increasing, with over 11 million in the US today. These survivors face a multitude of long-term and late effects as a result of their cancer and its treatment. It is increasingly recognized that this group has complex and ongoing needs for medical care education, surveillance, screening, and support. Many organizations have helped to advance survivorship care; key among them are the National Coalition for Cancer Survivorship, the Institute of Medicine, the Lance Armstrong Foundation, and the Office of Cancer Survivorship of the National Cancer Institute. Important reports have defined goals of care; identified interventions to improve outcomes among survivors; and recognized the need for posttreatment surveillance, healthy lifestyle behaviors, and continued research in all of these areas. With these advances, survivorship care is emerging as a distinct component of the continuum of care in oncology.

  5. Food Insecurity and Cost-Related Medication Underuse Among Nonelderly Adults in a Nationally Representative Sample

    PubMed Central

    Afulani, Patience; Coleman-Jensen, Alisha; Harrison, Gail G.

    2015-01-01

    Objectives. We investigated whether nonelderly US adults (aged 18–64 years) in food-insecure households are more likely to report cost-related medication underuse than the food-secure, and whether the relationship between food insecurity and cost-related medication underuse differs by gender, chronic disease, and health insurance status. Methods. We analyzed data from the 2011 and 2012 National Health Interview Survey (n = 67 539). We examined the relationship between food insecurity and cost-related medication underuse with the χ2 test and multivariate logistic regression with interaction terms. Results. Bivariate and multivariate analyses showed a dose–response relationship between food insecurity and cost-related medication underuse, with an increasing likelihood of cost-related medication underuse with increasing severity of food insecurity (P < .001). This association was conditional on health insurance status, but not substantially different by gender or chronic disease status. Being female, low-income, having no or partial health insurance, chronic conditions, functional limitations, or severe mental illness were positively associated with cost-related medication underuse. Conclusions. Using food insecurity as a risk factor to assess cost-related medication underuse could help increase identification of individuals who may need assistance purchasing medications and improve health for those in food-insecure households. PMID:26270308

  6. Nutritional care and support among adults living with HIV at Hawassa Referral Hospital, southern Ethiopia: A qualitative study.

    PubMed

    Tafese, Zelalem; Birhan, Yifru; Abebe, Hiwot

    2013-11-01

    Background Improving nutritional care and support for people living with HIV (PLHIV) is an integral part of comprehensive HIV treatment according to the National Nutritional Strategy of Ethiopia. However, there is no adequate published study that assesses the nutritional care and support services for adult people living with HIV/ AIDS (PLHIV) in this setting. Objective The objective of the study was to identify the existing nutritional care and support services and determine the challenges facing adults living with HIV at Hawassa Referral Hospital in southern Ethiopia. Methods A qualitative study was carried out using focus group discussions (FGDs), in-depth interviews and participant observation. Four FDGs were held and five in-depth interviews were conducted. A two-week participant observation was also conducted by trained nurses. All interviews and FDGs were tape-recorded and transcribed; those conducted in Amharic were translated back to English. Finally thematic analysis of the transcripts was performed. Results Most of the FDG participants were unsatisfied with their nutritional care and support services and expressed difficulty with disclosing their HIV status for fear of stigma and discrimination. The in-depth interviews and participant observation showed results similar to those of the FDG. Some key informants expressed a fear that such poor nutritional care and support may threaten the quality of life of people living with HIV and suggested that all stakeholders work on improving the services. Conclusion Current nutritional care and support services for people living with HIV are not well coordinated. They focus mainly on monthly supplementation of antiretroviral drugs and occasional handouts of food. The need to provide health education on antiretroviral drugs and nutrition, and to emphasise strategies aimed at improving the nutritional status of peoples living with HIV is critical. Furthermore, the study recommended strengthening the initiatives of some

  7. Geriatric simulation: practicing management and leadership in care of the older adult.

    PubMed

    Miller, Sally; Overstreet, Maria

    2015-06-01

    According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS.

  8. Transitioning the Adolescent with IBD from Pediatric to Adult Care: A Review of the Literature

    PubMed Central

    Nguyen, Geoffrey C.

    2015-01-01

    The incidence of inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), has increased in pediatric populations over the last decade. Patients diagnosed during childhood often survive well into adulthood, and therefore their healthcare requires transfer to an adult gastroenterologist, usually at age 18 years. Transition has been defined in the literature as the “purposeful planned movement of adolescents and young adults with chronic conditions from child-centered to adult-oriented health care systems” (Blum et al., 1993). The purpose of this review is to establish the current state of knowledge regarding the transition from pediatric to adult care in IBD. This review highlights that developmentally appropriate transitional care is now recognized as a healthcare priority and thoughtful targeted intervention is needed. PMID:26064100

  9. Model of Care for Adolescents and Young Adults with Cancer: The Youth Project in Milan

    PubMed Central

    Magni, Chiara; Veneroni, Laura; Silva, Matteo; Casanova, Michela; Chiaravalli, Stefano; Massimino, Maura; Clerici, Carlo Alfredo; Ferrari, Andrea

    2016-01-01

    Adolescents and young adults (AYA) with cancer form a particular group of patients with unique characteristics, who inhabit a so-called “no man’s land” between pediatric and adult services. In the last 10 years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed toward patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to AYA with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes. PMID:27606308

  10. Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System

    PubMed Central

    Armstrong, Joshua J.; Sims-Gould, Joanie

    2016-01-01

    Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial. PMID:27904234

  11. Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

    PubMed

    Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

    2016-01-01

    Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

  12. An Update on Geriatric Medication Safety and Challenges Specific to the Care of Older Adults

    PubMed Central

    Koronkowski, Michael; Eisenhower, Christine; Marcum, Zachary

    2016-01-01

    The prescribing of drug therapies in older adults presents a number of safety challenges. The increased complexity of chronic care for older adults has led to polypharmacy and potentially inappropriate medication use, which can contribute to drug-induced diseases, adverse drug reactions, drug interactions, cognitive impairment, falls, hospitalization, and mortality. In this review, the authors discuss recent medication safety literature pertaining to the classes of medications commonly prescribed to older adults: anticholinergics, psychiatric medications, and antibiotics. Safety concerns associated with the use of these medications and the implications for long-term care practitioners are reviewed. The information provided can be used to inform and improve geriatric care delivered by practitioners across health care environments. PMID:27340375

  13. Carers' quality of life and experiences of adult social care support in England.

    PubMed

    Rand, Stacey; Malley, Juliette

    2014-07-01

    Informal carers make a vital contribution to the well-being of the people they care for or look after. Against the policy background in England, the purpose of this study was to explore the views of carers who are in contact with adult social care support services. A qualitative study with 31 carers, who were recruited via local authorities and carers' organisations, was conducted between April and July 2012 to collect data on carers' experiences and perceptions of their quality of life (QoL) with and without adult social care and support for themselves or the person they look after. Through framework analysis, three key themes were identified: (i) definitions of social care services 'for' the carer or 'for' care recipient and social care outcomes; (ii) carers' access to social care services; and (iii) the meaning and value of informal care. We find that carers' QoL is affected by social care support directed at carers and support directed at those they care for, as well as access to services, the experience of stigma in communities, and in how individual needs and preferences are considered when making decisions about care. While there is much to welcome in the direction of policy in England, this study has shown that there are some gaps in thinking around these areas that will need to be addressed if the lives of carers are to be improved.

  14. Health and social care costs for young adults with epilepsy in the UK.

    PubMed

    Beecham, Jennifer; Snell, Tom; Perkins, Margaret; Knapp, Martin

    2010-09-01

    Maintaining contact with services will help improve clinical and social outcomes as children with epilepsy move into their adult lives. This study has collated evidence on the extent to which young adults with epilepsy are supported by health and social care services posttransition, and the costs of such support. UK prevalence and service use data were taken from policy and research literature, as well as national data sets and reports. Costs were attached to these data to arrive at agency and overall total costs. There are approximately 42,000 young adults (18-25 years) with epilepsy costing the UK health and social care budgets 715.3 pound million per annum, on average 17,000 found per young adult with epilepsy. A further 61 pound million falls to the social security budget. Most young adults with epilepsy will rarely use these services, but those with additional health needs have high and often long-term support needs, including supported accommodation and personal care. Current resources used by these young adults are summarised but deficits in service availability can mean long waiting times and sub-optimal treatment. Young adults also want more support to help them take advantage of education and employment opportunities and more information about managing the impacts of epilepsy on their lives. Improving services will cost money, but has the potential to lead to better outcomes for young adults.

  15. Optimizing undergraduate nursing education: demystifying care of older adults in the home setting.

    PubMed

    Neal-Boylan, Leslie

    2006-01-01

    It is a challenge to provide experiences for nursing students that allow them to experience a professional relationship with older adults in the home setting. Home health agencies are under pressure related to productivity demands and may not provide preceptored experiences for students. Nursing students may not know any older adults outside of the institutional setting and consequently may have many misconceptions about what is and is not normal aging. This article describes an undergraduate nursing class and the out-of-classroom assignments that increased student understanding of nursing practice in the home, the effects of the home environment on the care of older adults, and the experiences of older adults living in the community. This article has relevance to nurses because it is important that we participate in creative methods of teaching students to value older adults and how to care for them in the community.

  16. When it is costly to have a caring mother: food limitation erases the benefits of parental care in earwigs.

    PubMed

    Meunier, Joël; Kölliker, Mathias

    2012-08-23

    The aggregation of parents with offspring is generally associated with different forms of care that improve offspring survival at potential costs to parents. Under poor environments, the limited amount of resources available can increase the level of competition among family members and consequently lead to adaptive changes in parental investment. However, it remains unclear as to what extent such changes modify offspring fitness, particularly when offspring can survive without parents such as in the European earwig, Forficula auricularia. Here, we show that under food restriction, earwig maternal presence decreased offspring survival until adulthood by 43 per cent. This effect was independent of sibling competition and was expressed after separation from the female, indicating lasting detrimental effects. The reduced benefits of maternal presence on offspring survival were not associated with higher investment in future reproduction, suggesting a condition-dependent effect of food restriction on mothers and local mother-offspring competition for food. Overall, these findings demonstrate for the first time a long-term negative effect of maternal presence on offspring survival in a species with maternal care, and highlight the importance of food availability in the early evolution of family life.

  17. The adult day care workforce in England at a time of policy change: implications for learning disability support services.

    PubMed

    Hussein, Shereen; Manthorpe, Jill

    2010-06-01

    More people will receive personal budgets to pay for social care services in England. Such people may or may not continue using services such as adult day care centres. Many day centres are under threat of closure. These trends will affect those working in adult day care. This article examines the profile of this workforce, using recent NMDS-SC data and applying multinomial statistical modelling. We identified nearly 6000 adult day care workers, over half supporting adults with learning disability. The results of the analysis show significant variations between the adult day care, residential care and domiciliary workforces. At the personal level, day care workers are significantly older and less ethnically diverse than other workers. They tend to have been working in the sector for longer, and their work patterns are more stable. The findings are discussed within the context of policy changes affecting learning disabilities and social care workforce strategies.

  18. Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Hutchison, Andrew; Kroese, Biza Stenfert

    2016-01-01

    Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

  19. Food Group Intakes as Determinants of Iodine Status among US Adult Population

    PubMed Central

    Lee, Kyung Won; Shin, Dayeon; Cho, Mi Sook; Song, Won O.

    2016-01-01

    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. PMID:27240399

  20. 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.

  1. Young Adults Seeking Medical Care: Do Race and Ethnicity Matter?

    MedlinePlus

    ... Other health care professional includes physician assistants, psychologists, nurses, physical therapists, chiropractors, etc. Doctor or other health ... Subcommittee on Federal Workforce, Postal Service, and the District of Columbia Committee on Oversight and Government Reform ...

  2. 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.

  3. Food patterns measured by principal component analysis and obesity in the Nepalese adult

    PubMed Central

    Shrestha, Archana; Koju, Rajendra Prasad; Beresford, Shirley A A; Gary Chan, Kwun Chuen; Karmacharya, Biraj Man; Fitzpatrick, Annette L

    2016-01-01

    Objective About one-fourth of Nepalese adults are overweight or obese but no studies have examined their risk factors, especially pertaining to diet. The present study aimed to identify dietary patterns in a suburban Nepalese community and assess their associations with overweight and obesity prevalence. Methods This cross-sectional study used data from 1073 adults (18 years or older) participating in the baseline survey of the Dhulikhel Heart Study. We derived major dietary patterns from a principal component analysis of reported intake from a Food Frequency Questionnaire. Overweight was defined as Body Mass Index (BMI) of 25 kg/m2 or higher and obesity was defined as BMI of 30 kg/m2 or higher. Statistical analysis was conducted using generalised estimating equations with multivariate logistic regression (with household as cluster) adjusting for age, sex, ethnicity, religion, marital status, income, education, alcohol consumption, smoking, physical activity and systolic blood pressure. Results Four dietary patterns were derived: mixed, fast food, refined grain–meat–alcohol and solid fats–dairy. The refined grain–rice–alcohol pattern was significantly associated with overweight (adjusted OR 1.19, 95% CI 1.03 to 1.39; p=0.02) after adjusting for demographic and traditional cardiovascular risk factors. In adults of 40 years or older, the fast food pattern was associated with obesity controlling for demographic and traditional risk factors (adjusted OR 1.69, 95% CI 1.19 to 2.39; p value=0.003). Conclusions Our results suggest that refined grains–meat–alcohol intake is associated with higher prevalence of overweight, and fast food intake is associated with higher prevalence of obesity in older adults (40 years or above) in suburban Nepalese adults. PMID:27326232

  4. 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

  5. Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands.

    PubMed

    Broese van Groenou, Marjolein; Jacobs, Marianne; Zwart-Olde, Ilse; Deeg, Dorly J H

    2016-01-01

    As part of long-term care reforms, home-care organisations in the Netherlands are required to strengthen the linkage between formal and informal caregivers of home-dwelling older adults. Information on the variety in mixed care networks may help home-care organisations to develop network type-dependent strategies to connect with informal caregivers. This study first explores how structural (size, composition) and functional features (contact and task overlap between formal and informal caregivers) contribute to different types of mixed care networks. Second, it examines to what degree these network types are associated with the care recipients' characteristics. Through home-care organisations in Amsterdam, the Netherlands, we selected 74 frail home-dwelling clients who were receiving care in 2011-2012 from both informal and formal caregivers. The care networks of these older adults were identified by listing all persons providing help with five different types of tasks. This resulted in care networks comprising an average of 9.7 caregivers, of whom 67% were formal caregivers. On average, there was contact between caregivers within 34% of the formal-informal dyads, and both caregivers carried out at least one similar type of task in 29% of these dyads. A principal component analysis of size, composition, contact and task overlap showed two distinct network dimensions from which four network types were constructed: a small mixed care network, a small formal network, a large mixed network and a large formal network. Bivariate analyses showed that the care recipients' activities of daily living level, memory problems, social network, perceived control of care and level of mastery differed significantly between these four types. The results imply that different network types require different actions from formal home-care organisations, such as mobilising the social network in small formal networks, decreasing task differentiation in large formal networks and assigning

  6. 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.

  7. The Adolescent and Young Adult HIV Cascade of Care in the United States: Exaggerated Health Disparities

    PubMed Central

    Zanoni, Brian C.

    2014-01-01

    Abstract Little is known about how adolescents and young adults contribute to the declines in the cascade of care from HIV-1 diagnosis to viral suppression. We reviewed published literature from the Unites States reporting primary data for youth (13–29 years of age) at each stage of the HIV cascade of care. Approximately 41% of HIV-infected youth in the United States are aware of their diagnosis, while only 62% of those diagnosed engage medical care within 12 months of diagnosis. Of the youth who initiate antiretroviral therapy, only 54% achieve viral suppression and a further 57% are not retained in care. We estimate less than 6% of HIV-infected youth in the United States remain virally suppressed. We explore the cascade of care from HIV diagnosis through viral suppression for HIV-infected adolescents and young adults in the United States to highlight areas for improvement in the poor engagement of the infected youth population. PMID:24601734

  8. The neurologist's role in supporting transition to adult health care: A consensus statement.

    PubMed

    Brown, Lawrence W; Camfield, Peter; Capers, Melissa; Cascino, Greg; Ciccarelli, Mary; de Gusmao, Claudio M; Downs, Stephen M; Majnemer, Annette; Miller, Amy Brin; SanInocencio, Christina; Schultz, Rebecca; Tilton, Anne; Winokur, Annick; Zupanc, Mary

    2016-08-23

    The child neurologist has a critical role in planning and coordinating the successful transition from the pediatric to adult health care system for youth with neurologic conditions. Leadership in appropriately planning a youth's transition and in care coordination among health care, educational, vocational, and community services providers may assist in preventing gaps in care, delayed entry into the adult care system, and/or health crises for their adolescent patients. Youth whose neurologic conditions result in cognitive or physical disability and their families may need additional support during this transition, given the legal and financial considerations that may be required. Eight common principles that define the child neurologist's role in a successful transition process have been outlined by a multidisciplinary panel convened by the Child Neurology Foundation are introduced and described. The authors of this consensus statement recognize the current paucity of evidence for successful transition models and outline areas for future consideration.

  9. A course on the transition to adult care of patients with childhood-onset chronic illnesses.

    PubMed

    Hagood, James S; Lenker, Claire V; Thrasher, Staci

    2005-04-01

    Children with special health care needs born today have a 90% chance of surviving into adulthood, making their transition to adult systems of care an issue that will affect almost all physicians. However, many adult generalists and specialists are not familiar with the management of chronic diseases that begin in childhood. While the public health system has made transition to appropriate adult care a priority, and many specialty organizations have endorsed this concept, there are no published studies addressing how the concept of transition can be taught to medical students or residents. The authors describe a one-week course for medical students, begun in 2001 at their institution, that addresses the transition for youth with special health care needs, emphasizing patient and family-centered care, cultural competence, and decision making in end-of-life issues. Cystic fibrosis, a common genetic disease with increasing life expectancy, is used as the model for the course. Involvement of interdisciplinary faculty, interviews with youth with special health care needs and family caregivers, readings from academic and nonacademic literature, and group discussions are presented as teaching methods. Key insights based on experience with the course are the need to include the voices of patients and families, the use of faculty from various professions and specialties to model interdisciplinary care, and the insight that problems specific to transition offer into contemporary health care financing. Future studies should measure the impact of such courses on students' knowledge of transition issues, and determine essential information required for physicians in practice.

  10. Larval food quantity affects the capacity of adult mosquitoes to transmit human malaria

    PubMed Central

    Shapiro, Lillian L. M.; Murdock, Courtney C.; Jacobs, Gregory R.; Thomas, Rachel J.; Thomas, Matthew B.

    2016-01-01

    Adult traits of holometabolous insects are shaped by conditions experienced during larval development, which might impact interactions between adult insect hosts and parasites. However, the ecology of larval insects that vector disease remains poorly understood. Here, we used Anopheles stephensi mosquitoes and the human malaria parasite Plasmodium falciparum, to investigate whether larval conditions affect the capacity of adult mosquitoes to transmit malaria. We reared larvae in two groups; one group received a standard laboratory rearing diet, whereas the other received a reduced diet. Emerging adult females were then provided an infectious blood meal. We assessed mosquito longevity, parasite development rate and prevalence of infectious mosquitoes over time. Reduced larval food led to increased adult mortality and caused a delay in parasite development and a slowing in the rate at which parasites invaded the mosquito salivary glands, extending the time it took for mosquitoes to become infectious. Together, these effects increased transmission potential of mosquitoes in the high food regime by 260–330%. Such effects have not, to our knowledge, been shown previously for human malaria and highlight the importance of improving knowledge of larval ecology to better understand vector-borne disease transmission dynamics. PMID:27412284

  11. Instructor Guides for Training Food Service Supervisors in Long Term Care Facilities.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

    This final report describes a project to develop postsecondary teacher resource guides for supervisor courses in food service management, preparation and service of modified diets, and meal service in long-term care facilities in Iowa. Introductory material includes the following: project objective, a description of how the objective was met, the…

  12. Is Personality Associated with Health Care Use by Older Adults?

    PubMed Central

    Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

    2013-01-01

    Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and

  13. Transition of Care for Young Adult Survivors of Childhood and Adolescent Cancer: Rationale and Approaches

    PubMed Central

    Freyer, David R.

    2010-01-01

    Purpose Young adult survivors of childhood and adolescent cancer are an ever-growing population of patients, many of whom remain at lifelong risk for potentially serious complications of their cancer therapy. Yet research shows that many of these older survivors have deficient health-related knowledge and are not engaging in recommended health promotion and screening practices that could improve their long-term outcomes. The purpose of this review is to address these disparities by discussing how formal transition of care from pediatric to adult-focused survivorship services may help meet the unique medical, developmental, and psychosocial challenges of these young adults. Design Literature review and discussion. Results This article summarizes current research documenting the medical needs of young adult survivors, their suboptimal compliance with recommended follow-up, and the rationale, essential functions, current models, and innovative approaches for transition of follow-up care. Conclusion Systematic health care transition constitutes the standard of care for young adult survivors of childhood cancer. In developing a transitional care program, it is necessary to consider the scope of services to be provided, available resources, and other local exigencies that help determine the optimal model for use. Additional research is needed to improve health services delivery to this population. Effective advocacy is needed, particularly in the United States, to ensure the availability of uninterrupted health insurance coverage for survivorship services in young adulthood. PMID:20351333

  14. Functional decline and satisfaction with nursing care among older hospitalized adults.

    PubMed

    Zisberg, Anna; Zlotnick, Cheryl; Gur-Yaish, Nurit; Admi, Hanna; Sinoff, Gary; Shadmi, Efrat

    2015-10-01

    Around hospitalization, older adults often experience functional decline which can be a reflection of their need for nursing care. Given a shortage of nurses, determining the relationship between functional change and patients' satisfaction with nursing care can help to gauge the need for care. We assessed this relationship in a mixed prospective-correlational cohort study with 393 patients, 70 years or older. The art, tangible aspects and general satisfaction with nursing care were measured through interviews conducted at discharge. Patients' functional status was assessed at admission and discharge. Decline in functioning during hospitalization was the most powerful predictor of higher satisfaction with art and tangible aspects of nursing care in multivariate regression (β = 0.17-0.19, P < 0.01). This finding suggests that patients whose functioning deteriorates during hospitalization, have a greater need for and more contact with professional nursing care, and therefore report higher satisfaction with specific aspects of nursing care.

  15. Child care choices, food intake, and children's obesity status in the United States.

    PubMed

    Mandal, Bidisha; Powell, Lisa M

    2014-07-01

    This article studies two pathways in which selection into different types of child care settings may affect likelihood of childhood obesity. Frequency of intake of high energy-dense and low energy-dense food items may vary across care settings, affecting weight outcomes. We find that increased use of paid and regulated care settings, such as center care and Head Start, is associated with higher consumption of fruits and vegetables. Among children from single-mother households, the probability of obesity increases by 15 percentage point with an increase in intake of soft drinks from four to six times a week to daily consumption and by 25 percentage point with an increase in intake of fast food from one to three times a week to four to six times a week. Among children from two-parent households, eating vegetables one additional time a day is associated with 10 percentage point decreased probability of obesity, while one additional drink of juice a day is associated with 10 percentage point increased probability of obesity. Second, variation across care types could be manifested through differences in the structure of the physical environment not captured by differences in food intake alone. This type of effect is found to be marginal and is statistically significant among children from two-parent households only. Data are used from the Early Childhood Longitudinal Study - Birth Cohort surveys (N=10,700; years=2001-2008). Children's age ranged from four to six years in the sample.

  16. Fetal Programming of Adult Disease: Implications for Prenatal Care

    EPA Science Inventory

    The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult ...

  17. Pertussis knowledge, attitude and practices among European health care professionals in charge of adult vaccination

    PubMed Central

    Hanlon, David; Benninghoff, Bernd; Calcoen, Stijn

    2011-01-01

    Despite successful infant vaccination program, pertussis remains endemic in many countries. Waning immunity leaves adolescents and adults susceptible to disease and potential reservoirs of infection allowing transmission to vulnerable infants. Misdiagnosis leads to significant underestimation of disease burden and inappropriate treatment. This online survey of 517 European health care professionals (HCP) examined their knowledge, attitudes and practices regarding pertussis and adult vaccination. Compared with other vaccine-preventable diseases, HCPs did not perceive pertussis as a serious disease in adults and there was a low perceived need for adult vaccination; only 17% mentioned pertussis as a disease they would usually vaccinate adults against. Pertussis incidence was considered to be low. Although the majority of HCPs agreed that vaccination is useful to prevent pertussis transmission from adults to susceptible infants, respondents discussed pertussis vaccination with ≤5% of patients; 58% respondents had never prescribed a pertussis vaccine to adults. The perceived low incidence of pertussis in adults and the lack of official guidelines/recommendations were cited as key reasons for not administering pertussis boosters. Despite only taking place in four countries, our results suggest that the incidence and burden of adult pertussis is not reflected in the attitudes of European HCP s to the disease. Awareness of adult pertussis, its diagnosis and guidance on pertussis boosters should be raised to protect adults and vulnerable infants and to manage the consequences of waning pertussis immunity. PMID:21368583

  18. Pertussis knowledge, attitude and practices among European health care professionals in charge of adult vaccination.

    PubMed

    Hoffait, Muriel; Hanlon, David; Benninghoff, Bernd; Calcoen, Stijn

    2011-02-01

    Despite successful infant vaccination programmes, pertussis remains endemic in many countries. Waning immunity leaves adolescents and adults susceptible to disease and potential reservoirs of infection allowing transmission to vulnerable infants. Misdiagnosis leads to significant underestimation of disease burden and inappropriate treatment. This online survey of 517 European health care professionals (HCP) examined their knowledge, attitudes and practices regarding pertussis and adult vaccination. Compared with other vaccine-preventable diseases, HCPs did not perceive pertussis as a serious disease in adults and there was a low perceived need for adult vaccination; only 17% mentioned pertussis as a disease they would usually vaccinate adults against. Pertussis incidence was considered to be low. Although the majority of HCPs agreed that vaccination is useful to prevent pertussis transmission from adults to susceptible infants, respondents discussed pertussis vaccination with ≤5% of patients; 58% respondents had never prescribed a pertussis vaccine to adults. The perceived low incidence of pertussis in adults and the lack of official guidelines/ recommendations were cited as key reasons for not administering pertussis boosters. Despite only taking place in four countries, our results suggest that the incidence and burden of adult pertussis is not reflected in the attitudes of European HCPs to the disease. Awareness of adult pertussis, its diagnosis and guidance on pertussis boosters should be raised to protect adults and vulnerable infants and to manage the consequences of waning pertussis immunity.

  19. Association of Overweight with Food Portion Size among Adults of São Paulo – Brazil

    PubMed Central

    Mendes, Aline; Crispim, Sandra Patricia; Marchioni, Dirce Maria; Fisberg, Regina Mara

    2016-01-01

    Background Although studies show that portion size affects energy intake, few have demonstrated a link between portion size and weight status, especially in free-living populations. The objective of the present study was to assess the relationship between food portion sizes and overweight in a representative population of adults of São Paulo, Brazil. Methods Cross-sectional population-based study with 1005 adults from São Paulo, Brazil. Dietary data were obtained from two 24-hour recalls. Reported foods were classified into groups and energy contribution, prevalence of consumers and portion sizes were calculated. Individuals were classified according to BMI in with and without overweight. Logistic regression models were used to evaluate the association between food portion sizes and being overweight. Results The most consumed food groups were: beans, breads/rolls, coffee/tea, milk, rice, and sugar. Rice, red meat, breads/rolls, and white meat were the groups with the highest percentage of contribution to total energy intake. Butter/margarine, toasts/biscuits, sugar, and cakes were the groups with the highest energy density. After adjustment for confounding variables, overweight was associated with larger portions of pizza (OR = 1.052; p = 0.048), red meat (OR = 1.025; p = 0.043), rice (OR = 1.033; p<0.001), salted snacks (OR = 1.078; p = 0.022), and soft drinks (OR = 1.016; p = 0.007). Conclusions Larger portions of few food groups with different energy densities were associated with being overweight, suggesting that overweight may be related to the consumption of larger portion sizes of a series of food groups, not a food group alone. Additionally, we highlight the importance of considering underreporting as a confounding factor in these associations. PMID:27706222

  20. 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.

  1. Educational and economic determinants of food intake in Portuguese adults: a cross-sectional survey

    PubMed Central

    Moreira, Pedro A; Padrão, Patricia D

    2004-01-01

    Background Understanding the influences of educational and economic variables on food consumption may be useful to explain food behaviour and nutrition policymaking. The aim of this study was to evaluate the importance of educational and economic factors in determining food pattern in Portuguese adults. Methods A cross-sectional study in a representative sample of Portuguese adults (20977 women and 18663 men). Participants were distributed in four categories according to years of education (≤4, 5–9, 10–12, and >12) and income (≤314 euros, 315–547 euros, 548–815 euros, and >815 euros). Logistic regression models were fitted to estimate the magnitude of the association between food groups and education/income, adjusting for confounders. Results In both genders, the odds favouring milk, vegetable soup, vegetables, fruit, and fish consumption, increased significantly with education, for those having >12 years of education compared to those with ≤4 years; the odds favouring wine, and spirits consumption decreased significantly with education, for those having >12 years of education compared to those with ≤4 years. In males, the odds favouring starchy foods and meat consumption decreased significantly with income, while for milk, the odds increased with higher income (those having >815 euros compared to those with ≤314 euros). Conclusions The low and high income groups are or tend to be similar in regard to several food groups consumption, and access to education/information appears to be the key element to a better food pattern as indicated by higher frequency of milk, vegetable soup, vegetables, fruit, and fish consumption. PMID:15575953

  2. Short term aerobic exercise alters the reinforcing value of food in inactive adults.

    PubMed

    Panek, Leah M; Jones, Kelly R; Temple, Jennifer L

    2014-10-01

    Motivation to eat, or the reinforcing value of food, may be influenced by a number of factors, including physical activity. The purpose of these studies was to test the hypothesis that short-term moderate-vigorous intensity aerobic exercise would alter the reinforcing value of high (HED) and low (LED) energy density foods in inactive adults. The reinforcing value of LED and HED food was measured at baseline and again after two weeks of aerobic exercise. In Experiment 1, 41 participants were randomized to a no exercise condition or aerobic exercise for 3 days per week for two weeks. In Experiment 2, 76 participants were randomized to one of four aerobic exercise frequencies, 0, 1, 3, or 5 days per week for two weeks. In both experiments, exercise reduced the reinforcing value of HED food compared to baseline and to non-exercise controls. In Experiment 2, the 5 day group also showed a significant increase in the reinforcing value of LED food compared to baseline and other exercise frequencies. Liking of HED and LED foods and consumption of HED food were not affected by exercise treatment. Finally, in Experiment 2, the 5 day group reported consuming more energy outside of the laboratory than the other groups. Taken together, these data suggest, in inactive individuals, motivation to obtain HED and LED foods can be altered with a short-term moderate-vigorous intensity exercise intervention. Further research is needed to understand the cognitive and physiological processes involved in food choices paired with exercise.

  3. Consumption of ultra-processed foods and their impact on the diet of young adults

    PubMed Central

    Bielemann, Renata M; Motta, Janaína V Santos; Minten, Gicele C; Horta, Bernardo L; Gigante, Denise P

    2015-01-01

    OBJECTIVE To evaluate the consumption of ultra-processed foods, its associated factors, and its influence on nutrient intake in young adults. METHODS In 2004-2005, the individuals belonging to the Pelotas birth cohort of 1982 were identified for a home interview. A total of 4,297 individuals were interviewed and 4,202 individuals were included in the study (follow-up rate of 77.4%). Diet was assessed using a questionnaire on dietary intake and the percentage of daily caloric intake attributed to ultra-processed foods as well as the intake of macro- and micronutrients were estimated. The association between cohort characteristics and the consumption of ultra-processed foods was assessed using linear regression. Analysis of variance and Pearson’s Chi-square test were used to evaluate the association between the quintiles of the consumption of ultra-processed food, nutrient intake and adequacy of nutrient intake, respectively. RESULTS The consumption of ultra-processed foods corresponded to 51.2% of the total caloric intake. The consumption of ultra-processed foods was higher among women, individuals with higher education, and individuals who were never poor and eutrophic. The increased consumption of ultra-processed foods was positively correlated with the consumption of fat, cholesterol, sodium, iron, calcium, and calories (p < 0.001) and was negatively correlated with the consumption of carbohydrates, protein, and dietary fiber (p < 0.001). CONCLUSIONS The high consumption of ultra-processed foods and its positive correlation with the intake of sodium, cholesterol, and fats underscores the need to perform interventions aimed at decreasing the intake of this food group. PMID:26018785

  4. Food label use and its relation to dietary intake among US adults.

    PubMed

    Ollberding, Nicholas Jay; Wolf, Randi L; Contento, Isobel

    2011-05-01

    Rates of diet-related chronic disease combined with the lack of current data on patterns of food label use by the US population warrant re-examination of the use and potential influence of this public health tool. The purpose of this study was to describe the prevalence of food label use and the association between food label use and nutrient intake in a nationally representative sample of US adults who participated in the 2005-2006 National Health and Nutrition Examination Survey. Data on food label use were collected during the interview portion of the survey, and nutrient intake was estimated using the average of two 24-hour dietary recalls. In this sample, 61.6% of participants reported using the Nutrition Facts panel, 51.6% looked at the list of ingredients, 47.2% looked at serving size, and 43.8% reviewed health claims at least sometimes when deciding to purchase a food product. There were significant differences (P<0.05) in food label use across all demographic characteristics examined. Significant differences (P<0.05) in mean nutrient intake of total energy, total fat, saturated fat, cholesterol, sodium, dietary fiber, and sugars were observed between food label users and non-users with label users reporting healthier nutrient consumption. The greatest differences observed were for total energy and fat and for use of specific nutrient information on the food label. Despite food label use being associated with improved dietary factors, label use alone is not expected to be sufficient in modifying behavior ultimately leading to improved health outcomes.

  5. Food label use and its relation to dietary intake among US adults.

    PubMed

    Ollberding, Nicholas Jay; Wolf, Randi L; Contento, Isobel

    2010-08-01

    Rates of diet-related chronic disease combined with the lack of current data on patterns of food label use by the US population warrant re-examination of the use and potential influence of this public health tool. The purpose of this study was to describe the prevalence of food label use and the association between food label use and nutrient intake in a nationally representative sample of US adults who participated in the 2005-2006 National Health and Nutrition Examination Survey. Data on food label use were collected during the interview portion of the survey, and nutrient intake was estimated using the average of two 24-hour dietary recalls. In this sample, 61.6% of participants reported using the Nutrition Facts panel, 51.6% looked at the list of ingredients, 47.2% looked at serving size, and 43.8% reviewed health claims at least sometimes when deciding to purchase a food product. There were significant differences (P<0.05) in food label use across all demographic characteristics examined. Significant differences (P<0.05) in mean nutrient intake of total energy, total fat, saturated fat, cholesterol, sodium, dietary fiber, and sugars were observed between food label users and non-users with label users reporting healthier nutrient consumption. The greatest differences observed were for total energy and fat and for use of specific nutrient information on the food label. Despite food label use being associated with improved dietary factors, label use alone is not expected to be sufficient in modifying behavior ultimately leading to improved health outcomes.

  6. Respite Care as a Community Care Service: Factors Associated with the Effects on Family Carers of Adults with Intellectual Disability in Taiwan

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Tzou, Ping-Yi; Pu, Cheng-Yun; Kroger, Teppo; Lee, Wan-Ping

    2008-01-01

    Background: This study examines the effects and associated factors of respite care, which was legislated as a community service for adults with an intellectual disability (ID) in Taiwan in 1997. Method: A total of 116 family carers who live with an adult with ID and have utilised the respite care program were surveyed using standardised measures.…

  7. The postoperative care of the adult renal transplant recipient.

    PubMed

    Barone, Claudia P; Martin-Watson, Alice L; Barone, Gary W

    2004-10-01

    Advances in transplantation immunology management have contributed to more frequent transplants and better long-term graft survival. Nurses must consider many issues facing the transplant recipient such as medication management, infection prevention, chronic disease management, fluid balance, urine output, and the many psychological issues that surround receiving a transplant. Important guidelines of care of complex transplant patients in the postoperative period are provided.

  8. Perspectives on Health Care of Adults with Developmental Disabilities

    ERIC Educational Resources Information Center

    Parish, Susan L.; Moss, Kathryn; Richman, Erica L.

    2008-01-01

    A focus group study was conducted with individuals with developmental disabilities to understand their perspectives on their health status, health promotion behaviors, and health care services they receive. The majority of participants reported good to excellent health, and all had some form of medical insurance. However, participants reported…

  9. Special needs: caring for the older adult with Down syndrome.

    PubMed

    Herron-Foster, Bobbi J; Bustos, Jacquelyn J

    2014-01-01

    Over the last 30 years, the life expectancy of people with Down syndrome has increased dramatically. Significant medical advances have allowed affected persons to be seen more in the hospital setting, making it imperative that nurses understand their health care needs in order to provide positive health outcomes.

  10. Barriers to Eye Care Faced by Adult Hispanics with Diabetes

    ERIC Educational Resources Information Center

    Griffin-Shirley, Nora; Trusty, Sharon; Kelley, Emily; Siew-Jin, Lai Keun; Macias, Eduardo P.

    2004-01-01

    Current diabetes vision care guidelines suggest that people receive at least an annual dilated eye examination 5 years after the diagnosis of Type I diabetes and a dilated eye examination at the time of diagnosis of Type II diabetes, and at least annually thereafter. Hispanics in the United States have a three-fold greater prevalence of diabetes…

  11. Transitioning from pediatric to adult dental care for adolescents with special health care needs: adolescent and parent perspectives (Part I)

    PubMed Central

    Cruz, Stephanie; Neff, John; Chi, Donald L.

    2015-01-01

    Purpose The purpose of this investigation was to understand transitions from pediatric dental care to adult dental care for adolescents with special health care needs (ASHCN) from the parent and adolescent perspectives. Methods We conducted focus groups and interviews with 59 parents and 13 adolescent-parent dyads to identify factors associated with transitions to adult-centered dental care for ASHCN. Results Most parents believed ASHCN were at-risk for caries, but ASHCN were not concerned about tooth decay. Parents of adolescents with complex SHCN believed it would be acceptable to continue seeing a pediatric dentist. Parents of Medicaid-enrolled ASHCN reported lower efficacy in transitioning. ASHCN desired personalized, adolescent-centered care and were motivated to transition when they felt out of place at the pediatric dentist office. Parents believed pediatric dentists have an important role in initiating and facilitating transitions. Conclusions Pediatric dentists are well-positioned to implement family- and adolescent-centered policies to ensure dental transitions for ASHCN and their families. PMID:26531087

  12. Perceived control in health care: a conceptual model based on experiences of frail older adults.

    PubMed

    Claassens, L; Widdershoven, G A; Van Rhijn, S C; Van Nes, F; Broese van Groenou, M I; Deeg, D J H; Huisman, M

    2014-12-01

    Frail older adults are increasingly encouraged to be in control of their health care, in Western societies. However, little is known about how they themselves perceive control in health care. Therefore, this study aims to investigate the concept of health care-related perceived control from the viewpoint of frail older adults. A qualitative interview study was conducted following a Grounded Theory approach. Thirty-two Dutch frail older adults, aged 65 and over, participated in 20 in-depth interviews (n=20) and three focus group discussions (n=12). Data were analysed according to techniques of coding and constant comparison. From this analysis constituting factors of perceived control emerged, providing elements of a conceptual model. Perceived control reflects the feeling or belief that health care is under control, which is constituted by five, either internal or external, factors: (I) self-confidence in organising professional and/or informal care, (II) self-confidence in health management in the home setting, (III) perceived support from people in the social network, (IV) perceived support from health care professionals and organisations, and (V) perceived support from (health care) infrastructure and services. Therefore, the concept does not only consist of people's own perceived efforts, but also includes the influence of external sources. Our conceptual model points out what external factors should be taken into consideration by health care professionals and policy makers when enhancing older people's perceived control. Moreover, it can serve as the basis for the development of a measurement instrument, to enable future quantitative research on health care-related perceived control among older adults.

  13. Transition from pediatric to adult health care in inflammatory bowel disease.

    PubMed

    Escher, Johanna C

    2009-01-01

    Inflammatory bowel disease (IBD) is a lifelong disease that has great psychosocial impact on the adolescent patient and his/her family. Starting around age 12-14 years, many changes take place related to school, work, and sexual development. At some point, usually around the age of 16-18 years, these patients need to move from the pediatric clinic to the adult caregivers. A stepwise program for transition of care, aimed at coaching the adolescent patient into self-management will benefit patients, parents, and the 'adult gastroenterologist' who will take over the care from the pediatric gastroenterologist. Differences in pediatric and adult health care, transition goals, tips and tools for successful transition will be discussed.

  14. Liquid and solid meal replacement products differentially affect postprandial appetite and food intake in older adults.

    PubMed

    Stull, April J; Apolzan, John W; Thalacker-Mercer, Anna E; Iglay, Heidi B; Campbell, Wayne W

    2008-07-01

    Liquid and solid foods are documented to elicit differential appetitive and food intake responses. This study was designed to assess the influences of liquid vs solid meal replacement products on postprandial appetite ratings and subsequent food intake in healthy older adults. This study used a randomized and crossover design with two 1-day trials (1 week between trials), and 24 adults (12 men and 12 women) aged 50 to 80 years with body mass index (calculated as kg/m2) between 22 and 30 participated. After an overnight fast, the subjects consumed meal replacement products as either a beverage (liquid) or a bar (solid). The meal replacement products provided 25% of each subject's daily estimated energy needs with comparable macronutrient compositions. Subjects rated their appetite on a 100 mm quasilogarithmic visual analog scale before and 15, 30, 45, 60, 90, 120, and 150 minutes after consuming the meal replacement product. At minute 120, each subject consumed cooked oatmeal ad libitum to a "comfortable level of fullness." Postprandial composite (area under the curve from minute 15 to minute 120) hunger was higher (P=0.04) for the liquid vs solid meal replacement products and desire to eat (P=0.15), preoccupation with thoughts of food (P=0.07), and fullness (P=0.25) did not differ for the liquid vs solid meal replacement products. On average, the subjects consumed 13.4% more oatmeal after the liquid vs solid (P=0.006) meal replacement product. These results indicate that meal replacement products in liquid and solid form do not elicit comparable appetitive and ingestive behavior responses and that meal replacement products in liquid form blunt the postprandial decline in hunger and increase subsequent food intake in older adults.

  15. Liquid and Solid Meal Replacement Products Differentially Affect Postprandial Appetite and Food Intake in Older Adults

    PubMed Central

    Stull, April J.; Apolzan, John W.; Thalacker-Mercer, Anna E.; Iglay, Heidi B.; Campbell, Wayne W.

    2008-01-01

    Liquid and solid foods are documented to elicit differential appetitive and food intake responses. This study was designed to assess the influences of liquid vs solid meal replacement products on postprandial appetite ratings and subsequent food intake in healthy older adults. This study used a randomized and crossover design with two 1-day trials (1 week between trials), and 24 adults (12 men and 12 women) aged 50 to 80 years with body mass index (calculated as kg/m2) between 22 and 30 participated. After an overnight fast, the subjects consumed meal replacement products as either a beverage (liquid) or a bar (solid). The meal replacement products provided 25% of each subject's daily estimated energy needs with comparable macro-nutrient compositions. Subjects rated their appetite on a 100 mm quasilogarithmic visual analog scale before and 15, 30, 45, 60, 90, 120, and 150 minutes after consuming the meal replacement product. At minute 120, each subject consumed cooked oatmeal ad libitum to a “comfortable level of fullness.” Postprandial composite (area under the curve from minute 15 to minute 120) hunger was higher (P=0.04) for the liquid vs solid meal replacement products and desire to eat (P=0.15), preoccupation with thoughts of food (P=0.07), and fullness (P=0.25) did not differ for the liquid vs solid meal replacement products. On average, the subjects consumed 13.4% more oatmeal after the liquid vs solid (P=0.006) meal replacement product. These results indicate that meal replacement products in liquid and solid form do not elicit comparable appetitive and ingestive behavior responses and that meal replacement products in liquid form blunt the postprandial decline in hunger and increase subsequent food intake in older adults. PMID:18589034

  16. Continuity of outpatient and inpatient care for hospitalized older adults

    PubMed Central

    Sharma, Gulshan; Fletcher, Kathlyn E.; Zhang, Dong; Kuo, Yong-Fang; Freeman, Jean L.; Goodwin, James S.

    2009-01-01

    Context Little is known about the extent of continuity of care across the transition from outpatient care to hospitalization. Objective To describe continuity of care in older hospitalized patients, its change over time, and factors associated with discontinuity. Design, Setting and Participants Retrospective cohort study of hospital admissions from a 5% national sample of Medicare patients between1996 and 2006 (n=3,020,770). Main Outcome Measures Percent of hospitalized patients who were seen while hospitalized by any outpatient physician they had seen in the year prior to hospitalization (Continuity with any outpatient physician) or by their primary care physician (Continuity with a PCP). Results In 1996, 50.5% (95% CI: 50.3% – 50.7%, n=125,789) of hospitalized patients saw at least one physician that they had seen in an outpatient setting in the prior year, whereas 44.3% (95% CI: 44.1% – 44.6%, n=58,046) of patients with an identifiable PCP saw that physician while hospitalized. These percentages had dropped to 39.8% (95% CI: 39.6%–40.0%, n=99,463) and 31.9% (95% CI: 31.6%–32.1%, n=47,761), respectively, by 2006. Greater absolute declines in continuity with any outpatient physician from 1996 to 2006 occurred in patients admitted on weekends (13.9%, 95% CI: 12.9%– 14.7%), those living in large metropolitan areas (11.7%, 95% CI: 11.1% – 12.3%) and in New England (16.2%, 95% CI: 14.4% – 18.0%). In multivariable, multilevel models, increasing involvement of hospitalists was associated with approximately one third of the decrease in continuity of care from 1996 to 2006. Conclusion Between 1996 and 2006, physician continuity from outpatient to inpatient settings declined in the Medicare population. PMID:19383958

  17. Potential Effect of Physical Activity Calorie Equivalent (PACE) Labeling on Adult Fast Food Ordering and Exercise

    PubMed Central

    Antonelli, Ray; Viera, Anthony J.

    2015-01-01

    Introduction Numeric calorie content labels show limited efficacy in reducing the number of calories ordered from fast food meals. Physical activity calorie equivalent (PACE) labels are an alternative that may reduce the number of calories ordered in fast food meals while encouraging patrons to exercise. Methods A total of 1000 adults from 47 US states were randomly assigned via internet survey to one of four generic fast food menus: no label, calories only, calories + minutes, or calories + miles necessary to walk to burn off the calories. After completing hypothetical orders participants were asked to rate the likelihood of calorie-only and PACE labels to influence (1) food choice and (2) physical activity. Results Respondents (n = 823) ordered a median of 1580 calories from the no-label menu, 1200 from the calories-only menu, 1140 from the calories + minutes menu, and 1210 from the calories + miles menu (p = 0.0001). 40% of respondents reported that PACE labels were “very likely” to influence food item choice vs. 28% for calorie-only labels (p<0.0001). 64% of participants reported that PACE labels were “somewhat likely” or “very likely” to influence their level of physical activity vs. 49% for calorie-only labels (p<0.0001). Conclusions PACE labels may be helpful in reducing the number of calories ordered in fast food meals and may have the added benefit of encouraging exercise. PMID:26222056

  18. Management of adults with paediatric-onset chronic liver disease: strategic issues for transition care.

    PubMed

    Vajro, Pietro; Ferrante, Lorenza; Lenta, Selvaggia; Mandato, Claudia; Persico, Marcello

    2014-04-01

    Advances in the management of children with chronic liver disease have enabled many to survive into adulthood with or without their native livers, so that the most common of these conditions are becoming increasingly common in adult hepatology practice. Because the aetiologies of chronic liver disease in children may vary significantly from those in adulthood, adults with paediatric-onset chronic liver disease may often present with clinical manifestations unfamiliar to their adulthood physician. Transition of medical care to adult practice requires that the adulthood medical staff (primary physicians and subspecialists) have a comprehensive knowledge of childhood liver disease and their implications, and of the differences in caring for these patients. Pending still unavailable Scientific Society guidelines, this article examines causes, presentation modes, evaluation, management, and complications of the main paediatric-onset chronic liver diseases, and discusses key issues to aid in planning a program of transition from paediatric to adult patients.

  19. High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.

    PubMed

    Shah, Manish N; Gillespie, Suzanne M; Wood, Nancy; Wasserman, Erin B; Nelson, Dallas L; Dozier, Ann; McConnochie, Kenneth M

    2013-11-01

    Accessing timely acute medical care is a challenge for older adults. This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. This program, based in a primary care geriatrics practice that cares for SLC residents, is designed to offer acute care through telemedicine for complaints that are felt to need attention before the next available outpatient visit but not to require emergency department (ED) resources. This option gives residents access to care in their residence. Measures used to evaluate the program include successful completion of telemedicine visits, satisfaction of residents and caregivers with telemedicine care, and site of care that would have been recommended had telemedicine been unavailable. During the first 2 years of the program's operation, 281 of 301 requested telemedicine visits were completed successfully. Twelve residents were sent to an ED for care after the telemedicine visit. Ninety-four percent of residents reported being satisfied or very satisfied with telemedicine care. Had telemedicine not been available, residents would have been sent to an ED (48.1%) or urgent care center (27.0%) or been scheduled for an outpatient visit (24.4%). The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use. Continuation of the program will require evaluation demonstrating equal or better resident-level outcomes and the development of sustainable business models.

  20. Providers' Perspectives of Survivorship Care for Young Adult Survivors of Childhood Cancer.

    PubMed

    Berg, Carla; Stratton, Erin; Esiashvili, Natia; Mertens, Ann; Vanderpool, Robin C

    2016-03-01

    We examined healthcare providers' perceptions of the goals of survivorship care and survivor programs, systems-level barriers and individual patient-level barriers to engaging patients in survivorship care, and potential resources for increasing engagement. In 2012, we recruited 21 healthcare providers of young adult survivors of childhood cancers from a children's hospital and a cancer center in the Southeastern USA to complete telephone-based semi-structured interviews. The sample was 45.95 years old (SD = 7.57) on average, 52.4 % female, and 81.0 % MDs. The major goals of survivorship programs identified were medical care management (e.g., addressing late and long-term effects, providing survivorship care plans (SCPs), assisting in transition of care) and holistic care including addressing psychosocial issues and promoting healthy lifestyles. Systems-level barriers to engagement in survivorship care included limited resources (e.g., time), role confusion (e.g., within cancer centers, from treatment team to survivorship care, role of primary care providers), communication challenges within the medical system (e.g., limited tracking of patients, lack of understanding of the role of survivorship clinic), communication challenges with patients (e.g., setting expectations regarding transition to survivorship care), and lack of insurance coverage. Perceived patient-level factors included psychological barriers (e.g., fear, avoidance), resistance to survivorship care, and physical barriers (e.g., distance from survivorship clinics). Resources to address these barriers included increased access to information, technology-based resources, and ensuring valuable services. There are several systems-level and patient-level barriers to survivorship care, thus requiring multilevel interventions to promote engagement in care among young adult survivors of childhood cancer.

  1. Nutritional Status and Food Habits of Middle-aged Adults in Selected Areas of Selangor.

    PubMed

    Karim, Norimah A; Mydenkather, Hajamohaideen

    2003-09-01

    A food habits and health status study was carried out among 100 Malay adults aged 40 years and above. The study protocol incorporated anthropometric measurements, evaluation of food habits and determination of blood glucose, cholesterol and blood pressure. Mean body mass index (BMI) for men and women were 27.2 ± 4.2 kg/m2 and 27.0 ± 5.2 kg/m2 respectively, which on average showed that the subjects were overweight. Food habits evaluation indicated that rice, fish and vegetables were the foods consumed almost everyday by the majority of the subjects. Meat, dairy products and fruits were eaten once to three times per week. Food intake score for sugar and salt demonstrated that a majority of men and women consumed moderate amounts of these foods. Most subjects exercised twice to three times a week for 15 min per session. Blood glucose tests revealed a mean of 5.04 ± 1.60 mmol/l in men and 4.86 ± 2.10 mmol/l for women. Mean cholesterol for men was 5.06 ± 1.22 mmol/l while it was 4.90 ± 1.34 mmol/l in women. Mean systolic and diastolic blood pressure in men was normal of 127.69 ± 13.60 mm Hg dan 85.87 ± 7.97 mm Hg, while in women it was 127.42 ± 17.54 mm Hg, 83.53 ± 9.50 mm Hg. The mean value for glucose, cholesterol and blood pressure increased with age. The food habits of these adults were satisfactory; however blood test for the nutrients of interest exhibited an increasing trend towards blood pressure, blood cholesterol and glucose with age. Middle-aged adults should adapt to a more active lifestyle and be more cautious of their food habits. This is to ensure a healthy well being throughout their life span.

  2. [Preventive measures of food poisoning at care facilities for the elderly--current status and problems in food poisoning by noroviruses].

    PubMed

    Ezoe, Kumiko; Nagatomi, Hideki; Imaizumi, Iwao

    2012-08-01

    Food poisoning at care facilities for the elderly has been breaking out approximately ten cases per year nationwide from 2001 to 2010. Especially, it reflected the characteristics of food poisoning caused by noroviruses at a high rate. Usually we have been preventing from food poisoning by noroviruses working on existing measures such as temperature control of food materials, sanitary handlings of cooking tools and table wares, and so on. Additionally, the most effective measures to avoid secondary pollution at care facilities for the elderly is that all members at these facilities have to have a sense of crisis about food poisoning by noroviruses and managers at these facilities must take care of health control for all staff.

  3. The role of the physical therapist in the care of the older adult.

    PubMed

    Richards, Shana; Cristian, Adrian

    2006-05-01

    Physical therapists play an important role in the care of older adults who have physical disabilities. Proper patient selection, a thorough medical, social, and functional history, and a physical examination emphasizing the neuromusculoskeletal system are the cornerstones of the evaluation process. Treatment is individualized and goal driven, with appropriate precautions being followed. Gait training is an integral part of the treatment process for many older adults with disabilities, and various assistive devices may be used to ensure safe mobility.

  4. Healthcare workforce development through an international workshop series: nursing care of older adults.

    PubMed

    Schoessler, Mary Theresa; Van Son, Catherine; Overall, Judith W; Koleva, Yordanka; Ostrovskaya, Irina; Marriott, Dedre; Surma, Mariya

    2009-01-01

    A critical need exists to educate the international healthcare workforce on the care of the older adult. This article describes an interdisciplinary program to address the nursing needs of older adults via a series of workshops in Russia. Strategies to bridge international healthcare and educational cultures are demonstrated. Implications for international workforce development, such as establishing collaborative partnerships, creating culturally appropriate materials, and modeling active learning strategies, are discussed.

  5. Difference in adult food group intake by sex and age groups comparing Brazil and United States nationwide surveys

    PubMed Central

    2014-01-01

    Background International comparisons of dietary intake are an important source of information to better understand food habits and their relationship to nutrition related diseases. The objective of this study is to compare food intake of Brazilian adults with American adults identifying possible dietary factors associated with the increase in obesity in Brazil. Methods This research used cross-national analyses between the United States and Brazil, including 5,420 adults in the 2007–2008 What We Eat In America, National Health and Nutrition Examination Survey and 26,390 adults in the 2008–2009 Brazilian Household Budget Survey, Individual Food Intake. Dietary data were collected through 24 h recalls in the U.S. and through food records in Brazil. Foods and beverages were combined into 25 food categories. Food intake means and percentage of energy contribution by food categories to the population’s total energy intake were compared between the countries. Results Higher frequencies of intake were reported in the United States compared to Brazil for the majority of food categories except for meat, rice and rice dishes; beans and legumes; spreads; and coffee and tea. In either country, young adults (20-39 yrs) had greater reports of meat, poultry and fish mixed dishes; pizza and pasta; and soft drinks compared to older adults (60 + yrs). Meat, poultry and fish mixed dishes (13%), breads (11%), sweets and confections (8%), pizza and pasta (7%), and dairy products (6%) were the top five food category sources of energy intake among American adults. The top five food categories in Brazil were rice and rice dishes (13%), meat (11%), beans and legumes (10%), breads (10%), and coffee and tea (6%). Thus, traditional plant-based foods such as rice and beans were important contributors in the Brazilian diet. Conclusion Although young adults had higher reports of high-calorie and nutrient-poor foods than older adults in both countries, Brazilian young adults did not

  6. Health and access to care among employed and unemployed adults: United States, 2009-2010.

    PubMed

    Driscoll, Anne K; Bernstein, Amy B

    2012-01-01

    Lack of health insurance has been shown to be associated with problems obtaining needed health care (3), and the unemployed are less likely to have health insurance than are their employed counterparts. The number and rate of adults aged 18–64 years lacking health insurance has been increasing, in part due to the historically high unemployment rates. However, even having comprehensive health insurance coverage does not guarantee access to needed services, in part because of cost-sharing, including copayments and deductibles. Unemployed persons may retain their health insurance through the Consolidated Omnibus Budget Reconciliation Act (COBRA) or through other programs, but COBRA payments in particular may be quite expensive, and individual insurance plans may be less comprehensive than many employer-sponsored plans (4). Thus, although some unemployed adults may retain coverage for some period of time, they may be less able to meet cost-sharing requirements because of reduced income associated with unemployment. This analysis compares the health status and access to care of employed and unemployed adults and shows that unemployment is associated with unfavorable health and access to care among adults in the labor force over and above the loss of health insurance. However, it is not possible to know from these data the extent to which unemployment is a cause or effect of poor health. Poor health may be both a cause and effect of unemployment. Adults with private health insurance were more likely to have serious psychological distress and respondent-reported fair or poor health status if they were unemployed. In fact, unemployed privately insured persons were more than three times as likely to have serious psychological distress as their employed counterparts. Similar patterns were found for adults with public insurance and no health insurance. There were no significant differences between employed and unemployed adults in the percentage who had ever been diagnosed

  7. Solid-organ transplantation in childhood: transitioning to adult health care.

    PubMed

    LaRosa, Christopher; Glah, Caryle; Baluarte, H Jorge; Meyers, Kevin E C

    2011-04-01

    Pediatric solid-organ transplantation is an increasingly successful treatment for solid-organ failure. With dramatic improvements in patient survival rates over the last several decades, there has been a corresponding emergence of complications attributable to pretransplant factors, transplantation itself, and the management of transplantation with effective immunosuppression. The predominant solid-organ transplantation sequelae are medical and psychosocial. These sequelae have a substantial effect on transition to adult care; as such, hurdles to successful transition of care arise from the patients, their families, and pediatric and adult health care providers. Crucial to successful transitioning is the ongoing development of a sense of autonomy and responsibility for one's own care. In this article we address the barriers to transitioning that occur with long-term survival in pediatric solid-organ transplantation. Although a particular transitioning model is not promoted, practical tools and strategies that contribute to successful transitioning of pediatric patients who have received a transplant are suggested.

  8. Waterborne Elizabethkingia meningoseptica in Adult Critical Care1

    PubMed Central

    Owens, Daniel S.; Jepson, Annette; Turton, Jane F.; Ashworth, Simon; Donaldson, Hugo; Holmes, Alison H.

    2016-01-01

    Elizabethkingia meningoseptica is an infrequent colonizer of the respiratory tract; its pathogenicity is uncertain. In the context of a 22-month outbreak of E. meningoseptica acquisition affecting 30 patients in a London, UK, critical care unit (3% attack rate) we derived a measure of attributable morbidity and determined whether E. meningoseptica is an emerging nosocomial pathogen. We found monomicrobial E. meningoseptica acquisition (n = 13) to have an attributable morbidity rate of 54% (systemic inflammatory response syndrome >2, rising C-reactive protein, new radiographic changes), suggesting that E. meningoseptica is a pathogen. Epidemiologic and molecular evidence showed acquisition was water-source–associated in critical care but identified numerous other E. meningoseptica strains, indicating more widespread distribution than previously considered. Analysis of changes in gram-negative speciation rates across a wider London hospital network suggests this outbreak, and possibly other recently reported outbreaks, might reflect improved diagnostics and that E. meningoseptica thus is a pseudo-emerging pathogen. PMID:26690562

  9. Current Clinical Care of Older Adults With Sarcopenia.

    PubMed

    Roberts, Helen C; Dodds, Richard; Sayer, Avan A

    2015-01-01

    As sarcopenia is common and associated with risk of adverse health consequences, strategies for clinical care of such patients are needed. Individuals with slow gait speed (<0.8 m/s) should be evaluated for low grip strength and low muscle mass. Progressive resistance exercise in patients with sarcopenia is beneficial, but evidence for protein or vitamin D supplementation is inconclusive. Comprehensive geriatric assessment with involvement of a multidisciplinary team enables clinicians to optimize treatment of complex older individuals with sarcopenia.

  10. Caring for adult patients who require nasogastric feeding tubes.

    PubMed

    Curtis, Kristine

    Nasogastric tubes provide a safe means of delivering nutrition support to many patients in hospital and the community. Insertion and care of these tubes will be familiar to many nurses. Evidence has shown that misplaced tubes, either on insertion or during use, can cause serious harm or even death to patients. This article explores the safety challenges posed during the insertion and maintenance of nasogastric tubes. Guidance and evidence should provide nurses with the knowledge, skills and reassurance to manage these tubes safely.

  11. 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.

  12. Care of Older Adults: Role of Primary Care Physicians in the Treatment of Cataracts and Macular Degeneration.

    PubMed

    Marra, Kyle V; Wagley, Sushant; Kuperwaser, Mark C; Campo, Rafael; Arroyo, Jorge G

    2016-02-01

    This article aims to facilitate optimal management of cataracts and age-related macular degeneration (AMD) by providing information on indications, risk factors, referral guidelines, and treatments and to describe techniques to maximize quality of life (QOL) for people with irreversible vision loss. A review of PubMed and other online databases was performed for peer-reviewed English-language articles from 1980 through August 2012 on visual impairment in elderly adults. Search terms included vision loss, visual impairment, blind, low vision, QOL combined with age-related, elderly, and aging. Articles were selected that discussed vision loss in elderly adults, effects of vision impairment on QOL, and care strategies to manage vision loss in older adults. The ability of primary care physicians (PCPs) to identify early signs of cataracts and AMD in individuals at risk of vision loss is critical to early diagnosis and management of these common age-related eye diseases. PCPs can help preserve vision by issuing aptly timed referrals and encouraging behavioral modifications that reduce risk factors. With knowledge of referral guidelines for soliciting low-vision rehabilitation services, visual aids, and community support resources, PCPs can considerably increase the QOL of individuals with uncorrectable vision loss. By offering appropriately timed referrals, promoting behavioral modifications, and allocating low-vision care resources, PCPs may play a critical role in preserving visual health and enhancing the QOL for the elderly population.

  13. Diabetes Self-care among a Multiethnic Sample of Older Adults

    PubMed Central

    Schoenberg, Nancy E.; Traywick, LaVona S.; Jacobs-Lawson, Joy; Kart, Cary S.

    2011-01-01

    Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial/ethnic/residential groups engaged in in-depth interviews, focusing on approaches to and explanations for diabetes self-care. Certain self-care activities (medication-taking, diet, foot care) were performed regularly while others (blood glucose monitoring, exercise) were practiced less frequently. Despite research suggestions to the contrary, only one in four elders used unconventional diabetes therapies, and only one-third listed someone other than a health care provider as a primary information source. Few self-care differences emerged according to race/ethnicity/residence, perhaps because of the influential and common circumstance of low income. Thematic analyses suggest that inadequate resources, perceived efficacy of medication, great respect for biomedical authority, and lack of familiarity with and concerns about unconventional therapies are influential in establishing these patterns of self-care. We discuss the similarity of self-care practices and perspectives irrespective of race/ethnicity/residence and the predominance of biomedical acceptability. PMID:18369715

  14. Time well spent: the duration of foster care and early adult labor market, educational, and health outcomes.

    PubMed

    Fallesen, Peter

    2013-12-01

    Individuals who spent time in foster care as children fare on average worse than non-placed peers in early adult life. Recent research on the effect of foster care placement on early adult life outcomes provides mixed evidence. Some studies suggest negative effects of foster care placement on early adult outcomes, others find null effects. This study shows that differences in the average duration of foster care stays explain parts of these discordant findings and then test how foster care duration shapes later life outcomes using administrative data on 7220 children. The children experienced different average durations of foster care because of differences in exposure to a reform. Later born cohorts spent on average 3 months longer in foster care than earlier born cohorts. Isolating exogenous variation in duration of foster care, the study finds positive effects of increased duration of foster care on income and labor market participation.

  15. Engaging Chinese American Adults in Advance Care Planning: A Community-Based, Culturally Sensitive Seminar.

    PubMed

    Lee, Mei Ching; Hinderer, Katherine A; Friedmann, Erika

    2015-08-01

    Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre-posttest, repeated measures design, the current study explored the effectiveness of a nurseled, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age=61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar (p<0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults.

  16. Curriculum on Resident Education in Care of Older Adults in Acute, Transitional and Extended Care Settings

    ERIC Educational Resources Information Center

    Kumar, Chandrika; Bensadon, Benjamin A.; Van Ness, Peter H.; Cooney, Leo M.

    2016-01-01

    Most geriatric care is provided in non-hospital settings. Internal Medicine and Family Medicine residents should therefore learn about these different clinical sites and acuity levels of care. To help facilitate this learning, a geriatrics training curriculum for internal medicine residents was developed that focused on cognition, function, goals…

  17. Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults

    PubMed Central

    Hernandez-Boussard, Tina; Morrison, Doug; Goldstein, Ben A.; Hsia, Renee Y.

    2016-01-01

    Study objective The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promotes efficient use of emergency department (ED) services. Our objective was to use population-level emergency department data to characterize any changes in diagnoses seen in ED among young adults since the implementation of the ACA dependent coverage expansion. Methods We performed a difference-in-differences analysis of 2009 to 2011 ED visits from California, Florida, and New York, using all-capture administrative data to determine how the use of ED services changed for clinical categories after the ACA provision among young adults aged 19 to 25 years compared with slightly older adults unaffected by the provision, aged 26 to 31 years. Results We analyzed a total of 10,158,254 ED visits made by 4,734,409 patients. After the implementation of the 2010 ACA provision, young adults had a relative decrease of 0.5% ED visits per 1,000 people compared with the older group. For the majority of diagnostic categories, young adults’ rates and risk of visit did not change relative to that of slightly older adults after the implementation of the ACA. However, although young adults’ ED visits significantly increased for mental illnesses (2.6%) and diseases of the circulatory system (eg, nonspecific chest pain) (4.8%), visits decreased for pregnancy-related diagnoses and diseases of the skin (eg, cellulitis, abscess) compared with that of the older group (3.7% and 3.1%, respectively). Conclusion Our results indicate that increased coverage has kept young adults out of the ED for specific conditions that can be cared for through access to other channels. As EDs face capacity challenges, these results are encouraging and offer insight into what could be expected under further insurance expansions from health care reform. PMID

  18. Link between Food Energy Density and Body Weight Changes in Obese Adults.

    PubMed

    Stelmach-Mardas, Marta; Rodacki, Tomasz; Dobrowolska-Iwanek, Justyna; Brzozowska, Anna; Walkowiak, Jarosław; Wojtanowska-Krosniak, Agnieszka; Zagrodzki, Paweł; Bechthold, Angela; Mardas, Marcin; Boeing, Heiner

    2016-04-20

    Regulating the energy density of food could be used as a novel approach for successful body weight reduction in clinical practice. The aim of this study was to conduct a systemic review of the literature on the relationship between food energy density and body weight changes in obese adults to obtain solid evidence supporting this approach. The search process was based on the selection of publications in the English language listed in public databases. A meta-analysis was performed to combine individual study results. Thirteen experimental and observational studies were identified and included in the final analysis. The analyzed populations consist of 3628 individuals aged 18 to 66 years. The studies varied greatly in terms of study populations, study design and applied dietary approaches. The meta-analysis revealed a significant association between low energy density foods and body weight reduction, i.e., -0.53 kg when low energy density foods were eaten (95% CI: -0.88, -0.19). In conclusions, this study adds evidence which supports the energy density of food as a simple but effective measure to manage weight in the obese with the aim of weight reduction.

  19. Associations between dairy food consumption and chronic kidney disease in older adults

    PubMed Central

    Gopinath, Bamini; Harris, David C.; Flood, Victoria M.; Burlutsky, George; Mitchell, Paul

    2016-01-01

    We aimed to assess the association between dairy product consumption and calcium intake with the prevalence and 10-year incidence of chronic kidney disease (CKD). 1185 participants aged ≥50 years at baseline were examined between 1992–4 and 2002–4. Dietary data were collected using a food frequency questionnaire, and servings of dairy food consumption were calculated. Baseline biochemistry including serum creatinine was measured. CKD was defined as Modification of Diet in Renal Disease Study estimated glomerular filtration rate <60 mL·min−1.1.73 m−2. Cross-sectional analysis showed that older adults in the highest quintile compared to the lowest quintile (reference group) of low/reduced fat dairy food consumption had reduced odds of CKD, multivariable-adjusted odds ratio, OR, 0.64 (95% confidence intervals, CI, 0.43–0.96). Increasing total intake of dietary calcium was associated with reduced odds of CKD (P-trend = 0.02); comparing highest versus lowest quintile: OR 0.62 (95% CI 0.42–0.92). Participants in the second versus first quintile of low/reduced fat dairy food consumption at baseline had 49% reduced risk of CKD 10 years later, OR 0.51 (95% CI 0.29–0.89). Higher consumption of low/reduced fat dairy foods was independently associated with lower risk of CKD. Additional population-based studies are warranted to confirm these findings. PMID:27996057

  20. Associations between dairy food consumption and chronic kidney disease in older adults.

    PubMed

    Gopinath, Bamini; Harris, David C; Flood, Victoria M; Burlutsky, George; Mitchell, Paul

    2016-12-20

    We aimed to assess the association between dairy product consumption and calcium intake with the prevalence and 10-year incidence of chronic kidney disease (CKD). 1185 participants aged ≥50 years at baseline were examined between 1992-4 and 2002-4. Dietary data were collected using a food frequency questionnaire, and servings of dairy food consumption were calculated. Baseline biochemistry including serum creatinine was measured. CKD was defined as Modification of Diet in Renal Disease Study estimated glomerular filtration rate <60 mL·min(-1.)1.73 m(-2). Cross-sectional analysis showed that older adults in the highest quintile compared to the lowest quintile (reference group) of low/reduced fat dairy food consumption had reduced odds of CKD, multivariable-adjusted odds ratio, OR, 0.64 (95% confidence intervals, CI, 0.43-0.96). Increasing total intake of dietary calcium was associated with reduced odds of CKD (P-trend = 0.02); comparing highest versus lowest quintile: OR 0.62 (95% CI 0.42-0.92). Participants in the second versus first quintile of low/reduced fat dairy food consumption at baseline had 49% reduced risk of CKD 10 years later, OR 0.51 (95% CI 0.29-0.89). Higher consumption of low/reduced fat dairy foods was independently associated with lower risk of CKD. Additional population-based studies are warranted to confirm these findings.

  1. Link between Food Energy Density and Body Weight Changes in Obese Adults

    PubMed Central

    Stelmach-Mardas, Marta; Rodacki, Tomasz; Dobrowolska-Iwanek, Justyna; Brzozowska, Anna; Walkowiak, Jarosław; Wojtanowska-Krosniak, Agnieszka; Zagrodzki, Paweł; Bechthold, Angela; Mardas, Marcin; Boeing, Heiner

    2016-01-01

    Regulating the energy density of food could be used as a novel approach for successful body weight reduction in clinical practice. The aim of this study was to conduct a systemic review of the literature on the relationship between food energy density and body weight changes in obese adults to obtain solid evidence supporting this approach. The search process was based on the selection of publications in the English language listed in public databases. A meta-analysis was performed to combine individual study results. Thirteen experimental and observational studies were identified and included in the final analysis. The analyzed populations consist of 3628 individuals aged 18 to 66 years. The studies varied greatly in terms of study populations, study design and applied dietary approaches. The meta-analysis revealed a significant association between low energy density foods and body weight reduction, i.e., −0.53 kg when low energy density foods were eaten (95% CI: −0.88, −0.19). In conclusions, this study adds evidence which supports the energy density of food as a simple but effective measure to manage weight in the obese with the aim of weight reduction. PMID:27104562

  2. The Built Food Environment and Dietary Intake among African-American Adults

    PubMed Central

    Reitzel, Lorraine R.; Okamoto, Hiroe; Hernandez, Daphne C.; Regan, Seann D.; McNeill, Lorna H.; Obasi, Ezemenari M.

    2016-01-01

    Objectives The built food environment surrounding people's homes may influence their dietary intake. This exploratory study examined how the density of different sources of food in the residential environment was associated with dietary consumption among 77 African-American adults in Houston, Texas. Methods The number of fast-food-type restaurants, large grocery stores, and convenience-type stores within 2- and 5-mile residential buffers were divided by the respective areas to obtain food environment density variables. Intake of fruit and vegetables [FV], fiber [FI], and percent energy from fat [PEF] was assessed using National Health Interview Survey items. Covariate-adjusted regressions were used to assess relations of interest. Results Greater density of fast-food-type restaurants within 2 miles was associated with greater FV, FI, and PEF (ps ≤ .012); and for FV and FI within 5 miles (ps < .004). Density of large grocery stores was unrelated to intake. Greater density of convenience-type stores within 2 miles was negatively associated with FV and FI (ps ≤ .03); results became marginal at 5 miles for FV (p = .10) but not FI (p = .03). Conclusion Maximizing healthy offerings in venue-rich metropolitan areas might provide direction for policies to reduce obesity. PMID:26685808

  3. Effect of food and antacids on the pharmacokinetics of pirfenidone in older healthy adults.

    PubMed

    Rubino, C M; Bhavnani, S M; Ambrose, P G; Forrest, A; Loutit, J S

    2009-08-01

    Pirfenidone is a small, synthetic molecule under investigation for treatment of idiopathic pulmonary fibrosis. In an open-label, single-dose crossover study, the pharmacokinetics (PK) of pirfenidone were investigated with or without food and antacids in healthy adult volunteers. Concentrations of pirfenidone and its metabolites in plasma and urine were determined by liquid chromatography with tandem mass spectrometry, and candidate pharmacokinetic models were fit to plasma data using weighted, non-linear regression. The effect of food and antacids on pirfenidone exposure was evaluated by determining 'equivalence' using FDA guidelines. Adverse events were recorded by site personnel and classified by investigators on the basis of severity and relationship to study drug. Sixteen subjects yielded 64 pharmacokinetic profiles. The best fit was achieved using a five-compartment, linear model with an allowance for direct conversion to the primary metabolite (5-carboxy-pirfenidone). Coadministration with food decreased the rate and, to a lesser degree, the extent of pirfenidone absorption of absorption. Analysis of adverse events revealed a correlation between pirfenidone C(max) and the risk of gastrointestinal (GI) adverse events, suggesting that food may reduce the risk of certain adverse events associated with pirfenidone. Administration of pirfenidone with food has a modest effect on overall exposure but results in lower peak concentrations, which may improve tolerability.

  4. Frequency of consumption of foods and beverages by Inuvialuit adults in Northwest Territories, Arctic Canada.

    PubMed

    Zotor, Francis; Sheehy, Tony; Lupu, Madalina; Kolahdooz, Fariba; Corriveau, Andre; Sharma, Sangita

    2012-11-01

    Limited data exist regarding nutrient intakes and overall dietary quality in Canadian Arctic populations. This cross-sectional study determined the frequency of consumption of traditional meats (e.g. caribou, polar bear, seal, char and whale) and non-traditional store-bought foods including non-traditional meats (e.g. beef, pork and chicken), grains, dairy, fruits, vegetables and non-nutrient dense foods (NNDFs) (e.g. butter, chocolate, chips, candy and pop) by Inuvialuit adults (175 women, mean age 44 ± 14 years; 55 men, mean age 41 ± 13 years) in three remote communities in the Northwest Territories. Using a validated quantitative food frequency questionnaire, frequency of consumption over a 30-day period was determined for 141 commonly reported foods. Mean consumption of traditional meats (1.6 times/day), fruits (1 time/day) and vegetables (0.6 times/day) was less frequent than that of NNDFs (5.0 times/day). Nutritional intervention strategies are needed to promote more frequent consumption of nutrient-rich foods and less frequent consumption of NNDFs in these Arctic communities.

  5. Impact of an activities-based adult dementia care program

    PubMed Central

    Higgins, Margaret; Koch, Kathleen; Hynan, Linda S; Carr, Sandra; Byrnes, Kathleen; Weiner, Myron F

    2005-01-01

    The investigators studied over one year the impact of a newly established once-a-week activity-based day care program for dementia patients combined with 17 educational sessions for caregivers held at the same facility. Outcome measures were patient and caregiver quality of life (QOL), patient behavioral disturbance, and use of community-based resources. Of the 37 enrollees, 3 chose not to start the program and 13 dropped out before the end of one year, largely due to health-related issues. Of the initial group, 21 attended for the entire year. The average patient Mini-Mental State Exam (MMSE) score at entry was 16, indicating a moderate level of dementia. Average score on the CERAD Behavior Rating Scale for Dementia (BRSD) was 30.1, indicating a mild level of behavioral disturbance. Attendance at day care was 91%; at the caregiver educational sessions, 74%. Patient and caregiver enthusiasm for the program was high and all wanted to continue attendance beyond the study period despite the fact that patients reported no change in QOL. Caregivers rated patients as having significantly less QOL, and rated their own QOL as unchanged. Symptomatic patient behaviors, as measured by the BRSD, increased significantly over the period of study. Caregivers reported greater use of community resources. PMID:18568062

  6. Volunteers in Specialist Palliative Care: A Survey of Adult Services in the United Kingdom

    PubMed Central

    Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila

    2014-01-01

    Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743

  7. Connecting teens to caring adults in a school-based health center: a case study.

    PubMed

    Blacksin, Beth A; Kelly, Patricia J

    2015-01-01

    The traditional medical care system is generally unable to provide the broad health and wellness services needed by many adolescents, especially those from low-income and racial/ethnic minority communities. Using a theoretical framework adapted from Bronfenbrenner's ecological model of multiple influencers, this case study examined how a school-based health center was able to provide a network of connections for adolescents to caring adults within the school and the local community. Contributors to this network were the creation of a student-centered community with access to adolescent-friendly services, providers acting as connectors, and care of the whole adolescent.

  8. Palliative care answers the challenges of transitioning serious illness of childhood to adult medicine.

    PubMed

    Ajayi, Toluwalase A; Edmonds, Kyle P

    2014-04-01

    Advances in the field of medicine have improved the overall life expectancy in children. Consequently, many children with previously lethal diseases now live into adulthood. There is an urgent need to develop approaches that assist with the transition of care from pediatrics to adult medicine. Palliative care, by virtue of its unique skills, is ideally positioned to play a part in this transition. This report will summarize the urgency for proper transition modalities and then introduce palliative care as a proposed solution for current challenges in transition. Along the way, it will touch on financial and workforce obstacles to this solution and will offer a potential funding option.

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

    PubMed

    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.

  10. Differential parental care by adult Mountain Plovers, Charadrius montanus

    USGS Publications Warehouse

    Dinsmore, S.J.; Knopf, F.L.

    2005-01-01

    We studied chick survival of the Mountain Plover (Charadrius montanus) in Montana and found that chicks tended by females had higher survival rates than chicks tended by males, and that chick survival generally increased during the nesting season. Differences in chick survival were most pronounced early in the nesting season, and may be related to a larger sample of nests during this period. When compared to information about the nest survival of male- and female-tended plover nests, our chick data suggest a trade-off for adult plovers between the egg and chick phases of reproduction. Because Mountain Plover pairs have clutches at two nests at two different locations and show differential success between the sexes during the egg and chick phases, we offer that the Mountain Plover breeding system favours optimizing annual recruitment in a dynamic ecologic setting driven by annually unpredictable drought, grazing, and predation pressures.

  11. Linking neighborhood characteristics to food insecurity in older adults: the role of perceived safety, social cohesion, and walkability.

    PubMed

    Chung, Wai Ting; Gallo, William T; Giunta, Nancy; Canavan, Maureen E; Parikh, Nina S; Fahs, Marianne C

    2012-06-01

    Among the 14.6% of American households experiencing food insecurity, approximately 2 million are occupied by older adults. Food insecurity among older adults has been linked to poor health, lower cognitive function, and poor mental health outcomes. While evidence of the association between individual or household-level factors and food insecurity has been documented, the role of neighborhood-level factors is largely understudied. This study uses data from a representative sample of 1,870 New York City senior center participants in 2008 to investigate the relationship between three neighborhood-level factors (walkability, safety, and social cohesion) and food insecurity among the elderly. Issues relating to food security were measured by three separate outcome measures: whether the participant had a concern about having enough to eat this past month (concern about food security), whether the participant was unable to afford food during the past year (insufficient food intake related to financial resources), and whether the participant experienced hunger in the past year related to not being able to leave home (mobility-related food insufficiency). Unadjusted and adjusted logistic regression was performed for each measure of food insecurity. Results indicate that neighborhood walkability is an important correlate of mobility-related food insufficiency and concern about food insecurity, even after controlling the effects of other relevant factors.

  12. Larval Temperature–Food Effects on Adult Mosquito Infection and Vertical Transmission of Dengue-1 Virus

    PubMed Central

    Buckner, Eva A.; Alto, Barry W.; Lounibos, L. Philip

    2016-01-01

    Temperature–food interactions in the larval environment can affect life history and population growth of container mosquitoes Aedes aegypti (L.) and Aedes albopictus Skuse, the primary vectors of chikungunya and dengue viruses. We used Ae. aegypti, Ae. albopictus, and dengue-1 virus (DENV-1) from Florida to investigate whether larval rearing temperature can alter the effects of larval food levels on Ae. aegypti and Ae. albopictus life history and DENV-1 infection and vertical transmission. Although we found no effect of larval treatments on survivorship to adulthood, DENV-1 titer, or DENV-1 vertical transmission, rates of vertical transmission up to 16–24% were observed in Ae. albopictus and Ae. aegypti, which may contribute to maintenance of this virus in nature. Larval treatments had no effect on number of progeny and DENV-1 infection in Ae. aegypti, but the interaction between temperature and food affected number of progeny and DENV-1 infection of the female Ae. albopictus parent. The cooler temperature (24°C) yielded the most progeny and this effect was accentuated by high food relative to the other conditions. Low and high food led to the highest (∼90%) and lowest (∼65%) parental infection at the cooler temperature, respectively, whereas intermediate infection rates (∼75–80%) were observed for all food conditions at the elevated temperature. These results suggest that temperature and food availability have minimal influence on rate of vertical transmission and a stronger influence on adults of Ae. albopictus than of Ae. aegypti, which could have consequences for dengue virus epidemiology. PMID:26489999

  13. Food restriction increases long-term memory persistence in adult or aged mice.

    PubMed

    Talhati, F; Patti, C L; Zanin, K A; Lopes-Silva, L B; Ceccon, L M B; Hollais, A W; Bizerra, C S; Santos, R; Tufik, S; Frussa-Filho, R

    2014-04-03

    Food restriction (FR) seems to be the unique experimental manipulation that leads to a remarkable increase in lifespan in rodents. Evidences have suggested that FR can enhance memory in distinct animal models mainly during aging. However, only few studies systemically evaluated the effects FR on memory formation in both adult (3-month-old) and aged (18-24-month-old) mice. Thus, the aim of the present study was to investigate the effects of acute (12h) or repeated (12h/day for 2days) FR protocols on learning and memory of adult and aged mice evaluated in the plus-maze discriminative avoidance task (PM-DAT), an animal model that concurrently (but independently) evaluates learning and memory, anxiety and locomotion. We also investigated the possible role of FR-induced stress by the corticosterone concentration in adult mice. Male mice were kept at home cage with food ad libitum (CTRL-control condition) or subjected to FR during the dark phase of the cycle for 12h/day or 12h/2days. The FR protocols were applied before training, immediately after it or before testing. Our results demonstrated that only FR for 2days enhanced memory persistence when applied before training in adults and before testing in aged mice. Conversely, FR for 2days impaired consolidation and exerted no effects on retrieval irrespective of age. These effects do not seem to be related to corticosterone concentration. Collectively, these results indicate that FR for 2days can promote promnestic effects not only in aged mice but also in adults.

  14. Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults

    PubMed Central

    Nansel, Tonja R.; Lipsky, Leah M.; Eisenberg, Miriam H.; Haynie, Denise L.; Liu, Danping; Simons-Morton, Bruce

    2016-01-01

    Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p < 0.001), sweet and salty snacks (0.21 ± 0.05, p < 0.001), foods made with cheese (0.14 ± 0.06, p = 0.03), soda (0.12 ± 0.04, p = 0.009), processed meats (0.12 ± 0.05, p = 0.045), and fish (0.08 ± 0.03, p = 0.03) but was not associated with intake frequency of fruit or juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods. PMID:27588287

  15. Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults.

    PubMed

    Nansel, Tonja R; Lipsky, Leah M; Eisenberg, Miriam H; Haynie, Denise L; Liu, Danping; Simons-Morton, Bruce

    2016-01-01

    Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p < 0.001), sweet and salty snacks (0.21 ± 0.05, p < 0.001), foods made with cheese (0.14 ± 0.06, p = 0.03), soda (0.12 ± 0.04, p = 0.009), processed meats (0.12 ± 0.05, p = 0.045), and fish (0.08 ± 0.03, p = 0.03) but was not associated with intake frequency of fruit or juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods.

  16. Reducing high calorie snack food in young adults: a role for social norms and health based messages

    PubMed Central

    2013-01-01

    Background Consumption of high calorie junk foods has increased recently, especially among young adults and higher intake may cause weight gain. There is a need to develop public health approaches to motivate people to reduce their intake of junk food. Objective To assess the effect of health and social norm messages on high calorie snack food intake (a type of junk food) as a function of usual intake of junk food. Design In a between-subjects design, 129 young adults (45 men and 84 women, mean age = 22.4 years, SD = 4.5) were assigned to one of three conditions: 1) a social norm condition, in which participants saw a message about the junk food eating habits of others; 2) a health condition, in which participants saw a message outlining the health benefits of reducing junk food consumption and; 3) a control condition, in which participants saw a non-food related message. After exposure to the poster messages, participants consumed a snack and the choice and amount of snack food consumed was examined covertly. We also examined whether usual intake of junk food moderated the effect of message type on high calorie snack food intake. Results The amount of high calorie snack food consumed was significantly lower in both the health and the social norm message condition compared with the control message condition (36% and 28%, both p < 0.05). There was no significant difference in snack food or energy intake between the health and social norm message conditions. There was no evidence that the effect of the messages depended upon usual consumption of junk food. Conclusions Messages about the health effects of junk food and social normative messages about intake of junk food can motivate people to reduce their consumption of high calorie snack food. PMID:23738741

  17. Child Care Training for Adults with Mental Retardation. Volume I: Infants. Instructor's Manual.

    ERIC Educational Resources Information Center

    Dickerson, Martha Ufford; And Others

    The volume is intended to help mentally retarded adults learn how to interact with infants and children in a caring and safe manner. The manual may be used by counselors or trainers in one-to-one or small group sessions. Each unit includes line drawings to illustrate proper techniques; the drawings have been designed for the trainees' use and are…

  18. Mixed Methods Research of Adult Family Care Home Residents and Informal Caregivers

    ERIC Educational Resources Information Center

    Jeanty, Guy C.; Hibel, James

    2011-01-01

    This article describes a mixed methods approach used to explore the experiences of adult family care home (AFCH) residents and informal caregivers (IC). A rationale is presented for using a mixed methods approach employing the sequential exploratory design with this poorly researched population. The unique challenges attendant to the sampling…

  19. Care of the Older Adult in the Emergency Department: Nurses Views of the Pressing Issues

    ERIC Educational Resources Information Center

    Boltz, Marie; Parke, Belinda; Shuluk, Joseph; Capezuti, Elizabeth; Galvin, James E.

    2013-01-01

    Purpose: The purpose of the study was to describe nurses' views of the issues to be addressed to improve care of the older adult in the emergency department (ED). Design and Methods: An exploratory content analysis examined the qualitative responses of 527 registered nurses from 49U.S. hospitals who completed the Geriatric Institutional Profile.…

  20. An Inventory of Skills and Attitudes Necessary for a Career in Human Services/Adult Care.

    ERIC Educational Resources Information Center

    Broadbent, William

    This document is an inventory of skills identified as necessary by professionals in the human services field specializing in adult care. It is intended as a mechanism whereby educators can compare that which they teach against what the human services industry feels is relevant. Introductory material discusses the process of the occupational…

  1. Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

    ERIC Educational Resources Information Center

    Hsieh, Chang-Ming

    2009-01-01

    This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

  2. Caring for Adults with Intellectual Disability: The Perspectives of Family Carers in South Africa

    ERIC Educational Resources Information Center

    McKenzie, Judith; McConkey, Roy

    2016-01-01

    Background: Internationally adults with intellectual disability are largely cared for by their families, especially in low- to middle-income countries (LAMIC). Compared to high-income countries, little is known about their experiences in LAMIC such as South Africa. Methods: Focus group discussions were carried out with 37 family caregivers (FCGs)…

  3. Personalisation of Adult Social Care: Self-Directed Support and the Choice and Control Agenda

    ERIC Educational Resources Information Center

    Kendall, Sophie; Cameron, Ailsa

    2014-01-01

    In 2007, "self-directed support" was introduced in adult social care in England to establish choice and control--in the assessment process itself and over service provision--for "all" service users. The personalisation agenda is underpinned by a range of ideologies, particularly a civil rights empowerment approach and…

  4. How Do Health Care Providers Perceive Technologies for Monitoring Older Adults?

    PubMed Central

    Thompson, Hilaire J.; Thielke, Stephen M.

    2010-01-01

    Monitoring and assistive technologies for the older adults, by sensing and recording activities and status, provide an objective record of a patient’s functioning within natural environments. Yet the data derived from these technologies do not directly address the clinical aims of health care providers. We conducted focus groups with health care providers who work with older adults to elicit their perspectives on monitoring technologies. Identified themes centered around the benefits and risks of technologies, patient needs, the clinical utility of information, and specific monitoring domains that might improve the health care of older adults. Providers highlighted the primary importance of involving families and caregivers, and of sustaining human interactions. They explored the difficulties with how to use information for clinical ends, and challenged the notion that more objective information would automatically improve their heath care. Designers, developers, and researchers might improve the utility and uptake of health-related technologies for older adults and their families by eliciting the viewpoints of clinical providers. PMID:19964352

  5. Hazards of Immobility: Bedsores. Adult Residential Care Home, Lesson Plan No. 5.

    ERIC Educational Resources Information Center

    Lin, Kathleen

    Developed as part of a 104-hour course on adult residential care homes (ARCHs), this 50-minute lesson is designed to enable a student to: (1) define a bedsore; (2) list and describe three major causes of bedsores; (3) identify potential bedsore sites in the back-lying, side-lying, and sitting positions; and (4) calculate the risk for developing…

  6. Prevalence of Epilepsy in Adults with Mental Retardation and Related Disabilities in Primary Care

    ERIC Educational Resources Information Center

    McDermott, Suzanne; Moran, Robert; Platt, Tan; Wood, Hope; Isaac, Terri; Dasari, Srikanth

    2005-01-01

    Two primary care practices were used to recruit adults with and without disability. Disability groups included autism, Down syndrome, cerebral palsy, and mental retardation. The patients without disability had an epilepsy prevalence rate of 1%. The prevalence of epilepsy within the disability groups was 13% for cerebral palsy, 13.6% for Down…

  7. Older Adults With Intellectual Disability in Residential Care Centers in Israel: Health Status and Service Utilization

    ERIC Educational Resources Information Center

    Merrick, Joav; Davidson, Philip W.; Morad, Mohammed; Janicki, Matthew P.; Wexler, Orren; Henderson, C. Michael

    2004-01-01

    To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased…

  8. 25 CFR 20.333 - How do I apply for Adult Care Assistance?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20.333 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Direct Assistance Adult Care Assistance § 20.333 How do I apply for... submit an application form to the social services worker....

  9. Health and Social Care Interventions Which Promote Social Participation for Adults with Learning Disabilities: A Review

    ERIC Educational Resources Information Center

    Howarth, Sharon; Morris, David; Newlin, Meredith; Webber, Martin

    2016-01-01

    People with learning disabilities are among the most socially excluded in society. There is a significant gap in research evidence showing how health and social care workers can intervene to improve the social participation of adults with learning disabilities. A systematic review and modified narrative synthesis was used to appraise the quality…

  10. Caregivers' Perceptions of a Consumer-Directed Care Program for Adults with Developmental Disabilities

    ERIC Educational Resources Information Center

    Vinton, Linda

    2010-01-01

    This article examines results from a consumer and caregiver-directed care pilot program for families with adults with developmental disabilities. Surveys were administered to 50 caregivers and three project coordinators, and focus groups were conducted with 44 individuals, including caregivers, consumers, and support coordinators. Significant pre-…

  11. Outdoor Behavioral Health Care: Client and Treatment Characteristics Effects on Young Adult Outcomes

    ERIC Educational Resources Information Center

    Roberts, Sean D.; Stroud, Daniel; Hoag, Matthew J.; Combs, Katie M.

    2016-01-01

    A lack of clarity exists regarding how different clients respond to outdoor behavioral health care (OBH). In this study, specific client and treatment characteristics were assessed for 186 young adults completing an OBH therapeutic wilderness program. Clinical outcomes were measured with the Outcome Questionnaire-45.2. Hierarchical linear modeling…

  12. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

  13. Foods and Nutrition Curriculum Guide for Junior High, Secondary, and Adult Vocational Home Economics Programs. Bulletin 1595.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This comprehensive curriculum guide for junior high through adult levels presents foods and nutrition as they relate to quality living, career orientation, and occupational training. The first section is a conceptual outline of core material in foods and nutrition. Five instructional levels are I (grades 7-9), II (9-10), III (10-11), IV (11-12),…

  14. Does Food Group Consumption Vary by Differences in Socioeconomic, Demographic, and Lifestyle Factors in Young Adults? The Bogalusa Heart Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study is to examine if food group consumption varies by differences in socioeconomic, demographic, and lifestyle factors in young adults from a semirural setting in Louisiana. The design is cross-sectional. The subjects are young adults (n = 1,266, 74% European-American, 26% ...

  15. On Site Training for Adult Day Care Program Aides that Meet State Certification Requirements and National Standards.

    ERIC Educational Resources Information Center

    Medley, Pamilea

    This document describes a practicum that was conducted to develop a training program appropriate for adult day care program aides that would meet Oklahoma state certification requirements and national standards. The training curriculum for use in delivering onsite competency-based training to students studying to become adult day care program…

  16. Prevalence of Advance Directives Among Older Adults Admitted to Intensive Care Units and Requiring Mechanical Ventilation.

    PubMed

    Gamertsfelder, Elise M; Seaman, Jennifer Burgher; Tate, Judith; Buddadhumaruk, Praewpannarai; Happ, Mary Beth

    2016-04-01

    Because older adults are at high risk for hospitalization and potential decisional incapacity, advance directives are important components of pre-hospital advanced care planning, as they document individual preferences for future medical care. The prevalence of pre-hospital advance directive completion in 450 critically ill older adults requiring mechanical ventilation from two Mid-Atlantic hospitals is described, and demographic and clinical predictors of pre-hospital advance directive completion are explored. The overall advance directive completion rate was 42.4%, with those in older age groups (75 to 84 years and 85 and older) having approximately two times the odds of completion. No significant differences in the likelihood of advance directive completion were noted by sex, race, or admitting diagnosis. The relatively low prevalence of advance directive completion among older adults with critical illness and high mortality rate (24%) suggest a need for greater awareness and education.

  17. The hidden harm of home-based care: pulmonary tuberculosis symptoms among children providing home medical care to HIV/AIDS-affected adults in South Africa.

    PubMed

    Cluver, Lucie; Orkin, Mark; Moshabela, Mosa; Kuo, Caroline; Boyes, Mark

    2013-01-01

    Millions of children in sub-Saharan Africa undertake personal and medical care for family members who are unwell with AIDS. To date, no research has investigated whether such care provision places children at heightened risk for pulmonary tuberculosis. This study aimed to address this gap by identifying risk factors for paediatric pulmonary tuberculosis symptomatology. In 2009-2011, 6002 children aged 10-17 years were surveyed using door-to-door household sampling of census enumeration areas. These were randomly sampled from six urban and rural sites with over 30% HIV prevalence, within South Africa's three highest tuberculosis-burden provinces. Validated scales and clinical tuberculosis symptom checklists were modelled in multivariate logistic regressions, controlling for socio-demographic co-factors. Findings showed that, among children, severe pulmonary tuberculosis symptomatology was predicted by primary caregiver HIV/AIDS-illness [odds ratio (OR): 1.63, confidence interval (CI): 1.23-2.15, p<0.001], and AIDS-orphanhood (OR: 1.44, CI: 1.04-2.00, p<0.029). Three-fold increases in severe tuberculosis symptoms were predicted by the child's exposure to body fluids through providing personal or medical care to an ill adult (OR: 3.12, CI: 1.96-4.95, p<0.001). Symptoms were also predicted by socio-economic factors of food insecurity (OR: 1.52, CI: 1.15-2.02, p<0.003) and household overcrowding (OR: 1.35, CI: 1.06-1.72, p<0.017). Percentage probability of severe tuberculosis symptoms rose from 1.4% amongst least-exposed children, to 18.1% amongst those exposed to all above-stated risk factors, independent of biological relationship of primary caregiver-child and other socio-demographics. Amongst symptomatic children, 75% had never been tested for tuberculosis. These findings identify the risk of tuberculosis among children providing home medical care to their unwell caregivers, and suggest that there are gaps in the health system to screen and detect these cases of

  18. Consumption of industrialized food by infants attending child day care centers

    PubMed Central

    Toloni, Maysa Helena de A.; Longo-Silva, Giovana; Konstantyner, Tulio; Taddei, José Augusto de A. C.

    2014-01-01

    Objective: To identify the age of introduction of petit suisse cheese and instant noodles in the diet of infants attending nurseries of public day care centers and to compare the nutritional composition of these foods with the healthy recommended diet (breast milk and salt meal) for this age, in order to estimate nutritional errors. Methods: Cross-sectional study of 366 children (from nine to 36 months old) who attended day care centers, whose mothers were interviewed about the age of introduction of those foods. The means of the nutrients indicated on the labels of the most consumed brands were considered. For the calculation of the percent composition of breast milk and salt meal, Tables of Food Composition were used. To assess the nutritional adequacy, we used the Dietary Reference Intakes by age group. The percentage of adequacy evaluation of the petit suisse cheese and the instant noodles nutritional compositions was made by comparing them with those of the human milk and the salt meal, respectively. Results: The petit suisse cheese and the instant noodles were consumed by 89.6 and 65.3% of the children in the first year of life. The percentages of adequacy for carbohydrates were more than twice and the percentages for sodium were 20 times higher than those found in the recommended foods. Conclusions: Both industrialized products are inappropriate for infants, emphasizing the need for adoption of norms that can inform health professionals, educators and parents about the risks of consumption. PMID:24676188

  19. Determinants of Utilization of Eye Care Services in a Rural Adult Population of a Developing Country

    PubMed Central

    Olusanya, Bolutife A.; Ashaye, Adeyinka O.; Owoaje, Eme T.; Baiyeroju, Aderonke M.; Ajayi, Benedictus G.

    2016-01-01

    Purpose: To describe the factors that determine the utilization of eye care services in a rural community in South-Western Nigeria. Methods: A descriptive cross-sectional survey using a multistage sampling technique was conducted. The main outcome measure was self-reported previous consultation of an orthodox medical facility for eye care. Results: The study sample included 643 participants. Only 122 (19%) respondents had previously visited orthodox facilities in search of eye care and 24% of those with presenting visual acuity <6/18 had sought eye care. Characteristics associated with previous utilization of eye care services were age of =70 years (odds ratio [OR] ≥ 1.7, P = 0.02); male gender (OR = 1.5, P = 0.04); literacy (OR = 1.7, P = 0.007); and residing close to an eye care facility (OR = 2.8, P < 0.001). Blind respondents were three times more likely to seek eye care (P < 0.001). Regression analysis revealed that factors associated with increased likelihood of utilization of eye care services included age ≥70 years; literacy; residence close to an eye facility; being diabetic or hypertensive; history of ocular symptoms, and blindness. Conclusions: These findings suggest that a significant proportion (75%) of adults in the study area are not utilizing eye care services and that blindness is an important determinant of utilization of eye care services. Health education and awareness campaigns about the importance and benefits of seeking eye care early, and the provision of community-based eye care programs are essential to boost the uptake of eye care services in this community as well as other rural areas of West Africa. PMID:26957847

  20. [Family dynamics in the caring context of adults on the fourth age].

    PubMed

    Polaro, Sandra Helena Isse; Gonçalves, Lucia Hisako Takase; Nassar, Silvia Modesto; Lopes, Márcia Maria Bragança; Ferreira, Viviane Ferraz; Monteiro, Hellen Karinna

    2013-01-01

    This study aimed to determine the pattern of family functioning on everyday care relationships of adults in the fourth age. This is a study of diagnostic-evaluative nature of adults with 80 or more years old who depend on care, and of their relatives as caregivers. The participants were selected among the registered patients of a Family Health Unit in a district in the suburbs of Belém-PA, Brazil. They were evaluated according to the dynamics of their family, and quality of life related health lifestyle. Most of the elderly rated their families with good functionality. However, data on the elderly and caregivers' quality of life and caregivers' life style only reached the median level, showing some difficulty in the family functioning system. It was concluded that the multiple results obtained through the assessments indicate some practical implications of care to the family unity and confirm the need for multidimensional assessment about the family intervention.

  1. Understanding observed and unobserved health care access and utilization disparities among US Latino adults.

    PubMed

    Vargas Bustamante, Arturo; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2009-10-01

    This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder-Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.

  2. Provision of Transition Education and Referral Patterns from Pediatric Cardiology to Adult Cardiac Care.

    PubMed

    Harbison, Anna L; Grady, Stafford; Chi, Kevin; Fernandes, Susan M

    2016-02-01

    ACC/AHA guidelines recommend a structured preparation for and transfer to adult-oriented cardiac care for adult survivors of pediatric onset heart disease (POHD). Given this, we sought to describe the transition and transfer practices for a cohort of young adults with POHD and to determine factors associated with successful transfer to adult-oriented cardiac care. We performed a single-center, retrospective chart review on patients ≥18 years of age, with POHD likely to require lifelong cardiac care, who were seen in outpatient pediatric cardiology (PC) between 2008 and 2011. Successful transfer was defined as the subsequent attendance at adult cardiology (AC) within 2 years of PC visit. We identified 118 patients who met study criteria. Mean age 22.4 ± 2.0 years, 59 % male, 64 % white and 40 % Hispanic. Mean transition education topics noted was 3.3 ± 1.8 out of 20 and covered the underlying cardiac disease (89 %), follow-up and current medications (56 %) and exercise limitations (34 %). Recommendations for follow-up were AC (57 %) and PC (33 %). Of those told to transfer to AC, 79 % successfully transferred. Characteristics of successful transfer included: prior cardiac surgery (p = 0.008), cardiac medication use (p = 0.006) and frequency of follow-up ≤1 year (p = 0.037). One-quarter of all subjects did not follow-up within at least 2 years. Despite published guidelines, transition education appears lacking and the approach to transfer to adult cardiac care is not consistent. Given the increased risk of morbidity and mortality in this patient population, standardization of transition education and transfer processes appear warranted.

  3. Comparing dietary macronutrient composition and food sources between native and diasporic Ghanaian adults

    PubMed Central

    Gibson, Rachel; Knight, Annemarie; Asante, Matilda; Thomas, Jane; Goff, Louise M.

    2015-01-01

    Background Dietary acculturation may contribute to the increased burden of non-communicable diseases (NCDs) in diasporic populations of African ancestry. Objective To assess nutritional composition and the contribution that traditional foods make to the diets of native and UK-dwelling Ghanaian adults. Design An observational study of Ghanaian adults living in Accra (n=26) and London (n=57) was undertaken. Three-day food records were translated to nutrient data using culturally sensitive methods and comparisons were made for energy, macronutrients, and dietary fibre between cohorts. The contribution of traditional foods to dietary intake was measured and the foods contributing to each nutrient were identified. Results Compared to native Ghanaians, UK-Ghanaians derived a significantly higher proportion of energy from protein (16.9±3.9 vs. 14.1±2.8%, p=0.001), fat (29.9±7.9 vs. 24.4±8.5%, p=0.005), and saturated fat (8.5±3.4 vs. 5.8±3.7%, p<0.001) and a significantly lower energy from carbohydrate (52.2±7.7 vs. 61.5±9.3%, p<0.001). Dietary fibre intake was significantly higher in the UK-Ghanaian diet compared to the native Ghanaian diet (8.3±3.1 vs. 6.7±2.2 g/1,000 kcal, p=0.007). There was significantly less energy, macronutrients, and fibre derived from traditional foods post-migration. Non-traditional foods including breakfast cereals, wholemeal bread, and processed meats made a greater contribution to nutrient intake post-migration. Conclusions Our findings show the migrant Ghanaian diet is characterised by significantly higher intakes of fat, saturated fat, and protein and significantly lower intakes of carbohydrate; a macronutrient profile which may promote increased risk of NCDs amongst UK-Ghanaians. These differences in the nutrient profile are likely to be modulated by the consumption of ‘Western’ foods observed in migrant communities. PMID:26610275

  4. Quality Measures for the Care of Adult Patients with Obstructive Sleep Apnea

    PubMed Central

    Aurora, R. Nisha; Collop, Nancy A.; Jacobowitz, Ofer; Thomas, Sherene M.; Quan, Stuart F.; Aronsky, Amy J.

    2015-01-01

    Obstructive sleep apnea (OSA) is a prevalent disorder associated with a multitude of adverse outcomes when left untreated. There is significant heterogeneity in the evaluation and management of OSA resulting in variation in cost and outcomes. Thus, the goal for developing these measures was to have a way to evaluate the outcomes and reliability of the processes involved with the standard care approaches used in the diagnosis and management of OSA. The OSA quality care measures presented here focus on both outcomes and processes. The AASM commissioned the Adult OSA Quality Measures Workgroup to develop quality care measures aimed at optimizing care for adult patients with OSA. These quality care measures developed by the Adult OSA Quality Measures Workgroup are an extension of the original Centers for Medicare & Medicaid Services (CMS) approved Physician Quality Reporting System (PQRS) measures group for OSA. The measures are based on the available scientific evidence, focus on public safety, and strive to improve quality of life and cardiovascular outcomes for individual OSA patients. The three outcomes that were selected were as follows: (1) improve disease detection and categorization; (2) improve quality of life; and (3) reduce cardiovascular risk. After selecting these relevant outcomes, a total of ten process measures were chosen that could be applied and assessed for the purpose of accomplishing these outcomes. In the future, the measures described in this document may be reported through the PQRS in addition to, or as a replacement for, the current OSA measures group. The overall objective for the development of these measures is that implementation of these quality measures will result in improved patient outcomes, reduce the public health burden of OSA, and provide a measurable standard for evaluating and managing OSA. Citation: Aurora RN, Collop NA, Jacobowitz O, Thomas SM, Quan SF, Aronsky AJ. Quality measures for the care of adult patients with

  5. The importance of paternal care on pup survival and pup growth in Peromyscus californicus when required to work for food.

    PubMed

    Wright, Sandra L.; Brown, Richard E.

    2002-10-31

    We examined paternal care in the monogamous California mouse when wheel running was necessary to obtain food. Paternal and maternal care, pup survival and feeding were compared in litters with single females (Male Absent) and paired females (Male Present) under three different foraging requirements. When wheel running was required for obtaining food (Wheel Contingent), the male's presence significantly increased pup survival. There were no significant effects of the male's presence on pup survival in the No Wheel (standard laboratory housing with ad lib food) or Wheel Noncontingent (running wheel with ad lib food) groups. Males may have indirectly increased pup survival by helping generate food through wheel running and then subsequently spending less time eating than females. While females reduced the time spent in parental care as pups aged, males increased the time spent in parental care as pups aged. Thus as pups became larger and more expensive to rear, the male increased parental care. These results indicate that paternal care benefits pup survival more under conditions where the parents must forage to obtain food than when food is provided ad lib in the standard laboratory environment.

  6. Protein Beverage vs. Protein Gel on Appetite Control and Subsequent Food Intake in Healthy Adults

    PubMed Central

    Zhang, Sha; Leidy, Heather J.; Vardhanabhuti, Bongkosh

    2015-01-01

    The objective of this study was to compare the effects of food form and physicochemical properties of protein snacks on appetite and subsequent food intake in healthy adults. Twelve healthy subjects received a standardized breakfast and then 2.5 h post-breakfast consumed the following snacks, in randomized order: 0 kcal water (CON) or 96 kcal whey protein snacks as beverages with a pH of either 3.0 (Bev-3.0) or 7.0 (Bev-7.0) or gels as acid (Gel-Acid) or heated (Gel-Heated). In-vitro study showed that Bev-3.0 was more resistant to digestion than Bev-7.0, while Gel-Acid and Gel-Heated had similar digestion pattern. Appetite questionnaires were completed every 20 min until an ad libitum lunch was provided. Post-snack hunger, desire to eat, and prospective food consumption were lower following the beverages and gels vs. CON (all, p < 0.05), and post-snack fullness was greater following the snacks (except for the Bev-3.0) vs. CON (all, p < 0.05). Gel-Heated treatment led to lower prospective food consumption vs. Bev-3.0; however, no other differences were detected. Although all snacks reduced energy intake vs. CON, no differences were observed among treatments. This study suggested that whey protein in either liquid or solid form improves appetite, but the physicochemical property of protein has a minimal effect. PMID:26506378

  7. [Food habits and caries experience in young adults from Rosario, Argentina].

    PubMed

    Kohli, A; Poletto, L; Pezzotto, S M

    2007-12-01

    Odontological assistance in Rosary City is offered in private and public services. The public ones lack programs to avoid dental loss in adults. Our aim was to describe the caries experience and dietetic habits in three sub-populations of young adults. Applying a standardized anamnesis, 517 patients, both sexes, 15-45 years old, attending to a private service (19%) and two public ones (81%), were investigated. Studied variables: oral health, lacteal and sweet food consumed, and instruction level. Student t-test, ANOVA and chi-square tests were applied. Average decayed teeth were 1.7+/-2.0 in the private service, and 4.1+/-2.8 in the public ones (p<0.0001); missing teeth were 5.4+/-5.2 and 6.8+/-5.4 (p=0.04); and filled teeth were 4.4+/-4.2 and 1.3+/-2.2, respectively (p<0.0001). Dairy foods daily consumption was higher in the private service (p<0.001). Patients in the public services expressed to replace milk by mate, and to relate its consumption with pregnancy and lactation, or to leave it for children. Sweets delicacies consumed in the private sector -considered of risk- were sweet breads, cakes, cookies and sweets, and in the public ones were soft candies, "alfajores" and sweet made with milk. Minor risk sweets consumption in private patients were ice creams, sodas and chocolates, and in the public ones, hard candies and chewing gums, with and without sugar. Although a high number of patients consume delicacies and sweet foods at any hour, private patients were a minority; and they were a majority when considering its ingestion only after a food.

  8. Reproducibility and relative validity of a food-frequency questionnaire among French adults and adolescents

    PubMed Central

    Deschamps, Valérie; De Lauzon-Guillain, Blandine; Lafay, Lionel; Borys, Jean-Michel; Charles, Marie-Aline; Romon, Monique

    2009-01-01

    Objective Our aim was to evaluate the reproducibility of a food frequency questionnaire (FFQ) developed in a French population, and its validity against four 24-hour dietary recalls (24-HR). Methods 57 adults (aged 18 to 63), 17 adolescents (aged 14 to 18), and 20 children (aged 10 to 14) completed four 24-HRs (one per season) and two FFQs over a 1-year interval. Reproducibility of the FFQ was estimated by intraclass correlation coefficients (ICCs). The validity of FFQ was assessed by comparison with the four 24-HRs. Results For most nutrients, the first FFQ measurements gave higher mean values than the second FFQ. The ICCs for nutrients ranged from 0.39 for total protein to 0.83 for alcohol. The ICCs were higher for food items consumed daily such as milk (0.80) or sugars and confectionnery (0.65), and lower for rarely eaten food such as inner organs (0.11). Nutrient intakes as assessed by FFQs were higher than those from the 24-HRs, except for alcohol. The de-attenuated Pearson’s correlation coefficient for nutrients varied from 0.25 (dietary fiber) to 0.90 (alcohol), but the adjustment for energy did not improve these coefficients. When nutrient intakes were categorized into quintiles, FFQ and 24-HRs produced agreement rates (same or adjacent quintile) between 55% (for PUFA) and 95% (for alcohol), while misclassification to an extreme quintile was rare (<5%). Conclusion The FFQ developed for the FLVS II Study can be used to classify adults or adolescents according to their nutrients and food intakes over a one-year period. PMID:17882132

  9. Delivery of epilepsy care to adults with intellectual and developmental disabilities.

    PubMed

    Devinsky, Orrin; Asato, Miya; Camfield, Peter; Geller, Eric; Kanner, Andres M; Keller, Seth; Kerr, Michael; Kossoff, Eric H; Lau, Heather; Kothare, Sanjeev; Singh, Baldev K; Wirrell, Elaine

    2015-10-27

    Epilepsy is common in people with intellectual and developmental disabilities (IDD). In adulthood, patients with IDD and epilepsy (IDD-E) have neurologic, psychiatric, medical, and social challenges compounded by fragmented and limited care. With increasing neurologic disability, there is a higher frequency of epilepsy, especially symptomatic generalized and treatment-resistant epilepsies. The causes of IDD-E are increasingly recognized to be genetic based on chromosomal microarray analysis to identify copy number variants, gene panels (epilepsy, autism spectrum disorder, intellectual disability), and whole-exome sequencing. A specific genetic diagnosis may guide care by pointing to comorbid disorders and best therapy. Therapy to control seizures should be individualized, with drug selection based on seizure types, epilepsy syndrome, concomitant medications, and comorbid disorders. There are limited comparative antiepileptic drug data in the IDD-E population. Vagus nerve and responsive neural stimulation therapies and resective surgery should be considered. Among the many comorbid disorders that affect patients with IDD-E, psychiatric and sleep disorders are common but often unrecognized and typically not treated. Transition from holistic and coordinated pediatric to adult care is often a vulnerable period. Communication among adult health care providers is complex but essential to ensure best care when these patients are seen in outpatient, emergency room, and inpatient settings. We propose specific recommendations for minimum care standards for people with IDD-E.

  10. Transitions in Care among Older Adults with Dementia in a Nationally Representative Sample of Older Americans

    PubMed Central

    Callahan, Christopher M.; Tu, Wanzhu; Unroe, Kathleen T.; LaMantia, Michael A.; Stump, Timothy E.; Clark, Daniel O.

    2016-01-01

    Background Older adults with dementia experience frequent transitions in care Objectives To describe transitions in care among older adults with dementia identified from a nationally representative cohort and to describe transition rates among subjects with more severe levels of cognitive and functional impairment Design Longitudinal cohort study Setting Health and Retirement Study (HRS) Participants 16,186 HRS respondents aged 65 years or over whose survey data were linked with Medicare claims from 1999-2008 Measurements Transitions in care between home, home with formal services, hospital, and nursing facility care, as well as cognitive function, activities of daily living, and mortality. Results The 3,447 (21.3%) HRS subjects who were ever diagnosed with dementia experienced frequent transitions. Among subjects transitioning from a hospital stay, 52.2% returned home without home care services while 33.8% transitioned to a nursing facility. Among subjects transitioning from a nursing facility, 59.2% transitioned to the hospital while 25.3% returned home without services. There were 2,139 transitions to death and 58.7% of HRS subjects with dementia died at home. Even among persons with moderate to severe dementia, we documented multiple transitions in care, including transitions from the hospital to home and back to the hospital. Conclusion In this nationally representative sample of older adults, subjects diagnosed with dementia experience frequent transitions. Those persons with dementia who are cared for at home and who transition back to home often have moderate to severe impairments in both function and cognition. PMID:26200764

  11. 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,…

  12. 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.

  13. Health Care for Older Adults in Uganda: Lessons for the Developing World.

    PubMed

    Tam, Wai Jia; Yap, Philip

    2016-10-22

    Approximately two-thirds of the world's older adults live in developing nations. By 2050, as many as 80% of such older people will live in low- and middle-income countries. In sub-Saharan Africa alone, the number of individuals aged 60 and older is projected to reach 163 million. Despite this demographic wave, the majority of Africa has limited access to qualified geriatric health care.(3) Although foreign aid and capacity-building efforts can help to close this gap over time, it is likely that failure to understand the unique context of Africa's older adults, many of whom are marginalized, will lead to inadequacies in service delivery and poor health outcomes.(4) As the need for culturally competent care of older adults gains recognition in the developed world, research in geriatric care in developing countries should progress in tandem.(4) By examining the multidimensional challenges that an older woman with the human immunodeficiency virus (HIV) in rural Uganda faces, this article makes contextualized policy recommendations for older adults in Africa and provides lessons for the developing world.

  14. Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care

    PubMed Central

    Dhar, Sumitrajit; Nielsen, Donald W.; Griffith, James W.; Lundy, Larry B.; Driscoll, Colin; Neff, Brian; Beatty, Charles; Barrs, David; Zapala, David A.

    2016-01-01

    Purpose The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems. Method Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting. Results Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting. Conclusions Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients. PMID:27679840

  15. Reimagining care for adolescent and young adult cancer programs: Moving with the times.

    PubMed

    Gupta, Abha A; Papadakos, Janet K; Jones, Jennifer M; Amin, Leila; Chang, Eugene K; Korenblum, Chana; Santa Mina, Daniel; McCabe, Lianne; Mitchell, Laura; Giuliani, Meredith E

    2016-04-01

    Literature regarding the development of adolescent and young adult (AYA) cancer programs has been dominantly informed by pediatric centers and practitioners. However, the majority of young adults are seen and treated at adult cancer centers, in which cancer volumes afford the development of innovative supportive care services. Although the supportive care services in adult cancer centers are helpful to AYAs, some of the most prominent and distinct issues faced by AYAs are not adequately addressed through these services alone. This article describes how the AYA Program at Princess Margaret Cancer Centre has collaborated with existing supportive care services in addition to supplying its own unique services to meet the comprehensive needs of AYAs in the domains of: symptom management (sexuality and fatigue), behavior modification (return to work and exercise), and health services (advanced cancer and survivorship). These collaborations are augmented by patient education interventions and timely referrals. The objective of this article was to assist other centers in expanding existing services to address the needs of AYA patients with cancer.

  16. Delivering Flexible Education and Training to Health Professionals: Caring for Older Adults in Disasters.

    PubMed

    Altman, Brian A; Gulley, Kelly H; Rossi, Carlo; Strauss-Riggs, Kandra; Schor, Kenneth

    2016-08-01

    The National Center for Disaster Medicine and Public Health (NCDMPH), in collaboration with over 20 subject matter experts, created a competency-based curriculum titled Caring for Older Adults in Disasters: A Curriculum for Health Professionals. Educators and trainers of health professionals are the target audience for this curriculum. The curriculum was designed to provide breadth of content yet flexibility for trainers to tailor lessons, or select particular lessons, for the needs of their learners and organizations. The curriculum covers conditions present in the older adult population that may affect their disaster preparedness, response, and recovery; issues related to specific types of disasters; considerations for the care of older adults throughout the disaster cycle; topics related to specific settings in which older adults receive care; and ethical and legal considerations. An excerpt of the final capstone lesson is included. These capstone activities can be used in conjunction with the curriculum or as part of stand-alone preparedness training. This article describes the development process, elements of each lesson, the content covered, and options for use of the curriculum in education and training for health professionals. The curriculum is freely available online at the NCDMPH website at http://ncdmph.usuhs.edu (Disaster Med Public Health Preparedness. 2016;10:633-637).

  17. Cystic fibrosis: addressing the transition from pediatric to adult-oriented health care.

    PubMed

    Kreindler, James L; Miller, Victoria A

    2013-12-11

    Survival for patients with cystic fibrosis (CF) increased to nearly 40 years in 2012 from the early childhood years in the 1940s. Therefore, patients are living long enough to require transition from pediatric CF centers to adult CF centers. The goal of transition is for the young adult to be engaged in the adult health care system in ways that optimize health, maximize potential, and increase quality of life. A successful transition promotes autonomy and responsibility with respect to one's own health. Currently, there is an information gap in the literature with respect to psychological models that can help guide informed transition processes. In this review, we establish the framework in which transition exists in CF; we review some of the published literature from the last 20 years of experience with transition in CF centers around the world; and we discuss psychological models of pediatric illness that can help to explain the current state of transition to adult-oriented care from pediatric-oriented care and help to formulate new models of ascertaining readiness for transition. Finally, we look at our current knowledge gaps and opportunities for future research endeavors.

  18. Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults.

    PubMed

    Chalmers, James D; Sethi, Sanjay

    2017-12-01

    Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.

  19. [Food for health: primary-care prevention and public health--relevance of the medical role].

    PubMed

    Ravasco, Paula; Ferreira, Catarina; Camilo, Maria Ermelinda

    2011-12-01

    Each individual is unique, with genetic factors that interact with a particular environment. Therefore, the daily energy requirements should be calculated individually and have to consider the several factors which influence them: basal metabolic rate, diet-induced thermogenesis, physical activity, specific diseases, among other factors. Food provides macronutrients: carbohydrates, proteins and lipids, as well as micronutrients: vitamins, minerals and oligoelements, which should be eaten daily in the recommended amounts during the life cycle, e.g. pregnancy, childhood, adolescence, adulthood and aging. Health professionals can use the "Roda dos Alimentos Portuguesa" to teach and guide the population on how to eat, whether they are healthy or ill individuals, in order to meet their nutritional needs. Through this tool it is possible for everyone to understand and to practice a diet that is: 1) complete (eating foods from all groups), 2) balanced (to respect the proportions of each food group, adjusting the recommended portions/amounts for each individual), and 3) diversified (to choose different foods within each group). Some studies show that food marketing and advertising influence the consumers' choices since childhood. There is already some Regulation in this field, especially about nutrition and health claims. However, a permanent supervision of food marketing is necessary, to ensure compliance with the European Regulation from EFSA. It is crucial to teach and to encourage people to carefully read the food labels before purchasing. Health professionals should also be aware, academically and professionally, about the basics principles of Food and Health Promotion. The unique and essential role of the Professionals of Nutrition needs to be valued and recognized, and these professionals have to be integrated in sufficient number, in the multidisciplinary teams of the National Health Service, whether in Hospitals or Health Care Centers for the ambulatory population

  20. Transferring young people with profound intellectual and multiple disabilities from pediatric to adult medical care: parents' experiences and recommendations.

    PubMed

    Bindels-de Heus, Karen G C B; van Staa, Anneloes; van Vliet, Ingeborg; Ewals, Frans V P M; Hilberink, Sander R

    2013-06-01

    Many children with profound intellectual and multiple disabilities (PIMD) now reach adulthood. The aim of this study was to elicit parents' experiences with the transfer from pediatric to adult medical care. A convenience sample of 131 Dutch parents of young people with PIMD (16-26 years) completed a web-based questionnaire. Twenty-two percent of the young persons were still in pediatric care; 22% of the others had no care coordinator, although their health needs were the same. Parents valued the care provided by the pediatrician, and wished to see it continued. They were critical about how they had been prepared for transfer to adult care. Parents provided suggestions to improve transitional care, such as early start, information provision, and a joint consultation between pediatric and adult care.

  1. 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

  2. IgE Sensitization Patterns to Commonly Consumed Foods Determined by Skin Prick Test in Korean Adults.

    PubMed

    Kim, Sung Ryeol; Park, Hye Jung; Park, Kyung Hee; Lee, Jae-Hyun; Park, Jung-Won

    2016-08-01

    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.

  3. Biomass Reallocation between Juveniles and Adults Mediates Food Web Stability by Distributing Energy Away from Strong Interactions.

    PubMed

    Caskenette, Amanda L; McCann, Kevin S

    2017-01-01

    Ecological theory has uncovered dynamical differences between food web modules (i.e. low species food web configurations) with only species-level links and food web modules that include within-species links (e.g. non-feeding links between mature and immature individuals) and has argued that these differences ought to cause food web theory that includes within-species links to contrast with classical food web theory. It is unclear, however, if life-history will affect the observed connection between interaction strength and stability in species-level theory. We show that when the predator in a species-level food chain is split into juvenile and adult stages using a simple nested approach, stage-structure can mute potentially strong interactions through the transfer of biomass within a species. Within-species biomass transfer distributes energy away from strong interactions promoting increased system stability consistent with classical food web theory.

  4. Biomass Reallocation between Juveniles and Adults Mediates Food Web Stability by Distributing Energy Away from Strong Interactions

    PubMed Central

    Caskenette, Amanda L.; McCann, Kevin S.

    2017-01-01

    Ecological theory has uncovered dynamical differences between food web modules (i.e. low species food web configurations) with only species-level links and food web modules that include within-species links (e.g. non-feeding links between mature and immature individuals) and has argued that these differences ought to cause food web theory that includes within-species links to contrast with classical food web theory. It is unclear, however, if life-history will affect the observed connection between interaction strength and stability in species-level theory. We show that when the predator in a species-level food chain is split into juvenile and adult stages using a simple nested approach, stage-structure can mute potentially strong interactions through the transfer of biomass within a species. Within-species biomass transfer distributes energy away from strong interactions promoting increased system stability consistent with classical food web theory. PMID:28114339

  5. Developing Navigation Competencies to Care for Older Rural Adults with Advanced Illness.

    PubMed

    Duggleby, Wendy; Robinson, Carole A; Kaasalainen, Sharon; Pesut, Barbara; Nekolaichuk, Cheryl; MacLeod, Roderick; Keating, Norah C; Santos Salas, Anna; Hallstrom, Lars K; Fraser, Kimberly D; Williams, Allison; Struthers-Montford, Kelly; Swindle, Jennifer

    2016-06-01

    Navigators help rural older adults with advanced illness and their families connect to needed resources, information, and people to improve their quality of life. This article describes the process used to engage experts - in rural aging, rural palliative care, and navigation - as well as rural community stakeholders to develop a conceptual definition of navigation and delineate navigation competencies for the care of this population. A discussion paper on the important considerations for navigation in this population was developed followed by a four-phased Delphi process with 30 expert panel members. Study results culminated in five general navigation competencies for health care providers caring for older rural persons and their families at end of life: provide patient/family screening; advocate for the patient/family; facilitate community connections; coordinate access to services and resources; and promote active engagement. Specific competencies were also developed. These competencies provide the foundation for research and curriculum development in navigation.

  6. The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

    PubMed

    Hernandez-Boussard, Tina; Burns, Carson S; Wang, N Ewen; Baker, Laurence C; Goldstein, Benjamin A

    2014-09-01

    The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009-11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19-25 before and after the ACA provision was implemented with changes in the same period for people ages 26-31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group--a relative change of -2.1 percent. The largest relative decreases were found in women (-3.0 percent) and blacks (-3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19-25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (-0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.

  7. 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

  8. 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.

  9. Associations between food consumption habits with meal intake behaviour in Spanish adults.

    PubMed

    Keller, Kristin; Rodríguez López, Santiago; Carmenate Moreno, M Margarita; Acevedo Cantero, Paula

    2014-12-01

    The aim of the present study is to explore the contribution of different types of meal intake behaviour on a healthy diet and seeks to find associations with food consumption habits. A cross-sectional survey with data from 1332 Spanish adults aged between 20 and 79 years was conducted. The survey was carried out during the cardiovascular health event 'Semanas del Corazon 2008' in four Spanish cities. Several food consumption habits such as the recommended intake of fruits, vegetables, milk and dairy products, as well as the regular consumption of fatty and salty food and ready-made meals, were used as dependent variables in logistic regression. We evaluated different meal intake behaviour such as the type of meals, snacking, and drinks taken with a meal. Our survey revealed that snacking is positively associated with the regular consumption of salty and fatty food, and having sugary drinks with meals was positively associated with the regular consumption of ready-made meals. Having a forenoon meal is positively associated with the consumption of two or more portions of milk and dairy products and vegetables, and taking an afternoon meal with the recommended intake of milk and dairy products and fruits. Drinking water during a meal increases the probability of consuming two or more portions of fruits and vegetables. Our results enhance the understanding of the contribution that meal intake behaviour makes to a healthy diet based on food consumption habits. This work provides an insight into eating behaviour and would make a useful contribution to interventions aimed at promoting healthier eating habits.

  10. Facial affective reactions to bitter-tasting foods and body mass index in adults.

    PubMed

    Garcia-Burgos, D; Zamora, M C

    2013-12-01

    Differences in food consumption among body-weight statuses (e.g., higher fruit intake linked with lower body mass index (BMI) and energy-dense products with higher BMI) has raised the question of why people who are overweight or are at risk of becoming overweight eat differently from thinner people. One explanation, in terms of sensitivity to affective properties of food, suggests that palatability-driven consumption is likely to be an important contributor to food intake, and therefore body weight. Extending this approach to unpalatable tastes, we examined the relationship between aversive reactions to foods and BMI. We hypothesized that people who have a high BMI will show more negative affective reactions to bitter-tasting stimuli, even after controlling for sensory perception differences. Given that hedonic reactions may influence consumption even without conscious feelings of pleasure/displeasure, the facial expressions were included in order to provide more direct access to affective systems than subjective reports. Forty adults (28 females, 12 males) participated voluntarily. Their ages ranged from 18 to 46 years (M=24.2, SD=5.8). On the basis of BMI, participants were classified as low BMI (BMI<20; n=20) and high BMI (BMI>23; n=20). The mean BMI was 19.1 for low BMI (SD=0.7) and 25.2 for high BMI participants (SD=1.8). Each subject tasted 5 mL of a grapefruit juice drink and a bitter chocolate drink. Subjects rated the drinks' hedonic and incentive value, familiarity and bitter intensity immediately after each stimulus presentation. The results indicated that high BMI participants reacted to bitter stimuli showing more profound changes from baseline in neutral and disgust facial expressions compared with low BMI. No differences between groups were detected for the subjective pleasantness and familiarity. The research here is the first to examine how affective facial reactions to bitter food, apart from taste responsiveness, can predict differences in BMI.

  11. Food Environment Interventions to Improve the Dietary Behavior of Young Adults in Tertiary Education Settings: A Systematic Literature Review.

    PubMed

    Roy, Rajshri; Kelly, Bridget; Rangan, Anna; Allman-Farinelli, Margaret

    2015-10-01

    The current obesity-promoting food environment, typified by highly accessible unhealthy foods and drinks, may lead to an increased risk of chronic disease, particularly within young adults. A number of university-based intervention trials have been conducted in the United States and Europe to improve the food environment in this setting. However, there are no systematic reviews focusing on these interventions conducted exclusively in tertiary education settings. Our objective was to conduct a systematic literature review evaluating food environment interventions targeting dietary behavior in young adults in college and university settings. Eight databases were searched for randomized controlled trials, pre- and postintervention studies, quasiexperimental studies, cross-sectional studies, and other nonexperimental studies from 1998 to December 2014 that were conducted in tertiary education settings (ie, colleges and universities). Studies that evaluated a food environment intervention and reported healthier food choices, reductions in unhealthy food choices, nutrition knowledge, and/or food and drink sales as primary outcomes were included. Fifteen studies of high (n=5), medium (n=7), and poor quality (n=3) met the inclusion criteria, 13 of which showed positive improvements in outcome measures. Information relating to healthy foods through signage and nutrition labels (n=10) showed improvements in outcomes of interest. Increasing the availability of healthy foods (n=1) and decreasing the portion size of unhealthy foods (n=2) improved dietary intake. Price incentives and increased availability of healthy foods combined with nutrition information to increase purchases of healthy foods (n=2) were identified as having a positive effect on nutrition-related outcomes. Potentially useful interventions in tertiary education settings were nutrition messages/nutrient labeling, providing healthy options, and portion size control of unhealthy foods. Price decreases for and

  12. Integrating mental health parity for homebound older adults under the medicare home health care benefit.

    PubMed

    Davitt, Joan K; Gellis, Zvi D

    2011-04-01

    Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.

  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. Stepped care for depression and anxiety in visually impaired older adults: multicentre randomised controlled trial

    PubMed Central

    van Rens, Ger H M B; Comijs, Hannie C; Margrain, Tom H; Gallindo-Garre, Francisca; Twisk, Jos W R; van Nispen, Ruth M A

    2015-01-01

    Study question Is stepped care compared with usual care effective in preventing the onset of major depressive, dysthymic, and anxiety disorders in older people with visual impairment (caused mainly by age related eye disease) and subthreshold depression and/or anxiety? Methods 265 people aged ≥50 were randomly assigned to a stepped care programme plus usual care (n=131) or usual care only (n=134). Supervised occupational therapists, social workers, and psychologists from low vision rehabilitation organisations delivered the stepped care programme, which comprised watchful waiting, guided self help based on cognitive behavioural therapy, problem solving treatment, and referral to a general practitioner. The primary outcome was the 24 month cumulative incidence (seven measurements) of major depressive dysthymic and/or anxiety disorders (panic disorder, agoraphobia, social phobia, and generalised anxiety disorder). Secondary outcomes were change in symptoms of depression and anxiety, vision related quality of life, health related quality of life, and adaptation to vision loss over time up to 24 months’ follow-up. Study answer and limitations 62 participants (46%) in the usual care group and 38 participants (29%) from the stepped care group developed a disorder. The intervention was associated with a significantly reduced incidence (relative risk 0.63, 95% confidence interval 0.45 to 0.87; P=0.01), even if time to the event was taken into account (adjusted hazard ratio 0.57, 0.35 to 0.93; P=0.02). The number needed to treat was 5.8 (3.5 to 17.3). The dropout rate was fairly high (34.3%), but rates were not significantly different for the two groups, indicating that the intervention was as acceptable as usual care. Participants who volunteered and were selected for this study might not be representative of visually impaired older adults in general (responders were significantly younger than non-responders), thereby reducing the generalisability of the outcomes. What

  15. Nursing home staffing and training recommendations for promoting older adults' quality of care and life: Part 1. Deficits in the quality of care due to understaffing and undertraining.

    PubMed

    Maas, Meridean L; Specht, Janet P; Buckwalter, Kathleen C; Gittler, Josephine; Bechen, Kate

    2008-04-01

    Caught between the inability or unwillingness of nursing home corporations and owners to redistribute revenue and the reluctance of federal and state agencies to increase payments to nursing homes, the nation's most vulnerable older adults are not receiving the care they deserve. Widespread recognition of substandard care and quality of life of older adults in nursing homes has existed for decades. In addition, there is substantial evidence that poor quality of care is related to inadequate numbers and training of nursing staff. Still, policy makers and nursing home owners have failed to take needed action. In the first article of this two-part series, major deficits in the care of older adult nursing home residents are reviewed, and research documenting the relationship between nursing home staffing and the quality of care and life of residents is summarized.

  16. Prevalence of urinary incontinence among community-dwelling adults receiving home care.

    PubMed

    Du Moulin, M F M T; Hamers, J P H; Ambergen, A W; Janssen, M A P; Halfens, R J G

    2008-12-01

    We conducted a cross-sectional survey in 2005 to determine the prevalence of and factors associated with urinary incontinence (UI) in adults receiving home care. Of the 2,866 patients surveyed, 46% suffered from UI; 6.5% had stress, 16.6% had urge, 9% had mixed, and 17.6% had functional incontinence. No diagnosis regarding type of UI had been established in 50.2%. Factors associated with UI were advanced age, higher body mass index, and impaired mobility. UI is prevalent in older persons receiving home care, but the lack of diagnosis of type of UI in half of the participants surveyed impedes management of UI.

  17. Relocating care: negotiating nursing skillmix in a mental health unit for older adults.

    PubMed

    Henderson, Julie; Curren, David; Walter, Bonnie; Toffoli, Luisa; O'Kane, Debra

    2011-03-01

    Mental health care in Australia in the last 20 years has moved from stand-alone psychiatric hospitals to general hospitals and the community. This paper reports an action research project exploring the experiences of nurses on an acute mental health unit for older adults staffed with a skillmix of mental health and general nurses, which recently transitioned from a psychiatric to a general hospital. The new service provides comprehensive health care, including the management of physical co-morbidity and a recovery orientation. Recovery acknowledges the role and rights of consumers and carers in planning and management of care, choice and individual strengths (Shepherd). The new ward received additional resources to establish the model of care, including a broader skillmix. The paper explores the dynamics of development of a new model of care and of bringing together staff with different professional orientations, cultures and priorities. Focus groups and interviews were conducted with 18 staff. Analysis resulted in three themes relating to the impact of competing goals and foci of care upon professional boundaries; competing organisational cultures and the impact of service change upon work practices. The findings are explored in relation to ideas about health care delivery associated with neoliberalism.

  18. Paid sick leave and preventive health care service use among U.S. working adults.

    PubMed

    DeRigne, LeaAnne; Stoddard-Dare, Patricia; Collins, Cyleste; Quinn, Linda

    2017-02-09

    Managing work and health care can be a struggle for many American workers. This paper explored the relationship between having paid sick leave and receiving preventive health care services, and hypothesized that those without paid sick leave would be less likely to obtain a range of preventive care services. In 2016, cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS) were examined to determine the relationship between having paid sick leave and obtaining eight preventive care services including: (1) blood pressure check; (2) cholesterol check; (3) fasting blood sugar check; (4) having a flu shot; (5) having seen a doctor for a medical visit; (6) getting a Pap test; (7) getting a mammogram; (8) getting tested for colon cancer. Findings from multivariable logistic regressions, holding 10 demographic, work, income, and medical related variables stable, found respondents without paid sick leave were significantly less likely to report having used six of eight preventive health services in the last 12months. The significant findings remained robust even for workers who had reported having been previously told they had risk factors related to the preventive services. These findings support the idea that without access to paid sick leave, American workers risk foregoing preventive health care which could lead to the need for medical care at later stages of disease progression and at a higher cost for workers and the American health care system as a whole.

  19. Food Allergy

    MedlinePlus

    Food allergy is an abnormal response to a food triggered by your body's immune system. In adults, the foods ... a severe reaction called anaphylaxis. Symptoms of food allergy include Itching or swelling in your mouth Vomiting, ...

  20. Impact of Food Matrix on Isoflavone Metabolism and Cardiovascular Biomarkers in Adults with Hypercholesterolemia

    PubMed Central

    Ahn-Jarvis, Jennifer; Clinton, Steven K.; Riedl, Kenneth M.; Vodovotz, Yael; Schwartz, Steven J.

    2012-01-01

    The role of food matrix and gender on soy isoflavone metabolism and biomarkers of activity were examined in twenty free-living adults (34.7±11.5 yrs old) with hypercholesterolemia (221.9 ±18.7mg/dL). In a randomized crossover design study, participants consumed soy-bread (3 wk) or soy-beverage (3 wk) containing 20 g soy protein with 99 and 93 mg isoflavones aglycone equivalents per day, respectively. During soy bread intervention, women had significantly greater microbial metabolite excretion (P=0.05) of isoflavonoids than men. In men, isoflavone metabolite excretion was not discernibly different between the two matrices. Significant reductions (P ≤ 0.05) in triglycerides (24.8%), LDL cholesterol (6.0%), apolipoprotein A-I (12.3%), and lipid oxidative stress capacity (25.5%), were observed after soy food intervention. Our findings suggest that the food matrix significantly impacts soy isoflavone metabolism, particularly microbial metabolites in women. PMID:22739802

  1. Early mobilization in the critical care unit: A review of adult and pediatric literature.

    PubMed

    Cameron, Saoirse; Ball, Ian; Cepinskas, Gediminas; Choong, Karen; Doherty, Timothy J; Ellis, Christopher G; Martin, Claudio M; Mele, Tina S; Sharpe, Michael; Shoemaker, J Kevin; Fraser, Douglas D

    2015-08-01

    Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations.

  2. Natural variation in maternal care shapes adult social behavior in rats.

    PubMed

    Starr-Phillips, Emily J; Beery, Annaliese K

    2014-07-01

    Features of the early postnatal environment profoundly shape later physical and behavioral phenotypes. The amount of licking/grooming that rat dams direct towards their offspring has durable consequences, including behavioral and physiological dimensions of stress reactivity, cognition, and reproductive behavior. We examined how natural variation in maternal care alters social behavior in adult offspring and how this relates to anxiety behavior and oxytocin receptor density. Male and female offspring of mothers who received high levels of licking spent significantly more time in social contact with unfamiliar individuals than did offspring whose dams provided less grooming. Reduced anxiety behavior was associated with greater social interaction. No differences in oxytocin receptor binding assessed by (125) I-OVTA autoradiography were detected between groups. The present investigation characterizes a novel impact of maternal care on adult social interaction behavior, replicates anxiety behavior differences, and illustrates connections between social behavior and anxiety in adulthood across maternal treatment groups.

  3. Impact of a Complex Care Management Model on Cost and Utilization Among Adolescents and Young Adults with Special Care and Health Needs.

    PubMed

    Maeng, Daniel D; Snyder, Susan R; Davis, Thomas W; Tomcavage, Janet F

    2017-03-24

    Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan. This study examines the CCC impact on total cost of care and utilization by analyzing Geisinger Health Plan claims data obtained from 83 Medicaid patients enrolled in CCC. A set of multivariate regression models with patient fixed effects was estimated to obtain adjusted differences in cost and acute care utilization between the months in which the patients were enrolled and the months not enrolled in CCC. The results indicate that CCC enrollment was associated with a 28% reduction in per-member-per-month total cost ($3931 observed vs. $5451 expected; P = 0.028), driven by reductions in hospitalization and emergency department visits. This finding suggests a clinical redesign focused on adolescent and young adults with complex care needs can potentially reduce total cost and acute care utilization among such patients.

  4. Evaluating patient-centered care: feasibility of electronic data collection in hospitalized older adults.

    PubMed

    Duffy, Joanne R; Kooken, Wendy Carter; Wolverton, Cheryl L; Weaver, Michael T

    2012-01-01

    Evaluating patient-centered care (PCC) is crucial to its improvement. This pilot study tested the feasibility of an electronic format to assess PCC during hospitalization. Using a validated indicator of PCC embedded on a mobile device, 86 older adults evaluated its delivery by registered nurses. Patients older than 85 years rated PCC poorer than those who were younger (r = -0.22; P = .04). The electronic format was appraised as feasible; it performed well and took on average 30 minutes to complete.

  5. Epilepsy in adults and access to care--United States, 2010.

    PubMed

    2012-11-16

    Epilepsy is a neurologic disorder that negatively affects the quality of life for millions of persons in the United States; however, nationally representative U.S. estimates of the prevalence of epilepsy are scant. To determine epilepsy prevalence among adults, assess their access to care, and provide baseline estimates for a Healthy People 2020 objective ("Increase the proportion of persons with epilepsy and uncontrolled seizures who receive appropriate medical care"), CDC analyzed data from the 2010 National Health Interview Survey (NHIS). The results of that analysis indicated that, in 2010, an estimated 1.0% of U.S. adults and 1.9% of those with annual family income levels ≤$34,999 had active epilepsy. In addition, only 52.8% of adults with active epilepsy reported seeing a neurologic specialist in the preceding 12 months. Public health agencies can work with Epilepsy Foundation state affiliates and other health and human service providers to eliminate identified barriers to care for persons with epilepsy.

  6. [Cancer in adolescents and young adults in France: Epidemiology and pathways of care].

    PubMed

    Desandes, Emmanuel; Lacour, Brigitte; Clavel, Jacqueline

    2016-12-01

    In adolescents and young adults (AYA), cancers are rare but represent the third significant cause of death. The aim of this paper was to investigate epidemiological data and pathways of care of AYA in France. During the 2000-2008 period, overall age-standardized incidence rates (ASR) were 254.1/10(6) in 15-24-year-olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's lymphoma, and were melanoma, thyroid carcinoma and Hodgkin's disease in females. The ASR appeared stable over time. During the 2000-2004 period, the 5-year overall survival for all cancers was 81.8%, with differences between genders and age groups: 78.8% for males and 85.2% for females; 78.5% in 15-19-year-olds and 84.3% in 20-24-year-olds. Survival has significantly improved over time. During the 2006-2007 period, the pathways of care for French adolescent patients with cancer were heterogeneous: 82% were treated in an adult environment, 27% were included in clinical studies, and in 54% of cases the management decisions were taken in the context of a multidisciplinary team. Studies looking at management of AYA with cancer have shown a wide disparity and a lack of collaboration between adult oncologists and pediatric oncologist. An AYA cancer multidisciplinary interest group has been created to determine priorities and coordinate efforts to improve AYA cancer services and care.

  7. Oral self-care and periodontal health indicators among adults with diabetes in Finland.

    PubMed

    Karikoski, A; Ilanne-Parikka, P; Murtomaa, H

    2001-12-01

    We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral self-care, and more attention is needed for improving the quality and outcome of these habits.

  8. Care of the Older Adult in the Emergency Department: Nurses Views of the Pressing Issues

    PubMed Central

    Boltz, Marie

    2013-01-01

    Purpose: The purpose of the study was to describe nurses’ views of the issues to be addressed to improve care of the older adult in the emergency department (ED). Design and Methods: An exploratory content analysis examined the qualitative responses of 527 registered nurses from 49U.S. hospitals who completed the Geriatric Institutional Profile. Results: 5 central themes emerged from the analysis, representing a lack of older personhospital environment fit in the ED: (a) respect for the older adult and carers, (b) correct and best procedures and treatment, (c) time and staff to do things right, (d) transitions, and (e) a safe and enabling environment. The nurses offered solutions to address lack of fit, including modifications to the social climate, policies and procedures, care systems and processes, and physical design. Implications: The nurses’ descriptions of the pressing issues surrounding care of older adults in the ED provide useful information to consider when developing a senior-friendly ED. Results also illuminate solutions that can be taken to address issues. These solutions give direction for future intervention research. PMID:23442380

  9. Bad Mothers and Monstrous Sons: Autistic Adults, Lifelong Dependency, and Sensationalized Narratives of Care.

    PubMed

    Allen, Holly

    2017-03-01

    Sensationalized representations of autistic families in film and other media frequently feature violent encounters between mothers and sons. This essay analyzes two media stories and three films that suggest how limited-and therefore misleading-popular representations of the autism family are. Except for one of the films, these representations blame the problem of adult autistic dependency on either monstrous autism or bad mothering. Doing so elides collective social responsibility for autism care and denies the reality that autistic adults continue to have complex dependency needs that families cannot always meet. Narratives that sensationalize youth and adults with autism or scapegoat their maternal caregivers also diminish opportunities for social inclusion and for autistic people to live fully and dependently.

  10. [Screening for attention deficit hyperactivity disorder in adult patients in primary care].

    PubMed

    Aragonès, Enric; Cañisá, Anna; Caballero, Antònia; Piñol-Moreso, Josep Lluís

    2013-05-01

    AIMS. To estimate the proportion of adult patients in primary care with a positive screening test for attention deficit hyper-activity disorder (ADHD) and to analyse their characteristics. PATIENTS AND METHODS. A cross-sectional descriptive study was performed in nine primary care clinics in the province of Tarragona. The sample consisted of 432 consecutive patients in primary care who visited for any reason, with ages ranging from 18 to 55 years. Screening for ADHD was carried out by means of the Adult ADHD Self-Report Scale (ASRS). Data about functional impact (Sheehan Disability Inventory) were obtained and a review of the patient records provided data concerning psychiatric comorbidity and the consumption of psychopharmaceuticals. RESULTS. The percentage of positive results in the screening tests was 19.9% (95% CI = 16.4-23.9%). Taking into account the sensitivity and specificity of the ASRS, the 'real' prevalence was estimated to be 12.5% (95% CI = 8.2-16.8%). None of these patients were diagnosed or treated for ADHD. Positive screening tests are associated with occupational, social and familial dysfunction, and greater perceived stress. There is also a higher level of comorbidity with affective disorders and substance abuse, as well as greater use of psychopharmaceuticals. CONCLUSIONS. Screening for ADHD in adult patients in primary care gives rise to a notably high proportion of positive screening test results, which suggests that there could be a significant prevalence of patients with ADHD. These data contrast with the absence of this diagnosis in the patient records. Further research is needed to determine the usefulness of the diagnosis of ADHD and the possible role that must be played by primary care.

  11. Problems in the organization of care for patients with adult congenital heart disease.

    PubMed

    Meijboom, Folkert; Mulder, Barbara

    2010-01-01

    The prevalence of congenital heart disease among adults in Europe, or in any country in Europe, is not known. This is due to a lack of agreement on the incidence of congenital heart disease, with estimations varying from four per 1000 births to 50 per 1000 births, and it is not known how many patients with congenital heart disease have died. Based on several studies that estimated and calculated the number of adult patients with congenital heart disease, the number of patients should be much higher than the number of patients that are actually seen in specialized centres throughout Europe. This implies that either a large proportion of adult patients with congenital heart disease do not receive appropriate medical care, or that the calculations and estimations are grossly wrong. A combination of the two is also possible. A substantial expansion of the number and size of specialized centres for adult congenital heart disease is advocated, but since setting up (and running) a service for this disease is a costly affair, and because uncertainty remains about the actual number of patients needing specialized care, this has been difficult to realize in most European countries in the past few years.

  12. Nurses Improving the Care of Healthsystem Elders: creating a sustainable business model to improve care of hospitalized older adults.

    PubMed

    Capezuti, Elizabeth A; Bricoli, Barbara; Briccoli, Barbara; Boltz, Marie P

    2013-08-01

    The Nurses Improving the Care of Healthsystem Elders (NICHE) program helps its more than 450 member sites to build the leadership capabilities to enact system-level change that targets the unique needs of older adults and embeds evidence-based geriatrics knowledge into practice. NICHE received expansion funding to establish a sustainable business model for operations while positioning the program to continue as a leader in innovative senior care programs. The expansion program focused on developing an internal business infrastructure, expanding NICHE-specific resources, creating a Web platform, increasing the number of participating NICHE hospitals, enhancing and expanding the NICHE benchmarking service, supporting research that generates evidence-based practices, fostering interorganizational collaboration, developing sufficient diversified revenue sources, and increasing the penetration and level of activity of current NICHE sites. These activities (improved services, Web-based tools, better benchmarking) added value and made it feasible to charge hospitals an annual fee for access and participation. NICHE does not stipulate how institutions should modify geriatric care; rather, NICHE principles and tools are meant to be adapted to each site's unique institutional culture. This article describes the historical context, the rationale, and the business plan that has resulted in successful organizational outcomes, including financial sustainability of the business operations of NICHE.

  13. Sanitation in classroom and food preparation areas in child-care facilities in North Carolina and South Carolina.

    PubMed

    Wohlgenent, Kelly C; Cates, Sheryl C; Fraser, Angela; Chapman, Benjamin; Jaykus, Lee-Ann; Chen, Xi

    2014-11-01

    Approximately 60% of U.S. children aged five and younger spend time in child-care settings. Such environments increase the risk of diarrheal disease, including diseases caused by enteric pathogens. To describe adherence to sanitation standards in classrooms and food preparation areas in child-care facilities, the authors conducted site visits in 40 North Carolina and South Carolina child-care facilities. Audits in up to two classrooms (rooms providing care for infants and toddlers) and the kitchen were performed using a form similar to a regulatory inspection form. Audit data were used to calculate indices to describe adherence to sanitation standards and were based on state environmental health regulations for child-care centers, the Food and Drug Administration's Food Code 2009, and guidance from food safety experts. Most facilities participating in the authors' study adhered to sanitation standards within the classroom; however, deficiencies with regard to sanitation in food preparation areas and refrigerator operating temperatures were noted. These results provide insight into possible risk factors for enteric disease transmission in child-care facilities.

  14. Care Coordination Challenges Among High-Needs, High-Costs Older Adults in a Medigap Plan

    PubMed Central

    Wells, Timothy S.; Bhattarai, Gandhi R.; Hawkins, Kevin; Cheng, Yan; Ruiz, Joann; Barnowski, Cynthia A.; Spivack, Barney; Yeh, Charlotte S.

    2016-01-01

    Purpose of the Study: Many adults 65 years or older have high health care needs and costs. Here, we describe their care coordination challenges. Primary Practice Setting: Individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York). Methodology and Sample: The three groups included the highest needs, highest costs (the “highest group”), the high needs, high costs (the “high group”), and the “all other group.” Eligibility was determined by applying an internally developed algorithm based upon a number of criteria, including hierarchical condition category score, the Optum ImpactPro prospective risk score, as well as diagnoses of coronary artery disease, congestive heart failure, or diabetes. Results: The highest group comprised 2%, although consumed 12% of health care expenditures. The high group comprised 20% and consumed 46% of expenditures, whereas the all other group comprised 78% and consumed 42% of expenditures. On average, the highest group had $102,798 in yearly health care expenditures, compared with $34,610 and $7,634 for the high and all other groups, respectively. Fifty-seven percent of the highest group saw 16 or more different providers annually, compared with 21% and 2% of the high and all other groups, respectively. Finally, 28% of the highest group had prescriptions from at least seven different providers, compared with 20% and 5% of the high and all other groups, respectively. Implications for Case Management Practice: Individuals with high health care needs and costs have visits to numerous health care providers and receive multiple prescriptions for pharmacotherapy. As a result, these individuals can become overwhelmed trying to manage and coordinate their health care needs. Care coordination programs may help these individuals coordinate their care. PMID:27301064

  15. The functions and value of reminiscence for older adults in long-term residential care facilities.

    PubMed

    Henkel, Linda A; Kris, Alison; Birney, Sarah; Krauss, Kaitlyn

    2017-03-01

    For the many older adults living in long-term care facilities, the ability to connect with others, as well as with one's own personal past, may be of particular value. Reflecting on the past and sharing reminiscences with others serves different psychosocial functions in various settings. This study examined the functions of reminiscence for long-term care residents in the United States (Mage = 86.5) by addressing the self-reported frequency of reminiscence, the counterparties involved, the overall purpose and value of reminiscence, and the relation to residents' mental health and well-being. Results demonstrated that although some functions of reminiscence were comparable to those found in community-dwelling older adults, others were unique to the long-term care setting. Residents were most likely to reminisce alone and they found the experience enjoyable. They reported engaging in and enjoying reminiscence with family more than with fellow residents, and a subset desired increased opportunities to share memories with healthcare providers. Residents with lower morale and more depressive symptoms were more likely to engage in unhealthy styles of reminiscence. These findings suggest that interventions shaping reminiscence encounters may have positive outcomes for long-term care residents.

  16. Cost implications to health care payers of improving glucose management among adults with type 2 diabetes.

    PubMed

    Nuckols, Teryl K; McGlynn, Elizabeth A; Adams, John; Lai, Julie; Go, Myong-Hyun; Keesey, Joan; Aledort, Julia E

    2011-08-01

    Objective. To assess the cost implications to payers of improving glucose management among adults with type 2 diabetes. Data Source/Study Setting. Medical-record data from the Community Quality Index (CQI) study (1996-2002), pharmaceutical claims from four Massachusetts health plans (2004-2006), Medicare Fee Schedule (2009), published literature. Study Design. Probability tree depicting glucose management over 1 year. Data Collection/Extraction Methods. We determined how frequently CQI study subjects received recommended care processes and attained Health Care Effectiveness Data and Information Set (HEDIS) treatment goals, estimated utilization of visits and medications associated with recommended care, assigned costs based on utilization, and then modeled how hospitalization rates, costs, and goal attainment would change if all recommended care was provided. Principal Findings. Relative to current care, improved glucose management would cost U.S.$327 (U.S.$192-711 in sensitivity analyses) more per person with diabetes annually, largely due to antihyperglycemic medications. Cost-effectiveness to payers, defined as incremental annual cost per patient newly attaining any one of three HEDIS goals, would be U.S.$1,128; including glycemic crises reduces this to U.S.$555-1,021. Conclusions. The cost of improving glucose management appears modest relative to diabetes-related health care expenditures. The incremental cost per patient newly attaining HEDIS goals enables payers to consider costs as well as outcomes that are linked to future profitability.

  17. Appreciating the work of nurses caring for adults with intellectual disability and mental health issues.

    PubMed

    Taua, Chris; Neville, Christine; Scott, Theresa

    2016-12-29

    This paper presents findings from a study exploring the nurses' experience of caring for adults with intellectual disability and mental health issues in inpatient settings. Semi structured interviews were undertaken with 13 nurses from various regions of New Zealand. Methods suggested by an Appreciative Inquiry methodology were used to explore the nurses' positive experiences of their role. Interviews were transcribed and analysed using open coding and Leximancer (an online data mining tool) analysis to identify dominant themes in the discourse. Analysis revealed themes around 'Contextualising behaviour', 'Communication', 'Confidence to care' and 'Time'. Participants reflected upon their experiences offering personal interpretations in identifying the aspects of nursing that mattered and that worked. What is shown is that nurses were able to describe a range of creative and adaptive ways of nursing in responding to numerous complex factors they faced in their roles. This suggests a strong foundation on which to advance nursing care in this field.

  18. Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods

    PubMed Central

    2013-01-01

    Background Our aim was to investigate the factors that affect health related quality of life (HRQL) in adult Swedish food allergic patients objectively diagnosed with allergy to at least one of the staple foods cow’s milk, hen’s egg or wheat. The number of foods involved, the type and severity of symptoms, as well as concomitant allergic disorders were assessed. Methods The disease-specific food allergy quality of life questionnaire (FAQLQ-AF), developed within EuroPrevall, was utilized. The questionnaire had four domains: Allergen Avoidance and Dietary Restrictions (AADR), Emotional Impact (EI), Risk of Accidental Exposure (RAE) and Food Allergy related Health (FAH). Comparisons were made with the outcome of the generic questionnaire EuroQol Health Questionnaire, 5 Dimensions (EQ-5D). The patients were recruited at an outpatient allergy clinic, based on a convincing history of food allergy supplemented by analysis of specific IgE to the foods in question. Seventy-nine patients participated (28 males, 51 females, mean-age 41 years). Results The domain with the most negative impact on HRQL was AADR, assessing the patients’ experience of dietary restrictions. The domain with the least negative impact on HRQL was FAH, relating to health concerns due to the food allergy. One third of the patients had four concomitant allergic disorders, which had a negative impact on HRQL. Furthermore, asthma in combination with food allergy had a strong impact. Anaphylaxis, and particularly prescription of an epinephrine auto-injector, was associated with low HRQL. These effects were not seen using EQ-5D. Analyses of the symptoms revealed that oral allergy syndrome and cardiovascular symptoms had the greatest impact on HRQL. In contrast, no significant effect on HRQL was seen by the number of food allergies. Conclusions The FAQLQ-AF is a valid instrument, and more accurate among patients with allergy to staple foods in comparison to the commonly used generic EQ-5D. It adds

  19. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres

    PubMed Central

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel

    2016-01-01

    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  20. Adolescents growing with HIV/AIDS: experiences of the transition from pediatrics to adult care.

    PubMed

    Machado, Daisy Maria; Galano, Eliana; de Menezes Succi, Regina Célia; Vieira, Carla Maria; Turato, Egberto Ribeiro

    2016-01-01

    The main objective of this work is to describe the formation of the Transition Adolescent Clinic (TAC) and understand the process of transitioning adolescents with HIV/AIDS from pediatric to adult care, from the vantage point of individuals subjected to this process. A qualitative method and an intentional sample selected by criteria were adopted for this investigation, which was conducted in São Paulo, Brazil. An in-depth semi-structured interview was conducted with sixteen HIV-infected adolescents who had been part of a transitioning protocol. Adolescents expressed the need for more time to become adapted in the transition process. Having grown up under the care of a team of health care providers made many participants have reluctance toward transitioning. Concerns in moving away from their pediatricians and feelings of disruption, abandonment, or rejection were mentioned. Participants also expressed confidence in the pediatric team. At the same time they showed interest in the new team and expected to have close relationships with them. They also ask to have previous contacts with the adult health care team before the transition. Their talks suggest that they require slightly more time, not the time measured in days or months, but the time measured by constitutive experiences capable of building an expectation of future. This study examines the way in which the adolescents feel, and help to transform the health care transition model used at a public university. Listening to the adolescents' voices is crucial to a better understanding of their needs. They are those who can help the professionals reaching alternatives for a smooth and successful health care transition.