Development of the Mealtime Emotions Measure for adolescents (MEM-A): gender differences in emotional responses to family mealtimes and eating psychopathology.

PubMed

White, Hannah J; Haycraft, Emma; Wallis, Deborah J; Arcelus, Jon; Leung, Newman; Meyer, Caroline

2015-02-01

This study aimed to examine the factor structure of the Mealtime Emotions Measure for adolescents (MEM-A), a novel measure of emotional responses experienced during family mealtimes. Additionally, it examined gender differences in mealtime emotions and also the relationships between mealtime emotions and levels of eating psychopathology, when controlling for anxiety or depression. Adolescent participants (N = 527; 282 girls, 245 boys) with a mean age of 15.9 years completed the new mealtime measure for adolescents (MEM-A), in addition to questions about family mealtime atmosphere, and measures assessing symptoms of anxiety, depression, and eating psychopathology. Factor analysis produced a three factor solution for the MEM-A with two subscales relating to different types of negative mealtime emotions (Anxiety-related mealtime emotions and Anger-related mealtime emotions) and one subscale relating to Positive mealtime emotions. Generally, girls reported experiencing more Anxiety-related mealtime emotions compared to boys. Having conducted separate analyses controlling for levels of either anxiety or depression, there were several significant associations for both girls and boys between mealtime emotions, particularly Anxiety-related emotions, and eating psychopathology. The findings suggest that some mealtime emotions are associated with increased eating psychopathology. Replication and detailed examination of these emotional responses is required. Copyright © 2014 Elsevier Ltd. All rights reserved.

Enteral feeding and its impact on family mealtime routines for caregivers of children with cerebral palsy: A mixed method study.

PubMed

Russell, Marion; Jewell, Vanessa; Poskey, Gail A; Russell, Asa

2018-02-01

Enteral feedings are part of the daily mealtime experience for many caregivers of children with cerebral palsy. The scope of occupational therapy practice incorporates multiple aspects of the enteral feeding process. Yet, the research in this area is very limited. The purpose of this study was to provide practitioners with better understanding of the impact enteral feedings of children with cerebral palsy have on family mealtime routines. Using a complimentary mixed method approach, data were obtained through an online survey containing the Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8) and supplementary questions, and qualitative semi-structured phone interviews. Participants were caregivers of children with cerebral palsy who receive their primary nutrition through a gastrostomy tube. This study's cohort consisted of n = 36, SAGA-8, and n = 6 in-depth interviews. The mean age of children of was 9.4 (6.94 SD) with a mean age of 3.4 (5.35 SD) when enteral feeding was introduced. While families' overall situations positively changed after the gastronomy tube placement, environmental barriers and length of feeding time continued to present a challenge to mealtime routines. The mixed methods data analysis revealed that successful adjustment to having a child with a gastronomy tube and problem solving are closely linked and a consistent part of mealtime experience. Findings highlighted the necessity of comprehensive support from health professionals in achieving positive mealtime experience. Themes in this study indicated that caregivers would benefit from a professional with knowledge in the development and integration of rituals and routines to support positive outcomes. © 2017 Occupational Therapy Australia.

Parent perceptions of nutritional issues during their child's treatment for cancer.

PubMed

Gerhardt, Cynthia A; Baughcum, Amy E; Johnston, Amy; Vannatta, Kathryn; Hobart Davies, W; Mackner, Laura M; Noll, Robert B

2006-07-01

To examine family mealtime interactions, parental concerns about nutrition, and body mass index (BMI) among children with cancer who did not have primary central nervous system involvement. Parents of 95 children receiving treatment for cancer and 95 comparisons completed the About Your Child's Eating-Revised (AYCE-R) measure. Anthropometric data for children with cancer were obtained from medical charts at diagnosis and again when the AYCE-R was administered. No differences in mealtime interactions were found between children with cancer and comparisons, but parents of children with cancer reported greater concern about their child's weight. Anthropometric measures for children with cancer were consistent with national norms. However, children with cancer were somewhat underweight at diagnosis and became heavier over time. Lower BMI was associated with mother and father report of greater resistance from the child at mealtime, father report of his own aversion to family meals, and more severe treatment. The impact of cancer on family mealtime interactions and BMI appeared minimal during treatment. However, further longitudinal research is needed given the risk for late effects, such as growth problems and obesity, among cancer survivors. Families also may benefit from ongoing education to optimize healthy lifestyles among survivors.

Perspectives on mealtime management in residential aged care: insights from a cross-disciplinary investigation.

PubMed

Bennett, Michelle K; Ward, Elizabeth; Scarinci, Nerina; Waite, Monique

2014-01-01

Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: ( 1 ) mealtimes are highly valued; ( 2 ) service providers face common barriers to mealtime management; ( 3 ) communication among service providers is challenging; and ( 4 ) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care.

Quality of life in children with CF: Psychometrics and relations with stress and mealtime behaviors.

PubMed

Driscoll, Kimberly A; Modi, Avani C; Filigno, Stephanie S; Brannon, Erin E; Chamberlin, Leigh Ann; Stark, Lori J; Powers, Scott W

2015-06-01

The purpose of this study was to evaluate the utility of the Cystic Fibrosis Questionnaire-Revised (CFQ-R) with toddlers and preschool-aged children. Clinically relevant relations between health-related quality of life (HRQOL), stress, and mealtime behaviors have not been examined. It was hypothesized that problematic mealtime behaviors and increased stress would be negatively associated with HRQOL. Parents of 73 children (2-6 years) with CF completed questionnaires assessing their children's generic (PedsQL) and CF-specific HRQOL, parenting and CF-specific stress, and mealtime behaviors. CFQ-R Physical, Eating, and Respiratory HRQOL subscales had acceptable to strong reliability (alphas = 0.73-0.86); other scales approached acceptable reliability. Lower CF-specific stress was associated with higher CFQ-R Eating HRQOL (B = -0.84; P < 0.05) scores. Fewer eating problems were associated with higher CFQ-R Eating (B = -1.17; P < 0.0001) and Weight HRQOL (B = -0.78; P < 0.01) scores. As hypothesized, problematic eating and higher CF-specific stress was associated with lower CF-specific HRQOL. The CFQ-R has promise for use in young children with CF, but will need to be modified to exchange items not relevant to preschoolers with items that are more relevant to this age group. © 2014 Wiley Periodicals, Inc.

The effect of tongue strength on meal consumption in long term care.

PubMed

Namasivayam, Ashwini M; Steele, Catriona M; Keller, Heather

2016-10-01

As many as 74% of residents in long-term care (LTC) are anticipated to have swallowing difficulties (dysphagia). Low food intake is commonly reported in persons with swallowing problems, but food intake may also be affected by fatigue in the swallowing muscles. As fatigue sets in during mealtimes, the strength of the tongue may decline. Tongue strength is also known to decline with age but it is unclear how this functional change may influence food intake. In this pilot study, we explored the relationship between tongue strength and meal consumption in persons not previously diagnosed with dysphagia. The Iowa Oral Performance Instrument was used to collect maximum anterior isometric tongue-palate pressures from 12 LTC residents (5 male; mean age: 85, range 65-99). Residents were also screened for dysphagia with applesauce and a water swallow test. Each resident was observed at three different meals to record the length of time taken to eat the meal, amount of food consumed, and any indication of overt signs of swallowing difficulty (e.g. coughing). Residents who displayed observable swallowing difficulties at mealtimes had significantly lower tongue strength than those without swallowing difficulties (p < 0.01). Those with lower tongue strength took significantly longer to complete meals (p < 0.05) and consumed less food. Tongue strength was not predictive of performance on the water screen and the water swallow test was not a good predictor of which participants were observed to display mealtime difficulties. Among seniors in long term care, reduced tongue strength is associated with longer meal times, reduced food consumption, and the presence of observable signs of swallowing difficulty. Further exploration of these relationships is warranted. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Examining mealtime behaviors in families of young children with type 1 diabetes on intensive insulin therapy.

PubMed

Patton, Susana R; Dolan, Lawrence M; Smith, Laura B; Brown, Morton B; Powers, Scott W

2013-12-01

This study examined mealtime behaviors in families of young children with type 1 diabetes (T1DM) on intensive insulin therapy. Behaviors were compared to published data for children on conventional therapy and examined for correlations with glycemic control. Thirty-nine families participated and had at least three home meals videotaped while children wore a continuous glucose monitor. Videotaped meals were coded for parent, child, and child eating behaviors using a valid coding system. A group difference was found for child request for food only. There were also associations found between children's glycemic control and child play and away. However, no associations were found between parent and child behaviors within meals and children's corresponding post-prandial glycemic control. Results reinforce existing research indicating that mealtime behavior problems exist for families of young children even in the context of intensive therapy and that some child behaviors may relate to glycemic control. © 2013.

"Eating-together" mealtimes with African-American fathers and their toddlers.

PubMed

A Horodynski, Mildred; Arndt, Mary Jo

2005-05-01

The prevalence of obesity is increasing at an alarming rate in African-American children. Fathers influence mealtime behaviors but are often overlooked in nutrition education. A sample of six African-American fathers of toddlers participated in a focus group to describe mealtime behaviors with their toddlers. The focus group was audiotaped and transcribed verbatim. Five thematic categories were identified: mealtime rituals and routines, division of responsibility, family constellation, nutritional knowledge, and tension during mealtimes. Fathers expressed frustration with the toddler's "picky-eater" developmental stage. Fathers need to be included in nutrition education that promotes healthy mealtime habits with their toddlers.

Racial and Ethnic Differences in Longitudinal Patterns of Family Mealtimes: Link to Adolescent Fruit and Vegetable Consumption.

PubMed

Surjadi, Florensia F; Takeuchi, David T; Umoren, Josephine

2017-03-01

To examine the longitudinal patterns of family mealtimes across racial/ethnic groups and to investigate whether the associations between longitudinal patterns of family mealtimes, baseline family and demographic characteristics, and healthy food consumption in adolescence differ by race/ethnicity. Data from the Early Childhood Longitudinal Study spanning from kindergarten to eighth grade were used for this study. Longitudinal patterns of family mealtimes and their link to baseline characteristics and healthy food consumption in adolescence, as defined by fruit and vegetable intakes, were determined using latent growth curves. From childhood to adolescence, family mealtimes were stable among Asian families. Although Hispanic families displayed a downward pattern, mealtimes declined more steeply in non-Hispanic white and black families. The links among family mealtimes, baseline characteristics, and healthy food consumption were not observed equally across racial/ethnic groups. Differences in longitudinal patterns of family mealtimes and in the association between family mealtimes and adolescent healthy food consumption across racial/ethnic groups call for targeted intervention in this nutritionally vulnerable period. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Impact of Trained Volunteer Mealtime Assistants on Dietary Intake and Satisfaction with Mealtime Care in Adult Hospital Inpatients: A Systematic Review.

PubMed

Howson, F F A; Sayer, A A; Roberts, H C

2017-01-01

Malnutrition is common in hospital inpatients and is associated with increased morbidity and mortality. Insufficient assistance at mealtimes can contribute to this and therefore trained volunteer mealtime assistants may be of benefit. To identify and review the current evidence for the impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients. A systematic search of Medline, Embase and CINAHL was conducted to identify relevant articles. Articles of any methodology were considered. Quality assessment and data extraction were carried out by two reviewers independently. Participants were inpatients in a hospital setting, including rehabilitation units. Participants in long term care facilities were excluded. Articles that examined the effect of trained volunteer mealtime assistants on nutritional outcomes or satisfaction with mealtime care were included. 5576 articles were identified, of which 14 were included in the review. Nine were small research studies and five were quality improvement initiatives. The quality of eight studies was moderate, with one study being of lower quality. Eight articles reported dietary intake and seven demonstrated an improvement, with protein intakes at volunteer mealtimes increasing by 4.3g-10.1g and energy intakes by 44-105kcal. Ten articles reported positive staff, patient and volunteer feedback. No adverse events were reported. There is evidence from small studies and improvement projects that trained volunteer mealtime assistants are safe and improve satisfaction with mealtime care in hospital inpatients, although evidence for an effect on dietary intake was less consistent. Larger studies with robust methodology are required to confirm this.

Brief Report: Mealtime Behaviors of Chinese American Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gray, Heewon Lee; Chiang, Hsu-Min

2017-01-01

This study investigated mealtime behaviors of Chinese-American children with autism spectrum disorder (ASD). Thirty-one parents of Chinese-American children with ASD participated in this study and the Brief Autism Mealtime Behavior Inventory (BAMBI) was used. The top problematic mealtime behaviors reported by parents were prefers…

The Behavioral Function of Feeding Problems as Assessed by the Questions about Behavioral Function (QABF)

ERIC Educational Resources Information Center

Matson, Johnny L.; Mayville, Stephen B.; Kuhn, David E.; Sturmey, Peter; Laud, Rinita; Cooper, Chris

2005-01-01

Differences in subscale scores on the questions about behavioral function (QABF) were assessed for participants identified with pica, rumination, food stealing, food refusal, and mealtime behavior problems (e.g., aggression, self-injurious behavior). The QABF was administered to informants for 125 individuals identified with problematic feeding…

Influence of mealtime habits on the risk of weight gain and obesity in Mexican adults.

PubMed

Dosamantes-Carrasco, Libia Darina; Méndez-Hernández, Pablo; Flores, Yvonne N; Siani, Carole; Denova-Gutiérrez, Edgar; Gallegos-Carrillo, Katia; Ramírez, Paula; Rivera-Paredez, Berenice; Salazar-Martínez, Eduardo; Salmerón, Jorge

2017-02-01

To prospectively examine the extent to which mealtime habits influences the risk of weight gain and obesity in Mexican adults. We performed a prospective cohort study. The Mealtime Habits Quality (MHQ) scale was used for assessing participants' MHQ; the outcomes of interest were gain ≥5 % of body weight, developing overweight/obesity and abdominal obesity, after 7 years of follow-up. In order to estimate the independent effect of MHQ on anthropometric indicators, generalized linear models were computed to obtain adjusted relative risks (95 % CI). The state of Morelos, Mexico. Mexican adults (n 837) aged 18-70 years participating in a cohort study. Compared with participants classified in the higher MHQ category, individuals in the middle and lower MHQ groups had a 4·1 (2·5, 6·7) and 6·2 (3·9, 9·7) fold greater risk of gain ≥5 % of body weight, respectively; 6·6 (2·8, 15·5) and 8·6 (3·7, 19·8) fold greater risk of becoming overweight/obese, respectively; and 3·8 (2·0, 7·3) and 5·3 (2·8, 9·8) fold greater risk of developing abdominal obesity, respectively. This study provides evidence about the influence of a set of mealtime habits on obesity indicators, showing that greater adherence to unadvisable mealtime habits increases the risk of developing unhealthy anthropometric indicators. Since the meal is one of the most important sources of food intake, and consequently weight status, the MHQ scale can be a useful population tool to predict weight gain and obesity.

Making Mealtime a Happy Time for Preschoolers: A Guide for Teachers. 1982 Edition.

ERIC Educational Resources Information Center

Lundin, Janet, Ed.; Smith, Theodore, Ed.

Practical suggestions for improving the mealtime environment in child care centers are provided for child development personnel. Nine factors to ensure a successful mealtime environment are given along with suggestions for introducing new foods and for encouraging independence and socialization during mealtime. A section dealing with special…

Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach.

PubMed

Ottrey, Ella; Palermo, Claire; Huggins, Catherine E; Porter, Judi

2018-04-01

To explore multiple perspectives and experiences of volunteer and visitor involvement and interactions at hospital mealtimes. In addition, to understand how the volunteer and visitor role at mealtimes is perceived within the hospital system. Mealtime assistance can improve patients' food intake and mealtime experience. Barriers to providing mealtime assistance include time pressures, staff availability and inadequate communication. Volunteers and visitors can encourage and assist patients at mealtimes. There is a lack of evidence on the relationship between hospital staff, volunteers and visitors. A qualitative, ethnographic approach. Sixty-seven hours of fieldwork were conducted on two subacute wards within an Australian healthcare network in 2015. Mealtime practices and interactions of hospital staff, volunteers and visitors were observed. Sixty-one staff, volunteers and visitors were interviewed in 75 ethnographic and semi-structured interviews. Data were inductively and thematically analysed. Three key themes emerged as follows: "help"-volunteers and visitors were considered helpful when they assisted patients at mealtimes, supported well-being and aided staff-patient communication; "hindrance"-staff perceived visitors as negative presences when they inhibited patient progress and impacted staff work practices; and "reality of practice"-visiting hours, visitor engagement in patient therapy and communication between staff, volunteers and visitors were important practical considerations of mealtime involvement. The findings show how and why volunteers and visitors can be helpful and unhelpful at hospital mealtimes on subacute wards. More research on the role and contribution of volunteers and visitors on hospital wards will inform future practice in healthcare settings. This healthcare organisation should continue to encourage volunteer and visitor involvement at hospital mealtimes. More effort is needed to educate visitors about patients' therapeutic goals and the importance of nutrition. The working relationship between hospital staff, volunteers and visitors should be strengthened to improve nutritional care. © 2018 John Wiley & Sons Ltd.

The ABCs of Family Mealtimes: Observational Lessons for Promoting Healthy Outcomes for Children with Persistent Asthma

ERIC Educational Resources Information Center

Fiese, Barbara H.; Winter, Marcia A.; Botti, Joanna C.

2011-01-01

Family mealtimes have the potential to promote healthy child development. This observational study of 200 family mealtimes examined the relation between child health in a group of children (ages 5 to 12) with persistent asthma and 3 dimensions of mealtime interaction: Action, Behavior Control, and Communication. Percent time spent in Action and…

Insulin use and persistence in patients with type 2 diabetes adding mealtime insulin to a basal regimen: a retrospective database analysis

PubMed Central

2011-01-01

Background The objective of this study was to characterize insulin use and examine factors associated with persistence to mealtime insulin among patients with type 2 diabetes (T2D) on stable basal insulin therapy initiating mealtime insulin therapy. Methods Insulin use among patients with T2D initiating mealtime insulin was investigated using Thomson Reuters MarketScan® research databases from July 2001 through September 2006. The first mealtime insulin claim preceded by 6 months with 2 claims for basal insulin was used as the index event. A total of 21 months of continuous health plan enrollment was required. Patients were required to have a second mealtime insulin claim during the 12-month follow-up period. Persistence measure 1 defined non-persistence as the presence of a 90-day gap in mealtime insulin claims, effective the date of the last claim prior to the gap. Persistence measure 2 required 1 claim per quarter to be persistent. Risk factors for non-persistence were assessed using logistic regression. Results Patients initiating mealtime insulin (n = 4752; 51% male, mean age = 60.3 years) primarily used vial/syringe (87%) and insulin analogs (60%). Patients filled a median of 2, 3, and 4 mealtime insulin claims at 3, 6, and 12 months, respectively, with a median time of 76 days between refills. According to measure 1, persistence to mealtime insulin was 40.7%, 30.2%, and 19.1% at 3, 6, and 12 months, respectively. Results for measure 2 were considerably higher: 74.3%, 55.3%, and 42.2% of patients were persistent at 3, 6, and 12 months, respectively. Initiating mealtime insulin with human insulin was a risk factor for non-persistence by both measures (OR < 0.80, p < 0.01). Additional predictors of non-persistence at 12 months included elderly age, increased insulin copayment, mental health comorbidity, and polypharmacy (p < 0.05 for all). Conclusions Mealtime insulin use and persistence were both considerably lower than expected, and were significantly lower for human insulin compared to analogs. PMID:21226935

It is not just a meal, it is an emotional experience - a segmentation of older persons based on the emotions that they associate with mealtimes.

PubMed

den Uijl, Louise C; Jager, Gerry; de Graaf, Cees; Waddell, Jason; Kremer, Stefanie

2014-12-01

Worldwide, the group of older persons is growing fast. To aid this important group in their food and meal requirements, a deeper insight into the expectations and experiences of these persons regarding their mealtimes and snack times is needed. In the current study, we aim to identify consumer segments within the group of vital community-dwelling older persons on the basis of the emotions they associate with their mealtimes and snack times (from now on referred to as mealtimes). Participants (n = 392, mean age 65.8 (years) ± 5.9 (SD)) completed an online survey. The survey consisted of three questionnaires: emotions associated with mealtimes, functionality of mealtimes, and psychographic characteristics (health and taste attitudes, food fussiness, and food neophobia). Consumer segments were identified and characterised based on the emotions that the respondents reported to experience at mealtimes, using a hierarchical cluster analysis. Clusters were described using variables previously not included in the cluster analysis, such as functionality of mealtimes and psychographic characteristics. Four consumer segments were identified: Pleasurable averages, Adventurous arousals, Convivial indulgers, and Indifferent restrictives. These segments differed significantly in their emotional associations with mealtimes both in valence and level of arousal. The present study provides actionable insights for the development of products and communication strategies tailored to the needs of vital community-dwelling older persons. Copyright © 2014 Elsevier Ltd. All rights reserved.

Longing for homeliness: exploring mealtime experiences of patients suffering from a neurological disease.

PubMed

Beck, Malene; Poulsen, Ingrid; Martinsen, Bente; Birkelund, Regner

2018-03-01

Many patients suffering from a neurological disease experience eating difficulties during mealtimes in the hospital. Consequently, they often refrain from eating in public places to avoid potentially awkward situations. Eating is an essential part of life, providing patients with comfort during their hospitalisation. Therefore, attention should be paid to these patients, who encounter eating difficulties to foster a positive mealtime experience. To study what patients afflicted with a neurological disease experience and assign meaning when participating in mealtimes during hospitalisation. Ten semi-structured interviews with patients were conducted and recorded. After transcription the text was analysed, and interpreted compromising three methodological steps inspired by the French philosopher, Paul Ricouer. Three themes were identified through data analysis and interpretation: i) The missing feeling of homeliness, ii) The battle between socialisation vs. isolation, and iii) The sense of time, rhythm, and presence. To patients suffering from a neurological disease, mealtimes are not only a manageable task, but also a part of existential care that leads to positive experience. Aesthetic elements were shown to have the potential of making the patients feel comfortable and homely when hospitalised. This was important, as our study also identified that patients were longing for homeliness when participating in mealtimes during hospitalisation. Our findings emphasised the need of proceeding to interventions that includes mealtime assistance and protects the mealtime activity. Hence, it informs hospital organisations of the importance of restructuring mealtime environment, so that existential care can take place. © 2017 Nordic College of Caring Science.

Nutrition Knowledge, Attitudes, and Fruit and Vegetable Intake as Predictors of Head Start Teachers' Classroom Mealtime Behaviors.

PubMed

Halloran, Katherine Marie; Gorman, Kathleen; Fallon, Megan; Tovar, Alison

2018-04-01

To examine the association between nutrition knowledge, attitudes, and fruit/vegetable intake among Head Start teachers and their classroom mealtime behaviors (self-reported and observed). Cross-sectional design using observation and survey. Sixteen Head Start centers across Rhode Island between September, 2014 and May, 2015. Teachers were e-mailed about the study by directors and were recruited during on-site visits. A total of 85 participants enrolled through phone/e-mail (19%) or in person (81%). Independent variables were nutrition knowledge, attitudes, and fruit/vegetable intake. The dependent variable was classroom mealtime behaviors (self-reported and observed). Regression analyses conducted on teacher mealtime behavior were examined separately for observation and self-report, with knowledge, attitudes, and fruit and vegetable intake as independent variables entered into the models, controlling for covariates. Nutrition attitudes were positively associated with teacher self-reported classroom mealtime behavior total score. Neither teacher nutrition knowledge nor fruit/vegetable intake was associated with observed or self-reported classroom mealtime behavior total scores. There was limited support for associations among teacher knowledge, attitudes, and fruit/vegetable intake, and teacher classroom mealtime behavior. Findings showed that teacher mealtime behavior was significantly associated with teacher experience. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Alcohol and tobacco use during adolescence: the importance of the family mealtime environment.

PubMed

White, James; Halliwell, Emma

2010-05-01

Despite evidence that frequent family meals are associated with low levels of substance use during adolescence, prior studies have not examined the role of how adolescents perceive mealtimes. We examined family meal frequency, family connectedness, perceived priority, atmosphere and structure of mealtimes as predictors of alcohol and tobacco consumption, using data from 550 adolescents (50% boys; age range 11-16). Frequent family meals were significantly associated with a lower likelihood of alcohol and tobacco use. However, this association was explained by adolescents' perception of the atmosphere at mealtimes. These findings suggest adolescents' perception of the mealtime environment contributes to family meals' protective effect.

Modifying problematic mealtime interactions of children with cystic fibrosis and their parents via behavioral parent training.

PubMed

Stark, L J; Powers, S W; Jelalian, E; Rape, R N; Miller, D L

1994-12-01

Implemented behavioral parent training targeting maladaptive mealtime behavior with two children with cystic fibrosis (CF) and their parents. Treatment was implemented in multiple baseline fashion across the two families. Primary dependent measure was coding of parent and child behaviors from videotaped dinners. Data were also collected on the children's daily calorie intake and weight. During treatment and at the posttreatment follow-ups, parents' attention to disruptive behavior decreased, attention to appropriate eating increased, and parental control at meals increased. The children showed an increase in appropriate behavior and a decrease in disruptive behavior; caloric intake and weight also improved. Results are discussed in terms of the applicability of behavioral intervention with feeding problems in children with CF.

Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study.

PubMed

Keller, Heather H; Martin, Lori Schindel; Dupuis, Sherry; Reimer, Holly; Genoe, Rebecca

2015-10-09

Mealtimes are an essential part of living and quality of life for everyone, including persons living with dementia. A longitudinal qualitative study provided understanding of the meaning of mealtimes for persons with dementia and their family care partners. Strategies were specifically described by families to support meaningful mealtimes. The purpose of this manuscript is to describe the strategies devised and used by these families living with dementia. A longitudinal qualitative study was undertaken to explore the meaning and experience of mealtimes for families living with dementia over a three-year period. 27 families [older person with dementia and at least one family care partner] were originally recruited from the community of South-Western Ontario. Individual and dyad interviews were conducted each year. Digitally recorded transcripts were analyzed using grounded theory methodology. Strategies were identified and categorized. Strategies to support quality mealtimes were devised by families as they adapted to their evolving lives. General strategies such as living in the moment, as well as strategies specific to maintaining social engagement and continuity of mealtime activities were reported. In addition to nutritional benefit, family mealtimes provide important opportunities for persons with dementia and their family care partners to socially engage and continue meaningful roles. Strategies identified by participants provide a basis for further education and support to families living with dementia.

The Interactive Effect of Diabetes Family Conflict and Depression on Insulin Bolusing Behaviors for Youth.

PubMed

Maliszewski, Genevieve; Patton, Susana R; Midyett, L Kurt; Clements, Mark A

2017-05-01

Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R 2 = .13, F(2, 88) = 6.66, P < .05. The interaction of diabetes family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R 2 = .18, F change (1, 87) = 4.63, P < .05. BOLUS was negatively related to youths' hemoglobin A1c, r = -.556, P < .001 and mean daily blood glucose levels, r = -.428, P < .001. Among depressed youth, mealtime insulin BOLUS scores declined with greater diabetes-related family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.

Assistance at mealtimes in hospital settings and rehabilitation units for older adults from the perspective of patients, families and healthcare professionals: a mixed methods systematic review protocol.

PubMed

Edwards, Deborah; Carrier, Judith; Hopkinson, Jane

2015-11-01

The review question is: assistance at mealtimes for older adults in hospital settings and rehabilitation units: what goes on, what works and what do patients, families and healthcare professionals think about it?The specific objectives are:This mixed methods review seeks to develop an aggregated synthesis of quantitative and qualitative data on assistance at mealtimes for older adults in hospital settings and rehabilitation units in order to derive conclusions and recommendations useful for clinical practice and policy decision making. Worldwide, it is estimated that between 20% and 50% of all adult patients admitted to hospital wards are malnourished. Reported prevalence occurs, depending on the specific patient group of interest, type of healthcare setting, disease state and criteria used to assess malnutrition. For older adults in hospital (over 65 years) the prevalence of malnutrition has been reported as being as high as 60% and can continue to deteriorate during the hospital stay. This is an area of concern as it is associated with prolonged hospital stays and increased morbidity (pressure ulcers, infections and falls) and mortality, especially for those with chronic conditions.Malnutrition in adults in developed countries is frequently associated with disease and may occur because of reduced dietary intake, malabsorption, increased nutrient losses or altered metabolic demands, with reduced dietary intake being considered the single most important aetiological factor. For the hospitalized older adult patient with pre-existing malnutrition, further nutritional problems are often encountered due to a reduced dietary intake. Poor food intake for older patients in hospital may be due to the effects of acute illness, poor appetite, nausea or vomiting, "nil by mouth" orders, medication side effects, catering limitations, swallowing and/or oral problems, difficulty with vision and opening containers, the placement of food out of the patients' reach, limited access to snacks, and cultural or religious food preferences.In the UK, national reports have shown some older patients with good appetites were not receiving sufficient nourishment because of inadequate feeding assistance. An initial search of literature has found that this problem has also been identified in Australia, New Zealand, Sweden, and the USA.A variety of initiatives have been developed to try to ensure that patients receive mealtime assistance if required, and include, for example:Mealtime assistance has the potential to enhance nutritional intake, clinical outcomes, and patient experience. Four reviews and one scoping review have previously been conducted in this area. All of the reviews included adult patients over 18 years of age. The focus of the systematic review by Green et al. was volunteers providing feeding assistance in any institutional setting; it included a narrative analysis of 10 empirical studies from a limited number of database searches. Weekes et al. conducted a structured literature review focusing on improving nutritional care for patients in any healthcare setting, with specific emphasis on feeding assistance and the dining environment. The review was limited to quantitative study designs (randomized controlled trials, controlled trials and observational studies and audits). A systematic review by Wade et al. investigated nutritional models of care (feeding assistance, protected mealtimes, red tray initiative and communal dining) for hospitalized and rehabilitation inpatients. This review focused on data from trials only and only three databases were searched. A Joanna Briggs Institute (JBI) systematic review has also been published on the topic of mealtime assistance. A comprehensive search strategy was outlined and the review included six randomized controlled trials and quasi experimental designs covering a range of outcomes, but was limited to inpatients in acute care hospitals. The scoping review by Cheung et al. included intervention studies published from 2001 to 2012 from across three databases. The focus was on the evidence for dietary, food service and mealtime interventions in the acute care setting.In this proposed mixed methods review, the quantitative component will seek to incorporate a wider range of study designs, including but not limited to, cohort studies (with control), case-controlled studies, descriptive and case series designs. A qualitative component will also be incorporated to help understand why initiatives do or do not work. Combining both quantitative and qualitative studies in the same review will make this the first mixed methods systematic review which considers assistance at mealtimes for older adults over 65 years of age in both hospital settings and rehabilitation units. For the purposes of this review mealtime assistance is defined as receiving help from another person to eat or complete the eating process when a meal or snack is served. This may include, for example, making sure that suitable cutlery is available; taking lids off food products; cutting food into smaller pieces; providing verbal encouragement; or physically feeding a patient by transferring food from the plate to the person's mouth, either at the bedside or in a separate dining room.The review will seek to investigate the feasibility, acceptability and effectiveness of initiatives for improving assistance at mealtimes for older adults in hospital settings and rehabilitation units, and will ask these questions: what goes on, what works and what do patients, families and healthcare professionals think about it?

Mealtime Behaviors Associated with Consumption of Unfamiliar Foods by Young Children with Autism Spectrum Disorder

PubMed Central

Stough, Cathleen Odar; Dreyer Gillette, Meredith L.; Roberts, Michael C.; Jorgensen, Terrence D.; Patton, Susana R.

2015-01-01

Parent and child mealtime behaviors associated with consumption of unfamiliar foods by children with ASD were examined. Families of 38 children aged 2 through 8 years old and diagnosed with ASD videotaped a typical home mealtime during which parents presented the child with an unfamiliar food and mealtime behaviors were subsequently coded through an observational coding system. The child taking sips of their drink was the only behavior related to whether the child took a bite of the unfamiliar food throughout the course of the meal. Parent direct commands and parents feeding the child were related to greater frequency of subsequent bites in a close temporal window, while child play, the child being away from the table, and child talk about things other than food related to lower frequencies of subsequent bites. Clinical interventions for food selectivity in children with ASD might provide parents education on effective mealtime parenting strategies and decreasing inappropriate child mealtime behaviors. PMID:26206175

Problem behaviours and parenting in preschool children with cystic fibrosis.

PubMed

Ward, C; Massie, J; Glazner, J; Sheehan, J; Canterford, L; Armstrong, D; Jaffe, A; Hiscock, H

2009-05-01

Problems with sleep, eating and adherence to therapy may adversely affect health outcomes in children with cystic fibrosis (CF). Data on the prevalence of such problems, associated parenting styles and caregiver mental health are limited. To determine: (a) the prevalence of sleep, mealtime, therapy adherence and externalising and internalising behavioural problems in preschool children with CF; (b) the prevalence of caregiver mental health problems and poor sleep quality; and (c) associations between child behavioural problems and parenting styles. This was a cross sectional survey of caregivers of children aged 6 months to 5 years attending CF outpatient clinics at Royal Children's Hospital (Melbourne), Monash Medical Centre (Melbourne) and Sydney Children's Hospital. Main outcome measures were child externalising and internalising behaviours, sleep, eating and adherence with therapy; the predictor was parenting styles (harsh, inconsistent, overprotective). 117 of 139 families participated. Problems were common with child sleep (small 31.6%; moderate/large problem: 21.9%), eating (32.4%) and adherence with physiotherapy (50.4%). Compared to normative data, sleep and mealtime problems were more prevalent. Caregivers reported high rates of symptoms indicating depression (33.3%), anxiety (16.4%) and stress (34.2%). Harsh parenting was associated with internalising behaviours (adjusted OR 3.9, 95% CI 1.16 to 13.17, p = 0.03). Problems with sleeping, eating and physiotherapy adherence were common in preschool children with CF. Caregivers reported high rates of symptoms indicative of mental health problems. Harsh parenting was associated with internalising problems. An intervention targeting child problem behaviours and parental mental health would be appropriate for CF families.

The Transmission of Family Food and Mealtime Practices From Adolescence to Adulthood: Longitudinal Findings From Project EAT-IV.

PubMed

Watts, Allison; Berge, Jerica M; Loth, Katie; Larson, Nicole; Neumark-Sztainer, Dianne

2018-02-01

To determine whether family food and mealtime practices experienced in adolescence are carried forward into parenthood. Baseline (Project Eating and Activity in Teens and Young Adults [EAT]-I) and 15-year follow-up (EAT-IV) survey data from a population-based cohort study (Project EAT). Cohort members identified as parents at follow-up (n = 727). To gain additional data about the practices of both parents in the household, significant others completed surveys at EAT-IV (n = 380). Frequency of family meals, healthfulness of foods at home, frequency of meals in front of the television, and expectations of being home for dinner. Linear regression models tested associations between parent food and mealtime practices reported at baseline and follow-up controlling for demographics. Healthy and unhealthy home food availability, expectations to be home for dinner, and eating in front of the television in adolescence predicted similar outcomes 15 years later among female parents (effect sizes range: β = .2-.3; P < .001), and to a lesser extent among males. Families ate more frequent family meals when either 1 or both parents reported frequent family meals as an adolescent compared with when neither parent reported frequent family meals as an adolescent. It is important to invest in parenting interventions that target healthful family food and mealtime practices because of the potential long-term impact on their own children's parenting practices. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices

PubMed Central

Benjasuwantep, Banchaun; Chaithirayanon, Suthida; Eiamudomkan, Monchutha

2013-01-01

The aim of this study was to determine the prevalence, characteristics, and factors related to feeding problems among normal children, and the differences in feeding practices between those with and without feeding problems. Caregivers of 402 healthy children aged between one and four years of age were interviewed by pediatricians involved in the research. Data included the child’s medical history, food intake within a day, and feeding behaviors and practices. Parental socio-economic and demographic information, as well as information on parental education and occupation, and their concerns about feeding their children, was collected. Physical examination and anthropometric measurements were taken. The percentage of children identified as having feeding problems was 26.9%. The first child of a family had an increased risk of having feeding problems [P=0.032, odds ratio 1.68, 95% confidence interval (95%CI) 1.04-2.71]. Children with feeding problems were fed less frequently, were less likely to be fed at their own table or at the family table, and had mealtimes longer than 30 min when compared with children without feeding problems (P=0.015, 0.004 and 0.025, respectively). The results highlight that feeding problems in normally developing children are common. During consultations about feeding issues, pediatricians should focus on families with a first child. Topics such as frequency of meals per day, duration of mealtimes, and appropriate places for feeding should be discussed. PMID:23904965

Studying Perspectives on Kindergarten Mealtime: Methodological Reflections

ERIC Educational Resources Information Center

Hansen, Stine Rosenlund; Hansen, Mette Weinreich; Kristensen, Niels Heine

2016-01-01

Drawing on a recent doctoral research project that examined the everyday life perspectives during kindergarten mealtime, this paper discusses the methodological issues related to the concepts of child and adult perspectives during mealtime, and to the children's participation in research. Through the paper, we take part in a critical discussion of…

Mealtime Companionship and Morale in the Rural Elderly.

ERIC Educational Resources Information Center

Kinard, James D.; Kivett, Vira R.

The importance of mealtime companionship and social interaction to improvements of food consumption, nutritional status, and morale in the elderly have been stressed, but the research supporting this concept is minimal. To determine the relationship between mealtime companionship and morale, a representative group of rural adults (N=418) aged 65…

Functional Analysis and Treatment of Multiply Controlled Inappropriate Mealtime Behavior

ERIC Educational Resources Information Center

Bachmeyer, Melanie H.; Piazza, Cathleen C.; Fredrick, Laura D.; Reed, Gregory K.; Rivas, Kristi D.; Kadey, Heather J.

2009-01-01

Functional analyses identified children whose inappropriate mealtime behavior was maintained by escape and adult attention. Function-based extinction procedures were tested individually and in combination. Attention extinction alone did not result in decreases in inappropriate mealtime behavior or a significant increase in acceptance. By contrast,…

Time to Eat: Improving Mealtimes of Young Children with Autism

ERIC Educational Resources Information Center

Bruns, Deborah A.; Thompson, Stacy

2011-01-01

Many young children with autism exhibit feeding-related difficulties, such as accepting a limited diet, demonstrating texture aversions, or using only specific mealtime utensils. Young children with autism need assistance to acquire skills to improve mealtime behavior, including increased acceptance of a variety of foods (types and textures) at…

Changing the food environment: the effect of trained volunteers on mealtime care for older people in hospital.

PubMed

Roberts, Helen C

2018-05-01

This review will describe the evidence for changing the hospital environment to improve nutrition of older people, with particular emphasis on the role of additional mealtime assistance. Poor nutrition among older people in hospital is well recognised in many countries and is associated with poor outcomes of hospital care including increased mortality and longer lengths of stay. Factors recognised to contribute to poor dietary intake include acute illness, co-morbidities, cognitive impairment, low mood and medication. The hospital environment has also been scrutinised with reports from many countries of food being placed out of reach or going cold because time-pressured ward and catering staff often struggle to help an increasingly dependent group of patients at mealtimes. Routine screening in hospital for people at risk of under nutrition is recommended. Coloured trays and protected mealtimes are widespread although there is relatively little evidence for their impact on dietary intake. Volunteers can be trained to sfely give additional mealtime assistance including feeding to older patients on acute medical wards. They can improve the quality of mealtime care for patients and nursing staff although the evidence for improved dietary intake is mixed. In conclusion, improving the nutrition of older patients in hospital is challenging. Initiatives such as routine screening, the use of coloured trays, protected mealtimes and additional mealtime assistance can work together synergistically. Volunteers are likely to be increasingly important in an era when healthcare systems are generally limited in both financial resources and the ability to recruit sufficient nursing staff.

Talk at Mealtimes

ERIC Educational Resources Information Center

Clark, Christina

2013-01-01

This short report explores how many young people sit down with their family at mealtimes, how often they talk with their family when they do and the relationship between mealtime talk and young people's confidence in and attitudes towards communication skills. Using data from the latest annual survey of 34,910 children and young people, it shows…

Toddlers' Use of Peer Rituals at Mealtime: Symbols of Togetherness and Otherness

ERIC Educational Resources Information Center

Mortlock, Anita

2015-01-01

Mealtimes and their associated rituals are recognised as important aspects of human socialisation; however, much of the research about mealtimes in early childhood education settings has focused on health or on adult-child discursive exchanges. The present study aimed to investigate children's interactions with each other and their influence on…

The expert's guide to mealtime interventions - A Delphi method survey.

PubMed

Conchin, Simone; Carey, Sharon

2017-09-27

Prevalence of malnutrition and a myriad of barriers to adequate oral diet in hospitalised patients warrants further investment to improve the patient mealtime experience. The aim of this study was to explore barriers and enablers to implementing effective mealtime interventions and develop a process framework to guide clinicians and researchers in the area. Potential experts in the area of hospital mealtime intervention were identified as having published in this field of work within the Australasian setting. Further information was sought by email and telephone communication on professional background; research experience; interest; and capacity to participate. Recruited participants were surveyed using a modified Delphi method to establish opinion and experience in the area of mealtime interventions. Results were collated and content was coded using a thematic analysis approach by the primary researcher and two additional reviewers. Thirty-two Australian authors in the area of mealtime interventions within the hospital environment were identified from publication. Twenty-one participants were able to be contacted and nineteen of these consented to enrol in the study. Participants included those from a dietetic (n = 14), nursing (n = 4) and medical (n = 1) background. Participants were deemed to have expert knowledge if they had significant involvement in the published research and demonstrated a deep level of understanding of hospital mealtime interventions. All participants provided key insights into barriers to oral intake in the hospital environment and suggestions for interventions to address these barriers. From the survey, an eight step framework to guide mealtime interventions was developed. Hospital mealtime interventions are complex processes. Interventions should be implemented after careful consideration of the local context and baseline data; and tailored to address barriers. Roles and responsibilities for nutrition care should be clear and consistent. Implementation planning is recommended to ensure that an ongoing process is in place to engage executive support and staff involvement, foster project team resilience and ensure sustainability of interventions. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The Extent and Nature of Need for Mealtime Support among Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Ball, S. L.; Panter, S. G.; Redley, M.; Proctor, C.-A.; Byrne, K.; Clare, I. C. H.; Holland, A. J.

2012-01-01

Background: For many adults with an intellectual disability (ID), mealtimes carry significant health risks. While research and allied clinical guidance has focused mainly on dysphagia, adults with a range of physical and behavioural difficulties require mealtime support to ensure safety and adequate nutrition. The extent of need for and nature of…

Contextualized Language Practices as Sites for Learning: Mealtime Talk in Short-Term Chinese Homestays

ERIC Educational Resources Information Center

Kinginger, Celeste; Lee, Sheng-Hsun; Wu, Qian; Tan, Dali

2016-01-01

When, in homestays abroad, mealtime is understood as key to the maintenance and development of family identity and involves routine gathering for nourishment and convivial talk, students attribute much of their language learning to these events. In this project, we adopt a microgenetic approach to the study of mealtime discourse as a learning…

Similarities and differences between families who have frequent and infrequent family meals: A qualitative investigation of low-income and minority households.

PubMed

Berge, Jerica M; Draxten, Michelle; Trofholz, Amanda; Hanson-Bradley, Carrie; Justesen, Kathryn; Slattengren, Andrew

2018-04-01

Numerous quantitative studies have examined the association between family meal frequency and child/adolescent weight and weight-related behaviors. However, limited qualitative research has been conducted to identify mealtime characteristics (e.g., child behavior during meals, rules/expectations, family dynamics) that occur during family meals that may explain why some families engage in frequent family meals and others do not. This is particularly important within racially/ethnically diverse households, as these demographic groups are at higher risk for weight-related problems. The current study aimed to identify similarities and differences in mealtime characteristics between households that have frequent and infrequent family meals within a low-income and minority population. This qualitative study included 118 parents who participated in Family Meals, LIVE!, a mixed-methods, cross-sectional study. Parents (90% female; mean age = 35) were racially/ethnically diverse (62% African American, 19% White, 4% Native American, 4% Asian, 11% Mixed/Other) and from low-income (73% < $35,000/yr.) households. Data were analyzed using inductive content analysis. Results indicated some similar mealtime characteristics (i.e., picky eating, involving family members in meal preparation) between households having frequent and infrequent family meals. Additionally, several differences in mealtime characteristics were identified between households having frequent (i.e., importance of family meals, flexibility in the definition of family meals, family meal rules, no pressure-to-eat feeding practices) versus infrequent family meals (i.e., pressure-to-eat parent feeding practices, family meals are dinner meals only, and difficult meal time behaviors). Study findings may be useful for developing intervention targets for low-income and racially/ethnically diverse households so more families can benefit from the protective nature of family meals. Copyright © 2018 Elsevier Ltd. All rights reserved.

The feasibility and acceptability of training volunteer mealtime assistants to help older acute hospital inpatients: the Southampton Mealtime Assistance Study.

PubMed

Roberts, Helen C; De Wet, Sanet; Porter, Kirsty; Rood, Gemma; Diaper, Norma; Robison, Judy; Pilgrim, Anna L; Elia, Marinos; Jackson, Alan A; Cooper, Cyrus; Aihie Sayer, Avan; Robinson, Sian

2014-11-01

To determine the feasibility and acceptability of using trained volunteers as mealtime assistants for older hospital inpatients. Poor nutrition among hospitalised older patients is common in many countries and associated with poor outcomes. Competing time pressures on nursing staff may make it difficult to prioritise mealtime assistance especially on wards where many patients need help. Mixed methods evaluation of the introduction of trained volunteer mealtime assistants on an acute female medicine for older people ward in a teaching hospital in England. A training programme was developed for volunteers who assisted female inpatients aged 70 years and over on weekday lunchtimes. The feasibility of using volunteers was determined by the proportion recruited, trained, and their activity and retention over one year. The acceptability of the training and of the volunteers' role was obtained through interviews and focus groups with 12 volunteers, nine patients and 17 nursing staff. Fifty-nine potential volunteers were identified: 38 attended a training session, of whom 29 delivered mealtime assistance, including feeding, to 3911 (76%) ward patients during the year (mean duration of assistance 5·5 months). The volunteers were positive about the practical aspects of training and ongoing support provided. They were highly valued by patients and ward staff and have continued to volunteer. Volunteers can be recruited and trained to help acutely unwell older female inpatients at mealtimes, including feeding. This assistance is sustainable and is valued. This paper describes a successful method for recruitment, training and retention of volunteer mealtime assistants. It includes a profile of those volunteers who provided the most assistance, details of the training programme and role of the volunteers and could be replicated by nursing staff in other healthcare units. © 2014 John Wiley & Sons Ltd.

Improving patients' and staff's experiences of acute care.

PubMed

Chaplin, Rob; Crawshaw, Jacob; Hood, Chloe

2015-03-01

The aim of this audit was to assess the effect of the Quality Mark programme on the quality of acute care received by older patients by comparing the experiences of staff and older adults before and after the programme. Data from 31 wards in 12 acute hospitals were collected over two stages. Patients and staff completed questionnaires on the perceived quality of care on the ward. Patients rated improved experiences of nutrition, staff availability and dignity. Staff received an increase in training and reported better access to support, increased time and skill to deliver care and improved morale, leadership and teamwork. Problems remained with ward comfort and mealtimes. Overall, results indicated an improvement in ratings of care quality in most domains during Quality Mark data collection. Further audits need to explore ways of improving ward comfort and mealtime experience.

Do Family Mealtime Interactions Mediate the Association between Asthma Symptoms and Separation Anxiety?

ERIC Educational Resources Information Center

Fiese, Barbara H.; Winter, Marcia A.; Wamboldt, Frederick S.; Anbar, Ran D.; Wamboldt, Marianne Z.

2010-01-01

Background: Respiratory problems have been shown to be associated with the development of panic anxiety. Family members play an essential role for children to emotionally manage their symptoms. This study aimed to examine the relation between severity of respiratory symptoms in children with asthma and separation anxiety. Relying on direct…

Feeding Frenzy: Using Picture Schedules to Reduce Mealtime Struggles

ERIC Educational Resources Information Center

Vedora, Joseph; Ross, Robert; Kelm, Kelly

2008-01-01

Children with autism and other disabilities frequently do not eat a variety of foods, eating only a few very specific foods. Additionally, many children are extremely resistant to trying different foods and attempts to introduce new foods often result in problem behaviors. This can have serious health implications for some children, as the foods…

Prevalence of Malnutrition and Feeding Difficulties in Children With Esophageal Atresia.

PubMed

Menzies, Jessica; Hughes, Jennifer; Leach, Steven; Belessis, Yvonne; Krishnan, Usha

2017-04-01

Growth and feeding problems have been described in children with esophageal atresia (EA). Ongoing gastrointestinal and respiratory complications such as Gastroesophageal reflux disease, esophageal dysmotility, strictures, and respiratory infections may contribute. The aim of the study was to document the prevalence of malnutrition and feeding difficulties and examine predictive factors, which may influence feeding and growth in children attending a multidisciplinary EA clinic in Sydney, Australia. A retrospective review of 75 children, ages 0 to 16 years, who attended a multidisciplinary EA clinic between 2011 and 2014. Data on demographics, comorbidities, nutrition, and mealtime behaviors were collected from their initial clinic appointment. Factors that may affect on growth and mealtime behaviors were identified and analyzed. Nine percent of children were malnourished and 9% were stunted. Infants, children with prior fundoplication, at risk of aspiration, or those who had surgery in the first year of life additional to EA repair were significantly more likely to be malnourished (P < 0.05). Fifty-four percent of children required texture modification at their meals, with parental concern being the most common reason. Younger children were less likely to be eating age-appropriate textures (P = 0.04) which improved after 5 years of age. Poor growth and inability to manage age-appropriate textures are often present in children with EA, particularly in the younger years. This highlights the need for early intervention in a specialist multidisciplinary EA clinic in which dietetics and speech pathology are available.

Reclaiming the Family Table: Mealtimes and Child Health and Wellbeing. Social Policy Report. Volume 22, Number 4

ERIC Educational Resources Information Center

Fiese, Barbara H.; Schwartz, Marlene

2008-01-01

While lasting only twenty minutes, on average, family mealtimes are embedded in a social, cultural, and economic context that are associated with a variety of indicators of children's health and wellbeing. Shared family mealtimes have been associated with such diverse outcomes as reduced risk for substance abuse, promotion of language development,…

More than Just Not Being Alone: The Number, Nature, and Complementarity of Meal-Time Social Interactions Influence Food Intake in Hospitalized Elderly Patients

ERIC Educational Resources Information Center

Paquet, Catherine; St.-Arnaud-McKenzie, Danielle; Ma, Zhenfeng; Kergoat, Marie-Jeanne; Ferland, Guylaine; Dube, Laurette

2008-01-01

Purpose: This study evaluated the social facilitation of elderly patients' food intake beyond the presence of mealtime companions by assessing various relationships. The study examined the relationships between patients' intake and (a) the number of interpersonal exchanges with mealtime fellows, (b) the nature of behaviors expressed by the…

Mealtime Behaviors of Preschool Children: Comparison of Children with Autism Spectrum Disorder and Children with Typical Development

ERIC Educational Resources Information Center

Provost, Beth; Crowe, Terry K.; Osbourn, Patricia L.; McClain, Catherine; Skipper, Betty J.

2010-01-01

This study identified mealtime behaviors of young children (3-6 years old) with autism spectrum disorder (ASD) and compared these behaviors to children with typical development matched for age, gender, and ethnicity. The parents of children with ASD (n = 24) and children with typical development (n = 24) completed a mealtime survey to assess early…

Caregiver Person-Centeredness and Behavioral Symptoms during Mealtime Interactions: Development and Feasibility of a Coding Scheme

PubMed Central

Gilmore-Bykovskyi, Andrea L.

2015-01-01

Mealtime behavioral symptoms are distressing and frequently interrupt eating for the individual experiencing them and others in the environment. In order to enable identification of potential antecedents to mealtime behavioral symptoms, a computer-assisted coding scheme was developed to measure caregiver person-centeredness and behavioral symptoms for nursing home residents with dementia during mealtime interactions. The purpose of this pilot study was to determine the acceptability and feasibility of procedures for video-capturing naturally-occurring mealtime interactions between caregivers and residents with dementia, to assess the feasibility, ease of use, and inter-observer reliability of the coding scheme, and to explore the clinical utility of the coding scheme. Trained observers coded 22 observations. Data collection procedures were feasible and acceptable to caregivers, residents and their legally authorized representatives. Overall, the coding scheme proved to be feasible, easy to execute and yielded good to very good inter-observer agreement following observer re-training. The coding scheme captured clinically relevant, modifiable antecedents to mealtime behavioral symptoms, but would be enhanced by the inclusion of measures for resident engagement and consolidation of items for measuring caregiver person-centeredness that co-occurred and were difficult for observers to distinguish. PMID:25784080

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

PubMed Central

Beck, Malene; Martinsen, Bente; Birkelund, Regner; Poulsen, Ingrid

2017-01-01

ABSTRACT The British concept named Protected Mealtimes is known for stopping all non-acute activities and giving health professionals an opportunity to focus on providing patients their meals without being interrupted or disturbed. PM involves a cultural and behavioural change in the clinical setting, since health professionals are asked to adjust their daily routines. This study investigate how health professionals experience participating in a mealtime intervention inspired by the concept of Protected Mealtimes and intend to change mealtime practices. Three focus group interviews was conducted and included a total of 15 interdisciplinary staff members. After transcribing the interviews, the text material was analysed and interpreted in a three-methodological-step process inspired by the French philosopher Paul Ricoeur. In the analysis and interpretation three themes was identified. The themes were: (1) a chance towards a new and better scene; (2) a step towards a more neurologically friendly environment; and (3) a renewed view of the neurological patients. This study concludes that to the health professionals, the intervention was meaningful in several ways because it created structure during mealtimes and emphasized the importance of creating a calm environment for both patients and health professionals. The intervention was described as an eye-opening and well-regarded event in the field of neurological care that facilitated community, and reflections on nursing care and professional identity were expressed. PMID:28835178

Changes in Food Selectivity in Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Bandini, Linda G.; Curtin, Carol; Phillips, Sarah; Anderson, Sarah E.; Maslin, Melissa; Must, Aviva

2017-01-01

Food selectivity is a common problem in children with autism spectrum disorder (ASD) and has an adverse impact on nutrient adequacy and family mealtimes. Despite recent research in this area, few studies have addressed whether food selectivity present in children with ASD persists into adolescence. In this study, we assessed food selectivity in 18…

"Music & Memory" and improved swallowing in advanced dementia.

PubMed

Cohen, Dan; Post, Stephen G; Lo, Angela; Lombardo, Robin; Pfeffer, Brandon

2018-01-01

Background Dysphagia and difficulty with eating affects a significant portion of individuals with advanced dementia. Such problems with oral intake can have serious health consequences including mealtime distress, dehydration and malnutrition, aspiration, reduced quality of life, and increased mortality risk. Design We present the first data indicating that "Music & Memory" interventions improve swallowing in individuals with advanced dementia, thereby making oral feeding easier and potentially diminishing reliance on PEG. Setting Columbia Health Care Center, Wyocena, WI (with Music&Memory.org, Mineola, NY and Stony Brook University). Participants Residents with advanced dementia (N = 5). Observation by eight professional caregivers. Results (1) Enhanced swallowing mechanism with Music & Memory prior to dining; (2) decreased incidents of choking during mealtime; (3) improved nutritional status; (4) reduced weight loss; (5) reduced need for speech interventions; (6) enhanced quality of life. Conclusions The preliminary results call for additional research.

The feasibility and acceptability of training volunteer mealtime assistants to help older acute hospital in-patients: the Southampton Mealtime Assistance Study

PubMed Central

Roberts, Helen C; De Wet, Sanet; Porter, Kirsty; Rood, Gemma; Diaper, Norma; Robison, Judy; Pilgrim, Anna L; Elia, Marinos; Jackson, Alan A; Cooper, Cyrus; Sayer, Avan Aihie; Robinson, Sian

2014-01-01

Aims and objectives To determine the feasibility and acceptability of using trained volunteers as mealtime assistants for older hospital inpatients. Background Poor nutrition among hospitalised older patients is common in many countries and associated with poor outcomes. Competing time pressures on nursing staff may make it difficult to prioritise mealtime assistance especially on wards where many patients need help. Design Mixed methods evaluation of the introduction of trained volunteer mealtime assistants on an acute female Medicine for Older People ward in a teaching hospital in England. Methods A training programme was developed for volunteers who assisted female inpatients aged 70 years and over on weekday lunchtimes. The feasibility of using volunteers was determined by the proportion recruited, trained, and their activity and retention over 1 year. The acceptability of the training and of the volunteers’ role was obtained through interviews and focus groups with 12 volunteers, 9 patients and 17 nursing staff. Results 59 potential volunteers were identified: 38 attended a training session of whom 29 delivered mealtime assistance, including feeding, to 3,911 (76%) ward patients during the year (mean duration of assistance 5.5 months). The volunteers were positive about the practical aspects of training and on-going support provided. They were highly valued by patients and ward staff and have continued to volunteer. Conclusions Volunteers can be recruited and trained to help acutely unwell older female inpatients at mealtimes, including feeding. This assistance is sustainable and is valued. Relevance to clinical practice This paper describes a successful method for recruitment, training and retention of volunteer mealtime assistants. It includes a profile of those volunteers who provided the most assistance, details of the training programme and role of the volunteers, and could be replicated by nursing staff in other healthcare units. PMID:24666963

Time 2 tlk 2nite: Youths’ use of electronic media during family meals and associations with demographic characteristics, family characteristics and foods served

PubMed Central

Loth, Katie; Bruening, Meg; Berge, Jerica; Eisenberg, Marla E.; Neumark-Sztainer, Dianne

2014-01-01

The study purpose was to examine the frequency of adolescents’ use of electronic media (TV/movie watching, text messaging, talking on the phone, listening to music with headphones and playing with handheld games) at family meals and examine associations with demographic characteristics, rules about media use, family characteristics and the types of foods served at meals using an observational, cross-sectional design. Data were drawn from two coordinated, population-based studies of adolescents (EAT 2010) and their parents (Project F-EAT (Families and Eating Among Teens)). Surveys were completed in 2009–2010. Frequent TV/movie watching during family meals by youth was reported by 25.5% of parents. Multivariate logistic regression analyses indicated significantly higher odds of mealtime media use (p<.05) for girls and older teens. Additionally, higher odds of mealtime media use (p<.05) were also seen among those whose parents had low education levels or were black or Asian; having parental rules about media use significantly reduced these odds. Frequent mealtime media use was significantly associated with lower scores on family communication (p <.05) and scores indicating less importance placed on mealtimes (p<.001). Furthermore, frequent mealtime media use was associated with lower odds of serving green salad, fruit, vegetables, 100% juice and milk at meals whereas higher odds were seen for serving sugar-sweetened beverages (p<.05). The ubiquitous use of mealtime media by adolescents, differences by gender, race/ethnicity, age and parental rules suggest that supporting parents in their efforts to initiate and follow-through on setting mealtime media use rules may be an important public health strategy. PMID:24361006

Time 2 tlk 2nite: use of electronic media by adolescents during family meals and associations with demographic characteristics, family characteristics, and foods served.

PubMed

Fulkerson, Jayne A; Loth, Katie; Bruening, Meg; Berge, Jerica; Eisenberg, Marla E; Neumark-Sztainer, Dianne

2014-07-01

We examined the frequency of adolescents' use of electronic media (ie, television/movie watching, text messaging, talking on the telephone, listening to music with headphones, and playing with hand-held games) at family meals and examined associations with demographic characteristics, rules about media use, family characteristics, and the types of foods served at meals using an observational, cross-sectional design. Data were drawn from two coordinated, population-based studies of adolescents (Project Eating Among Teens 2010) and their parents (Project Families and Eating Among Teens). Surveys were completed during 2009-2010. Frequent television/movie watching during family meals by youth was reported by 25.5% of parents. Multivariate logistic regression analyses indicated significantly higher odds of mealtime media use (P<0.05) for girls and older teens. In addition, higher odds of mealtime media use (P<0.05) were also seen among those whose parents had low education levels or were black or Asian; having parental rules about media use significantly reduced these odds. Frequent mealtime media use was significantly associated with lower scores on family communication (P<0.05) and scores indicating less importance placed on mealtimes (P<0.001). Furthermore, frequent mealtime media use was associated with lower odds of serving green salad, fruit, vegetables, 100% juice, and milk at meals, whereas higher odds were seen for serving sugar-sweetened beverages (P<0.05). The ubiquitous use of mealtime media by adolescents and differences by sex, race/ethnicity, age, and parental rules suggest that supporting parents in their efforts to initiate and follow-through on setting mealtime media use rules may be an important public health strategy. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Differences and Agreement in Perception of Child Picky Eating Among Center- and Home-Based Childcare Providers and Parents and Its Impact on Utilized Mealtime Strategies.

PubMed

Luchini, Virginia; Musaad, Salma M; Donovan, Sharon M; Lee, Soo-Yeun

2017-01-01

Picky eating is a problematic eating behavior caregivers may encounter with children under their care. A picky eater (PE) is typically characterized as consuming a narrow range of food, as well as rejecting several food items. Much of the literature regarding PEs involves parents, although use of nonparental childcare arrangements in the United States has increased in the past several decades. Although data on parental mealtime strategies exist, little is known about how parent and childcare provider pickiness perceptions differ between types of childcare, such as center-based childcare (CBCC) and home-based childcare (HBCC), or how these perceptions influence the mealtime strategies utilized. The objectives of this study were to (1) compare perceptions of child pickiness between parents and childcare providers, (2) compare percent agreement in pickiness perception between the dyads of CBCC parents and providers and HBCC parents and providers, and (3) identify mealtime strategy utilization based on pickiness perception. A total of 52 child, parent, and childcare provider triads participated in the study and completed the Mealtime Assessment Survey and the Parent/Teacher Mealtime Strategy Survey regarding the same child. Results showed that parents are 1.4 times more likely than childcare providers to perceive a child as being picky, HBCC parents and providers are 1.4 times more likely to perceive a child as being picky than CBCC parents and providers, CBCC parents and providers disagree more in their perception of child pickiness than HBCC parents and providers (41% vs 26%), and finally, perception of child pickiness has a greater influence on mealtime strategies utilized by parents. These results can be used to focus intervention efforts aimed at improving child eating habits across the home and childcare location.

Differences and Agreement in Perception of Child Picky Eating Among Center- and Home-Based Childcare Providers and Parents and Its Impact on Utilized Mealtime Strategies

PubMed Central

Luchini, Virginia; Musaad, Salma M; Donovan, Sharon M; Lee, Soo-Yeun

2017-01-01

Picky eating is a problematic eating behavior caregivers may encounter with children under their care. A picky eater (PE) is typically characterized as consuming a narrow range of food, as well as rejecting several food items. Much of the literature regarding PEs involves parents, although use of nonparental childcare arrangements in the United States has increased in the past several decades. Although data on parental mealtime strategies exist, little is known about how parent and childcare provider pickiness perceptions differ between types of childcare, such as center-based childcare (CBCC) and home-based childcare (HBCC), or how these perceptions influence the mealtime strategies utilized. The objectives of this study were to (1) compare perceptions of child pickiness between parents and childcare providers, (2) compare percent agreement in pickiness perception between the dyads of CBCC parents and providers and HBCC parents and providers, and (3) identify mealtime strategy utilization based on pickiness perception. A total of 52 child, parent, and childcare provider triads participated in the study and completed the Mealtime Assessment Survey and the Parent/Teacher Mealtime Strategy Survey regarding the same child. Results showed that parents are 1.4 times more likely than childcare providers to perceive a child as being picky, HBCC parents and providers are 1.4 times more likely to perceive a child as being picky than CBCC parents and providers, CBCC parents and providers disagree more in their perception of child pickiness than HBCC parents and providers (41% vs 26%), and finally, perception of child pickiness has a greater influence on mealtime strategies utilized by parents. These results can be used to focus intervention efforts aimed at improving child eating habits across the home and childcare location. PMID:28469463

Mealtime Insulin Dosing by Carbohydrate Counting in Hospitalized Cardiology Patients: A Retrospective Cohort Study.

PubMed

Thurber, Kristina M; Dierkhising, Ross A; Reiland, Sarah A; Pearson, Kristina K; Smith, Steven A; O'Meara, John G

2016-01-01

Carbohydrate counting may improve glycemic control in hospitalized cardiology patients by providing individualized insulin doses tailored to meal consumption. The purpose of this study was to compare glycemic outcomes with mealtime insulin dosed by carbohydrate counting versus fixed dosing in the inpatient setting. This single-center retrospective cohort study included 225 adult medical cardiology patients who received mealtime, basal, and correction-scale insulin concurrently for at least 72 h and up to 7 days in the interval March 1, 2010-November 7, 2013. Mealtime insulin was dosed by carbohydrate counting or with fixed doses determined prior to meal intake. An inpatient diabetes consult service was responsible for insulin management. Exclusion criteria included receipt of an insulin infusion. The primary end point compared mean daily postprandial glucose values, whereas secondary end points included comparison of preprandial glucose values and mean daily rates of hypoglycemia. Mean postprandial glucose level on Day 7 was 204 and 183 mg/dL in the carbohydrate counting and fixed mealtime dose groups, respectively (unadjusted P=0.04, adjusted P=0.12). There were no statistical differences between groups on Days 2-6. Greater rates of preprandial hypoglycemia were observed in the carbohydrate counting cohort on Day 5 (8.6% vs. 1.5%, P=0.02), Day 6 (1.7% vs. 0%, P=0.01), and Day 7 (7.1% vs. 0%, P=0.008). No differences in postprandial hypoglycemia were seen. Mealtime insulin dosing by carbohydrate counting was associated with similar glycemic outcomes as fixed mealtime insulin dosing, except for a greater incidence of preprandial hypoglycemia. Additional comparative studies that include hospital outcomes are needed.

How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment.

PubMed

White, Hannah J; Haycraft, Emma; Madden, Sloane; Rhodes, Paul; Miskovic-Wheatley, Jane; Wallis, Andrew; Kohn, Michael; Meyer, Caroline

2015-01-01

To examine the range and frequency of parental mealtime strategies used during the family meal session of Family-Based Treatment (FBT) for adolescent anorexia nervosa, and to explore the relationships between parental mealtime strategies, mealtime emotional tone and parental 'success' at encouraging adolescent food consumption. Participants were 21 families with a child aged between 12 and 18 years receiving FBT for adolescent anorexia nervosa. Video recordings of the family meal session (FBT session two) were coded using the Family Mealtime Coding System adapted in this study for use with adolescents (FMCS-A) to identify frequency of parental strategies, emotional tone of the meal (measured by adolescent positive and negative vocalisations) and frequency of prompted mouthfuls consumed by the adolescent (measured by the number of mouthfuls consumed by the adolescent immediately following parental interactions). A range of parental mealtime strategies were in use. Those used repeatedly included direct eating prompts, non-direct eating prompts, physical prompts, and providing information or food-related choices. Several parental mealtime strategies (direct and non-direct eating prompts) were found to be consistently associated with the tone of adolescents' vocalisations and the number of mouthfuls consumed in response to a parental prompt. Despite associations with negativity from the adolescent, the use of food-related prompts (both verbal and physical) seems to be associated with increased eating. This indicates the potentially important role of parental control of eating. Following replication, these findings might provide a focus for therapists when supporting and coaching parents during the family meal session. © 2014 Wiley Periodicals, Inc.

Hot tea and juk: the institutional meaning of food for Chinese elders in an American nursing home.

PubMed

Wu, Shirley; Barker, Judith C

2008-11-01

This qualitative study describes how Chinese elders in an American nursing home perceived their food and mealtime experiences. Data collection included 20 meal observations and interviews with 7 residents, 9 family members, and 17 staff members. Field notes and interviews were coded and analyzed using an iterative approach similar to grounded theory. All participant groups described institutional food and meals as individualized, nutritious therapy for medical illnesses. Mealtimes lacked sociability and sharing, and although family members provided Chinese food, they did not eat with residents. Residents generally did not consider the institution's effort to provide an "Asian diet" of hot tea and juk (rice porridge) to be Chinese food. These findings suggest that, for these Chinese elders, the biomedicalized, individualized food service and mealtime caregiving practices stripped food of its meaning as a social, shared mealtime experience with family. Nursing professionals and researchers should understand that provision of culturally competent mealtime care for ethnic (Chinese) long-term care residents involves important food service practices in addition to kinds of food.

The Impact of Trained Volunteer Mealtime Assistants on the Dietary Intake of Older Female In-Patients: The Southampton Mealtime Assistance Study.

PubMed

Roberts, H C; Pilgrim, A L; Jameson, K A; Cooper, C; Sayer, A A; Robinson, S

2017-01-01

Malnutrition among older hospital inpatients is common and is associated with poor clinical outcomes. Time-pressured staff may struggle to provide mealtime assistance. This study aimed to evaluate the impact of trained volunteer mealtime assistants on the dietary intake of older inpatients. Quasi-experimental two year pre and post- test study of the introduction of volunteer mealtime assistants to one acute medical female ward, with contemporaneous comparison with a control ward. Two acute medical female wards in a university hospital in England. Female acute medical inpatients aged 70 years and over who were not tube fed, nil by mouth, terminally ill or being nursed in a side room. The introduction of volunteer mealtime assistants to one ward to help patients during weekday lunchtimes in the intervention year. Patients' background and clinical characteristics were assessed; 24-hour records were completed for individual patients to document dietary intake in both years on the two wards. A total of 407 patients, mean (SD) age 87.5 (5.4) years, were studied over the two-year period; the majority (57%) needed mealtime assistance and up to 50% were confused. Patients' clinical characteristics did not differ between wards in the observational or intervention years. Throughout the intervention year volunteers provided mealtime assistance on weekday lunchtimes on the intervention ward only. Daily energy (median 1039 kcal; IQR 709, 1414) and protein (median 38.9 g: IQR 26.6, 54.0) intakes were very low (n=407). No differences in dietary intake were found between the wards in the observational or intervention years, or in a pre-post-test comparison of patients on the intervention ward. Data were therefore combined for further analysis to explore influences on dietary intake. In a multivariate model, the only independent predictor of energy intake was the feeding assistance required by patients; greater need for help was associated with lower energy intake (P<0.001). Independent predictors of protein intake were the feeding assistance given (P<0.001) and use of sip feeds; sip feed users had slightly higher protein intakes (P=0.014). Trained volunteers were able to deliver mealtime assistance on a large scale in an effective and sustainable manner, with the potential to release time for nursing staff to complete other clinical tasks. The study participants had a low median intake of energy and protein highlighting the importance of patient factors associated with acute illness; a stratified approach including oral and parenteral nutritional supplementation may be required for some acutely unwell patients. The level of mealtime assistance required was the factor most strongly associated with patients' poor intake of energy and protein and may be a useful simple indicator of patients at risk of poor nutrition.

[Mealtime support for patients with eating disorders: a survey on the clinical practice in German eating disorders centers].

PubMed

Brockmeyer, Timo; Friederich, Hans-Christoph; Jäger, Burkard; Schwab, Michael; Herzog, Wolfgang; de Zwaan, Martina

2015-03-01

Mealtime support is a cornerstone of eating disorders (ED) inpatient and day-care treatment but has received only little attention in research so far and no valid recommendations are available for this type of intervention. Thus, the aim of the present study was to gather a comprehensive picture of how mealtime support is currently practiced in Germany. In a nationwide survey, 97 staff members from 66 ED centers across Germany completed a survey-form that covered 4 broad topics: (a) setting, (b) general conditions, (c) specific interventions, and (d) treatment providers' perspective. For the most part, mealtime support is delivered by nurses. Two thirds of the centers provide at least one therapeutically supported meal per day. Most centers offer their patients a kitchen and/or a guided cooking group. Patient eating behavior and amount of food eaten is documented by three quarters of staff members. Most staff members offer some kind of role modeling by eating their own meals at the same table. Food exposure is provided by a minority. Whereas two thirds use sanctions when patients did not achieve their eating goals, only one third use positive reinforcement when patients achieved their goals. Less than one half offer some kind of post-meal support. The results provide important insights into the current practice of mealtime support and will thus inform future studies that examine the efficacy of different types and interventions of mealtime support. © Georg Thieme Verlag KG Stuttgart · New York.

Real-world clinical responses in patients with type 2 diabetes mellitus adding exenatide BID (EBID) or mealtime insulin to basal insulin: a retrospective study using electronic medical record data.

PubMed

Lang, Kathleen; Nguyen, Hiep; Huang, Huan; Bauer, Elise; Levin, Philip

2018-06-01

Exenatide twice daily (EBID) and mealtime insulin are effective add-on therapies to basal insulin for type 2 diabetes patients in clinical trials. This study used electronic medical record (EMR) data to evaluate analogous real-world clinical responses. Adult patients initiating EBID or mealtime insulin as add-on to basal insulin during January 2008-March 2013 were identified in a US EMR database. EBID patients were propensity score matched 1:1 to mealtime insulin patients. Cohorts were followed for 12 months before (baseline) and 6 months after the index. A1C, hypoglycemic events, change in weight, and other clinical measures were evaluated by A1C attainment level (<6.5, < 7, < 7.5, <8, <9%) and baseline A1C. In total, 1249 EBID patients were matched to 1249 mealtime insulin patients. During follow-up, the percentage reaching A1C levels was similar for EBID vs mealtime insulin cohorts for all attainment levels (<7%: 27.8% vs 24.2%; < 9%: 79.7% vs 79.2%; p = NS). The percentage reaching A1C < 7% was similar for both cohorts with different baseline A1C. EBID patients had less hypoglycemia at all attainment levels (3.1% vs 11.1% [<6.5%]; 2.5% vs 4.7% [<9%]; all p < .03) and more weight loss (-9.0 vs -3.2 lb [<6.5%]; -3.4 vs +0.8 lb [<9%]; all p < .01). EBID added to basal insulin was as effective in a real-world setting as mealtime insulin added to basal insulin in reducing A1C, with less weight gain and less hypoglycemia for a wide range of A1C attainment levels and baseline values.

Observation of parental functioning at mealtime using a sibling design.

PubMed

Moens, Ellen; Braet, Caroline; Vandewalle, Julie

2013-09-01

This study investigates whether parental feeding practices are part of the shared environment or responsive to characteristics of different children from the same family. Thirty-six mothers with two children (4-12 y) of which 10 sibling-pairs were discordant for weight status (healthy weight-overweight), were invited to the lab for a standard meal. Maternal responsive and controlling behaviour was observed and coded. Children's weight status and eating behaviour was assessed. Results indicated that in general, mothers show similar levels of responsiveness and controlling behaviour within families. However, the use of mothers' authoritarian and permissive behaviour and her expressions of involvement at mealtime were consequently related to children's amount of food eaten and their restraining eating style. Thus, the amount of food children eat, both observed and assessed by questionnaire, seems related to more maladaptive parenting practices in mothers. This pleads for more tailor-made guidelines when advising parents of children with eating- and weight problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

Cheung, Grace; Pizzola, Lisa; Keller, Heather

2013-01-01

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

Mealtime Interactions and Life Satisfaction Among Older Adults in Shanghai.

PubMed

Ye, Minzhi; Chen, Lin; Kahana, Eva

2017-06-01

We examined the association between older adults' mealtime interactions at senior centers in Shanghai and their life satisfaction. Competing hypotheses, derived from socioemotional selectivity theory and activity theory, were tested. Data were obtained from the 2011 Shanghai senior center service utilization survey ( N = 320). Relationships between respondents' mealtime interactions and life satisfaction were tested using multilevel regression modeling. After adjusting for demographics, interactions with tablemates (companionship, self-disclosure, and instrumental support) were positively associated with respondents' life satisfaction. These associations varied by senior centers. However, the number of tablemates was not significantly associated with respondents' life satisfaction. Findings support the activity-theory-based hypothesis that mealtime interactions are related to older adults' life satisfaction independent of the number of tablemates. This study illuminates the value of social interactions in the context of community dining programs for the rapidly increasing older population in urban China.

Maternal behavior as a predictor of sibling interactions during mealtimes.

PubMed

Mosli, Rana H; Miller, Alison L; Peterson, Karen E; Gearhardt, Ashley N; Lumeng, Julie C

2016-04-01

Children who frequently experience encouragement or pressure to eat are more likely to exhibit less favorable eating behaviors and dietary outcomes. Siblings can encourage or pressure each other to eat during mealtimes, but the role of mothers in shaping sibling mealtime interactions is not understood. The objective of this study was to examine the association between the behavior of mothers and siblings during mealtimes. The associations of maternal presence and maternal engagement with children during mealtimes with encouragements to eat delivered by the child to his/her sibling were examined. Children aged 4-8years (n=73) were videotaped while eating a routine evening meal at home with one sibling present. Encouragement to eat delivered by the index child to the sibling, maternal presence, and non-food-related and food-related maternal engagement were coded from the videotapes. Poisson regression showed that maternal presence was associated with fewer encouragements to eat from the index child to the sibling (rate ratio (RR): 0.40, 95% confidence interval (CI): 0.26, 0.62). Each type of maternal engagement was independently associated with the number of encouragements to eat from the index child to the sibling: maternal engagement that was not food-related was associated with fewer encouragements to eat (RR: 0.62, 95% CI: 0.53, 0.73), while maternal engagement that was food-related was associated with more encouragements to eat (RR: 1.49, 95% CI: 1.22, 1.81). Future studies may explore how sibling interactions may mediate links between maternal behavior during mealtimes and children's health-related outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Physical Status and Feeding Behavior of Children with Autism.

PubMed

Attlee, Amita; Kassem, Hanin; Hashim, Mona; Obaid, Reyad Shaker

2015-08-01

To assess the physical status and feeding behavior among children with autism. Twenty three autistic children aged 5-16 y enrolled in Sharjah Autism Center were studied. A questionnaire was administered to the parents of these children. Demographic information; gastrointestinal symptoms; mealtime behavior through Brief Assessment of Mealtime Behavior Inventory, Food Preference Inventory; and nutrient intake through a 3 day food record were collected. Physical status was determined in terms of height, weight and body mass index. Male-female ratio of autism in the sample was 3.6:1. Twelve children were obese and another 5 were overweight. Mealtime behavior revealed that 69.6 % of the children never/rarely cried/screamed during mealtimes, turned their face or body away from food (52 %), or expelled food (61 %) that he/she has eaten. Food Preference Inventory showed food refusal of 59.1 ± 20.6 % for combined food groups in autistic children. Specifically, higher preference was found for starches (55.8 %) and least for protein (32.6 %). A 3 day food record revealed that their diets were repetitive with limited variety and evidence of nutrient inadequacy. Comparatively higher enrolment of males with autism was found and three-fourth of the total children had difficulty in maintaining normal weight. Mealtime behavior concerns were displayed occasionally including rigidity in mealtime routines, unwillingness to try new foods and not being able to be seated until the meal was finished. High rates of food rejection, notably protein and limited variety resulting into nutrient inadequacy were evident.

Family meals with young children: an online study of family mealtime characteristics, among Australian families with children aged six months to six years.

PubMed

Litterbach, Eloise-Kate V; Campbell, Karen J; Spence, Alison C

2017-01-24

Evidence suggests that family meals influence food intakes and behaviours, which in turn impact children's eating habits, diets and health. Mealtimes therefore offer potential as settings for health promotion. Given diet, health behaviours and health are often socioeconomically patterned, it is important to consider whether family meals differ by socioeconomic position (SEP). The Family Meals with Young Kids study was an online survey completed by parents in 2014. Mealtime characteristics measured included; frequency of shared meals across the day, duration and location of mealtimes, parental modelling, and parental perceived importance of the evening meal. Maternal education was used to assess SEP. The aims of this study were to describe family meal characteristics among Australian families with children aged six months to six years and to describe the socioeconomic patterning of these. Participants (n = 992) were mostly mothers (97%) with a university degree (71%). The evening meal was the most frequently reported meal eaten together with the responding parent and child (77% ≥ five nights/week). Snacks were least commonly eaten together (39% ≥ five days/week). The frequency of having everyone present for the evening meal was inversely associated with SEP (OR 0.70, CI 0.54-0.92). Parent rated importance of family meals was generally high and positively associated with higher SEP (OR 1.32, CI 1.00-1.76). Most children consumed breakfast (73%), lunch (58%) and dinner (82%) sitting at a table or bench and this was positively associated with higher SEP for all meal types (OR 1.61-2.37, p < 0.05). Increased television (TV) viewing during meals was inversely associated with SEP (OR 0.63, CI 0.54-0.72). Less than half of children (36%) watched TV during meals more than once a day. Australian families engage in many healthy mealtime behaviours. Evidence that parents share meals with children and place high value on mealtimes with children provides important opportunities for promoting healthy behaviours in families. The choice of eating location and the practice of viewing TV during mealtimes are examples of two such opportunities. Socioeconomic patterning of the location of mealtimes and TV viewing during meals may contribute to socioeconomic differences in dietary intakes and may be important targets for future health promotion.

Breast is best: Positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom

PubMed Central

Rudolf, MCJ; Feltbower, RG; Mohebati, L; Hetherington, M

2015-01-01

We examined mealtime interactions to assess whether they varied according to maternal body mass index, country and mode of feeding in 41 Israeli and UK mother–infant dyads. Feeding behaviours were coded using the Simple Feeding Element Scale. Significantly, more UK mothers breastfed during the filmed meal compared to Israeli mothers. Mealtime interactions did not vary according to maternal body mass index or country. Women who breastfed (as opposed to those who bottle fed or fed solids) provided fewer distractions during the meal, a more ideal feeding environment and fed more responsively. PMID:28070352

About feeding children: mealtimes in child-care centers in four western states.

PubMed

Sigman-Grant, Madeleine; Christiansen, Elizabeth; Branen, Laurel; Fletcher, Janice; Johnson, Susan L

2008-02-01

This study was conducted to describe mealtimes and explore routines, policies, and training in child-care centers. Following an intensive review of mealtimes, staff and director questionnaires were created. Using a stratified random sampling protocol and following the Tailored Design Method, directors and staff from licensed child-care centers from California, Colorado, Idaho, and Nevada were surveyed. Center and staff characteristics were compared among the four states and three census areas using analysis of variance and chi(2) analyses, as appropriate. To adjust for multiple comparisons, a stringent P value of <0.001 was used for post hoc comparisons. Responses were received from 568 centers (representing 1,190 staff and 464 directors). Mealtimes generally occurred in the classroom, where an adult sat at the table with the children, served some food, poured the drinks, and ate some of the center-provided food. Less than half of centers reported using "family-style" service, although this style allows children the opportunity to self-serve food. Staff received substantially less training on feeding children (42%) than on nutrition (68%) and child development (95%). These findings bring focus to the need to educate child-care staff and directors about the impact of mealtime environments on child health and development.

Effect of music on mealtime disruptions.

PubMed

Hooper, Jeff; Carson, Derek; Lindsay, Bill

People with learning disabilities can disrupt mealtimes with non-cooperative, aggressive and self-injurious behaviours that challenge other people to tolerate and manage them. These behaviours appear to arise because the proximity of other people, and the heightened activity and noise of a dining room, causes anxiety and agitation. To examine how delivering calming background music via headphones affected anxiety-driven behaviours that disrupted mealtimes. A sample of 30 adults with mild, moderate or severe learning disabilities were videotaped during mealtimes on two consecutive days. On the first day, half the group ate without any calming music while the other half sat opposite them wearing earphones and listening to calming music. On the second day, the non-music and music groups swapped around. Of the participants who tolerated the earphones, only three showed disruptive behaviour; all three had been sitting at the table waiting for their food. With so few examples, meaningful inferential analysis was not possible. However, there were signs that calming music had a positive effect on disruptive mealtime behaviours. It eliminated physical harm, complaining and verbal repetition in one person, and stopped another from shouting/swearing. It also reduced the incidence of shouting/swearing, restlessness and vocalising. Calming music and reduced waiting at tables for food may reduce disruptive behaviours.

Honoring Identity Through Mealtimes in Chinese Canadian Immigrants.

PubMed

Lam, Ivy T Y; Keller, Heather H

2015-11-01

Mealtimes are opportunities for social interactions and expressions of individual and family identity, and serve as a microcosm of the broader lives of families living with dementia. The Eating Together study and its resulting Life Nourishment Theory (LNT) explicated the importance of mealtimes for honouring individual and family identities in the context of dementia. This sub-study examined a specific ethnocultural group with cultural food-ways and caring expectations, to determine if the concept of honouring identity needed to be modified or extended. Using active interview techniques, two Cantonese speaking researchers completed dyad/triad family and individual interviews with six Chinese Canadian immigrant families, recruited from two service providers in a large, urban, multicultural city. This sub-study provided insight into the challenges and rewards of mealtimes for Chinese immigrant families with dementia in the community and specifically provided further insights into the honouring identity concept. Although LNT and specifically the honouring identity concept was generally confirmed in this group, some culturally-specific themes were also identified. This work serves as a basis for future studies examining the meaning and experience of mealtimes in specific cultural groups living with dementia. Such work would confirm if the LNT can be applied to specific ethnocultural groups as well as the general population living with dementia. © The Author(s) 2012.

Mealtimes in a neurological ward: a phenomenological-hermeneutic study.

PubMed

Beck, Malene; Martinsen, Bente; Poulsen, Ingrid; Birkelund, Regner

2016-06-01

To examine the environment surrounding hospital meals for patients with neurological diseases. A determined effort has been made to optimise the nutrition of hospitalised patients. However, the organisation of mealtimes and their relational and aesthetic aspects have not received similar attention. The result is that all other tasks continue with undiminished intensity when patient meals are served and eaten. Based on a qualitative design, 25 mealtime situations were systematically observed. The observations varied by time of day, date, staff and patients present. Field notes were taken on the spot, and quotes were written directly. After transcription, the text materials were analysed and interpreted using a phenomenological-hermeneutic approach inspired by the philosopher Paul Ricouer. Three main themes were identified in the analysis: eating in a railway station, creating aesthetic mealtimes in an unaesthetic atmosphere and using familiar rituals in unfamiliar surroundings. The inclusion of aesthetic elements and familiarity was found to play an important role in the desire of patients to eat. However, these elements were challenged by the design of the physical space and institutional structures. This study contributes to our understanding of the environment surrounding hospital meals for patients with neurological diseases. Based on this study, it can be concluded that meals were at a high risk of being served as a mindless task without the recognition that mealtimes are sensed with the whole body of the patient and not only by the mouth. The importance of the mealtime environment must be acknowledged because it serves as a communicative aspect for neurological patients by letting them know what to expect from the coming hospital meal. © 2016 John Wiley & Sons Ltd.

Mealtime habits and risk of developing the metabolic syndrome or insulin resistance among Mexican adults.

PubMed

Méndez-Hernández, Pablo; Dosamantes-Carrasco, Libia Darina; Siani, Carole; Pierlot, Romain; Martínez-Gómez, Margarita; Rivera-Paredez, Berenice; Cervantes-Popoca, Laura; Rojas-Lima, Elodia; Salazar-Martínez, Eduardo; Flores, Yvonne N; Salmerón, Jorge

2016-11-15

Meals are an important source of food intake, contributing to body weight and health status. Previous studies have examined the relationship between isolated mealtime behaviours and the metabolic syndrome (MetS). The aim of this study was to examine the influence over time of ten interrelated mealtime habits on the risk of developing the MetS and insulin resistance (IR) among Mexican adults. We conducted a prospective cohort study with a sample of 956 health workers. The Mealtime Habits Quality (MHQ) scale is based on four mealtime situations (availability of time to eat, distractions while eating, environmental and social context of eating, and familiar or cultural eating habits), which were used to assess the participants' MHQ at the baseline (2004-2006) and follow-up (2010-2012) evaluations. The MetS was assessed using criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). IR was defined using the homoeostasis model assessment. Crude and adjusted relative risks were calculated to estimate the relationship between MHQ and the risk of developing the MetS or IR. Participants classified in the lower MHQ category had an 8·8 (95 % CI 3·1, 25) and 11·1 (95 % CI 3·4, 36·1) times greater risk of developing the MetS (using the NCEP-ATP III and IDF criteria, respectively), and an 11·2 times (95 % CI 3·9, 31·5) greater likelihood of developing IR, compared with those in the higher MHQ group. This prospective study reveals that individuals who engaged in more undesirable than recommended mealtime behaviours had a >10-fold risk of developing the MetS or IR.

Controlled study of critical parent and family factors in the obesigenic environment.

PubMed

Zeller, Meg H; Reiter-Purtill, Jennifer; Modi, Avani C; Gutzwiller, Joeanne; Vannatta, Kathryn; Davies, W Hobart

2007-01-01

Critical gaps remain in our understanding of the obesigenic family environment. This study examines parent and family characteristics among obese youth presenting for treatment in a clinic setting. Families of 78 obese youth (BMI z-score = 2.4; age, 8 to 16 years; 59% girls; 49% African-American) were compared with 71 non-overweight (BMI z-score = -0.02) demographically matched comparisons. Parents completed measures assessing family demographics, psychological distress (Symptom Checklist 90-Revised), and family functioning both broadly (Family Environment Scale: Conflicted, Support, Control) and at mealtimes (About Your Child's Eating-Revised: Mealtime Challenges, Positive Mealtime Interaction). Height and weight were obtained from all participants. Compared with mothers and fathers of non-overweight youth, parents of obese youth had significantly higher BMIs (p < 0.001). Mothers of obese youth reported significantly greater psychological distress (p < 0.01), higher family conflict (p < 0.05), and more mealtime challenges (p < 0.01). Less positive family mealtime interactions were reported by both mothers (p < 0.01) and fathers (p < 0.05) of obese youth. These group differences did not vary by child sex or race. Logistic regression analyses indicated that maternal distress and mealtime challenges discriminated between obese and non-overweight youth after controlling for maternal BMI. Family conflict was explained, in part, by maternal distress. Obese youth who present for treatment in a clinic setting are characterized by psychosocial factors at the parent and family level that differ from non-overweight youth. These data are critical because they identify factors that may be serving as barriers to a family's or youth's ability to implement healthy lifestyle behaviors but that are potentially modifiable.

Correlates of Bulimia Nervosa: Early Family Mealtime Experiences.

ERIC Educational Resources Information Center

Miller, Debra A. F.; And Others

1993-01-01

Examined relationship of early mealtime experiences to later bulimia in 128 female college students. Found significant group differences among bulimics, nonbulimics, and repeat dieters on early meal experience questionnaire, with bulimic group reporting most negative and unusual experiences. Found significant differences among groups on depression…

Caregiver person-centeredness and behavioral symptoms during mealtime interactions: development and feasibility of a coding scheme.

PubMed

Gilmore-Bykovskyi, Andrea L

2015-01-01

Mealtime behavioral symptoms are distressing and frequently interrupt eating for the individual experiencing them and others in the environment. A computer-assisted coding scheme was developed to measure caregiver person-centeredness and behavioral symptoms for nursing home residents with dementia during mealtime interactions. The purpose of this pilot study was to determine the feasibility, ease of use, and inter-observer reliability of the coding scheme, and to explore the clinical utility of the coding scheme. Trained observers coded 22 observations. Data collection procedures were acceptable to participants. Overall, the coding scheme proved to be feasible, easy to execute and yielded good to very good inter-observer agreement following observer re-training. The coding scheme captured clinically relevant, modifiable antecedents to mealtime behavioral symptoms, but would be enhanced by the inclusion of measures for resident engagement and consolidation of items for measuring caregiver person-centeredness that co-occurred and were difficult for observers to distinguish. Published by Elsevier Inc.

Southampton mealtime assistance study: design and methods

PubMed Central

2013-01-01

Background Malnutrition is common in older people in hospital and is associated with adverse clinical outcomes including increased mortality, morbidity and length of stay. This has raised concerns about the nutrition and diet of hospital in-patients. A number of factors may contribute to low dietary intakes in hospital, including acute illness and cognitive impairment among in-patients. The extent to which other factors influence intake such as a lack of help at mealtimes, for patients who require assistance with eating, is uncertain. This study aims to evaluate the effectiveness of using trained volunteer mealtime assistants to help patients on an acute medical ward for older people at mealtimes. Methods/design The study design is quasi-experimental with a before (year one) and after (year two) comparison of patients on the intervention ward and parallel comparison with patients on a control ward in the same department. The intervention in the second year was the provision of trained volunteer mealtime assistance to patients in the intervention ward. There were three components of data collection that were repeated in both years on both wards. The first (primary) outcome was patients’ dietary intake, collected as individual patient records and as ward-level balance data over 24 hour periods. The second was clinical outcome data assessed on admission and discharge from both wards, and 6 and 12 months after discharge. Finally qualitative data on the views and experience of patients, carers, staff and volunteers was collected through interviews and focus groups in both years to allow a mixed-method evaluation of the intervention. Discussion The study will describe the effect of provision of trained volunteer mealtime assistants on the dietary intake of older medical in-patients. The association between dietary intake and clinical outcomes including malnutrition risk, body composition, grip strength, length of hospital stay and mortality will also be determined. An important component of the study is the use of qualitative approaches to determine the views of patients, relatives, staff and volunteers on nutrition in hospital and the impact of mealtime assistance. Trial registration Trial registered with ClinicalTrials.gov NCTO1647204 PMID:23294981

Southampton Mealtime Assistance Study: design and methods.

PubMed

Roberts, Helen C; Pilgrim, Anna L; Elia, Marinos; Jackson, Alan A; Cooper, Cyrus; Sayer, Avan Aihie; Robinson, Sian M

2013-01-07

Malnutrition is common in older people in hospital and is associated with adverse clinical outcomes including increased mortality, morbidity and length of stay. This has raised concerns about the nutrition and diet of hospital in-patients. A number of factors may contribute to low dietary intakes in hospital, including acute illness and cognitive impairment among in-patients. The extent to which other factors influence intake such as a lack of help at mealtimes, for patients who require assistance with eating, is uncertain. This study aims to evaluate the effectiveness of using trained volunteer mealtime assistants to help patients on an acute medical ward for older people at mealtimes. The study design is quasi-experimental with a before (year one) and after (year two) comparison of patients on the intervention ward and parallel comparison with patients on a control ward in the same department. The intervention in the second year was the provision of trained volunteer mealtime assistance to patients in the intervention ward. There were three components of data collection that were repeated in both years on both wards. The first (primary) outcome was patients' dietary intake, collected as individual patient records and as ward-level balance data over 24 hour periods. The second was clinical outcome data assessed on admission and discharge from both wards, and 6 and 12 months after discharge. Finally qualitative data on the views and experience of patients, carers, staff and volunteers was collected through interviews and focus groups in both years to allow a mixed-method evaluation of the intervention. The study will describe the effect of provision of trained volunteer mealtime assistants on the dietary intake of older medical in-patients. The association between dietary intake and clinical outcomes including malnutrition risk, body composition, grip strength, length of hospital stay and mortality will also be determined. An important component of the study is the use of qualitative approaches to determine the views of patients, relatives, staff and volunteers on nutrition in hospital and the impact of mealtime assistance. Trial registered with ClinicalTrials.gov NCTO1647204.

What's the fuss about? Parent presentations of fussy eating to a parenting support helpline.

PubMed

Harris, Holly A; Ria-Searle, Bonnie; Jansen, Elena; Thorpe, Karen

2018-06-01

To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline. Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions. Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim. From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6-48 months. Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13-48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child's eating behaviour as a battle (conflict), in which their children's agency over limited intake and variety of foods (child control) was constructed as 'bad' or 'wrong'. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred. Real-time descriptions of young children's fussy eating at a time of crisis that initiated parents' call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child's emerging assertion of food autonomy can escalate parents' emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.

Interaction of mealtime ad libitum beverage and food intake with meal advancement in healthy young men and women.

PubMed

El Khoury, Dalia; Panahi, Shirin; Luhovyy, Bohdan L; Douglas Goff, H; Harvey Anderson, G

2015-05-01

The objective of this study was to describe the interaction of beverage and food intake with meal advancement in healthy adults. In a randomized controlled study, 29 men and women consumed to satiation, over 20 min, a pizza meal with one of the five beverages including water, 1% milk, orange juice, regular cola and diet cola. Mealtime food and fluid intake were measured, within each of three 7-min phases of the meal. A progressive decline occurred from phase 1 to 3 in fluid intake and food intake, averaging 59 mL and 268 kcal (P < 0.0001) respectively; however, the relative intake of fluid to food (mL/kcal) increased (P < 0.0001). Beverage type was not a factor. All beverages resulted in similar fluid volume intake compared to water. However, caloric beverages led to higher mealtime total energy intake compared to water (P < 0.001) and diet cola (P < 0.0001). Baseline thirst correlated positively with both fluid (r = 0.28; P < 0.001) and food (r = 0.16; P < 0.05) intakes at the meal, whereas baseline appetite associated positively only with mealtime food intake (r = 0.23; P<0.01). In conclusion, mealtime fluid and food intakes interact, unaffected by beverage characteristics, to increase the ratio of fluid to food intake with meal progression. Copyright © 2015 Elsevier Inc. All rights reserved.

Home feeding environment and picky eating behavior in preschool-aged children: A prospective analysis.

PubMed

Cole, Natasha Chong; Musaad, Salma M; Lee, Soo-Yeun; Donovan, Sharon M

2018-06-07

Picky eating is prevalent in young children and is associated with poor dietary quality and nutrient deficiencies. Identifying predictors of picky eating could inform the development of anticipatory feeding guidance for parents and caregivers of young children. This study identified the association between factors of the home feeding environment with picky eating behavior in a cohort of preschool-aged children. Parents of preschool-aged children (n = 497) completed questionnaires including measures of the home feeding environment (i.e., television during mealtime, family mealtime routines, and feeding practices) and child picky eating behavior. The questionnaire was repeated one year later, in which 326 parent-child dyads participated. Logistic regression was used to determine the cross-sectional and prospective associations between home feeding environment measures and child picky eating behavior outcomes. Child control over feeding and watching television during mealtime were associated with higher odds of picky eating behavior in both cross-sectional and prospective analyses. A higher sense of positive climate during family meals and mealtime ritualization was associated with lower odds of picky eating behavior one year later. The home feeding environment plays a role in the development of young children's picky eating behavior. Avoiding the television and maintaining parent control of food choices during mealtimes could lead to improvements in children's food preferences and dietary intake. Copyright © 2018. Published by Elsevier Ltd.

Self-regulation and household routines at age three and obesity at age eleven: longitudinal analysis of the UK Millennium Cohort Study

PubMed Central

Anderson, Sarah E; Sacker, Amanda; Whitaker, Robert C; Kelly, Yvonne

2017-01-01

Objective To examine, in a population-based cohort of three-year-old children, the association between self-regulation and exposure to the household routines of regular bedtime, regular mealtime, and limits on watching television/video; and to determine whether self-regulation and these routines predict the risk of obesity at age 11. Methods Analyses included 10 955 children in the nationally-representative UK Millennium Cohort Study. When children were age 3, parents reported whether children had a regular bedtime and mealtime and the amount of television/video watched. Emotional and cognitive self-regulation at age 3 were assessed by parent-report with the Child Social Behaviour Questionnaire. Children’s height and weight were measured at age 11 and obesity was defined using the International Obesity Task Force (IOTF) criteria. Results At age 3, 41% of children always had a regular bedtime, 47% always had a regular mealtime, and 23% were limited to ≤1 hour television/video daily. At age 11, 6.2% of children were obese. All three household routines were significantly associated with better emotional self-regulation, but not better cognitive self-regulation. In a multi-variable logistic regression model including emotional and cognitive self-regulation, all routines, and controlling for sociodemographic covariates, a 1 unit difference in emotional self-regulation at age 3 was associated with an OR (95% CI) for obesity of 1.38 (1.11, 1.71) at age 11, and inconsistent bedtimes with an OR (95% CI) for obesity of 1.87 (1.39, 2.51) at age 11. There was no evidence that emotional self-regulation mediated the relationship between regular bedtimes and later obesity. Cognitive self-regulation was not associated with later obesity. Conclusions Three-year-old children who had regular bedtimes, mealtimes, and limits on their television/video time had better emotional self-regulation. Lack of a regular bedtime and poorer emotional self-regulation at age 3 were independent predictors of obesity at age 11. PMID:28435162

Arguments at Mealtime and Child Energy Intake

ERIC Educational Resources Information Center

Burnier, Daniel; Dubois, Lise; Girard, Manon

2011-01-01

Objective: To examine how arguments at mealtimes relate to children's daily energy intake. Design: A cross-sectional study using data obtained through the Quebec Longitudinal Study of Child Development 1998-2010 (QLSCD), a representative sample of children born in 1998, in the province of Quebec, Canada. Setting: Face-to-face interviews,…

Emergent Subjectivity in Caring Institutions for Teenagers

ERIC Educational Resources Information Center

Severinsson, Susanne; Nord, Catharina

2015-01-01

We investigate how different mealtime situations help shape teenager and staff subjectivities in two Swedish residential care homes and a special school for girls and boys, 12-15 years old, with social, emotional and behavioural difficulties. Three mealtime networks are analysed using concepts from actor-network theory, treating architectural…

Descriptive Analyses of Pediatric Food Refusal: The Structure of Parental Attention

ERIC Educational Resources Information Center

Woods, Julia N.; Borrero, John C.; Laud, Rinita B.; Borrero, Carrie S. W.

2010-01-01

Mealtime observations were conducted and occurrences of appropriate and inappropriate mealtime behavior and various forms of parental attention (e.g., coaxing, reprimands) were recorded for 25 children admitted to an intensive feeding program and their parents. Using the data from the observations, lag sequential analyses were conducted to…

Family Voices at Mealtime: Experiences with Young Children with Visual Impairment

ERIC Educational Resources Information Center

Smyth, Catherine A.; Spicer, Carol L.; Morgese, Zoe L.

2014-01-01

Infants with visual impairment often require additional interaction from adults to reinforce behaviors that lead to competency at mealtimes, but parental and professional confidence in teaching these skills is often limited. In the following collective case study, the authors, a speech/language pathologist (S/LP), occupational therapist (OT), and…

Assessing the relationship between family mealtime communication and adolescent emotional well-being using the experience sampling method.

PubMed

Offer, Shira

2013-06-01

While most prior research has focused on the frequency of family meals the issue of which elements of family mealtime are most salient for adolescents' well-being has remained overlooked. The current study used the experience sampling method, a unique form of time diary, and survey data drawn from the 500 Family Study (N = 237 adolescents with 8122 observations) to examine the association between family mealtime communication and teens' emotional well-being. Results showed that in approximately half of the time spent on family meals (3 h per week on average) adolescents reported talking to their parents. Hierarchical linear model analyses revealed that controlling for the quality of family relationships family mealtime communication was significantly associated with higher positive affect and engagement and with lower negative affect and stress. Findings suggest that family meals constitute an important site for communication between teens and parents that is beneficial to adolescents' emotional well-being. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Sleep and meal-time misalignment alters functional connectivity: a pilot resting-state study.

PubMed

Yoncheva, Y N; Castellanos, F X; Pizinger, T; Kovtun, K; St-Onge, M-P

2016-11-01

Delayed sleep and meal times promote metabolic dysregulation and obesity. Altered coordination of sleeping and eating times may impact food-reward valuation and interoception in the brain, yet the independent and collective contributions of sleep and meal times are unknown. This randomized, in-patient crossover study experimentally manipulates sleep and meal times while preserving sleep duration (7.05±0.44 h for 5 nights). Resting-state functional magnetic resonance imaging scans (2 × 5-minute runs) were obtained for four participants (three males; 25.3±4.6 years), each completing all study phases (normal sleep/normal meal; late sleep/normal meal; normal sleep/late meal; and late sleep/late meal). Normal mealtimes were 1, 5, 11 and 12.5 h after awakening; late mealtimes were 4.5, 8.5, 14.5 and 16 h after awakening. Seed-based resting-state functional connectivity (RSFC) was computed for a priori regions-of-interest (seeds) and contrasted across conditions. Statistically significant (P<0.05, whole-brain corrected) regionally specific effects were found for multiple seeds. The strongest effects were linked to the amygdala: increased RSFC for late versus normal mealtimes (equivalent to skipping breakfast). A main effect of sleep and interaction with meal time were also observed. Preliminary findings support the feasibility of examining the effects of sleep and meal-time misalignment, independent of sleep duration, on RSFC in regions relevant to food reward and interoception.

Introducing a simplified approach to insulin therapy in type 2 diabetes: a comparison of two single-dose regimens of insulin glulisine plus insulin glargine and oral antidiabetic drugs.

PubMed

Lankisch, M R; Ferlinz, K C; Leahy, J L; Scherbaum, W A

2008-12-01

To investigate whether the addition of a single bolus of insulin glulisine (glulisine), administered at either breakfast or main mealtime, in combination with basal insulin glargine (glargine) and oral antidiabetic drugs (OADs), provides equivalent glycaemic control in patients with type 2 diabetes, irrespective of the time of glulisine injection. A national, multicentre, randomized, open-label, parallel-group study of 393 patients with type 2 diabetes who were suboptimally controlled [haemoglobin A(1c) (HbA(1c)) > 6.5-9.0% and fasting blood glucose (BG) 7.0% at baseline and who reached HbA(1c)

"I don't eat when I'm sick": Older people's food and mealtime experiences in hospital.

PubMed

Hope, Kelti; Ferguson, Maree; Reidlinger, Dianne P; Agarwal, Ekta

2017-03-01

Inadequate dietary intake is a common problem amongst older acute-care patients and has been identified as an independent risk factor for in-hospital mortality. This study aimed to explore whether food and mealtime experiences contribute to inadequate dietary intake in older people during hospitalisation. This was a qualitative phenomenological study, data for which were collected using semi-structured interviews over a three-week period. During this time, 26 patients aged 65 years or more, admitted to medical and surgical wards in a tertiary acute-care hospital, were asked to participate if they were observed to eat less than half of the meal offered at lunch. Participants provided their perspectives on food and mealtimes in hospital. Responses were recorded as hand-written notes, which were agreed with the interviewee, and analysed thematically using the framework method. Twenty-five older people were interviewed across six wards. Two main themes, 'validating circumstances' and 'hospital systems', were identified. Each theme had several sub-themes. The sub-themes within validating circumstances included 'expectations in hospital', 'prioritising medical treatment', 'being inactive', and 'feeling down'. Those within 'hospital systems' were 'accommodating inconvenience', 'inflexible systems', and 'motivating encouragement'. Inadequate dietary intake by older hospital patients is complex and influenced by a range of barriers. Multilevel and multidisciplinary interventions based on a shared understanding of food and nutrition as an important component of hospital care are essential to improve dietary intake and reduce the risk of adverse clinical outcomes. Improving awareness of the importance of food for recovery amongst hospitalised older people and healthcare staff is a priority. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A review of nateglinide in the management of patients with type 2 diabetes

PubMed Central

Tentolouris, Nicholas; Voulgari, Christina; Katsilambros, Nicholas

2007-01-01

Impaired insulin secretion occurs early in the pathogenesis of type 2 diabetes mellitus (T2DM) and is chronic and progressive, resulting initially in impaired glucose tolerance (IGT) and eventually in T2DM. As most patients with T2DM have both insulin resistance and insulin deficiency, therapy for T2DM should aim to control not only fasting, but also postprandial plasma glucose levels. While oral glucose-lowering treatment with metformin and thiazolidinediones corrects fasting plasma glucose, these agents do not address the problem of mealtime glucose spikes that have been shown to trigger atherogenic processes. Nateglinide is a derivative of the amino acid D-phenylalanine, which acts directly on the pancreatic β-cells to stimulate insulin secretion. Nateglinide monotherapy controls significantly mealtime hyperglycemia and results in improved overall glycemic control in patients with T2DM by reducing glycosylated hemoglobin (HbA1c) levels. The combination of nateglinide with insulin-sensitising agents, such as metformin and thiazolidinediones, targets both insulin deficiency and insulin resistance and results in reductions in HbA1c that could not be achieved by monotherapy with other antidiabetic agents. In prediabetic subjects with IGT, nateglinide restores early insulin secretion and reduces postprandial hyperglycemia. Nateglinide has an excellent safety and tolerability profile and provides a lifetime flexibility that other antidiabetic agents could not accomplish. The aim of this review is to identify nateglinide as an effective “gate-keeper” in T2DM, since it restores early-phase insulin secretion and prevents mealtime glucose spikes throughout the day and to evaluate the results of ongoing research into its potential role in delaying the progression to overt diabetes and reducing its complications and mortality. PMID:18200800

Preschool Teachers' Explanations for Hygiene Habits and Young Children's Biological Awareness of Contamination

ERIC Educational Resources Information Center

Toyama, Noriko

2016-01-01

Research Findings: Preschools have many norms and rules children are supposed to follow. Among them, behavioral norms associated with mealtime are of great consequence because eating is an essential life function. The present study examined young Japanese children's understanding of hygiene norms and rules at mealtime from the standpoint of their…

Association of Enjoyable Childhood Mealtimes with Adult Eating Behaviors and Subjective Diet-Related Quality of Life

ERIC Educational Resources Information Center

Ainuki, Tomomi; Akamatsu, Rie; Hayashi, Fumi; Takemi, Yukari

2013-01-01

Objective: This study examined whether the experience of enjoyable mealtimes at home during childhood was related to eating behaviors and subjective diet-related quality of life in adulthood. Methods: The study used data (n = 2,936) obtained from a research program about "Shokuiku" (food and nutrition education) conducted by the Cabinet…

Improving the estimation of mealtime insulin dose in adults with type 1 diabetes: the Normal Insulin Demand for Dose Adjustment (NIDDA) study.

PubMed

Bao, Jiansong; Gilbertson, Heather R; Gray, Robyn; Munns, Diane; Howard, Gabrielle; Petocz, Peter; Colagiuri, Stephen; Brand-Miller, Jennie C

2011-10-01

Although carbohydrate counting is routine practice in type 1 diabetes, hyperglycemic episodes are common. A food insulin index (FII) has been developed and validated for predicting the normal insulin demand generated by mixed meals in healthy adults. We sought to compare a novel algorithm on the basis of the FII for estimating mealtime insulin dose with carbohydrate counting in adults with type 1 diabetes. A total of 28 patients using insulin pump therapy consumed two different breakfast meals of equal energy, glycemic index, fiber, and calculated insulin demand (both FII = 60) but approximately twofold difference in carbohydrate content, in random order on three consecutive mornings. On one occasion, a carbohydrate-counting algorithm was applied to meal A (75 g carbohydrate) for determining bolus insulin dose. On the other two occasions, carbohydrate counting (about half the insulin dose as meal A) and the FII algorithm (same dose as meal A) were applied to meal B (41 g carbohydrate). A real-time continuous glucose monitor was used to assess 3-h postprandial glycemia. Compared with carbohydrate counting, the FII algorithm significantly decreased glucose incremental area under the curve over 3 h (-52%, P = 0.013) and peak glucose excursion (-41%, P = 0.01) and improved the percentage of time within the normal blood glucose range (4-10 mmol/L) (31%, P = 0.001). There was no significant difference in the occurrence of hypoglycemia. An insulin algorithm based on physiological insulin demand evoked by foods in healthy subjects may be a useful tool for estimating mealtime insulin dose in patients with type 1 diabetes.

Improving the Estimation of Mealtime Insulin Dose in Adults With Type 1 Diabetes

PubMed Central

Bao, Jiansong; Gilbertson, Heather R.; Gray, Robyn; Munns, Diane; Howard, Gabrielle; Petocz, Peter; Colagiuri, Stephen; Brand-Miller, Jennie C.

2011-01-01

OBJECTIVE Although carbohydrate counting is routine practice in type 1 diabetes, hyperglycemic episodes are common. A food insulin index (FII) has been developed and validated for predicting the normal insulin demand generated by mixed meals in healthy adults. We sought to compare a novel algorithm on the basis of the FII for estimating mealtime insulin dose with carbohydrate counting in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 28 patients using insulin pump therapy consumed two different breakfast meals of equal energy, glycemic index, fiber, and calculated insulin demand (both FII = 60) but approximately twofold difference in carbohydrate content, in random order on three consecutive mornings. On one occasion, a carbohydrate-counting algorithm was applied to meal A (75 g carbohydrate) for determining bolus insulin dose. On the other two occasions, carbohydrate counting (about half the insulin dose as meal A) and the FII algorithm (same dose as meal A) were applied to meal B (41 g carbohydrate). A real-time continuous glucose monitor was used to assess 3-h postprandial glycemia. RESULTS Compared with carbohydrate counting, the FII algorithm significantly decreased glucose incremental area under the curve over 3 h (–52%, P = 0.013) and peak glucose excursion (–41%, P = 0.01) and improved the percentage of time within the normal blood glucose range (4–10 mmol/L) (31%, P = 0.001). There was no significant difference in the occurrence of hypoglycemia. CONCLUSIONS An insulin algorithm based on physiological insulin demand evoked by foods in healthy subjects may be a useful tool for estimating mealtime insulin dose in patients with type 1 diabetes. PMID:21949219

Mealtime family interactions in home environments of children with loss of control eating.

PubMed

Czaja, Julia; Hartmann, Andrea Sabrina; Rief, Winfried; Hilbert, Anja

2011-06-01

Experimental and self-report studies have shown that parents have a strong influence on their normal or overweight children's eating behavior, i.e. through parental feeding behavior or communication. Studies in children with loss of control (LOC) eating that have investigated this relationship are scarce, and ecologically valid observational studies are missing. This study examined family functioning at mealtimes in home environments in 43 families of a child with LOC eating and 31 families of a child without LOC eating; the children were 8-13 years old. Familial interactions, child eating behavior, and parental mealtime behavior were assessed using the Mealtime Family Interaction Coding System, observation of bite speed of the child, and self-report questionnaires. Less healthy patterns of communication (U=201.53, p<.01) and interpersonal involvement (U=207.54, p<.01) and more maladaptive overall family functioning (U=233.52, p<.05) were observed but not self-reported in families of a child with LOC eating compared to those without LOC eating. Children with LOC eating (M=4.73, SD=1.88) ate faster than controls (M=3.71, SD=1.19; p<.05), with highest bite speed in a group with high recurrent LOC eating (p<.01). The results indicate that maladaptive patterns of family functioning during family mealtimes are present in LOC eating in children and are associated with the child's eating behavior. Parent-child communication training should be tested as an intervention for children with LOC episodes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Patterns of Communicative Interaction between a Child with Severe Speech and Physical Impairments and Her Caregiver during a Mealtime Activity

ERIC Educational Resources Information Center

Ferm, Ulrika; Ahlsen, Elisabeth; Bjorck-Akesson, Eva

2012-01-01

Background: Interaction between caregivers and children with severe impairments is closely related to the demands of daily activities. This study examines the relationship between interaction and the routine mealtime activity at home. Method: Patterns of interaction between a child (aged 6 years and 6 months) with severe speech and physical…

Assessing the Relationship between Family Mealtime Communication and Adolescent Emotional Well-Being Using the Experience Sampling Method

ERIC Educational Resources Information Center

Offer, Shira

2013-01-01

While most prior research has focused on the frequency of family meals the issue of which elements of family mealtime are most salient for adolescents' well-being has remained overlooked. The current study used the experience sampling method, a unique form of time diary, and survey data drawn from the 500 Family Study (N = 237 adolescents with…

A Retrospective Chart Review of Dietary Diversity and Feeding Behavior of Children with Autism Spectrum Disorder before and after Admission to a Day-Treatment Program

ERIC Educational Resources Information Center

Sharp, William G.; Jaquess, David L.; Morton, Jane F.; Miles, Aida G.

2011-01-01

The nutritional status and mealtime performance among a group of children with autism spectrum disorders (ASD) were examined before and after admission to an intensive feeding day-treatment program. Treatment involved escape extinction, reinforcement, and stimulus fading procedures. Outcomes focused on dietary diversity and mealtime performance,…

Optimizing Eating Performance for Older Adults With Dementia Living in Long-term Care: A Systematic Review.

PubMed

Liu, Wen; Galik, Elizabeth; Boltz, Marie; Nahm, Eun-Shim; Resnick, Barbara

2015-08-01

Review of research to date has been focusing on maintaining weight and nutrition with little attention on optimizing eating performance. To evaluate the effectiveness of interventions on eating performance for older adults with dementia in long-term care (LTC). A systematic review was performed. Five databases including Pubmed, Medline (OVID), EBM Reviews (OVID), PsychINFO (OVID), and CINAHL (EBSCOHost) were searched between January 1980 and June 2014. Keywords included dementia, Alzheimer, feed(ing), eat(ing), mealtime(s), oral intake, autonomy, and intervention. Intervention studies that optimize eating performance and evaluate change of self-feeding or eating performance among older adults (≥65 years) with dementia in LTC were eligible. Studies were screened by title and abstract, and full texts were reviewed for eligibility. Eligible studies were classified by intervention type. Study quality was accessed using the Quality Assessment Tool for Quantitative Studies, and level of evidence using the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Eleven intervention studies (five randomized controlled trials [RCTs]) were identified, and classified into four types: training program, mealtime assistance, environmental modification, and multicomponent intervention. The quality of the 11 studies was generally moderate (four studies were rated as strong, four moderate, and three weak in quality), with the main threats as weak designs, lack of blinding and control for confounders, and inadequate psychometric evidence for measures. Training programs targeting older adults (Montessori methods and spaced retrieval) demonstrated good evidence in decreasing feeding difficulty. Mealtime assistance offered by nursing staff (e.g., verbal prompts and cues, positive reinforcement, appropriate praise and encouragement) also showed effectiveness in improving eating performance. This review provided preliminary support for using training and mealtime assistance to optimize eating performance for older adults with dementia in LTC. Future effectiveness studies may focus on training nursing caregivers as interventionists, lengthening intervention duration, and including residents with varying levels of cognitive impairment in diverse cultures. The effectiveness of training combined with mealtime assistance may also be tested to achieve better resident outcomes in eating performance. © 2015 Sigma Theta Tau International.

Insufficient amounts and inadequate distribution of dietary protein intake in apparently healthy older adults in a developing country: implications for dietary strategies to prevent sarcopenia

PubMed Central

Valenzuela, Roxana E Ruiz; Ponce, José A; Morales-Figueroa, Gloria Guadalupe; Muro, Karina Aguilar; Carreón, Virginia Ramírez; Alemán-Mateo, Heliodoro

2013-01-01

Background Both low dietary protein intake and inadequate distribution of protein over the three mealtimes have been reported in older Caucasian adults, but the association between protein intake at each meal and muscle mass has not been studied. The purpose of this study was to evaluate dietary protein intake and distribution by mealtimes, and to explore their association with appendicular skeletal muscle mass in apparently healthy older adults. Methods This was a cross-sectional pilot study that included 78 people over the age of 60 years. Caloric and protein intake were estimated on the basis of three nonconsecutive 24-hour diet recalls and appendicular skeletal muscle mass by dual-energy X-ray absorptiometry. Results Men consumed 13.4 g of protein/day more than women (P < 0.05). The estimated value of dietary protein intake was 0.9 g/kg/day. In this sample, 28% of subjects did not cover 100% of the dietary reference intake for protein. Lower consumption of dietary protein was found at breakfast and dinnertime compared with the recommended amount of 25–30 g (P < 0.05). Also, the study observed that appendicular skeletal muscle mass in men and women who consumed <25 g of protein at each mealtime was different from that found in the group that consumed >25 g of protein at one, two, or three mealtimes. Conclusion While protein intake was higher than current recommendations, it failed to achieve the values reported as necessary to prevent sarcopenia. In addition, there was under-consumption of protein per mealtime, especially at breakfast and dinner. PMID:24039411

Assisted-living elderly and the mealtime experience.

PubMed

Mahadevan, M; Hartwell, H J; Feldman, C H; Ruzsilla, J A; Raines, E R

2014-04-01

Although there is increasing evidence of barriers to nutritional health among elderly assisted-living residents, there has not been the same emphasis when examining the ways in which these individuals experience their mealtimes, as well as the factors that they perceive as contributing to their overall sense of health and well-being. Mealtimes may be disregarded as being particularly unimportant or hurried and overlooked, especially for those residents who may be lonely and have feelings of isolation, ultimately leading to a reduced food intake and poor nutrition. A convenience sample of 38 men and women, aged ≥65 years, were selected from four assisted-living facilities in and around Montclair, NJ, USA, to participate in focus group discussions. Data were analysed using content analysis procedures. Participants described their experiences of mealtimes, and the factors contributing to an overall sense of well-being during these occasions. The ability to make healthy food choices, socialise, interact with staff, friends and family members, and enjoy a tasty meal in a warm and inviting dining environment, may provide a dignity that is unmatched by other services. The findings of the present study highlight the importance of maintaining the health of elderly assisted-living residents through strategies that enhance their mealtime experiences. Listening to the food voice of elderly through research such as that carried out in the present study will help policy makers develop a plan that will effectively deal with systemic barriers prevalent in these facilities, and incorporate strategies to motivate and encourage their residents to increase their food intake and improve their health and well-being. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Diets labelled with (13)C-starch and (15)N-protein reveal daily rhythms of nutrient use in gilthead sea bream (Sparus aurata).

PubMed

Felip, Olga; Blasco, Josefina; Ibarz, Antoni; Martín-Pérez, Miguel; Fernández-Borràs, Jaume

2015-01-01

All functions in animals rely on daily rhythms, and mealtime can act as a rhythm-marker of nutrients assimilation and use. The effects of meal timing and food composition on carbohydrate use and protein retention of gilthead sea bream were studied. Three groups were fed twice a day (10am and at 5pm) for two months with two alternating diets: a commercial diet (Cd) and a high-carbohydrate, low-protein diet (Ed). The Ed/Cd group received the Ed diet in the morning and the Cd diet in the afternoon, and the Cd/Ed group received these diets in the reverse order. The Cd/Cd group only received the commercial diet (control group). After 56days, two force-feeding experiments (PF1 and PF2) measured for all three groups the fate of a single meal labelled with (15)N-protein and (13)C-starch through the retention of both isotopes in the main organs and tissue reserves. In PF1 fish were fed at 10am (morning mealtime), and in PF2 at 5pm (afternoon mealtime). Fish were sampled at the next two mealtimes (PF1: 7 and 24h post-feeding, PF2: 17 and 24h post-feeding). Nutrients recovery differed according to, first, the dietary regime, and second, the last meal received (Cd or Ed). Daily lower protein intake was compensated with higher protein retention combined with more use of carbohydrates for energy. Nevertheless, carbohydrates from the morning meal were used more efficiently. So, the use of carbohydrate for energy production and protein for growth can be improved by adjusting diet composition and mealtime. Copyright © 2014 Elsevier Inc. All rights reserved.

A Video-Based Intervention on and Evaluation of Nursing Aides' Therapeutic Communication and Residents' Agitation During Mealtime in a Dementia Care Unit.

PubMed

Levy-Storms, Lené; Harris, Lesley M; Chen, Xiao

2016-01-01

The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication. Additional analyses using specific CNAs' therapeutic communication behaviors indicated a significant negative association with refusals at post-test but not pretest. The findings suggest some communication mechanisms for how the intervention positively influenced residents' refusals.

How a Young Child Learns How to Take Part in Mealtimes in a Japanese Day-Care Center: A Longitudinal Case Study

ERIC Educational Resources Information Center

Ishiguro, Hiroaki

2016-01-01

This research is a longitudinal, ethnographic study that focuses on mealtimes with one boy from 9 to 78 months of age in a day-care center in Japan. It looks at routine interactions between a child, his nursery teachers, and the environment, which is a shared and mutually available communicative space between participants in collaboration. The aim…

Maternal Perceptions of Nutrition, Stress, Time, and Assistance during Mealtimes: Similarities and Differences between Mothers of Children with Autism Spectrum Disorders and Mothers of Children with Typical Development

ERIC Educational Resources Information Center

Crowe, Terry K.; Freeze, Brenna; Provost, Elizabeth; King, Lauriann; Sanders, Margaret

2016-01-01

This study examined similarities and differences between mothers of preschool children with autism spectrum disorders (ASD) and mothers of preschool children with typical development (TD) in their perceptions of four mealtime outcomes: nutritional intake, stress, time, and assistance given. One group of 24 mothers of children with ASD and one…

Abnormal eating behavior in video-recorded meals in anorexia nervosa.

PubMed

Gianini, Loren; Liu, Ying; Wang, Yuanjia; Attia, Evelyn; Walsh, B Timothy; Steinglass, Joanna

2015-12-01

Eating behavior during meals in anorexia nervosa (AN) has long been noted to be abnormal, but little research has been done carefully characterizing these behaviors. These eating behaviors have been considered pathological, but are not well understood. The current study sought to quantify ingestive and non-ingestive behaviors during a laboratory lunch meal, compare them to the behaviors of healthy controls (HC), and examine their relationships with caloric intake and anxiety during the meal. A standardized lunch meal was video-recorded for 26 individuals with AN and 10 HC. Duration, frequency, and latency of 16 mealtime behaviors were coded using computer software. Caloric intake, dietary energy density (DEDS), and anxiety were also measured. Nine mealtime behaviors were identified that distinguished AN from HC: staring at food, tearing food, nibbling/picking, dissecting food, napkin use, inappropriate utensil use, hand fidgeting, eating latency, and nibbling/picking latency. Among AN, a subset of these behaviors was related to caloric intake and anxiety. These data demonstrate that the mealtime behaviors of patients with AN and HC differ significantly, and some of these behaviors may be associated with food intake and anxiety. These mealtime behaviors may be important treatment targets to improve eating behavior in individuals with AN. Copyright © 2015 Elsevier Ltd. All rights reserved.

A recipe for mealtime resilience for families living with dementia.

PubMed

Wong, Fiona; Keller, Heather H; Schindel Martin, Lori; Sutherland, Olga

2015-09-01

To date, research delving into the narratives of persons living with dementia is limited. Taking part in usual mealtime activities such as preparing food can sustain the identity of persons living with dementia. Yet if capacity for mealtime activities changes, this can put a strain or demand on the family, which must adjust and adapt to these changes. The aim of this study was to develop an in-depth story of resilience in one family living with dementia that was experiencing mealtime changes. Thematic narrative analysis following the elements of Clandinin and Connelly's (2000) 3D narrative inquiry space was used. One family's dementia journey was highlighted using the metaphor of a baking recipe to reflect their story of resilience. Developing positive strategies and continuing to learn and adapt were the two approaches used by this resilient family. Reminiscing, incorporating humour, having hope and optimism, and establishing social support were specific strategies. This family continued to learn and adapt by focusing on their positive gains and personal growth, accumulating life experiences, and balancing past pleasures while adapting to the new normal. Future work needs to further conceptualise resilience and how it can be supported in families living with dementia. © 2014 Nordic College of Caring Science.

[Recommendations for the prevention of organic foreign bodies aspiration].

PubMed

Rodríguez, Hugo; Cuestas, Giselle; Gregori, Darío; Lorenzoni, Giulia; Tortosa, Susana; Rodríguez D'Aquila, Máximo; Rodríguez D'Aquila, Juan A; Carrera, Sandra; Passali, Desiderio

2017-10-01

Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main characteristics of hazardous food and we present recommendations on age-appropriate meals, adequate forms of food preparation and behavioral rules at mealtimes in order to reduce food choking. Sociedad Argentina de Pediatría.

Stage-related behavioural problems in the 1-4 year old child: parental expectations in a child development unit referral group compared with a control group.

PubMed

Ticehurst, R L; Henry, R L

1989-02-01

Behavioural problems in preschool (1-4 years) children are a common cause of referral to health services. Parents of children presenting to the child development unit with behavioural problems (n = 18) were compared with a control group (n = 45). A questionnaire was utilized to examine the parents' expectations of the children's behaviours. As might be expected, the parents of children presenting to the Unit rated their children as having more difficult behaviours. These parents had unrealistic expectations, particularly for the 'negative' behaviours (disobedience, temper tantrums, defiance and whinging). However, they were able to anticipate normal age-related difficulties in some problem areas (dawdling during mealtimes, masturbating, not sharing toys and being jealous of one's siblings). Counselling should address the issue of matching the expectations of parents with the individual rates of development of their children.

Maternal Mental Representations of the Child and Mobile Phone Use During Parent-Child Mealtimes.

PubMed

Radesky, Jenny; Leung, Christy; Appugliese, Danielle; Miller, Alison L; Lumeng, Julie C; Rosenblum, Katherine L

2018-05-01

Qualities of the parent-child relationship have not been explored as predictors of parent mobile device use during parent-child activities. In 195 mother-child dyads enrolled in an ongoing cohort study, maternal mental representations of their child (ability to reflect on their child's characteristics, emotional state, and their parenting role) were evaluated through the Working Model of the Child Interview (WMCI), a validated semistructured interview. WMCI scale scores were examined as predictors of active maternal mobile device use during parent-child eating encounters (videotaped home mealtimes and a structured laboratory-based protocol) in multivariate logistic regression models. Children were aged 5.9 years (SD: 0.7), mothers were aged 31.5 years (SD: 7.4), and 73.3% of mothers were of white non-Hispanic race/ethnicity. During the family mealtime, 47 (24.1%) mothers actively used a mobile device at least once, whereas during the structured eating protocol, 44 (22.6%) mothers used a device. Controlling for maternal race/ethnicity, education level, and child's sex, WMCI subscales were associated with device use during home mealtimes (higher Child Difficulty) and the eating protocol (higher Child Difficulty and lower Richness of Perceptions and Caregiving Sensitivity). Maternal mental representations of their child were significantly associated with using mobile devices during eating encounters. More research studies are needed to understand directionality and longer-term associations between mobile device use and parent-child relationship characteristics.

Comparison of ethanol hand sanitizer versus moist towelette packets for mealtime patient hand hygiene.

PubMed

Rai, Herleen; Knighton, Shanina; Zabarsky, Trina F; Donskey, Curtis J

2017-09-01

To facilitate patient hand hygiene, there is a need for easy-to-use products. In a survey of 100 patients, a single-use ethanol hand sanitizer packet took less time to access than a single-use moist towelette packet (3 vs 23 seconds) and was preferred by 74% of patients for mealtime hand hygiene. Performance of patient hand hygiene increased when a reminder was provided at the time of meal tray delivery. Published by Elsevier Inc.

Mealtime Structure and Responsive Feeding Practices Are Associated With Less Food Fussiness and More Food Enjoyment in Children.

PubMed

Finnane, Julia M; Jansen, Elena; Mallan, Kimberley M; Daniels, Lynne A

2017-01-01

To identify associations between structure-related and non-responsive feeding practices and children's eating behaviors. Cross-sectional online survey design. Parents (n = 413) of 1- to 10-year-old children. Parental feeding practices and child eating behaviors were measured via the validated Feeding Practices and Structure and Children's Eating Behaviour questionnaires. Associations between parental feeding practices and children's eating behaviors were tested using hierarchical multivariable linear regression models, adjusted for covariates. Feeding practices accounted for 28% and 21% of the variance in food fussiness and enjoyment of food, respectively (P < .001). For all other eating behaviors the amount of variance explained by feeding practices was < 10% (P < .001). Key findings were that more structure and less non-responsive practices were associated with lower food fussiness and higher enjoyment of food. Overall, the findings suggested that mealtime structure and responsive feeding are associated with more desirable eating behaviors. Contrary to predictions, there was no evidence to indicate that these practices are associated with better self-regulation of energy intake. Longitudinal research and intervention studies are needed to confirm the importance of these feeding practices for children's eating behaviors and weight outcomes. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Correlates of psychosocial well-being among overweight adolescents: the role of the family.

PubMed

Fulkerson, Jayne A; Strauss, Jaine; Neumark-Sztainer, Dianne; Story, Mary; Boutelle, Kerri

2007-02-01

An ethnically diverse sample of at-risk-for-overweight and overweight youths (body mass index greater than the 85th percentile for age and gender; n = 667 male participants, and n = 684 female participants) completed a school-based survey measuring family variables (connectedness, mealtime environment, and weight commentary), psychosocial well-being (depressed mood, body satisfaction, and self-esteem), and unhealthy weight-control behaviors; all measures were assessed concurrently. Hierarchical linear regression analyses revealed that measures of general family connectedness, priority of family meals, and positive mealtime environment were significantly positively associated with psychological well-being and inversely associated with depressive symptoms and unhealthy weight-control behaviors. Familial weight commentary (i.e., weight-based teasing and parental encouragement to diet) was associated with many indicators of poor psychological health. The authors conclude that greater psychosocial well-being and fewer unhealthy weight-control behaviors are associated with making family time at meals a priority, creating a positive mealtime atmosphere, and refraining from weight commentary. Copyright 2007 APA, all rights reserved.

Family meals: perceptions of benefits and challenges among parents of 8- to 10-year-old children.

PubMed

Fulkerson, Jayne A; Story, Mary; Neumark-Sztainer, Dianne; Rydell, Sarah

2008-04-01

The study purpose was to examine parental perceptions of the mealtime environment in families with school-aged children and identify strategies to improve the dietary quality of meals. Cross-sectional surveys were completed by a convenience sample of 107 parents (86% mothers, 14% fathers) of 8- to 10-year-old children who were recruited from afterschool child care programs/elementary schools. SAS (version 9.1) was used to produce descriptive frequencies of parental reports of positive and negative perceptions of mealtime. Parents reported frequent family meals; however, they indicated that family dinners were eaten at full-service restaurants, purchased from fast-food establishments, or picked up as takeout foods at least weekly (47.0%, 28.3%, and 23.8%, respectively). Conflicts about food were problematic for some families (40.2% on at least some days), and appeared to be related to children's food pickiness. Parents reported many benefits of family meals, including time for conversation, feelings of togetherness, shared nutrition, and ceremony. Areas where parents desired change included assistance with meal planning, food preparation, and clean-up; spending more time at meals; assistance with children's food pickiness; new recipes and meal ideas; and decreasing conflict at mealtimes. Findings suggest that interventions to increase family meal frequency and promote healthful foods at mealtimes should address promoting food acceptance among children, sharing responsibilities among parents and children for meal planning and preparation, decreasing conflict at meals, and eating out healthfully.

The association between use of mealtime insulin pens versus vials and healthcare charges and resource utilization in patients with type 2 diabetes: a retrospective cohort study.

PubMed

Eby, Elizabeth L; Boye, Kristina S; Lage, Maureen J

2013-10-01

To compare all-cause and diabetes-related resource utilization and healthcare charges among adults with type 2 diabetes mellitus who initiated therapy with mealtime insulin disposable pens or vials. Data were obtained from the Innovus inVision database from January 1, 2006 through June 30, 2010. Generalized linear models with a gamma distribution and log link estimated the association between medical charges and use of mealtime insulin pens vs vials in the 1 year post-index date, while generalized linear models with a negative binomial distribution estimated resource utilization. Controlling for patient characteristics, general health, and patient copayments, insulin therapy initiation with disposable pens, compared to vials, was associated with significantly fewer all-cause hospitalizations (1.45 vs. 1.66; p < 0.0001) as well as a significantly shorter hospital length of stay (2.16 days vs. 3.53 days; p < 0.0001). Pen use, compared to vials, was also associated with significantly fewer diabetes-related hospitalizations (1.36 vs. 1.47; p < 0.0001), and shorter hospital length of stay (1.12 days vs. 1.72 days; p < 0.0001). Despite higher diabetes-related drug charges ($3593 vs. $2755; p < 0.0001) associated with the use of pens, results showed significantly lower all-cause total healthcare charges ($42,150 vs. $53,340; p < 0.0001) and significantly lower diabetes-related total healthcare charges ($12,722 vs. $14,540; p < 0.0001) for patients who initiated therapy on mealtime insulin with pens compared to vials. Data were drawn from administrative claims and included only patients with medical and outpatient prescription drug benefit coverage. Hence, the results may not be generalizable. The retrospective analyses relied on diagnostic codes to identify patients, assess patient general health, and determine other values, rather than formal, clinical assessments. The analyses did not include indirect healthcare costs. The administration of mealtime insulin via disposable pens, compared to vials, was associated with a significant reduction in all-cause and diabetes-related resource utilization and total healthcare charges.

Comparing cognition, mealtime performance, and nutritional status in people with dementia with or without ideational apraxia.

PubMed

Wu, Hua-Shan; Lin, Li-Chan

2015-03-01

To describe the prevalence rate of ideational apraxia (IA) affecting self-feeding in people with dementia, confirm the stage of dementia at which IA most commonly occurs, and compare mealtime performance and nutritional status between people with dementia (PWD) with and without IA. A cross-sectional design with between-subject comparison was used. Among the 395 potential participants recruited from dementia special care units at nine long-term care facilities in central and northern Taiwan, 98 met the operational definition of IA and were included in the PWD with IA group. From the remaining pool, 98 participants, matched for age and sex with the PWD with IA group, were randomly allocated to the PWD without IA group. Eating Behavior Scale (EBS) scores, food intake, total eating time, meal assistance, body mass index, Mini-Nutritional Assessment (MNA), and Mini-Mental State Examination scores were collected. The prevalence rate of IA affecting self-feeding in our study population of PWD was 24.8%. PWD with IA had significantly lower EBS scores, had more food intake (p < .001), spent more time being fed by caregivers, needed more verbal and feeding assistance, and had lower MNA scores than PWD without IA. Decline in the self-feeding ability of PWD affected by IA most commonly occurred in the severe stage of dementia. When dementia progresses to the late stage, staff should pay special attention to residents' mealtime performance and nutritional status. For PWD with IA, reassigning staff at mealtimes based on eating ability and providing memory training are recommended. © The Author(s) 2014.

The relationship between carbohydrate and the mealtime insulin dose in type 1 diabetes.

PubMed

Bell, Kirstine J; King, Bruce R; Shafat, Amir; Smart, Carmel E

2015-01-01

A primary focus of the nutritional management of type 1 diabetes has been on matching prandial insulin therapy with carbohydrate amount consumed. Different methods exist to quantify carbohydrate including counting in one gram increments, 10g portions or 15g exchanges. Clinicians have assumed that counting in one gram increments is necessary to precisely dose insulin and optimize postprandial control. Carbohydrate estimations in portions or exchanges have been thought of as inadequate because they may result in less precise matching of insulin dose to carbohydrate amount. However, studies examining the impact of errors in carbohydrate quantification on postprandial glycemia challenge this commonly held view. In addition it has been found that a single mealtime bolus of insulin can cover a range of carbohydrate intake without deterioration in postprandial control. Furthermore, limitations exist in the accuracy of the nutrition information panel on a food label. This article reviews the relationship between carbohydrate quantity and insulin dose, highlighting limitations in the evidence for a linear association. These insights have significant implications for patient education and mealtime insulin dose calculations. Copyright © 2015 Elsevier Inc. All rights reserved.

Parent-child mealtime interactions in racially/ethnically diverse families with preschool-age children.

PubMed

Kong, Angela; Jones, Blake L; Fiese, Barbara H; Schiffer, Linda A; Odoms-Young, Angela; Kim, Yoonsang; Bailey, Lauren; Fitzgibbon, Marian L

2013-12-01

Family meals may improve diet and weight outcomes in children; however, results from nationally representative samples suggest that these relationships vary by race/ethnicity. Observing parent-child mealtime interactions may lend insight to why racial/ethnic differences exist. In this pilot study, a multi-ethnic sample of low-income families (n = 30) with a preschool-age child was videotaped during a dinner in their home. A global coding scheme was used to assess the following: 'Action' (behaviors that divert attention from eating), 'Behavior Control' (behaviors intended to modify another person's behavior), and 'Communication' (i.e., meal-oriented, interpersonal, and critical). All families spent a significant amount of time in 'action' oriented behaviors that diverted their attention from eating. We also observed racial/ethnic differences in communication (i.e. critical) and behavior patterns (i.e. behavior control). This study demonstrated that this approach for observing parent-child mealtime interactions in a naturalistic setting among a diverse study sample was feasible; however, future studies should address how these patterns relate to dietary intake and weight status. © 2013.

Parent-child mealtime interactions in racially/ethnically diverse families with preschool-age children

PubMed Central

Kong, Angela; Jones, Blake L.; Fiese, Barbara H.; Schiffer, Linda A.; Odoms-Young, Angela; Kim, Yoonsang; Bailey, Lauren; Fitzgibbon, Marian L.

2013-01-01

Family meals may improve diet and weight outcomes in children; however, results from nationally representative samples suggest these relationships vary by race/ethnicity. Observing parent-child mealtime interactions may lend insight to why racial/ethnic differences exist. In this pilot study, a multi-ethnic sample of low-income families (n=30) with a preschool-age child were videotaped during a dinner in their home. A global coding scheme was used to assess the following: `Action' (behaviors that divert attention from eating), `Behavior Control' (behaviors intended to modify another person's behavior), and `Communication' (i.e., meal-oriented, interpersonal, and critical). All families spent a significant amount of time in `action' oriented behaviors that diverted their attention from eating. We also observed racial/ethnic differences in communication (i.e. critical) and behavior patterns (i.e. behavior control). This study demonstrated that this approach for observing parent-child mealtime interactions in a naturalistic setting among a diverse study sample was feasible; however, future studies should address how these patterns relate to dietary intake and weight status. PMID:24183134

Developing proper mealtime behaviors of the institutionalized retarded.

PubMed

O'brien, F; Azrin, N H

1972-01-01

The institutionalized mentally retarded display a variety of unsanitary, disruptive, and improper table manners. A program was developed that included (1) acquisition-training of a high standard of proper table manners and (2) maintenance procedures to provide continued motivation to maintain proper mealtime behaviors and decrease improper skills. Twelve retardates received acquisition training, individually, by a combination of verbal instruction, imitation, and manual guidance. The students then ate in their group dining arrangement where the staff supervisor provided continuing approval for proper manners and verbal correction and timeout for improper manners. The results were: (1) the trained retardates showed significant improvement, whereas those untrained did not; (2) the trained retardates ate as well in the institution as non-retarded customers did in a public restaurant; (3) proper eating was maintained in the group dining setting; (4) timeout was rarely needed; (5) the program was easily administered by regular staff in a regular dining setting. The rapidity, feasibility, and effectiveness of the program suggests the program as a solution to improper mealtime behaviors by the institutionalized mentally retarded.

Pros and cons of using paid feeding assistants in nursing homes.

PubMed

Remsburg, Robin E

2004-01-01

Recently the Centers for Medicare and Medicaid Services (CMS), citing increasing resident acuity, staffing shortages, and high turnover rates that make it difficult for nursing homes to provide adequate feeding assistance to residents who need minimal help at mealtimes, began allowing nursing facilities to use single-task workers to provide assistance during mealtimes. This article describes the use of single-task workers to provide feeding assistance to nutritionally at-risk residents during a 6-month clinical study designed to evaluate the effectiveness and feasibility of implementing a buffet-dining program in an academic long-term care facility.

Sibling Feeding Behavior: Mothers as Role Models During Mealtimes

PubMed Central

Mosli, Rana H.; Miller, Alison L.; Peterson, Karen E.; Lumeng, Julie C.

2015-01-01

Siblings may act as caregivers and role models during mealtimes, and develop caregiving skills by observing and imitating the behavior of their mothers. The objective of this study was to examine the association between maternal feeding behaviors and encouragements to eat delivered from the sibling to the index child during mealtimes. Index children aged 4-8 years (n = 69) were videotaped while eating a routine evening meal at home with one sibling present. Encouragements to eat delivered from the sibling to the index child were coded from the videotapes. Mothers completed the Child Feeding Questionnaire and the Caregiver's Feeding Styles Questionnaire. Poisson regression was used to examine the association of maternal Pressure to Eat, Restriction, Monitoring, Verbal Direction, and Coercion with number of encouragements to eat delivered from the sibling to the index child. Models were adjusted for index child's age, sex, and race/ethnicity, and maternal education. Results showed that maternal Pressure to Eat (Rate Ratio (RR): 1.39, 95% confidence interval (CI): 1.19, 1.69), Restriction (RR: 1.31, 95% CI: 1.07, 1.60), Verbal Direction (RR: 2.04, 95% CI: 1.68, 2.47), and Coercion (RR: 1.58, 95% CI: 1.29, 1.92) were each positively associated with the number of encouragements to eat delivered from the sibling to the index child. Maternal Monitoring was not associated with the number of encouragements to eat delivered from the sibling to the index child (RR: 0.92, 97% CI: 0.78, 1.09). Findings suggest that maternal behavior during mealtimes may affect the index child indirectly by shaping the behavior of siblings. Since controlling feeding behaviors have been associated with greater child obesity risk, future studies may evaluate the compounded effect of experiencing controlling feeding behaviors from both mothers and siblings. PMID:26585632

Perceived benefits and challenges for low-income mothers of having family meals with preschool-aged children: childhood memories matter.

PubMed

Malhotra, Khushi; Herman, Allison N; Wright, Gretchen; Bruton, Yasmeen; Fisher, Jennifer O; Whitaker, Robert C

2013-11-01

Eating regular family meals is associated with a lower risk of obesity among preschool-aged children. Children in lower-income households are at higher risk for obesity, but there is little information about their mothers' perceptions of family meals, and such information could improve nutrition counseling. To identify the perceived benefits and challenges of having family meals, four focus groups were conducted with 20 mothers of preschool-aged children living in low-income households in Philadelphia, PA. Three authors independently analyzed verbatim transcripts using an inductive method of open coding, and themes were established by consensus among all authors. Of the 20 mothers, 18 were black, 11 had education beyond high school, and 12 were living with an adult partner or husband. Mothers' strong childhood memories of mealtimes, both negative and positive, motivated them to have family meals because of the opportunities afforded by mealtimes to build strong relationships with their children. However, mothers also described needing help, especially from other household adults, in preparing meals and establishing calm and order with their children during mealtimes. To identify what motivates the mothers of low-income, preschool-aged children to have family meals, registered dietitians can benefit from asking about the mothers' own childhood experiences of family meals. Studies are needed to examine whether such an approach to identifying maternal motivations, when combined with practical advice about overcoming challenges with meal preparation and managing children's mealtime behavior, could lead to more frequent and nutritious family meals in this population. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Do physical environmental changes make a difference? Supporting person-centered care at mealtimes in nursing homes.

PubMed

Chaudhury, Habib; Hung, Lillian; Rust, Tiana; Wu, Sarah

2017-10-01

Purpose Drawing on therapeutic physical environmental design principles and Kitwood's theoretical view of person-centered care, this study examined the impact of environmental renovations in dining spaces of a long-term care facility on residents' mealtime experience and staff practice in two care units. Method The research design involved pre- and post-renovation ethnographic observations in the dining spaces of the care units and a post-renovation staff survey. The objective physical environmental features pre- and post-renovations were assessed with a newly developed tool titled Dining Environment Audit Protocol. We collected observational data from 10 residents and survey responses from 17 care aides and nurses. Findings Based on a systematic analysis of observational data and staff survey responses, five themes were identified: (a) autonomy and personal control, (b) comfort of homelike environment, (c) conducive to social interaction, (d) increased personal support, and (e) effective teamwork. Implications Although the physical environment can play an influential role in enhancing the dining experience of residents, the variability in staff practices reveals the complexity of mealtime environment and points to the necessity of a systemic approach to foster meaningful culture change.

An ecobehavioral examination of a simple strategy for increasing mealtime language in residential facilities.

PubMed

VanBiervliet, A; Spangler, P F; Marshall, A M

1981-01-01

Typically in large residential facilities for retarded person, meals are served in an institutional style that does not appear to encourage appropriate peer interactions. An ecological program alternative is serving meals in a family style. The present study was designed to examine both the feasibility of serving family style meals and the effects of family style meal service on mealtime language. Five retarded young adult male residents, who had some conversational skills and appropriate table manners, participated in this study. The experimental design involved a multiple baseline analysis across meals (dinner, lunch, and breakfast). Observers coded the youths' mealtime verbalizations according to the type, content, and direction of the verbalizations and they recorded the length of the meals. The analysis of the verbalization data indicated that during family style meals the participants spoke substantially more often than during institutional style meals. Increases in peer-directed conversation about the meals primarily accounted for the verbalization changes. Family style serving also resulted in the youths spending more time with their meals. In addition, social validation measures suggested that the family style procedures were preferred by the consumers (participants, staff, and concerned community members).

Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes.

PubMed

White, Hannah J; Haycraft, Emma; Madden, Sloane; Rhodes, Paul; Miskovic-Wheatley, Jane; Wallis, Andrew; Kohn, Michael; Meyer, Caroline

2017-04-01

Examine relationships between parental mealtime strategies used in the family meal session of family-based treatment (FBT) and adolescent outcomes at EOT (session 20). Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system. Change scores were calculated for both adolescent %EBW and EDE scores. Increased use of parental direct and non-direct eating prompts during the family meal was associated with greater adolescent weight gain at EOT. Use of parental mealtime strategies was not associated with any significant change in adolescent eating psychopathology at EOT. Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child's eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:433-436). © 2016 Wiley Periodicals, Inc.

Changes in Food Selectivity in Children with Autism Spectrum Disorder.

PubMed

Bandini, Linda G; Curtin, Carol; Phillips, Sarah; Anderson, Sarah E; Maslin, Melissa; Must, Aviva

2017-02-01

Food selectivity is a common problem in children with autism spectrum disorder (ASD) and has an adverse impact on nutrient adequacy and family mealtimes. Despite recent research in this area, few studies have addressed whether food selectivity present in children with ASD persists into adolescence. In this study, we assessed food selectivity in 18 children with ASD at two time points (mean age = 6.8 and 13.2 years), and examined changes in food selectivity. While food refusal improved overall, we did not observe an increase in food repertoire (number of unique foods eaten). These findings support the need for interventions early in childhood to increase variety and promote healthy eating among children with ASD.

Observations of mealtimes in hospital aged care rehabilitation wards.

PubMed

Walton, Karen; Williams, Peter; Tapsell, Linda; Hoyle, Matthew; Shen, Zhi Wei; Gladman, Lauren; Nurka, Martin

2013-08-01

Malnutrition is common in long-stay elderly hospitalized patients and their dietary intakes are often poor, despite the provision of adequate quantities of food to meet patient needs. The aim of this study was to identify environmental factors that were associated with achieving adequate food consumption in a hospital context. This study observed the daily routines of 30 elderly patients over 2days in rehabilitation wards in three Australian hospitals. All activities associated with mealtimes were recorded, from the commencement of breakfast to the conclusion of supper at the end of the day. Four key themes emerged: the eating location; assistance given at meals; negative and positive interruptions. The time taken to eat meals averaged 22min, ranging from 3 to 55min. Food intakes appeared to be better when meals were consumed communally in a dining room. There were many occasions when patients needed more assistance to eat than was available. The most common factors negatively affecting meal consumption were medication rounds, inappropriate placement of trays, packaging being hard to open, and patient showering. The presence of visitors, dietitians and nutrition assistants appeared to improve dietary intakes. Trials of protected mealtimes in Australian hospitals are certainly important and timely. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recovery of diminished mealtime-associated anticipatory behavior by aniracetam in aged rats.

PubMed

Tanaka, Y; Kurasawa, M; Nakamura, K

2000-08-01

Disease- or age-related neuropsychiatric symptoms and cognitive and chronobiological impairments greatly aggravate the activities of daily living (ADL) in patients. The present study evaluates the effects of aniracetam on a decline in mealtime-associated anticipatory behavior in aged rats, as an animal model of temporally regulated behaviors or habitual daily activities. Aged rats showed a lower but typical nocturnal motor activity rhythm than young rats when the animals were fed ad lib. Mealtime-associated anticipatory behavior emerged in young rats when the rats were fed at a fixed time for 6 days, but the activity in aged rats was diminished. Repeated administration of aniracetam (100 mg/kg PO) or physostigmine (0.1 mg/kg SC) for 7 days ameliorated the impaired anticipatory behavior in aged rats. Nefiracetam (10 mg/kg PO) was ineffective. All compounds tested had no effect on appetite or motor ability. These results indicate that aging disturbs the timing or temporal regulation of anticipatory behavior, probably resulting from dysfunction in a food-entrainable oscillator linked to central cholinergic systems. The restoration of the time-keeping ability by aniracetam may be mediated by the facilitation of reticulothalamic cholinergic neurotransmission, and the action may lead to the improvement of declined ADL in stroke patients.

Sibling feeding behavior: Mothers as role models during mealtimes.

PubMed

Mosli, Rana H; Miller, Alison L; Peterson, Karen E; Lumeng, Julie C

2016-01-01

Siblings may act as caregivers and role models during mealtimes, and develop caregiving skills by observing and imitating the behavior of their mothers. The objective of this study was to examine the association between maternal feeding behaviors and encouragements to eat delivered from the sibling to the index child during mealtimes. Index children aged 4-8 years (n = 69) were videotaped while eating a routine evening meal at home with one sibling present. Encouragements to eat delivered from the sibling to the index child were coded from the videotapes. Mothers completed the Child Feeding Questionnaire and the Caregiver's Feeding Styles Questionnaire. Poisson regression was used to examine the association of maternal Pressure to Eat, Restriction, Monitoring, Verbal Direction, and Coercion with number of encouragements to eat delivered from the sibling to the index child. Models were adjusted for index child's age, sex, and race/ethnicity, and maternal education. Results showed that maternal Pressure to Eat (Rate Ratio (RR): 1.39, 95% confidence interval (CI): 1.19, 1.69), Restriction (RR: 1.31, 95% CI: 1.07, 1.60), Verbal Direction (RR: 2.04, 95% CI: 1.68, 2.47), and Coercion (RR: 1.58, 95% CI: 1.29, 1.92) were each positively associated with the number of encouragements to eat delivered from the sibling to the index child. Maternal Monitoring was not associated with the number of encouragements to eat delivered from the sibling to the index child (RR: 0.92, 97% CI: 0.78, 1.09). Findings suggest that maternal behavior during mealtimes may affect the index child indirectly by shaping the behavior of siblings. Since controlling feeding behaviors have been associated with greater child obesity risk, future studies may evaluate the compounded effect of experiencing controlling feeding behaviors from both mothers and siblings. Copyright © 2015. Published by Elsevier Ltd.

Exploring the functional mealtime associations of older adults through consumer segmentation and a means-end chain approach.

PubMed

den Uijl, Louise C; Jager, Gerry; de Graaf, Cees; Kremer, Stefanie

2016-12-01

Senior consumers are a rapidly growing and highly heterogeneous part of the world's population. This group does not always meet its recommended protein intake, which can negatively impact on their physical functioning and quality of life. To date, little is known about their motivations to consume protein-rich meals. In the current study, we therefore aim to identify consumer segments within the group of vital community-dwelling older adults on the basis of mealtime functionality (for example 'I eat because I'm hungry', or 'I eat because it is cosy'). To this end, we first conducted an online survey to identify these functional mealtime expectations of older consumers (study I, n = 398, 158 males, mean age 65.8 (y) ± 5.9 (SD)). To obtain further insights regarding mealtime functionality and proteins/protein enrichment, laddering interviews were conducted with a subgroup of the segmentation study participants (study II, n = 40, 20 males, mean age 66.9 (y) ± 4.8 (SD)). The results of the online survey showed three consumer clusters: cosy socialisers, physical nutritioners, and thoughtless rewarders. Thoughtless rewarders tend to eat without having explicit thoughts about it, they eat for the reward, and score highest on environmental awareness. Both the segmentation and the in-depth interviews showed that, for the cosy socialisers, the cosiness and social function of a meal are important motivators, whereas for the physical nutritioners the focus is more on the health and nutrient aspects of a meal. For cosy socialisers, protein enrichment can best be achieved through addition of protein-rich ingredients, whereas, for physical nutritioners, addition of protein powder is preferred. These results provide practical guidelines for the development of protein-rich meals and communication strategies tailored to the needs of specific vital community-dwelling older subgroups. Copyright © 2016 Elsevier Ltd. All rights reserved.

Working nonstandard schedules and variable shifts in low-income families: associations with parental psychological well-being, family functioning, and child well-being.

PubMed

Hsueh, JoAnn; Yoshikawa, Hirokazu

2007-05-01

Longitudinal data from the New Hope Project--an experimental evaluation of a work-based antipoverty program in Milwaukee, Wisconsin--was used to explore concurrent and lagged associations of nonstandard schedules and variable shifts with parental psychological well-being, regularity of family mealtimes, and child well-being among low-income families. Working a combination of variable shifts and nonstandard hours was associated concurrently with lower teacher-reported school performance and engagement and higher levels of externalizing behavior problems. Fixed nonstandard schedules were associated with lagged decreases in parent-reported school performance, whereas working variable shifts was associated with lagged increases in parent-reported school performance. Copyright (c) 2007 APA, all rights reserved.

Making time for family meals: Parental influences, home eating environments, barriers and protective factors.

PubMed

Jones, Blake L

2018-04-06

Frequent family mealtimes have been associated with numerous positive dietary, health, and behavioral outcomes for children and families. This review article summarizes some of the beneficial outcomes associated with having frequent family dinners. Current trends in family dinner frequency are discussed in the context of barriers that influence how often families eat dinner together, including time issues, work issues, and distractions in the home environment. Next, several parental influences and home environment factors that promote healthy and consistent family dinners are outlined. Finally, limitations are discussed and a few practical suggestions are mentioned to help encourage families, employers, and policy-makers to make family mealtimes a regular practice for as many families as possible. Copyright © 2018. Published by Elsevier Inc.

Preventing Weight Gain and Obesity: Indirect Effects of the Family Check-Up in Early Childhood

PubMed Central

Smith, Justin D.; Montaño, Zorash; Dishion, Thomas J.; Shaw, Daniel S.; Wilson, Melvin N.

2014-01-01

The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children’s weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children’s weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers’ use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children’s weight trajectories. A total of 731 indigent caregiver–child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2 to 5. The child’s body mass index (BMI) was assessed yearly from age 5 to 9.5. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers’ PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Further, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed. PMID:25263212

Threats: power, family mealtimes, and social influence.

PubMed

Hepburn, Alexa; Potter, Jonathan

2011-03-01

One of the most basic topics in social psychology is the way one agent influences the behaviour of another. This paper will focus on threats, which are an intensified form of attempted behavioural influence. Despite the centrality to the project of social psychology, little attention has been paid to threats. This paper will start to rectify this oversight. It reviews early examples of the way social psychology handles threats and highlights key limitations and presuppositions about the nature and role of threats. By contrast, we subject them to a programme of empirical research. Data comprise video records of a collection of family mealtimes that include preschool children. Threats are recurrent in this material. A preliminary conceptualization of features of candidate threats from this corpus will be used as an analytic start point. A series of examples are used to explicate basic features and dimensions that build the action of threatening. The basic structure of the threats uses a conditional logic: if the recipient continues problem action/does not initiate required action then negative consequences will be produced by the speaker. Further analysis clarifies how threats differ from warnings and admonishments. Sequential analysis suggests threats set up basic response options of compliance or defiance. However, recipients of threats can evade these options by, for example, reworking the unpleasant upshot specified in the threat, or producing barely minimal compliance. The implications for broader social psychological concerns are explored in a discussion of power, resistance, and asymmetry; the paper ends by reconsidering the way social influence can be studied in social psychology. ©2010 The British Psychological Society.

RelAte: pilot study of the effects of a mealtime intervention on social cognitive factors and energy intake among older adults living alone.

PubMed

McHugh Power, Joanna E; Lee, Olga; Aspell, Niamh; McCormack, Emma; Loftus, Michelle; Connolly, Leona; Lawlor, Brian; Brennan, Sabina

2016-11-01

Mealtime interventions typically focus on institutionalised older adults, but we wanted to investigate whether they may also be effective among those living independently. Using a randomised controlled trial design, we assessed the effects of a novel mealtime intervention on self-efficacy, food enjoyment and energy intake. A total of 100 adults living alone aged over 60 years were randomised to the treatment or control conditions: all received a guidebook on nutrition and culinary skills. Treatment group participants received a weekly visit from a trained volunteer who prepared and shared a meal with them. Participants in the treatment group showed improvements relative to those in the control group at borderline significance (P=0·054) for self-efficacy and at significance for food enjoyment. Significant improvements were observed in female participants in the treatment but not in the control group in energy intake (although following corrections for multiple comparisons, only the effect on food enjoyment remained significant). These findings will inform the design of future complex interventions. For this type of intervention to be successful, more focus has to be placed on making interventions more personalised, potentially according to sex. Findings are important for nutritional sciences as they indicate that, in order to improve energy intake and food enjoyment among older adults, multimodal nutritional interventions including social components may be successful.

An explanatory framework of teachers' perceptions of a positive mealtime environment in a preschool setting.

PubMed

Mita, Satoko C; Gray, Samuel A; Goodell, L Suzanne

2015-07-01

Attending a preschool center may help preschoolers with growth and development that encourage a healthy lifestyle, including sound eating behaviors. Providing a positive mealtime environment (PME) may be one of the keys to fostering a child's healthy eating habits in the classroom. However, a specific definition of a PME, the components of a PME, or directions on how to create one have not been established. The purpose of this study, therefore, was to explore Head Start teachers' perceptions related to a PME and create a conceptual framework representing these perceptions. To achieve this purpose, researchers conducted 65 in-depth phone interviews with Head Start teachers around the US. Applying principles of grounded theory, researchers developed a conceptual framework depicting teachers' perceptions of PME, consisting of five key components: (1) the people (i.e., teachers, kitchen staff, parent volunteers, and children), (2) positive emotional tone (e.g., relaxed and happy), (3) rules, expectations, and routines (e.g., family-style mealtime), (4) operations of a PME (i.e., eating, socialization, and learning), and (5) both short- and long-term outcomes of a PME. With this PME framework, researchers may be able to enhance the effectiveness of nutrition interventions related to a PME, focusing on the factors in the conceptual framework as well as barriers associated with achieving these factors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Come and Get It! A Discussion of Family Mealtime Literature and Factors Affecting Obesity Risk123

PubMed Central

Martin-Biggers, Jennifer; Spaccarotella, Kim; Berhaupt-Glickstein, Amanda; Hongu, Nobuko; Worobey, John; Byrd-Bredbenner, Carol

2014-01-01

The L.E.A.D. (Locate, Evaluate, and Assemble Evidence to Inform Decisions) framework of the Institute of Medicine guided the assembly of transdisciplinary evidence for this comprehensive, updated review of family meal research, conducted with the goal of informing continued work in this area. More frequent family meals are associated with greater consumption of healthy foods in children, adolescents, and adults. Adolescents and children who consume fewer family meals consume more unhealthy food. School-aged children and adolescents who consume more family meals have greater intakes of typically underconsumed nutrients. Increased family meal frequency may decrease risk of overweight or obesity in children and adolescents. Frequent family meals also may protect against eating disorders and negative health behaviors in adolescents and young adults. Psychosocial benefits include improved perceptions of family relationships. However, the benefits of having a family meal can be undermined if the family consumes fast food, watches television at the meal, or has a more chaotic atmosphere. Although these findings are intriguing, inconsistent research methodology and instrumentation and limited use of validation studies make comparisons between studies difficult. Future research should use consistent methodology, examine these associations across a wide range of ages, clarify the effects of the mealtime environment and feeding styles, and develop strategies to help families promote healthful mealtime habits. PMID:24829470

“Just Three More Bites”: An Observational Analysis of Parents’ Socialization of Children’s Eating at Mealtime

PubMed Central

Orrell-Valente, Joan K.; Hill, Laura G.; Brechwald, Whitney A.; Dodge, Kenneth A.; Pettit, Gregory S.; Bates, John E.

2007-01-01

The objective of this study was to describe comprehensively the structure and process of the childhood mealtime environment. A socioeconomically-diverse sample of 142 families of kindergarteners (52% females) was observed at dinnertime using a focused-narrative observational system. Eighty-five percent of parents tried to get children to eat more, 83% of children ate more than they might otherwise have, with 38% eating moderately to substantially more. Boys were prompted to eat as often as girls and children were prompted to eat as many times in single-as in two-parent households. Children were very rarely restricted in their mealtime intake. High-SES parents used reasoning, praise, and food rewards significantly more often than low-SES families. Mothers used different strategies than fathers: fathers used pressure tactics with boys and mothers praised girls for eating. Future research should examine the meanings children ascribe to their parents’ communications about food intake and how perceived parental messages influence the development of long-term dietary patterns. Interpreted alongside the evidence for children’s energy self-regulation and the risk of disruption of these innate processes, it may be that parents are inadvertently socializing their children to eat past their internal hunger/satiety cues. These data reinforce current recommendations that parents should provide nutritious foods and children, not parents, should decide what and how much of these foods they eat. PMID:17000028

Mealtime exposure to food advertisements while watching television increases food intake in overweight and obese girls but has a paradoxical effect in boys.

PubMed

Anderson, G Harvey; Khodabandeh, Shokoufeh; Patel, Barkha; Luhovyy, Bohdan L; Bellissimo, Nick; Mollard, Rebecca C

2015-02-01

Food advertisements (ads) in TV programs influence food choice and have been associated with higher energy intake from snacks in children; however, their effects at mealtime have not been reported. Therefore, we measured energy intake at a pizza meal consumed by normal weight (NW) and overweight/obese (OW/OB) children (aged 9-14 years) while they watched a TV program with or without food ads and following pre-meal consumption of a sweetened beverage with or without calories. NW and OW/OB boys (experiment 1, n = 27) and girls (experiment 2, n = 23) were randomly assigned to consume equally sweetened drinks containing glucose (1.0 g/kg body weight) or sucralose (control). Food intake was measured 30 min later while children watched a program containing food or nonfood ads. Appetite was measured before (0-30 min) and after (60 min) the meal. Both boys and girls reduced energy intake at the meal in compensation for energy in the glucose beverage (p < 0.05). Food ads resulted in further compensation (51%) in boys but not in girls. Food ads increased energy intake at the meal (9%; p = 0.03) in OW/OB girls only. In conclusion, the effects of TV programs with food ads on mealtime energy intake and response to pre-meal energy consumption in children differ by sex and body mass index.

Come and get it! A discussion of family mealtime literature and factors affecting obesity risk.

PubMed

Martin-Biggers, Jennifer; Spaccarotella, Kim; Berhaupt-Glickstein, Amanda; Hongu, Nobuko; Worobey, John; Byrd-Bredbenner, Carol

2014-05-01

The L.E.A.D. (Locate, Evaluate, and Assemble Evidence to Inform Decisions) framework of the Institute of Medicine guided the assembly of transdisciplinary evidence for this comprehensive, updated review of family meal research, conducted with the goal of informing continued work in this area. More frequent family meals are associated with greater consumption of healthy foods in children, adolescents, and adults. Adolescents and children who consume fewer family meals consume more unhealthy food. School-aged children and adolescents who consume more family meals have greater intakes of typically underconsumed nutrients. Increased family meal frequency may decrease risk of overweight or obesity in children and adolescents. Frequent family meals also may protect against eating disorders and negative health behaviors in adolescents and young adults. Psychosocial benefits include improved perceptions of family relationships. However, the benefits of having a family meal can be undermined if the family consumes fast food, watches television at the meal, or has a more chaotic atmosphere. Although these findings are intriguing, inconsistent research methodology and instrumentation and limited use of validation studies make comparisons between studies difficult. Future research should use consistent methodology, examine these associations across a wide range of ages, clarify the effects of the mealtime environment and feeding styles, and develop strategies to help families promote healthful mealtime habits. © 2014 American Society for Nutrition.

Is frequency of shared family meals related to the nutritional health of children and adolescents?

PubMed

Hammons, Amber J; Fiese, Barbara H

2011-06-01

We used meta-analytic methods to examine the frequency of shared family mealtimes in relation to nutritional health in children and adolescents. The primary objective was to determine consistency and strength of effects across 17 studies that examined overweight and obese, food consumption and eating patterns, and disordered eating. The total sample size for all studies was 182 836 children and adolescents (mean sample age: 2.8-17.3 years). Pooled odds ratios were calculated. A random-effects model was used to estimate all outcomes. The frequency of shared family meals is significantly related to nutritional health in children and adolescents. Children and adolescents who share family meals 3 or more times per week are more likely to be in a normal weight range and have healthier dietary and eating patterns than those who share fewer than 3 family meals together. In addition, they are less likely to engage in disordered eating. Educational and public health initiatives aimed at promoting shared family mealtimes may improve nutritional health of children and adolescents. Clinicians may advise their patients about the benefits of sharing 3 or more family mealtimes per week; benefits include a reduction in the odds for overweight (12%), eating unhealthy foods (20%), and disordered eating (35%) and an increase in the odds for eating healthy foods (24%).

Is Frequency of Shared Family Meals Related to the Nutritional Health of Children and Adolescents?

PubMed Central

Fiese, Barbara H.

2011-01-01

OBJECTIVE: We used meta-analytic methods to examine the frequency of shared family mealtimes in relation to nutritional health in children and adolescents. The primary objective was to determine consistency and strength of effects across 17 studies that examined overweight and obese, food consumption and eating patterns, and disordered eating. METHODS: The total sample size for all studies was 182 836 children and adolescents (mean sample age: 2.8–17.3 years). Pooled odds ratios were calculated. A random-effects model was used to estimate all outcomes. RESULTS: The frequency of shared family meals is significantly related to nutritional health in children and adolescents. Children and adolescents who share family meals 3 or more times per week are more likely to be in a normal weight range and have healthier dietary and eating patterns than those who share fewer than 3 family meals together. In addition, they are less likely to engage in disordered eating. CONCLUSIONS: Educational and public health initiatives aimed at promoting shared family mealtimes may improve nutritional health of children and adolescents. Clinicians may advise their patients about the benefits of sharing 3 or more family mealtimes per week; benefits include a reduction in the odds for overweight (12%), eating unhealthy foods (20%), and disordered eating (35%) and an increase in the odds for eating healthy foods (24%). PMID:21536618

Real-world visual statistics and infants' first-learned object names

PubMed Central

Clerkin, Elizabeth M.; Hart, Elizabeth; Rehg, James M.; Yu, Chen

2017-01-01

We offer a new solution to the unsolved problem of how infants break into word learning based on the visual statistics of everyday infant-perspective scenes. Images from head camera video captured by 8 1/2 to 10 1/2 month-old infants at 147 at-home mealtime events were analysed for the objects in view. The images were found to be highly cluttered with many different objects in view. However, the frequency distribution of object categories was extremely right skewed such that a very small set of objects was pervasively present—a fact that may substantially reduce the problem of referential ambiguity. The statistical structure of objects in these infant egocentric scenes differs markedly from that in the training sets used in computational models and in experiments on statistical word-referent learning. Therefore, the results also indicate a need to re-examine current explanations of how infants break into word learning. This article is part of the themed issue ‘New frontiers for statistical learning in the cognitive sciences’. PMID:27872373

Insulin Secretagogues

MedlinePlus

... the Spikes Is mealtime insulin right for you? Insulin Secretagogues September 2017 Download PDFs English Espanol Editors ... Additional Resources Affordable Insulin Project FDA What are insulin secretagogues? Insulin secretagogues are one type of medicine ...

On the displacement of leisure items by food during multiple-stimulus preference assessments.

PubMed Central

Bojak, S L; Carr, J E

1999-01-01

Previous studies have demonstrated that when food and leisure stimuli are combined in multiple-stimulus preference assessments, individuals typically select food more often, although the leisure stimuli also have known reinforcing properties. The purpose of the current study was to replicate this effect and determine its durability by examining the effect after mealtimes. Four adults who had been diagnosed with severe mental retardation were given three initial multiple-stimulus (without replacement) preference assessments (i.e., food, leisure stimuli, and combined). All participants selected food items as the most preferred stimuli in the combined assessments. Combined assessments were then administered immediately before and after the evening meal for each participant for 1 week. The results showed similar data both before and after mealtimes. PMID:10641304

Prevalence and Determinants of Poor Food Intake of Residents Living in Long-Term Care.

PubMed

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

2017-11-01

Poor food intake is known to lead to malnutrition in long-term care homes (LTCH), yet multilevel determinants of food intake are not fully understood, hampering development of interventions that can maintain the nutritional status of residents. This study measures energy and protein intake of LTCH residents, describes prevalence of diverse covariates, and the association of covariates with food intake. Multisite cross-sectional study. Thirty-two nursing homes from 4 provinces in Canada. From a sample of 639 residents (20 randomly selected per home), 628 with complete data were included in analyses. Three days of weighed food intake (main plate, estimated beverages and side dishes, snacks) were completed to measure energy and protein intake. Health records were reviewed for diagnoses, medications, and diet prescription. Mini-Nutritional Assessment-SF was used to determine nutritional risk. Oral health and dysphagia risk were assessed with standardized protocols. The Edinburgh-Feeding Questionnaire (Ed-FED) was used to identify eating challenges; mealtime interactions with staff were assessed with the Mealtime Relational Care Checklist. Mealtime observations recorded duration of meals and assistance received. Dining environments were assessed for physical features using the Dining Environment Audit Protocol, and the Mealtime Scan was used to record mealtime experience and ambiance. Staff completed the Person Directed Care questionnaire, and managers completed a survey describing features of the home and food services. Hierarchical multivariate regression determined predictors of energy and protein intake adjusted for other covariates. Average age of participants was 86.3 ± 7.8 years and 69% were female. Median energy intake was 1571.9 ± 411.93 kcal and protein 58.4 ± 18.02 g/d. There was a significant interaction between being prescribed a pureed/liquidized diet and eating challenges for energy intake. Age, number of eating challenges, pureed/liquidized diet, and sometimes requiring eating assistance were negatively associated with energy and protein intake. Being male, a higher Mini-Nutritional Assessment-Short Form score, often requiring eating assistance, and being on a dementia care unit were positively associated with energy and protein intake. Energy intake alone was negatively associated with homelikeness scores but positively associated with person-centered care practices, whereas protein intake was positively associated with more dietitian time. This is the first study to consider resident, unit, staff, and home variables that are associated with food intake. Findings indicate that interventions focused on pureed food, restorative dining, eating assistance, and person-centered care practices may support improved food intake and should be the target for further research. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

GLP-1 Receptor Agonists

MedlinePlus

... Secretagogues TZDs Changing Your Lifestyle Diabetes Complications Nondiabetic Hypoglycemia Featured Resource Taming the Spikes Is mealtime insulin ... t cause low blood glucose, a condition called hypoglycemia. But you’re at risk for low blood ...

Eating extra calories when sick - children

MedlinePlus

Getting more calories - children; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories ... Change your children's eating habits to help them get more calories. Let your child eat when hungry, not just at mealtimes. ...

Intakes of Energy and Discretionary Food in Mexico Are Associated with the Context of Eating: Mealtime, Activity, and Place.

PubMed

Batis, Carolina; Rodríguez-Ramírez, Sonia; Ariza, Ana Carolina; Rivera, Juan A

2016-09-01

The prevalence of obesity and the intake of discretionary foods [high saturated fat and/or added sugar (HSFAS) products and sugar-sweetened beverages (SSBs)] are high in Mexico. It is important to understand whether the intakes of HSFAS products and SSBs are associated with the context in which they are consumed. Our aim was to estimate the associations between total energy and discretionary food (HSFAS products and SSBs) intakes and the context of eating (mealtime, activity, and place). We used data from 10,087 participants aged ≥1 y from the Mexican National Health and Nutrition Survey 2012. Dietary intake was estimated through a 24-h dietary recall that included questions on mealtime, activity, and place in which each food item was consumed. The associations between energy and discretionary food intakes and the context of eating were estimated by using multiple linear regression stratified by age group and adjusted for sociodemographic variables. Compared with breakfast, the percentage of energy that HSFAS products contributed was 16-29 (range in all age groups) percentage points higher during midafternoon snacks and 16-23 percentage points lower at lunch and almuerzo (Mexican brunch); the percentage of energy from SSBs was 3.4-7.6 percentage points higher during midmorning snacks (P < 0.05). In many age groups and mealtimes, we found that compared with eating only while seated, the percentage of energy as HSFAS was 5.3-14 percentage points higher when watching television (P < 0.05). Compared with eating at home, the percentage of energy from HSFAS was 12-26 percentage points higher on the street and the percentage of energy from SSBs was 3.4-6.0 percentage points higher at school and 2.9-15 percentage points higher at work (P < 0.05). These results highlight the need to promote healthier food selection among the Mexican population when snacking and watching television and healthier food environments at work, school, and on the street. © 2016 American Society for Nutrition.

The importance of standardized observations to evaluate nutritional care quality in the survey process.

PubMed

Schnelle, John F; Bertrand, Rosanna; Hurd, Donna; White, Alan; Squires, David; Feuerberg, Marvin; Hickey, Kelly; Simmons, Sandra F

2009-10-01

Guidelines written for government surveyors who assess nursing home (NH) compliance with federal standards contain instructions to observe the quality of mealtime assistance. However, these instructions are vague and no protocol is provided for surveyors to record observational data. This study compared government survey staff observations of mealtime assistance quality to observations by research staff using a standardized protocol that met basic standards for accurate behavioral measurement. Survey staff used either the observation instructions in the standard survey process or those written for the revised Quality Improvement Survey (QIS). Trained research staff observed mealtime care in 20 NHs in 5 states during the same time period that survey staff evaluated care in the same facilities, although it could not be determined if survey and research staff observed the same residents during the same meals. Ten NHs were evaluated by government surveyors using the QIS survey instructions and 10 NHs were evaluated by surveyors using the standard survey instructions. Research staff observations using a standardized observation protocol identified a higher proportion of residents receiving inadequate feeding assistance during meals relative to survey staff using either the standard or QIS survey instructions. For example, more than 50% of the residents who ate less than half of their meals based on research staff observation were not offered an alternative to the served meal, and the lack of alternatives, or meal substitutions, was common in all 20 NHs. In comparison, the QIS survey teams documented only 2 instances when meal substitutes were not offered in 10 NHs and the standard survey teams documented no instances in 10 NHs. Standardized mealtime observations by research staff revealed feeding assistance care quality issues in all 20 study NHs. Surveyors following the instructions in either the standard or revised QIS surveys did not detect most of these care quality issues. Survey staff instructions for observation of nutritional care are not clearly written; thus, these instructions do not permit accurate behavioral measurement. These instructions should be revised in consideration of basic principles that guide accurate behavioral measurement and shared with NH providers to enable them to effectively implement quality improvement programs.

Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers' Perspectives.

PubMed

Dev, Dipti A; Carraway-Stage, Virginia; Schober, Daniel J; McBride, Brent A; Kok, Car Mun; Ramsay, Samantha

2017-12-01

National childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. Using the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). Using a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. The study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. Child-care providers' perspectives regarding implementation of NE. Thematic analysis to derive themes using NVivo software. Three overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. Present study findings offer insights regarding providers' perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers' ability to deliver NE in child-care settings. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Oropharyngeal dysphagia in preschool children with cerebral palsy: oral phase impairments.

PubMed

Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N

2014-12-01

This study aimed to document the prevalence and patterns of oral phase oropharyngeal dysphagia (OPD) in preschool children with cerebral palsy (CP), and its association with mealtime duration, frequency and efficiency. Cross-sectional population-based cohort study of 130 children diagnosed with CP at 18-36 months ca (mean = 27.4 months, 81 males) and 40 children with typical development (mean = 26.2, 18 males). Functional abilities of children with CP were representative of a population sample (GMFCS I = 57, II = 15, III = 23, IV = 12, V = 23). Oral phase impairment was rated from video using the Dyspahgia Disorders Survey, Schedule for Oral Motor Impairment, and Pre-Speech Assessment Scale. Parent-report was collected on a feeding questionnaire. Mealtime frequency, duration and efficiency were calculated from a three day weighed food record completed by parents. Gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Overall, 93.8% of children had directly assessed oral phase impairments during eating or drinking, or in controlling saliva (78.5% with modified cut-points). Directly assessed oral phase impairments were associated with declining gross motor function, with children from GMFCS I having a 2-fold increased likelihood of oral phase impairment compared to the children with TD (OR = 2.0, p = 0.18), and all children from GMFCS II-V having oral phase impairments. Difficulty biting (70%), cleaning behaviours (70%) and chewing (65%) were the most common impairments on solids, and difficulty sipping from a cup (60%) for fluids. OPD severity and GMFCS were not related to mealtime frequency, duration or efficiency, although children on partial tube feeds had significantly reduced mealtime efficiency. Oral phase impairments were common in preschool children with CP, with severity increasing stepwise with declining gross motor function. The prevalence and severity of oral phase impairments were significantly greater for most tasks when compared to children with typical development, even for those with mild CP. Children who were partially tube fed had significantly lower feeding efficiency, so this could be a useful early indicator of children needing supplementation to their nutrition (through increasing energy density of foods/fluids, or tube feeds). Copyright © 2014 Elsevier Ltd. All rights reserved.

Adolescent and parent views of family meals.

PubMed

Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Story, Mary

2006-04-01

To examine and compare the family mealtime environment from the perspectives of both adolescents and parents. Adolescents completed a school-based survey and parents participated in a telephone interview as part of Project EAT (Eating Among Teens). Participants were 902 adolescent females (n=424) and males (n=478) and one of their guardians/parents. Frequencies, chi(2) analyses, and Spearman correlations were used to assess relationships. Parents were more likely than adolescents to report eating five or more family meals per week, the importance of eating together, and scheduling difficulties (P<0.001). Younger adolescents were more likely than older adolescents to report eating five or more family meals per week, higher importance of eating together, and more rule expectations at mealtime (P<0.001), whereas older adolescents were more likely to report scheduling difficulties (P<0.001). Girls reported more family meals per week and more scheduling conflicts than boys did; boys reported more rules at mealtime than girls did (P<0.001). Family meals are perceived positively by both adolescents and parents. Family meals may be a useful mechanism for enhancing family togetherness, and for role modeling behaviors that parents would like their children to emulate. Dietetics professionals can capitalize on positive attitudes toward family meals to help promote their frequency. Helping families learn to cook healthful, quick meals may reduce dependency on less healthful meal options, reduce the frequency of eating outside of the home, and promote greater nutritional intake.

"You must eat the salad because it is nutritious". Argumentative strategies adopted by parents and children in food-related discussions at mealtimes.

PubMed

Bova, Antonio; Arcidiacono, Francesco

2014-02-01

At mealtimes, the evaluation of the appropriate (or not appropriate) behavior concerning the food is often assumed as a topic of discourse. The aim of this study is to single out the argumentative strategies used by parents with their children and by children with their parents in order to convince the other party to eat or not to eat a certain food. Within a data corpus constituted by 30 video-recorded meals of 10 middle to upper-middle-class Swiss and Italian families, we selected a corpus of 77 argumentative discussions between parents and children arisen around a food-related issue. Data are presented through discursive excerpts of argumentative discussions that were found within the data corpus and analyzed through the pragma-dialectical model of critical discussion. The results of this study show that the feeding practices in families with young children during mealtimes are argumentatively co-constructed by participants. In most cases parents put forward arguments based on the quality (e.g., very good, nutritious, salty, or not good) and quantity (e.g., too little, quite enough, or too much) of food to convince their children to eat. Similarly, children put forward arguments based on the quality and quantity of food to convince their parents to change their standpoint, although their view on the issue is the opposite of that of their parents. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sleep, but not other daily routines, mediates the association between maternal employment and BMI for preschool children.

PubMed

Speirs, Katherine E; Liechty, Janet M; Wu, Chi-Fang

2014-12-01

It has been established that the more time mothers spend working outside of the home, the more likely their preschool-aged children are to be overweight. However, the mechanisms explaining this relationship are not well understood. Our objective was to explore child sleep, dietary habits, TV time, and family mealtime routines as mediators of the relationship between maternal employment status (full-time, part-time, and no or minimal employment) and child body mass index (BMI) percentile. Data were drawn from waves 1 and 2 of STRONG Kids, a prospective panel study examining childhood obesity among parent-preschooler dyads (n = 247). Mothers reported their own work hours, their child's hours of nighttime sleep, dietary habits, TV time, and mealtime routines. Trained staff measured child height and weight. Compared to working 0-19 h/week, both full-time (>35 h/week) and part-time (20-34 h/week) employment predicted higher child BMI percentile 1 year later. Hours of child nighttime sleep partially mediated the association between maternal full-time employment and child BMI percentile. Adjusting for individual and family characteristics, children whose mothers were employed full time were less likely to sleep longer hours than children whose mothers were employed 0-19 h/week (b = -0.49, p < 0.04). Shorter child nighttime sleep was associated with higher BMI percentile (b = -7.31, p < 0.001). None of the other mediation pathways tested were significant. These findings add to the growing literature on the importance of adequate sleep for young children's health. Copyright © 2014 Elsevier B.V. All rights reserved.

Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program.

PubMed

Greer, Ashley J; Gulotta, Charles S; Masler, Elizabeth A; Laud, Rinita B

2008-07-01

This study investigated the impact of an intensive interdisciplinary feeding program on caregiver stress and child outcomes of children with feeding disorders across three categories. Children were categorized into either tube dependent, liquid dependent, or food selective groups. Outcomes for caregiver stress levels, child mealtime behaviors, weight, and calories were examined at admission and discharge for 121 children. Repeated measures ANOVAs were used to examine differences pre- and post-treatment and across feeding categories. Caregiver stress, child mealtime behaviors, weight, and caloric intake improved significantly following treatment in the intensive feeding program, regardless of category placement. Few studies have examined the impact of an intensive interdisciplinary approach on caregiver stress, as well as on child outcome variables with such a diverse population. This study provides support that regardless of a child's medical and feeding history, an intensive interdisciplinary approach significantly improves caregiver stress and child outcomes.

Feeding Style and a Child's Body Mass Index.

PubMed

Boucher, Nicole Lynn

Early onset pediatric obesity has become a major health concern in the United States. A key contributing factor to early onset childhood is socialization to the eating and mealtime environment. Maternal feeding styles play an integral role in how children are socialized to the eating and mealtime environment. The study utilized a descriptive correlational research design. The sample was 126 mother/child dyads recruited from a southeastern Michigan Head Start program. Each mother completed a research packet. Results indicated that maternal beliefs such as nutritional belief and belief about the child's eating style were significantly associated with maternal feeding style. Maternal behaviors were associated with maternal feeding styles. Overall, the study provides a description of maternal beliefs and behaviors related to the body weight status of a preschool-aged child. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

From 'pleasure to chemistry': the experience of carbohydrate counting with and without carbohydrate restriction for people with Type 1 diabetes.

PubMed

Cresswell, Pip; Krebs, Jeremy; Gilmour, Jean; Hanna, Aoife; Parry-Strong, Amber

2015-12-01

Matching carbohydrate intake with insulin dosage is recommended management for people with Type 1 diabetes. However, international interest in restricted carbohydrate diets is growing. General practitioners and practice nurses need to know how to advise people with Type 1 diabetes regarding low-carbohydrate diets. This study aimed to explore the carbohydrate counting experiences of people with Type 1 diabetes in a trial with and without a diet restricted to 75 g of carbohydrate per day. Eight participants were interviewed by focus group or interview 12 weeks after a carbohydrate counting course with individual dietary choice or the same course with information on restricted carbohydrate eating and a daily maximum intake of 75 g of carbohydrate. Data were analysed using a qualitative thematic analysis approach. Themes included the need for insulin management skills, impact of the dietary experience, and need for dietary knowledge. The restricted-carbohydrate group encountered mealtime insulin resistance and difficulty managing insulin dosages when transitioning on and off the low-carbohydrate diet. The diet impacted on mood, feelings of satiety and it was reported that food changed from being 'a pleasure to chemistry'. Both groups described feeling empowered to manage their diabetes as a result of the carbohydrate counting course. Participants reported increased knowledge and challenging insulin management. The restricted-carbohydrate group reported mealtime insulin resistance and a strong dietary impact. Extra health professional support may be required, especially at dietary transition periods. More research is warranted into the reported mealtime insulin resistance.

Is the mealtime experience in nursing homes understood? A qualitative study.

PubMed

Palacios-Ceña, Domingo; Losa-Iglesias, Marta Elena; Cachón-Pérez, José Miguel; Gómez-Pérez, Daniel; Gómez-Calero, Cristina; Fernández-de-las-Peñas, César

2013-04-01

The aim of the present study was to explore the significance of the mealtime experience among residents of nursing homes in Spain. A qualitative phenomenological approach was followed. An initial purposeful sampling of Spanish residents in for-profit nursing homes in the southern area of Madrid was carried out. A theoretical sampling was also implemented in order to gain a more in-depth understanding of dependence. Inclusion criteria for nursing home residents were: age (60 years or older) and lack of any cognitive impairment. Data were collected using unstructured and semistructured interviews. Data collection was concluded once theoretical saturation was reached, and the data were analysed using the Giorgi proposal. A total of 26 residents with a mean age of 83 years were included. Three main themes that describe the significance of meals in nursing homes emerged from the data: (i) timing of the meals - mealtimes serve as a point of reference for organizing activities in the nursing home and orient the residents during the day; (ii) table allocation - table allocation depends on the judgment of the personnel, the behavior of each resident and on the input from the residents that use a table; and (iii) the meals themselves - food is experienced as a privilege, as a sign of autonomy and normality, and as an indicator of personal identity. Understanding the social significance of meals for residents in nursing homes would provide deeper insight into resident expectations. This will in turn help to improve service and quality of life for residents. © 2012 Japan Geriatrics Society.

Feeding a child with mealtime challenges: A mother's work.

PubMed

Winston, Kristin

2015-01-01

The literature suggests that at least 25% of all children and up to 80% of children with developmental disabilities have some type of feeding and/or eating difficulty. Currently there is limited information in the literature related to mothers who are mothering young children with difficulties in the area of feeding and eating. Specifically there is little information available regarding how mothering a young child with difficulties in feeding and eating impacts participation in the work of mothering. This paper discusses a piece of the qualitative portion of a mixed methods study. The qualitative portion of the study sought to examine the lived experience of mothers who were mothering a young child with feeding concerns. Five women between the ages of 26 and 41 years of age agreed to participate in this portion of the study. All of the women were married and were mothering a child between 12 and 36 months experiencing concerns related to feeding. Phenomenological methods were used to complete the qualitative portion of this study. Each woman participated in one interview in her own home that lasted between one and two hours. Five themes emerged from the data analysis, feeling supported, seeking support, the range of emotions/feelings, dealing with the system, and the complexity of feeding. Two of the themes are discussed in this paper in detail as they relate to maternal work. Data from this study were analyzed in relationship to maternal work. Findings highlight the difficulty of negotiating daily mealtime occupations and support the connection between mealtime occupations and maternal work as outlined by Ruddick.

The impact of environmental, parental and child factors on health-related behaviors among low-income children.

PubMed

Musaad, Salma M A; Speirs, Katherine E; Hayes, Jenna T; Mobley, Amy R; Fitzgerald, Nurgul; Jones, Blake L; VanBrackle, Angela; Sigman-Grant, Madeleine

2017-05-01

Multi-level factors act in concert to influence child weight-related behaviors. This study examined the simultaneous impact of variables obtained at the level of the home environment (e.g., mealtime ritualization), parent (e.g., modeling) and child (e.g., satiety responsiveness) with the outcomes of practicing healthy and limiting unhealthy child behaviors (PHCB and LUCB, respectively) in a low-income U.S. This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (β: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (β: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (β: -0.19, 95% CI: -0.29; -0.10). More parental covert control (β: 0.44, 95% CI: 0.35; 0.54), more parental overt control (β: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (β: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Real-world visual statistics and infants' first-learned object names.

PubMed

Clerkin, Elizabeth M; Hart, Elizabeth; Rehg, James M; Yu, Chen; Smith, Linda B

2017-01-05

We offer a new solution to the unsolved problem of how infants break into word learning based on the visual statistics of everyday infant-perspective scenes. Images from head camera video captured by 8 1/2 to 10 1/2 month-old infants at 147 at-home mealtime events were analysed for the objects in view. The images were found to be highly cluttered with many different objects in view. However, the frequency distribution of object categories was extremely right skewed such that a very small set of objects was pervasively present-a fact that may substantially reduce the problem of referential ambiguity. The statistical structure of objects in these infant egocentric scenes differs markedly from that in the training sets used in computational models and in experiments on statistical word-referent learning. Therefore, the results also indicate a need to re-examine current explanations of how infants break into word learning.This article is part of the themed issue 'New frontiers for statistical learning in the cognitive sciences'. © 2016 The Author(s).

Be a Healthy Role Model for Children: 10 Tips for Setting Good Examples

MedlinePlus

... model for children 10 tips for setting good examples You are the most important influence on your ... make mealtime a family time! 1 show by example Eat vegetables, fruits, and whole grains with meals ...

Interventions on mealtime difficulties in older adults with dementia: a systematic review.

PubMed

Liu, Wen; Cheon, Jooyoung; Thomas, Sue A

2014-01-01

To evaluate the effects of interventions on mealtime difficulties in older adults with dementia. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. Pubmed, Medline (OVID), CINAHL (EBSCOHost), EBM Reviews (OVID) and PsychINFO (OVID) were searched between January 2004 and September 2012 by using keywords as dementia, Alzheimer, feed(ing), eat(ing), mealtime(s), oral intake, nutrition, intervention, experimental, quasi-experimental and any matched terms. Other sources included Google Scholar and relevant bibliographies. Eligibility criteria were established by defining the population, intervention, comparator, outcomes, timing and setting of interest. Studies were reviewed by title and abstract screening, and full-text assessing for eligibility. Data were abstracted from eligible studies using a self-made structured tool. Eligible studies were classified by intervention, accessed for quality using the Quality Assessment Tool for Quantitative Studies, and graded for evidence using the Grading of Recommendations, Assessment, Development and Evaluation Working Group criteria. Twenty-two intervention studies (9 RCTs), including a total of 2082 older adults with dementia and 95 professionals from more than 85 long-term care facilities, were selected, and classified into five types: nutritional supplements, training/education programs, environment/routine modification, feeding assistance and mixed interventions. Eight studies were strong, eleven moderate and three weak in quality. Limitations of body of research included lack of randomization and/or control group, small sample size without power analysis, lack of theory-based interventions and blinding, inadequate statistical analysis and plausible confounding bias. "Nutritional supplements" showed moderate evidence to increase food intake, body weight and BMI. "Training/education programs" demonstrated moderate evidence to increase eating time and decrease feeding difficulty. Both "training/education programs" and "feeding assistance" were insufficient to increase food intake. "Environment/routine modification" indicated low evidence to increase food intake, and insufficient to decrease agitation. Evidence was sparse on nutritional status, eating ability, behavior disturbance, behavioral and cognitive function, or level of dependence. This review provides updated evidence for clinical practice and points out priorities for nursing research. Current evidence is based on a body of research with moderate quality and existing limitations, and needs to be further explored with more rigorous studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Asthma severity, child security, and child internalizing: using story stem techniques to assess the meaning children give to family and disease-specific events.

PubMed

Winter, Marcia A; Fiese, Barbara H; Spagnola, Mary; Anbar, Ran D

2011-12-01

Children with persistent asthma are at increased risk for mental health problems. Although mechanisms of effect are not yet known, it may be that children are less trusting of the family as a source of support and security when they have more severe asthma. This study tested whether asthma severity is related to children's perceptions of insecurity in the family, and whether insecurity is in turn associated with child adjustment. Children (N = 168; mean age = 8 years) completed story stems pertaining to routine family events (e.g., mealtimes) and ambiguous but potentially threatening asthma events such as tightness in the chest. Responses were evaluated for the extent to which appraisals portrayed the family as responding in cohesive, security-provoking ways. Asthma severity was assessed by both objective lung function testing and primary caregiver report. Caregivers reported child symptomatology. Beyond medication adherence, caregiver education, and child age and gender, greater asthma severity predicted more internalizing and externalizing symptoms. Greater asthma severity, assessed using spirometry (but not parent report), was related to less secure child narratives of the family, which in turn related to more child internalizing symptoms. Results suggest that asthma can take a considerable toll on children's feelings of security and mental health. Furthermore, given the difficulty in assessing young children's perceptions, this study helps demonstrate the potential of story stem techniques in assessing children's appraisals of illness threat and management in the family.

Asthma Severity, Child Security, and Child Internalizing: Using Story Stem Techniques to Assess the Meaning Children Give to Family and Disease-Specific Events

PubMed Central

Winter, Marcia A.; Fiese, Barbara H.; Spagnola, Mary; Anbar, Ran D.

2016-01-01

Children with persistent asthma are at increased risk for mental health problems. Although mechanisms of effect are not yet known, it may be that children are less trusting of the family as a source of support and security when they have more severe asthma. This study tested whether asthma severity is related to children’s perceptions of insecurity in the family, and whether insecurity is in turn associated with child adjustment. Children (N = 168; mean age = 8 years) completed story stems pertaining to routine family events (e.g., mealtimes) and ambiguous but potentially threatening asthma events such as tightness in the chest. Responses were evaluated for the extent to which appraisals portrayed the family as responding in cohesive, security-provoking ways. Asthma severity was assessed by both objective lung function testing and primary caregiver report. Caregivers reported child symptomatology. Beyond medication adherence, caregiver education, and child age and gender, greater asthma severity predicted more internalizing and externalizing symptoms. Greater asthma severity, assessed using spirometry (but not parent report), was related to less secure child narratives of the family, which in turn related to more child internalizing symptoms. Results suggest that asthma can take a considerable toll on children’s feelings of security and mental health. Furthermore, given the difficulty in assessing young children’s perceptions, this study helps demonstrate the potential of story stem techniques in assessing children’s appraisals of illness threat and management in the family. PMID:22059557

Meal and snack-time eating disorder cognitions predict eating disorder behaviors and vice versa in a treatment seeking sample: A mobile technology based ecological momentary assessment study.

PubMed

Levinson, Cheri A; Sala, Margarita; Fewell, Laura; Brosof, Leigh C; Fournier, Lauren; Lenze, Eric J

2018-06-01

Individuals with eating disorders experience high anxiety when eating, which may contribute to the high relapse rates seen in the eating disorders. However, it is unknown if specific cognitions associated with such anxiety (e.g., fears of gaining weight) may lead to engagement in eating disorder behaviors (e.g., weighing oneself). Participants (N = 66) recently treated at a residential eating disorder facility and diagnosed with an eating disorder (primarily anorexia nervosa; n = 40; 60.6%) utilized a mobile application to answer questions about mealtime cognitions, anxiety, and eating disorder behaviors four times a day for one week. Hierarchical linear models using cross-lag analyses identified that there were quasi-causal (and sometimes reciprocal) within-person relationships between specific eating disorder cognitions and subsequent eating disorder behaviors. These cognitions predicted higher anxiety during the next meal and eating disorder pathology at one-month follow-up. Interventions personalized to target these specific cognitions in real time might reduce eating disorder relapse. Copyright © 2018 Elsevier Ltd. All rights reserved.

Risk assessment models to predict caries recurrence after oral rehabilitation under general anaesthesia: a pilot study.

PubMed

Lin, Yai-Tin; Kalhan, Ashish Chetan; Lin, Yng-Tzer Joseph; Kalhan, Tosha Ashish; Chou, Chein-Chin; Gao, Xiao Li; Hsu, Chin-Ying Stephen

2018-05-08

Oral rehabilitation under general anaesthesia (GA), commonly employed to treat high caries-risk children, has been associated with high economic and individual/family burden, besides high post-GA caries recurrence rates. As there is no caries prediction model available for paediatric GA patients, this study was performed to build caries risk assessment/prediction models using pre-GA data and to explore mid-term prognostic factors for early identification of high-risk children prone to caries relapse post-GA oral rehabilitation. Ninety-two children were identified and recruited with parental consent before oral rehabilitation under GA. Biopsychosocial data collection at baseline and the 6-month follow-up were conducted using questionnaire (Q), microbiological assessment (M) and clinical examination (C). The prediction models constructed using data collected from Q, Q + M and Q + M + C demonstrated an accuracy of 72%, 78% and 82%, respectively. Furthermore, of the 83 (90.2%) patients recalled 6 months after GA intervention, recurrent caries was identified in 54.2%, together with reduced bacterial counts, lower plaque index and increased percentage of children toothbrushing for themselves (all P < 0.05). Additionally, meal-time and toothbrushing duration were shown, through bivariate analyses, to be significant prognostic determinants for caries recurrence (both P < 0.05). Risk assessment/prediction models built using pre-GA data may be promising in identifying high-risk children prone to post-GA caries recurrence, although future internal and external validation of predictive models is warranted. © 2018 FDI World Dental Federation.

Sleep and Your Preschooler

MedlinePlus

... minutes beforehand. Keep consistent playtimes and mealtimes. Avoid stimulants, such as caffeine, near bedtime. Make the bedroom quiet, cozy, and perfect for sleeping. Use the bed only for sleeping — not for playing or watching TV. Limit food and drink before bedtime. Allow your child to ...

Staff views on how to improve mealtimes for elderly people with dementia living at home.

PubMed

Johansson, Linda; Björklund, Anita; Sidenvall, Birgitta; Christensson, Lennart

2017-10-01

Dementia commonly leads to difficulties in performing daily activities, which can also often affect the ability to prepare and eat meals. As a result, formal support to maintain good nutritional intake might be needed, but there is a lack of knowledge concerning how to support older persons with dementia living at home. The aim of this study was to explore and describe staff views on how to improve mealtimes for persons with dementia who are still living at home. A qualitative descriptive study was performed and data were collected during 2011-2012 through four focus group interviews with staff working in the homes of persons with dementia. Data were analyzed using inductive content analysis. The participants described several ways to improve mealtimes for persons with dementia and advocated adjustments facilitating the preservation of the persons' independence. Finding suitable actions calls for knowledge about the person and his/her individual situation. Proposed actions were enabling meals at home, taking over, and moving meals outside of the home. In addition, it was found that, the types of meals served to these persons should be as familiar to the individual as possible. The results of this study indicate the importance of using a person-centered approach and meeting the individual needs when supporting people with dementia in regards to their meals when living at home. Individualized care in the home may be expensive, however, it is fair to say that people who become malnourished and admitted to hospitals is even more costly. Furthermore, sharing and reflecting experiences and knowledge can assist staff to identify ways to manage complex situations. Therefore, the use of refection should be a part of staff members' everyday work.

Comparing parents' and overweight adolescents' reports on parent mealtime actions.

PubMed

Volpe, Carolina Bertagnoli; Petty, Maria Luiza Blanques; de Souza, Altay Alves Lino; Escrivão, Maria Arlete Meil Schimith

2018-01-01

This study aimed to compare answers given by parents and their adolescent children to the Portuguese version of the Parent Mealtime Action Scale (PMAS) and to assess associations among the reported behaviors. To compare these answers, a cross-sectional study was conducted in a sample of 72 patients of the Obesity Clinic of the Division of Nutrology of the Pediatrics Department at the Federal University of São Paulo (Unifesp), Brazil. These patients were aged from 10 years to 19 years and 11 months, and their parents or legal guardians also participated. First, parents were interviewed and instructed to answer how often they perform each behavior measured by the PMAS (never, sometimes or always). Next, the same questions were answered by the adolescents. The general linear model (GLM) showed the effects of the interviewees and of the interaction between interviewees and sex. We also observed a triple interaction effect (sex x interviewees x categorized age). The internal reliability of the PMAS was higher for parental answers than for those given by the children. This finding is probably observed because the scale has been developed and validated to evaluate the pattern of parental responses concerning their eating practices during their children's meals. In addition, although parents believe they are engaging in certain behaviors, the effectiveness of these strategies may not be recognized by their children. Very low intraclass correlation coefficients were observed between parents' and children's answers to the original domains of the PMAS (ICC: 0.130-0.578), suggesting that the factorial structure of the PMAS may only be used to assess parental behavior, as it is not sufficiently accurate to assess the children's understanding of parent mealtime actions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Optimizing insulin secretagogue therapy in patients with type 2 diabetes: a randomized double-blind study with repaglinide.

PubMed

Schmitz, Ole; Lund, Sten; Andersen, Per Heden; Jønler, Morten; Pørksen, Nils

2002-02-01

Repaglinide, a novel antidiabetic agent that has a rapid onset and short duration of action, was developed for mealtime dosing. The purpose of this pharmacodynamic study was to validate a prandial regimen of repaglinide by comparing meal-related dosing with a regimen in which the same total daily dose was divided into only two doses at morning and evening meals. The study was a double-blind, randomized, parallel-group trial in 19 antidiabetic agent-naive subjects with type 2 diabetes (mean age 58 years, known duration of diabetes 3.5 years, HbA(1c) 7.3%, and BMI 32 kg/m(2)). Patients were randomly assigned to receive repaglinide either before each of the three main meals or before breakfast and before the evening meal. Patients in both groups received the same total daily dose of repaglinide. Twenty-four hour profiles of blood glucose, plasma insulin, and plasma C-peptide concentrations were measured at baseline and after 4 weeks of treatment. Repaglinide increased postprandial insulin levels and markedly reduced postprandial glucose levels relative to baseline in both groups. Significant reductions were also recorded in fasting blood glucose and HbA(1c) levels. The repaglinide regimen, in which a dose was taken before each main meal, was more effective in improving glycemic control (including postprandial glucose and HbA(1c) levels) than the same total dose of repaglinide divided into morning and evening mealtime doses. These data support the strategy of mealtime dosing with repaglinide. The improvements in glycemic control observed in these patients are encouraging. In addition to classic parameters of glycemic control, improvements in postprandial glucose excursions may prove to be important because postprandial hyperglycemia has been suggested to be an independent risk factor for cardiovascular disease in diabetes.

Flexible meal-related dosing with repaglinide facilitates glycemic control in therapy-naive type 2 diabetes.

PubMed

Moses, R G; Gomis, R; Frandsen, K B; Schlienger, J L; Dedov, I

2001-01-01

This double-blind randomized placebo-controlled parallel group study assessed the efficacy and safety (with particular regard to body weight and hypoglycemia) of repaglinide when used in a flexible mealtime dosing regimen in a situation close to everyday clinical practice. A total of 408 patients with type 2 diabetes considered poorly controlled by diet, but without a history of previous antidiabetic medication, were randomized to receive 0.5 mg repaglinide at mealtimes (increased to 1 mg after 4 weeks depending on blood glucose response) or placebo for 16 weeks. Patients were free to choose a flexible meal pattern, adjusting the dosing schedule from two to four preprandial doses per day in accordance with a "one meal, one dose; no meal, no dose" principle. Additional snacks were not a requirement of the treatment schedule. Treatment with repaglinide significantly improved glycemic control with respect to baseline and placebo, reducing HbA1c by 1.14% from baseline and fasting plasma glucose by 1.8 mmol/l. Improvement in glycemic control was independent of the meal pattern adopted by patients, including those most commonly taking two or four meals daily, with no correlation between meal pattern and risk of hypoglycemia. The improvement in glycemic control was also independent of degree of obesity and age < or =65 or >65 years. There was no significant body weight increase in the repaglinide group. Mealtime dosing with repaglinide is effective in improving overall glycemic control in type 2 diabetic patients for which control is suboptimal using diet alone. Patients are able to vary their meal pattern from a conventional regimen of three meals daily without compromising control or increasing the risk of adverse events.

Nutrition in space: lessons from the past applied to the future.

PubMed

Lane, H W; Smith, S M; Rice, B L; Bourland, C T

1994-11-01

From the basic impact of nutrient intake on health maintenance to the psychosocial benefits of mealtime, the role of nutrition in space is evident. In this discussion, dietary intake data from three space programs, Apollo, Space Shuttle, and Skylab, are presented. Data examination reveals that energy and fluid intakes are almost always lower than predicted. Nutrition in space has many areas of impact, including provision of required nutrients and maintenance of endocrine, immune, and musculoskeletal systems. Long-duration missions will require quantitation of nutrient requirements for maintenance of health and protection against the effects of microgravity. Psychosocial aspects of nutrition will also be important for more productive missions and crew morale. Realization of the full role of nutrition during spaceflight is critical for the success of extended-duration missions. Research conducted to determine the impact of spaceflight on human physiology and subsequent nutritional requirements will also have direct and indirect applications in Earth-based nutrition research.

38 CFR 52.140 - Dietary services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... meals. (1) At regular times comparable to normal mealtimes in the community, each participant may... management must provide each participant with a nourishing, palatable, well-balanced meal that proportionally... program management must employ a qualified dietitian either part-time or on a contract consultant basis to...

Mealtime Manual for the Aged and Handicapped.

ERIC Educational Resources Information Center

Klinger, Judith Lannefeld; And Others

Specific techniques to alleviate difficulties encountered in routine kitchen tasks are described for the elderly and the handicapped, particularly those persons with upper extremity weakness or amputees, arthritis, incoordination, wheelchair confinement, loss of sensation, and limited vision. Helpful information is provided in areas of kitchen…

Bone Up on the Need for Calcium.

ERIC Educational Resources Information Center

Mann, Peggy

1987-01-01

Most grade-schoolers drink milk at each meal, but teens, especially girls, often switch to carbonated soda at mealtime just as they should be building up their bone bank of calcium. Why calcium is important and how to get enough of it are covered. (MT)

After Delivery

MedlinePlus

... snack or mealtime. Low blood glucose is a real danger. It's important for your baby's safety to avoid blood glucose reactions that could confuse you. For all of the above reasons, it is important to check your blood glucose often during this time. And your records of your blood glucose levels ...

'It is nice to see someone coming in': exploring the social objectives of Meals-on-Wheels.

PubMed

Timonen, Virpi; O'Dwyer, Ciara

2010-09-01

Despite the fact that Meals-on-Wheels have both nutritional and social aspects, research on the social objectives of the service is lacking. This study set out to develop an understanding of the social objectives of Meals-on-Wheels and to explore the extent to which they are met by Ireland's Meals-on-Wheels services. A literature review suggested that Meals-on-Wheels services can potentially meet three social objectives: (a) providing meals recipients with social contact, (b) helping to restimulate an interest in meals and regularising mealtimes, and (c) helping to develop acceptance of the service. Interviews were conducted with 66 meals recipients to explore these themes and augment them as necessary. Study results show that meals recipients derive limited social contact from the service; regularising mealtimes was not important to most recipients; and many were reluctant to accept the service. The three objectives are therefore minimally met within the Irish system at present.

Equal and universal access?: water at mealtimes, inequalities, and the challenge for schools in poor and rural communities.

PubMed

Ramirez, Sarah M; Stafford, Randall

2013-05-01

As a result of the rising national obesity rates, public health researchers and advocates have initiated a number of obesity prevention interventions to reduce the rates of overweight and obesity along with their related medical conditions and costs. Policymakers have also initiated a wide range of environmental and policies to support healthy eating and physical activity. Policies such as California's SB1413, which requires that free drinking water be served in school cafeterias during mealtimes, and subsequently the Healthy Hunger-Free Kids Act of 2010, assume an equal access to safe and healthy drinking water. As a result, these policies and their application may unintentionally, exacerbate the inequities already present. Unless we take reasonable steps to address the needs of high-need communities, these one-size-fits-all policy efforts may result in an unequal patchwork of disparities and may have a greater negative impact in high-need poor and rural areas.

Equal and Universal Access? Water at Mealtimes, Inequalities, and the Challenge for Schools in Poor and Rural Communities

PubMed Central

Ramirez, Sarah M.; Stafford, Randall S.

2014-01-01

As a result of the rising national obesity rates, public health researchers and advocates have initiated a number of obesity prevention interventions to reduce the rates of overweight and obesity along with their related medical conditions and costs. Policymakers have also initiated a wide range of environmental and policies to support healthy eating and physical activity. Policies such as California’s SB1413, which requires that free drinking water be served in school cafeterias during mealtimes, and subsequently the Healthy Hunger-Free Kids Act of 2010, assume an equal access to safe and healthy drinking water. As a result, these policies and their application may unintentionally, exacerbate the inequities already present. Unless we take reasonable steps to address the needs of high-need communities, these one-size-fits-all policy efforts may result in an unequal patchwork of disparities and may have a greater negative impact in high-need poor and rural areas. PMID:23728054

"Are you done?" Child care providers' verbal communication at mealtimes that reinforce or hinder children's internal cues of hunger and satiation.

PubMed

Ramsay, Samantha A; Branen, Laurel J; Fletcher, Janice; Price, Elizabeth; Johnson, Susan L; Sigman-Grant, Madeleine

2010-01-01

To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Video observation transcripts of Head Start staff (n=29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Adults' verbal communication with children at mealtimes emphasized non-internal cues: (1) cueing children to amounts without referencing children's internal cues; (2) meal termination time; (3) asking children if they wanted more without referencing their internal cues; (4) asking children if they were done without referencing their internal cues; (5) telling children to take, try, eat, or finish food; (6) praising children for eating; and (7) telling children about food being good for you. Adults demonstrated an overriding effort to get children to eat. Training needs to be developed that gives specifics on verbally cueing young children to their internal hunger and satiation cues. Published by Elsevier Inc.

Feeding and gastrointestinal problems in children with cerebral palsy.

PubMed

Erkin, Gulten; Culha, Canan; Ozel, Sumru; Kirbiyik, Eylem Gulsen

2010-09-01

The aim of our study was to identify feeding and gastrointestinal system (GIS) problems in children with cerebral palsy (CP), and to evaluate the relationship between these problems and the severity of CP. A total of 120 children with CP were enrolled consecutively into the study (67 males, 53 females; mean age: 6.0±2.4 years; range: 2-12 years). The children were classified according to the Swedish classification as diplegic, hemiplegic, or quadriplegic. Severity of CP was classified based on the Gross Motor Function Classification System. The amount of time that the caregiver allocated to mealtimes, modifications of the food, as well as feeding and GIS problems was evaluated. Feeding dysfunction was classified as mild, moderate, or severe. Comparisons of GIS and feeding disorders and the severity of CP were carried out using χ test. The results indicated lack of appetite in 46 of the 120 children (38.3%), sialorrhea in 37 (30.8%), constipation in 30 (25%), difficulty in swallowing in 23 (19.2%), and feeding dysfunction in 26 (21.7%). On the basis of the Gross Motor Function Classification System (GMFCS), the incidence of GIS problems and feeding dysfunction was found to be significantly higher in the children classified in the severe group. The time taken to consume meals was significantly longer among children with feeding dysfunction. Feeding and GIS problems are frequent in children with CP, and more marked in those with severe CP. Approximately one fourth of children with CP suffer from feeding dysfunction, and more time has to be allocated to consume meals.

Astronaut Thomas Jones opens food package on middeck

NASA Image and Video Library

1994-04-10

STS059-14-004 (9-20 April 1994) --- On the Space Shuttle Endeavour's middeck astronaut Thomas D. Jones, mission specialist, cuts open a package of food as he prepares for mealtime. Jones was joined by five other NASA astronauts aboard Endeavour for the STS-59 mission.

Eating among Teens: Do Family Mealtimes Make a Difference for Adolescents' Nutrition?

ERIC Educational Resources Information Center

Neumark-Sztainer, Dianne

2006-01-01

Adolescents are at risk for poor dietary intake and unhealthy weight control behaviors. Family meals appear to play an important role in helping adolescents make healthier food choices and avoid engaging in unhealthy weight control and binge eating behaviors. (Contains 2 figures.)

Measuring feeding difficulties in toddlers with Down syndrome.

PubMed

van Dijk, Marijn; Lipke-Steenbeek, Wilma

2018-07-01

Early feeding problems occur frequently across the population, but have a higher incidence in children with Down syndrome (DS). Early identification can possibly be improved with the help of a valid screening instrument based on caregiver reports. In a previous study, we investigated the concurrent validity of the Dutch version of the Montreal Children's Hospital Feeding Scale (MCH-FS, SEP in Dutch) in a sample of typically developing toddlers, and we found a correlation between the score on the instrument and observed behavior during a regular meal. The current pilot study was a replication in a sample of children with DS (aged 1; 0-3; 0) and their primary caregivers (n = 32). The results showed that children in the sample did not score higher on the SEP than children in their respective norm groups. In addition, when caregivers reported more symptoms of feeding problems on the SEP, children showed more food refusal and negative affect during the observed meal. This suggests that the screening instrument is particularly associated with negative mealtime interactions. This is in contrast with earlier results, which mainly indicated a relation with eating skills. Copyright © 2018 Elsevier Ltd. All rights reserved.

The impact of managing school-aged children's diabetes: the role of child behavior problems and parental discipline strategies.

PubMed

Wilson, Anna C; DeCourcey, Wendy M; Freeman, Kurt A

2009-09-01

Models of diabetes management in children emphasize family relationships, particularly parent-child interactions. In adolescents, parental involvement in disease-specific management relates to better health and adherence. However, information about parental involvement in disease management for young children is limited and mixed. This study investigated behavior problems of school-aged children with Type 1 Diabetes Mellitus (T1DM) in association with parent discipline strategies and parents' perceptions of (1) time spent managing diabetes and (2) the impact their child's diabetes has on their discipline strategies. Parents of children ages 5-12 with T1DM completed standardized measures of child misbehavior, parent discipline strategies, and responded to questions regarding perceived time spent managing diabetes, and perceived impact of diabetes on ability to discipline. Results showed child mealtime misbehavior was common and associated with overreactive parental discipline. Further, overreactive discipline was also associated with reports of less time spent managing child's illness. Child misbehavior was positively associated with parents' perceived amount of time spent managing diabetes and with the impact of child diabetes on discipline. Findings suggest the importance of considering parent discipline strategies and child misbehavior when working with young children with diabetes.

Mealtime Observation

ERIC Educational Resources Information Center

Piedra, Betty

2012-01-01

By nature, lunchtime is a whirlwind of activity: from hand-washing to serving to clean-up, there are usually several things happening at once. Staff members have their hands full helping children transition into lunch from circle time or outside, keeping children focused and seated during the meal, and cleaning up after the meal, while…

Getting the Picture | Poster

Cancer.gov

By Ken Michaels, Guest Writer Recently, I attended the annual meeting of the BioCommunications Association in Asilomar, Calif. Not surprisingly, the speakers, all professional communicators, were very good and spoke knowledgeably on their various topics. But something else impressed me during the informal times between presentations, and at mealtimes. These folks not only

Relationship between Rate of Eating and Degree of Satiation

ERIC Educational Resources Information Center

Azrin, Nathan H.; Kellen, Michael J.; Brooks, Jeannie; Ehle, Chris; Vinas, Veronica

2008-01-01

Behavioral psychologists have developed effective methods of treatment for overeating and weight control, including mealtime regulation, avoidance of taboo foods, and removal of identified precursors to the bingeing behavior. The current study sought to examine the relationship between speed of eating and levels of satiation in weight conscious…

Stereotyped Behaviors in Blind Children: Relationships to Motility Behaviors of Autism.

ERIC Educational Resources Information Center

Iverson, Landa J.

Three groups of visually impaired children--10 with rubella, 7 with retrolental fibroplasia (RLF), and 9 with blindness other than rubella or RLF--were observed for stereotypic behaviors. Ss were observed in four different environmental settings: classroom/instruction; mealtime activity/breakfast, lunch, or supper; physical education/movement…

Playing with Rules around Routines: Children Making Mealtimes Meaningful and Enjoyable

ERIC Educational Resources Information Center

Alcock, Sophie

2007-01-01

Children attending early childhood education and care centres spend a lot of time fitting in with institutional routines. This paper uses ethnographic methods and sociocultural activity theory to describe and analyse the processes whereby young children in an early childhood centre collectively created meaning and interest during potentially…

Factors Influencing Childcare Providers' Food and Mealtime Decisions: An Ecological Approach

ERIC Educational Resources Information Center

Lynch, Meghan; Batal, Malek

2011-01-01

To better understand and promote healthy nutritional behaviour development in children, research suggests the need to develop a stronger comprehension of influences from their social environment. Yet research has favoured studying parents, with little attention being paid to other important individuals in children's lives, especially from a…

The Ecology of Some Middle Class Families at Dinner.

ERIC Educational Resources Information Center

Feiring, Candice; Lewis, Michael

1987-01-01

Three-year-old children and their families were observed during a dinner time situation in which all family members were present. Study results suggest how the mealtime experience, filled with information concerning sex-role behavior, social manners and habits, and interpersonal relations between parents and children, is a central multifaceted…

Descriptive Analyses of Pediatric Food Refusal and Acceptance

ERIC Educational Resources Information Center

Borrero, Carrie S. W.; Woods, Julia N.; Borrero, John C.; Masler, Elizabeth A.; Lesser, Aaron D.

2010-01-01

Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food…

Operant Control of Pathological Tongue Thrust in Spastic Cerebral Palsy.

ERIC Educational Resources Information Center

Thompson, George A., Jr.

1979-01-01

The behavior modification procedure, carried out at mealtime with a ten-year-old retarded boy who had spastic cerebral palsy, consisted of differential reinforcement and punishment, and resulted in substantial decreases in tongue thrust (reverse swallowing) and food expulsion, and a large increase in observed chewing. (Author/DLS)

Nurturing Healthy Eating Habits from the Start

ERIC Educational Resources Information Center

Kessler, Daniel B.

2012-01-01

Daniel B. Kessler, MD, a developmental and behavioral pediatrician, provides guidance on establishing healthy eating patterns in the early years. He emphasizes the importance of the feeding relationship as an important part of a child's social and emotional development. How parents approach feeding and mealtime is about so much more than physical…

Predicting respiratory hospital admissions in young people with cerebral palsy.

PubMed

Blackmore, Amanda Marie; Bear, Natasha; Blair, Eve; Langdon, Katherine; Moshovis, Lisa; Steer, Kellie; Wilson, Andrew C

2018-03-19

To determine the early predictors of respiratory hospital admissions in young people with cerebral palsy (CP). A 3-year prospective cohort study using linked data. Children and young people with CP, aged 1 to 26 years. Self-reported and carer-reported respiratory symptoms were linked to respiratory hospital admissions (as defined by the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) during the following 3 years. 482 participants (including 289 males) were recruited. They were aged 1 to 26 years (mean 10 years, 10 months; SD 5 years, 11 months) at the commencement of the study, and represented all Gross Motor Function Classification Scale (GMFCS) levels. During the 3-year period, 55 (11.4%) participants had a total of 186 respiratory hospital admissions, and spent a total of 1475 days in hospital. Statistically significant risk factors for subsequent respiratory hospital admissions over 3 years in univariate analyses were GMFCS level V, at least one respiratory hospital admission in the year preceding the survey, oropharyngeal dysphagia, seizures, frequent respiratory symptoms, gastro-oesophageal reflux disease, at least two courses of antibiotics in the year preceding the survey, mealtime respiratory symptoms and nightly snoring. Most risk factors for respiratory hospital admissions are potentially modifiable. Early identification of oropharyngeal dysphagia and the management of seizures may help prevent serious respiratory illness. One respiratory hospital admission should trigger further evaluation and management to prevent subsequent respiratory illness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Correlates of Psychosocial Well-Being among Overweight Adolescents: The Role of the Family

ERIC Educational Resources Information Center

Fulkerson, Jayne A.; Strauss, Jaine; Neumark-Sztainer, Dianne; Story, Mary; Boutelle, Kerri

2007-01-01

An ethnically diverse sample of at-risk-for-overweight and overweight youths (body mass index greater than the 85th percentile for age and gender; n = 667 male participants, and n = 684 female participants) completed a school-based survey measuring family variables (connectedness, mealtime environment, and weight commentary), psychosocial…

A Digital Program Informs Low-Income Caregivers of Preschool-Age Children about Family Meals

ERIC Educational Resources Information Center

Lohse, Barbara; Rifkin, Robin; Arnold, Kristen; Least, Christine

2012-01-01

Objective: To evaluate the digital program, "Mealtime is Family Time", as a means of educating caregivers of preschoolers on the importance of family meals within the division of feeding responsibility framework. Methods: Descriptive design using 2 approaches: focus group program review and discussion or self-report survey after independent…

What's Worth Talking about? Meaning-Making in Toddler-Initiated Co-Narratives in Preschool

ERIC Educational Resources Information Center

Odegaard, Elin Eriksen

2006-01-01

To elaborate narratives, toddlers are dependent on adult co-construction. Both children and teachers make meaning and learn together. This article examines what themes toddlers introduce in mealtime conversations in preschool. The object of analysis is 39 toddler-initiated co-narratives constructed by toddlers and teachers in 15 videotaped meals…

How You Can Take Medicine Safely | NIH MedlinePlus the Magazine

MedlinePlus

... your prescription to a different one that will work better for you. Use a memory aid to take your medicines on time. Some people use mealtime or bedtime as a reminder to take their medicine. Other people ... Find a system that works for you. Do not skip doses of medication ...

Infants and Toddlers in Group Care: Feeding Practices that Foster Emotional Health

ERIC Educational Resources Information Center

Branscomb, Kathryn R.; Goble, Carla B.

2008-01-01

The quality of child-teacher interactions during daily child care routines plays a significant role in young children's development. The nature of mealtimes--the pace, the caregiver's responsiveness, how food is offered--affects infants' and toddlers' emotional health. Maintaining consistency between how children are fed at home and at the center…

Improving Feeding Skills and Mealtime Behaviors in Children and Youth with Disabilities

ERIC Educational Resources Information Center

Bailey, Rita L.; Angell, Maureen E.

2005-01-01

A single-subject multiple treatment design counterbalanced across nine participants with moderate to severe and multiple disabilities was used to determine the efficacy of a school-based multi-treatment package (a combined dysphagia treatment and positive reinforcement behavior management program) for children and youth (ages 4-17) with feeding…

Limes and Lemons: Teaching and Learning in Preschool as the Coordination of Perspectives and Sensory Modalities

ERIC Educational Resources Information Center

Kultti, Anne; Pramling, Niklas

2015-01-01

This article proposes a conceptualization of teaching and learning in early childhood education, as the coordination of perspectives held by children and teachers through engaging different sensory modalities in the learning process. It takes a sociocultural theoretical perspective. An empirical example from a routine mealtime situation is…

Educators' Intervention, Communication and Peers' Conflict in Nurseries

ERIC Educational Resources Information Center

Majorano, Marinella; Corsano, Paola; Triffoni, Giulia

2015-01-01

The aim of the present study is to assess the role of educators' interventions and communications in peer conflicts between preschoolers. Ninety-nine children (47 females and 52 males) aged from zero to three years were observed in seven Italian nurseries during free-play, mealtime and structured activity. Their interactions (verbal and non-verbal…

Intra-Cultural Variation in Child Care Practices in Japan

ERIC Educational Resources Information Center

Toyama, Noriko

2016-01-01

This study, comprising three sub-studies, aims to examine how child-rearing practices vary according to different social circumstances in Japan. By comparing teacher-child interaction at mealtimes in day care centres both on an isolated small island located in Okinawa prefecture, Tarama, and in a large industrialised city, Tokyo, the following was…

Associations between Parental Concern for Adolescent Weight and the Home Food Environment and Dietary Intake

ERIC Educational Resources Information Center

MacFarlane, Abbie; Crawford, David; Worsley, Anthony

2010-01-01

Objective: Examine associations between parental concern about adolescent weight and adolescent perceptions of their dietary intake, home food availability, family mealtime environment, and parents' feeding practices. Design: Cross-sectional study. Setting: Adolescents, aged 12-15 years from 37 secondary schools in Victoria, Australia, and their…

Microanalytic Coding versus Global Rating of Maternal Parenting Behaviour

ERIC Educational Resources Information Center

Morawska, Alina; Basha, Allison; Adamson, Michelle; Winter, Leanne

2015-01-01

This study examined the relationship between microanalytic coding and global rating systems when coding maternal parenting behaviour in two contexts. Observational data from 55 mother--child interactions with two- to four-year-old children, in either a mealtime (clinic; N?=?20 or control; N?=?20) or a playtime context (community; N?=?15), were…

Assessment and Intervention for Young Children with Nonphysiological Feeding Concerns

ERIC Educational Resources Information Center

Olive, Melissa

2004-01-01

Among families who have young children, feeding concerns are quite common (Brazelton, 1992). Feeding concerns can include, but are not limited to, inappropriate mealtime behaviors, lack of self-feeding, food selectivity, and food refusal (Kerwin, 1999). Given the complex nature of assessment of and intervention for feeding concerns in young…

Turning Mealtimes into Learning Opportunities: Integrating Feeding Goals into IEPs

ERIC Educational Resources Information Center

Bruns, Deborah A.; Thompson, Stacy D.

2014-01-01

In this article, the authors use scenarios to describe three students with different individual needs related to feeding, as well as other developmental domains. Feeding difficulties affect students in multiple ways and addressing feeding-related skills on IEPs can include grocery shopping, food preparation, and placing food orders in various…

Children with Autistic Spectrum Disorders and Speech-Generating Devices: Communication in Different Activities at Home

ERIC Educational Resources Information Center

Thunberg, Gunilla; Ahlsen, Elisabeth; Sandberg, Annika Dahlgren

2007-01-01

The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech-generating device (SGD) in three different activities in their home environment: mealtime, story reading and "sharing experiences of the preschool day". An activity based communication analysis, in which collective and…

Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

ERIC Educational Resources Information Center

Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

2010-01-01

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

My child at mealtime: A visually enhanced self-assessment of feeding styles for low-income parents of preschoolers.

PubMed

Ontai, Lenna L; Sitnick, Stephanie L; Shilts, Mical K; Townsend, Marilyn S

2016-04-01

The importance of caregiver feeding styles on children's dietary outcomes is well documented. However, the instruments used to assess feeding style are limited by high literacy demands, making selfassessment with low-income audiences challenging. The purpose of the current study is to report on the development of My Child at Mealtime (MCMT), a self-assessment tool with reduced literacy demands, designed to measure feeding styles with parents of preschool-aged children. Cognitive interviews were conducted with 44 Head Start parents of 2-5 year old children to develop question wording and identify appropriate visuals. The resulting tool was administered to 119 ethnically diverse, low-income parents of 2-5 year old children. Factor analysis resulted in a two-factor structure that reflects responsiveness and demandingness in a manner consistent with existing assessment tools. Results indicate the final visually enhanced MCMT self-assessment tool provides a measure of parenting style consistent with existing measures, while reducing the literacy demand. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reasons Parents Buy Prepackaged, Processed Meals: It Is More Complicated Than "I Don't Have Time".

PubMed

Horning, Melissa L; Fulkerson, Jayne A; Friend, Sarah E; Story, Mary

2017-01-01

To investigate reasons why parents purchase prepackaged, processed meals and associations with parental cooking self-efficacy, meal-planning ability, and home food availability. This secondary data analysis uses Healthy Home Offerings via the Mealtime Environment Plus study data from parents of children aged 8-12 years (n = 160). Associations between reasons why parents purchase prepackaged, processed meals and the outcomes were assessed with chi-square, Fisher exact, and t tests. The most frequently endorsed reasons for purchasing prepackaged, processed meals included lack of time (57%) and family preferences (49%). Five of 6 reasons were associated with lower parental cooking self-efficacy and meal-planning ability. Some reasons were associated with less-healthful home food environments; few reasons varied by socio-demographic characteristics. Because lower cooking self-efficacy and meal-planning ability are associated with most reasons reported for purchasing prepackaged, processed meals, strategies to increase these attributes for parents of all backgrounds may reduce reliance on prepackaged processed meals for family mealtimes. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Nursing interventions for improving nutritional status and outcomes of stroke patients: descriptive reviews of processes and outcomes.

PubMed

Perry, Lin; Hamilton, Sharon; Williams, Jane; Jones, Susan

2013-02-01

Stroke produces many effects that impact eating. Nutrition is fundamental for recovery and rehabilitation, but the nursing nutritional role and associated outcomes have not been delineated. (1) To identify nursing interventions intended to improve nutritional status and related outcomes of stroke survivors, and (2) To examine the outcomes of identified nursing interventions on nutrition-related outcomes, including dietary intake, functional status, complications, activities of daily living, mortality, and quality of life for stroke survivors. A modified version of Cochrane literature searching and review methods was used to identify studies that described and evaluated nursing nutritional interventions for adult stroke patients in hospital and community settings. A minimum of 10 years content of seven databases and nine journals was searched to March 2011. Findings were presented descriptively. In total 27 papers from 26 studies were included: 5 randomized controlled trials, 5 clinical trials, 6 quasi-experiments, 4 case studies, and 6 qualitative/observational studies. Stroke nursing nutritional care encompassed screening of nutritional status and swallowing function; assessment of nutritional characteristics and preferences; referral; mealtime organization, supervision and monitoring; mealtime assistance and feeding skills. Nurses individualized care, coordinated or managed meal delivery and enteral feeding systems, were responsible for the dining environment and conduct of mealtimes; they taught staff, patients, and carers. There was little indication of integrated or psychosocial nursing nutritional care, or concepts, theories or models of nursing nutritional care. Many interventions were described but not evaluated. Little high quality evidence was of available. This review indicated the parameters of nursing nutritional care, and provided a framework for future research. A functional, supportive, and educational nursing nutritional role was described but little evidence was of sufficient quality to support policy and practice development or inform education. Nutritional care was revealed as an essential but under-recognized element of stroke nursing. © 2012 The authors. World Views on Evidence-Based Nursing © Sigma Theta Tau International.

Circadian Clocks for All Meal-Times: Anticipation of 2 Daily Meals in Rats

PubMed Central

Mistlberger, Ralph E.; Kent, Brianne A.; Chan, Sofina; Patton, Danica F.; Weinberg, Alexander; Parfyonov, Maksim

2012-01-01

Anticipation of a daily meal in rats has been conceptualized as a rest-activity rhythm driven by a food-entrained circadian oscillator separate from the pacemaker generating light-dark (LD) entrained rhythms. Rats can also anticipate two daily mealtimes, but whether this involves independently entrained oscillators, one ‘continuously consulted’ clock, cue-dependent non-circadian interval timing or a combination of processes, is unclear. Rats received two daily meals, beginning 3-h (meal 1) and 13-h (meal 2) after lights-on (LD 14∶10). Anticipatory wheel running began 68±8 min prior to meal 1 and 101±9 min prior to meal 2 but neither the duration nor the variability of anticipation bout lengths exhibited the scalar property, a hallmark of interval timing. Meal omission tests in LD and constant dark (DD) did not alter the timing of either bout of anticipation, and anticipation of meal 2 was not altered by a 3-h advance of meal 1. Food anticipatory running in this 2-meal protocol thus does not exhibit properties of interval timing despite the availability of external time cues in LD. Across all days, the two bouts of anticipation were uncorrelated, a result more consistent with two independently entrained oscillators than a single consulted clock. Similar results were obtained for meals scheduled 3-h and 10-h after lights-on, and for a food-bin measure of anticipation. Most rats that showed weak or no anticipation to one or both meals exhibited elevated activity at mealtime during 1 or 2 day food deprivation tests in DD, suggesting covert operation of circadian timing in the absence of anticipatory behavior. A control experiment confirmed that daytime feeding did not shift LD-entrained rhythms, ruling out displaced nocturnal activity as an explanation for daytime activity. The results favor a multiple oscillator basis for 2-meal anticipatory rhythms and provide no evidence for involvement of cue-dependent interval timing. PMID:22355393

Better Glycemic Control and Weight Loss With the Novel Long-Acting Basal Insulin LY2605541 Compared With Insulin Glargine in Type 1 Diabetes

PubMed Central

Rosenstock, Julio; Bergenstal, Richard M.; Blevins, Thomas C.; Morrow, Linda A.; Prince, Melvin J.; Qu, Yongming; Sinha, Vikram P.; Howey, Daniel C.; Jacober, Scott J.

2013-01-01

OBJECTIVE To compare effects of LY2605541 versus insulin glargine on daily mean blood glucose as part of a basal-bolus regimen for type 1 diabetes. RESEARCH DESIGN AND METHODS In this randomized, Phase 2, open-label, 2 × 2 crossover study, 137 patients received once-daily basal insulin (LY2605541 or glargine) plus mealtime insulin for 8 weeks, followed by crossover treatment for 8 weeks. Daily mean blood glucose was obtained from 8-point self-monitored blood glucose profiles. The noninferiority margin was 10.8 mg/dL. RESULTS LY2605541 met noninferiority and superiority criteria compared with insulin glargine in daily mean blood glucose (144.2 vs. 151.7 mg/dL, least squares mean difference = −9.9 mg/dL [90% CI −14.6 to −5.2], P < 0.001). Fasting blood glucose variability and A1C were reduced with LY2605541 compared with insulin glargine (both P < 0.001). Mealtime insulin dose decreased with LY2605541 and increased with insulin glargine. Mean weight decreased 1.2 kg with LY2605541 and increased 0.7 kg with insulin glargine (P < 0.001). The total hypoglycemia rate was higher for LY2605541 (P = 0.04) and the nocturnal hypoglycemia rate was lower (P = 0.01), compared with insulin glargine. Adverse events (including severe hypoglycemia) were similar, although more gastrointestinal-related events occurred with LY2605541 (15% vs. 4%, P < 0.001). Mean changes (all within normal range) were higher for alanine aminotransferase, aspartate aminotransferase, triglycerides, and LDL-cholesterol and lower for HDL-cholesterol with LY2605541 compared with insulin glargine (all P < 0.02). CONCLUSIONS In type 1 diabetes, compared with insulin glargine, LY2605541, a novel, long-acting basal insulin, demonstrated greater improvements in glycemic control, increased total hypoglycemia, and reduced nocturnal hypoglycemia, as well as reduced weight and lowered mealtime insulin doses. PMID:23193209

Family food talk, child eating behavior, and maternal feeding practices.

PubMed

Roach, Elizabeth; Viechnicki, Gail B; Retzloff, Lauren B; Davis-Kean, Pamela; Lumeng, Julie C; Miller, Alison L

2017-10-01

Families discuss food and eating in many ways that may shape child eating habits. Researchers studying how families talk about food have examined this process during meals. Little work has examined parent-child food-related interactions outside of mealtime. We assessed family food talk at home outside of mealtime and tested whether food talk was associated with obesogenic child eating behaviors, maternal feeding practices, or child weight. Preschool and school-aged mother-child dyads (n = 61) participated in naturalistic voice recording using a LENA (Language ENvironment Analysis) recorder. A coding scheme was developed to reliably characterize different types of food talk from LENA transcripts. Mothers completed the Children's Eating Behavior Questionnaire (CEBQ) and Child Feeding Questionnaire (CFQ) to assess child eating behaviors and maternal feeding practices. Child weight and height were measured and body mass index z-score (BMIz) calculated. Bivariate associations among food talk types, as a proportion of total speech, were examined and multivariate regression models used to test associations between food talk and child eating behaviors, maternal feeding practices, and child BMIz. Proportion of child Overall Food Talk and Food Explanations were positively associated with CEBQ Food Responsiveness and Enjoyment of Food (p's < 0.05). Child food Desire/Need and child Prep/Planning talk were positively associated with CEBQ Enjoyment of Food (p < 0.05). Child Food Enjoyment talk and mother Overt Restriction talk were positively associated with CEBQ Emotional Over-Eating (p < 0.05). Mother Monitoring talk was positively associated with CFQ Restriction (p < 0.05). Mother Prep/Planning talk was negatively associated with child BMIz. Food talk outside of mealtimes related to child obesogenic eating behaviors and feeding practices in expected ways; examining food talk outside of meals is a novel way to consider feeding practices and child eating behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Feeding Problems and Their Underlying Mechanisms in the Esophageal Atresia–Tracheoesophageal Fistula Patient

PubMed Central

Mahoney, Lisa; Rosen, Rachel

2017-01-01

Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding. The initial diagnostic evaluation for feeding difficulties in a patient with EA may involve an esophagram, videofluoroscopic imaging or fiberoptic endoscopic evaluation during swallowing, upper endoscopy with biopsies, pH-impedance testing, and/or esophageal motility studies. The main goal of management is to reduce the factors contributing to feeding difficulties and may include reducing esophageal stasis, maximizing reflux therapies, treating underlying lung disease, dilating strictures, and altering feeding methods, routes, or schedules. PMID:28620597

The Effects of Sleep Disruption on the Treatment of a Feeding Disorder

ERIC Educational Resources Information Center

Reed, Gregory K.; Dolezal, Danielle N.; Cooper-Brown, Linda J.; Wacker, David P.

2005-01-01

We evaluated the effects of sleep disruption on the mealtime behavior of a young boy with developmental disabilities. Results showed that bite acceptance was less likely to persist during meals following disrupted sleep, but only when escape extinction was not implemented. Findings are discussed in terms of establishing operations and the effects…

From Language Maintenance to Bilingual Parenting: Negotiating Behavior and Language Choice at the Dinner Table in Binational-Bilingual Families

ERIC Educational Resources Information Center

Meyer Pitton, Liliane

2013-01-01

This article contributes to the study of language maintenance as an everyday activity in binational-bilingual families. By embedding the question of language maintenance into a language socialization framework and adopting a conversation-analytic approach to language alternation, three excerpts of mealtime interactions in Russian-French speaking…

Teaching Independent Eating to a Developmentally Handicapped Child Showing Chronic Food Refusal and Disruption at Mealtimes.

ERIC Educational Resources Information Center

MacArthur, Judy; And Others

1986-01-01

A successful intervention to establish independent eating behaviors in a developmentally handicapped, autistic-like three-year-old involved teaching appropriate behavior in a hospital setting (where he was being treated for dehydration and malnutrition) and then teaching his mother to implement the strategies at home. Skills were maintained at…

Toddler Feeding: Expectations and Experiences of Low-Income African American Mothers

ERIC Educational Resources Information Center

Horodynski, Mildred A.; Brophy-Herb, Holly; Henry, Michelle; Smith, Katharine A.; Weatherspoon, Lorraine

2009-01-01

Objective: To ascertain maternal expectations and experiences with mealtimes and feeding of toddlers among low-income African American mothers in two mid- to large-size cities in the United States. Design: Qualitative focus group study. Setting: Two Early Head Start programme sites in a Midwestern state which serve low income families. Method:…

Vietnamese Female Spouses' Language Use Patterns in Self-Initiated Admonishment Sequences in Bilingual Taiwanese Families

ERIC Educational Resources Information Center

Wang, Li-Fen

2014-01-01

This paper aims to identify how Taiwanese and Mandarin (the two dominant languages in Taiwan) are used as interactional resources by Vietnamese female spouses in bilingual Taiwanese families. Three Vietnamese-Taiwanese transnational families (a total of seventeen people) participated in the research, and mealtime talks among the Vietnamese wives…

The Relationship between Childhood Sexual Abuse and Subsequent Onset of Bulimia Nervosa.

ERIC Educational Resources Information Center

Miller, Debra A. F.; And Others

1993-01-01

This study compared 72 young adult women identified as suffering from bulimia nervosa with 72 matched controls. Bulimic women reported higher rates of sexual abuse after the age of 12 with an adult relative as the perpetrator, reported dissociative experiences as more common, and reported more negative and unusual mealtime experiences. (Author/JDD)

Nutrition in the Early Childhood Setting: Arizona HSST/CDA Competency Based Training Module #15.

ERIC Educational Resources Information Center

Terrell, Ann

The purpose of this Child Development Associate (CDA) training module is to provide the CDA intern with knowledge of how to use nutrition information with children and parents, as well as how to structure and carry out a nutrition program, including mealtime and food preparation activities. Objectives are presented along with suggested activities…

Using Family Style Dining to Increase Social Interactions in Young Children

ERIC Educational Resources Information Center

Locchetta, Brandy M.; Barton, Erin E.; Kaiser, Ann

2017-01-01

During family style dining (FSD), caregivers are encouraged to sit with children at the table to support, promote, and facilitate conversations. FSD is considered a best practice in child care and is encouraged by many early childhood agencies. However, there is no current research documenting the effects of FSD on mealtime interactions in the…

eCoaching across Routines to Enhance Teachers' Use of Modeling

ERIC Educational Resources Information Center

Coogle, Christan Grygas; Rahn, Naomi L.; Ottley, Jennifer Riggie; Storie, Sloan

2016-01-01

The purpose of this research was to determine the impact of eCoaching on two special education teachers' use of modeling strategies across child-led, teacher-led, and mealtime routines. A multiple-probe, single-case design was used to determine the effects of eCoaching on teachers' use of three modeling strategies. Each of the three strategies…

Using a Chaser to Decrease Packing in Children with Feeding Disorders

ERIC Educational Resources Information Center

Vaz, Petula C. M.; Piazza, Cathleen C.; Stewart, Victoria; Volkert, Valerie M.; Groff, Rebecca A.; Patel, Meeta R.

2012-01-01

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During…

Head Start Teachers' Perceptions of Children's Eating Behavior and Weight Status in the Context of Food Scarcity

ERIC Educational Resources Information Center

Lumeng, Julie C.; Kaplan-Sanoff, Margot; Shuman, Steve; Kannan, Srimathi

2008-01-01

Objective: To describe Head Start teachers' perceptions of mealtime, feeding, and overweight risk in Head Start students. Design: Qualitative focus group study. Setting: Five Head Starts in a greater metropolitan area in the Northeast. Participants: Thirty-five teachers in 5 focus groups. Intervention: Two experienced focus group facilitators…

Informal Mealtime Pedagogies: Exploring the Influence of Family Structure on Young People's Healthy Eating Dispositions

ERIC Educational Resources Information Center

Quarmby, Thomas; Dagkas, Symeon

2015-01-01

Families are increasingly recognised as informal sites of learning, especially with regard to healthy eating. Through the use of Bourdieu's conceptual tools, this paper explores the role of family meals within different family structures and the informal pedagogic encounters that take place. How they help to construct young people's healthy eating…

Adding Scents to Symbols: Using Food Fragrances with Deafblind Young People Making Choices at Mealtimes

ERIC Educational Resources Information Center

Murdoch, Heather; Gough, Anne; Boothroyd, Eileen; Williams, Kate

2014-01-01

This article is written by Heather Murdoch, research consultant for the Seashell Trust, Anne Gough, deputy headteacher at Royal School Manchester/Seashell Trust, Eileen Boothroyd, consultant for the Seashell Trust, and Kate Williams, a creative perfumer for Seven (PZ Cussons). It describes the use of food fragrances with deafblind students who are…

Nutrition Education and Training Program. State Plan for Fiscal Years 1994 and 1995.

ERIC Educational Resources Information Center

Kansas State Board of Education, Topeka.

The Nutrition Education and Training Program (NETP) promotes healthy eating habits to improve the health and well-being of children. It integrates mealtime and learning experiences to help children make informed food choices part of a healthy lifestyle. Kansas NETP has adopted the national NETP philosophy and strategic direction, with goals…

Review of prandial glucose regulation with repaglinide: a solution to the problem of hypoglycaemia in the treatment of Type 2 diabetes?

PubMed

Nattrass, M; Lauritzen, T

2000-09-01

Type 2 diabetes mellitus is characterised by abnormal beta-cell function (present at the time of diagnosis) that is often associated with insulin resistance. An important and consistent pathophysiological finding is the failure to produce adequate increments in insulin secretion in response to carbohydrate intake. Therefore, insulin secretagogue therapy, particularly when focused on prandial glucose regulation, is a logical approach to treatment because it addresses one of the most fundamental pathophysiological aspects of the disease. However, the traditional secretagogues-the sulphonylureas--have long been associated with the unwanted effect of hypoglycaemia. This is particularly likely to occur when drugs with lengthy plasma half-lives, prolonged drug-receptor interactions, active metabolites or a reliance on renal clearance are used. The problem is most prevalent in elderly patients, where sulphonylurea-induced hypoglycaemia may be related to failure to comply with strict mealtimes or the need for supplementary food intake, often in the context of compromised renal function. Data from large-scale outcome studies demonstrate that when tight glycaemic control is achieved through aggressive antidiabetic therapy, late diabetic complications can be significantly reduced. However, the pursuit of stricter HbA1c targets with more aggressive interventions may increase the risk of hypoglycaemia. This is an irony because the clinical need to avoid hypoglycaemia and patients' apprehension of it present barriers to the achievement of beneficial glycaemic targets. However, an increased risk of hypoglycaemia may not be inevitable with insulin secretagogue therapy. The recently introduced carbamoylmethyl benzoic acid derivative, repaglinide, has pharmacological properties that are well suited to its intended role as a prandial glucose regulator. When taken prior to main meals, the rapid onset and relatively short duration of action of repaglinide aid disposal of the mealtime glucose load, without continued stimulation of pancreatic beta-cells in the postprandial fasting period. Repaglinide is also characterised by hepatic metabolism and elimination, which is an advantage in the context of impaired renal function. Prandial glucose regulation with repaglinide selectively increases insulin secretion, and hence limits glucose excursions, in the prandial phase. If a meal is omitted, so too is the corresponding dose. This more flexible approach to the management of Type 2 diabetes has a number of advantages when compared with the fixed daily dosing regimens of sulphonylureas, among them a reduced risk of hypoglycaemia--a benefit that is particularly marked in the context of missed or irregular meals.

The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study.

PubMed

van Dijk, Marijn; Bruinsma, Eke; Hauser, M Paulina

2016-04-01

Because feeding problems have clear negative consequences for both child and caretakers, early diagnosis and intervention are important. Parent-report questionnaires can contribute to early identification, because they are efficient and typically offer a 'holistic' perspective of the child's eating in different contexts. In this pilot study, we aim to explore the concurrent validity of a short screening instrument (the SEP, which is the Dutch MCH-FS) in one of its target populations (a group of premature children) by comparing the total score with the observed behavior of the child and caretaker during a regular home meal. 28 toddlers (aged 9-18 months) and their caretakers participated in the study. Video-observations of the meals were coded for categories of eating behavior and parent-child interaction. The results show that the total SEP-score correlates with food refusal, feeding efficiency, and self-feeding, but not with negative affect and parental instructions. This confirms that the SEP has a certain degree of concurrent validity in the sense that its total score is associated with specific 'benchmark' feeding behaviors: food refusal, feeding efficiency and autonomy. Future studies with larger samples are needed to generalize the findings from this pilot to a broader context. Copyright © 2016 Elsevier Ltd. All rights reserved.

SnoRNA Snord116 (Pwcr1/MBII-85) Deletion Causes Growth Deficiency and Hyperphagia in Mice

PubMed Central

Ding, Feng; Li, Hong Hua; Zhang, Shengwen; Solomon, Nicola M.; Camper, Sally A.; Cohen, Pinchas; Francke, Uta

2008-01-01

Prader-Willi syndrome (PWS) is the leading genetic cause of obesity. After initial severe hypotonia, PWS children become hyperphagic and morbidly obese, if intake is not restricted. Short stature with abnormal growth hormone secretion, hypogonadism, cognitive impairment, anxiety and behavior problems are other features. PWS is caused by lack of expression of imprinted genes in a ∼4 mb region of chromosome band 15q11.2. Our previous translocation studies predicted a major role for the C/D box small nucleolar RNA cluster SNORD116 (PWCR1/HBII-85) in PWS. To test this hypothesis, we created a ∼150 kb deletion of the >40 copies of Snord116 (Pwcr1/MBII-85) in C57BL/6 mice. Snord116del mice with paternally derived deletion lack expression of this snoRNA. They have early-onset postnatal growth deficiency, but normal fertility and lifespan. While pituitary structure and somatotrophs are normal, liver Igf1 mRNA is decreased. In cognitive and behavior tests, Snord116del mice are deficient in motor learning and have increased anxiety. Around three months of age, they develop hyperphagia, but stay lean on regular and high-fat diet. On reduced caloric intake, Snord116del mice maintain their weight better than wild-type littermates, excluding increased energy requirement as a cause of hyperphagia. Normal compensatory feeding after fasting, and ability to maintain body temperature in the cold indicate normal energy homeostasis regulation. Metabolic chamber studies reveal that Snord116del mice maintain energy homeostasis by altered fuel usage. Prolonged mealtime and increased circulating ghrelin indicate a defect in meal termination mechanism. Snord116del mice, the first snoRNA deletion animal model, reveal a novel role for a non-coding RNA in growth and feeding regulation. PMID:18320030

New Insulin Glargine 300 Units/mL Versus Glargine 100 Units/mL in People With Type 1 Diabetes: A Randomized, Phase 3a, Open-Label Clinical Trial (EDITION 4).

PubMed

Home, Philip D; Bergenstal, Richard M; Bolli, Geremia B; Ziemen, Monika; Rojeski, Maria; Espinasse, Melanie; Riddle, Matthew C

2015-12-01

Insulin therapy in type 1 diabetes still provides suboptimal outcomes. Insulin glargine 300 units/mL (Gla-300), with a flatter pharmacodynamic profile compared with insulin glargine 100 units/mL (Gla-100), is an approach to this problem. People with type 1 diabetes, using a mealtime and basal insulin regimen, were randomized open-label to Gla-300 or Gla-100 and to morning or evening injection, continuing the mealtime analog, and followed for 6 months. Participants (n = 549) were a mean age of 47 years and had a mean duration of diabetes of 21 years and BMI of 27.6 kg/m(2). The change in HbA1c (primary end point; baseline 8.1%) was equivalent in the two treatment groups (difference, 0.04% [95% CI -0.10 to 0.19]) (0.4 mmol/mol [-1.1 to 2.1]), and Gla-300 was thus noninferior. Similar results with wider 95% CIs were found for morning and evening injection times and for prebreakfast self-measured plasma glucose (SMPG) overall. Results were also similar for Gla-300 when morning and evening injection time was compared, including overlapping 8-point SMPG profiles. Hypoglycemia did not differ, except for the first 8 weeks of the study, when nocturnal confirmed or severe hypoglycemia was lower with Gla-300 (rate ratio 0.69 [95% CI 0.53-0.91]). Hypoglycemia with Gla-300 did not differ by time of injection. The basal insulin dose was somewhat higher at 6 months for Gla-300. The adverse event profile did not differ and was independent of the Gla-300 time of injection. Weight gain was lower with Gla-300. In long-duration type 1 diabetes, Gla-300 provides similar glucose control to Gla-100, with a lower risk of hypoglycemia after transfer from other insulins, independent of time of injection, and less weight gain. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Parent-reported indicators for detecting feeding and swallowing difficulties and undernutrition in preschool-aged children with cerebral palsy.

PubMed

Benfer, Katherine A; Weir, Kelly A; Ware, Robert S; Davies, Peter S W; Arvedson, Joan; Boyd, Roslyn N; Bell, Kristie L

2017-11-01

To determine the most accurate parent-reported indicators for detecting (1) feeding/swallowing difficulties and (2) undernutrition in preschool-aged children with cerebral palsy (CP). This was a longitudinal, population-based study, involving 179 children with CP, aged 18 to 60 months (mean 34.1mo [SD 11.9] at entry, 111 males, 68 females [Gross Motor Function Classification System level I, 84; II, 23; III, 28; IV, 18; V, 26], 423 data points). Feeding/swallowing difficulties were determined by the Dysphagia Disorders Survey and 16 signs suggestive of pharyngeal phase impairment. Undernutrition was indicated by height-weight and skinfold composite z-scores less than -2. Primary parent-reported indicators included mealtime duration, mealtime stress, concern about growth, and respiratory problems. Other indicators were derived from a parent feeding questionnaire, including 'significant difficulty eating and drinking'. Data were analysed using multilevel mixed-effects regression and diagnostic statistics. Primary parent-reported indicators associated with feeding/swallowing were 'moderate-severe parent stress' (odds ratio [OR]=3.2 [95% confidence interval {CI} 1.3-7.8]; p<0.01), 'moderate-severe concern regarding growth' (OR=4.5 [95% CI 1.7-11.9]; p<0.01), and 'any respiratory condition' (OR=1.8 [95% CI 1.4-5.8]; p<0.01). The indicator associated with undernutrition was 'moderate-severe concern regarding growth' (height-weight OR=13.5 [95% CI 3.0-61.3]; p<0.01; skinfold OR=19.1 [95% CI 3.7-98.9]; p<0.01). 'Significant difficulty eating and drinking' was most sensitive/specific for feeding outcome (sensitivity=58.6%, specificity=100.0%), and 'parent concern regarding growth' for undernutrition (sensitivity=77.8%, specificity=77.0%). Parent-reported indicators are feasible for detecting feeding and swallowing difficulties and undernutrition in children with CP, but need formal validation. Parent-reported indicators can detect feeding/swallowing difficulties and undernutrition in children with cerebral palsy. Most accurate screening questions were 0-10 scales for 'difficulty eating' and 'difficulty drinking'. Supplementation of these scales with additional indicators would improve detection. © 2017 Mac Keith Press.

Understanding Mealtime Changes for Adults with Cerebral Palsy and the Implications for Support Services

ERIC Educational Resources Information Center

Balandin, Susan; Hemsley, Bronwyn; Hanley, Leah; Sheppard, Justine Joan

2009-01-01

Background: Changes in the swallowing capabilities of adults with cerebral palsy as they age may impact on their health, safety, and well-being. Method: Thirty-two adults with cerebral palsy aged between 30 and 69 years participated in in-depth interviews about their experiences of changes in their swallowing and related management of their…

"Are You Done?" Child Care Providers' Verbal Communication at Mealtimes that Reinforce or Hinder Children's Internal Cues of Hunger and Satiation

ERIC Educational Resources Information Center

Ramsay, Samantha A.; Branen, Laurel J.; Fletcher, Janice; Price, Elizabeth; Johnson, Susan L.; Sigman-Grant, Madeleine

2010-01-01

Objective: To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Methods: Video observation transcripts of Head Start staff (n=29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Results: Adults' verbal…

Food in Foster Families: Care, Communication and Conflict

ERIC Educational Resources Information Center

Rees, Alyson; Holland, Sally; Pithouse, Andrew

2012-01-01

This study explores the significance of food and mealtimes in relation to the transition into foster care and the therapeutic settling of the child in a new family. In doing so, we draw upon an in-depth, qualitative case study of 10 experienced foster families in the UK focusing on what helped them to be successful. At the time of the study, there…

Creating Healthy Families through Shared Physical Activity and Nutritionally Sound Meals

ERIC Educational Resources Information Center

Robinson, Cheryl Malone; McNulty, Betty; McCoy, Merwin A.; Johnston, Linda

2012-01-01

Families today are very busy: parents hurry to jobs, workouts, school, church, and a plethora of other commitments and children are often hurried off to school or daycare. As a result, quality time for families seems to be scarce. Mealtimes, during which the family members sit down together for a relaxed time of eating and sharing, may be a thing…

Talk about Talk with Young Children: Pragmatic Socialization in Two Communities in Norway and the US

ERIC Educational Resources Information Center

Aukrust, Vibeke Grover

2004-01-01

Recent studies have suggested that cultures vary in subtle ways in the talk about talk that children hear and learn to produce. Twenty-two three-year-old children and their families in respectively Oslo, Norway and Cambridge, Massachusetts were observed during mealtime with the aim of identifying talk-focused talk. The analysis distinguished talk…

Together and Alone a Study of Interactions between Toddlers and Childcare Providers during Mealtime in Norwegian Childcare Centres

ERIC Educational Resources Information Center

Klette, Trine; Drugli, May Britt; Aandahl, Ann Mari

2018-01-01

The study investigated the quality of interactions between childcare providers and toddlers during a lunch in childcare centres. Meals in childcare centres are semi-structured adult-led situations where the children not only eat, but are also provided with opportunities for implicit learning and interactions. Participants were 13 toddlers aged…

eCoaching across Routines to Enhance Teachers' Use of Modeling

ERIC Educational Resources Information Center

Coogle, Christan Grygas; Rahn, Naomi L.; Ottley, Jennifer Riggie; Storie, Sloan

2016-01-01

The purpose of this research was to determine the impact of eCoaching on two special education teachers' use of modeling strategies across child-led, teacher-led, and mealtime routines. A multiple-probe, single-case design was used to determine the effects of eCoaching on teachers' use of three modeling strategies. Each of the three strategies was…

Relationship of glucose values to sliding scale insulin (correctional insulin) dose delivery and meal time in acute care patients with diabetes mellitus.

PubMed

Trotter, Barbara; Conaway, Mark R; Burns, Suzanne M

2013-01-01

Findings of this study suggest the traditional sliding scale insulin (SSI) method does not improve target glucose values among adult medical inpatients. Timing of blood glucose (BC) measurement does affect the required SSI dose. BC measurement and insulin dose administration should be accomplished immediately prior to mealtime.

Using Individualized Reinforcers and Hierarchical Exposure to Increase Food Flexibility in Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Koegel, Robert L.; Bharoocha, Amber A.; Ribnick, Courtney B.; Ribnick, Ryan C.; Bucio, Mario O.; Fredeen, Rosy M.; Koegel, Lynn Kern

2012-01-01

Inflexibility is a major characteristic of autism. In the present study we addressed inflexible mealtime behaviors and collected longitudinal data across 48 foods for 3 children, ages 6.4-7.8 years, diagnosed with autism spectrum disorder, for up to 22 weeks. Participants exhibited severe challenges with adherence to an extremely restricted…

Lunchtime School Water Availability and Water Consumption Among California Adolescents.

PubMed

Bogart, Laura M; Babey, Susan H; Patel, Anisha I; Wang, Pan; Schuster, Mark A

2016-01-01

To examine the potential impact of California SB 1413, which required school districts to provide free, fresh drinking water during mealtimes in food service areas by July 1, 2011, on greater water consumption among California adolescents. Data were drawn from the 2012 and 2013 state-representative California Health Interview Survey. A total of 2,665 adolescents aged 12-17 years were interviewed regarding their water consumption and availability of free water during lunchtime at their school. Three-fourths reported that their school provided free water at lunchtime, mainly via fountains. In a multivariate model that controlled for age, gender, income, race/ethnicity, body mass index, and school type, adolescents in schools that provided free water consumed significantly more water than adolescents who reported that water was not available, bivariate (standard error) = .67 (.28), p = .02. School water access did not significantly vary across the 2 years. Lunchtime school water availability was related to water consumption, but a quarter of adolescents reported that their school did not provide free water at lunch. Future research should explore what supports and inducements might facilitate provision of drinking water during school mealtimes. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

Lunchtime School Water Availability and Water Consumption among California Adolescents

PubMed Central

Bogart, Laura M.; Babey, Susan H.; Patel, Anisha I.; Wang, Pan; Schuster, Mark A.

2015-01-01

Purpose To examine the potential impact of California SB1413, which required school districts to provide free, fresh drinking water during mealtimes in food service areas by July 1, 2011, on greater water consumption among California adolescents. Methods Data were drawn from the 2012 and 2013 state-representative California Health Interview Survey. A total of 2,665 adolescents aged 12-17 were interviewed regarding their water consumption and availability of free water during lunchtime at their school. Results Three-fourths reported that their school provided free water at lunchtime, mainly via fountains. In a multivariate model that controlled for age, gender, income, race/ethnicity, BMI, and school type, adolescents in schools that provided free water consumed significantly more water than adolescents who reported that water was not available, b (SE) = 0.67 (0.28), p = .02. School water access did not significantly vary across the two years. Conclusions Lunchtime school water availability was related to water consumption, but a quarter of adolescents reported that their school did not provide free water at lunch. Future research should explore what supports and inducements might facilitate provision of drinking water during school mealtimes. PMID:26552740

Associations of family meal frequency with family meal habits and meal preparation characteristics among families of youth with type 1 diabetes

PubMed Central

Kornides, M. L.; Nansel, T. R.; Quick, V.; Haynie, D. L.; Lipsky, L. M.; Laffel, L. M. B.; Mehta, S. N.

2014-01-01

Background While benefits of family mealtimes, such as improved dietary quality and increased family communication, have been well-documented in the general population, less is known about family meal habits that contribute to more frequent family meals in youth with type 1 diabetes. Methods This cross-sectional study surveyed 282 youth ages 8–18 years with type 1 diabetes and their parents on measures regarding diabetes-related and dietary behaviours. T-tests determined significant differences in youth's diet quality, adherence to diabetes management and glycaemic control between those with and without regular family meals (defined as ≥5 meals per week). Logistic regression analyses determined unadjusted and adjusted associations of age, socio-demographics, family meal habits, and family meal preparation characteristics with regular family meals. Results 57% of parents reported having regular family meals. Families with regular family meals had significantly better diet quality as measured by the Healthy Eating Index (P < 0.05) and the NRF9.3 (P < 0.01), and adherence to diabetes management (P < 0.001); the difference in glycaemic control approached statistical significance (P = 0.06). Priority placed on, pleasant atmosphere and greater structure around family meals were each associated with regular family meals (P < 0.05). Meals prepared at home were positively associated with regular family meals, while convenience and fast foods were negatively associated (P < 0.05). Families in which at least one parent worked part-time or stayed at home were significantly more likely to have regular family meals than families in which both parents worked full-time (P < 0.05). In the multivariate logistic regression model, greater parental priority given to family mealtimes (P < 0.001) and more home-prepared meals (P < 0.001) predicted occurrence of regular family meals; adjusting for parent work status and other family meal habits. Conclusions Strategies for promoting families meals should not only highlight the benefits of family meals, but also facilitate parents' skills for and barriers to home-prepared meals. PMID:23731337

Associations of family meal frequency with family meal habits and meal preparation characteristics among families of youth with type 1 diabetes.

PubMed

Kornides, M L; Nansel, T R; Quick, V; Haynie, D L; Lipsky, L M; Laffel, L M B; Mehta, S N

2014-05-01

While benefits of family mealtimes, such as improved dietary quality and increased family communication, have been well-documented in the general population, less is known about family meal habits that contribute to more frequent family meals in youth with type 1 diabetes. This cross-sectional study surveyed 282 youth ages 8-18 years with type 1 diabetes and their parents on measures regarding diabetes-related and dietary behaviours. T-tests determined significant differences in youth's diet quality, adherence to diabetes management and glycaemic control between those with and without regular family meals (defined as ≥ 5 meals per week). Logistic regression analyses determined unadjusted and adjusted associations of age, socio-demographics, family meal habits, and family meal preparation characteristics with regular family meals. 57% of parents reported having regular family meals. Families with regular family meals had significantly better diet quality as measured by the Healthy Eating Index (P < 0.05) and the NRF9.3 (P < 0.01), and adherence to diabetes management (P < 0.001); the difference in glycaemic control approached statistical significance (P = 0.06). Priority placed on, pleasant atmosphere and greater structure around family meals were each associated with regular family meals (P < 0.05). Meals prepared at home were positively associated with regular family meals, while convenience and fast foods were negatively associated (P < 0.05). Families in which at least one parent worked part-time or stayed at home were significantly more likely to have regular family meals than families in which both parents worked full-time (P < 0.05). In the multivariate logistic regression model, greater parental priority given to family mealtimes (P < 0.001) and more home-prepared meals (P < 0.001) predicted occurrence of regular family meals; adjusting for parent work status and other family meal habits. Strategies for promoting families meals should not only highlight the benefits of family meals, but also facilitate parents' skills for and barriers to home-prepared meals. © 2013 John Wiley & Sons Ltd.

Mealtime Energy Intake and Feeding Behaviour in Children Who Fail to Thrive: A Population-Based Case-Control Study

ERIC Educational Resources Information Center

Parkinson, Kathryn N.; Wright, Charlotte M.; Drewett, Robert F.

2004-01-01

Background: The essential link between energy needs and energy intake is feeding behaviour, yet few studies have directly observed feeding behaviour in children who have failed to thrive. A cohort of 961 term infants was screened to identify children with first year weight gain below the 5th centile in order to examine their feeding behaviour and…

Adolescent Risk Behaviours and Mealtime Routines: Does Family Meal Frequency Alter the Association between Family Structure and Risk Behaviour?

ERIC Educational Resources Information Center

Levin, Kate A.; Kirby, Joanna; Currie, Candace

2012-01-01

Family structure is associated with a range of adolescent risk behaviours, with those living in both parent families generally faring best. This study describes the association between family structure and adolescent risk behaviours and assesses the role of the family meal. Data from the 2006 Health Behaviour in School-Aged Children survey were…

Functional Assessment and Behavioural Intervention for Eating Difficulties in Children with Autism: A Study Conducted in the Natural Environment Using Parents and ABA Tutors as Therapists

ERIC Educational Resources Information Center

Gale, Catherine M.; Eikeseth, Svein; Rudrud, Eric

2011-01-01

Two functional assessments (interview and direct observation) were used with three children with autism to identify the functions maintaining mealtime behaviour including acceptance, mouth clean, refusal, and other disruptive behaviours such as crying and pushing the spoon. Based on results of the functional assessments it was hypothesized that…

Associations of maternal employment and three-generation families with pre-school children's overweight and obesity in Japan.

PubMed

Watanabe, E; Lee, J S; Kawakubo, K

2011-07-01

Maternal employment has been shown to be associated with childhood overweight and obesity (Ow/Ob), but the presence of family members who care for children in place of the mothers might influence children's Ow/Ob and lifestyles. The influence of maternal employment on children's Ow/Ob should be examined together with the presence of caregivers such as grandparents. The effects of maternal employment and the presence of grandparents on lifestyles and Ow/Ob in Japanese pre-school children were investigated. Cross-sectional study on 2114 children aged 3-6 years who attended all childcare facilities in a city and primary caregivers was conducted. Children's weight and height, family environments (family members, maternal employment, single parent, number of siblings and parental Ow/Ob) and lifestyles (dietary, physical activity and sleeping habits) were surveyed using a self-administered questionnaire. Ow/Ob was defined by the International Obesity Task Force cut-offs. The eligible participants were 1765 children. The prevalence of Ow/Ob was 8.4% in boys and 9.9% in girls. Maternal employment was associated positively with irregular mealtimes, unfixed snacking times, bedtime after 10 p.m. and nighttime sleep duration of less than 10 h, whereas three-generation families were associated negatively with irregular mealtimes after adjustment for children's characteristics and family environments. Irregular mealtimes (OR (95% CI); 2.03 (1.36, 3.06)) and nighttime sleep duration of less than 10 h (1.96 (1.28, 3.01)) were associated with increased risks of being Ow/Ob. Both maternal employment and three-generation families were significantly associated with children's Ow/Ob. However, three-generation families maintained a significant association (1.59 (1.08, 2.35)) after adjustment for maternal employment. These study results suggest that the grandparents who care for pre-school children in place of mothers are more likely to contribute to childhood Ow/Ob than maternal employment. The family-focused lifestyle strategies to prevent childhood Ow/Ob must include grandparents who care for children.

Association between eating alone and depressive symptom in elders: a cross-sectional study.

PubMed

Wang, Xinyi; Shen, Wei; Wang, Chunmei; Zhang, Xiaoyi; Xiao, Yuanyuan; He, Fan; Zhai, Yujia; Li, Fudong; Shang, Xiaopeng; Lin, Junfen

2016-01-16

Depression is one of the main health concerns in elders which could lead to many negative outcomes. Eating alone is an emerging issue in elders in China and would become more serious along with the fast course of industrialization and urbanization, as well as population aging. However, their relationship was seldom researched. Using a two-stage cluster sampling strategy, an investigation was conducted in 2014 among 9,361 permanent residents aged 60 years and above in Zhejiang Province, China. Totally, 7,968 cognitively normal elders were included in our analysis. Multilevel logistic regression was used to explore the association between eating arrangement (number of companions in mealtime) and depressive symptom as well as the association between eating alone and depressive symptom in relation to living alone. In our sample, 17.1% of the elders ate alone and 8.7% had depressive symptom. We observed a distinct inverse association between eating arrangement (number of companions in mealtime) and geriatric depressive symptom (female: OR = 1.12, P = 0.027; aged 60-74 years: OR = 1.16, P = 0.002), after adjustment for demography, socioeconomic status, social relation, health behaviors, underlying conditions and living alone. We then introduced a combined variable of eating alone and living alone and examined its relationship with depressive symptom. We found that compared with elders who ate and lived with others, those who ate alone but lived with others had a significant increased odds of depressive symptom (female: OR = 1.62, P = 0.027; aged 60-74 years: OR = 1.59, P = 0.025). Our results suggested that a lack of companionship in mealtime might be independently associated with geriatric depressive symptom for females and those aged 60-74 years. What's more, eating alone might be a stronger factor associated with depressive symptom than living alone. We recommend interventions to be performed in encouraging elders especially females and those aged 60-74 years to eat with others. Longitudinal studies in different populations which focus on this topic are required to better understand this issue.

New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 1).

PubMed

Riddle, Matthew C; Bolli, Geremia B; Ziemen, Monika; Muehlen-Bartmer, Isabel; Bizet, Florence; Home, Philip D

2014-10-01

To compare the efficacy and safety of new insulin glargine 300 units/mL (Gla-300) with glargine 100 units/mL (Gla-100) in people with type 2 diabetes on basal insulin (≥42 units/day) plus mealtime insulin. EDITION 1 (NCT01499082) was a 6-month, multinational, open-label, parallel-group study. Adults with glycated hemoglobin A1c (HbA1c) 7.0-10.0% (53-86 mmol/mol) were randomized to Gla-300 or Gla-100 once daily with dose titration seeking fasting plasma glucose 4.4-5.6 mmol/L. Primary end point was HbA1c change from baseline; main secondary end point was percentage of participants with one or more confirmed (≤3.9 mmol/L) or severe nocturnal hypoglycemia from week 9 to month 6. Participants (n = 807) had mean age 60 years, diabetes duration 16 years, BMI 36.6 kg/m(2), and HbA1c 8.15% (65.6 mmol/mol). HbA1c reduction was equivalent between regimens; least squares mean difference -0.00% (95% CI -0.11 to 0.11) (-0.00 mmol/mol [-1.2 to 1.2]). Fewer participants reported one or more confirmed (≤3.9 mmol/L) or severe nocturnal hypoglycemic events between week 9 and month 6 with Gla-300 (36 vs. 46% with Gla-100; relative risk 0.79 [95% CI 0.67-0.93]; P < 0.005); nocturnal hypoglycemia incidence and event rates were also lower with Gla-300 in the first 8 weeks of treatment. No between-treatment differences in tolerability or safety were identified. Gla-300 controls HbA1c as well as Gla-100 for people with type 2 diabetes treated with basal and mealtime insulin but with consistently less risk of nocturnal hypoglycemia. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

New insulin glargine 300 U/ml versus glargine 100 U/ml in Japanese adults with type 1 diabetes using basal and mealtime insulin: glucose control and hypoglycaemia in a randomized controlled trial (EDITION JP 1)

PubMed Central

Koyama, M.; Cheng, X.; Takahashi, Y.; Riddle, M. C.; Bolli, G. B.; Hirose, T.

2016-01-01

Aim To compare efficacy and safety of new insulin glargine 300 U/ml (Gla‐300) with that of insulin glargine 100 U/ml (Gla‐100) in Japanese adults with type 1 diabetes. Methods The EDITION JP 1 study (NCT01689129) was a 6‐month, multicentre, open‐label, phase III study. Participants (n = 243) were randomized to Gla‐300 or Gla‐100 while continuing mealtime insulin. Basal insulin was titrated with the aim of achieving a fasting self‐monitored plasma glucose target of 4.4–7.2 mmol/l. The primary endpoint was change in glycated haemoglobin (HbA1c) over 6 months. Safety measures included hypoglycaemia and change in body weight. Results Gla‐300 was non‐inferior to Gla‐100 for the primary endpoint of HbA1c change over the 6‐month period {least squares [LS] mean difference 0.13 % [95 % confidence interval (CI) −0.03 to 0.29]}. The annualized rate of confirmed (≤3.9 mmol/l) or severe hypoglycaemic events was 34 % lower with Gla‐300 than with Gla‐100 at night [rate ratio 0.66 (95 % CI 0.48–0.92)] and 20 % lower at any time of day [24 h; rate ratio 0.80 (95 % CI 0.65–0.98)]; this difference was most pronounced during the first 8 weeks of treatment. Severe hypoglycaemia was infrequent. The basal insulin dose increased in both groups (month 6 dose: Gla‐300 0.35 U/kg/day, Gla‐100 0.29 U/kg/day). A between‐treatment difference in body weight change over 6 months favouring Gla‐300 was observed [LS mean difference −0.6 kg (95 % CI −1.1 to −0.0); p = 0.035]. Adverse event rates were comparable between the groups. Conclusions In Japanese adults with type 1 diabetes using basal plus mealtime insulin, less hypoglycaemia was observed with Gla‐300 than with Gla‐100, particularly during the night, while glycaemic control did not differ. PMID:26662964

New insulin glargine 300 U/ml versus glargine 100 U/ml in Japanese adults with type 1 diabetes using basal and mealtime insulin: glucose control and hypoglycaemia in a randomized controlled trial (EDITION JP 1).

PubMed

Matsuhisa, M; Koyama, M; Cheng, X; Takahashi, Y; Riddle, M C; Bolli, G B; Hirose, T

2016-04-01

To compare efficacy and safety of new insulin glargine 300 U/ml (Gla-300) with that of insulin glargine 100 U/ml (Gla-100) in Japanese adults with type 1 diabetes. The EDITION JP 1 study (NCT01689129) was a 6-month, multicentre, open-label, phase III study. Participants (n = 243) were randomized to Gla-300 or Gla-100 while continuing mealtime insulin. Basal insulin was titrated with the aim of achieving a fasting self-monitored plasma glucose target of 4.4-7.2 mmol/l. The primary endpoint was change in glycated haemoglobin (HbA1c) over 6 months. Safety measures included hypoglycaemia and change in body weight. Gla-300 was non-inferior to Gla-100 for the primary endpoint of HbA1c change over the 6-month period {least squares [LS] mean difference 0.13 % [95 % confidence interval (CI) -0.03 to 0.29]}. The annualized rate of confirmed (≤3.9 mmol/l) or severe hypoglycaemic events was 34 % lower with Gla-300 than with Gla-100 at night [rate ratio 0.66 (95 % CI 0.48-0.92)] and 20 % lower at any time of day [24 h; rate ratio 0.80 (95 % CI 0.65-0.98)]; this difference was most pronounced during the first 8 weeks of treatment. Severe hypoglycaemia was infrequent. The basal insulin dose increased in both groups (month 6 dose: Gla-300 0.35 U/kg/day, Gla-100 0.29 U/kg/day). A between-treatment difference in body weight change over 6 months favouring Gla-300 was observed [LS mean difference -0.6 kg (95 % CI -1.1 to -0.0); p = 0.035]. Adverse event rates were comparable between the groups. In Japanese adults with type 1 diabetes using basal plus mealtime insulin, less hypoglycaemia was observed with Gla-300 than with Gla-100, particularly during the night, while glycaemic control did not differ. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Development of the General Parenting Observational Scale to assess parenting during family meals.

PubMed

Rhee, Kyung E; Dickstein, Susan; Jelalian, Elissa; Boutelle, Kerri; Seifer, Ronald; Wing, Rena

2015-04-10

There is growing interest in the relationship between general parenting and childhood obesity. However, assessing general parenting via surveys can be difficult due to issues with self-report and differences in the underlying constructs being measured. As a result, different aspects of parenting have been associated with obesity risk. We developed a more objective tool to assess general parenting by using observational methods during a mealtime interaction. The General Parenting Observational Scale (GPOS) was based on prior work of Baumrind, Maccoby and Martin, Barber, and Slater and Power. Ten dimensions of parenting were included; 4 were classified in the emotional dimension of parenting (warmth and affection, support and sensitivity, negative affect, detachment), and 6 were classified in the behavioral dimension of parenting (firm discipline and structure, demands for maturity, psychological control, physical control, permissiveness, neglect). Overweight children age 8-12 years old and their parent (n = 44 dyads) entering a weight control program were videotaped eating a family meal. Parents were coded for their general parenting behaviors. The Mealtime Family Interaction Coding System (MICS) and several self-report measures of general parenting were also used to assess the parent-child interaction. Spearman's correlations were used to assess correlation between measures. The emotional dimensions of warmth/affection and support/sensitivity, and the behavioral dimension of firm discipline/structure were robustly captured during the family meals. Warmth/affection and support/sensitivity were significantly correlated with affect management, interpersonal involvement, and communication from the MICS. Firm discipline/structure was inversely correlated with affect management, behavior control, and task accomplishment. Parents who were older, with higher educational status, and lower BMIs were more likely to display warmth/affection and support/sensitivity. Several general parenting dimensions from the GPOS were highly correlated with similar family functioning constructs from the MICS. This new observational tool appears to be a valid means of assessing general parenting behaviors during mealtimes and adds to our ability to measure parent-level factors affecting child weight-related outcomes. Future evaluation of this tool in a broader range of the population and other family settings should be conducted.

Pediatric parenting stress and its relation to depressive symptoms and fear of hypoglycemia in parents of young children with type 1 diabetes mellitus.

PubMed

Patton, Susana R; Dolan, Lawrence M; Smith, Laura B; Thomas, Inas H; Powers, Scott W

2011-12-01

Parents of young children with type 1 diabetes (T1DM) maintain full responsibility for their child's daily diabetes self-care and thus may be vulnerable to experiencing parenting stress. This study examined several psychological correlates of pediatric parenting stress in parents of young children with T1DM. Parents of 39 young children with T1DM (ages 2-7 years) completed measures of pediatric parenting stress, mealtime behavior problems, depressive symptoms, and fear of hypoglycemia. For parents of young children, higher stress frequency and difficulty were associated with higher parental depressive symptoms and fear. Regression analyses identified that 58% of the variance in stress frequency was associated with parental depressive symptoms. For stress difficulty, 68% of the variance was associated with parental depressive symptoms and fear. Pediatric parenting stress is common in parents of young children with T1DM. Stress and the psychological correlates measured in this study are amenable to intervention and should be regularly assessed in parents of young children with T1DM.

Dysphagia in Rett Syndrome: A Descriptive Study.

PubMed

Mezzedimi, Chiara; Livi, Walter; De Felice, Claudio; Cocca, Serena

2017-09-01

Rett syndrome (RS) is a neurodevelopmental disorder and the second major cause of mental retardation in females. The aim of this study was to evaluate swallowing problems of RS patients by endoscopic assessment and compile a list of suggestions for managing feeding and preventing complications. The sample consisted of 61 female patients (mean age = 13.6 years, range, 2-33 years) admitted to the Department of Neuropsychiatry, where they had previously been diagnosed with RS. Speech evaluation associated with observation during mealtimes was useful to formulate suggestions for caregivers. Progressive deterioration of feeding was commonly noted by caregivers. Fifty-four patients had a history of recurrent episodes of bronchitis. Oral apraxia, dyskinetic tongue movements, prolonged oral stage, and poor bolus formation were the most common findings in all patients. Dysphagia was primarily limited to oral preparatory phases, while the pharyngeal phase was normal in most patients. The high percentage of dysphagia suggests the need to accurately monitor the feeding capability of RS children. It is critical to correctly inform caregivers about safe swallowing procedures to reduce the incidence of fatal complications.

Food as Touch/Touching the Food: The Body In-Place and Out-of-Place in Preschool

ERIC Educational Resources Information Center

Rossholt, Nina

2012-01-01

The article explores the need to eat as a biological and social practice among children in a preschool in Norway. The children in this preschool are aged from one to two years of age, and some of them have just started there. Different events from mealtimes relate to Derrida's concept of touch and Grosz's notion of bodies in-place and…

Continuous measurements at the urban roadside in an Asian megacity by Aerosol Chemical Speciation Monitor (ACSM): particulate matter characteristics during fall and winter seasons in Hong Kong

NASA Astrophysics Data System (ADS)

Sun, C.; Lee, B. P.; Huang, D.; Jie Li, Y.; Schurman, M. I.; Louie, P. K. K.; Luk, C.; Chan, C. K.

2016-02-01

Non-refractory submicron aerosol is characterized using an Aerosol Chemical Speciation Monitor (ACSM) in the fall and winter seasons of 2013 on the roadside in an Asian megacity environment in Hong Kong. Organic aerosol (OA), characterized by application of Positive Matrix Factorization (PMF), and sulfate are found to be dominant. Traffic-related organic aerosol shows good correlation with other vehicle-related species, and cooking aerosol displays clear mealtime concentration maxima and association with surface winds from restaurant areas. Contributions of individual species and OA factors to high NR-PM1 are analyzed for hourly data and daily data; while cooking emissions in OA contribute to high hourly concentrations, particularly during mealtimes, secondary organic aerosol components are responsible for episodic events and high day-to-day PM concentrations. Clean periods are either associated with precipitation, which reduces secondary OA with a lesser impact on primary organics, or clean oceanic air masses with reduced long-range transport and better dilution of local pollution. Haze events are connected with increases in contribution of secondary organic aerosol, from 30 to 50 % among total non-refractory organics, and the influence of continental air masses.

Socio-economic differences in predictors of frequent dairy food consumption among Australian adolescents: a longitudinal study.

PubMed

Stephens, Lena D; McNaughton, Sarah A; Crawford, David; Ball, Kylie

2015-12-01

Sufficient dairy food consumption during adolescence is necessary for preventing disease. While socio-economically disadvantaged adolescents tend to consume few dairy foods, some eat quantities more in line with dietary recommendations despite socio-economic challenges. Socio-economic variations in factors supportive of adolescents' frequent dairy consumption remain unexplored. The present study aimed to identify cross-sectional and longitudinal associations between intrapersonal, social and environmental factors and adolescents' frequent dairy consumption at baseline and two years later across socio-economic strata, and to examine whether socio-economic position moderated observed effects. Online surveys completed at baseline (2004-2005) and follow-up (2006-2007) included a thirty-eight-item FFQ and questions based on social ecological models examining intrapersonal, social and environmental dietary influences. Thirty-seven secondary schools in Victoria, Australia. Australian adolescents (n 1201) aged 12-15 years, drawn from a sub-sample of 3264 adolescents (response rate=33%). While frequent breakfast consumption was cross-sectionally associated with frequent dairy consumption among all adolescents, additional associated factors differed by socio-economic position. Baseline dairy consumption longitudinally predicted consumption at follow-up. No further factors predicted frequent consumption among disadvantaged adolescents, while four additional factors were predictive among advantaged adolescents. Socio-economic position moderated two predictors; infrequently eating dinner alone and never purchasing from school vending machines predicted frequent consumption among advantaged adolescents. Nutrition promotion initiatives aimed at improving adolescents' dairy consumption should employ multifactorial approaches informed by social ecological models and address socio-economic differences in influences on eating behaviours; e.g., selected intrapersonal factors among all adolescents and social factors (e.g., mealtime rules) among advantaged adolescents.

Predicting successful introduction of novel fruit to preschool children.

PubMed

Blissett, Jacqueline; Bennett, Carmel; Donohoe, Jessica; Rogers, Samantha; Higgs, Suzanne

2012-12-01

Few children eat sufficient fruits and vegetables despite their established health benefits. The feeding practices used by parents when introducing novel foods to their children, and their efficacy, require further investigation. We aimed to establish which feeding strategies parents commonly use when introducing a novel fruit to their preschool-aged children and assess the effectiveness of these feeding strategies on children's willingness to try a novel fruit. Correlational design. Twenty-five parents and their children aged 2 to 4 years attended our laboratory and consumed a standardized lunch, including a novel fruit. Interactions between parent and child were recorded and coded. Pearson's correlations and multiple linear regression analyses. The frequency with which children swallowed and enjoyed the novel fruit, and the frequency of taste exposures to the novel fruit during the meal, were positively correlated with parental use of physical prompting and rewarding/bargaining. Earlier introduction of solids was related to higher frequency of child acceptance behaviors. The child's age at introduction of solids and the number of physical prompts displayed by parents significantly predicted the frequency of swallowing and enjoying the novel fruit. Age of introduction to solids and parental use of rewards/bargaining significantly predicted the frequency of taste exposures. Prompting a child to eat and using rewards or bargains during a positive mealtime interaction can help to overcome barriers to novel fruit consumption. Early introduction of solids is also associated with greater willingness to consume a novel fruit. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Middle School Cafeteria Food Choice and Waste Prior to Implementation of Healthy, Hunger-Free Kids Act Changes in the National School Lunch Program

ERIC Educational Resources Information Center

Connors, Priscilla; Bednar, Carolyn

2015-01-01

Purpose/Objectives: The study objective was to document choices of entrées, vegetables, fruits, grains/breads, and beverages on lunch trays and to determine the amount of each that was discarded after mealtime. Methods: A convenience sample of two urban middle school cafeterias in Texas participated in the study which took place in the 2010-2011…

Australian children's consumption of caffeinated, formulated beverages: a cross-sectional analysis.

PubMed

Beckford, Kelsey; Grimes, Carley A; Riddell, Lynn J

2015-01-31

Caffeine is a common additive in formulated beverages, including sugar-sweetened beverages. Currently there are no data on the consumption of caffeinated formulated beverages in Australian children and adolescents. This study aimed to determine total intake and consumption patterns of CFBs in a nationally representative sample of Australian children aged 2-16 years and to determine contribution of CFBs to total caffeine intake. Consumption by day type, mealtime and location was also examined. Dietary data from one 24-hour recall collected in the 2007 Australian National Children's Nutrition and Physical Activity Survey were analysed. CFBs were defined as beverages to which caffeine has been added as an additive, including cola-type beverages and energy drinks. Socioeconomic status was based on the highest level of education attained by the participant's primary caregiver. Time of day of consumption was classified based on traditional mealtimes and type of day of consumption as either a school or non-school day. Location of consumption was defined by the participant during the survey. On the day of the survey 15% (n = 642) of participants consumed CFBs. Older children and those of low socioeconomic background were more likely to consume CFBs (both P < 0.001). Amongst the 642 consumers mean (95% CI) intakes were 151 (115-187)g/day, 287 (252-321)g/day, 442 (400-484)g/day, and 555 (507-602)g/day for 2-3, 4-8, 9-13 and 14-16 year olds respectively. Consumers of CFBs had higher intakes of caffeine (mean (95% CI) 61 (55-67)mg vs. 11 (10-12)mg) and energy (mean (95% CI) 9,612 (9,247-9978)kJ vs. 8,186 (8,040-8,335)kJ) than non-consumers (both P < 0.001). CFBs contributed 69% of total daily caffeine intake. CFB intake was higher on non-school days compared with school days (P < 0.005) and consumption occurred predominantly at the place of residence (56%), within the "dinner" time bracket (17:00-20:30, 44%). The consumption of CFBs by all age groups within Australian children is of concern. Modifications to the permissibility of caffeine as a food additive may be an appropriate strategy to reduce the intake of caffeine in this age group. Additional areas for intervention include targeting parental influences over mealtime beverage choices.

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

PubMed

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

2017-01-13

Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study. A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined. This rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake. ClinicalTrials.gov ID: NCT02800291 , retrospectively registered June 7, 2016.

Getting the Picture | Poster

Cancer.gov

By Ken Michaels, Guest Writer Recently, I attended the annual meeting of the BioCommunications Association in Asilomar, Calif. Not surprisingly, the speakers, all professional communicators, were very good and spoke knowledgeably on their various topics. But something else impressed me during the informal times between presentations, and at mealtimes. These folks not only tended to speak well, but they also tended to listen well. And there’s a very strong case to be made for the importance of listening in effective communication.

[The "wine bar", or a different way of caring].

PubMed

Guastella, Virginie; Raynaud, Nathalie

2016-04-01

The "wine bar" in the palliative care unit of Clermont-Ferrand general hospital is an example of a different way of providing care. It defends the right of patients at the end of life to treat themselves and others. Acknowledging that life is present right up until the end, patients are invited to drink wine at mealtimes and caregivers are encouraged to learn the basics of oenology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

PubMed

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

2015-02-01

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

A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy.

PubMed

Kantarcigil, Cagla; Sheppard, Justine Joan; Gordon, Andrew M; Friel, Kathleen M; Malandraki, Georgia A

2016-08-01

Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW=0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW=0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW=1); interrater agreement was substantial (85%; KW=0.76). Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Creating potential for common ground and communication between early childhood program staff and parents about young children's eating.

PubMed

Johnson, Susan L; Ramsay, Samantha; Shultz, Jill Armstrong; Branen, Laurel J; Fletcher, Janice W

2013-01-01

To explore child care staff and parent perspectives and communications about children's eating in child care. Focus groups (FGs) conducted with child care staff and parents. Four Western states in the United States. Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs. Thoughts and concerns about children's eating and opportunities to improve communication between staff and parents. Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes. Three meta-themes were identified: (1) recognition of positive influences of the child care setting in children's development of healthy eating; (2) concerns about children's eating in child care and at home; and (3) strategies to improve communications and transactions related to children's eating. Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their child's eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Head and neck cancer patients' perceptions of swallowing following chemoradiotherapy.

PubMed

Patterson, Joanne M; McColl, Elaine; Wilson, Janet; Carding, Paul; Rapley, Tim

2015-12-01

The study aims to describe patients' experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time. A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data. Patients' reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0-3 months) and late (6-18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle. Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.

Facilitating process changes in meal delivery and radiological testing to improve inpatient insulin timing using six sigma method.

PubMed

Yamamoto, J Jay; Malatestinic, Bill; Lehman, Angela; Juneja, Rattan

2010-01-01

The objective of this project was to improve the timing of inpatient insulin administration related to meal delivery and the scheduling of radiology tests by Lean Six Sigma method. A multidisciplinary hospital team and a Six Sigma team from a pharmaceutical manufacturer collaborated to evaluate food delivery and radiology scheduling processes related to the timing of insulin administration. Key factors leading to problems within each system were addressed to improve the efficiency of each process while improving the timeliness of glucose testing and insulin administration. Standardizing the food delivery schedule and utilizing scorecards to track on-time meal deliveries to the floor enabled nursing to more accurately administer insulin in coordination with the delivery of meals. Increasing communication and restricting the scheduling of inpatient procedures during mealtimes reduced disruptions to insulin administration. Data at 6 months postimplementation demonstrated that the institution met goals for most primary outcome metrics including increasing on-time meal delivery and the proportion of patients taking insulin scheduled for radiology tests during appropriate times. By implementing the recommendations identified via Lean Six Sigma, this collaborative effort improved the timing of inpatient insulin administration related to meal delivery and radiology testing.

Parent stress and child behaviour among young children with type 1 diabetes.

PubMed

Hilliard, M E; Monaghan, M; Cogen, F R; Streisand, R

2011-03-01

Parents of young children with type 1 diabetes (T1D) are responsible for executing a complex daily management regimen and are at risk for elevated levels of stress. Normative misbehaviour during the preschool years can complicate T1D management, and interpretation of behavioural concerns may vary because of child health status and parent stress. Within a paediatric transactional model framework, child characteristics (e.g. behaviour problems, metabolic control) and parent functioning (e.g. parenting stress, anxiety) likely impact one another. Parents of 2- to 6-year-old children with T1D completed self-report measures, including the Pediatric Inventory for Parents (PIP), State-Trait Anxiety Inventory (STAI), Eyberg Child Behavior Inventory (ECBI), and 24-h Recall Interviews. Medical data were obtained by parent report and medical record review. It was hypothesized that greater parent stress and child blood glucose variability would be significantly associated with greater parent-reported child behaviour concerns. Moderate levels of parent stress and child behaviour problems were endorsed; however, parents perceived children's misbehaviour as problematic, particularly with relation to tasks relevant to diabetes management (e.g. bedtimes and mealtimes). Structural equation modelling indicated that greater general anxiety and paediatric parenting stress was associated with parent report of more problematic child behaviour. Blood glucose variability did not significantly contribute to this relationship. The stress experienced by parents of young children with chronic illness appears to relate to their perception of their children's behaviour problems. Parents' experiences with developmentally normative misbehaviour may interfere with disease management and exacerbate parents' stress and the subsequent impact on well-being. Implications for supporting parents and children with T1D are discussed. © 2010 Blackwell Publishing Ltd.

Clinical differences in children with autism spectrum disorder with and without food selectivity.

PubMed

Postorino, Valentina; Sanges, Veronica; Giovagnoli, Giulia; Fatta, Laura Maria; De Peppo, Lavinia; Armando, Marco; Vicari, Stefano; Mazzone, Luigi

2015-09-01

Several studies have described the atypical eating behaviors frequently occurring in children with Autism Spectrum Disorder (ASD), and food selectivity is the most frequent of these problems. The everyday management of mealtime behaviors among children with ASD can have a negative impact on family routines and become a significant stressor for families. However, much remains unknown about why food selectivity is so prevalent among individuals with ASD. The objective of this study was to investigate clinical and behavioral features in individuals with ASD with the aim of identifying distinctive clinical profiles in children with and without food selectivity. A total of 158 children with ASD were enrolled in this study: 79 participants with food selectivity (FS) were age and sex matched with 79 participants without food selectivity (No FS). All participants and their parents completed a battery of psychological tests for a comprehensive evaluation of ASD symptoms, cognitive abilities, adaptive skills, behavioral problems and parental stress level. No statistically significant difference on gastrointestinal symptoms and growth adequacy was found between the FS group and the No FS group. Overall, the FS group showed significantly higher rates of ASD symptoms as compared to the No FS group in the questionnaires completed by parents. Furthermore, parents of the FS group reported significantly higher levels of parental stress and a larger degree of their children's behavioral problems as compared to the No FS group. Finally, there were no differences between the FS and the No FS group on any adaptive skill domain. Our findings suggest that the identification of distinctive clinical and behavioral patterns in children with ASD and food selectivity is a crucial issue for parents and therapists in the daily management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dopaminergic Regulation of Circadian Food Anticipatory Activity Rhythms in the Rat

PubMed Central

Smit, Andrea N.; Patton, Danica F.; Michalik, Mateusz; Opiol, Hanna; Mistlberger, Ralph E.

2013-01-01

Circadian activity rhythms are jointly controlled by a master pacemaker in the hypothalamic suprachiasmatic nuclei (SCN) and by food-entrainable circadian oscillators (FEOs) located elsewhere. The SCN mediates synchrony to daily light-dark cycles, whereas FEOs generate activity rhythms synchronized with regular daily mealtimes. The location of FEOs generating food anticipation rhythms, and the pathways that entrain these FEOs, remain to be clarified. To gain insight into entrainment pathways, we developed a protocol for measuring phase shifts of anticipatory activity rhythms in response to pharmacological probes. We used this protocol to examine a role for dopamine signaling in the timing of circadian food anticipation. To generate a stable food anticipation rhythm, rats were fed 3h/day beginning 6-h after lights-on or in constant light for at least 3 weeks. Rats then received the D2 agonist quinpirole (1 mg/kg IP) alone or after pretreatment with the dopamine synthesis inhibitor α-methylparatyrosine (AMPT). By comparison with vehicle injections, quinpirole administered 1-h before lights-off (19h before mealtime) induced a phase delay of activity onset prior to the next meal. Delay shifts were larger in rats pretreated with AMPT, and smaller following quinpirole administered 4-h after lights-on. A significant shift was not observed in response to the D1 agonist SKF81297. These results provide evidence that signaling at D2 receptors is involved in phase control of FEOs responsible for circadian food anticipatory rhythms in rats. PMID:24312417

A Qualitative Application of the Belsky Model to Explore Early Care and Education Teachers' Mealtime History, Beliefs, and Interactions.

PubMed

Swindle, Taren M; Patterson, Zachary; Boden, Carrie J

Studies on factors associated with nutrition practices in early care and education settings often focus on sociodemographic and programmatic characteristics. This qualitative study adapted and applied Belsky's determinants of parenting model to inform a broader exploration of Early Care and Education Teachers (ECETs) practices. Qualitative cross-sectional study with ECETs. The researchers interviewed ECETs in their communities across a Southern state. Purposive sampling was employed to recruit ECETs (n = 28) from Head Start or state-funded centers serving low-income families. Developmental histories of ECETs regarding food and nutrition, beliefs about child nutrition, and teaching interactions related to food. Qualitative interviews were coded using a deductive content analysis approach. Three distinct interrelationships were observed across the themes. First, rules and routines regarding food and mealtime in the educators' childhood often aligned with educator beliefs and behaviors at meals in their classroom. Second, some ECETs described motivations to leave a healthy food legacy for children in their class. Finally, an experience of food insecurity appeared in narratives that also emphasized making sure children got enough through various strategies. The influence of ECET developmental histories and their related beliefs can be addressed through professional development and ongoing support. Future study should quantify model constructs in a larger sample and study their relationships over time. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Social mixing in Fiji: Who-eats-with-whom contact patterns and the implications of age and ethnic heterogeneity for disease dynamics in the Pacific Islands.

PubMed

Watson, Conall H; Coriakula, Jeremaia; Ngoc, Dung Tran Thi; Flasche, Stefan; Kucharski, Adam J; Lau, Colleen L; Thieu, Nga Tran Vu; le Polain de Waroux, Olivier; Rawalai, Kitione; Van, Tan Trinh; Taufa, Mere; Baker, Stephen; Nilles, Eric J; Kama, Mike; Edmunds, W John

2017-01-01

Empirical data on contact patterns can inform dynamic models of infectious disease transmission. Such information has not been widely reported from Pacific islands, nor strongly multi-ethnic settings, and few attempts have been made to quantify contact patterns relevant for the spread of gastrointestinal infections. As part of enteric fever investigations, we conducted a cross-sectional survey of the general public in Fiji, finding that within the 9,650 mealtime contacts reported by 1,814 participants, there was strong like-with-like mixing by age and ethnicity, with higher contact rates amongst iTaukei than non-iTaukei Fijians. Extra-domiciliary lunchtime contacts follow these mixing patterns, indicating the overall data do not simply reflect household structures. Inter-ethnic mixing was most common amongst school-age children. Serological responses indicative of recent Salmonella Typhi infection were found to be associated, after adjusting for age, with increased contact rates between meal-sharing iTaukei, with no association observed for other contact groups. Animal ownership and travel within the geographical division were common. These are novel data that identify ethnicity as an important social mixing variable, and use retrospective mealtime contacts as a socially acceptable metric of relevance to enteric, contact and respiratory diseases that can be collected in a single visit to participants. Application of these data to other island settings will enable communicable disease models to incorporate locally relevant mixing patterns in parameterisation.

Social mixing in Fiji: Who-eats-with-whom contact patterns and the implications of age and ethnic heterogeneity for disease dynamics in the Pacific Islands

PubMed Central

Coriakula, Jeremaia; Ngoc, Dung Tran Thi; Flasche, Stefan; Kucharski, Adam J.; Lau, Colleen L.; Thieu, Nga Tran Vu; le Polain de Waroux, Olivier; Rawalai, Kitione; Van, Tan Trinh; Taufa, Mere; Baker, Stephen; Nilles, Eric J.; Kama, Mike; Edmunds, W. John

2017-01-01

Empirical data on contact patterns can inform dynamic models of infectious disease transmission. Such information has not been widely reported from Pacific islands, nor strongly multi-ethnic settings, and few attempts have been made to quantify contact patterns relevant for the spread of gastrointestinal infections. As part of enteric fever investigations, we conducted a cross-sectional survey of the general public in Fiji, finding that within the 9,650 mealtime contacts reported by 1,814 participants, there was strong like-with-like mixing by age and ethnicity, with higher contact rates amongst iTaukei than non-iTaukei Fijians. Extra-domiciliary lunchtime contacts follow these mixing patterns, indicating the overall data do not simply reflect household structures. Inter-ethnic mixing was most common amongst school-age children. Serological responses indicative of recent Salmonella Typhi infection were found to be associated, after adjusting for age, with increased contact rates between meal-sharing iTaukei, with no association observed for other contact groups. Animal ownership and travel within the geographical division were common. These are novel data that identify ethnicity as an important social mixing variable, and use retrospective mealtime contacts as a socially acceptable metric of relevance to enteric, contact and respiratory diseases that can be collected in a single visit to participants. Application of these data to other island settings will enable communicable disease models to incorporate locally relevant mixing patterns in parameterisation. PMID:29211731

Getting back on tap: the policy context and cost of ensuring access to low-cost drinking water in Massachusetts schools.

PubMed

Cradock, Angie L; Wilking, Cara L; Olliges, Sarah A; Gortmaker, Steven L

2012-09-01

Adequate water intake may have important health benefits for schoolchildren. Layers of federal, state, and local policy are relevant to provision of water within schools. Recently passed state and federal laws require free drinking-water access for students during mealtimes. To review Massachusetts local district wellness policies related to water access, provide estimates of costs for three water-provision strategies, and discuss implications for policy relevant to adequate drinking-water access. Legal research was conducted using the LexisNexis legal database and government websites. Local wellness policies were double-coded using existing research tools. Costs of three water-delivery options were estimated using a 10-year school-district perspective. Prior to 2010, most Massachusetts public school district wellness policies (92%-94%) did not address access to free drinking water. Ten-year costs per school for providing water during mealtimes to students, including dispenser unit, installation, water testing, water, cups, and labor, range between $12,544 and $27,922 (depending on water-delivery option) assuming the average Massachusetts school enrollment. Water-provision strategies relying on tap water are more economical than bottled water in the long term. Policy recommendations and cost considerations deserve attention at the local, state, and federal levels. Recommendations are discussed to ensure access to safe, free drinking water for all students. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Usual meal times in relation to age, sex, work activity and morningness-eveningness.

PubMed

Costa, G; Lievore, F; Ferrari, P; Gaffuri, E

1987-01-01

Meal-timing is considered an important socio-environmental synchronizer of circadian rhythms and influences human metabolism; the temporal distribution of food intake has also an influence on human performance. In these last years, in industrialized countries, remarkable changes, both in quality and quantity and in timing, have been determined in eating behavior brought about by changes in social and working organization. In this study the authors have verified the usual mealtimes during working and free-days in a population of 670 city-dwellers, 404 men and 266 women, aged between 17 and 60, including students, housewives, clerks, artisans, tradesmen and industrial workers. The results can be summarized as follows: a. the times of the two main meals show a high stability, both in working and in free-days, at about 1230 for lunch and 1915 for dinner, with a higher variability for the dinner-time; b. there are no relevant differences between men and women; c. there is a progressive advance of the breakfast-time (together with sleeping and waking times) with oncoming age; d. industrial workers advance the breakfast-time, on work days, compared to housewives, clerks, artisans and tradesmen, while the latter delay dinner-time as compared to the others; e. shiftwork breaks up the usual timetables interfering with at least one of the main meals, according to the different shifts (morning, afternoon, night); f. morning types anticipate meal and sleeping times in comparison to evening types, both while working and, above all, on free-days.

The effects of Young Adults Eating and Active for Health (YEAH): a theory-based Web-delivered intervention.

PubMed

Kattelmann, Kendra K; Bredbenner, Carol Byrd; White, Adrienne A; Greene, Geoffrey W; Hoerr, Sharon L; Kidd, Tandalayo; Colby, Sarah; Horacek, Tanya M; Phillips, Beatrice W; Koenings, Mallory M; Brown, Onikia N; Olfert, Melissa D; Shelnutt, Karla P; Morrell, Jesse Stabile

2014-01-01

To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process. A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail. Thirteen college campuses. A total of 1,639 college students. Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content. All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline. Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes. There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI (P = .001), vigorous PA in females (P = .05), fat intake (P = .002), self-instruction (P = .001), and regulation (P = .004) for mealtime behavior, and hours of sleep (P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action/maintenance stages for FVI (P = .019) and PA (P = .002) than control. Young Adults Eating and Active for Health is one of the first studies to use the community-based participatory research process of PRECEDE-PROCEED to develop a non-diet approach intervention. Although there were no differences between experimental and control participants in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain, such as increasing FVI and more healthful self-regulation mealtime behaviors immediately postintervention. Additional strategies to maintain the behavior changes need to be explored. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Association of Eating Performance and Environmental Stimulation among Older Adults with Dementia in Nursing Homes: A Secondary Analysis

PubMed Central

Liu, Wen; Jao, Ying-Ling; Williams, Kristine

2017-01-01

Background Nursing home residents with dementia experience increased risk for compromised eating performance due to intrapersonal, interpersonal, and environmental factors. Environmental stimulation is physical, social, and/or sensory stimulation present in the environment that can potentially trigger individuals’ emotion or motivate physical reactions. Beyond the personal factors, there is a lack of evidence on how environmental stimulation influences individuals’ eating performance at mealtimes. Objectives This study examined the association between environmental stimulation and eating performance among nursing home residents with dementia. Design This study was a secondary analysis using baseline videos selected from a communication intervention study, where videos were recorded to capture staff-resident interactions during care activities for nursing home residents with dementia. Videos were included in this study only if residents demonstrated eating activities at mealtimes. Sample and Setting A total of 36 videos were selected (mean length = 4 minutes). The sample included 15 residents with dementia (mean age = 86), and 19 certified nursing assistants (mean age = 36) in 8 nursing homes. Methods The dependent variable was eating performance as measured by the Level of Eating Independence scale (range: 15–36, with higher scores indicating better eating performance). The independent variables were characteristics of environmental stimulation measured by the Person-Environment Apathy Rating-Environment subscale (stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback). Each characteristic was rated on a 1–4 scale with higher scores indicating more desirable environmental stimulation. Multilevel models were used to examine the association between eating performance and environmental stimulation, adjusting for resident characteristics (i.e., age, gender, dementia stage, function, comorbidity, psychoactive medication use) and nesting effects of residents and staff. Results Resident participants demonstrated moderate levels of eating performance (M=27.08, SD = 5.16). Eating performance was significantly lower among older residents, those with more advanced dementia, and higher comorbidity. After controlling for resident characteristics, eating performance was significantly associated with stimulation specificity (how the stimulation is delivered and tailored to the resident), and was not associated with other environmental stimulation characteristics. For each 1 point increase in stimulation specificity, eating performance increased by 8.78 points (95% CI=.59, 16.97). Conclusions Environmental stimulation that is personally tailored to a resident’ needs and preferences and directly offered to a resident contributed to better eating performance among residents with dementia. The findings will direct future development and implementation of person-directed mealtime care programs and dining environment arrangements for residents with dementia in nursing homes. PMID:28340390

One-year sustained glycaemic control and less hypoglycaemia with new insulin glargine 300 U/ml compared with 100 U/ml in people with type 2 diabetes using basal plus meal-time insulin: the EDITION 1 12-month randomized trial, including 6-month extension.

PubMed

Riddle, M C; Yki-Järvinen, H; Bolli, G B; Ziemen, M; Muehlen-Bartmer, I; Cissokho, S; Home, P D

2015-09-01

To evaluate the maintenance of efficacy and safety of insulin glargine 300 U/ml (Gla-300) versus glargine 100 U/ml (Gla-100) in people with type 2 diabetes mellitus (T2DM) using basal plus meal-time insulin for 12 months in the EDITION 1 trial. EDITION 1 was a multicentre, randomized, open-label, two-arm, phase IIIa study. Participants completing the initial 6-month treatment period continued to receive Gla-300 or Gla-100, as previously randomized, once daily for a further 6-month open-label extension phase. Changes in glycated haemoglobin (HbA1c) and fasting plasma glucose concentrations, insulin dose, hypoglycaemic events and body weight were assessed. Of 807 participants enrolled in the initial phase, 89% (359/404) assigned to Gla-300 and 88% (355/403) assigned to Gla-100 completed 12 months. Glycaemic control was sustained in both groups (mean HbA1c: Gla-300, 7.24%; Gla-100, 7.42%), with more sustained HbA1c reduction for Gla-300 at 12 months: least squares mean difference Gla-300 vs Gla-100: HbA1c -0.17 [95% confidence interval (CI) -0.30 to -0.05]%. The mean daily basal insulin dose at 12 months was 1.03 U/kg for Gla-300 and 0.90 U/kg for Gla-100. Lower percentages of participants had ≥1 confirmed [≤3.9 mmol/l (≤70 mg/dl)] or severe hypoglycaemic event with Gla-300 than Gla-100 at any time of day [24 h; 86 vs 92%; relative risk 0.94 (95% CI 0.89-0.99)] and during the night [54 vs 65%; relative risk 0.84 (95% CI 0.75-0.94)], while the annualized rates of such hypoglycaemic events were similar. No between-treatment differences in adverse events were apparent. During 12 months of treatment of T2DM requiring basal and meal-time insulin, glycaemic control was better sustained and fewer individuals reported hypoglycaemia with Gla-300 than with Gla-100. The mean basal insulin dose was higher with Gla-300 compared with Gla-100, but total numbers of hypoglycaemic events and overall tolerability did not differ between treatments. © 2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

The association of eating performance and environmental stimulation among older adults with dementia in nursing homes: A secondary analysis.

PubMed

Liu, Wen; Jao, Ying-Ling; Williams, Kristine

2017-06-01

Nursing home residents with dementia experience increased risk for compromised eating performance due to intrapersonal, interpersonal, and environmental factors. Environmental stimulation is physical, social, and/or sensory stimulation present in the environment that can potentially trigger individuals' emotion or motivate physical reactions. Beyond the personal factors, there is a lack of evidence on how environmental stimulation influences individuals' eating performance at mealtimes. This study examined the association between environmental stimulation and eating performance among nursing home residents with dementia. This study was a secondary analysis using baseline videos selected from a communication intervention study, where videos were recorded to capture staff-resident interactions during care activities for nursing home residents with dementia. Videos were included in this study only if residents demonstrated eating activities at mealtimes. A total of 36 videos were selected (mean length=4min). The sample included 15 residents with dementia (mean age=86), and 19 certified nursing assistants (mean age=36) in 8 nursing homes. The dependent variable was eating performance as measured by the Level of Eating Independence scale (range: 15-36, with higher scores indicating better eating performance). The independent variables were characteristics of environmental stimulation measured by the Person-Environment Apathy Rating-Environment subscale (stimulation clarity, stimulation strength, stimulation specificity, interaction involvement, physical accessibility, and environmental feedback). Each characteristic was rated on a 1-4 scale with higher scores indicating more desirable environmental stimulation. Multilevel models were used to examine the association between eating performance and environmental stimulation, adjusting for resident characteristics (i.e., age, gender, dementia stage, function, comorbidity, psychoactive medication use) and nesting effects of residents and staff. Resident participants demonstrated moderate levels of eating performance (M=27.08, SD=5.16). Eating performance was significantly lower among older residents, those with more advanced dementia, and higher comorbidity. After controlling for resident characteristics, eating performance was significantly associated with stimulation specificity (how the stimulation is delivered and tailored to the resident), and was not associated with other environmental stimulation characteristics. For each 1 point increase in stimulation specificity, eating performance increased by 8.78 points (95% CI=0.59, 16.97). Environmental stimulation that is personally tailored to a resident' needs and preferences and directly offered to a resident contributed to better eating performance among residents with dementia. The findings will direct future development and implementation of person-directed mealtime care programs and dining environment arrangements for residents with dementia in nursing homes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study: design and methods.

PubMed

Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Story, Mary; Gurvich, Olga; Kubik, Martha Y; Garwick, Ann; Dudovitz, Bonnie

2014-05-01

Informed and engaged parents and healthful home environments are essential for the health of youth. Although research has shown health benefits associated with family meals, to date, no randomized controlled trial (RCT) has been developed to examine the impact of a family meals intervention on behavioral and health outcomes. The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study is a two-arm (intervention versus attention-only control) RCT being conducted in Minneapolis/St. Paul. Built on previous pilot research, HOME Plus aims to increase the frequency and healthfulness of family meals and snacks and reduce children's sedentary behavior, particularly screen time, to promote healthier eating and activity behaviors and prevent obesity. HOME Plus is delivered to families in community settings. The program includes 10 monthly sessions focused on nutrition and activity education, meal planning and preparation skill development. In addition, five motivational goal-setting phone calls are conducted with parents. The primary outcome measure is age- and gender-adjusted child BMI-z score at post-intervention by treatment group. Secondary household-level outcomes include family meal frequency, home availability of healthful foods (fruits/vegetables) and unhealthful foods (high-fat/sugary snacks) and beverages (sugar-sweetened beverages), and the quality of foods served at meals and snacks. Secondary child outcomes include dietary intake of corresponding foods and beverages and screen time. The HOME Plus RCT actively engages whole families of 8-12 year old children to promote healthier eating and activity behaviors and prevent obesity through promotion of family meals and snacks and limited media use. Copyright © 2014 Elsevier Inc. All rights reserved.

Parental modelling of eating behaviours: observational validation of the Parental Modelling of Eating Behaviours scale (PARM).

PubMed

Palfreyman, Zoe; Haycraft, Emma; Meyer, Caroline

2015-03-01

Parents are important role models for their children's eating behaviours. This study aimed to further validate the recently developed Parental Modelling of Eating Behaviours Scale (PARM) by examining the relationships between maternal self-reports on the PARM with the modelling practices exhibited by these mothers during three family mealtime observations. Relationships between observed maternal modelling and maternal reports of children's eating behaviours were also explored. Seventeen mothers with children aged between 2 and 6 years were video recorded at home on three separate occasions whilst eating a meal with their child. Mothers also completed the PARM, the Children's Eating Behaviour Questionnaire and provided demographic information about themselves and their child. Findings provided validation for all three PARM subscales, which were positively associated with their observed counterparts on the observational coding scheme (PARM-O). The results also indicate that habituation to observations did not change the feeding behaviours displayed by mothers. In addition, observed maternal modelling was significantly related to children's food responsiveness (i.e., their interest in and desire for foods), enjoyment of food, and food fussiness. This study makes three important contributions to the literature. It provides construct validation for the PARM measure and provides further observational support for maternal modelling being related to lower levels of food fussiness and higher levels of food enjoyment in their children. These findings also suggest that maternal feeding behaviours remain consistent across repeated observations of family mealtimes, providing validation for previous research which has used single observations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adult and child use of love, like, don't like and hate during family mealtimes. Subjective category assessments as food preference talk.

PubMed

Wiggins, Sally

2014-09-01

Food preference is now a ubiquitous concept in eating research, and closely associated with actual consumption, particularly in relation to children's food preferences. Research in this area is beginning to reveal the effects of parent-child interaction on eating practices though relatively little attention has been paid to the discursive and lexical processes involved. Food preferences are typically associated with the terms 'likes' and 'dislikes' in food preference research. By contrast, adults and children typically use the terms 'love', 'like', 'don't like' and 'hate' to construct and manage food preferences in everyday meal conversations. A corpus of 270 video- and audio-recorded English and Scottish family mealtimes, involving children aged 1-17 years, was searched and analysed for any and all occurrences of subjective category assessments (SCAs; e.g., 'I like X'), featuring the terms 'love', 'like', 'don't like' and 'hate'. Discursive psychology was used to analyse the transcripts and recordings, and illustrated the disparity between adult and child use of SCAs and food preference talk. Within the data set, parents typically made claims about what their children like, and in doing so claimed epistemic primacy over their children's food preferences. Children, by contrast, typically made claims about their own 'don't likes' and likes, and these were frequently countered by their parents or treated as inappropriate claims. Implications for how parents and researchers might reorient to the food preferences lexicon are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Dietary factors and their relation to appetite in children under two years with mild malnutrition].

PubMed

Quijada, Mariana Martínez; Gutiérrez, María Luisa Alvarez

2012-06-01

Malnutrition is conditioned by a series of factors, among them the dietary factors, which include appetite, eating behaviors and habits. In order to assess these factors, the following objective was pursued: describe the dietary factors and their relation to appetite in children under two years of age with mild malnutrition. A correlational study was conducted. The sample consisted of all children under two years of age (n = 168) diagnosed with primary (mild) malnutrition, who attended consultation at the Centro de Atención Nutricional Infantil Antímano, CANIA, during the period 2000-2008. The results showed intake of energy and macronutrients was lower than the individual requirement; iron intake < 85% of the requirement, in accordance with the Recommended Dietary Allowances (RDA) in over 50% of the sample; weekly consumption of vegetables (57%) and miscellaneous (66%) was inadequate; inadequate intake of formula and whole milk in more than 60%; 9% were exclusively breastfed during the first six months; 64% lacked a regular eating place; in child-caregiver interaction during mealtimes, more than half of the children showed rebellious behavior and caregivers were permissive. Protein adequacy, vegetable and whole milk consumption frequency, preparation type, identification of refusals and preferences, place and duration of meals, and child-caregiver interaction at mealtimes were significantly associated with appetite; if we consider this last one as a guide and we try to modify inadequate eating behaviors and habits, we will generate an impact over the child appetite that could improve the food consumption and prevent malnutrition.

The impact of conventional dietary intake data coding methods on foods typically consumed by low-income African-American and White urban populations.

PubMed

Mason, Marc A; Fanelli Kuczmarski, Marie; Allegro, Deanne; Zonderman, Alan B; Evans, Michele K

2015-08-01

Analysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized. Duplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods. Healthy Aging in Neighborhoods of Diversity across the Life Span study. African-American and White adults with two dietary recalls (n 2177). Differences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls. Use of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet-health relationships.

Exploring child-feeding style in childcare settings: how might nursery practitioners affect child eating style and weight?

PubMed

Elford, L; Brown, A

2014-04-01

Although considerable research has explored the role of parents in affecting child eating habits and weight, there has been little consideration of the impact of other key care providers in the early years. A controlling maternal child-feeding style (e.g. use of pressure to eat or restricting certain foods) has been associated with over consumption, fussy eating and weight issue. Conversely, responsive child-feeding styles whereby children are allowed to regulate their own intake but encouraged to eat a range of foods and try new tastes are associated with healthier eating styles and weight. Increasing numbers of preschool children now spend time in day care settings, many for up to fifty hours a week but interactions with caregivers during mealtimes remain unexplored. The aim of the current study was to begin to explore child-feeding styles of nursery practitioners working with children aged 0-5 years. Sixty three nursery practitioners completed an adapted version of the Child Feeding Questionnaire to examine their interactions with children during mealtimes. Themes included pressure to eat, encouragement to eat and use of reward. Typically practitioners reported responsive child-feeding styles with low levels of pressure to eat but high levels of encouragement to try new foods. Use of reward to eat certain foods or as a bribe to modify behaviour was however more common. The findings have important implications for understanding the role of childcare providers in affecting child eating habits and weight. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Insulin degludec and insulin aspart: novel insulins for the management of diabetes mellitus

PubMed Central

Atkin, Stephen; Javed, Zeeshan; Fulcher, Gregory

2015-01-01

Patients with type 2 diabetes mellitus require insulin as disease progresses to attain or maintain glycaemic targets. Basal insulin is commonly prescribed initially, alone or with one or more rapid-acting prandial insulin doses, to limit mealtime glucose excursions (a basal–bolus regimen). Both patients and physicians must balance the advantages of improved glycaemic control with the risk of hypoglycaemia and increasing regimen complexity. The rapid-acting insulin analogues (insulin aspart, insulin lispro and insulin glulisine) all have similar pharmacokinetic and pharmacodynamic characteristics and clinical efficacy/safety profiles. However, there are important differences in the pharmacokinetic and pharmacodynamic profiles of basal insulins (insulin glargine, insulin detemir and insulin degludec). Insulin degludec is an ultra-long-acting insulin analogue with a flat and stable glucose-lowering profile, a duration of action exceeding 30 h and less inter-patient variation in glucose-lowering effect than insulin glargine. In particular, the chemical properties of insulin degludec have allowed the development of a soluble co-formulation with prandial insulin aspart (insulin degludec/insulin aspart) that provides basal insulin coverage for at least 24 h with additional mealtime insulin for one or two meals depending on dose frequency. Pharmacokinetic and pharmacodynamic studies have shown that the distinct, long basal glucose-lowering action of insulin degludec and the prandial glucose-lowering effect of insulin aspart are maintained in the co-formulation. Evidence from pivotal phase III clinical trials indicates that insulin degludec/insulin aspart translate into sustained glycaemic control with less hypoglycaemia and the potential for a simpler insulin regimen with fewer daily injections. PMID:26568812

Typology of emergent eating patterns in early childhood.

PubMed

Hittner, James B; Faith, Myles S

2011-12-01

The stability of eating patterns from infancy through childhood is largely unknown. This study identified subgroups of children based on emergent eating patterns from ages 1 to 3 years and examined differences between groups in demographic, anthropometric and temperamental variables. We conducted secondary analyses of 262 boys and 225 girls from the Colorado Adoption Project. Three eating styles (Reactivity to Food, Predictable Appetite, Distractibility at Mealtime) and five temperaments were assessed at ages 1 and 3 years. Weight and height (length) were assessed on children and mothers. Correlations examined the stability of eating patterns, cluster analysis identified subgroups of emergent eating styles, and analysis of variance identified variables differentiating the derived subgroups. Eating styles were moderately stable over time, although all increased on average. Four subgroups were identified: Diet Expanding and Preference Establishing Eaters (37%), Emerging Reactive Tendency Eaters (23%), Emerging Food-Indifferent and Non-Fussy Eaters (31%), and Emerging High-Reactive and Fussy Eaters (9%). The subgroups differed in year 1 Wt/L and Reaction to Food, and year 1-to-3 changes in Emotionality and Reaction to Food. Four emergent eating patterns were identified. How these subgroups of children differ in later weight and health trajectories warrants research. Copyright © 2011 Elsevier Ltd. All rights reserved.

Thornton and Sacco eating; Sacco typing on PGSC

NASA Image and Video Library

1995-11-05

STS073-356-024 (20 October - 5 November 1995) --- Payload specialist Albert Sacco Jr. joins astronaut Kathryn C. Thornton, payload commander, for mealtime on the middeck of the Earth-orbiting Space Shuttle Columbia. Thornton is about to open a packet of strawberries, while a can of vanilla pudding floats before her. Sacco is about to grab a spoonful of rice pilaf while holding a peanut butter and jelly sandwich on a tortilla. The two were joined by five other crewmembers in support of 16-days' in-space research in support of the United States Microgravity Laboratory (USML-2) mission.

The world in a box? Food security, edible insects, and "One World, One Health" collaboration.

PubMed

Yates-Doerr, Emily

2015-03-01

Scientists in the Netherlands are cultivating edible insects to address concerns of international food security. Committed to the One World, One Health (OWOH) movement, their research aims to create a safe and effective global solution to the conjoined problems of climate change and an increasing worldwide demand for protein. Their preliminary work is promising, as it suggests that when compared to other sources of meat, insects can be an efficient, safe, and low-impact source of nutrients. Additionally, in many sites with endemic malnutrition, people find insects tasty. The problem these scientists are grappling with, however, is that insects that are easily mass-produced are not the insects people typically want to eat. This paper shows how the contingency of edibility complicates existing scientific models of travel that posit that singular objects spread peripherally outwards from a center into a globally connected, singular world. The scientists are finding that the production of successful food products necessitates that insects be constantly tinkered with: there is no "insect" that can be globally edible since "the global" itself is not a singular entity. This in turn complicates the vision of replicability and "scaling up" inherent in an OWOH vision of science. The researchers' process of moving their goods from the laboratory boxes they work with into the mealtime practices they seek to impact is compelling them to cultivate and articulate new ideals for research, methods of translation, and pathways by which goods can travel. They are finding that if they want to affect the health of "the world," they must engage with many different worlds. Copyright © 2014 Elsevier Ltd. All rights reserved.

Application of the multiphase optimization strategy to a pilot study: an empirical example targeting obesity among children of low-income mothers.

PubMed

Kugler, Kari C; Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

2016-11-22

Emerging approaches to building more efficient and effective behavioral interventions are becoming more widely available. The current paper provides an empirical example of the use of the engineering-inspired multiphase optimization strategy (MOST) to build a remotely delivered responsive parenting intervention to prevent obesity among children of low-income mothers with and without depressive symptoms. Participants were 107 mothers with (n = 45) and without (n = 62) depressive symptoms who had a child aged 12 to 42 months participating in the Women, Infants and Children program. Participants were randomized to one of sixteen experimental conditions using a factorial design that included a combination of the following eight remotely delivered intervention components: responsive feeding curriculum (given to all participants), parenting curriculum, portion size guidance, obesogenic risk assessment, personalized feedback on mealtime routines, feeding curriculum counseling, goal setting, mobile messaging, and social support. This design enabled efficient identification of components with low feasibility and acceptability. Completion rates were high (85%) and did not statistically differ by depressive symptoms. However, mothers with depressive symptoms who received obesogenic risk assessment and personalized feedback on mealtime routines components had lower completion rates than mothers without depressive symptoms. All intervention components were feasible to implement except the social support component. Regardless of experimental condition, most participants reported that the program increased their awareness of what, when, and how to feed their children. MOST provided an efficient way to assess the feasibility of components prior to testing them with a fully powered experiment. This framework helped identify potentially challenging combinations of remotely delivered intervention components. Consideration of how these results can inform future studies focused on the optimization phase of MOST is discussed.

Older people's involvement in activities related to meals in nursing homes.

PubMed

Grøndahl, Vigdis Abrahamsen; Aagaard, Heidi

2016-09-01

To explore how residents in nursing homes perceive their participation in activities related to food and meals, and possible factors influencing their involvement. Eating and drinking are fundamental human needs and consequently essential parts of nursing and nursing care. Therefore and as part of nursing care, encouraging older people in nursing homes to engage in different mealtime activities could be one way to increase participation in activities of daily living and more optimal nutrition status among older people. A cross-sectional survey design was used. A total of 204 residents (88%) in one Norwegian county agreed to participate and completed a face-to-face interview questionnaire about food and meal experiences. Descriptive and comparative statistics was used. Close to 30% of the residents were vulnerable to malnourishment. None of the residents were involved in menu planning, and more than 90% did not participate in food preparation or setting/clearing tables. Ten per cent were able to choose where they could eat and 5% when they could eat. Older persons living in nursing homes with more than 80 residents and those younger than 65 years of age participated the most, while older people with poor appetites were able to choose more often where they wanted to eat, compared to those with a healthy appetite. The residents in this study appeared to be vulnerable to malnourishment. The results indicated that they only to a limited extent were involved in activities concerning food and meals at the nursing homes. Management and nurses should focus on residents' eating and drinking, which are essentials of nursing care. The residents should be asked whether they would like to participate in different mealtime activities. Further, a person-centred care approach that facilitates activities concerning food and meals should be promoted. © 2016 John Wiley & Sons Ltd.

How we eat what we eat: identifying meal routines and practices most strongly associated with healthy and unhealthy dietary factors among young adults.

PubMed

Laska, Melissa N; Hearst, Mary O; Lust, Katherine; Lytle, Leslie A; Story, Mary

2015-08-01

(i) To examine associations between young adults' meal routines and practices (e.g. food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast-food and sugar-sweetened beverage intakes) and (ii) to develop indices of protective and risky meal practices most strongly associated with diet. Cross-sectional survey. Minneapolis/St. Paul metropolitan area, Minnesota (USA). A diverse sample of community college and public university students (n 1013). Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e. preparing meals at home, preparing meals with vegetables) and meal regularity (i.e. routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption and negatively associated with fast-food and sugar-sweetened beverage consumption (P<0·001). A Risky Factors Index yielded significant, positive associations with fast-food and sugar-sweetened beverage consumption (P<0·001). The probability test for the association between the Risky Factors Index and fruit/vegetable intake was P=0·05. Meal routines and practices were significantly associated with young adults' dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines.

How we eat what we eat: Identifying meal routines and practices most strongly associated with healthy and unhealthy dietary factors among young adults

PubMed Central

Laska, Melissa N.; Hearst, Mary O.; Lust, Katherine; Lytle, Leslie; Story, Mary

2017-01-01

Objectives (a) To examine associations between young adult meal routines and practices (e.g., food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast food and sugar-sweetened beverage intake), and (b) to develop indices of protective and risky meal practices most strongly associated with diet. Design Cross-sectional survey. Setting Minneapolis/St. Paul metropolitan area, Minnesota (USA). Subjects A diverse sample of community college and public university (n=1,013) students. Results Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e., preparing meals at home, preparing meals with vegetables) and meal regularity (i.e., routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating, and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption, and negatively associated with fast food and sugar-sweetened beverage consumption (p<0.001). A Risky Factors Index yielded significant, positive associations with fast food and sugar sweetened beverage (p<0.001) consumption. The probability test for the association between the Risky Factors Index and fruit/vegetable intake was p=0.05. Conclusions Meal routines and practices were significantly associated with young adult dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines. PMID:25439511

Using metaphorical techniques in focus groups to uncover mothers' feelings about family meals.

PubMed

Kling, Leslie; Cotugna, Nancy; Snider, Sue; Peterson, P Michael

2009-01-01

Traditional nutrition education has not been shown to consistently produce behavior change. While it has been suggested that using emotion-based messages may be a better way to influence nutrition behavior change, this has not been well tested. Producing emotion-based messages is a multi-step process that begins with exploring subconscious barriers to behavior change rather than the more obvious and typically reported barriers. The purpose of this research was to uncover the emotional reasons, sometimes referred to as emotional pulse points, for mothers' choosing or not choosing to have more family meals. This would then serve as the first step to developing emotion-based messages promoting the benefits of family meals. Five focus group interviews were conducted with 51 low-income Black (n=28) and white (n=23) mothers. Metaphorical techniques were used to determine underlying feelings toward family and family meals. Discussions were video-taped, transcribed, and manually analyzed using a content-driven, immersion/crystallization approach to qualitative data analysis. Four themes emerged around the definition of family: acceptance, sharing, chaos, and protective/loyal. Some mothers felt mealtime was merely obligatory, and described it as stressful. Some reported a preference for attending to their own needs instead of sitting down with their children, while others felt that mealtime should be used to interact with and educate children and felt guilty when they were not able to provide family meals. Three themes emerged around feelings towards having or not having family meals: unimportant, important, and guilty. When explored further, mothers indicated that using the feeling of guilt to encourage family meals might be effective. Data obtained are being used to develop innovative, emotion-based messages that will be tested for effectiveness in promoting family meals.

Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA.

PubMed

Larson, Nicole; Wang, Qi; Berge, Jerica M; Shanafelt, Amy; Nanney, Marilyn S

2016-06-01

Although existing evidence links breakfast frequency to better dietary quality, little is known specifically in regard to the benefits associated with eating breakfast together with one's family. The present study describes the prevalence and experience of having family meals at breakfast among rural families and examines associations between meal frequency and adolescent diet quality. Data were drawn from Project BreakFAST, a group-randomized trial aimed at increasing school breakfast participation in rural Minnesota high schools, USA. Linear mixed models were used to examine associations between student reports of family breakfast frequency and Healthy Eating Index 2010 (HEI-2010) scores while accounting for clustering within schools, demographics and household food security. Adolescent students from sixteen schools completed online surveys, height and weight measurements, and dietary recalls at baseline in 2012-2014. The sample included 827 adolescents (55·1 % girls) in grades 9-10 who reported eating breakfast on at most three days per school week. On average, adolescents reported eating breakfast with their family 1·3 (sd 1·9) times in the past week. Family breakfast meals occurred most frequently in the homes of adolescents who reported a race other than white (P=0·002) or Hispanic ethnicity (P=0·02). Family breakfast frequency was directly associated with adolescent involvement in preparing breakfast meals (P<0·001) and positive attitudes (P≤0·01) about mealtime importance, interactions and structure. Family breakfast frequency was unrelated to most diet quality markers. Family meals may be one important context of opportunity for promoting healthy food patterns at breakfast. Additional research is needed to better inform and evaluate strategies.

Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA

PubMed Central

Larson, Nicole; Wang, Qi; Berge, Jerica; Shanafelt, Amy; Nanney, Marilyn S.

2017-01-01

Objective Although existing evidence links breakfast frequency to better dietary quality, little is known specifically in regards to the benefits associated with eating breakfast together with one's family. This study describes the prevalence and experience of having family meals at breakfast among rural families and examines associations between meal frequency and adolescent diet quality. Design Data were drawn from Project BreakFAST, a group-randomized trial aimed at increasing school breakfast participation in rural Minnesota high schools. Linear mixed models were used to examine associations between student reports of family breakfast frequency and Healthy Eating Index 2010 (HEI-2010) scores while accounting for clustering within schools, demographics, and household food security. Setting Adolescent students from 16 schools completed online surveys, height and weight measurements, and dietary recalls at baseline in 2012-2014. Subjects The sample included 827 adolescents (55.1% girls) in grades 9-10 who reported eating breakfast at most three days per school week. Results On average, adolescents reported eating breakfast with their family 1.3±1.9 times in the past week. Family breakfast meals occurred most frequently in the homes of adolescents that reported a race other than white (P=0.002) or Hispanic ethnicity (P=0.02). Family breakfast frequency was directly associated with adolescent involvement in preparing breakfast meals (P<0.001) and positive attitudes (P≤0.01) about mealtime importance, interactions, and structure. Family breakfast frequency was unrelated to most diet quality markers. Conclusions Family meals may be one important context of opportunity for promoting healthy food patterns at breakfast. Additional research is needed to better inform and evaluate strategies. PMID:26973150

Maternal Concern for Child Undereating.

PubMed

Brown, Callie L; Pesch, Megan H; Perrin, Eliana M; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine; Lumeng, Julie C

To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates. Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43-0.77) and picky eating (OR = 2.41; 95% CI, 1.26-4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55-2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50-4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08-3.36) during mealtimes. Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Maternal Concern for Child Undereating

PubMed Central

Brown, Callie L.; Pesch, Megan H.; Perrin, Eliana M.; Appugliese, Danielle P.; Miller, Alison L.; Rosenblum, Katherine; Lumeng, Julie C.

2016-01-01

OBJECTIVE To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. METHODS This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age 71 months). Maternal concern for undereating was assessed using a semi-structured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed by videotaped mealtime observations. Logistic regression assessed the association of maternal and child characteristics with maternal concern for undereating. Regression assessed the association of maternal concern for undereating with feeding practices, controlling for covariates. RESULTS Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child BMIz (OR 0.58, 95% CI 0.43–0.77) and picky eating (OR 2.41, 95% CI 1.26–4.59). Maternal concern for undereating was associated with greater reported pressure to eat (RR 1.97, 95% CI 1.55–2.50); and greater observed bribery (OR 2.63, 95% CI 1.50–4.60) and higher observed pressure (OR 1.90, 95% CI 1.08–3.36) during mealtimes. CONCLUSIONS Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing their children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. PMID:27354196

Mealtime glucose regulation with nateglinide in healthy volunteers: comparison with repaglinide and placebo.

PubMed

Kalbag, J B; Walter, Y H; Nedelman, J R; McLeod, J F

2001-01-01

This study was designed to compare the pharmacodynamic effects of single doses of nateglinide (A-4166), repaglinide, and placebo on mealtime insulin secretion and glycemic control in healthy subjects. Fifteen healthy volunteers participated in this open-label five-period crossover study. They received single 10-min preprandial doses of 120 mg nateglinide, 0.5 or 2 mg repaglinide, or placebo or 1 min preprandially of 2 mg repaglinide. Subjects received each dose only once, 48 h apart. Pharmacodynamic and pharmacokinetic assessments were performed from 0 to 12 h postdose. Nateglinide induced insulin secretion more rapidly than 2 and 0.5 mg repaglinide and placebo (10 min preprandial), with mean rates of insulin rise of 2.3, 1.3, 1.15, and 0.8 microU x ml(-1) x min(-1), respectively, over the 0- to 30-min postmeal interval. After peaking, insulin concentrations decreased rapidly in the nateglinide-treated group and were similar to placebo within 2 h postdose. After 2 mg repaglinide, peak insulin concentrations were delayed and returned to baseline more slowly than with nateglinide treatment. Nateglinide treatment produced lower average plasma glucose concentrations in the 0- to 2-h postdose interval than either dose of repaglinide and placebo (P < 0.05 vs. 0.5 mg repaglinide and placebo). Plasma glucose concentrations returned more rapidly to predose levels with nateglinide treatment than with either dose of repaglinide. Treatment with repaglinide produced a sustained hypoglycemic effect up to 6 h postdose. In this single-dose study in nondiabetic volunteers, nateglinide provided a more rapid and shorter-lived stimulation of insulin secretion than repaglinide, resulting in lower meal-related glucose excursions. If similar results are observed in diabetes, nateglinide may produce a more physiological insulin secretory response with the potential for a reduced risk of postabsorptive hypoglycemia.

Four-year evolution of insulin regimens, glycaemic control, hypoglycaemia and body weight after starting insulin therapy in type 2 diabetes across three continents.

PubMed

Home, Philip D; Dain, Marie-Paule; Freemantle, Nick; Kawamori, Ryuzo; Pfohl, Martin; Brette, Sandrine; Pilorget, Valérie; Scherbaum, Werner A; Vespasiani, Giacomo; Vincent, Maya; Balkau, Beverley

2015-05-01

It is of interest to understand how insulin therapy currently evolves in clinical practice, in the years after starting insulin in people with type 2 diabetes. We aimed to describe this evolution prospectively over 4 years, to assist health care planning. People who had started any insulin were identified from 12 countries on three continents. Baseline, then yearly follow-up, data were extracted from clinical records over 4 years. Of the 2999 eligible people, 2272 were followed over 4 years. When starting insulin, mean (SD) duration of diabetes was 10.6 (7.8) years, HbA1c 9.5 (2.0)% (80 [22]mmol/mol) and BMI 29.3 (6.3)kg/m(2). Initial insulin therapy was basal 52%, premix 23%, mealtime+basal 14%, mealtime 8% and other 3%; at 4 years, 30%, 25%, 33%, 2% and 5%, respectively, with 5% not on insulin. Insulin dose was 20.2U/day at the start and 45.8U/day at year 4. There were 1258 people (55%) on their original regimen at 4 years, and this percentage differed according to baseline insulin regimen. HbA1c change was -2.0 (2.2)% (-22 [24]mmol/mol) and was similar by final insulin regimen. Hypoglycaemia prevalence was <20% in years 1-4. Body weight change was mostly in year 1, and was very variable, mean +2.7 (7.5)kg at year 4. Different insulin regimens were started in people with differing characteristics, and they evolved differently; insulin dose, hypoglycaemia and body weight change were diverse and largely independent of regimen. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The impact of conventional dietary intake data coding methods on foods typically consumed by low-income African-American and White urban populations

PubMed Central

Mason, Marc A; Kuczmarski, Marie Fanelli; Allegro, Deanne; Zonderman, Alan B; Evans, Michele K

2016-01-01

Objective Analysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized. Design Duplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods. Setting Healthy Aging in Neighborhoods of Diversity across the Life Span study. Subjects African-American and White adults with two dietary recalls (n 2177). Results Differences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls. Conclusions Use of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet–health relationships. PMID:25435191

The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study: Design and methods1

PubMed Central

Fulkerson, Jayne A.; Neumark-Sztainer, Dianne; Story, Mary; Gurvich, Olga; Kubik, Martha Y.; Garwick, Ann; Dudovitz, Bonnie

2014-01-01

Background Informed and engaged parents and healthful home environments are essential for the health of youth. Although research has shown health benefits associated with family meals, to date, no randomized controlled trial (RCT) has been developed to examine the impact of a family meals intervention on behavioral and health outcomes. Methods/Design The Healthy Home Offerings via the Mealtime Environment (HOME) Plus study is a two-arm (intervention versus attention-only control) RCT being conducted in Minneapolis/St. Paul. Built on previous pilot research, HOME Plus aims to increase the frequency and healthfulness of family meals and snacks and reduce children’s sedentary behavior, particularly screen time, to promote healthier eating and activity behaviors and prevent obesity. HOME Plus is delivered to families in community settings. The program includes 10 monthly sessions focused on nutrition and activity education, meal planning and preparation skill development. In addition, five motivational goal-setting phone calls are conducted with parents. The primary outcome measure is age- and gender-adjusted child BMI-z score at post-intervention by treatment group. Secondary household-level outcomes include family meal frequency, home availability of healthful foods (fruits/vegetables) and unhealthful foods (high-fat/sugary snacks) and beverages (sugar-sweetened beverages), and the quality of foods served at meals and snacks. Secondary child outcomes include dietary intake of corresponding foods and beverages and screen time. Conclusions The HOME Plus RCT actively engages whole families of 8–12 year old children to promote healthier eating and activity behaviors and prevent obesity through promotion of family meals and snacks and limited media use. PMID:24480729

Clinical signs suggestive of pharyngeal dysphagia in preschool children with cerebral palsy.

PubMed

Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N

2015-03-01

This study aimed to determine the discriminative validity, reproducibility, and prevalence of clinical signs suggestive of pharyngeal dysphagia according to gross motor function in children with cerebral palsy (CP). It was a cross-sectional population-based study of 130 children diagnosed with CP at 18-36 months (mean=27.4, 81 males) and 40 children with typical development (TD, mean=26.2, 18 males). Sixteen signs suggestive of pharyngeal phase impairment were directly observed in a videoed mealtime by a speech pathologist, and reported by parents on a questionnaire. Gross motor function was classified using the Gross Motor Function Classification System. The study found that 67.7% of children had clinical signs, and this increased with poorer gross motor function (OR=1.7, p<0.01). Parents reported clinical signs in 46.2% of children, with 60% agreement with direct clinical mealtime assessment (kappa=0.2, p<0.01). The most common signs on direct assessment were coughing (44.7%), multiple swallows (25.2%), gurgly voice (20.3%), wet breathing (18.7%) and gagging (11.4%). 37.5% of children with TD had clinical signs, mostly observed on fluids. Dysphagia cut-points were modified to exclude a single cough on fluids, with a modified prevalence estimate proposed as 50.8%. Clinical signs suggestive of pharyngeal dysphagia are common in children with CP, even those with ambulatory CP. Parent-report on 16 specific signs remains a feasible screening method. While coughing was consistently identified by clinicians, it may not reflect children's regular performance, and was not sufficiently discriminative in children aged 18-36 months. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

The relation between family meals and health of infants and toddlers: A review.

PubMed

Verhage, Chantal L; Gillebaart, Marleen; van der Veek, Shelley M C; Vereijken, Carel M J L

2018-04-11

Family meals are associated with multiple health benefits in children and adolescents including evidence that eating together as a family may play a role in reducing childhood obesity. The current review aims to investigate whether the beneficial health effects of the family meal also apply to infants and toddlers. PubMed, Web of Science, Scopus and PsycInfo were searched and 14 empirical studies were identified. The findings were discussed according to frequency of having a family meal and parental perception, associations between the family meal and health aspects (e.g., eating behaviors and diet quality) and causal influences of these associations. Descriptive data showed that mothers offer food at a structured mealtime, but that eating together as a family was not always upheld. The frequency of family meals was positively associated with more nutrient-dense food intake and a more balanced diet. Different advantages (e.g., social importance, practical considerations) and obstacles (e.g., planning, possible mess) of the family meal were mentioned by parents. Further, having structured mealtimes and family meals was associated with more food enjoyment and less fussy and emotional eating. Finally, no causal studies were identified. The limited number of studies suggests that the pattern of positive associations between family meal and child health which has been shown in older children may also exist in infants and toddlers. More specific research is needed to examine the causality of the associations between the family meal and health of the infant and toddler. The associations between the family meal and less fussiness and emotional eating, more food enjoyment and better nutrient intake suggest that the family meal is a valuable moment to promote healthy eating in toddlers and infants. Copyright © 2018. Published by Elsevier Ltd.

Recovery in Young Children with Weight Faltering: Child and Household Risk Factors

PubMed Central

Black, Maureen M.; Tilton, Nicholas; Bento, Samantha; Cureton, Pamela; Feigelman, Susan

2015-01-01

Objective To examine whether weight recovery among children with weight faltering varied by enrollment age and child and household risk factors. Study design Observational, conducted in an interdisciplinary specialty practice with a skill-building mealtime behavior intervention, including coaching with video-recorded interactions. Eligibility included age 6–36 months with weight/age <5th percentile or crossing of two major percentiles. Children were categorized as <24 months vs ≥24 months. Child and household risk factors were summed into risk indices (top quartile, elevated risks, vs. reference). Outcome was weight/age z-score change over 6 months. Analyses were conducted with longitudinal linear mixed-effects models, including age by risk index interaction terms. Results Enrolled 286 children (mean age 18.8 months, SD 6.8). Significant weight/age recovery occurred regardless of risk index or age. Mean weight/age z-score change was significantly greater among younger, compared with older age (0.29 vs. 0.17, p=0.03); top household risk quartile, compared with reference (0.34 vs. 0.22, p=0.046); and marginally greater among top child risk quartile, compared with reference (0.37 vs. 0.25, p=0.058). Mean weight/age z-score change was not associated with single risk factors, or interactions; greatest weight gain occurred in most underweight children. Conclusions Weight recovery over 6 months was statistically significant, although modest, and greater among younger children and among children with multiple child and household risk factors. Findings support Differential Susceptibility Theory, whereby some children with multiple risk factors are differentially responsive to intervention. Future investigations should evaluate components of the mealtime behavior intervention. PMID:26687578

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

PubMed

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

2014-09-01

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

Shared meals among young adults are associated with better diet quality and predicted by family meal patterns during adolescence.

PubMed

Larson, Nicole; Fulkerson, Jayne; Story, Mary; Neumark-Sztainer, Dianne

2013-05-01

To describe shared meal patterns and examine associations with dietary intake among young adults. Population-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults). Participants completed surveys and FFQ in high-school classrooms in Minneapolis/St. Paul, MN, USA in 1998-1999 (mean age = 15·0 years, 'adolescence') and follow-up measures online or by mail in 2008-2009 (mean age = 25·3 years, 'young adulthood'). There were 2052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals. Among young adults, the frequency of shared meals during the past week was as follows: never (9·9 %), one or two times (24·7 %), three to six times (39·1 %) and seven or more times (26·3 %). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared with young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products and some key nutrients among females. Nutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes.

Shared meals among young adults are associated with better diet quality and predicted by family meal patterns during adolescence

PubMed Central

Fulkerson, Jayne; Story, Mary; Neumark-Sztainer, Dianne

2012-01-01

Objective To describe shared meal patterns and examine associations with dietary intake among young adults. Design Population-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults). Setting Participants completed surveys and food frequency questionnaires in Minneapolis/St. Paul, Minnesota high school classrooms in 1998–1999 (mean age=15.0, “adolescence”) and follow-up measures online or by mail in 2008–2009 (mean age=25.3, “young adulthood”). Subjects There were 2,052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals. Results Among young adults, the frequency of shared meals during the past week was as follows: never (9.9%), one or two times (24.7%), three to six times (39.1%), and seven or more times (26.3%). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared to young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products, and some key nutrients among females. Conclusions Nutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes. PMID:22857517

Ability to Categorize Food Predicts Hypothetical Food Choices in Head Start Preschoolers.

PubMed

Nicholson, Jody S; Barton, Jennifer M; Simons, Ali L

2018-03-01

To investigate whether preschoolers are able to identify and categorize foods, and whether their ability to classify food as healthy predicts their hypothetical food choice. Structured interviews and body measurements with preschoolers, and teacher reports of classroom performance. Six Head Start centers in a large southeastern region. A total of 235 preschoolers (mean age [SD], 4.73 [0.63] years; 45.4% girls). Teachers implemented a nutrition education intervention across the 2014-2015 school year in which children were taught to identify and categorize food as sometimes (ie, unhealthy) and anytime (ie, healthy). Preschooler responses to a hypothetical snack naming, classifying, and selection scenario. Hierarchical regression analyses to examine predictors of child hypothetical food selection. While controlling for child characteristics and cognitive functioning, preschoolers who were better at categorizing food as healthy or unhealthy were more likely to say they would choose the healthy food. Low-contrast food pairs in which food had to be classified based on multiple dimensions were outside the cognitive abilities of the preschoolers. Nutrition interventions may be more effective in helping children make healthy food choices if developmental limitations in preschoolers' abilities to categorize food is addressed in their curriculum. Classification of food into evaluative categories is challenging for this age group. Categorizing on multiple dimensions is difficult, and dichotomous labeling of food as good or bad is not always accurate in directing children toward making food choices. Future research could evaluate further preschoolers' developmental potential for food categorization and nutrition decision making and consider factors that influence healthy food choices at both snack and mealtime. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Severity of pain is associated with insufficient energy coverage in hospitalised patients: A cross-sectional study.

PubMed

Makhlouf, Anne-Marie; Kossovsky, Michel P; Gurba, France; Pautex, Sophie; Chikhi, Marinette; Pichard, Claude; Genton, Laurence

2018-03-17

The severity of pain is routinely assessed in hospitalised patients but the impact of pain and pain control on energy coverage has been poorly studied. This One-day cross-sectional observational study assessed the association between severity of pain and coverage of energy needs in hospitalised patients. Foods provided and consumed were assessed on one day by dedicated dieticians for unselected hospitalised patients receiving three meals per day. Severity of pain was evaluated by a visual analogue scale at the mealtimes, averaged over the study day, and categorized as no pain, slight, moderate or severe pain. The coverage of energy needs was expressed in percentage of predicted needs. Among the 755 included patients, 63% reported having pain. Severe pain was associated with a lower energy coverage than no pain (p = 0.001) or slight pain (p = 0.001). Insufficient energy coverage, defined as ≤70% of predicted needs, occurred in 13% of the patients. In univariate logistic regressions, predictors of insufficient energy coverage were severe pain as compared to no pain (OR 2.38; 95% CI 1.21, 4.64) and treatment with opioid drugs as compared to no pain killer (OR 1.73; 95% CI 1.07, 2.79). When including sex, age, body mass index, treatment with analgesics and severity of pain in a multivariate logistic regression, severe pain more than doubled the risk of insufficient energy coverage (OR 2.32; CI 1.15, 4.66). Patients experiencing severe pain have a high risk of insufficient energy coverage. Optimal pain control is probably critical to prevent underfeeding in the hospital. Identifier no NCT02463565 on www.ClinicalTrials.gov. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Nutritional status and health outcomes for older people with dementia living in institutions.

PubMed

Lou, Meei-Fang; Dai, Yu-Tzu; Huang, Guey-Shiun; Yu, Po-Jui

2007-12-01

This paper is a report of a study to determine changes over a 3-month period among older people with dementia living in long-term care settings, related to: (1) changes in body mass index, and (2) health outcomes and associated factors. Nutritional deficiencies are common problems among older people, but frequently unrecognized, both in long-term care settings and in the community. A cross-sectional design with repeated measures of body weights and medical record reviews was adopted. The study was conducted in 2003 in two long-term care facilities for older people with dementia in Taiwan. Fifty-five residents participated in the study. Eighteen percent of the residents were under-nourished (body mass index <18.5). There was a trend toward decreasing body mass index over the 3-month study period. Residents with low body mass index tended to need assistance at mealtimes. Nineteen residents, many receiving naso-gastric tube-feeding, experienced adverse health events during the study period. Dependency in eating was the major factor differentiating residents with normal or low body mass index values, and also in distinguishing those who experienced adverse health outcomes. Assessment of eating ability, mode of feeding and measurement of body weight can be used by nurses in long-term care settings for early identification of the nutritional status of older people with dementia.

Temperament and Parenting during the First Year of Life Predict Future Child Conduct Problems

PubMed Central

Lahey, Benjamin B.; Van Hulle, Carol A.; Keenan, Kate; Rathouz, Paul J.; D’Onofrio, Brian M.; Rodgers, Joseph Lee; Waldman, Irwin D.

2010-01-01

Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct problems during ages 4–13 years. Furthermore, a significant interaction indicated that infants who were both low in fussiness and high in predictability were at very low risk for future conduct problems. Fussiness was a stronger predictor of conduct problems in boys whereas fearfulness was a stronger predictor in girls. Conduct problems also were robustly predicted by low levels of early mother-report cognitive stimulation. Interviewer-rated maternal responsiveness was a robust predictor of conduct problems, but only among infants low in fearfulness. Spanking during infancy predicted slightly more severe conduct problems, but the prediction was moderated by infant fussiness and positive affect. Thus, individual differences in risk for mother-rated conduct problems across childhood are already partly evident in maternal ratings of temperament during the first year of life and are predicted by early parenting and parenting-by-temperament interactions. PMID:18568397

Do subjective symptoms predict our perception of jet-lag?

PubMed

Waterhouse, J; Edwards, B; Nevill, A; Atkinson, G; Reilly, T; Davies, P; Godfrey, R

2000-10-01

A total of 39 subjects were studied after a flight from the UK to either Sydney or Brisbane (10 time-zones to the east). Subjects varied widely in their age, their athletic ability, whether or not they were taking melatonin, and in their objectives when in Australia. For the first 6 days after arrival, subjects scored their jet-lag five times per day and other subjective variables up to five times per day, using visual analogue scales. For jet-lag, the scale was labelled 0 = no jet-lag to 10 = very bad jet-lag; the extremes of the other scales were labelled - 5 and + 5, indicating marked changes compared with normal, and the centrepoint was labelled 0 indicating 'normal'. Mean daily values for jet-lag and fatigue were initially high (+ 3.65 +/- 0.35 and + 1.55 +/- 0.22 on day 1, respectively) and fell progressively on subsequent days, but were still raised significantly (p < 0.05) on day 5 (fatigue) or day 6 (jet-lag). In addition, times of waking were earlier on all days. By contrast, falls in concentration and motivation, and rises in irritability and nocturnal wakings, had recovered by day 4 or earlier, and bowel activity was less frequent, with harder stools, on days 1 and 2 only. Also, on day 1, there was a decrease in the ease of getting to sleep (- 1.33 +/- 0.55), but this changed to an increase from day 2 onwards (for example, + 0.75 +/- 0.25 on day 6). Stepwise regression analysis was used to investigate predictors of jet-lag. The severity of jet-lag at all the times that were measured was strongly predicted by fatigue ratings made at the same time. Its severity at 08:00 h was predicted by an earlier time of waking, by feeling less alert 30 min after waking and, marginally, by the number of waking episodes. Jet-lag at 12:00 and 16:00 h was strongly predicted by a fall of concentration at these times; jet-lag at mealtimes (12:00, 16:00 and 20:00 h) was predicted by the amount of feeling bloated. Such results complicate an exact interpretation that can be placed on an assessment of a global term such as jet-lag, particularly if the assessment is made only once per day.

STS-34 crewmembers eat meal on OV-104's middeck

NASA Technical Reports Server (NTRS)

1989-01-01

STS-34 crewmembers, on their first space flight, appear to enjoy mealtime in a zero-gravity environment. They are Pilot Michael J. McCulley and Mission Specialist (MS) Ellen S. Baker. The two, who were in the 1984 class of NASA astronauts, balance their meal trays and attempt to eat in an area of Atlantis', Orbiter Vehicle (OV) 104's, middeck that pays tribute to their astronaut roots. The 'maggot' decal or insignia has direct reference to the group. During the flight, the two made former Astronaut Paul J. Weitz, now JSC Deputy Director, an honorary member of the 1984 class. Weitz's flight suit portrait hangs on the galley facing.

A Study on Dietary Habits and Lifestyle of Girls with Precocious Puberty

PubMed Central

Heo, Jae-Seong; Moon, Hyeok-Soo

2016-01-01

Purpose This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. Methods Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. Results The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. Conclusion Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling. PMID:27437190

[Television and children: is television responsible for all the evils attributed to it?].

PubMed

Caviedes Altable, B E; Quesada Fernández, E; Herranz, J L

2000-02-28

The purpose of this study was to analyze children's television viewing habits and their parents attitudes towards such viewing. Cross-sectional descriptive study. Primary care. A survey was undertaken with 317 three to fourteen year old children and their parents as part of the primary care check-up program for healthy children. Time devoted to television viewing was 106 +/- 50 minutes on weekdays and 141 +/- 80 minutes weekends. Despite this, 49.2% of parents thought their children saw little television, especially those with children under six (57.6%). Children of parents in highly qualified positions and of parents in the uppermost socioeconomic group saw television the least, on non-working days (70 +/- 61 minutes and 144 +/- 78 minutes respectively, p < or = 0.0001). Some 71.9% of children watched television alone and 34% did so at meal-times. Altogether 48.3% of parents were unaware as to what their children watched and some 61.5% encouraged television viewing, above all those having children of under six (76%). The youngest children preferred to watch cartoons which were generally of a violent nature. For those aged from 11 to 14, 19.5% chose as their favorite programs those having a high level of violence. Television habits are an educational problem for parents, an important shake-up in their attitudes being called for, in which pediatricians should be involved in developing health programs aimed at proper use of the television.

Two-year efficacy and safety of AIR inhaled insulin in patients with type 1 diabetes: An open-label randomized controlled trial.

PubMed

Garg, Satish K; Mathieu, Chantal; Rais, Nadeem; Gao, Haitao; Tobian, Janet A; Gates, Jeffrey R; Ferguson, Jeffrey A; Webb, David M; Berclaz, Pierre-Yves

2009-09-01

Patients with type 1 diabetes require intensive insulin therapy for optimal glycemic control. AIR((R)) inhaled insulin (system from Eli Lilly and Company, Indianapolis, IN) (AIR is a registered trademark of Alkermes, Inc., Cambridge, MA) may be an efficacious and safe alternative to subcutaneously injected (SC) mealtime insulin. This was a Phase 3, 2-year, randomized, open-label, active-comparator, parallel-group study in 385 patients with type 1 diabetes who were randomly assigned to receive AIR insulin or SC insulin (regular human insulin or insulin lispro) at mealtimes. Both groups received insulin glargine once daily. Efficacy measures included mean change in hemoglobin A1C (A1C) from baseline to end point, eight-point self-monitored blood glucose profiles, and insulin dosage. Safety assessments included hypoglycemic events, pulmonary function tests, adverse events, and insulin antibody levels. In both treatment groups, only 20% of subjects reached the target of A1C <7.0%. A significant A1C difference of 0.44% was seen favoring SC insulin, with no difference between the groups in insulin doses or hypoglycemic events at end point. Patients in both treatment groups experienced progressive decreases in lung function, but larger (reversible) decrements in diffusing capacity of the lung for carbon monoxide (DL(CO)) were associated with AIR insulin treatment. Greater weight gain was seen with SC insulin treatment. The AIR inhaled insulin program was terminated by the sponsor prior to availability of any Phase 3 data for reasons unrelated to safety or efficacy. Despite early termination, this trial provides evidence that AIR insulin was less efficacious in lowering A1C and was associated with a greater decrease in DL(CO) and increased incidence of cough than SC insulin in patients with type 1 diabetes.

Behaviours, thoughts and perceptions around mealtime insulin usage and wastage among people with type 1 and type 2 diabetes mellitus: A cross-sectional survey study.

PubMed

Van Brunt, Kate; Pedersini, Riccardo; Rooney, Jillian; Corrigan, Sheila M

2017-04-01

People with diabetes who use mealtime insulin (MTI) were surveyed about insulin wastage and injection habits when insufficient insulin remains in a disposable prefilled pen/cartridge to administer a full dose in a single injection. Cross-sectional, online, self-reported survey of MTI usage/wastage behaviour in 400 adults with type 1 (n=120) or type 2 (n=280) diabetes mellitus administering >20units/day of MTI via 100units/ml prefilled pens/cartridges for ⩾1month, conducted in France, Germany, Italy and UK. Participants' mean±standard deviation age was 54.5±12.2years, body mass index was 29.9±7.2kg/m 2 and duration of MTI therapy was 8.6±7.8years. They administered 3.7±5.9 injections/day with meals, using 11.3±18.0 prefilled pens/cartridges per month. Overall, 63.5% split the dose across two prefilled pens/cartridges (i.e. administered two injections to obtain a full dose), 15.0% used just what remained in their current pen (i.e. took a lower-than-prescribed dose) and 36.3% discarded prefilled pens/cartridges still containing insulin (i.e. took full dose with new pen). The latter participants discarded a mean 5.5±8.2 prefilled pens/cartridges monthly still containing insulin, each containing 8.6±8.7 units of insulin. Participants who wasted insulin considered it frustrating, time-consuming and painful to inject twice. Patients taking >20units/day MTI can find transitions between insulin pens challenging. This study highlights the need to identify ways of improving transitions between pens to make transitions easier for insulin users, which could potentially improve adherence to prescribed doses and reduce waste. Copyright © 2016 Eli Lilly and Company. Published by Elsevier B.V. All rights reserved.

Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review.

PubMed

Bunn, Diane K; Abdelhamid, Asmaa; Copley, Maddie; Cowap, Vicky; Dickinson, Angela; Howe, Amanda; Killett, Anne; Poland, Fiona; Potter, John F; Richardson, Kate; Smithard, David; Fox, Chris; Hooper, Lee

2016-05-04

Risks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service or dining environment modification, education, exercise or behavioural interventions in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). We comprehensively searched Medline and twelve further databases, plus bibliographies, for intervention studies with ≥3 cognitively impaired adult participants (any type/stage). The review was conducted with service user input in accordance with Cochrane Collaboration's guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data. Meta-analysis (statistical pooling) was not appropriate so data were tabulated and synthesised narratively. We included 56 interventions (reported in 51 studies). Studies were small and there were no clearly effective, or clearly ineffective, interventions. Promising interventions included: eating meals with care-givers, family style meals, soothing mealtime music, constantly accessible snacks and longer mealtimes, education and support for formal and informal care-givers, spaced retrieval and Montessori activities, facilitated breakfast clubs, multisensory exercise and multicomponent interventions. We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. A variety of promising indirect interventions need to be tested in large, high-quality RCTs, and may be approaches that people with dementia and their formal or informal care-givers would wish to try. The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007611).

Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh.

PubMed

Adams, M S; Khan, N Z; Begum, S A; Wirz, S L; Hesketh, T; Pring, T R

2012-11-01

The majority of children with cerebral palsy have feeding difficulties, which, if not managed, result in stressful mealtimes, chronic malnutrition, respiratory disease, reduced quality of life for caregiver and child, and early death. In well-resourced countries, high- and low-cost medical interventions, ranging from gastrostomy tube feeding to caregiver training, are available. In resource-poor countries such as Bangladesh, the former is not viable and the latter is both scarce and its effectiveness not properly evaluated. The aim of this study was to evaluate the effectiveness of a low-cost, low-technology intervention to improve the feeding practices of carers of children with moderate-severe cerebral palsy and feeding difficulties in Bangladesh. An opportunistic sample of 37 caregivers and their children aged 1-11 years were invited to a six-session training programme following an initial feeding assessment with brief advice. During home visits, pre- and post-measures of nutritional status, chest health and feeding-related stress were taken and feeding practices were observed. A control phase was evaluated for 20 of the participant pairs following initial assessment with advice, while awaiting full training. A minimum of four training sessions showed significant improvements in the children's respiratory health (P = 0.005), cooperation during mealtimes (P = 0.003) and overall mood (P < 0.001). Improvements in growth were inconsistent. Dramatic reductions were observed in caregiver stress (P < 0.001). A significant difference in the outcomes following advice only compared with advice plus training was also observed. In situations of poverty, compliance is restricted by lack of education, finances and time. Nonetheless, carers with minimal formal education, living in conditions of extreme poverty were able to change feeding practices after a short, low-cost training intervention, with highly positive consequences. The availability of affordable food supplementation for this population, however, requires urgent attention. © 2011 Blackwell Publishing Ltd.

A comparison of father-infant interaction between primary and non-primary care giving fathers.

PubMed

Lewis, S N; West, A F; Stein, A; Malmberg, L-E; Bethell, K; Barnes, J; Sylva, K; Leach, P

2009-03-01

This study examined the socio-demographic characteristics and attitudes of primary care giving fathers and non-primary care giving fathers and the quality of their interaction with their infants. Two groups of fathers of 11.9-month old infants were compared - 25 primary care giving fathers (20 h per week or more of sole infant care) and 75 non-primary care giving fathers - with regard to socio-demographic characteristics, attitudinal differences and father-infant interaction during play and mealtimes. The quality of father-child interaction in relation to the total number of hours of primary care provided by fathers was also examined. Primary care giving fathers had lower occupational status and earned a smaller proportion of the family income but did not differ in educational level or attitudes compared with non-primary care giving fathers. There were no differences between the partners of the two groups of fathers on any variables, and their infants did not differ in temperament. Primary care giving fathers and their infants exhibited more positive emotional tone during play than non-primary care giving fathers, although fathers did not differ in responsivity. There were no differences between the groups during mealtimes. There was a positive association between total number of child care hours provided by all fathers and infant positive emotional tone. Primary and non-primary care giving fathers were similar in many respects, but primary care giving fathers and their infants were happier during play. This suggests a possible link between the involvement of fathers in the care of their children and their children's emotional state. The finding of a trend towards increased paternal happiness with increased hours of child care suggests that there may also be a gain for fathers who are more involved in the care of their infants. Further research is needed to determine whether these differences ultimately have an effect on children's development.

Elderly peoples' meals. A comparative study between elderly living in a nursing home and frail, self-managing elderly.

PubMed

Engelheart, S; Lammes, E; Akner, G

2006-01-01

Sweden is one of few countries that have specific recommendations regarding mealtime habits. The importance of mealtime habits for health outcome is inadequately studied in elderly subjects. The aim of this study was to investigate the distribution of the daily meals/energy intake; the number of eating episodes per day and subjectively estimated meal-dependent variables (appetite, motivation to eat, sense of taste and sense of smell) and compare the results of elderly living in a nursing home with frail, self-managing elderly living at home. Explorative study. All analyses of energy intake were based on food records; weighed in the nursing home and estimated in the frail, self-managing elderly. Participants or contact persons estimated the subjective variables using a 10-point VAS scale. On average there were 4-5 daily eating episodes in both groups. The eating episodes were much more widespread over the day in the self-managing elderly, and their length of fasting at night was significantly shorter. The subjects estimated appetite and sense of smell was reduced in about 30-40% in both groups. Sense of taste was reduced in 40 % of the males and 10-20 % of the females. Energy intake was similar in both groups, 25 kcal/kg body weight/day, with more than a threefold variation among individual subjects. Energy intake/kg body weight correlated with a shorter length of fasting at night in the nursing home residents, however, did not correlate with ADL, number of eating episodes per day, appetite, motivation to eat, or senses of taste or smell. The self-managing elderly had more widespread eating episodes than the elderly in the nursing home, indicating that self-managing elderly exhibit larger variations in food intake preferences, however, without affecting mean energy intake. The lack of correlation between energy intake and estimated appetite, taste and smell is in line with previous findings in elderly.

The fear of food measure: a novel measure for use in exposure therapy for eating disorders.

PubMed

Levinson, Cheri A; Byrne, Meghan

2015-04-01

Exposure therapy for mealtime anxiety has preliminarily been effective at increasing food intake and decreasing anxiety in individuals with anorexia nervosa (AN). To enhance our knowledge of exposure therapy for AN researchers and clinicians need a comprehensive measure that assesses outcomes relevant to exposure therapy for AN. In the current four studies we developed Fear of Food Measure (FOFM) that assesses three cognitive and behavioral outcomes: trait anxiety about eating, food avoidance behaviors, and feared concerns related to eating. In a community (N = 399) and undergraduate female sample (N = 203) the FOFM exhibited a good three-factor structure and convergent and divergent validity. In a sample of women (N = 72) we showed that the anxiety about eating subscale significantly predicted in vivo food intake over and above other established predictors of eating (e.g., restraint). In a clinical sample diagnosed with an eating disorder (N = 41) we showed that anxiety about eating was associated with food intake and anxiety during an exposure meal and that all subscales of the FOFM significantly decreased over the course of a four-session exposure intervention. Finally, we found that participants diagnosed with an eating disorder had higher levels of fear of food than did matched controls (N = 23). The FOFM is a psychometrically valid measure that can assess if patients are improving while undergoing exposure therapy and could be used to pinpoint problematic behaviors that can be addressed in exposure therapy. © 2014 Wiley Periodicals, Inc.

Repaglinide--prandial glucose regulator: a new class of oral antidiabetic drugs.

PubMed

Owens, D R

1998-01-01

The highest demand on insulin secretion occurs in connection with meals. In normal people, following a meal, the insulin secretion increases rapidly, reaching peak concentration in the blood within an hour. The mealtime insulin response in patients with Type 2 diabetes is blunted and delayed, whereas basal levels often remain within the normal range (albeit at elevated fasting glucose levels). Restoration of the insulin secretion pattern at mealtimes (prandial phase)--without stimulating insulin secretion in the 'postabsorptive' phase--is the rationale for the development of 'prandial glucose regulators', drugs that are characterized by a very rapid onset and short duration of action in stimulating insulin secretion. Repaglinide, a carbamoylmethyl benzoic acid (CMBA) derivative is the first such compound, which recently has become available for clinical use. Repaglinide is very rapidly absorbed (t(max) less than 1 hour) with a t1/2 of less than one hour. Furthermore, repaglinide is inactivated in the liver and more than 90% excreted via the bile. The implications of tailoring repaglinide treatment to meals were examined in a study where repaglinide was dosed either morning and evening, or with each main meal (i.e. breakfast, lunch, dinner), with the total daily dose of repaglinide being identical. The mealtime dosing caused a significant improvement in both fasting and 24-hour glucose profiles, as well as a significant decrease in HbA1c. In other studies, repaglinide caused a decrease of 5.8 mmol x l(-1) in peak postprandial glucose levels, and a decrease of 3.1 mmol x l(-1) in fasting levels with a reduction in HbA1c of 1.8% compared with placebo. In comparative studies with either sulphonylurea or metformin, repaglinide caused similar or improved control (i.e. HbA1c, mean glucose levels) and the drug was well tolerated (e.g. reported gastrointestinal side-effects were more than halved when patients were switched from metformin to repaglinide). A hallmark of repaglinide treatment is that this medication follows the eating pattern, and not vice versa. Hence the risk of developing severe hypoglycaemia (BG < or = 2.5 mmol x l(-1)) in connection with flexible lifestyles should be reduced. This concept was examined in a study in which patients well controlled on repaglinide skipped their lunch on one occasion. When a meal (i.e. lunch) was skipped--so was the repaglinide dose, whereas in the comparative group on glibenclamide the recommended morning and evening doses were taken. Twenty-four per cent of the patients in the glibenclamide group developed severe hypoglycaemia, whereas no hypoglycaemic events occurred in the group receiving repaglinide. However, in long-term studies the overall prevalence of hypoglycaemia was similar to that found with other insulin secretagogues. In summary, current evidence shows that the concept of prandial glucose regulation offers good long-term glycaemic control combined with a low risk of severe hypoglycaemia with missed meals. The concept should meet the needs of Type 2 diabetic patients, allowing flexibility in their lifestyle.

The mediating role of perceived peer support in the relation between quality of attachment and internalizing problems in adolescence: a longitudinal perspective.

PubMed

Pace, Ugo; Zappulla, Carla; Di Maggio, Rosanna

2016-10-01

The study was aimed to verify, from a longitudinal perspective, whether perceived peer support would mediate the relationship between attachment and internalizing problems. Longitudinal participants included 482 adolescents (245 boys) aged 14-15 years in Wave 1 and 17-18 years in Wave 2. Participants in Wave 1 completed the Relationship Questionnaire, and those in Wave 2 completed the Social Support Questionnaire and the Youth Self-Report. Results showed that secure attachment positively predicted high levels of perceived peer support and negatively predicted internalizing problems, whereas fearful and preoccupied attachment negatively predicted perceived peer support and positively predicted internalizing problems. The mediation models showed that perceived peer support partially mediated the relationship between secure attachment and internalizing problems as well as between preoccupied attachment and internalizing problems and between fearful attachment and internalizing problems. Our results confirm the role of subjective perception of peer support in contributing to the prediction of internalizing problems beyond attachment styles.

Effects of a feeding skills training programme on nursing assistants and dementia patients.

PubMed

Chang, Chia-Chi; Lin, Li-Chan

2005-11-01

The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. A quasi-experimental study was conducted. Two convenience-chosen dementia-specialized long-term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty-seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in-service classes and one hour of hands-on training, whereas the control group did not receive any training. The treatment group had significantly more knowledge (F = 47.7, P < 0.001), more positive attitude (F = 15.75, P = 0.001) and better behaviours (t = 6.0, P < 0.001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2.7, P < 0.05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2.1, P < 0.05) than the control group. There was no significant difference on food intake between the two groups (t = 0.8, P = 0.49). This feeding skills training programme has been found to change nursing assistants' knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. This study raises attention regarding on-the-job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.

Matched and mismatched appraisals of the effectiveness of communication strategies by family caregivers of persons with Alzheimer's disease.

PubMed

Savundranayagam, Marie Y; Orange, J B

2014-01-01

Communication problems stemming from Alzheimer's disease (AD) often result in misunderstandings that can be linked with problem behaviours and increased caregiver stress. Moreover, these communication breakdowns also can result either from caregivers' use of ineffective communication strategies, which paradoxically are perceived as helpful, or can occur as a result of not using effective communication strategies that are perceived as unhelpful. The two primary aims were to determine the effectiveness of strategies used to resolve communication breakdowns and to examine whether caregivers' ratings of strategy effectiveness were consistent with evidence from video-recorded conversations and with effective communication strategies documented in the literature. Twenty-eight mealtime conversations were recorded using a sample of 15 dyads consisting of individuals with early, middle and late clinical-stage AD and their family caregivers. Conversations were analysed using the trouble-source repair paradigm to identify the communication strategies used by caregivers to resolve breakdowns. Family caregivers also rated the helpfulness of communication strategies used to resolve breakdowns. Analyses were conducted to assess the overlap or match between the use and appraisals of the helpfulness of communication strategies. Matched and mismatched appraisals of communication strategies varied across stages of AD. Matched appraisals by caregivers of persons with early-stage AD were observed for 68% of 22 communication strategies, whereas caregivers of persons with middle- and late-stage AD had matched appraisals for 45% and 55% of the strategies, respectively. Moreover, caregivers of persons with early-stage AD had matched appraisals over and above making matched appraisals by chance alone, compared with caregivers of persons in middle- and late-stage AD. Mismatches illustrate the need for communication education and training, particularly to establish empirically derived evidence-based communication strategies over the clinical course of AD. © 2013 Royal College of Speech and Language Therapists.

Prediction of shipboard electromagnetic interference (EMI) problems using artificial intelligence (AI) technology

NASA Technical Reports Server (NTRS)

Swanson, David J.

1990-01-01

The electromagnetic interference prediction problem is characteristically ill-defined and complicated. Severe EMI problems are prevalent throughout the U.S. Navy, causing both expected and unexpected impacts on the operational performance of electronic combat systems onboard ships. This paper focuses on applying artificial intelligence (AI) technology to the prediction of ship related electromagnetic interference (EMI) problems.

Improving the quality of life of aged care residents through the joy of food: The Lantern Project.

PubMed

Hugo, Cherie; Dwonczyk, Marcia; Skinner, Jan; Isenring, Liz

2018-03-23

Mealtimes directly impact the quality of life of residents in aged care. The objective of The Lantern Project is to improve the dining experience of aged care residents to reduce malnutrition risk through improving dietary intake, meal. A transdisciplinary team of aged care professionals and resident advocates was formed as a collaboration collectively known as The Lantern Project. This paper outlines the journey and timeline of The Lantern Project collaboration since its inception and the interplay between the monthly stakeholder meetings and inter-related research projects demonstrating improved outcomes. Transdisciplinary collaboration offers well-grounded benefits and realistic strategies sensitive to the complexity of the aged care setting. © 2018 AJA Inc.

Pilot Fullerton plans menu as packaged food and beverages float around him

NASA Image and Video Library

1982-03-31

S82-28912 (March 1982) --- This picture, photographed with a 35mm camera operated by astronaut Jack R. Lousma, STS-3 commander, shows astronaut C. Gordon Fullerton, crew pilot, busy with mealtime preparations aboard the Earth-orbiting Columbia. The astronaut has positioned himself in the corner of the middeck area. Fullerton holds a beverage in his right hand in an accordion-like squeeze dispenser. Many packages of pre-packaged dehydrated foods and other meal items can be seen in the photo. Many are fastened to the locker doors and to trays in the locker doors by velcro. Reminiscent of STS-2 days, a portrait of George W. S. Abbey, director of flight operations at JSC, is at left edge. Photo credit: NASA

Voluntary sodium intake during effort in hot environments

NASA Technical Reports Server (NTRS)

Sohar, E.; Adar, R.; Hershco, A.

1982-01-01

The factors that influence the amount of salt that a person adds to his food at mealtime, and the part played by the general requirement for salt in the daily diet stemming from the coluntary input of salt are studied. Careful measurements of salt intake and outflow were performed on ten marchers in a high temperature environment who were given individual salt shakers that were weighed before and after each meal. Some marchers were told to add salt to their meals on specific days. No parallelity was found between the voluntary sodium intake and the general sodium intake, the excretion of sodium in the urine or the environmental heat stress. Individual food habit was found to be the most important factor.

Parenting Style and Family Meals: Cross-Sectional and 5-year Longitudinal Associations

PubMed Central

Berge, Jerica M.; Wall, Melanie; Neumark-Sztainer, Dianne; Larson, Nicole; Story, Mary

2010-01-01

Background Research on family meals in the last decade has shown a positive association between family meal frequency and adolescent healthy dietary intake. However, less is known about factors within the home environment, such as parenting style, which may be associated with family meal patterns. Objective The purpose of this study is to test cross-sectional and five-year longitudinal associations between parenting styles (authoritative, authoritarian, permissive, neglectful) and the frequency of family meals among adolescents. Study Design Data were from Project EAT (Eating Among Teens), a population-based study comprised of youth from diverse ethnic/racial and socioeconomic backgrounds. Two cohorts of adolescents (middle school, high school) completed in-class surveys in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean frequency of family meals at Time 1 and Time 2 from adolescent report of parenting style (both mother and father) at Time 1. Cross-sectional analyses included both adolescent cohorts (n = 4,746) and longitudinal analyses included only the younger cohort (n = 806) because family meal frequency was not assessed in the older cohort at Time 2. Results Cross-sectional results for adolescent girls indicated a positive association between maternal and paternal authoritative parenting style and frequency of family meals. For adolescent boys, maternal authoritative parenting style was associated with more frequent family meals. Longitudinal results indicated that authoritative parenting style predicted higher frequency of family meals five years later, but only between opposite sex parent/adolescent dyads. Conclusions Future research should identify additional factors within the home environment that are associated with family meal frequency in order to develop effective interventions that result in increased family meals for youth. Also, future research should investigate the mealtime behaviors of authoritative parents and identify specific behaviors that dietitians and other health care providers could share with parents of adolescents to help them increase family meal frequency. PMID:20630160

Parenting style and family meals: cross-sectional and 5-year longitudinal associations.

PubMed

Berge, Jerica M; Wall, Melanie; Neumark-Sztainer, Dianne; Larson, Nicole; Story, Mary

2010-07-01

Research on family meals in the past decade has shown a positive association between family meal frequency and adolescent healthy dietary intake. However, less is known about factors within the home environment, such as parenting style, that may be associated with family meal patterns. The purpose of this study is to test cross-sectional and 5-year longitudinal associations between parenting styles (authoritative, authoritarian, permissive, and neglectful) and the frequency of family meals among adolescents. Data were from Project Eating Among Teens, a population-based study comprised of youth from diverse ethnic/racial and socioeconomic backgrounds. Two cohorts of adolescents (middle school and high school) completed in-class surveys in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean frequency of family meals at Time 1 and Time 2 from adolescent report of parenting style (both mother and father) at Time 1. Cross-sectional analyses included both adolescent cohorts (n=4,746) and longitudinal analyses included only the younger cohort (n=806) because family meal frequency was not assessed in the older cohort at Time 2. Cross-sectional results for adolescent girls indicated a positive association between maternal and paternal authoritative parenting style and frequency of family meals. For adolescent boys, maternal authoritative parenting style was associated with more frequent family meals. Longitudinal results indicated that authoritative parenting style predicted higher frequency of family meals 5 years later, but only between opposite sex parent/adolescent dyads. Future research should identify additional factors within the home environment that are associated with family meal frequency to develop effective interventions that result in increased family meals for youth. Also, future research should investigate the mealtime behaviors of authoritative parents and identify specific behaviors that dietetics practitioners and other health care providers could share with parents of adolescents to help them increase family meal frequency. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Improving Resource Selection and Scheduling Using Predictions. Chapter 1

NASA Technical Reports Server (NTRS)

Smith, Warren

2003-01-01

The introduction of computational grids has resulted in several new problems in the area of scheduling that can be addressed using predictions. The first problem is selecting where to run an application on the many resources available in a grid. Our approach to help address this problem is to provide predictions of when an application would start to execute if submitted to specific scheduled computer systems. The second problem is gaining simultaneous access to multiple computer systems so that distributed applications can be executed. We help address this problem by investigating how to support advance reservations in local scheduling systems. Our approaches to both of these problems are based on predictions for the execution time of applications on space- shared parallel computers. As a side effect of this work, we also discuss how predictions of application run times can be used to improve scheduling performance.

The effects of family, school, and classroom ecologies on changes in children's social competence and emotional and behavioral problems in first grade.

PubMed

Hoglund, Wendy L; Leadbeater, Bonnie J

2004-07-01

This study tested the independent and interactive influences of classroom (concentrations of peer prosocial behaviors and victimization), family (household moves, mothers' education), and school (proportion of students receiving income assistance) ecologies on changes in children's social competence (e.g., interpersonal skills, leadership abilities), emotional problems (e.g., anxious, withdrawn behaviors), and behavioral problems (e.g., disruptiveness, aggressiveness) in first grade. Higher classroom concentrations of prosocial behaviors and victimization predicted increases in social competence, and greater school disadvantage predicted decreases. Multiple household moves and greater school disadvantage predicted increases in behavioral problems. Multiple household moves and low levels of mothers' education predicted increases in emotional problems for children in classrooms with few prosocial behaviors. Greater school disadvantage predicted increases in emotional problems for children in classrooms with low prosocial behaviors and high victimization. Policy implications of these findings are considered. Copyright 2004 APA, all rights reserved

Predicting change in early adolescent problem behavior in the middle school years: a mesosystemic perspective on parenting and peer experiences.

PubMed

Véronneau, Marie-Hélène; Dishion, Thomas J

2010-11-01

The transition into middle school may be a risky period in early adolescence. In particular, friendships, peer status, and parental monitoring during this developmental period can influence the development of problem behavior. This study examined interrelationships among peer and parenting factors that predict changes in problem behavior over the middle school years. A longitudinal sample (580 boys, 698 girls) was assessed in Grades 6 and 8. Peer acceptance, peer rejection, and their interaction predicted increases in problem behavior. Having high-achieving friends predicted less problem behavior. Parental monitoring predicted less problem behavior in general, but also acted as a buffer for students who were most vulnerable to developing problem behavior on the basis of being well liked by some peers, and also disliked by several others. These findings highlight the importance of studying the family-peer mesosystem when considering risk and resilience in early adolescence, and when considering implications for intervention.

Externalizing problems in childhood and adolescence predict subsequent educational achievement but for different genetic and environmental reasons.

PubMed

Lewis, Gary J; Asbury, Kathryn; Plomin, Robert

2017-03-01

Childhood behavior problems predict subsequent educational achievement; however, little research has examined the etiology of these links using a longitudinal twin design. Moreover, it is unknown whether genetic and environmental innovations provide incremental prediction for educational achievement from childhood to adolescence. We examined genetic and environmental influences on parental ratings of behavior problems across childhood (age 4) and adolescence (ages 12 and 16) as predictors of educational achievement at age 16 using a longitudinal classical twin design. Shared-environmental influences on anxiety, conduct problems, and peer problems at age 4 predicted educational achievement at age 16. Genetic influences on the externalizing behaviors of conduct problems and hyperactivity at age 4 predicted educational achievement at age 16. Moreover, novel genetic and (to a lesser extent) nonshared-environmental influences acting on conduct problems and hyperactivity emerged at ages 12 and 16, adding to the genetic prediction from age 4. These findings demonstrate that genetic and shared-environmental factors underpinning behavior problems in early childhood predict educational achievement in midadolescence. These findings are consistent with the notion that early-childhood behavior problems reflect the initiation of a life-course persistent trajectory with concomitant implications for social attainment. However, we also find evidence that genetic and nonshared-environment innovations acting on behavior problems have implications for subsequent educational achievement, consistent with recent work arguing that adolescence represents a sensitive period for socioaffective development. © 2016 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Describing and Predicting Developmental Profiles of Externalizing Problems from Childhood to Adulthood

PubMed Central

Petersen, Isaac T.; Bates, John E.; Dodge, Kenneth A.; Lansford, Jennifer E.; Pettit, Gregory S.

2014-01-01

This longitudinal study considers externalizing behavior problems from ages 5 to 27 (N = 585). Externalizing problem ratings by mothers, fathers, teachers, peers, and self-report were modeled with growth curves. Risk and protective factors across many different domains and time frames were included as predictors of the trajectories. A major contribution of the study is in demonstrating how heterotypic continuity and changing measures can be handled in modeling changes in externalizing behavior over long developmental periods. On average, externalizing problems decreased from early childhood to preadolescence, increased during adolescence, and decreased from late adolescence to adulthood. There was strong nonlinear continuity in externalizing problems over time. Family process, peer process, stress, and individual characteristics predicted externalizing problems beyond the strong continuity of externalizing problems. The model accounted for 70% of the variability in the development of externalizing problems. The model’s predicted values showed moderate sensitivity and specificity in prediction of arrests, illegal drug use, and drunk driving. Overall, the study showed that by using changing, developmentally-relevant measures and simultaneously taking into account numerous characteristics of children and their living situations, research can model lengthy spans of development and improve predictions of the development of later, severe externalizing problems. PMID:25166430

Workplace responsibility, stress, alcohol availability and norms as predictors of alcohol consumption-related problems among employed workers.

PubMed

Hodgins, David C; Williams, Robert; Munro, Gordon

2009-01-01

The objectives of this study were to determine the prevalence of alcohol use and problems among employed individuals in Alberta, Canada (N = 1,890), and to conduct a multivariate examination of predictors of alcohol consumption-related problems. General alcohol problems were identified by 10%, although very few workers described any specific work-related alcohol problems (1%). Structural equation modeling revealed that, as hypothesized, workplace alcohol availability predicted general alcohol problems. Job responsibility and workplace norms also predicted alcohol problems but only for men. Perceived work stress did not predict alcohol problems. Results support the development of interventions that focus on re-shaping alcohol use norms.

Development of the Metacognitive Skills of Prediction and Evaluation in Children With or Without Math Disability

PubMed Central

Garrett, Adia J.; Mazzocco, Michèle M. M.; Baker, Linda

2009-01-01

Metacognition refers to knowledge about one’s own cognition. The present study was designed to assess metacognitive skills that either precede or follow task engagement, rather than the processes that occur during a task. Specifically, we examined prediction and evaluation skills among children with (n = 17) or without (n = 179) mathematics learning disability (MLD), from grades 2 to 4. Children were asked to predict which of several math problems they could solve correctly; later, they were asked to solve those problems. They were asked to evaluate whether their solution to each of another set of problems was correct. Children’s ability to evaluate their answers to math problems improved from grade 2 to grade 3, whereas there was no change over time in the children’s ability to predict which problems they could solve correctly. Children with MLD were less accurate than children without MLD in evaluating both their correct and incorrect solutions, and they were less accurate at predicting which problems they could solve correctly. However, children with MLD were as accurate as their peers in correctly predicting that they could not solve specific math problems. The findings have implications for the usefulness of children’s self-review during mathematics problem solving. PMID:20084181

The influence of impulsiveness on binge eating and problem gambling: A prospective study of gender differences in Canadian adults.

PubMed

Farstad, Sarah M; von Ranson, Kristin M; Hodgins, David C; El-Guebaly, Nady; Casey, David M; Schopflocher, Don P

2015-09-01

This study investigated the degree to which facets of impulsiveness predicted future binge eating and problem gambling, 2 theorized forms of behavioral addiction. Participants were 596 women and 406 men from 4 age cohorts randomly recruited from a Canadian province. Participants completed self-report measures of 3 facets of impulsiveness (negative urgency, sensation seeking, lack of persistence), binge-eating frequency, and problem-gambling symptoms. Impulsiveness was assessed at baseline, and assessments of binge eating and problem gambling were followed up after 3 years. Weighted data were analyzed using zero-inflated negative binomial and Poisson regression models. We found evidence of transdiagnostic and disorder-specific predictors of binge eating and problem gambling. Negative urgency emerged as a common predictor of binge eating and problem gambling among women and men. There were disorder-specific personality traits identified among men only: High lack-of-persistence scores predicted binge eating and high sensation-seeking scores predicted problem gambling. Among women, younger age predicted binge eating and older age predicted problem gambling. Thus, there are gender differences in facets of impulsiveness that longitudinally predict binge eating and problem gambling, suggesting that treatments for these behaviors should consider gender-specific personality and demographic traits in addition to the common personality trait of negative urgency. (c) 2015 APA, all rights reserved).

Childhood internalizing and externalizing problems predict the onset of clinical panic attacks over adolescence: the TRAILS study.

PubMed

Mathyssek, Christina M; Olino, Thomas M; Verhulst, Frank C; van Oort, Floor V A

2012-01-01

Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. This study is part of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10-12). At age 18-20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10-20 years, using survival analysis in univariate and multivariate models. There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05), and YSR Thought Problems (HR 1.15, p<.05) and Social Problems (HR 1.26, p<.01) predicted panic attack onset. Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence.

Intuitive reasoning about abstract and familiar physics problems

NASA Technical Reports Server (NTRS)

Kaiser, Mary Kister; Jonides, John; Alexander, Joanne

1986-01-01

Previous research has demonstrated that many people have misconceptions about basic properties of motion. Two experiments examined whether people are more likely to produce dynamically correct predictions about basic motion problems involving situations with which they are familiar, and whether solving such problems enhances performance on a subsequent abstract problem. In experiment 1, college students were asked to predict the trajectories of objects exiting a curved tube. Subjects were more accurate on the familiar version of the problem, and there was no evidence of transfer to the abstract problem. In experiment 2, two familiar problems were provided in an attempt to enhance subjects' tendency to extract the general structure of the problems. Once again, they gave more correct responses to the familiar problems but failed to generalize to the abstract problem. Formal physics training was associated with correct predictions for the abstract problem but was unrelated to performance on the familiar problems.

Infant Sleep Predicts Attention Regulation and Behavior Problems at 3-4 Years of Age.

PubMed

Sadeh, Avi; De Marcas, Gali; Guri, Yael; Berger, Andrea; Tikotzky, Liat; Bar-Haim, Yair

2015-01-01

This longitudinal study assessed the role of early sleep patterns in predicting attention regulation and behavior problems. Sleep of 43 infants was assessed using actigraphy at 12 months of age and then reassessed when the children were 3-4 years old. During this follow-up, their attention regulation and behavior problems were also assessed using a computerized test and parental reports. Lower quality of sleep in infancy significantly predicted compromised attention regulation and behavior problems. These findings underscore the need to identify and treat early sleep problems.

More than just fun and games: the longitudinal relationships between strategic video games, self-reported problem solving skills, and academic grades.

PubMed

Adachi, Paul J C; Willoughby, Teena

2013-07-01

Some researchers have proposed that video games possess good learning principles and may promote problem solving skills. Empirical research regarding this relationship, however, is limited. The goal of the presented study was to examine whether strategic video game play (i.e., role playing and strategy games) predicted self-reported problem solving skills among a sample of 1,492 adolescents (50.8 % female), over the four high school years. The results showed that more strategic video game play predicted higher self-reported problem solving skills over time than less strategic video game play. In addition, the results showed support for an indirect association between strategic video game play and academic grades, in that strategic video game play predicted higher self-reported problem solving skills, and, in turn, higher self-reported problem solving skills predicted higher academic grades. The novel findings that strategic video games promote self-reported problem solving skills and indirectly predict academic grades are important considering that millions of adolescents play video games every day.

Does Early Childhood Callous-Unemotional Behavior Uniquely Predict Behavior Problems or Callous-Unemotional Behavior in Late Childhood?

ERIC Educational Resources Information Center

Waller, Rebecca; Dishion, Thomas J.; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Hyde, Luke W.

2016-01-01

Callous-unemotional (CU) behavior has been linked to behavior problems in children and adolescents. However, few studies have examined whether CU behavior in "early childhood" predicts behavior problems or CU behavior in "late childhood". This study examined whether indicators of CU behavior at ages 2-4 predicted aggression,…

Using Predictive Analytics to Detect Major Problems in Department of Defense Acquisition Programs

DTIC Science & Technology

2012-03-01

research is focused on three questions. First, can we predict the contractor provided estimate at complete (EAC)? Second, can we use those predictions to...develop an algorithm to determine if a problem will occur in an acquisition program or sub-program? Lastly, can we provide the probability of a problem...more than doubling the probability of a problem occurrence compared to current tools in the cost community. Though program managers can use this

Distance estimation and collision prediction for on-line robotic motion planning

NASA Technical Reports Server (NTRS)

Kyriakopoulos, K. J.; Saridis, G. N.

1992-01-01

An efficient method for computing the minimum distance and predicting collisions between moving objects is presented. This problem is incorporated into the framework of an in-line motion-planning algorithm to satisfy collision avoidance between a robot and moving objects modeled as convex polyhedra. In the beginning, the deterministic problem where the information about the objects is assumed to be certain is examined. L(1) or L(infinity) norms are used to represent distance and the problem becomes a linear programming problem. The stochastic problem is formulated where the uncertainty is induced by sensing and the unknown dynamics of the moving obstacles. Two problems are considered: First, filtering of the distance between the robot and the moving object at the present time. Second, prediction of the minimum distance in the future in order to predict the collision time.

Level of self-esteem and contingencies of self-worth: unique effects on academic, social, and financial problems in college students.

PubMed

Crocker, Jennifer; Luhtanen, Riia K

2003-06-01

The unique effects of level of self-esteem and contingencies of self-worth assessed prior to college on academic, social, and financial problems experienced during the freshman year were examined in a longitudinal study of 642 college students. Low self-esteem predicted social problems, even controlling for demographic and personality variables (neuroticism, agreeableness, and social desirability), but did not predict academic or financial problems with other variables controlled. Academic competence contingency predicted academic and financial problems and appearance contingency predicted financial problems, even after controlling for relevant personality variables. We conclude that contingencies of self-worth uniquely contribute to academic and financial difficulties experienced by college freshmen beyond level of self-esteem and other personality variables. Low self-esteem, on the other hand, appears to uniquely contribute to later social difficulties.

Family correlates of childhood binge eating: A systematic review.

PubMed

Saltzman, Jaclyn A; Liechty, Janet M

2016-08-01

Binge Eating Disorder is the most prevalent eating disorder in the US, and binge eating has been identified in children as young as five. As part of a larger registered systematic review, we identified family correlates of binge eating in children (C-BE) aged 12 and under. Using established guidelines, we searched PubMed and PsycInfo for peer-reviewed studies published in English between 1980 and April 2015 that examined family correlates and predictors of C-BE. This yielded 736 records for review; after exclusions fifteen studies were reviewed. Risk of bias was assessed. A risk factor typology was used to classify correlates. Nine of the included studies were cross-sectional and six longitudinal. Family weight teasing and parent emotional unresponsiveness were correlates of C-BE. Parent weight, education/socio-economic situation, and parent race/ethnicity were not associated with C-BE in any study reviewed. There was insufficient or unclear evidence regarding associations between C-BE and parent disordered eating, weight or thinness concern, harsh discipline, maternal dieting, attachment security, and mealtimes and feeding practices. Limitations included too few studies on many of the correlates to summarize, inconsistency of findings, homogenous samples, and predominately cross-sectional designs. Weight-related teasing in families and parental emotional unresponsiveness are correlates of C-BE and important areas to address in parent education and eating disorder prevention programs with families. Further longitudinal studies on putative risk factors for binge eating in childhood are needed to address current limitations, enable synthesis across studies, and inform public health efforts to prevent binge eating problems in children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Implications of gambling problems for family and interpersonal adjustment: results from the Quinte Longitudinal Study.

PubMed

Cowlishaw, Sean; Suomi, Aino; Rodgers, Bryan

2016-09-01

To evaluate (1) whether gambling problems predict overall trajectories of change in family or interpersonal adjustment and (2) whether annual measures of gambling problems predict time-specific decreases in family or interpersonal adjustment, concurrently and prospectively. The Quinte Longitudinal Study (QLS) involved random-digit dialling of telephone numbers around the city of Belleville, Canada to recruit 'general population' and 'at-risk' groups (the latter oversampling people likely to develop problems). Five waves of assessment were conducted (2006-10). Latent Trajectory Modelling (LTM) estimated overall trajectories of family and interpersonal adjustment, which were predicted by gambling problems, and also estimated how time-specific problems predicted deviations from these trajectories. Southeast Ontario, Canada. Community sample of Canadian adults (n = 4121). The Problem Gambling Severity Index (PGSI) defined at-risk gambling (ARG: PGSI 1-2) and moderate-risk/problem gambling (MR/PG: PGSI 3+). Outcomes included: (1) family functioning, assessed using a seven-point rating of overall functioning; (2) social support, assessed using items from the Non-support subscale of the Personality Assessment Inventory; and (3) relationship satisfaction, measured by the Kansas Marital Satisfaction Scale. Baseline measures of ARG and MR/PG did not predict rates of change in trajectories of family or interpersonal adjustment. Rather, the annual measures of MR/PG predicted time-specific decreases in family functioning (estimate: -0.11, P < 0.01), social support (estimate: -0.28, P < 0.01) and relationship satisfaction (estimate: -0.53, P < 0.01). ARG predicted concurrent levels of family functioning (estimate: -0.07, P < 0.01). There were time-lagged effects of MR/PG on subsequent levels of family functioning (estimate: -0.12, P < 0.01) and social support (estimate: -0.24, P < 0.01). In a longitudinal study of Canadian adults, moderate-risk/problem gambling did not predict overall trajectories of family or interpersonal adjustment. Rather, the annual measures of moderate-risk/problem gambling predicted time-specific and concurrent decreases in all outcomes, and lower family functioning and social support across adjacent waves. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

A Conceptual Model for the Development of Externalizing Behavior Problems Among Kindergarten Children of Alcoholic Families: Role of Parenting and Children's Self-Regulation

PubMed Central

Eiden, Rina D.; Edwards, Ellen P.; Leonard, Kenneth E.

2009-01-01

The purpose of this study was to test a conceptual model predicting children's externalizing behavior problems in kindergarten in a sample of children with alcoholic (n = 130) and nonalcoholic (n = 97) parents. The model examined the role of parents' alcohol diagnoses, depression, and antisocial behavior at 12–18 months of child age in predicting parental warmth/sensitivity at 2 years of child age. Parental warmth/sensitivity at 2 years was hypothesized to predict children's self-regulation at 3 years (effortful control and internalization of rules), which in turn was expected to predict externalizing behavior problems in kindergarten. Structural equation modeling was largely supportive of this conceptual model. Fathers' alcohol diagnosis at 12–18 months was associated with lower maternal and paternal warmth/sensitivity at 2 years. Lower maternal warmth/sensitivity was longitudinally predictive of lower child self-regulation at 3 years, which in turn was longitudinally predictive of higher externalizing behavior problems in kindergarten, after controlling for prior behavior problems. There was a direct association between parents' depression and children's externalizing behavior problems. Results indicate that one pathway to higher externalizing behavior problems among children of alcoholics may be via parenting and self-regulation in the toddler to preschool years. PMID:17723044

The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management.

PubMed

Paterson, Megan; Bell, Kirstine J; O'Connell, Susan M; Smart, Carmel E; Shafat, Amir; King, Bruce

2015-09-01

A primary focus of the management of type 1 diabetes has been on matching prandial insulin therapy with carbohydrate amount consumed. However, even with the introduction of more flexible intensive insulin regimes, people with type 1 diabetes still struggle to achieve optimal glycaemic control. More recently, dietary fat and protein have been recognised as having a significant impact on postprandial blood glucose levels. Fat and protein independently increase the postprandial glucose excursions and together their effect is additive. This article reviews how the fat and protein in a meal impact the postprandial glycaemic response and discusses practical approaches to managing this in clinical practice. These insights have significant implications for patient education, mealtime insulin dose calculations and dosing strategies.

Behavioral Risk Assessment From Newborn to Preschool: The Value of Older Siblings.

PubMed

Rodrigues, Michelle; Binnoon-Erez, Noam; Plamondon, Andre; Jenkins, Jennifer M

2017-08-01

The aim of this study was to examine the plausibility of a risk prediction tool in infancy for school-entry emotional and behavioral problems. Familial aggregation has been operationalized previously as maternal psychopathology. The hypothesis was tested that older sibling (OS) psychopathology, as an indicator of familial aggregation, would enable a fair level of risk prediction compared with previous research, when combined with traditional risk factors. By using a longitudinal design, data on child and family risk factors were collected on 323 infants ( M = 2.00 months), all of whom had OSs. Infants were followed up 4.5 years later when both parents provided ratings of emotional and behavioral problems. Multiple regression and receiver operating characteristic curve analyses were conducted for emotional, conduct, and attention problems separately. The emotional and behavioral problems of OSs at infancy were the strongest predictors of the same problems in target children 4.5 years later. Other risk factors, including maternal depression and socioeconomic status provided extra, but weak, significant prediction. The area under the receiver operating characteristic curve for emotional and conduct problems yielded a fair prediction. This study is the first to offer a fair degree of prediction from risk factors at birth to school-entry emotional and behavioral problems. This degree of prediction was achieved with the inclusion of the emotional and behavioral problems of OSs (thus limiting generalizability to children with OSs). The inclusion of OS psychopathology raises risk prediction to a fair level. Copyright © 2017 by the American Academy of Pediatrics.

Differential Effects of Parent and Grandparent Drug Use on Behavior Problems of Male and Female Children.

ERIC Educational Resources Information Center

Stein, Judith A.; And Others

1993-01-01

Grandparents' and mothers' drug use predicted hyperactivity, psychosomatic complaints, and social problems for boys, and acting-out behaviors for boys and girls. Maternal drug use predicted fearfulness, hyperactivity, and social problems for boys, and developmental problems for boys and girls. (BC)

A Comparative Study of Classification and Regression Algorithms for Modelling Students' Academic Performance

ERIC Educational Resources Information Center

Strecht, Pedro; Cruz, Luís; Soares, Carlos; Mendes-Moreira, João; Abreu, Rui

2015-01-01

Predicting the success or failure of a student in a course or program is a problem that has recently been addressed using data mining techniques. In this paper we evaluate some of the most popular classification and regression algorithms on this problem. We address two problems: prediction of approval/failure and prediction of grade. The former is…

Predicting Motor Skills from Strengths and Difficulties Questionnaire Scores, Language Ability, and Other Features of New Zealand Children Entering Primary School

ERIC Educational Resources Information Center

Sargisson, Rebecca J.; Powell, Cheniel; Stanley, Peter; de Candole, Rosalind

2014-01-01

The motor and language skills, emotional and behavioural problems of 245 children were measured at school entry. Fine motor scores were significantly predicted by hyperactivity, phonetic awareness, prosocial behaviour, and the presence of medical problems. Gross motor scores were significantly predicted by the presence of medical problems. The…

Development of a theory-based questionnaire to assess structure and control in parent feeding (SCPF).

PubMed

Savage, Jennifer S; Rollins, Brandi Y; Kugler, Kari C; Birch, Leann L; Marini, Michele E

2017-01-26

Parents shape children's eating environments and act as powerful socialization agents, impacting young children's behavioral controls of food intake. Most feeding measures assess parents' use of control to manage children's intake of energy dense foods. The Structure and Control in Parent Feeding (SCPF) questionnaire was developed to assess more positive aspects of feeding practices with their young children -setting limits, providing routines-that promote self-regulation, as well as controlling feeding practices. A mixed method approach was used to develop the SCPF. In 2013, cognitive interviews informed the modification, deletion and/or replacement of items. In 2014, the survey was distributed statewide to mothers of toddlers aged 12 to 36 months participating in the Women, Infants, and Children program. In 2016, exploratory factor analyses was conducted to test our theoretical parenting model and content validity and criterion validity were assessed (n = 334). Exploratory factor analysis (EFA) and second-order EFA revealed a 2-factor, 22-item Structure model and a 2-factor, 12-item Control model. Internal consistencies for all factors exceeded 0.70. As predicted, the Structure superfactor was positivity associated with responsiveness, whereas the Control superfactor was positively associated with demandingness on the Caregiver's Feeding Styles Questionnaire. The Structure subscales were also positively associated with mealtime behaviors and Control subscales were positively associated with control-oriented feeding measures from the Control in Parent Feeding Practices questionnaire. The SCPF questionnaire is a reliable tool that can be used to assess aspects of structure- and control-based feeding practices to better understand how parents feed their toddlers.

Randomized Crossover Comparison of Personalized MPC and PID Control Algorithms for the Artificial Pancreas

PubMed Central

Pinsker, Jordan E.; Lee, Joon Bok; Dassau, Eyal; Seborg, Dale E.; Bradley, Paige K.; Gondhalekar, Ravi; Bevier, Wendy C.; Huyett, Lauren; Zisser, Howard C.; Doyle, Francis J.

2016-01-01

OBJECTIVE To evaluate two widely used control algorithms for an artificial pancreas (AP) under nonideal but comparable clinical conditions. RESEARCH DESIGN AND METHODS After a pilot safety and feasibility study (n = 10), closed-loop control (CLC) was evaluated in a randomized, crossover trial of 20 additional adults with type 1 diabetes. Personalized model predictive control (MPC) and proportional integral derivative (PID) algorithms were compared in supervised 27.5-h CLC sessions. Challenges included overnight control after a 65-g dinner, response to a 50-g breakfast, and response to an unannounced 65-g lunch. Boluses of announced dinner and breakfast meals were given at mealtime. The primary outcome was time in glucose range 70–180 mg/dL. RESULTS Mean time in range 70–180 mg/dL was greater for MPC than for PID (74.4 vs. 63.7%, P = 0.020). Mean glucose was also lower for MPC than PID during the entire trial duration (138 vs. 160 mg/dL, P = 0.012) and 5 h after the unannounced 65-g meal (181 vs. 220 mg/dL, P = 0.019). There was no significant difference in time with glucose <70 mg/dL throughout the trial period. CONCLUSIONS This first comprehensive study to compare MPC and PID control for the AP indicates that MPC performed particularly well, achieving nearly 75% time in the target range, including the unannounced meal. Although both forms of CLC provided safe and effective glucose management, MPC performed as well or better than PID in all metrics. PMID:27289127

Childhood Internalizing and Externalizing Problems Predict the Onset of Clinical Panic Attacks over Adolescence: The TRAILS Study

PubMed Central

Mathyssek, Christina M.; Olino, Thomas M.; Verhulst, Frank C.; van Oort, Floor V. A.

2012-01-01

Background Panic attacks are a source of individual suffering and are an independent risk factor for later psychopathology. However, much less is known about risk factors for the development of panic attacks, particularly during adolescence when the incidence of panic attacks increases dramatically. We examined whether internalizing and externalizing problems in childhood predict the onset of panic attacks in adolescence. Method This study is part of the TRacking Adolescents’ Individual Lives Survey (TRAILS), a Dutch longitudinal population cohort study (N = 1,584). Internalizing and Externalizing Problems were collected using the Youth Self-Report (YSR) and the parent-report Child Behavior Checklist (CBCL) at baseline (age 10–12). At age 18–20, DSM-IV defined panic attacks since baseline were assessed with the Composite International Diagnostic Interview (CIDI). We investigated whether early adolescent Internalizing and Externalizing Problems predicted panic attacks between ages 10–20 years, using survival analysis in univariate and multivariate models. Results There were N = 314 (19.8%) cases who experienced at least one DSM-IV defined panic attack during adolescence and N = 18 (1.2%) who developed panic disorder during adolescence. In univariate analyses, CBCL Total Problems, Internalizing Problems and three of the eight syndrome scales predicted panic attack onset, while on the YSR all broad-band problem scales and each narrow-band syndrome scale predicted panic attack onset. In multivariate analyses, CBCL Social Problems (HR 1.19, p<.05), and YSR Thought Problems (HR 1.15, p<.05) and Social Problems (HR 1.26, p<.01) predicted panic attack onset. Conclusion Risk indicators of panic attack include the wide range of internalizing and externalizing problems. Yet, when adjusted for co-occurring problem behaviors, Social Problems were the most consistent risk factor for panic attack onsets in adolescence. PMID:23251576

Emotion dysregulation and peer drinking norms uniquely predict alcohol-related problems via motives.

PubMed

Simons, Raluca M; Hahn, Austin M; Simons, Jeffrey S; Murase, Hanako

2017-08-01

This study examined the relationships between emotion dysregulation, peer drinking norms, drinking motives, and alcohol-related outcomes among 435 college students. We examined the mediating roles of drinking motives when predicting alcohol consumption and related problems from the subscales of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) via negative and positive reinforcement models. First, we hypothesized that individuals who lack in emotion regulation strategies or have difficulties in accepting negative emotions are more likely to drink to cope. Additionally, we hypothesized that individuals who act impulsively or become distracted when upset as well as those with higher peer drinking norms are more likely to drink for social and enhancement motives. The results of the path model indicated that limited access to emotion regulation strategies significantly predicted alcohol-related problems via both depression and anxiety coping motives, but did not predict alcohol consumption. Nonacceptance of emotional responses was not significantly associated with coping motives. Impulsivity had a significant direct relationship with alcohol problems. Difficulty in engaging in goal-directed behaviors predicted both enhancement and social motives, but only enhancement motives in turn predicted consumption. Norms indirectly predicted problems via enhancement motives and consumption. The results indicated that using alcohol to reduce negative or to increase positive emotions increases alcohol consumption and alcohol-related problems. Overall, results advance our understanding of the mechanisms of increased alcohol use and problems among college students. Copyright © 2017 Elsevier B.V. All rights reserved.

Distance estimation and collision prediction for on-line robotic motion planning

NASA Technical Reports Server (NTRS)

Kyriakopoulos, K. J.; Saridis, G. N.

1991-01-01

An efficient method for computing the minimum distance and predicting collisions between moving objects is presented. This problem has been incorporated in the framework of an in-line motion planning algorithm to satisfy collision avoidance between a robot and moving objects modeled as convex polyhedra. In the beginning the deterministic problem, where the information about the objects is assumed to be certain is examined. If instead of the Euclidean norm, L(sub 1) or L(sub infinity) norms are used to represent distance, the problem becomes a linear programming problem. The stochastic problem is formulated, where the uncertainty is induced by sensing and the unknown dynamics of the moving obstacles. Two problems are considered: (1) filtering of the minimum distance between the robot and the moving object, at the present time; and (2) prediction of the minimum distance in the future, in order to predict possible collisions with the moving obstacles and estimate the collision time.

Cortisol Secretion and Change in Sleep Problems in Early Childhood: Moderation by Maternal Overcontrol

PubMed Central

Kiel, Elizabeth J.; Hummel, Alexandra C.; Luebbe, Aaron M.

2015-01-01

Childhood sleep problems are prevalent and relate to a wide range of negative psychological outcomes. However, it remains unclear how biological processes, such as HPA activity, may predict sleep problems over time in childhood in the context of certain parenting environments. Fifty-one mothers and their 18–20 month-old toddlers participated in a short-term longitudinal study assessing how shared variance among morning levels, diurnal change, and nocturnal change in toddlers’ cortisol secretion predicted change in sleep problems in the context of maternal overprotection and critical control. A composite characterized by low variability in, and, to a lesser extent, high morning values of cortisol, predicted increasing sleep problems from age 2 to age 3 when mothers reported high critical control. Results suggest value in assessing shared variance among different indices of cortisol secretion patterns and the interaction between cortisol and the environment in predicting sleep problems in early childhood. PMID:25766262

A Confidant Support and Problem Solving Model of Divorced Fathers’ Parenting

PubMed Central

DeGarmo, David S.; Forgatch, Marion S.

2011-01-01

This study tested a hypothesized social interaction learning (SIL) model of confidant support and paternal parenting. The latent growth curve analysis employed 230 recently divorced fathers, of which 177 enrolled support confidants, to test confidant support as a predictor of problem solving outcomes and problem solving outcomes as predictors of change in fathers’ parenting. Fathers’ parenting was hypothesized to predict growth in child behavior. Observational measures of support behaviors and problem solving outcomes were obtained from structured discussions of personal and parenting issues faced by the fathers. Findings replicated and extended prior cross-sectional studies with divorced mothers and their confidants. Confidant support predicted better problem solving outcomes, problem solving predicted more effective parenting, and parenting in turn predicted growth in children’s reduced total problem behavior T scores over 18 months. Supporting a homophily perspective, fathers’ antisociality was associated with confidant antisociality but only fathers’ antisociality influenced the support process model. Intervention implications are discussed regarding SIL parent training and social support. PMID:21541814

A confidant support and problem solving model of divorced fathers' parenting.

PubMed

Degarmo, David S; Forgatch, Marion S

2012-03-01

This study tested a hypothesized social interaction learning (SIL) model of confidant support and paternal parenting. The latent growth curve analysis employed 230 recently divorced fathers, of which 177 enrolled support confidants, to test confidant support as a predictor of problem solving outcomes and problem solving outcomes as predictors of change in fathers' parenting. Fathers' parenting was hypothesized to predict growth in child behavior. Observational measures of support behaviors and problem solving outcomes were obtained from structured discussions of personal and parenting issues faced by the fathers. Findings replicated and extended prior cross-sectional studies with divorced mothers and their confidants. Confidant support predicted better problem solving outcomes, problem solving predicted more effective parenting, and parenting in turn predicted growth in children's reduced total problem behavior T scores over 18 months. Supporting a homophily perspective, fathers' antisociality was associated with confidant antisociality but only fathers' antisociality influenced the support process model. Intervention implications are discussed regarding SIL parent training and social support.

Child maltreatment, parent alcohol and drug-related problems, polydrug problems, and parenting practices: a test of gender differences and four theoretical perspectives.

PubMed

Locke, Thomas F; Newcomb, Michael

2004-03-01

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting.

Prediction of Sea Surface Temperature Using Long Short-Term Memory

NASA Astrophysics Data System (ADS)

Zhang, Qin; Wang, Hui; Dong, Junyu; Zhong, Guoqiang; Sun, Xin

2017-10-01

This letter adopts long short-term memory(LSTM) to predict sea surface temperature(SST), which is the first attempt, to our knowledge, to use recurrent neural network to solve the problem of SST prediction, and to make one week and one month daily prediction. We formulate the SST prediction problem as a time series regression problem. LSTM is a special kind of recurrent neural network, which introduces gate mechanism into vanilla RNN to prevent the vanished or exploding gradient problem. It has strong ability to model the temporal relationship of time series data and can handle the long-term dependency problem well. The proposed network architecture is composed of two kinds of layers: LSTM layer and full-connected dense layer. LSTM layer is utilized to model the time series relationship. Full-connected layer is utilized to map the output of LSTM layer to a final prediction. We explore the optimal setting of this architecture by experiments and report the accuracy of coastal seas of China to confirm the effectiveness of the proposed method. In addition, we also show its online updated characteristics.

Evolutionary Dynamic Multiobjective Optimization Via Kalman Filter Prediction.

PubMed

Muruganantham, Arrchana; Tan, Kay Chen; Vadakkepat, Prahlad

2016-12-01

Evolutionary algorithms are effective in solving static multiobjective optimization problems resulting in the emergence of a number of state-of-the-art multiobjective evolutionary algorithms (MOEAs). Nevertheless, the interest in applying them to solve dynamic multiobjective optimization problems has only been tepid. Benchmark problems, appropriate performance metrics, as well as efficient algorithms are required to further the research in this field. One or more objectives may change with time in dynamic optimization problems. The optimization algorithm must be able to track the moving optima efficiently. A prediction model can learn the patterns from past experience and predict future changes. In this paper, a new dynamic MOEA using Kalman filter (KF) predictions in decision space is proposed to solve the aforementioned problems. The predictions help to guide the search toward the changed optima, thereby accelerating convergence. A scoring scheme is devised to hybridize the KF prediction with a random reinitialization method. Experimental results and performance comparisons with other state-of-the-art algorithms demonstrate that the proposed algorithm is capable of significantly improving the dynamic optimization performance.

Minority stress and sexual problems among African-American gay and bisexual men.

PubMed

Zamboni, Brian D; Crawford, Isiaah

2007-08-01

Minority stress, such as racism and gay bashing, may be associated with sexual problems, but this notion has not been examined in the literature. African-American gay/bisexual men face a unique challenge in managing a double minority status, putting them at high risk for stress and sexual problems. This investigation examined ten predictors of sexual problems among 174 African-American gay/bisexual men. Covarying for age, a forward multiple regression analysis showed that the measures of self-esteem, male gender role stress, HIV prevention self-efficacy, and lifetime experiences with racial discrimination significantly added to the prediction of sexual problems. Gay bashing, psychiatric symptoms, low life satisfaction, and low social support were significantly correlated with sexual problems, but did not add to the prediction of sexual problems in the regression analysis. Mediation analyses showed that stress predicted psychiatric symptoms, which then predicted sexual problems. Sexual problems were not significantly related to HIV status, racial/ethnic identity, or gay identity. The findings from this study showed a relationship between experiences with racial and sexual discrimination and sexual problems while also providing support for mediation to illustrate how stress might cause sexual problems. Addressing minority stress in therapy may help minimize and treat sexual difficulties among minority gay/bisexual men.

Mental health of adolescents before and after the death of a parent or sibling.

PubMed

Stikkelbroek, Yvonne; Bodden, Denise H M; Reitz, Ellen; Vollebergh, Wilma A M; van Baar, Anneloes L

2016-01-01

The death of a parent or sibling (family bereavement) is associated with mental health problems in approximately, 25 % of the affected children. However, it is still unknown whether mental health problems of family-bereaved adolescents are predicted by pre-existing mental health problems, pre-loss family functioning, or multiple bereavements. In this study, a prospective longitudinal assessment of change in mental health following bereavement was done in a large representative sample from the 'Tracking Adolescents Individual Lives Survey' (TRAILS). This is a four-wave prospective cohort study of Dutch adolescents (n = 2230) of whom 131 (5.9 %) had experienced family bereavement at the last wave (T4). Family-bereaved adolescents reported more internalizing problems, within 2 years after family bereavement, compared to the non-bereaved peers, while taking into account the level of internalizing problems before the bereavement. A clinically relevant finding was that 22 % new cases were found in family-bereaved, in comparison to 5.5 % new cases in non-bereaved. Low SES predicted more internalizing problems in family-bereaved but not in non-bereaved adolescents. Family functioning, reported by the adolescent, did not predict mental health problems within 2 years. Multiple family bereavements predicted fewer externalizing problems. In conclusion, internalizing problems increase in adolescents after family bereavement in comparison to non-bereaved and these can be predicted by pre-loss factors. Awareness among professionals regarding the risks for aggravation of mental health problems after family loss is needed.

Temperament and Parenting during the First Year of Life Predict Future Child Conduct Problems

ERIC Educational Resources Information Center

Lahey, Benjamin B.; Van Hulle, Carol A.; Keenan, Kate; Rathouz, Paul J.; D'Onofrio, Brian M.; Rodgers, Joseph Lee; Waldman, Irwin D.

2008-01-01

Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct…

Acculturation Stress and Drinking Problems Among Urban Heavy Drinking Latinos in the Northeast

PubMed Central

Lee, Christina S.; Colby, Suzanne M.; Rohsenow, Damaris J.; López, Steven R.; Hernández, Lynn; Caetano, Raul

2014-01-01

This study investigates the relationship between level of acculturation and acculturation stress, and the extent to which each predicts problems related to drinking. Hispanics who met criteria for hazardous drinking completed measures of acculturation, acculturation stress, and drinking problems. Sequential multiple regression was used to determine whether levels of self-reported acculturation stress predicted concurrent alcohol problems after controlling for the predictive value of acculturation level. Acculturation stress accounted for significant variance in drinking problems while adjusting for acculturation, income, and education. Choosing to drink in response to acculturation stress should be an intervention target with Hispanic heavy drinkers. PMID:24215224

Acculturation stress and drinking problems among urban heavy drinking Latinos in the Northeast.

PubMed

Lee, Christina S; Colby, Suzanne M; Rohsenow, Damaris J; López, Steven R; Hernández, Lynn; Caetano, Raul

2013-01-01

This study investigates the relationship between the level of acculturation and acculturation stress and the extent to which each predicts problems related to drinking. Hispanics who met criteria for hazardous drinking completed measures of acculturation, acculturation stress, and drinking problems. Sequential multiple regression was used to determine whether the levels of self-reported acculturation stress predicted concurrent alcohol problems after controlling for the predictive value of the acculturation level. Acculturation stress accounted for a significant variance in drinking problems, while adjusting for acculturation, income, and education. Choosing to drink in response to acculturation stress should be an intervention target with Hispanic heavy drinkers.

How much do residential aged care staff members know about the nutritional needs of residents?

PubMed

Beattie, Elizabeth; O'Reilly, Maria; Strange, Elise; Franklin, Sara; Isenring, Elisabeth

2014-03-01

Undernutrition, weight loss and dehydration are major clinical issues for people with dementia in residential care, with excessive weight loss contributing to increased risk of frailty, immobility, illness and premature morbidity. This paper discusses a nutritional knowledge and attitudes survey conducted as part of a larger project focused on improving nutritional intake of people with dementia within a residential care facility in Brisbane, Australia. The specific aims of the survey were to identify (i) knowledge of the nutritional needs of aged care facility residents; (ii) mealtime practices; and (iii) attitudes towards mealtime practices and organisation. A survey based on those used in other healthcare settings was completed by 76 staff members. The survey included questions about nutritional knowledge, opinions of the food service, frequency of feeding assistance provided and feeding assessment practices. Nutritional knowledge scores ranged from 1 to 9 of a possible 10, with a mean score of 4.67. While 76% of respondents correctly identified risk factors associated with malnutrition in nursing home residents, only 38% of participants correctly identified the need for increased protein and energy in residents with pressure ulcers, and just 15% exhibited correct knowledge of fluid requirements. Further, while nutritional assessment was considered an important part of practice by 83% of respondents, just 53% indicated that they actually carried out such assessments. Identified barriers to promoting optimal nutrition included insufficient time to observe residents (56%); being unaware of residents' feeding issues (46%); poor knowledge of nutritional assessments (44%); and unappetising appearance of food served (57%). An important step towards improving health and quality of life for residents of aged care facilities would be to enhance staff nutritional awareness and assessment skills. This should be carried out through increased attention to both preservice curricula and on-the-job training. The residential facility staff surveyed demonstrated low levels of nutrition knowledge, which reflects findings from the international literature. This has implications for the provision of responsive care to residents of these facilities and should be explored further. © 2013 Blackwell Publishing Ltd.

Fetal response to maternal hunger and satiation - novel finding from a qualitative descriptive study of maternal perception of fetal movements.

PubMed

Bradford, Billie; Maude, Robyn

2014-08-26

Maternal perception of decreased fetal movements is a specific indicator of fetal compromise, notably in the context of poor fetal growth. There is currently no agreed numerical definition of decreased fetal movements, with the subjective perception of a decrease on the part of the mother being the most significant definition clinically. Both qualitative and quantitative aspects of fetal activity may be important in identifying the compromised fetus.Yet, how pregnant women perceive and describe fetal activity is under-investigated by qualitative means. The aim of this study was to explore normal fetal activity, through first-hand descriptive accounts by pregnant women. Using qualitative descriptive methodology, interviews were conducted with 19 low-risk women experiencing their first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis and patterns of fetal activity identified were then considered along-side the characteristics of the women and their birth outcomes. This paper focuses on a novel finding; the description by pregnant women of fetal behaviour indicative of hunger and satiation. Full findings will be presented in later papers. Most participants (74% 14 of 19) indicated mealtimes were a time of increased fetal activity. Eight participants provided detailed descriptions of increased activity around meals, with seven (37% 7 of 19) of these specifying increased fetal activity prior to meals or in the context of their own hunger. These movements were interpreted as a fetal demand for food often prompting the mother to eat. Interestingly, the women who described increased fetal activity in the context of hunger subsequently gave birth to smaller infants (mean difference 364 gm) than those who did not describe a fetal response to hunger. Food seeking behaviour may have a pre-birth origin. Maternal-fetal interaction around mealtimes could constitute an endocrine mediated communication, in the interests of maintaining optimal intrauterine conditions. Further research is warranted to explore this phenomenon and the potential influence of feeding on the temporal organisation of fetal activity in relation to growth.

Patients' and caregivers' experiences of using continuous glucose monitoring to support diabetes self-management: qualitative study.

PubMed

Lawton, J; Blackburn, M; Allen, J; Campbell, F; Elleri, D; Leelarathna, L; Rankin, D; Tauschmann, M; Thabit, H; Hovorka, R

2018-02-20

Continuous glucose monitoring (CGM) enables users to view real-time interstitial glucose readings and provides information on the direction and rate of change of blood glucose levels. Users can also access historical data to inform treatment decisions. While the clinical and psychological benefits of CGM are well established, little is known about how individuals use CGM to inform diabetes self-management. We explored participants' experiences of using CGM in order to provide recommendations for supporting individuals to make optimal use of this technology. In-depth interviews (n = 24) with adults, adolescents and parents who had used CGM for ≥4 weeks; data were analysed thematically. Participants found CGM an empowering tool because they could access blood glucose data effortlessly, and trend arrows enabled them to see whether blood glucose was rising or dropping and at what speed. This predicative information aided short-term lifestyle planning and enabled individuals to take action to prevent hypoglycaemia and hyperglycaemia. Having easy access to blood glucose data on a continuous basis also allowed participants to develop a better understanding of how insulin, activity and food impacted on blood glucose. This understanding was described as motivating individuals to make dietary changes and break cycles of over-treating hypoglycaemia and hyperglycaemia. Participants also described how historical CGM data provided a more nuanced picture of blood glucose control than was possible with blood glucose self-monitoring and, hence, better information to inform changes to background insulin doses and mealtime ratios. However, while participants expressed confidence making immediate adjustments to insulin and lifestyle to address impending hypoglycaemia and hypoglycaemia, most described needing and expecting health professionals to interpret historical CGM data and determine changes to background insulin doses and mealtime ratios. While alarms could reinforce a sense of hypoglycaemic safety, some individuals expressed ambivalent views, especially those who perceived alarms as signalling personal failure to achieve optimal glycaemic control. CGM can be an empowering and motivational tool which enables participants to fine-tune and optimize their blood glucose control. However, individuals may benefit from psycho-social education, training and/or technological support to make optimal use of CGM data and use alarms appropriately.

Increased prandial air swallowing and postprandial gas-liquid reflux among patients refractory to proton pump inhibitor therapy.

PubMed

Bravi, Ivana; Woodland, Philip; Gill, Ravinder S; Al-Zinaty, Mohannad; Bredenoord, Albert J; Sifrim, Daniel

2013-07-01

Many patients with gastroesophageal reflux disease (GERD) have persistent reflux despite treatment with proton pump inhibitors (PPIs). Mixed gas-liquid reflux events are more likely to be perceived as symptomatic. We used esophageal impedance monitoring to investigate whether esophageal gas is processed differently among patients with GERD who do and do not respond to PPI therapy. We performed a prospective study of 44 patients with typical reflux symptoms with high levels of esophageal acid exposure during a 24-hour period; 18 patients were fully responsive, and 26 did not respond to PPI therapy. Twenty-four-hour pH impedance recordings were analyzed for fasting and prandial air swallows and reflux characteristics, including the presence of gas in the refluxate. PPI-refractory patients had a higher number (83.1 ± 12.7 vs 47.8 ± 7.3, P < .05) and rate (10.5 ± 1.4 vs 5.9 ± 0.8/10 minutes, P < .05) of prandial air swallows than patients who responded to PPI therapy; they also had a higher number (25.5 ± 4.0 vs 16.8 ± 3.3, P < .05) and proportion (70% ± 0.03% vs 54% ± 0.06%, P < .05) of postprandial, mixed gas-liquid reflux. Symptoms of PPI-refractory patients were more often preceded by mixed gas-liquid reflux events than those of PPI responders. Fasting air swallowing and other reflux characteristics did not differ between patients who did and did not respond to PPIs. Some patients with GERD who do not respond to PPI therapy swallow more air at mealtime than those who respond to PPIs and also have more reflux episodes that contain gas. These factors, combined with mucosal sensitization by previous exposure to acid, could affect perception of symptoms. These patients, who can be identified on standard 24-hour pH impedance monitoring, might be given behavioral therapy to reduce mealtime air swallowing. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Methodological considerations for observational coding of eating and feeding behaviors in children and their families.

PubMed

Pesch, Megan H; Lumeng, Julie C

2017-12-15

Behavioral coding of videotaped eating and feeding interactions can provide researchers with rich observational data and unique insights into eating behaviors, food intake, food selection as well as interpersonal and mealtime dynamics of children and their families. Unlike self-report measures of eating and feeding practices, the coding of videotaped eating and feeding behaviors can allow for the quantitative and qualitative examinations of behaviors and practices that participants may not self-report. While this methodology is increasingly more common, behavioral coding protocols and methodology are not widely shared in the literature. This has important implications for validity and reliability of coding schemes across settings. Additional guidance on how to design, implement, code and analyze videotaped eating and feeding behaviors could contribute to advancing the science of behavioral nutrition. The objectives of this narrative review are to review methodology for the design, operationalization, and coding of videotaped behavioral eating and feeding data in children and their families, and to highlight best practices. When capturing eating and feeding behaviors through analysis of videotapes, it is important for the study and coding to be hypothesis driven. Study design considerations include how to best capture the target behaviors through selection of a controlled experimental laboratory environment versus home mealtime, duration of video recording, number of observations to achieve reliability across eating episodes, as well as technical issues in video recording and sound quality. Study design must also take into account plans for coding the target behaviors, which may include behavior frequency, duration, categorization or qualitative descriptors. Coding scheme creation and refinement occur through an iterative process. Reliability between coders can be challenging to achieve but is paramount to the scientific rigor of the methodology. Analysis approach is dependent on the how data were coded and collapsed. Behavioral coding of videotaped eating and feeding behaviors can capture rich data "in-vivo" that is otherwise unobtainable from self-report measures. While data collection and coding are time-intensive the data yielded can be extremely valuable. Additional sharing of methodology and coding schemes around eating and feeding behaviors could advance the science and field.

Feasibility and Acceptability of Brighter Bites: A Food Co-Op in Schools to Increase Access, Continuity and Education of Fruits and Vegetables Among Low-Income Populations.

PubMed

Sharma, Shreela; Helfman, Lisa; Albus, Katherine; Pomeroy, Mike; Chuang, Ru-Jye; Markham, Christine

2015-08-01

Intake of fruits and vegetables (F&V) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh F&V and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of: (1) Weekly distribution of 50-60 servings of fresh F&V; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA (n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p < 0.05). Process data using parent surveys, teacher surveys, attendance logs, and produce cost data were used to determine feasibility and acceptability of program. Participants received on average 61 servings of F&V weekly for 16 weeks at the cost of $4.31/family/week. Results showed significant increases in child reported self-efficacy, outcome expectations and attitudes towards consuming F&V (p < 0.05). We found significant increases in child exposure to F&V and child preference of various F&V from baseline to post-intervention (p < 0.05). Parent surveys showed significant improvements in mealtime practices at home: decrease in children eating while watching TV, increase in eating dinner with the family, less fast food, less sugary drinks with meals, more children asking for F&V as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase F&V access and education in low-income populations using existing infrastructure of schools and food banks.

Qualitative observation instrument to measure the quality of parent-child interactions in young children with type 1 diabetes mellitus.

PubMed

Nieuwesteeg, Anke; Hartman, Esther; Pouwer, Frans; Emons, Wilco; Aanstoot, Henk-Jan; Van Mil, Edgar; Van Bakel, Hedwig

2014-06-10

In young children with type 1 diabetes mellitus (T1DM), parents have complete responsibility for the diabetes-management. In toddlers and (pre)schoolers, the tasks needed to achieve optimal blood glucose control may interfere with normal developmental processes and could negatively affect the quality of parent-child interaction. Several observational instruments are available to measure the quality of the parent-child interaction. However, no observational instrument for diabetes-specific situations is available. Therefore, the aim of the present study was to develop a qualitative observation instrument, to be able to assess parent-child interaction during diabetes-specific situations. First, in a pilot study (n = 15), the observation instrument was developed in four steps: (a) defining relevant diabetes-specific situations; (b) videotaping these situations; (c) describing all behaviors in a qualitative observation instrument; (d) evaluating usability and reliability. Next, we examined preliminary validity (total n = 77) by testing hypotheses about correlations between the observation instrument for diabetes-specific situations, a generic observation instrument and a behavioral questionnaire. The observation instrument to assess parent-child interaction during diabetes-specific situations, which consists of ten domains: "emotional involvement", "limit setting", "respect for autonomy", "quality of instruction", "negative behavior", "avoidance", "cooperative behavior", "child's response to injection", "emphasis on diabetes", and "mealtime structure", was developed for use during a mealtime situation (including glucose monitoring and insulin administration). The present study showed encouraging indications for the usability and inter-rater reliability (weighted kappa was 0.73) of the qualitative observation instrument. Furthermore, promising indications for the preliminary validity of the observation instrument for diabetes-specific situations were found (r ranged between |.24| and |.45| for significant correlations and between |.10| and |.23| for non-significant trends). This observation instrument could be used in future research to (a) test whether parent-child interactions are associated with outcomes (like HbA1c levels and psychosocial functioning), and (b) evaluate interventions, aimed at optimizing the quality of parent-child interactions in families with a young child with T1DM.

Prediction-Correction Algorithms for Time-Varying Constrained Optimization

DOE PAGES

Simonetto, Andrea; Dall'Anese, Emiliano

2017-07-26

This article develops online algorithms to track solutions of time-varying constrained optimization problems. Particularly, resembling workhorse Kalman filtering-based approaches for dynamical systems, the proposed methods involve prediction-correction steps to provably track the trajectory of the optimal solutions of time-varying convex problems. The merits of existing prediction-correction methods have been shown for unconstrained problems and for setups where computing the inverse of the Hessian of the cost function is computationally affordable. This paper addresses the limitations of existing methods by tackling constrained problems and by designing first-order prediction steps that rely on the Hessian of the cost function (and do notmore » require the computation of its inverse). In addition, the proposed methods are shown to improve the convergence speed of existing prediction-correction methods when applied to unconstrained problems. Numerical simulations corroborate the analytical results and showcase performance and benefits of the proposed algorithms. A realistic application of the proposed method to real-time control of energy resources is presented.« less

Soft Computing Methods for Disulfide Connectivity Prediction.

PubMed

Márquez-Chamorro, Alfonso E; Aguilar-Ruiz, Jesús S

2015-01-01

The problem of protein structure prediction (PSP) is one of the main challenges in structural bioinformatics. To tackle this problem, PSP can be divided into several subproblems. One of these subproblems is the prediction of disulfide bonds. The disulfide connectivity prediction problem consists in identifying which nonadjacent cysteines would be cross-linked from all possible candidates. Determining the disulfide bond connectivity between the cysteines of a protein is desirable as a previous step of the 3D PSP, as the protein conformational search space is highly reduced. The most representative soft computing approaches for the disulfide bonds connectivity prediction problem of the last decade are summarized in this paper. Certain aspects, such as the different methodologies based on soft computing approaches (artificial neural network or support vector machine) or features of the algorithms, are used for the classification of these methods.

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents

PubMed Central

Wong, Maria M.; Roberson, Gail; Dyson, Rachel

2014-01-01

Background Previous studies showed that poor sleep prospectively predicted alcohol related problems and illicit drug use in adolescents and young adults (Wong et al., 2010, 2012). However, more works needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance related problems, e.g., binge drinking, driving under the influence of alcohol, risky sexual behavior. Methods Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). Data were collected from interviews and questionnaires. The current study analyzed data from the first three waves of data (T1: 1994–95; T2: 1996; T3: 2001–02). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. Results Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs and drugs-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems were consistent with previous waves, though the effect was weaker. Conclusions Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene and the potential consequences of poor sleep on drinking and related behaviors. PMID:25598438

Transitioning to adolescence: how changes in child personality and overreactive parenting predict adolescent adjustment problems.

PubMed

van den Akker, Alithe L; Deković, Maja; Prinzie, Peter

2010-01-01

The present study examined how changes in child Big Five personality characteristics and overreactive parenting during the transition from childhood to adolescence predict adolescent adjustment problems. The sample included 290 children, aged 8-9 years. At three moments, with 2-year intervals, mothers, fathers, and a teacher reported on the child's personality, and mothers and fathers reported on their parenting behavior. At the third measurement moment, mothers, fathers, and children reported on the child's adjustment problems. Rank-order stability of the personality dimensions and overreactive parenting were high. Univariate latent growth models revealed mean-level decreases for extraversion, conscientiousness, and imagination. Mean levels of benevolence, emotional stability, and overreactive parenting were stable. Multivariate latent growth models revealed that decreases in extraversion and emotional stability predicted internalizing problems, whereas decreases in benevolence, conscientiousness, and emotional stability predicted externalizing problems. Increases in overreactive parenting predicted externalizing, but not internalizing problems. The associations were similar for boys and girls. The results indicate that changes in child personality and overreactive parenting during the transition to adolescence are associated with adolescent adjustment problems. Overall, child personality was more important than overreactive parenting, and children were more likely to "act out" than to "withdraw" in reaction to overreactive parenting.

Detecting math problem solving strategies: an investigation into the use of retrospective self-reports, latency and fMRI data.

PubMed

Tenison, Caitlin; Fincham, Jon M; Anderson, John R

2014-02-01

This research explores how to determine when mathematical problems are solved by retrieval versus computation strategies. Past research has indicated that verbal reports, solution latencies, and neural imaging all provide imperfect indicators of this distinction. Participants in the current study solved mathematical problems involving two distinct problem types, called 'Pyramid' and 'Formula' problems. Participants were given extensive training solving 3 select Pyramid and 3 select Formula problems. Trained problems were highly practiced, whereas untrained problems were not. The distinction between untrained and trained problems was observed in the data. Untrained problems took longer to solve, more often used procedural strategies and showed a greater activation in the horizontal intraparietal sulcus (HIPS) when compared to trained problems. A classifier fit to the neural distinction between trained-untrained problems successfully predicted training within and between the two problem types. We employed this classifier to generate a prediction of strategy use. By combining evidence from the classifier, problem solving latencies, and retrospective reports, we predicted the strategy used to solve each problem in the scanner and gained unexpected insight into the distinction between different strategies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Near Real-Time Optimal Prediction of Adverse Events in Aviation Data

NASA Technical Reports Server (NTRS)

Martin, Rodney Alexander; Das, Santanu

2010-01-01

The prediction of anomalies or adverse events is a challenging task, and there are a variety of methods which can be used to address the problem. In this paper, we demonstrate how to recast the anomaly prediction problem into a form whose solution is accessible as a level-crossing prediction problem. The level-crossing prediction problem has an elegant, optimal, yet untested solution under certain technical constraints, and only when the appropriate modeling assumptions are made. As such, we will thoroughly investigate the resilience of these modeling assumptions, and show how they affect final performance. Finally, the predictive capability of this method will be assessed by quantitative means, using both validation and test data containing anomalies or adverse events from real aviation data sets that have previously been identified as operationally significant by domain experts. It will be shown that the formulation proposed yields a lower false alarm rate on average than competing methods based on similarly advanced concepts, and a higher correct detection rate than a standard method based upon exceedances that is commonly used for prediction.

Predicting Development of Mathematical Word Problem Solving Across the Intermediate Grades

PubMed Central

Tolar, Tammy D.; Fuchs, Lynn; Cirino, Paul T.; Fuchs, Douglas; Hamlett, Carol L.; Fletcher, Jack M.

2012-01-01

This study addressed predictors of the development of word problem solving (WPS) across the intermediate grades. At beginning of 3rd grade, 4 cohorts of students (N = 261) were measured on computation, language, nonverbal reasoning skills, and attentive behavior and were assessed 4 times from beginning of 3rd through end of 5th grade on 2 measures of WPS at low and high levels of complexity. Language skills were related to initial performance at both levels of complexity and did not predict growth at either level. Computational skills had an effect on initial performance in low- but not high-complexity problems and did not predict growth at either level of complexity. Attentive behavior did not predict initial performance but did predict growth in low-complexity, whereas it predicted initial performance but not growth for high-complexity problems. Nonverbal reasoning predicted initial performance and growth for low-complexity WPS, but only growth for high-complexity WPS. This evidence suggests that although mathematical structure is fixed, different cognitive resources may act as limiting factors in WPS development when the WPS context is varied. PMID:23325985

Can items used in 4-year-old well-child visits predict children's health and school outcomes?

PubMed

Smithers, Lisa G; Chittleborough, Catherine R; Stocks, Nigel; Sawyer, Michael G; Lynch, John W

2014-08-01

To examine whether items comprising a preschool well-child check for use by family doctors in Australia with 4-5-year old children predicts health and academic outcomes at 6-7 years. The well-child check includes mandatory (anthropometry, eye/vision, ear/hearing, dental, toileting, allergy problems) and non-mandatory (processed food consumption, low physical activity, motor, behaviour/mood problems) items. The predictive validity of mandatory and non-mandatory items measured at 4-5 years was examined using data from the Longitudinal Study of Australian Children. Outcomes at 6-7 years included overweight/obesity, asthma, health care/medication needs, general health, mental health problems, quality of life, teacher-reported mathematics and literacy ability (n = 2,280-2,787). Weight or height >90th centile at 4-5 years predicted overweight/obesity at 6-7 years with 60% sensitivity, 79% specificity and 40% positive predictive value (PPV). Mood/behaviour problems at 4-5 predicted mental health problems at 6-7 years with 86% sensitivity, 40% specificity and 8% PPV. Non-mandatory items improved the discrimination between children with and without mental health problems at 6-7 years (area under the receiver operating characteristic curve 0.75 compared with 0.69 for mandatory items only), but was weak for most outcomes. Items used in a well-child health check were moderate predictors of overweight/obesity and mental health problems at 6-7 years, but poor predictors of other health and academic outcomes.

The dopamine receptor D4 gene and familial loading interact with perceived parenting in predicting externalizing behavior problems in early adolescence: the TRacking Adolescents' Individual Lives Survey (TRAILS).

PubMed

Marsman, Rianne; Oldehinkel, Albertine J; Ormel, Johan; Buitelaar, Jan K

2013-08-30

Although externalizing behavior problems show in general a high stability over time, the course of externalizing behavior problems may vary from individual to individual. Our main goal was to investigate the predictive role of parenting on externalizing behavior problems. In addition, we investigated the potential moderating role of gender and genetic risk (operationalized as familial loading of externalizing behavior problems (FLE), and presence or absence of the dopamine receptor D4 (DRD4) 7-repeat and 4-repeat allele, respectively). Perceived parenting (rejection, emotional warmth, and overprotection) and FLE were assessed in a population-based sample of 1768 10- to 12-year-old adolescents. Externalizing behavior problems were assessed at the same age and 212 years later by parent report (CBCL) and self-report (YSR). DNA was extracted from blood samples. Parental emotional warmth predicted lower, and parental overprotection and rejection predicted higher levels of externalizing behavior problems. Whereas none of the parenting factors interacted with gender and the DRD4 7-repeat allele, we did find interaction effects with FLE and the DRD4 4-repeat allele. That is, the predictive effect of parental rejection was only observed in adolescents from low FLE families and the predictive effect of parental overprotection was stronger in adolescents not carrying the DRD4 4-repeat allele. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The impact of early behavior disturbances on academic achievement in high school.

PubMed

Breslau, Joshua; Miller, Elizabeth; Breslau, Naomi; Bohnert, Kipling; Lucia, Victoria; Schweitzer, Julie

2009-06-01

Previous research has indicated that childhood behavioral disturbances predict lower scores on academic tests and curtail educational attainment. It is unknown which types of childhood behavioral problems are most likely to predict these outcomes. An ethnically diverse cohort was assessed at 6 years of age for behavioral problems and IQ and at 17 years of age for academic achievement in math and reading. Of the original cohort of 823 children, 693 (84%) had complete data. Multiple regressions were used to estimate associations of attention and internalizing and externalizing problems at age 6 and with math and reading achievement at age 17, adjusting for IQ and indicators of family socioeconomic status. Adjusting for IQ, inner-city community, and maternal education and marital status, teacher ratings of attention, internalizing behavior, and externalizing problems at age 6 significantly predict math and reading achievement at age 17. When types of problems are examined simultaneously, attention problems predict math and reading achievement with little attenuation, whereas the influence of externalizing and internalizing problems is materially reduced and not significant. Interventions that target attention problems at school entry should be tested as a potential avenue for improving educational achievement.

Learning to Predict Combinatorial Structures

NASA Astrophysics Data System (ADS)

Vembu, Shankar

2009-12-01

The major challenge in designing a discriminative learning algorithm for predicting structured data is to address the computational issues arising from the exponential size of the output space. Existing algorithms make different assumptions to ensure efficient, polynomial time estimation of model parameters. For several combinatorial structures, including cycles, partially ordered sets, permutations and other graph classes, these assumptions do not hold. In this thesis, we address the problem of designing learning algorithms for predicting combinatorial structures by introducing two new assumptions: (i) The first assumption is that a particular counting problem can be solved efficiently. The consequence is a generalisation of the classical ridge regression for structured prediction. (ii) The second assumption is that a particular sampling problem can be solved efficiently. The consequence is a new technique for designing and analysing probabilistic structured prediction models. These results can be applied to solve several complex learning problems including but not limited to multi-label classification, multi-category hierarchical classification, and label ranking.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

PubMed

Pino, María J; Castillo, Rosa A; Raya, Antonio; Herruzo, Javier

2017-11-09

To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Does Problem Behavior Elicit Poor Parenting?: A Prospective Study of Adolescent Girls

PubMed Central

Huh, David; Tristan, Jennifer; Wade, Emily; Stice, Eric

2006-01-01

This study tested the hypothesis that perceived parenting would show reciprocal relations with adolescents' problem behavior using longitudinal data from 496 adolescent girls. Results provided support for the assertion that female problem behavior has an adverse effect on parenting; elevated externalizing symptoms and substance abuse symptoms predicted future decreases in perceived parental support and control. There was less support for the assertion that parenting deficits foster adolescent problem behaviors; initially low parental control predicted future increases in substance abuse, but not externalizing symptoms, and low parental support did not predict future increases in externalizing or substance abuse symptoms. Results suggest that problem behavior is a more consistent predictor of parenting than parenting is of problem behavior, at least for girls during middle adolescence. PMID:16528407

How Anticipated and Experienced Stigma Can Contribute to Self-Stigma: The Case of Problem Gambling.

PubMed

Hing, Nerilee; Russell, Alex M T

2017-01-01

The degree to which anticipated and experienced public stigma contribute to self-stigma remains open to debate, and little research has been conducted into the self-stigma of problem gambling. This study aimed to examine which aspects of anticipated and experienced stigma (if any) predict the anticipated level of public stigma associated with problem gambling and the degree of self-stigma felt by people experiencing problem gambling. An online survey of 177 Australians experiencing problem gambling examined whether aspects of the public characterization of problem gambling, anticipated reactions to problem gamblers, and experiences of devaluation and discrimination predicted anticipated level of public stigma and self-stigma. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives. These variables directly predicted anticipated level of public stigma and indirectly predicted self-stigma. These findings lend weight to conceptualizations of self-stigma as an internalization of actual or anticipated public stigma. They also highlight the need for stigma reduction efforts, particularly those that lower negative stereotyping and prejudicial attitudes, to improve currently low rates of help-seeking amongst people with gambling problems.

How Anticipated and Experienced Stigma Can Contribute to Self-Stigma: The Case of Problem Gambling

PubMed Central

Hing, Nerilee; Russell, Alex M. T.

2017-01-01

The degree to which anticipated and experienced public stigma contribute to self-stigma remains open to debate, and little research has been conducted into the self-stigma of problem gambling. This study aimed to examine which aspects of anticipated and experienced stigma (if any) predict the anticipated level of public stigma associated with problem gambling and the degree of self-stigma felt by people experiencing problem gambling. An online survey of 177 Australians experiencing problem gambling examined whether aspects of the public characterization of problem gambling, anticipated reactions to problem gamblers, and experiences of devaluation and discrimination predicted anticipated level of public stigma and self-stigma. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives. These variables directly predicted anticipated level of public stigma and indirectly predicted self-stigma. These findings lend weight to conceptualizations of self-stigma as an internalization of actual or anticipated public stigma. They also highlight the need for stigma reduction efforts, particularly those that lower negative stereotyping and prejudicial attitudes, to improve currently low rates of help-seeking amongst people with gambling problems. PMID:28270787

Mental Health Problems and Educational Attainment in Adolescence: 9-Year Follow-Up of the TRAILS Study

PubMed Central

Veldman, Karin; Bültmann, Ute; Stewart, Roy E.; Ormel, Johan; Verhulst, Frank C.; Reijneveld, Sijmen A.

2014-01-01

Background This study examines if mental health problems at age 11 and changes in mental health problems between age 11 and 16 predict educational attainment of adolescents at age 19, overall and stratified by gender. Methods Data from 1711 adolescents (76.8% from initial cohort) of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9year follow-up, were used. Mental health problems (externalizing, internalizing and attention problems) were measured by the Youth Self Report and the Child Behavior Checklist at ages 11 and 16. Difference scores for mental health problems between age 11 and 16 were calculated. Educational attainment was assessed at age 19. Results Externalizing, internalizing and attention problems at age 11 were significantly associated with low educational attainment at age 19 (crude model). When adjusted for demographic variables and the other mental health problems, only the association for attention problems remained significant (odds ratio (OR), 95% confidence interval: 3.19, 2.11–4.83). Increasing externalizing problems between age 11 and 16 also predicted low educational attainment at age 19 (OR 3.12, 1.83–5.32). Among girls, increasing internalizing problems between age 11 and 16 predicted low educational attainment (OR 2.21, 1.25–3.94). For boys, no significant association was found for increasing internalizing problems and low educational attainment. For increasing attention problems between age 11 and 16 no significant association with low educational attainment was found. Conclusions Externalizing, internalizing and attention problems at age 11 and an increase of these problems during adolescence predicted low educational attainment at age 19. Early treatment of these mental health problems may improve educational attainment, and reduce socioeconomic health differences in adulthood. PMID:25047692

Social problem-solving abilities and personality disorder characteristics among dual-diagnosed persons in substance abuse treatment.

PubMed

Herrick, S M; Elliott, T R

2001-01-01

We examined the relation of self-appraised social problem-solving abilities and personality-disorder characteristics to the adjustment and compliance of persons with dual diagnoses in substance-abuse treatment. It was hypothesized that elements of the problem-orientation component would remain predictive of depressive behavior and distress after considering personality-disorder characteristics among 117 persons receiving inpatient-substance-abuse treatment. Furthermore, self-appraised problem-solving abilities were expected to predict the occurrence of "dirty" drug and alcohol screens during treatment and compliance with the first scheduled community follow-up visit. Results supported predictions concerning the relation of problem-solving confidence to depressive behavior, distress, and substance-use screens; however, a paradoxical relation was observed between the problem-orientation variables and compliance with the first outpatient visit. The results are interpreted within the context of contemporary models of social problem solving and the implications for cognitive-behavioral assessment and intervention are considered.

Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age.

PubMed

Bennema, Anne N; Schendelaar, Pamela; Seggers, Jorien; Haadsma, Maaike L; Heineman, Maas Jan; Hadders-Algra, Mijna

2016-03-01

General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations. To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age. Prospective cohort study. A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents. GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated. DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p<0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome. GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of socioeconomic status on behavioral problems from preschool to early elementary school - A Japanese longitudinal study.

PubMed

Hosokawa, Rikuya; Katsura, Toshiki

2018-01-01

Social inequalities are widely accepted to have a deleterious effect on children's mental health, and those with lower socioeconomic status generally experience more mental health issues. In this study, we examine the impact of socioeconomic situations of children's families during their early childhood on the children's social adaptation in Japanese elementary school. The current investigation consisted of two sets of data relating to two separate years (with a one-year interval). The participants included preschoolers aged five years at Time 1 (the first year) and first graders aged six years at Time 2 (the second year); 1,712 met the inclusion criteria for both years. Parents of the participants completed a self-reported questionnaire regarding their SES (i.e., family economy and mother's education) and their children's mental health. Mental health was assessed using the Child Behavior Checklist/4-18, Parent Report. For each SES indicator, we found an inverse relationship across all the symptom dimensions. Specifically, bivariate analyses revealed that lower family income, maternal education level, and paternal education level predict all three domains of behavioral problems (i.e., internalized problems, externalized problems, and total behavioral problems). Further, multivariate analyses revealed that lower family income consistently predicts all domains of behavioral problems, lower maternal education level predicted externalized problems and total behavioral problems, and paternal education level did not predict any clinically significant behavioral problems. In this sample, we found that, for children, family income and parental education when entering preschool were significant predictors of mental health problems after elementary school enrollment; in particular, low income and low maternal educational achievement predicted a high probability of the development of a psychiatric disorder. A greater understanding of the mechanisms of these associations could contribute to improvements in interventions aimed at preventing child maladjustment.

Early-onset Conduct Problems: Predictions from daring temperament and risk taking behavior.

PubMed

Bai, Sunhye; Lee, Steve S

2017-12-01

Given its considerable public health significance, identifying predictors of early expressions of conduct problems is a priority. We examined the predictive validity of daring, a key dimension of temperament, and the Balloon Analog Risk Task (BART), a laboratory-based measure of risk taking behavior, with respect to two-year change in parent, teacher-, and youth self-reported oppositional defiant disorder (ODD), conduct disorder (CD), and antisocial behavior. At baseline, 150 ethnically diverse 6- to 10-year old (M=7.8, SD=1.1; 69.3% male) youth with ( n =82) and without ( n =68) DSM-IV ADHD completed the BART whereas parents rated youth temperament (i.e., daring); parents and teachers also independently rated youth ODD and CD symptoms. Approximately 2 years later, multi-informant ratings of youth ODD, CD, and antisocial behavior were gathered from rating scales and interviews. Whereas risk taking on the BART was unrelated to conduct problems, individual differences in daring prospectively predicted multi-informant rated conduct problems, independent of baseline risk taking, conduct problems, and ADHD diagnostic status. Early differences in the propensity to show positive socio-emotional responses to risky or novel experiences uniquely predicted escalating conduct problems in childhood, even with control of other potent clinical correlates. We consider the role of temperament in the origins and development of significant conduct problems from childhood to adolescence, including possible explanatory mechanisms underlying these predictions.

Treatment, alcoholics anonymous, and 16-year changes in impulsivity and legal problems among men and women with alcohol use disorders.

PubMed

Blonigen, Daniel M; Timko, Christine; Moos, Bernice S; Moos, Rudolf H

2009-09-01

The link between impulsive personality traits and alcohol use disorders (AUDs) is well established. No studies, however, have investigated whether receipt of help for AUDs predicts change in impulsivity or whether such change is associated with relevant outcomes such as legal problems. The present study examined predictive associations between the duration of help for AUDs (Alcoholics Anonymous [AA], professional treatment) and impulsivity and legal problems over 16 years in men and women with AUDs. Participants who were initially untreated for their AUDs (n(men) = 332, n(women) = 296) completed follow-up telephone interviews at 1 and 16 years after their baseline assessment. Impulsivity and legal problems declined between baseline and the 1-year and 16-year follow-ups among both women and men. A longer duration of participation in AA predicted a decline in impulsivity at both follow-up assessments, and, in turn, a decline in impulsivity predicted a decline in legal problems at Years 1 and 16. In addition, a longer duration of participation in AA predicted fewer legal problems at Year 1, and this association was moderated by gender (significant in men) and impulsivity (significant for individuals with higher baseline scores). The results highlight the potential for AA and professional treatment to reduce the expression of impulsivity and related disinhibitory traits and legal problems in individuals with AUDs.

The continuity of psychopathology from early childhood to preadolescence: a prospective cohort study of 3-12-year-old children.

PubMed

Pihlakoski, Leena; Sourander, Andre; Aromaa, Minna; Rautava, Päivi; Helenius, Hans; Sillanpää, Matti

2006-10-01

To study the continuity of psychopathology from the age of 3-12 years. In a population-based birth cohort, children's emotional and behavioral problems were assessed at age 3 using the Child Behavior Checklist 2-3 (CBCL 2-3), and at age 12 by parents using the CBCL 11-18, and the Youth Self Report (YSR) completed by the children. Behavioral ratings were obtained from 800 subjects at both time points. externalizing problems at age 3 predicted both externalizing and internalizing problems among both genders in preadolescence. In girls, internalizing behavior at age 3 predicted parent-reported internalizing behavior, and associated negatively with externalizing behavior in self-reports at age 12. Aggressive behavior was found to be remarkably stable, and both aggressive and destructive behavior independently predicted a wide range of later externalizing and internalizing problems. Parent ratings of withdrawal showed stability from early childhood to preadolescence in both genders. Somatic complaints of 3-year-old girls independently predicted both externalizing and internalizing problems. The results show the complexity of pathways in psychopathology from early childhood to preadolescence. In particular, aggressive and destructive behaviors in very early childhood predict later problems and necessitate early recognition and possible intervention at an early age. An instrument like the CBCL 2-3 is valuable in the early detection of children at risk of long-term problems.

Enhancing the quality of oral nutrition support for hospitalized patients: a mixed methods knowledge translation study (The EQONS study).

PubMed

Gerrish, Kate; Laker, Sara; Taylor, Carolyn; Kennedy, Fiona; McDonnell, Ann

2016-12-01

The aim of this study was to report a multifaceted knowledge translation intervention to facilitate use of the Malnutrition Universal Screening Tool and innovation in nutritional care for patients at risk of malnutrition. Malnutrition among hospitalized patients is a widespread problem leading to adverse health outcomes. Despite evidence of the benefits of malnutrition screening and recommendations for achieving good nutrition, shortfalls in practice continue. A mixed method integrated knowledge translation study. The knowledge translation intervention comprised nutrition champions supported by knowledge translation facilitators and an action planning process. Data collection was undertaken over 18 months between 2011-2012 in a hospital in England. Data comprised observation of mealtimes, audit of patient records, survey of nurses and semi-structured interviews with nutrition champions, knowledge translation facilitators, senior ward nurses and nurse managers. Statistically significant relationships (Chi Square) were observed between self-reported confidence of nurses (a) to assess patients using the Malnutrition Universal Screening Tool, (b) to teach colleagues how to use the Malnutrition Universal Screening Tool and (c) to ensure that patients were assessed within 24 hours of admission. Ward-based nutrition champions facilitated successful innovation in nutrition support. Contextual factors operating at micro (ward), meso (organization) and macro (healthcare system) levels acted as barriers and enablers for change. Nutrition champions were successful in increasing the timely assessment of patients at risk of malnutrition and promoting innovation in nutritional care. Support from knowledge translation facilitators helped nutrition champions develop their role and work collaboratively with senior ward nurses to implement action plans for improving nutrition. © 2016 John Wiley & Sons Ltd.

Characterization of sleep patterns and problems in healthcare workers in a tertiary care hospital.

PubMed

Buscemi, Dolores; Anvari, Rezza; Raj, Rishi; Nugent, Kenneth

2014-01-01

Restrictions in sleep can have important adverse effects on health and job performance. We collected information about sleep from US healthcare workers to determine whether they had sleep difficulties. We used an Internet-based survey to collect information on sleep patterns and sleep quality in healthcare workers at a tertiary care hospital. We classified these workers into short sleepers (<7 hours), normal sleepers (7-8 hours), and long sleepers (≥9 hours). We compared these three groups using simple descriptive statistics. We used logistic regression to identify factors associated with short sleep times. Of 3012 questionnaires distributed, 376 healthcare workers (12.5%) replied to this survey. The median age was 38 years, the median body mass index was 28 kg/m, and 76% were women. The median sleep duration on weekdays was 7 hours. Sixty-nine respondents (18.4%) were short sleepers, 269 of the respondents (71.5%) were normal sleepers, and 38 respondents (10.1%) were long sleepers. A total of 113 (30.1%) had sleep difficulties more than 50% of the time and 140 respondents (37.3%) were bothered by lack of energy from poor sleep. Short sleepers were less likely than other types of sleepers to have normal bedtimes and regular mealtimes. Eighty-four respondents (22.3%) went to bed between 2 AM and 2 PM. These workers were younger; slept less on the weekdays and weekends; and reported more difficulty with sleeping, feeling depressed, overconsumption of alcoholic beverages, and personal stressors. Most healthcare workers have healthy sleep patterns; however, many workers have poor sleep quality. Workers with "odd" bedtimes have abnormal sleep patterns and abnormal sleep quality; these workers need additional evaluation to understand the causes and consequences of their sleep patterns.

Prediction and Stability of Reading Problems in Middle Childhood

ERIC Educational Resources Information Center

Ritchey, Kristen D.; Silverman, Rebecca D.; Schatschneider, Christopher; Speece, Deborah L.

2015-01-01

The longitudinal prediction of reading problems from fourth grade to sixth grade was investigated with a sample of 173 students. Reading problems at the end of sixth grade were defined by significantly below average performance (= 15th percentile) on reading factors defining word reading, fluency, and reading comprehension. Sixth grade poor reader…

Behavioral Problems in Childhood and Adolescence as Predictors of Ego-Level Attainment in Early Adulthood.

ERIC Educational Resources Information Center

Krettenauer, Tobias; Ullrich, Manuela; Hofmann, Volker; Edelstein, Wolfgang

2003-01-01

Examined how externalizing as well as internalizing behavioral problems in childhood and adolescence predict young adults' personalities as represented by Loevinger's (1976) model of ego development. Demonstrated that behavioral problems in childhood and adolescence predict young adults' ego-level attainment in unique and meaningful ways.…

A reinforcement sensitivity model of affective and behavioral dysregulation in marijuana use and associated problems.

PubMed

Emery, Noah N; Simons, Jeffrey S

2017-08-01

This study tested a model linking sensitivity to punishment (SP) and reward (SR) to marijuana use and problems via affect lability and poor control. A 6-month prospective design was used in a sample of 2,270 young-adults (64% female). The hypothesized SP × SR interaction did not predict affect lability or poor control, but did predict use likelihood at baseline. At low levels of SR, SP was associated with an increased likelihood of abstaining, which was attenuated as SR increased. SP and SR displayed positive main effects on both affect lability and poor control. Affect lability and poor control, in turn, mediated effects on the marijuana outcomes. Poor control predicted both increased marijuana use and, controlling for use level, greater intensity of problems. Affect lability predicted greater intensity of problems, but was not associated with use level. There were few prospective effects. SR consistently predicted greater marijuana use and problems. SP however, exhibited both risk and protective pathways. Results indicate that SP is associated with a decreased likelihood of marijuana use. However, once use is initiated SP is associated with increased risk of problems, in part, due to its effects on both affect and behavioral dysregulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Evaluation of the Interactionist Model of Socioeconomic Status and Problem Behavior: A Developmental Cascade across Generations

PubMed Central

Martin, Monica J.; Conger, Rand D.; Schofield, Thomas J.; Dogan, Shannon J.; Widaman, Keith F.; Donnellan, M. Brent; Neppl, Tricia K.

2010-01-01

The current multigenerational study evaluates the utility of the Interactionist Model of Socioeconomic Influence on human development (IMSI) in explaining problem behaviors across generations. The IMSI proposes that the association between socioeconomic status (SES) and human development involves a dynamic interplay that includes both social causation (SES influences human development) and social selection (individual characteristics affect SES). As part of the developmental cascade proposed by the IMSI, the findings from this investigation showed that G1 adolescent problem behavior predicted later G1 SES, family stress, and parental emotional investments, as well as the next generation of children's problem behavior. These results are consistent with a social selection view. Consistent with the social causation perspective, we found a significant relation between G1 SES and family stress, and in turn, family stress predicted G2 problem behavior. Finally, G1 adult SES predicted both material and emotional investments in the G2 child. In turn, emotional investments predicted G2 problem behavior, as did material investments. Some of the predicted pathways varied by G1 parent gender. The results are consistent with the view that processes of both social selection and social causation account for the association between SES and human development. PMID:20576188

Phylogenetic prediction of Alternaria leaf blight resistance in wild and cultivated species of carrots (Daucus, Apiaceae)

USDA-ARS?s Scientific Manuscript database

Plant scientists make inferences and predictions from phylogenetic trees to solve scientific problems. Crop losses due to disease damage is an important problem that many plant breeders would like to solve, so the ability to predict traits like disease resistance from phylogenetic trees derived from...

Externalizing Problems in Childhood and Adolescence Predict Subsequent Educational Achievement but for Different Genetic and Environmental Reasons

ERIC Educational Resources Information Center

Lewis, Gary J.; Asbury, Kathryn; Plomin, Robert

2017-01-01

Background: Childhood behavior problems predict subsequent educational achievement; however, little research has examined the etiology of these links using a longitudinal twin design. Moreover, it is unknown whether genetic and environmental innovations provide incremental prediction for educational achievement from childhood to adolescence.…

Language Ability Predicts the Development of Behavior Problems in Children

PubMed Central

Petersen, Isaac T.; Bates, John E.; D’Onofrio, Brian M.; Coyne, Claire A.; Lansford, Jennifer E.; Dodge, Kenneth A.; Pettit, Gregory S.; Van Hulle, Carol A.

2013-01-01

Prior studies have suggested, but not fully established, that language ability is important for regulating attention and behavior. Language ability may have implications for understanding attention-deficit hyperactivity disorder (ADHD) and conduct disorders, as well as subclinical problems. This article reports findings from two longitudinal studies to test (a) whether language ability has an independent effect on behavior problems, and (b) the direction of effect between language ability and behavior problems. In Study 1 (N = 585), language ability was measured annually from ages 7 to 13 years by language subtests of standardized academic achievement tests administered at the children’s schools. Inattentive-hyperactive (I-H) and externalizing (EXT) problems were reported annually by teachers and mothers. In Study 2 (N = 11,506), language ability (receptive vocabulary) and mother-rated I-H and EXT problems were measured biannually from ages 4 to 12 years. Analyses in both studies showed that language ability predicted within-individual variability in the development of I-H and EXT problems over and above the effects of sex, ethnicity, socioeconomic status (SES), and performance in other academic and intellectual domains (e.g., math, reading comprehension, reading recognition, and short-term memory [STM]). Even after controls for prior levels of behavior problems, language ability predicted later behavior problems more strongly than behavior problems predicted later language ability, suggesting that the direction of effect may be from language ability to behavior problems. The findings suggest that language ability may be a useful target for the prevention or even treatment of attention deficits and EXT problems in children. PMID:23713507

Role of temperament in early adolescent pure and co-occurring internalizing and externalizing problems using a bifactor model: Moderation by parenting and gender

PubMed Central

WANG, FRANCES L.; EISENBERG, NANCY; VALIENTE, CARLOS; SPINRAD, TRACY L.

2015-01-01

We contribute to the literature on the relations of temperament to externalizing and internalizing problems by considering parental emotional expressivity and child gender as moderators of such relations and examining prediction of pure and co-occurring problem behaviors during early to middle adolescence using bifactor models (which provide unique and continuous factors for pure and co-occurring internalizing and externalizing problems). Parents and teachers reported on children’s (4.5- to 8-year-olds; N = 214) and early adolescents’ (6 years later; N = 168) effortful control, impulsivity, anger, sadness, and problem behaviors. Parental emotional expressivity was measured observationally and with parents’ self-reports. Early-adolescents’ pure externalizing and co-occurring problems shared childhood and/or early-adolescent risk factors of low effortful control, high impulsivity, and high anger. Lower childhood and early-adolescent impulsivity and higher early-adolescent sadness predicted early-adolescents’ pure internalizing. Childhood positive parental emotional expressivity more consistently related to early-adolescents’ lower pure externalizing compared to co-occurring problems and pure internalizing. Lower effortful control predicted changes in externalizing (pure and co-occurring) over 6 years, but only when parental positive expressivity was low. Higher impulsivity predicted co-occurring problems only for boys. Findings highlight the probable complex developmental pathways to adolescent pure and co-occurring externalizing and internalizing problems. PMID:26646352

Role of temperament in early adolescent pure and co-occurring internalizing and externalizing problems using a bifactor model: Moderation by parenting and gender.

PubMed

Wang, Frances L; Eisenberg, Nancy; Valiente, Carlos; Spinrad, Tracy L

2016-11-01

We contribute to the literature on the relations of temperament to externalizing and internalizing problems by considering parental emotional expressivity and child gender as moderators of such relations and examining prediction of pure and co-occurring problem behaviors during early to middle adolescence using bifactor models (which provide unique and continuous factors for pure and co-occurring internalizing and externalizing problems). Parents and teachers reported on children's (4.5- to 8-year-olds; N = 214) and early adolescents' (6 years later; N = 168) effortful control, impulsivity, anger, sadness, and problem behaviors. Parental emotional expressivity was measured observationally and with parents' self-reports. Early-adolescents' pure externalizing and co-occurring problems shared childhood and/or early-adolescent risk factors of low effortful control, high impulsivity, and high anger. Lower childhood and early-adolescent impulsivity and higher early-adolescent sadness predicted early-adolescents' pure internalizing. Childhood positive parental emotional expressivity more consistently related to early-adolescents' lower pure externalizing compared to co-occurring problems and pure internalizing. Lower effortful control predicted changes in externalizing (pure and co-occurring) over 6 years, but only when parental positive expressivity was low. Higher impulsivity predicted co-occurring problems only for boys. Findings highlight the probable complex developmental pathways to adolescent pure and co-occurring externalizing and internalizing problems.

Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease.

PubMed

Ingadottir, Arora R; Beck, Anne M; Baldwin, Christine; Weekes, C Elizabeth; Geirsdottir, Olof G; Ramel, Alfons; Gislason, Thorarinn; Gunnarsdottir, Ingibjorg

2018-03-01

Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

Factors influencing the degree of eating ability among people with dementia.

PubMed

Lee, Kyoung Min; Song, Jun-Ah

2015-06-01

To explore the degree of eating ability in people with dementia and identify what factors affect their eating ability. Appropriate food consumption is important to human life. Although eating difficulties are common among people with dementia, little is known about what factors might influence their eating ability. Descriptive, cross-sectional study. A total of 149 people with dementia residing in nursing facilities in Seoul or the Gyeonggi area of Korea were evaluated using the Korean Mini-Mental State Examination, Korean Activities of Daily Living Scale and Eating Behaviour Scale. Data were analysed using descriptive statistics, one-way analysis of variance, Pearson correlation coefficient and multiple regression analysis. The participants showed a moderate level of dependency with respect to eating ability and were most dependent on the use of utensils. There were significant differences in eating ability according to general characteristics such as duration of residence, duration of illness, degree of visual impairment, eating place, and diet type. The eating ability of the participants was significantly correlated with cognitive function and physical function. Cognitive function, physical function, duration of illness, eating place (living room or dining room), and diet type (soft or liquid) significantly predicted eating ability in people with dementia. The findings of this study suggest that it is necessary to thoroughly assess the eating ability of people with dementia and to develop appropriate training programs to maintain or improve their remaining eating ability. The creation of a pleasurable physical and social environment for eating might also be helpful. These findings would be able to serve a useful basis in the development of materials for nursing intervention programs for people with dementia during mealtimes by improving the techniques and care qualities of nursing caregivers. © 2015 John Wiley & Sons Ltd.

Development of a brief parent-report risk index for children following parental divorce.

PubMed

Tein, Jenn-Yun; Sandler, Irwin N; Braver, Sanford L; Wolchik, Sharlene A

2013-12-01

This article reports on the development of a brief 15-item parent-report risk index (Child Risk Index for Divorced or Separated Families; CRI-DS) to predict problem outcomes of children who have experienced parental divorce. A series of analyses using 3 data sets were conducted that identified and cross-validated a parsimonious set of items representing parent report of child behavior problems and family level risk and protective factors, each of which contributed to the predictive accuracy of the index. The index predicted child behavior outcomes and substance abuse problems up to 6 years later. The index has acceptable levels of sensitivity and specificity as a screening measure to predict problem outcomes up to 1 year later. The use of the index to identify the need for preventive services is discussed, along with limitations of the study.

Disorganized attachment and inhibitory capacity: predicting externalizing problem behaviors.

PubMed

Bohlin, Gunilla; Eninger, Lilianne; Brocki, Karin Cecilia; Thorell, Lisa B

2012-04-01

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.

The Meaning and Predictive Value of Self-rated Mental Health among Persons with a Mental Health Problem.

PubMed

McAlpine, Donna D; McCreedy, Ellen; Alang, Sirry

2018-06-01

Self-rated health is a valid measure of health that predicts quality of life, morbidity, and mortality. Its predictive value reflects a conceptualization of health that goes beyond a traditional medical model. However, less is known about self-rated mental health (SRMH). Using data from the Medical Expenditure Panel Survey ( N = 2,547), we examine how rating your mental health as good-despite meeting criteria for a mental health problem-predicts outcomes. We found that 62% of people with a mental health problem rated their mental health positively. Persons who rated their mental health as good (compared to poor) had 30% lower odds of having a mental health problem at follow-up. Even without treatment, persons with a mental health problem did better if they perceived their mental health positively. SRMH might comprise information beyond the experience of symptoms. Understanding the unobserved information individuals incorporate into SRMH will help us improve screening and treatment interventions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simonetto, Andrea; Dall'Anese, Emiliano

This article develops online algorithms to track solutions of time-varying constrained optimization problems. Particularly, resembling workhorse Kalman filtering-based approaches for dynamical systems, the proposed methods involve prediction-correction steps to provably track the trajectory of the optimal solutions of time-varying convex problems. The merits of existing prediction-correction methods have been shown for unconstrained problems and for setups where computing the inverse of the Hessian of the cost function is computationally affordable. This paper addresses the limitations of existing methods by tackling constrained problems and by designing first-order prediction steps that rely on the Hessian of the cost function (and do notmore » require the computation of its inverse). In addition, the proposed methods are shown to improve the convergence speed of existing prediction-correction methods when applied to unconstrained problems. Numerical simulations corroborate the analytical results and showcase performance and benefits of the proposed algorithms. A realistic application of the proposed method to real-time control of energy resources is presented.« less

Novel applications of multitask learning and multiple output regression to multiple genetic trait prediction.

PubMed

He, Dan; Kuhn, David; Parida, Laxmi

2016-06-15

Given a set of biallelic molecular markers, such as SNPs, with genotype values encoded numerically on a collection of plant, animal or human samples, the goal of genetic trait prediction is to predict the quantitative trait values by simultaneously modeling all marker effects. Genetic trait prediction is usually represented as linear regression models. In many cases, for the same set of samples and markers, multiple traits are observed. Some of these traits might be correlated with each other. Therefore, modeling all the multiple traits together may improve the prediction accuracy. In this work, we view the multitrait prediction problem from a machine learning angle: as either a multitask learning problem or a multiple output regression problem, depending on whether different traits share the same genotype matrix or not. We then adapted multitask learning algorithms and multiple output regression algorithms to solve the multitrait prediction problem. We proposed a few strategies to improve the least square error of the prediction from these algorithms. Our experiments show that modeling multiple traits together could improve the prediction accuracy for correlated traits. The programs we used are either public or directly from the referred authors, such as MALSAR (http://www.public.asu.edu/~jye02/Software/MALSAR/) package. The Avocado data set has not been published yet and is available upon request. dhe@us.ibm.com. © The Author 2016. Published by Oxford University Press.

Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood

PubMed Central

Creswell, Kasey G.; Chung, Tammy; Clark, Duncan B.; Martin, Christopher S.

2015-01-01

Adolescent solitary drinking may represent an informative divergence from normative behavior, with important implications for understanding risk for alcohol-use disorders later in life. Within a self-medication framework, we hypothesized that solitary alcohol use would be associated with drinking in response to negative affect and that such a pattern of drinking would predict alcohol problems in young adulthood. We tested these predictions in a longitudinal study in which we examined whether solitary drinking in adolescence (ages 12–18) predicted alcohol-use disorders in young adulthood (age 25) in 466 alcohol-using teens recruited from clinical programs and 243 alcohol-using teens recruited from the community. Findings showed that solitary drinking was associated with drinking in response to negative affect during adolescence and predicted alcohol problems in young adulthood. Results indicate that drinking alone is an important type of alcohol-use behavior that increases risk for the escalation of alcohol use and the development of alcohol problems. PMID:25977842

Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood.

PubMed

Creswell, Kasey G; Chung, Tammy; Clark, Duncan B; Martin, Christopher S

2014-09-01

Adolescent solitary drinking may represent an informative divergence from normative behavior, with important implications for understanding risk for alcohol-use disorders later in life. Within a self-medication framework, we hypothesized that solitary alcohol use would be associated with drinking in response to negative affect and that such a pattern of drinking would predict alcohol problems in young adulthood. We tested these predictions in a longitudinal study in which we examined whether solitary drinking in adolescence (ages 12-18) predicted alcohol-use disorders in young adulthood (age 25) in 466 alcohol-using teens recruited from clinical programs and 243 alcohol-using teens recruited from the community. Findings showed that solitary drinking was associated with drinking in response to negative affect during adolescence and predicted alcohol problems in young adulthood. Results indicate that drinking alone is an important type of alcohol-use behavior that increases risk for the escalation of alcohol use and the development of alcohol problems.

Identifying at-risk children at school entry: the usefulness of multibehavioral problem profiles.

PubMed

Flanagan, Kelly S; Bierman, Karen L; Kam, Chi-Ming

2003-09-01

Found that 1st-grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of prosocial behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at risk for school problems. A broad screening strategy, in which children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk," showed lower specificity but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Results are discussed in terms of implications for the screening and design of preventive interventions.

Longitudinal Associations Between Marital Instability and Child Sleep Problems across Infancy and Toddlerhood in Adoptive Families

PubMed Central

Mannering, Anne M.; Harold, Gordon T.; Leve, Leslie D.; Shelton, Katherine H.; Shaw, Daniel S.; Conger, Rand D.; Neiderhiser, Jenae M.; Scaramella, Laura V.; Reiss, David

2009-01-01

This study examined the longitudinal association between marital instability and child sleep problems at ages 9 and 18 months in 357 families with a genetically unrelated infant adopted at birth. This design eliminates shared genes as an explanation for similarities between parent and child. Structural equation modeling indicated that T1 marital instability predicted T2 child sleep problems, but T1 child sleep problems did not predict T2 marital instability. This pattern of results was replicated when models were estimated separately for mothers and children and for fathers and children. Thus, even after controlling for stability in sleep problems and marital instability and eliminating shared genetic influences on associations using a longitudinal adoption design, marital instability prospectively predicts early childhood sleep patterns. PMID:21557740

The influence of chronic health problems and work-related factors on loss of paid employment among older workers.

PubMed

Leijten, Fenna R M; de Wind, Astrid; van den Heuvel, Swenne G; Ybema, Jan Fekke; van der Beek, Allard J; Robroek, Suzan J W; Burdorf, Alex

2015-11-01

With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations. Self-report questionnaire data was used from the Dutch longitudinal Study on Transitions in Employment, Ability and Motivation with 3 years of follow-up (2010-2013), among employees aged 45-64 years (N=8149). The influence of baseline chronic health problems and work-related factors on transitions from paid employment to disability benefits, unemployment and early retirement during follow-up was estimated in a competing risks proportional hazards model. Relative excess risk of transitions due to the interaction between chronic health problems and work-related factors was assessed. Severe headache, diabetes mellitus and musculoskeletal, respiratory, digestive and psychological health problems predicted an increased risk of disability benefits (HR range 1.78-2.79). Circulatory (HR=1.35) and psychological health problems (HR=2.58) predicted unemployment, and musculoskeletal (HR=1.23) and psychological health problems (HR=1.57) predicted early retirement. Work-related factors did not modify the influence of health problems on unemployment or early retirement. Psychosocial work-related factors, especially autonomy, modified the influence of health problems on disability benefits. Specifically, among workers with health problems, higher autonomy, higher support and lower psychological job demands reduced the risk of disability benefits by 82%, 49%, and 11%, respectively. All health problems affected disability benefits to a similar extent, but psychological health problems especially predicted unemployment and early retirement. For older workers with health problems, promoting an optimal work environment has the potential to contribute to sustainable employment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Severity of Autism Symptoms and Degree of Attentional Difficulties Predicts Emotional and Behavioral Problems in Children with High-Functioning Autism; a Two-Year Follow-up Study

PubMed Central

Andersen, Per N.; Hovik, Kjell T.; Skogli, Erik W.; Øie, Merete G.

2017-01-01

Children with autism often struggle with emotional and behavioral problems (EBP). This study investigated whether level of autism symptoms, attention problems or verbal IQ at baseline can predict EBP 2 years later in children with High-Functioning Autism (HFA). Thirty-four participants with HFA and 45 typically developing children (TD) (ages 9–16) were assessed with parent ratings of EBP, autism symptoms, attention problems, and a test of verbal IQ. The amount of autism symptoms and degree of attention problems at baseline significantly predicted EBP at follow-up, whereas verbal IQ did not. The findings from this study emphasize the importance of assessing and understanding the consequences of autism symptoms and attention problems when treating EBP in children with HFA. Furthermore, interventions aimed at improving ASD symptoms may positively affect the prevalence of EBP in children with HFA. PMID:29184527

Gender Roles, Externalizing Behaviors, and Substance Use Among Mexican-American Adolescents

PubMed Central

KULIS, STEPHEN; MARSIGLIA, FLAVIO F.; NAGOSHI, JULIE L.

2010-01-01

A sample of 60 male and 91 female Mexican-American adolescents (age 13–18) were administered measures of positive (i.e., assertive masculinity, affective femininity) and negative (i.e., aggressive masculinity, submissive femininity) gender roles, internalizing and externalizing problem behaviors, peer substance use, and own substance use (alcohol, cigarettes, marijuana). Negative gender roles were significantly correlated with internalizing and externalizing problems for both boys and girls, with aggressive masculinity also predicting peer substance use for both genders. Assertive masculinity significantly predicted lower alcohol use in boys, and this effect was not mediated by internalizing problems, externalizing problems, or peer substance use. Negative gender roles significantly predicted higher alcohol use in girls, but this effect was almost completely mediated by internalizing problems, externalizing problems, and peer substance use. Results are discussed in terms of gender role socialization among Mexican Americans. PMID:21031145

Prediction and stability of reading problems in middle childhood.

PubMed

Ritchey, Kristen D; Silverman, Rebecca D; Schatschneider, Christopher; Speece, Deborah L

2015-01-01

The longitudinal prediction of reading problems from fourth grade to sixth grade was investigated with a sample of 173 students. Reading problems at the end of sixth grade were defined by significantly below average performance (≤ 15th percentile) on reading factors defining word reading, fluency, and reading comprehension. Sixth grade poor reader status was predicted by fall of fourth grade passage reading fluency, spelling fluency, and the number of reading problems identified by teachers. Reading fluency and spelling fluency were significant predictors in logistic regression equation that combined to yield a screening battery with an area under the curve of .91. These results suggest that brief assessments of reading and spelling fluency in fourth grade may be able to identify students in middle childhood who have a reading problem or who are at risk for experiencing reading problems in sixth grade. © Hammill Institute on Disabilities 2013.

Child-Level Predictors of Responsiveness to Evidence-Based Mathematics Intervention.

PubMed

Powell, Sarah R; Cirino, Paul T; Malone, Amelia S

2017-07-01

We identified child-level predictors of responsiveness to 2 types of mathematics (calculation and word-problem) intervention among 2nd-grade children with mathematics difficulty. Participants were 250 children in 107 classrooms in 23 schools pretested on mathematics and general cognitive measures and posttested on mathematics measures. We assigned classrooms randomly assigned to calculation intervention, word-problem intervention, or business-as-usual control. Intervention lasted 17 weeks. Path analyses indicated that scores on working memory and language comprehension assessments moderated responsiveness to calculation intervention. No moderators were identified for responsiveness to word-problem intervention. Across both intervention groups and the control group, attentive behavior predicted both outcomes. Initial calculation skill predicted the calculation outcome, and initial language comprehension predicted word-problem outcomes. These results indicate that screening for calculation intervention should include a focus on working memory, language comprehension, attentive behavior, and calculations. Screening for word-problem intervention should focus on attentive behavior and word problems.

Internet use and video gaming predict problem behavior in early adolescence.

PubMed

Holtz, Peter; Appel, Markus

2011-02-01

In early adolescence, the time spent using the Internet and video games is higher than in any other present-day age group. Due to age-inappropriate web and gaming content, the impact of new media use on teenagers is a matter of public and scientific concern. Based on current theories on inappropriate media use, a study was conducted that comprised 205 adolescents aged 10-14 years (Md = 13). Individuals were identified who showed clinically relevant problem behavior according to the problem scales of the Youth Self Report (YSR). Online gaming, communicational Internet use, and playing first-person shooters were predictive of externalizing behavior problems (aggression, delinquency). Playing online role-playing games was predictive of internalizing problem behavior (including withdrawal and anxiety). Parent-child communication about Internet activities was negatively related to problem behavior. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Structured Parent-Child Observations Predict Development of Conduct Problems: the Importance of Parental Negative Attention in Child-Directed Play.

PubMed

Fleming, Andrew P; McMahon, Robert J; King, Kevin M

2017-04-01

Structured observations of parent-child interactions are commonly used in research and clinical settings, but require additional empirical support. The current study examined the capacity of child-directed play, parent-directed play, and parent-directed chore interaction analogs to uniquely predict the development of conduct problems across a 6-year follow-up period. Parent-child observations were collected from 338 families from high-risk neighborhoods during the summer following the child's first-grade year. Participating children were 49.2 % female, 54.4 % white, and 45.6 % black, and had an average age of 7.52 years at the first assessment. Conduct problems were assessed via parent report and teacher report at five assessment points between first grade and seventh grade. Latent growth curve modeling was used to analyze predictors of conduct problem trajectory across this 6-year follow-up period. When race, sex, socioeconomic status, and maternal depressive symptoms were controlled, parental negative attention during child-directed play predicted higher levels of parent-reported conduct problems concurrently and after a 6-year follow-up period. Parental negative attention during child-directed play also predicted higher teacher-reported conduct problems 6 years later. Findings support the use of child-directed play and parent-directed chore analogs in predicting longitudinal development of conduct problems. The presence of parental negative attention during child-directed play appears to be an especially important predictor of greater conduct problems over time and across multiple domains. Additionally, the potential importance of task-incongruent behavior is proposed for further study.

EEG Estimates of Cognitive Workload and Engagement Predict Math Problem Solving Outcomes

ERIC Educational Resources Information Center

Beal, Carole R.; Galan, Federico Cirett

2012-01-01

In the present study, the authors focused on the use of electroencephalography (EEG) data about cognitive workload and sustained attention to predict math problem solving outcomes. EEG data were recorded as students solved a series of easy and difficult math problems. Sequences of attention and cognitive workload estimates derived from the EEG…

Behavior problems and placement change in a national child welfare sample: a prospective study.

PubMed

Aarons, Gregory A; James, Sigrid; Monn, Amy R; Raghavan, Ramesh; Wells, Rebecca S; Leslie, Laurel K

2010-01-01

There is ongoing debate regarding the impact of youth behavior problems on placement change in child welfare compared to the impact of placement change on behavior problems. Existing studies provide support for both perspectives. The purpose of this study was to prospectively examine the relations of behavior problems and placement change in a nationally representative sample of youths in the National Survey of Child and Adolescent Well-Being. The sample consisted of 500 youths in the child welfare system with out-of-home placements over the course of the National Survey of Child and Adolescent Well-Being study. We used a prospective cross-lag design and path analysis to examine reciprocal effects of behavior problems and placement change, testing an overall model and models examining effects of age and gender. In the overall model, out of a total of eight path coefficients, behavior problems significantly predicted placement changes for three paths and placement change predicted behavior problems for one path. Internalizing and externalizing behavior problems at baseline predicted placement change between baseline and 18 months. Behavior problems at an older age and externalizing behavior at 18 months appear to confer an increased risk of placement change. Of note, among female subjects, placement changes later in the study predicted subsequent internalizing and externalizing behavior problems. In keeping with recommendations from a number of professional bodies, we suggest that initial and ongoing screening for internalizing and externalizing behavior problems be instituted as part of standard practice for youths entering or transitioning in the child welfare system.

Polygenic scores predict alcohol problems in an independent sample and show moderation by the environment.

PubMed

Salvatore, Jessica E; Aliev, Fazil; Edwards, Alexis C; Evans, David M; Macleod, John; Hickman, Matthew; Lewis, Glyn; Kendler, Kenneth S; Loukola, Anu; Korhonen, Tellervo; Latvala, Antti; Rose, Richard J; Kaprio, Jaakko; Dick, Danielle M

2014-04-10

Alcohol problems represent a classic example of a complex behavioral outcome that is likely influenced by many genes of small effect. A polygenic approach, which examines aggregate measured genetic effects, can have predictive power in cases where individual genes or genetic variants do not. In the current study, we first tested whether polygenic risk for alcohol problems-derived from genome-wide association estimates of an alcohol problems factor score from the age 18 assessment of the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 4304 individuals of European descent; 57% female)-predicted alcohol problems earlier in development (age 14) in an independent sample (FinnTwin12; n = 1162; 53% female). We then tested whether environmental factors (parental knowledge and peer deviance) moderated polygenic risk to predict alcohol problems in the FinnTwin12 sample. We found evidence for both polygenic association and for additive polygene-environment interaction. Higher polygenic scores predicted a greater number of alcohol problems (range of Pearson partial correlations 0.07-0.08, all p-values ≤ 0.01). Moreover, genetic influences were significantly more pronounced under conditions of low parental knowledge or high peer deviance (unstandardized regression coefficients (b), p-values (p), and percent of variance (R2) accounted for by interaction terms: b = 1.54, p = 0.02, R2 = 0.33%; b = 0.94, p = 0.04, R2 = 0.30%, respectively). Supplementary set-based analyses indicated that the individual top single nucleotide polymorphisms (SNPs) contributing to the polygenic scores were not individually enriched for gene-environment interaction. Although the magnitude of the observed effects are small, this study illustrates the usefulness of polygenic approaches for understanding the pathways by which measured genetic predispositions come together with environmental factors to predict complex behavioral outcomes.

The Roles of Family and Teacher Support in Moderating and Mediating Externalized and Internalized Outcomes of Exposure to Community Violence Among Arab and Jewish Adolescents in Israel.

PubMed

Haj-Yahia, Muhammad M; Leshem, Becky; Guterman, Neil B

2018-02-01

The study examined family and teacher support as factors that can protect adolescents from internalized and externalized problems after exposure to community violence (ECV). Self-administered questionnaires were filled out by a sample of 1,832 Arab and Jewish Israeli high school students. The Arab adolescents reported significantly higher levels of community violence victimization, internalized problems, externalized problems, family support, and teacher support than the Jewish adolescents. The girls reported higher levels of internalized problems, and the boys reported higher levels of externalized problems. ECV predicted high levels of internalized and externalized problems, family support predicted low levels of internalized and externalized problems, and teacher support had no predictive role. Path analysis confirmed the significance of the relationships between ECV effects, support variables, and gender. The limitations of the study and implications of the findings for future research and for the development of family care and family intervention programs are discussed.

Role of Parent and Peer Relationships and Individual Characteristics in Middle School Children's Behavioral Outcomes in the Face of Community Violence

PubMed Central

Salzinger, Suzanne; Rosario, Margaret; Feldman, Richard S.; Ng-Mak, Daisy S.

2010-01-01

This study examines processes linking inner-city community violence exposure to subsequent internalizing and externalizing problems. Hypothesized risk and protective factors from three ecological domains -- children's parent and peer relationships and individual characteristics -- were examined for mediating, moderating or independent roles in predicting problem behavior among 667 children over three years of middle school. Mediation was not found. However, parent and peer variables moderated the association between exposure and internalizing problems. Under high exposure, normally protective factors (e.g., attachment to parents) were less effective in mitigating exposure's effects than under low exposure; attachment to friends was more effective. Individual competence was independently associated with decreased internalizing problems. Variables from all domains, and exposure, were independently associated with externalizing problems. Protective factors (e.g., parent attachment) predicted decreased problems; risk factors (e.g., friends' delinquency) predicted increased problems. Results indicate community violence reduction as essential in averting inner-city adolescents' poor behavioral outcomes. PMID:21643493

A geostatistical approach to the change-of-support problem and variable-support data fusion in spatial analysis

NASA Astrophysics Data System (ADS)

Wang, Jun; Wang, Yang; Zeng, Hui

2016-01-01

A key issue to address in synthesizing spatial data with variable-support in spatial analysis and modeling is the change-of-support problem. We present an approach for solving the change-of-support and variable-support data fusion problems. This approach is based on geostatistical inverse modeling that explicitly accounts for differences in spatial support. The inverse model is applied here to produce both the best predictions of a target support and prediction uncertainties, based on one or more measurements, while honoring measurements. Spatial data covering large geographic areas often exhibit spatial nonstationarity and can lead to computational challenge due to the large data size. We developed a local-window geostatistical inverse modeling approach to accommodate these issues of spatial nonstationarity and alleviate computational burden. We conducted experiments using synthetic and real-world raster data. Synthetic data were generated and aggregated to multiple supports and downscaled back to the original support to analyze the accuracy of spatial predictions and the correctness of prediction uncertainties. Similar experiments were conducted for real-world raster data. Real-world data with variable-support were statistically fused to produce single-support predictions and associated uncertainties. The modeling results demonstrate that geostatistical inverse modeling can produce accurate predictions and associated prediction uncertainties. It is shown that the local-window geostatistical inverse modeling approach suggested offers a practical way to solve the well-known change-of-support problem and variable-support data fusion problem in spatial analysis and modeling.

The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study

PubMed Central

Demirjian, Louise; Horvath, Frances; Doxsey, Lauri

2018-01-01

A mixed-methods design was used to explore the outcomes of a 6-wk, occupational therapist–led Comfortable Cafeteria program designed to build cafeteria supervisors’ and students’ capacity to create a positive mealtime environment so that all students can successfully participate in and enjoy a healthy meal and socialization with peers. Students whose scores were in the low and mid-range at the outset had statistically significant improvements in pretest–posttest visual analog scale ratings of participation and enjoyment. Cafeteria supervisors demonstrated statistically significant improvements in their perceptions of knowledge and skills to supervise and to encourage healthy eating. Qualitative findings add further insight into the program, suggesting that students learned prosocial values (e.g., being kind, helping others), supervisors actively encouraged positive social interaction, and occupational therapists enjoyed implementing the program and recognized positive supervisor and student changes as a result of integrating services in the cafeteria. PMID:29689174

The Effect of Dining Room Physical Environmental Renovations on Person-Centered Care Practice and Residents' Dining Experiences in Long-Term Care Facilities.

PubMed

Hung, Lillian; Chaudhury, Habib; Rust, Tiana

2016-12-01

This qualitative study evaluated the effect of dining room physical environmental changes on staff practices and residents' mealtime experiences in two units of a long-term care facility in Edmonton, Canada. Focus groups with staff (n = 12) and individual interviews with unit managers (n = 2) were conducted. We also developed and used the Dining Environment Assessment Protocol (DEAP) to conduct a systematic physical environmental evaluation of the dining rooms. Four themes emerged on the key influences of the renovations: (a) supporting independence and autonomy, (b) creating familiarity and enjoyment, (c) providing a place for social experience, and (d) challenges in supporting change. Feedback from the staff and managers provided evidence on the importance of physical environmental features, as well as the integral nature of the role of the physical environment and organizational support to provide person-centered care for residents. © The Author(s) 2015.

Healthy eating for rural low-income toddlers: caregivers' perceptions.

PubMed

Omar, M A; Coleman, G; Hoerr, S

2001-01-01

Caregivers exert a powerful influence on young children's eating habits. This qualitative study used focus groups to assess nutritional needs and barriers in establishing healthy eating habits in toddlers. Three focus groups were conducted with rural, low-income caregivers, 2 with men and 1 with women, in 3 rural Michigan counties. Four major themes emerged: (a) barriers to providing healthy meals, (b) division of responsibility, (c) mealtime behavior, and (d) desired nutrition education. The major barriers identified were work schedules; cost of food; inadequate time to shop, plan, and prepare nutritious meals; or a combination thereof. Caregivers expressed concern for the nutritional well-being of their toddlers. The perceived needs and perceptions of low-income caregivers need to be considered when providing nutrition education. Findings from this study provided the basis for developing a nutrition education intervention for low-income parents of young children.

A Comparison of Glide Force Characteristics Between 2 Prefilled Insulin Lispro Pens

PubMed Central

Lennartz, Amanda H.; Ignaut, Debra A.

2015-01-01

Background: Glide force, average glide force, and glide force variability of the insulin lispro 200 units/mL pen (Eli Lilly and Company, Indianapolis, IN, USA) were compared to the Humalog® KwikPen® 100 units/mL pen (hereafter, KwikPen; Eli Lilly and Company, Indianapolis, IN, USA). Methods: Data were collected on 2 doses, 2 injection speeds, and 2 needle types. Results: Insulin lispro 200 units/mL pen showed significantly lower maximum glide force, average glide force, and glide force variability than the KwikPen across all combinations of dose size, dose speed, and needle type. Conclusions: The lower glide force observed with the insulin lispro 200 units/mL pen offers another treatment option for patients with type 1 or type 2 diabetes who require greater than 20 units of mealtime insulin daily. PMID:25591858

Routines of families with adolescents with autistic disorders: a comparison study.

PubMed

Bagatell, Nancy J; Cram, Megan; Alvarez, Christian G; Loehle, Laura

2014-02-01

Research has consistently shown that families with children with autism spectrum disorders (ASD) have difficulty engaging in family routines, yet little is known about families with adolescents with ASD. The purpose of this study is to compare the routines of families with adolescents with ASD (FASD) and families with typically developing adolescents. Twenty families in each group were compared using the Family Routines Inventory and supplemental questions. Data were analyzed using a Mann-Whitney U and content analysis. No significant difference between groups was found; however, there was a trending toward significance in the subscale of mealtime routines in both endorsement and adherence. Analysis of open-ended questions revealed differences in how routines were carried out. Occupational therapists should consider assessing and addressing routines of importance to FASD to increase family health and well-being. Further research is needed to better understand the routines of FASD.

Narratives of mothers of children with autism spectrum disorders: focus on eating behavior.

PubMed

Lázaro, Cristiane P; Pondé, Milena P

2017-01-01

To investigate the eating behavior of individuals with autism through their mothers' narratives. The study of narratives was used to report on the narrators' experiences. Data on the eating habits of individuals with autism were collected using semi-structured interviews held individually with the mothers. The interviews were recorded, transcribed and codified using the NVivo software program. Eighteen mothers of boys/young men with autism participated in the study. Analysis yielded three major categories: eating patterns, the family's attitudes to the child's eating habits, and food-related behavior. Results show that autism-related factors may affect the child's food choices. Environmental factors, particularly the parents' behavior, may also play a decisive role, both in reinforcing the child's food choices and in encouraging a healthier and more diversified diet. Professionals should instruct parents regarding their decisive role in reinforcing or discouraging inappropriate mealtime behavior in children with autism.

EAT-UP™ Family-Centered Feeding Intervention to Promote Food Acceptance and Decrease Challenging Behaviors: A Single-Case Experimental Design Replicated Across Three Families of Children with Autism Spectrum Disorder.

PubMed

Cosbey, Joanna; Muldoon, Deirdre

2017-03-01

This study evaluated the effectiveness of a family-centered feeding intervention, Easing Anxiety Together with Understanding and Perseverance (EAT-UP™), for promoting food acceptance of children with autism spectrum disorder at home. A concurrent multiple-baseline design was used with systematic replication across three families. Baseline was followed by an 'Intervention-Coaching' phase and then an 'Intervention-Independent' phase. Using direct observation and pre- and post-intervention questionnaires, data on acceptance of less preferred foods and challenging mealtime behaviors were collected. Procedural fidelity was monitored throughout all study phases. Data were analyzed using visual analysis and measures of effect size. All children demonstrated increases in food acceptance (effect size >0.90) and dietary diversity and decreased challenging behaviors. Implications for practice and research are discussed.

Predicting protein structures with a multiplayer online game.

PubMed

Cooper, Seth; Khatib, Firas; Treuille, Adrien; Barbero, Janos; Lee, Jeehyung; Beenen, Michael; Leaver-Fay, Andrew; Baker, David; Popović, Zoran; Players, Foldit

2010-08-05

People exert large amounts of problem-solving effort playing computer games. Simple image- and text-recognition tasks have been successfully 'crowd-sourced' through games, but it is not clear if more complex scientific problems can be solved with human-directed computing. Protein structure prediction is one such problem: locating the biologically relevant native conformation of a protein is a formidable computational challenge given the very large size of the search space. Here we describe Foldit, a multiplayer online game that engages non-scientists in solving hard prediction problems. Foldit players interact with protein structures using direct manipulation tools and user-friendly versions of algorithms from the Rosetta structure prediction methodology, while they compete and collaborate to optimize the computed energy. We show that top-ranked Foldit players excel at solving challenging structure refinement problems in which substantial backbone rearrangements are necessary to achieve the burial of hydrophobic residues. Players working collaboratively develop a rich assortment of new strategies and algorithms; unlike computational approaches, they explore not only the conformational space but also the space of possible search strategies. The integration of human visual problem-solving and strategy development capabilities with traditional computational algorithms through interactive multiplayer games is a powerful new approach to solving computationally-limited scientific problems.

Relationship of drug-addicted patients' personality disorders to social problem-solving changes during the rehabilitation process.

PubMed

Kolesnikova, Jelena; Miezitis, Solveiga; Osis, Guntars

2013-08-01

Drug-addicted patients exhibit various personality disorders that interfere with their adaptation to society, as well as their ability to participate in the rehabilitation process. The Latvian Rehabilitation Programme for drug addicts includes social problem-solving training to help patients reintegrate into society. However, the role of personality disorders has not been investigated in relation to this process. The aim of the study is to assess whether personality disorders predict changes in dimensions of social problem-solving after 6 months of rehabilitation for drug-addicted patients. The sample of this study consists of 31 drug-addicted patients from the Latvian rehabilitation centres aged 21-35 (females 21%, males 79%). Two inventories are used: the Social Problem-Solving Inventory--Revised (SPSI-R) and Millon(TM) Clinical Multiaxial Inventory--III (MCMI-III) adapted into Russian. Results of the study indicated that some MCMI-III personality disorders (Schizoid and Histrionic) negatively predicted SPSI-R Positive problem orientation, and narcissistic disorder positively predicted SPSI-R Avoidance style after 6 months in the Latvian Rehabilitation Programme. The other personality disorders did not predict social problem-solving dimensions. The results of the study suggest that some personality disorders are related to changes in social problem-solving dimensions for drug-addicted patients. Hence, it is important to consider the implications of particular personality disorders to facilitate the implementation of social problem-solving rehabilitation programmes.

Dynamic longitudinal relations between binge eating symptoms and severity and style of interpersonal problems.

PubMed

Luo, Xiaochen; Nuttall, Amy K; Locke, Kenneth D; Hopwood, Christopher J

2018-01-01

Despite wide recognition of the importance of interpersonal problems in binge eating disorder (BED), the nature of this association remains unclear. Examining the direction of this longitudinal relationship is necessary to clarify the role that interpersonal problems play in the course of binge eating problems, and thus to specify treatment targets and mechanisms. This study aimed to articulate the bidirectional, longitudinal associations between BED and both the general severity of interpersonal problems as well as warm and dominant interpersonal styles. Severity and styles of interpersonal problems and BED symptoms were measured at baseline, 12 weeks, 24 weeks, and 36 weeks in a sample of 107 women in treatment for BED. Results from bivariate latent change score models indicated that interpersonal problem severity and BED symptoms are associated longitudinally but do not directly influence each other. The results indicated a bidirectional interrelation between binge eating symptoms and dominance such that less dominance predicted greater decreases in binge eating problems, and less binge eating symptoms predicted greater increases in dominance. We also found that binge eating symptoms positively predicted changes in warmth (i.e., less binge eating symptoms predicted less increases or more decreases in warmth). These findings highlight the importance of using dynamic models to examine directionality and delineate the distinct roles of interpersonal severity and styles in BED trajectories. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Analysis of superconducting electromagnetic finite elements based on a magnetic vector potential variational principle

NASA Technical Reports Server (NTRS)

Schuler, James J.; Felippa, Carlos A.

1991-01-01

Electromagnetic finite elements are extended based on a variational principle that uses the electromagnetic four potential as primary variable. The variational principle is extended to include the ability to predict a nonlinear current distribution within a conductor. The extension of this theory is first done on a normal conductor and tested on two different problems. In both problems, the geometry remains the same, but the material properties are different. The geometry is that of a 1-D infinite wire. The first problem is merely a linear control case used to validate the new theory. The second problem is made up of linear conductors with varying conductivities. Both problems perform well and predict current densities that are accurate to within a few ten thousandths of a percent of the exact values. The fourth potential is then removed, leaving only the magnetic vector potential, and the variational principle is further extended to predict magnetic potentials, magnetic fields, the number of charge carriers, and the current densities within a superconductor. The new element produces good results for the mean magnetic field, the vector potential, and the number of superconducting charge carriers despite a relatively high system condition number. The element did not perform well in predicting the current density. Numerical problems inherent to this formulation are explored and possible remedies to produce better current predicting finite elements are presented.

Does early childhood callous-unemotional behavior uniquely predict behavior problems or callous-unemotional behavior in late childhood?

PubMed Central

Waller, Rebecca; Dishion, Thomas J.; Shaw, Daniel S.; Gardner, Frances; Wilson, Melvin N.; Hyde, Luke W.

2016-01-01

Callous unemotional (CU) behavior has been linked to behavior problems in children and adolescents. However, few studies have examined whether CU behavior in early childhood predicts behavior problems or CU behavior in late childhood. This study examined whether indicators of CU behavior at ages 2–4 predicted aggression, rule-breaking, and CU behavior across informants at age 9.5. To test the unique predictive and convergent validity of CU behavior in early childhood, we accounted for stability in behavior problems and method effects to rule out the possibility that rater biases inflated the magnitude of any associations found. Cross-informant data were collected from a multi-ethnic, high-risk sample (N = 731; female = 49%) at ages 2–4 and again at age 9.5. From age 3, CU behavior uniquely predicted aggression and rule-breaking across informants. There were also unique associations between CU behavior assessed at ages 3 and 4 and CU behavior assessed at age 9.5. Findings demonstrate that early-childhood indicators of CU behavior account for unique variance in later childhood behavior problems and CU behavior, taking into account stability in behavior problems over time and method effects. Convergence with a traditional measure of CU behavior in late childhood provides support for the construct validity of a brief early childhood measure of CU behavior. PMID:27598253

Predicting protein function and other biomedical characteristics with heterogeneous ensembles

PubMed Central

Whalen, Sean; Pandey, Om Prakash

2015-01-01

Prediction problems in biomedical sciences, including protein function prediction (PFP), are generally quite difficult. This is due in part to incomplete knowledge of the cellular phenomenon of interest, the appropriateness and data quality of the variables and measurements used for prediction, as well as a lack of consensus regarding the ideal predictor for specific problems. In such scenarios, a powerful approach to improving prediction performance is to construct heterogeneous ensemble predictors that combine the output of diverse individual predictors that capture complementary aspects of the problems and/or datasets. In this paper, we demonstrate the potential of such heterogeneous ensembles, derived from stacking and ensemble selection methods, for addressing PFP and other similar biomedical prediction problems. Deeper analysis of these results shows that the superior predictive ability of these methods, especially stacking, can be attributed to their attention to the following aspects of the ensemble learning process: (i) better balance of diversity and performance, (ii) more effective calibration of outputs and (iii) more robust incorporation of additional base predictors. Finally, to make the effective application of heterogeneous ensembles to large complex datasets (big data) feasible, we present DataSink, a distributed ensemble learning framework, and demonstrate its sound scalability using the examined datasets. DataSink is publicly available from https://github.com/shwhalen/datasink. PMID:26342255

Not the Same Old Thing: Establishing the Unique Contribution of Drinking Identity as a Predictor of Alcohol Consumption and Problems Over Time

PubMed Central

Lindgren, Kristen P.; Ramirez, Jason J.; Olin, Cecilia C.; Neighbors, Clayton

2016-01-01

Drinking identity – how much individuals view themselves as drinkers– is a promising cognitive factor that predicts problem drinking. Implicit and explicit measures of drinking identity have been developed (the former assesses more reflexive/automatic cognitive processes; the latter more reflective/controlled cognitive processes): each predicts unique variance in alcohol consumption and problems. However, implicit and explicit identity’s utility and uniqueness as a predictor relative to cognitive factors important for problem drinking screening and intervention has not been evaluated. Thus, the current study evaluated implicit and explicit drinking identity as predictors of consumption and problems over time. Baseline measures of drinking identity, social norms, alcohol expectancies, and drinking motives were evaluated as predictors of consumption and problems (evaluated every three months over two academic years) in a sample of 506 students (57% female) in their first or second year of college. Results found that baseline identity measures predicted unique variance in consumption and problems over time. Further, when compared to each set of cognitive factors, the identity measures predicted unique variance in consumption and problems over time. Findings were more robust for explicit, versus, implicit identity and in models that did not control for baseline drinking. Drinking identity appears to be a unique predictor of problem drinking relative to social norms, alcohol expectancies, and drinking motives. Intervention and theory could benefit from including and considering drinking identity. PMID:27428756

Not the same old thing: Establishing the unique contribution of drinking identity as a predictor of alcohol consumption and problems over time.

PubMed

Lindgren, Kristen P; Ramirez, Jason J; Olin, Cecilia C; Neighbors, Clayton

2016-09-01

Drinking identity-how much individuals view themselves as drinkers-is a promising cognitive factor that predicts problem drinking. Implicit and explicit measures of drinking identity have been developed (the former assesses more reflexive/automatic cognitive processes; the latter more reflective/controlled cognitive processes): each predicts unique variance in alcohol consumption and problems. However, implicit and explicit identity's utility and uniqueness as predictors relative to cognitive factors important for problem drinking screening and intervention has not been evaluated. Thus, the current study evaluated implicit and explicit drinking identity as predictors of consumption and problems over time. Baseline measures of drinking identity, social norms, alcohol expectancies, and drinking motives were evaluated as predictors of consumption and problems (evaluated every 3 months over 2 academic years) in a sample of 506 students (57% female) in their first or second year of college. Results found that baseline identity measures predicted unique variance in consumption and problems over time. Further, when compared to each set of cognitive factors, the identity measures predicted unique variance in consumption and problems over time. Findings were more robust for explicit versus implicit identity and in models that did not control for baseline drinking. Drinking identity appears to be a unique predictor of problem drinking relative to social norms, alcohol expectancies, and drinking motives. Intervention and theory could benefit from including and considering drinking identity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Change in Maternal Criticism and Behavior Problems in Adolescents and Adults with Autism Across a Seven-Year Period

PubMed Central

Baker, Jason K.; Smith, Leann E.; Greenberg, Jan S.; Seltzer, Marsha Mailick; Taylor, Julie Lounds

2010-01-01

In a previous study from our laboratory, high levels of maternal criticism predicted increased behavior problems in adolescents and adults with autism spectrum disorders (ASD) over an 18-month period (Greenberg, Seltzer, Hong, & Orsmond, 2006). The current investigation followed these families over a period of seven years to examine the longitudinal course of criticism and behavior problems, to assess the association between their trajectories, and to determine the degree to which change in each of these factors predicted levels of criticism and behavior problems at the end of the study period. A sample of 118 mothers co-residing with their adolescents and adults with ASD provided open-ended narratives about their children and reported on the children's behavior problems at four waves. Maternal criticism was derived from expressed emotion ratings of the narratives. Criticism exhibited low but significant stability over the seven year period and behavior problems exhibited high stability. Using latent growth curve modeling, (a) criticism was found to have increased over time, but only for the group of families in which the sons or daughters transitioned from high school services during the study period, (b) individual changes in criticism and behavior problems were positively correlated over the seven-year period, and (c) changes in criticism predicted levels of behavior problems at the conclusion of the study. Changes in behavior problems were not predictive of end levels of criticism. Implications for intervention and prevention efforts are discussed. PMID:21319925

Predicting Change in Early Adolescent Problem Behavior in the Middle School Years: A Mesosystemic Perspective on Parenting and Peer Experiences

ERIC Educational Resources Information Center

Veronneau, Marie-Helene; Dishion, Thomas J.

2010-01-01

The transition into middle school may be a risky period in early adolescence. In particular, friendships, peer status, and parental monitoring during this developmental period can influence the development of problem behavior. This study examined interrelationships among peer and parenting factors that predict changes in problem behavior over the…

Predicting problems in school performance from preschool health, developmental and behavioural assessments.

PubMed Central

Cadman, D; Walter, S D; Chambers, L W; Ferguson, R; Szatmari, P; Johnson, N; McNamee, J

1988-01-01

To determine the accuracy of various predictors of school problems, we conducted a 3-year prospective study of 1999 children who began school in the Niagara region of Ontario in 1980. During the year before school entry the parents gave a health, developmental and behavioural history during an interview with a community health nurse, and the children underwent vision and hearing screening tests and the Denver Developmental Screening Test (DDST). At the end of the 1980-81 school year the kindergarten teachers rated the children's learning problems. At the end of the 1982-83 school year the presence of school problems was ascertained, and the predictive accuracy of items from the preschool history and examination and of the kindergarten teachers' ratings was calculated. The health, developmental and behavioural history with or without the DDST was found to predict later school problems with acceptable accuracy. The kindergarten teachers' ratings gave slightly more accurate predictions. We conclude that in communities where prompt diagnostic evaluation and effective therapeutic or preventive help can be provided to children identified as being at high risk, health professionals may play a useful role in screening for future school problems. PMID:3383038

Longitudinal associations between marital instability and child sleep problems across infancy and toddlerhood in adoptive families.

PubMed

Mannering, Anne M; Harold, Gordon T; Leve, Leslie D; Shelton, Katherine H; Shaw, Daniel S; Conger, Rand D; Neiderhiser, Jenae M; Scaramella, Laura V; Reiss, David

2011-01-01

This study examined the longitudinal association between marital instability and child sleep problems at ages 9 and 18 months in 357 families with a genetically unrelated infant adopted at birth. This design eliminates shared genes as an explanation for similarities between parent and child. Structural equation modeling indicated that T1 marital instability predicted T2 child sleep problems, but T1 child sleep problems did not predict T2 marital instability. This result was replicated when models were estimated separately for mothers and fathers. Thus, even after controlling for stability in sleep problems and marital instability and eliminating shared genetic influences on associations using a longitudinal adoption design, marital instability prospectively predicts early childhood sleep patterns. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

Analyzing Log Files to Predict Students' Problem Solving Performance in a Computer-Based Physics Tutor

ERIC Educational Resources Information Center

Lee, Young-Jin

2015-01-01

This study investigates whether information saved in the log files of a computer-based tutor can be used to predict the problem solving performance of students. The log files of a computer-based physics tutoring environment called Andes Physics Tutor was analyzed to build a logistic regression model that predicted success and failure of students'…

Parenting and Infant Difficulty: Testing a Mutual Exacerbation Hypothesis to Predict Early Onset Conduct Problems

ERIC Educational Resources Information Center

Lorber, Michael F.; Egeland, Byron

2011-01-01

The prediction of conduct problems (CPs) from infant difficulty and parenting measured in the first 6 months of life was studied in a sample of 267 high-risk mother-child dyads. Stable, cross-situational CPs at school entry (5-6 years) were predicted by negative infancy parenting, mediated by mutually angry and hostile mother-toddler interactions…

Calibration plots for risk prediction models in the presence of competing risks.

PubMed

Gerds, Thomas A; Andersen, Per K; Kattan, Michael W

2014-08-15

A predicted risk of 17% can be called reliable if it can be expected that the event will occur to about 17 of 100 patients who all received a predicted risk of 17%. Statistical models can predict the absolute risk of an event such as cardiovascular death in the presence of competing risks such as death due to other causes. For personalized medicine and patient counseling, it is necessary to check that the model is calibrated in the sense that it provides reliable predictions for all subjects. There are three often encountered practical problems when the aim is to display or test if a risk prediction model is well calibrated. The first is lack of independent validation data, the second is right censoring, and the third is that when the risk scale is continuous, the estimation problem is as difficult as density estimation. To deal with these problems, we propose to estimate calibration curves for competing risks models based on jackknife pseudo-values that are combined with a nearest neighborhood smoother and a cross-validation approach to deal with all three problems. Copyright © 2014 John Wiley & Sons, Ltd.

Predictors of Adolescent Functioning in Girls with Attention-deficit/Hyperactivity Disorder (ADHD): The Role of Childhood ADHD, Conduct Problems, and Peer Status

PubMed Central

2010-01-01

Predictors of adolescent functioning were studied in an ethnically diverse sample of girls with attention-deficit/hyperactivity disorder (ADHD) (n = 140) and age- and ethnicity-matched comparison girls (n = 88) who participated in naturalistic summer programs during childhood. Over a five-year follow-up (sample retention = 92%; age range = 11.3–18.2 years), conduct problems were predicted by hyperactivity-impulsivity (HI) symptoms and noncompliance (NC). Academic achievement was predicted only by inattention symptoms, whereas school suspensions/expulsions were predicted by inattention symptoms (ADHD sample only), NC, and negative peer status. Substance use was predicted by NC and HI symptoms. Internalizing problems were predicted by HI symptoms, noncompliance, and covert antisocial behavior. Finally, initial peer status was the only significant predictor of later negative social preference. PMID:16836474

Hurricane Prediction: Progress and Problem Areas

ERIC Educational Resources Information Center

Simpson, R. H.

1973-01-01

Describes progress made in recent decades in predicting the track and landfall of hurricanes. Examines the problems of detecting, tracking, and describing tropical cyclones, and the difficulties which continue to complicate the matter of warning and evacuating coastal residents. (JR)

Child Involvement in Interparental Conflict and Child Adjustment Problems: A Longitudinal Study of Violent Families

PubMed Central

Jouriles, Ernest N.; Rosenfield, David; McDonald, Renee; Mueller, Victoria

2014-01-01

This study examined whether child involvement in interparental conflict predicts child externalizing and internalizing problems in violent families. Participants were 119 families (mothers and children) recruited from domestic violence shelters. One child between the ages of 7 and 10 years in each family (50 female, 69 male) completed measures of involvement in their parents’ conflicts, externalizing problems, and internalizing problems. Mothers completed measures of child externalizing and internalizing problems, and physical intimate partner violence. Measures were completed at three assessments, spaced 6 months apart. Results indicated that children’s involvement in their parents’ conflicts was positively associated with child adjustment problems. These associations emerged in between-subjects and within-subjects analyses, and for child externalizing as well as internalizing problems, even after controlling for the influence of physical intimate partner violence. In addition, child involvement in parental conflicts predicted later child reports of externalizing problems, but child reports of externalizing problems did not predict later involvement in parental conflicts. These findings highlight the importance of considering children’s involvement in their parents’ conflicts in theory and clinical work pertaining to high-conflict families. PMID:24249486

Sensitivity and specificity of a brief personality screening instrument in predicting future substance use, emotional, and behavioral problems: 18-month predictive validity of the Substance Use Risk Profile Scale.

PubMed

Castellanos-Ryan, Natalie; O'Leary-Barrett, Maeve; Sully, Laura; Conrod, Patricia

2013-01-01

This study assessed the validity, sensitivity, and specificity of the Substance Use Risk Profile Scale (SURPS), a measure of personality risk factors for substance use and other behavioral problems in adolescence. The concurrent and predictive validity of the SURPS was tested in a sample of 1,162 adolescents (mean age: 13.7 years) using linear and logistic regressions, while its sensitivity and specificity were examined using the receiver operating characteristics curve analyses. Concurrent and predictive validity tests showed that all 4 brief scales-hopelessness (H), anxiety sensitivity (AS), impulsivity (IMP), and sensation seeking (SS)-were related, in theoretically expected ways, to measures of substance use and other behavioral and emotional problems. Results also showed that when using the 4 SURPS subscales to identify adolescents "at risk," one can identify a high number of those who developed problems (high sensitivity scores ranging from 72 to 91%). And, as predicted, because each scale is related to specific substance and mental health problems, good specificity was obtained when using the individual personality subscales (e.g., most adolescents identified at high risk by the IMP scale developed conduct or drug use problems within the next 18 months [a high specificity score of 70 to 80%]). The SURPS is a valuable tool for identifying adolescents at high risk for substance misuse and other emotional and behavioral problems. Implications of findings for the use of this measure in future research and prevention interventions are discussed. Copyright © 2012 by the Research Society on Alcoholism.

Missile Guidance Law Based on Robust Model Predictive Control Using Neural-Network Optimization.

PubMed

Li, Zhijun; Xia, Yuanqing; Su, Chun-Yi; Deng, Jun; Fu, Jun; He, Wei

2015-08-01

In this brief, the utilization of robust model-based predictive control is investigated for the problem of missile interception. Treating the target acceleration as a bounded disturbance, novel guidance law using model predictive control is developed by incorporating missile inside constraints. The combined model predictive approach could be transformed as a constrained quadratic programming (QP) problem, which may be solved using a linear variational inequality-based primal-dual neural network over a finite receding horizon. Online solutions to multiple parametric QP problems are used so that constrained optimal control decisions can be made in real time. Simulation studies are conducted to illustrate the effectiveness and performance of the proposed guidance control law for missile interception.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dall-Anese, Emiliano; Simonetto, Andrea

This paper focuses on the design of online algorithms based on prediction-correction steps to track the optimal solution of a time-varying constrained problem. Existing prediction-correction methods have been shown to work well for unconstrained convex problems and for settings where obtaining the inverse of the Hessian of the cost function can be computationally affordable. The prediction-correction algorithm proposed in this paper addresses the limitations of existing methods by tackling constrained problems and by designing a first-order prediction step that relies on the Hessian of the cost function (and do not require the computation of its inverse). Analytical results are establishedmore » to quantify the tracking error. Numerical simulations corroborate the analytical results and showcase performance and benefits of the algorithms.« less

Highway noise measurements for verification of prediction models

DOT National Transportation Integrated Search

1978-01-01

Accurate prediction of highway noise has been a major problem for state highway departments. Many noise models have been proposed to alleviate this problem. Results contained in this report will be used to analyze some of these models, and to determi...