Movement disorders in cell surface antibody mediated autoimmune encephalitis: a meta-analysis.

Background: Autoimmune encephalitis (AE) is an increasingly recognized neuroinflammatory disease entity in which early detection and treatment leads to the best clinical outcomes. Movement disorders occur in AE but their characteristics are not well defined. Objectives: To identify the frequency, classification, and prognostic significance of movement disorders in AE. Methods: We conducted a systematic review and random-effects meta-analysis of movement disorders in cell surface antibody mediated AE. The frequency of any movement disorder as well as the classification of movement disorders in AE serotypes was determined. We looked at adults 18 years and older and included publications that described at least 10 cases. We used the following four electronic databases: Medline (Ovid), EMBASE (Ovid), APA Psychinfo, and Cochrane library. Results: A total of 1,192 titles and abstracts were reviewed. Thirty-seven studies were included in the final meta-analysis. At least one kind of movement disorder was present in 40% of the entire AE cohort, 53% with anti-NMDA receptor antibodies, 33% with anti-CASPR2 antibodies, 30% with anti-LGI1 antibodies and 13% with anti-GABA receptor antibodies. Dyskinesia was the commonest movement disorder in anti-NMDA antibody mediated AE and faciobrachial dystonic seizures were most frequent in anti-LGI1 antibody mediated AE. Patients with a movement disorder tended to have a higher mortality. The risk of bias in the included studies was mostly moderate or high. Conclusion: Movement disorders are common in AE and their identification, in conjunction with other clinical and paraclinical features, may facilitate earlier diagnosis. The prognostic implications of movement disorders in AE warrant further dedicated study. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42023386920.

Applied Behavior Analysis in Children and Youth with Autism Spectrum Disorders: A Scoping Review.

This manuscript provides a comprehensive overview of the impact of applied behavior analysis (ABA) on children and youth with autism spectrum disorders (ASD). Seven online databases and identified systematic reviews were searched for published, peer-reviewed, English-language studies examining the impact of ABA on health outcomes. Measured outcomes were classified into eight categories: cognitive, language, social/communication, problem behavior, adaptive behavior, emotional, autism symptoms, and quality of life (QoL) outcomes. Improvements were observed across seven of the eight outcome measures. There were no included studies that measured subject QoL. Moreover, of 770 included study records, only 32 (4%) assessed ABA impact, had a comparison to a control or other intervention, and did not rely on mastery of specific skills to mark improvement. Results reinforce the need for large-scale prospective studies that compare ABA with other non-ABA interventions and include measurements of subject QoL to provide policy makers with valuable information on the impacts of ABA and other existing and emerging interventions. Supplementary Information: The online version contains supplementary material available at 10.1007/s40614-022-00338-x.

Point-of-Care Diagnostic Tools for Surveillance of SARS-CoV-2 Infections.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a recently emerged and highly contagious virus that causes coronavirus disease 2019 (COVID-19). As of August 24, 2021, there were more than 212 million confirmed COVID-19 cases and nearly 4.4 million deaths reported globally. Early diagnosis and isolation of infected individuals remains one of the most effective public health interventions to control SARS-CoV-2 spread and for effective clinical management of COVID-19 cases. Currently, SARS-CoV-2 infection is diagnosed presumptively based on clinical symptoms and confirmed by detecting the viral RNA in respiratory samples using reverse transcription polymerase chain reaction (RT-PCR). Standard RT-PCR protocols are time consuming, expensive, and technically demanding, which makes them a poor choice for large scale and point-of-care screening in resource-poor settings. Recently developed isothermal nucleic acid amplification tests (iNAAT), antigen and/or serological tests are cost-effective to scale COVID-19 testing at the point-of-care (PoC) and for surveillance activities. This review discusses the development of rapid PoC molecular tools for the detection and surveillance of SARS-CoV-2 infections.

Comparisons of Cooking, Dietary, and Food Safety Characteristics of Food Secure and Food Insecure Sophomores at a University in Appalachia.

Introduction: Food insecurity means lacking access to adequate, nutritious, and safe food. Collegiate food insecurity rates at ten Appalachian campuses range from 22.4% to 51.8% and have been associated with unfavorable health and academic outcomes. Purpose: This study compared cooking, dietary, and food safety characteristics of food secure (FS) and food insecure (FI) sophomores at a university in Appalachia in the context of the USDA definition of food security. Methods: Data were collected using an online questionnaire. Descriptive and inferential procedures compared FS and FI sophomores (p < 0.05). Results: Participants (n = 226) were 65.0% females, 76.1% whites, and 46% FI. About 40% of on-campus and 50% of off-campus residents were FI, and 70% of FI students reported needing help accessing food. Cooking was undertaken "less often" by 61.5% of FS and 55.8% of FI sophomores. Mean cooking self-efficacy scores for FS and FI students were 44.9, vs 43.4, (p > 0.05) out of 52 points. Grains were consumed most often by 40% of FS and FI students and vegetables were consumed least often by 70% of both groups. Mean food safety test scores for FS and FI students were 6.2 1.60 vs 6.6 1.52 (p > 0.05) out of 11 points. Requested educational activities included making a budget and planning balanced meals. Implications: The high rate of food insecurity reflects an ongoing need among sophomores for campus and community food assistance and for educational activities that teach purchasing and preparation of affordable, healthy and safe foods.

Review of Burden, Clinical Definitions, and Management of COVID-19 Cases.

Our understanding of SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), its clinical manifestations, and treatment options continues to evolve at an unparalleled pace. This review sought to summarize the key literature regarding transmission, case definitions, clinical management, and the burden of COVID-19. Our review of the literature showed that SARS-CoV-2 was mainly transmitted via inhalation of respiratory droplets containing the virus and had a mean incubation period of 4-6 days. The commonly reported symptoms were fever (75.3% ± 18.7%) and cough (62.6% ± 17.7%) across the spectrum of clinical disease-mild, moderate, severe, and critical, but with the disease phenotype varying with severity. Categorization of these cases for home care or hospital management needs to be defined, with risk stratification accounting for the age of the patient and the presence of underlying comorbidities. The case definitions varied among countries, which could have contributed to the differences in the case fatality rates among affected countries. The severity and risk of death due to COVID-19 was associated with age and underlying comorbidities. Asymptomatic cases, which constitute 40-80% of COVID-19 cases are a considerable threat to control efforts. The presence of fever and cough may be sufficient to warrant COVID-19 testing, but using these symptoms in isolation will miss a proportion of cases. A clear definition of a COVID-19 case is essential for the management, treatment, and tracking of clinical illness, and to inform the quarantine measures and social distancing that can help control the spread of SARS-CoV-2.

Use and Perceptions of a Campus Food Pantry Among Food Insecure College Students An Exploratory Study from Appalachia.

Introduction: Food insecurity has emerged as a public health problem among college students in Appalachia, jeopardizing their physical, mental, and emotional health and academic success. Campus food pantries have been established in this region, but no data are available concerning student use or perception of services. Purpose: This study measured use and perceptions of a campus food pantry by students at a mid-sized university in rural North Carolina. Methods: An online questionnaire collected behavioral and perceptual data, and follow-up interviews explored these variables. Descriptive statistics with significance at p<0.05 and thematic analytical procedures were used. Results: Questionnaires were submitted by 896 of 6000 recruited students (14.9%), and four students granted interviews. Food insecurity affected 437 (48.8%) of participants, of whom 76 (17.4%) were pantry shoppers. Shoppers (n = 94) were 27.7% males, 65.1% females, and 7.2% non-cisgender, 63.8% non-Hispanic white, 84.5% undergraduate, and 14.3% graduate students. Reasons for non-pantry use by food insecure students included: others need it more (30.1%) and feel embarrassed (20.7%). Benefits of pantry use were: spent more on necessities (56.4%) and job performance improved (18.1%). Shoppers perceived the pantry's physical environment most favorably and food offerings less favorably. Implications: The low use of the campus food pantry by food insecure students suggests that these students may be jeopardizing their physical and mental health and academic success. Greater efforts by faculty, academic advisers, and student leaders are needed to promote pantry use and decrease the associated stigma.

Food Insecurity Among College Students with and without Medical Disorders at a University in Appalachia.

Objective: This study compared severity of food insecurity, characteristics, and behaviors of college students with and without diagnosed medical disorders. Design: Data were collected using a cross-sectional online questionnaire. Variables measured were food security status, disorders, coping strategies, and perceived barriers to food access. Descriptive and inferential statistics examined associations and compared groups. Statistical significance was p≤0.05. Setting: Data were collected at Appalachian State University in North Carolina. Participants: The sample was 247 food insecure students, of whom 60% were females, 50% 3rd- and 4th-year students, and 75% whites. Results: Medical disorders were reported by 67.2% of food insecure students, and a greater proportion of students with than without disorders experienced very low food security (63.3% vs. 43.2%, p=0.003). The most common disorder categories were psychiatric (40.5%) and gastrointestinal (31.6%). Characteristics of food insecure students with disorders included female gender, suboptimal academic performance, employed, off-campus residence. Coping strategies used by students with and without disorders, respectively, to improve food access, included brought food back to school after visiting family, friends, significant others (90.9% vs. 63.0%) and ate less healthy food so you could eat more (77.7% vs. 49.4%). Perceived barriers among students with disorders included feel overwhelmed making food choices (12.7%) and meal plan runs out (10.2%). Food insecure students with disorders made greater use of coping strategies and identified more perceived barriers. Conclusions: Food insecure students with disorders experienced more severe food deprivation and require multidimensional food assistance programs beyond those generally available on college campuses.

Expenditure, Coping, and Academic Behaviors among Food-Insecure College Students at 10 Higher Education Institutes in the Appalachian and Southeastern Regions.

BACKGROUND: A number of studies have measured college student food insecurity prevalence higher than the national average; however, no multicampus regional study among students at 4-y institutions has been undertaken in the Appalachian and Southeast regions of the United States. OBJECTIVES: The aims of this study were to determine the prevalence of food insecurity among college students in the Appalachian and Southeastern regions of the United States, and to determine the association between food-insecurity status and money expenditures, coping strategies, and academic performance among a regional sample of college students. METHODS: This regional, cross-sectional, online survey study included 13,642 college students at 10 public universities. Food-insecurity status was measured through the use of the USDA Adult Food Security Survey. The outcomes were associations between food insecurity and behaviors determined with the use of the money expenditure scale (MES), the coping strategy scale (CSS), and the academic progress scale (APS). A forward-selection logistic regression model was used with all variables significant from individual Pearson chi-square and Wilcoxon analyses. The significance criterion α for all tests was 0.05. RESULTS: The prevalence of food insecurity at the universities ranged from 22.4% to 51.8% with an average prevalence of 30.5% for the full sample. From the forward-selection logistic regression model, MES (OR: 1.47; 95% CI: 1.40, 1.55), CSS (OR: 1.19; 95% CI: 1.18, 1.21), and APS (OR: 0.95; 95% CI: 0.91, 0.99) scores remained significant predictors of food insecurity. Grade point average, academic year, health, race/ethnicity, financial aid, cooking frequency, and health insurance also remained significant predictors of food security status. CONCLUSIONS: Food insecurity prevalence was higher than the national average. Food-insecure college students were more likely to display high money expenditures and exhibit coping behaviors, and to have poor academic performance.

Freshmen at a University in Appalachia Experience a Higher Rate of Campus than Family Food Insecurity.

Food insecurity means having limited or uncertain access, in socially acceptable ways, to an adequate and safe food supply. Ample evidence has identified college students as vulnerable to this problem, but little research has focused on freshmen. This cross-sectional study examined family and campus food insecurity among freshmen at a university in Appalachia. An online questionnaire contained sociodemographic items and scales that measured food security status, academic progress, coping strategies for accessing food, and social support. T-tests and Chi square analyses compared food insecure and food secure students. Statistical significance was p < .05. Participants were 456 freshmen, 118 males (26%) and 331 females (73%). Family and campus food insecurity were experienced by 32 (7.1%) and 98 (21.5%) of the freshmen, respectively, and 42.5% of those who experienced campus food insecurity believed their food access had worsened since starting college. Family and campus coping strategies, respectively, included stretching food (72.9 vs. 18.4%) and purchasing cheap, processed food (68.8 vs. 16.3%). Food secure students scored significantly higher on self-rated measures of academic progress (p < .01), and greater proportions of food secure students (60.7 vs. 43.9%, p < .01) perceived their eating habits since starting college as "healthy/very healthy," and perceived their health status as "good/excellent" (86.0 vs. 71.4%, p < .01). Students requested assistance with job opportunities (19.4%), affordable meal plans (18.4%), money management (13.3%), and eating healthy (11.2%). Findings suggest that college student food insecurity begins during the freshmen year, and that there is a need for campus and community-based interventions to increase food access among these freshmen and their families.

Brain-stem serotonin transporter availability in maternal uniparental disomy and deletion Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is a rare condition because of the deletion of paternal chromosomal material (del PWS), or a maternal uniparental disomy (mUPD PWS), at 15q11-13. Affective psychosis is more prevalent in mUPD PWS. We investigated the relationship between the two PWS genetic variants and brain-stem serotonin transporter (5-HTT) availability in adult humans. Mean brain-stem 5-HTT availability determined by [123I]-beta-CIT single photon emission tomography was lower in eight adults with mUPD PWS compared with nine adults with del PWS (mean difference -0.93, t = -2.85, P = 0.014). Our findings confirm an association between PWS genotype and brain-stem 5-HTT availability, implicating a maternally expressed/paternally imprinted gene, that is likely to account for the difference in psychiatric phenotypes between the PWS variants. Declaration of interest None.

Health Belief Model Offers Opportunities for Designing Weight Management Interventions for College Students.

OBJECTIVE: Identify weight-related beliefs of college students and test the predictive power of the Health Belief Model for body mass index (BMI). DESIGN: Cross-sectional online survey with beliefs measured on 5-point scales. SETTING: University in North Carolina. PARTICIPANTS: Undergraduates (n = 516; 91.9%), females (n = 399; 71.3%), white non-Hispanic students (n = 507; 86.2%), and 20.3% of overweight or obese status. VARIABLES MEASURED: Perceived severity, susceptibility, barriers, benefits, and internal and external cues to action. ANALYSIS: One-way ANOVA and regression. Significance was P < .05. RESULTS: Strongest beliefs concerned benefits of healthy eating and physical activity (mean, 4.1 ± 0.7); weakest beliefs concerned barriers to adopting such behaviors (mean, 2.6 ± 0.9). The regression model was statistically significant (P < .001) and explained 17% of variance in BMI (multivariate coefficient = 0.177). Perceived severity, susceptibility, external cues, barriers, and benefits predicted BMI. CONCLUSIONS AND IMPLICATIONS: Several beliefs were identified that could serve as the basis for weight-related interventions addressing specific concerns, needs, and goals of college students.

A High Prevalence of Food Insecurity Among University Students in Appalachia Reflects a Need for Educational Interventions and Policy Advocacy.

OBJECTIVES: To measure prevalence and correlates of food insecurity among college students in Appalachia, compare food-insecure and food-secure students on correlates, and identify predictor variables. DESIGN: Cross-sectional, online questionnaire. SETTING: University in Appalachia. PARTICIPANTS: Nonprobability, random sample of 1,093 students (317 male [30.1%]; 723 females [68.4%]). MAIN OUTCOME MEASURES: Food insecurity, coping strategies, money expenditure, academic progress, and demographics. ANALYSIS: Correlational, chi-square, and regression. RESULTS: A total of 239 students experienced low food security (21.9%) whereas 266 had experienced very low food security (24.3%) in the past 12 months. Predictor variables were higher money expenditure and coping strategy scale scores, lower grade point averages, male gender, receiving financial aid, fair or poor self-rated health status, and never cooking for self or others. These variables accounted for 48.1% of variance in food security scores. Most frequently used coping strategies included purchasing cheap, processed food (n = 282; 57.4%), stretching food (n = 199; 40.5%), and eating less healthy meals to eat more (n = 174; 35.4%). CONCLUSIONS AND IMPLICATIONS: Food-insecure students need interventions that teach budgeting skills and how to purchase and prepare healthy foods, as well as policies that increase access to food resource assistance.

Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study.

BACKGROUND: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. METHOD: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses. RESULTS: Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation. CONCLUSIONS: Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care.

Knowledge of healthy foods does not translate to healthy snack consumption among exercise science undergraduates.

This cross-sectional survey study compared the on- and off-campus snack choices and related correlates of convenience samples of exercise science (ES) ( n = 165, M = 45%, F = 55%) and non-exercise science (NES) ( n =160, M = 43%, F = 57%) undergraduates. The hypothesis posed was that knowledge of healthy foods will not translate to healthier snack consumption by the ES students, and that the snack choices and related correlates of ES and NES students will be similar. Data were collected using self-administered questionnaires completed in classrooms (ES sample) and at high-traffic locations on-campus (NES sample). Chi-square and t-test analyses compared ES and NES students on snack correlates. Snacks consumed most often by the ES and NES students on-campus were health bars/squares ( n = 56 vs. n = 48) and savory snacks ( n = 55 vs. n = 71), and off-campus were savory snacks ( n = 60 vs. n = 71) and fruits ( n = 41 vs. n = 34). Over half of both samples believed their snack choices were a mix of unhealthy and healthy. Fruits were considered healthier snacks and chips less healthy by both samples, and fruits were the most often recommended snack. About 20% believed these choices would impact their health unfavorably, and about two thirds self-classified in the action stages for healthy snacking. Since knowledge about healthy food choices did not translate to healthy snack selection, these students would benefit from interventions that teach selection and preparation of healthy snacks on a restricted budget.

Snacking Patterns and Snack Correlates in Third- and Fourth-Year Nursing and Dietetics Students: An Exploratory Study from the Midwestern United States.

AIMS: To compare snacking behaviors and psychosocial correlates of third- and fourth-year nursing (n=52) and dietetics (n=48) students. METHODS: Questionnaires assessed snack choices, awareness of healthy snacks, snack recommendations and beliefs, stage of change and perceived benefits/barriers for healthy snacking, and situational snacking. RESULTS: The snacks purchased most often on and off campus by the nursing students were soft drinks/caffeinated beverages (58%) and chips (42%), and for the dietetics students were chips (35%) and fresh fruit (33%). One-third of the nursing and 8% of the dietetics students believed their snack choices would have an unfavorable effect on their long-term health. Two-thirds of the nursing and 75% of the dietetics students self-classified in the action stages for healthy snacking. Snacks considered healthy and recommended by both samples were fresh fruits/vegetables and granola bars. More than 90% of both samples believed their job responsibilities would include modeling and teaching healthy snacking to patients. The barriers to healthy snacking identified most often by both samples were limited budget and not readily available. CONCLUSIONS: On-campus vendors should be approached with suggestions about featuring nutrient-dense snacks at discounted prices and offering smaller snack packs of popular products.

Rural Latino parents offer preschool children few nutrient-dense snacks: a community-based study in Western Illinois.

The aims of this descriptive study were to identify the snacks offered to preschool children by Latino parents living in a rural community, assess the overall healthfulness of those snacks, and measure related psychosocial correlates. Data were collected using Spanish-language questionnaires and interviews completed by 96 parents. Thirty-two percent of snack offerings were nutrient dense. The energy-dense snacks offered most often by the greatest proportion of parents were regular yogurt (17%), whole milk (16%), and fruit drinks (16%); the nutrient-dense snacks offered most often were fresh fruit (43%), low-fat milk (37%), and fruit juice (34%). Two-thirds of parents felt confident about offering healthy snacks, and 67% self-classified in the action stages. The primary barrier to offering healthy snacks was children's refusal to eat these products. These parents would benefit from interventions that teach how to overcome perceived barriers and how to purchase and prepare healthy snacks appealing to preschoolers.

Practice nurse health checks for adults with intellectual disabilities: a cluster-design, randomised controlled trial.

BACKGROUND: Adults with intellectual disabilities have substantial health inequalities and poor access to health care. We assessed whether practice nurse-delivered health checks could improve the health of adults with intellectual disabilities compared with standard care. METHODS: In this cluster-design, single-blind, randomised controlled trial, we included general practices in Scotland, UK. From June to December, 2011, we randomly assigned (1:1) these general practices to either health checks plus standard care (health-checks group), or standard care only (control group), and we recruited the patients from these practices. Randomisation was done with stratification by number of GPs per practice and number of registered patients with intellectual disabilities (<20 or ≥20). Two research assistants were masked to allocation, and undertook the review of 9 month medical records and interviews. Participants and carers were not masked. The intervention was one health check designed especially for people with intellectual disabilities delivered by a practice nurse. The objective was improvement in health and health care 9 months after randomisation, and the primary outcome was the incidence of newly detected health needs being met by this timepoint. Whether needs were met was established by the investigators being masked to group allocation. The analysis was by intention to treat. This trial is registered with Current Controlled Trials, number ISRCTN43324841. FINDINGS: Between June 26 and Dec 20, 2011, we recruited 38 practices. 85 participants (from 16 practices) were randomly assigned to intervention and 67 (from 17 practices) to standard care; five of the identified practices did not supply any participants. 83 intervention and 66 standard care participants completed the trial. More newly detected health needs were met in the intervention group than in the control standard care group (median 1 [range 0-8], 76·4% met [SD 36·5] vs 2 [0-11], 72·6% met [35·4]; odds ratio [OR] 1·73 [95% CI 0·93-3·22], p=0·085), although this difference was not significant. Significantly more health monitoring needs were met in the intervention group than standard care (median 2 [0-20], 69·9% [SD 34·2] vs 2 [0-22], 56·8% [29·4], OR 2·38 [95% CI 1·31-4·32, p=0·0053]). The probability that health checks are cost effective was between 0·6 and 0·8, irrespective of the cost-effectiveness threshold level. Costs per patient were -£71·48 for health checks and -£20·56 for standard care. The difference (-£50·92) was not significant [95% CI -434 to 362]. No adverse events were attributable to the intervention. INTERPRETATION: Health checks given by practice nurses to adults with intellectual disabilities produced health-care improvements that were more conducive to longer-term health than standard care given to this population. The intervention dominated standard care, being both cheaper and more effective. Health-check programmes might therefore be indicated for adults with intellectual disabilities. FUNDING: Scottish Government Change Fund, NHS Greater Glasgow and Clyde Research and Development.

Young parenthood program: supporting positive paternal engagement through coparenting counseling.

OBJECTIVES: Because of their youth, adolescent parents often lack the interpersonal skills necessary to manage the relationship challenges involved in parenting, leaving them and their children vulnerable to the health risks associated with relational stress and conflict. The primary goal of this study was to test the efficacy of the Young Parenthood Program (YPP), a 10-week counseling program administered during pregnancy and designed to facilitate interpersonal skill development and positive parenting among adolescent parents. METHODS: Participants included 105 pregnant adolescents and their partners randomly assigned to YPP or treatment as usual. Assessments measured coparenting skills and parental functioning during the second trimester, 12 weeks after birth, and 18 months after birth. RESULTS: Results indicated that fathers completing YPP demonstrated more positive parenting than did fathers in the control group. Moreover, the positive outcomes in paternal functioning were mediated through changes in the mother's interpersonal skill development. CONCLUSIONS: Results supported the efficacy of this couples-focused, coparenting support program, particularly for facilitating positive paternal engagement. These findings underscored the relevance of including fathers in the delivery of maternal-child public health services.

Is field of study or location associated with college students' snacking patterns?

Objective. To compare on- and off-campus snacking patterns among college students pursuing degrees in health-related fields (HRFs) and nonhealth-related fields (NHRFs). Materials and Methods. Snack frequency questionnaire, scales measuring barriers, self-efficacy, and stage of change for healthy snacking, and a snack knowledge test (SKT). Participants. 513 students, 46% HRFs, and 54% NHRFs. The students' mean ± SD BMI was 24.1 ± 4.3 kg/m(2) (range 14.6 to 43.8), and 32.2% were overweight/obese. Results. Softdrinks (on-campus), lowfat milk (off-campus), and sports drinks were popular among HRFs and NHRFs. Cost and availability were barriers to healthy snacking, students felt least confident to choose healthy snacks when emotionally upset, and 75% (65%) of HRFs (NHRFs) self-classified in the action stage of change for healthy snacking. The HRFs scored higher on the SKT. Conclusions. Neither location nor field of study strongly influenced snacking patterns, which featured few high-fiber foods.

A quantitative assessment of the cultural knowledge, attitudes, and experiences of junior and senior dietetics students.

OBJECTIVE: To assess the cultural competence of dietetics majors. DESIGN: Self-administered questionnaire. SETTING: Classrooms at 7 universities. PARTICIPANTS: Two hundred eighty-three students-98 juniors (34.6%) and 185 seniors (65.4%)-recruited during class time. MAIN OUTCOME MEASURES: Knowledge was measured using a multiple-choice test, attitudes were assessed using scales, and experiences were measured using a list of activities. ANALYSIS: Descriptive statistics were obtained on all variables. Correlation analyses identified associations between competencies. Statistical significance was P < .05. RESULTS: Knowledge scores were highest on questions concerning food habits and lowest on questions concerning health beliefs. Approximately 45% of the students preferred to counsel clients from their own culture. A majority (89.2%) favored allocation of nutrition resources to assist culturally diverse clients in managing chronic diseases, and 65.7% favored the inclusion of more cultural information in their dietetics curriculum. The intercultural activities engaged in most often were eating ethnic food and watching films about other cultures, whereas those undertaken least often were completing a study abroad program or an internship abroad. CONCLUSIONS AND IMPLICATIONS: These students would benefit from more interactive intercultural learning opportunities to enhance their knowledge base and communication skills.