Validity of short food questionnaire items to measure intake in children and adolescents: a systematic review.

BACKGROUND: Short food questions are appealing to measure dietary intakes. METHODS: A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. RESULTS: Most questions assessed foods or food groups (n = 29), with the most commonly assessed being fruit (n = 22) or vegetable intake (n = 23), dairy foods and discretionary foods (n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency (n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. CONCLUSIONS: The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development.

A systematic review of community-based interventions for the treatment of adolescents with overweight and obesity.

Adolescent obesity is a risk factor for obesity and other chronic disease in adulthood. Evidence for the effectiveness of community-based obesity treatment programs for adolescents is required to inform policy and clinical decisions. This systematic review aims to evaluate recent effective and scalable community-based weight management programs for adolescents (13-17 years) who are overweight or obese. Eight databases (Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Informit, and Scopus) were searched for studies published between January 2011-2 March 2017 which are scalable in a community setting and reported primary outcome measures relating to weight. Following deduplication, 10,074 records were screened by title/abstract with 31 publications describing 21 programs included in this review. Programs were heterogeneous in nature (including length, number and frequency of sessions, parent-involvement and technology involvement). Reduction in adolescent BMIz ranged from 2 to 9% post-program and from 2 to 11% after varied lengths of follow-up. Study quality varied (n = 5 weak; n = 8 moderate; n = 8 high), and findings are limited by the risk of selection and retention bias in the included studies. Factors including the effectiveness and acceptability to the target population must be considered when selecting such community programs.

Synergistic potentiation by epinephrine of collagen or thrombin-induced calcium mobilization in human platelets.

Changes in cytoplasmic free calcium in response to epinephrine in combination with other agonists were studied in human platelets loaded with the fluorescent calcium indicator, quin 2. In the presence of 1mM external calcium, epinephrine augmented the increase in cytoplasmic free calcium in response to collagen or thrombin, and this was inhibited by yohimbine. In the absence of extracellular calcium, thrombin and collagen only caused a small increase in cytoplasmic free calcium, and the response was not enhanced by epinephrine. High concentrations of epinephrine alone caused a small increase in cytoplasmic free calcium in platelets when calcium was present externally. Inhibition of cyclooxygenase by aspirin markedly reduced the calcium response to collagen and almost completely inhibited potentiation by epinephrine. The calcium response to thrombin was inhibited to a lesser extent by aspirin, and aspirin did not prevent potentiation by epinephrine. These findings suggest that augmentation of the cytoplasmic free calcium level may be involved in the potentiation of platelet responses to agonists by epinephrine, and that metabolites of arachidonic acid make an important contribution to this action of epinephrine.

Collagen increases cytoplasmic free calcium in human platelets.

The role of changes in cytoplasmic free calcium in response to collagen was studied in human platelets loaded with the fluorescent calcium indicator, quin2. In the presence of 1mM external calcium, collagen caused a biphasic increase in cytoplasmic free calcium. In the absence of external calcium, there was a much smaller increase in cytoplasmic free calcium. These findings suggest that collagen increases cytoplasmic free calcium, partly by discharge of internal calcium, but mainly by stimulating calcium influx. Inhibition of cyclooxygenase by aspirin markedly reduced the second phase of the calcium response. Removal of ADP with apyrase resulted in complete inhibition of the second phase of the calcium response. The combination of apyrase and aspirin completely inhibited aggregation and the shape change caused by collagen. The calcium-entry blocking agent, verapamil, also inhibited the second phase of the calcium response to collagen. The increase in cytoplasmic free calcium is fast enough to be involved in the platelet response to collagen and these findings suggest that ADP and metabolites of arachidonic acid mediate the second phase of the calcium response to collagen.

The influence of child-preferred activities on autistic children's social behavior.

One of the characteristics of autistic children is severe social avoidance behavior. We assessed whether the type of activity (child-preferred vs. activities that were arbitrarily determined by an adult) engaged in during an interaction was correlated with the amount of social avoidance behaviors these children exhibit. Results revealed a negative correlation between appropriate child-preferred activities and social avoidance behavior. Additional analyses revealed that (a) social avoidance behaviors could be manipulated within a reversal design, and would predictably decrease when the children were prompted to initiate appropriate child-preferred activities; and (b) these procedures could be used to teach children to initiate child-preferred activities in community settings, resulting in reductions in social avoidance responses even after the therapist's prompts were completely removed. These data suggest that the manipulation of task variables may influence the severe social unresponsiveness that is characteristic of autistic children.

Dietary patterns of Australian children aged 14 and 24 months, and associations with socio-demographic factors and adiposity.

BACKGROUND/OBJECTIVES: Previous research has shown, in predominantly European populations, that dietary patterns are evident early in life. However, little is known about early-life dietary patterns in Australian children. We aimed to describe dietary patterns of Australian toddlers and their associations with socio-demographic characteristics and adiposity. SUBJECTS/METHODS: Principal component analysis was applied to 3 days (1 × 24-h recall and 2 × 24-h record) data of 14 (n=552)- and 24 (n=493)-month-old children from two Australian studies, NOURISH and South Australian Infant Dietary Intake (SAIDI). Associations with dietary patterns were investigated using regression analyses. RESULTS: Two patterns were identified at both ages. At 14 months, the first pattern was characterised by fruit, grains, vegetables, cheese and nuts/seeds ('14-month core foods') and the second pattern was characterised by white bread, milk, spreads, juice and ice-cream ('basic combination'). Similarly, at 24 months the '24-month core foods' pattern included fruit, vegetables, dairy, nuts/seeds, meat and water, whereas the 'non-core foods' included white bread, spreads, sweetened beverages, snacks, chocolate and processed meat. Lower maternal age and earlier breastfeeding cessation were associated with higher 'basic combination' and 'non-core foods' pattern scores, whereas earlier and later solid introduction were associated with higher 'basic combination' and '24-month core foods' pattern scores, respectively. Patterns were not associated with body mass index (BMI) z-score. CONCLUSIONS: Dietary patterns reflecting core and non-core food intake are identifiable in Australian toddlers. These findings support the need to intervene early with parents to promote healthy eating in children and can inform future investigations on the effects of early diet on long-term health.

Cost analysis of kinetic therapy in the prevention of complications of stroke.

We prospectively evaluated the costs of medical care in a group of 43 patients with acute severe stroke. Patients were assigned to either a routine hospital bed or a rotational bed. The rotational study bed (kinetic therapy) is designed to prevent complications of prolonged bed confinement by keeping patients in continuous slow rotation. The average number of acute care days was 11.2 in the study group and 16.4 in the control group. Study patients had similar costs per day for laboratory testing, x-ray studies, respiratory therapy, total acute care expenses, and total hospital expenses. Among study patients, reduction in medication costs per day did approach statistical significance, by unpaired t test, at P = .014, with a corrected significance level of .008. Overall, the average acute care costs per day were $544 in the study group verus $410 in the control group. This difference was approximately the average per day charge for the rotational bed ($130). We conclude that therapy designed to prevent complications of prolonged bed confinement is cost effective.