Cognitive ability, social desirability, body mass index and socioeconomic status as correlates of fourth-grade children's dietary-reporting accuracy.

BACKGROUND/OBJECTIVES: To investigate the relationship of reporting accuracy in 24-h dietary recalls to child-respondent characteristics-cognitive ability, social desirability, body mass index (BMI) percentile and socioeconomic status (SES). SUBJECTS/METHODS: Fourth-grade children (mean age 10.1 years) were observed eating two school meals and interviewed about dietary intake for 24 h that included those meals. (Eight multiple-pass interview protocols operationalized the conditions of an experiment that crossed two retention intervals-short and long-with four prompts (ways of eliciting reports in the first pass)). Academic achievement-test scores indexed cognitive ability; social desirability was assessed by questionnaire; height and weight were measured to calculate BMI; nutrition-assistance program eligibility information was obtained to index SES. Reported intake was compared to observed intake to calculate measures of reporting accuracy for school meals at the food-item (omission rate; intrusion rate) and energy (correspondence rate; inflation ratio) levels. Complete data were available for 425 of 480 validation-study participants. RESULTS: Controlling for manipulated variables and other measured respondent characteristics, for one or more of the outcome variables, reporting accuracy increased with cognitive ability (omission rate, intrusion rate, correspondence rate, P<0.001), decreased with social desirability (correspondence rate, P<0.0004), decreased with BMI percentile (correspondence rate, P=0.001) and was better by higher- than by lower-SES children (intrusion rate, P=0.001). Some of these effects were moderated by interactions with retention interval and sex. CONCLUSIONS: Children's dietary-reporting accuracy is systematically related to such respondent characteristics as cognitive ability, social desirability, BMI percentile and SES.

Accuracy of children's school-breakfast reports and school-lunch reports (in 24-h dietary recalls) differs by retention interval.

BACKGROUND/OBJECTIVES: Validation-study data were analyzed to investigate the effect of retention interval (time between the to-be-reported meal and interview) on accuracy of children's school-breakfast reports and school-lunch reports in 24-h recalls, and to compare accuracy of children's school-breakfast reports for two breakfast locations (classroom; cafeteria). SUBJECTS/METHODS: Each of 374 fourth-grade children was interviewed to obtain a 24-h recall using one of six conditions from crossing two target periods (prior 24 h; previous day) with three interview times (morning; afternoon; evening). Each condition had 62 or 64 children (half boys). A recall's target period included one school breakfast and one school lunch, for which the child had been observed. Food-item variables (observed number; reported number; omission rate; intrusion rate) and energy variables (observed; reported; report rate; correspondence rate; inflation ratio) were calculated for each child for school breakfast and school lunch separately. RESULTS: Accuracy for school-breakfast reports and school-lunch reports was inversely related to retention interval. Specifically, as indicated by smaller omission rates, smaller intrusion rates, larger correspondence rates and smaller inflation ratios, accuracy for school-breakfast reports was best for prior-24-h recalls in the morning, and accuracy for school-lunch reports was best for prior-24-h recalls in the afternoon. For neither school meal was a significant sex effect found for any variable. For school-breakfast reports, there was no significant school-breakfast location effect for any variable. CONCLUSIONS: By shortening the retention interval, accuracy can be improved for school-breakfast reports and school-lunch reports in children's 24-h recalls.

Reaching across the pond: a global exchange between health systems.

AIM: This article describes a unique programme begun in 2001 through a partnership between the historic St Bartholomew's Hospital and the London National Health Service Trust, in London, England and Valley Health in Winchester, Virginia, USA. Dubbed the RN International Exchange Program, selected registered nurses have the opportunity to experience first-hand healthcare delivery in another country and participate in a creative way of expanding knowledge about nursing. BACKGROUND: Professional nurses are persistent in seeking new ways to enhance nursing practice and improve patient care. This happens in several ways, including academic study, research, continuing education and dialogue with other healthcare professionals. One method to advance nursing practice is through the sharing of knowledge between nurses, both at home and across the globe. CONCLUSION: Participating nurses see this type of global educational opportunity as a once-in-a-lifetime experience that could never be duplicated in the traditional classroom setting.

The virtual standardized patient. Simulated patient-practitioner dialog for patient interview training.

We describe the Virtual Standardized Patient (VSP) application, having a computerized virtual person who interacts with medical practitioners in much the same way as actors hired to teach and evaluate patient assessment, diagnosis, and interviewing skills. The VSP integrates technologies from two successful research projects conducted at Research Triangle Institute. AVATALK provides natural language processing, emotion and behavior modeling, and composite facial expression and lip-shape modeling for a natural patient-practitioner dialog. Trauma Patient Simulator provides case-based patient history and trauma casualty data, real-time physiological modeling, interactive patient assessment, 3-D scenario simulation, and instructional record-keeping capabilities. The VSP offers training benefits that include enhanced adaptability, availability, and assessment.

Immigration reform and the browning of America: tensions, conflicts and community instability in metropolitan Los Angeles.

"Tensions, conflicts, and community instability associated with heightened immigration--especially of nonwhite immigrant groups--threaten to balkanize America. This article highlights the root causes of the growing opposition to both immigrants and U.S. immigration policy--the nativist backlash, presents a typology of the community-level conflicts that have arisen as a consequence of heightened immigration--legal and illegal--to the United States over the last 30 years, and outlines the conditions under which diversity can be brought to the forefront as one of society's strengths.... The 1992 Los Angeles County Social Survey (LACSS)...provides insights into the nature and magnitude of intergroup stereotyping and prejudice in a community in which large numbers of immigrants have settled."