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.

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.

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.

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.

Development and application of rapid assessment diet and physical activity indexes, which suggest high consumption of energy-dense foods and inadequate exercise among adolescents from 6 Latin American cities: a pilot study.

This study describes the development and application of a rapid assessment diet quality index (RADQI) and a rapid assessment physical activity index (RAPAI) to characterize the energy intake and expenditure patterns of 1279 Latin American adolescents. Secondary aims were to describe the strength of the relationships of energy intakes and expenditures with sex, socioeconomic status, body mass index, and city of residence and to identify the students' reasons for undertaking physical activity and the types of activities they most enjoyed. Participants were eighth and ninth grade students from Buenos Aires, Argentina; Guatemala City, Guatemala; Havana, Cuba; Lima, Peru; Panama City, Panama; and Santiago, Chile. The RADQI and RAPAI scores were rescaled to T scores with a mean of 50 points (+/-10) for comparison. The RADQI scores ranged from 53.0 points (+/-10.5) in Panama City to 44.7 points (+/-8.3) in Santiago, and RAPAI scores ranged from 54.8 points (+/-9.2) in Panama City to 46.2 points (+/-8.6) in Santiago. The correlation between RADQI and RAPAI scores for the combined data set was weak but positive. The 2 reasons most often given for undertaking physical activity were to improve their physical health and to improve their psychological well-being, whereas the types of physical activities most enjoyed involved competitive sports. Results suggest frequent intakes of energy-dense diets and inadequate physical activity participation, prompting a need for learning opportunities targeted at adolescents and their families that teach healthy food choices and encourage greater physical activity participation.

Platelet adhesion testing may predict early hemodialysis arteriovenous graft and fistula failure in end-stage renal disease patients.

Vascular access thrombosis (VAT) is the most morbid and costly complication in end-stage renal disease (ESRD) patients. Although hypercoagulability is a major risk factor for VAT, in most patients, the cause of hypercoagulability cannot be identified despite clinical suspicion. In this study, platelet hyperreactivity was investigated for a possible role in the hypercoagulability of ESRD and VAT in 42 patients with arteriovenous (AV) grafts or fistulas. Platelet adhesion, platelet aggregation, and the history of VAT were assessed. The statistics included a nonparametric 2-factor ANOVA, a Mann-Whitney analysis, and a Kaplan-Meier analysis of hemodialysis angioaccess survival to examine platelet hyperadhesiveness as a predictor of access survival. The study showed a significant correlation between increased platelet adhesiveness and shortened survival of the primary hemodialysis angioaccess. Collagen-induced platelet aggregation reflected a significantly higher response in those with shortened access survival. These findings may have significant clinical implications for risk assessment and prevention of VAT.

The effect of an effortful swallow on the normal adult esophagus.

The effect of an effortful swallow on the healthy adult esophagus was investigated using concurrent oral and esophageal manometry (water perfusion system) on ten normal adults (5 males and 5 females, 20-35 years old) while swallowing 5-ml boluses of water. The effects of gender, swallow condition (effortful versus noneffortful swallows), and sensor site within the oral cavity, esophageal body, and lower esophageal sphincter (LES) were examined relative to amplitude, duration, and velocity of esophageal body contractions, LES residual pressure, and LES relaxation duration. The results of this study provide novel evidence that an effortful oropharyngeal swallow has an effect on the esophageal phase of swallowing. Specifically, effortful swallowing resulted in significantly increased peristaltic amplitudes within the distal smooth muscle region of the esophagus, without affecting the more proximal regions containing striated muscle fibers. The findings pertaining to the LES are inconclusive and require further exploration using methods that permit more reliable measurements of LES function. The results of this study hold tremendous clinical potential for esophageal disorders that result in abnormally low peristaltic pressures in the distal esophageal body, such as achalasia, scleroderma, and ineffective esophageal motility. However, additional studies are necessary to both replicate and extend the present findings, preferably using a solid-state manometric system in conjunction with bolus flow testing on both normal and disordered populations, to fully characterize the effects of an effortful swallow on the esophagus.

An 18-yr prospective study of pediatric diabetic ketoacidosis: an approach to minimizing the risk of brain herniation during treatment.

BACKGROUND: During the late 1900s, raised intracranial pressure (ICP) during treatment of pediatric diabetic ketoacidosis (DKA) surfaced as the most important cause of morbidity and mortality in pediatric DKA. The contribution of fluid and electrolyte therapy to neurologic deterioration during treatment remains controversial. METHODS: We proposed a physiologic approach to treatment of DKA, incorporating the principles of rehydration of hypertonic states. Consecutive episodes of pediatric DKA were managed using continuous intravenous insulin, an individualized assessment of the degree of dehydration, and rehydration solutions of tonicity approximating that of the patient. Gradual replacement of the volume of deficit after correction of shock, if present, was planned over 48 h with special attention to changes in effective osmolality along with intensive cardiorespiratory, neurologic, and biochemical monitoring. Mannitol was given for signs or symptoms of raised ICP. RESULTS: Six hundred and thirty-five consecutive episodes of pediatric DKA were treated from January 1988 to September 2005. Means +/- standard deviation (SD) for initial measured concentrations of total carbon dioxide, glucose, and urea nitrogen were 7.8 +/- 3.3 mmol/L, 602 +/- 271 mg/dL (33.4 +/- 15 mmol/L), and 21 +/- 1 mg/dL (7.4 +/- 3.6 mmol/L), respectively. Pretreatment blood gases were available for 477 episodes. The mean initial partial pressures of arterial and venous carbon dioxide +/- SD were 16.8 +/- 7 mmHg (kP(a)CO(2)= 2.24 +/- 0.93) for n = 308 and 26.6 +/- 7 mmHg (kP(v)CO(2)= 3.54 +/- 0.93) for n = 169, respectively. Although repair was planned to occur over 48 h, the mean time to achieve clinical rehydration and correction of DKA was 11.6 +/- 6.2 h. Mannitol was given in 35 (5.5%) episodes. There was no neurologic morbidity or mortality. CONCLUSION: Management of pediatric DKA using this multifaceted physiologic approach and the principles of rehydration described is safe and appears to minimize the risk of brain herniation during treatment.

The use of theory by occupational therapists working with adults with developmental disabilities.

This paper reports a national survey conducted to explore the practitioners' use of theoretical models to guide their practice of occupational therapy with adults with mental retardation. Results from 145 returned surveys (54%) indicated that only 26% of the respondents considered theory important as a guide for their daily practice. The value placed on theory decreased as years of experience increased. The most frequently used theoretical model was a remedial approach, but the most frequently used intervention was based on a compensational approach.

Correlations between radiation-induced double strand breaks and cell cycle checkpoints in X-irradiated NIH/3T3 fibroblasts.

BACKGROUND: To better understand the relationship between the formation of radiation-induced DNA double strand breaks (DSB) and cell cycle checkpoint activation, studies were conducted in the NIH/3T3 fibroblast cell line in order to establish correlations between the temporal appearance of gamma-H2AX foci (a DSB) and the expression of the cell cycle regulatory proteins, the cyclins, and their cyclin kinase inhibitor, p21. MATERIALS AND METHODS: Immunocytochemistry was used to determine the expression of cyclin E, A, B1, p21, and the generation of DSB in NIH/3T3 cells exposed to 2 or 4 Gy X-irradiation. RESULTS AND DISCUSSION: The data suggest that the G1/S- and S-phase delay (cyclin E and cyclin A protein levels) are dependent on the dose of radiation while the G2/M (cyclin B1 protein levels) delay is dependent on the quantity of DSB sustained by the irradiated cell.

The effects of mild traumatic brain injury on confrontation naming in adults.

PRIMARY OBJECTIVE: To compare confrontation-naming in adults with MTBI to a group of normal adults under increased processing load conditions. RESEARCH DESIGN: A randomized block, repeated measures design was used to examine confrontation-naming response latency and accuracy using a computerized experimental program. METHODS AND PROCEDURES: Twenty-four adults having sustained a MTBI (aged 18-53) and 24 age-matched controls named pictures from three levels of vocabulary as quickly and accurately as possible. All MTBI participants were assessed with the Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) for later comparison. MAIN OUTCOMES AND RESULTS: The results revealed a main effect of group ( p < or = 0.001) for the latency data and a group by vocabulary level interaction ( p = 0.043) for the accuracy data. No significant correlations were found between response latency and accuracy with performance on the SCATBI. Reaction time measures may reveal inefficiencies not tapped by traditional measures.

Humidified compared with dry, heated carbon dioxide at laparoscopy to reduce pain.

OBJECTIVE: To study whether using 95% humidified, heated carbon dioxide (CO(2)) at laparoscopy reduces pain compared with dry, heated CO(2). METHODS: Patients were randomly assigned to either heated, 95% humidified CO(2) (study group) or heated, dry CO(2) (control group) during laparoscopy. Pain control was achieved per standard protocols. Pain scales were administered the first 4 hours and 24 and 48 hours postoperatively. RESULTS: The 89 patients available in the intent-to-treat model revealed a decrease in total morphine equivalents and a decrease in pain scores at 1, 2, and 24 hours in the study group (directional P values < .05). Subgroup analysis in patients without chronic pelvic pain revealed lower mean pain scores at 1, 2, 24, and 48 hours and decreases in postoperative and total morphine equivalents (directional P values < .05) in the study group. CONCLUSION: At laparoscopy, heated, 95% humidified CO(2) effectively decreases postoperative pain and narcotics usage compared with heated, dry CO(2). LEVEL OF EVIDENCE: II-2.

Choral reading with filtered speech: effect on stuttering.

This study investigated use of choral reading with filtered components of speech and whispered speech on the frequency of stuttering. Three passages read by a normal adult male were lowpass filtered with kneepoint frequencies at 100 Hz (approximate glottal source), 500 Hz (source and first formant), and 1 kHz (source and the first two formants). Along with a whispered passage, a normal passage, and a control condition, these stimuli were used in a repeated-measures design with 12 adult stutterers as they read passages while listening to one of the stimuli. Frequencies of stuttering in each condition were analyzed. The choral speech, the 500-Hz, the 1-kHz, and the whispered speech conditions all decreased the frequency of stuttering while the 100-Hz stimuli did not. It is suggested that articulatory events, chiefly the encoded speech output from the vocal tract, create effective cues and may induce fluent speech in people who stutter.

An exploration of the attitudinal and perceptual dimensions of body image among male and female adolescents from six Latin American cities.

Using survey methodology, this exploratory study examined the attitudinal and perceptual dimensions of body image among 1,272 eighth- and ninth-grade males and females from higher and lower socioeconomic backgrounds in Buenos Aires, Argentina (n = 195), Guatemala City, Guatemala (n = 212), Havana, Cuba (n = 213), Lima, Peru (n = 218), Panama City, Panama (n = 195), and Santiago, Chile (n = 239). The two dimensions of body image were assessed by showing the participants nine male and nine female silhouettes depicting body sizes ranging from extremely thin (#1) to extremely obese (#9). Approximately 50% of the male and female adolescents chose silhouette #3 as best depicting the attractive male body. Silhouette #2 was chosen by 45% of the females as best depicting feminine attractiveness, while 45% of the males chose silhouette #3. When identifying the silhouette that best depicted the healthy male body, 26% of the participants chose silhouette #2, 41% chose #3, and 19% chose #4. Silhouette #2 was selected by 33% of the adolescents as best depicting the healthy female body, 38% chose #3, and 14% chose #4. In all cities, the effect of body mass index (BMI) on body satisfaction was highly significant (p < 0.001). Almost 40% of the middle weight adolescents indicated a preference to be thinner, even though 72% of the males and 84% of the females in this subgroup already perceived themselves as thin. Similarly, 89% of the heavier weight participants indicated a preference to be thinner, even though only 10% of the males and 2% of the females in this subgroup perceived themselves as heavy. In five of the six cities, a significantly higher (p < 0.05) percentage of females than males desired to be thinner, the exception being Havana, where the distribution of desired change in body size was almost identical for males and females. Findings suggest a need for culturally sensitive, age- and gender-specific preventive interventions focusing on the importance of achieving a healthy weight during adolescence to promote body size acceptance among adolescents who are at a healthy weight.

Altered hamstring-quadriceps muscle balance in patients with knee osteoarthritis.

BACKGROUND: To compare hamstring to quadriceps muscle coactivity during level walking, stair ascent, and stair decent between individuals with and without knee osteoarthritis. METHODS: In a cross-sectional study, subjects with grade II knee osteoarthritis (n = 26), healthy age- and gender-matched (n = 20) and healthy, young adults (n = 20) performed three activities of daily living. During the stance phase of these activities surface electromyography was measured. Two coactivity ratios were computed, the biceps femoris to vastus lateralis ratio and the ratio of the biceps femoris EMG activity relative to the EMG activity measured during contraction- and velocity-specific maximal voluntary biceps femoris contraction, i.e., biceps femoris to maximal biceps femoris activity. FINDINGS: Subjects with knee osteoarthritis had significantly higher coactivity than age-matched healthy adults and young adults and healthy adults had more coactivity than young adults regardless the type of coactivity ratio. The biceps femoris to vastus lateralis ratio yielded 25% higher coactivity value than the biceps femoris to maximal biceps femoris ratio (P < 0.0001). The EMG activity of the vastus lateralis relative to maximal vastus lateralis EMG activity was 92% in subjects with knee osteoarthritis, 57% in age-matched controls, and 47% in young adults (P < 0.0001). INTERPRETATION: Patients with knee osteoarthritis revealed increased hamstring muscle activation while executing activities of daily living. Altered muscle activation at the knee may interfere with normal load distribution in the knee and facilitate disease progression. Therapeutic interventions should focus not only on quadriceps strengthening but also on improving muscle balance at the knee.

Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis.

OBJECTIVE: To characterize the distribution of error in knee joint proprioception, quadriceps force accuracy and steadiness, and muscle strength in patients with knee osteoarthritis (OA). Special attention was paid to eccentric strength. METHODS: We compared knee OA patients (n=20: 15 women, 5 men) with age- and sex-matched, symptom-free adults. Knee pain and mobility were assessed with standard tests. Knee joint proprioception was measured with a repositioning test. Quadriceps force accuracy and steadiness were determined during a force target-tracking task. Maximal voluntary quadriceps force was measured during eccentric, isometric, and concentric contractions. RESULTS: OA patients had knee pain, needed 67% more time to complete 4 functional tasks, and produced 82% more proprioception errors (all P < 0.05). About 80% of this error was due to overshooting the target and 68% of the overshooting error occurred at 2 of the 5 least flexed knee joint positions. OA patients had 89% more errors in accurately matching target forces during submaximal quadriceps contractions and in the same tasks, OA patients also produced these forces with 155% more variability (all P < 0.05). OA patients had especially weakened ability to produce maximal voluntary eccentric strength. CONCLUSION: Quadriceps dysfunction in knee OA includes impaired proprioception, especially in the more extended knee joint positions; impaired ability to accurately and steadily control submaximal force; and impaired eccentric strength. These results have implications for designing exercise and rehabilitation programs for patients with knee OA.

Can within-category naming identify subtle cognitive deficits in the mild traumatic brain-injured patient?

BACKGROUND: This investigation examined the effect of a speeded, computer-controlled task on detecting differences in latency and accuracy of within-category name generation in adults having sustained a mild traumatic brain injury (MTBI). METHODS: Twenty-four adults in acute recovery and 24 age-matched controls were instructed to view 72 pictures on a computer monitor, and then name another item belonging to the same category as the visual stimulus as quickly as possible. RESULTS: The MTBI group demonstrated significantly longer latencies (p < 0.001) and lower accuracy (p < 0.001) than the control group. Both groups displayed similar patterns of response, although the MTBI group produced significantly more perseverative errors (p < 0.001). No significant correlations were found between performance on the Scales of Cognitive Ability for Traumatic Brain Injury and response latency or accuracy. CONCLUSION: The MTBI group performed the task significantly slower and less accurately than controls. Reaction time measures may prove more sensitive than traditional assessment measures in detecting subtle difficulties.