Maternal feeding practices and toddlers' fruit and vegetable consumption: results from the DIT-Coombe Hospital birth cohort in Ireland.

BACKGROUND: Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers' dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers' fruit and vegetable consumption in Ireland. METHODS: A follow-up to the DIT-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to participate in the present follow-up study by phone. A questionnaire assessing maternal feeding behavior and the child's 3-day food diary was sent to mothers who agreed to take part in the present study by post, together with a self-addressed stamped envelope. RESULTS: There were 193 mother-children pairs included in the analysis, and the mean age of children was 2.4 (SD 0.7) years old. Toddlers' mean daily intakes of vegetable and fruit were 67.57 (SD 45.95) g and 213.35 (SD 170.78) g, respectively. Logistic regression analyses showed that maternal practice of breastfeeding for more than 4 weeks was positively associated with fruit (OR = 2.93, 95% CI: 1.29-6.64) and vegetable (OR = 1.95, 95% CI: 1.00-3.81) intake or the contribution of fruit (OR = 2.62, 95% CI: 1.19-5.80) and vegetable (OR = 2.02, 95% CI: 1.02-3.99) to the total diet. Letting the child eat with other family members was associated with high vegetable intake (OR = 5.45, 95%CI: 1.69-17.61) and high contribution of vegetable to total diet (OR = 3.78, 95% CI: 1.04-13.82). Not being too worried about the child's refusal to eat was positively associated with toddlers' vegetable intake (OR = 2.10, 95%CI: 1.09-4.05). CONCLUSIONS: To increase children's fruit and vegetable intake, and develop good eating habits, parents should eat with their toddlers, be patient and not put much pressure on their children in the context of meal feeding.

Standardized Consent: The Effect of Information Sheets on Information Retention.

INTRODUCTION: Informed consent embodies the ethical principle of autonomy of the surgical patient. Effective communication is essential to this decision-making process. Variability in consent can lead to confusion among patients and can expose the surgeon to risk in an increasingly litigious environment. OBJECTIVES: This study aimed to evaluate the use of a standardized consenting process and assess the pattern of information recall following provision of patient information sheets. METHODS: One hundred orthopedic clinic patients were randomly selected to participate in this prospective audit. Mean age was 41 years. Each participant was consented to undergo wrist manipulation under anaesthesia and K-wiring using a standardized British Orthopaedic Association consent form. A 22-item questionnaire was completed based on the information provided. Half of the cohort received additional printed take-home material. Each questionnaire was repeated 1 day later to determine which aspects of consent were best retained. RESULTS: Baseline scores were low on initial questioning for each section. There was a significant decrease in information retained over 24-hour interval (mean, 8.94 versus 7.98, P ≤ 0.000). Where standardized forms were provided, individual baseline scores rose significantly 24 hours after initial questioning. In particular, arthritis, neurovascular injury, and infection were more likely to be remembered with provision of written information (P = 0.01). Significantly lower scores were seen in those who had not received written information (mean, 9.542 versus 6.449; P ≤ 0.00). CONCLUSIONS: Consent remains challenging even with a standardized process. Information retention improves significantly with the use of information sheets. We advocate the use of standard consent and provision of patient information sheets for commonly performed procedures.