Resistiveness to care (RTC) is common in older adults with dementia. RTC disrupts nursing care, increasing costs of care by 30%. Elderspeak (infantilizing communication used by nursing staff) may trigger RTC in individuals with dementia. Videotaped care episodes (N=80) of nursing home residents with dementia (N=20) were coded for type of staff communication (normal talk and elderspeak) and subsequent resident behavior (cooperative or RTC). Bayesian statistical analysis tested relationships between staff communication and subsequent resident RTC. The probability of RTC varied significantly with communication (Bayes p = .0082). An increased probability of RTC occurred with elderspeak (.55, CrI = .44 -.66), compared to normal talk (.26, CrI = .12-.44). Communication training has been shown to reduce elderspeak and may reduce RTC in future research.

The NLit is a valid and reliable tool for measuring nutrition literacy in adult primary care patients.

Objective To describe the relationship between adherence to distinct dietary patterns and nutrition literacy. Design We identified distinct dietary patterns using principal covariates regression (PCovR) and principal components analysis (PCA) from the Diet History Questionnaire (DHQ) II. Nutrition literacy was assessed using the Nutrition Literacy Assessment Instrument (NLit). Cross-sectional relationships between dietary pattern adherence and global and domain-specific NLit scores were tested by multiple linear regression. Mean differences in diet pattern adherence among three pre-defined nutrition literacy performance categories were tested by ANOVA. Setting Metropolitan Kansas City Participants Adults (n=386) with at least one of four diet-related diseases. Results Three diet patterns of interest were derived; a PCovR prudent pattern and PCA-derived Western and Mediterranean patterns. After controlling for age, sex, BMI, race, household income, education level, and diabetes status, PCovR prudent pattern adherence positively related to global NLit scores (p<0.001, β=0.36), indicating more intake of prudent diet foods with improved nutrition literacy. Validating the PCovR findings, PCA Western pattern adherence inversely related to global NLit (p=0.003, β=−0.13) while PCA Mediterranean pattern positively related to global NLit (p=0.02, β=0.12). Using predefined cut points, those with poor nutrition literacy consumed more food associated with the Western diet (fried food, sugar sweetened beverages, red meat, and processed food) while those with good nutrition literacy consumed more food associated with prudent and Mediterranean diets (vegetables, olive oil, and nuts). Conclusion Nutrition literacy predicted adherence to healthy/unhealthy diet patterns. These findings warrant future research to determine if improving nutrition literacy effectively improves eating patterns.

Investigators need good statistical tools for the initial planning and for the ongoing monitoring of clinical trials. In particular, they need to carefully consider the accrual rate-how rapidly patients are being recruited into the clinical trial. A slow accrual decreases the likelihood that the research will provide results at the end of the trial with sufficient precision (or power) to make meaningful scientific inferences. In this paper, we present a method for predicting accrual. Using a Bayesian framework we combine prior information with the information known up to a monitoring point to obtain a prediction. We provide posterior predictive distributions of the accrual. The approach is attractive since it accounts for both parameter and sampling distribution uncertainties. We illustrate the approach using actual accrual data and discuss practical points surrounding the accrual problem.

Objective To estimate the reliability and validity of the Nutrition Literacy Assessment Instrument for Parents (NLit-P) and to investigate relationships between parental nutrition literacy, parental and child BMI, and child diet quality (Healthy Eating Index, HEI). Methods Cross-sectional study of 101 parent-child dyads which collected measures of socioeconomic status, nutrition literacy, 2–24 hour child diet recalls, and BMI. Reliability of NLit-P was assessed by confirmatory factor analysis. Pearson correlation and multiple linear regression was used. Results Fair to substantial reliability was seen across 5 NLit-P domains, while Pearson correlations support concurrent validity for the NLit-P related to child diet quality and parental income, age, and educational attainment (p<0.001). For every 1% increase in NLit-P, there was a 0.51 increase in child HEI (R2=0.174; p<0.001). Conclusions and Implications The NLit-P demonstrates potential for measuring parental nutrition literacy, which may be an important educational target for improving child diet quality.