Background-For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy.
Background Practitioners and researchers are interested in assessing children’s dietary intake and physical activity together to maximize resources and minimize subject burden. Objective To investigate differences in dietary and/or physical-activity recall accuracy by content (diet-only; physical-activity-only; diet-&-physical-activity), retention interval (same-day-recalls-in-the-afternoon; previous-day-recalls-in-the-morning), and grade (third; fifth). Design Children (n=144; 66% African American, 13% White, 12% Hispanic, 9% Other; 50% girls) from four schools were randomly selected for interviews about one of three contents. Each content group was equally divided by retention interval, each equally divided by grade, each equally divided by sex. Information concerning diet and physical activity at school was validated with school-provided breakfast and lunch observations, and accelerometry, respectively. Dietary accuracy measures were food-item omission and intrusion rates, and kilocalorie correspondence rate and inflation ratio. Physical activity accuracy measures were absolute and arithmetic differences for moderate-to-vigorous-physical-activity minutes. Statistical analyses performed For each accuracy measure, linear models determined effects of content, retention interval, grade, and their two-way and three-way interactions; ethnicity and sex were control variables. Results Content was significant within four interactions: intrusion rate (content-×-retention-interval-×-grade; p=.0004), correspondence rate (content-×-grade; p=.0004), inflation ratio (content-×-grade; p=.0104), and arithmetic difference (content-×-retention-interval-×-grade; p=.0070). Retention interval was significant for correspondence rate (p=.0004), inflation ratio (p=.0014), and three interactions: omission rate (retention-interval-×-grade; p=.0095), intrusion rate, and arithmetic difference (both already mentioned). Grade was significant for absolute difference (p=.0233) and five interactions mentioned. Content effects depended on other factors. Grade effects were mixed. Dietary accuracy was better with same-day than previous-day retention interval. Conclusions Results do not support integrating dietary intake and physical activity in children’s recalls, but do support using shorter rather than longer retention intervals to yield more accurate dietary recalls. Further validation studies need to clarify age effects and identify evidence-based practices to improve children’s accuracy for recalling dietary intake and/or physical activity.
BackgroundData from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria).MethodsData were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age.ResultsBreakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria.ConclusionsFor fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.
Objective This study estimates the impact of a statewide centralized emergency department telepsychiatry service provided in non-psychiatric emergency departments on use of mental health services. Methods Individuals treated via telepsychiatry were compared to a matched sample of individuals with mental health diagnoses who were treated in non-participating hospitals. Bivariate and two part and generalized linear regression models were used to assess differences in outpatient follow up, admission following the emergency department visit, length of stay, inpatient and total costs between the two groups. Results Between March 2009 and June 2013 there were 9,066 patients with at least one telepsychiatry visit. Of these, 7,261 had index telepsychiatry visits which we were able to successfully match. The telepsychiatry group was more likely to receive 30 day outpatient follow up than the matched controls (46% versus 16%, p,.001) and more likely to receive 90 day outpatient follow up (54% versus 20%, p<.001). Those receiving telepsychiatry were less likely to be admitted to the hospital at the index emergency department visit than the control group (11% versus 22%). The combined effect of having a telepsychiatry consult during the index emergency department visit was a 0.86 day reduction in inpatient length of stay associated with receiving telepsychiatry care. 30-day inpatient costs were $2,336 (p=0.04) lower for the telepsychiatry group. 30-day total health care costs were not statistically different. Conclusions Telepsychiatry delivered in the emergency department through a centralized coordinated program has great promise for improving linkage with outpatient mental health services while reducing inpatient utilization and hospital costs.
Background Data from a school-based study concerning fourth-grade children’s dietary recall accuracy were linked with data from the South Carolina Department of Education (SCDE) through the South Carolina Budget and Control Board Office of Research and Statistics (ORS) to investigate the relationships of children’s school absenteeism with body mass index (BMI), academic achievement, and socioeconomic status (SES). Methods Data for all variables were available for 920 fourth-grade children during two school years (2005–2006, 2006–2007). Number of school days absent for each child and eligibility for free/reduced-price school meals (SES measure) were provided to ORS by SCDE. Children’s weight and height were measured by research staff; age/sex specific BMI percentile was calculated and grouped into categories. For academic achievement, Palmetto Achievement Challenge Tests scores were provided by the school district. The associations of absenteeism with BMI, academic achievement, SES, and school year were investigated with logistic binomial models using the modified sandwich variance estimator to adjust for multiple outcomes within schools. Results The relationships between absenteeism and each of BMI percentile category and SES were not significant (all coefficient p values > 0.118). The relationship between absenteeism and academic achievement was inversely significant (p value < 0.0001; coefficient = −0.087). Conclusions These results support the inverse relationship between absenteeism and academic achievement that was expected and has been found by other researchers. The lack of significant results concerning the relationships between absenteeism and both BMI and SES disagrees with earlier, limited research. More research to investigate these relationships is needed.
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