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INTRODUCTION Until recently, it was believed that attention deficit hyperactivity disorder (ADHD) was exclusively a pediatric condition. 1 However, current research indicates that 60% to 70% of children diagnosed with ADHD continue to manifest symptoms into adulthood. 2 Persistence of symptoms of ADHD can have a pressing impact on the safety and personal relationships of patients, as well as having secondary effects in adulthood such as lost days of productivity and continual negative feedback or social and educational disadvantages. 3 A recent study that used the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for ADHD, which was conducted in both developed and underdeveloped countries, estimated that the worldwide prevalence of ADHD was 3.4% and showed that it was higher among underdeveloped countries. 4 Currently, there are no biomarkers available for diagnosing ADHD. All diagnoses require careful assessments by clinicians through interviews and appropriate classification criteria. 5 Two diagnostic tools are used today to classify this disorder: DSM-5 and the International Statistical Classification of Diseases and Related Health Problems (ICD-10). These two diagnostic tools define ADHD as a hyperkinetic disorder, a disorder characterized by inattention, hyperactivity and impulsivity with onset in childhood or adolescence. It is believed that the current diagnostic criteria (both DSM-5 and the ICD-10) are inadequate for evaluation of adults because they focus on early childhood problems and they do not fully account for developmental and maturation changes. 6 The symptoms and functional impairments identified among adults for making a diagnosis of ADHD tend to be different from those observed among children.

This study aimed to assess change in school-based food waste after training and implementing the Smarter Lunchrooms Movement (SLM) strategies with school food service workers. This non-controlled trial was implemented in a random sample of 15 elementary and middle schools in a Community Eligibility Program school district in the Northeast, the United States. Baseline and post-intervention food waste measurements were collected at two different time points in each school (n = 9258 total trays measured). Descriptive statistics, independent t-tests, and regression analyses were used to assess SLM strategies’ impact on changes in percent food waste. The mean number of strategies schools implemented consistently was 7.40 ± 6.97 SD, with a range of 0 to 28 consistent strategies. Independent t-tests revealed that at post-test, there was a significant (p < 0.001) percent reduction (7.0%) in total student food waste and for each food component: fruit (13.6%), vegetable (7.1%), and milk (4.3%). Overall, a training session on food waste and the SLM strategies with school-based food service workers reduced school food waste. However, the extent of the training and SLM strategies to reduce food waste varied on the basis of the consistency and type of strategies implemented.

for-profits, universities, and hospitals, partner with schools to provide nutrition education programs (NEPs). Objective: This study assessed NEPs in NYC schools. Study Design, Setting, Participants, Intervention: Cross sectional study of the 40 organizations that run 101 NEPs in NYC schools in the 1,840 NYC public schools. Outcome Measures and Analysis: Survey completed by organizations that run NEPs with questions on organizational structure, program characteristics, and schools worked with during 2016-17 school year; and publically available data from NYC Department of Education on school demographics. Descriptive statistical analysis. Results: Most NEPs surveyed (68%) have ≤10 full time staff. Forty-three percent of NEPs started after 2011. Common student activities include cooking (69%), classroom lessons (66%), gardening (46%), and field trips (31%). Reported barriers include limited time for NEPs (37%) and limited space for implementation (34%). Overall, 56% of NYC schools had at least one NEP. Only 27% of schools had more than one. NEPs were evenly distributed across schools with varying percentage of students qualifying for free/reduced price lunch and percentage Black and Hispanic students. NEPs varied by school type: 69% of elementary schools had one or more NEP; 50% of middle schools; and 32% of high schools. A previous study from 2011-2012 found 39% of elementary schools in the NYC boroughs of Brooklyn, Manhattan and Queens had one or more NEPs. An analysis of elementary schools in these boroughs for the 2016-2017 data found a rate of 71%. Conclusions and Implications: There are not enough NEPs being implemented in NYC schools for students to receive the full benefits of nutrition education. Policy makers, researchers, funders, and advocates need to effectively collaborate for more schools to have more NEPs. This study can be a model for other cities, regions, or states to conduct landscape assessments of NEPs.