Carl de Moor

Availability, Accessibility, and Preferences for Fruit, 100% Fruit Juice, and Vegetables Influence Children's Dietary Behavior

The relationships among home fruit (F), 100% fruit juice (J), and vegetable (V) availability and accessibility separately, as reported by 225 fourth- through sixth-grade children and their parents (n = 88), separately, and FJV preferences to child-reported FJV consumption were assessed. For girls, child-reported FJV availability and accessibility accounted for 35% of the variability in FJV consumption. Child-reported availability and parent-reported accessibility were significantly correlated with child FJV consumption in a combined model. For children with high FJV preferences, FJV availability was the only significant predictor, whereas both avail-ability and accessibility were significantly related to consumption for children with low FJV preferences. Interventions targeting child dietary behaviors may need to tailor to the home environment, separately by gender. Extra efforts are necessary by parents to enhance accessibility among children who do not like FJV.

The NIH MRI study of normal brain development: Performance of a population based sample of healthy children aged 6 to 18 years on a neuropsychological battery

The National Institutes of Health (NIH) Magnetic Resonance Imaging (MRI) Study of Normal Brain Development is a landmark study in which structural and metabolic brain development and behavior are followed longitudinally from birth to young adulthood in a population-based sample of healthy children. The neuropsychological assessment protocol for children aged 6 to 18 years is described and normative data are presented for participants in that age range (N = 385). For many measures, raw score performance improved steeply from 6 to 10 years, decelerating during adolescence. Sex differences were documented for Block Design (male advantage), CVLT, Pegboard and Coding (female advantage). Household income predicted IQ and achievement, as well as externalizing problems and social competence, but not the other cognitive or behavioral measures. Performance of this healthy sample was generally better than published norms. This linked imaging-clinical/behavioral database will be an invaluable public resource for researchers for many years to come.

First Year After Head and Neck Cancer: Quality of Life

PURPOSE Treatment regimens for head and neck cancer patients profoundly affect several quality-of-life domains. Rehabilitative needs have been identified through cross-sectional analyses; however, few studies have prospectively assessed quality of life, included assessment of psychosocial variables, and identified predictors of long-term follow-up. PARTICIPANTS AND METHODS The present study addresses these limitations through a prospective assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity, pharynx, or larynx. Participants were enrolled onto a larger randomized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition. Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality-of-life instruments at 1 and 12 months after initial smoking cessation advice. RESULTS Participants displayed improvements at 12 months in functional status (P = .006) and in the areas of eating, diet, and speech; however, the latter three represent areas of continued dysfunction, and the changes were not statistically significant. Despite these improvements, patients reported a decline in certain quality-of-life domains, including marital (P = .002) and sexual functioning (P = .017), as well as an increase in alcohol use (P < .001). Predictors of quality of life at 12 months included treatment type, the Vigor subscale of the Profile of Mood States instrument, and quality-of-life scores obtained 1 month after initial smoking cessation advice. CONCLUSION Results reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up.

Effect of a La Carte and Snack Bar Foods at School on Children's Lunchtime Intake of Fruits and Vegetables

OBJECTIVES To compare lunch fruit, juice, and vegetable (FJV) intake of fourth-grade students who receive only National School Lunch Program meals and fifth-grade students who also have access to a school snack bar and to compare FJV intake by meal source among fifth-grade students. DESIGN Cross-sectional study: students completed FJV preference questionnaires and 5 days of lunch food records in classrooms. SUBJECTS/SETTING 312 fourth- and 282 fifth-grade students in south Texas. MAIN OUTCOME MEASURES Mean FJV consumption. STATISTICAL ANALYSES PERFORMED Descriptive statistics, correlation analyses, analysis of variance, analysis of covariance. RESULTS Fourth-grade students (n = 312) consumed significantly more fruits, juices, and vegetables (0.80 serving) than fifth-grade students (n = 282) (0.60 serving). Students whose parents reported a high school education or less consumed more regular and total vegetables than students whose parents reported some college or higher education. There were no interaction effects among gender, grade, ethnic, or family education groups. Fifth-grade students who ate only snack bar meals consumed significantly less total fruits, juices, and vegetables (0.40 serving) than fifth-grade students who ate school lunch meals (0.82 serving). Controlling for FJV preferences did not change the main effect for grade level in the FJV consumption models. APPLICATIONS/CONCLUSIONS FJV consumption during school lunch is low. School foodservice staff should identify FJV items that middle school students prefer and increase availability of those items in middle school cafeterias and snack bars.

Validation of the modified Fagerstrom Tolerance Questionnaire with salivary cotinine among adolescents

This study was conducted to gain evidence of validity for a nicotine dependence measure for adolescent smokers. We hypothesized that the individual item responses and the total Fagerström Tolerance Questionnaire (FTQ) score would be positively correlated with cotinine values. We examined the relationship between a seven-item modified FTQ and saliva continine among 131 adolescent volunteers in a smoking cessation program. As anticipated, the total FTQ score was related to saliva cotinine (r = .40, p < .01), as were six of the seven individual FTQ items (p < .05). Our findings provide preliminary evidence that the modified FTQ scale is valid and applicable to adolescent smokers.

The Food Intake Recording Software System is Valid Among Fourth-grade Children

OBJECTIVES To assess the validity of the Food Intake Recording Software System (FIRSSt) against observation of school lunch and a 24-hour dietary recall (24hDR); and to test the effects of sequencing, observation and a hair sample as a bogus pipeline on accuracy of dietary report. DESIGN Six-group design systematically varying sequence of self-report (FIRSSt vs 24hDR), observation of school lunch and hair sample as a bogus pipeline manipulation, with random assignment of participants. SUBJECTS/SETTING 138 fourth-grade students in 2 elementary schools. MAIN OUTCOME MEASURES Accuracy of reported food consumption was measured in terms of matches, intrusions, and omissions among the FIRSSt, 24hDR, and as observed at school lunch. Students also completed self-report of performance with FIRSSt. STATISTICAL ANALYSIS PERFORMED t tests, Pearson correlations, analysis of variance, factor analysis. RESULTS When compared with school lunch observation for one meal, FIRSSt attained 46% match, 24% intrusion and 30% omission rates, while a dietitian-conducted 24hDR obtained 59% match, 17% intrusion, and 24% omission rates. FIRSSt attained 60% match, 15% intrusion, and 24% omission rates against 24hDR for all meals in the previous day. There was no evidence of sequence of assessment affecting accuracy indicators, but there was a weak effect of school lunch observation on percent intrusions. Obtaining a hair sample reduced the omission rate for FIRSSt vs 24hDR and increased the match rate for 24hDR vs observation, thereby enhancing this as a bogus pipeline procedure. Children generally enjoyed completing FIRSSt. Hispanic children were more likely to report problems using FIRSSt. APPLICATIONS/CONCLUSIONS FIRSSt is somewhat less accurate than a dietitian-conducted 24hDR. However, this lower-cost procedure provides a promising method for assessing diet among children. Observation of consumption at school lunch may be reactive and artificially increase agreement. Obtaining a hair sample as a bogus pipeline may be a valuable technique for enhancing the accuracy of dietary assessment among children.

A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma.

Forty-two patients with metastatic renal cell carcinoma who were participating in a Phase II clinical trial were randomly assigned to an expressive writing (EW) or neutral writing (NW) group. Patients in the EW group wrote about their cancer, and patients in the NW group wrote about health behaviors. No statistically significant group differences were found in symptoms of distress, perceived stress, or mood disturbance, except for the Vigor subscale of the Profile of Mood States. However, patients in the EW group reported significantly less sleep disturbance, better sleep quality and sleep duration, and less daytime dysfunction compared with patients in the NW group. The results suggest that EW may have sleep-related health benefits in terminally ill cancer patients.

Socioenvironmental influences on children's fruit, juice and vegetable consumption as reported by parents: reliability and validity of measures.

OBJECTIVE To pilot test theory-based questionnaires to measure socioenvironmental influences on childrens fruit, juice and vegetable (FJV) consumption as reported by parents. DESIGN Cross-sectional. SETTING Parents of fourth to sixth grade students completed socioenvironmental questionnaires. The students completed food records (FRs) for 2 days in the classroom. SUBJECTS Interviews were completed by 109 parents (17% African-American, 32% Hispanic-American and 51 Euro-American). RESULTS Student mean daily FJV intake was 2.1 servings. Principal components analyses revealed subscales measuring positive and negative parenting practices; self-efficacy for modelling and planning/encouraging FJV consumption, and making FJV available; encouraging, consequences and discouraging food socialization practices; negative home, cost and canned/frozen food barriers; meal planning; child shopping; mother food preparation; and child lunch and dinner FJV preparation practices. Internal consistencies were adequate to high. Negative parent practices and negative home FJV barriers were significantly negatively correlated with child FJV consumption variables. Planning/encouraging self-efficacy was positively associated with fruit consumption, and child dinner FJV preparation was significantly negatively correlated with child juice consumption. CONCLUSIONS These questionnaires may provide important insights about the relationship between parent-reported socioenvironmental influences and childrens FJV consumption. Future work should test these questionnaires with larger groups of parents and youths, with more reliable estimates of usual FJV intake, e.g. 7-day food records, to obtain a detailed understanding of how parents influence what children eat. Tests of models of relationships among these variables are warranted, but should control for possible confounding variables, e.g. socioeconomic status, gender of the child, etc.

Differences in cancer-risk-related behaviors in Latino and Anglo adults

METHODS. Latino (n = 358) and Anglo (n = 113) adults living in the San Diego area were surveyed on nutrition, smoking, and cancer screening behaviors. The Latino respondents were dichotomized into a low (L-Latino) or high (H-Latino) acculturation group according to a median split of an acculturation index. RESULTS. After controlling for age, years of education, gender, marital status, and income, significant cross-cultural differences were found in saturated fat/cholesterol avoidance, and fiber and high calorie food consumption. L-Latino respondents had the lowest degree of saturated fat/cholesterol avoidance, followed by H-Latinos and Anglos. A pattern of decreasing consumption with increasing acculturation was observed for fiber and high calorie foods. Significant differences were found among women in the prevalence of Pap smear exams, with L-Latinas having the lowest prevalence of ever and in the past year having had a Pap smear, followed by H-Latinas and Anglos. A similar significant pattern was observed among women 50 years of age or older with respect to the prevalence of ever having had a mammogram.

bcl-2 and apoptosis in lymph node positive breast carcinoma†

Because bcl‐2 can block apoptosis in vitro, and because lower levels of apoptosis might lead to malignant cell accumulation and therefore to a more aggressive clinical course, the authors tested the hypothesis that high bcl‐2 and low apoptosis would result in a worse prognosis for breast carcinoma patients.