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Background Acute kidney injury (AKI) is independently associated with increased morbidity and mortality across the life course, yet care for AKI remains mostly supportive. Raising awareness of this life-threatening clinical syndrome through education and advocacy efforts is the key to improving patient outcomes. Here, we describe the unique roles education and advocacy play in the care of children with AKI, discuss the importance of customizing educational outreach efforts to individual groups and contexts, and highlight the opportunities created through innovations and partnerships to optimize lifelong health outcomes. Methods During the 26th Acute Disease Quality Initiative (ADQI) consensus conference, a multidisciplinary group of experts discussed the evidence and used a modified Delphi process to achieve consensus on recommendations on AKI research, education, practice, and advocacy in children. Results The consensus statements developed in response to three critical questions about the role of education and advocacy in pediatric AKI care are presented here along with a summary of available evidence and recommendations for both clinical care and research. Conclusions These consensus statements emphasize that high-quality care for patients with AKI begins in the community with education and awareness campaigns to identify those at risk for AKI. Education is the key across all healthcare and non-healthcare settings to enhance early diagnosis and develop mitigation strategies, thereby improving outcomes for children with AKI. Strong advocacy efforts are essential for implementing these programs and building critical collaborations across all stakeholders and settings., Author(s): Theresa Mottes [sup.1] , Shina Menon [sup.2] , Andrea Conroy [sup.3] , Jennifer Jetton [sup.4] , Kristin Dolan [sup.5] , Ayse Akcan Arikan [sup.6] , Rajit K. Basu [sup.7] [...]

INTRODUCTION Lung cancer is the leading cause of cancer-related mortality and accounts for an estimated 22% of all cancer deaths. (1) In 2011, the National Lung Screening Trial (NLST) showed [...], PURPOSE We assessed low-dose computed tomography (LDCT) screening for lung cancer using a proactive patient education/recruitment program. METHODS We identified patients aged 55-80 years from a family medicine group. In the retrospective phase (March-August, 2019), patients were categorized as current/former/ never smokers, and screening eligibility was determined. Patients who underwent LDCT in the past year, along with outcomes, were documented. In the prospective phase (2020), patients in the same cohort who did not undergo LDCT were proactively contacted by a nurse navigator to discuss eligibility and prescreening. Eligible and willing patients were referred to their primary care physician. RESULTS In the retrospective phase, of 451 current/former smokers, 184 (40.8%) were eligible for LDCT, 104 (23.1%) were ineligible, and 163 (36.1%) had an incomplete smoking history. Of those eligible, 34 (18.5%) had LDCT ordered. In the prospective phase, 189 (41.9%) were eligible for LDCT (150 [79.4%] of whom had no prior LDCT or diagnostic CT), 106 (23.5%) were ineligible, and 156 (34.6%) had an incomplete smoking history. The nurse navigator identified an additional 56/451 (12.4%) patients as eligible after contacting patients with incomplete smoking history. In total, 206 patients (45.7%) were eligible, an increase of 37.3% compared with the retrospective phase (150). Of these, 122 (59.2%) verbally agreed to screening, 94 (45.6%) met with their physician, and 42 (20.4%) were prescribed LDCT. CONCLUSIONS A proactive education/recruitment model increased eligible patients for LDCT by 37.3%. Proactive identification/education of patients desiring to pursue LDCT was 59.2%. It is essential to identify strategies that will increase and deliver LDCT screening among eligible and willing patients. Key words: low-dose computed tomography; lung cancer screening; nurse navigator; patient identification https://doi.org/10.1370/afm.2905

Introduction Nearly 13 million homes in the United States (U.S.) burn wood fuel in wood stoves or fireplaces as a primary or secondary heating source (EIA 2015). Approximately half of [...], Background: Millions of rural U.S. households are heated with wood stoves. Wood stove use can lead to high indoor concentrations of fine particulate matter [airborne particles [less than or equal to] 2.5 [micro]m in aerodynamic diameter ([PM.sub.2.5])] and is associated with lower respiratory tract infection (LRTI) in children. Objectives: We assessed the impact of low-cost educational and air filtration interventions on childhood LRTI and indoor [PM.sub.2.5] in rural U.S. homes with wood stoves. Methods: The Kids Air Quality Interventions for Reducing Respiratory Infections (KidsAIR) study was a parallel three-arm (education, portable air filtration unit, control), post-only randomized trial in households from Alaska, Montana, and Navajo Nation (Arizona and New Mexico) with a wood stove and one or more children RESULTS: There were 61 LRTI cases from 14,636 child-weeks of follow-up among 461 children. In the intent-to-treat analysis, children in the education arm [odds ratio (OR) = 0.98; 95% confidence interval (CI): 0.35, 2.72] and the filtration arm (OR = 1.23; 95% CI: 0.46, 3.32) had similar odds of LRTI vs. control. Geometric mean [PM.sub.2.5] concentrations were similar to control in the education arm (11.77% higher; 95% CI: -16.57, 49.72) and air filtration arm (6.96% lower; 95% CI: -30.50, 24.55). In the exposure-response analysis, odds of LRTI were 1.45 times higher (95% CI: 1.02, 2.05) per interquartile range (25 [micro]g/[m.sup.3]) increase in mean indoor [PM.sub.2.5]. Discussion: We did not observe meaningful differences in LRTI or indoor [PM.sub.2.5] in the air filtration or education arms compared with the control arm. Results from the exposure-response analysis provide further evidence that biomass air pollution adversely impacts childhood LRTI. Our results highlight the need for novel, effective intervention strategies in households heated with wood stoves. https://doi.org/10.1289/EHP9932

Introduction Parent training (PT) for disruptive behaviors is not new. The efficacy of PT in typically developing children with disruptive behavior from preschool through adolescence is supported by over 30 [...], Guidance on effective interventions for disruptive behavior in young children with autism spectrum disorders (ASDs) is limited. We present feasibility and initial efficacy data on a structured parent training program for 16 children (ages 3-6) with ASD and disruptive behavior. The 6-month intervention included 11 Core and up to 2 Optional sessions. The program was acceptable to parents as evidenced by an attendance rate of 84 % for Core sessions. Fourteen of 16 families completed the treatment. An independent clinician rated 14 of 16 subjects as much improved or very much improved at Week 24. Using last observation carried forward, the parent-rated Aberrant Behavior Checklist-Irritability subscale decreased 54 % from 16.00 (SD = 9.21) to 7.38 (SD = 6.15). Keywords Autism * Parent training * Disruptive behavior * Adaptive skills

Introduction An estimated 16.7 million of total global deaths result from various forms of cardiovascular disease (World Health Organization, 2003), and several very well-identified lifestyle factors influence the development of [...], The objective of the study was to evaluate the efficacy of an interdisciplinary intervention known as Educoeur in reducing cardiovascular risk and improving health behaviors in people without evidence of cardiovascular disease and to compare the Educoeur program to interventions in a specialized clinic and in usual care family practice. In a parallel, randomized, controlled trial of 185 adults with at least two modifiable cardiovascular risk factors, patients were randomly assigned to either Educoeur, specialized clinic or usual care. Cardiovascular risk, biological and lifestyle measures were assessed at baseline and at 2 years. In Educoeur, measurements were also taken before and after the lifestyle group treatment program. In 12 weeks, patients in Educoeur significantly lowered their cardiovascular risk, weight, body mass index, waist circumference, systolic blood pressure, kilocalories intake and improved their V[O.sub.2] Max and mental health. Changes remained significant at 2 years. Between group comparisons at 2 years demonstrated that Educoeur was significantly better in reducing cardiovascular risk than interventions in usual care. Together, these results highlight the importance of providing interdisciplinary programs that optimize cardiovascular risk reduction and promote active lifestyles in patients at risk of cardiovascular disease. Keywords Cardiovascular risk factors * Primary prevention * Cardiovascular disease * Hypertension * Interdisciplinary lifestyle intervention * Health behavior * Nutritional intervention * Exercise

Population health intervention research (PHIR) was developed to redress a particular trajectory. Researchers and policymakers were accumulating more knowledge about population health problems than population health solutions. (1-8) A similar [...], Population health intervention research requires stronger definition. There are overlaps and differences between it and established domains such as evaluation, health impact assessment, knowledge translation, health services research, and social and public policy analysis. The value added of this growing field is its potential to draw more resources as well as diverse expertise, methods and ways of knowing under one umbrella at a critical time in history. That is, at a time when actions to reduce health inequities have become paramount. Key words: Population health; intervention research; evaluation La recherche interventionnelle en sante des populations doit etre plus etroitement definie. Il y a des chevauchements et des differences entre ce type de recherche et les domaines bien etablis comme l'evaluation, l'evaluation des incidences sur la sante, l'application des connaissances, la recherche sur les services de sante et l'analyse des politiques sociales et publiques. La valeur ajoutee de ce domaine en pleine croissance est qu'il a le potentiel d'attirer davantage de ressources, ainsi que divers savoirs, methodes et modes d'acquisition des connaissances sous un meme toit a un moment critique de l'histoire, alors que les interventions visant a reduire les iniquites en sante deviennent primordiales. Mots cles : sante des populations; recherche d'intervention; evaluation

From bench to bedside, and from the care of individuals to the health of populations, the scope of general surgery has exploded in recent years, as new scientific and technical [...]

Children with obstetrical brachial plexus palsy may have chronic physical impairment in their affected upper extremity. Affected children and their families may benefit from psychosocial interventions including therapeutic relationships with [...]

Dear Editor, I am writing to the Journal of Alcohol and Drug Education to present results from a regional study investigating prevalence of substance use among 12 Irish secondary schools [...]

This paper discusses the way in which Asabano children of Papua New Guinea (PNG) learn. The question of how Asabano children learn is interesting because parents believe children to be incapable of heeding instruction, and so they consciously do not attempt to teach children and may even intervene to stop activities that they see as educational. Thus, with little or no instruction, children come to possess a rich corpus of skills and knowledge. To explain how this is possible, I draw upon the concepts of guided participation and play, illustrating that the routine arrangements of children's lives are critical to their education and enculturation. This traditional Asabano system of education contrasts starkly with the formal schooling system in the village, which I argue should better address the local socio-cultural context Keywords: Papua New Guinea, Asabano, children, socialization, education., The term socialization refers to the process of bringing up the next generation through a set of practices that mediates between the cultural worlds in which humans live and our [...]

Introduction Reliable vital statistics based on births and deaths are necessary for population health assessment, epidemiological research, health planning and programme evaluation. Civil registration is considered the optimal source of [...], Problem Birth and death registration rates are low in most parts of India. Poor registration rates are due to constraints in both the government system (supply-side) and the general population (demand-side). Approach We strengthened vital event registration at the local level within the existing legal framework by: (i) involving a non-profit organization as an interface between the government and the community; (ii) conducting supply-side interventions such as sensitization workshops for government officials, training for hospital staff and building data-sharing partnerships between stakeholders; (iii) monitoring for vital events by active surveillance through lay-informants; and (iv) conducting demand-side interventions such as publicity campaigns, education of families and assistance with registration. Local setting In the government sector, registration is given low priority and there is an attitude of blaming the victim, ascribing low levels of vital event registration to 'cultural reasons/ignorance'. In the community, low registration was due to lack of awareness about the importance of and procedures for registration. Relevant changes This initiative helped improve registration of births and deaths at the subdistrict level. Vital event registration was significantly associated with local equity stratifiers such as gender, socioeconomic status and geography. Lessons learnt The voluntary sector can interface effectively between the government and the community to strengthen vital registration. With political support from the government, outreach activities can dramatically improve vital event registration rates, especially in disadvantaged populations. The potential relevance of the data and the data collection process to stakeholders at the local level is a critical factor for success. Probleme Les taux d'enregistrement des naissances et des deces sont faibles dans la plupart des regions d'lnde. Ces taux si bas sont dus aux contraintes du systeme public (cote offre) et de la population generale (cote demande), Approche Dans le cadre juridique existant, nous avons renforce L'enregistrement des evenements relatifs a I'etat civil au niveau local comme suit: (i) en impliquant une organisation a but non lucratif comme interface entre le gouvernement et la communaute; (ii) en effectuant des interventions cote offre, telles que des ateliers de sensibilisation pour les fonctionnaires d'Etat, la formation du personnel hospitalier et la creation de partenariats de partage des donnees entre les parties prenantes; (iii) en controlant les evenements relatifs a l'etat civil par la surveillance active via des informateurs non specialistes; et (iv) en effectuant des interventions cote demande, telles que des campagnes publicitaires, I'education des families et l'assistance a I'enregistrement. Environnement locale Dans le secteur public, on donne une faible priorite a L'enregistrement des evenements relatifs a l'etat civil et on constate une attitude qui consiste a blamer la victime, en attribuant ces niveaux faibles d'enregistrement a <>. Au sein de la communaute, ce faible taux d'enregistrement etait du a un manque de sensibilisation quant a I'importance de L'enregistrement et de ses procedures. Changements significatifs Cette initiative a permis d'ameliorer L'enregistrement des naissances et des deces au niveau du sous-district. L'enregistrement des evenements relatifs a l'etat civil etait largement associe aux facteurs de stratification de requite locale, comme le sexe, le statut socioeconomique et la geographie. Lecons tirees Le secteur associatif peut efficacement etre le point de contact entre le gouvernement et la communaute afin de renforcer L'enregistrement des evenements relatifs a l'etat civil. Avec ie soutien politique des autorites, les activites sociales sur le terrain peuvent considerablement ameliorer les taux d'enregistrement des naissances et des deces, en particulier chez les populations defavorisees. La pertinence potentielle des donnees et le processus de collecte des donnees des parties prenantes au niveau local est un facteur de succes fondamental. Situacien La mayor parte de la India presenta unos indices bajos de registros de nacimientos y defunciones. Estos bajos indices de registro se deben a las limitaciones existentes, tanto en el sistema gubernamental (suministro) como en la poblacien en general (demanda). Enfoque Hemos consolidado las inscripciones del registro civil a nivel local dentro del marco legal existente, aplicando los siguientes metodos: (a) implicacion de una organizacion sin animo de lucro para actuar como intermediaria entre el Gobierno y la comunidad; (b) intervenciones dirigidas al sistema publico, como talleres de sensibilizacien destinados a los funcionarios publicos, formacion del personal hospitalario y creacion de asociaciones entre los interesados para compartir informacion al respecto; (c) supervision de las inscripciones en el registro civil mediante un control activo a traves de informadores no especializados; y (d) intervenciones dirigidas a la poblacien en general como campanas de publicidad, formacien de las familias y ayuda en el registro. Marco regional El sector gubernamental asigna un nivel bajo de prioridad al registro y suele culpar a la victima, atribuyendo el bajo porcentaje de inscripciones a <>. En la comunidad, el bajo porcentaje se debio a una falta de concienciacion sobre la importancia del registro y sus procedimientos. Cambios importantes Esta iniciativa ayudo a mejorar la inscripcion de nacimientos y defunciones en los subdistritos. La inscripcien en el registro civil se asocio de manera significativa a estratificadores locales de equidad como el genero, el nivel socioeconemico y la geografia. Lecciones aprendidas El voluntariado puede intermediar de forma efectiva entre el Gobierno y la comunidad para consolidar el registro civil. Con el apoyo politico del Gobierno, las actividades de divulgacion pueden mejorar enormemente los indices de inscripciones en el registro civil, especialmente entre las poblaciones menos favorecidas. La importancia potencial de los datos y del proceso de recopilacion de datos para los interesados a nivel local es un factor fundamental de exito.

Objectives. We examined whether adding behavioral weight loss strategies could improve the outcomes of a community weight loss campaign. Methods. Shape Up RI is a 12-week, online, team-based program for health improvement in Rhode Island. In study 1, we randomly assigned participants to the standard Shape Up RI program or to the program plus video lessons on weight loss. In study 2, we randomly assigned participants to the standard program or to the program plus video lessons; daily self-monitoring of weight, eating, and exercise; and computer-generated feedback. Results. Adding video lessons alone (study 1) did not result in significantly improved weight loss (2.0 [+ or -]2.8 kg vs 1.4 [+ or -]2.9 kg; P=.15). However, when the video lessons were supplemented with self-monitoring and feedback (study 2), the average weight loss more than doubled (3.5 [+ or -]3.8 kg vs 1.4 [+ or -]2.7 kg; P Conclusions. Adding behavioral strategies to community campaigns may improve weight loss outcomes with minimal additional cost. (Am J Public Health. 2010; 100:2513-2519. doi: 10.2105/AJPH.2009.183616)

Objectives. We evaluated changing patterns of tobacco use following a period of forced tobacco abstinence in a US military cohort to determine rates of harm elimination (e.g., tobacco cessation), harm reduction (e.g., from smoking to smokeless tobacco use), and harm escalation (e.g., from smoking to dual use or from smokeless tobacco use to smoking or dual use). Methods. Participants were 5225 Air Force airmen assigned to the health education control condition in a smoking cessation and prevention trial. Tobacco use was assessed by self-report at baseline and 12 months. Results. Among 114 baseline smokers initiating smokeless tobacco use after basic military training, most demonstrated harm escalation (87%), which was 5.4 times more likely to occur than was harm reduction (e.g., smoking to smokeless tobacco use). Harm reduction was predicted, in part, by higher family income and belief that switching from cigarettes to smokeless tobacco is beneficial to health. Harm escalation predictors included younger age, alcohol use, longer smoking history, and risk-taking. Conclusions. When considering a harm reduction strategy with smokeless tobacco, the tobacco control community should balance anticipated benefits of harm reduction with the risk of harm escalation and the potential for adversely affecting public health. (Am J Public Health. 2010;100:2487-2492. doi: 10.2105/AJPH.2009.175091)

Objectives. Disability is conceptualized as a life course process and measured using either transitions or trajectories. Previous research does not simultaneously explore both aspects of disablement, accounting for timing and trajectory. The role of education is noted in disability research, but its independent effects over time have not been fully examined. I investigate the effects of education and income on disability onset and progression over a decade. Methods. I use a latent curve modeling approach with four waves of the Duke Established Populations for Epidemiologic Studies of the Elderly data to independently test the preventive and mediating effects education and income provide for disability. Results. Education has a preventive effect for disability onset but no significant effect on progression once income is held constant. Income has both a preventive and mediating effect on disability, although preventive effects are stronger for education. Discussion. Later life disability is measured here using both onset and trajectory. Findings are consistent with health research suggesting that education and income work through shared and independent mechanisms to affect disability over time. These findings also highlight the importance of modeling timing when studying health trajectories. Key Words: Disability--Education--Socioeconomic status--Stratification and health. doi: 10.1093/geronb/gbq018.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2010.03.012 Byline: Latasha T. Johnson, Penny A. Ralston, Ethel Jones Abstract: African Americans, especially women, have low fruit and vegetable consumption, which is related to higher rates of obesity, morbidity, and mortality in comparison to whites. Community-based approaches are recommended to address this problem, including beauty salons, which are conducive environments for health information dissemination. The purpose of this pilot study, conducted in 2007, was to determine the effectiveness of a 6-week beauty salon-based health intervention, Steps for a New You, in improving diet, physical activity, and water consumption behaviors in African-American women using a quasiexperimental design. A random sample of 20 African-American women was selected from a list of regular clients at two beauty salons (n=10 each for treatment and comparison salons) located in a Southern rural community. The intervention included scripted motivational sessions between the cosmetologist and clients, information packets, and a starter kit of sample items. Data were collected using pre- and posttest questionnaires. The results showed that mean intake of fruit and vegetables was significantly higher at posttest for the treatment group but not for the comparison group. These findings suggest that the intervention may have had a positive effect on fruit and vegetable consumption by treatment group participants. However, further work is needed to refine the methodology, especially strengthening the intervention to increase physical activity and water consumption. Article History: Accepted 16 October 2009

Objectives. We evaluated the impact of a mailed, tailored intervention on skin cancer prevention and skin self-examination behaviors of adults at moderate and high risk for skin cancer. Methods. Adults at moderate and high risk for skin cancer were recruited in primary health care settings in Honolulu, HI, and Long Island, NY. After completing a baseline survey, participants were randomized to 2 groups. The treatment group received tailored materials, including personalized risk feedback, and the control group received general educational materials. Multivariate analyses compared sun protection and skin self-examination between groups, controlling for location, risk level, gender, and age. Results. A total of 596 adults completed the trial. The tailored materials had a significant effect on overall sun-protection habits, the use of hats, the use of sunglasses, and the recency of skin self-examination. Some effects were moderated by location and risk level. Conclusions. Tailored communications including personalized risk feedback can improve sun-protection behaviors and skin self-examination among adults at increased risk for skin cancer. These convenient, low-cost interventions can be implemented in a variety of settings and should be tested further to assess their long-term effectiveness. (Am J Public Health. 2010;100:735-741. doi:10.2105/AJPH.2008.155705)

ABSTRACT Skin cancer is the most commonly diagnosed cancer in populations of predominantly Caucasian origins. As the main cause of skin cancer is excessive sun exposure among a sun-sensitive population, [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.07.003 Byline: Catalina Lopez-Quintero, Elliot M. Berry, Yehuda Neumark Abstract: The prevalence of obesity, diabetes, and cardiovascular disease is reaching epidemic proportions among Hispanics in the United States. Health care providers play an important role in motivating patients to make healthful lifestyle changes to reduce the burden of such conditions. Data from the US 2000 National Health Interview Survey was analyzed to determine differences in report of physician-provided physical activity and/or dietary advice by level of English proficiency among obese Hispanics or those who reported having diabetes or cardiovascular disease and who contacted a physician during the past year (n=1,186). Only one third of the sample reported receiving advice to increase their physical activity or to improve their dietary habits; one fifth reported receipt of advice about both. English-proficient Hispanics were about 50% more likely to report receiving advice on physical activity (adjusted odd ratio [AOR]=1.5; 95% confidence interval [CI]: 1.1 to 2.1), diet (AOR=1.5; 95% CI: 1.1 to 2.2) or both (AOR=1.6; 95% CI: 1.1 to 2.3), as compared with limited English-proficient Hispanics, after controlling for health insurance coverage and number of visits to a physician during the last year. Sex, age, region of residence, level of education, annual family income, and smoking status were not significantly associated with receiving physical activity and/or dietary advice. In order to address racial health disparities, and lower the burden of chronic illness, culturally sensitive strategies must be implemented to enhance delivery of effective health-promotion messages by physicians, particularly among at-risk communities. Article History: Accepted 2 March 2009

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.06.366 Byline: Heather L. Hartline-Grafton, Donald Rose, Carolyn C. Johnson, Janet C. Rice, Larry S. Webber Abstract: Little is known about the dietary intake of school employees, a key target group for improving school nutrition. Article History: Accepted 13 March 2009

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.06.367 Byline: Shino Oba, Chisato Nagata, Kozue Nakamura, Kaori Fujii, Toshiaki Kawachi, Naoyoshi Takatsuka, Hiroyuki Shimizu Abstract: The Japanese Food Guide Spinning Top was developed by the Japanese Ministry of Health, Labor, and Welfare and the Ministry of Agriculture, Forestry, and Fishery to promote healthful diets. Article History: Accepted 6 March 2009 Article Note: (footnote) Meets Learning Need Codes 1060, 3000, 4000, and 4030. To take the Continuing Professional Education quiz for this article, log in to ADA's Online Business Center at www.eatright.org/obc, click the "Journal Article Quiz" button, click "Additional Journal CPE Articles," and select this article's title from a list of available quizzes.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.06.363 Byline: Ann M. Albertson, Sandra G. Affenito, Robert Bauserman, Norton M. Holschuh, Alison L. Eldridge, Bruce A. Barton Abstract: To examine sex differences and longitudinal changes in ready-to-eat (RTE) cereal and breakfast consumption in the Dietary Intervention Study in Children, and the relationship between RTE cereal intake with nutrient intake, blood lipids, and body mass index (BMI). Article History: Accepted 24 March 2009

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.06.362 Byline: Kendra K. Kattelmann, Kibbe Conti, Cuirong Ren Abstract: The Northern Plains Indians of the Cheyenne River Sioux Tribe have experienced significant lifestyle and dietary changes over the past seven generations that have resulted in increased rates of diabetes and obesity. The objective of this study was to determine if Northern Plains Indians with type 2 diabetes mellitus who are randomized to receive culturally adapted educational lessons based on the Medicine Wheel Model for Nutrition in addition to their usual dietary education will have better control of their type 2 diabetes than a nonintervention, usual care group who received only the usual dietary education from their personal providers. Article History: Accepted 2 March 2009 Article Note: (footnote) Meets Learning Need Codes 1040, 4000, 4010, and 5190. To take the Continuing Professional Education quiz for this article, log in to ADA's Online Business Center at www.eatright.org/obc, click the "Journal Article Quiz" button, click "Additional Journal CPE Articles," and select this article's title from a list of available quizzes.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2009.04.009 Byline: Stephanie Heim, Jamie Stang, Marjorie Ireland Abstract: Fruit and vegetable intake among children is inadequate. Garden-based nutrition education programs may offer a strategy for increasing fruit and vegetable intake in children. A 12-week pilot intervention was designed to promote fruit and vegetable intake among 4th to 6th grade children (n=93) attending a YMCA summer camp. Children participated in garden-based activities twice per week. Weekly educational activities included fruit and vegetable taste tests, preparation of fruit and vegetable snacks, and family newsletters sent home to parents. The pilot intervention was evaluated using a pre and post survey to determine participant satisfaction and the short-term impacts of the program. The process evaluation focused on program satisfaction, whereas the short-term impact evaluation assessed fruit and vegetable exposure, preference, self-efficacy, asking behavior, and availability of fruits and vegetables in the home. Data from the impact evaluation were compared from baseline to follow-up using McNemar's test (dichotomous variables) and Wilcoxon signed rank test (scales/continuous variables). Children reported high levels of enjoyment in the intervention activities. Most children (97.8%) enjoyed taste-testing fruits and vegetables. Children also liked preparing fruit and vegetable snacks (93.4%), working in their garden (95.6%), and learning about fruits and vegetables (91.3%). Impact data suggest that the intervention led to an increase in the number of fruits and vegetables ever eaten (P<0.001), vegetable preferences (P<0.001), and fruit and vegetable asking behavior at home (P<0.002). Garden-based nutrition education programs can increase fruit and vegetable exposure and improve predictors of fruit and vegetable intake through experiential learning activities. Participation in the "seed to table" experience of eating may help promote healthful eating behaviors among youth. Food and nutrition professionals should consider garden-based nutrition education programs that connect children with healthful foods through fun, hands-on activities. Article History: Accepted 19 December 2008

The aim of this study was to test the effect of increasing the personal relevance of stroke symptom information on learning stroke symptoms/emergency response. A randomized pretest--posttest double-blind study design was used. A total of 173 community-dwelling adults participated. Treatment participants read the personally relevant statement, 'Learn about stroke to save someone you love,' completed the Stroke Action Test pretest, read the National Institute of Neurological Disorder and Stroke pamphlet titled Know Stroke. Know the Signs. Act in Time, and responded to the Stroke Action Test posttest. The control condition differed only in the omission of the personally relevant statement. The treatment group learned significantly more than the control group, F(1, 170) = 7.46, p < .007, [[eta].sup.2] = .02. The mean items learned by the treatment group was 8.3 (SD = 5.67) compared to the control group mean of 6.2 (SD = 5.76). Prefacing stroke prevention information with the statement, 'Learn about stroke to save someone you love,' could result in greater learning of stroke symptoms/response. Keywords: cardiovascular; neurology; community; experiment; adults

The Pediatric AIDS Corps (PAC) are a group of physicians that were hired to provide clinical care and treatment to children and their families infected with HIV/AIDS and to help educate local health care professionals in the management of children with HIV/AIDS located in the high prevalence areas of sub-Saharan Africa. Prior to their departure the PAC were required to participate in a 4-week educational training program that included travel and tropical medicine and HIV infections in children, teaching skills, bioethics, and good clinical practice in human research training. Evaluation of the program was done using a 50-question pretest/posttest design, a standard postcourse evaluation, and a PAC focus group follow-up. Fifty-two physicians were hired who had been trained in the following specialties: pediatrics (77%), medicine/pediatrics (9%), family medicine (8%), and internal medicine (6%). Posttest scores improved by a mean of 10 points for all PAC physicians (p < 0.001) but those that had been in Africa for 5 months or more prior to the course continued to score higher than the other participants. Reviewing the results by category demonstrated significant improvement in all areas (p [less than or equal to] 0.002) except for general pediatrics for the HIV/AIDS infected patients (p = 0.124) and psychosocial issues (p = 0.376). Changes for the next training were implemented based upon the information obtained from the PAC focus group. The foundation provided by this educational course was an important beginning for the PAC physicians. Other groups providing specialized care to patients in developing countries might consider a similar educational program.

Systematic reviews of health care education have consistently reported a lack of long-term effects, failure to use theory, and inadequate methodological rigour. Such findings have highlighted the lack of a clear causality and predictability in health care education research and therefore the inadequacy of a traditional scientific framework with its focus on analysis, prediction and control. This article argues that in order to develop an effective and standardised framework we must go beyond such a restrictive agenda and toward one that appreciates education as a complex adaptive system. It uses the example of interprofessional education in the UK to showcase its discussion. Keywords: Complexity theory Interprofessional education Management of chronic illness Health care education Diabetes management UK

The effectiveness of behavioral intervention programs can be assessed by measuring changes in behavior using reliable and valid instruments. To our knowledge, a reliable instrument designed to measure changes in psychosocial determinants of whole-grain intake by children due to an intervention does not exist in the literature. This article describes the development and testing of two questionnaires designed to measure psychosocial determinants of whole-grain intake among children and their parents. The questionnaires were pilot-tested with 39 parent/child pairs from one school and subsequently used in an intervention program with 150 parent/child pairs from two schools. Internal consistencies for the child and parent scales were modest ([alpha]=.41 to .63), with the exception of intention to choose whole-grain foods for children, which was low ([alpha]=.19). Test-retest reliability of the child and parent scales was acceptable (r=0.58 to 0.90). Principal components analysis confirmed three parenting subscales: enabling behaviors, whole grain health benefits, and role modeling. Identification of whole-grain foods remains a substantial barrier to the development of a questionnaire that accurately measures psychosocial determinants related to whole-grain intake. Future work should focus on instrument development and testing on a broader scale. doi: 10.1016/j.jada.2008.01.013

The purpose of this study was to determine whether food consumed by children while in center-based child care meets the new MyPyramid food group recommendations for children 2 to 5 years of age. Dietary observation of 117 children from 20 child-care centers throughout North Carolina was conducted. The type and amount of food served to and consumed by children was observed and assessed using Nutrition Data System for Research (NDS-R) software (version 2005, Nutrition Coordinating Center, University of Minnesota, Minneapolis). Portion sizes were then compared to the new MyPyramid food group recommendations to see whether 1/2 to 2/3 (for time spent in full-day child care) of the recommended amounts were consumed. On average, of the five main food groups, children consumed only the 1/2 to 2/3 recommendation for milk. Children also consumed less than 13% of MyPyramid recommendations for whole grains and 7% of MyPyramid recommendations for dark vegetables. Also noteworthy, 50% of milk consumed was whole milk and 75% of the meat consumed was of the high-fat or fried variety. Overall, our data suggest that children are not consuming recommended amounts of whole grains, fruits (excluding 100% fruit juice), or vegetables while attending full-time child care, and are consuming excess amounts of saturated fat and added sugar. doi: 10.1016/j.jada.2008.01.014