Purpose: Children with inflammatory bowel disease (IBD) frequently undergo clinical assessments, involving triadic communication between clinician, parent, and child. During such encounters parents are traditionally the main communicator of information on their child's IBD, including subjective symptom reports. The level of agreement between children and their parents for IBD symptoms is poorly understood, and this study aimed to examine this factor. Methods: This was a cross-sectional study among children with IBD, and one parent. A validated paediatric IBD symptom report tool (IBDnow) enabled children and their parent to rate seven pain, well-being, and stool metrics, with dyads completing the tool concurrently. Results were assessed using: Individual agreement: proportion of identical symptom reports by each dyad (ideal score >0.7); Category agreement: percentage of identical reports for IBDnow metrics for the cohort; Inter-rater reliability: Gwet's AC1 coefficient with higher scores indicating better reliability (maximum=1). Results: Seventy-four parent/child dyads participated; child's mean age 12.2 years (standard deviation [SD] 2.9, range 6-16), mean time since diagnosis 2.8 years (SD 3), 54% female, 73% had Crohn's Disease. Mean individual agreement level was 0.6, with 27% of dyads agreeing on ≥6/7 IBDnow metrics. Category agreement was reported by 61% of dyads, 20% of parents overestimated, and 19% underestimated, their child's symptoms. Inter-rater reliability ranged from fair to good. Conclusion: These results should improve clinician awareness of how IBD symptom reports from parents may introduce bias. Children should be considered the most important source of symptom reports, and tools such as IBDnow utilised to enhance communication.
This study examined food safety management at preschool establishments in Daegu and Gyeongbuk province, to provide data that can be used for food safety improvements. Field assessments of 60 foodservice establishments were executed from July to October, 2007. Statistical analyses of the data were conducted using the SPSS package program (version 14.0 for windows). The results are summarized as follows: 93.3% of the preschool foodservices were self-operated, and 24.1% of the child care centers and 96.7% of the kindergartens had employed dietitians. According to the averaged food safety evaluation scores the kindergartens (80.73) had a significantly higher score than the child care centers (50.37), and the public centers (85.00) had a significantly higher score than the private centers (54.29). While the average score of facilities that employed dietitian (73.58) was significantly higher than that of facilities that did not employ a dietitian (52.65). In addition, the average score of facilities that served meals in a dining room (80.83) was significantly higher than that of facilities that served meals in a classroom (59.33). The highest scoring food safety items included verifying employee health inspection reports (1.87), utilizing non-municipal water and routinely cleaning and well-maintaining the water storage tank (1.85), and disposing small amounts of leftovers in a vat after serving (1.83). In contrast, the lowest scores were for physical separation of clean areas and unclean areas to prevent cross-contamination (0.52), and physical separation between staff and food material entry areas (0.62). In conclusion, the preschool foodservice evaluated in this study required improvements in food safety management, and many of the child care centers were in need of immediate attention. To improve food safety at these establishments, administrators should implement prerequisite food safety programs.
This study was conducted to evaluate nutritional status of Korean women of child-bearing age. A comparison was made between 113 non-pregnant and 200 pregnant women. Pregnant women of 24-28 weeks of gestation were recruited from prenatal clinic in Seoul. Nonpregnant women were included college students, nurses, office employers, and sales women. General characteristics, anthropometric measurements, dietary intakes, and hematological values were assessed. There was no difference in mean BMI for nonpregnant and pregnant (pre-gravid) women, which were 20.2 kg/m$^2$and 20.6 kg/m$^2$respectively. The pregnant women showed a tendency of better health-caring behavior, evidenced by stop smoking and drinking, and in taking nutrient supplements. The mean intakes of energy, vitamin A, vitamin B$_2$, calcium, and iron did not meet Korean RDA for adult women. In particular, calcium and iron intakes of both nonpregnant and pregnant women were under 60% of the Korean RDA. Judging by MDA score, dietary quality was better in pregnant than in nonpregnant women. Mean serum values of albumin, total cholesterol, LDL-cholesterol, HDL-cholesterol, Hb, IgA, IgG were in normal range. However, more than 13% of the nonpregnant subjects showed mild hypercholesterolemia (cholesterol > 200 mg/dl) and anemia (Hb < 12.0 g/dl) . The percentage of anemia in pregnant women were much higher; the subject with Hb < 11.0 g/dl were approximately 30%. The pregnant subjects showed significantly higher serum concentrations of triglycerides and cholesterol, and significantly lower concentrations of albumin, IgA, and IgG compared to nonpregnant women. Correlation analysis showed that Hb concentrations were correlated with the intakes of iron- and protein- containing foods such as meat and vegetables. This study strongly suggest that iron-deficient anemia is a major nutrition problem in Korean child-bearing women and this condition is correlated with dietary intakes.
This study analyzed results of the rounding guidance by applying the nutrition management check list at of the Center for Children's Foodservice Management (CCFM). Totally, 271 foodservices for children (65 institutional foodservices, 53 small scale foodservices, 153 family child care homes) were examined to identify the necessity of implementing a nutrition management strategy, and subsequently creating a priority list for nutrition management improvement measures. Of the 13 items examined in the nutrition management check list for children's foodservices from the Ministry of Food and Drug Safety, 8 performed well, with an overall performance rate of 90% or more. Improvement plans were required for items (all belonging to the menu area) such as 'Post menu on noticeboard at children's foodservice' (62.0%), 'Use the menu planned by dietician' (64.9%), 'Use menu suitable for recipients in children's foodservice' (76.8%), and 'Provide menu to parents' (79.0%)'. In the analysis of service size, the performance rate for 'Use menu suitable for recipients in children's foodservice' revealed a substantially lower result (P<0.01) for institutional foodservices (64.6%), as compared to small scale foodservices (71.7%) and family child care homes (83.7%). Since other check list items, did not show much differences by the service size, we ascertained it pointless to establish separate strategies based on different foodservice sizes.
Hyeji Yoon;Hyoung su Park;Xiangxue An;Seok Jun Park;Gwang Woong Go;Hyunjung Kim;Hyesoon Lee;Mee Na Kim;Yoo Kyoung Park
Clinical Nutrition Research
/
v.11
no.1
/
pp.20-31
/
2022
Through a survey on dietary intake of children and adolescents with brain lesions, the present study aimed to analyze the current status of nutrient intake and examine the effect of high-protein nutrient drink on their nutritional and muscle statuses. The study participants were 90 juvenile participants aged 8-19 years, with brain lesions. The participants were provided with a protein nutrient drink for 12 weeks and a questionnaire survey on dietary intake was performed to analyze the level of nutrient intake before and after ingestion. The physical measurements were taken to determine the improvements in nutrient and muscle statuses. The results showed that, before the intake of protein nutrient drink as a supplement, the participants exhibited lower height, weight, and body mass index than those of the standard levels of healthy individuals, and the level of nutrient intake through diet was lower than those of the required and recommended levels of nutrient intake for Koreans. Conversely, after the intake of protein nutrient drink for 12 weeks, the level of nutrient intake and physical statuses such as weight showed significant improvements. In addition, the muscle status had undergone approximately 10% of change during the intervention with no significant difference. Thus, to ensure an adequate level of nutrient supply to children and adolescents with brain lesions, there is an urgent need to develop a guideline of nutrient intake. The findings in this study are expected to serve as the basic data for such guidelines.
A large sample (1090) of randomly selected early childhood education professionals and government officials rated each of the 133 standards of "A Model for Institutional Accreditation for Early Childhood Education and Care"(Yang, 1999) on a scale of 1 (least important) to 5 (most important). Findings were that all kindergartens and child care centers should be evaluated for accreditation every 3 years with 3-6 months for self-study and on-site validation visits by representatives of the appropritates agencies for 1-2 days. Evaluation results are should be used by institution personnel as a guide to self-supervision, by government officials as a funding standard and by parents as criteria of program quality. Essential accreditation standards included: facilities and equipment; curriculum; nutrition, health and safety; administration and management; and support systems. Safety and teacher-child interactions were most highly rated while parent involvement was not highly rated.
Purpose: This study was done to identify perceived body image, intentional caloric restriction and physical manifestations of unbalanced nutrition according to the Body Mass Index (BMI) in elementary school students. Methods: The research design was a cross-sectional descriptive study. Data collection was done by using a structured questionnaire that consisted of 34 items. Participants were 151 students in 5th and 6th grades of elementary schools in Gangwon province. Frequency and percentage, one-way ANOVA, and $\chi^2$-test with SPSS WIN 12.0 were used to analyze the data. Results: In elementary school students, over-weight/obesity and normal weight groups reported that they would be satisfied with a thinner body image compared to the present image. The score for intentional caloric restriction was significantly higher in the over-weight/obesity group than in the under-weight group. In physical manifestations of unbalanced nutrition, students in the under-weight group frequently were pale and had dry skin, whereas the over-weight/obesity group reported frequent upper respiratory symptoms. Conclusion: The results suggest that elementary school students need to develop the perception of an adequate body image and to avoid inadequate caloric intake if promotion of the child's growth and development is to be without physical manifestations of unbalanced nutrition.
We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.
Purpose: Considering the various health benefits of vegetables, it is necessary to identify maternal correlates of vegetable preference and consumption in children for shaping desirable vegetable-related eating habits. This study aimed to investigate the maternal factors related to vegetable preferences and consumption in preschool-aged children. Methods: This is a cross-sectional study that surveyed 303 mother-child pairs (146 boys, 157 girls) to explore general characteristics, vegetable preferences, and cooked vegetable consumption in mothers and children using a questionnaire method. Maternal correlates of the child's vegetable preference and consumption were tested using a generalized linear model using SAS program. Results: Mothers' vegetable preferences and consumption were significantly higher than those in their children (p < 0.001). Mothers' vegetable preferences showed a significant positive correlation with the vegetable preferences of their children (mother-son, p < 0.001; mother-daughter, p < 0.001). Additionally, mothers' cooked vegetable consumption showed a significant positive correlation with the cooked vegetable consumption of children (mother-son, p < 0.001; mother-daughter, p < 0.001). Mothers' vegetable preferences and consumption respectively increased those of their children, in both boys and girls. Conclusion: Findings that mothers' vegetable preference and consumption correlates of children's vegetable preferences and consumption, indicate the importance of the mothers' role in increasing vegetable consumption in children. Mothers should be aware of the effects of their vegetable eating habits on their children's vegetable consumption and try to develop healthy eating habits. We suggest that the government or local communities provide nutrition education for mothers to adopt healthy eating habits and present information to educate their children on food and healthy dietary habits.
Adequate nutrition in early life is proposed to shape a child's future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.
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