scholarly journals Evaluation of a Technological Image-Based Dietary Assessment Tool for Children during Pubertal Growth: A Pilot Study

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2527 ◽  
Author(s):  
Jiao-Syuan Wang ◽  
Rong-Hong Hsieh ◽  
Yu-Tang Tung ◽  
Yue-Hwa Chen ◽  
Chen Yang ◽  
...  

We designed an image-based dietary assessment tool called COFIT, which means “fit together” and pilot-tested it in the Taipei Puberty Longitudinal Study (TPLS). Children aged 6–17 years were invited to use COFIT over three days for recording all instances of eating in addition to maintaining written food records (FR). Spearman’s correlation and Bland–Altman analysis were used to compare the intake of macronutrients and micronutrients estimated using the image-based dietary assessment and the FR method. Intra-class correlation coefficients were used to estimate reliability between dietitians. In the final analysis, 23 children (mean age: 10.47 ± 0.47 years) with complete data obtained using two dietary assessment methods were included. Reliability among dietitians was high. Most assessments of macronutrients and micronutrients revealed moderate correlations between the two methods (range: 0.27–0.94); moreover, no significant differences in nutrients assessments were observed between the two methods, except for energy and fat. The average difference in energy intake between the methods was 194 kcal/day. Most limits of agreement were within an acceptable range. The Bland–Altman plots showed robust agreement with minimum bias. The limitation was the small sample size and not dividing the population into children and teenagers since the two groups may have different food consumption habits. Overall, the results showed that the image-based assessment tool is suitable for assessing children’s dietary intake of macronutrients and micronutrients during pubertal growth.

2019 ◽  
Vol 33 (1) ◽  
pp. 120-144
Author(s):  
Rebecca Amati ◽  
Tommaso Bellandi ◽  
Amer A. Kaissi ◽  
Annegret F. Hannawa

Purpose Identifying the factors that contribute or hinder the provision of good quality care within healthcare institutions, from the managers’ perspective, is important for the success of quality improvement initiatives. The purpose of this paper is to test the Integrative Quality Care Assessment Tool (INQUAT) that was previously developed with a sample of healthcare managers in the USA. Design/methodology/approach Written narratives of 69 good and poor quality care episodes were collected from 37 managers in Italy. A quantitative content analysis was conducted using the INQUAT coding scheme, to compare the results of the US-based study to the new Italian sample. Findings The core frame of the INQUAT was replicated and the meta-categories showed similar distributions compared to the US data. Structure (i.e. organizational, staff and facility resources) covered 8 percent of all the coded units related to quality aspects; context (i.e. clinical factors and patient factors) 10 percent; process (i.e. communication, professional diligence, timeliness, errors and continuity of care) 49 percent; and outcome (i.e. process- and short-term outcomes) 32 percent. However, compared to the US results, Italian managers attributed more importance to different categories’ subcomponents, possibly due to the specificity of each sample. For example, professional diligence, errors and continuity of care acquired more weight, to the detriment of communication. Furthermore, the data showed that process subcomponents were associated to perceived quality more than outcomes. Research limitations/implications The major limitation of this investigation was the small sample size. Further studies are needed to test the reliability and validity of the INQUAT. Originality/value The INQUAT is proposed as a tool to systematically conduct in depth analyses of successful and unsuccessful healthcare events, allowing to better understand the factors that contribute to good quality and to identify specific areas that may need to be targeted in quality improvement initiatives.


2019 ◽  
Vol 26 (5) ◽  
pp. 1-8
Author(s):  
Gyu-wan Lee ◽  
Chung-hwi Yi ◽  
Gyoung-mo Kim ◽  
Young-jung Lee ◽  
Jang-whon Yoon

Background and aim The Work Osteoarthritis or joint-Replacement Questionnaire (WORQ) is a new assessment tool developed in the Netherlands. It needs translation and cross-cultural adaptation for use in each country. The aim of this study was to translate the Work Osteoarthritis or joint-Replacement Questionnaire into Korean and to verify its reliability and validity. Methods To evaluate the clinimetric quality of the Korean-WORQ, we performed tests for internal consistency (Cronbach's alpha), reliability (intra-class correlation coefficients) and concurrent validity (Spearman's correlation coefficient). Factor analysis was carried out to identify the principal components of the questionnaire. Findings Both the internal consistency and intra-class correlation coefficients showed the reliability of the Korean-WORQ to be excellent. The Korean-WORQ had a strong positive correlation with the Western Ontario and McMaster Universities Osteoarthritis Index and three components were extracted in factor analysis. Conclusions Based on these results, the Korean-WORQ seems to be a suitable questionnaire for assessing the disability levels of patients with knee injuries.


2009 ◽  
Vol 102 (S1) ◽  
pp. S10-S37 ◽  
Author(s):  
Patricia Henríquez-Sánchez ◽  
Almudena Sánchez-Villegas ◽  
Jorge Doreste-Alonso ◽  
Adriana Ortiz-Andrellucchi ◽  
Karina Pfrimer ◽  
...  

The EURRECA Network of Excellence is working towards the development of aligned micronutrient recommendations across Europe. The purpose of the present study was to define how to identify dietary intake validation studies in adults pertaining to vitamins. After establishing a search strategy, we conducted a MEDLINE and EMBASE literature review. A scoring system was developed to rate the quality of each validation study according to sample size, statistical methods, data collection procedure, seasonality and vitamin supplement use. This produced a quality index with possible scores obtained ranging from 0·5 to 7. Five thousand four-hundred and seventy-six papers were identified. The numbers meeting the inclusion criteria were: for vitamin A, 76; vitamin C, 108; vitamin D, 21; vitamin E, 75; folic acid, 47; vitamin B12, 19; vitamin B6, 21; thiamine, 49; riboflavin, 49; and niacin, 32. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24-h recalls were the most used reference methods. The correlation coefficients (CC) between vitamin intakes estimated by FFQ and the reference method were weighted according to the study's quality index and ranged from 0·41 to 0·53 when the reference method was the DR and from 0·43 to 0·67 when the reference was 24-h recalls. A minority of studies (n33) used biomarkers for validation and in these the CC ranged from 0·26 to 0·38. The FFQ is an acceptable method of assessing vitamin intake. The present review provides new insights regarding the characteristics that assessment methods for dietary intake should fulfil.


2021 ◽  
Vol 13 ◽  
Author(s):  
Jakob Norgren ◽  
Makrina Daniilidou ◽  
Ingemar Kåreholt ◽  
Shireen Sindi ◽  
Ulrika Akenine ◽  
...  

Background: β-hydroxybutyrate (BHB) can upregulate brain-derived neurotrophic factor (BDNF) in mice, but little is known about the associations between BHB and BDNF in humans. The primary aim here was to investigate whether ketosis (i.e., raised BHB levels), induced by a ketogenic supplement, influences serum levels of mature BDNF (mBDNF) and its precursor proBDNF in healthy older adults. A secondary aim was to determine the intra-individual stability (repeatability) of those biomarkers, measured as intra-class correlation coefficients (ICC).Method: Three of the arms in a 6-arm randomized cross-over trial were used for the current sub-study. Fifteen healthy volunteers, 65–75 y, 53% women, were tested once a week. Test oils, mixed in coffee and cream, were ingested after a 12-h fast. Labeled by their level of ketosis, the arms provided: sunflower oil (lowK); coconut oil (midK); caprylic acid + coconut oil (highK). Repeated blood samples were collected for 4 h after ingestion. Serum BDNF levels were analyzed for changes from baseline to 1, 2 and 4 h to compare the arms. Individual associations between BHB and BDNF were analyzed cross-sectionally and for a delayed response (changes in BHB 0–2 h to changes in BDNF at 0–4 h). ICC estimates were calculated from baseline levels from the three study days.Results: proBDNF increased more in highK vs. lowK between 0 and 4 h (z-score: β = 0.25, 95% CI 0.07–0.44; p = 0.007). Individual change in BHB 0–2 h, predicted change in proBDNF 0–4 h, (β = 0.40, CI 0.12–0.67; p = 0.006). Change in mBDNF was lower in highK vs. lowK at 0–2 h (β = −0.88, CI −1.37 to −0.40; p < 0.001) and cumulatively 0–4 h (β = −1.01, CI −1.75 to −0.27; p = 0.01), but this could not be predicted by BHB levels. ICC was 0.96 (95% CI 0.92–0.99) for proBDNF, and 0.72 (CI 0.47–0.89) for mBDNF.Conclusions: The findings support a link between changes in peripheral BHB and proBDNF in healthy older adults. For mBDNF, changes differed between arms but independent to BHB levels. Replication is warranted due to the small sample. Excellent repeatability encourages future investigations on proBDNF as a predictor of brain health.Clinical Trial Registration:ClinicalTrials.gov, NCT03904433.


2009 ◽  
Vol 7 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Su-I Hou

Purpose: Reliable tools on measuring outcomes of service-learning (SL) are scarce. This study aimed to develop and test a service-learning assessment tool to measure students’ perceived self-efficacy on program planning related competencies (SL-SEPP) and an overall SL impact scale. Methods: Students in a core Master of Public Health (MPH) course on program planning participated in the study (n=44). Course-based SL projects were incorporated into the learning process. Data from the baseline survey were used to assess the reliability of the 12-item SL-SEPP, and data from the posttest survey were used to assess the 5-item overall SL impact scale at the end of the course. Results: Data showed satisfactory reliability scores, with Cronbach alpha of .87 for the SL-SEPP and .84 for the overall impact scale. Even with this relatively small sample size, preliminary analyses showed that the SL-SEPP was sensitive to detect meaningful changes of self-efficacy scores after the course. Conclusion: This study provides needed pilot data supporting the reliabilities of the SL-SEPP tool. The study has implications for researchers and educators to apply or adapt this tool to assess student self-efficacy outcomes on program planning competencies.


2021 ◽  
Author(s):  
Clare Whitton ◽  
Janelle D Healy ◽  
Clare E Collins ◽  
Barbara Mullan ◽  
Megan E Rollo ◽  
...  

BACKGROUND The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. OBJECTIVE The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. METHODS Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. RESULTS Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. CONCLUSIONS This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s INTERNATIONAL REGISTERED REPORT DERR1-10.2196/32891


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6579-6579
Author(s):  
B. S. Mann ◽  
J. R. Johnson ◽  
K. He ◽  
R. Sridhara ◽  
A. T. Farrell ◽  
...  

6579 Background: In Oct 2006, FDA approved vorinostat for treatment of cutaneous manifestations of CTCL–based on response rate and duration of response observed in CTCL skin lesions. Response was determined by change in SWAT score at follow up compared to the baseline score. SWAT Score: sum of % Body Surface Area weighted by factor 1, 2, or 4 for patch (no elevation from normal skin), plaque (< 5 mm elevation) and tumor (= 5 mm elevation), respectively. All responses but one were partial. A partial response required = 50% reduction in whole body SWAT score lasting = 4 weeks. FDA also reviewed serial photographs of all patients (standard whole body views and close-ups of skin lesions), submitted as supportive evidence. Methods: An expert external reviewer, blind to SWAT scores, adjudicated responses by examining photographs and response determinations by photographs and by SWAT scores were compared. Results: Based on SWAT scores, skin lesions in 18 of 61 stage = IIB CTCL patients responded to vorinostat; there were 17 partial and 1 complete responses. Blinded reviewer adjudicated 4 photographs not evaluable (reasons: blurred image, color or light problem, wrong label), easily confirmed 7 responses, and called 7 responses equivocal. Responses seemed easier to determine in skin lesions with tumors or ulcers. Predominantly patch or plaque lesions were harder to evaluate: patches due to poor color reproduction and plaques due to inability to palpate. A response from plaque to patch morphology decreases SWAT score 50%, but the change may not manifest adequately in a photograph. Small sample size did not allow a reliable statistical analysis for correlation between different lesion types and ability to confirm objective responses (based on SWAT scores) by photography. Conclusions: Photography allows a limited evaluation of skin lesions in CTCL: inability to measure lesion thickness in photographs limits direct confirmation of SWAT scores. Photography complements SWAT evaluation: in half the cases in the vorinostat pivotal trial, a response by SWAT score was easily confirmed by the reviewer blind to SWAT scores. Further experience and technological advances in photography may reduce the number of not evaluable photographs. No significant financial relationships to disclose.


Author(s):  
Stefanie A. J. Koch ◽  
Johanna Conrad ◽  
Janet E. Cade ◽  
Leonie Weinhold ◽  
Ute Alexy ◽  
...  

Abstract Purpose We aimed to validate myfood24-Germany, a web-based 24-h dietary recall (24HDR), by comparing its performance with a weighed dietary record (WDR) and biomarkers. Methods 97 adults (77% female) completed a 3-day WDR with a 24-h urine collection on day 3, followed by at least one 24HDR with myfood24-Germany (corresponding to day 3 of the WDR). Intake of energy and 32 nutrients assessed by myfood24-Germany and the WDR for the same day were compared (method comparison). Intakes of protein and potassium assessed by myfood24-Germany/WDR were compared with intake estimated from urinary biomarkers for protein and potassium (biomarker comparison). Results In the method comparison, significant correlations were found for energy and all tested nutrients (range 0.45–0.87). There was no significant difference between both methods in the assessed mean energy and macronutrient intake. However, myfood24-Germany underestimated mean intake of 15 nutrients. In the biomarker comparison, protein intake reported by myfood24-Germany/WDR was on average 10%/8% lower than estimated by biomarker. There was no significant difference in mean potassium intake assessed by myfood24-Germany/WDR and biomarker. However, a shared bias in the assessment of potassium intake was observed for both instruments. Concordance correlation coefficients (pc) and weighted Kappa coefficients (κ) confirmed good agreement with the biomarker estimates for myfood24-Germany/WDR in case of protein (pc = 0.58/0.66, κ = 0.51/0.53) and moderate agreement in case of potassium (pc = 0.44/0.51; κ = 0.30/0.33). Conclusion Our results suggest that myfood24-Germany is of comparable validity to traditional dietary assessment methods.


2020 ◽  
Vol 41 (S1) ◽  
pp. s445-s446
Author(s):  
Megan DiGiorgio ◽  
Lori Moore ◽  
Greg Robbins ◽  
Albert Parker ◽  
James Arbogast

Background: Hand hygiene (HH) has long been a focus in the prevention of healthcare-associated infections. The limitations of direct observation, including small sample size (often 20–100 observations per month) and the Hawthorne effect, have cast doubt on the accuracy of reported compliance rates. As a result, hospitals are exploring the use of automated HH monitoring systems (AHHMS) to overcome the limitations of direct observation and to provide a more robust and realistic estimation of HH behaviors. Methods: Data analyzed in this study were captured utilizing a group-based AHHMS installed in a number of North American hospitals. Emergency departments, overflow units, and units with <1 year of data were excluded from the study. The final analysis included data from 58 inpatient units in 10 hospitals. Alcohol-based hand rub and soap dispenses HH events (HHEs) and room entries and exits (HH opportunities (HHOs) were used to calculate unit-level compliance rates. Statistical analysis was performed on the annual number of dispenses and opportunities using a mixed effects Poisson regression with random effects for facility, unit, and year, and fixed effects for unit type. Interactions were not included in the model based on interaction plots and significance tests. Poisson assumptions were verified with Pearson residual plots. Results: Over the study period, 222.7 million HHOs and 99 million HHEs were captured in the data set. There were an average of 18.7 beds per unit. The average number of HHOs per unit per day was 3,528, and the average number of HHEs per unit per day was 1,572. The overall median compliance rate was 35.2 (95% CI, 31.5%–39.3%). Unit-to-unit comparisons revealed some significant differences: compliance rates for medical-surgical units were 12.6% higher than for intensive care units (P < .0001). Conclusions: This is the largest HH data set ever reported. The results illustrate the magnitude of HHOs captured (3,528 per unit per day) by an AHHMS compared to that possible through direct observation. It has been previously suggested that direct observation samples between 0.5% to 1.7% of all HHOs. In healthcare, it is unprecedented for a patient safety activity that occurs as frequently as HH to not be accurately monitored and reported, especially with HH compliance as low as it is in this multiyear, multicenter study. Furthermore, hospitals relying on direct observation alone are likely insufficiently allocating and deploying valuable resources for improvement efforts based on the scant information obtained. AHHMSs have the potential to introduce a new era in HH improvement.Funding: GOJO Industries, Inc., provided support for this study.Disclosures: Lori D. Moore and James W. Arbogast report salary from GOJO.


2009 ◽  
Vol 102 (S1) ◽  
pp. S118-S149 ◽  
Author(s):  
Adriana Ortiz-Andrellucchi ◽  
Almudena Sánchez-Villegas ◽  
Jorge Doreste-Alonso ◽  
Jeanne de Vries ◽  
Lisette de Groot ◽  
...  

The European micronutrient recommendations aligned (EURRECA) Network of Excellence seeks to establish clear guidelines for assessing the validity of reported micronutrient intakes among vulnerable population groups. A systematic literature review identified studies validating the methodology used in elderly people for measuring usual dietary micronutrient intake. The quality of each validation study selected was assessed using a EURRECA-developed scoring system. The validation studies were categorised according to whether the reference method applied reflected short-term intake ( < 7 d), long-term intake ( ≥ 7 d) or used biomarkers (BM). A correlation coefficient for each micronutrient was calculated from the mean of the correlation coefficients from each study weighted by the quality of the study. Thirty-three papers were selected, which included the validation of twenty-five different FFQ, six diet histories (DH), one 24-h recall (24HR) and a videotaped dietary assessment method. A total of five publications analysed BM, which were used to validate four FFQ, and one 24HR, presenting very good correlations only for vitamin E. The analysis of weighted correlation coefficients classified by FFQ or DH showed that most of the micronutrients had higher correlations when the DH was used as the dietary method. Comparing only FFQ results showed very good correlations for measuring short-term intakes of riboflavin and thiamin and long-term intakes of P and Mg. When frequency methods are used for assessing micronutrient intake, the inclusion of dietary supplements improves their reliability for most micronutrients.


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