Effects of portion size on chronic energy intake

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Incidence of Syndromes Associated With Frontotemporal Lobar Degeneration in 9 European Countries

Importance Diagnostic incidence data for syndromes associated with frontotemporal lobar degeneration (FTLD) in multinational studies are urgent in light of upcoming therapeutic approaches.Objective To assess the incidence of FTLD across Europe.Design, Setting, and Participants The Frontotemporal Dementia Incidence European Research Study (FRONTIERS) was a retrospective cohort study conducted from June 1, 2018, to May 31, 2019, using a population-based registry from 13 tertiary FTLD research clinics from the UK, the Netherlands, Finland, Sweden, Spain, Bulgaria, Serbia, Germany, and Italy and including all new FTLD-associated cases during the study period, with a combined catchment population of 11 023 643 person-years. Included patients fulfilled criteria for the behavioral variant of frontotemporal dementia (BVFTD), the nonfluent variant or semantic variant of primary progressive aphasia (PPA), unspecified PPA, progressive supranuclear palsy, corticobasal syndrome, or frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS). Data were analyzed from July 19 to December 7, 2021.Main Outcomes and Measures Random-intercept Poisson models were used to obtain estimates of the European FTLD incidence rate accounting for geographic heterogeneity.Results Based on 267 identified cases (mean [SD] patient age, 66.70 [9.02] years; 156 males [58.43%]), the estimated annual incidence rate for FTLD in Europe was 2.36 cases per 100 000 person-years (95% CI, 1.59-3.51 cases per 100 000 person-years). There was a progressive increase in FTLD incidence across age, reaching its peak at the age of 71 years, with 13.09 cases per 100 000 person-years (95% CI, 8.46-18.93 cases per 100 000 person-years) among men and 7.88 cases per 100 000 person-years (95% CI, 5.39-11.60 cases per 100 000 person-years) among women. Overall, the incidence was higher among men (2.84 cases per 100 000 person-years; 95% CI, 1.88-4.27 cases per 100 000 person-years) than among women (1.91 cases per 100 000 person-years; 95% CI, 1.26-2.91 cases per 100 000 person-years). BVFTD was the most common phenotype (107 cases [40.07%]), followed by PPA (76 [28.46%]) and extrapyramidal phenotypes (69 [25.84%]). FTD-ALS was the rarest phenotype (15 cases [5.62%]). A total of 95 patients with FTLD (35.58%) had a family history of dementia. The estimated number of new FTLD cases per year in Europe was 12 057.Conclusions and Relevance The findings suggest that FTLD-associated syndromes are more common than previously recognized, and diagnosis should be considered at any age. Improved knowledge of FTLD incidence may contribute to appropriate health and social care planning and in the design of future clinical trials.Peer reviewe

Predictors of Care Home Admission and Survival Rate in Patients With Syndromes Associated With Frontotemporal Lobar Degeneration in Europe

Background and Objectives Data on care home admission and survival rates of patients with syndromes associated with frontotemporal lobar degeneration (FTLD) are limited. However, their estimation is essential to plan trials and assess the efficacy of intervention. Population-based registers provide unique samples for this estimate. The aim of this study was to assess care home admission rate, survival rate, and their predictors in incident patients with FTLD-associated syndromes from the European FRONTIERS register-based study. Methods We conducted a prospective longitudinal multinational observational registry study, considering incident patients with FTLD-associated syndromes diagnosed between June 1, 2018, and May 31, 2019, and followed for up to 5 years till May 31, 2023. We enrolled patients fulfilling diagnosis of the behavioral variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), progressive supranuclear palsy (PSP) or corticobasal syndrome (CBS), and FTD with motor neuron disease (FTD-MND). Kaplan-Meier analysis and Cox multivariable regression models were used to assess care home admission and survival rates. The survival probability score (SPS) was computed based on independent predictors of survivorship. Results A total of 266 incident patients with FTLD were included (mean age ± SD = 66.7 ± 9.0; female = 41.4%). The median care home admission rate was 97 months (95% CIs 86–98) from disease onset and 57 months (95% CIs 56–58) from diagnosis. The median survival was 90 months (95% CIs 77–97) from disease onset and 49 months (95% CIs 44–58) from diagnosis. Survival from diagnosis was shorter in FTD-MND (hazard ratio [HR] 4.59, 95% CIs 2.49–8.76, p &lt; 0.001) and PSP/CBS (HR 1.56, 95% CIs 1.01–2.42, p = 0.044) compared with bvFTD; no differences between PPA and bvFTD were found. The SPS proved high accuracy in predicting 1-year survival probability (area under the receiver operating characteristic curve = 0.789, 95% CIs 0.69–0.87), when defined by age, European area of residency, extrapyramidal symptoms, and MND at diagnosis. Discussion In FTLD-associated syndromes, survival rates differ according to clinical features and geography. The SPS was able to predict prognosis at individual patient level with an accuracy of;80% and may help to improve patient stratification in clinical trials. Future confirmatory studies considering different populations are needed.</p

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

Introduction - Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective - To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods - A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results - Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions - The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments

Parental control and overconsumption of snack foods in overweight and obese children

The associations between snack food consumption, parent feeding practices and general parenting in overweight in obese children are largely unknown. Therefore, we examined these relationships in 117 treatment-seeking overweight and obese children (10.40 ± 1.35 years; 53% female; 52% Caucasian; BMI-z: 2.06 ± 0.39). Children consumed a dinner meal, completed an Eating in the Absence of Hunger (EAH) free access paradigm (total EAH intake=EAH%-total; sweet food intake=EAH%-sweet), and completed the Child Report of Parent Behavior Inventory. Parents completed the Child Feeding Questionnaire. Child EAH%-total and EAH%-sweet were positively associated with dinner consumption (p’s<.01). Girls had significantly higher EAH%-total compared to boys (p<.05). In separate models, higher EAH%-total was associated with greater use of maternal psychological control (p<.05) and EAH%-sweet was positively associated with parent monitoring (p<.05). In analyses examining factors associated with the consumption of specific foods, EAH snack food, parent restriction, pressure to eat, monitoring, and maternal psychological control were positively correlated with intake of Hershey’s® chocolate bars (p’s<.05). In summary, parental monitoring is associated with child sweet snack food intake and maternal psychological control is associated with child total snack food consumption. Future research should evaluate the complex relationship between child eating and parenting, especially with regard to subgroups of foods

Nurses' experiences of caring for persons with behavioral and psychological symptoms in dementia disease (BPSD) : A qualitative literature review

Bakgrund: Demenssjukdom är en av världens största utmaningar för folkhälsan med en prevalens på 55 miljoner diagnostiserade fall. Någon gång under sjukdomsperioden drabbas  nio av tio personer med demenssjukdom av beteendemässiga och psykiska symtom så som aggitation, aggression, apati, hallucinationer, ångest eller depression relaterade till smärta, infektion, miljö, över-eller understimulering eller att inte bli förstådda. Syfte: Beskriva sjuksköterskors erfarenheter av omvårdnad för personer med beteendemässiga och psykiska symtom vid demenssjukdom (BPSD) på vårdboende.  Metod: En kvalitativ litteraturöversikt med induktiv ansats. Artikelsökningar gjordes i CINAHL, MEDLINE och PsycInfo där slutligen 14 artiklar kvalitetsgranskades och analyserades enligt Fribergs beskrivning av analys i fyra steg. Resultat: Analys av materialet ledde fram till tre teman med totalt sju subteman. Första temat var Miljön på vårdboende med tre subteman: Att beskriva organisatoriska utmaningar, Att beskriva sjuksköterskors positiva känslor, Att beskriva den fysiska miljönspåverkan. Andra temat var Kompetens för god omvårdnad med två subteman: Att beskriva erfarenhet och kunskap, Att beskriva behov av utbildning. Sista temat var Relationer med två subteman: Att lära känna personen, Att beskriva samspelet med närstående.  Slutsatser: Litteraturöversikten visar att sjuksköterskor behöver tid och kunskap för att utföra personcentrerad vård för att minimera BPSD för personer på vårdboende. Background: Dementia disease is one of the world's greatest public health challanges with a prevalence of 55 million diagnosed cases. At some point during the illness, nine out of ten persons with dementia disease experience behavioral and psychological symptoms such as agitation, aggression, apathy, hallucinations, anxiety or depression related to pain, infection, environment, over- or understimulation or not being understood. Aim: Describe nurses' experiences of caring for persons with behavioral and psychological symptoms in dementia disease (BPSD) in nursing homes.  Method: A qualitative literature review with an inductive approach. Artical searches were done in CINAHL, MEDLINE and PsycInfo where finally 14 articles were quality checked and analyzed according to Friberg's description of analysis in four steps.  Results: Analysis of the material led to three themes with a total of seven subthemes. The first theme was The enviroment in nursing homes with three subthemes: To describe organizational challenges, To describe nurses positive experiences, To describe the impact of the physical enviroment. The second theme was Competence for good caring with two subthemes: To describe experience and knowledge, To describe the need for education. The last theme was Relationships with two subthemes: Getting to know the person, To describe interaction with relatives.  Conclusions: The literature review shows that nurses need time and knowledge to perform personcentred-care to minimize BPSD for persons in nursing homes.

Nurses' experiences of caring for persons with behavioral and psychological symptoms in dementia disease (BPSD) : A qualitative literature review

Bakgrund: Demenssjukdom är en av världens största utmaningar för folkhälsan med en prevalens på 55 miljoner diagnostiserade fall. Någon gång under sjukdomsperioden drabbas  nio av tio personer med demenssjukdom av beteendemässiga och psykiska symtom så som aggitation, aggression, apati, hallucinationer, ångest eller depression relaterade till smärta, infektion, miljö, över-eller understimulering eller att inte bli förstådda. Syfte: Beskriva sjuksköterskors erfarenheter av omvårdnad för personer med beteendemässiga och psykiska symtom vid demenssjukdom (BPSD) på vårdboende.  Metod: En kvalitativ litteraturöversikt med induktiv ansats. Artikelsökningar gjordes i CINAHL, MEDLINE och PsycInfo där slutligen 14 artiklar kvalitetsgranskades och analyserades enligt Fribergs beskrivning av analys i fyra steg. Resultat: Analys av materialet ledde fram till tre teman med totalt sju subteman. Första temat var Miljön på vårdboende med tre subteman: Att beskriva organisatoriska utmaningar, Att beskriva sjuksköterskors positiva känslor, Att beskriva den fysiska miljönspåverkan. Andra temat var Kompetens för god omvårdnad med två subteman: Att beskriva erfarenhet och kunskap, Att beskriva behov av utbildning. Sista temat var Relationer med två subteman: Att lära känna personen, Att beskriva samspelet med närstående.  Slutsatser: Litteraturöversikten visar att sjuksköterskor behöver tid och kunskap för att utföra personcentrerad vård för att minimera BPSD för personer på vårdboende. Background: Dementia disease is one of the world's greatest public health challanges with a prevalence of 55 million diagnosed cases. At some point during the illness, nine out of ten persons with dementia disease experience behavioral and psychological symptoms such as agitation, aggression, apathy, hallucinations, anxiety or depression related to pain, infection, environment, over- or understimulation or not being understood. Aim: Describe nurses' experiences of caring for persons with behavioral and psychological symptoms in dementia disease (BPSD) in nursing homes.  Method: A qualitative literature review with an inductive approach. Artical searches were done in CINAHL, MEDLINE and PsycInfo where finally 14 articles were quality checked and analyzed according to Friberg's description of analysis in four steps.  Results: Analysis of the material led to three themes with a total of seven subthemes. The first theme was The enviroment in nursing homes with three subthemes: To describe organizational challenges, To describe nurses positive experiences, To describe the impact of the physical enviroment. The second theme was Competence for good caring with two subthemes: To describe experience and knowledge, To describe the need for education. The last theme was Relationships with two subthemes: Getting to know the person, To describe interaction with relatives.  Conclusions: The literature review shows that nurses need time and knowledge to perform personcentred-care to minimize BPSD for persons in nursing homes.

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program: A Randomized Clinical Trial

ImportanceStrategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers.ObjectiveTo evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants' diets.Design, setting, and participantsLower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits); (2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period.Main outcomes and measuresPrimary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality.ResultsA number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (-96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (-64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (-0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms.Conclusions and relevanceA food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions.Clinical trial registrationclinicaltrials.gov Identifier: NCT02643576

Associations between child emotional eating and general parenting style, feeding practices, and parent psychopathology.

Emotional eating is the tendency to eat in response to negative emotions. Prior research has identified a relationship between parenting style and child emotional eating, but this has not been examined in clinical samples. Furthermore, the relationship between specific parenting practices (e.g., parent feeding practices) and child emotional eating has not yet been investigated. The current study examined relationships between child emotional eating and both general and specific parenting constructs as well as maternal symptoms of depression and binge eating among a treatment-seeking sample of overweight children. Participants included 106 mother-child dyads who attended a baseline assessment for enrollment in a behavioral intervention for overeating. Ages of children ranged from 8 to 12  years old. Mothers completed self-report measures of their child's emotional eating behavior, their own feeding practices, and symptoms of depression and binge eating. Children completed a self-report measure of their mothers' general parenting style. A stepwise regression analysis was conducted to identify the parent variable that was most strongly related to child emotional eating, controlling for child age and gender. Emotional feeding behavior (i.e., a tendency to offer food to soothe a child's negative emotions) was the parent factor most significantly related to child emotional eating. Findings suggest that emotional feeding practices in parents may be related to emotional eating in children. Treatment with overweight children who engage in emotional eating may be improved by targeting parent feeding practices