Prognostic Role of the Prognostic Nutritional Index in Pancreatic Cancer: A Meta-analysis

Objective: The prognostic nutritional index (PNI) has been reported to play an important prognostic role in various malignancies. Here we performed a meta-analysis to explore the predictive value of PNI in pancreatic cancer (PC).

Methods: Clinical studies about PNI and prognosis in PC were retrieved from Pubmed, Embase, Web of Science and Cochrane Libarary updated on 31 December 2017. Stata 12 was used to compute pooled hazard radio (HR) and 95% confidence interval (CI) to estimate the relationship between PNI and overall survival (OS).

Results: Ten studies with 2064 patients were eligible for final analysis. The pooled HR (1.48, 95%CI: 1.32–1.66, I ² = 25.5% P?=?0.201）revealed that low PNI was related to poor prognosis in patients with PC. The significant relationship between PNI and prognosis was not affected by subgroup analysis based on tumor stage, treatment method, sample size, cutoff value, HR data source and study quality.

Conclusion: Our meta-analysis suggests PNI maybe a potential prognostic indicator for patients with PC.     

Open defecation explains differences in nutritional status between Bengali and tribal children in the Chittagong Hill Tracts of Bangladesh

Objective: We describe differences in linear growth as measured by height-for-age z-score (HAZ) between children from Bengali and tribal populations in the Chittagong Hill Tracts of Bangladesh and examine factors associated with HAZ in both groups.

Design: We used nutritional surveillance data collected in Bangladesh from 2003 to 2006 to analyze HAZ among 12,006 children aged 6–23 months and conducted multivariate linear regression and Blinder-Oaxaca decomposition to quantify the relative contribution of independent variables to differences in HAZ between Bengali and tribal children.

Results: Mean HAZ was stable for Bengali children (?1.88 in 2003 to ?1.90 in 2006) but improved for tribal children (?1.87 in 2003 to ?1.68 in 2006). The difference between groups was significant across the study period (p?=?0.008). Among Bengali children, HAZ was positively associated with father’s schooling (β?=?0.221; 95% CI: 0.079–0.363). Among tribal children, HAZ was positively associated with consumption of animal source foods (β?=?0.073; 95% CI: 0.051–0.096) and goat ownership (β?=?0.240; 95% CI: 0.025–0.454). Results of a likelihood ratio test indicated that distance to a health center was inversely associated with HAZ among tribal children (p?<?0.001). Blinder-Oaxaca decomposition demonstrated a difference in pooled coefficients between groups (p?=?0.004), explained primarily by differences in coefficients for paternal education (p?=?0.001) and village-level prevalence of open defecation (p?=?0.004).

Conclusions: Different responses among Bengali and tribal children to village-level open defecation are an explanatory factor for the difference in HAZ between Bengali and tribal populations. Open defecation may also act a proxy for unmeasured factors such as household environmental conditions and food hygiene.

Abbreviations: Chittagong Hill Tracts (CHT); height-for-age z-scores (HAZ); Nutrition Surveillance Project (NSP); World Health Organization (WHO)     

Enteral Nutrition Support Does Not Improve PNI in Radiotherapy Patients with Locally Advanced Esophageal Cancer

Objective: The assessment of prognostic nutritional index (PNI) before and during radiotherapy is an important parameter for the prognosis in patients with cancer. In this study, enteral tube feeding (ETF) was used during radiotherapy in patients with EC. Dynamic changes of various nutritional indicators (including PNI) were monitored.

Methods: Patients with EC who underwent radiotherapy between June 2016 and July 2017 were enrolled. ETF was performing with the energy of 25?kcal?×?kg/d. Nutritional status were evaluated. Least significant difference (LSD) was used for multiple comparisons between groups.

Results: A total of 148 patients were admitted, including 51 patients fed via ETF. For patients who were not scheduled to nutritional support, significant difference were observed in albumin (ALB) (P?<?0.001), prealbimnin (PA) (P?=?0.05) and PNI (P?<?0.001) compared to levels before radiotherapy. In the patients fed via enteral tube, no significant difference were found in weight, BMI, ALB, retinol binding protein (RBP) and PA before and after radiotherapy, while PNI significantly decreased (P?<?0.001).

Conclusion: After preforming ETF with the energy of 25?kcal?×?kg/d in patients with EC during radiotherapy, PNI, the key nutritional index reflecting prognosis, significantly decreased.     

Effects of dog-assisted intervention on quality of life in nursing home residents with dementia

Background: People with dementia often have a poor quality of life. Therefore, methods that can improve their life situation must be identified. One promising method is dog-assisted intervention.

Aim: This study aimed to investigate the effects of dog-assisted intervention on quality of life in nursing home residents with dementia.

Materials and methods: A one-group, pretest post-test study design was used. Quality of life was measured using the QUALID in 59 nursing home residents prior to and after a dog-assisted intervention. Non-parametric tests were used to analyze the data, and effect sizes were calculated.

Results: The participants’ total scores improved significantly between baseline and post-test 1 (p?=?<?0.001) and worsened significantly at post-test 2 (p?=?0.025). The largest effect size was found for the item ‘Verbalization suggests discomfort’ (p?=?0.001).

Conclusion: The results indicate that dog-assisted interventions can have positive effects on quality of life in nursing home residents with moderate to severe dementia.

Significance: The results contribute to a growing knowledge base about non-pharmacological methods that can be used in dementia care. Occupational therapists should consider dog-assisted interventions when planning activities that can reduce the illness burden and improve the quality of life for people with dementia.     

Higher Waist Circumference Is Related to Lower Plasma Polyunsaturated Fatty Acids in Healthy Participants: Metabolic Implications

Objective: We evaluated whether the relationship between waist circumference (WC) and cardiometabolic risk is related to usual diet and plasma fatty acid composition.

Methods: This cross-sectional study included 226 health professionals from 20 to 59?years old. Anthropometric features, oxidative stress, inflammatory markers, and plasma fatty acid profile were assessed. Dietary intake was evaluated with a semi-quantitative food frequency questionnaire, the quality of dietary habits by Healthy Eating Index, and insulin resistance by homeostasis model assessment–insulin resistance and triglyceride-glucose index.

Results: Higher WC was associated with lower concentrations of high-density lipoprotein cholesterol (p?=?0.000) and adiponectin (p?=?0.000) and higher uric acid levels (p?=?0.011). Plasma polyunsaturated fatty acid (PUFA) levels were negatively associated with weight (p?=?0.046), systolic blood pressure (p?=?0.035), fasting glucose (p?=?0.000), triglyceride-glucose index (p?=?0.023), and IL-1β (p?=?0.037). Individuals with elevated WC consumed more calories (p?=?0.002), niacin (p?=?0.002), and pyridoxine (p?=?0.017), but less calcium (p?=?0.001), phosphorus (p?=?0.016), and vitamin B2 (p?=?0.011). In addition, individuals with higher WC denoted lower PUFA concentrations (p?=?0.036).

Conclusion: The results suggest that participants with higher WC have lower plasma PUFA concentrations and higher levels of saturated fatty acids. This could be related to metabolic and inflammatory changes that could trigger increased risk of metabolic syndrome and cardiovascular disease.     

Racial/ethnic differences in healthcare use among patients with uncontrolled and controlled diabetes

Objectives: To examine racial/ethnic differences in healthcare use among patients classified as having controlled and uncontrolled diabetes.

Design: Data from the Carolinas HealthCare System electronic data warehouse were used. Glycemic control was defined as glycosylated hemoglobin (HbA1c)?<?8% (64?mmol/mol) in 2012 (n?=?9996). Patients with HbA1c?≥?8% (64?mmol/mol) in 2012 were classified as uncontrolled (n?=?2576). Race and ethnicity were jointly classified as non-Hispanic Black, non-Hispanic White or Other. Separate mixed effects negative binomial models estimated the independent effect of race/ethnicity on the number of emergency department (ED) visits, hospitalizations and physician office visits in 2013, in each patient group, adjusting for significant confounding variables.

Results: Rates of diabetes-related ED visits were two to three times higher for non-Hispanic Blacks compared to non-Hispanic Whites (uncontrolled rate ratio [RR]: 3.41 95% CI: 1.41–8.22; controlled RR: 2.95; 95% CI: 1.78–4.91). Similar differences were observed for all-cause ED visits (uncontrolled RR: 1.83, 95% CI: 1.50–2.24; controlled RR: 2.45, 95% CI: 2.17–2.77). Non-Hispanic Blacks with controlled and uncontrolled diabetes also had lower rates of all-cause physician office visits when compared to non-Hispanic Whites (uncontrolled RR: 0.84, 95% CI: 0.77–0.91; controlled RR: 0.81, 95% CI: 0.78–0.84).

Conclusion: Notable racial/ethnic disparities exist in the use of emergency services and physician offices for diabetes care. Strategies such as patient education and care delivery changes that address healthcare access issues in racial/ethnic minorities should be considered to offer better diabetes management and address diabetes disparities.     

Maternal breastfeeding and autism spectrum disorder in children: A systematic review and meta-analysis

Objectives: Autism spectrum disorder (ASD) refers to a group of conditions variably affecting communicative and social interactive abilities presenting alongside behaviors with various restricted and repetitive patterns. In addition to genetic factors that influence the onset of the symptoms, there is growing interest in the potential involvement of non-genetic environmental factors. Some aspects of breastfeeding practices, including rates, timing, or optimality, have been put forward as environmental risk factors for autism. However, previous studies showed a controversial relationship between ASD and breastfeeding.

Methods: A meta-analysis on the association between maternal breastfeeding and ASD in children was conducted. We also explored potential moderating factors which might influence this association. Articles reporting the association between breastfeeding and a diagnosis of ASD were included.

Results: Seven articles were included in the meta-analysis. Cumulatively, children with ASD (n?=?1463), either in the form of clinical diagnosis or self-report, were significantly less likely to have been breastfed than children without ASD (n?=?1180) (OR?=?0.61, 95% CI?=?0.45–0.83, P?=?0.002). Subgroup analyses revealed that results remained significant for children who were breastfed with additional supplementation.

Discussion: This meta-analysis provides evidence that breastfeeding (exclusively or including additional supplements) may protect against ASD. Prospective longitudinal research is required to disentangle the complex relationships and to explore potential pathophysiological mechanisms.     

An exploratory decision tree analysis to predict physical activity compliance rates in breast cancer survivors

Background: The study of physical activity in cancer survivors has been limited to one cause, one effect relationships. In this exploratory study, we used recursive partitioning to examine multiple correlates that influence physical activity compliance rates in cancer survivors.

Methods: African American breast cancer survivors (N?=?267, Mean age?=?54 years) participated in an online survey that examined correlates of physical activity. Recursive partitioning (RP) was used to examine complex and nonlinear associations between sociodemographic, medical, cancer-related, theoretical, and quality of life indicators.

Results: Recursive partitioning revealed five distinct groups. Compliance with physical activity guidelines was highest (82% met guidelines) among survivors who reported higher mean action planning scores (P?<?0.001) and lower mean barriers to physical activity (P?=?0.035). Compliance with physical activity guidelines was lowest (9% met guidelines) among survivors who reported lower mean action and coping (P?=?0.002) planning scores. Similarly, lower mean action planning scores and poor advanced lower functioning (P?=?0.034), even in the context of higher coping planning scores, resulted in low physical activity compliance rates (13% met guidelines). Subsequent analyses revealed that body mass index (P?=?0.019) and number of comorbidities (P?=?0.003) were lowest in those with the highest compliance rates.

Conclusion: Our findings support the notion that multiple factors determine physical activity compliance rates in African American breast cancer survivors. Interventions that encourage action and coping planning and reduce barriers in the context of addressing function limitations may increase physical activity compliance rates.     

Rationale and Design of an Online Educational Program Using Game-Based Learning to Improve Nutrition and Physical Activity Outcomes Among University Students in the United Kingdom

Objective: To assess the impact of an online game-based educational program on nutrition knowledge and dietary and physical activity habits among university students in the United Kingdom.

Design: Randomized controlled trial with pre- and postintervention comparisons.

Setting: Two higher education settings in London, UK.

Subjects: Current undergraduate and postgraduate students of two universities (n?=?88) aged 18–34 years are randomly allocated to an intervention (n?=?44) or a control group (n?=?44).

Intervention: The intervention group will receive access to an educational website and online quizzes with gamification elements, including information about healthy eating and physical activity. The control group will receive no information. Duration of the intervention will be 10 weeks.

Measures of Outcome: Primary outcome is nutrition knowledge. Secondary outcomes include dietary and activity habits. Nutrition knowledge and dietary and activity habits will be assessed using questionnaires. Weekly steps will be counted using pedometers. Assessment of anthropometric and metabolic risk factors will take place.

Analysis: Quantitative analysis will investigate changes in nutrition knowledge between the two groups of the study population. Linear regression analysis will be used, if the data follow the normal distribution (otherwise binomial regression analysis), to examine whether field of study, residence status, body mass index (BMI), and demographic factors affect nutrition knowledge. Associations between changes in knowledge and dietary and physical activity behavior will be assessed by correlations.

Conclusions/Implications: The study will provide insights with regard to the design and use of online game-playing as a cost-effective approach to improve nutritional knowledge among university students.     

Associations of Nut Intakes with Incident Sporadic Colorectal Adenoma: A Pooled Case-Control Study

Introduction: Consumption of nuts, which contain multiple anti-carcinogenic components, has been inversely associated with colorectal cancer (CRC), particularly among women, but has not been investigated in relation to colorectal adenoma, the immediate precursor to most CRCs.

Methods: We pooled data from three case-control studies of incident, sporadic colorectal adenoma (n?=?785 cases, 2107 controls) in which dietary intakes were assessed using food frequency questionnaires, and analyzed the data using multivariable unconditional logistic regression.

Results: Among men and women combined, the multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association of total nut product (all nuts and peanut butter combined) intakes, for those who consumed 0.5–1.5, 2.0–5.5, and ≥6 servings/week relative to no nut consumption were 0.81 (0.58, 1.12), 0.86 (0.61, 1.23), and 0.93 (0.65, 1.31), respectively. However, among women, the corresponding ORs and 95% CIs were 0.62 (0.40, 0.97), 0.57 (0.35, 0.94), and 0.78 (0.48, 1.25), respectively.

Conclusions: These results suggest that moderate nut consumption may be associated with lower risk for colorectal adenoma, primarily among women.     

Self-rated health among multiracial young adults in the United States: findings from the add health study

Objective: The multiracial adult population is one of the fastest growing segments of the U.S. population, yet much remains to be learned about multiracial health. Considerable research finds racial/ethnic disparities in self-rated health, however subgroups within the multiracial population have not been consistently described.

Design: We use data from the National Longitudinal Survey of Adolescent Health (Add Health) and multivariate logistic regression analyses to compare self-rated health of multiracial and monoracial young adults (n?=?7880).

Results: Overall, there were no significant differences in poor self-rated health status of multiracial adults as a single group odds ratio 0.84 (95% CI: 0.52–1.36) compared to monoracial White adults. Analyses further revealed important variations in health-status by specific subgroups and show that some multiracial subgroups may not fit existing patterns of health disparities. For instance, Asian-White multiracial adults do not fit documented patterns of health disparities and report better health than monoracial Asian and monoracial White adults.

Conclusion: This study illustrates that the inclusion of specific multiracial categories provides evidence to enhance understanding of the pathways that are linked to health outcomes and the implications for health disparities.     

The weight of networks: the role of social ties and ethnic media in mitigating obesity and hypertension among Latinas

Objectives: Latinos have a disproportionately high risk for obesity and hypertension. The current study analyzes survey data from Latin American women to detect differences in rates of obesity and hypertension based on their number of health-related social ties. Additionally, it proposes individuals’ health-related media preference (ethnic/ mainstream) as a potential moderator.

Design: The dataset includes 364 Latinas (21–50 years old) from the greater Los Angeles metropolitan area, who responded to a series of sociodemographic, physiological, health-related, and media-related questions.

Results: Controlling for various sociodemographic and health variables, each additional health-related tie in a Latina’s social network significantly decreased her likelihood of being obese OR?=?.79, p?=?.041, 95% CI [.66, .95], but did not affect hypertension. Further, the analysis revealed a significant interaction between media preference and health-related social ties, such that exposure to ethnic media tended to compensate for the absence of social ties for the likelihood of obesity OR?=?.75, p?=?.041, 95% CI [.52, .97], as well as hypertension OR?=?.79, p?=?.045, 95% CI [.55, .98].

Conclusion: In concurrence with the literature, increases in health-related ties reduced the likelihood of obesity in this population. Moreover, ethnic media preference may play an important role in mitigating the likelihood of obesity and hypertension among Latinas.     

The Norwegian Occupational Balance Questionnaire (OBQ11-N) – development and pilot study

Background: The concept occupational balance has been linked with health and well-being, and it is therefore viewed as an important concept for occupational therapy practice, theory and research. To operationalize and measure occupational balance, the Occupational Balance Questionnaire (OBQ) was developed in Sweden. To date, no Norwegian translations of the OBQ exists.

Aim: To describe the process of developing a Norwegian version of the 11-items Occupational Balance Questionnaire (OBQ11-N) and to evaluate its feasibility and face validity.

Methods: The development process followed a predetermined series of steps, including forward and back translation and cognitive interviews with a pilot sample.

Results: The pilot study sample (n?=?8) varied with respect to age, gender and education level. There was high level of agreement between the participants with regard to their understanding of the content of the items. Three of the items were slightly modified in terms of words and phrasing.

Conclusion: The OBQ11-N was developed according to established translation guidelines and appears to be feasible and have good face validity.

Significance: The OBQ11-N may prove useful for assessing occupational balance and associated factors in Norwegian population groups. However, more research is needed to establish the Norwegian version of the questionnaire as psychometrically valid.     

Low Phase Angle Is Correlated With Worse General Condition in Patients with Advanced Cancer

Objectives: Phase angle (PA) is a poor prognostic factor in patients with advanced cancer. This study aimed to identify possible correlations between PA and symptoms, quality of life, fluid retention, and laboratory data in cancer patients in palliative care settings.

Methods: Individuals who visited the outpatient clinic or were admitted to the palliative care unit were eligible. Patients with a performance status of 4 and/or those unable to complete questionnaires were excluded. PA was evaluated using a bioanalyzer device. The correlation coefficient between PA and the variables of interest was analyzed.

Results: A total of 102 patients were analyzed. PA was weakly correlated with age (ρ = ?0.22), performance status (ρ = ?0.30), functional well-being (ρ?=?0.20), anorexia/cachexia subscale (ρ?=?0.22), and Functional Assessment of Anorexia/Cachexia Therapy trial outcome index (ρ?=?0.26). PA was also correlated with fluid retention (ρ = ?0.34) and albumin (ρ?=?0.32), C-reactive protein (ρ = ?0.31), and hemoglobin (ρ?=?0.41) levels. Sub-analysis stratified according to sex revealed that males demonstrated the same results; however, female sex demonstrated a correlation between PA and social well-being (ρ = ?0.43).

Conclusions: PA was correlated with physical condition, but not with psychological well-being.     

Role of mycotoxins in the pathobiology of autism: A first evidence

Objectives: Gene–environment interaction is an emerging hypothesis to expound not only the autism pathogenesis but also the increased incidence of neurodevelopmental disorders (such as autistic spectrum disorder, attention-deficit, hyperactivity disorder). Among xenobiotics, mycotoxins are worldwide contaminants of food that provoke toxicological effects, crucially resembling several symptoms associated with autism such as oxidative stress, intestinal permeability, and inflammation. Here, we focused on a group of mycotoxins to test their role in the manifestation of autism, try to explain their mechanism of action, and discuss possible preventive and therapeutic interventions.

Methods: Autistic children (n?=?52) and healthy children [n?=?58 (31 siblings and 27 unrelated subjects)] were recruited and body fluids and clinical data collected. The diagnosis of autism was made according to DSM V criteria, then with GMDS 0-2, WPPSI, and ADOS. Ochratoxin A (OTA), gliotoxin, zearalenone, and sphingosine/sphinganine ratio were determined by LC analysis in sera and urines. Statistical analysis was performed by the Wilcoxon Rank Sum (Mann–Whitney) test and Spearman test.

Results: By comparing the results of autistic patients with those of unrelated controls, a significant association was found for OTA levels in urines (P?=?0.0002) and sera (P?=?0.0017), and also comparing patients with siblings and unrelated controls together (P?=?0.0081).

Discussion: Our results are the first describing a possible role of OTA in the pathobiology of autism. Recalling the male prevalence of ASD (male/female?=?4–5/1), it is noted that, in animal models, OTA exerts its neurotoxicity especially in males. Moreover, in vitro, OTA increases microRNA-132 that is dysregulated in autistic patients and involved in reciprocal regulation of the autism-related genes MeCP2 and PTEN. A personalized diet coupled with probiotic administration, especially OTA adsorbing Lactobacillus, could ameliorate autistic symptoms in OTA-positive patients.     

Factors associated with routine screening for the early detection of breast cancer in cultural-ethnic and faith-based communities

Objectives: Studies have shown a lower adherence to health behaviors among women in cultural-ethnic minorities and faith-based communities, especially lower screening attendance for the early detection of breast cancer. This study compares factors related to cancer screening adherence in two distinct cultural-ethnic minorities in Israel: Arab women as a cultural-ethnic minority and Jewish ultra-Orthodox women as a cultural-ethnic faith-based minority.

Design: During the year 2014, a total of 398 Jewish ultra-Orthodox women and 401 Arab women between the ages of 40–60, were randomly selected using population-based registries. These women answered questionnaires regarding adherence to mammography and clinical breast examination (CBE), health beliefs and cultural barriers.

Results: Arab women adhered more than ultra-Orthodox women to mammography (p?<?.001) and CBE exams (p?<?.01). Religious beliefs, exposure barriers and perceived risk were higher among the ultra-Orthodox women, while social barriers, accessibility barriers and perceived severity were higher among the Arab women (p?<?.01). Adjusting for background factors, higher adherence to CBE and mammography were associated with lower levels of religious beliefs (AOR?=?0.90, 95% CI?=?0.69–1.17 AOR?=?0.62, 95% CI?=?0.39–0.82, respectively), perceiving a higher risk of cancer (AOR?=?1.93, 95% CI?=?1.23–3.04 and AOR?=?3.22, 95% CI?=?1.53–6.61), and having more fears related to cancer-related losses (AOR?=?1.51, 95% CI?=?1.19–3.00 and AOR?=?1.24, 95% CI?=?0.63–1.22). In addition, perceiving greater advantages of CBE was associated with higher adherence to CBE (AOR?=?1.82, 95% CI?=?1.45–2.29), while not receiving a physician’s recommendation was associated with lower adherence to mammography (AOR?=?1.82, 95% CI?=?1.45–2.29).

Conclusion: This study addressed a lacuna in screening behaviors of women from cultural-ethnic and faith-based communities. In order to increase adherence, health care professionals and policymakers should direct their attention to the specific nature of each community.     

Intensive client-centred occupational therapy in the home improves older adults’ occupational performance. Results from a Danish randomized controlled trial

Background: There is growing interest in enabling older adults’ occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults.

Methods: An assessor-masked randomized controlled trial among adults 60?+?with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N?=?59) or to receive usual practice with a maximum three sessions of occupational therapy (N?=?60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM).

Results: No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p?=?0.001.

Conclusions: ICC-OT improved older adults’ occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.     

Inter-rater and test-retest reliability of the Danish version of the everyday technology use questionnaire

Background: Everyday technologies are naturally integrated in people’s daily life. For older adults and adults living with a chronic disease like chronic obstructive pulmonary disease (COPD), the ability to use technologies for health management has become increasingly important. The aim of this study was to investigate inter-rater and test-retest reliability of the Danish version of the Everyday Technology Use Questionnaire (ETUQ) in a sample of older adults with (n?=?23) and without (n?=?24) COPD.

Material and method: The ETUQ was initially translated in accordance with the dual panel approach and then administered to a sample of 47 participants. Svensson’s method for paired ordinal data was utilized to calculate and analyze reliability.

Results: Overall, inter-rater and test-retest reliability of the Danish version of the ETUQ demonstrated excellent percentage agreement (PA) (>75%), although for test-retest reliability, nine items demonstrated fair (53%) to good (73%) agreement.

Conclusion: This study supports the use of the Danish version of the ETUQ in a sample of older adults with or without COPD.

Application to practice: The Danish version of the ETUQ is an evidence-based evaluation that can reliably contribute to clinical occupational therapy and research in Denmark focusing on everyday technology use.     

Fruit and Vegetable Consumption and Their Association With the Indicators of Iron and Inflammation Status Among Adolescent Girls

Background: The objective of this study was to identify an association among dietary components, iron, and inflammatory status among adolescent girls.

Method: Dietary information for 85 adolescent girls was collected through food frequency questionnaires. Biomarkers of iron and inflammatory status were analyzed.

Results: We found that 28.2% of adolescent girls had anemia and 65.9% girls were iron-deficient. Girls who did not consume guava had 3.8-fold (95% confidence interval =1.1–9.4; p?=?0.020) increased the risk of having low serum iron levels. Girls who consumed amaranth had significantly (p?=?0.024) higher serum hepcidin levels (n?=?44; 129.7?±?81.40?pg/mL vs n?=?41; 94.6?±?55.8?pg/mL) as well as ferritin levels (n?=?44; 19.7?±?16.4?µg/L vs n?=?41; 14.0?±?10.2?µg/L). Overall consumption of fruits and green leafy vegetables among girls significantly affects their iron status.

Conclusions: Regular consumption of vitamin C–rich fruits and green leafy vegetable intake are imperative for improvement of iron status among adolescent girls.