Inadequacy of Micronutrients, Fat, and Fiber Consumption in the Diets of Haitian-, African- and Cuban-Americans with and without Type 2 Diabetes

Micronutrient insufficiency, low dietary fiber, and high saturated fat intake have been associated with chronic diseases. Micronutrient insufficiencies may exacerbate poor health outcomes for persons with type 2 diabetes and minority status. We examined dietary intakes using the Recommended Dietary Allowances (RDAs) of micronutrients, and Adequate Intakes (AIs) of fiber, and Dietary Guidelines for Americans (DGA) for saturated fat in Haitian-, African-, and Cuban- Americans (n = 868), approximately half of each group with type 2 diabetes. Insufficient intakes of vitamins D and E and calcium were found in over 40 % of the participants. Over 50 % of African- and Cuban- Americans consumed over 10 % of calories from saturated fat. Haitian-Americans were more likely to have insufficiencies in iron, B-vitamins, and vitamins D and E, and less likely to have inadequate intake of saturated fat as compared to Cuban-Americans. Vitamin D insufficiency was more likely for Haitian-Americans as compared to African- Americans. Diabetes status alone did not predict micronutrient insufficiencies; however, Haitian-Americans with no diabetes were more likely to be insufficient in calcium. Adjusting for age, gender, energy, smoking, physical activity, access to health care, and education negated the majority of micronutrient insufficiency differences by ethnicity. These findings suggest that policies are needed to ensure that low-cost, quality produce can be accessed regardless of neighborhood and socioeconomic status.

Making the grade: The perceived impact of Florida's A+ Plan on the learning environment of one elementary school

The purpose of this study was to ascertain the perceptions of educators at one elementary school regarding the changes in the teaching and learning environment and their related effects following the implementation of Florida's A+ high-stakes accountability system. This study also assessed whether these changes were identified by participants as meaningful and enduring, in terms of the definition by Lieberman and Miller (1999). Twenty-one educators, including 17 teachers and four administrators, at Blue Ribbon Elementary school were interviewed. Data were inductively coded and categorized into four major themes: (a) teaching and learning environment consistency, (b) changes in the teaching and learning environment since the implementation of A+, (c) effects of the changes, and (d) significant and enduring change. Findings fell into three categories (a) identified changes since A+ implementation, (b) effects of changes, and (c) what participants believed was significant and long term change, which included those characteristics of the school that had been identified as consistent in the teaching and learning environment. Statements of the participants explained their perceptions about what instructional decisions where made in response to the A+ Plan including the modification of curriculum, the addition or omission of subject matter taught, and the positive or negative impact these decisions had on the teaching and learning environment. It was found that study participants felt all changes and their effects were a direct result of the A+ Plan and viewed many of the changes as being neither significant nor long term Analysis of the educators' perceptions of the changes they experienced revealed the overall feeling that the changes were not indicative of what was necessary to make a school successful. For the participants, the changes lacked the characteristics that they had described as vital in what constituted success. This led to the conclusion that, by Lieberman and Miller's definition, the majority of changes and effects that were implemented at the school as a result of the mandated A+ Plan, were not meaningful and enduring for effective school reform. ^

Investigative interviewing and memory: How accurate are interviewers recollections of investigative interviews?

Contrary to interviewing guidelines, a considerable portion of witness interviews are not recorded. Investigators’ memory, their interview notes, and any subsequent interview reports therefore become important pieces of evidence; the accuracy of interviewers’ memory or such reports is therefore of crucial importance when interviewers testify in court regarding witness interviews. A detailed recollection of the actual exchange during such interviews and how information was elicited from the witness will allow for a better assessment of statement veracity in court. ^ Two studies were designed to examine interviewers’ memory for a prior witness interview. Study One varied interviewer note-taking and type of subsequent interview report written by interviewers by including a sample of undergraduates and implementing a two-week delay between interview and recall. Study Two varied levels of interviewing experience in addition to report type and note-taking by comparing experienced police interviewers to a student sample. Participants interviewed a mock witness about a crime, while taking notes or not, and wrote an interview report two weeks later (Study One) or immediately after (Study Two). Interview reports were written either in a summarized format, which asked interviewers for a summary of everything that occurred during the interview, or verbatim format, which asked interviewers to record in transcript format the questions they asked and the witness’s responses. Interviews were videotaped and transcribed. Transcriptions were compared to interview reports to score for accuracy and omission of interview content. ^ Results from both studies indicate that much interview information is lost between interview and report especially after a two-week delay. The majority of information reported by interviewers is accurate, although even interviewers who recalled information immediately after still reported a troubling amount of inaccurate information. Note-taking was found to increase accuracy and completeness of interviewer reports especially after a two week delay. Report type only influenced recall of interviewer questions. Experienced police interviewers were not any better at recalling a prior witness interview than student interviewers. Results emphasize the need to record witness interviews to allow for more accurate and complete interview reconstruction by interviewers, even if interview notes are available. ^

Application and evaluation of an Institute of Medicine approach to dietary assessment and planning in long -term care

The primary purpose of these studies was to determine the effect of planning menus using the Institute of Medicine's (IOMs) Simple Nutrient Density Approach on nutrient intakes of long-term care (LTC) residents. In the first study, nutrient intakes of 72 subjects were assessed using Dietary Reference Intakes (DRIs) and IOM methodology. The intake distributions were used to set intake and menu planning goals. In the second study, the facility's regular menus were modified to meet the intake goals for vitamin E, magnesium, zinc, vitamin D and calcium. An experiment was used to test whether the modified menu resulted in intakes of micronutrients sufficient to achieve a low prevalence (<3%) of nutrient inadequacies. Three-day weighed food intakes for 35 females were adjusted for day-to-day variations in order to obtain an estimate of long-term average intake and to estimate the proportion of residents with inadequate nutrient intakes. ^ In the first study, the prevalence of inadequate intakes was determined to be between 65-99% for magnesium, vitamin E, and zinc. Mean usual intakes of Vitamin D and calcium were far below the Adequate Intakes (AIs). In the experimental study, the prevalence of inadequacies was reduced to <3% for zinc and vitamin E but not magnesium. The groups' mean usual intake from the modified menu met or exceeded the AI for calcium but fell short for vitamin D. Alternatively, it was determined that addition of a multivitamin and mineral (MVM) supplement to intakes of the regular menu could be used to achieve goals for vitamin E, zinc and vitamin D but not calcium and magnesium. ^ A combination of menu modification and MVM supplementation may be necessary to achieve a low prevalence of micronutrient inadequacies among LTC residents. Menus should be planned to optimize intakes of those nutrients that are low in an MVM, such as calcium, magnesium, and potassium. A MVM supplement should be provided to fill the gap for nutrients not provided in sufficient amounts by the diet, such as vitamin E and vitamin D. ^

Making the grade : the perceived impact on Florida's A+ plan on the learning environment of one elementary school

The purpose of this study was to ascertain the perceptions of educators at one elementary school regarding the changes in the teaching and learning environment and their related effects following the implementation of Florida's A+ high-stakes accountability system. This study also assessed whether these changes were identified by participants as meaningful and enduring, in terms of the definition by Lieberman and Miller (1999). Twenty-one educators, including 17 teachers and four administrators, at Blue Ribbon Elementary school were interviewed. Data were inductively coded and categorized into four major themes: (a) teaching and learning environment consistency, (b) changes in the teaching and learning environment since the implementation of A+, (c) effects of the changes, and (d) significant and enduring change. Findings fell into three categories (a) identified changes since A+ implementation, (b) effects of changes, and (c) what participants believed was significant and long term change, which included those characteristics of the school that had been identified as consistent in the teaching and learning environment. Statements of the participants explained their perceptions about what instructional decisions where made in response to the A+ Plan including the modification of curriculum, the addition or omission of subject matter taught, and the positive or negative impact these decisions had on the teaching and learning environment. It was found that study participants felt all changes and their effects were a direct result of the A+ Plan and viewed many of the changes as being neither significant nor long term Analysis of the educators' perceptions of the changes they experienced revealed the overall feeling that the changes were not indicative of what was necessary to make a school successful. For the participants, the changes lacked the characteristics that they had described as vital in what constituted success. This led to the conclusion that, by Lieberman and Miller's definition, the majority of changes and effects that were implemented at the school as a result of the mandated A+ Plan, were not meaningful and enduring for effective school reform.

Investigative Interviewing and Memory: How Accurate Are Interviewers’ Recollections of Investigative Interviews?

Contrary to interviewing guidelines, a considerable portion of witness interviews are not recorded. Investigators’ memory, their interview notes, and any subsequent interview reports therefore become important pieces of evidence; the accuracy of interviewers’ memory or such reports is therefore of crucial importance when interviewers testify in court regarding witness interviews. A detailed recollection of the actual exchange during such interviews and how information was elicited from the witness will allow for a better assessment of statement veracity in court. Two studies were designed to examine interviewers’ memory for a prior witness interview. Study One varied interviewer note-taking and type of subsequent interview report written by interviewers by including a sample of undergraduates and implementing a two-week delay between interview and recall. Study Two varied levels of interviewing experience in addition to report type and note-taking by comparing experienced police interviewers to a student sample. Participants interviewed a mock witness about a crime, while taking notes or not, and wrote an interview report two weeks later (Study One) or immediately after (Study Two). Interview reports were written either in a summarized format, which asked interviewers for a summary of everything that occurred during the interview, or verbatim format, which asked interviewers to record in transcript format the questions they asked and the witness’s responses. Interviews were videotaped and transcribed. Transcriptions were compared to interview reports to score for accuracy and omission of interview content. Results from both studies indicate that much interview information is lost between interview and report especially after a two-week delay. The majority of information reported by interviewers is accurate, although even interviewers who recalled information immediately after still reported a troubling amount of inaccurate information. Note-taking was found to increase accuracy and completeness of interviewer reports especially after a two week delay. Report type only influenced recall of interviewer questions. Experienced police interviewers were not any better at recalling a prior witness interview than student interviewers. Results emphasize the need to record witness interviews to allow for more accurate and complete interview reconstruction by interviewers, even if interview notes are available.

A comparison between homemaker prepared meals and traditional home delivered meals on the dietary intake of frail homebound elders

To frail elders, the consumption of nutrients is a challenge. Individuals participating in home delivered meal programs achieve higher daily intakes of key nutrients over non participants. However many elders require special diet and modifications in food texture, features generally not provided by such programs.^ This study compared a pilot program providing individual homemaker prepared meals based on special needs with the traditional home delivered meal program. Eight participants in the model group and 19 participants in the control group completed the 180 day study. The high drop out rate in the model group was due to scheduling difficulties.^ No significant differences existed between the two groups with respect to weight gain/maintenance, macronutrient intake, intake of most micronutrients and customer satisfaction. Homemaker prepared meals is a viable option for individuals needing dietary adjustments. ^