Systematic research review of observational approaches used to evaluate mother-child mealtime interactions during preschool years.

The family meal and social interactions during the meal are important events in a child's life. Specifically, mealtime interactions have been linked to child weight status, the development of children's eating patterns, and socialization. Mealtime interactions may be observed and evaluated to provide insights into this important event beyond self-reported measurements.

Food policy, dietary intakes and chronic disease in prisons

International research on prisoners demonstrates poor health outcomes, including chronic disease, with the overall burden to the community high. Prisoners are predominantly male and young. In Australia, the average incarceration length is 3 years, sufficient to impact long term health, including nutrition. Food in prisons is highly controlled, yet gaps exist in policy. In most Western countries prisons promote healthy foods, often incongruent with prisoner expectations or wants. Few studies have been conducted on dietary intakes during incarceration in relation to food policy. In this study detailed diet histories were collected on 120/945 men (mean age = 32 years), in a high-secure prison. Intakes were verified via individual purchase records, mealtime observations, and audits of food preparation, purchasing and holdings. Physical measurements (including fasting bloods) were taken and medical records reviewed. Results showed the standard food provided consistent with current dietary guidelines, however limited in menu choice. Diet histories revealed self-funded foods contributing 1–63% of energy (mean = 30%), 0–83% sugar (mean = 38%), 1–77% saturated fats (mean = 31%) and 1–59% sodium (mean = 23%). High levels of modification to food provided was found using minimal cooking amenities and inclusion of self-funded foods and/or foods retained from previous meals. Medical records and physical measurements confirmed markers of chronic disease. This study highlights the need to establish clear guidelines on all food available in prisons if chronic disease risk reduction is a goal. This study has also supported evidenced based food and nutrition policy including menu choice, food quality, quantity and safety as well as type and access to self-funded foods.

Reported and observed controlling feeding practices predict child eating behavior after 12 months

BACKGROUND: Controlling feeding practices are linked to children's self-regulatory eating practices and weight status. Maternal reports of controlling feeding practices are not always significantly related to independently rated mealtime observations. However, prior studies only assessed 1 mealtime observation, which may not be representative of typical mealtime settings or routines. OBJECTIVES: The first aim was to examine associations between reported and observed maternal pressure to eat and restriction feeding practices at baseline (T1) and after ∼12 mo (T2). The second aim was to evaluate relations between maternal and child factors [e.g., concern about child weight, child temperament, child body mass index (BMI)-for-age z scores (BMIz)] at T1 and reported and observed maternal pressure to eat and restriction feeding practices (T1 and T2). The third aim was to assess prospective associations between maternal feeding practices (T1) and child eating behaviors (T2) and child BMIz (T2). METHODS: A sample of 79 mother-child dyads in Victoria, Australia, participated in 2 lunchtime home observations (T1 and T2). BMI measures were collected during the visits. Child temperament, child eating behaviors, maternal parenting styles, and maternal feeding practices were evaluated at T1 and T2 via questionnaires. Associations were assessed with Pearson's correlation coefficients, paired t tests, and hierarchical regressions. RESULTS: Reported restriction (T1) was inversely associated with observed restriction at T1 (r = -0.24, P < 0.05). Reported pressure to eat (T2) was associated with observed pressure to eat (T2) (r = 0.48, P < 0.01) but only for mothers of girls. Maternal weight concern was associated with reported restriction at T1 (r = 0.29, P < 0.01) and T2 (r = 0.36, P < 0.01), whereas observed restriction (T1) was prospectively associated child BMI at T2 (β = -0.18, P < 0.05). CONCLUSIONS: Maternal reports may not always reflect feeding practices performed during mealtimes; it is possible some mothers may not be aware of their practices or observations may not capture covert controlling strategies.

Encouraging, assisting, and time to eat : comparison of mealtime assistance interventions in elderly medical inpatients

BACKGROUND: The prevalence of protein-energy malnutrition in older adults is reported to be as high as 60% and is associated with poor health outcomes. Inadequate feeding assistance and mealtime interruptions may contribute to malnutrition and poor nutritional intake during hospitalisation. Despite being widely implemented in practice in the United Kingdom and increasingly in Australia, there have been few studies examining the impact of strategies such as Protected Mealtimes and dedicated feeding assistant roles on nutritional outcomes of elderly inpatients. AIMS: The aim of this research was to implement and compare three system-level interventions designed to specifically address mealtime barriers and improve energy intakes of medical inpatients aged ≥65 years. This research also aimed to evaluate the sustainability of any changes to mealtime routines six months post-intervention and to gain an understanding of staff perceptions of the post-intervention mealtime experience. METHODS: Three mealtime assistance interventions were implemented in three medical wards at Royal Brisbane and Women's Hospital: AIN-only: Additional assistant-in-nursing (AIN) with dedicated nutrition role. PM-only: Multidisciplinary approach to meals, including Protected Mealtimes. PM+AIN: Combined intervention: AIN + multidisciplinary approach to meals. An action research approach was used to carefully design and implement the three interventions in partnership with ward staff and managers. Significant time was spent in consultation with staff throughout the implementation period to facilitate ownership of the interventions and increase likelihood of successful implementation. A pre-post design was used to compare the implementation and nutritional outcomes of each intervention to a pre-intervention group. Using the same wards, eligible participants (medical inpatients aged ≥65 years) were recruited to the preintervention group between November 2007 and March 2008 and to the intervention groups between January and June 2009. The primary nutritional outcome was daily energy and protein intake, which was determined by visually estimating plate waste at each meal and mid-meal on Day 4 of admission. Energy and protein intakes were compared between the pre and post intervention groups. Data were collected on a range of covariates (demographics, nutritional status and known risk factors for poor food intake), which allowed for multivariate analysis of the impact of the interventions on nutritional intake. The provision of mealtime assistance to participants and activities of ward staff (including mealtime interruptions) were observed in the pre-intervention and intervention groups, with staff observations repeated six months post-intervention. Focus groups were conducted with nursing and allied health staff in June 2009 to explore their attitudes and behaviours in response to the three mealtime interventions. These focus group discussions were analysed using thematic analysis. RESULTS: A total of 254 participants were recruited to the study (pre-intervention: n=115, AIN-only: n=58, PM-only: n=39, PM+AIN: n=42). Participants had a mean age of 80 years (SD 8), and 40% (n=101) were malnourished on hospital admission, 50% (n=108) had anorexia and 38% (n=97) required some assistance at mealtimes. Occasions of mealtime assistance significantly increased in all interventions (p<0.01). However, no change was seen in mealtime interruptions. No significant difference was seen in mean total energy and protein intake between the preintervention and intervention groups. However, when total kilojoule intake was compared with estimated requirements at the individual level, participants in the intervention groups were more likely to achieve adequate energy intake (OR=3.4, p=0.01), with no difference noted between interventions (p=0.29). Despite small improvements in nutritional adequacy, the majority of participants in the intervention groups (76%, n=103) had inadequate energy intakes to meet their estimated energy requirements. Patients with cognitive impairment or feeding dependency appeared to gain substantial benefit from mealtime assistance interventions. The increase in occasions of mealtime assistance by nursing staff during the intervention period was maintained six-months post-intervention. Staff focus groups highlighted the importance of clearly designating and defining mealtime responsibilities in order to provide adequate mealtime care. While the purpose of the dedicated feeding assistant was to increase levels of mealtime assistance, staff indicated that responsibility for mealtime duties may have merely shifted from nursing staff to the assistant. Implementing the multidisciplinary interventions empowered nursing staff to "protect" the mealtime from external interruptions, but further work is required to empower nurses to prioritise mealtime activities within their own work schedules. Staff reported an increase in the profile of nutritional care on all wards, with additional non-nutritional benefits noted including improved mobility and functional independence, and better identification of swallowing difficulties. IMPLICATIONS: The PhD research provides clinicians with practical strategies to immediately introduce change to deliver better mealtime care in the hospital setting, and, as such, has initiated local and state-wide roll-out of mealtime assistance programs. Improved nutritional intakes of elderly inpatients was observed; however given the modest effect size and reducing lengths of hospital stays, better nutritional outcomes may be achieved by targeting the hospital-to-home transition period. Findings from this study suggest that mealtime assistance interventions for elderly inpatients with cognitive impairment and/or functional dependency show promise.

Maternal symptoms of depression are related to observations of controlling feeding practices in mothers of young children

Maternal depression can impair parenting practices and has been linked with less sensitive feeding interactions with children, but existing research is based on self-reports of feeding practices. This study examined relationships between maternal self-reported symptoms of depression with observations of mothers' child feeding practices during a mealtime. Fifty-eight mothers of 3-and 4-year-old children were video recorded eating a standardized lunch. The recording was then coded for instances of maternal controlling feeding practices and maternal vocalizations using the Family Mealtime Coding System. Mothers also provided information on current symptoms of depression and anxiety. Mothers who reported greater symptoms of depression were observed to use more verbal and physical pressure for their child to eat and to offer more incentives or conditions in exchange for their child eating. Mothers also used more vocalizations with their child about food during the observed mealtime when they had greater symptoms of depression. There was no link between symptoms of depression and observations of maternal use of restriction. Symptoms of depression are linked with observations of mothers implementing a more controlling, less sensitive feeding style with their child. Health professionals working with families in which mothers have symptoms of depression may benefit from receiving training about the possible impact of maternal depression on child-feeding practices, and mothers with symptoms of depression may benefit from guidance regarding its potential impact on their child-feeding interactions ©2013 American Psychological Association.

Breast-feeding, maternal feeding practices and mealtime negativity at one year

This paper explores whether breast-feeding, mediated by lower maternal use of controlling strategies, predicts more positive mealtime interactions between mothers and their 1 year old infants. Eighty-seven women completed questionnaires regarding breast-feeding, assessing their control over child feeding and mealtime negativity at 1 year of infant age. Seventy-four of these women were also observed feeding their infants solid food at 1 year. Mediation analyses demonstrated that the experience of breast-feeding, mediated by lower reported maternal control over child feeding, predicted maternal reports of less negative mealtime interactions. The experience of breast-feeding also predicted observations of less conflict at mealtimes, mediated by observations of maternal sensitivity during feeding interactions. The implications of these findings are discussed.

Mutually responsive orientation: a novel observational assessment of mother-child mealtime interactions

Mother-child mealtime interactions during preschool years is an important but overlooked factor when evaluating the influence of parent-child relationships on child eating and weight. This paper describes the validation of the Mutually Responsive Orientation (MRO) coding system adapted for assessing parent-child interactions during food preparation and consumption situations. Home-based mealtimes of 94 mothers and their children (3.03 ± 0.75 years) were filmed at two time points, 12-months apart. Filmed dimensions of mutual mother-child responsiveness, shared positive affect, maternal control relating to food and child compliance were assessed. Objective BMI and maternal reports of parenting, feeding, child eating, diet and child temperament were also collected. Correlations, repeated measures ANOVAs and regressions were performed to examine the validity of MRO variables and their stability across both time points. Validation analysis showed the MRO coding system performed as expected: dyads with higher MRO scores expressed lower control/power assertion, lower child non-compliance, and greater committed compliance. The measure demonstrated sensitivity to specific contexts: maternal responsiveness, mother and child positive affect were higher during food consumption compared to food preparation. Coded dimensions were stable across time points, with the exception of decreases in maternal responsiveness in food consumption and child non-compliance in food preparation. MRO and maternal dimensions were correlated with maternally reported parenting and feeding measures. Maternal responsiveness (inversely) and child responsiveness (positively) were concurrently associated with child fussy eating, and child refusal was prospectively and inversely associated with child fussy eating. Findings suggest the adapted MRO coding system is a useful measure for examining observed parent-child mealtime interactions potentially implicated in preschoolers' eating and weight development.

Lady Nugent and Tom Cringle on the veranda : early nineteenth century observations on a Caribbean architectural feature

This study of the veranda as seen through the eyes of Lady Maria Nugent and Michael Scott, alias Tom Cringle, clearly demonstrates the important role that the piazza, as it was then more commonly known, played in the life of early nineteenth century Caribbean colonial society. The popularity of the veranda throughout the region, in places influenced by different European as well as African cultures, and among all classes of people, suggests that the appeal of this typical feature was based on something more than architectural fashion. A place of relative comfort in hot weather, the veranda is also a space at the interface of indoors and outdoors which allows for a wide variety of uses, for solitary or small or large group activities, many of which were noted by Nugent and Scott. Quintessentially, the veranda is a place in which to relax and take pleasure, not least of which is the enjoyment of the prospect, be it a panoramic view, a peaceful garden or a lively street scene. Despite the great changes in the nature of society, in the Caribbean and in many other parts of the world, the veranda and related structures such as the balcony continue to play at least as important a role in daily life as they did two centuries ago. The veranda of today’s Californian or Australian bungalow, and the balcony of the apartment block in the residential area of the modern city are among the contemporary equivalents of the lower and upper piazzas of Lady Nugent’s and Tom Cringle’s day.

What is that place? Observations of the impact of environment colour through photographic analysis

Isolating the impact of a colour, or a combination of colours, is extremely difficult to achieve because it is difficult to remove other environmental elements such as sound, odours, light, and occasion from the experience of being in a place. In order to ascertain the impact of colour on how we interpret the world in day to day situations, the current study records participant responses to achromatic scenes of the built environment prior to viewing the same scene in colour. A number of environments were photographed in colour or copied from design books; and copies of the images saved as both colour and black/grey/white. An overview of the study will be introduced by firstly providing examples of studies which have linked colour to meaning and emotions. For example, yellow is said to be connected to happiness1 ; or red evokes feelings of anger2 or passion. A link between colour and the way we understand and/or feel is established however, there is a further need for knowledge of colour in context. In response to this need, the current achromatic/chromatic environmental study will be described and discussed in light of the findings. Finally, suggestions for future research are posed. Based on previous research the authors hypothesised that a shift in environmental perception by participants would occur. It was found that the impact of colour includes a shift in perception of aspects such as its atmosphere and youthfulness. Through studio-class discussions it was also noted that the predicted age of the place, the function, and in association, the potential users when colour was added (or deleted) were often challenged. It is posited that the ability of a designer (for example, interior designer, architect, or landscape architect) to design for a particular target group—user and/or clients will be enhanced through more targeted studies relating colour in situ. The importance of noting the perceptual shift for the participants in our study, who were young designers, is the realisation that colour potentially holds the power to impact on the identity of an architectural form, an interior space, and/or particular elements such as doorways, furniture settings, and the like.

Student autonomy enhancing science learning : Observations from a Primary Connections implementation

This case study involved a detailed analysis of the changes in beliefs and teaching practices of teachers who adopted the Primary Connections program as a professional development initiative. When implementing an inquiry-based learning model, teachers observed that their students learnt more when they intervened less. By scaffolding open-ended nquiries they achieved more diverse, complex and thorough learning outcomes than previously achieved with teacher-led discussions or demonstrations. Initially, student autonomy presented erceived threats to teachers, including possible selection of topics outside the teachers’ science knowledge. In practice, when such issues arose, resolving them became a stimulating part of the earning for both teachers and students. The teachers’ observation of enhanced student learning became a powerful motivator for change in their beliefs and practices. Implications for developers of PD programs are (1) the importance of modeling student-devised inquiries, and (2) recognising the role of successful classroom implementation in facilitating change.

Experimentally induced diesel engine injector faults and some preliminary acoustic emission signal observations

Diesel engine fuel injector faults can lead to reduced power, increased fuel consumption and greater exhaust emission levels and if left unchecked, can eventually lead to premature engine failure. This paper provides an overview of the Diesel, or compression ignition combustion process, and of the two basic fuel injector nozzle designs used in Diesel engines, namely, the pintle-type and hole-type nozzles. Also described are some common faults associated with these two types of fuel injector nozzles and the techniques previously used to experimentally simulate these faults. This paper also presents a recent experimental campaign undertaken using two different diesel engines whereby various fuel injector nozzle faults were induced into the engines. The first series of tests was undertaken using a turbo-charged 5.9 litre; Cummins Diesel engine whist the second series of tests was undertaken using a naturally aspirated 4 cylinder, 2.216 litre, Perkins Diesel engine. Data corresponding to different injector fault conditions was captured using in-cylinder pressure, and acoustic emission transducers along with both crank-angle encoder and top-dead centre reference signals. Using averaged in-cylinder pressure signals, it was possible to qualify the severity of the faults whilst averaged acoustic emission signals were in turn, used as the basis for wavelets decomposition. Initial observations from this signal decomposition are also presented and discussed.

Knowledge management for enterprise systems: observations from small, medium and large organizations

Anecdotal evidence suggests that the lifecycle-wide management of Enterprise System (ES) related knowledge is critical for ES health and longevity. At a time where many ES-vendors now offering solutions to Small and Medium size organizations, this paper investigates the ability of Small and Medium size organizations to maintain a lifecycle-wide knowledge management strategy. The paper explores the alleged differences in the knowledge management practices across 27 small, medium and large organizations that had implemented a market-leading ES. Results suggest that: (1) despite similar knowledge creation efforts in all three organizational sizes, small organizations struggle with retaining, transferring and applying the knowledge. The study also reveals that, (2) the overall goodness of the knowledge management process in larger organizations remains higher than their small and medium counterparts.

Service delivery in one-stop government portals : observations based on a market research study in Queensland

New government service delivery models based on a “franchise” metaphor are being proposed recently to allow more citizen-centric service delivery by decoupling the government’s internal departmental structure from the way services are presented and delivered to citizens. In order to evaluate the approach from an online channel perspective, the Queensland Government commissioned a market research study to compare their websites with the online presences of the UK Government and the South Australian Government, who both have adopted the “franchise” approach. The study aimed to inform an understanding of citizens’ preferred model for interacting in the online channel and to identify the relative strengths and weaknesses of the existing websites. In this paper, we will a) report on the findings of this third party usability study and b) position the study, in the form of a critical reflection, against the background of a more comprehensive “Transformational Government” approach using a “franchise marketplace”. The critical reflection points towards limitations of the study with regard to this bigger picture and discusses the potential benefits of service bundling that remained unconsidered in the study.

The social orders of family mealtime

This study examined the everyday practices of families within the context of family mealtime to investigate how members accomplished mealtime interactions. Using an ethnomethodological approach, conversation analysis and membership categorization analysis, the study investigated the interactional resources that family members used to assemble their social orders moment by moment during family mealtimes. While there is interest in mealtimes within educational policy, health research and the media, there remain few studies that provide fine-grained detail about how members produce the social activity of having a family meal. Findings from this study contribute empirical understandings about families and family mealtime. Two families with children aged 2 to 10 years were observed as they accomplished their everyday mealtime activities. Data collection took place in the family homes where family members video recorded their naturally occurring mealtimes. Each family was provided with a video camera for a one-month period and they decided which mealtimes they recorded, a method that afforded participants greater agency in the data collection process and made available to the analyst a window into the unfolding of the everyday lives of the families. A total of 14 mealtimes across the two families were recorded, capturing 347 minutes of mealtime interactions. Selected episodes from the data corpus, which includes centralised breakfast and dinnertime episodes, were transcribed using the Jeffersonian system. Three data chapters examine extended sequences of family talk at mealtimes, to show the interactional resources used by members during mealtime interactions. The first data chapter explores multiparty talk to show how the uniqueness of the occasion of having a meal influences turn design. It investigates the ways in which members accomplish two-party talk within a multiparty setting, showing how one child "tells" a funny story to accomplish the drawing together of his brothers as an audience. As well, this chapter identifies the interactional resources used by the mother to cohort her children to accomplish the choralling of grace. The second data chapter draws on sequential and categorical analysis to show how members are mapped to a locally produced membership category. The chapter shows how the mapping of members into particular categories is consequential for social order; for example, aligning members who belong to the membership category "had haircuts" and keeping out those who "did not have haircuts". Additional interactional resources such as echoing, used here to refer to the use of exactly the same words, similar prosody and physical action, and increasing physical closeness, are identified as important to the unfolding talk particularly as a way of accomplishing alignment between the grandmother and grand-daughter. The third and final data analysis chapter examines topical talk during family mealtimes. It explicates how members introduce topics of talk with an orientation to their co-participant and the way in which the take up of a topic is influenced both by the sequential environment in which it is introduced and the sensitivity of the topic. Together, these three data chapters show aspects of how family members participated in family mealtimes. The study contributes four substantive themes that emerged during the analytic process and, as such, the themes reflect what the members were observed to be doing. The first theme identified how family knowledge was relevant and consequential for initiating and sustaining interaction during mealtime with, for example, members buying into the talk of other members or being requested to help out with knowledge about a shared experience. Knowledge about members and their activities was evident with the design of questions evidencing an orientation to coparticipant’s knowledge. The second theme found how members used topic as a resource for social interaction. The third theme concerned the way in which members utilised membership categories for producing and making sense of social action. The fourth theme, evident across all episodes selected for analysis, showed how children’s competence is an ongoing interactional accomplishment as they manipulated interactional resources to manage their participation in family mealtime. The way in which children initiated interactions challenges previous understandings about children’s restricted rights as conversationalists. As well as making a theoretical contribution, the study offers methodological insight by working with families as research participants. The study shows the procedures involved as the study moved from one where the researcher undertook the decisions about what to videorecord to offering this decision making to the families, who chose when and what to videorecord of their mealtime practices. Evident also are the ways in which participants orient both to the video-camera and to the absent researcher. For the duration of the mealtime the video-camera was positioned by the adults as out of bounds to the children; however, it was offered as a "treat" to view after the mealtime was recorded. While situated within family mealtimes and reporting on the experiences of two families, this study illuminates how mealtimes are not just about food and eating; they are social. The study showed the constant and complex work of establishing and maintaining social orders and the rich array of interactional resources that members draw on during family mealtimes. The family’s interactions involved members contributing to building the social orders of family mealtime. With mealtimes occurring in institutional settings involving young children, such as long day care centres and kindergartens, the findings of this study may help educators working with young children to see the rich interactional opportunities mealtimes afford children, the interactional competence that children demonstrate during mealtimes, and the important role/s that adults may assume as co-participants in interactions with children within institutional settings.