This document summarizes a presentation titled "Hand Me Those Dyes and Additives, I am Not Hyper Enough: Relationship of Food Additives and Dyes in Children". The presentation discusses attention deficit hyperactivity disorder (ADHD) and hyperactivity in children, and examines whether artificial food dyes and additives are related to these conditions. It outlines the results of two studies - a randomized controlled trial found artificial food dyes increased hyperactive behaviors in 3-year-olds, and a review concluding that some hyperactive children respond positively to a diet eliminating certain foods and dyes. The presentation aims to determine if restricted diets could reduce hyperactivity and ADHD medication prevalence in children.
Case Management and Outcomes for Neglected Children: A 5 year follow up studyBASPCAN
This document summarizes a study examining case management and outcomes for 138 neglected children over 5 years. It finds that outcomes were often unstable, with 65% of returns to parents ending within 5 years and 48% of children being re-abused. Younger age at return, proactive case management, and placement in a changed household predicted stability. Barriers like late intervention, failure to address parental issues, and over-identification with parents hindered effectiveness. The conclusion calls for earlier intervention and addressing barriers to improve management of neglected children's cases.
Original paper parents’ experiences of home based applied bSAHIL781034
This document summarizes a study that interviewed parents of children with autism who received 2 years of early intensive behavioral intervention (EIBI) therapy. The study aimed to obtain first-hand accounts of the perceived benefits and challenges of home-based EIBI programs from the parents' perspectives. In general, parents reported positive experiences with EIBI and benefits for their children, families, and themselves. However, interviews also revealed some challenging aspects of managing intensive therapy programs at home, such as financial burdens and disruptions to family routines. The implications of these findings could help improve support for families undertaking EIBI.
Intergenerational pathways between child maltreatment, health and socioeconom...BASPCAN
PhD Candidate James Doidge, University of South Australia
Supervisors: Prof Leonie Segal, University of South Australia, A/Prof Paul Delfabbro, University of South Australia
“STUDY ON THE IMPACT OF PRAKRITI IN CHILDREN WITH ACADEMIC STRESS AND EVALUAT...Dr-sumod Khedekar
“STUDY ON THE IMPACT OF PRAKRITI IN CHILDREN WITH ACADEMIC STRESS AND EVALUATION OF ANTISTRESS EFFECT OF SARASWAT CHURNA”
presented in Kochi International seminar.
Dogs can make a difference: Research overview and results by Professor Daniel...Dogs for the Disabled
This talk was presented at the conference "Autism in the Family: Can Dogs Help" held in London on the 22nd June 2013. Professor Daniel Mills is the UK's first Professor of Veterinary Behavioural Medicine and is based in the School of Life Sciences at the University of Lincoln. His research has focused on human –animal interactions, the assessment of emotion in companion animals and the use of semiochemicals to manage pet behavioural problems. He is a member of the Companion Animal Welfare Society. He has been the lead researcher on the ‘Pet Dogs for Children with Autism’ research project for the past 3 years.
Home visiting programs aim to improve child outcomes by supporting parents. Successful programs are intensive, focus on high-risk families, and are staffed by nurses. They improve parenting skills, child development, and link families to services. Integrating home visitors into pediatric primary care teams may augment medical homes and improve adherence to care plans. Major evidence-based home visiting models discussed include Nurse-Family Partnership, Parents as Teachers, Early Head Start, and Healthy Steps. An ideal system provides a continuum of services tailored to family needs through collaboration between home visitors and medical/behavioral health providers.
This document provides an overview and update on autism spectrum disorder (ASD) research. It summarizes several studies on various topics:
- Genetic factors are strongly implicated in ASD risk, though hundreds of genes may be involved.
- Early intensive behavioral intervention shows benefits for social/communication skills but evidence is limited.
- Some treatments like risperidone and melatonin show benefits for specific symptoms but evidence is still limited overall.
- Joint attention interventions effectively improve joint attention skills in children with ASD.
- Ongoing research is exploring new drug treatments and personalized approaches.
Case Management and Outcomes for Neglected Children: A 5 year follow up studyBASPCAN
This document summarizes a study examining case management and outcomes for 138 neglected children over 5 years. It finds that outcomes were often unstable, with 65% of returns to parents ending within 5 years and 48% of children being re-abused. Younger age at return, proactive case management, and placement in a changed household predicted stability. Barriers like late intervention, failure to address parental issues, and over-identification with parents hindered effectiveness. The conclusion calls for earlier intervention and addressing barriers to improve management of neglected children's cases.
Original paper parents’ experiences of home based applied bSAHIL781034
This document summarizes a study that interviewed parents of children with autism who received 2 years of early intensive behavioral intervention (EIBI) therapy. The study aimed to obtain first-hand accounts of the perceived benefits and challenges of home-based EIBI programs from the parents' perspectives. In general, parents reported positive experiences with EIBI and benefits for their children, families, and themselves. However, interviews also revealed some challenging aspects of managing intensive therapy programs at home, such as financial burdens and disruptions to family routines. The implications of these findings could help improve support for families undertaking EIBI.
Intergenerational pathways between child maltreatment, health and socioeconom...BASPCAN
PhD Candidate James Doidge, University of South Australia
Supervisors: Prof Leonie Segal, University of South Australia, A/Prof Paul Delfabbro, University of South Australia
“STUDY ON THE IMPACT OF PRAKRITI IN CHILDREN WITH ACADEMIC STRESS AND EVALUAT...Dr-sumod Khedekar
“STUDY ON THE IMPACT OF PRAKRITI IN CHILDREN WITH ACADEMIC STRESS AND EVALUATION OF ANTISTRESS EFFECT OF SARASWAT CHURNA”
presented in Kochi International seminar.
Dogs can make a difference: Research overview and results by Professor Daniel...Dogs for the Disabled
This talk was presented at the conference "Autism in the Family: Can Dogs Help" held in London on the 22nd June 2013. Professor Daniel Mills is the UK's first Professor of Veterinary Behavioural Medicine and is based in the School of Life Sciences at the University of Lincoln. His research has focused on human –animal interactions, the assessment of emotion in companion animals and the use of semiochemicals to manage pet behavioural problems. He is a member of the Companion Animal Welfare Society. He has been the lead researcher on the ‘Pet Dogs for Children with Autism’ research project for the past 3 years.
Home visiting programs aim to improve child outcomes by supporting parents. Successful programs are intensive, focus on high-risk families, and are staffed by nurses. They improve parenting skills, child development, and link families to services. Integrating home visitors into pediatric primary care teams may augment medical homes and improve adherence to care plans. Major evidence-based home visiting models discussed include Nurse-Family Partnership, Parents as Teachers, Early Head Start, and Healthy Steps. An ideal system provides a continuum of services tailored to family needs through collaboration between home visitors and medical/behavioral health providers.
This document provides an overview and update on autism spectrum disorder (ASD) research. It summarizes several studies on various topics:
- Genetic factors are strongly implicated in ASD risk, though hundreds of genes may be involved.
- Early intensive behavioral intervention shows benefits for social/communication skills but evidence is limited.
- Some treatments like risperidone and melatonin show benefits for specific symptoms but evidence is still limited overall.
- Joint attention interventions effectively improve joint attention skills in children with ASD.
- Ongoing research is exploring new drug treatments and personalized approaches.
- The document discusses different models of eating behavior including developmental, cognitive, and psychophysiological models. The developmental model highlights the role of exposure, social learning, and associative learning in developing food preferences from a young age. The cognitive model emphasizes how beliefs and attitudes impact food choices. And the psychophysiological model examines the role of senses, neurochemicals, and stress in eating behavior. The document also provides 8 strategies for encouraging healthy eating habits in children, such as getting them involved in food preparation, focusing on balance, and leading by example through one's own behaviors and choices.
This document discusses factors that influence food choices and eating behaviors. It explores how mood, social learning from parents and family, and health concerns can shape attitudes towards food. Several studies are summarized that show: 1) people in negative moods tend to consume more unhealthy foods, 2) children's food preferences correlate with their parents' choices and attitudes, and 3) media characters can influence children to try healthy foods but not override preferences for salty or sweet snacks. Social and emotional factors significantly impact eating behaviors.
The document summarizes an after-school program for teens with autism spectrum disorder (ASD) that focuses on nutrition education. The program aims to address food selectivity commonly seen in ASD. Each session introduces a food topic through a presentation followed by hands-on cooking activities. Parents report their children are willing to try new foods and have improved attitudes toward healthy eating. Teens also express enjoying learning in the fun environment. The goal is to promote healthy eating habits and positive attitudes toward food through social and educational activities.
This document discusses factors that influence eating behavior and food choices. It explores how mood, social learning from parents and family, and health concerns can impact attitudes towards food. Several studies are summarized that show: 1) People in negative moods tend to consume more unhealthy snacks; 2) Children's food preferences and habits are influenced by observing and learning from their parents; and 3) Media characters on TV can encourage children to try healthy foods, but not necessarily choose them over salty or sugary snacks.
Children's food liking and intake relationships are complex. The study found:
1) Liking predicted intake for some foods but not others, and liking did not predict overall intake.
2) Child weight status and sex moderated some liking-intake relationships. Overweight children's low energy density food liking positively correlated with intake, while girls' high energy density food liking positively correlated with intake.
3) Reported parental food preparation time negatively correlated with children's test meal energy density. Children whose parents spent more time cooking ate lower energy density meals.
This document discusses the role of nutrition in ADHD. It finds that children with ADHD are less likely to have been breastfed or breastfed for as long compared to non-ADHD children. Essential fatty acids like DHA are important for brain development but the body cannot produce them, so breastfeeding provides these. Gluten intolerance can also impact nutrient absorption and neurotransmitter production. Exercise is shown to improve cognitive performance, brain function, and reduce ADHD symptoms. Artificial food dyes, especially Red 40, are found to increase hyperactivity and behavioral issues in some children. The Feingold diet eliminates certain foods and additives to manage symptoms. A healthy diet of fruits, vegetables, whole grains, uns
Local Determinants of Malnutrition: An Expanded Positive Deviance Studyjehill3
Local Determinants of Malnutrition: An Expanded Positive Deviance Study
Julie Hettinger, Food for the Hungry
Nutrition Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Dietary paterrns of autistic chidren - Copy.pptxArif Majeed
Autism is a complex developmental and non-curable neurobiological condition that typically appears during the first three years of life. (Christensen et al., 2016).
Although the onset of symptoms for most children occurs during late infancy some may not display any symptoms until they are of 2 years after a period of comparative growth.
It effects brain function predominantly in the areas of social interaction and communication skills that results in varying degrees of difficult socialization, verbal and nonverbal communications, repetitive and problematic behavior.
The challenging manners of these children disrupt the food choices which in turn affect nutritional status and growth. Irritabilities and anxiety can be associated with introduction of new food.(K. Barnhill et al., 2017).
Autism is prevalent worldwide with male are effected almost five times more than female.(Salih,et.al,2017). In Honk Kong 1 in 27 and in Norway 1 in 196, whereas in Pakistan 1 in every 50 children can be autistic. There are approximately 350,000 autistic children in Pakistan however, the actual number remains hidden due to underreporting, misdiagnosis and social causes.
Regular nutritional screening and evaluation of Autistic children is an important clinical deliberation as they may have numerous risk factors that seem to intensify the occurrence of nutrient insufficiencies.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
This document proposes a randomized controlled trial to test the effectiveness of Interpersonal Therapy in Groups (IPT-G) at reducing maternal depression and improving child health behaviors and outcomes. The trial would involve screening 3600 mothers in Malawi for depression and enrolling 750 depressed mothers to receive either IPT-G plus care group promotion of health behaviors or care group promotion only. The trial aims to determine if reducing maternal depression through IPT-G leads to improved adoption of nutrition and hygiene behaviors and better child growth indicators. It is hoped the results can help scale up effective models for integrating depression treatment into development programs.
Healthy Lifestyles Presentation to BOE: August 2014Lynn McMullin
The document summarizes the proposed policy on school nutrition and physical activity. It provides background on parent survey responses calling for healthier options and less junk food. Classroom celebrations were noted to frequently include unhealthy foods like cupcakes and donuts. The proposed policy aims to offer healthier celebration options and food choices while still allowing celebrations. It is presented as thoughtful, research-based, and focused on student health and well-being rather than being punitive. The policy does not ban food but provides guidelines and resources for healthier options.
This document summarizes a study examining how past experiences with food insecurity influence parents' use of child feeding practices recommended to prevent childhood obesity. The study involved interviewing 12 parents about their childhood food experiences, current feeding practices, and challenges. Preliminary themes that emerged from the interviews included parents wanting to shelter their children from problems, using feeding strategies to avoid wasting food, and seeing meals as important family time. The researchers aim to understand how past food insecurity may create barriers for parents adopting recommended practices and to apply their findings to improve nutrition education programs.
The document summarizes an autism clinic's development of the Autism Spectrum Food Activity Lab program. The program aims to promote healthy eating habits and a positive relationship with food for teenagers on the autism spectrum through hands-on food and nutrition activities. Sessions include activities like smoothie making, pizza making with alternative crusts, and non-dairy ice cream making. Feedback from parents and teens suggests the program is helping participants broaden their palates and increasing their interest in food preparation. The organizers plan to continue building upon what they have learned to further their goals.
This document outlines a proposed study to investigate whether food additives cause hyperactivity in children. The study will use a single-blind experimental design with 160 children ages 3-10 split into four test groups. Each group will receive drinks with or without certain food dyes over 10 weeks, and parental surveys and computer tests will assess hyperactivity levels before and after each drink. Statistical analysis using t-tests will determine if differences exist between the additive and placebo conditions. Ethical considerations like parental consent, confidentiality, and ensuring no health risks are addressed.
Lauren Lissner, Pester-power and screen time in relation to weight status in ...THL
This document summarizes findings from the IDEFICS study on childhood obesity. It discusses factors like screen time, food marketing, and "pester power" that influence childhood obesity. The IDEFICS study involved surveys and interventions in 8 countries with over 16,000 children ages 2-9. The study found the interventions were more effective at normalizing weight in children who were already overweight at baseline, but did not significantly impact sedentary behaviors. Targeted prevention for those with weight problems may be more effective than universal prevention alone. The document concludes with suggestions for health nudges and possibilities for structural changes in Nordic countries.
Presenter: Gregory Fabiano, Ph.D.
From: UB Alberti Center for Bullying Abuse Prevention, Colloquium Series (April 9, 2015)
More: gse.buffalo.edu/alberticenter
........
Attention-deficit/hyperactivity disorder (ADHD) is a chronic, pervasive childhood mental health disorder with a typical onset during early childhood, and it results in considerable impairments in social, academic, and family functioning.
Evidence-based treatments for ADHD include pharmacological interventions and behavioral interventions. Behavioral interventions typically include teaching parents and teachers how to manipulate and control the antecedents and consequences of behavior to promote increased adaptive functioning and reduce problematic behaviors. Recent innovations in behavioral interventions include using social, recreational activities to engage fathers in treatment programs, combining pharmacological and behavioral interventions to promote appropriate behaviors in schools, and enhancing special education services for youth with ADHD.
Emphasis within the talk will include a discussion of how youth with ADHD and their families can be effectively treated to reduce their roles as both perpetrators and recipients of aggressive, bullying, and other negative social behaviors.
FAMILY ASSESSMENT 1
FAMILY ASSESSMENT
Institution Affiliation
Student Name
Date
Family-Focused Functional Assessment
The questions asked in the interview with the family that agreed to participate were based on the eleven functional health patterns. The family that participated in the family health assessment program was a single parent structure, a mother with two children. The questions were directed towards the personal life of the respondent; therefore, their names will not be mentioned. It was an African American parent who is single, middle class income. The family is religious, Christians and live in the Chicago neighbourhood. It is a mother who is always there for her daughters and works hard to meet their needs.
The overall health behaviour of the family include eating healthy meals, drink plenty of fluids, and children are given junk once in a while. The children snore and the mother works two jobs and gets time to sleep for only 5hours in a day because she works in the afternoon and evening. The family’s bowel movements are normal and temporary changes are experienced but it’s nothing to worry about. The mother creates time to engage in physical activities, twice a week and the types of exercises she does are morning runs and home work-out just to keep fit. She makes all the decisions that involve her children’s schooling and future plans, and she reported that she doesn’t get confused. She has healthy eyesight. She feels that the future will be great because she has done several investments that will yield positive outcomes.
Children are disciplined using praise positive behaviour because she wants her children to grow into a functional family that does not instil fear and reflect negative behaviour when they become adults. She has started seeing someone recently and has never experienced any sexual dysfunction. The most recent stressful event she experienced is increased pressure from work and creating time to spend with her children. Unfortunately, coping strategies were not well defined. The current health of the family is moderate considering the constraints that the single parent has to undergo to ensure that the children are happy and safe. The family eats a healthy diet that includes vegetables and fruits with less junk food.
Based on the findings of the role relationship, I saw this as strength because the parent disciplines her daughters through praise positive behaviour. Descriptive praise is what she mentioned that works best for her children. Descriptive praise means that a parent takes the initiative to tell their children exactly what they like. Praise helps change a child’ negative behaviour and based on what I observed her children are disciplined, they have confidence and self-esteem, (Campbell-Salome, et.al, 2019). At times, she has to use rewards to encourage her two daughters to perform well in academics and at home. The healthy diet and drinking more fluids habit is another strength t.
FAMILY ASSESSMENT 1FAMILY ASSESSMENTIn.docxmglenn3
FAMILY ASSESSMENT 1
FAMILY ASSESSMENT
Institution Affiliation
Student Name
Date
Family-Focused Functional Assessment
The questions asked in the interview with the family that agreed to participate were based on the eleven functional health patterns. The family that participated in the family health assessment program was a single parent structure, a mother with two children. The questions were directed towards the personal life of the respondent; therefore, their names will not be mentioned. It was an African American parent who is single, middle class income. The family is religious, Christians and live in the Chicago neighbourhood. It is a mother who is always there for her daughters and works hard to meet their needs.
The overall health behaviour of the family include eating healthy meals, drink plenty of fluids, and children are given junk once in a while. The children snore and the mother works two jobs and gets time to sleep for only 5hours in a day because she works in the afternoon and evening. The family’s bowel movements are normal and temporary changes are experienced but it’s nothing to worry about. The mother creates time to engage in physical activities, twice a week and the types of exercises she does are morning runs and home work-out just to keep fit. She makes all the decisions that involve her children’s schooling and future plans, and she reported that she doesn’t get confused. She has healthy eyesight. She feels that the future will be great because she has done several investments that will yield positive outcomes.
Children are disciplined using praise positive behaviour because she wants her children to grow into a functional family that does not instil fear and reflect negative behaviour when they become adults. She has started seeing someone recently and has never experienced any sexual dysfunction. The most recent stressful event she experienced is increased pressure from work and creating time to spend with her children. Unfortunately, coping strategies were not well defined. The current health of the family is moderate considering the constraints that the single parent has to undergo to ensure that the children are happy and safe. The family eats a healthy diet that includes vegetables and fruits with less junk food.
Based on the findings of the role relationship, I saw this as strength because the parent disciplines her daughters through praise positive behaviour. Descriptive praise is what she mentioned that works best for her children. Descriptive praise means that a parent takes the initiative to tell their children exactly what they like. Praise helps change a child’ negative behaviour and based on what I observed her children are disciplined, they have confidence and self-esteem, (Campbell-Salome, et.al, 2019). At times, she has to use rewards to encourage her two daughters to perform well in academics and at home. The healthy diet and drinking more fluids habit is another strength t.
Integrating the Functional, Psychodynamic, and Immunologic Matrix: New Advent...Louis Cady, MD
In this presentation (here represented in English before translation) Dr. Cady deconstructs the curious and sometimes perplexing manifestations of delayed sensitivity food allergy testing, supporting it with citations from the peer-reviewed medical literature and extensive bibliographic references. The importance of understanding the potential immunologic contribution to a patient's mental state is reviewed.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
- The document discusses different models of eating behavior including developmental, cognitive, and psychophysiological models. The developmental model highlights the role of exposure, social learning, and associative learning in developing food preferences from a young age. The cognitive model emphasizes how beliefs and attitudes impact food choices. And the psychophysiological model examines the role of senses, neurochemicals, and stress in eating behavior. The document also provides 8 strategies for encouraging healthy eating habits in children, such as getting them involved in food preparation, focusing on balance, and leading by example through one's own behaviors and choices.
This document discusses factors that influence food choices and eating behaviors. It explores how mood, social learning from parents and family, and health concerns can shape attitudes towards food. Several studies are summarized that show: 1) people in negative moods tend to consume more unhealthy foods, 2) children's food preferences correlate with their parents' choices and attitudes, and 3) media characters can influence children to try healthy foods but not override preferences for salty or sweet snacks. Social and emotional factors significantly impact eating behaviors.
The document summarizes an after-school program for teens with autism spectrum disorder (ASD) that focuses on nutrition education. The program aims to address food selectivity commonly seen in ASD. Each session introduces a food topic through a presentation followed by hands-on cooking activities. Parents report their children are willing to try new foods and have improved attitudes toward healthy eating. Teens also express enjoying learning in the fun environment. The goal is to promote healthy eating habits and positive attitudes toward food through social and educational activities.
This document discusses factors that influence eating behavior and food choices. It explores how mood, social learning from parents and family, and health concerns can impact attitudes towards food. Several studies are summarized that show: 1) People in negative moods tend to consume more unhealthy snacks; 2) Children's food preferences and habits are influenced by observing and learning from their parents; and 3) Media characters on TV can encourage children to try healthy foods, but not necessarily choose them over salty or sugary snacks.
Children's food liking and intake relationships are complex. The study found:
1) Liking predicted intake for some foods but not others, and liking did not predict overall intake.
2) Child weight status and sex moderated some liking-intake relationships. Overweight children's low energy density food liking positively correlated with intake, while girls' high energy density food liking positively correlated with intake.
3) Reported parental food preparation time negatively correlated with children's test meal energy density. Children whose parents spent more time cooking ate lower energy density meals.
This document discusses the role of nutrition in ADHD. It finds that children with ADHD are less likely to have been breastfed or breastfed for as long compared to non-ADHD children. Essential fatty acids like DHA are important for brain development but the body cannot produce them, so breastfeeding provides these. Gluten intolerance can also impact nutrient absorption and neurotransmitter production. Exercise is shown to improve cognitive performance, brain function, and reduce ADHD symptoms. Artificial food dyes, especially Red 40, are found to increase hyperactivity and behavioral issues in some children. The Feingold diet eliminates certain foods and additives to manage symptoms. A healthy diet of fruits, vegetables, whole grains, uns
Local Determinants of Malnutrition: An Expanded Positive Deviance Studyjehill3
Local Determinants of Malnutrition: An Expanded Positive Deviance Study
Julie Hettinger, Food for the Hungry
Nutrition Working Group Showcase
CORE Group Spring Meeting, April 29, 2010
Dietary paterrns of autistic chidren - Copy.pptxArif Majeed
Autism is a complex developmental and non-curable neurobiological condition that typically appears during the first three years of life. (Christensen et al., 2016).
Although the onset of symptoms for most children occurs during late infancy some may not display any symptoms until they are of 2 years after a period of comparative growth.
It effects brain function predominantly in the areas of social interaction and communication skills that results in varying degrees of difficult socialization, verbal and nonverbal communications, repetitive and problematic behavior.
The challenging manners of these children disrupt the food choices which in turn affect nutritional status and growth. Irritabilities and anxiety can be associated with introduction of new food.(K. Barnhill et al., 2017).
Autism is prevalent worldwide with male are effected almost five times more than female.(Salih,et.al,2017). In Honk Kong 1 in 27 and in Norway 1 in 196, whereas in Pakistan 1 in every 50 children can be autistic. There are approximately 350,000 autistic children in Pakistan however, the actual number remains hidden due to underreporting, misdiagnosis and social causes.
Regular nutritional screening and evaluation of Autistic children is an important clinical deliberation as they may have numerous risk factors that seem to intensify the occurrence of nutrient insufficiencies.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
This document proposes a randomized controlled trial to test the effectiveness of Interpersonal Therapy in Groups (IPT-G) at reducing maternal depression and improving child health behaviors and outcomes. The trial would involve screening 3600 mothers in Malawi for depression and enrolling 750 depressed mothers to receive either IPT-G plus care group promotion of health behaviors or care group promotion only. The trial aims to determine if reducing maternal depression through IPT-G leads to improved adoption of nutrition and hygiene behaviors and better child growth indicators. It is hoped the results can help scale up effective models for integrating depression treatment into development programs.
Healthy Lifestyles Presentation to BOE: August 2014Lynn McMullin
The document summarizes the proposed policy on school nutrition and physical activity. It provides background on parent survey responses calling for healthier options and less junk food. Classroom celebrations were noted to frequently include unhealthy foods like cupcakes and donuts. The proposed policy aims to offer healthier celebration options and food choices while still allowing celebrations. It is presented as thoughtful, research-based, and focused on student health and well-being rather than being punitive. The policy does not ban food but provides guidelines and resources for healthier options.
This document summarizes a study examining how past experiences with food insecurity influence parents' use of child feeding practices recommended to prevent childhood obesity. The study involved interviewing 12 parents about their childhood food experiences, current feeding practices, and challenges. Preliminary themes that emerged from the interviews included parents wanting to shelter their children from problems, using feeding strategies to avoid wasting food, and seeing meals as important family time. The researchers aim to understand how past food insecurity may create barriers for parents adopting recommended practices and to apply their findings to improve nutrition education programs.
The document summarizes an autism clinic's development of the Autism Spectrum Food Activity Lab program. The program aims to promote healthy eating habits and a positive relationship with food for teenagers on the autism spectrum through hands-on food and nutrition activities. Sessions include activities like smoothie making, pizza making with alternative crusts, and non-dairy ice cream making. Feedback from parents and teens suggests the program is helping participants broaden their palates and increasing their interest in food preparation. The organizers plan to continue building upon what they have learned to further their goals.
This document outlines a proposed study to investigate whether food additives cause hyperactivity in children. The study will use a single-blind experimental design with 160 children ages 3-10 split into four test groups. Each group will receive drinks with or without certain food dyes over 10 weeks, and parental surveys and computer tests will assess hyperactivity levels before and after each drink. Statistical analysis using t-tests will determine if differences exist between the additive and placebo conditions. Ethical considerations like parental consent, confidentiality, and ensuring no health risks are addressed.
Lauren Lissner, Pester-power and screen time in relation to weight status in ...THL
This document summarizes findings from the IDEFICS study on childhood obesity. It discusses factors like screen time, food marketing, and "pester power" that influence childhood obesity. The IDEFICS study involved surveys and interventions in 8 countries with over 16,000 children ages 2-9. The study found the interventions were more effective at normalizing weight in children who were already overweight at baseline, but did not significantly impact sedentary behaviors. Targeted prevention for those with weight problems may be more effective than universal prevention alone. The document concludes with suggestions for health nudges and possibilities for structural changes in Nordic countries.
Presenter: Gregory Fabiano, Ph.D.
From: UB Alberti Center for Bullying Abuse Prevention, Colloquium Series (April 9, 2015)
More: gse.buffalo.edu/alberticenter
........
Attention-deficit/hyperactivity disorder (ADHD) is a chronic, pervasive childhood mental health disorder with a typical onset during early childhood, and it results in considerable impairments in social, academic, and family functioning.
Evidence-based treatments for ADHD include pharmacological interventions and behavioral interventions. Behavioral interventions typically include teaching parents and teachers how to manipulate and control the antecedents and consequences of behavior to promote increased adaptive functioning and reduce problematic behaviors. Recent innovations in behavioral interventions include using social, recreational activities to engage fathers in treatment programs, combining pharmacological and behavioral interventions to promote appropriate behaviors in schools, and enhancing special education services for youth with ADHD.
Emphasis within the talk will include a discussion of how youth with ADHD and their families can be effectively treated to reduce their roles as both perpetrators and recipients of aggressive, bullying, and other negative social behaviors.
FAMILY ASSESSMENT 1
FAMILY ASSESSMENT
Institution Affiliation
Student Name
Date
Family-Focused Functional Assessment
The questions asked in the interview with the family that agreed to participate were based on the eleven functional health patterns. The family that participated in the family health assessment program was a single parent structure, a mother with two children. The questions were directed towards the personal life of the respondent; therefore, their names will not be mentioned. It was an African American parent who is single, middle class income. The family is religious, Christians and live in the Chicago neighbourhood. It is a mother who is always there for her daughters and works hard to meet their needs.
The overall health behaviour of the family include eating healthy meals, drink plenty of fluids, and children are given junk once in a while. The children snore and the mother works two jobs and gets time to sleep for only 5hours in a day because she works in the afternoon and evening. The family’s bowel movements are normal and temporary changes are experienced but it’s nothing to worry about. The mother creates time to engage in physical activities, twice a week and the types of exercises she does are morning runs and home work-out just to keep fit. She makes all the decisions that involve her children’s schooling and future plans, and she reported that she doesn’t get confused. She has healthy eyesight. She feels that the future will be great because she has done several investments that will yield positive outcomes.
Children are disciplined using praise positive behaviour because she wants her children to grow into a functional family that does not instil fear and reflect negative behaviour when they become adults. She has started seeing someone recently and has never experienced any sexual dysfunction. The most recent stressful event she experienced is increased pressure from work and creating time to spend with her children. Unfortunately, coping strategies were not well defined. The current health of the family is moderate considering the constraints that the single parent has to undergo to ensure that the children are happy and safe. The family eats a healthy diet that includes vegetables and fruits with less junk food.
Based on the findings of the role relationship, I saw this as strength because the parent disciplines her daughters through praise positive behaviour. Descriptive praise is what she mentioned that works best for her children. Descriptive praise means that a parent takes the initiative to tell their children exactly what they like. Praise helps change a child’ negative behaviour and based on what I observed her children are disciplined, they have confidence and self-esteem, (Campbell-Salome, et.al, 2019). At times, she has to use rewards to encourage her two daughters to perform well in academics and at home. The healthy diet and drinking more fluids habit is another strength t.
FAMILY ASSESSMENT 1FAMILY ASSESSMENTIn.docxmglenn3
FAMILY ASSESSMENT 1
FAMILY ASSESSMENT
Institution Affiliation
Student Name
Date
Family-Focused Functional Assessment
The questions asked in the interview with the family that agreed to participate were based on the eleven functional health patterns. The family that participated in the family health assessment program was a single parent structure, a mother with two children. The questions were directed towards the personal life of the respondent; therefore, their names will not be mentioned. It was an African American parent who is single, middle class income. The family is religious, Christians and live in the Chicago neighbourhood. It is a mother who is always there for her daughters and works hard to meet their needs.
The overall health behaviour of the family include eating healthy meals, drink plenty of fluids, and children are given junk once in a while. The children snore and the mother works two jobs and gets time to sleep for only 5hours in a day because she works in the afternoon and evening. The family’s bowel movements are normal and temporary changes are experienced but it’s nothing to worry about. The mother creates time to engage in physical activities, twice a week and the types of exercises she does are morning runs and home work-out just to keep fit. She makes all the decisions that involve her children’s schooling and future plans, and she reported that she doesn’t get confused. She has healthy eyesight. She feels that the future will be great because she has done several investments that will yield positive outcomes.
Children are disciplined using praise positive behaviour because she wants her children to grow into a functional family that does not instil fear and reflect negative behaviour when they become adults. She has started seeing someone recently and has never experienced any sexual dysfunction. The most recent stressful event she experienced is increased pressure from work and creating time to spend with her children. Unfortunately, coping strategies were not well defined. The current health of the family is moderate considering the constraints that the single parent has to undergo to ensure that the children are happy and safe. The family eats a healthy diet that includes vegetables and fruits with less junk food.
Based on the findings of the role relationship, I saw this as strength because the parent disciplines her daughters through praise positive behaviour. Descriptive praise is what she mentioned that works best for her children. Descriptive praise means that a parent takes the initiative to tell their children exactly what they like. Praise helps change a child’ negative behaviour and based on what I observed her children are disciplined, they have confidence and self-esteem, (Campbell-Salome, et.al, 2019). At times, she has to use rewards to encourage her two daughters to perform well in academics and at home. The healthy diet and drinking more fluids habit is another strength t.
Integrating the Functional, Psychodynamic, and Immunologic Matrix: New Advent...Louis Cady, MD
In this presentation (here represented in English before translation) Dr. Cady deconstructs the curious and sometimes perplexing manifestations of delayed sensitivity food allergy testing, supporting it with citations from the peer-reviewed medical literature and extensive bibliographic references. The importance of understanding the potential immunologic contribution to a patient's mental state is reviewed.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Hand me those dyes and additives,
1. "Hand Me Those Dyes
and Additives, I am Not
Hyper Enough:
Relationship of Food
Additives and Dyes in
Children"
Presented by:
Tuesday, May 14, 2013
Sara Mastrine, Chelsea Keady, Rebecca Dean, Erin Shirk, & Brandon King
2. Outline
• What is Hyperactivity and ADHD?
• Symptoms
• Causes
• Diagnoses
•
•
•
•
•
•
•
•
•
•
•
Video “Rise in Prescriptions Unnecessary”
Alternatives (Diet)
Artificial Food Dyes/Additives
Current Regulations/News
Formulation of PICO
Databases
Articles
Group Tally Sheets
Group Conclusion/ Summary
Grade
References
4. ADHD
• Attention Deficit Hyperactivity Disorder
• National Institute of Mental Health says 3%-5% of children are
affected with ADHD but some experts suggest number may be as
high as 8%-10%.
• Unclear whether children ever actually outgrow ADHD.
• Symptoms include:
•
•
•
•
•
•
•
•
•
Easily distracted
Difficulty following directions or finishing tasks
Forgetful
Often loses things
Squirms, fidgets, unable to sit still
Difficulty playing quietly
Talks excessively
Difficulty taking turns
Often interrupts
•
http://www.webmd.com
5. ADHD (Cont.)-Causes
• Causes are not certain.
• Hereditary
• Chemical: Possibly due to an imbalance of neurotransmitters
in the brain.
• Cigarette or alcohol use during pregnancy.
• Exposure to toxins (lead)
• We questioned whether nutrition may play a role..
6. Hyperactivity & ADHD Diagnoses
• “According to National Health Insurance
Corporation’s statistics, the number of
adolescents diagnosed with ADHD jumped
2.4 times over the past six years from
18,967 in 2003 to 64,066 in 2009.
• The corporation said 6.5 percent of young
people from the ages 6 to 18 have ADHD.
• About 70 percent of patients suffer from
the disorder until they reach adulthood,
while 30 percent are successfully treated.
• Male children are four more times likely to
be affected than females.
• Children with ADHD have difficulty
focusing on tasks, controlling their
behavior and are hyperactive in ways that
are more severe than in average kids.”
7. Rise in Prescriptions Unnecessary?
• http://www.youtube.com/watch?NR=1&v=ieqOQCZJ5I&feature=endscreen
8. Can Diet Be Used Before Medication?
• Insurance companies are looking for ways to make it harder to be
written a prescription for ADHD
• Our studies discuss how the diet can affect one’s state of
hyperactivity and ADHD
• Observes what can make hyperactivity more severe
• Reviews diets that could potentially decrease the number of children
being prescribed medications
9. Artificial Food Dyes/Additives
• What are they?
• Synthetically produced substances added to foods to enhance
flavor, appearance, or shelf-life.
• What are they used for?
• Taste tests have shown that people enjoyed foods more when
they had a variety of colors.
• What are they added to?
• Candy, cakes, sports drinks
• Macaroni and cheese, medicines, salad dressing, and canned
fruits
10. Current Regulations/News
• United States is one of the only
countries without regulations on
artificial food dyes.
• Countries such as Russia, Peru,
Japan, India, etc. penalize
companies for adding
unnecessary
additives.(Harvard.edu)
• In Britain, Nutri Grain bars are
colored with natural coloring, but
food dyes are used in the United
States.(www.cspinet.org)
• There is currently a petition
against Kraft Foods to remove
artificial colors from macaroni and
cheese in the US. Kraft Foods do
not contain dyes in any other
country.
“A brand can sell the perception of
quality even though the product is
actually low in quality.” (harvard.edu)
11. Formulation of PICO Question
•
•
•
•
Population: Children
Intervention: Restricted diets or treatments of additives
Comparison: Diets containing food dyes and additives
Outcome: Reduce hyperactivity in children; reduce the prevalence
of ADHD medications
PICO question: What is the relationship between consuming food
additives and hyperactivity in children?
12. Databases used
• Sara Mastrine
• EbscoHost
• Erin Shirk
• Google Scholar
• Rebecca Dean
• EbscoHost
• Brandon King
• EbscoHost
• Chelsea Keady
• MedLine
• Google Scholar
13. Original Article
Sara Mastrine Article 1
• McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L.,
Grimshaw, K., & ... Stevenson, J. (2007). Food additives and
hyperactive behaviour in 3-year-old and 8/9 year-old children
in the community: a randomised, double-blinded, placebocontrolled trial. Lancet, 370(9598), 1560-1567.
• Randomized, double-blinded, placebo-controlled crossover trial
• Purpose was to test whether consumption of artificial food
additives and colors affected children’s behavior.
14. Original Article
Sara Mastrine Article 1
• Inclusion
• Children age 3 or children age 8-9 attending schools in Southampton, UK
• Exclusion
• Age criteria, allergies, availability to participate (time)
• Recruitment/Participants
• 3 year olds:
• 153 (79 males, 74 females)
• 137 completed study
• 8/9 year olds:
• 144 (75 males, 69 females)
• 130 completed study
15. Original Article
Sara Mastrine Article 1
• Design
• Children were given a crossover between two active juice
mixes (A and B) and placebo drink.
• 3 year old group:
• Mix A- 20 mg artificial food coloring and 45 mg sodium benzoate
• Mix B- 30 mg artificial food coloring and 45 mg sodium benzoate
• 8/9 year old group
• Mix A- 24.98 mg artificial food colors and 45 mg sodium
benzoate
• Mix B- 62.4 mg artificial food colors and 45 mg sodium benzoate
*Sodium benzoate: Chemical preservative commonly found in highly processed
foods.
16. Original Article
Sara Mastrine Article 1
• Design (cont.)
• Blinding
• Each child was assigned to one of six sequences of placebo, mix A,
and mix B.
• Families and researchers masked to challenge assignments.
• Juices tested and found to have no differences in looks or taste.
• Juices prepared and packaged by administrator and delivered to
homes by masked researchers.
17. Original Article
Sara Mastrine Article 1
• Design (cont.)
• Children were assessed weekly using a Global Hyperactivity
Aggregate (GHA), which included 3 measures to obtain a GHA
score. A fourth measure was added for 8/9 year old age group.
• Measures
•
•
•
•
ADHD rating scale
Weiss-Werry-Peters (WWP) hyperactivity scale
Classroom observation
Conners continuous performance test II (CPTII)
18. Original Article
Sara Mastrine Article 1
• Measures Explained
• ADHD rating scale: Questionnaire filled out by teachers
describing frequency of behaviors such as inattentiveness and
hyperactivity.
• Weiss-Werry-Peters (WWP) hyperactivity scale: Parents assessed
children’s behavior based on 7 items (switching activities,
interrupting or talking too much, wriggling, fiddling with objects
or own body, restless, always on the go, and concentration) to
obtain a score.
• Classroom observation: Trained observers (psychology graduates)
observed children in classroom to assess occurrence of
hyperactive behaviors during structured work and independent
work.
• Conners continuous performance test II (CPTII): Only used for
8/9 year old group. Tested attention using computerized visual
stimuli.
19. Original Article
Sara Mastrine Article 1
• Statistical Analysis
• Two age groups were treated as parallel but independent studies.
• Data analyzed using linear mixed-model methods in SPSS.
• Tested the affects of Mix A and Mix B against placebo.
20. Original Article
Sara Mastrine Article 1
• Results
Mix A vs. Placebo GHA Scores
Groups
Mix A
Placebo
P-value/
significance
3 year old group
131
129
P= 0.004
(Significant
difference)
8/9 year old group
132
127
P= 0.123 (Not
significantly
different)
21. Original Article
Sara Mastrine Article 1
• Results (cont.)
Mix B vs. Placebo GHA Scores
Group
Mix B
Placebo
P-value/
significance
3 year old group
134
129
P=0.093 (Not
significantly
different)
8/9 year old group
133
127
P=0.012
(Significantly
different)
22. Original Article
Sara Mastrine Article 1
• Conclusion
• Authors: The authors concluded that their findings
support the case that food additives increase the
occurrence of hyperactive behaviors in children. The
study shows that adverse effects are seen not only in
children already affected with ADHD or hyperactivity,
but in the general population as well.
• This study lends strong support towards our PICO
question of whether or not artificial food additives and
preservatives lead to hyperactive behaviors in children.
23. Review Article
Sara Mastrine Article 2
• Stevens, L. J., Kuczek, T., Burgess, J. R., Hurt, E., & Arnold, L. (2011).
Dietary Sensitivities and ADHD Symptoms: Thirty-five Years of
Research. Clinical Pediatrics, 50(4), 279-293.
doi:10.1177/0009922810384728
• Review of previous studies testing the effects of food
additives on hyperactive behaviors and ADHD symptoms
in children including Kaiser-Permanente (K-P) Diet
studies and Artificial Food Color (AFC) studies.
24. Review Article
Sara Mastrine Article 2
• Inclusion: Double- blind, placebo-controlled studies
• Exclusion: Age criteria
• Interventions: cookies, candy bars, beverages, and capsules
containing food dyes compared with placebos.
• Data collection methods: parent/teacher rating scales, visual
motor tests, neuropsychological tests
25. Review Article
Sara Mastrine Article 2
• Kaiser-Permanente (K-P) Diet
• Created by Benjamin Feingold in 1973.
• Diet completely free of foods containing natural salicylates
(almonds, apples, peppers, coffee, and teas) and all artificial food
colors and flavors.
• Review of 5 K-P diet studies led the authors to conclude that a
small amount of hyperactive children respond to this diet in such
a way that their behavior at home and school is improved.
*salicylates: naturally occurring chemicals in plants that act
as a defense against insects and diseases.
26. Review Article
Sara Mastrine Article 2
• Artificial Food Color (AFC) Studies
• Focused exclusively on artificial food colors and their effects on
behavior.
• Included dyes such as allura red, brilliant blue, and sunset yellow.
• Most of the studies reviewed showed that AFCs resulted in
significant changes in behaviors among children and adolescents.
27. Review Article
Sara Mastrine Article 2
• Results
Double-blind, Placebo-controlled Studies of AFC and Additives in Children with Behavior
Problems
Study
Diet
Test
P-value
Goyette et al exp. 2
Additive Free
Parent rating scale
P< 0.025
Williams and Cram
Modified K-P
Parent/teacher rating
scale
P<0.005
Swanson and
Kinsbourne
K-P diet
Learning Task
P<0.05
Pollock and Warner
Additive Free
Parent rating scale
P<0.01
Rowe and Rowe
Additive Free
Parent rating scale
P<0.001
28. Review Article
Sara Mastrine Article 2
• Conclusion
• Authors: The authors concluded that there is evidence
of a relationship between artificial food dyes and
hyperactivity in children. They strongly suggest
continuing research in this area.
• This article discusses the results of many studies done
on this topic, further showing that there is definitely a
strong relationship between artificial food additives
and hyperactivity/ADHD in children.
29. Primary Article
Chelsea Keady (Article 1)
• Boris, N., & Mandel, F. (1994). Foods and additives are
common causes of the attention deficit hyperactive disorder
in children. Annals of Allergy, 73, p462-466
• Subjects:
• All school aged children
• 3 children withdrew from the study
• All of the children experimented with both diets, the children
that responded favorably to the elimination diet, then
completed a double-blind placebo challenge
30. Primary Article
Chelsea Keady (Article 1)
• Inclusion:
• Children who met the criteria for ADHD
• ADHD developed before 7 years of age and has been noticeable
for at least 6 months with certain criteria present
• All members had a high score of over 66 on the Conners’ Parent
Rating Scale-48
• Exclusion:
• None included
31. Primary Article
Chelsea Keady (Article 1)
• Intervention:
• All of the subjects completed a 2 week elimination diet
• After the 2 weeks, the parents completed another CPRS-48 form
• Those children who responded favorably to the elimination diet,
then completed two phases of the DBPCFC that were each one
week in length
32. Primary Article
Chelsea Keady (Article 1)
• Results:
• 73% of the subjects that completed the first elimination diet
challenge responded favorably
• All of these subjects continued to show improvement in their
behavior during the two phase DBPCFC
33. Primary Article
Chelsea Keady (Article 1)
• Author’s Conclusion:
• The DBPCFC study supports the role of dietary factors in ADHD.
Through a simple elimination diet symptoms can be controlled
• My Conclusion:
• This study shows that the elimination diet is effective in
helping control the symptoms of ADHD
• The study was completed in a controlled and well monitored
manner, so I feel that the results are reliable
34. Review Article
Chelsea Keady (Article 2)
• Schnoll, R., Burshteyn, D., Cea-Aravena, J. (2003.). Nutrition in
the treatment of attention-deficit hyperactivity disorder: A
neglected but important aspect, 28 (1), 63-66.
• 3 studies included
• Subjects:
• Ages ranged from 3-12
• All subjects completed the study they were in– no dropouts
• All double-blind crossover studies
35. Review Article Cont.
Chelsea Keady (Article 2)
• Inclusion:
• All of the studies included children who met the criteria for ADHD
• Exclusion:
• None included
36. Primary Article Cont.
Chelsea Keady (Article 2)
• First Study
• Intervention:
• Harley et al.–
• Each child was maintained on the Feingold diet (elimination diet)
and the control diet for a period of 3 or 4 weeks
• The study team provided all foods and dietitians made home
visits to ensure adherence
• Parents and teachers rated their behavior
37. Review Article Cont.
Chelsea Keady (Article 2)
• Results:
• Parental ratings found that some of the boys responded favorably
when following the Feingold diet
• Teacher ratings, however did not agree with these findings
• Significant behavior change was found for the preschool boys—
teacher ratings were not available for this group
• All of the 10 mothers found their children to be more
manageable when following the experimental diet
38. Review Article Cont.
Chelsea Keady (Article 2)
• Second Study
• Intervention:
• Conners et al.—
• Each child was maintained on the Feingold and control diet for 4
weeks
39. Review Article Cont.
Chelsea Keady (Article 2)
• Results:
• Improvement in behavior was found in 4 out of the 15 children,
but only when the control diet was given first followed by the
elimination diet
40. Review Article Cont.
Chelsea Keady (Article 2)
• Third Study
• Intervention:
• Swanson and Kisbourne—
• Admitted the children to hospital, so elimination diet could be
administered in a controlled manner
• Used a laboratory test of cognitive functioning to assess their
behavior
41. Review Article Cont.
Chelsea Keady (Article 2)
• Results:
• They found that the performance on the laboratory test was
significantly worse after the dye challenge than after the placebo
challenge
42. Review Article Cont.
Chelsea Keady (Article 2)
• Authors’ Conclusion:
• These studies suggest that there is a small subset of children who
do demonstrate a dramatic reduction in hyperactive behavior
when following the elimination diet.
• Preschool children, as compared to school-age children, may be
more sensitive to food dyes, and may respond more favorably to
the elimination diet.
• My Conclusion:
• I think the studies are all of good quality. All of them were
double-blind the people evaluating the behaviors of the children
and the children themselves, did not know what diet they were
receiving.
43. Original Article
Erin Shirk (Article 1)
• Buitelaar, Jan K., Frankena, Klaas, Pelsser, Lidy M.J.,
Pereira, Rob Rodrigues, Savelkoul, Huub F.J.,
Toorman, Jan. (March 2008). A randomized
controlled trial into the effects of food on ADHD.
European Child & Adolescent Psychiatry 18;1, p 1219
• Randomized controlled trial
• Purpose: To assess the efficacy of a restricted
elimination diet in reducing symptoms in an
unselected group of children with Attention
deficit/hyperactivity disorder (ADHD).
44. Original Article
Erin Shirk (Article 1)
• Exclusion Criteria:
• Adopted or foster
children, co-existing
neurological diseases, an
IQ below 70,
prematurity or
dysmaturity, use of
alcohol, or smoking by
mother during
pregnancy
• Co-existence of other
psychiatric disorders,
except for oppositional
defiant disorder (ODD)
and conduct disorder
(CD)
• Inclusions Criteria:
• Dutch children referred
to ADHD Research
Center between January
and June 2006
• Diagnostic and Statistical
Manual of Mental
Disorders, Fourth Edition
(DSM-IV) for ADHD
Combined Type or
Predominantly
Hyperactivity-Impulsive
Type criteria
45. Original Article
Erin Shirk (Article 1)
72 children screened
for eligibility
52 excluded:
43 not meeting
inclusion criteria
9 refused to participate
27 randomized
15 assigned to
intervention group
12 assigned to
control group
2 dropped out:
1 child sick
1 withdrawn
1 dropped out:
withdrawn
13 completed trial
11 completed the
trial
46. Original Article
Erin Shirk (Article 1)
•
•
•
•
•
Initial N: 79 children screened for eligibility
Attrition (final N): 27 randomized; 24 actually completed
Age: Between 3.8 and 8.5 years old (mean age: 6.2)
Ethnicity: Not noted
Other relevant demographics: Children referred to the
ADHD Research Center
• Anthropometrics: Not noted
• Location: The Netherlands
47. Original Article: Design
Erin Shirk (Article 1)
• Design: 1 test group and 1 control group
• Blinding used- Subjects were randomly assigned to one
of the two groups by means of a sequence of numbered
cards in sealed unmarked envelopes that were prepared
by an independent pediatrician. The envelopes were
picked and opened by the parents in the presence of the
researcher, and treatment was then dispensed in
accordance to the allocation on the card.
• Intervention- Elimination diet – “Few Foods” i.e.
Restricted Diet
48. Original Article: Design
Erin Shirk (Article 1)
Measure
Points
Week 1
Rating scales Rating scales
parents
teacher
Intervention Control
group
group
1
Entrance trial
ACS-1, ARS-1
Start of
Start of
baseline diet baseline diet
Week 2
Week 3
Baseline diet Baseline diet
2
ACS-2, ARSAfter baseline 2, SPI
ACS-2, ARS-2
Week 9
3
At endpoint
ACS-3, ARS3, SPI
ACS-3, ARS-3
Baseline diet
ends
Waiting list
starts
Elimination
diet
Week 4-9
Baseline diet
ends
Elimination
diet starts
Waiting list
Elimination
diet ends
Waiting list
ends
Elimination
diet starts (if
desired)
49. Original Article: Rating Scales
Erin Shirk (Article 1)
• ACS: Abbreviated ten-item Conner’s scale
• Consists of ten items of behavior, focusing on overactivity,
impulsitivity, and inattention
• Uses a four-point rating scale (0-never, 1-sometimes, 2-often, 3always)
• ARS: ADHD Rating Scale
• Scores are divided in three parts:
• The number of ADHD criteria (18 in all)
• Nine items regarding impulsivity and hyperactivity
• Remaining marked out on a four-point rating scale
• SPI: Structured Psychiatric Interview
• Secondary endpoints
• Parent Ratings on ODD (oppositional defiant disorder) based on
DSM-IV-criteria for ODD.
50. Original Article: Statistical
Analysis
Erin Shirk (Article 1)
• SPSS version 9.0 was used for all statistical analyses.
• Analyzed on an intention-to-treat basis (ITT)
• Intended to avoid various misleading artifacts that can arise in
intervention research.
• Effect Size
• % Scale Reduction
• Cohen’s d – the difference between two means divided by a
standard deviation for the data
• A p-value of <.05 was considered statistically significant
• All testing was two-tailed
• Testing whether the treatment results in outcomes that are
different than chance, either better or worse
51. Original Article: Statistical
Analysis
Erin Shirk (Article 1)
• Subjects were defined as showing clinically significant
improvement if the difference between measure point 3
and measure point 2 was 50% or more on both the ACS
and the ARS.
• Student’s t test – Used to determine if two sets of data
are significantly different from each other
• Fisher’s exact test – Used when sample sizes are small;
useful for categorical data to examine the significance
of the association between categories
52. Original Article: Results
Erin Shirk (Article 1)
• Primary Outcomes
• No significant difference in the scores of both measurement
points for the ACS or ARS
• At the end of the trial, the mean scores of the
intervention group showed a 62.6% improvement on
the ACS and 70.3% improvement on the ARS
Number of ADHD criteria (P>0.001).
• In the waiting list (control group), scores increased by
4.4% (ACS) and decreased by 2.2% (ARS Number of
ADHD criteria).
• Difference on the improvements between the
intervention group and control group—17.6 (95%
Confidence Interval, 12.5-22.6 on the ACS and 9.4%
(95% CI 5.9-12.8, p< 0.001) on the ARS Number of
ADHD criteria. The control group had no responders.
53. Original Article: Results
Erin Shirk (Article 1)
• The effect size (Cohen’s d) was a 2.8 (67.3% scale reduction)
on the ACS and 2.1 (69.4% scale reduction) on the ARS
Number of ADHD criteria
• Parent ratings 11/13 children (85%) in the intervention group
who completed the study showed an improvement of 50% or
more
• Teacher ratings confirmed parent conclusions
• 64.3% scale reduction on the ACS
• 70.6% scale reduction on ARS Number of ADHD criteria
• Intervention Group – 11/15 (73%) classified as responders
• Did not meet the DSM-IV-criteria for ADHD anymore
• Control Group – 0/12
54. Original Article: Results
Erin Shirk (Article 1)
• Secondary Outcomes
• ODD (Oppositional Defiant Disorder)
• Entrance of trial
• 12/15 children in the intervention group
• 10/12 children in the control group
• End of trial
• 4/15 children in the intervention group
• 10/12 children in the control group
Intervention group’s co-existent ODD-criteria was diminished by
66%.
55. Original Article: Conclusions
Erin Shirk (Article 1)
• Author:
• Elimination diet triggers a significant change in both ADHDsymptoms and ODD-symptoms
• The appliance of an elimination diet in young children might
reduce risks of maladjustment
• Toxic, pharmacological, or immunologic mechanisms and the
physiological effects of different foods need to be further studied.
Elimination diets could possibly serve ADHD diagnoses as well as
they serve food sensitivity diagnoses . Rather than put
children on ADHD stimulant medication, elimination diets
should be followed. A larger study on the benefits of the
elimination diet in children with hyperactivity disorders is
needed.
56. Review Article
Erin Shirk (Article 2)
• Schab, David W., Trinh, Nhi-Ha T., (2004). Do Artificial Food
Colors Promote Hyperactivity in Children with Hyperactive
Syndromes? A Meta-Analysis of Double-Blind PlaceboControlled Trials. Journal of Developmental and Behavioral
Pediatrics. 25 (6); 423-434, 2004
• Purpose: Investigate the significance on the intake of artificial
food colors (AFCs) and hyperactivity symptoms in children
with hyperactive syndromes.
57. Review Article
Erin Shirk (Article 2)
• Exclusion Criteria:
• A trial would be
excluded if its subjects
had participated in
another included trial.
• Inclusion Criteria:
• Randomized and
employment of any of
several reversal designs
were acceptable
• Trials had to have
subjects under 18 years
of age and had to meet
the ADHD diagnostic
criteria.
• Trials had to employ an
intervention that could
isolate the effects of
AFCs.
58. Review Article Cont.
Erin Shirk (Article 2)
• Recruitment: OldMedline, MedLine, PubMed, PsychInfo,
Digital Dissertations/UMI ProQuest, ToxLine, Current Contents,
Biosis, the Cochrane Controlled Trials Register, and EMBASE
• Blinding used (if applicable): Double-blind placebo-controlled
trials
• Intervention: Artificial Food Colors
59. Review Article: Databases
Erin Shirk (Article 2)
•
•
•
•
•
•
•
•
•
Abstracted data
Graded for validity/bias threats
Segregation
Random effects
Variance for SMD 2(1-r)/n
Imputation & Noncontinuous
Homogeneity tests
Sensitivity tests
Publication bias tests
60. Review Article Cont.
Erin Shirk (Article 2)
• Statistical Methods
• DerSimonian and Laird random effects model with the
standardized mean difference for effect size (ES)
• Describes the difference in outcome between active and control
arms of a trial in terms of the number of pooled standard deviations
by which the two groups differ.
• Mantel-Haenszel test of homogeneity demonstrated that withingroup statistical homogeneity was unlikely (p<0.20).
• Funnel plot was created to evaluate the potential for publication
bias.
• Fail-safe n for ES represented the number of unpublished studies
with an ES of zero (ES of 0.15)
63. Review Article: Conclusion
Erin Shirk (Article 2)
Author:
• Our meta-analysis supports the hypothesis that AFCs promote
hyperactivity in hyperactive children, as measured on
behavioral rating scales.
• At the very least, regulators should track consumption of
AFCs; we know only that domestic production of food dyes
quadrupled between 1955 and 1998
Longitudinal studies should be done to determine the safety of
food additives and artificial food dyes. Elimination diets should
be utilized in attempting to reduce hyperactivity symptoms
64. Original Article
Rebecca Dean Article 1
• Connolly, A. A., Boylan, E. E., Flynn, A. A., Gibney, M. J., Hearty, A. A.,
Nugent, A. A., & McKevitt, A. A. (2010). Pattern of intake of food
additives associated with hyperactivity in Irish children and
teenagers. Food Additives & Contaminants. Part A, Chemistry,
Analysis, Control, Exposure & Risk Assessment, 27 (4), 447-456.
•
Double-blinded, randomized-controlled study
•
Purpose
•
To test whether or not there is a relationship between the consumption of
various mixes of seven target additives by children and the onset of hyperactive
behavior
65. Original Article
Rebecca Dean Article 1
• Inclusion Criteria
• Children ages 5-12
• Teenagers ages 13-17
• Irish nationality
• Exclusion Criteria
• N/A
• Recruitment
• Children (surveyed by the National Children’s Food Survey)
• 594
• Teenagers (surveyed by the National Teen Food Survey)
• 441
• Reasons for Withdrawals
• N/A
66. Original Article
Rebecca Dean Article 1
• Design
• Adolescents were surveyed (intake diaries) over seven days on quantitative
food intake containing seven different food additives as compared to the
previous Southampton study (UK)
• Intake diaries included the day of the week and type of meal (i.e. breakfast),
as well as physical activity measurements, lifestyle, and attitude information
• Additives (maximum permitted level)
•
•
•
•
•
•
•
Sunset Yellow (E110)
Carmoisine (E122)
Tartrazine (E 102)
Ponceau 4R (E124)
Allura Red (E 129)
Quinoline Yellow (E 104)
Sodium Benzoate (E 211)
• Food-Eating Occasions Consumed
• Children: 72,024
• Teenagers: 46, 473
• Meal-Eating Occasions Recorded
• Children: 19,795
• Teenagers: 13,541
67. Original Article
Rebecca Dean Article 1
• Design (cont.)
• Importance of Brands
• 36 branded food items
• Linked to identification codes according to the Irish National Food
Ingredient Database (INFID)
• Listed general information about the food i.e. brand name, product
description, product weight, country of origin, ingredients, and
nutritional information
68. Original Article
Rebecca Dean Article 1
• Statistical Analysis
• Irish children and teenagers were tested in comparison to the
previous Southampton study
• Food Consumption Data
• Exported from dietary analysis software WISP as food files into SPSS
(categorized food groups)
• Creme software conducted exposure assessments
• Raw food intake data from the survey diaries
• European Union Directive food groups
• Occurrence of target additives per food group
69. Original Article
Rebecca Dean Article 1
• Results
• The majority of additive containing food-eating occasions for both
children and teenagers only contained a maximum of one target
additive
• Children: 3.8%
• Teenagers: 3.1%
• The majority did not contain any of the target additives
• Children: 94.8%
• Teenagers: 96.2%
• Brands containing at least one target additive
• Children: 5.0%
• Teenagers: 3.9%
• Unique Brand Codes
• Children: 5,551 brand codes
• Teenagers: 4,921 brand codes
70. Original Article
Rebecca Dean Article 1
• Results (cont.)
• Children: no food-eating occasion contained five or more of the
target additives
• Teenagers: no food-eating occasion contained six or more of the
target additives
• The majority of meals for both populations contained at least one
target additive
• As the number of foods per meal-eating occasion decreased, the
presence of an additive-containing food increased
• Higher occurrence of additives in snack foods
71. Original Article
Rebecca Dean Article 1
• Results (cont.)
• “Fine Bakery Wares” and “Non-Alcoholic Flavored Drinks” food groups
contained the most brands containing target additives for both populations
• Many food groups consumed did not contain any of the target additives
• Children: consumed 20 of the 36 food groups allowing the target additives
• Teenagers: consumed 16 of the 34 food groups allowing the target additives
• In all cases, none of the subjects who ever achieved an intake on all seven
days at the levels of the Southampton study
• The conservative estimates of intake of food additives in Irish teenagers and
children are below those used in the Southampton study which
demonstrated a relationship between food additive intake and hyperactivity
in UK children
• The estimated upper intakes for a very small proportion of Irish teenagers
and children exceeded the intake levels used in the Southampton study on
individual days, but never on seven consecutive days
• When analyzing the food groups permitted to contain the target food
additives, it is clear that even though the food additives were permitted in a
number of food groups, the children and teenagers only consumed a small
proportion of these food groups (approximately half)
• The majority of the brands consumed did not contain any target additives
72. Original Article
Rebecca Dean Article 1
• Conclusion
• Authors’ Conclusion
• In Irish children and teenagers, levels of exposure to food additives rarely, if ever, reach
the levels used in the Southampton study
• The consumption of the combination of additives in single foods or in eating occasions of
multiple foods hardly ever occurs
• The data suggests that the risk-assessment process that followed from the Southampton
study should be reconsidered
• Limitations
•
•
•
•
•
•
•
Overestimation of food intakes
Age
Sample size
One location/nationality
Low exposure to food additives
Low exposure to combined food additives
Invalid adjustment to energy needs according to age
• My Conclusion
• The study does not strongly support the PICO question of whether or not artificial food
additives have an effect on hyperactivity. It states that more research must be conducted
in order to have enough supporting evidence. The study was of decent quality. There was
a respectably large sample, but it only pertained to one country. Statistics were clear but
broad. The non-bias, double-blinded qualities benefitted the study. I would like to see
more studies researching other factors related to food additives and the effects on
hyperactivity.
73. Original Article
Rebecca Dean Article 2
• Spring, C., & Perry, L. (1981). Case studies of effects of artificial food
colors on hyperactivity. Journal Of Special Education, 15361-372.
•
Double-blinded, double-crossover study
•
Purpose:
• To test Feingold's hypothesis that synthetic food colors cause
hyperactivity in some children
• Feingold’s Diet: Controls hyperactivity by eliminating
artificial colors and flavors
74. Original Article
Rebecca Dean Article 2
Inclusion Criteria
• Caucasian
• Male
• Ages 8-13
• Middle-income families (except Subject B, receiving some welfare support)
• All on diets effectively restricting artificial food colors and flavors
Exclusion Criteria
• N/A
Recruitment
• Initial: 8 Caucasian Males
• Final: 6 Caucasian Males
Reasons for Withdrawals
• Pre-diet hyperactivity ratings were below the 15-point cutoff (initial recruitment)
• Taken out of school to begin an early summer vacation with the child’s parents (Subject C)
• Serious family problem (Subject F)
75. Original Article
Rebecca Dean Article 2
Design
• Subjects challenged twice, for 3-day periods, with synthetic colors introduced in chocolate
cookies
• Contained all artificial colors currently approved by the FDA
• 2 cookies/day results in a full challenge equivalent to the average daily dose
• Cookies identical in appearance and taste contained no synthetics on control days
• Each cookie contained 13 mg of food colors in the following proportions:
• Red 40 - 38.78%
• Yellow 5 - 26.91%
• Yellow 6 - 22.74%
• Red 3 - 6.08%
• Blue 1 - 3.12%
• Blue 2 - 1.70%
• Orange B - 0.54%
• Green 3 - 0.13%
76. Original Article
Rebecca Dean Article 2
Design (cont.)
• 8 week study
• 2 week baseline period
• Hyperactivity ratings taken for Tuesday, Wednesday, and Thursday per week
• 6 week experimental period
• 2 cookies (one before and after school) eaten on Tuesdays, Wednesdays, and Thursdays
per week
• Diet diary by mothers listing all food items and amounts eaten by their child
• Group 1: Challenged during experimental weeks 1 and 4
• Group 2: Challenged during experimental weeks 3 and 6
• Diet history taken before baseline phase through interviews with mothers
• Ratings by mothers of typical behavior before and after the Feingold diet
• Ratings of subjects’ attitudes toward the Feingold diet
77. Original Article
Rebecca Dean Article 2
Design (cont.)
• Butylated hydroxytoluene (BHT), naturally occurring salycilates, and white sugar eliminated or
reduced in diets of certain subjects
• Artificial colors and flavors
Eliminated from all subjects
• BHT
A , B, D – reduced
C – eliminated
E , F – N/A
• Natural salycilates
F – reduced
B – eliminated
A, C, D, E – N/A
• White sugar
A , B, D – reduced
C – eliminated
E, F – N/A
78. Original Article
Rebecca Dean Article 2
Design (cont.)
•
•
•
•
Hyperactivity ratings before diet
A – 26
B – 26
C – 27
D – 27
E – 25
F – 23
Hyperactivity ratings during diet
A – 15
B – 13
C – 12
D – 13
E – 12
F – 14
Approximate months on diet
A–8
B–7
C – 32
D – 23
E – 32
F – 30
Attitudes towards the Feingold diet (0 = Does not like the diet; 1 = Does not mind the diet)
A , B, C, D, & F = 0; E = 1
79. Original Article
Rebecca Dean Article 2
Design (cont.)
• Learning Disabilities
A – R (Reading), Sp (Spelling), AR (Arithmetic)
B – R, Sp, AR
C – R, Sp, AR
D – R, Sp
E – N/A
F–R
• Special Classes
A, B, C, D: Yes
E, F: No
• Medication
B, C, D, F: Yes
A, E: No
*Subjects C and F discontinued medication before going on the Feingold diet
80. Original Article
Rebecca Dean Article 2
Statistical Analysis
• Abbreviated hyperactivity rating scale
• Ratings obtained by mothers
• Responses identical with those used with Conners' 10-item hyperactivity
scale
• (0 - not at all, 1 - just a little, 2 - pretty much, 3 - very much)
1. Restless or overactive
2. Excitable, emotional behavior
3. Fails to finish things, short attention span
4. Acts without thinking
5. Inattentive, easily distracted
6. Defiant, difficult to discipline
7. Temper outbursts, explosive unpredictable behavior
8. Constantly fidgeting
9. Demands must be met immediately, easily frustrated
10. Problem interacting with other children
• Total hyperactivity ratings computed by adding ratings for each item (0-30
points)
81. Original Article
Rebecca Dean Article 2
Statistical Analysis
• Global Behavior Judgment
• Mothers and teachers responded to behavior on a given day
• Guessed whether challenge or control cookies consumed
• Fisher Exact-Probability Tests
• Determine how closely the guesses of each subject's mother and teacher
matched actual daily cookie treatments
• Low probabilities indicate a close match between guesses and actual
treatments
• Point-Biserial Correlations
• Measured hyperactivity for each subject, of daily hyperactivity ratings
with daily diet-challenge treatments
82. Original Article
Rebecca Dean Article 2
Results
• Initial 8 subjects
• Correlation b/t mothers' pre-diet hyperactivity ratings and positive neurological signs
• 0.81 (p<0.01, one-tailed test)
• Correlation b/t mothers' during-diet hyperactivity ratings and positive neurological signs
• 0.51 (not significant)
• Correlation b/t mothers' pre-diet hyperactivity ratings and the composite index
• 0.68 (p<0.05, one-tailed test)
83. Original Article
Rebecca Dean Article 2
Results (cont.)
• Global Behavior Judgment
• Mothers’ guesses
(correct/incorrect)
• Challenge days
A – 4/2
B – 2/4
C – 2/4
D – 0/6
E – 3/3
F – 1/5
• Control days
A – 9/3
B – 8/4
C – 5/1
D – 9/3
E – 10/2
F – 5/4
Results (cont.)
–
Global Behavior Judgment
• Teachers’ guesses
(correct/incorrect)
– Challenge days
A – 1/5
B – 4/2
C – 1/5
D – 1/3
E – 4/1
F – 1/4
– Control days
A – 6/3
B – 6/5
C – 5/1
D – 6/4
E – 8/2
F – 6/3
84. Original Article
Rebecca Dean Article 2
Results (cont.)
• Fisher Exact-Probability Tests
• Subject E: Mother and his teacher fairly accurate in their guesses; only the teacher's data
were significant (p=0.05)
• Subject A: Mother fairly accurate, but not significantly
• Data for remaining subjects: Indicated little accuracy, failing to demonstrate the expected
relationship between hyperactivity and food color challenges for these subjects
• Point-Biserial Correlations
•
•
Mothers' ratings
A – 51 (p<0.05)
B – 0.33
C – (-0.07)
D – (-0.05)
E – 0.55 (p<0.05)
F – 0.10
Teacher’s ratings
A – (-0.08)
B – (-37)
C – 15
D – 0.00
E – 65 (p<0.05)
F – 0.14
85. Original Article
Rebecca Dean Article 2
Results (cont.)
•
•
•
•
•
Subject E
• Strongest results; mother and teacher were both able to relate diet challenges to episodes of
hyperactivity
• Regard the positive relationship between subject E's diet challenges and his behavior as casual
Subject A
• Weakest results; only mother detected the relationship
• Mother revealed that during the first challenge week an event occurred at home that strained
relations with his parents for several days
• Likely that the positive relationship between subject A's home behavior and the first challenge was
coincidental
Data for the remaining subjects
• Little relationship b/t daily hyperactivity ratings and daily treatments
Subject E
• Lowest infraction rate
• Did not mind the diet
• Relationship b/t diet challenges and behavior is casual
• Failed to replicate the relationship
High infractions for subjects A, C, and F
• Daily diet-challenge treatments redefined
• Analyses yielded results that gave less support to Feingold’s hypothesis than original analysis
86. Original Article
Rebecca Dean Article 2
Conclusion
Authors’ Conclusion
• Subject E might be responsive to artificial food colors
• The challenge-behavior relationship was not duplicated in a subsequent replication
attempt
• Cannot conclude that Feingold's hypothesis received obvious support from subject E's
data
• Support does not justify the broad claims made for the efficacy of a diet eliminating
artificial food colors
• The possibility that a very small percentage of hyperactive children are responsive to
artificial food colors, however, cannot be ruled out
• Feingold's hypothesis has not fared well under experimental study
Limitations
-Diet infractions/violations
-Inconsistent mothers’ reports of diet effectiveness
-Sensitivity to synthetic flavors rather than colors
My Conclusion
•
The study does not strongly support the PICO question of whether or not artificial food additives have an
effect on hyperactivity. It states that more research must be conducted in order to have enough
supporting evidence. The study was of decent quality. Sample size was small, but the non-bias, doubleblinded double-crossover qualities benefitted the study. I would like to see more studies researching
other factors related to food additives and the effects on hyperactivity.
87. Primary Article
Brandon King (Article 1)
• Harley, J., Matthews, C. G., & Eichrnan, P. (1978). Synthetic Food
Colors and Hyperactivity in Children: A Double-Blind Challenge
Experiment. Pediatrics, 62(6), 975.
• Subjects:
• 9 males with an average age of 9 years old
• These 9 males were selected from a group of 46 from a previous study that were
most affected by additives and were in the top 50th percentile for hyperactivity of
the 46 from the previous study
• None of the subjects withdrew
• Double blind challenge experiment
88. Primary Article
Brandon King (Article 1)
• Inclusion:
•
•
•
•
All subjects were 9 years old
All average students
None of them had been taking behavioral modification drugs prior to study
Top 50th percentile for hyperactivity from the previous study
• Exclusion:
• None stated
89. Primary Article
Brandon King (Article 1)
• Intervention
• The first two weeks the subjects stayed on their regular diet and behavior was
observed
• The next two weeks the subjects were put on an elimination diet along with the
rest of their family for the remainder of the study
• The subjects were then supplied with a placebo or challenge which came in the
form of candy bars or cookies twice a day with the code kept secret from the
observers
• 5 subjects received placebo for a two week period followed by two weeks of
challenge, then another two weeks of placebo and ending with three weeks of
challenge material
• The other four subjects received the opposite sequence after baseline
• The challenge material contained 27mg of food colors and the placebo contained
none
90. Primary Article
Brandon King (Article 1)
• Results
PT-Q showed a significant difference of (p>0.001) by mothers, (p>0.001)
by
fathers, and (p<0.01) by teachers in behavioral ratings, and (p>0.01) by
mothers,
(p>0.001) by fathers, and (p<0.01) by teachers of the hyperactive group
versus
the control group. The challenge group showed a significant difference
of
(p<0.001) by mothers, (p>0.001) by fathers, and (p<0.01) by teachers
during
placebo conditions as well as challenge conditions, showing symptoms
were more
severe and significant by the hyperactive group. The "disruptive
behavior index"
showed a significant difference of (p<0.05) in the first four weeks, but
an
insignificant difference of (p>0.05) during the placebo and challenge
weeks. This
91. Primary Article
Brandon King (Article1)
• Authors conclusion:
• The elimination diet or K-P diet has shown evidence supporting that it may
decrease hyperactivity by taking out food coloring but that there is not enough
research to say that it is effective.
• My conclusion:
• Food coloring and the link between hyperactivity does not have enough evidence
to support it but the elimination diet may help with decreasing hyperactivity in
children but more studies need to be conducted.
92. Primary Article
Brandon King (Article 2)
• Rapp, D. J. (1978). Does Diet Affect Hyperactivity?. Journal Of
Learning Disabilities, 11(6),
• Subjects:
• 24 children, 6 females and 18 males
• 5-16 years in age with a mean age of 10
• 7 children withdrew for unknown reasons
• Started with a sublingual dye test, if showed hyperactivity this test
was repeated, they then did an elimination diet.
93. Primary Article
Brandon King (Article 2)
• Inclusion
• Short attention spans, easily distractible, impulsive, and had
behavior or learning disabilities and had been recommended for
the study by a physician, psychologist, or members of Association
for children with learning disabilities
• They are also on a behavior modifying drug or have previously
used them unsuccessfully
• Exclusion
• No exculsions
94. Primary Article
Brandon King (Article 2)
• Intervention
• Parents completed Abbott Hyperkinesis index sheets before and
at varying intervals throughout study
• Children given sublingual dyes to see if any hyperactivity was
observed and if so this was repeated
• Subjects were put on an elimination diet for 12 weeks and
observed by parents
95. Primary Article
Brandon King (Article 2)
• Results
• 12 of 23 showed improvement in activity in the first week
• 11 of 17 continued to show improvement throughout the study
• The subjects that completed all 12 weeks scored a decrease
mean of 11.5 points on the Abbotts Hyperkinesis index sheet
96. Primary Article
Brandon King (Article 2)
• Authors conclusion:
• There is a relationship between hyperactivity and food additives
and allergies but further study needs to be done.
• My conclusion:
• There is evidence that supports hyperactivity and a relationship
with food coloring but further testing needs to be done on a
larger group.
97. Tally Sheets
Tally Sheet of Quality Ratings: Primary Research
Student Name
Sara Mastrine
Chelsea Keady
Rebecca Dean
Rebecca Dean
Erin Shirk
Author
McCann,
Donna, et al
2007
Boris, M.,
Mandel, F.
1994
Connolly, A. A.,
et al
2010
Spring, C., &
Perry, L.
1981
Buitelaar, Jan
K., et al
2008
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
+
Unclear
Unclear
No
No
No
Yes
Yes
Yes
Yes
Unclear
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
+
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
+
Year
Relevance
Questions
1
2
3
4
Brandon
King
Rapp, B,J
1978
Brandon
King
Preston, H
et al
1978
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Unclear
Yes
Yes
Yes
Yes
Yes
+
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
+
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
+
Validity Questions
1
2
3
4
5
6
7
8
9
10
Quality Rating
(+, 0, -)
98. Group Tally Sheet (review)
Tally Sheet of Quality Ratings: Review Articles
Student Name
Author
Sara Mastrine
Stevens, Laura J. et al
Chelsea Keady
Schnoll, R., Dmitry, B.,
Cea-Aravena, J.
Year
Relevance Questions
2011
2003
Erin Shirk
Schab, David W. & Trinh,
Nhi-Ha T.
2004
1
2
3
4
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Unclear
Yes
Yes
Yes
Yes
Yes
Yes
+
Yes
Yes
Unclear
Yes
Yes
Yes
Yes
Yes
Yes
Yes
+
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Unclear
+
Validity Questions
1
2
3
4
5
6
7
8
9
10
Quality Rating
(+, 0, -)
99. Group Conclusion/ Summary
• In our group’s opinion, our articles conclude that in general,
consumption of various Artificial Food Colors (AFCs), food dyes, and
other food additives do show increases in hyperactivity in children
who meet the DSM-IV criteria for ADHD prior to the ingestion of
these additives. Eliminations diets or alternative diet therapies that
reduce the consumption of these ingredients have shown to
improve behaviors and decrease hyperactivity in children that meet
the DSM-IV criteria for ADHD. Therefore, these should be considered
when approaching alternatives to traditional ADHD medications in
hopes of decreasing the amount of children having these
prescriptions written for them.
100. Grade
• Grade II: Fair
• We felt our articles and research provided fair evidence that
supported the conclusions of the authors. Our uncertainty
attached to the conclusion was due to generally small sample
sizes that were not very long in terms of the length of time
these studies were being conducted for. Despite these
uncertainties, all of our articles suggest that further research
would only add to the positive results that were published.
• Withdrawals
• Inadequate sample sizes
• Blinding discrepancies
• Testing on children
101. References
•
•
•
•
•
•
•
•
•
•
•
•
•
McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., & ... Stevenson, J.
(2007). Food
additives and hyperactive behaviour in 3-year-old and 8/9 year-old children
in the community: a
randomised, double-blinded, placebo-controlled trial. Lancet,
370(9598), 1560-1567.
Stevens, L. J., Kuczek, T., Burgess, J. R., Hurt, E., & Arnold, L. (2011). Dietary Sensitivities and ADHD
Symptoms: Thirty-five Years of Research. Clinical Pediatrics, 50(4), 279-293.
doi:10.1177/0009922810384728
http://www.webmd.com/add-adhd/guide/attention-deficit-hyperactivity-disorder-adhd
Boris, N., & Mandel, F. (1994). Foods and additives are common causes of the attention deficit hyperactive
disorder in children. Annals of Allergy, 73, p462-466
Schnoll, R., Burshteyn, D., Cea-Aravena, J. (2003.). Nutrition in the treatment of attention-deficit hyperactivity
disorder: A neglected but important aspect, 28 (1), 63-66.
Connolly, A. A., Boylan, E. E., Flynn, A. A., Gibney, M. J., Hearty, A. A., Nugent, A. A., & McKevitt, A. A. (2010).
Pattern of intake of food additives associated with hyperactivity in Irish children and teenagers. Food Additives &
Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment, 27 (4), 447-456.
Spring, C., & Perry, L. (1981). Case studies of effects of artificial food colors on hyperactivity. Journal of Special
Education, 15 361-372.
2003. Food Labeling Regulations: A Historical and Comparative Survey . (ONLINE) Available at http://nrs
.harvard.edu/urn-3:HUL. (Last Accessed May 11, 2013).
http://www.cspinet.org/fooddyes/
Buitelaar, Jan K., Frankena, Klaas, Pelsser, Lidy M.J., Pereira, Rob Rodrigues, Savelkoul, Huub F.J., Toorman, Jan.
(March 2008). A randomized controlled trial into the effects of food on ADHD. European Child & Adolescent
Psychiatry 18;1, p 12-19
Schab, David W., Trinh, Nhi-Ha T., (2004). Do Artificial Food Colors Promote Hyperactivity in Children with
Hyperactive Syndromes? A Meta-Analysis of Double-Blind Placebo-Controlled Trials. Journal of Developmental and
Behavioral Pediatrics. 25 (6); 423-434, 2004
Harley, J., Matthews, C. G., & Eichrnan, P. (1978). Synthetic Food Colors and Hyperactivity in Children: A DoubleBlind Challenge Experiment. Pediatrics, 62(6), 975.
Rapp, D. J. (1978). Does Diet Affect Hyperactivity?. Journal Of Learning Disabilities, 11(6),