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Healthful dietary intakes are crucial for stemming the current childhood obesity epidemic. We examined the dietary intakes of 392 Michigan children aged 1-12 years. About 70% and 58% of children ate fruits and vegetables, respectively, each day; 26% drank sugar-sweetened beverages; and 31% ate with a television on. Children's vegetable intakes were significantly and moderately correlated with their parents' vegetable intakes (r = .34-.38), but their fruit intakes were more related to their grandparents' fruit intakes (r = .31). Due to the relative representativeness of our sample and similarities in eating patterns across the region, Extension professionals may consider our study findings when designing tailored nutrition education programs for families in the midwestern United States. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) therapies are often used with 'mainstream' medical treatments. Estimates of use by cancer survivors range from 7-64%. It is important for oncology nurses to understand factors influencing CAM use and implications for nursing care. This study aimed to determine patterns, predictors and purpose of use of CAM providers, practices and products in the U.S. cancer population in relationship to symptom management. The CAM Healthcare Model, an extension of the Behavioral Model for Health Services Use, guided the study. Predisposing, enabling and need-for-care factors were examined for ability to predict CAM use. A secondary analysis of the National Health Interview Survey (NHIS) using STATA 9.2 software for population estimation was conducted. The sample included all individuals reporting a cancer diagnosis in the NHIS (N=2262). Study participants were asked if they used any of the 22 CAM therapies listed in the Alternative Health Supplement of the NHIS. CAM therapies were categorized as provider services, practices or products for analysis. Dependent variables included: (a) overall use/non-use of at least one of the identified CAM therapies, (b) use/non-use of specific CAM categories and (c) purpose of use (treatment/health promotion). Independent variables included: Predisposing factors (gender, age, race, education, marital status), Enabling factors (income, health insurance, provider-contact), and Need factors (cancer site, symptoms, co-morbidity, health status). Binary and Multinomial Logistic Regression, the primary statistical models employed in the analysis, focused on between-subject differences in CAM use. A stepwise procedure was followed and potential predictor variables were excluded from the model if their p-value exceeded 0.10 Multivariate analysis has identified characteristics that distinguish CAM users from non-users in the U.S. cancer population, representing an estimated 14.3 million cancer survivors. Empirical findings confirm CAM use was more prevalent among female, middle-aged, white, and well-educated people; women were specifically more likely to use CAM practices than men. Higher income, private insurance, contact with nurse practitioners, reported pain and co-morbidity were strong predictors of CAM use by cancer survivors. CAM use was reported by 39% of all cancer survivors, highlighting the need for oncology nurses to assess CAM use by their patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate what specific ostomy self-care educational content is considered the most useful by the new ostomy patient after discharge., Design: A cross-sectional, correlational design was used to address study aims., Subjects and Setting: The sample comprised 33 men and 27 women with a mean age of 55.58 ± 15.56 (mean ± SD) years, range 27 to 79 years old. The study setting was a 587-bed teaching hospital, level 1 trauma center in the Midwest, with Magnet designation., Methods: Demographic data were collected during the patients' hospital stay as part of routine care. This information is used for follow-up with all ostomy patients who have surgery in this hospital. All of the participants in this study completed an interview administered by phone or in person. A semistructured interview guide was used to elicit participant perceptions of the usefulness of 4 categories of ostomy care, including (1) ostomy information (ostomy function), (2) activities of daily living (strategies to manage travel, bathing, intimacy, odor), (3) ostomy care (strategies for managing the ostomy), and (4) other informational needs (social support resources). Participants were asked to rate these 4 areas from most useful to least useful, using a 4-point scale. At the end of the interview, participants were asked, "Has there been anything that has happened or event related to your ostomy that your ostomy teaching did not prepare you for?" The interview took place several weeks after surgery or during their readmission visit for surgical ostomy takedown., Results: Sixty-two patients were enrolled into the study, and 60 participants completed the data collection. The sample included 26 (43%) patients with ileostomies, 18 (30%) with colostomies, and 16 (27%) with urostomies. Ninety percent ranked the education category of ostomy self-care as the most useful content, 55% ranked information on resuming activities of daily living as the second most useful category, and 55% ranked general information as third most useful content area. Fifty respondents (83%) ranked ostomy support as the least useful. Nine (15%) of the participants felt unprepared for their first pouch leak, and 2 (3%) reported difficulty adjusting to the feel of the stool entering the pouch. Two patients would have liked more photos of peristomal skin conditions and how to treat them., Conclusions: Since the category of ostomy self-care ranked highest, patient teaching for the new ostomy patient should focus on this skill set, including stoma care, how, and when to empty and change the pouch.

The authors report on results from a survey assessing the attitudes of medical residents toward the American Osteopathic Association and the Accreditation Council for Graduate Medical Education duty-hour standards that became effective for all accredited residency programs on July 1, 2003. Data were gathered from 128 residents in four medical specialties: family medicine, general surgery, internal medicine, and obstetrics and gynecology. Participating residents worked at four teaching hospitals with allopathic, osteopathic, or dual-accredited programs. The dominant response of medical residents to duty-hour restrictions is clearly-though not uniformly-positive. Residents tend to agree that there are safety benefits for patients and quality-of-life benefits for themselves. A consistent pattern of positive responses toward the standards among internal medicine residents contrasts with less favorable responses among residents in general surgery programs. Gender differences are noted as well, with women generally more positive about duty-hour restrictions than their male colleagues. Male residents in surgery and obstetrics especially tend to agree that duty-hour restrictions could have negative effects on physician education with regard to their continuity of experience. The most consistent pattern in resident survey responses appears to be by medical specialty, perhaps reflecting variations in the nature of patient care and contact in each specialty.

The authors address the need for a better understanding of the reasons for greater indebtedness among today's osteopathic medical students. In May 2000, a survey was mailed to all 219 osteopathic interns at participating institutions in Michigan. The self-administered survey contained 19 questions designed to gather basic financial information, demographic characteristics, and subjective perceptions of student debt loads from participating interns. One hundred seventy completed surveys were returned, for a response rate of 78%. The authors attempted to focus on demographic predictors of debt and found that although there is no indication that such predictors have a significant effect on a student's total debt load, financial support from the student's family remains the single most important factor in predicting low levels of student debt. The authors suggest that the higher debt rate of students entering specialty fields may reflect the fact that students incur these debts with the knowledge that those debts will be more easily repaid once the student has begun to practice medicine.