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ObjectiveEstimating dietary intake is challenging in patients with chronic diseases. The aim of this study was to calibrate the Block Brief 2000 food frequency questionnaire (BFFQ) using 3-day food diary records among patients on dialysis.MethodsData from 3-day food diary records from 146 patients new to dialysis were reviewed and entered into National Cancer Institute self-administered 24-hour dietary recall (ASA24), a web-based dietary interview system. The information was then re-entered omitting foods reported in the diaries that were not in the BFFQ to generate a "BFFQ-restricted" set of intakes. We modeled each major dietary component (i.e., energy [total calories], protein, carbohydrate, fat) separately using linear regression. The main independent variables were BFFQ-restricted food diary estimates computed as the average of the 3 days of diaries, restricted to items included in the BFFQ, with the unrestricted 3-day food diary averages as dependent variables.ResultsThe BFFQ-restricted diary energy estimate of 1,325 ± 545 kcal was 87% of the energy intake in the full food diary (1,510.3 ± 510.4, P < .0001). The BFFQ-restricted diary carbohydrate intake was 83% of the full food diary (156.7 ± 78.7 g vs. 190.4 ± 72.7, P < .0001). The BFFQ-restricted fat intake was 90% of the full-diary-reported fat intake (50.1 ± 24.1 g vs. 56.4 ± 21.6 g, P < .0001). Daily protein intake assessments were not statistically different by BFFQ-restricted diary and full diary assessment (63.1 ± 28.5 vs. 64.1 ± 21.4 g, P = .60). The associations between BFFQ-restricted diary intake and unrestricted intake were linear. Three-day diary-reported intake could be estimated from BFFQ-restricted intake with r2 ranging from 0.36 to 0.56 (P < .0001 for energy [total calories], protein, carbohydrate, and fat). Final equations did not include adjustments for age, sex, or race because the patterns of associations were not significantly different.ConclusionEnergy and macronutrient estimates by BFFQ are lower than estimates from 3-day food diaries, but simple calibration equations can be used to approximate total intake from BFFQ responses.

Patients with kidney failure who receive dialysis in the morning may live longer than those who receive it in the afternoon, according to a study of 242 patients with end-stage kidney failure. More research is needed to confirm this conclusion and to determine how morning dialysis differs from afternoon dialysis., Context Patients with end-stage renal disease (ESRD) typically undergo hemodialysis (HD) during the morning or afternoon, with time of treatment generally based on space availability or patient preference. No studies have investigated variation in patient survival as a function of the time of day when they receive dialysis. Objective To investigate the association of elderly patients&apos; HD treatment shift with their continued survival, controlling for well-established HD-related mortality risk factors. Design, Setting, and Participants An 11-year follow-up cohort study conducted among 242 ESRD patients aged 60 years or older who underwent HD at 58 dialysis facilities in Georgia either during a morning shift (n = 167) or an afternoon shift (n=75) and who completed baseline (1998) and follow-up (1991) interviews. Main Outcome Measure Mortality from all causes occurring through July 7, 1999, as verified by death-certificate reviews, and compared by morning- vs afternoon-shift HD. Results Morning-shift HD patients survived significantly longer than afternoon-shift patients (median survival, 941 days vs 470 days; P Conclusions Possible explanations for differential survival in association with morning vs afternoon dialysis include salutary effects of sleep in the morning or less efficient biochemical exchange during afternoon dialysis. Results from this cohort study may warrant prospective observational studies and randomized clinical trials that systematically alter the time of day at which HD is administered.

'Friendships' (ongoing interpersonal interactions) and agitated behavior were studied among 59 residents of a dementia special care unit; most residents had mild to moderate cognitive impairment. Behavior scan data were recorded by trained observers over six months. Three scans per hour were conducted, seven days a week, between 9 a.m. and 9 p.m., producing more than 17,000 observations. A marginal model for binary longitudinal data was developed to associate covariates with repeated observations of agitation, the dependent variable; generalized estimating equations were used to estimate regression parameters. Friendship behavior was significantly associated with (less) observed agitation in this group of dementia residents, controlling for additional variables expected to predict agitation. Opportunity for self-initiated interpersonal engagement may contribute significantly to the wellbeing of moderately impaired dementia residents. Repeated over-time assessments are important in understanding factors related to expression of problem behaviors in this population.

Older persons who are willing to begin exercise programs are often not willing to continue them. At the Atlanta FICSIT (Frailty and Injuries: Cooperative Studies of Intervention Techniques) site, individuals aged 70+ were randomized to Tai Chi (TC), individualized balance training (BT), and exercise control education (ED) groups for 15 weeks. In a follow-up assessment 4 months post-intervention, 130 subjects responded to exit interview questions asking about perceived benefits of participation. Both TC and BT subjects reported increased confidence in balance and movement, but only TC subjects reported that their daily activities and their overall life had been affected; many of these subjects had changed their normal physical activity to incorporate ongoing TC practice. The data suggest that when mental as well as physical control is perceived to be enhanced, with a generalized sense of improvement in overall well-being, older persons' motivation to continue exercising also increases.