Johnson, Cara M.; Bednar, Carolyn; Kwon, Junehee; Gustof, Alissa
Purpose: The purpose of this study was to compare nutrient content and cost of home-packed lunches to nutrient standards and prices for reimbursable school lunches. Methods: Researchers observed food and beverage contents of 333 home packed lunches at four north Texas elementary schools. Nutritionist Pro was used to analyze lunches for calories,…
US Department of Agriculture, 2009
The National School Lunch Program is a federally assisted meal program operating in over 101,000 public and non-profit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to more than 30.5 million children each school day in 2008. In 1998, Congress expanded the National School Lunch…
The U.S. Department of Agriculture proposed and adopted a new set of meal pattern requirements for the National School Lunch Program that will allow schools to claim 6 cents more in lunch reimbursement rates. This study analyzes the food costs of school menus in 2005 that met many of the proposed requirements. Overall, schools that served more, and more diverse, non-starchy vegetables had higher average food costs, and schools that served menus with lower calories had lower food costs. The fo...
Schanzenbach, Diane Whitmore
This paper assesses whether school lunches contribute to childhood obesity. I employ two methods to isolate the causal impact of school lunches on obesity. First, using panel data, I ?nd that children who consume school lunches are more likely to be obese than those who brown bag their lunches even though they enter kindergarten with the same…
Members of the personnel are reminded that only school fees from educational establishments recognized by local legislation are reimbursed by the Organization. Human Resources Division Tel. 72862/74474
. The concept of foodscape captures the school lunch as a specific configuration of food products, social practices and values. The concept of human well-being defined by Amartya Sen and elaborated by Martha C. Nussbaum helps to characterize the needs involved in the school lunch. The assessment is performed...
In order to answer regular enquiries on this subject, members of the personnel are reminded that only school fees from educational establishments recognized as such by the competent authorities of the Member State concerned are reimbursed by the Organization. Human Resources Division Tel. 72862/74474
大迫, 康子; 小住, フミ子; Yasuko, OSAKO; Fumiko, OZUMI
There are many small islands, villages and fishing ports in Kagoshima. This study was designed to investigate whether a local color in school lnuch exist or not. It was found that the school lunch served in small island had the best nutritional quantity and quality and menu contents. Contradictionus results, vitamin deficiency in village and protein deficiency in fishing ports, were also obtained. There is a correlation between lunch cost and menu contents. The shotage of potatos and beans ob...
Litchfield, Ruth E.; Wenz, Betsy
Purpose/Objectives: The school nutrition environment includes food policy and practices, advertising, and presence of competitive foods (CF). CF provide schools with revenue; however, CF decrease National School Lunch Program (NSLP) participation and reimbursement as well as the nutrient density of children's diets. Local wellness policies (LWPs)…
Stevens, Lesley; Nicholas, Jo; Wood, Lesley; Nelson, Michael
To compare food choices and nutrient intakes of pupils taking a school lunch or a packed lunch in eighty secondary schools in England, following the introduction of the food-based and nutrient-based standards for school food. Cross-sectional data collected between October 2010 and April 2011. Pupils' lunchtime food choices were recorded over five consecutive days. Secondary schools, England. A random selection of 5925 pupils having school lunches and 1805 pupils having a packed lunch in a nationally representative sample of eighty secondary schools in England. The differences in the specific types of food and drink consumed by the two groups of pupils are typical of differences between a hot and cold meal. On average, school lunches as eaten contained significantly more energy, carbohydrate, protein, fibre, vitamin A, folate, Fe and Zn than packed lunches, and 8 % less Na. Although neither school lunches nor packed lunches provided the balance of nutrients required to meet the nutrient-based standards (based on about one-third of daily energy and nutrient requirements), school lunches generally had a healthier nutrient profile, with lower Na and percentage of energy from fat, and higher fibre and micronutrient content. These differences were greater than those reported prior to the introduction of compulsory standards for school lunches. In order to ensure more pupils have a healthy lunch, schools could introduce and enforce a packed lunch policy or make school meals the only option at lunchtime.
Food waste, student rejection of Type A meals, and the difficulty of keeping school food service departments in the black have been the three major problems in the school lunch program. The Las Vegas Fast Food Combo Program provides an answer. By providing the foods students want to eat--foods of the type advertised everywhere--and making that…
Morris, Patricia McGrath; And Others
This report provides information on the content of school lunches offered to middle school children in the public schools. A total of 163 middle schools in 42 states responded to the school lunch survey. Survey findings are given on: (1) the contents of the main course, vegetable and fruit offerings, desserts, and beverages; and (2) lunches…
... 27, 2012. The Office of Management and Budget (OMB) cleared the associated information collection... 2010 regarding performance-based cash assistance for school food authorities (SFA) certified compliant... receive performance-based cash assistance for each reimbursable lunch served (an additional six cents per...
Smith, Stephanie; Cunningham-Sabo, Leslie; Auld, Garry
Purpose/Objectives: The purpose of this study was to determine middle school students' satisfaction with the school lunch experience, using two validated surveys; the Middle/Junior High School Student Participation Survey and the Middle/Junior High School Student Non-Participation Survey, both developed by the National Food Service Management…
Andersen, Sidse Schoubye; Holm, Lotte; Baarts, Charlotte
the social life of a school class, and how these arrangements involve strategies of both inclusion and exclusion. Two types of school meals are compared in the intervention study: a hot meal based on Nordic ingredients and the normal Danish school meal arrangement in which children bring lunch packs...... to school. The study discusses commensality by examining and comparing lunchtime interactions within the same group of children in the two contrasting meal situations. The results fail to confirm the conventional view that shared meals have greater social impacts and benefits than eating individualized...... foods. The article argues that the social entrepreneurship involved in sharing individual lunch packs might even outweigh some of the benefits of shared meals where everyone is served the same food....
Minaya, Sarah; Rainville, Alice Jo
Through reinforcement of policies and nutrition standards linked to the National School Lunch Program (NSLP), school environments play an important role in preventing childhood obesity. The NSLP includes mandated nutrition standards that specify recommended servings of vegetables, fruit, whole grains, dairy and protein, as well as limits on…
Paxton, Amy; Baxter, Suzanne Domel; Fleming, Phyllis; Ammerman, Alice
Children's dietary intake is a key variable in evaluations of school-based interventions. Current methods for assessing children's intake, such as 24-hour recalls and meal observations, are time- and resource-intensive. As part of a study to evaluate the impact of farm-to-school programs, the school lunch recall was developed from a need for a valid and efficient tool to assess school lunch intake among large samples of children. A self-administered paper-and-pencil questionnaire, the school lunch recall prompts for school lunch items by asking children whether they chose a menu item, how much of it they ate, how much they liked it, and whether they would choose it again. The school lunch recall was validated during summer school in 2008 with 18 third- to fifth-grade students (8 to 11 years old) in a North Carolina elementary school. For 4 consecutive days, trained observers recorded foods and amounts students ate during school lunch. Students completed the school lunch recall immediately after lunch. Thirty-seven total observation school lunch recall sets were analyzed. Comparison of school lunch recalls against observations indicated high accuracy, with means of 6% for omission rate (items observed but unreported), 10% for intrusion rate (items unobserved but reported), and 0.63 servings for total inaccuracy (a measure that combines errors for reporting items and amounts). For amounts, accuracy was high for matches (0.06 and 0.01 servings for absolute and arithmetic differences, respectively) but lower for omissions (0.47 servings) and intrusions (0.54 servings). In this pilot study, the school lunch recall was a valid, efficient tool for assessing school lunch intake for a small sample of third- to fifth-grade students. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Hoff, Mary E.
The variety of school lunch foods available has dramatically expanded as school food managers strive to increase sales and generate revenue. Though lunchtime offerings are often based on student preferences versus nutritional value, with a small investment of effort and commitment to student well-being, schools can create lunch programs that…
Beaulieu, Dominique; Godin, Gaston
Purpose: Easy access to fast-food restaurants in the immediate environment of a high school is such that a high proportion of students do not remain in school for lunch. Hence, the probability that they will eat a healthy meal is reduced. The aim of this study is to identify the behavioral determinants of "staying in school to eat lunch" among…
Haas, Jessica; Cunningham-Sabo, Leslie; Auld, Garry
Purpose/Objectives: The purpose of this study was to determine: (1) What foods high school students participating in the National School Lunch Program (NSLP) are discarding the most? (2) How much of these foods they are discarding? and (3) What are their perceptions towards school lunch? Methods: Researchers measured plate waste at two high…
Full Text Available The first lunch programs in Palestine were the “soup kitchens,” which were established in Jerusalem before the First World War to feed the poor. Then, in 1923, Henrietta Szold launched a lunch initiative in schools in order to supply basic nutrition to students. As the children at most of the schools prepared the meals themselves with local products, they also learned good, low-cost eating habits and the appropriate use of domestic goods and had educational goals as well. These educational goals were in line with Zionist ideology. School lunch programs lasted through the early years of the nation of Israel, albeit without official governmental support, but they came to an end amid the rising prosperity of the early 1970s. In 2004, in response to the alarming results of a food security survey conducted by the Ministry of Health, the Knesset passed a law establishing a new school lunch program on a trial basis. This article reviews the history of lunch programs in Israel, highlighting both their achievements and their limitations, in order to establish a framework for judging the success of the current school lunch policy.
.... To foster school environments that encourage physical activity and nourishing diets, ``Let's Move... for nutritional quality in school food, participation in meal programs, physical activity, and... National School Lunch Week, we recognize the vital importance of this historic program, and we recommit to...
Rowe, Bradley; Rocha, Samuel
School lunch is one of the least critiqued aspects of compulsory schooling. As a result, there may be a tendency to think of school lunch as part of the hidden curriculum, but what and how students eat are evident and ubiquitous parts of the schooling experience. In demarcating the school lunch as an overt educational event, this article attempts…
Thorsen, Anne Vibeke; Lassen, Anne Dahl; Christensen, Lene M.
Background and objectives: The majority of Danish children do not eat in accordance with the national dietary guidelines. The OPUS School Meal Study is a school-based intervention study testing the health effects of the New Nordic Diet (NND). The aim of this sub-study was to compare edible plate.......0; 119.0). Lunches rated as ‘really bad’ or ‘bad’ in the self-reported likings had more waste than lunches rated ‘really good’ (P ... schools were assigned to the food waste sub-study. Edible plate waste was measured by weighing individually the meal for 5 consecutive days before and after lunch at the end of each dietary period. Self-reported smiley ratings from a web-based dietary assessment software for children were compared...
accuracy differ by the lunch format consumed (Paper III) Material and methods The study was conducted as a cross-sectional dietary reporting study. The population consisted of 11-year-old children from three public schools in Copenhagen. The study was conducted on two consecutive days and assessed...... in general. Objectives The aim of the present thesis was to assess food level reporting accuracy in Danish 11-year-old children’s self-reported school lunch consumption, and the aim was operationalized in following objectives. 1- To identify food items clustering by lunch format (Preliminary analyses) 2......- To assess reporting accuracy in relation to gender and self-reported methods (Paper I) 3- To address aspects of reporting inaccuracy from intrusions by food group, against different objective measures, and classification of intrusions in stretches and confabulations (Paper II) 4- To assess how reporting...
Thorsen, Anne Vibeke; Lassen, Anne Dahl; Christensen, Lene M.
Background and objectives: The majority of Danish children do not eat in accordance with the national dietary guidelines. The OPUS School Meal Study is a school-based intervention study testing the health effects of the New Nordic Diet (NND). The aim of this sub-study was to compare edible plate.......0; 119.0). Lunches rated as ‘really bad’ or ‘bad’ in the self-reported likings had more waste than lunches rated ‘really good’ (P
Jensen, Jørgen Dejgård; Smed, Sinne; Mørkbak, Morten Raun
activities related to the schools’ support and the users’ feeling of ownership, as well as internal professionalism and leadership in the implementation of the school lunch programme are important for the viability of the programme. Strong performance on the latter factors might to some extent compensate...
Gosliner, Wendi Anne
AbstractThe National School Lunch Program:Ideas, proposals, policies, and politics shaping students' experiences with school lunch in the United States, 1946 - presentBy Wendi Anne GoslinerDoctor of Public HealthUniversity of California, BerkeleyProfessor Ann Keller, ChairOn an average school day in 2012, The National School Lunch Program (NSLP) supported the provision of lunch meals to almost 2/3 of school-age youth in the United States. Recent spikes in childhood obesity rates and the emerg...
... Program: Nutrition Standards for All Foods Sold in Schools as Required by the Healthy, Hunger-Free Kids... interim rule entitled National School Lunch Program and School Breakfast Program: Nutrition Standards for..., 2013 / Rules and Regulations [[Page 79567
Allison P Hawkes
Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.
Pedersen, Trine Pagh; Holstein, Bjørn E; Krølner, Rikke; Ersbøll, Annette Kjær; Jørgensen, Thea Suldrup; Aarestrup, Anne Kristine; Utter, Jennifer; McNaughton, Sarah A; Neumark-Stzainer, Dianne; Rasmussen, Mette
OBJECTIVE: To investigate: (i) how lunch frequency of adolescents varies between schools and between classes within schools; (ii) the associations between frequency of lunch and individual sociodemographic factors and school characteristics; and (iii) if any observed associations between lunch frequency and school characteristics vary by gender and age groups.DESIGN: Cross-sectional study in which students and school headmasters completed self-administered questionnaires. Associations were es...
Lazor, Kathleen; Chapman, Nancy; Levine, Elyse
Background: Soyfoods provide healthful options for school breakfasts and lunches that are lower in saturated fat, cholesterol, fat, and calories and can help meet demands for vegetarian choices. Researchers tested acceptance of soy-based options substituted for popular lunch items with a diverse student population. Methods: Researchers conducted a…
Chutani, Alka Mohan
The School Lunch Program in India (SLP) is the largest food and nutrition assistance program feeding millions of children every day. This paper provides a review of the background information on the SLP in India earlier known as national program for nutrition support to primary education (NP-NSPE) and later as mid day meal scheme, including historical trends and objectives and components/characteristics of the scheme. It also addresses steps being taken to meet challenges being faced by the administrators of the program in monitoring and evaluation of the program. This program was initially started in 1960 in few states to overcome the complex problems malnutrition and illiteracy. Mid Day Meal Scheme is the popular name for school meal program. In 2001, as per the supreme court orders, it became mandatory to give a mid day meal to all primary and later extended to upper primary school children studying in the government and government aided schools. This scheme benefitted 140 million children in government assisted schools across India in 2008, strengthening child nutrition and literacy. In a country with a large percent of illiterate population with a high percent of children unable to read or write; governmental and non-governmental organizations have reported that mid day meal scheme has consistently increased enrollment in schools in India. One of the main goals of school lunch program is to promote the health and well-being of the Nation's children.
This study assessed student perceptions of school meals under the new federal meal patterns for the National School Lunch Program (NSLP). Student feedback is instrumental in developing strategies to increase and maintain NSLP participation, satisfaction, and ultimately provide students with a health...
Full Text Available School plate waste is of particular concern worldwide due to its adverse impacts not only on resource use and the environment, but also on students’ health, physical maturation, and academic achievement in the long term. Previous studies on school plate waste have all been conducted in industrialized countries, and more studies are badly needed in developing countries. In this paper, we report a pilot study on the patterns and causes of plate waste in school lunch programs in Beijing, China, by a combination of physical weighing, questionnaire survey, and semi-structured interview approaches. Our results show that the average amount of food waste generated by school students in Beijing in 2014 was 130 g/cap/meal, accounting for 21% of total food served. Staple food (43% and vegetables (42% were the dominant proportions. Buffet meals resulted in less plate waste than packed meals and set meals. Food supply patterns, the quality of canteen service, and the dietary habit and students’ knowledge of food production were the main influencing factors behind plate waste. To our best knowledge, our pilot study provides a first understanding of the overlooked plate waste in school lunch programs in China, and a good basis for further analysis in this field, and will be helpful in informing policy-making in relevant nutrition and education programs in schools in China.
Full Text Available Abstract Objectives This study examined associations between high school students' lunch patterns and vending machine purchases and the school food environment and policies. Methods A randomly selected sample of 1088 high school students from 20 schools completed surveys about their lunch practices and vending machine purchases. School food policies were assessed by principal and food director surveys. The number of vending machines and their hours of operation were assessed by trained research staff. Results Students at schools with open campus policies during lunchtime were significantly more likely to eat lunch at a fast food restaurant than students at schools with closed campus policies (0.7 days/week vs. 0.2 days/week, p Conclusion School food policies that decrease access to foods high in fats and sugars are associated with less frequent purchase of these items in school among high school students. Schools should examine their food-related policies and decrease access to foods that are low in nutrients and high in fats and sugars.
Pedersen, Trine Pagh; Holstein, Bjørn E; Krølner, Rikke; Ersbøll, Annette Kjær; Jørgensen, Thea Suldrup; Aarestrup, Anne Kristine; Utter, Jennifer; McNaughton, Sarah A; Neumark-Stzainer, Dianne; Rasmussen, Mette
To investigate: (i) how lunch frequency of adolescents varies between schools and between classes within schools; (ii) the associations between frequency of lunch and individual sociodemographic factors and school characteristics; and (iii) if any observed associations between lunch frequency and school characteristics vary by gender and age groups. Cross-sectional study in which students and school headmasters completed self-administered questionnaires. Associations were estimated by multilevel multivariate logistic regression. The Danish arm of the Health Behaviour in School-Aged Children study 2010. Students (n 4922) aged 11, 13 and 15 years attending a random sample of seventy-three schools. The school-level and class-level variations in low lunch frequency were small (intraclass correlation coefficient lunch frequency was most common among students who were boys, 13- and 15-year-olds, from medium and low family social class, descendants of immigrants, living in a single-parent family and in a reconstructed family. School-level analyses suggested that having access to a canteen at school was associated with low lunch frequency (OR=1·47; 95% CI 1·14, 1·89). Likewise not having an adult present during lunch breaks was associated with low lunch frequency (OR=1·44; 95% CI 1·18, 1·75). Cross-level interactions suggested that these associations differed by age group. Lunch frequency among Danish students appears to be largely influenced by sociodemographic factors. Additionally, the presence of an adult during lunch breaks promotes frequent lunch consumption while availability of a canteen may discourage frequent lunch consumption. These findings vary between older and younger students.
Cluss, Patricia A.; Fee, LuAnn; Culyba, Rebecca J.; Bhat, Kiran B.; Owen, Kay
Background: Schools can play a major role in prevention and intervention for childhood obesity. We describe changes in elementary school cafeteria lunch sales patterns resulting from nutritional improvements in menu offerings that were part of a community-wide focus on health. Methods: Elementary school lunch sales data were collected for 1 week…
... National School Lunch Program: School Food Service Account Revenue Amendments Related to the Healthy... Food Service Account Revenue Amendments Related to the Healthy, Hunger-Free Kids Act of 2010'' on June... sold in a school and purchased with funds from the nonprofit school food service account, other than...
Tabak, Rachel G; Moreland-Russell, Sarah
Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.
Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J
Dietary intake among children in the United States falls short of national recommendations. Schools can play an important role in improving children's preferences and food consumption patterns. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) aims to improve children's nutrient intake patterns by offering fresh fruits and vegetables as snacks outside the reimbursable meals programs in elementary schools that serve large numbers of low-income children. Using a nationally representative sample of public elementary schools, this cross-sectional study investigated FFVP participation patterns among schools by demographic and school characteristics. Further, the study investigated the association between FFVP participation and availability of fresh fruits, salads, and vegetables at lunch as reported by school administrators and foodservice staff. Data collected via a mail-back survey from 620 public elementary schools participating in the National School Lunch Program during 2009-2010 were analyzed. Almost 70% of the FFVP-participating schools had a majority of students (>50%) eligible for free and reduced-cost meals. Participating in US Department of Agriculture Team Nutrition Program and having a registered dietitian or a nutritionist on staff were significantly associated with FFVP participation. Based on the results from logistic regression analyses schools participating in the FFVP were significantly more likely (odds ratio 2.07; 95% CI 1.12 to 3.53) to serve fresh fruit during lunch meals. Slightly >25% of public elementary schools across the United States participated in the FFVP, and participation was associated with healthier food availability in school lunches. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Liu, Yao; Cheng, Shengkui; Liu, Xiaojie
School plate waste is of particular concern worldwide due to its adverse impacts not only on resource use and the environment, but also on students' health, physical maturation, and academic achievement in the long term. Previous studies on school plate waste have all been conducted in industrial...... in China, and a good basis for further analysis in this field, and will be helpful in informing policy-making in relevant nutrition and education programs in schools in China.......School plate waste is of particular concern worldwide due to its adverse impacts not only on resource use and the environment, but also on students' health, physical maturation, and academic achievement in the long term. Previous studies on school plate waste have all been conducted...... in industrialized countries, and more studies are badly needed in developing countries. In this paper, we report a pilot study on the patterns and causes of plate waste in school lunch programs in Beijing, China, by a combination of physical weighing, questionnaire survey, and semi-structured interview approaches...
Mirtcheva, Donka M.; Powell, Lisa M.
Background: This study examined the effect of stigma (proxied by school-level peer participation), neighborhood food environment, and demographic characteristics on participation in the U.S. Department of Agriculture National School Lunch Program (NSLP). Methods: The 1997 and 2003 waves of the Child Development Supplement to the Panel Study of…
... snack--80 cents, reduced price snack--40 cents, paid snack--07 cents; Alaska--free snack--130 cents, reduced price snack--65 cents, paid snack--11 cents; Hawaii--free snack--94 cents, reduced price snack--47..., afterschool snacks and breakfasts served to children participating in the National School Lunch and School...
... collection burden inventory for the National School Lunch Program is 12,181,012. These changes are contingent... American children and adolescents: What changes in prevalence rates could not reveal. International Journal... purchase and consume at school. Researchers concluded that these kinds of changes in food exposure and...
Au, Lauren E; Rosen, Nila J; Fenton, Keenan; Hecht, Kenneth; Ritchie, Lorrene D
Few studies have assessed the dietary quality of children who eat meals from home compared with school meals according to the 2010 Dietary Guidelines for Americans. The objective of this study was to examine diet quality for elementary school students in relation to source of breakfast and lunch (whether school meal or from an outside source). An observational study was conducted of students in 43 schools in San Diego, CA, during the 2011-2012 school year. Fourth- and fifth-grade students (N=3,944) completed a diary-assisted 24-hour food recall. The Healthy Eating Index-2010 (HEI-2010) scores of children who ate breakfast and lunch at school were compared with the HEI-2010 scores of children who obtained their meals from home and a combination of both school and home. Analysis of variance, χ 2 test, and generalized estimating equation models adjusted for age, sex, race/ethnicity, grade, language, and school level clustering were performed. School lunch eaters had a higher mean±standard deviation overall diet quality score (HEI-2010=49.0±11.3) compared with students who ate a lunch obtained from home (46.1±12.2; P=0.02). There was no difference in overall diet quality score by breakfast groups. Students who ate school breakfast had higher total fruit (P=0.01) and whole fruit (P=0.0008) scores compared with students who only ate breakfast obtained from home. Students who ate school foods had higher scores for dairy (P=0.007 for breakfast and Pempty calories from solid fats and added sugars (P=0.01 for breakfast and P=0.007 for lunch). Eating school lunch was associated with higher overall diet quality compared with obtaining lunch from home. Future studies are needed that assess the influence of the Healthy Hunger-Free Kids Act on children's diet quality. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Cullen, Karen Weber; Watson, Kathleen B.; Fithian, Ashley R.
Background: This study compares the impact of the Texas Public School Nutrition Policy on lunch consumption of low- and middle-income students in sixth through eighth grades. Methods: Students in 1 middle socioeconomic status (SES) and 1 low SES school completed lunch food records before (2001/2002) and after (2005/2006) implementation of the…
This study compared the impact of the Texas Public School Nutrition Policy on lunch consumption of low- and middle-income students in sixth through eighth grades. Students in one middle socioeconomic status (SES), and one low SES school completed lunch food records before (2001/2002), and after (200...
Lowe, Janet; Cagginello, Joan; Compton, Linda
Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.
Farris, Alisha R; Misyak, Sarah; Duffey, Kiyah J; Mann, Georgianna R; Davis, George C; Hosig, Kathy; Atzaba-Poria, Naama; McFerren, Mary M; Serrano, Elena L
An estimated 40% of children bring a packed lunch to school. These lunches are not required to meet nutrition standards. The aim of this study was to compare differences in the nutritional quality of elementary packed lunches by the presence or absence of sugar-sweetened beverages (SSB), desserts, and fruits and vegetables (FVs). Observational data for prekindergarten and kindergarten packed lunches were collected from three schools in rural Virginia for 5 consecutive school days and analyzed for macro- and micronutrients and by the presence or absence of food and beverage items. Of the 561 packed lunch observations collected, 41.7% contained no FV, 41.2% contained an SSB, and 61.1% contained a dessert. The nutrient profile of packed lunches with at least one fruit or vegetable had significantly higher levels of carbohydrate, fiber, sugar, vitamin A, and vitamin C. Packed lunches containing an SSB had significantly higher levels of sugar and vitamin C and significantly lower levels of protein, fiber, vitamin A, calcium, and iron. Packed lunches containing a dessert had significantly higher levels of energy, carbohydrate, fat, saturated fat, sodium, sugar, vitamin C, and iron and significantly lower levels of vitamin A. Additional research is needed to fully understand parent and child motivations for packing lunches and the decision processes that influence the inclusion of food items. The development of packed lunch interventions, encouragement of National School Lunch Program participation, or enactment of school policies to increase the nutritional value of packed lunches is warranted.
Wong, Yueching; Chang, Yu-Jhen
Nutrition-related problems among school-age children nowadays become potentially serious. In order to prevent obesity and other nutritionally related diseases in the young generation, a school lunch program has been proposed and conducted in Taiwan. It is to ensure that students' nutritional intake meets the daily requirement and to help students develop correct eating habits and maintain a healthy lifestyle. A professional dietitian who has a clear concept regarding food material utilization, cooking methods and nutritional values thus becomes important. However, the majority of schools in Taiwan are unable to offer the post of dietitian due to budgetary constraints and lack of organization. The responsibility of a dietitian is usually held by teachers, school nurses and other administrative staff. This problem has hindered the nutritional education in schools and made school lunches less beneficial to the children's nutritional needs. For the current status of dietitians in schools, a large gap is found between the currently supplied school lunches and the nutritionally standardized school lunches. It also exists in relation to education and hygiene. One of the solutions requires an infrastructure to support plans and policy, reasonable adequate budget, well human affairs establishment and coordination of all aspects. While the needed infrastructure is being proposed, an access to the professionalism of the currently employed dietitians can be strategically explored by constructing an education system. Through the system, schools without on-campus dietitians will be able to utilize their expertise with which the improvement of school lunches can be expectedly accomplished.
Cohen, Juliana F W; Richardson, Scott; Austin, S Bryn; Economos, Christina D; Rimm, Eric B
The National School Lunch Program has been guided by modest nutrient standards, and the palatability of meals, which drives consumption, receives inadequate attention. School food waste can have important nutritional and cost implications for policymakers, students, and their families. Nutrient losses and economic costs associated with school meal waste were examined. The study also assessed if school foods served were valid proxies for foods consumed by students. Plate waste measurements were collected from middle school students in Boston attending two Chef Initiative schools (n=1609) and two control schools (n=1440) during a 2-year pilot study (2007-2009) in which a professional chef trained cafeteria staff to make healthier school meals. The costs associated with food waste were calculated and the percentage of foods consumed was compared with a gold standard of 85% consumption. Analyses were conducted in 2010-2011. Overall, students consumed less than the required/recommended levels of nutrients. An estimated $432,349 of food (26.1% of the total food budget) was discarded by middle school students annually at lunch in these Boston middle schools. For most meal components, substantially less than 85% was consumed. There is substantial food waste among middle school students in Boston. Overall, students' nutrient consumption levels were below school meal standards, and foods served were not valid proxies for foods consumed. The costs associated with discarded foods are high; if translated nationally for school lunches, roughly $1,238,846,400 annually is wasted. Students might benefit if additional focus were given to the quality and palatability of school meals. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Cohen, Juliana F.W.; Richardson, Scott; Austin, S. Bryn; Economos, Christina D.; Rimm, Eric B.
Background The National School Lunch Program has been guided by modest nutrient standards, and the palatability of meals, which drives consumption, receives inadequate attention. School food waste can have important nutritional and cost implications for policy makers, students, and their families. Purpose Nutrient losses and economic costs associated with school meal waste were examined. The study also assessed if school foods served were valid proxies for foods consumed by students. Methods Plate waste measurements were collected from middle school students in Boston attending two Chef Initiative schools (n=1609) and two control schools (n=1440) during a two-year pilot study (2007-2009) where a professional chef trained cafeteria staff to make healthier school meals. The costs associated with food waste were calculated and the percent of foods consumed was compared with a gold standard of 85% consumption. Analyses were conducted in 2010-2011. Results Overall, students consumed less than the required/recommended levels of nutrients. An estimated $432,349 of food (26.1% of the total food budget) was discarded by middle school students annually at lunch in Boston middle schools. For most meal components, significantly less than 85% was consumed. Conclusions There is substantial food waste among middle school students in Boston. Overall, students' nutrient consumption levels were below school meal standards and foods served were not valid proxies for foods consumed. The costs associated with discarded foods are high; if translated nationally for school lunches, roughly $1,238,846,400 annually is wasted. Students would benefit if additional focus was given to the quality and palatability of school meals. PMID:23332326
... local educational agencies (LEAs) that participate in the NSLP and/or School Breakfast Program to... performance benchmarks for directly certifying for free school meals those children who are members of... requirements, School breakfast and lunch programs. 7 CFR Part 272 Alaska, Civil rights, Claims, Food stamps...
Fenton, Keenan; Rosen, Nila J; Wakimoto, Patricia; Patterson, Tracey; Goldstein, Lauren H; Ritchie, Lorrene D
Scheduling play before eating lunch has been suggested as a relatively simple environmental strategy to increase fruit and vegetable (FV) intake among elementary school students. However, the few small studies to date have had mixed findings. The primary aim of this observational study was to evaluate the possible relationship between the relative order of play and eating and students' lunch intake of FV. A secondary aim was to examine whether any differences existed in this relationship by student sex, ethnicity, language spoken at home, and school lunch source. A diary-assisted 24-hour recall was collected during the 2011-2012 school year from 2,167 fourth- and fifth-graders attending 31 elementary schools in California. The association of play before eating with FV intake was estimated using Generalized Estimation Equations. Overall, lunch FV intake was not significantly higher for students who had a play-before-eating vs a play-after-eating lunch schedule at school. However, variables included in the model showed significant interaction with play before eating, resulting in the need for separate effect estimates for distinct strata based on sex, ethnicity, language spoken at home, and school lunch source. For 10 of the 16 strata, no significant effect of play before eating was observed on lunch FV intake, while increases in intake were observed in four strata and decreases in two strata. Before rescheduling play before eating for the purpose of improving student FV intake, additional research is recommended. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Tilles-Tirkkonen, Tanja; Pentikäinen, Saara; Lappi, Jenni; Karhunen, Leila; Poutanen, Kaisa; Mykkänen, Hannu
To explore how the quality of school lunch consumed reflected overall eating patterns in school-aged children. Children filled in an Internet-based questionnaire about their eating patterns. The children were then divided into balanced and imbalanced school lunch eaters on the basis of their responses in the questionnaire. A balanced school lunch consisted of, by the definition used in the present study, a main dish, salad and bread. Eleven primary schools and one middle school in eastern Finland. A total of 531 schoolchildren (247 boys and 284 girls) aged 11-16 years. The school lunch was balanced in 46·5% of children. Eating a balanced school lunch was associated with overall healthier eating patterns outside school. Children who ate a balanced school lunch had more regular meal times and consumed healthier snacks. They ate fruit or berries and vegetables, dairy products and wholegrain foods more often, consumed fewer salty snacks, pizzas, meat pies and drank fewer soft drinks and energy drinks. Their eating patterns at home were also healthier, with vegetables being offered at every family dinner and fruit being offered daily, whereas soft drinks were offered seldom. The choices made by children in their school lunch reflect the overall eating patterns among school-aged children. Eating a balanced school lunch is associated with more regular meal patterns, the availability of healthier foods at home and an overall healthier diet, suggesting that healthy eating patterns are learnt at home.
Winpenny, Eleanor M; Corder, Kirsten L; Jones, Andy; Ambrosini, Gina L; White, Martin; van Sluijs, Esther M F
There is limited evidence on how diet changes over the transition from primary to secondary school. In this study we investigated changes in diet from age 10 (2007) to age 14 years (2011) and the contribution of school-time consumption and school lunch choice to such changes. The 351 participants with dietary data (4 day food record) available at baseline (age 10 years) and follow-up (age 14 years) were included. Multi-level regression models were fitted for absolute or change in food and nutrient intake, cross-classified by primary and secondary school attended as appropriate, with adjustment for covariates and mis-reporting. From age 10 to age 14 years, children decreased energy intake from sugars (-2.6% energy (%E)) (standard error (SE) 0.44) and from saturated fats (-0.54%E (SE 0.18)), decreased fruit (-3.13 g/MJ (SE 1.04)) and vegetables (-1.55 g/MJ (SE 0.46)) consumption and increased sugar sweetened beverage (SSB) (4.66 g/MJ (SE 1.87)) and fries (1.31 g/MJ (SE 0.39)) consumption. Intake of snack foods, SSBs, and fries, but also fruits and vegetables was higher outside school hours. Prospective change from non-school lunch to school lunch, compared to maintaining non-school lunch consumption, was associated with decreased consumption of savoury snacks (-8.32 g/day (SE 2.03)), increased consumption of fries (12.8 g/day (SE 4.01)) and decreased consumption of fruit (-25.16 g/day (SE 11.02)) during school hours. Changes in diet from age 10 to age 14 years differed within and outside of school hours. Consumption of a school lunch, compared to lunch obtained elsewhere, was associated with negative as well as positive changes in diet, suggesting that any efforts to encourage school lunch take-up need to be accompanied by further efforts to improve school lunch provision to meet nutritional guidelines. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Cohen, Juliana F W; Gorski, Mary T; Hoffman, Jessica A; Rosenfeld, Lindsay; Chaffee, Ruth; Smith, Lauren; Catalano, Paul J; Rimm, Eric B
In 2012, the updated U.S. Department of Agriculture school meals standards and a competitive food law similar to the fully implemented version of the national Smart Snack standards went into effect in Massachusetts. This study evaluated the impact of these updated school meal standards and Massachusetts' comprehensive competitive food standards on school food revenues and school lunch participation. Revenue and participation data from 11 Massachusetts school districts were collected from 2011 to 2014 and analyzed in 2015 using multilevel modeling. The association between the change in compliance with the competitive food standards and revenues/participation was assessed using linear regression. Schools experienced declines in school food revenues of $15.40/student in Year 1 from baseline (p=0.05), due to competitive food revenue losses. In schools with 3 years of data, overall revenues rebounded by the second year post-implementation. Additionally, by Year 2, school lunch participation increased by 15% (p=0.0006) among children eligible for reduced-price meals. Better competitive food compliance was inversely associated with school food revenues in the first year only; an absolute change in compliance by 10% was associated with a $9.78/student decrease in food revenues over the entire school year (p=0.04). No association was seen between the change in compliance and school meal participation. Schools experienced initial revenue losses after implementation of the standards, yet longer-term school food revenues were not impacted and school meal participation increased among children eligible for reduced-price meals. Weakening the school meal or competitive food guidelines based on revenue concerns appears unwarranted. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Cullen, Karen Weber; Watson, Kathy; Zakeri, Issa; Ralston, Katherine
This study assessed the impact of changes in school food policy on student lunch consumption in middle schools. Two years of lunch food records were collected from students at three middle schools in the Houston, Texas area. During the first year, no changes occurred in the school food environment. After that school year was completed, chips and dessert foods were removed from the snack bars of all schools by the Food Service Director. Students recorded the amount and source of food and beverage items consumed. Point-of-service purchase machines provided a day-by-day electronic data file with food and beverage purchases from the snack bars during the 2-year period. Independent t-tests and time series analyses were used to document the impact of the policy change on consumption and sales data between the two years. In general, student consumption of sweetened beverages declined and milk, calcium, vitamin A, saturated fat and sodium increased after the policy change. Snack chips consumption from the snack bar declined in year 2; however, consumption of snack chips and candy from vending increased and the number of vending machines in study schools doubled during the study period. Ice cream sales increased significantly in year 2. Policy changes on foods sold in schools can result in changes in student consumption from the targeted environments. However, if all environments do not make similar changes, compensation may occur.
Canterberry, Melanie; Francois, Samantha; van Hattum, Taslim; Rudov, Lindsey; Carton, Thomas W
Louisiana has one of the highest rates of overweight and obese children in the United States. The Healthy School Food Collaborative (HSFC) was created to allow New Orleans's schools to select their own healthy school Food Service Provider (FSP) with requirements for higher nutritional standards than traditional options. The goal of this cross-sectional study was to examine whether HSFC membership was associated with lunch consumption rates in elementary school children. An 8-week plate waste study examining 18,070 trays of food among fourth and fifth graders was conducted. Participants included 7 schools and the 3 FSPs (2 HSFC and 1 non-HSFC member) that serviced them. Mixed models analysis examined whether consumption rates of food items differed among FSPs. On average, students consumed 307 cal during lunch. Analyses showed significant differences in consumption rates of entrée, vegetables, fruit, and milk between the 3 FSPs (p < .01). The highest consumption rate was among entrées at 65%. One HSFC provider had consumption levels consistent with the non-HSFC FSP. Overall, students consumed less than 60% of the US Department of Agriculture recommended calories for school lunch. While overall caloric consumption was higher among the non-HSFC schools, interventions to increase lunch consumption across all schools are needed. © 2018, American School Health Association.
Pittman, D W; Parker, J S; Getz, B R; Jackson, C M; Le, T-A P; Riggs, S B; Shay, J M
We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.
Golembiewski, Elizabeth H.; Askelson, Natoshia M.; Elchert, Daniel M.; Leicht, Erika A.; Scheidel, Carrie A.; Delger, Patti J.
Purpose/Objectives: The purpose of this study was to investigate parent awareness and perceptions of changes to the National School Lunch Program (NSLP) implemented as a result of the Healthy, Hunger-Free Kids Act (HHKA) of 2010. Methods: An online survey of parents of school age (K-12) children in a Midwestern state was conducted (n = 2,189). The…
Smith, Katherine; Bergman, Ethan A.; Englund, Tim; Ogan, Dana; Barbee, Mary
Purpose/Objectives: This study investigates the effect of meal component changes by the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) on school lunch quality and consumption in elementary school students, grade 2-5 before and after the HHFKA guidelines were implemented in July 2012 using the Healthy Eating Index. Methods: In Spring 2012, before…
Berggren, Linda; Talvia, Sanna; Fossgard, Eldbjørg; Arnfjörð, Unnur Björk; Hörnell, Agneta; Ólafsdóttir, Anna Sigríður; Gunnarsdóttir, Ingibjörg; Wergedahl, Hege; Lagström, Hanna; Waling, Maria; Olsson, Cecilia
Purpose: Pupils' perspective should be better taken into account when developing nutrition education at school. The purpose of this paper is to explore Nordic children's perspectives on the healthiness of meals in the context of school lunches. Design/methodology/approach: In total, 78 focus group discussions were conducted with 10-11-year-old…
嶋田, さおり; 若林, 良和; 西村, 栄恵; 逸見, 幾代
We conducted a survey of the eating habits of children in elementary schools that work actively in food education and take advantage of local products, and analyzed the trends in eating behavior and the attitude toward school lunches in each grade. The results of this study are summarized as follows: 1. 88.1% of children eat breakfast every day: second graders represent the highest percentage at 97.1% and sixth graders the lowest at 83.7%. The most common reason for not eating breakfast was "...
Full Text Available Abstract Background Speed of eating, an important aspect of eating behaviour, has recently been related to loss of control of food intake and obesity. Very little time is allocated for lunch at school and thus children may consume food more quickly and food intake may therefore be affected. Study 1 measured the time spent eating lunch in a large group of students eating together for school meals. Study 2 measured the speed of eating and the amount of food eaten in individual school children during normal school lunches and then examined the effect of experimentally increasing or decreasing the speed of eating on total food intake. Methods The time spent eating lunch was measured with a stop watch in 100 children in secondary school. A more detailed study of eating behaviour was then undertaken in 30 secondary school children (18 girls. The amount of food eaten at lunch was recorded by a hidden scale when the children ate amongst their peers and by a scale connected to a computer when they ate individually. When eating individually, feedback on how quickly to eat was visible on the computer screen. The speed of eating could therefore be increased or decreased experimentally using this visual feedback and the total amount of food eaten measured. Results In general, the children spent very little time eating their lunch. The 100 children in Study 1 spent on average (SD just 7 (0.8 minutes eating lunch. The girls in Study 2 consumed their lunch in 5.6 (1.2 minutes and the boys ate theirs in only 6.8 (1.3 minutes. Eating with peers markedly distorted the amount of food eaten for lunch; only two girls and one boy maintained their food intake at the level observed when the children ate individually without external influences (258 (38 g in girls and 289 (73 g in boys. Nine girls ate on average 33% less food and seven girls ate 23% more food whilst the remaining boys ate 26% more food. The average speed of eating during school lunches amongst groups
Zandian, Modjtaba; Ioakimidis, Ioannis; Bergström, Jakob; Brodin, Ulf; Bergh, Cecilia; Leon, Michael; Shield, Julian; Södersten, Per
Speed of eating, an important aspect of eating behaviour, has recently been related to loss of control of food intake and obesity. Very little time is allocated for lunch at school and thus children may consume food more quickly and food intake may therefore be affected. Study 1 measured the time spent eating lunch in a large group of students eating together for school meals. Study 2 measured the speed of eating and the amount of food eaten in individual school children during normal school lunches and then examined the effect of experimentally increasing or decreasing the speed of eating on total food intake. The time spent eating lunch was measured with a stop watch in 100 children in secondary school. A more detailed study of eating behaviour was then undertaken in 30 secondary school children (18 girls). The amount of food eaten at lunch was recorded by a hidden scale when the children ate amongst their peers and by a scale connected to a computer when they ate individually. When eating individually, feedback on how quickly to eat was visible on the computer screen. The speed of eating could therefore be increased or decreased experimentally using this visual feedback and the total amount of food eaten measured. In general, the children spent very little time eating their lunch. The 100 children in Study 1 spent on average (SD) just 7 (0.8) minutes eating lunch. The girls in Study 2 consumed their lunch in 5.6 (1.2) minutes and the boys ate theirs in only 6.8 (1.3) minutes. Eating with peers markedly distorted the amount of food eaten for lunch; only two girls and one boy maintained their food intake at the level observed when the children ate individually without external influences (258 (38) g in girls and 289 (73) g in boys). Nine girls ate on average 33% less food and seven girls ate 23% more food whilst the remaining boys ate 26% more food. The average speed of eating during school lunches amongst groups increased to 183 (53)% in the girls and to 166 (47
Whitaker, R C; Wright, J A; Finch, A J; Deyo, R A; Psaty, B M
To compare the fat and cholesterol content of the foods offered and selected in an elementary school lunch program with current dietary guidelines. For 105 school days we recorded the food items selected by elementary school students in an entire school district (262,851 meals) who were given a choice between two entrees. The nutrient content of foods was assessed with a computerized nutrient data base supplemented by the food manufacturers' data. Sixteen elementary schools in the Bellevue (Washington) School District. The number of students eating school lunch averaged 2500 per day, of whom 25% were from households with incomes less than 185% of poverty. None. We determined the nutritional content of the average meal selected; the proportion of days when one of the two offered entrees met fat and cholesterol guidelines; and the proportion of children selecting the entrees that met the guidelines. The average lunch selected had 35.9% of calories from total fat and 12.6% from saturated fat, exceeding the guidelines of 30% and 10%, respectively. Lunch contained an average of 57 mg cholesterol (106 mg/1000 kcal) and met guidelines. One of the two daily entree choices met guidelines for both total fat and saturated fat on 20% of days, and met both fat and cholesterol guidelines on 14% of days. When available, entrees meeting the fat guidelines were chosen by 37% of students, and entrees meeting both fat and cholesterol guidelines were chosen by 34% of students. In this school district the average lunch selected did not meet the current guidelines for dietary fat; when given the choice, more than one third of students selected the entrees that met these guidelines.
... 0584-AD54 [FNS-2007-0023] Applying for Free and Reduced Price Meals in the National School Lunch Program and School Breakfast Program and for Benefits in the Special Milk Program, and Technical... school meals to implement nondiscretionary provisions of the Child Nutrition and WIC Reauthorization Act...
Miyawaki, A; Lee, J S; Kobayashi, Y
Japan has experienced a low prevalence of childhood obesity. The Japanese nationwide school lunch program is suggested to have helped this phenomenon, but it has not been proven. From official statistics, we combined annual data for 2006-15 about the prefecture-level school lunch coverage rate for public junior high school students and the prefecture-level nutritional indicators calculated by randomly selected age-sex groups of 13-15-year olds: the percentage of overweight, obese or underweight children, who are 20% heavier, 30% heavier or 20% lighter than the standard weight by sex, age and height; and mean body weight (kg) or height (cm). We estimated the impact of the school lunch coverage rate on the nutritional indicators in subsequent years, adjusting for the lagged dependent variable and dummies for prefecture, age and year. A 10 percentage point increase in the prefecture-level school lunch coverage rate significantly decreased the percentage of overweight (0.37%, 95% CI: 0.18-0.56) and obesity (0.23%, 0.10-0.37) in subsequent years among boys, but not among girls. No significant effect on the percentage of underweight or mean body weight/height was observed for either sex. Appropriate nutritional intake through school lunch may be effective to reduce childhood obesity.
Echon, Roger M.
Purpose/Objectives: The purpose of this paper is to provide baseline data and characteristics of food served and consumed prior to the recently mandated nutrition standards as authorized by the Healthy, Hunger-Free Kids Act of 2010 (HHFKA). Methods: Over 600,000 school lunch menus with associated food production records from 61 elementary schools…
Morrison, Shelley B.
Arizona's Future for Child Nutrition organization hired a professional public relations and advertising agency to increase student participation in school lunches. After, the opinions and needs of students were researched, and the agency launched a campaign that featured radio advertising, television and radio talk shows, and press coverage, with…
Rutledge, Jennifer Geist
This paper explores the historical formation of the National School Lunch Program (NSLP) in the United States and argues that programme emergence depended on the ability of policy entrepreneurs to link the economic concerns of agricultural production with the ideational concern of national security. Using a historical institutionalist framework…
... National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy... Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010'' on February 22, 2013... performance benchmarks and to develop and implement continuous improvement plans if they fail to do so. The...
Johnston, James B.
A New York State school district employed a management company to privatize the food-service program with the goal of enticing all students to eat lunch. Expertise in marketing, menu planning, and food-service operation turned the program around. Suggests questions to ask when selecting a management company. (MLF)
Bergman, Ethan A.; Englund, Tim; Ogan, Dana; Watkins, Tracee; Barbee, Mary; Rushing, Keith
Purpose/Objectives: The purposes of this study were to: 1) analyze beverage selections of elementary students consuming National School Lunch Program meals (NSLP) and lunches brought from home (LBFH), 2) compare overall meal quality (MQ) of NSLP and LBFH by food components using Healthy Eating Index 2010 (HEI-2010), and 3) investigate the impact…
Siegel, Robert; Lockhart, Mary Kate; Barnes, Allison S; Hiller, Elizabeth; Kipp, Roger; Robison, Debora L; Ellsworth, Samantha C; Hudgens, Michelle E
As obesity has become a pressing health issue for American children, greater attention has been focused on how schools can be used to improve how students eat. Previously, we piloted the use of small prizes in an elementary school cafeteria to improve healthful food selection. We hoped to increase healthful food selection in all the elementary schools of a small school district participating in the United States Department of Agriculture Lunch Program by offering prizes to children who selected a Power Plate (PP), which consisted of an entrée with whole grains, a fruit, a vegetable, and plain low-fat milk. In this study, the PP program was introduced to 3 schools sequentially over an academic year. During the kickoff week, green, smiley-faced emoticons were placed by preferred foods, and children were given a prize daily if they chose a PP on that day. After the first week, students were given a sticker or temporary tattoo 2 days a week if they selected a PP. Combining data from the 3 schools in the program, students increased PP selection from 4.5% at baseline to 49.4% (p small prizes as rewards dramatically improves short-term healthful food selection in elementary school children.
Dubuisson, C; Lioret, S; Dufour, A; Volatier, J L; Lafay, L; Turck, D
Our objective was to investigate whether school lunch attendance was associated with overall eating habits and sedentary behaviour in a French sample of children and adolescents. Data for the study were taken from the second French cross-sectional dietary survey (INCA2-2006-07). In total, 1413 school children aged 3-17 years old were classified according to their school type and their usual school lunch attendance. Eating habits included meal regularity, dietary diversity, purchase in vending machine, snacking habits and frequency of eating in fast-foods. Two composite indices of eating habits were derived from multiple correspondence analyses. Sedentary behaviour was assessed by the average daily screen times for TV and computer. The association between school lunch attendance and each variable was tested. Multivariate association between school lunch attendance and the composite indices of eating habits and sedentary behaviours was studied. In all, 69.0% (CI(95%): 64.2-73.9) of secondary school children and 63.0% (CI(95%): 58.5-67.5) of pre- and elementary school children usually attended school lunch at least once a week. Pre- and elementary school children attending school lunches showed a higher dietary diversity score (P=0.02) and ate morning snacks more frequently (P=0.02). In secondary school children, attending school canteen was related to a lower rate of skipping breakfast (P=0.04) and main meals (P=0.01). In all school children, school lunch attendance was simultaneously associated with healthier overall eating habits and less sedentary behaviour. In France, children attending school canteens seem to have healthier eating habits and display less sedentary behaviour, independently of their socio-economic and demographic background.
... professionals, chefs, students, parents, and communities have also used their talents to develop nutritious foods for schools through the Recipes for Healthy Kids competition and the Chefs Move to Schools...
This study explores the association between parental perception of the nutritional quality of school meals and whether students eat lunch served at school. We use data from five low-income cities in New Jersey that have high minority populations. Students whose parents perceive the quality of school meals to be healthy have greater odds of eating meals served at school. Recent changes in guidelines for the United States Department of Agriculture's National School Lunch Program met with resistance from several fronts. Advocates for and implementers of improved school meals may benefit from partnering with parents to increase the acceptance and utilization of improved school offerings. Copyright © 2013 Elsevier Ltd. All rights reserved.
Rosen, Renee A.; Hauge, Denise A.; Arndt, Elizabeth A.; Veal, Mike; Marquart, Len
Pasta is a popular grain food served as an entree or side dish in both home and away-from-home settings. In schools, pasta is served less frequently than other entrees. Pasta, especially whole-grain pasta, offers an opportunity to incorporate less expensive, nutritious, and versatile dishes into school meals. A need exists to develop whole-grain…
Behrens, Timothy K; Liebert, Mina L; Peterson, Hannah J; Howard Smith, Jennifer; Sutliffe, Jay T; Day, Aubrey; Mack, Jodi
The purpose of this study is to examine the impact of a districtwide food best practices and preparation changes in elementary schools lunches, implemented as part of the LiveWell@School childhood obesity program, funded by LiveWell Colorado/Kaiser Permanente Community Health Initiative. Longitudinal study examining how school changes in best practices for food preparation impacted the types of side items offered from 2009 to 2015 in elementary school cafeterias in a high-need school district in southern Colorado. Specifically, this study examined changes in side items (fruits, vegetables, potatoes, breads, and desserts). In Phase 1 (2009-2010), baseline data were collected. During Phase 2 (2010-2011), breaded and processed foods (e.g., frozen nuggets, pre-packaged pizza) were removed and school chefs were trained on scratch cooking methods. Phase 3 (2011-2012) saw an increased use of fresh/frozen fruits and vegetables after a new commodity order. During Phase 4 (2013-2015), chef consulting and training took place. The frequency of side offerings was tracked across phases. Analyses were completed in Fall 2016. Because of limited sample sizes, data from Phases 2 to 4 (intervention phases) were combined for potatoes and desserts. Descriptive statistics were calculated. After adjusting for length of time for each phase, Pearson chi-square tests were conducted to examine changes in offerings of side items by phase. Fresh fruit offerings increased and canned fruit decreased in Phases 1-4 (p=0.001). A significant difference was observed for vegetables (p=0.001), with raw and steamed vegetables increasing and canned vegetables decreasing from Phase 1 to 4. Fresh potatoes (low in sodium) increased and fried potatoes (high in sodium) decreased from Phase 1 to Phases 2-4 (p=0.001). Breads were eliminated entirely in Phase 2, and dessert changes were not significant (p=0.927). This approach to promoting healthier lunch sides is a promising paradigm for improving elementary
Dubuisson, Carine; Lioret, Sandrine; Dufour, Ariane; Calamassi-Tran, Gloria; Volatier, Jean-Luc; Lafay, Lionel; Turck, Dominique
Recently, school meal composition regulations have been implemented in France in order to improve the nutritional status of children. The present study investigated the link between school lunch attendance and the food intakes of schoolchildren aged 3-17 years. Second French cross-sectional dietary survey (2006-2007). Eating frequencies were assessed for twenty-four food groups with a 7 d food record. Eating locations were recorded for main meals. Food group intakes at weekday lunches were compared for the school canteen and for other locations. The children's overall dietary intake was compared based on school lunch attendance. Mainland France. Schoolchildren aged 3-17 years (n 1068). Lunchtime food intake differed between the school canteen and other locations. Some intakes at school canteens were more in accordance with the regulations (more fruit and vegetables, fish and dairy products, and less sandwiches, soft drinks, chocolate and confectionery), whereas others highlighted needs for improvement (more sweet biscuits and pastries, ice cream and dairy desserts, pizzas and salty pastries). Many of these differences were also observed in the children's overall diet: children regularly attending school lunches ate more mashed fruit, fish and sweet biscuits or pastries, and less sandwiches and soft drinks. The link between school lunch attendance and overall diet was less pronounced in secondary-school children. School canteen attendance is associated with both potentially beneficial and deleterious differences in the lunchtime and overall diets of French children. These findings are important to consider when setting national regulations for school meal composition.
Nutritional and health status have powerful influences on a child's ... well-being and cognitive development of school children. Students who ... Department of Pediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Abstract.
Huang, Jin; Barnidge, Ellen; Kim, Youngmi
In 2012, 20% of households in the United States with children lacked consistent access to adequate food. Food insufficiency has significant implications for children, including poor physical and mental health outcomes, behavior problems, and low educational achievements. The National School Lunch Program (NSLP) is one policy solution to reduce food insufficiency among children from low-income families. The objective of this project was to evaluate the association between NSLP participation and household food insufficiency by examining trajectories of food insufficiency over 10 calendar months. The calendar months included both nonsummer months when school is in session and summer months when school is out of session. The study used the data from the Survey of Income and Program Participation and conducted linear growth curve analyses in the multilevel modeling context. Comparisons were made between the trajectories of food insufficiencies among recipients of free or reduced-price lunch and their counterparts who are eligible but choose not to participate in the program. Heads of households that included children receiving free or reduced-price lunch (n = 6867) were more likely to be female, black, unmarried, and unemployed, and have a lower educational attainment than those whose children were eligible but did not receive free or reduced-price lunch (n = 11,396). For households participating in the NSLP, the food insufficiency rate was consistent from January to May at ∼4%, and then increased in June and July to >5%. Meanwhile, food insufficiency among eligible nonrecipients was constant throughout the year at nearly 2%. The NSLP protects households from food insufficiency. Policies should be instituted to make enrollment easier for households. © 2015 American Society for Nutrition.
Pagh Pedersen, Trine; Holstein, Bjørn Evald; Rasmussen, Mette
in a multilevel model controlled for factors at the individual level. Further, we investigated whether grade modified the association. Methods: We used data from the Danish 2010 contribution to the international collaborative cross-sectional study ‘Health Behaviour in School-Aged Children (HBSC). Data collection...... were conducted in 2010 among schoolchildren aged 11, 13 and 15 years (in Denmark, equivalent to 5th, 7th and 9th grade, respectively) from a random sample of schools, i.e. cluster sampling. The schoolchildren completed the self-administered and internationally standardised anonymous HBSC questionnaire...
South Carolina State Dept. of Education, Columbia.
THE TYPE AND CAPACITY OF A WIDE RANGE OF SCHOOL KITCHEN EQUIPMENT IS RECOMMENDED WITH RESPECT TO THE NUMBER OF MEALS SERVED PER DAY. THESE RECOMMENDATIONS ARE GIVEN FOR RANGES, SINKS, ELECTRIC HEATING, GAS HEATING, REFRIGERATION, TABLES, KITCHEN MACHINES, TRUCK DOLLIES, SCALES, STORAGE CABINETS, OFFICE SPACES, LOUNGES, GARBAGE AND CAN WASHING…
... more of our children are at risk for preventable health problems including diabetes and heart disease... their children with decent meals for the long school day, President Harry Truman signed the National... child should go hungry. And today, with more than 32 million children participating in the National...
...) establishes National Average Payments for free, reduced price and paid afterschool snacks as part of the...--free lunch-- 303 cents, reduced price lunch--263 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--78 cents, reduced price snack--39 cents, paid snack...
... National Average Payments for free, reduced price and paid afterschool snacks as part of the National...; Hawaii--free lunch-- 288 cents, reduced price lunch--248 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--74 cents, reduced price snack--37 cents, paid...
... National Average Payments for free, reduced price and paid afterschool snacks as part of the National...; Hawaii--free lunch-- 294 cents, reduced price lunch--254 cents. Afterschool Snacks in Afterschool Care Programs--The payments are: Contiguous States--free snack--76 cents, reduced price snack--38 cents, paid...
Nakagawa, Naoko; Hasui, Seiichiro; Haraguchi, Yayoi
After the reactor accident of Fukushima nuclear power plant in Japan on March 11, 2011, many food adopted widely in school food service such as rice, wheat, milk are known to have risk for radioactivity contamination. To protect all children from exposure, the authors quantitatively examined risk assessment coming from food and conclude that radioactivity due to cesium 137 in rice, wheat, and milk for school lunch should be less than 10 Bq/kg and, furthermore from 2013, as lower as possible and less than 5 Bq/kg. (S. Ohno)
Full Text Available OBJECTIVE: To explore the feasibility and implementation efficiency of Nutritional Report Cards (NRCs in helping children make healthier food choices at school. METHODS: Pilot testing was conducted in a rural New York school district (K-12. Over a five-week period, 27 parents received a weekly e-mail containing a NRC listing how many meal components (fruits, vegetables, starches, milk, snacks, and a-la-carte foods their child selected. We analyzed choices of students in the NRC group vs. the control group, both prior to and during the intervention period. Point-of-sale system data for a-la-carte items was analyzed using Generalized Least Squares regressions with clustered standard errors. RESULTS: NRCs encouraged more home conversations about nutrition and more awareness of food selections. Despite the small sample, the NRC was associated with reduced selection of some items, such as the percentage of those selecting cookies which decreased from 14.3 to 6.5 percent. Additionally, despite requiring new keys on the check-out registers to generate the NRC, checkout times increased by only 0.16 seconds per transaction, and compiling and sending the NRCs required a total weekly investment of 30 minutes of staff time. CONCLUSIONS: This test of concept suggests that NRCs are a feasible and inexpensive tool to guide children towards healthier choices.
Purpose/Objectives: Schools that participate in the National School Lunch Program (NSLP) receive a portion of their annual federal funding as commodity entitlement foods--now called USDA Foods--rather than cash payments. Due to rising food prices in recent years, it has been recommended that schools compare the costs and benefits of commodity and…
Schools that participate in the National School Lunch Program receive a portion of their federal funding as commodity foods rather than cash payments. This research compared the product costs and estimated total procurement costs of commodity and commercial foods from the school district perspective using data from 579 Minnesota ordering sites in…
Guinn, Caroline H.; Baxter, Suzanne Domel; Finney, Christopher J.; Hitchcock, David B.
Purpose/Objectives: Analyses were conducted to examine variations in fourth-grade children's participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, gender, and school-breakfast location. Methods: Fourth-grade children were participants in a dietary-reporting validation study during either…
Sabinsky, Marianne; Toft, Ulla; Andersen, Klaus K.
Objective School lunch programmes are one strategy to promote healthier dietary habits in children, but better evaluation tools for assessing the dietary quality of such programmes are needed. The aim of the present study was to develop and validate a simple index to assess the dietary quality...... of school lunches for children aged 7–13 years. Design A Meal Index of dietary Quality (Meal IQ) was developed to consist of seven components (nutrients and food groups) based on dietary issues for children aged 7–13 years, which were identified in a national dietary survey. The Meal IQ was validated......, higher contents of fibre, various vitamins and minerals, and more fruits, vegetables and fish. Conclusions The Meal IQ is a valid and useful evaluation tool for assessing the dietary quality of lunches provided by schools or brought to school from home....
... low-fat cheese on whole wheat tortillas) cold pizza (shredded mozzarella cheese with pizza sauce on a flour tortilla, whole wheat pita, English muffin, or mini pizza shell) cracker sandwiches (whole-grain crackers filled with ...
Harrison, Flo; Jennings, Amy; Jones, Andy; Welch, Ailsa; van Sluijs, Esther; Griffin, Simon; Cassidy, Aedín
To examine the differences in dietary intakes of children consuming school meals and packed lunches, the contribution of lunchtime intake to overall dietary intake, and how lunchtime intake relates to current food-based recommendations for school meals. Cross-sectional analysis of overall intake of macronutrients and food choice from 4 d food diaries and school lunchtime intake from the two diary days completed while at school. Norfolk, UK. One thousand six hundred and twenty-six children (aged 9-10 years) attending ninety Norfolk primary schools. At school, lunchtime school meal eaters consumed more vegetables, sweet snacks, chips, starchy foods and milk, and less squash/cordial, fruit, bread, confectionery and savoury snacks than packed lunch eaters. These differences were also reflected in the overall diet. On average school meal eaters met the School Food Trust (SFT) food-based standards, while food choices among packed lunch eaters were less healthy. The contribution of food consumed at school lunchtime to overall diet varied by food and lunch type, ranging from 0.8 % (milk intake in packed lunches) to 74.4 % (savoury snack intake in packed lunches). There were significant differences in the foods consumed by school meal and packed lunch eaters, with food choices among school meal eaters generally in line with SFT standards. The food choices made at school lunchtime make a significant contribution to overall diet.
Jacey A. Greece
Full Text Available Modifying the school food environment is on the national agenda as one strategy to improve the nutritional quality of children’s diets. Because few environmental-level interventions have been rigorously evaluated, the evidence base to inform programs and policies is limited. Of concern is the impact that changes to cafeteria offerings will have on participation in school meal programs. This study evaluates school lunch participation in the setting of a year-long middle school cafeteria intervention by examining the association between body mass index (BMI, sociodemographics, and the purchases of school lunch meals. IMOVE meals were healthier choices that met stringent nutritional criteria and were offered alongside standard lunch meals. Students who were overweight had a significantly higher purchase rate for both types of meals compared to those with a healthy BMI. Non-white race, younger age, being male, and low-income status were also significantly associated with participation in school lunch. Results indicate that nutritionally vulnerable students participate in school lunch and are equally likely to buy healthy alternatives or standard meals. This behavioral observation has important implications for school foodservice programs and policies. These results are timely given recent federal legislation to improve the school food environment to influence students’ food choice behaviors.
Greece, Jacey A; Kratze, Alyssa; DeJong, William; Cozier, Yvette C; Quatromoni, Paula A
Modifying the school food environment is on the national agenda as one strategy to improve the nutritional quality of children's diets. Because few environmental-level interventions have been rigorously evaluated, the evidence base to inform programs and policies is limited. Of concern is the impact that changes to cafeteria offerings will have on participation in school meal programs. This study evaluates school lunch participation in the setting of a year-long middle school cafeteria intervention by examining the association between body mass index (BMI), sociodemographics, and the purchases of school lunch meals. IMOVE meals were healthier choices that met stringent nutritional criteria and were offered alongside standard lunch meals. Students who were overweight had a significantly higher purchase rate for both types of meals compared to those with a healthy BMI. Non-white race, younger age, being male, and low-income status were also significantly associated with participation in school lunch. Results indicate that nutritionally vulnerable students participate in school lunch and are equally likely to buy healthy alternatives or standard meals. This behavioral observation has important implications for school foodservice programs and policies. These results are timely given recent federal legislation to improve the school food environment to influence students' food choice behaviors.
Pagh Pedersen, Trine; Holstein, Bjørn Evald; Krølner, Rikke
.52 (1.26-1.82). At the individual level, irregular lunch consumption was associated with being a boy, attending 7th grade, medium and low family social class, migration status, and living in a single and reconstructed family structure. Analyses stratified by gender showed similar results but among girls...... schoolchildren, and 2) examine whether gender modified these associations. Methods: Danish data from the international cross-sectional study ‘Health Behaviour in School-Aged Children in 2010 were used. Data were collected among schoolchildren aged 11, 13 and 15 years from a random sample of 75 schools....... The schoolchildren (N=4922) completed a self-administered questionnaire at school (response rate=86.3%). School principals (N=69) completed the school setting questionnaire (response rate=92 %). Associations between school level variables and irregular lunch consumption were estimated by multilevel logistic...
Sabinsky, Marianne S; Toft, Ulla; Andersen, Klaus Kaae
OBJECTIVE: School lunch programmes are one strategy to promote healthier dietary habits in children, but better evaluation tools for assessing the dietary quality of such programmes are needed. The aim of the present study was to develop and validate a simple index to assess the dietary quality...
Ishdorj, Ariun; Capps, Oral; Murano, Peter S
Vegetables are the major source of the dietary fiber, magnesium, potassium, and vitamins A and C that are crucial in the diets of children. This study assessed the nutrient content of vegetables offered through the National School Lunch Program and examined the relation between the overall nutrient density of vegetable subgroups and the costs of nutrients offered and wasted before and after the changes in school meal standards. Using data collected from 3 elementary schools before and after the changes in school meal standards, we found that vegetable plate waste increased from 52% to 58%. Plate waste for starchy vegetables, exclusive of potatoes, was relatively high compared with other subgroups; however, plate waste for white potatoes was the lowest among any type of vegetable. Energy density; cost per 100 g, per serving, and per 100 kcal; and percentage daily value were calculated and used to estimate nutrient density value and nutrient density per dollar. Cost per 100 kcal was highest for red/orange vegetables followed by dark green vegetables; however, nutrient density for red/orange vegetables was the highest in the group and provided the most nutrients per dollar compared with other subgroups. Given that many vegetables are less energy dense, measuring vegetable costs per 100 g and per serving by accounting for nutrient density perhaps is a better way of calculating the cost of vegetables in school meals. © 2016 American Society for Nutrition.
Ishdorj, Ariun; Capps, Oral; Murano, Peter S
Vegetables are the major source of the dietary fiber, magnesium, potassium, and vitamins A and C that are crucial in the diets of children. This study assessed the nutrient content of vegetables offered through the National School Lunch Program and examined the relation between the overall nutrient density of vegetable subgroups and the costs of nutrients offered and wasted before and after the changes in school meal standards. Using data collected from 3 elementary schools before and after the changes in school meal standards, we found that vegetable plate waste increased from 52% to 58%. Plate waste for starchy vegetables, exclusive of potatoes, was relatively high compared with other subgroups; however, plate waste for white potatoes was the lowest among any type of vegetable. Energy density; cost per 100 g, per serving, and per 100 kcal; and percentage daily value were calculated and used to estimate nutrient density value and nutrient density per dollar. Cost per 100 kcal was highest for red/orange vegetables followed by dark green vegetables; however, nutrient density for red/orange vegetables was the highest in the group and provided the most nutrients per dollar compared with other subgroups. Given that many vegetables are less energy dense, measuring vegetable costs per 100 g and per serving by accounting for nutrient density perhaps is a better way of calculating the cost of vegetables in school meals. PMID:26773034
Beaulieu, Dominique; Godin, Gaston
Many schools have recently adopted food policies and replaced unhealthy products by healthy foods. Consequently, adolescents are more likely to consume a healthy meal if they stay in school for lunch to eat a meal either prepared at home or purchased in school cafeterias. However, many continue to eat in nearby fast-food restaurants. The present…
Nicholson, Lisa; Turner, Lindsey; Schneider, Linda; Chriqui, Jamie; Chaloupka, Frank
State laws and farm-to-school programs (FTSPs) have the potential to increase fruit and vegetable (FV) availability in school meals. This study examined whether FV were more available in public elementary school lunches in states with a law requiring/encouraging FTSPs or with a locally grown-related law, and whether the relationship between state laws and FV availability could be explained by schools opting for FTSPs. A pooled, cross-sectional analysis linked a nationally representative sample of public elementary schools with state laws. A series of multivariate logistic regressions, controlling for school-level demographics were performed according to mediation analysis procedures for dichotomous outcomes. Roughly 50% of schools reported FV availability in school lunches on most days of the week. Schools with the highest FV availability (70.6%) were in states with laws and schools with FTSPs. State laws requiring/encouraging FTSPs were significantly associated with increased FV availability in schools and a significant percentage (13%) of this relationship was mediated by schools having FTSPs. Because state farm-to-school laws are associated with significantly higher FV availability in schools-through FTSPs, as well as independently-enacting more state legislation may facilitate increased FTSP participation by schools and increased FV availability in school meals. © 2014, American School Health Association.
Hur, In Young; Marquart, Len; Reicks, Marla
Pizza is a popular food that can contribute to high intakes of saturated fat and sodium among children and adolescents. The objective of this study was to compare daily nutrient intakes when a pizza product meeting the US Department of Agriculture's criteria for competitive food entrées under the HealthierUS School Challenge (HUSSC) was substituted for usual pizza products consumed during foodservice-prepared school lunch. The study used National Health and Nutrition Examination Survey (2005-2008) dietary recall data from a cross-sectional sample of US children and adolescents (age 5 to 18 years, n=337) who ate pizza during school lunch on 1 day of dietary recall. Daily nutrient intakes based on the consumption of usual pizza products for school lunch (pre-modeled) were compared with intakes modeled by substituting nutrient values from an HUSSC whole-grain pizza product (post-modeled). Paired t tests were used to make the comparison. Post-modeled intakes were lower in daily energy, carbohydrate, total fat, saturated fat, cholesterol, and sodium compared with pre-modeled intakes among children and adolescents (Ppizza product for usual pizza products may significantly improve dietary quality of children and adolescents eating pizza for school lunch, indicating that it could be an effective approach to improve the nutritional quality of school lunch programs. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
The objective was to determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders. Two hundred seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy ...
...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2013 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures. The 2013 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.
...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2012 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures. The 2012 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.
...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2011 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures that are extended nationwide by enactment of the Fiscal Year 2008 Consolidated Appropriations Act. The 2011 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.
...This notice informs the public of the annual adjustments to the reimbursement rates for meals served in the Summer Food Service Program for Children. These adjustments address changes in the Consumer Price Index, as required under the Richard B. Russell National School Lunch Act. The 2010 reimbursement rates are presented as a combined set of rates to highlight simplified cost accounting procedures that are extended nationwide by enactment of the Fiscal Year 2008 Consolidated Appropriations Act. The 2010 rates are also presented individually, as separate operating and administrative rates of reimbursement, to show the effect of the Consumer Price Index adjustment on each rate.
Smith, Stephanie L; Cunningham-Sabo, Leslie
To (i) evaluate food choices and consumption patterns of elementary- and middle-school students who participate in the National School Lunch Program (NSLP) and (ii) compare students' average nutrient intake from lunch with NSLP standards. Plate waste from elementary- and middle-school students' lunch trays was measured in autumn 2010 using a previously validated digital photography method. Percentage waste was estimated to the nearest 10 % for the entrée, canned fruit, fresh fruit, vegetable, grain and milk. Univariate ANOVA determined differences in percentage waste between schools, grades and genders. Daily nutrient intake was calculated using the district's menu analysis and percentage waste. Elementary and middle schools in northern Colorado (USA). Students, grades 1-8. Plate waste was estimated from 899 lunch trays; 535 elementary- and 364 middle-school students. Only 45 % of elementary- and 34 % middle-school students selected a vegetable. Elementary-school students wasted more than a third of grain, fruit and vegetable menu items. Middle-school students left nearly 50 % of fresh fruit, 37 % of canned fruit and nearly a third of vegetables unconsumed. Less than half of the students met the national meal standards for vitamins A and C, or Fe. Few students' lunch consumption met previous or new, strengthened NSLP lunch standards. Due to the relatively low intake of vegetables, intakes of vitamins A and C were of particular concern. Effective behavioural interventions, combined with marketing, communications and behavioural economics, will likely be necessary to encourage increased vegetable intake to meet the new meal standards.
Kempe, Allison; Daley, Matthew F; Pyrzanowski, Jennifer; Vogt, Tara; Fang, Hai; Rinehart, Deborah J; Morgan, Nicole; Riis, Mette; Rodgers, Sarah; McCormick, Emily; Hammer, Anne; Campagna, Elizabeth J; Kile, Deidre; Dickinson, Miriam; Hambidge, Simon J; Shlay, Judith C
To assess rates of immunization; costs of conducting clinics; and reimbursements for a school-located influenza vaccination (SLIV) program that billed third-party payers. SLIV clinics were conducted in 19 elementary schools in the Denver Public School district (September 2010 to February 2011). School personnel obtained parental consent, and a community vaccinator conducted clinics and performed billing. Vaccines For Children vaccine was available for eligible students. Parents were not billed for any fees. Data were collected regarding implementation costs and vaccine cost was calculated using published private sector prices. Reimbursement amounts were compared to costs. Overall, 30% of students (2784 of 9295) received ≥1 influenza vaccine; 39% (1079 of 2784) needed 2 doses and 80% received both. Excluding vaccine costs, implementation costs were $24.69 per vaccination. The percentage of vaccine costs reimbursed was 62% overall (82% from State Child Health Insurance Program (SCHIP), 50% from private insurance). The percentage of implementation costs reimbursed was 19% overall (23% from private, 27% from Medicaid, 29% from SCHIP and 0% among uninsured). Overall, 25% of total costs (implementation plus vaccine) were reimbursed. A SLIV program resulted in vaccination of nearly one third of elementary students. Reimbursement rates were limited by 1) school restrictions on charging parents fees, 2) low payments for vaccine administration from public payers and 3) high rates of denials from private insurers. Some of these problems might be reduced by provisions in the Affordable Care Act. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Cohen, Juliana F W; Smit, Liesbeth A; Parker, Ellen; Austin, S Bryn; Frazier, A Lindsay; Economos, Christina D; Rimm, Eric B
School cafeterias can play an important role in providing healthy meals. Although schools participating in the National School Lunch Program are required to meet minimum program standards, advocates recommend that innovations be sought to enhance menu dietary quality. This study evaluated the Chef Initiative, a 2-year pilot study in two Boston middle schools, designed to increase the availability and consumption of healthier school foods. Between 2007 and 2009, a professional chef trained cafeteria staff to prepare healthier school lunches (ie, more whole grains, fresh/frozen fruits and vegetables, and less sugar, salt, saturated fats, and trans fats). Meal nutrient compositions were monitored from 2007 to 2009, and a plate waste study conducted in the spring of 2009 compared food selection and consumption patterns among students at Chef Initiative schools, with students receiving standard school lunches at two matched control schools. Paired t tests and descriptive statistics were used to examine differences in menus and mixed-model analysis of variance was used to analyze differences in students' food selection and consumption between Chef Initiative and control schools. Overall, the Chef Initiative schools provided healthier lunches and the percent of foods consumed at Chef Initiative and control schools were similar (61.6% vs 57.3%; P=0.63). Of the areas targeted, there was greater whole-grain selection and vegetable consumption; 51% more students selected whole grains (P=0.02) and students consumed 0.36 more vegetable servings/day (P=0.01) at Chef Initiative schools. The potential of chefs collaborating with cafeteria staff to improve the availability, selection, and consumption of healthier meals is promising. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Hunsberger, Monica; Pena, Pablo; Lissner, Lauren; Grafström, Lisen; Vanaelst, Barbara; Börnhorst, Claudia; Pala, Valeria; Eiben, Gabriele
Previous studies have suggested that young children are inaccurate reporters of dietary intake. The purpose of this study was to validate a single recall of the previous day's school lunch reported by 6-8 year old Swedish children and to assess teacher-recorded intake of the same meal in a standardized food journal. An additional research question was whether parents could report their child's intake of the previous day's lunch. Subjects constituted a convenience sample from the large, multi-country study Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). Validations of both children's recalls and teachers' records were made by comparing results with the duplicate plate reference method. Twenty-five children (12 boys/13 girls) aged 6-8 years participated in the validation study at one school in western Sweden. Children were accurate self-reporters of their dietary intake at lunch, with no significant difference between reported and weighed intake (Mean difference (SD): 7(50) kcals, p=0.49). Teachers significantly over-reported intake (Mean difference (SD): 65(79) kcals, p=0.01). For both methods, child-reported and teacher-recorded, correlations with weighed intake were strong (Pearson's correlations r=0.92, pteacher-records and weighed intakes. Foods were recalled by children with a food-match rate of 90%. In all cases parents themselves were unable to report on quantities consumed and only four of 25 children had parents with knowledge regarding food items consumed. Children 6-8 years of age accurately recalled their school lunch intake for one occasion while teachers recorded with less accuracy. Our findings suggest that children as young as six years of age may be better able to report on their dietary intake than previously suggested, at least for one main meal at school. Teacher-recorded intake provides a satisfactory estimate but with greater systematic deviation from the weighed intake
Journal of School Health, 1996
This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…
Connors, Priscilla; Bednar, Carolyn
Purpose/Objectives: The study objective was to document choices of entrées, vegetables, fruits, grains/breads, and beverages on lunch trays and to determine the amount of each that was discarded after mealtime. Methods: A convenience sample of two urban middle school cafeterias in Texas participated in the study which took place in the 2010-2011…
Sabinsky, Marianne; Toft, Ulla; Andersen, Klaus K
Background: It is a challenge to assess children’s dietary intake. The digital photographic method (DPM) may be an objective method that can overcome some of these challenges. Objective: The aim of this study was to evaluate the validity and reliability of a DPM to assess the quality of dietary....... The lunches were photographed using a standardised DPM. From the digital images, the dietary components were estimated by a trained image analyst using weights or household measures and the dietary quality was assessed using a validated Meal Index of Dietary Quality (Meal IQ). The dietary components...... and the Meal IQ obtained from the digital images were validated against the objective weighed foods of the school lunch sandwiches. To determine interrater reliability, the digital images were evaluated by a second image analyst. Results: Correlation coefficients between the DPM and the weighed foods ranged...
Just, David R; Wansink, Brian; Hanks, Andrew S
To demonstrate the feasibility of introducing a main dish designed by a professional chef in the National School Lunch Program and to document the impact on child participation, a chef was recruited to design pizza to be served in an upstate New York school district. The pizza was designed to meet both the cost and ingredient requirements of the NSLP. High school students were significantly more likely to select the pizza prepared by the chef. While the chef had no significant impact on main dish consumption given selection, more students took a vegetable and vegetable consumption increased by 16.5%. This pilot study demonstrates the plausibility of using chefs to boost participation in the school lunch program, and potentially increase nutrition through side selection, among high school students. Copyright © 2014 Elsevier Ltd. All rights reserved.
...,557 $3,629 $17,108 Number of breakfasts 2,091 2,187 2,253 2,298 2,332 11,160 * Equals less than $500... 356 schools within those SFAs. Financial statements, meal production records, recipes, invoices, and... Foods, school recipe records, and school menus. With this information, the study estimated the share of...
Spence, Suzanne; Delve, Jennifer; Stamp, Elaine; Matthews, John N S; White, Martin; Adamson, Ashley J
In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9) and saturated fat (-1.0%; -1.6 to -0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 µg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.
Full Text Available In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9. We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9 and saturated fat (-1.0%; -1.6 to -0.5 than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6, protein (3.6 g, 1.1 to 6.0, non-starch polysaccharides (1.5 g, 0.5 to 1.9, vitamin C (0.7 mg, 0.6 to 0.8, and folate (12.3 µg, 9.7 to 20.4 in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.
Full Text Available School environments influence student food choices. À la carte foods and beverages are often low nutrient and energy dense. This study assessed how much money students spent for these foods, and the total kilocalories purchased per student during the 2012–2013 school year. Six elementary and four intermediate schools in the Houston area provided daily food purchase transaction data, and the cost and the calories for each item. Chi-square analysis assessed differences in the number of students purchasing à la carte items by grade level and school free/reduced-price meal (FRP eligibility. Analysis of covariance assessed grade level differences in cost and calories of weekly purchases, controlling for FRP eligibility. Intermediate grade students spent significantly more on à la carte food purchases and purchased more calories (both p < 0.001 than elementary school students. Lower socioeconomic status (SES elementary and intermediate school students purchased fewer à la carte foods compared to those in higher SES schools (p < 0.001. Intermediate school students purchased more à la carte foods and calories from à la carte foods than elementary students. Whether the new competitive food rules in schools improve student food selection and purchase, and dietary intake habits across all grade levels remains unknown. Keywords: National School Lunch Program, Elementary schools, Intermediate schools, À la carte foods, Competitive foods, Costs, Calories
Woodruff, Sarah J; Hanning, Rhona M; McGoldrick, Kathryn
Among students, little is known about the physical and social context of eating lunch. The objective of this study was to determine if food intake (including the type of food and beverages and portion sizes) was associated with specific aspects of the physical and social lunch environment (location, with whom lunch was consumed, who prepared the food, and where the food was originally purchased). A total of 1236 participants (males = 659, females = 566) in grades 6 (n = 359), 7 (n = 409), and 8 (n = 463) from southern Ontario, Canada, completed the Food Behavior Questionnaire during the 2005-2006 academic year. A total of 8159 foods and 2200 beverages were consumed during the lunch meal, which contributed to 552 kcal (SD = 429) or 30% (SD = 16) of total daily energy intake (kcal/day). Higher amounts of energy, meats and alternatives, other foods, fried foods, and pizza were consumed when participants ate in between places or at a restaurant/fast food outlet (compared with at home or school, p lunch, despite a school board-level policy restricting the sales of "junk food," which appears to be brought from home. Our findings support schools in policy efforts that restrict fast food access (by leaving school grounds, preventing fast food companies from coming onto school grounds, or restricting sugar-sweetened beverage sales in vending machines) and that eating in between places should be discouraged.
...-free and low-fat fluid milk in school meals; reduce the levels of sodium, saturated fat and trans fat... mitigate the childhood obesity trend. The proposed rule took comments on the associated ICR until March 14...
Kenney, Erica L; Gortmaker, Steven L; Carter, Jill E; Howe, M Caitlin W; Reiner, Jennifer F; Cradock, Angie L
We evaluated a low-cost strategy for schools to improve the convenience and appeal of drinking water. We conducted a group-randomized, controlled trial in 10 Boston, Massachusetts, schools in April through June 2013 to test a cafeteria-based intervention. Signage promoting water and disposable cups were installed near water sources. Mixed linear regression models adjusting for clustering evaluated the intervention impact on average student water consumption over 359 lunch periods. The percentage of students in intervention schools observed drinking water during lunch nearly doubled from baseline to follow-up compared with controls (+ 9.4%; P convenience by providing cups can increase student water consumption.
... dietary fiber and when consumed in excess can contribute extra calories. Schools should offer fresh fruit... potassium and other minerals, vitamins and fiber, and are naturally low in fat and sodium. Many stakeholders...) are a source of nutrients such as iron, magnesium, selenium, B vitamins, and dietary fiber. Evidence...
Chinchanachokchai, Sydney; Jamelske, Eric M.
Purpose/Objectives: Existing research has investigated the effects of using individual incentives and positive reinforcements to influence children to eat more fruits and vegetables for lunch and snack during school. This study explored using group-level incentives to motivate children in a Wisconsin elementary school to eat more fruits and…
Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro
School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children’s nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein (p nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren. PMID:28805668
... family income is above 185 percent of the Federal poverty guidelines. The lower cash assistance level... income at or below 130 percent of the Federal poverty level are eligible for free meals, while those from... considering that the provision reinforces the concept that the performance reimbursement is only applied to...
Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro
School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children's nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein ( p < 0.05), calcium ( p < 0.05), and vitamin C ( p < 0.001) significantly increased, while that of fat significantly decreased ( p < 0.001). After the intervention, hemoglobin ( p < 0.05) and hematocrit ( p < 0.05) levels were significantly improved, thereby almost halving the rate of anemia. These changes were significantly larger in the baseline anemic group than the non-anemic group ( p < 0.01). BMI significantly increased in the baseline underweight/normal group ( p < 0.001) but not in the overweight/obese group. The school lunch intervention significantly improved nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren.
Contaminated Frozen Strawberries in School Lunches. Hearing before the Committee on Agriculture, Nutrition, and Forestry. United States Senate, One Hundred Fifth Congress, First Session (June 5, 1997).
Congress of the U.S., Washington, DC. Senate Committee on Agriculture, Nutrition, and Forestry.
This hearing includes testimony on contaminated strawberries in school lunches. Contaminated strawberries were determined to be the cause of an outbreak of hepatitis in the state of Michigan. In addition to statements by the committee members, testimony was given by: (1) Mary Ann Keeffe, Acting Under Secretary, Food Nutrition and Consumer…
Beaulieu, Dominique; Godin, Gaston
Many schools have recently adopted food policies and replaced unhealthy products by healthy foods. Consequently, adolescents are more likely to consume a healthy meal if they stay in school for lunch to eat a meal either prepared at home or purchased in school cafeterias. However, many continue to eat in nearby fast-food restaurants. The present paper describes the development of a theory-based intervention programme aimed at encouraging high school students to stay in school for lunch. Intervention Mapping and the Theory of Planned Behaviour served as theoretical frameworks to guide the development of a 12-week intervention programme of activities addressing intention, descriptive norm, perceived behavioural control and attitude. It was offered to students and their parents with several practical applications, such as structural environmental changes, and educational activities, such as audio and electronic messages, posters, cooking sessions, pamphlets, improvisation play theatre, quiz, and conferences. The programme considers theoretical and empirical data, taking into account specific beliefs and contexts of the target population. This paper should help programme planners in the development of appropriate interventions addressing the problem. Copyright © 2012 Elsevier Ltd. All rights reserved.
Preston, Alan M; Venegas, Heidi; Rodríguez, Cindy A; Vélez-Rodríguez, Rose M
Extensive evaluations of the national school lunch program (NSLP) have been carried out on the U.S. mainland. Puerto Rico, a commonwealth of the U.S. is a participant in this program, but has never been included in assessment studies. Herein, we present assessment information and compare results with comparable mainland studies. Multiple 24-hr recall questionnaires were administered to groups of participating (P) and non-participating (NP) children in the lunch program at 3 educational levels. Comparisons were made for children within the study as well as between comparable children in mainland studies for total intake of several macro- and micro-nutrients, contribution of the lunch to the total daily intake and adherence to U.S. Recommended Dietary Allowances (RDA's) or to Dietary Reference Intakes (DRI's) including acceptable macronutrient distribution ranges (AMDR's). Target intakes were met by P for % of the RDA of energy from protein, for all water soluble vitamins, iron, zinc and cholesterol. P did not achieve target intakes for total energy, energy from carbohydrates and fat nor for fat soluble vitamins, calcium, magnesium, phosphorus, potassium and fiber. Recommended levels were exceeded for sodium, total fat and saturated fat. Comparing P vs NP, the vast majority of both groups fell within AMDR recommendations for macronutrients but not all micronutrients. For the most part, our results parallel those obtained in the National sample however, results suggest that P in the lunch program in Puerto Rico have a healthier intake of several nutrients than NP students. The unique feature of this study is that it is the first assessment of the NSLP in a completely Hispanic population.
Krehbiel, Caroline F; DuPaul, George J; Hoffman, Jessica A
Obtaining valid and reliable estimates of usual dietary intake at a reasonable cost is a challenge in school-based nutrition research. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2014 version (ASA24 Kids-2014), a self-administered, computerized 24-hour dietary recall, offers improved feasibility over traditional interviewer-administered 24-hour recalls. This mixed-methods study examined ASA24 Kids-2014's validity for measuring dietary intake from National School Lunch Program lunches. After 24% attrition, 96 middle-school students from three urban schools in eastern Pennsylvania participated in the study. A subsample of 27 participants completed qualitative interviews. Data were collected in the spring of 2014. Self-reported ASA24 Kids-2014 data were compared to direct observations of school lunch, which served as the criterion measure. Dependent variables included eight meal components selected from the National School Lunch Program guidelines (fruit, vegetables, grains, protein-rich foods, dairy, oils, solid fats, and added sugars). A supplemental interview collected qualitative data regarding students' perceptions of content and substantive validity. The Wilcoxon signed rank test and Spearman's ρ examined criterion-related validity; qualitative content analysis examined content and substantive validity. Participants inaccurately recalled food items eaten at lunch, as 58% of foods were reported in error. However, among foods recalled correctly, no statistically significant differences emerged for estimates of portions consumed for six meal components (fruit, vegetables, grains, protein-rich foods, oils, and added sugars). In addition, statistically significant positive correlations emerged between ASA24 Kids-2014 and direct observation for all estimates. Qualitative data identified students' interest and motivation, comprehension, memory, and English-language fluency as relevant sources of error. Middle school students have difficulty
Serving meals and snacks at school is fraught with politics and pitfalls. While the battle rages in school cafeterias over menu choices, beverage sales, vending foods, and outright bans on what students can buy or even bring to school, there is some good news. More school districts are reducing the number of fried foods, increasing the levels of…
Park, Sohyun; Sappenfield, William M; Huang, Youjie; Sherry, Bettylou; Bensyl, Diana M
Childhood obesity is a major public health concern and is associated with substantial morbidities. Access to less-healthy foods might facilitate dietary behaviors that contribute to obesity. However, less-healthy foods are usually available in school vending machines. This cross-sectional study examined the prevalence of students buying snacks or beverages from school vending machines instead of buying school lunch and predictors of this behavior. Analyses were based on the 2003 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,322 students in grades six through eight in 73 Florida public middle schools. Analyses included χ2 tests and logistic regression. The outcome measure was buying a snack or beverage from vending machines 2 or more days during the previous 5 days instead of buying lunch. The survey response rate was 72%. Eighteen percent of respondents reported purchasing a snack or beverage from a vending machine 2 or more days during the previous 5 school days instead of buying school lunch. Although healthier options were available, the most commonly purchased vending machine items were chips, pretzels/crackers, candy bars, soda, and sport drinks. More students chose snacks or beverages instead of lunch in schools where beverage vending machines were also available than did students in schools where beverage vending machines were unavailable: 19% and 7%, respectively (P≤0.05). The strongest risk factor for buying snacks or beverages from vending machines instead of buying school lunch was availability of beverage vending machines in schools (adjusted odds ratio=3.5; 95% confidence interval, 2.2 to 5.7). Other statistically significant risk factors were smoking, non-Hispanic black race/ethnicity, Hispanic ethnicity, and older age. Although healthier choices were available, the most common choices were the less-healthy foods. Schools should consider developing policies to reduce the availability of less-healthy choices
Lisa Dragoset; Anne Gordon
This brief describes exploratory work to develop a simulation model to predict the potential implications of changes that may be coming in policies and practices related to school meals and school food environments.
Cohen, Juliana F. W.; Rimm, Eric B.; Austin, S. Bryn; Hyatt, Raymond R.; Kraak, Vivica I.; Economos, Christina D.
Background: Whole grain (WG) options are often limited in schools, which may impact rural, low-income students who rely on school meals for a substantial portion of their food intake. This study examined the changes in the availability and quantity of WG and refined grain foods offered in schools participating in the Creating Healthy, Active and…
Canterberry, Melanie; Francois, Samantha; van Hattum, Taslim; Rudov, Lindsey; Carton, Thomas W.
Background: Louisiana has one of the highest rates of overweight and obese children in the United States. The Healthy School Food Collaborative (HSFC) was created to allow New Orleans's schools to select their own healthy school Food Service Provider (FSP) with requirements for higher nutritional standards than traditional options. The goal of…
Cohen, Juliana F W; Jahn, Jaquelyn L; Richardson, Scott; Cluggish, Sarah A; Parker, Ellen; Rimm, Eric B
There are currently no national standards for school lunch period length and little is known about the association between the amount of time students have to eat and school food selection and consumption. Our aim was to examine plate-waste measurements from students in the control arm of the Modifying Eating and Lifestyles at School study (2011 to 2012 school year) to determine the association between amount of time to eat and school meal selection and consumption. We used a prospective study design using up to six repeated measures among students during the school year. One thousand and one students in grades 3 to 8 attending six participating elementary and middle schools in an urban, low-income school district where lunch period lengths varied from 20 to 30 minutes were included. School food selection and consumption were collected using plate-waste methodology. Logistic regression and mixed-model analysis of variance was used to examine food selection and consumption. Compared with meal-component selection when students had at least 25 minutes to eat, students were significantly less likely to select a fruit (44% vs 57%; Peat. There were no significant differences in entrée, milk, or vegetable selections. Among those who selected a meal component, students with eat consumed 13% less of their entrée (Peat. During the school year, a substantial number of students had insufficient time to eat, which was associated with significantly decreased entrée, milk, and vegetable consumption compared with students who had more time to eat. School policies that encourage lunches with at least 25 minutes of seated time might reduce food waste and improve dietary intake. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D
To present data on trends in foods and beverages offered through the National School Lunch Program (NSLP) in public middle and high schools in the years immediately preceding and following implementation of new NSLP standards. From 2011 to 2013, primary data collection through the annual Youth, Education, and Society study involved use of mailed questionnaires to obtain data on NSLP meals from schools attended by nationally representative samples of US 8(th), 10(th), and 12(th) grade students (N=792 middle schools and 751 high schools). Each school was weighted to represent the percentage of target grade students enrolled, thus allowing analyses examining changes over time in the percentage of students enrolled in (attending) schools with specified NSLP measure outcomes, as well as disparities in NSLP measures based on school characteristics. Significantly more US secondary students attended schools with specified NSLP measures in 2013 than in 2011; increases were observed at both middle and high school levels. Increase rates for some NSLP measures were moderated by school characteristics; where this was the case, moderating associations decreased prior NSLP nutrition environment disparities that were especially evident in smaller schools and schools with higher percentages of minority students. Meaningful improvements have been made in the nutritional content of NSLP meals offered to US secondary students; these improvements have reduced prior NSLP meal disparities associated with school characteristics. Schools will need continued help with implementation and compliance monitoring in order to have the best opportunity to improve the nutrition environments for US students. Copyright © 2015 Elsevier Inc. All rights reserved.
Clark County school district in Las Vegas, Nevada, has combination lunches available for high school students that meet Type A nutrition requirements but which resemble the commercial fast food menus teenagers prefer. (MLF)
Cohen, Juliana F.W.; Jahn, Jaquelyn L.; Richardson, Scott; Cluggish, Sarah A.; Parker, Ellen; Rimm, Eric B.
Background There are currently no national standards for school lunch period lengths and little is known about the association between the amount of time students have to eat and school food selection and consumption. Objectives To examine plate waste measurements from students in the control arm from the MEALS study (2011-2012 school year) for the association of the amount of time to eat with school meal selection and consumption. Design Prospective study using up to six repeated measures among students over the school year. Participants/Setting 1001 students in grades 3-8 attending 6 participating elementary/middle schools in an urban, low-income school district where lunch period lengths varied from 20-30 minutes. Main Outcome Measures School food selection and consumption were collected using plate waste methodology. Statistical Analyses Performed Logistic regression and mixed-model ANOVA was used to examine food selection and consumption. Results Compared with meal component selection when students had at least 25 minutes to eat, students were significantly less likely to select a fruit (44% vs. 57%; p=0.0001) compared with when students had fewer than 20 minutes to eat. There were no significant differences in entrée, milk, or vegetable selection. Among those who selected a meal component, students with fewer than 20 minutes to eat consumed 13% less of their entrée (peat. Conclusions Over the school year, a substantial number of students had insufficient time to eat, which was associated with significantly decreased entrée, milk, and vegetable consumption compared with students who had more time to eat. School policies that encourage lunches with at least 25 minutes of seated time may reduce food waste and improve dietary intake. PMID:26372337
Direct Certification in the National School Lunch Program: State Implementation Progress School Year 2010-2011. Report to Congress. Nutrition Assistance Program Report Series. Special Nutrition Programs Report Number CN-11-DC
Moore, Quinn; Conway, Kevin; Kyler, Brandon
This report responds to the legislative requirement of the Food, Conservation, and Energy Act of 2008 (P.L.110-246) to assess the effectiveness of State and local efforts to directly certify children for free school meals under the National School Lunch Program (NSLP). Direct certification is a process conducted by the States and by local…
Full Text Available Abstract Background The prevalence of self-reported low back pain among professional cooks was estimated to examine the effects of daily life conditions, job-related factors, and psychological factors on this disorder. Methods Data was collected using a mailed self-administered questionnaire. Results Of 7100 cooks, 5835 (82% replied to the questionnaire, including 1010 men and 4825 women. The mean age was 41.4 for men and 47.5 for women. The prevalence of low back pain during a 1-month period was 72.2% among men and 74.7% among women, with no significant differences between groups. By logistic regression analyses, factors significantly associated with the prevalence of low back pain in 1 month were female gender (prevalence ratio [PR] 1.32; 95% CI, 1.03–1.68, current smoking (PR 1.57; 95% CI, 1.24–1.98, and past smoking (PR 1.35; 95% CI, 1.01–1.79. As for job-related factors, the number of cooked lunches per person (PR 1.28; 95% CI, 1.05–1.56, breaks in the morning session (PR 1.33; 95% CI, 1.13–1.56, kitchen environment (PR 1.09; 95%, CI, 1.03–1.15, and height of cooking equipment (PR 1.13; 95% CI, 1.08–1.19 were associated with the prevalence of low back pain. As for psychological factors, job satisfaction (PR 1.22; 95% CI, 1.03–1.45, stress at work (PR 1.68; 95% CI, 1.42–1.99, financial constraints (PR 1.23; 95% CI, 1.03–1.47, health-related stress (PR 1.31; 95% CI, 1.08–1.59 and worries about the future (PR 1.24; 95% CI, 1.01–1.52 were similarly associated. Conclusion Daily life conditions, job-related factors, and psychological factors are associated with the occurrence of low back pain. It is important to take comprehensive preventive measures to address a range of work and life conditions that can be improved to decrease the incidence of low back pain for professional cooks.
Nagasu, Miwako; Sakai, Kazuhiro; Ito, Akiyoshi; Tomita, Shigeru; Temmyo, Yoshiomi; Ueno, Mitsuo; Miyagi, Shigeji
The prevalence of self-reported low back pain among professional cooks was estimated to examine the effects of daily life conditions, job-related factors, and psychological factors on this disorder. Data was collected using a mailed self-administered questionnaire. Of 7100 cooks, 5835 (82%) replied to the questionnaire, including 1010 men and 4825 women. The mean age was 41.4 for men and 47.5 for women. The prevalence of low back pain during a 1-month period was 72.2% among men and 74.7% among women, with no significant differences between groups. By logistic regression analyses, factors significantly associated with the prevalence of low back pain in 1 month were female gender (prevalence ratio [PR] 1.32; 95% CI, 1.03-1.68), current smoking (PR 1.57; 95% CI, 1.24-1.98), and past smoking (PR 1.35; 95% CI, 1.01-1.79). As for job-related factors, the number of cooked lunches per person (PR 1.28; 95% CI, 1.05-1.56), breaks in the morning session (PR 1.33; 95% CI, 1.13-1.56), kitchen environment (PR 1.09; 95%, CI, 1.03-1.15), and height of cooking equipment (PR 1.13; 95% CI, 1.08-1.19) were associated with the prevalence of low back pain. As for psychological factors, job satisfaction (PR 1.22; 95% CI, 1.03-1.45), stress at work (PR 1.68; 95% CI, 1.42-1.99), financial constraints (PR 1.23; 95% CI, 1.03-1.47), health-related stress (PR 1.31; 95% CI, 1.08-1.59) and worries about the future (PR 1.24; 95% CI, 1.01-1.52) were similarly associated. Daily life conditions, job-related factors, and psychological factors are associated with the occurrence of low back pain. It is important to take comprehensive preventive measures to address a range of work and life conditions that can be improved to decrease the incidence of low back pain for professional cooks.
Briefel, Ronette R; Wilson, Ander; Gleason, Philip M
Access to foods and beverages on school campuses, at home, and other locations affects children's diet quality, energy intake, and risk of obesity. To describe patterns of consumption of "empty calories"--low-nutrient, energy-dense foods, including sugar-sweetened beverages--by eating location among National School Lunch Program (NSLP) participants and nonparticipants. Cross-sectional study using 24-hour dietary recall data from the 2004-2005 third School Nutrition Dietary Assessment Study. A nationally representative sample of 2,314 children in grades one through 12, including 1,386 NSLP participants. Comparisons, using t tests, of the proportion of children consuming low-nutrient, energy-dense foods and beverages, mean daily energy and energy from low-nutrient, energy-dense foods, and energy density by NSLP participation status. On a typical school day, children consumed 527 "empty calories" during a 24-hour period. Eating at home provided the highest mean amount of energy from low-nutrient, energy-dense foods (276 kcal vs 174 kcal at school and 78 kcal at other locations). NSLP participants consumed less energy from sugar-sweetened beverages at school than nonparticipants (11 kcal vs 39 kcal in elementary schools and 45 kcal vs 61 kcal in secondary schools, Pkcal vs 127 kcal, Plunch participants' consumption at school was less energy-dense than nonparticipants' consumption at school (Pdaily and energy from low-nutrient, energy-dense foods are consumed (especially from sugar-sweetened beverages, chips, and baked goods) is warranted. At schools, consumption of energy from low-nutrient, energy-dense foods may be reduced by limiting access to competitive foods and beverages, enforcing strong school wellness policies, and minimizing the frequency of offering french fries and similar potato products and higher-fat baked goods in school meals or à la carte.
Nanney, Marilyn S.; Olaleye, Temitope M.; Wang, Qi
Background: This study tested the feasibility and acceptability of adding a reimbursable snack that meets the Institute of Medicine nutrition recommendations to an afterschool homework program for middle school students. Methods: Snack menu was developed and administered to students attending an afterschool homework program over 12 weeks. In…
Biltoft-Jensen, Anja; Bysted, Anette; Trolle, Ellen; Christensen, Tue; Knuthsen, Pia; Damsgaard, Camilla T; Andersen, Lene F; Brockhoff, Per; Tetens, Inge
Web-based Dietary Assessment Software for Children (WebDASC) was developed to estimate dietary intake in a school meal intervention study among 8- to 11-year-old Danish children. The present study validates self-reported fruit, juice and vegetable (FJV) intakes in 8- to 11-year-old children by comparing intake with plasma carotenoid concentration, and by comparing the reported FJV intake to actually eaten FJV, as observed by a photographic method. A total of eighty-one children, assisted by parents, reported their diet for seven consecutive days. For the same five schooldays as they reported their diet, the children's school lunch was photographed and weighed before and after eating. In the week after the diet reporting, fasting blood samples were taken. Self-reported intake of FJV and estimated intake of carotenoids were compared with plasma carotenoid concentration. Accuracy of self-reported food and FJV consumption at school lunch was measured in terms of matches, intrusion, omission and faults, when compared with images and weights of lunch intake. Self-reported intake of FJV was significantly correlated with the total carotenoid concentration (0·58) (Pjuice consumption showed higher correlations than vegetables with plasma carotenoid concentration (0·38 and 0·42 v. 0·33) (P< 0·01). A total of 82 % of the participants fell into the same or adjacent quartiles when cross-classified by FJV intake and carotenoids biomarkers. WebDASC attained 82 % reporting matches overall and a higher percentage match for reporting fruits compared with beverages. The present study indicated that WebDASC can be used to rank 8- to 11-year-old Danish children according to their intake of FJV overall and at school meals.
Guinn, Caroline H; Baxter, Suzanne D; Royer, Julie A; Hitchcock, David B
A 2010 publication showed a positive relationship between children's body mass index (BMI) and energy intake at school-provided meals (as assessed by direct meal observations). To help explain that relationship, we investigated 7 outcome variables concerning aspects of school-provided meals: energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. Fourth-grade children (N = 465) from Columbia, SC, were observed eating school-provided breakfast and lunch on 1 to 4 days per child. Researchers measured children's weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). BMI was positively related to amounts eaten of standardized school-meal portions (p kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m(2) for every 100 kcal received. BMI was not significantly related to 4 outcome variables. Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. © 2013, American School Health Association.
Baxter, Suzanne Domel; Royer, Julie A.; Hitchcock, David B.
BACKGROUND A positive relationship exists between children’s body mass index (BMI) and energy intake at school-provided meals. To help explain this relationship, we investigated 7 outcome variables concerning aspects of school-provided meals—energy content of items selected, number of meal components selected, number of meal components eaten, amounts eaten of standardized school-meal portions, energy intake from flavored milk, energy intake received in trades, and energy content given in trades. METHODS We observed children in grade 4 (N=465) eating school-provided breakfast and lunch on one to 4 days per child. We measured children’s weight and height. For daily values at school meals, a generalized linear model was fit with BMI (dependent variable) and the 7 outcome variables, sex, and age (independent variables). RESULTS BMI was positively related to amounts eaten of standardized school-meal portions (p kcal consumed. BMI was negatively related to energy intake received in trades (p = .0003) and decreased 0.468 kg/m2 for every 100-kcal received. BMI was not significantly related to 4 outcome variables. CONCLUSIONS Knowing that relationships between BMI and actual consumption, not selection, at school-provided meals explained the (previously found) positive relationship between BMI and energy intake at school-provided meals is helpful for school-based obesity interventions. PMID:23517000
Woodruff, Sarah J.; Hanning, Rhona M.; McGoldrick, Kathryn
Background: Among students, little is known about the physical and social context of eating lunch. The objective of this study was to determine if food intake (including the type of food and beverages and portion sizes) was associated with specific aspects of the physical and social lunch environment (location, with whom lunch was consumed, who…
Biltoft-Jensen, Anja Pia; Bysted, Anette; Trolle, Ellen
Web-based Dietary Assessment Software for Children (WebDASC) was developed to estimate dietary intake in a school meal intervention study among 8- to 11-year-old Danish children. The present study validates self-reported fruit, juice and vegetable (FJV) intakes in 8- to 11-year-old children...... by comparing intake with plasma carotenoid concentration, and by comparing the reported FJV intake to actually eaten FJV, as observed by a photographic method. A total of eighty-one children, assisted by parents, reported their diet for seven consecutive days. For the same five schooldays as they reported...... their diet, the children's school lunch was photographed and weighed before and after eating. In the week after the diet reporting, fasting blood samples were taken. Self-reported intake of FJV and estimated intake of carotenoids were compared with plasma carotenoid concentration. Accuracy of self...
Thorsen, Anne Vibeke; Lassen, Anne Dahl; Andersen, Elisabeth Wreford
for the NND period and 43 (sd 60) g for the packed lunch period whereas the relative edible plate waste was no different between periods for meals having waste (n 1050). Edible plate waste differed between menus (P soup days (36 %) and vegetarian days (23 %) compared...
Thorsen, Anne Vibeke; Lassen, Anne Dahl; Andersen, Elisabeth Wreford
for the NND period and 43 (sd 60) g for the packed lunch period whereas the relative edible plate waste was no different between periods for meals having waste (n 1050). Edible plate waste differed between menus (P vegetarian days (23 %) compared...
Taylor, Jennifer C; Sutter, Carolyn; Ontai, Lenna L; Nishina, Adrienne; Zidenberg-Cherr, Sheri
Although increasing attention is placed on the quality of foods in children's packed lunches, few studies have examined the capacity of observational methods to reliably determine both what is selected and consumed from these lunches. The objective of this project was to assess the feasibility and inter-rater reliability of digital imaging for determining selection and consumption from students' packed lunches, by adapting approaches previously applied to school lunches. Study 1 assessed feasibility and reliability of data collection among a sample of packed lunches (n = 155), while Study 2 further examined reliability in a larger sample of packed (n = 386) as well as school (n = 583) lunches. Based on the results from Study 1, it was feasible to collect and code most items in packed lunch images; missing data were most commonly attributed to packaging that limited visibility of contents. Across both studies, there was satisfactory reliability for determining food types selected, quantities selected, and quantities consumed in the eight food categories examined (weighted kappa coefficients 0.68-0.97 for packed lunches, 0.74-0.97 for school lunches), with lowest reliability for estimating condiments and meats/meat alternatives in packed lunches. In extending methods predominately applied to school lunches, these findings demonstrate the capacity of digital imaging for the objective estimation of selection and consumption from both school and packed lunches. Copyright © 2017 Elsevier Ltd. All rights reserved.
General Accounting Office, Washington, DC. Resources, Community, and Economic Development Div.
In the Healthy Meals for Healthy Americans Act of 1994, Congress directed the Government Accounting Office (GAO) to examine the use of private food establishments and caterers by schools participating in federal programs for school meals. In conducting its review, the GAO relied primarily on questionnaires returned by food authorities that had…
Price, Joseph; Just, David R
In this study, we evaluate if moving recess before lunch has an effect on the amount of fruits and vegetables elementary school students eat as part of their school-provided lunch. Participants were 1st-6th grade students from three schools that switched recess from after to before lunch and four similar schools that continued to hold recess after lunch. We collected data for an average of 14 days at each school (4 days during spring 2011, May 3 through June 1, 2011 and 9 days during fall 2011, September 19 through November 11, 2011). All of the schools were in Orem, UT. Data was collected for all students receiving a school lunch and was based on observational plate waste data. We find that moving recess before lunch increased consumption of fruits and vegetables by 0.16 servings per child (a 54% increase) and increased the fraction of children eating at least one serving of fruits or vegetables by 10 percentage points (a 45% increase). In contrast, the schools in our control group actually experienced a small reduction in fruit and vegetable consumption during the same time period. Our results show the benefits of holding recess before lunch and suggest that if more schools implement this policy, there would be significant increases in fruit and vegetable consumption among students who eat school lunch as part of the National School Lunch Program. Copyright © 2014 Elsevier Inc. All rights reserved.
Malcarney, Mary-Beth; Horton, Katherine; Seiler, Naomi
Background: School nurses can provide direct services for children with asthma, educate, and reinforce treatment recommendations to children and their families, and coordinate the school-wide response to students' asthma emergencies. Unfortunately, school-based health services today depend on an unreliable patchwork of funding. Limited state and…
Lyng, Nina; Fagt, Sisse; Davidsen, Michael
Background: Packed lunch is the dominant lunch format in many countries including Denmark. School lunch is consumed unsupervised, and self-reported recalls are appropriate in the school setting. However, little is known about the accuracy of recalls in relation to packed lunch. Objective: To assess...... the qualitative recall accuracy of self-reported consumption of packed lunch among Danish 11-year-old children in relation to gender and dietary assessment method. Design: A cross-sectional dietary recall study of packed lunch consumption. Digital images (DIs) served as an objective reference method to determine...... food items consumed. Recalls were collected with a lunch recall questionnaire (LRQ) comprising an open-ended recall (OE-Q) and a pre-coded food group prompted recall (PC-Q). Individual interviews (INTs) were conducted successively. The number of food items was identified and accuracy was calculated...
Miller, Nicole; Reicks, Marla; Redden, Joseph P; Mann, Traci; Mykerezi, Elton; Vickers, Zata
Increasing portion size can increase children's consumption of food. The goal of this study was to determine whether increasing the portion sizes of fruits and vegetables in an elementary school cafeteria environment would increase children's consumption of them. We measured each child's consumption of the fruit and vegetables served in a cafeteria line on a control day (normal cafeteria procedures) and on two intervention days. When we increased the portion size of 3 of the 4 fruits and vegetables by about 50%, children who took those foods increased their consumption of them. Although this was an effective strategy for increasing fruit and vegetable consumption among students who took those foods, many children chose not to take any fruits or vegetables. Further efforts are needed to increase children's selection and consumption of fruits and vegetables in an environment of competing foods of higher palatability. Copyright © 2015 Elsevier Ltd. All rights reserved.
Somura, Yoshiko; Kimoto, Kana; Oda, Mayuko; Okutsu, Yuta; Kato, Rei; Suzuki, Yasunori; Siki, Dai; Hirai, Akihiko; Akiba, Tetsuya; Shinkai, Takayuki; Sadamasu, Kenji
In February 2017, four food poisoning outbreaks occurred in Tokyo, involving ten schools. Shredded dried laver seaweed processed by a single food manufacturer in December 2016 was provided in common for the school meals that caused all four outbreaks. Of 4,209 persons exposed, 1,193 (28.3%) had symptoms of gastroenteritis. Norovirus (NoV) GII was detected in 207 (78.1%) of 265 cases by real-time RT-PCR. Thirty-one shredded dried laver seaweed samples were examined and seven (22.6%) of them were positive for NoV GII. PCR fragments of NoV ORF1/2 junction region (302 bp) from seven shredded dried laver seaweed samples and 20 clinical samples derived from the four outbreaks were sequenced. All of them displayed complete homology, and the genotype was classified as GII.17. A nearly full-length sequence (7,420 bp) of NoV RNA derived from a case was obtained by next-generation sequencer analysis and phylogenetic analysis indicated that this strain belongs to the same cluster as Hu/GII/JP/2015/GII.P17_GII.17/Kawasaki308. Thus, our investigation elucidated that the causative agent of these four serial food poisoning outbreaks was NoV GII.17 and the infectious source was a single batch of shredded dried laver seaweed. The water activity of the shredded dried laver seaweed was found to be 0.119 to 0.129. It was epidemiologically clarified that NoV does not lose infectivity for about two months even in the dry state. We conclude that a large diffuse outbreak of food poisoning caused by NoV GII.17 contamination of shredded dried laver seaweed had occurred in Tokyo. Our elucidation of the causative agent indicated that the food poisoning outbreaks in multiple areas of Japan, including Tokyo, during January to February 2017 were caused by the same contaminated food.
Dellatte, E.; Brambilla, G.; De Filippis, S.P.; Di Domenico, A.; Pulkrabova, J.; Eschauzier, C.; Klenow, S.; Heinemeyer, G.; de Voogt, P.
Ready-to-eat servings may be more contaminated with perfluorinated alkyl acids (PFAAs) than the corresponding unprocessed foods due to the presence of PFAAs in and transfer from food contact materials (FCM) and cookware. Therefore, the presence of selected PFAAs in meals served weekly at lunch time
Francois Butin; Markus Nordberg
The end of the year ATLAS pit lunch is now a well established tradition: the 4th edition took place in the most prestigious place at CERN; the "Globe de l'innovation", or simply "the Globe". This end-of-year event is the opportunity to thank all those working so hard at Point 1. The first event took place in December 2003. At that time, there was no Globe yet, and the party took place in SX1 building, at the top of the shafts leading to the ATLAS cavern, with some 100 guests. In December 2004, we had the privilege to be the first to organize a lunch in the Globe with some 200 guests. Since then, many have followed our example! Well, almost: we were requested to refrain from serving "Tartiflette" again in there (a Savoyard specialty, using vast amounts of Reblochon, a smelly cheese...). It was said to have left a poignant odour for following events throughout 2004... Long queues formed for this special event. In December 2005, we were authorized to party in the Globe again (once we promised we would b...
Page 1. Description: Lunch to discuss IDRC's programming. Date: 2017-02-10. Attendees: 2 (IDRC 1). Location: Ottawa. Total: $79.92. Comments: 2016-2017 Hospitality Expense. Reports for Jean Lebel, President.
... reimbursement for each half-pint (236 ml.) of milk served to children exceed the cost of the milk to the school or child care institution. (2) The rate of reimbursement for milk purchased and served free to needy... shall be the average cost of milk, i.e., the total cost of all milk purchased during the claim period...
This work explores the problem of cross-lingual pairwise similarity, where the task is to extract similar pairs of documents across two different languages. Solutions to this problem are of general interest for text mining in the multilingual context and have specific applications in statistical machine translation. Our approach takes advantage of cross-language information retrieval (CLIR) techniques to project feature vectors from one language into another, and then uses locality-sensitive hashing (LSH) to extract similar pairs. We show that effective cross-lingual pairwise similarity requires working with similarity thresholds that are much lower than in typical monolingual applications, making the problem quite challenging. We present a parallel, scalable MapReduce implementation of the sort-based sliding window algorithm, which is compared to a brute-force approach on German and English Wikipedia collections. Our central finding can be summarized as "no free lunch": there is no single optimal solution. Instead, we characterize effectiveness-efficiency tradeoffs in the solution space, which can guide the developer to locate a desirable operating point based on application- and resource-specific constraints.
... 42 Public Health 1 2010-10-01 2010-10-01 false Loan cancellation reimbursement. 57.213a Section 57... Professions Student Loans § 57.213a Loan cancellation reimbursement. (a) For loans made prior to October 22... credited to this insurance fund), and used only to reimburse the school for the institutional share of any...
Evans, C E L; Greenwood, D C; Thomas, J D; Cleghorn, C L; Kitchen, M S; Cade, J E
Government standards are now in place for children's school meals but not for lunches prepared at home. The aim of this trial is to improve the content of children's packed lunches. A cluster randomised controlled trial in 89 primary schools across the UK involving 1291 children, age 8-9 years at baseline. Follow-up was 12 months after baseline. A "SMART" lunch box intervention programme consisted of food boxes, bag and supporting materials. The main outcome measures were weights of foods and proportion of children provided with sandwiches, fruit, vegetables, dairy food, savoury snacks and confectionery in each packed lunch. Levels of nutrients provided including energy, total fat, saturated fat, protein, non-milk extrinsic sugar, sodium, calcium, iron, folate, zinc, vitamin A and vitamin C. Moderately higher weights of fruit, vegetables, dairy and starchy food and lower weights of savoury snacks were provided to children in the intervention group. Children in the intervention group were provided with slightly higher levels of vitamin A and folate. 11% more children were provided with vegetables/salad in their packed lunch, and 13% fewer children were provided with savoury snacks (crisps). Children in the intervention group were more likely to be provided with packed lunches meeting the government school meal standards. The SMART lunch box intervention, targeting parents and children, led to small improvements in the food and nutrient content of children's packed lunches. Further interventions are required to bring packed lunches in line with the new government standards for school meals. Current controlled trials ISRCTN77710993.
Pedersen, Trine Pagh; Holstein, Bjørn E; Krølner, Rikke
frequency was most common among students who were boys, 13- and 15-year-olds, from medium and low family social class, descendants of immigrants, living in a single-parent family and in a reconstructed family. School-level analyses suggested that having access to a canteen at school was associated with low...
Nollen, Nicole L; Kimminau, Kim S; Nazir, Niaman
Reducing à la carte items in schools-foods and beverages sold outside the reimbursable meals program-can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Dresler-Hawke, Emma; Whitehead, Dean; Coad, Jane
Eating patterns among school-aged children continue to be highly reliant on frequent consumption of food items that are perceived to have low or poor nutritional value. This has become a serious public health concern. In this New Zealand-based study, primary school children's food consumption behaviour was investigated via two sources: a…
Since opening, Amuse Restaurant has garnered rave reviews from the Country’s most trusted and renowned food critics. Praise has flowed for Conor’s individual style of cooking, which brings Asian flavours, namely Japanese, to modern French cuisine. The menu focuses mainly on tasting menus as it is the best way to experience this kind of food, however there is a three course set menu available Tuesday to Thursday for mid week dining. The lunch menu is a three course affair with the option of a ...
Since opening, Amuse Restaurant has garnered rave reviews from the Country’s most trusted and renowned food critics. Praise has flowed for Conor’s individual style of cooking, which brings Asian flavours, namely Japanese, to modern French cuisine. The menu focuses mainly on tasting menus as it is the best way to experience this kind of food, however there is a three course set menu available Tuesday to Thursday for mid week dining. The lunch menu is a three course affair with the option of a ...
Andrepont, Emmy; Cullen, Karen W.; Taylor, Wendell C.
Background: Computerized point-of-sale (POS) machine software that allows parents to place restrictions on their child's school meal accounts is available. Parents could restrict specific foods (e.g., chips), identify specific days the child can purchase extra foods, or set monetary limits. This descriptive study examines the use of parental…
Computerized point-of-sale (POS) machine software that allows parents to place restrictions on their child’s school meal accounts is available. Parents could restrict specific foods (eg, chips), identify specific days the child can purchase extra foods, or set monetary limits. This descriptive study...
Dresler-Hawke, Emma; Whitehead, Dean; Parker, Leigh
Background: Internationally, it is well established that the behaviour, performance, and achievement of schoolchildren is directly linked to the nutritional status of overall diet -- including the contents of their school lunch-boxes. In a previous survey study by the lead authors, primary school children's food consumption behaviour was…
Stites, Shana D; Singletary, S Brook; Menasha, Adeena; Cooblall, Clarissa; Hantula, Donald; Axelrod, Saul; Figueredo, Vincent M; Phipps, Etienne J
The objective of this study was to evaluate an intervention that combined mindful eating and online pre-ordering to promote healthier lunch purchases at work. The study took place at an urban hospital with 26 employees who were overweight or obese. The design included a contemporaneous comparison with delayed-treatment control and a three-phase prospective study. A minimum 4-week baseline period preceded a 4-week full-intervention, in which participants received mindful eating training, pre-ordered their lunches, and received price discounts toward lunch purchases. In a 4-week reduced intervention phase, participants pre-ordered lunches without price discounts. Participant lunch purchases were tracked electronically at the point of purchase. The primary outcome measures were the amounts of kilocalories and fat grams in purchased lunches. In contemporaneous comparisons, the treatment group purchased lunches with an average of 144.6 fewer kilocalories (p = 0.01) and 8.9 fewer grams of fat (p = 0.005) compared to controls. In multivariable longitudinal analyses, participants decreased the average number of calories in their meals by 114.6 kcal per lunch and the average grams of fat by 5.4 per lunch during the partial-intervention compared to the baseline (p ordering system if offered in the future. Combined mindful eating training and online pre-ordering appears a feasible and useful worksite intervention to improve food choices by employees. Copyright © 2014 Elsevier Ltd. All rights reserved.
Formação para merendeiras: uma proposta metodológica aplicada em escolas estaduais atendidas pelo programa nacional de alimentação escolar, em Salvador, Bahia Professional training for school lunch cooks: a methodological experiment done in state schools supported by the National School Feeding Program in Salvador, Bahia, Brazil
Catarina Lima Leite
directed at school lunch cooks in state schools supported by the National School Feeding Program. METHODS: This descriptive study was carried out among school lunch cooks from 97 state schools, in Salvador (Bahia , Brazil. Definition and implementation of the professional training consisted of three stages: a preliminary survey among the cooks in search of contents and methodology, professional training activities and the subjects' assessment of such activities. RESULTS: The preliminary survey pointed to both those contents of major interest among the cooks and the methodology. Professional training activities were designed as a 20-hour event for groups of about 35 people, taking place in school units. The activity program carried a number of different contents, including the National School Feeding Program, the school lunch cooks in the school feeding system, feeding and nutrition principles, and Good Manufacturing Practices. Methodological resources comprised dramatization, dialogued presentations, workshops, group contests, practical activities, interactive games, form completion, guided group activities and a printed brochure with all presentations. At the end of the event, an assessment was requested from the subjects as to the following features: content presentation, resources employed, pace of activities, question answering, content learning, positive and negative aspects as well as suggestions. CONCLUSION: The experiment showed the feasibility of building a new professional training model by using and valuing the contributions from the target subjects, thus allowing the reframing of traditional professional training practices and increasing the chances of success, since the subjects' specific demands were taken into account.
Merenda no dia alimentar de crianças matriculadas em Centros de Educação e Alimentação do Pré-Escolar School-lunch as part of the eating habits of children enrolled in Pre-school Education and Feeding Centers
Rosa Nilda Mazzilli
Full Text Available Estudou-se o papel da merenda no comportamento alimentar de 346 pré-escolares (PE matriculados em Centros de Educação e Alimentação do Pré-Escolar (CEAPEs de seis municípios do Estado de São Paulo, Brasil. Em entrevista domiciliar com a mãe ou responsável pela alimentação do PE, obteve-se o número e a quantidade dos alimentos ingeridos pela criança antes e após sua participação no CEAPE. Verificou-se que essa refeição escolar interfere tanto na quantidade dos alimentos consumidos quanto no número das refeições diárias feitas no lar. Os resultados mostraram que 178 (51,4% PE reduziram a ingestão alimentar de casa, mediante exclusão de refeições e/ou diminuição da quantidade de alimentos habitualmente ingerida, após receberem a merenda no CEAPE. Destas, 115 (64,6% apresentaram dieta insuficiente em energia; 48 (13,9% aumentaram a quantidade dos alimentos habituais e/ou incluíram refeições. Ainda assim, 23 (47,9% apresentaram consumo energético deficiente. Entre os 120 (34,7% que não tiveram nenhuma modificação em seu dia alimentar, 61 (51,7% mostraram ingestão calórica inadequada. Concluiu-se ser necessário orientar a família sobre o papel da merenda como suplemento alimentar e não como substituto de refeições no lar.It was studied the role of the school lunch in the dietary behaviour of the three hundred and forty-six preschool children drawn from the Preschool Education and Feeding Centre (CEAPE, in six towns of the State of S. Paulo, Brazil. In home entreviews, the mothers or persons responsible for the preschool children's diet gave the number of meals and the quantity of their food intake before and after their participation in the Program. It was noted that the school lunch as interfered in the dietary intake of children insofar as quantity of food and number of meals usually eaten at home is concerned. The results showed that one hundred and seventy-eight (51.4% preschool children decrease their
Zirkel, P A
The spring 1996 issue of The Future of Children on special education reviewed the legislative and litigation history of the Individuals with Disabilities Education Act (IDEA). This Revisiting article examines the impact of the two U.S. Supreme Court cases setting forth school districts' responsibility to reimburse parents of students with disabilities for private school tuition under certain circumstances. An extensive examination of published cases reveals that the number of cases litigated has increased but that the courts are no more likely to decide in favor of parents than they were before the Supreme Court rulings.
VanEgmont-Pannell, Dorothy; And Others
This menu planning guide for school lunches and breakfasts contains: (1) lunch requirements, recommendations, and policies; (2) the basics of menu planning; (3) how to vary portions for various age/grade groups; (4) planning breakfasts; (5) merchandising school lunches and breakfasts; and (6) nutrition education and menu planning; Appendixes…
Higgs, Suzanne; Donohoe, Jessica E
We investigated whether eating lunch mindfully, in contrast to eating with distractions or no particular focus, reduces later snack intake and if this is related to a measure of meal memory. The design was between-subjects with three conditions. Twenty-nine female undergraduate students either ate a fixed lunch while (1) focusing on the sensory characteristics of the food as they ate (food focus group), (2) reading a newspaper article about food (food thoughts control group) or (3) in the absence of any secondary task (neutral control group). Cookie intake later that afternoon was measured as well as rated vividness of memory of the lunch. Participants ate significantly fewer cookies in the food focus group than in both the food thoughts control group or the neutral control group. Rated appetite before the snack session was lower in the food focus group than in the other two groups and rated vividness of lunch memory was higher. Rated vividness of lunch memory was negatively correlated with snack intake. These results suggest that enhancing meal memory by paying attention to food while eating can reduce later intake and are consistent with the suggestion that memory plays an important role in appetite control. Copyright © 2011 Elsevier Ltd. All rights reserved.
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement procedures. 208... Reimbursement Claims and Appeals § 208.52 Reimbursement procedures. (a) General. A Sponsoring Agency must present a claim for reimbursement to DHS in such manner as the Assistant Administrator specifies . (b...
Selecting Policy Indicators and Developing Simulation Models for the National School Lunch and Breakfast Programs. Final Report. Special Nutrition Programs Report Series. Special Nutrition Programs Report No. CN-10-PRED
Dragoset, Lisa; Gordon, Anne
This report describes work using nationally representative 2005 data from the School Nutrition Dietary Assessment-III (SNDA-III) study to develop a simulation model to predict the potential implications of changes in policies or practices related to school meals and school food environments. The model focuses on three domains of outcomes: (1) the…
Daily food intake and lunch choices were assessed using 24-hour recall and quantitative food frequency questionnaire, respectively. The 24-hour dietary recall was done for 2 consecutive days. Statistical Package for Social Sciences vs 20.0 was used to analyse the data. Choice of lunch consumed in a week was reported ...
Treviño, Roberto P; Pham, Trang; Mobley, Connie; Hartstein, Jill; El Ghormli, Laure; Songer, Thomas
Food service directors have a concern that federal reimbursement is not meeting the demands of increasing costs of healthier meals. The purpose of this article is to report the food option changes and the annual revenues and expenses of the school food service environment. The HEALTHY study was a 3-year (2006 to 2009) randomized, cluster-designed trial conducted in 42 middle schools at 7 field centers. The schools selected had at least 50% of students who were eligible for free or reduced-price lunch or who belonged to a minority group. A randomly assigned half of the HEALTHY schools received a school health intervention program consisting of 4 integrated components: nutrition, physical activity, behavioral knowledge and skills, and social marketing. The nutrition component consisted of changing the meal plans to meet 5 nutrition goals. Revenue and expense data were collected from income statements, federal meal records, à la carte sale sheets, school store sale sheets, donated money/food records, and vending machines. Although more intervention schools reached the nutritional goals than control schools, revenues and expenses were not significantly different between groups. The HEALTHY study showed no adverse effect of school food policies on food service finances. © 2012, American School Health Association.
Bittner, Martin-Immanuel; Donnelly, Maria; van Zanten, Arthur Rh
Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can...... be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries' reimbursement schemes---despite all...... of them originating from a DRG system, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to help the intensivist clinician and researcher to understanding neighbouring countries...
... DEPARTMENT OF DEFENSE 32 CFR Part 199 [DoD-2010-HA-0072] RIN 0720-AB41 TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals; Correction... TRICARE; Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access...
Müller, Katrin; Libuda, Lars; Terschlüsen, Anna Maria; Kersting, Mathilde
Because of widespread irregular lunch consumption by both children and adults, information on the effects of lunch on short-term cognitive functioning is relevant to public health. In September 2012, a MEDLINE search was conducted for studies in which the effects of lunch on cognitive performance were examined. Eleven experimental studies published from 1981 to 1996 were found and evaluated; all involved adults. In three studies, the effects of lunch and lunch skipping were compared; the remaining studies involved a determination of the effects of lunch size and lunch composition. Results of studies in which lunch was compared with no lunch indicate that lunch leads to potential impairment of some aspects of cognitive functioning in the early afternoon. Lunch size may influence cognitive functioning, with impairment more likely to occur after a large lunch than a small lunch. Furthermore, in comparison with low-fat lunches, high-fat lunches seem to result in slower but more accurate responses to some cognitive tasks. However, these suggestions must be viewed with caution, as they are based on only a few studies and are not thoroughly supported by high-quality evidence. In addition, results obtained with adults are not applicable to children. Thus, the potential effects of lunch need further examination in children and adults.
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Reimbursement policy. 1214.803 Section 1214... Spacelab Services § 1214.803 Reimbursement policy. (a) Reimbursement basis. (1) This policy is established...) Standard flight price. During this phase, customers covered by subpart 1214.1 or subpart 1214.2 shall...
... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.807 Section 140.807 Highways... Highway Agency Audit Expense § 140.807 Reimbursable costs. (a) Federal funds may be used to reimburse an SHA for the following types of project related audit costs: (1) Salaries, wages, and related costs...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement obligation. 27.1239 Section 27... Policies Governing the Transition of the 2500-2690 Mhz Band for Brs and Ebs § 27.1239 Reimbursement obligation. (a) A proponent may request reimbursement from BRS licensees and lessees, EBS lessees, and...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement. 352.28 Section... Participation § 352.28 Reimbursement. In accordance with Executive Order 12657, Section 6(d), and to the extent permitted by law, FEMA will coordinate full reimbursement, either jointly or severally, to the agencies...
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cost reimbursement. 37.46 Section 37.46... NATIONAL WILDLIFE REFUGE, ALASKA General Administration § 37.46 Cost reimbursement. (a) Each applicant for or holder of a special use permit issued under this part shall reimburse the Department for its...
Jayaram, Raja; Ramakrishnan, Nagarajan
There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India. PMID:23833469
Full Text Available Stratified Medicine (SM has the potential to target patient populations who will most benefit from a therapy while reducing unnecessary health interventions associated with side effects. The link between clinical biomarkers/diagnostics and therapies provides new opportunities for value creation to strengthen the value proposition to pricing and reimbursement (P&R authorities. However, the introduction of SM challenges current reimbursement schemes in many EU countries and the US as different P&R policies have been adopted for drugs and diagnostics. Also, there is a lack of a consistent process for value assessment of more complex diagnostics in these markets. New, innovative approaches and more flexible P&R systems are needed to reflect the added value of diagnostic tests and to stimulate investments in new technologies. Yet, the framework for access of diagnostic–based therapies still requires further development while setting the right incentives and appropriate align stakeholders interests when realizing long- term patient benefits. This article addresses the reimbursement challenges of SM approaches in several EU countries and the US outlining some options to overcome existing reimbursement barriers for stratified medicine.
... school shall: (1) Amend its Free and Reduced Price Policy Statement, specified in § 245.10, to include a... REDUCED PRICE MEALS AND FREE MILK IN SCHOOLS § 245.9 Special assistance certification and reimbursement... children determined eligible for free or reduced price meals may, at its option, authorize the school to...
Policymakers who are striving to achieve better health care, improved health outcomes and lower costs are considering new strategies and technologies. Telehealth is a tool that uses technology to provide health services remotely, and state leaders are looking to it now more than ever as a way to address workforce gaps and reach underserved patients. Among the challenges facing state lawmakers who are working to introduce or expand telehealth is how to handle covering patients and reimbursing providers.
Bartira Mendes Gorgulho
Full Text Available The objective of this study was to assess the quality of lunch consumed by adults in Brazil and its sociodemographic determinants in each Brazilian region. A cross-sectional study was carried out and a representative sample of regional populations was used. The sample comprised of 16,096 adults from the Brazilian National Dietary Survey, part of the Brazilian Household Budget Survey (POF. The lunch quality was evaluated by applying the main meal quality index (MMQI, comprised of 10 items of equal weights that resulted in a score that ranged from zero to 100 points. Linear regression models measured the association between lunch quality and sociodemographic factors. The average energy consumption at lunch was 704kcal (SD = 300, and the meal quality score mean was 57 points (SE = 0.30. The North Region had the worst MMQI score (56 points, SE = 0.07, while the Central had the best MMQI adjusted score (59 points, SE = 0.05. The MMQI final score was positively associated with male gender and ages between 20-39 years, and was inversely associated with having eight years or more of education, per capita income of at least three minimum wages, and with the consumption of meals prepared away from home. Despite differences among sociodemographic factors, all Brazilian regions had a lunch composed of foods rich in sugars and fats, with insufficient portions of fruits and vegetables, resulting in a low meal quality.
Linsenmeyer, Whitney; Kelly, Patrick; Jenkins, Steve; Mattfeldt-Berman, Mildred
Purpose/Objectives: The purpose of this study was to explore the school food environment of charter schools in Saint Louis, Missouri. The objectives were to: (1) describe the participation of charter schools in the National School Lunch Program and (2) describe the prevalence of competitive foods in charter schools. Methods: School administrators…
Ward, Stephanie; Bélanger, Mathieu; Donovan, Denise; Vatanparast, Hassan; Engler-Stringer, Rachel; Leis, Anne; Carrier, Natalie
Childcare centres (CCs) typically offer one meal and snacks daily. This study compared what is served in CCs with what the nutritional recommendations are; described and compared the nutritional composition of lunches served in CCs in New Brunswick and Saskatchewan; and examined differences between French and English, and urban and rural centres. The study involved 61 randomly selected CCs in New Brunswick and Saskatchewan, Canada. Lunch content was measured on two consecutive days by weighing each food item served to children and by visually documenting the food items using digital photography. Food items were categorized into food groups according to Health Canada's Eating Well with Canada's Food Guide, and nutrients were analyzed using a nutritional analysis software. One-sample t tests compared lunch content with nutritional recommendations. Independent t tests compared the nutrient and food group content of lunches in New Brunswick and Saskatchewan, French and English, and urban and rural CCs. On average, CCs did not meet provincial recommendations. Lunches in both provinces were low in calories (<517 kcal) and fibre (<7 g). Overall, Saskatchewan centres served greater amounts of food than New Brunswick centres (p < 0.05). French-speaking centres provided less fat (p = 0.047), less saturated fat (p = 0.01), and fewer servings of meat and alternatives (p = 0.02), and more trans fat (p = 0.03) than English-speaking centres. There were no differences between rural and urban centres. Few CC lunches met nutritional recommendations. Interventions are required to improve the quality of foods offered in CCs. Reviewing or developing comprehensive nutrition guidelines is warranted.
... Owned Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General... Privately Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) special review of privately owned vehicle (POV) mileage reimbursement rates has resulted in adjusting the...
... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.505 Section 140.505 Highways... Administrative Settlement Costs-Contract Claims § 140.505 Reimbursable costs. (a) Federal funds may participate in administrative settlement costs which are: (1) Incurred after notice of claim, (2) Properly...
... is a reimbursement of travel expenses for food and beverages that Y pays in performing services as an... entertainment, amusement, recreation, or travel. * * * * * (f) * * * (2) * * * (iv) Reimbursed entertainment, food, or beverage expenses--(A) Introduction. In the case of any expenditure for entertainment...
Carnell, S; Pryor, K; Mais, LA; Warkentin, S; Benson, L; Cheng, R
Children’s appetitive characteristics measured by parent-report questionnaires are reliably associated with body weight, as well as behavioral tests of appetite, but relatively little is known about relationships with food choice. As part of a larger preloading study, we served 4-5y olds from primary school classes five school lunches at which they were presented with the same standardized multi-item meal. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing satie...
Guerrero, Kayla; Olsen, Anne Marie; Wistoft, Karen
that interventions around improving school lunch mainly focus on increasing intake of target foods or food groups, and few studies exist that examine other outcomes such as food enjoyment or well-being. Future interventions could explore the impact of increasing student engagement around school lunch and opening...
Conduff, Joseph H; Coelho, Daniel H
Objective To study state Medicaid reimbursement rates for inpatient and outpatient otolaryngology services and to compare with federal Medicare benchmarks. Study Design State and federal database query. Setting Not applicable. Methods Based on Medicare claims data, 26 of the most common Current Procedural Terminology codes reimbursed to otolaryngologists were selected and the payments recorded. These were further divided into outpatient and operative services. Medicaid payment schemes were queried for the same services in 49 states and Washington, DC. The difference in Medicaid and Medicare payment in dollars and percentage was determined and the reimbursement per relative value unit calculated. Medicaid reimbursement differences (by dollar amount and by percentage) were qualified as a shortfall or excess as compared with the Medicare benchmark. Results Marked differences in Medicaid and Medicare reimbursement exist for all services provided by otolaryngologists, most commonly as a substantial shortfall. The Medicaid shortfall varied in amount among states, and great variability in reimbursement exists within and between operative and outpatient services. Operative services were more likely than outpatient services to have a greater Medicaid shortfall. Shortfalls and excesses were not consistent among procedures or states. Conclusions The variation in Medicaid payment models reflects marked differences in the value of the same work provided by otolaryngologists-in many cases, far less than federal benchmarks. These results question the fairness of the Medicaid reimbursement scheme in otolaryngology, with potential serious implications on access to care for this underserved patient population.
Stewart, Alexandra M; Lindley, Megan C; Cox, Marisa A
State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. Copyright © 2015 Elsevier Ltd. All rights reserved.
Alexy, U; Freese, J; Kersting, M; Clausen, K
Data from the ongoing, open-cohort Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were used to describe warm family lunch meals and the association of the lunch composition with total diet quality. 2,095 three-day weighed dietary records, collected between 2004 and 2009, from a 4- to 18-year-old DONALD study subgroup were used. Warm lunch (eating occasions between 11.30 a.m. and 2.29 p.m. including at least one course that is typically consumed warm) was eaten on 68.8% of all record days. Meat lunch (>50%) was predominant, followed by vegetarian (25%), fish (13%) and sweet lunch meals (3%). The prevalence of desserts at lunch was high and beverages were drunk at 80% of lunch meals. A meat lunch was associated with a higher protein (+1.4% energy intake, %E) and fat intake (+1.7%E) than a sweet lunch; also densities of vitamin A, folate and iron were higher. A dessert at lunch decreased protein intake slightly (-0.2%E), but increased carbohydrate (+0.7%E) and added sugar intake (+1.4%E) as well as density of calcium (+18 mg/MJ). Our study proves the impact of lunch on daily dietary quality and yields valuable insights on the development of food and meal-based dietary guidelines. Copyright © 2012 S. Karger AG, Basel.
Full Text Available The specific accounting approaches in preuniversity accounting are reduced, including the segment accounted for the reimbursementof students travel expenses and other benefits. This paper aims to outline an image of the social aspects of education in the preuniversity public education, represented by reimbursement to the beneficiaries of education, how they are reflected in accounting through the budget classification and disclosed to users via public media. Specifically, our approach refers to scholarships provided by the local administration to support learning, professionalscholarships, as well as various support programs for students who come from families with material difficulties, whose financial backer is the state through school inspectorates.
... application forms may be filed. In any such case, the reimbursement application shall show the names... Cotton Board shall make reimbursement to the importer. For joint applications, the reimbursement shall be... procedures prescribed in this section. (a) Application form. An importer shall obtain a reimbursement...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a Reimbursement Obligation. 27.1168... a Reimbursement Obligation. (a) The clearinghouse will apply the following test to determine when an... reimbursement obligation exists, the clearinghouse will calculate the reimbursement amount in accordance with...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false General reimbursement rules. 149.300 Section 149... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.300 General reimbursement rules. Reimbursement under this program is conditioned on provision of accurate information by the...
... reimbursement. Prior written approval from DOT OSDBU is required. Attorney fees will be reimbursed on a pro-rata... 49 Transportation 1 2010-10-01 2010-10-01 false Eligible reimbursements to participating lenders... PROGRAM (STLP) Participating Lenders § 22.27 Eligible reimbursements to participating lenders...
... § 295.31 Reimbursement of claim expenses. (a) FEMA will reimburse Claimants for the reasonable costs they incur in copying documentation requested by OCGFC. FEMA will also reimburse Claimants for the... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of claim...
... lodging I select affect my reimbursement? (a) Your agency will reimburse you for different types of...; Docket Number 2011-0024, Sequence 1] RIN 3090-AJ22 Federal Travel Regulation (FTR); Lodging Reimbursement... (GSA) is amending the Federal Travel Regulation (FTR) regarding reimbursement of lodging per diem...
...-notification remedies and identify the type of remedy eligible for reimbursement; (3) Identify any limits on..., and arguments, that all covered vehicles are under warranty or that no person would be eligible for...
Human Resources Division
Affected by the salary adjustments on 1 January 2001 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maxima, has changed significantly. An adjustment of the amounts of the reimbursement maxima and the fixed contributions is therefore necessary, as from 1 January 2001. Reimbursement maxima The revised reimbursement maxima will appear on the leaflet summarizing the benefits for the year 2001, which will be sent out with the forthcoming issue of the CHIS Bull'. This leaflet will also be available from the divisional secretariats and from the UNIQA office at CERN. Fixed contributions The fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions) : voluntarily insured member of the personnel, with normal health insurance cover : 910.- (was 815.- in 2000) voluntarily insured member of the personnel, with reduced heal...
Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...
.... Those rates together with the number of troops provided are used to calculate the level of reimbursement to be made to a participating country for the incremental costs incurred for providing troops...
Jesper Linde; Christopher J. Erceg
This paper uses a DSGE model to examine the effects of an expansion in government spending in a liquidity trap. If the liquidity trap is very prolonged, the spending multiplier can be much larger than in normal circumstances, and the budgetary costs minimal. But given this "fiscal free lunch," it is unclear why policymakers would want to limit the size of fiscal expansion. Our paper addresses this question in a model environment in which the duration of the liquidity trap is determined endoge...
Rosângela Fachel de Medeiros
Full Text Available This paper presents and analyzes the intersemiotic translation process performed by filmmaker David Cronenberg of William Burroughs' novel Naked Lunch, and the intertextual bifurcations involved in this process. Investigating the similarities and differences between the creative worlds of both artists and how they reframe each other. For this, are used as the theoretical the idea of transcreation proposed by Haroldo de Campos, and the notion of the translator as a reader proposed by Jorge Luis Borges.
Pedersen, Line; Hansen, Anneli Borge; Svendsen, Kristian; Skurtveit, Svetlana; Borchgrevink, Petter C; Fredheim, Olav Magnus S
The prevalence of chronic non-malignant pain in Norway is between 24% and 30%. The proportion of the population using opioids for non-malignant pain on a long-term basis is around 1%. The purpose of our study was to investigate how many were prescribed analgesics on reimbursable prescription under reimbursement code -71 (chronic non-malignant pain) in 2009 and 2010, which analgesics were prescribed and whether prescribing practices were in accordance with national guidelines. We retrieved pseudonymised data from the National Prescription Database on all those who received drugs with reimbursement code -71 in 2009 and 2010. The data contain information on drug, dosage, formulation, reimbursement code and date of issue. 90,731 patients received reimbursement for drugs indicated for chronic non-malignant pain in 2010. Of these, 6,875 were given opioids, 33,242 received paracetamol, 25,865 non-steroid inflammatory drugs (NSAIDs), 20,654 amitryptiline and 16,507 gabapentin. Oxycodone was the most frequently prescribed opioid, followed by buprenorphine, tramadol and codeine/paracetamol. Of those who were prescribed opioids, 4,047 (59%) received mainly slow-release opioids, 2,631 (38%) also received benzodiazepines and 2,418 (35%) received benzodiazepine-like sleep medications. The number of patients who received analgesics and opioids on reimbursable prescriptions was low compared to the proportion of the population with chronic pain and the proportion using opioids long-term. 38% of those reimbursed for opioids also used benzodiazepines, which is contrary to official Norwegian guidelines.
Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.
Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369
Yoong, S L
Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.
REMINDERYou are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:the academic year is defined as the period going from 1st September to 31st August, only paid bills can be subject to reimbursement, a claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child, bills for one child may be grouped on a claim by periods of term, semester or academic year, the months of July and August should be included in the third term, or the second semester, or the academic year, for each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have received and paid all bills, including those for...
Bullock, Sally Lawrence; Craypo, Lisa; Clark, Sarah E; Barry, Jason; Samuels, Sarah E
States and school districts around the country are developing policies that set nutrition standards for competitive foods and beverages sold outside of the US Department of Agriculture's reimbursable school lunch program. However, few tools exist for monitoring the implementation of these new policies. The objective of this research was to develop a computerized assessment tool, the Food and Beverage Environment Analysis and Monitoring System (FoodBEAMS), to collect data on the competitive school food environment and to test the inter-rater reliability of the tool among research and nonresearch professionals. FoodBEAMS was used to collect data in spring 2007 on the competitive foods and beverages sold in 21 California high schools. Adherence of the foods and beverages to California's competitive food and beverage nutrition policies for schools (Senate Bills 12 and 965) was determined using the data collected by both research and nonresearch professionals. The inter-rater reliability between the data collectors was assessed using the intraclass correlation coefficient. Researcher vs researcher and researcher vs nonresearcher inter-rater reliability was high for both foods and beverages, with intraclass correlation coefficients ranging from .972 to .987. Results of this study provide evidence that FoodBEAMS is a promising tool for assessing and monitoring adherence to nutrition standards for competitive foods sold on school campuses and can be used reliably by both research and nonresearch professionals. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Gianfrancesco, F D
In FY 1984 the Medicare program implemented a new method of reimbursing hospitals for inpatient services, the Prospective Payment System (PPS). Under this system, hospitals are paid a predetermined amount per Medicare discharge, which varies according to certain patient and hospital characteristics. This article investigates the presence of systematic biases and other potential imperfections in the PPS reimbursement methodology as revealed by its effects on Medicare operating ratios. The study covers the first three years of the PPS (approximately 1984-1986) and is based on hospital data from the Medicare cost reports and other related sources. Regression techniques were applied to these data to determine how Medicare operating ratios were affected by specific aspects of the reimbursement methodology. Several possible imbalances were detected. The potential undercompensation relating to these can be harmful to certain classes of hospitals and to the Medicare populations that they serve. PMID:2109738
Afendulis, Christopher C; Kessler, Daniel P
Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients' best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism.
Radu, Ciprian-Paul; Chiriac, Delia Nona; Vladescu, Cristian
To evaluate the effects of the change in the diagnosis-related group (DRG) system on patient morbidity and hospital financial performance in the Romanian public health care system. Three variables were assessed before and after the classification switch in July 2007: clinical outcomes, the case mix index, and hospital budgets, using the database of the National School of Public Health and Health Services Management, which contains data regularly received from hospitals reimbursed through the Romanian DRG scheme (291 in 2009). The lack of a Romanian system for the calculation of cost-weights imposed the necessity to use an imported system, which was criticized by some clinicians for not accurately reflecting resource consumption in Romanian hospitals. The new DRG classification system allowed a more accurate clinical classification. However, it also exposed a lack of physicians' knowledge on diagnosing and coding procedures, which led to incorrect coding. Consequently, the reported hospital morbidity changed after the DRG switch, reflecting an increase in the national case-mix index of 25% in 2009 (compared with 2007). Since hospitals received the same reimbursement over the first two years after the classification switch, the new DRG system led them sometimes to change patients' diagnoses in order to receive more funding. Lack of oversight of hospital coding and reporting to the national reimbursement scheme allowed the increase in the case-mix index. The complexity of the new classification system requires more resources (human and financial), better monitoring and evaluation, and improved legislation in order to achieve better hospital resource allocation and more efficient patient care.
... outlays for the month covered. These estimates shall be made on a cash basis, even if the recipient uses an accrual accounting system. (b) Reimbursements. If payments are made through reimbursement or by...
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 416.405 Section 416.405 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement incentive contracts. ...
O'Connor, M; Kiely, D; Mulvihill, M; Winters, A; Bollard, C; Hamilton, A; Corrigan, C; Moore, E
Food we eat has an important influence on health and well-being. Many eating habits are established in childhood. 456 children aged eight to 12 years participated in this survey of food eaten at school. Of all the food items eaten as a snack, 48.6% were categorised as junk. 75.8% of the sandwiches brought to school for lunch were made with white bread. Of the remaining food items brought for lunch 63.5% were of the junk variety. Compared with those who brought a snack or lunch from home, those given money to buy their own were more likely to eat junk (p daily food intake but health food practises for even a third of food intake may be of a value for health and long term eating habits. Nutritional education with the reinforcement of high nutritional standards in schools could improve the situation.
Emer, Jason; Waldorf, Heidi
Injection of neurotoxins and filling agents for the treatment of facial aesthetics has increased dramatically during the past few decades due to an increased interest in noninvasive aesthetic improvements. An aging but still youth-oriented population expects effective treatments with minimal recovery time and limited risk of complications. Injectable neurotoxins and soft tissue stimulators and fillers have filled this niche of "lunch-time" procedures. As demand for these procedures has increased, supply has followed with more noncore cosmetic specialty physicians, as well as unsupervised ancillary staff, becoming providers and advertising them as easy fixes. Despite an excellent record of safety and efficacy demonstrated in scores of published studies, injectable agents do carry risks of complications. These procedures require a physician with in-depth knowledge of facial anatomy and injection techniques to ensure patient safety and satisfaction. In general, adverse events are preventable and technique-dependent. Although most adverse events are minor and temporary, more serious complications can occur. The recognition, management, and treatment of poor outcomes are as important as obtaining the best aesthetic results. This review addresses important considerations regarding the complications of injectable neurotoxins and fillers used for "lunch-time" injectable procedures. Copyright © 2011 Elsevier Inc. All rights reserved.
Swan, James H.; Harrington, Charlene; Grant, Leslie A.
State Medicaid reimbursement methods and rates are reported for the period 1978-86 for skilled nursing and intermediate care facilities. A cross-sectional time series regression analysis of Medicaid reimbursement rates on methods showed that States using prospective class reimbursement had significantly lower rates for the period 1982-86. States using prospective facility-specific reimbursement methods had lower rates than retrospective methods in 1983-84. PMID:10312516
Guerrero, Kayla; Olsen, Anne Marie; Wistoft, Karen
dialogue around taste on factors such as physical and psychological well-being, empowerment, school enjoyment, and academic outcomes. By taking steps to accurately evaluate and improve the taste of school food and by creating avenues for students to express their opinions and develop a meaningful sense......School lunch plays an important role in the well-being of students. However, studies have given evidence that school lunch may not be satisfactory to students. Evidence shows that taste plays an influential role in students’ food decisions and eating experiences. This narrative review finds...... that interventions around improving school lunch mainly focus on increasing intake of target foods or food groups, and few studies exist that examine other outcomes such as food enjoyment or well-being. Future interventions could explore the impact of increasing student engagement around school lunch and opening...
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Reimbursement for expenses. 97.527 Section 97... AMATEUR RADIO SERVICE Qualifying Examination Systems § 97.527 Reimbursement for expenses. VEs and VECs may be reimbursed by examinees for out-of-pocket expenses incurred in preparing, processing...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Amount of reimbursement. 149.100 Section 149.100... REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reinsurance Amounts § 149.100 Amount of reimbursement... reimbursement in the amount of 80 percent of the costs for health benefits (net of negotiated price concessions...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of other... Reimbursement of other Federal agencies. (a) Assistance furnished under § 206.5 (a) or (b) of this subpart may... Administrator or the Regional Director may not approve reimbursement of costs incurred while performing work...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a reimbursement obligation. 27.1184... reimbursement obligation. (a) The clearinghouse will apply the following test to determine when an AWS entity... paragraphs (a)(3)(i) and (ii) of this section, indicates that a reimbursement obligation exists, the...
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Changes-Cost-Reimbursement....243-2 Changes—Cost-Reimbursement. As prescribed in 43.205(b)(1), insert the following clause. The 30-day period may be varied according to agency procedures. Changes—Cost-Reimbursement (AUG 1987) (a) The...
...-Reimbursement). 52.249-6 Section 52.249-6 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION....249-6 Termination (Cost-Reimbursement). As prescribed in 49.503(a)(1), insert the following clause: Termination (Cost-Reimbursement) (MAY 2004) (a) The Government may terminate performance of work under this...
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement for offering Lifeline. 54.407... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Low-Income Consumers § 54.407 Reimbursement for... carrier may receive universal service support reimbursement for each qualifying low-income consumer served...
... Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General Services... Mileage Reimbursement Rates. SUMMARY: The General Services Administration's annual privately owned vehicle (POV) mileage reimbursement rate reviews have resulted in new CY 2013 rates for the use of privately...
... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN55 Reimbursement Offsets for Medical Care... Veterans Affairs (VA) proposes to amend its regulations concerning the reimbursement of medical care and... situations where third-party payers are required to reimburse VA for costs related to care provided by VA to...
... reimbursement. 2052.215-77 Section 2052.215-77 Federal Acquisition Regulations System NUCLEAR REGULATORY....215-77 Travel approvals and reimbursement. As prescribed at 2015.209-70(d), the contracting officer shall insert the following clause in cost reimbursement solicitations and contracts which require travel...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Use of reimbursements. 149.200 Section 149.200 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Use of Reimbursements § 149.200 Use of reimbursements...
... Cooperative Agreements § 208.35 Reimbursement for Advisory. DHS will not reimburse costs incurred during an... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for Advisory. 208.35 Section 208.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY...
... Owned Vehicle Mileage Reimbursement Rates AGENCY: Office of Governmentwide Policy (OGP), General... Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) annual privately owned vehicle (POV) mileage reimbursement rate reviews have resulted in new CY 2011 rates for the...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other costs... Cooperative Agreements § 208.44 Reimbursement for other costs. (a) Except as allowed under paragraph (b) of this section, DHS will not reimburse other costs incurred preceding, during or upon the conclusion of...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reimbursement conditioned upon available funds... TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.315 Reimbursement conditioned upon available funds. Notwithstanding a sponsor's compliance with...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Triggering a reimbursement obligation. 24.247... Mhz Band § 24.247 Triggering a reimbursement obligation. (a) Licensed PCS. The clearinghouse will... the Proximity Threshold test indicates that a reimbursement obligation exists, the clearinghouse will...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... CONTRACT MANAGEMENT TRANSPORTATION General 47.104-3 Cost-reimbursement contracts. (a) 49 U.S.C. 10721 and... accrues to the Government, i.e., the Government shall pay the charges or directly and completely reimburse...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement service... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.305 Cost-reimbursement service contracts. The contracting officer shall insert the clause at 52.246-5, Inspection of Services—Cost Reimbursement, in...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 16.405 Section 16.405 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement incentive contracts. See 16.301 for requirements applicable to all cost-reimbursement contracts...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement supply... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.303 Cost-reimbursement supply contracts. The contracting officer shall insert the clause at 52.246-3, Inspection of Supplies—Cost-Reimbursement, in...
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Reimbursement of members. 703.9 Section 703.9... AND FUNCTIONS OF STATE ADVISORY COMMITTEES § 703.9 Reimbursement of members. (a) Advisory Committee members may be reimbursed by the Commission by a per diem subsistence allowance and for travel expenses at...
... Department shall complete a final review of all relevant information prior to making a reimbursement decision... 10 Energy 4 2010-01-01 2010-01-01 false Procedures for processing reimbursement claims. 765.21... AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.21...
... provided for in cooperative agreements, the Internal Revenue Service will provide amounts to program.... Cooperative agreements will establish the items for which reimbursements will be allowed and the method of..., and accounting and financial control systems. (b) Direct, reasonable, and prudent expenses...
The meaning of indirect costs in an industrial environment is discussed. Other factors considered are corporate policies; nature of work being supported; the uniqueness of the work; who is doing the negotiating for industry; and indirect rates. Suggestions are offered for approaches to indirect cost reimbursement. (Author/MLW)
... Section 8 Project-Based Assistance Family Payment § 5.632 Utility reimbursements. (a) Applicability. This... the utility supplier to pay the utility bill on behalf of the family. If the PHA elects to pay the utility supplier, the PHA must notify the family of the amount paid to the utility supplier. (3) In the...
... specific numeric diagnosis-related group values and replacing them with their narrative description. DATES... reference to specific DRG numbers and descriptions became obsolete, so we are removing the numeric... follows: Sec. 199.14 Provider reimbursement methods. * * * * * (a) * * * (1) * * * (ii) * * * (C) * * * (3...
... according to the reimbursement schedule plus short term call-up additional costs. The additional costs will... services. (2) The price will be based on estimated costs. (3) The price will be held constant for flights...) Subsequent to the first three years, the price will be adjusted annually to insure that total operating costs...
... as compensation and wages, the employee may be able to deduct the expense as an employee business...(e)(3) has the same meaning as in section 62(2)(A) (dealing with employee business expenses, later... Reimbursed Entertainment Expenses AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of...
Yang, Juan; Atkins, Katherine E; Feng, Luzhao; Pang, Mingfan; Zheng, Yaming; Liu, Xinxin; Cowling, Benjamin J; Yu, Hongjie
To explore the current landscape of seasonal influenza vaccination across China, and estimate the budget of implementing a national "free-at-the-point-of-care" vaccination program for priority populations recommended by the World Health Organization. In 2014 and 2016, we conducted a survey across provincial Centers for Disease Control and Prevention to collect information on regional reimbursement policies for influenza vaccination, estimated the national uptake using distributed doses of influenza vaccines, and evaluated the budget using population size and vaccine cost obtained from official websites and literatures. Regular reimbursement policies for influenza vaccination are available in 61 mutually exclusive regions, comprising 8 provinces, 45 prefectures, and 8 counties, which were reimbursed by the local Government Financial Department or Basic Social Medical Insurance (BSMI). Finance-reimbursed vaccination was offered mainly for the elderly, and school children for free in Beijing, Dongli district in Tianjin, Karamay, Shenzhen and Xinxiang cities. BSMI-reimbursement policies were limited to specific medical insurance beneficiaries with distinct differences in the reimbursement fractions. The average national vaccination coverage was just 1.5-2.2% between 2004 and 2014. A free national vaccination program for priority populations (n=416million), would cost government US$ 757million (95% CI 726-789) annually (uptake rate=20%). An increasing number of regional governments have begun to pay, partially or fully, for influenza vaccination for selected groups. However, this small-scale policy approach has failed to increase national uptake. A free, nationwide vaccination program would require a substantial annual investment. A cost-effectiveness analysis is needed to identify the most efficient methods to improve coverage. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
... 7 Agriculture 4 2010-01-01 2010-01-01 false Commodity schools. 250.57 Section 250.57 Agriculture... TERRITORIES AND POSSESSIONS AND AREAS UNDER ITS JURISDICTION National School Lunch Program (NSLP) and Other Child Nutrition Programs § 250.57 Commodity schools. (a) Categorization of commodity schools. Commodity...
Nelson, Richard E; Hicken, Bret; Cai, Beilei; Dahal, Arati; West, Alan; Rupper, Randall
To improve access to care, the Veterans Health Administration (VHA) increased its patient travel reimbursement rate from 11 to 28.5 cents per mile on February 1, 2008, and again to 41.5 cents per mile on November 17, 2008. We identified characteristics of veterans more likely to receive travel reimbursements and evaluated the impact of these increases on utilization of the benefit. We examined the likelihood of receiving any reimbursement, number of reimbursements, and dollar amount of reimbursements for VHA patients before and after both reimbursement rate increases. Because of our data's longitudinal nature, we used multivariable generalized estimating equation models for analysis. Rurality and categorical distance from the nearest VHA facility were examined in separate regressions. Our cohort contained 214,376 veterans. During the study period, the average number of reimbursements per veteran was higher for rural patients compared to urban patients, and for those living 50-75 miles from the nearest VHA facility compared to those living closer. Higher reimbursement rates led to more veterans obtaining reimbursement regardless of urban-rural residence or distance traveled to the nearest VHA facility. However, after the rate increases, urban veterans and veterans living reimbursement utilization slightly more than other patients. Our findings suggest an inverted U-shaped relationship between veterans' utilization of the VHA travel reimbursement benefit and travel distance. Both urban and rural veterans responded in roughly equal manner to changes to this benefit. © 2013 National Rural Health Association.
Kwon, Sooyoun; Yeoh, Yoonjae; Abe, Satoko
This study aimed to investigate the nutritional quality and patterns of lunch menus provided by child care centers in South Korea and Japan. The weekly lunch menus from Monday to Saturday that child care centers provided in November 2014 in South Korea and Japan were analyzed. For Korea, a total of 72 meals provided by 12 centers in Seoul were analyzed by referring to the homepage of the Center for Children's Foodservice Management, which serviced menus for child care centers. For Japan, a total of 30 meals provided by 5 child care centers in Tokyo were analyzed. Nutrient content and pattern in lunch menus were evaluated. The lunch menus in Korea and Japan provided 359.5 kcal (25.7% of the estimated energy requirement) and 376.3 kcal (29.5% of the estimated energy requirement), respectively. 'Rice + Soup + Main dish + Side dish I + Side dish II' were provided in 66.7% of meals in Korea, while various patterns with rice and soup as their bases were provided in Japan. The lunch menus of child care centers in Korea and Japan provide similar amounts of energy, protein, carbohydrate, vitamin A, calcium, and other nutrients. However, there were significant differences in the lunch menu patterns in Korea and Japan. This study provides information about the nutritional content and pattern of lunch menus at child care centers in Asian countries with rice as a staple food.
Kawalec, Paweł; Sagan, Anna; Stawowczyk, Ewa; Kowalska-Bobko, Iwona; Mokrzycka, Anna
The Act of 12 May 2011 on the Reimbursement of Medicines, Foodstuffs Intended for Particular Nutritional Uses and Medical Devices constitutes a major change of the reimbursement policy in Poland. The main aims of this Act were to rationalize the reimbursement policy and to reduce spending on reimbursed drugs. The Act seems to have met these goals: reimbursement policy (including pricing of reimbursed drugs) was overhauled and the expenditure of the National Health Fund on reimbursed drugs saw a significant decrease in the year following the Act's introduction. The annual savings achieved since then (mainly due to the introduction of risk sharing schemes), have made it possible to include new drugs into the reimbursement list and improve access to innovative drugs. However, at the same time, the decrease in prices of reimbursed drugs, that the Act brought about, led to an uncontrolled outflow of some of these drugs abroad and shortages in Poland. This paper analyses the main changes introduced by the Reimbursement Act and their implications. Since the Act came into force relatively recently, its full impact on the reimbursement policy is not yet possible to assess. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Members of the personnel are kindly requested to note that only documents proving that a payment has been made are accepted as proof of payment for any claims for reimbursement, including specifically the reimbursement of education fees. In particular, the following will be accepted as proof of payment: bank or post office bank statements indicating the name of the institution to which the payment was made; photocopies of cheques made out to the institution to which the payments were made together with bank statements showing the numbers of the relevant cheques; proof of payment in the form of discharged payment slips; invoices with acknowledgement of settlement, receipts, bank statements detailing operations crediting another account or similar documents. As a result, the following documents in particular will no longer be accepted as proof of payment: photocopies of cheques that are not submitted together with bank or post office bank statements showing the numbers of the relevant cheques; details of ...
This paper evaluates the impact of state-level Medicaid reimbursement rates for obstetric care on prenatal care utilization across demographic groups. It also uses these rates as an instrumental variable to assess the importance of prenatal care on birth weight. The analysis is conducted using a unique dataset of Medicaid reimbursement rates and 2001-2010 Vital Statistics Natality data. Conditional on county fixed effects, the study finds a modest, but statistically significant positive relationship between Medicaid reimbursement rates and the number of prenatal visits obtained by pregnant women. Additionally, higher rates are associated with an increase in the probability of obtaining adequate care, as well as a reduction in the incidence of going without any prenatal care. However, the effect of an additional prenatal visit on birth weight is virtually zero for black disadvantaged mothers, while an additional visit yields a substantial increase in birth weight of over 20 g for white disadvantaged mothers. Copyright © 2015 Elsevier B.V. All rights reserved.
Talsma, Elise F.; Borgonjen-van den Berg, Karin J.; Melse-Boonstra, Alida; Mayer, Eva V.; Verhoef, Hans; Demir, Ayşe Y.; Ferguson, Elaine L.; Kok, Frans J.; Brouwer, Inge D.
Objective: Introduction of biofortified cassava as school lunch can increase vitamin A intake, but may increase risk of other deficiencies due to poor nutrient profile of cassava. We assessed the potential effect of introducing a yellow cassava-based school lunch combined with additional
Too often, lost and lonely students seem to find their way to the school library. School librarians are blessed with the opportunity to make a difference in the lives of these young people. In this article, the author describes how she developed a program called the "Lunch Bunch" to help lost and lonely students who were seeking a place of refuge.…
Full Text Available Abstract Background Frequency of eating breakfast, lunch and evening meal as a determinant of fruit and vegetable intake among young people is little studied. We investigated whether irregular meal consumption was associated with fruit and vegetable intake among adolescents. We used separate analyses, and special emphasis was on the potentially modifying effect of sex and age. Methods Data were from the Danish contribution to the international collaborative Health Behavior in School-Aged Children Study (HBSC in 2002. We used a questionnaire-based, cross-sectional design to study schoolchildren aged 11, 13 and 15 years (n = 3913 selected from a random sample of schools in Denmark. Fruit intake and vegetable intake were measured by a food frequency questionnaire and analyses were conducted using multivariate logistic regression. Results Overall, statistically significant associations were found between irregular breakfast, lunch and evening meal consumption and low frequency of fruit intake and vegetable intake (breakfast: fruit OR = 1.42, vegetables OR = 1.48; lunch: fruit OR = 1.68, vegetables OR = 1.83; evening meal: vegetables OR = 1.70. No association was found for irregular evening meal consumption and low frequency of fruit intake. Analyses stratified by sex showed that the associations between irregular breakfast consumption and both fruit and vegetable intake remained statistically significant only among girls. When analyses were stratified by both sex and age, different patterns appeared. Overall, skipping meals seemed to be a less serious risk factor for low frequency of fruit and vegetable intake among younger participants compared with those who were older. This was especially evident for skipping breakfast. The same tendency was also seen for skipping lunch and evening meal, although the age pattern varied between boys and girls and between fruit and vegetable intake. Conclusion Our results showed that irregular breakfast, lunch and
Romo-Palafox, Maria Jose; Ranjit, Nalini; Sweitzer, Sara J.; Roberts-Gray, Cindy; Hoelscher, Deanna M.; Byrd-Williams, Courtney E.; Briley, Margaret E.
Background Eating habits are developed during the preschool years and track into adulthood, but few studies have quantified dietary quality of meals packed by parents for preschool children enrolled in early care and education centers. Objective Our aim was to evaluate the dietary quality of preschoolers’ sack lunches using the Healthy Eating Index (HEI) 2010 to provide parents of preschool children with guidance to increase the healthfulness of their child’s lunch. Design This study is a cross-sectional analysis of baseline dietary data from the Lunch Is in the Bag trial. Participants A total of 607 parent–child dyads from 30 early care and education centers in Central and South Texas were included. Main outcome measures Total and component scores of the HEI were computed using data obtained from direct observations of packed lunches and of children’s consumption. Statistical analysis Three-level regression models with random intercepts at the early care and education center and child level were used; all models were adjusted for child sex, age, and body mass index (calculated as kg/m2). Results Mean HEI-2010 total scores were 58 for lunches packed and 52 for lunches consumed, out of 100 possible points. Mean HEI component scores for packed and consumed lunches were lowest for greens and beans (6% and 8% of possible points), total vegetables (33% and 28%), seafood and plant proteins (33% and 29%), and whole grains (38% and 34%); and highest for empty calories (85% and 68% of possible points), total fruit (80% and 70%), whole fruit (79% and 64%), and total protein foods (76% and 69%). Conclusions Parents of preschool children pack lunches with low dietary quality that lack vegetables, plant proteins, and whole grains, as measured by the HEI. Education of parents and care providers in early care and education centers is vital to ensure that preschoolers receive high dietary-quality meals that promote their preference for and knowledge of a healthy diet. PMID
Romo-Palafox, Maria Jose; Ranjit, Nalini; Sweitzer, Sara J; Roberts-Gray, Cindy; Hoelscher, Deanna M; Byrd-Williams, Courtney E; Briley, Margaret E
Eating habits are developed during the preschool years and track into adulthood, but few studies have quantified dietary quality of meals packed by parents for preschool children enrolled in early care and education centers. Our aim was to evaluate the dietary quality of preschoolers' sack lunches using the Healthy Eating Index (HEI) 2010 to provide parents of preschool children with guidance to increase the healthfulness of their child's lunch. This study is a cross-sectional analysis of baseline dietary data from the Lunch Is in the Bag trial. A total of 607 parent-child dyads from 30 early care and education centers in Central and South Texas were included. Total and component scores of the HEI were computed using data obtained from direct observations of packed lunches and of children's consumption. Three-level regression models with random intercepts at the early care and education center and child level were used; all models were adjusted for child sex, age, and body mass index (calculated as kg/m(2)). Mean HEI-2010 total scores were 58 for lunches packed and 52 for lunches consumed, out of 100 possible points. Mean HEI component scores for packed and consumed lunches were lowest for greens and beans (6% and 8% of possible points), total vegetables (33% and 28%), seafood and plant proteins (33% and 29%), and whole grains (38% and 34%); and highest for empty calories (85% and 68% of possible points), total fruit (80% and 70%), whole fruit (79% and 64%), and total protein foods (76% and 69%). Parents of preschool children pack lunches with low dietary quality that lack vegetables, plant proteins, and whole grains, as measured by the HEI. Education of parents and care providers in early care and education centers is vital to ensure that preschoolers receive high dietary-quality meals that promote their preference for and knowledge of a healthy diet. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Community Partnership School (CPS) serves 90 to 95 students annually in preK-5th grade. Of these, 100 percent are African American or multiracial, and all qualify for free or reduced-price lunch. Community Partnership School began as a collaboration between Germantown Academy, which had trouble recruiting low-income students to its suburban…
... available funding, the approved claim amounts will be reimbursed on a prorated basis. All reimbursements are...., statutory increases in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium...
...) Reimbursement of additional salary and overtime costs. DHS will reimburse any identified additional salary and...). (g) Reimbursement for Backfill costs upon Activation. DHS will reimburse the cost to Backfill System... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for personnel...
Full Text Available Tania Stafinski1, Devidas Menon2, Caroline Davis1, Christopher McCabe31Health Technology and Policy Unit, 2Health Policy and Management, School of Public Health, University of Alberta, Edmonton, Alberta, Canada; 3Academic Unit of Health Economics, Leeds Institute for Health Sciences, University of Leeds, Leeds, UKBackground: The purpose of this study was to compare centralized reimbursement/coverage decision-making processes for health technologies in 23 European countries, according to: mandate, authority, structure, and policy options; mechanisms for identifying, selecting, and evaluating technologies; clinical and economic evidence expectations; committee composition, procedures, and factors considered; available conditional reimbursement options for promising new technologies; and the manufacturers' roles in the process.Methods: A comprehensive review of publicly available information from peer-reviewed literature (using a variety of bibliographic databases and gray literature (eg, working papers, committee reports, presentations, and government documents was conducted. Policy experts in each of the 23 countries were also contacted. All information collected was reviewed by two independent researchers.Results: Most European countries have established centralized reimbursement systems for making decisions on health technologies. However, the scope of technologies considered, as well as processes for identifying, selecting, and reviewing them varies. All systems include an assessment of clinical evidence, compiled in accordance with their own guidelines or internationally recognized published ones. In addition, most systems require an economic evaluation. The quality of such information is typically assessed by content and methodological experts. Committees responsible for formulating recommendations or decisions are multidisciplinary. While criteria used by committees appear transparent, how they are operationalized during deliberations
Eltorai, Adam E M; Durand, Wesley M; Haglin, Jack M; Rubin, Lee E; Weiss, Arnold-Peter C; Daniels, Alan H
Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values. To assess mean growth rate for each procedure and subspecialty, compound annual growth rates were calculated. Year-to-year dollar amount changes were calculated for each procedure and subspecialty. Reimbursement trends for individual procedures and across subspecialties were compared. Between 2000 and 2016, annual reimbursements decreased for all orthopedic procedures examined except removal of orthopedic implant. The orthopedic procedures with the greatest mean annual decreases in reimbursement were shoulder arthroscopy/decompression, total knee replacement, and total hip replacement. The orthopedic procedures with the least annual reimbursement decreases were carpal tunnel release and repair of ankle fracture. Rate of Medicare procedure reimbursement change varied between subspecialties. Trauma had the smallest decrease in annual change compared with spine, sports, and hand. Annual reimbursement decreased at a significantly greater rate for adult reconstruction procedures than for any of the other subspecialties. These findings indicate that reimbursement for procedures has steadily decreased, with the most rapid decrease seen in adult reconstruction. [Orthopedics. 2018; 41(2):95-102.]. Copyright 2018, SLACK Incorporated.
Biltoft-Jensen, Anja Pia; Nielsen, Trine Holmgaard; Ygil, Karin Hess
Visual aids, such as food photographs, are widely used in estimating food quantities in dietary surveys. The present study aimed to assess how accurately Danish adults and children can estimate food portion sizes using 37 series of photographs illustrating four to six different portion sizes under...... real-life conditions; determine whether adults were more accurate than children; and estimate the error caused by using portion size photographs to estimate weights of foods consumed in macronutrient calculation. Six hundred and twenty-two adults and 109 children were recruited in three workplace...... canteens and in two schools, respectively, to estimate their lunchtime portions based on photographs. Participants were instructed to keep the foods separated on their plate when taking lunch. Participants thereafter estimated their own portions by looking at the relevant series of photographs. The actual...
A cautious analysis of demand-side management programs is presented. Utility demand-side management (DSM) programs deserve to be given full and careful consideration as a potential way to give consumers better end-use energy services for their money, utilities an edge in an increasingly competitive market, and society a way to reduce the environmental costs of energy production. But in each of these areas, DSM programs offer no free lunches and have no inherent advantages over supply-side programs. If energy conservation makes sense on economic and business grounds, it can meet the standard economic and business tests applied to most of the rest of the economy; it neither requires nor deserves to be exempt from market concepts and disciplines. If utility DSM programs make sense on environmental grounds, they should be able to demonstrate their cost-effectiveness relative to other, primarily supply-side measures society is willing to undertake in order to control environmental effects. Subsidizing DSM measures in the hope that something good will happen far upstream can waste much money and cause disappointment and frustration
Mirjam E. van de Kamp
Full Text Available The aim of this study was to determine the environmental impact, nutrient intake, appreciation and tastiness of three buffet-style lunches served at the workplace, consisting of (1 animal-based foods; (2 plant-based foods; and (3 both animal-based and plant-based foods. Employees of the National Institute for Public Health and the Environment in the Netherlands participated in the study. Participants scored the lunch for appreciation and tastiness (scores from 1 to 10. Greenhouse gas (GHG emissions and land use associated with foods consumed were calculated using life cycle assessments. Nutrient intake was calculated using food composition data. The results show that both the plant-based and the combination lunch received higher scores for tastiness than the animal-based lunch. GHG emissions and land use were lowest for the plant-based lunch and highest for the animal-based lunch. The combination lunch was associated with increased fiber and decreased saturated fat intake compared to the animal-based lunch, but also lead to increased energy intake. The plant-based lunch did not increase energy intake, while increasing fiber intake and decreasing sodium (salt and saturated fat intakes. These initial results show that plant-based lunches have the potential to improve nutrient intake and tastiness while reducing environmental impact. Additional research in this field is worthwhile.
Becker, Thelma L.
Outlines (1) the changes that have occurred in school food service since the National School Lunch Act of 1946, (2) the choices in foods served and in new markets, and (3) an action plan for the challenges facing school food service professionals. (MLF)
Your attention is drawn to the 20 km distance limit set in Article R A 8.01 of the Staff Regulations, namely, that only accommodation fees of students attending an educational establishment which is more than 20 km from the place of residence and the duty station of the member of the personnel are reimbursed by the Organization, subject to the percentage rate and maximum amounts set out in this article and in Administrative Circular N° 12. Human Resources Division Tel : 72862 / 74474
Your attention is drawn to the 20 km distance limit set in Article R A 8.01 of the Staff Regulations, namely, that only accommodation fees of students attending an educational establishment which is more than 20 km from the place of residence and the duty station of the member of the personnel are reimbursed by the Organization, subject to the percentage rate and maximum amounts set out in this article and in Administrative Circular N° 12. Human Resources Division Tel: 72862 / 74474
...) Loss adjustment expenses; (vii) Sales commission; (viii) Marketing costs; (ix) Indirect overhead costs..., development, preparation or marketing of the policy; (xiii) Costs of making program changes as a result of any... submission may be eligible for a one-time payment of research and development costs and reimbursement of...
...: Federal Docket Management System Office, Room 3C843, 1160 Defense Pentagon, Washington, DC 20301-1160... paid under the Medicare Diagnosis- Related Group (DRG) method for all of that hospital's Medicare... reimbursement is usually substantially greater than what would be paid using the Diagnosis- Related Group (DRG...
Freed, Gary L; Cowan, Anne E; Gregory, Sashi; Clark, Sarah J
The purpose of this work was to collect data regarding vaccine prices and reimbursements in private practices. Amid reports of physicians losing money on vaccines, there are limited supporting data to show how much private practices are paying for vaccines and how much they are being reimbursed by third-party payers. We conducted a cross-sectional survey of a convenience sample of private practices in 5 states (California, Georgia, Michigan, New York, and Texas) that purchase vaccines for administration to privately insured children/adolescents. Main outcome measures included prices paid to purchase vaccines recommended for children and adolescents and reimbursement from the 3 most common, non-Medicaid payers for vaccine purchase and administration. Detailed price and reimbursement data were provided by 76 practices. There was a considerable difference between the maximum and minimum prices paid by practices, ranging from $4 to more than $30 for specific vaccines. There was also significant variation in insurance reimbursement for vaccine purchase, with maximum and minimum reimbursements for a single vaccine differing from $8 to more than $80. Mean net yield per dose (reimbursement for vaccine purchase minus price paid per dose) varied across vaccines from a low of approximately $3 to more than $24. Reimbursement for the first dose of vaccine administered ranged from $0 to more than $26, with a mean of $16.62. There is a wide range of prices paid by practices for the same vaccine product and in the reimbursement for vaccines and administration fees by payers. This variation highlights the need for individual practices to understand their own costs and reimbursements and to seek opportunities to reduce costs and increase reimbursements.
... of Asset and Transportation Management; Privately Owned Vehicle Mileage Reimbursement Rates AGENCY... Bulletin 12-02, Calendar Year (CY) 2012 Privately Owned Vehicle Mileage Reimbursement Rates. SUMMARY: The General Services Administration's (GSA) annual privately owned vehicle (POV) mileage reimbursement rate...
... 1121-AA78 International Terrorism Victim Expense Reimbursement Program AGENCY: Office of Justice... promulgating this interim-final rule for its International Terrorism Victim Expense Reimbursement Program... international terrorism. DATES: Effective date: This interim-final rule is effective April 11, 2011. Comment...
... manners: (1) If the gift has been newly purchased or is readily available in the market, the value shall... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Gifts and reimbursements. 2634.304....304 Gifts and reimbursements. (a) Gifts. Except as indicated in § 2634.308(b), each financial...
... PROVIDERS IN THE WASHINGTON, DC AREA General Provisions § 331.7 What losses will be reimbursed? (a) You may... which you are or were an operator or provider not been closed as the result of Federal government...-recurring, or unusual adjustments, and capital losses are normally ineligible for reimbursement. If you wish...
Schaefer, Elmar; Schnell, Gerald; Sonsalla, Jessica
Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. © 2015 Diabetes Technology Society.
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 1316.405 Section 1316.405 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 1316.405 Cost-reimbursement...
... 42 Public Health 1 2010-10-01 2010-10-01 false Loan cancellation reimbursement. 57.313a Section 57.313a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR... Loans § 57.313a Loan cancellation reimbursement. In the event that insufficient funds are available to...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other administrative costs. 208.42 Section 208.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... SYSTEM Response Cooperative Agreements § 208.42 Reimbursement for other administrative costs. Costs...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement costs of transitioning. 27.1233 Section 27.1233 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Policies Governing the Transition of the 2500-2690 Mhz Band for Brs and Ebs § 27.1233 Reimbursement costs...
... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 216.405 Section 216.405 Federal Acquisition Regulations System DEFENSE ACQUISITION... Contracts 216.405 Cost-reimbursement incentive contracts. ...
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false How will I be reimbursed? 86.71 Section 86.71 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR...) PROGRAM How States Manage Grants § 86.71 How will I be reimbursed? For details on how we will pay you...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursable relocation costs. 63.6 Section 63.6 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT... OF SECTION 1306(c) OF THE NATIONAL FLOOD INSURANCE ACT OF 1968 General § 63.6 Reimbursable relocation...
Lalezari, Ramin M; Pozen, Alexis; Dy, Christopher J
Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount. Variability was quantified by determining the range and coefficient of variation for those reimbursement amounts. The range of variability of Medicaid reimbursements among states exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.32 (hip hemiarthroplasty) to 0.57 (posterior or posterolateral lumbar interbody arthrodesis) (a higher coefficient indicates greater variability), compared with 0.07 for Medicare reimbursements for all 10 procedures. Adjusted as a dollar difference between Medicaid and Medicare per RVU, the median values ranged from -$8/RVU (total knee arthroplasty) to -$17/RVU (open reduction and internal fixation of the femur). Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost-reimbursement incentive contracts. 1816.405 Section 1816.405 Federal Acquisition Regulations System NATIONAL AERONAUTICS... 1816.405 Cost-reimbursement incentive contracts. [62 FR 3478, Jan. 23, 1997. Redesignated at 62 FR...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 916.405 Section 916.405 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 916.405 Cost-reimbursement...
... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Financial reporting requirements and reimbursements. 64.15 Section 64.15 Parks, Forests, and Public Property NATIONAL PARK SERVICE... RIGHTS-OF-WAY § 64.15 Financial reporting requirements and reimbursements. Payments to applicants will...
... Procedure GSA posts the POV mileage reimbursement rates, formerly published in 41 CFR Chapter 301, solely on... official travel. Notices published periodically in the Federal Register, such as this one, and the changes... reimbursement rates for Federal agencies. Dated: December 12, 2013. Carolyn Austin-Diggs, Acting Deputy...
A reimbursement category for "apps" does not exist in German statutory health insurance. Nevertheless different ways for reimbursement of digital health care products or processes exist. This article provides an overview and a description of the most relevant finance and reimbursement categories for apps in German statutory health insurance. The legal qualifications and preconditions of reimbursement in the context of single contracts with one health insurance fund will be discussed as well as collective contracts with national statutory health insurance funds. The benefit of a general outline appeals especially in respect to the numerous new players and products in the health care market. The article will highlight that health apps can challenge existing legal market access and reimbursement criteria and paths. At the same time, these criteria and paths exist. In terms of a learning system, they need to be met and followed.
... the relationship between the Federal Government and Indian Tribes, or on the distribution of power and... meals and helping children develop healthful eating habits early in life. USDA will respond in a timely...
... protein, calcium, iron, vitamin A, and vitamin C. These are key nutrients that promote growth and... now major health concerns affecting children and adolescents. Studies indicate that excess food... concern for children: Calcium, fiber, potassium, magnesium and vitamin E. [[Page 2496
..., potassium, vitamin D or dietary fiber). Effective July 1, 2016, this criterion is obsolete and may not be..., although it is not possible to quantify those benefits on overall diets or student health. Excess body... consequences for affected adults, and recent research has also demonstrated that excess body weight has...
... following correction: On page 45181, the Table titled ``AFTERSCHOOL SNACKS SERVED IN AFTERSCHOOL CARE PROGRAMS'' is corrected to read as set forth below: Afterschool Snacks Served in Afterschool Care Programs CONTIGUOUS STATES: PAID 0.07 REDUCED PRICE 0.40 FREE 0.80 ALASKA: PAID 0.11 REDUCED PRICE 0.65 FREE 1.30...
Grant, David C; Iserson, Kenneth V
Why does gifting exist in the medical marketplace? It provides a sales advantage in a competitive marketplace by establishing crucial relationships with the patients' fiduciary: the physician and surgeon. Do gifts to physicians from industry harm patients? One can cite mountains of indirect evidence that they do, and maybe in the case of recalled devices and drugs there are actual corpses, but these examples are retrospective and it is impossible to prove that removing detailing eliminates the harm. Banning gifts to surgeons would not completely fix the ethical problem of pharmaceutical and device marketing. Gifts are important because they buy access and foster relationships, but inherent bias in research and the medical literature makes it very difficult to remain objective. It is a race, and education has not kept pace with advertising; only 10% of 575 internal medicine physicians thought they had had sufficient training during medical school and residency regarding professional interaction with sales representatives. Would banning gifts help at all? Would enforcing an unpopular ethical code protect patients? There might be a small improvement, but not as significant as eliminating representatives and product samples altogether. This is not likely to happen without an enormous fight against the wealthiest industry in America. The solution is education. To borrow industry's argument, physicians and surgeons are ethical creatures with capacity for judgment and integrity. They need to understand and believe the magnitude of the problem. Detailing exists because there is a market for it, empowering surgeons with ethical training reduces the demand for goodies, and at some point the popular choice will be to buy their own lunch. Business ethics are not medical ethics. Industry is behaving exactly as it must to maximize profits. Although it is painful for some surgeons, surgical residencies, and professional organizations to envision a future with diminished corporate
Bishop, Christine E.
This review of nursing home cost function research shows that certain provider and service characteristics are systematically associated with differences in the average cost of care. This information can be used to group providers for reasonable cost related rate-setting or to adjust their rates or rate ceilings. However, relationships between average cost and such service characteristics as patient mix, service intensity, and quality of care have not been fully delineated. Therefore, econometric cost functions cannot yet provide rate-setters with predictions about the cost of the efficient provision of nursing home care appropriate to patient needs. In any case, the design of reimbursement systems must be founded not only on technical information but also on public policy goals for long-term care. PMID:10309223
Paul, D P
Direct reimbursement, or DR, has been a popular topic in organized dentistry for much of the last decade, and the concept is beginning to be more widely known. This article explores the underpinnings of and future for DR. TYPES OF LITERATURE REVIEWED: This article is based on an online review of the dental, medical and business literature. The author explores the advantages of DR for patients, employers and dentists. He also presents purported disadvantages of DR, and refutes them. Organized dentistry's marketing efforts and the importance of third-party administrators also are examined. During the next several years, DR has the potential to become the vehicle of choice for financing much of the dental care provided in the United States. Dentists need to become more aware of what DR is and what it can offer the public. They then will be better able to promote DR, which is a significantly better payment system for dental care than any other available today.
Bishop, C E
This review of nursing home cost function research shows that certain provider and service characteristics are systematically associated with differences in the average cost of care. This information can be used to group providers for reasonable cost related rate-setting or to adjust their rates or rate ceilings. However, relationships between average cost and such service characteristics as patient mix, service intensity, and quality of care have not been fully delineated. Therefore, econometric cost functions cannot yet provide rate-setters with predictions about the cost of the efficient provision of nursing home care appropriate to patient needs. In any case, the design of reimbursement systems must be founded not only on technical information but also on public policy goals for long-term care.
Barry, Michael; Tilson, Lesley; Ryan, Máirín
Expenditure on healthcare in Ireland, which is mainly derived from taxation, has increased considerably in recent years to an estimated 9.2 billion euro in 2003. Pharmaceuticals account for approximately 10% of total healthcare expenditure. Approximately one-third of patients receive their medications free of charge whilst the remaining two-thirds are subject to a co-payment threshold of 78 euro per month, i.e. 936 euro per year. The price of medications in Ireland is linked to those of five other member states where the price to the wholesaler of any medication will not exceed the lesser of the currency-adjusted wholesale price in the United Kingdom or the average of wholesale prices in Denmark, France, Germany, The Netherlands and the United Kingdom. A price freeze at the introduction price has been in existence since 1993. Despite the price freeze, expenditure on medicines on the community drugs scheme has increased from 201 million euro in 1993 to 898 million euro in 2002. The two main factors contributing to the increased expenditure on medicines include "product mix", the prescribing of new and more expensive medication, and "volume effect" comprising growth in the number of prescription items. Changing demographics and the extension of the General Medical Services (GMS) Scheme to provide free medicines for all those over the age of 70 years have also contributed. Prior to reimbursement under the community drugs schemes, a medicine must be included in the GMS code book or positive list. A demonstration of cost-effectiveness is not a pre-requisite for reimbursement.
Students, parents, and school staff often believe there are no healthful foods available in schools for children with diabetes. This paper explains modern school food environments and how children with diabetes can eat school foods. National School Lunch Program meals usually consist of an entree, t...
Chi, Donald L; Singh, Jennifer
Little is known about Medicaid policies regarding reimbursement for placement of sealants on primary molars. The authors identified Medicaid programs that reimbursed dentists for placing primary molar sealants and hypothesized that these programs had higher reimbursement rates than did state programs that did not reimburse for primary molar sealants. The authors obtained Medicaid reimbursement data from online fee schedules and determined whether each state Medicaid program reimbursed for primary molar sealants (no or yes). The outcome measure was the reimbursement rate for permanent tooth sealants (calculated in 2012 U.S. dollars). The authors compared mean reimbursement rates by using the t test (α = .05). Seventeen Medicaid programs reimbursed dentists for placing primary molar sealants (34 percent), and the mean reimbursement rate was $27.57 (range, $16.00 [Maine] to $49.68 [Alaska]). All 50 programs reimbursed dentists for placement of sealants on permanent teeth. The mean reimbursement for permanent tooth sealants was significantly higher in programs that reimbursed for primary molar sealants than in programs that did not ($28.51 and $23.67, respectively; P = .03). Most state Medicaid programs do not reimburse dentists for placing sealants on primary molars, but programs that do so have significantly higher reimbursement rates. Medicaid reimbursement rates are related to dentists' participation in Medicaid and children's dental care use. Reimbursement for placement of sealants on primary molars is a proxy for Medicaid program generosity.
Meilstrup, Charlotte; Pagh Pedersen, Trine; Holstein, Bjørn Evald
Abstract Purpose: Regular meal habits facilitate healthy dietary habits and especially low breakfast frequency shows associations with risk of overweight among adolescents. Studies on social inequality in meal frequencies among children and adolescents are limited, and especially studies of lunch...... measured by frequency questionnaire. Multivariate logistic regressions were conducted adjusted by age, gender and family structure. Results: Analyses showed that adolescents from low family social class had significantly higher odds of low breakfast, lunch and evening meal frequency than adolescents from...... high family social class (breakfast: odds ratio (OR) = 2.22, lunch: OR = 1.56, evening meal: OR = 1.80). For all three meal types the odds of low frequency increased gradually by decreasing social class. There were no significant interactions with gender. Conclusion: The results indicate social...
de Bloom, Jessica; Sianoja, Marjaana; Korpela, Kalevi; Tuomisto, Martti; Lilja, Ansa; Geurts, Sabine; Kinnunen, Ulla
Lunch breaks constitute the longest within-workday rest period, but it is unclear how they affect recovery from job stress. We conducted two randomized controlled trials with 153 Finnish knowledge workers who engaged for 15 min daily in prescribed lunch break activities for ten consecutive working
Hubbard, C M
Net present value estimates cannot be made in health care finance without the appropriate cost reimbursement adjustments. The results of new regulations could radically alter the effects of reimbursement on capital budgeting. Debates on the effects of cost reimbursement on decision making in hospitals will continue as long as reimbursement exists in a manner that affects operating cash flows or the cost of capital.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to RSVP... Reimbursements and Volunteer Assignments § 2553.43 What cost reimbursements are provided to RSVP volunteers? RSVP volunteers are provided the following cost reimbursements within the limits of the project's available...
... in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... reimbursement under Title X of the Energy Policy Act of 1992. In our Federal Register Notice of November 24...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to Senior..., and Cost Reimbursements § 2551.46 What cost reimbursements are provided to Senior Companions? Cost reimbursements include: (a) Stipend. Senior Companions who are income eligible will receive a stipend in an...
... in the reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... reimbursement under Title X of the Energy Policy Act of 1992. DATES: In our Federal Register Notice of November...
...-Reimbursement Contracts AGENCIES: Department of Defense (DoD), General Services Administration (GSA), and... addresses the use and management of cost- reimbursement contracts. DATES: Effective Date: April 2, 2012 FOR...-reimbursement contracts in the following three areas: 1. Circumstances when cost-reimbursement contracts are...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement under the Cost-Sharing Plan. 27... § 27.1166 Reimbursement under the Cost-Sharing Plan. (a) Registration of reimbursement rights. Claims for reimbursement under the cost-sharing plan are limited to relocation expenses incurred on or after...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false What cost reimbursements are provided to Foster..., Status and Cost Reimbursements § 2552.46 What cost reimbursements are provided to Foster Grandparents? Cost reimbursements include: (a) Stipend. Foster Grandparents who are income eligible will receive a...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Reimbursement under the Cost-Sharing Plan. 24... 1850-1990 Mhz Band § 24.245 Reimbursement under the Cost-Sharing Plan. (a) Registration of reimbursement rights. (1) To obtain reimbursement, a PCS relocator must submit documentation of the relocation...
... reimbursement sought from DHS. (c) DHS will not reimburse the Sponsoring Agency for fringe benefit costs for... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement of fringe... RESCUE RESPONSE SYSTEM Response Cooperative Agreements § 208.40 Reimbursement of fringe benefit costs...
Escalating costs of health care delivery and the current constraints imposed by the federal budget deficit seriously threaten to compromise patient care and innovative biomedical research. Recent third-party refusal to cover some patients treated in protocols has had considerable impact on trial research. In addition, reimbursement for conventional care sometimes has been refused if delivered as part of a study (e.g., MOPP therapy versus ABVD therapy) or for an indication that is not specifically cited on the Food and Drug Administration label. Who should cover the patient care costs of patients participating in clinical trials? One approach would have patients cover these costs themselves. A second approach is the reinstitution of patient care costs into research grants. A third possibility is that the pharmaceutical industry support patient care costs of clinical research. Historically, hospital expenses of patients participating in studies have been paid by health insurance policies. In the absence of a clinical trial, many patients would be treated with Food and Drug Administration-approved therapies despite a lack of substantial benefit. Such marginal treatments are compensated by third-party payers routinely. The current system is arbitrary and expensive, compromises research and development, and equates new treatment with no treatment. By refusing to reimburse the patient care costs of investigational therapy, third-party carriers are, in fact, making medical decisions. There is a growing and legitimate concern that the pace of clinical research will be impeded significantly at a time when many exciting developments will be ready for clinical trials. The molecular steps in carcinogenesis are being documented rapidly for common malignancies, such as colon cancer. Immunologic, biologic, and hormonal approaches, and emerging technologies, such as marrow transplant or antibody toxin conjugates, already are being studied in the clinic. Health policy legislation
... passing to, or in the possession of, any person other than the duly qualified executor or administrator... specific provisions giving the executor the right to reimbursement from life insurance beneficiaries and...
... Part IV The President Memorandum of June 25, 2010--Providing Stability and Security for Medicare Reimbursements #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 75, No. 125 / Wednesday...
Chowdhury, E A; Richardson, J D; Tsintzas, K; Thompson, D; Betts, J A
Breakfast omission is positively associated with obesity and increased risk of disease. However, little is known about the acute effects of extended morning fasting upon subsequent energy intake and associated metabolic/regulatory factors in obese adults. In a randomised cross-over design, 24 obese men (n=8) and women (n=16) extended their overnight fast by omitting breakfast consumption or ingesting a typical carbohydrate-rich breakfast of 2183±393 kJ (521±94 kcal), before an ad libitum pasta lunch 3 h later. Blood samples were obtained throughout the day until 3 h post lunch and analysed for hormones implicated in appetite regulation, along with metabolic outcomes and subjective appetite measures. Lunch intake was unaffected by extended morning fasting (difference=218 kJ, 95% confidence interval -54 kJ, 490 kJ; P=0.1) resulting in lower total intake in the fasting trial (difference=-1964 kJ, 95% confidence interval -1645 kJ, -2281 kJ; Pfasting (P⩽0.06). Plasma-acylated ghrelin concentrations were also lower following the ad libitum lunch in the fasting trial (Pfasting trial (P=0.05), with plasma glucose also greater 1 h after lunch (Pfasting did not result in greater appetite ratings after lunch, with some tendency for lower appetite 3 h post lunch (P=0.09). We demonstrate for the first time that, in obese adults, extended morning fasting does not cause compensatory intake during an ad libitum lunch nor does it increase appetite during the afternoon. Morning fasting reduced satiety hormone responses to a subsequent lunch meal but counterintuitively also reduced concentrations of the appetite-stimulating hormone-acylated ghrelin during the afternoon relative to lunch consumed after breakfast.
Conner, David; Estrin, Hans; Becot, Florence
This article discusses High School Harvest (HSH), an Extension educator-led project in five Vermont schools to provide students with job training and food system education and to provide lightly processed produce to school lunch programs. One hundred and twenty-one students participated, logging 8,752 hours growing, harvesting, and processing…
This report is based on a study made during the school year 1962-63. Comparison with a benchmark survey conducted five years earlier shows that during the intervening period the number of public school districts decreased by one-third, while pupil enrollment increased by about 10 percent. The number of lunches served in the National School Lunch…
Millimet, Daniel L.; Tchernis, Rusty; Husain, Muna
Given the recent rise in childhood obesity, the School Breakfast Program (SBP) and National School Lunch Program (NSLP) have received renewed attention. Using panel data on more than 13,500 primary school students, we assess the relationship between SBP and NSLP participation and (relatively) long-run measures of child weight. After documenting a…
Xu, Zeyu; Özek, Umut; Hansen, Michael
This study explores whether teacher performance trajectory over time differs by school-poverty settings. Focusing on elementary school mathematics teachers in North Carolina and Florida, we find no systematic relationship between school student poverty rates and teacher performance trajectories. In both high- (=60% free/reduced-price lunch [FRPL])…
Andersen, Rikke; Biltoft-Jensen, Anja Pia; Christensen, Tue
Background and objectives: The OPUS study is a school-based intervention study testing selected health effects of New Nordic Diet (NND). Children are served lunch and snacks based on NND. The hypothesis is that Danish school children eat a healthier diet when receiving NND school meals as compared...... with packed lunch brought from home. To investigate the effects on intake of selected macronutrients in Danish school children when served school meals based on NND compared with packed lunch. Methods: In a cluster-randomized controlled unblinded cross-over study children received school meals based on NND...... for 3 months and their usual packed lunch for 3 months. The daily intake of food and beverages was recorded 3 times during 7 consecutive days using a validated self-administered web-based dietary assessment software tool for children. Statistical analysis was performed by hierarchical mixed models...
McCullough, J Mac
A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt. Reimbursement records for all transactions at Maricopa County Department of Public Health immunization clinics from January 2013 through June 2014 were compiled and analyzed to determine the duration between service and reimbursement. Outcomes included daily and cumulative revenues received. Time to reimbursement for Medicaid and private payers was also compared. Reimbursement for immunization services was received a median of 68 days after service. Payments were sometimes taken back by payers through credit transactions that occurred a median of 333 days from service. No differences in time to reimbursement between Medicaid and private payers were found. Billing represents an important financial opportunity for LHDs to continue to sustainably assure population health. Yet, the lag from service provision to reimbursement may complicate budgeting, especially in initial years of new billing activities. Special consideration may be necessary to establish flexibility in the budget-setting processes for services with clinical billing revenues, because funds for services delivered in one budget period may not be received in the same period. LHDs may also benefit from exploring strategies used by other delivery organizations to streamline billing processes.
Chen, Gau-Tzu; Chang, Shu-Chen; Chang, Chee-Jen
Taiwan has implemented a national health insurance system for more than 20 years now. The benefits of pharmaceutical products and new drug reimbursement scheme are determined by the Expert Advisory Meeting and the Pharmaceutical Benefit and Reimbursement Scheme (PBRS) Joint Committee in Taiwan. To depict the pharmaceutical benefits and reimbursement scheme for new drugs and the role of health technology assessment (HTA) in drug policy in Taiwan. All data were collected from the Expert Advisory Meeting and the PBRS meeting minutes; new drug applications with HTA reports were derived from the National Health Insurance Administration Web site. Descriptive statistics were used to analyze the timeline of a new drug from application submission to reimbursement effective, the distribution of approved price, and the approval rate for a new drug with/without local pharmacoeconomic study. After the second-generation national health insurance system, the timeline for a new drug from submission to reimbursement effective averages at 436 days, and that for an oncology drug reaches an average of 742 days. New drug approval rate is 67% and the effective rate (through the approval of the PBRS Joint Committee and the acceptance of the manufacturer) is 53%. The final approved price is 53.6% of the international median price and 70% of the proposed price by the manufacturer. Out of 95 HTA reports released during the period January 2011 to February 2017, 28 applications (30%) conducted an HTA with a local pharmacoeconomic study, and all (100%) received reimbursement approval. For the remaining 67 applications (70%) for which HTA was conducted without a local pharmacoeconomic analysis, 54 cases (81%) were reimbursed. New drug applications with local pharmacoeconomic studies are more likely to get reimbursement. Copyright © 2018. Published by Elsevier Inc.
3349-357 Objectives: The aim of our study is to compare five European drug reimbursement systems, describe similarities and differences, and obtain insight into their strengths and weaknesses and formulate policy recommendations. Methods: We used the analytical Hutton Framework to assess in detail drug reimbursement systems in Austria, Belgium, France, the Netherlands, and Sweden. We investigated policy documents, explored literature, and conducted fifty-seven interviews with relevant s...
Ba, Harouna; Meade, Terri; Pierson, Elizabeth; Ferguson, Camille; Roy, Amanda; Williams, Hakim
The Hattiesburg Public School District (HPSD) is a small urban school system located in southern Mississippi. Of the almost 4,500 students enrolled in its nine schools, 92 percent are African American and 90 percent receive free or reduced lunch. Currently, HPSD employs 34 administrators, 375 teachers, and 11 technology specialists. When the 21st…
Foltin, R W; Fischman, M W; Moran, T H; Rolls, B J; Kelly, T H
Two groups of three subjects participated in a residential study that assessed the effects of varying the macronutrient and caloric content of a required lunch meal on subsequent food choice and intake. Lunches contained 431 or 844 kcal, with the caloric differential created by manipulating the calories derived from either fat or carbohydrate (CHO). Each lunch condition (high-fat, high-CHO, low-fat, and low-CHO) was examined for 3 consecutive days. Subjects controlled their own patterns of food intake and could consume any item or number of items at any time during the day or night. There were no significant differences in total daily caloric intake across conditions, indicating that subjects compensated for the caloric content of the lunch regardless of the macronutrient content. Total daily caloric intake under the high-fat and high-CHO conditions was 2824 +/- 151 (mean +/- SEM) and 2988 +/- 187 kcal, respectively, whereas intake under the low-fat and low-CHO conditions was 2700 +/- 131 and 2890 +/- 247 kcal, respectively.
Dan Booth is the director of hospitality services for MaineGeneral Health. For this 450-bed health care organization, he directs six departments, which include environmental services, food and nutrition, security, laundry services, telecommunications, and transportation. In this article he describes how his Take a Nurse to Lunch program operates, what its benefits are, and how it was implemented.
School catering is one form of public catering. People who work in sphere of school catering have to observe very strict rules of sanitary code and to follow conventions of rational nutrition. Nutritious food is important for young people and their growth. The experience with the school dining should be very useful for the child. He should learn how to intercommon and how to follow healthy lifestyle. In the last five years, fewer children eat school lunches in Czech Republic. This fact is cau...
Full Text Available Optimizing physical activity (PA in children is paramount to attenuate the incidence of chronic disease and to improve social and cognitive health. Limited research exists examining the observed PA patterns during school leisure times in children from the U.S. The purpose of this study was to examine the observed PA patterns of children during three school leisure times: before school, during lunch, and after school. The SOPLAY instrument was used to observe PA during the three leisure times across six weeks at four elementary schools in the U.S. Observer PA counts were stratified by sex, PA intensity (sedentary, walking, and very active, and leisure time. Multi-level models were employed to examine the effect of leisure time and PA intensity on observer PA counts, adjusting for day and school-level clustering. Lunch displayed the greatest number of counts for sedentary, walking, and very active PA intensities (p 0.05. After school displayed the fewest counts for walking and very active PA in both sexes (p < 0.05. An emphasis should be placed on increasing walking and very active PA intensities before school and during lunch in girls and after school in both sexes. Keywords: after school, before school, lunch, SOPLAY, systematic observation
Full Text Available Background: The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Methods: Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC, iron, vitamin A (VitA, folate and vitamin B12 (VitB12. Results: On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA. The sets contained a high mean share of VitC (159% RDA, VitA (66% RDA, and folate (44% RDA, but were low in VitB12 (29% RDA and iron (20% RDA. Conclusions: Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of <1 USD/person/day at large scale. Data on quantitative total dietary intake as well as physical activity among workers are needed to further optimize the concept of staff canteens.
Food we eat has an important influence on health and well-being. Many eating habits are established in childhood. 456 children aged eight to 12 years participated in this survey of food eaten at school. Of all the food items eaten as a snack, 48.6% were categorised as junk. 75.8% of the sandwiches brought to school for lunch were made with white bread. Of the remaining food items brought for lunch 63.5% were of the junk variety. Compared with those who brought a snack or lunch from home, those given money to buy their own were more likely to eat junk (p < 0.01). Food eaten at school reflects approximately one third of a child\\'s daily food intake but health food practises for even a third of food intake may be of a value for health and long term eating habits. Nutritional education with the reinforcement of high nutritional standards in schools could improve the situation.
Romo-Palafox, Maria Jose; Ranjit, Nalini; Sweitzer, Sara J; Roberts-Gray, Cindy; Byrd-Williams, Courtney E; Briley, Margaret E; Hoelscher, Deanna M
Sweet drinks early in life could predispose to lifelong consumption, and the beverage industry does not clearly define fruit drinks as part of the sweet drink category. To ascertain the relationship between beverage selection and dietary quality of the lunches packed for preschool-aged children evaluated using the Healthy Eating Index-2010. Foods packed by parents (n=607) were observed at 30 early care and education centers on two nonconsecutive days. Three-level regression models were used to examine the dietary quality of lunches by beverage selection and the dietary quality of the lunch controlling for the nutrient composition of the beverage by removing it from the analysis. Fruit drinks were included in 25% of parent-packed lunches, followed by 100% fruit juice (14%), milk (14%), and flavored milk (3.7%). Lunches with plain milk had the highest Healthy Eating Index-2010 scores (59.3) followed by lunches with 100% fruit juice (56.9) and flavored milk (53.2). Lunches with fruit drinks had the lowest Healthy Eating Index-2010 scores at 48.6. After excluding the nutrient content of the beverage, the significant difference between lunches containing milk and flavored milk persisted (+5.5), whereas the difference between fruit drinks and 100% fruit juice did not. Dietary quality is associated with the type of beverage packed and these differences hold when the lunch is analyzed without the nutrient content of the beverage included. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Talsma, Elise F; Borgonjen-van den Berg, Karin J; Melse-Boonstra, Alida; Mayer, Eva V; Verhoef, Hans; Demir, Ayşe Y; Ferguson, Elaine L; Kok, Frans J; Brouwer, Inge D
Introduction of biofortified cassava as school lunch can increase vitamin A intake, but may increase risk of other deficiencies due to poor nutrient profile of cassava. We assessed the potential effect of introducing a yellow cassava-based school lunch combined with additional food-based recommendations (FBR) on vitamin A and overall nutrient adequacy using Optifood (linear programming tool). Cross-sectional study to assess dietary intakes (24 h recall) and derive model parameters (list of foods consumed, median serving sizes, food and food (sub)group frequency distributions, food cost). Three scenarios were modelled, namely daily diet including: (i) no school lunch; (ii) standard 5d school lunch with maize/beans; and (iii) 5d school lunch with yellow cassava. Each scenario and scenario 3 with additional FBR were assessed on overall nutrient adequacy using recommended nutrient intakes (RNI). Eastern Kenya. Primary-school children (n 150) aged 7-9 years. Best food pattern of yellow cassava-based lunch scenario achieved 100 % RNI for six nutrients compared with no lunch (three nutrients) or standard lunch (five nutrients) scenario. FBR with yellow cassava and including small dried fish improved nutrient adequacy, but could not ensure adequate intake of fat (52 % of average requirement), riboflavin (50 % RNI), folate (59 % RNI) and vitamin A (49 % RNI). Introduction of yellow cassava-based school lunch complemented with FBR potentially improved vitamin A adequacy, but alternative interventions are needed to ensure dietary adequacy. Optifood is useful to assess potential contribution of a biofortified crop to nutrient adequacy and to develop additional FBR to address remaining nutrient gaps.
Billich, Natassja; Adderley, Marijke; Ford, Laura; Keeton, Isabel; Palermo, Claire; Peeters, Anna; Woods, Julie; Backholer, Kathryn
School canteens have an important role in modelling a healthy food environment. Price is a strong predictor of food and beverage choice. This study compared the relative price of healthy and less healthy lunch and snack items sold within Australian school canteens. A convenience sample of online canteen menus from five Australian states were selected (100 primary and 100 secondary schools). State-specific canteen guidelines were used to classify menu items into 'green' (eat most), 'amber' (select carefully) and 'red' (not recommended in schools). The price of the cheapest 'healthy' lunch (vegetable-based 'green') and snack ('green' fruit) item was compared to the cheapest 'less healthy' ('amber/red') lunch and snack item, respectively, using an un-paired t-test. The relative price of the 'healthy' items and the 'less healthy' items was calculated to determine the proportion of schools that sold the 'less healthy' item cheaper. The mean cost of the 'healthy' lunch items was greater than the 'less healthy' lunch items for both primary (AUD $0.70 greater) and secondary schools ($0.50 greater; p snack was cheaper than the 'healthy' snack. These proportions were greatest for primary schools located in more, compared to less, disadvantaged areas. The relative price of foods sold within Australian school canteens appears to favour less healthy foods. School canteen healthy food policies should consider the price of foods sold.
Carnell, S; Pryor, K; Mais, L A; Warkentin, S; Benson, L; Cheng, R
Children's appetitive characteristics measured by parent-report questionnaires are reliably associated with body weight, as well as behavioral tests of appetite, but relatively little is known about relationships with food choice. As part of a larger preloading study, we served 4-5year olds from primary school classes five school lunches at which they were presented with the same standardized multi-item meal. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing satiety responsiveness (CEBQ-SR), food responsiveness (CEBQ-FR) and enjoyment of food (CEBQ-EF), and children were weighed and measured. Despite differing preload conditions, children showed remarkable consistency of intake patterns across all five meals with day-to-day intra-class correlations in absolute and percentage intake of each food category ranging from 0.78 to 0.91. Higher CEBQ-SR was associated with lower mean intake of all food categories across all five meals, with the weakest association apparent for snack foods. Higher CEBQ-FR was associated with higher intake of white bread and fruits and vegetables, and higher CEBQ-EF was associated with greater intake of all categories, with the strongest association apparent for white bread. Analyses of intake of each food group as a percentage of total intake, treated here as an index of the child's choice to consume relatively more or relatively less of each different food category when composing their total lunch-time meal, further suggested that children who were higher in CEBQ-SR ate relatively more snack foods and relatively less fruits and vegetables, while children with higher CEBQ-EF ate relatively less snack foods and relatively more white bread. Higher absolute intakes of white bread and snack foods were associated with higher BMI z score. CEBQ sub-scale associations with food intake variables were largely unchanged by controlling for daily metabolic needs. However, descriptive comparisons of lunch intakes with
Carnell, S; Pryor, K; Mais, LA; Warkentin, S; Benson, L; Cheng, R
Children’s appetitive characteristics measured by parent-report questionnaires are reliably associated with body weight, as well as behavioral tests of appetite, but relatively little is known about relationships with food choice. As part of a larger preloading study, we served 4-5y olds from primary school classes five school lunches at which they were presented with the same standardized multi-item meal. Parents completed Child Eating Behavior Questionnaire (CEBQ) sub-scales assessing satiety responsiveness (CEBQ-SR), food responsiveness (CEBQ-FR) and enjoyment of food (CEBQ-EF), and children were weighed and measured. Despite differing preload conditions, children showed remarkable consistency of intake patterns across all five meals with day-to-day intra-class correlations in absolute and percentage intake of each food category ranging from .78 to .91. Higher CEBQ-SR was associated with lower mean intake of all food categories across all five meals, with the weakest association apparent for snack foods. Higher CEBQ-FR was associated with higher intake of white bread and fruits and vegetables, and higher CEBQ-EF was associated with greater intake of all categories, with the strongest association apparent for white bread. Analyses of intake of each food group as a percentage of total intake, treated here as an index of the child’s choice to consume relatively more or relatively less of each different food category when composing their total lunch-time meal, further suggested that children who were higher in CEBQ-SR ate relatively more snack foods and relatively less fruits and vegetables, while children with higher CEBQ-EF ate relatively less snack foods and relatively more white bread. Higher absolute intakes of white bread and snack foods were associated with higher BMI z score. CEBQ sub-scale associations with food intake variables were largely unchanged by controlling for daily metabolic needs. However, descriptive comparisons of lunch intakes with
Full Text Available Beneficial effects of napping or bright light exposure on cognitive performance have been reported in participants exposed to sleep loss. Nonetheless, few studies investigated the effect of these potential countermeasures against the temporary drop in performance observed in mid-afternoon, and even less so on cognitive flexibility, a crucial component of executive functions. This study investigated the impact of either an afternoon nap or bright light exposure on post-prandial alterations in task switching performance in well-rested participants. Twenty-five healthy adults participated in two randomized experimental conditions, either wake versus nap (n=15, or bright light versus placebo (n=10. Participants were tested on a switching task three times (morning, post-lunch and late afternoon sessions. The interventions occurred prior to the post-lunch session. In the nap/wake condition, participants either stayed awake watching a 30-minute documentary or had the opportunity to take a nap for 30 minutes. In the bright light/placebo condition, participants watched a documentary under either bright blue light or dim orange light (placebo for 30 minutes. The switch cost estimates cognitive flexibility and measures task-switching efficiency. Increased switch cost scores indicate higher difficulties to switch between tasks. In both control conditions (wake or placebo, accuracy switch-cost score increased post lunch. Both interventions (nap or bright light elicited a decrease in accuracy switch-cost score post lunch, which was associated with diminished fatigue and decreased variability in vigilance. Additionally, there was a trend for a post-lunch benefit of bright light with a decreased latency switch-cost score. In the nap group, improvements in accuracy switch-cost score were associated with more NREM sleep stage N1. Thus, exposure to bright light during the post-lunch dip, a countermeasure easily applicable in daily life, results in similar
Mackelprang Alyssa J
Full Text Available Abstract Background Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria. Methods Data were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day, average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese using pooled ordered logistic regression models that excluded sex and age. Results Breakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for
Caban-Martinez, Alberto J; Moore, Kevin J; Clarke, Tainya C; Davila, Evelyn P; Clark, John D; Lee, David J; Fleming, Lora E
The transient nature of construction work makes it difficult to conduct longitudinal worksite-based health promotion activities. As part of a workplace health assessment pilot study, we worked with a commercial lunch truck company to disseminate four types of health education materials including cancer screening, workplace injury prevention, fruit and vegetable consumption, and smoking cessation to construction workers purchasing food items from the truck during their job breaks. Two weeks following the worksite assessment, we followed up with these workers to ascertain their use of the health promotion materials. Of the 54 workers surveyed, 83% reported reviewing and sharing the cancer screening materials with their families, whereas 44% discussed the cancer screening materials with coworkers. Similar proportions of workers reviewed, shared, and discussed the other health promotion materials with their family. Lunch trucks may be an effective strategy and delivery method for educating construction workers on healthy behaviors and injury prevention practices.
Kevin M Kniffin
Full Text Available Do people believe that sharing food might involve sharing more than just food? To investigate this, participants were asked to rate how jealous they (Study 1--or their best friend (Study 2--would be if their current romantic partner were contacted by an ex-romantic partner and subsequently engaged in an array of food- and drink-based activities. We consistently find--across both men and women--that meals elicit more jealousy than face-to-face interactions that do not involve eating, such as having coffee. These findings suggest that people generally presume that sharing a meal enhances cooperation. In the context of romantic pairs, we find that participants are attuned to relationship risks that extra-pair commensality can present. For romantic partners left out of a meal, we find a common view that lunch, for example, is not "just lunch."
Kniffin, Kevin M; Wansink, Brian
Do people believe that sharing food might involve sharing more than just food? To investigate this, participants were asked to rate how jealous they (Study 1)--or their best friend (Study 2)--would be if their current romantic partner were contacted by an ex-romantic partner and subsequently engaged in an array of food- and drink-based activities. We consistently find--across both men and women--that meals elicit more jealousy than face-to-face interactions that do not involve eating, such as having coffee. These findings suggest that people generally presume that sharing a meal enhances cooperation. In the context of romantic pairs, we find that participants are attuned to relationship risks that extra-pair commensality can present. For romantic partners left out of a meal, we find a common view that lunch, for example, is not "just lunch."
Kniffin, Kevin M.; Wansink, Brian
Do people believe that sharing food might involve sharing more than just food? To investigate this, participants were asked to rate how jealous they (Study 1) – or their best friend (Study 2) – would be if their current romantic partner were contacted by an ex-romantic partner and subsequently engaged in an array of food- and drink-based activities. We consistently find – across both men and women – that meals elicit more jealousy than face-to-face interactions that do not involve eating, such as having coffee. These findings suggest that people generally presume that sharing a meal enhances cooperation. In the context of romantic pairs, we find that participants are attuned to relationship risks that extra-pair commensality can present. For romantic partners left out of a meal, we find a common view that lunch, for example, is not “just lunch.” PMID:22792327
Benn, Jette; Carlsson, Monica Susanne
the lelarning potentials of school meals. The corss-case analysis focuses on the involved actors' perceptions of the school meal project and the meals, including Places Places, times and contexts, and the pupils' concepts and competencies in relation to food, meals and Health, as well as their involvement......This article is based on a qualitative multiple case study aimed at ealuating the effects of free school meal intervention on pupils' learning, and on the learning environment i schools. The study was conducted at four schools, each offereing free school meals for 20 weeks. At each school...... individual and focus Group interviws were conducted with students in grade 5-7 and grades 8-9- Furthermor, students were obserede during lunch breaks, and interviews were conducted with the class teacher, headmaster and/or the person responsible for school meals. The pupose of the article is to explore...
Cullen, Karen Weber; Watson, Kathy; Zakeri, Issa
We assessed the effect of the Texas Public School Nutrition Policy on middle school student lunchtime food consumption. Three years of lunch food records were collected from middle school students in southeast Texas: baseline (2001-2002), after local district changes (2002-2003), and 1 year after implementation of the Texas Public School Nutrition Policy (2005-2006). Students recorded amount and source of foods and beverages they consumed. Analysis of variance and covariance and nonparametric tests were used to compare intake after the policy change with intake during the 2 previous years. After implementation of the nutrition policy, student lunch consumption of vegetables, milk, and several nutrients increased (protein, fiber, vitamins A and C, calcium, and sodium), and consumption of less desirable items (sweetened beverages, snack chips) decreased, as did percentage of energy from fat. Most of the desired nutrients and foods (vegetables and milk) were obtained from the National School Lunch Program meal. Fewer sweetened beverages, candy, chips, and dessert foods were purchased and consumed, but more of these items were brought from home and purchased from the snack bar. Overall, state school nutrition policies can improve the healthfulness of foods consumed by students at lunch.
Frid, Anders H; Nilsson, Mikael; Holst, Jens Juul
glycemic index (GI) with whey proteins may increase insulin secretion and improve blood glucose control in type 2 diabetic subjects. DESIGN: Fourteen diet-treated subjects with type 2 diabetes were served a high-GI breakfast (white bread) and subsequent high-GI lunch (mashed potatoes with meatballs...... insulin release and reduces postprandial blood glucose excursion after a lunch meal consisting of mashed potatoes and meatballs in type 2 diabetic subjects....
Castellanos, Victoria H; Marra, Melissa Ventura; Johnson, Paulette
Nursing facilities often provide enhanced or fortified foods as part of a "food-first" approach to increasing nutrient intakes in residents with inadequate intakes or who are experiencing weight loss. The study objective was to determine whether energy and protein enhancement of a small number of menu items would result in increased three-meal (breakfast, lunch, and supper) calorie and protein intakes in long-term care residents. A randomized cross-over design was used to compare investigator-weighed food intakes under three menu conditions: control (no meals enhanced); lunch only enhanced; and both breakfast and lunch enhanced. Two breakfast foods (juice and hot cereal) and two lunch foods (soup and potato side dish) were chosen for enhancement. Participants were 33 nursing home residents from a facility in South Florida (average age=87.3 years). Repeated-measures analysis of variance was used to test the effects of the within-subjects factor (control, lunch enhanced, breakfast and lunch enhanced conditions), the between-subjects factor (smaller vs bigger eater), and the interaction on intakes (gram, kilocalories, and protein). Results revealed that bigger eaters consumed considerably more calories when breakfast foods, but not lunch foods, were enhanced. Smaller eaters achieved an increase in energy intake when either breakfast or lunch was enhanced. Overall daily protein intakes were not substantially increased by food enhancement. These data suggest that for an enhanced food program to be most effective for smaller eaters, who are at greatest risk for undernutrition and weight loss, it should include several enhanced foods at more than one meal.
Droste, Stefan; Jansen, Thomas; Wegener, Ingo
It is often claimed that Evolutionary Algorithms are superior to other optimization techniques, in particular, in situations where not much is known about the objective function to be optimized. In contrast to that Wolpert and Macready (1997) proved that all optimization techniques have the same behavior - on average over all f : X -> Y where X and Y are finite sets. This result is called No Free Lunch Theorem. Here different scenarios of optimization are presented. It is argued why the scena...
This paper argues that the strong member states of the European Currency Union are hostages of a financially distressed member state so that they are compelled to provide financial support. Moreover, due to the dynamics of the interaction game, a debt relief is a free lunch for the distressed country. This fosters moral hazard of distressed countries. In the absence of capital market control, European politics do not effectively monitor fiscal politics of member states. The lack of a long ter...
Florentsen, Bjarne; Møller, Michael; Nielsen, Niels Chr.
In many OECD countries, a seller has a right to reimbursement of VAT (RVAT) she has paid on goods sold, but for which she has not yet received payment. Such reimbursement of VAT on receivables is economically inefficient. It leads to:@* Distortion of credit markets, by subsidizing direct credit...... at the cost of financial intermediaries.@* Price discrimination, by subsidizing buyers with low creditworthiness.@* A less efficient collection of bad debts, as trade with bad debts is made extremely expensive.The finance literature presents several `good' arguments in favor of trade credits, e.g. transaction...
Luo, Jing; Avorn, Jerry; Kesselheim, Aaron S
Insulin is a vital medicine for patients with diabetes mellitus. Newer, more expensive insulin products and the lack of generic insulins in the United States have increased costs for patients and insurers. To examine Medicaid payment trends for insulin products. Cost information is available for all 50 states and has been recorded since the 1990s. A time-series analysis comparing reimbursements and prices. Using state- and national-level Medicaid data from 1991 to 2014, we identified all patients who used 1 or more of the 16 insulin products that were continuously available in the United States between 2006 and 2014. Insulin products were classified into rapid-acting and long-acting analogs, short-acting, intermediate, and premixed insulins based on American Diabetes Association Guidelines. Inflation-adjusted payments made to pharmacies by Medicaid per 1 mL (100 IU) of insulin in 2014 US dollars. Since 1991, Medicaid reimbursement per unit (1 mL) of insulin dispensed has risen steadily. In the 1990s, Medicaid reimbursed pharmacies between $2.36 and $4.43 per unit. By 2014, reimbursement for short-acting insulins increased to $9.64 per unit; intermediate, $9.22; premixed, $14.79; and long-acting, $19.78. Medicaid reimbursement for rapid-acting insulin analogs rose to $19.81 per unit. The rate of increase in reimbursement was higher for insulins with patent protection ($0.20 per quarter) than without ($0.05 per quarter) (Preimbursements peaked at $407.4 million dollars in quarter 2 of 2014. Total volume peaked at 29.9 million units in quarter 4 of 2005 and was 21.2 million units in quarter 2 of 2014. Between 1991 and 2014, there was a near-exponential upward trend in Medicaid payments on a per-unit basis for a wide variety of insulin products regardless of formulation, duration of action, and whether the product was patented. Although reimbursements for newer, patent-protected insulin analogs increased at a faster rate than reimbursements for older insulins, payments
Cohen, J; Holahan, J
One of the more controversial issues in reimbursement policy is how to set the capital cost component of facilities rates. In this article we examine in detail the various approaches used by states to reimburse nursing homes for capital costs. We conclude that newer approaches that recognize the increasing value of nursing home assets over time, commonly called fair rental systems, are preferable to the methodologies that have been used historically in both the Medicare and the Medicaid programs to set capital rates. When properly designed, fair rental systems should provide more rational incentives and less encouragement of property manipulation than do more traditional systems, with little or no increase in state costs.
Full Text Available AbstractObjective: This study evaluates the suitability of the food consumed by children in primary schools including the role of the lunch menus in satisfying the children’s needs. Methods: 852 first-grade students were chosen from 14 randomly selected primary schools in Gaziantep to participate in this descriptive, cross-sectional study. Demographic and personal data of the students and their parents, their anthropometric measurements, food consumption habits and the lunch menus served in schools were studied. The Body Mass Index (BMI of students was evaluated according to World Health Organization (WHO’s percentile tables. Data were analyzed by SPSS 18 software, using the chi-square test for analyses. The study was approved by the Ethics Committee. Results: 51.4% of students were male, 48.6% were female (mean age, 7.05±0.24 years. According to the BMI results, 26.6% of the students were thin and 25.9% were overweight/obese. 73.5% and 85.8% of the children were having breakfast or lunch regularly, respectively. Maternal education levels and employment status did not affect the child’s having breakfast on a daily basis (p>0.05. 27.7 % of children who ate lunch regularly, 15.7% of children who did not eat lunch regularly were overweight/obese (p<0.05. The most consumed food on a regular basis was bread (92.6 %, followed by milk and dairy products (76.5%. When lunch was served in schools (for 24.9% of the students, regular lunch consumption increased among children (p<0.05. The food group the most consumed by the students having lunch at school was fats-sugars-cereals. Only 43.3% of the lunch menus served at schools were found adequate. Conclusions: This study demonstrates that there is a need to improve lunch menus served in primary schools in order to satisfy energy and nutritional needs of children.Keywords: Nutrition, school health, primary school
Thomas, Nadine; Emond, Ruth
Dining out is most often associated with pleasure and gratification, principally since it presents opportunities for sociability. However, access to dining out experiences is influenced by multiple factors, including age. Little is known about the dining out habits of older people. In particular, the food practices of those living alone in the community is under-researched compared to those in hospital or residential care. This study explores the perceptions and preferences of ten older people towards domestic and communal meals in South East Scotland. Qualitative data were generated from 5-day food diaries and in-depth interviews with individuals who lived alone and attended a community-based senior citizen's lunch club. Data were coded and thematically analysed using a symbolic interactionist perspective. A number of key themes were identified, including the meaning of mealtimes. It was found that most participants ate the majority of their meals at home alone. Despite this, dining alone was not necessarily experienced as 'lonely'. Participants reported that dining out at the lunch club was a pleasurable experience given the social interaction and the separation of consumption from food work. Moreover, due to restricted mobility and limited access to transport, the lunch club was viewed by participants as one of the few places that they could go to dine out. Copyright © 2017. Published by Elsevier Ltd.
Krajewski, Jarek; Wieland, Rainer; Sauerland, Martin
The aim of the worksite study is to elucidate the strain reducing impact of different forms of spending lunch breaks. With the help of the so-called silent room cabin concept, it was possible to induce a lunch-break relaxation opportunity that provided visual and territorial privacy. To evaluate the proposed effects, 14 call center agents were assigned to either 20 min progressive muscle relaxation (PMR) or small-talk (ST) break groups. We analyzed the data in a controlled trial for a period of 6 months (every 2 months four measurements a day at 12:00, 13:00, 16:00, 20:00) using independent observer and self-report ratings of emotional, mental, motivational, and physical strain. Results indicated that only the PMR break reduced postlunchtime and afternoon strain. Although further intervention research is required, our results suggest that PMR lunch break may sustainable reduce strain states in real worksite settings. Copyright 2010 APA, all rights reserved.
Roberta de Oliveira Santos
Full Text Available Abstract Background The association of obesity and dietary patterns has been well documented in scientific literature; however, information on the impact of meal patterns on obesity is scarce. The objective of this study was to investigate the association of adherence to lunch patterns and body mass index (BMI in a representative sample of individuals aged 20 years or older in Sao Paulo. Methods Data for 933 participants were retrieved from the Health Survey of São Paulo (ISA-Capital 2008, a cross-sectional population-based survey. The usual dietary intake of individuals with at least one 24-h recall was estimated by the Multiple Source Method. The definition of lunch was self-reported by the participant. Five lunch patterns were derived from twenty-two food groups by exploratory factor analysis: Traditional, Western, Sweetened juice, Salad, and Meats. To estimate the effect of lunch patterns on BMI, we used a generalized linear model with link identity and inverse Gaussian distribution. Analyses were adjusted by age, gender, household income per capita, physical activity levels, smoking status, alcohol consumption, total energy intake, and misreporting status. Results The greater adherence to the traditional pattern at the lunch meal was associated with lower BMI, only in insufficiently active individuals (ß = −0.78; 95% CI -1.57; −0.02. Conclusions The traditional Brazilian lunch pattern might protect the insufficiently active individuals against obesity.
... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form) Activity Under OMB Review AGENCY: Veterans Health... Control No. 2900- NEW (Beneficiary Travel Mileage Reimbursement Application Form)'' in any correspondence...
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 428.307 Section 428.307 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement contracts. ...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 1028.307 Section 1028.307 Federal Acquisition Regulations System DEPARTMENT OF THE...-reimbursement contracts. ...
Larrier, Yvonne I.; Bakerson, Michelle A.; Linton, Jeremy M.; Walker, Lynne R.; Woolford, Susan J.
Childhood obesity is a significant public health concern. Since 1960, the prevalence of childhood obesity in the United States increased dramatically from 5% to 16.9%. To date many interventions to address obesity in schools have focused on healthy changes to the content of vending machines, school lunches, and the addition of after school…
Yáñez, A M; López, R; Serra-Batlles, J; Roger, N; Arnau, A; Roura, P
Smoking represents a public health problem, one which begins during adolescence. The main objective of this study was to analyze the association between smoking and parental and school factors. The study sample consisted of the students from the 20 secondary schools in the region of Osona, Barcelona, Spain. A self-report questionnaire was used to obtain information on the following variables: smoking habit, age of initiation, frequency, type of school (state school or private-subsidized), sex, age, persons living in the home, town, whether the student had lunch at school, whether the student often had lunch or dinner alone at home. A total of 2280 students participated in the study (91%). Mean age was 15.5 years. Of the participants, 20% said they were smokers; 5%, ex-smokers; 34% had tried smoking at least once, and 41% had never smoked. Factors significantly associated with smoking in the multivariate analysis were age, rural town, state school, single parent family, eating alone, and not lunching at school. Smoking prevalence is high among adolescents in our society and there is no gender difference. Our results show that family structure and dynamics can influence smoking in adolescents. Smoking is less prevalent among adolescents who have lunch at school.
In Uxbridge, Massachusetts, a small working-class mill town, free-market reform rhetoric has become reality. The tiny district has adopted controversial changes, such as giving vouchers to parents of Title I students, reimbursing home-schooling parents, lengthening the school day and year, adopting flexible scheduling, allowing credit for Internet…
National Center for Education Statistics, 2011
This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…
National Center for Education Statistics, 2011
This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…
National Center for Education Statistics, 2011
This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…
National Center for Education Statistics, 2011
Talsma, Elise F.; Borgonjen-van den Berg, Karin J.; Melse-Boonstra, Alida; Mayer, Eva V.; Verhoef, Hans; Demir, Ayşe Y.; Ferguson, Elaine L.; Kok, Frans J.; Brouwer, Inge D.
Objective: Introduction of biofortified cassava as school lunch can increase vitamin A intake, but may increase risk of other deficiencies due to poor nutrient profile of cassava. We assessed the potential effect of introducing a yellow cassava-based school lunch combined with additional food-based recommendations (FBR) on vitamin A and overall nutrient adequacy using Optifood (linear programming tool). Design: Cross-sectional study to assess dietary intakes (24 h recall) and derive model par...
Donnan, Caroline S.
Describes a program, developed in a small Vermont elementary school, that centered on world hunger and global awareness by involving students in helping stop food waste during lunch. Community members and businesses pledged money as an incentive for stopping waste, and the money raised went to UNICEF. (MD)
Jensen, Jørgen Dejgard; Thorsen, Anne Vibeke; Damsgaard, Camilla Trab
programme consisting of a morning snack and a hot lunch based on fixed seasonal menu plans and with 75 per cent organic content is 37 per cent more expensive in terms of ingredient costs than corresponding packed school meals. This cost differential can be almost halved by introducing more flexible...
Students need more than just "any" lunch or breakfast to do well in school--the "quality" of these meals counts also. Studies have demonstrated the role healthy diets can play in students' academic achievement. That's why President Obama signed into law the Healthy, Hunger-Free Kids Act in December 2010. This historic legislation provides free…
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement for revenue forgone in offering a... § 54.413 Reimbursement for revenue forgone in offering a Link Up program. (a) Eligible telecommunications carriers may receive universal service support reimbursement for the revenue they forgo in...
...-Cost-Reimbursement. 52.246-5 Section 52.246-5 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-5 Inspection of Services—Cost-Reimbursement. As prescribed in 46.305, insert... furnishing of services, when a cost-reimbursement contract is contemplated: Inspection of Services—Cost...
... DEPARTMENT OF ENERGY Reimbursement for Costs of Remedial Action at Active Uranium and Thorium... in FY 2011 from eligible active uranium and thorium processing site licensees for reimbursement under... approximately $24.3 million of Recovery Act funds available for reimbursement in FY 2011, as well as the $10...
... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement for clinical laboratory services... Criteria for Determining Reasonable Charges § 405.515 Reimbursement for clinical laboratory services billed... limitation on reimbursement for markups on clinical laboratory services billed by physicians. If a physician...
Van Boven, J.F.; Vemer, P.
Background: The discussion on the reimbursement of Smoking Cessation Treatment (SCT) has known many stages in The Netherlands. From January 2011, SCTs were reimbursed, until January 2012 when the reimbursement of nicotine replacement therapies (NRTs) and pharmacotherapeutic SCT (pSCT) was
... program reimbursement. 405.1803 Section 405.1803 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Provider Reimbursement Determinations and Appeals § 405.1803 Intermediary determination and notice of amount of program reimbursement. (a) General requirement. Upon receipt of a provider's cost report, or...
...-Reimbursement Contracts. 52.229-8 Section 52.229-8 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.229-8 Taxes—Foreign Cost-Reimbursement Contracts. As prescribed in 29.402-2(a), insert the following clause: Taxes—Foreign Cost-Reimbursement Contracts (MAR 1990) (a) Any tax or duty from which the...
... DEPARTMENT OF AGRICULTURE Farm Service Agency 7 CFR Part 755 RIN 0560-AI08 Reimbursement... Reimbursement Transportation Cost Payment (RTCP) Program for geographically disadvantaged farmers and ranchers.... To be eligible for reimbursement, the transportation costs must have been incurred in the FY for...
...-reimbursement). 2452.232-71 Section 2452.232-71 Federal Acquisition Regulations System DEPARTMENT OF HOUSING AND... Clauses 2452.232-71 Voucher submission (cost-reimbursement). As prescribed in 2432.908(c)(2), insert a clause substantially the same as the following in all cost-reimbursement solicitations and contracts...
... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Reimbursement for Bond... Provisions and Clauses 452.232-70 Reimbursement for Bond Premiums—Fixed-Price Construction Contracts. As prescribed in 432.111, insert the following clause: Reimbursement for Bond Premiums—Fixed-Price Construction...
... reimbursement determination. 149.610 Section 149.610 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES... of Data Inaccuracies § 149.610 Secretary's authority to reopen and revise a reimbursement determination. (a) The Secretary may reopen and revise a reimbursement determination upon the Secretary's own...
...-Reimbursement). 652.232-71 Section 652.232-71 Federal Acquisition Regulations System DEPARTMENT OF STATE CLAUSES... Voucher Submission (Cost-Reimbursement). As prescribed in 632.908(b), the contracting officer may insert a clause substantially the same as follows: Voucher Submission (Cost-Reimbursement) (AUG 1999) (a) General...
...-Cost-Reimbursement. 52.246-3 Section 52.246-3 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-3 Inspection of Supplies—Cost-Reimbursement. As prescribed in 46.303, insert... furnishing of supplies, when a cost-reimbursement contract is contemplated: Inspection of Supplies—Cost...
... insurance coverage-cost reimbursement. 1352.228-71 Section 1352.228-71 Federal Acquisition Regulations... Provisions and Clauses 1352.228-71 Deductibles under required insurance coverage—cost reimbursement. As... Coverage—Cost Reimbursement (APR 2010) (a) The contractor is required to present evidence of the amount of...
... Development-Cost-Reimbursement. 52.246-8 Section 52.246-8 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-8 Inspection of Research and Development—Cost-Reimbursement. As prescribed in... (b) a cost-reimbursement contract is contemplated; unless use of the clause is impractical and the...
... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Reimbursement for war... CLAUSES Text of Provisions And Clauses 252.228-7000 Reimbursement for war-hazard losses. As prescribed in 228.370(a), use the following clause: Reimbursement for War-Hazard Losses (DEC 1991) (a) Costs for...
... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Taxes-Cost-Reimbursement... Provisions and Clauses 52.229-9 Taxes—Cost-Reimbursement Contracts With Foreign Governments. As prescribed in 29.402-2(b), insert the following clause: Taxes—Cost-Reimbursement Contracts With Foreign Governments...
... costs eligible for reimbursement or credit. 219.7104 Section 219.7104 Federal Acquisition Regulations... reimbursement or credit. (a) Developmental assistance provided under an approved mentor-protege agreement is... eligible for reimbursement are set forth in appendix I. (b) Before incurring any costs under the Program...
...-reimbursement term contract. 1552.211-73 Section 1552.211-73 Federal Acquisition Regulations System... Provisions and Clauses 1552.211-73 Level of effort—cost-reimbursement term contract. As prescribed in 1511.011-73, insert the following contract clause in cost-reimbursement term contracts including cost...
....S.C. 2354-cost reimbursement. 252.235-7001 Section 252.235-7001 Federal Acquisition Regulations.... 2354—cost reimbursement. As prescribed in 235.070-3, use the following clause: Indemnification Under 10 U.S.C. 2354—Cost Reimbursement (DEC 1991) (a) This clause provides for indemnification under 10 U.S...
... installation support services (cost-reimbursement contracts). 5152.245-9001 Section 5152.245-9001 Federal... CONTRACT CLAUSES 5152.245-9001 Government property for installation support services (cost-reimbursement... Installation Support Services (Cost-Reimbursement Contracts) (OCT 1989) (DEV) (a) Government-furnished property...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for equipment... SEARCH AND RESCUE RESPONSE SYSTEM Response Cooperative Agreements § 208.37 Reimbursement for equipment and supply costs incurred during Activation. (a) Allowable costs. DHS will reimburse costs incurred...
..., Sequence 1] RIN 9000-AL78 Federal Acquisition Regulation; Proper Use and Management of Cost-Reimbursement... other than firm-fixed-price contracts (e.g., cost-reimbursement, time-and-material, and labor-hour...-reimbursement contracts and identifies the following three areas that the Defense Acquisition Regulation Council...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Reimbursement for other... Principles and Procedures 831.7001-7 Reimbursement for other supplies and services. VA will provide reimbursement for other services and assistance that may be authorized under provisions of applicable Chapter 31...
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Reimbursement procedures where the subscriber... Preferred Telecommunications Service Providers § 64.1170 Reimbursement procedures where the subscriber has... reimburse the authorized carrier for reasonable expenses. (e) If the authorized carrier has not received...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement....603-5 Cost-reimbursement contracts—partial termination. [Insert the following in Block 14 of SF 30, Amendment of Solicitation/Modification of Contract, for settlement agreements for cost-reimbursement...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Foreign cost-reimbursement... GENERAL CONTRACTING REQUIREMENTS TAXES Contract Clauses 29.402-2 Foreign cost-reimbursement contracts. (a) The contracting officer shall insert the clause at 52.229-8, Taxes—Foreign Cost-Reimbursement...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement... ACQUISITION REGULATION CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 46.308 Cost-reimbursement... of Research and Development—Cost-Reimbursement, in solicitations and contracts for research and...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Insurance under cost-reimbursement contracts. 28.307 Section 28.307 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement contracts. Cost-reimbursement contracts (and subcontracts, if the terms of the prime contract are...
... reimbursement. 599.303 Section 599.303 Transportation Other Regulations Relating to Transportation (Continued... PROCEDURES FOR CONSUMER ASSISTANCE TO RECYCLE AND SAVE ACT PROGRAM Qualifying Transactions and Reimbursement § 599.303 Agency disposition of dealer application for reimbursement. (a) Application review. Upon...
... specifically excludes: (i) Payment (by reimbursement to an official or direct credit union payment to a third... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Reimbursement, insurance, and indemnification... Reimbursement, insurance, and indemnification of officials and employees. (a) Official. An official is a person...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Acceptance of reimbursement from a client. 1609.5... CORPORATION FEE-GENERATING CASES § 1609.5 Acceptance of reimbursement from a client. (a) When a case results in recovery of damages or statutory benefits, a recipient may accept reimbursement from the client...
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS reimburse me for my expenses related... Conducted Under SAPs, COPs and GAPs Inspections and Assessments § 285.823 Will MMS reimburse me for my expenses related to inspections? Upon request, MMS will reimburse you for food, quarters, and...
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Will MMS reimburse me for my expenses related... Inspection of Operations § 250.133 Will MMS reimburse me for my expenses related to inspections? Upon request, MMS will reimburse you for food, quarters, and transportation that you provide for MMS representatives...
... (Request for Transportation Expense Reimbursement) Activity; Comment Request AGENCY: Veterans Benefits... needed to determine children with spina bifida eligibility for reimbursement of transportation expenses...: Request for Transportation Expense Reimbursement (38 CFR 21.8370). OMB Control Number: 2900-0580. Type of...
M. Drummond (Michael); B. Jönsson (Bengt); F.F.H. Rutten (Frans); T. Stargardt (Tom)
textabstractReference pricing and health technology assessment are policies commonly applied in order to obtain more value for money from pharmaceuticals. This study focussed on decisions about the initial price and reimbursement status of innovative drugs and discussed the consequences for market
...-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.1-Establishment, Modification, and Discontinuance of Interagency Fleet... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reimbursement. 101-39.104-2 Section 101-39.104-2 Public Contracts and Property Management Federal Property Management...
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reimbursement for services. 101-26.506-5 Section 101-26.506-5 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT...
... 7 Agriculture 15 2010-01-01 2010-01-01 false Request for advance or reimbursement. 3015.84 Section 3015.84 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Financial Reporting...
... sufficient to recover applicable costs. Failure by using agencies to reimburse GSA for vehicle services will... or neglect. (e) Agencies may be charged for recovery of expenses for repairs or services to GSA IFMS... services. 101-39.207 Section 101-39.207 Public Contracts and Property Management Federal Property...
... § 208.41 of this part. (4) Food and beverages for Task Force Members and Support Specialists when DHS does not provide meals during the Alert. DHS will limit food and beverage reimbursement to the amount... where such food and beverages were provided, multiplied by the number of personnel who received them. (b...
Boon, W.P.C.; Martins, Luis; Koopmanschap, Marc
When entering the market, orphan drugs are associated with substantial prices and a high degree of uncertainty regarding safety and effectiveness. This makes decision making about the reimbursement of these drugs a complex exercise. To advance on this, the Dutch government introduced a conditional
... STATES CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, AS AMENDED Reimbursement of...' Compensation to the disallowance or reduction of a claim within 60 days of the Office's decision. A carrier outside the United States has six months within which to file objections with the Associate Director. The...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Reimbursement Rates for Calendar Year 2012 AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: Notice is given that the Director of Indian Health Service (IHS), under the authority of sections 321(a) and 322(b) of the Public...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Reimbursement Rates for Calendar Year 2010 AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: Notice is given that the Director of Indian Health Service (IHS), under the authority of sections 321(a) and 322(b) of the Public...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Reimbursement Rates for Calendar Year 2012 Correction AGENCY: Indian Health Service, HHS. ACTION: Notice; correction. SUMMARY: The Indian Health Service published a document in the Federal Register on June 6, 2012, concerning rates for...
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Reimbursement Rates for Calendar Year 2011 AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: Notice is given that the Director of Indian Health Service (IHS), under the authority of sections 321(a) and 322(b) of the Public...
Clawson, Robb E; Davis, Stephanie Y; Miller, Richard B; Webster, Tabitha N
A case is made for why it may now be in the best interest of insurance companies to reimburse for marital therapy to treat marital distress. Relevant literature is reviewed with a considerable focus on the reasons that insurance companies would benefit from reimbursing marital therapy - the high costs of marital distress, the growing link between marital distress and a host of related physical and mental health problems, as well as the availability of empirically supported treatments for marital distress. This is followed by a focus on the major reasons insurance companies cite for not reimbursing marital therapy, along with a discussion of advances in several growing bodies of research to address these concerns. Main arguments include the direct medical offset costs of couple and family therapy (including for high utilizers of health insurance), and the fact that insurance companies already find it cost effective to reimburse for prevention of other health and psychological problems. This is followed by implications for practitioners and researchers. © 2017 American Association for Marriage and Family Therapy.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Reimbursement Rates for Calendar Year 2013 AGENCY: Indian Health Service, HHS. ACTION: Notice. SUMMARY: Notice is given that the Director of the Indian Health Service (IHS), under the authority of sections 321(a) and 322(b) of the...
... and profit-making organizations. (6) That there should be a recognition of the need of hospitals and... fide efforts at collection). (7) Charity and courtesy allowances are not includable, although “fringe... residents in the care of individual patients) furnished in a teaching hospital may be reimbursed as a...
..., Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: Background To be... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2011-0104] RIN 0960-AH45 Electronic Interim Assistance Reimbursement Program AGENCY: Social Security Administration. ACTION: Notice of...
... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Computation of amount of reimbursement. 362.12 Section 362.12 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND... the cost of repair is the amount payable. (b) Depreciation in value of an item of personal property is...
... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit, or other means... acceptable to the authorized officer, by bond, guaranty, cash, certificate of deposit or other means... shall reimburse the United States for costs incurred by the United States in monitoring the construction...
....74 Payment or reimbursement. (a) Within thirty days after any adjustment of a noncompliance penalty... timely payment of a deficiency shall pay a nonpayment penalty. The nonpayment penalty shall be calculated as of the due date of the deficiency payment and shall be equal to 20% of the deficiency not paid...
Centers for Disease Control and Prevention, 2014
The Child Nutrition and WIC Reauthorization Act of 2004 and, more recently, the Healthy, Hunger-Free Kids Act of 2010 required all school districts participating in the federal Child Nutrition Programs (e.g., National School Lunch Program, School Breakfast Program, Special Milk Program, Afterschool Snack Program) to adopt and implement a local…
Bevans, Katherine B.; Sanchez, Betty; Teneralli, Rachel; Forrest, Christopher B.
Background: To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch…
Caine-Bish, Natalie L.; Scheule, Barbara
Background: Schools have the opportunity, through the National School Lunch Program and Local School Wellness Policies, to have a significant impact on healthy eating behaviors. An understanding of children's and adolescents' food preferences in relation to gender and age will facilitate the successful creation of both healthy and financially…
Li, Ji; Hooker, Neal H.
Background: The international prevalence of childhood obesity and obesity-related diseases has received increasing attention. Applying data from the Centers for Disease Control and Prevention, we explore relationships between childhood obesity and school type, National School Lunch Program (NSLP) and School Breakfast Program (SBP) eligibility,…
Nolte, M. Chester
A 1983 federal appeals court decision says the Secretary of Agriculture cannot establish time and place restrictions on the sale of snack items in schools. If snack items are to be banned from schools, the School Lunch Act must be reworded. (MD)
Leone, Claudio; And Others
Clinically examined and interviewed 847 elementary students (ages six to 19 years) to determine their nutritional status and acceptance of school food. Findings indicated high prevalence of protein energy malnutrition and high rates of students coming to school with no food, nonacceptance of the school lunch, and strong preference for salty food.…
Landry, Alicia S.; Lingsch, Kelsey J.; Weiss, Caitlin; Connell, Carol L.; Yadrick, Kathleen
The purpose of this study was to evaluate child nutrition directors' (CNDs) Farm to School (F2S) Week participation. This cross-sectional, census survey was completed by CNDs working in Mississippi public school districts participating in the National School Lunch Program. Descriptive statistics were used to summarize demographic data and the…
Hanks, Andrew S; Just, David R; Wansink, Brian
New US Department of Agriculture regulations have altered what foods schools offer for lunch, but schools cannot require students to eat specific foods. An intervention using the behavioral science principle known as "libertarian paternalism" led junior-senior high school students to eat more fruits and vegetables by making these foods more convenient, attractive, and normative. Copyright © 2013 Mosby, Inc. All rights reserved.
Bessette, Russell W; Carter, Randy L
Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Chronic kidney disease (CKD) typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS) based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR), and CKD stage over time to average monthly reimbursement. We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average monthly values of phosphorus, parathyroid hormone, glucose, hemoglobin, bicarbonate, albumin, creatinine, blood urea nitrogen, potassium, calcium, sodium, alkaline phosphatase, alanine aminotransferase, and white blood cells. The results of our study demonstrated that the association
Mincarone, Pierpaolo; Leo, Carlo Giacomo; Sabina, Saverio; Sarriá-Santamera, Antonio; Taruscio, Domenica; Serrano-Aguilar, Pedro Guillermo; Kanavos, Panos
The pricing and reimbursement policies for pharmaceuticals are relevant to balance timely and equitable access for all patients, financial sustainability, and reward for valuable innovation. The proliferation of high-cost specialty medicines is particularly true in rare diseases (RDs) where the pricing mechanism is characterised by a lack of transparency. This work provides an overall picture of current strategies for the definition of the reimbursed prices of orphan drugs (ODs) and highlights some potential improvements. Current strategies and suggestions are presented along 4 dimensions: (1) comprehensive value assessment, (2) early dialogs among relevant stakeholders, (3) innovative reimbursement approaches, and (4) societal participation in producing ODs. Comprehensive value assessment could be achieved by clarifying the approach of distributive justice to adopt, ensuring a representative participation of stakeholders, and with a broad consideration of value-bearing factors. With respect to early dialogs, cross-border cooperation can be determinant to companies and agencies. The cost-benefit ratio of early dialogs needs to be demonstrated and the "regulatory capture" effect should be monitored. Innovative reimbursement approaches were developed to balance the need for evidence-based decisions with the timely access to innovative drugs. The societal participation in producing ODs needs to be recognised in a collaborating framework where adaptive agreements can be developed with mutual satisfaction. Such agreements could also impact on coverage and reimbursement decisions as additional elements for the determination of a comprehensive societal value of ODs. Further research is needed to investigate the highlighted open challenges so that RDs will not remain, in practical terms, orphan diseases. © 2017 S. Karger AG, Basel.
Reid, A W N; Szpalski, C; Sheppard, N N; Morrison, C M; Blondeel, P N
The deep inferior epigastric artery perforator (DIEAP) flap is currently considered the gold standard for autologous breast reconstruction. With the current economic climate and health cutbacks, we decided to survey reimbursement for DIEAP flaps performed at the main international centres in order to assess whether they are funded consistently. Data were collected confidentially from the main international centres by an anonymous questionnaire. Our results illustrate the wide disparity in international DIEAP flap breast reconstruction reimbursement: a unilateral DIEAP flap performed in New York, USA, attracts €20,759, whereas the same operation in Madrid, Spain, will only be reimbursed for €300. Only 35.7% of the surgeons can set up their own fee. Moreover, 85.7% of the participants estimated that the current fees are insufficient, and most of them feel that we are evolving towards an even lower reimbursement rate. In 55.8% of the countries represented, there is no DIEAP-specific coding; in comparison, 74.4% of the represented countries have a specific coding for transverse rectus abdominis (TRAM) flaps. Finally, despite the fact that DIEAP flaps have become the gold standard for breast reconstruction, they comprise only a small percentage of all the total number of breast reconstruction procedures performed (7-15%), with the only exception being Belgium (40%). Our results demonstrate that DIEAP flap breast reconstruction is inconsistently funded. Unfortunately though, it appears that the current reimbursement offered by many countries may dissuade institutions and surgeons from offering this procedure. However, substantial evidence exists supporting the cost-effectiveness of perforator flaps for breast reconstruction, and, in our opinion, the long-term clinical benefits for our patients are so important that this investment of time and money is absolutely essential. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons
Ansaripour, Amir; Uyl-de Groot, Carin A; Steenhoek, Adri; Redekop, William K
Previous studies of health policies in Iran have not focused exclusively on the drug reimbursement process. The aim of this study was to describe the entire drug reimbursement process and the stakeholders, and discuss issues faced by policymakers. Review of documents describing the administrative rules and directives of stakeholders, supplemented by published statistics and interviews with experts and policymakers. Iran has a systematic process for the assessment, appraisal, and judgment of drug reimbursements. The two most important organizations in this process are the Food and Drug Organization, which considers clinical effectiveness, safety, and economic issues, and the Supreme Council of Health Insurance, which considers various criteria, including budget impact and cost-effectiveness. Ultimately, the Iranian Cabinet approves a drug and recommends its use to all health insurance organizations. Reimbursed drugs account for about 53.5% of all available drugs and 77.3% of drug expenditures. Despite its strengths, the system faces various issues, including conflicting stakeholder aims, lengthy decision-making duration, limited access to decision-making details, and rigidity in the assessment process. The Iranian drug reimbursement system uses decision-making criteria and a structured approach similar to those in other countries. Important shortcomings in the system include out-of-pocket contributions due to lengthy decision making, lack of transparency, and conflicting interests among stakeholders. Iranian policymakers should consider a number of ways to remedy these problems, such as case studies of individual drugs and closer examination of experiences in other countries. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Hicks, Bonnie; Montequin, Leah; Hicks, Jason
Forms part of a themed issue describing "Parent-Kid-Teacher Investigators," a program in which parents, children, and teachers gather regularly to use language and literacy for action research projects. Offers a portrait of the weekly meetings. Summarizes what three particular groups learned about their topics: the underground railroad;…
... week. NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, do hereby proclaim... Independence of the United States of America the two hundred and thirty-fourth.BARACK OBAMA ...
... that the rule does a good job implementing statutory requirements and provides a sensible approach to... some States, under pressure to meet the benchmarks, may purposely relax their matching criteria in... a State uses district- or local-level matching, it might choose to use this same method for its non...
How accurate are parental responses concerning their fourth-grade children's school-meal participation, and what is the relationship between children's body mass index and school-meal participation based on parental responses?
Paxton-Aiken Amy E
Full Text Available Abstract Background This article investigated (1 parental response accuracy of fourth-grade children's school-meal participation and whether accuracy differed by children's body mass index (BMI, sex, and race, and (2 the relationship between BMI and school-meal participation (based on parental responses. Methods Data were from four cross-sectional studies conducted from fall 1999 to spring 2003 with fourth-grade children from 13 schools total. Consent forms asked parents to report children's usual school-meal participation. As two studies' consent forms did not ask about lunch participation, complete data were available for breakfast on 1,496 children (51% Black; 49% boys and for lunch on 785 children (46% Black; 48% boys. Researchers compiled nametag records (during meal observations of meal participation on randomly selected days during children's fourth-grade school year for breakfast (average nametag days across studies: 7-35 and for lunch (average nametag days across studies: 4-10 and categorized participation as "usually" (≥ 50% of days or "not usually" ( Results Concerning breakfast participation and lunch participation, 74% and 92% of parents provided accurate responses, respectively. Parental response accuracy was better for older children for breakfast and lunch participation, and for Black than White children for lunch participation. Usual school-meal participation was significantly related to children's BMI but in opposite directions -- positively for breakfast and inversely for lunch. Conclusions Parental response accuracy of children's school-meal participation was moderately high; however, disparate effects for children's age and race warrant caution when relying on parental responses. The BMI results, which showed a relationship between school-meal participation (based on parental responses and childhood obesity, conflict with results from a recent article that used data from the same four studies and found no significant
Verger, Pierre; Rolland, Sophie; Paraponaris, Alain; Bouvenot, Julien; Ventelou, Bruno
This study sought to identify the effect of drug reimbursability--a decision made in France by the National Authority for Health--on physicians' prescribing practices for a diet drug such as rimonabant, approved for obese or overweight patients with type-2 diabetes. A cross-sectional survey of French general practitioners (GPs) presented a case-vignette about a patient for whom this drug is indicated in two alternative versions, differing only in its reimbursability, to two separate randomized subsamples of GPs in early 2007, before any decision was made about reimbursement. The results indicate that (i) more than 20% of GPs in private practice would be willing to prescribe a non-reimbursed diet drug for patients with obesity complicated by type 2 diabetes; (ii) the number of GPs willing to prescribe it would increase by 47.6% if the drug were reimbursed, and (iii) such a drug would be adopted at a higher rate by GPs who have regular contacts with pharmaceutical sales representatives. In France, unlike most other countries, drug reimbursement status is a signal of quality. However, our results suggest that a significant proportion of GPs would spontaneously adopt anti-obesity drugs even if they were not reimbursed. Decisions about reimbursement of pharmaceutical products should be made taking into account that reimbursement is likely to intensify prescription.
This study assessed associations between selective school-level factors and students' consumption of fruits and vegetables at school. Better understanding of school factors associated with increased produce consumption is especially important, as students are served more produce items at school. This cross-sectional study included 5439 seventh- and ninth-grade students from 31 schools in California in 2010. Multilevel regression models estimated whether the odds of consuming fruits or vegetables at school among students eating the school lunch were associated with the length of the lunch period, quality/variety of produce options, or other factors. A longer lunch period was associated with increased odds of a student eating fruits (odds ratio [OR] = 1.40) and vegetables (OR = 1.54) at school. Better fruit quality increased the odds of a student consuming fruit (OR = 1.44). Including a salad bar and involving students in food service decisions increased a student's odds of consuming vegetables (OR = 1.48 and OR = 1.34, respectively). This study suggests that institutional factors in schools are positively associated with middle and high school students' consumption of produce items at school. Additional efforts to structure school meal environments to enhance students' consumption of produce items can benefit students' nutrition and health. © 2014, American School Health Association.
Afsar, Baris; Elsurer, Rengin; Kanbay, Mehmet
To evaluate the relationship between eating pattern (regular breakfast, lunch and dinner) and dialysis sessions, laboratory and sociodemographic characteristics in hemodialysis (HD) patients. In this cross-sectional study eating patterns, sociodemographic, laboratory and clinical parameters, depressive symptoms, quality of life, cognitive function and appetite status were assessed. Eighty-two HD patients on morning session and 60 patients on midday HD session schedules were included. Ten patients had only breakfast, 17 patients had only lunch, 26 patients had only dinner, 5 patients had breakfast and lunch but not dinner, 28 patients had breakfast and dinner but not lunch, 29 patients had lunch and dinner but not breakfast, and 19 patients had neither breakfast, nor lunch, nor dinner. In the whole group, only 8 patients reported that they had regularly eaten breakfast, lunch or dinner in all days of the week. Midday HD session, better appetite, and higher income were independently associated with having breakfast. Morning HD session, better appetite score, and higher income were independently associated with having lunch. Morning session versus midday session, nPNA, presence of hypertension, and the Mental Component Summary Score of SF-36 were independently associated with having dinner. The majority of HD patients eat one or two meals per day. Having breakfast (or lunch) is associated with midday dialysis session (or morning dialysis session, respectively), better appetite, and satisfactory income. Eating dinner was associated with morning dialysis session, hypertension, higher protein intake and higher SF-36 mental component summary score.
... reimbursement ceilings). Title X requires DOE to reimburse eligible uranium and thorium licensees for certain... DEPARTMENT OF ENERGY Update on Reimbursement for Costs of Remedial Action at Active Uranium and... not currently available for reimbursement for cleanup work performed by licensees at eligible uranium...
Biltoft-Jensen, A; Holmgaard Nielsen, T; Hess Ygil, K; Christensen, T; Fagt, S
Visual aids, such as food photographs, are widely used in estimating food quantities in dietary surveys. The present study aimed to assess how accurately Danish adults and children can estimate food portion sizes using 37 series of photographs illustrating four to six different portion sizes under real-life conditions; determine whether adults were more accurate than children; and estimate the error caused by using portion size photographs to estimate weights of foods consumed in macronutrient calculation. Six hundred and twenty-two adults and 109 children were recruited in three workplace canteens and in two schools, respectively, to estimate their lunchtime portions based on photographs. Participants were instructed to keep the foods separated on their plate when taking lunch. Participants thereafter estimated their own portions by looking at the relevant series of photographs. The actual food portions were then weighed. The proportion of correct estimations was 42% overall (range 19-77%). The mean difference (%) between estimated and actual weight was 17% (range 1-111%). Small portion size photographs were more often used correctly compared to larger portion photographs. Children had as many correct estimations as adults, although they overestimated portions more. Participants using fractions of (or more than) one photograph to estimate the portion of a food had significantly larger errors. When calculating the macronutrient content of a weekly menu using the estimated portion sizes, protein had the largest error (29%). When used in a real-life situation, the portion size photographs validated in the present study showed a certain inaccuracy compared to the actual weights. © 2017 The British Dietetic Association Ltd.
Dixon, Shauna G.; Eusebio, Eleazar C.; Turton, William J.; Wright, Peter W. D.; Hale, James B.
The 2009 "Forest Grove School District v. T.A." United States Supreme Court case could have significant implications for school psychology practice. The Court ruled that the parents of a student with a disability were entitled to private school tuition reimbursement even though T.A. had not been identified with a disability or previously…
Adams, E. Kathleen; Schlenker, Robert E.
Nursing home reimbursement based on case mix is a matter of growing interest. Several States either use or are considering this reimbursement method. In this article, we present a method for evaluating key outcomes of such a change for Connecticut nursing homes. A simulation model is used to replicate payments under the case-mix systems used in Maryland, Ohio, and West Virginia. The findings indicate that, compared with the system presently used in Connecticut, these systems would better relate dollar payments to measure patient need, and for-profit homes would benefit relative to nonprofit homes. The Ohio methodology would impose the most additional costs, the West Virginia system would actually be somewhat less expensive in terms of direct patient care payments. PMID:10311776
Full Text Available Russell W Bessette1, Randy L Carter2,3 1Department of Health Sciences, Institute for Healthcare Informatics, 2Department of Biostatistics, 3Population Health Observatory, University at Buffalo, State University of New York, Buffalo, NY, USA Background: Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Objectives: Chronic kidney disease (CKD typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR, and CKD stage over time to average monthly reimbursement. Methods: We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average
Adams, E K; Schlenker, R E
Nursing home reimbursement based on case mix is a matter of growing interest. Several States either use or are considering this reimbursement method. In this article, we present a method for evaluating key outcomes of such a change for Connecticut nursing homes. A simulation model is used to replicate payments under the case-mix systems used in Maryland, Ohio, and West Virginia. The findings indicate that, compared with the system presently used in Connecticut, these systems would better relate dollar payments to measure patient need, and for-profit homes would benefit relative to nonprofit homes. The Ohio methodology would impose the most additional costs, the West Virginia system would actually be somewhat less expensive in terms of direct patient care payments.
Prokop, Jessica L.; Galon, Patricia
Implementation of the Healthy Hunger-Free Kids Act of 2010 will provide an opportunity for school nurses to intervene in the serious childhood obesity problem in the United States. Major changes in the management of the National School Lunch Program (NSLP) will likely challenge schools yet may provide the impetus for a collaborative effort by the…
Newhouse, Joseph Paul; Berndt, Ernst R.
In this survey chapter on pricing and reimbursement in U.S. pharmaceutical markets, we first provide background information on important federal legislation, institutional details regarding distribution channel logistics, definitions of alternative price measures, related historical developments, and reasons why price discrimination is highly prevalent among branded pharmaceuticals. We then present a theoretical framework for the pricing of branded pharmaceuticals, without and then in the pre...
The first step to a successful reimbursement strategy is to ensure that your wound care product has the most appropriate Healthcare Common Procedure Coding System (HCPCS) code (or billing) for your product. The correct HCPCS code plays an essential role in patient access to new and existing technologies. When devising a strategy to obtain a HCPCS code for its product, companies must consider a number of factors as follows: (1) Has the product gone through the Food and Drug Administration (FDA) regulatory process or does it need to do so? Will the FDA code designation impact which HCPCS code will be assigned to your product? (2) In what "site of service" do you intend to market your product? Where will your customers use the product? Which coding system (CPT ® or HCPCS) applies to your product? (3) Does a HCPCS code for a similar product already exist? Does your product fit under the existing HCPCS code? (4) Does your product need a new HCPCS code? What is the linkage, if any, between coding, payment, and coverage for the product? Researchers and companies need to start early and place the same emphasis on a reimbursement strategy as it does on a regulatory strategy. Your reimbursement strategy staff should be involved early in the process, preferably during product research and development and clinical trial discussions.
Wright, Shana; McNeely, Jennifer; Rotrosen, John; Winitzer, Rebecca F.; Pollack, Harold; Abel, Stephen; Metsch, Lisa
Introduction: Screening and delivery of evidence-based interventions by dentists is an effective way to reduce tobacco use. However, dental visits remain an underutilized opportunity for the treatment of tobacco dependence. This is, in part, because the current reimbursement structure does not support expansion of dental providers’ role in this arena. The purpose of this study was to interview dental insurers to assess attitudes toward tobacco use treatment in dental practice, pros and cons of offering dental provider reimbursement, and barriers to instituting a tobacco use treatment-related payment policy for dental providers. Methods: Semi-structured interviews were conducted with 11 dental insurance company executives. Participants were identified using a targeted sampling method and represented viewpoints from a significant share of companies within the dental insurance industry. Results: All insurers believed that screening and intervention for tobacco use was an appropriate part of routine care during a dental visit. Several indicated a need for more evidence of clinical and cost-effectiveness before reimbursement for these services could be actualized. Lack of purchaser demand, questionable returns on investment, and segregation of the medical and dental insurance markets were cited as additional barriers to coverage. Conclusions: Dissemination of findings on efficacy and additional research on financial returns could help to promote uptake of coverage by insurers. Wider issues of integration between dental and medical care and payment systems must be addressed in order to expand opportunities for preventive services in dental care settings. PMID:22387994
Frid, Anders H; Nilsson, Mikael; Holst, Jens Juul; Björck, Inger M E
Whey proteins have insulinotropic effects and reduce the postprandial glycemia in healthy subjects. The mechanism is not known, but insulinogenic amino acids and the incretin hormones seem to be involved. The aim was to evaluate whether supplementation of meals with a high glycemic index (GI) with whey proteins may increase insulin secretion and improve blood glucose control in type 2 diabetic subjects. Fourteen diet-treated subjects with type 2 diabetes were served a high-GI breakfast (white bread) and subsequent high-GI lunch (mashed potatoes with meatballs). The breakfast and lunch meals were supplemented with whey on one day; whey was exchanged for lean ham and lactose on another day. Venous blood samples were drawn before and during 4 h after breakfast and 3 h after lunch for the measurement of blood glucose, serum insulin, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide 1 (GLP-1). The insulin responses were higher after both breakfast (31%) and lunch (57%) when whey was included in the meal than when whey was not included. After lunch, the blood glucose response was significantly reduced [-21%; 120 min area under the curve (AUC)] after whey ingestion. Postprandial GIP responses were higher after whey ingestion, whereas no differences were found in GLP-1 between the reference and test meals. It can be concluded that the addition of whey to meals with rapidly digested and absorbed carbohydrates stimulates insulin release and reduces postprandial blood glucose excursion after a lunch meal consisting of mashed potatoes and meatballs in type 2 diabetic subjects.
Full Text Available The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR, during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST group during a period of seven months. Participants’ levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements and self-reports administered five times per day, once per month (490 measurements. Results indicate that, in comparison to ST, the PMR break (a induces immediate, intermediate, and anticipatory reductions in sleepiness; (b these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness.
Vasiliu, Oana E; Stover, Jeffrey A; Mays, Marissa J E; Bissette, Jennifer M; Dolan, Carrie B; Sirbu, Corina M
We investigated the effect of providing mailing cost reimbursements to local health departments on the timeliness of the reporting of sexually transmitted diseases (STDs) in Virginia. The Division of Disease Prevention, Virginia Department of Health, provided mailing cost reimbursements to 31 Virginia health districts from October 2002 to December 2004. The difference (in days) between the diagnosis date (or date the STD paperwork was initiated) and the date the case/STD report was entered into the STD surveillance database was used in a negative binomial regression model against time (as divided into three periods-before, during, and after reimbursement) to estimate the effect of providing mailing cost reimbursements on reporting timeliness. We observed significant decreases in the number of days between diagnosis and reporting of a case, which were sustained after the reimbursement period ended, in 25 of the 31 health districts included in the analysis. We observed a significant initial decrease (during the reimbursement period) followed by a significant increase in the after-reimbursement phase in one health district. Two health districts had a significant initial decrease, while one health district had a significant decrease in reporting timeliness in the period after reimbursement. Two health districts showed no significant changes in the number of days to report to the central office. Providing reimbursements for mailing costs was statistically associated with improved STD reporting timeliness in almost all of Virginia's health districts. Sustained improvement after the reimbursement period ended is likely indicative of improved local health department reporting habits.
Jones, Christine D.; Scott, Serena J.; Anoff, Debra L.; Pierce, Read G.; Glasheen, Jeffrey J.
Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion. PMID:26310500
Han, Everett; Baisiwala, Shivani; Jain, Atul; Bundorf, M Kate; Pershing, Suzann
To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. Retrospective, cross-sectional study. A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement. Published by Elsevier Inc.
Aherrera, Andrew S; Pandya, Sonal N
The overall number of patients undergoing body contouring procedures after massive weight loss (MWL) has progressively increased over the past decade. The purpose of this study was to evaluate the charges and reimbursements for panniculectomy after MWL at a large academic institution in Massachusetts. A retrospective review was performed and included all identifiable panniculectomy procedures performed at our institution between January 2008 and January 2014. The annual number of patients undergoing panniculectomy, the type of insurance coverage and reimbursement method of each patient, and the amounts billed and reimbursed were evaluated. During our study period, 114 patients underwent a medically necessary panniculectomy as a result of MWL. The average surgeon fee billed was $3496 ± $704 and the average amount reimbursed was $1271 ± $589. Ten cases (8.8%) had no reimbursements, 31 cases (21.8%) reimbursed less than $1000, 66 cases (57.9%) reimbursed between $1000 and $2000, and no cases reimbursed the full amount billed. When evaluated by type of insurance coverage, collection ratios were 37.4% ± 17.4% overall, 41.7% ± 16.4% for private insurance, and 24.0% ± 13.0% for Medicare/Medicaid insurance (P Reimbursements for panniculectomy are remarkably low, and in many instances, absent, despite obtaining previous preauthorization of medical necessity. Although panniculectomy is associated with improvements in quality of life and high levels of patient satisfaction, poor physician reimbursement for this labor intensive procedure may preclude access to appropriate care required by the MWL patient population.
V.R. Kuchma; Zh.Yu. Gorelova
The experience of organizing school nutrition in Europe and usais analyzed. It is noted that long term programs aimed at optimizing schoolchildren nutrition have a beneficial effect on the children's health, culture of their nutrition and quality of life. The importance of carrying out similar programs in Russia is beyond any doubt: according to population research, the basic principles of good nutrition are often not observed, and school breakfasts and lunches do not correspond to the age ph...
Full Text Available One of the most contentious urban education policy issues in the United States today is the expansion of charter schools and its repercussions. Does the expansion of charter schools affect the racial and socioeconomic composition of traditional public schools in the United States? This study provides empirical evidence on this question by relying on a panel design that uses school-level data from two states that have experimented with charter schools for more than 15 years: Ohio and Texas. Using county-level, spatial, and enrollment-based measures of charter exposure, the changes from pre- to post-charter-legislation stages in the student compositions of public schools that do and do not face competition from charters are examined. The results suggest that charter school presence contributes to aggregate-level changes in the share of non-Hispanic White and free-lunch-eligible students in traditional public schools in both states in different ways.
Andersen, Rikke; Biltoft-Jensen, Anja Pia; Christensen, Tue
The OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (NND)) School Meal Study investigated the effects on the intake of foods and nutrients of introducing school meals based on the principles of the NND covering lunch and all snacks during...
Samuels, Christina A.
With food and fuel prices increasing sharply, food and nutrition directors in school districts around the country are finding themselves facing some uncomfortable choices. In some districts, school lunch menus are being pared down to fewer selections, instead of the array of healthy options districts would like to offer. In other areas, canned and…
Lim, Carol Sunghye; Lee, Yun-Gyoo; Koh, Youngil; Heo, Dae Seog
Reimbursement policies for anti-cancer drugs vary among countries even though they rely on the same clinical evidence. We compared the pattern of publicly funded drug programs and analyzed major factors influencing the differences. We investigated reimbursement policies for 19 indications with targeted anti-cancer drugs that are used variably across ten countries. The available incremental cost-effectiveness ratio (ICER) data were retrieved for each indication. Based on the comparison between actual reimbursement decisions and the ICERs, we formulated a reimbursement adequacy index (RAI): calculating the proportion of cost-effective decisions, either reimbursement of cost-effective indications or non-reimbursement of cost-ineffective indications, out of the total number of indications for each country. The relationship between RAI and other indices were analyzed, including governmental dependency on health technology assessment, as well as other parameters for health expenditure. All the data used in this study were gathered from sources publicly available online. Japan and France were the most likely to reimburse indications (16/19), whereas Sweden and the United Kingdom were the least likely to reimburse them (5/19 and 6/19, respectively). Indications with high cost-effectiveness values were more likely to be reimbursed (ρ = -0.68, P = 0.001). The three countries with high RAI scores each had a healthcare system that was financed by general taxation. Although reimbursement policies for anti-cancer drugs vary among countries, we found a strong correlation of reimbursements for those indications with lower ICERs. Countries with healthcare systems financed by general taxation demonstrated greater cost-effectiveness as evidenced by reimbursement decisions of anti-cancer drugs.
Kinney, E D; Lefkowitz, B
Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.
Anttalainen, Ulla; Polo, Olli; Vahlberg, Tero; Saaresranta, Tarja
Co-morbidities in men and women with sleep-disordered breathing (SDB) were compared retrospectively to an age-standardized, general Finnish population. The prevalence of diseases was based on the reimbursement refunds of medications. Two hundred thirty-three age- and BMI-matched male-female pairs and 368 consecutive women identified from our sleep recording database were included. Data on medication were gathered from the National Agency for Medicines and Social Insurance Institution database. Men with SDB had three-fold prevalence of reimbursed medication for diabetes and two-fold prevalence of reimbursed medication for chronic arrhythmia. Women with SDB had three-fold prevalence of reimbursed medication for thyroid insufficiency, and postmenopausal women had two-fold prevalence of reimbursed medication for psychosis. BMI and age did not explain prevalence of reimbursed medications for chronic arrhythmia or psychosis. In both genders with SDB, prevalence of reimbursed medications compared to the general population was two-fold for hypertension and seven-fold for asthma and/or chronic obstructive pulmonary disease (COPD). Partial upper airway obstruction was associated with three-fold prevalence of reimbursed medication for asthma and/or COPD in both genders and 60% reduced prevalence of reimbursed medication for hypertension in females matched for age and BMI. Co-morbidity profile differed between genders. Our results emphasize the importance of diagnosis and treatment of co-morbidities and partial upper airway obstruction. Copyright 2009 Elsevier B.V. All rights reserved.
During October 2010-February 2011, an outbreak of 91 Salmonella Enteritidis (SE) infections in Alberta, Canada, was investigated by a local public health department (Alberta Health Services, Calgary Zone). Index cases initially were linked through a common history of consumption of food purchased from mobile food-vending vehicles (lunch trucks) operating at worksites in Alberta. Further investigation implicated one catering company that supplied items for the lunch trucks and other vendors. In 85 cases, patients reported consumption of food prepared by the catering company in the 7 days before illness. Six patients were employees of the catering company, and two food samples collected from the catering company were positive for SE. Foods likely were contaminated directly or indirectly through the use of illegally sourced, SE-contaminated eggs at the implicated catering facility and by catering employees who were infected with SE. Public health interventions put into place to control the outbreak included screening employees for Salmonella, excluding those infected from food-handling duties, and training employees in safe food-handling procedures. No further outbreak cases were identified after full implementation of the interventions. This investigation highlights the potential for lunch trucks to be a source of foodborne illness and the need for robust regulatory compliance monitoring of lunch trucks and their food suppliers.
Yip, Wilson; Wiessing, Katy R; Budgett, Stephanie; Poppitt, Sally D
The aim of the study was to determine whether plate size affects ad libitum energy intake (EI) at a buffet-style lunch in overweight, yet unrestrained women. Twenty overweight/obese (BMI=25-40 kg/m(2)) women attended two study visits, and were randomly assigned to small (19.5 cm) or large (26.5 cm) diameter plate size at a free choice lunch meal. At 9 am participants were given a small (0.5 MJ) breakfast, followed at 12 noon by the lunch meal from which they ate ad lib until comfortably full. Mean (SEM) EI at lunch was 3975 (239)kJ and 3901 (249) kJ respectively for small and large plate size. There was no detectable difference in EI between the two plate sizes (P>0.05). When in a raised state of hunger and offered a palatable buffet meal, altering the diameter of the dining plate onto which food was self-served did not significantly alter ad lib EI. We conclude there was no evidence that a smaller plate suppressed EI in a group of unrestrained, overweight women encouraged to eat to appetite from a wide choice of items. Whether plate size is a useful cue for portion size, and hence control of EI, in individuals actively restricting intake however remains possible, and requires investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.
Akehurst, Ronald L; Abadie, Eric; Renaudin, Noël; Sarkozy, François
It has been suggested that differences in health technology assessment (HTA) processes among countries, particularly within Europe, have led to inequity in patient access to new medicines. To provide an up-to-date snapshot analysis of the present status of HTA and reimbursement systems in select European countries, and to investigate the implications of these processes, especially with regard to delays in market and patient access. HTA and reimbursement processes were assessed through a review of published and gray literature, and through a series of interviews with HTA experts. To quantify the impact of differences among countries, we conducted case studies of 12 products introduced since 2009, including 10 cancer drugs. In addition to the differences in HTA and reimbursement processes among countries, the influence of particular sources of information differs among HTA bodies. The variation in the time from the authorization by the European Medicines Agency to the publication of HTA decisions was considerable, both within and among countries, with a general lack of transparency as to why some assessments take longer than others. In most countries, market access for oncology products can occur outside the HTA process, with sales often preceding HTA decisions. It is challenging even for those with considerable personal experience in European HTA processes to establish what is really happening in market access for new drugs. We recommend that efforts should be directed toward improving transparency in HTA, which should, in turn, lead to more effective processes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Moos, Rudolf M; Sprengel, Kai; Jensen, Kai Oliver; Jentzsch, Thorsten; Simmen, Hans-Peter; Seifert, Burkhardt; Ciritsis, Bernhard; Neuhaus, Valentin; Volbracht, Jörk; Mehra, Tarun
Treatment of patients with severe injuries is costly, with best results achieved in specialised care centres. However, diagnosis-related group (DRG)-based prospective payment systems have difficulties in depicting treatment costs for specialised care. We analysed reimbursement of care for severe trauma in the first 3 years after the introduction of the Swiss DRG reimbursement system (2012-2014). The study included all patients with solely basic insurance, hospital admission after 01.01.2011 and discharge in 2011 or 2012, who were admitted to the resuscitation room of the University Hospital of Zurich, aged ≥16 years and with an injury severity score (ISS) ≥16 (n = 364). Clinical, financial and administrative data were extracted from the electronic medical records. All cases were grouped into DRGs according to different SwissDRG versions. We considered results to be significant if p ≤0.002. The mean deficit decreased from 12 065 CHF under SwissDRG 1.0 (2012) to 2 902 CHF under SwissDRG 3.0 (2014). The main reason for the reduction of average deficits was a refinement of the DRG algorithm with a regrouping of 23 cases with an ISS ≥16 from MDC 01 to DRGs within MDC21A. Predictors of an increased total loss per case could be identified: for example, high total number of surgical interventions, surgeries on multiple anatomical regions or operations on the pelvis (p ≤0.002). Psychiatric diagnoses in general were also significant predictors of deficit per case (p<0.001). The reimbursement for care of severely injured patients needs further improvement. Cost neutral treatment was not possible under the first three versions of SwissDRG.
Kerstiens, John [Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Johnstone, Peter A.S., E-mail: firstname.lastname@example.org [Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States)
Purpose: To determine whether all the existing and planned proton beam therapy (PBT) centers in the United States can survive on a local patient mix that is dictated by insurers, not by number of patients. Methods and Materials: We determined current and projected cancer rates for 10 major US metropolitan areas. Using published utilization rates, we calculated patient percentages who are candidates for PBT. Then, on the basis of current published insurer coverage policies, we applied our experience of what would be covered to determine the net number of patients for whom reimbursement is expected. Having determined the net number of covered patients, we applied our average beam delivery times to determine the total number of minutes needed to treat that patient over the course of their treatment. We then calculated our expected annual patient capacity per treatment room to determine the appropriate number of treatment rooms for the area. Results: The population of patients who will be both PBT candidates and will have treatments reimbursed by insurance is significantly smaller than the population who should receive PBT. Coverage decisions made by insurers reduce the number of PBT rooms that are economically viable. Conclusions: The expansion of PBT centers in the US is not sustainable under the current reimbursement model. Viability of new centers will be limited to those operating in larger regional metropolitan areas, and few metropolitan areas in the US can support multiple centers. In general, 1-room centers require captive (non–PBT-served) populations of approximately 1,000,000 lives to be economically viable, and a large center will require a population of >4,000,000 lives. In areas with smaller populations or where or a PBT center already exists, new centers require subsidy.
Mobley, Connie C.; Stadler, Diane D.; Staten, Myrlene A.; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy
Background: The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program…
Lopez-Neyman, Stephanie M.; Warren, Cynthia A.
Participation in school meals is a preventive measure against childhood hunger. Participation in the School Breakfast Program (SBP) continues to lag behind that of the National School Lunch Program. The purpose of this literature review was to investigate the barriers and advantages to student participation in the SBP. Using the adaptable…
This paper explores the political, economic, and social life of Nelson Mandela through his food choices from 1918 to the present. A description of the minutiae of one particular 1950s Sunday lunch is used to examine the broader role of first colonial and later apartheid legislation in determining the dietary choices and options of South Africans past and present. How such policies shaped attitudes and access to Nelson Mandela’s ancestral Xhosa cuisine is assessed. The long-term cultural, economic, and political impact of a lack of access to core indigenous African ingredients is evaluated. Most of all this paper offers a snapshot portrayal of two families (one white, one black) trying to sustain a normal friendship within a grossly abnormal society.
In Naked Lunch, the institutions and practices of science and medicine, specifically with regard to psychiatry/psychology, are symptoms of a bureaucratic system of control that shapes, constructs, defines, and makes procrustean alterations to both the mind and body of human subjects. Using sickness and junk (or heroin) as convenient metaphors for both a Cold War binary mentality and the mandatory consumption of twentieth-century capitalism, Burroughs presents modern man as fundamentally alienated from any sense of a personal self. Through policing the health of citizens, the doctors are some of the novel's most overt "Senders," or agents of capital-C Control, commodifying and exploiting the individual's humanity (mind and body) as a raw material in the generation of a knowledge that functions only in the legitimation and reinforcement of itself as authoritative.
Menegotto, Giovana; Moraes Silva, Flávia; de Azevedo, Mirela Jobim; de Almeida, Jussara Carnevale
The aim of the present study was to investigate the possible associations between dietary energy density (ED) and the metabolic syndrome (MetS) in patients with type 2 diabetes. In the present case-control study, the dietary ED of 125 patients with type 2 diabetes (seventy-eight with (cases) the MetS and forty-seven without (controls) the MetS; mean age 62·0 (SD 9·4) years, mean diabetes duration 12·5 (SD 8·4) years and mean glycated Hb 7·2 (SD 1·3) %) was assessed by weighed diet records. The MetS was defined according to the 2009 Joint Interim Statement and ED by the amount of energy (kJ) in a given weight of food. Data are expressed as means (standard deviations) or medians (interquartile ranges). Patients with the MetS reported lower intakes of total energy and fibre, and a higher total food amount than the controls; the total ED did not differ, but the cases had a higher ED at lunch (mean 6·3 (SD 1·3) v. 5·9 (SD 0·8) kJ/g; P= 0·017). In this meal, patients with the MetS had lower intakes of beans (median 0·7 (interquartile range 0·4-1·1) v. 1·1 (interquartile range 0·6-1·6) g/kg; P= 0·020), vegetables (median 1·2 (interquartile range 0·6-1·7) v. 1·4 (interquartile range 1·0-2·0) g/kg; P= 0·046) and total meat (median 1·3 (interquartile range 1·0-1·6) v. 1·4 (interquartile range 1·2-1·8) g/kg; P= 0·034) than patients without the MetS. The associations between lunch ED (kJ/g) and food groups (g/kg) were confirmed for vegetables (r - 0·584; P< 0·001), fruits (r - 0·233; P= 0·070), beans (r - 0·189; P= 0·037) and oils (r 0·323; P< 0·001). In a multivariate logistic regression model, a high lunch ED was associated with the MetS (OR 6·89, 95 % CI 1·35, 35·15; P =0·020) after adjusting for confounders. In conclusion, a high ED at lunch increased the odds of the presence of the MetS in patients with type 2 diabetes. Beans and vegetables may be the major contributors to this association and their consumption might be
Kidder, D; Sullivan, D
This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest that hospitals responded to PR by lowering payroll expenditures. PR also seems to have been associated with reductions in full-time equivalent staff per adjusted inpatient day. However, tests did not confirm the hypothesis that hospitals reduce payroll per full-time equivalent staff as a result of PR.
... (72 FR 63785). All memoranda are located on the FNS Web site at http://www.fns.usda.gov/cnd/ , click... understandable communication with families by providing LEAs with prototype application materials on our Web site.... FNS also provides translations of the prototype application materials on our Web site in 33 languages...