Background: A primary mechanism by which carbohydrates are thought to regulate satiety and food intake is through their effect on blood glucose. Objectives: The objectives were to describe the effect of defined carbohydrate preloads on food intake and blood glucose and to determine the association between food intake and blood glucose. Design: Three experiments were conducted in which selected carbohydrates as 1255-kJ isovolumetric beverages were administered to young men after an overnight fast. Measurements of blood glucose and appetite were made at specified times during the next 60 min. Food intake was measured at 60 min. Results: Glucose resulted in the highest glycemic response, which was followed, in order, by the responses to polycose, sucrose, amylopectin, a fructose-glucose mixture, and amylose. The high-glycemic-index preloads (glucose, polycose, and sucrose) resulted in lower mealtime energy intake during a test meal at 1 h, but the low-glycemic-index preloads (amylose, amylopectin, and a fructose-glucose mixture) did not. An inverse relation was observed between the blood glucose concentrations in the area under the curve and the subjective appetite (r = −0.23, P < 0.05) and food intake at 60 min (r = −0.24, P < 0.05). Conclusions: Food intake and subjective appetite are inversely associated with blood glucose response in the 60 min after consumption of carbohydrates. Carbohydrates with a high glycemic index (glucose, polycose, and sucrose) suppress subjective appetite and food intake in the short term, but those with a low glycemic index (amylose and amylopectin) do not.

: This study aims to determine whether the age-specific incidences (1) of publicly reported cases of shaken baby syndrome (SBS) and (2) of publicly reported cases of SBS with crying as the stimulus have similar properties to the previously reported normal crying curve. : The study reports cases of SBS by age of the child at the time of the inflicted trauma from the data set of the National Center on Shaken Baby Syndrome using cases entered between January 1, 2003 and August 31, 2004. : There were 591 cases of infants up to 1.5 years of age who had been reported to have been shaken or shaken and physically abused. Of these, crying was reported as the stimulus in 166 cases. In both samples, the curves of age-specific incidence started at 2-3 weeks, reached a clear peak at about 9-12 weeks of age, and declined to lower more stable levels by about 29-32 weeks of age, similar to the normal crying curve. These curves have similar onsets and shapes and a slightly later peak compared to the normal crying curve. : The findings provide convergent indirect evidence that crying, especially in the first 4 months of age, is an important stimulus for SBS.

Background: Shaken baby syndrome often occurs after shaking in response to crying bouts. We questioned whether the use of the educational materials from the Period of PURPLE Crying program would change maternal knowledge and behaviour related to shaking. Methods: We performed a randomized controlled trial in which 1279 mothers received materials from the Period of PURPLE Crying program or control materials during a home visit by a nurse by 2 weeks after the birth of their child. At 5 weeks, the mothers completed a diary to record their behaviour and their infants9 behaviour. Two months after giving birth, the mothers completed a telephone survey to assess their knowledge and behaviour. Results: The mean score (range 0–100 points) for knowledge about infant crying was greater among mothers who received the PURPLE materials (63.8 points) than among mothers who received the control materials (58.4 points) (difference 5.4 points, 95% confidence interval [CI] 4.1 to 6.5 points). The mean scores were similar for both groups for shaking knowledge and reported maternal responses to crying, inconsolable crying and self-talk responses. Compared with mothers who received control materials, mothers who received the PURPLE materials reported sharing information about walking away if frustrated more often (51.5% v. 38.5%, difference 13.0%, 95% CI 6.9% to 19.2%), the dangers of shaking (49.3% v. 36.4%, difference 12.9%, 95% CI 6.8% to 19.0%), and infant crying (67.6% v. 60.0%, difference 7.6%, 95% CI 1.7% to 13.5%). Walking away during inconsolable crying was significantly higher among mothers who received the PURPLE materials than among those who received control materials (0.067 v. 0.039 events per day, rate ratio 1.7, 95% CI 1.1 to 2.6). Interpretation: The receipt of the Period of PURPLE Crying materials led to higher maternal scores for knowledge about infant crying and for some behaviours considered to be important for the prevention of shaking. (ClinicalTrials.gov trial register no. NCT00175422.)

The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.

Background: Effective strategies for participant retention are critical in health research to ensure validity, generalizability and efficient use of resources. Yet standardized guidelines for planning and reporting on retention efforts have been lacking. As with randomized controlled trial (RCT) and systematic review (SR) protocols, retention protocols are an opportunity to improve transparency and rigor. An RCT being conducted in British Columbia (BC), Canada provides a case example for developing a priori retention frameworks for use in protocol planning and reporting. Methods: The BC Healthy Connections Project RCT is examining the effectiveness of a nurse home-visiting program in improving child and maternal outcomes compared with existing services. Participants (N = 739) were girls and young women preparing to parent for the first time and experiencing socioeconomic disadvantage. Quantitative data were collected upon trial entry during pregnancy and during five follow-up interviews until participants’ children reached age 2 years. A framework was developed to guide retention of this study population throughout the RCT. We reviewed relevant literature and mapped essential retention activities across the study planning, recruitment and maintenance phases. Interview completion rates were tracked. Results: Results from 3302 follow-up interviews (in-person/telephone) conducted over 4 years indicate high completion rates: 90% (n = 667) at 34 weeks gestation; and 91% (n = 676), 85% (n = 626), 80% (n = 594) and 83% (n = 613) at 2, 10, 18 and 24 months postpartum, respectively. Almost all participants (99%, n = 732) provided ongoing consent to access administrative health data. These results provide preliminary data on the success of the framework. Conclusions: Our retention results are encouraging given that participants were experiencing considerable socioeconomic disadvantage. Standardized retention planning and reporting may therefore be feasible for health research in general, using the framework we have developed. Use of standardized retention protocols should be encouraged in research to promote consistency across diverse studies, as now happens with RCT and SR protocols. Beyond this, successful retention approaches may help inform health policy-makers and practitioners who also need to better reach, engage and retain underserved populations. Trial registration: ClinicalTrials.gov, NCT01672060. Registered on 24 August 2012.