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To determine the changes in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) serologic status and SARS-CoV-2 infection rates in healthcare workers (HCWs) over 6-months of follow-up.
Prospective cohort study.
Setting and participants:
HCWs in the Chicago area.
Cohort participants were recruited in May and June 2020 for baseline serology testing (Abbott anti-nucleocapsid IgG) and were then invited for follow-up serology testing 6 months later. Participants completed monthly online surveys that assessed demographics, medical history, coronavirus disease 2019 (COVID-19), and exposures to SARS-CoV-2. The electronic medical record was used to identify SARS-CoV-2 polymerase chain reaction (PCR) positivity during follow-up. Serologic conversion and SARS-CoV-2 infection or possible reinfection rates (cases per 10,000 person days) by antibody status at baseline and follow-up were assessed.
In total, 6,510 HCWs were followed for a total of 1,285,395 person days (median follow-up, 216 days). For participants who had baseline and follow-up serology checked, 285 (6.1%) of the 4,681 seronegative participants at baseline seroconverted to positive at follow-up; 138 (48%) of the 263 who were seropositive at baseline were seronegative at follow-up. When analyzed by baseline serostatus alone, 519 (8.4%) of 6,194 baseline seronegative participants had a positive PCR after baseline serology testing (4.25 per 10,000 person days). Of 316 participants who were seropositive at baseline, 8 (2.5%) met criteria for possible SARS-CoV-2 reinfection (ie, PCR positive >90 days after baseline serology) during follow-up, a rate of 1.27 per 10,000 days at risk. The adjusted rate ratio for possible reinfection in baseline seropositive compared to infection in baseline seronegative participants was 0.26 (95% confidence interval, 0.13–0.53).
Seropositivity in HCWs is associated with moderate protection from future SARS-CoV-2 infection.
It is generally acknowledged that alternative strategies are required to enable children with disability to access storytelling activities. In this study, we sought to analyse the benefits of one such strategy: an arts-based multisensory story and rhyme program delivered to children with Down syndrome and autism spectrum disorder. In order to determine the engagement and impact of the program on the participants, data were collected through a series of multisensory session observations, focus group interviews with parents of participants, and interviews with performing artists delivering the program. The findings of this study revealed multiple benefits of using sensory stimuli to engage children with disability in storytelling processes, including increased engagement, focus, and interaction with other children and family members. The performing artists used their knowledge and skills to create an engaging environment that was responsive to the children’s needs. It was observed that language development could be further enhanced by integrating written text into the performance and increasing the use of nonverbal communication methods. Further, the engagement of siblings without disability in this program suggested that it could be developed to be inclusive of children with and without disability.
The loss of methyl bromide led vegetable growers to rely more heavily on herbicides to control weeds. Although herbicides can be effective, limited options in vegetable production challenge growers. Identifying new, effective tools to be applied over plastic mulch before planting, for improved weed control with minimal crop injury, would be beneficial. The objective of these experiments was to evaluate the persistence of preplant applications of glyphosate (1,125 or 2,250 g ae ha−1) plus 2,4-D (1,065 or 2,130 g ae ha−1) or dicamba (560 g ae ha−1) over plastic mulch, using analytical techniques and subsequent yellow squash and watermelon response. Glyphosate and 2,4-D were not analytically detected at damaging concentrations on plastic mulch when at least 3.5 cm of rainfall was received after application and before planting. In addition, bioassay results showing less than 10% visual injury for either squash and watermelon, with no growth or yield suppression observed, supported analytical results. In contrast, dicamba concentrations on plastic mulch, regardless of rainfall amount or time between application and planting, remained at damaging levels. Squash yields were reduced by dicamba applied 1 to 30 d before planting, whereas watermelon was more resilient. 2,4-D plus glyphosate applied preplant over plastic mulch can provide an additional herbicide option for vegetable growers. More research is needed to understand the impact of residual activity of 2,4-D when transplants land directly in holes in plastic mulch at the time of application. The relationship of dicamba with plastic mulch is complex, because the herbicide cannot be easily removed by rainfall. Thus, dicamba should not be included in a weed management system in plasticulture vegetable production.
Agronomic crops engineered with resistance to 2,4-D or dicamba have been commercialized and widely adopted throughout the United States. Because of this, increased use of these herbicides in time and space has increased damage to sensitive crops. From 2014 to 2016, cucumber and cantaloupe studies were conducted in Tifton, GA, to demonstrate how auxinic herbicides (namely, 2,4-D or dicamba), herbicide rate (1/75 or 1/250 field use), and application timing (26, 16, and 7 d before harvest [DBH] of cucumber; 54, 31, and 18 DBH of cantaloupe) influenced crop injury, growth, yield, and herbicide residue accumulation in marketable fruit. Greater visual injury, reductions in vine growth, and yield loss were observed at higher rates when herbicides were applied during early-season vegetative growth compared with late-season with fruit development. Dicamba was more injurious in cucumber, whereas cantaloupe responded similarly to both herbicides. For cucumber, total fruit number and relative weights were reduced (16% to 19%) when either herbicide was applied at the 1/75 rate 26 DBH. Cantaloupe fruit weight was also reduced 21% and 10% when either herbicide was applied at the 1/75 rate 54 or 31 DBH, respectively. Residue analysis noted applications made closer to harvest were more likely to be detectable in fruit than earlier applications. In cucumber, dicamba was detected at both rates when applied 7 DBH, whereas in cantaloupe, it was detected at both rates when applied 18 or 31 DBH in 2016 and at the 1/75 rate applied 18 or 31 DBH in 2014. Detectable amounts of 2,4-D were not observed in cucumber but were detected in cantaloupe when applied at either rate 18 or 31 DBH. Although early-season injury will more likely reduce cucumber or cantaloupe yields, the quantity of herbicide residue detected will be most influenced by the time interval between the off-target incident and sampling.
Jahnsite-(CaMnZn), CaMn2+Zn2Fe3+2(PO4)4(OH)2⋅8H2O, is a new jahnsite-group mineral associated with alteration of phosphophyllite at the Hagendorf-Süd pegmatite, Bavaria. It forms as thin yellow crusts and brown epitactic growths on altered phosphophyllite, both of which comprise lath-like crystals in orthogonal orientation, up to 100 μm long. The crystals contain intergrowths of jahnsite-(CaMnZn) and jahnsite-(CaMnMn) on a scale of ~50 μm. The calculated density is 2.87 g cm−3 based on the empirical formula. Optically it is biaxial (–), with α = 1.675(2), β = 1.686(2) and γ = 1.691(2) (white light). The calculated 2V is 68°. Dispersion could not be observed, and the optical orientation is Z = b. Pleochroism was imperceptible. Electron microprobe analyses together with results from Mössbauer spectroscopy gives the formula (Ca0.59Mn0.24)Σ0.83Mn(Zn0.74Mn2+0.48Mg0.18Fe2+0.13Fe3+0.47)Σ2Fe3+2(P0.995O4)4(OH)2.03(H2O)7.97.
Jahnsite-(CaMnZn) is monoclinic, P2/a, with a = 15.059(1), b = 7.1885(6), c = 10.031(2) Å, β = 111.239(8)° and V = 1012.1(2) Å3. The recent International Mineralogical Association approved nomenclature system for jahnsite-group minerals was applied to establish jahnsite-(CaMnZn) from the empirical formula. The structural flexibility of jahnsite-group minerals to accommodate cations of quite different sizes in the X and M1 sites is discussed in terms of rotations about the 7 Å axis of two independent octahedra centred at the M3 sites.
Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to ‘problem-solve’ complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly ‘home mission’ assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents’ engagement with these elements of the intervention was linked to the quality of their children’s participation and performance. Sixty-eight 8–14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children’s competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children’s social and emotional skill gains over the course of the program.
John Gray widens the perspective to look at the fear of insecurity as it has spread in recent times across the European continent from Italy to Hungary. He details the various reactions to migrants from the Middle East and the reforms and policy decisions they have created at the state level. His argument is that the security state has transcended politics. With piercing insights, he examines the populism of France’s Macron and asks whether Russia’s Putin is a Hobbesian strategist, and if so, what that suggests for geopolitical strategies from the US, China, and elsewhere.
Flowering rush (Butomus umbellatus L.) is an invasive aquatic and wetland plant capable of developing monotypic stands in emergent and submersed sites. This plant can rapidly outcompete native vegetation and impede human practices by reducing recreation (boating, fishing, and skiing) and disrupting agricultural use of water resources (irrigation canals). Mechanical removal practices occurring biweekly, monthly, bimonthly, and once per growing season were compared with chemical control with diquat applied sequentially at 0.19 ppmv ai for two consecutive months over 2 yr (2016 and 2017). Biweekly removal gave the most consistent control of B. umbellatus biomass and propagules. Diquat application along with monthly and bimonthly clippings gave varying degrees of B. umbellatus control. Clipping once per growing season did not control B. umbellatus when compared with reference plants, while clipping B. umbellatus every 2 wk (biweekly) controlled rush propagules most effectively. However, it is unlikely this method will be sufficient as a stand-alone control option due to the slow speed of harvester boats, the potential these boats have to spread B. umbellatus propagules to more sites, and the expense of mechanical operations. However, clipping could be used as part of an integrated strategy for B. umbellatus control.
This year 2018 has great historical and current significance for stellar spectral classification. Two hundred years ago in Reggio Emilia, Italy, was born Angelo Secchi, a pioneer of observing and classifying the spectra of stars. At the beginning of the IAU, almost a hundred years ago, one of its original Commissions was entitled the Spectral Classification of Stars, from which was generated Commission 45, Spectral Classification and Multi-band Colour Indices. And seventy-five years ago, was published the system-changing MKK, An Atlas of Stellar Spectra. Through this necessarily brief, historical view we shall recall how spectral classification, supported internationally by the IAU, continually updated its techniques, while remaining anchored to standards. This has ensured that the MK classification process stays very relevant to the initial characterizing of stars in the 21st century era of large spectral surveys.
Sepsis – syndrome of infection complicated by organ dysfunction – is responsible for over 750 000 hospitalisations and 200 000 deaths in the USA annually. Despite potential nutritional benefits, the association of diet and sepsis is unknown. Therefore, we sought to determine the association between adherence to a Mediterranean-style diet (Med-style diet) and long-term risk of sepsis in the REasons for Geographic Differences in Stroke (REGARDS) cohort. We analysed data from REGARDS, a population-based cohort of 30 239 community-dwelling adults age ≥45 years. We determined dietary patterns from a baseline FFQ. We defined Med-style diet as a high consumption of fruit, vegetables, legumes, fish, cereal and low consumption of meat, dairy products, fat and alcohol categorising participants into Med-style diet tertiles (low: 0–3, moderate: 4–5, high: 6–9). We defined sepsis events as hospital admission for serious infection and at least two systematic inflammatory response syndrome criteria. We used Cox proportional hazard models to determine the association between Med-style diet tertiles and first sepsis events, adjusting for socio-demographics, lifestyle factors, and co-morbidities. We included 21 256 participants with complete dietary data. Dietary patterns were: low Med-style diet 32·0 %, moderate Med-style diet 42·1 % and high Med-style diet 26·0 %. There were 1109 (5·2 %) first sepsis events. High Med-style diet was independently associated with sepsis risk; low Med-style diet referent, moderate Med-style diet adjusted hazard ratio (HR) 0·93 (95 % CI 0·81, 1·08), high Med-style diet adjusted HR=0·74 (95 % CI 0·61, 0·88). High Med-style diet adherence is associated with lower risk of sepsis. Dietary modification may potentially provide an option for reducing sepsis risk.
Schmidite, Zn(Fe3+0.5Mn2+0.5)2ZnFe3+(PO4)3(OH)3(H2O)8 and wildenauerite, Zn(Fe3+0.5Mn2+0.5)2Mn2+Fe3+(PO4)3(OH)3(H2O)8 are two new oxidised schoonerite-group minerals from the Hagendorf-Süd pegmatite, Hagendorf, Oberpfalz, Bavaria, Germany. Schmidite occurs as radiating sprays of orange–brown to copper-red laths on and near to altered phosphophyllite in a corroded triphylite nodule, whereas wildenauerite forms dense compacts of red laths, terminating Zn-bearing rockbridgeite. The minerals are biaxial (+) with α = 1.642(2), β = 1.680(1), γ = 1.735(2) and 2Vmeas = 81.4(8)° for schmidite, and with α = 1.659(3), β = 1.687(3), γ = 1.742(3) and 2Vmeas = 73(1)° for wildenauerite. Electron microprobe analyses, with H2O from thermal analysis and FeO/Fe2O3 from Mössbauer spectroscopy, gave FeO 0.4, MgO 0.3, Fe2O3 23.5, MnO 9.0, ZnO 15.5, P2O5 27.6, H2O 23.3, total 99.6 wt.% for schmidite, and FeO 0.7, MgO 0.3, Fe2O3 25.2, MnO 10.7, ZnO 11.5, P2O5 27.2, H2O 24.5, total 100.1 wt.% for wildenauerite. The empirical formulae, scaled to 3 P and with OH– adjusted for charge balance are Zn1.47Mn2+0.98Mg0.05Fe2+0.04Fe3+2.27(PO4)3(OH)2.89(H2O)8.54 for schmidite and Zn1.11Mn2+1.18Mg0.05Fe2+0.08Fe3+2.47(PO4)3(OH)3.25(H2O)9.03 for wildenauerite. The two minerals have orthorhombic symmetry, space group Pmab and Z = 4. The unit-cell parameters from refinement of powder X-ray diffraction data are a = 11.059(1), b = 25.452(1) and c = 6.427(1) Å for schmidite, and a = 11.082(1), b = 25.498(2) and c = 6.436(1) Å for wildenauerite. The crystal structures of schmidite and wildenauerite differ from that of schoonerite in having minor partitioning of Zn from the Zn site to an adjacent vacant tetrahedral site Zn, separated by ~1.0 Å from Zn. The two minerals are distinguished by the cation occupancies in the octahedral M1 to M3 sites. Schmidite has M1 = M2 = (Fe3+0.5Mn2+0.5) and M3 = Zn and wildenauerite has M1 = M2 = (Fe3+0.5Mn2+0.5) and M3 = Mn2+.
The commercial release of crops with engineered resistance to 2,4-D and dicamba will alter the spatial and temporal use of these herbicides. This, in turn, has elicited concerns about off-target injury to sensitive crops. In 2014 and 2015, studies were conducted in Tifton, GA, to describe how herbicide (2,4-D and dicamba), herbicide rate (1/75 and 1/250 field use), and application timing (20, 40, and 60 DAP) influence watermelon injury, vine development, yield, and the accumulation of herbicide residues in marketable fruit. In general, greater visual injury and reductions in vine growth, relative to the non-treated check, were observed when herbicide applications were made before watermelon plants had begun to flower. Although the main effects of herbicide and rate were less influential than the timing of applications with respect to plant development, the 1/75 rates were more injurious than the 1/250 rates; dicamba was more injurious than 2,4-D. In 2014, the 1/75 and 1/250 rates of each herbicide reduced marketable fruit numbers 13 to 20%, but only for the 20 DAP application. The 1/75 rate of each herbicide when applied at either 20 or 40 DAP reduced the number of fruit harvested per plot in 2015. Dicamba residues were detected in marketable fruit when the 1/75 rate in 2014 and 2015 and the 1/250 rate in 2015 was applied to plants at 40 or 60 DAP. Residues of 2,4-D were detected in 2015 when the 1/75 and 1/250 rates were applied at 60 DAP. Across both years, the maximum level of residue detected was 0.030 ppm. While early season injury may reduce watermelon yields, herbicide residue detection is more likely in marketable fruit when an off-target contact incident occurs closer to harvest.
The number of people living with dementia in sub-Saharan Africa (SSA) is expected to increase rapidly in the coming decades. However, our understanding of how best to reduce dementia risk in the population is very limited. As a first step in developing intervention strategies to manage dementia risk in this setting, we investigated rates of cognitive decline in a rural population in Tanzania and attempted to identify associated factors.
The study was conducted in the rural Hai district of northern Tanzania. In 2014, community-dwelling people aged 65 years and over living in six villages were invited to take part in a cognitive screening program. All participants from four of the six villages were followed-up at two years and cognitive function re-tested. At baseline and follow-up, participants were assessed for functional disability, hypertension, and grip strength (as a measure of frailty). At follow-up, additional assessments of visual acuity, hearing impairment, tobacco and alcohol consumption, and clinical assessment for stroke were completed.
Baseline and follow-up data were available for 327 people. Fifty people had significant cognitive decline at two-year follow-up. Having no formal education, low grip strength at baseline, being female and having depression at follow-up were independently associated with cognitive decline.
This is one of the first studies of cognitive decline conducted in SSA. Rates of decline at two years were relatively high. Future work should focus on identification of specific modifiable risk factors for cognitive decline with a view to developing culturally appropriate interventions.
The goal of this study was to examine the mental health needs of children and youth who present to the emergency department (ED) for mental health care and to describe the type of, and satisfaction with, follow-up mental health services accessed.
A 6-month to 1.5-year prospective cohort study was conducted in three Canadian pediatric EDs and one general ED, with a 1-month follow-up post-ED discharge. Measures included 1) clinician rating of mental health needs, 2) patient and caregiver self-reports of follow-up services, and 3) interviews regarding follow-up satisfaction. Data analysis included descriptive statistics and the Fisher’s exact test to compare sites.
The cohort consisted of 373 children and youth (61.1% female; mean age 15.1 years, 1.5 standard deviation). The main reason for ED presentations was a mental health crisis. The three most frequent areas of need requiring action were mood (43.8%), suicide risk (37.4%), and parent-child relational problems (34.6%). During the ED visit, 21.6% of patients received medical clearance, 40.9% received a psychiatric consult, and 19.4% were admitted to inpatient psychiatric care. At the 1-month post-ED visit, 84.3% of patients/caregivers received mental health follow-up. Ratings of service recommendations were generally positive, as 60.9% of patients obtained the recommended follow-up care and 13.9% were wait-listed.
Children and youth and their families presenting to the ED with mental health needs had substantial clinical morbidity, were connected with services, were satisfied with their ED visit, and accessed follow-up care within 1-month with some variability.
Regulatory impact analyses (RIAs) weigh the benefits of regulations against the burdens they impose and are invaluable tools for informing decision makers. We offer 10 tips for nonspecialist policymakers and interested stakeholders who will be reading RIAs as consumers.
1. Core problem: Determine whether the RIA identifies the core problem (compelling public need) the regulation is intended to address.
2. Alternatives: Look for an objective, policy-neutral evaluation of the relative merits of reasonable alternatives.
3. Baseline: Check whether the RIA presents a reasonable “counterfactual” against which benefits and costs are measured.
4. Increments: Evaluate whether totals and averages obscure relevant distinctions and trade-offs.
5. Uncertainty: Recognize that all estimates involve uncertainty, and ask what effect key assumptions, data, and models have on those estimates.
6. Transparency: Look for transparency and objectivity of analytical inputs.
7. Benefits: Examine how projected benefits relate to stated objectives.
8. Costs: Understand what costs are included.
9. Distribution: Consider how benefits and costs are distributed.
10. Symmetrical treatment: Ensure that benefits and costs are presented symmetrically.
In the above article (Paddick, 2017) The corresponding author's details were previously listed incorrectly. The correct details are; contact number +44 191 293 2709 and email address William.email@example.com. The original article has been updated with the correct contact details. The publishers apologise for any inconvenience and confusion this error has caused.
This study aimed to assess the feasibility of a low-literacy adaptation of the Alzheimer’s Disease Assessment Scale – Cognitive (ADAS-Cog) for use in rural sub-Saharan Africa (SSA) for interventional studies in dementia. No such adaptations currently exist.
Tanzanian and Nigerian health professionals adapted the ADAS-Cog by consensus. Validation took place in a cross-sectional sample of 34 rural-dwelling older adults with mild/moderate dementia alongside 32 non-demented controls in Tanzania. Participants were oversampled for lower educational level. Inter-rater reliability was conducted by two trained raters in 22 older adults (13 with dementia) from the same population. Assessors were blind to diagnostic group.
Median ADAS-Cog scores were 28.75 (interquartile range (IQR), 22.96–35.54) in mild/moderate dementia and 12.75 (IQR 9.08–16.16) in controls. The area under the receiver operating characteristic curve (AUC) was 0.973 (95% confidence interval (CI) 0.936–1.00) for dementia. Internal consistency was high (Cronbach’s α 0.884) and inter-rater reliability was excellent (intra-class correlation coefficient 0.905, 95% CI 0.804–0.964).
The low-literacy adaptation of the ADAS-Cog had good psychometric properties in this setting. Further evaluation in similar settings is required.
Cognitive stimulation therapy (CST) is a psychosocial group-based intervention for dementia shown to improve cognition and quality of life with a similar efficacy to cholinesterase inhibitors. Since CST can be delivered by non-specialist healthcare workers, it has potential for use in low-resource environments, such as sub-Saharan Africa (SSA). We aimed to assess the feasibility and clinical effectiveness of CST in rural Tanzania using a stepped-wedge design.
Participants and their carers were recruited through a community dementia screening program. Inclusion criteria were DSM-IV diagnosis of dementia of mild/moderate severity following detailed assessment. No participant had a previous diagnosis of dementia and none were taking a cholinesterase inhibitor. Primary outcomes related to the feasibility of conducting CST in this setting. Key clinical outcomes were changes in quality of life and cognition. The assessing team was blind to treatment group membership.
Thirty four participants with mild/moderate dementia were allocated to four CST groups. Attendance rates were high (85%) and we were able to complete all 14 sessions for each group within the seven week timeframe. Substantial improvements in cognition, anxiety, and behavioral symptoms were noted following CST, with smaller improvements in quality of life measures. The number needed to treat was two for a four-point cognitive (adapted Alzheimer's Disease Assessment Scale-Cognitive) improvement.
This intervention has the potential to be low-cost, sustainable, and adaptable to other settings across SSA, particularly if it can be delivered by non-specialist health workers.
Bettertonite, [Al6(AsO4)3(OH)9(H2O)5]•11H2O and penberthycroftite, [Al6(AsO4)3(OH)9(H2O)5].8H2O, two new minerals from the Penberthy Croft mine, Cornwall, have flexible layer structures based on corner-connected heteropolyhedral columns. Their response to dehydration on heating was studied using in situ synchrotron powder X-ray diffraction at temperatures in the range -53 to 157°C. The bettertonite sample transforms to penberthycroftite in a narrow temperature range of 67 to 97°C with a large (8%) contraction of the layer separation and a 6 Å sliding of adjacent layers relative to each other. Above 100°C a second phase transition occurs to a DL (displaced layer) phase, involving another 8% inter-layer contraction combined with a rotation of the columns. On heating the penberthycroftite sample the phase transition to the DL phase occurs at a lower temperature of ∼80°C. The DL phase is stable to a temperature of ∼120°C. At higher temperatures, increased rotation of the columns is accompanied by a progressive amorphization of the sample. Bettertonite, penberthycroftite and the DL phase exhibit negative thermal expansion (NTE) along all three axes with large NTE coefficients, of the order of-100 x 10 -6 °C-1.
To quantify the association of dietary quality with prospective changes in adiposity.
Children participating in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) study underwent examination at baseline and at 2-year follow-up. Dietary quality was assessed by the Diet Quality Index–International (DQII) using three non-consecutive 24 h diet recalls at baseline. The DQII has four main categories: dietary adequacy, variety, moderation and overall balance. Fat mass index (FMI; [fat mass (kg)]/[height (m)]2), central FMI (CFMI; [trunk fat mass (kg)]/[height (m)]2), percentage body fat (%BF; [total fat mass (kg)]/[total mass (kg)]) and percentage central BF (%CBF; [trunk fat mass (kg)]/[total mass (kg)]) were assessed through dual-energy X-ray absorptiometry.
Children were selected from schools in the greater Montreal, Sherbrooke and Quebec City metropolitan areas between 2005 and 2008, Quebec, Canada.
A total of 546 children aged 8–10 years, including 244 girls and 302 boys.
Regression analysis adjusting for age, sex, energy intake, physical activity and Tanner stage revealed that every 10-unit improvement in overall DQII score was associated with lower gain in CFMI (β=−0·08; 95 % CI −0·17, −0·003) and %BF (β=−0·55; 95 % CI −1·08, −0·02). Each unit improvement in dietary adequacy score was associated with lower gain in FMI (β=−0·05; 95 % CI −0·08, −0·008), CFMI (β=−0·03; 95 % CI −0·05, −0·007), %BF (β=−0·15; 95 % CI −0·28, −0·03) and %CBF (β=−0·09; 95 % CI −0·15, −0·02).
Promotion of dietary quality and adequacy may reduce weight gain in childhood and prevent chronic diseases later in life.