Thriving in Stepfamilies: Exploring Competence and Well-being Among African American Youth

Although scholars conclude that children/adolescents in two-parent nuclear families have an advantage over those in stepfamilies, emerging evidence indicates that the experiences of African American youths have been overshadowed. In three replicated studies, we detected no differences on several important and commonly assessed well-being and competence indicators among samples of African American youth in two-parent nuclear and stepfamilies.     

Salvage therapy with nelarabine,etoposide, and cyclophosphamide in relapsed/refractory paediatric T‐cell lymphoblastic leukaemia and lymphoma

A combination of 5 d of nelarabine (AraG) with 5 d of etoposide (VP) and cyclophosphamide (CPM) and prophylactic intrathecal chemotherapy was used as salvage therapy in seven children with refractory or relapsed T‐cell leukaemia or lymphoma. The most common side effects attributable to the AraG included Grade 2 and 3 sensory and motor neuropathy and musculoskeletal pain. Haematological toxicity was greater for the combination than AraG alone, although median time to neutrophil and platelet recovery was consistent with other salvage therapies. All patients had some response to the combined therapy and five of the seven went into complete remission after one or two courses of AraG/VP/CPM. Our experience supports the safety of giving AraG as salvage therapy in synchrony with etoposide and cyclophosphamide, although neurological toxicity must be closely monitored.     

Influence of intrinsic signals and environmental cues on the endocrine control of feeding in fish: Potential application in aquaculture

Optimization of food consumption and ultimately growth are major concerns for aquaculture. In fish, food intake is regulated by several hormones produced by both brain and peripheral tissues. Changes in feeding behavior and appetite usually occur through the modulation of the gene expression and/or action of these appetite-regulating hormones and can be due not only to variations in intrinsic factors such as nutritional/metabolic or reproductive status, but also to changes in environmental factors, such as temperature and photoperiod. In addition, the gene expression and/or plasma levels of appetite-regulating hormones might also display daily as well as circannual (seasonal) rhythms. Despite recent advances, our current understanding of the regulation of feeding in fish is still limited. We give here a brief overview of our current knowledge of the endocrine regulation of feeding in fish and describe how a better understanding of appetite-related hormones in fish might lead to the development of sustainable aquaculture.     

Resident interactions at mealtime: an exploratory study

Social interaction is thought to be important for psychological wellbeing and is necessary for developing relationships between older adults living in facilities. This study seeks to describe the social interaction that occurs amongst tablemates at mealtime in retirement homes, as well those things that influence resident-to-resident interaction. Fourteen lunch time periods were the basis for qualitative participant observation. Two or three researchers collected data in each period, with each observing two tables, resulting in 63 individual table observations at a retirement living facility dining room in a medium-sized city in Southern Ontario. Residents attending mealtime in the dining room were (~ 100). The type, extent and influences on social interactions amongst tablemates were recorded in detailed field notes. Qualitative thematic analysis, using a constant comparison procedure, was used to summarize and make sense of the data. A variety of social interactions occurred amongst tablemates including: making conversation, providing assistance, sharing, humouring, showing appreciation and affection, and rebuffing/ignoring/excluding. Interactions were influenced by tablemate roles, resident characteristics, and the social and physical environment, including staff. Social interactions or lack thereof are important for relationship development and mealtime environment. Describing the types of interaction and what influences them is a first step towards promoting social engagement which can enhance quality of life for residents. Further investigation through interviews with residents on the meaning of mealtime and companionship at meals will build a deeper understanding of the importance and influences on social interaction in this setting.     

Development and Reliability Testing of a Food Store Observation Form

ObjectiveTo develop a reliable food store observational data collection instrument to be used for measuring product availability, pricing, and promotion.DesignObservational data collection.SettingA total of 120 food stores (26 supermarkets, 34 grocery stores, 54 gas/convenience stores, and 6 mass merchandise stores) in the Chicago metropolitan statistical area.Main Outcome MeasuresInter-rater reliability for product availability, pricing, and promotion measures on a food store observational data collection instrument.AnalysisCohen's kappa coefficient and proportion of overall agreement for dichotomous variables and intra-class correlation coefficient for continuous variables.ResultsInter-rater reliability, as measured by average kappa coefficient, was 0.84 for food and beverage product availability measures, 0.80 for interior store characteristics, and 0.70 for exterior store characteristics. For continuous measures, average intra-class correlation coefficient was 0.82 for product pricing measures; 0.90 for counts of fresh, frozen, and canned fruit and vegetable options; and 0.85 for counts of advertisements on the store exterior and property.Conclusions and ImplicationsThe vast majority of measures demonstrated substantial or almost perfect agreement. Although some items may require revision, results suggest that the instrument may be used to reliably measure the food store environment.     

A Community Breast Center Report Card Determined by Participation in the National Quality Measures for Breast Centers Program

Abstract: Measurement of quality indicators and peer comparison has been demonstrated to improve quality of care. The goal of this study was to determine whether a community breast center, in collaboration with the National Consortium of Breast Centers (NCBC), could voluntarily audit the quality of breast cancer care, confidentially transmit quality information to the NCBC, and receive peer performance comparisons. Quality indicator metrics from consecutive breast cancer patients undergoing care at a community interdisciplinary breast center were entered into a prospective database of quality measures that were defined by the NCBC. Retrospective review of patients from 2004 to 2006 was performed and subsequent quality indicator data was submitted electronically to the NCBC National Quality Measures for Breast Centers (NQMBC^TM) program. The percentage of new cancer diagnoses made by needle biopsy techniques was 94%, 95% and 96% from 2004 to 2006. Sentinel lymph node utilization in eligible patients was 93%, 96% and 91% from 2004 to 2006 and the immediate intraoperative pathologic frozen section false negative rate of the sentinel lymph node was 6.5%, 4.7% and 4%. Chart documentation of “patient participation in shared decision making for breast conserving therapy versus mastectomy” improved from 74% to 99% (p < 0.05) from 2004 to 2006. Adjuvant systemic treatment for stage 2 breast cancer occurred in 76%, 89% and 77% of patients from 2004 to 2006. Neutropenia requiring hospital admission occurred in no patients in 2004 but in 4.8% and 2.9% in 2005 and 2006. The re‐excision lumpectomy rates for stage 0, 1, 2, and 3 breast cancer patients from 2004 to 2006 was 14.2%, 22% and 24.8%. Quality indicator data was submitted to the NQMBC^TM with successful confidential receipt of peer performance comparisons. Voluntary interdisciplinary institutional audits of breast cancer quality can be successfully submitted to the NQMBC^TM with confidential peer performance comparison.