Social support and self‐efficacy for the consumption of fruit and vegetables by adolescents: “Gimme 5"—A fresh nutrition concept for students

Two psychosocial variables associated with initiation and maintenance of healthy diets are social support and self‐efficacy. Questionnaires for assessing social support and self‐efficacy for fruit/vegetable consumption were designed for Gimme 5, a controlled 5‐A‐Day study with a high school cohort. Both questionnaires had good internal consistency and factor solutions consistent with theoretical intent. Females had significantly higher family support and self‐efficacy than males (p < 0.0001). Positive family support and self‐efficacy were related to self‐reported daily fruit/vegetable intake (N= 1,786;p < 0.0001). Analysis revealed that negative family support and negative or positive peer support were not relevant with this population for fruit/vegetable consumption. The Gimme 5 program was designed to use the positive effects of social support and self‐efficacy for improving diet.     

Diabetes self-management among Arab Americans: patient and provider perspectives

Background

Arab Americans have a high burden of diabetes and poor outcomes compared to the general U.S. population. Diabetes self-management (DSM) requires a partnership between patients and providers that fosters mutual understanding and shared decision-making. Cultural factors influence this process; however, little is known regarding the cultural impact on DSM or if perceptions differ between patients and providers.

Methods

Qualitative content analysis was used to analyze five focus groups–two groups with Arab American providers (n?=?8) and three groups with adult Arab Americans with diabetes (n?=?23). Focus groups examined patient and provider perspectives on the meaning of DSM and cultural barriers and facilitators among Arab American patients.

Results

Four distinct themes included limited resources for DSM education and support, stigma as a barrier to ongoing support, family support as an opportunity and challenge, and Arab American patient-provider relationships.

Conclusions

Findings indicate several domains should be considered for clinical practice including a need to develop linguistically and culturally reliant educational materials and relevant supports for use in the Arab American population. Findings highlight differing views among providers and patients on the familial role in supporting DSM efforts and why some patients feel dissatisfied with clinical encounters.

     

Granular layer induction following the topical application of proliferating agents

Summary Evidence is provided for a possible dermal influence on the epidermis. Topical vitamin A stimulates a number of dermal cells with different enzyme reactions, and these invade the epidermis at about the time a granular layer is induced in mouse tail scale epidermis.N-hexadecane also induced a granular layer formation in the tail scale epidermis but the application of this agent only results in the invasion of the epidermis by non-specific esterase cells.These non-specific esterase cells are present in the follicular zone where a granular layer is usually present.It appears that dendritic cells may be responsible for the formation of a granular layer and that these cells in some way influence the keratinocytes to discharge their lyosomal enzymes and thus form a granular layer. It appears unlikely that the dendritic cells actually contribute their own acid hydrolases to the cell cytolysis necessary for the production of granular layer.     

Robotic nerve-sparing radical hysterectomy: feasibility and technique

Objective

To describe the anatomy of pelvic autonomic nerves as it applies to nerve-sparing radical hysterectomy, and the technique, feasibility, and results of robotic nerve-sparing radical hysterectomy.

Methods

Prospective evaluation of 6 patients undergoing robotic nerve-sparing radical hysterectomy (type C1) for cervical cancer Stage IB (1B1 in 3 and 1B2 in 3 patients). Pelvic lymphadenectomy was performed in 3 patients and pelvic and aortic in the remaining 3 patients.

Results

The operation was completed in all patients. The mean age of the patients was 51.0 (range 33-73) and mean BMI 27.8 (range 23.2-35.1). The mean operating time was 238.6 min (range 207-256), mean blood loss 135 ml (range 100-150), mean number of lymph nodes was 23.6 (range 19-29), mean hospital stay was 2 days (range 1-4). There were no intraoperative complications. Postoperative complications occurred in 1 patient with an ileus who required an extended hospital stay. One patient did not regain normal urinary voidings until the fourth week after surgery. All patients remain free of disease.

Conclusion

Robotic nerve-sparing radical hysterectomy is safe and feasible. Urinary dysfunction may occur.     

Robotic approach for ovarian cancer: perioperative and survival results and comparison with laparoscopy and laparotomy

Objective

Comparison of perioperative outcomes and survival of patients undergoing primary surgical treatment for epithelial ovarian cancer (EOC) by a robotic, laparoscopy, or laparotomy approach.

Methods

Retrospective case-control analysis of 25 patients with EOC undergoing robotic surgical treatment between March 2004 and December 2008. Comparison was made with similar patients treated by laparoscopy and laparotomy and matched by age, body mass index (BMI), and type of procedures between January 1999 and December 2006.

Results

The mean operating times were 314.8, 253.8 and 260.7 min for robotic, laparoscopy and laparotomy patients, respectively (p < 0.05); the mean blood loss was 164.0, 266.7, and 1307.0 ml, respectively (p = 0.001); the mean length of hospital stay was 4.2, 3.2, and 9.4 days, respectively (p = 0.001). The overall survival (OS) for robotics, laparoscopy and laparotomy patients was 67.1%, 75.6% and 66.0%, respectively (p = 0.08). Patients were subdivided and compared according to the extent of surgery by the type and number of major procedures. Type I and II debulking patients operated by robotics and laparoscopy had improved perioperative outcomes as compared to laparotomy. For patients undergoing a type III debulking, robotic outcomes were not improved over laparotomy.

Conclusion

Laparoscopy and robotics are preferable to laparotomy for patients with ovarian cancer requiring primary tumor excision alone or with one additional major procedure. Laparotomy is preferable for patients requiring two or more additional major procedures. Survival is not affected by the type of surgical approach.