Independent Early Childhood Education Centers’ Experiences Implementing the Revised Child and Adult Care Food Program Meal Pattern Standards: A Qualitative Exploratory Study

BackgroundNationally, approximately one-third of early childhood education centers participating in the Child and Adult Care Food Program (CACFP) are independently owned and operated (ie, not owned by a corporation, not affiliated with Head Start, and with no food program sponsor). Independent providers are less likely to meet CACFP standards and best practices and would benefit from additional support and technical assistance.ObjectiveTo explore independent early childhood education center key informants’ (KIs) (ie, directors or relevant staff) perspectives on implementing the revised CACFP standards.DesignFollowing qualitative exploratory design, semistructured, in-depth, telephone interviews were conducted with KIs individually.Participants/settingIn summer 2018, 30 randomly sampled KIs from independent CACFP-participating early childhood education centers serving children ages 2 to 5 years nationwide were interviewed. Participants were sampled from respondents to a previously completed nationwide survey of providers.Main outcomesKIs’ perspectives on the CACFP program and revised meal pattern standard implementation.Analysis performedAfter audio recordings were professionally transcribed and reviewed, constant comparative analysis was conducted using Atlas.ti v8 qualitative software (Atlas.ti. version 8 for Windows, 2018, Scientific Software Development GmbH).ResultsKIs indicated that program benefits (eg, health and nutrition benefits, reimbursement, guidelines, and training) outweighed challenges experienced. Challenges associated with revised CACFP standards implementation (eg, availability or acceptability of new, creditable foods) were impacted by enhanced CACFP standards status, reported revised standards, and availability or utilization of outside support. KIs desired more contact with their state representative. KIs found the training and technical assistance on the revised standards useful and suggestions to enhance future training and technical assistance (eg, increasing accessibility, training resources, and audience-specific training).ConclusionsOverall, KIs desired additional resources, training, and increased communication from CACFP state representatives specific to CACFP-approved and reimbursable products, menu ideas, recipes, and cooking demonstrations. The present study suggests that a more tailored training and technical assistance approach is necessary as reported benefits, challenges, and program needs varied based on state-enhanced CACFP standards, reported familiarity with the revised meal pattern, and reported outside support.     

Patient and public involvement cultures and the perceived impact in the vulnerable context of palliative care: A qualitative study

BackgroundCultural values are crucial to the practice and impact of patient and public involvement (PPI) in research.ObjectiveTo understand different PPI cultures among research teams and the impacts of PPI associated with each culture type.DesignA participatory action research design.Setting and participantsThe setting was 10 palliative care research projects. Seventeen patients and members of the public and 31 researchers participated.InterventionA programme consisting of four components: (1) training and coaching of patients and the public to prepare them for participation in research, (2) tailored coaching of the 10 research teams over 12‐18 months, (3) a community of practice, and (4) a qualitative evaluation.ResultsWe identified three cultures types: relationship cultures, task cultures, and control cultures. We identified four areas of impact: the project aim became more relevant to the target audience, methodological reliability increased, the research products were better able to reach the public, and the awareness increased, associated with behavioural changes, among researchers regarding PPI.DiscussionA relationship culture appears to be long‐lasting due to impacting the behaviours of the researchers during future projects. Different cultural types require different types of patients and researcher participants, assigned to different tasks.ConclusionsFurther research remains necessary to investigate the support required by researchers to enable relationship‐ and task‐oriented PPI cultures.Patient or public contributionPatient advocates and representatives contributed to our research team throughout the entire research process, as well as within the 10 implementation projects.     

Shared decision making in consultations for hypertension: Qualitative study in general practice

BackgroundHypertension is mainly managed in primary care. Shared decision making is widely recommended as an approach to treatment decision making. However, no studies have investigated; in detail, what happens during primary care consultations for hypertension.AimTo understand patients’ and clinicians’ experience of shared decision making for hypertension in primary care, in order to propose how it might be better supported.DesignLongitudinal qualitative study.SettingFive general practices in south‐west England.MethodInterviews with a purposive sample of patients with hypertension, and with the health‐care practitioners they consulted, along with observations of clinical consultations, for up to 6 appointments. Interviews and consultations were audio‐recorded and observational field notes taken. Data were analysed thematically.ResultsForty‐six interviews and 18 consultations were observed, with 11 patients and nine health‐care practitioners (five GPs, one pharmacist and three nurses). Little shared decision making was described by participants or observed. Often patients’ understanding of their hypertension was limited, and they were not aware there were treatment choices. Consultations provided few opportunities for patients and clinicians to reach a shared understanding of their treatment choices. Opportunities for patients to engage in choices were limited by structured consultations and the distribution of decisions across consultations.ConclusionFor shared decision making to be better supported, consultations need to provide opportunities for patients to learn about their condition, to understand that there are treatment choices, and to discuss these choices with clinicians.Patient or Public ContributionA patient group contributed to the design of this study.     

新疆和田红葡萄体外抑制肿瘤作用的研究

目的：研究和田红葡萄体外抑瘤效果。方法：采用体外细胞培养方法观察和田红葡萄与红葡萄皮的醇提液对四株细胞株。即：正常小鼠成纤维细胞株（3T3）、胃癌细胞株（MGC－803,NKM）和肝癌细胞株（Q3）细胞存活率及蛋白质含量影响。结果：（1）和田红葡萄醇提液与和田红葡萄皮醇提液都显著抑制NKM和Q3存活（P＜0．01）,后者对MGC－803存活率亦显著影响（P＜0．01）,最强作用浓度0．01g/ml。两种醇提液作用于NKM、Q3、MGC－803的抑制率分别为11．0％、14．0％、24．0％。葡萄皮醇提液抑瘤效果强于葡萄醇提液（P＜0．05）;（2）两种醇提液皆对细胞蛋白质含量无影响（P＞0．05）;（3）葡萄醇提液促进3T3生长作用较葡萄皮醇提液强（P＜0．05）。结论：和田红葡萄可能具有一定的体外抑癌作用。     

发皇古义，继承创新——孙桐教授谈中医基础理论的继承与发展

中医基础理论现代化是整个中医药学现代化的基础,其研究方式可以从文献学角度、实验角度、中西医结合角度等多方面展开,当务之急是统一中医理论中一些最基本的概念和术语,用现代精确的科学术语来表述它们,使之规范化、标准化。     

正常人人迎寸口脉动相关性的季节观察

目的 进行正常人人迎寸口脉动相关性的季节观察。方法 借助经颅多普勒血流检测仪（简称TCD）分别于1月中旬（冬季）、7月中旬（夏季）检测随机选择的62例正常人的迎脉寸口脉搏情况,并分不同性别、不同年龄比较分析了人迎脉,寸口脉的变化。结果 ①正常人人迎脉与寸口脉的血流速度无明显差异（P＞0.05）,在不同了组、不同年龄组、不同性别组中均是如此;②下人冬季的寸口脉的血流速度 较夏季稍大;正常人夏季的人迎脉的血流速度较冬季稍大,但均无显著性差异（P＞0.05）;③正常人冬季寸口脉的血汉速度稍大于人迎脉的血流速度 ,人迎的血流速度稍大于寸口脉的血流速度,在不同性别组中是如此,在不同年龄组中基本如此,唯60－75岁组夏季的寸口脉反而稍大于人迎脉。结论 初步建立了正常人不同季节人迎脉、寸口脉脉动及其相关性的TCD指标。     

Research trends of prostatitis over past 20 years: A bibliometric analysis

In the past two decades, thousands of documents in the field of prostatitis have been published. This bibliometric analysis aimed to assess the characteristics, hotspots and frontiers trend of global scientific output on prostatitis. With the trend of moderate growth, altogether 2,423 papers were reviewed. The leading role of the United States in global prostatitis research was obvious, while China had developed rapidly in recent years. Queen's University and JOURNAL OF UROLOGY were the most prolific affiliation and journal respectively. Nickel, J. C made the greatest contribution to the field of prostatitis. Five hotspots have been confirmed: (a) male infertility associated with prostatitis and the molecular mechanisms; (b) diagnosis and treatment of prostatitis; (c) inflammation, pain and bladder irritation symptoms; (d) relationship between chronic prostatitis/chronic pelvic pain syndrome, benign prostatic hyperplasia and prostate cancer; (e) epidemiology, complications of prostatitis and improvement of acupuncture. This bibliometric analysis reveals that the international cooperation was becoming more and more close. Hotspot analysis shows that the molecular mechanism of prostatitis will be a hotspot in the future, mainly focussing on inflammatory immunity and oxidative stress.