Evaluating a Food Pantry–Based Intervention to Improve Food Security,Dietary Intake,and Quality in Midwestern Food Pantries

BackgroundVoices for Food was a longitudinal community, food pantry–based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states.ObjectiveOur objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes.DesignA multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time.Participants/settingAdult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160).InterventionCommunity coaching served as the experimental component, which only “treatment” communities received, and a food council guide and food pantry toolkit were provided to both “treatment” and matched “comparison” communities.Main outcome measuresChange in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures.Statistical analyses performedLinear mixed models estimated changes in outcomes by intervention group and by adult food security status over time.ResultsImprovements in adult food security score (–0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed.ConclusionsFood pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.     

Careful assistance? Personal assistance within the family as hybridization of modern welfare policy and traditional family care

The aim of this article is to examine how different ideological perspectives on Swedish disability policy, are reflected in the experiences of disabled people and their families personal assistants. Personal assistance provided within the family can be seen as a hybridization between publicly regulated and paid work performed in the private family sphere, and thus conflicting norms and practices may coexist. In Sweden, family members of the assistant user can be employed as paid personal assistants. Many users combine personal assistance from family members with non-family assistance. Approximately 20–25% of the employed personal assistants are relatives of the assistance users. The empirical data consists of qualitative interviews with seventeen adult users and twenty-three family members employed as PAs with different types of family ties; parent-child relationships, sibling relationships and partner relationships. The findings show that family assistance could entail advantages such as personalised services, to combine instrumental and emotional assistance as well as achieving a power-balance between the parties. But there were also disadvantages, such as unwanted or enforced dependency, with a risk for both parties to be ‘locked up’ in the family. In an overall analysis, we distinguished three broad approaches towards family assistance, family as a substitute, family as a supplement and family first.     

员工援助计划服务对心内科护士职业认同感、职业价值观、职业压力的影响

目的 探讨员工援助计划服务对心内科护士职业认同感、职业价值观、职业压力的影响。 方法 选择2018年1-3月我院心内科护理人员58名,为其实施员工援助计划服务,评价实施前后心内科护士的职业认同感、职业价值观、职业压力感知、职业压力反应。 结果 实施后,心内科护士工作压力源各维度评分、压力感知与压力反应各维度得分均较实施前下降(P＜0.05);职业价值观各维度及职业认同感各维度评分均较实施前显著提高(P＜0.001)。 结论 员工援助计划可提高心内科护士职业认同感、职业价值观,缓解其职业压力感知以及职业压力反应。     

Gerontology in the developing Brazil: Achievements and challenges in public policies

Aim:   In the last three decades, the segment of population aged 60 years and older has more than doubled in Brazil. People aged 80 years and older are expected to be the fastest-growing segment in the near future. This aim of this study was to analyze the legal structures currently in place in Brazil and to provide a framework for care policies and practices towards older-adults.
Methods:   This article focuses on past and present major socioeconomic burdens on this segment of the Brazilian population as well as on public achievements to overcome inequities.
Results:   Both the public health and the social security systems have been directed to provide preferential assistance to the aged. Nonetheless, the elderly remain the most impoverished segment of Brazil and carry the burden of an overall lack of specialized services. Moreover, socioeconomic inequalities and population diversity in Brazil affects elderly care, adding complexity to this unique scenario.
Conclusion:   Brazil has adopted legal hallmarks that substantially shifted public practices towards the elderly segment from a philanthropic status to a legitimate right for care and assistance. The demographic transition that took place provides an opportunity for innovative solutions in public policies for older adults in a developing economic environment.     

Robotic telesurgery for achalasia

The craft of surgery has always relied on the use of instruments. Innovations in surgery have paralleled innovations in instrumentation. Advances in surgical instrumentation continue today and have enabled huge strides in surgical procedures and outcomes during this generation. Computers and related technology are now changing the interface between the surgeon and the patient, and are poised to improve patient outcomes by enhancing the surgeon’s skills and training. The application of computer enhanced telemanipulators, or “robots”, may specifically enhance operations, for example Heller myotomy, that require good visualization and precise careful dissection of delicate structures. This review covers the pathophysiology of achalasia and its history of medical and surgical treatment, leading to modern robotic telesurgical approaches. Improvements in outcome from medical to standard surgical to robotic telesurgical approaches are discussed. Current operative technique for robotic telesurgical treatment of achalasia is described and the authors conclude with a glimpse of where, in the future, current research endeavors will lead us in the treatment of achalasia.     

壮医针挑并艾灸治疗糖尿病周围神经病变临床观察

目的：观察壮医针挑并艾灸对糖尿病周围神经病变200例的疗效。方法：取龙路、火路网络在体表的反应穴或皮下反应点，每次选2～3个穴位，持针尖快速刺入皮肤0．1～0．2cm，绞断表皮少许纤维，尽量不出血，每3天1次，配合艾灸，10次为1疗程。结果：显效102例，有效78例，无效20例。总有效率为90％。结论：壮医针挑并艾灸治疗糖尿病周围神经病变疗效仍显著。     

Pulmonary and haemodynamic effects of extracorporeal circulation in the cat and the beneficial effects of prostacyclin

Side-effects of a veno-venous extracorporeal system and possible beneficial effects of prostacyclin (epoprostenol) are analyzed on the cat. Three groups were studied; one control group without extracorporeal circulation and two groups with an extracorporeal flow of 10–12 ml/kg/min, one of which was given prostacyclin (70–110 ng/kg/min). The extracorporeal circulation triggered a decrease in arterial saturation (from 99 to 91 %) and carbon dioxide elimination (increase in arterial to end-tidal PCO₂ by about 1 kpa) a metabolic acidosis (pH7.20), a platelet consumption (50%) and shortened survival time, side-effects reduced by prostacyclin. Further, there was a marked increase in haemoglobin concentration indicating hypovolemia via capillary fluid filtration. None of these side-effects were seen in the control group. Extracorporeal circulation as a trigger for pulmonary dysfunction and for impaired tissue nutrition with possible beneficial effects of prostacyclin is discussed, and also from a clinical point of view (i.e. extracorporeal lung assistance, ECLA), on the basis of the results.     

超声辅助大孔树脂技术富集荆芥穗中总黄酮和总酚的工艺研究

目的 通过超声辅助大孔树脂对荆芥穗Schizonepetae Spica水提物中总黄酮和总酚类化合物进行富集并对比处理前后化合物含量及活性变化。方法 从7种不同类型树脂中筛选超声辅助最佳树脂型号,在吸附动力学和吸附热力学研究下,对超声温度、功率、上样质量浓度及解吸溶剂百分比等影响因素进行工艺优化。测定了优化处理前后各成分含量及活性变化。结果 动力学和热力学的研究表明,荆芥穗总黄酮适用于Langmuir模型,且吸附过程为自发吸热熵增,总酚则为自发放热熵减并适用于Freundlich模型,据此不同的吸附机制优化了2类成分同时富集的最佳工艺,在超声辅助AB-8大孔树脂,温度25 ℃、时间2.5 h,功率150 W,上样质量浓度0.1 g/mL,70%乙醇解吸附的过程下,荆芥穗水提物中总黄酮和总酚类化合物含量增加2～3倍,其单体成分的含量及抗氧化和神经氨酸酶抑制活性均显著增加。结论 超声辅助大孔树脂技术为荆芥穗总黄酮和总酚类成分的有效可行富集技术。