An Environmental Scan and Qualitative Inquiry of Cancer Patient Navigation Services in North Carolina.

Background and Objectives: Patient navigation services reduce barriers to accessing cancer care and lead to improved outcomes for patients. North Carolina (NC) has thousands of cancer patients seeking cancer care services each year. We sought to complete a digital environmental scan and qualitative inquiry of cancer patient navigation services throughout the state to better inform patients, hospitals administrators, and state officials about the current state of patient navigation programs for cancer patients throughout NC. Methods: For seven cancer hospitals in NC, two steps were used: an environmental scan of publicly available information on the hospitals' websites about navigation services, and key informant interviews with navigation staff at each site. Results: The website scans revealed information about navigation services was incomplete. Each hospital had a page dedicated to cancer navigation, but many did not outline the specific services available to patients. Interviews revealed that navigation services are available to cancer patients across diagnoses, although only a subset of patients receive services. Cancer navigators reported that their work includes care coordination, patient advocacy, emotional support, and addressing non-medical barriers to health care access (transportation, finances, childcare, etc.). Each navigation service had a unique configuration and referral pattern. Conclusions: Cancer hospitals throughout NC are working to address barriers to care commonly faced by patients, with some programs offering more robust services compared to others. Hospitals would benefit from updating their websites at regular intervals to fully report the services available to patients through their programs, including direct and clear patient navigation contact methods.

Exploring the long-term sustainability of school-based nutrition and food programs: What works, where and why?

ISSUE ADDRESSED: Most food and nutrition programs cease within 2 years. Understanding the determinants of program sustainability is crucial to maximise output from funding, whilst allowing sufficient time for program benefits to be achieved. This study applied the Consolidated Framework for Implementation Research (CFIR) to map the barriers and enablers of successful long-term implementation of school-based nutrition and food programs. METHODS: Qualitative methods with purposive and snowball sampling were used to recruit experts who were identified as being influential in implementing and sustaining long-term (>2 years) school-based food and nutrition programs. Semi-structured interviews with global experts were conducted, transcribed verbatim and coded deductively (by applying the CFIR constructs) and inductively when required. Thematic analysis informed the development of themes. RESULTS: Interviews were conducted with 11 experts including researchers, government employees, and a consultant of an international agency, from seven countries. Forty-eight deductive codes and eight inductive codes identified six main themes: (1) funding and integrity of its source; (2) political landscape; (3) nutrition policies and their monitoring; (4) involvement of community actors; (5) adaptability of the program and (6) effective program evaluation. Themes related mainly to the 'outer setting' domain of the CFIR. CONCLUSIONS: The CFIR highlighted pertinent factors that influence the successful long-term implementation of school-based food and nutrition programs. SO WHAT?: The findings suggest that to sustain program implementation beyond its initial funding, relationships across government departments, local organisations and communities, need to be nurtured and prioritised from the outset.

Applying the Integrated Sustainability Framework to explore the long-term sustainability of nutrition education programmes in schools: a systematic review.

OBJECTIVE: This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes. DESIGN: Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5-14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. SETTING: International school-based nutrition programmes. SUBJECTS: Individuals involved with the implementation of school-based nutrition programmes. RESULTS: From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment. CONCLUSIONS: These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the 'outer contextual factors' of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.

Reserves of Calcium, Copper, Iron, Potassium, Magnesium, Manganese, Sodium, Phosphorus, Strontium and Zinc in Goose Egg Yolk during Embryo Development.

This study evaluated the changes in calcium (Ca), copper (Cu), iron (Fe), potassium (K), magnesium (Mg), manganese (Mn), sodium (Na), phosphorus (P), strontium (Sr) and zinc (Zn) values in goose egg yolk during the incubation period. This study was conducted on a completely random selection using 200 fertile eggs from a local flock of geese. A selection of 30 fertile eggs were randomly sampled on days 0, 9.5, 19.5, 25 and 30 of incubation (total: 150 eggs), and the yolks of 5 eggs in each replicate were mixed together and considered as one replicate (six replicates in each incubation period). The mineral content of the yolks was measured using the inductively coupled plasma (ICP) spectroscopy method. The results of this study show that, during the incubation of goose eggs from 0 to 30 days of embryo growth, except for Ca, the yolk content (absolute weight) of all the measured minerals, including Cu, Fe, K, Mg, Mn, Na, P, Sr and Zn, on day 30 of incubation were statistically significantly lower than on day 0 of incubation. Additionally, the yolk concentrations of Fe, K, Mg, Na, P and Zn declined, the yolk concentrations of Ca and Sr increased, and the yolk concentrations of Cu and Mn were unchanged on day 30 compared to the first day of incubation. The results of the current study demonstrate that goose egg yolks' mineral concentrations change in absolute value during the incubation period, which could be the basis for further studies on chick feeding during the embryonic and post-embryonic phases.

A Rapid Review of the Impact of Family-Based Digital Interventions for Obesity Prevention and Treatment on Obesity-Related Outcomes in Primary School-Aged Children.

Virtual delivery of obesity prevention and treatment programs may be effective for supporting children and families to adopt healthy lifestyle changes while enhancing program accessibility. This rapid review aimed to summarize the impact of family-based digital interventions for childhood obesity prevention and treatment. Four databases were searched up to February 2021 for trials of interactive digital programs aimed to prevent and/or treat obesity in children aged 5-12 years and reported diet, physical activity, sedentary behavior, sleep, or weight-related outcomes in children. A total of 23 publications (from 18 interventions) were included. Behavior change theories were used in 13 interventions with "Social Cognitive Theory" applied most frequently (n = 9). Interventions included websites (n = 11), text messaging (n = 5), video gaming (n = 2), Facebook (n = 3), and/or mobile applications (n = 2). Studies reported changes in body mass index (BMI; n = 11 studies), diet (n = 11), physical activity (n = 10), screen time (n = 6), and/or sleep (n = 1). Significant improvements were reported for diet (n = 5) or physical activity (n = 4). Two of the six interventions were effective in reducing screen time. Digital interventions have shown modest improvements in child BMI and significant effectiveness in diet and physical activity, with emerging evidence supporting the use of social media and video gaming to enhance program delivery.

Association between maternal serum uric acid and preeclampsia.

OBJECTIVE: The aim of this study is to compare the changes in serum uric acid levels among preeclamptic pregnant women and healthy pregnant women. METHODS: Two hundred and twenty-four (224) pregnant women were enrolled. Serum uric acid levels were analysed in the two groups at the time of referral and prior to the delivery. RESULTS: The mean uric acid in all pregnant women was 5.61 mg/dL. The mean uric acid in women with preeclampsia was 6.51 ± 1.53 and in normotensive women was 4.72 ± 1.58, which was seen significant. The mean age of the mother, gestational age and BMI were not significant with the levels of uric acid. The elevation in serum levels of uric acid increased the risk of preeclampsia by 1.98 folds. CONCLUSION: There is a significant increase in the serum levels of uric acid in pregnant women with preeclampsia as compared to normotensive women. This can be one of a significant indicator of preeclampsia.

The Effect of Oral Intake of Honey Syrup on the Pain Intensity of Active Phase of Parturition of nulliparous women: A Randomized clinical trial.

BACKGROUND: Labor is a natural pain despite the fact that the severity of the pain and response to it differ in various people, but most women refer to labor as an unpleasant experience of their lives. The present study was carried out to determine the effect of honey on the severity of labor in primigravida women. METHODS: In this study, 80 healthy volunteer primigravida women were entered to the research as randomized clinical trial (40 subjects in each group) after studying and signing consent form and they were randomly divided into two intervention honey group and control group. The data gathering tool comprised four main parts of the personal profile questionnaire, controls performance in the labor, records fluid intake rate and pain intensity using a 0-10 cm ruler. RESULTS: The mean of pain intensity in the honey syrup intervention group was significant. CONCLUSION: Honey syrup consumption without side effects significantly affected the severity of labor.