ABSTRACT
OBJECTIVE: The Table Talk tool is an observational assessment of early care and education teacher (ECET) mealtime practices. The Table Talk Revised (TT-R) tool incorporates new constructs that emerged from qualitative research and teases apart existing categories to improve nuance of data capture. The objective of this study was to evaluate the TT-R, document interrater reliability for the TT-R, and report on ECET feeding communications in broader settings than previously studied (i.e., beyond a single Lunch and Head Start only). METHODS: Trained observers conducted mealtime observations in classrooms (Nclassroms = 63, 10 sites) during Breakfast and two Lunches for both Lead and Assistant ECETs (N = 126). Classrooms were spread across Head Start in an urban area (60%), Head Starts in a rural area (24%), and a state-funded preschool (16%). RESULTS: On average, there were 22.17 (SD = 10.92) total verbal feeding communications at Breakfast, 37.72 (SD = 15.83) at Lunch1, and 34.39 (SD = 15.05) at Lunch2 with meals averaging 25 min. The most commonly observed supportive statement category was Exploring Foods for Lead (Breakfast = 1.61, Lunch1 = 3.23, Lunch2 = 2.70) and Assistant ECETs (Breakfast = .89, Lunch1 = 2.03) except for Lunch2 which was Encourages Trying in a Positive Way (Lunch2 = 1.30). The most commonly observed unsupportive statement category was Firm Behavioral Control for both Lead (Breakfast = 3.61, Lunch1 = 5.84, Lunch2 = 5.51) and Assistants ECETs (Breakfast = 3.11, Lunch1 = 6.38, Lunch2 = 4.32). The majority of Interclass Correlation Coefficients indicating interrater reliability were in the excellent range (64%) for commonly occurring statement categories, and 14 of the 19 low frequency statement categories had > 80% agreement. CONCLUSIONS AND IMPLICATIONS: Overall, items added to the Table Talk tool performed well, and interrater reliability was favorable. Our study also documented differences between Lead and Assistant teachers in mealtime practices and illustrated differing patterns of interaction between lunches and breakfast, important findings to inform future research and practice. The TT-R may be a useful measurement tool for monitoring and evaluating ECET practices in mealtime environments as well as informing intervention.
Subject(s)
Lunch , Meals , Breakfast , Child, Preschool , Feeding Behavior , Health Knowledge, Attitudes, Practice , Humans , Reproducibility of ResultsABSTRACT
We describe a case of sebaceous carcinoma (SC) in a 75-year-old man who presented with a rapidly growing nodule on the left cheek for four weeks. A 75-year-old man presented with a crusted non-tender nodule on the left cheek that had been present for six months. The nodule showed rapid growth in the four weeks before the visit. Shave biopsy of the lesion was reported as SC. SC is a rare but aggressive type of skin cancer that can develop from any sebaceous gland in the body. However, it mostly occurs in the eyelids. In this case, SC developed on the left cheek of the patient, which is an atypical presentation. Extraocular variant of SC has a greater potential to metastasize and has a lower survival rate compared to ocular variant. Early and accurate diagnosis followed by a wide excision surgery or Mohs micrographic surgery carries a favorable prognosis. Early detection of extraocular variant of SC may be difficult. It is imperative for primary care providers to order a histopathology examination to investigate a rapidly growing mass in the head and neck region where there are numerous sebaceous glands.
ABSTRACT
We describe a giant cell tumor in a 74-year-old man who presented with pain and swelling in the left thumb. Radiographs of the left hand showed some lytic changes at the tip of the thumb. Magnetic resonance imaging suggested the diagnosis of giant cell tumor, which was later confirmed by biopsy. A good treatment response was achieved with disarticulation of the interphalangeal joint and amputation of the distal phalanx of the left thumb.
