Braswellmikkelsen6176

school policies to address child behavioral challenges. At the provider level, barriers included a lack of qualified professionals, negative attitudes, and lack of guidance navigating services. For family/cultural-related barriers, these included language and communication difficulties, out-of-pocket costs, and stigma impeded service access. Facilitators at the system level included family-centered care and prioritization of mental health supports. At the provider level, strengths included culturally competent and bilingual professionals. The family/cultural-related facilitators identified were informal support networks, characteristics of the parent, and connections to cultural community organizations. The findings emphasize the need to understand and consider diverse experiences, preferences, and values in the design and provision of autism services for families and their children.Purpose The study aimed to determine current practice, barriers, and enablers of foodservices in Canadian hospitals relative to guiding principles for best practice to prevent malnutrition.Methods Foodservice managers completed a 55-item cross-sectional, online survey (closed- and open-ended questions).Results Survey responses (n = 286) were from diverse hospitals in all Canadian regions; 56% acute care; 13% had foodservices contracted out; and 60% had a reporting structure combined with clinical nutrition. Predominantly, foodservice systems were 43% in-house versus 41% pre-prepared, 46% cook-serve food production, 64% meals assembled centrally (on-site), and 40% non-selective menus with limited opportunities for patient choice in advance or at meals. The "regular menu" (44%) was most commonly served as 3 meals, no snacks at specific times. Energy and protein-dense menus were available, but not widespread (9%). Daily energy targets ranged from 1200 to 2400 kcal and 32% of respondents viewed protein targets as important. The number of therapeutic diets varied from 2 to 150.Conclusions Although hospital foodservice practices vary across Canada, the survey results demonstrate gaps in national evidence-based practices and an opportunity to formalize guiding principles. This work highlights the need for standards to improve practice through patient-centered, foodservice practices focused on addressing malnutrition.Purpose The COVID-19 pandemic has impacted the lives of lesbian, gay, bi, trans, queer, and other groups (LGBTQ+) within Canada. This research aimed to explore the experiences of LGBTQ+ Canadians in relation to their nutritional needs, practices, and supports during the COVID-19 pandemic.Methods The qualitative study was framed within a poststructuralism and queer theory paradigm and consisted of an online questionnaire. Participants were recruited and asked to complete open-ended questions. Responses were coded using thematic analysis.Results Seventy participants completed the questionnaire. Data analysis resulted in 3 major themes, including (i) (dis)comforts of food and eating, (ii) shifting views of food and food practices, and (iii) what supports? The themes revealed that many LGBTQ+ individuals experienced stress and anxiety during the COVID-19 pandemic. It was a time in which their views and practices of food, cooking, and eating were changed. Nutritional supports were discussed in terms of family, friends, and partners.Conclusion The findings highlight the complexity to the meanings people give to food, cooking, and eating during stressful times. It is recommended that dietitians familiarize themselves with the experiences of LGBTQ+ people, especially during times of global health emergencies to ensure equitable health care for LGBTQ+ communities.

To determine the relationship between cartilage lesion etiology and clinical outcomes after second-generation autologous chondrocyte implantation (ACI) in the patellofemoral joint (PFJ) with a minimum of 2 years' follow-up.

A retrospective review of all patients that underwent ACI in the PFJ by a single surgeon was performed. Seventy-two patients with a mean follow-up of 4.2 ± 2.0 years were enrolled in this study and were stratified into 3 groups based on the etiology of PFJ cartilage lesions patellar dislocation (group 1;

= 23); nontraumatic lesions, including chondromalacia, osteochondritis dissecans, and degenerative defects (group 2;

= 28); and other posttraumatic lesions besides patellar dislocations (group 3;

= 21). Patient's mean age was 29.6 ± 8.7 years. Patients in group 1 were significantly younger (25.4 ± 7.9 years) than group 2 (31.7 ± 9.6 years;

= 0.025) and group 3 (31.5 ± 6.6 years;

= 0.05). Body mass index averaged 26.2 ± 4.3 kg/m

, with a significant difference between group 1 (24.4 ± 3.2 kg/m

) and group 3 (28.7 ± 4.5 kg/m

 ;

= 0.005). A clinical comparison was established between groups based on patient-reported outcome measures (PROMs) and failure rates.

Neither pre- nor postoperative PROMs differed between groups (

> 0.05). No difference was seen in survivorship between groups (95.7% vs. 82.2% vs. 90.5%,

> 0.05).

Cartilage lesion etiology did not influence clinical outcome in this retrospective study after second generation ACI in the PFJ.

Level III, retrospective comparative study.

Level III, retrospective comparative study.The quantitative assay of protein S can help in rapidly identifying carriers of abnormal protein S molecules through a simple procedure (by determining the total protein S mass, total protein S activity, and protein S-specific activity in blood), without genetic testing. To clarify the relationship between venous thromboembolism (VTE) and protein S-specific activity, and its role in the diagnosis of thrombosis in Japanese persons, the protein S-specific activity was measured and compared between patients with thrombosis and healthy individuals. The protein S-specific activity of each participant was calculated from the ratio of total protein S activity to total protein S antigen level. Plasma samples were collected from 133 healthy individuals, 57 patients with venous thrombosis, 118 patients with arterial thrombosis, and 185 non-thrombotic patients. The protein S-specific activity of one-third of the patients with VTE was below the line of Y = 0.85X (-2 S.D.). Most protein S activities in the plasma of non-thrombotic patients were near the Y = X line, as observed in healthy individuals. Epigenetic inhibitor mouse In conclusion, it was clearly shown that monitoring protein S activity and protein S-specific activity in blood is useful for predicting the onset and preventing venous thrombosis in at least the Japanese population.

Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors.

We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case.

The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either.

Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes.

Level IV, case series.

Level IV, case series.This qualitative study explored the impressions of pregnant Canadian women toward Canada's Food Guide (CFG) snapshot released in January 2019. Semi-structured interviews were conducted with 8 physically active pregnant women. Interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis. Three themes emerged (i) pregnancy changes what I eat; (ii) what is healthy to me? and (iii) a connection with people and food. Pregnancy was the primary factor influencing dietary changes, and messages in the snapshot reinforced some dietary behaviours that participants had already incorporated. Participants wanted information specific to pregnancy but were not aware of available resources pertaining to nutrition on existing websites. Dietitians and other health care professionals should take steps to raise awareness of and ensure wider dissemination of reliable resources on healthy eating during pregnancy including Canada's Food Guide website.The present study investigated the potential subchronic toxicity of self-assembled-micelle inhibitory RNA-targeting amphiregulin (SAMiRNA-AREG) in mice. The test reagent was administered once-daily by intravenous injection for 4 weeks at 0, 100, 200, or 300 mg/kg/day doses. Additional recovery groups (vehicle control and high dose groups) were observed for a 2-week recovery period. During the test period, mortality, clinical signs, body weight, food consumption, ophthalmology, urinalysis, hematology, serum biochemistry, gross pathology, organ weight, and histopathology were examined. An increase in the percentages of basophil and large unstained cells was observed in the 200 and 300 mg/kg/day groups of both sexes. In addition, the absolute and relative weights of the spleen were higher in males given 300 mg/kg/day relative to the concurrent controls. However, these findings were considered of no toxicological significance because the changes were minimal, were not accompanied by other relevant results (eg, correlating microscopic changes), and were not observed at the end of the 2-week recovery period indicating recovery of the findings. Based on the results, SAMiRNA-AREG did not cause treatment-related adverse effects at dose levels of up to 300 mg/kg/day in mice after 4-week repeated intravenous doses. Under these conditions, the no-observed-adverse-effect level of the SAMiRNA-AREG was ≥300 mg/kg/day in both sexes and no target organs were identified.A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.