17 research outputs found
Rx ActivitĂ© physique : DĂ©veloppement et implantation dâobjectifs dâapprentissage en matiĂšre de counseling et de prescription dâactivitĂ© physique dans les cursus des facultĂ©s de mĂ©decine canadiennes
Physical activity is an important component of health and well-being, and is effective in the prevention, management, and treatment of numerous non-communicable chronic diseases. Despite the known health benefits of physical activity in all populations, most Canadians do not meet physical activity recommendations. Physicians play a key role in assessing, counselling, and prescribing physical activity. Unfortunately, many barriers, including the lack of adequate education and training, prevent physicians from promoting this essential health behaviour. To support Canadian medical schools in physical activity curriculum development, a team of researchers, physicians, and exercise physiologists collaborated to develop a key set of learning objectives deemed essential to physican education in physical activity counselling and prescription. This commentary will review the newly developed Canadian Physical Activity Counselling Learning Objectives and give case examples of three Canadian medical schools that have implemented these learning objectives.LâactivitĂ© physique est une composante importante de la santĂ© et du bien-ĂȘtre, et elle est efficace dans la prĂ©vention, la prise en charge et le traitement de nombreuses maladies chroniques non transmissibles. MalgrĂ© les bienfaits quâon lui reconnaĂźt pour la santĂ© des populations, la plupart des Canadiens ne suivent pas les recommandations en matiĂšre dâexercice. Les mĂ©decins jouent un rĂŽle clĂ© dans lâĂ©valuation, le counseling et la prescription de lâactivitĂ© physique, mais de nombreux obstacles, dont le manque de formation adĂ©quate, les empĂȘchent de promouvoir cette habitude de vie essentielle pour la santĂ©. Afin dâaider les facultĂ©s de mĂ©decine canadiennes dans lâĂ©laboration de leur cursus sur lâactivitĂ© physique, une Ă©quipe composĂ©e de chercheurs, de mĂ©decins et de physiologistes de lâexercice a collaborĂ© Ă la dĂ©finition dâun ensemble dâobjectifs dâapprentissage jugĂ©s indispensables Ă la formation des mĂ©decins pour quâils puissent offrir des conseils sur lâactivitĂ© physique et la prescrire. Ce commentaire passe en revue les nouveaux objectifs dâapprentissage en matiĂšre de counseling en activitĂ© physique et donne des exemples de cas de trois facultĂ©s de mĂ©decine canadiennes qui ont mis en Ćuvre ces objectifs dâapprentissage
Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)
Genomic investigations of unexplained acute hepatitis in children
Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Tailoring the Evidence for Exercise Oncology within Breast Cancer Care
Exercise is safe and effective for those living with and beyond breast cancer, with evidence supporting exercise guidelines, and position statements from international organizations. Despite the clearly recognized benefits of exercise for these individuals, many do not participate or maintain recommended exercise levels throughout the breast cancer continuum, highlighting the lack of translation from research into practice. In addition, discerning how exercise can be tailored to address breast cancer-related impairments, so that individuals are able to participate safely and effectively, has also not been studied extensively. Thus, we propose that implementing exercise screening, triage, and referral pathways across the breast cancer continuum may allow for increased accessibility and adoption among those living with and beyond breast cancer. This paper provides an overview of exercise prescription tailoring for common breast cancer and treatment-related impairments, proposes a simplified screening tool for identifying physical activity and movement-related impairments, and considers how best to channel evidence into practice via proposed implementation pathways that may better connect individuals living with and beyond breast cancer with exercise oncology resources through screening, triage, and referral
Newsletter Fall 2018:Â Clinician Investigator Trainee Association of Canada (CITAC)
Message from the President: Optimism for the Future
The Clinician-Investigator Trainee Association of Canada (CITAC) was established in 2006 to address issues relevant to Canadian trainees seeking dual training in medicine and research. As clinician-investigator (CI) trainees, we comprise but a fraction (less than 5%) of all medical trainees. Our âbilingualâ careers render our individual paths less straightforward and more challenging. As a community, we have had to confront several disappointments, perhaps most notably the cessation of funding support for MD/PhD programs in 2015, previously offered by the Canadian Institutes of Health Research (CIHR). Despite these individual and collective challenges, I remain optimistic and incredibly excited about our future. In my own work, I am reminded constantly that being trusted with the dual responsibility of patient care and innovation in medicine is a privilege to be cherished, rather than a burden to be feared. That which makes our path doubly challenging also makes it doubly rewarding. The progress that CITAC has made over the years only adds to my optimism, and I wish to take this opportunity to remind you of how far we have come and how much further we hope to go
Time course of high-fat diet-induced reductions in adipose tissue mitochondrial proteins: potential mechanisms and the relationship to glucose intolerance
Exercise and nutrition for head and neck cancer patients: a patient oriented, clinic-supported randomized controlled trial
Abstract Background Research on physical activity and nutrition interventions aimed at positively impacting symptom management, treatment-related recovery and quality of life has largely excluded head and neck (HN) cancer populations. This translates into a lack of clinical programming available for these patient populations. HN cancer patients deal with severe weight loss, with more than 70% attributed to lean muscle wasting, leading to extended recovery times, decreased quality of life (QoL), and impaired physical functioning. To date, interventions to address body composition issues have focused solely on diet, despite findings that nutritional therapy alone is insufficient to mitigate changes. A combined physical activity and nutrition intervention, that also incorporates important educational components known to positively impact behaviour change, is warranted for this population. Our pilot work suggests that there is large patient demand and clinic support from the health care professionals for a comprehensive program. Methods/Design Therefore, the purpose of the present study is to examine the impact and timing of a 12-week PA and nutrition intervention (either during or following treatment) for HN cancer patients on body composition, recovery, serum inflammatory markers and quality of life. In addition, we will examine the impact of a 12-week maintenance program, delivered immediately following the intervention, on adherence, patient-reported outcomes (i.e., management of both physical and psychosocial treatment-related symptoms and side-effects), as well as return to work. Discussion This research will facilitate advancements in patient wellness, survivorship, and autonomy, and carve the path for a physical-activity and wellness-education model that can be implemented in other cancer centers. Trial registration Current Controlled Trials NCT01681654</p