Nutritional factors associated with early childhood caries: A systematic review and meta-analysis.

Background: Many studies have examined the relationship between nutrition and dental caries. However further studies are needed regarding nutritional factors that can have a strong impact on the incidence of early childhood caries (ECC). Nutrition is one factor that determines caries occurrence. Exposure to carbohydrates in the oral cavity causes carbohydrate fermentation, which produces acids. This acidic substance erodes the enamel surface of teeth, leading to ECC. This systematic review and meta-analysis of cohort studies assessed the aspects of nutrition and diet that contribute to the incidence of ECC in children. Materials and methods: We conducted a systematic review by extracting data according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A search was conducted of published articles in Scopus, MEDLINE via PubMed, and Science Direct using the keywords "nutrition," "sugar," "carbohydrate," "dietary habit," "dental caries," and "oral health." The protocol was registered at PROSPERO 2023 (Registration ID: CRD42023394583). Results: The article screening yielded 6 articles that met the inclusion criteria. From the total of 443 studies found. Those that could not determine a correlation between the ECC variables and nutrition and with data analyses that only used a bivariate analysis were excluded. The results of the meta-analysis showed that nutritional factors had the strongest impact on caries including feeding practice (OR 3.64; 95% CI 2.03, 6.55), sugar intake (OR 3.24; 95% CI 2.59, 4.03), and low fruit and vegetable intake (OR 2.71; 95% CI 1.47, 5.01). Conclusion: Two nutritional factors had the strongest relationship with the risk of ECC: feeding practice and sugar intake. The lowest risk factor for causing ECC was low fruit and vegetable intake.

Comparing apples to manzanas and oranges to naranjas: A new measure of English-Spanish vocabulary for dual language learners.

The valid assessment of vocabulary development in dual-language-learning infants is critical to developmental science. We developed the Dual Language Learners English-Spanish (DLL-ES) Inventories to measure vocabularies of U.S. English-Spanish DLLs. The inventories provide translation equivalents for all Spanish and English items on Communicative Development Inventory (CDI) short forms; extended inventories based on CDI long forms; and Spanish language-variety options. Item-Response Theory analyses applied to Wordbank and Web-CDI data (n = 2603, 12-18 months; n = 6722, 16-36 months; half female; 1% Asian, 3% Black, 2% Hispanic, 30% White, 64% unknown) showed near-perfect associations between DLL-ES and CDI long-form scores. Interviews with 10 Hispanic mothers of 18- to 24-month-olds (2 White, 1 Black, 7 multi-racial; 6 female) provide a proof of concept for the value of the DLL-ES for assessing the vocabularies of DLLs.

Cd2+ Detection by an Electrochemical Electrode Based on MWCNT-Orange Peel Activated Carbon.

This study reports the development of a new electrochemical sensor based on a carbon paste electrode (CPE) composed of biomass-based orange peel activated carbon (ACOP) and multiwalled carbon nanotubes (MWCNTs), and this composite is used for the electrochemical detection of cadmium ions (Cd2+). The ACOP/MWCNT composite was characterized by FTIR, Raman, and electrochemical impedance spectroscopy. The electrochemical evaluation of Cd2+ was performed using square wave and cyclic voltammetry. The ACOP/MWCNT-CPE electrochemical sensor exhibited a coefficient of determination r2 of 0.9907, a limit of detection of 0.91 ± 0.79 µmol L-1, and a limit of quantification of 3.00 ± 2.60 µmol L-1. In addition, the developed sensor can selectively detect Cd2+ in the presence of different interferents such as Zn2+, Pb2+, Ni2+, Co2+, Cu2+, and Fe2+ with a relative standard deviation (RSD) close to 100%, carried out in triplicate experiments. The ACOP/MWCNT-CPE presented high sensitivity, stability, and reproducibility and was successfully applied for the detection of Cd2+ in river water samples with recovery rate values ranging from 97.33 to 115.6%, demonstrating to be a very promising analytical alternative for the determination of cadmium ions in this matrix.

Voltammetric Sensing of Nifedipine Using a Glassy Carbon Electrode Modified with Carbon Nanofibers and Gold Nanoparticles.

Nifedipine, a widely utilized medication, plays a crucial role in managing blood pressure in humans. Due to its global prevalence and extensive usage, close monitoring is necessary to address this widespread concern effectively. Therefore, the development of an electrochemical sensor based on a glassy carbon electrode modified with carbon nanofibers and gold nanoparticles in a Nafion® film was performed, resulting in an active electrode surface for oxidation of the nifedipine molecule. This was applied, together with a voltammetric methodology, for the analysis of nifedipine in biological and environmental samples, presenting a linear concentration range from 0.020 to 2.5 × 10-6 µmol L-1 with a limit of detection 2.8 nmol L-1. In addition, it presented a good recovery analysis in the complexity of the samples, a low deviation in the presence of interfering potentials, and good repeatability between measurements.

The Construct Validity of the Childhood Joint Attention Rating Scale (C-JARS) in School-Aged Autistic Children.

Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n  = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n  = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.

Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic.

INTRODUCTION: The coronavirus disease pandemic has pro-foundly affected emergency medical services (EMS) profes-sionals, but the emotional impact is unknown. METHODS: This was a cross-sectional survey of North Carolina EMS profes-sionals from April to May 2021. EMS professionals on an ac-tive roster were included. With pandemic-related perceptions, the 15-item Posttraumatic Maladaptive Beliefs Scale (PMBS) was used to quantify the severity of maladaptive cognition. Significant univariate variables were used to create a hier-archical linear regression to assess the potential impact of pandemic-related factors on maladaptive cognition scores. RESULTS: Overall, 811 respondents were included; of those, 33.3% were female, 6.7% were minorities, and 3.2% were Latinx; the mean age was 41.11 ± 12.42 years. Mean scores on the PMBS were 37.12 ± 13.06 and ranged from 15 to 93. PMBS scores were 4.62, 3.57, and 3.99 points higher, respec-tively, in those with increased anxiety, those who trusted their sources of information, and those who reported to work de-spite being symptomatic. Pandemic-specific factors accounted for 10.6% of the variance in PMBS total scores (ΔR2 = 0.106, ΔF[9, 792]; p < .001). Psychopathological factors accounted for an additional 4.7% of the variance in PMBS total scores (ΔR2 = 0.047, ΔF[3, 789]; p < .001). CONCLUSION: Given that 10.6% of the difference in PMBS scores can be explained by pandemic- related factors, maladaptive cognitions in EMS are a considerable concern and could lead to the development of significant psychopathology post-trauma.

Diagnostic potential of the amniotic fluid cells transcriptome in deciphering mendelian disease: a proof-of-concept.

RNA sequencing (RNA-seq) is emerging in genetic diagnoses as it provides functional support for the interpretation of variants of uncertain significance. However, the use of amniotic fluid (AF) cells for RNA-seq has not yet been explored. Here, we examined the expression of clinically relevant genes in AF cells (n = 48) compared with whole blood and fibroblasts. The number of well-expressed genes in AF cells was comparable to that in fibroblasts and much higher than that in blood across different disease categories. We found AF cells RNA-seq feasible and beneficial in prenatal diagnosis (n = 4) as transcriptomic data elucidated the molecular consequence leading to the pathogenicity upgrade of variants in CHD7 and COL1A2 and revising the in silico prediction of a variant in MYRF. AF cells RNA-seq could become a reasonable choice for postnatal patients with advantages over fibroblasts and blood as it prevents invasive procedures.

Plant Virus and Virus-like Disease Threats to Australia's North Targeted by the Northern Australia Quarantine Strategy.

The Northern Australia Quarantine Strategy (NAQS) is a biosecurity initiative operated by the Australian federal government's Department of Agriculture, Water and the Environment (DAWE). It is unique worldwide because it deals specifically with the potential arrival via unregulated pathways of exotic threats from overseas in a vast and sparsely populated region. It aims to protect the nation's animal- and plant-based production industries, as well as the environment, from incursions of organisms from countries that lie immediately to the north. These are diseases, pests, and weeds present in these countries that are currently either absent from, or under active containment in, Australia and may arrive by natural or human-assisted means. This review article focuses on the plant viruses and virus-like diseases that are most highly targeted by the NAQS program. It presents eight pathogen species/group entries in the NAQS A list of target pathogens, providing an overview of the historical and current situation, and collates some new data obtained from surveillance activities conducted in northern Australia and collaborative work overseas.

Association between productive parameters and intestinal histomorphological findings in broilers supplemented with probiotics (Saccharomyces cerevisiae, Lactobacillus acidophilus and Bacillus subtilis) / Asociación entre parámetros productivos y hallazgos histomorfológicos en pollos de engorde suplementados con probióticos (Saccharomyces cerevisiae, Lactobacillus acidophilus y Bacillus subtilis)

SUMMARY: This study evaluates the effect of probiotics Saccharomyces cerevisiae, Lactobacillus acidophilus and Bacillus subtilis on production parameters and intestinal histomorphology of broilers of 45 days of age. Eleven 45-day-old Ross 500 broilers were used and classified as control group (CG) (n = 5) or supplemented with probiotics group (n = 8). Histopathological evaluation of duodenum, ileum, and jejunum was performed. The area of the villi height, base and apex were evaluated as well as the size and number of crypts. In addition, mucus production was quantified in different portions of the small intestine. The villi present duodenum of broilers supplemented with probiotics had a greater area (p = 0.0127), a greater basal width (p = 0.0049) and a greater apical width (p = 0.0024), as well as a greater crypt area (p = 0.0189). Significantly higher levels of mucus were noted in the duodenum (p = 0.0480) and jejunum (p = 0.0480) of broilers supplemented with probiotics. We suggest that probiotic supplementation improve the intestinal nutrients absorption.

RESUMEN: Este estudio evalúa el efecto del uso de probióticos como: Saccharomyces cerevisiae, Lactobacillus acidophilus, Bacillus subtilis en parámetros productivos e histomorfologia intestinal de pollos de engorde de 45 días de edad. Fueron usados 11, los cuales fueron clasificados en grupo control (CG) (n = 5) y grupo suplementado con probióticos (PG) (n = 8). Fue realizado análisis histopatológico de secciones de duodeno, íleon y yeyuno. Fue evaluado ancho, altura y área del ápice de la vellosidad, área y número de criptas. Además, fue estimada la producción de moco en los diferentes segmentos del intestino delgado. Fue observada mayor área de la vellosidad en duodeno, PG (p = 0.0127), ancho basal mayor en PG (p = 0.0049) ancho apical mayor en PG (p = 0.0024), así como mayor área de criptas en PG (p = 0.0189). No fueron encontradas diferencias significativas respecto a los segmentos de yeyuno e íleon. PG presentó mayor producción de moco en duodeno (p = 0.0480) y en yeyuno (p = 0.0480). Concluimos que la suplementación con probióticos en pollos de engorde genera cambios en la histomorfologia intestinal, evidenciables en áreas apicales y basales de las vellosidades intestinales. Soporte financiero: Dirección General de Investigaciones - Universidad de los Llanos.

(Hyper)active Data Curation: A Video Case Study from Behavioral Science.

Video data are uniquely suited for research reuse and for documenting research methods and findings. However, curation of video data is a serious hurdle for researchers in the social and behavioral sciences, where behavioral video data are obtained session by session and data sharing is not the norm. To eliminate the onerous burden of post hoc curation at the time of publication (or later), we describe best practices in active data curation-where data are curated and uploaded immediately after each data collection to allow instantaneous sharing with one button press at any time. Indeed, we recommend that researchers adopt "hyperactive" data curation where they openly share every step of their research process. The necessary infrastructure and tools are provided by Databrary-a secure, web-based data library designed for active curation and sharing of personally identifiable video data and associated metadata. We provide a case study of hyperactive curation of video data from the Play and Learning Across a Year (PLAY) project, where dozens of researchers developed a common protocol to collect, annotate, and actively curate video data of infants and mothers during natural activity in their homes at research sites across North America. PLAY relies on scalable standardized workflows to facilitate collaborative research, assure data quality, and prepare the corpus for sharing and reuse throughout the entire research process.

Pediatric Telehealth in the COVID-19 Pandemic Era and Beyond.

The coronavirus disease 2019 (COVID-19) pandemic led to an unprecedented demand for health care at a distance, and telehealth (the delivery of patient care using telecommunications technology) became more widespread. Since our 2018 state-of-the-art review assessing the pediatric telehealth landscape, there have been many changes in technology, policy, payment, and physician and patient acceptance of this care model. Clinical best practices in telehealth, on the other hand, have remained unchanged during this time, with the primary difference being the need to implement them at scale.Because of the pandemic, underlying health system weaknesses that have previously challenged telehealth adoption (including inequitable access to care, unsustainable costs in a fee-for-service system, and a lack of quality metrics for novel care delivery modalities) were simultaneously exacerbated. Higher volume use has provided a new appreciation of how patients from underrepresented backgrounds can benefit from or be disadvantaged by the shift toward virtual care. Moving forward, it will be critical to assess which COVID-19 telehealth changes should remain in place or be developed further to ensure children have equitable access to high-quality care.With this review, we aim to (1) depict today's pediatric telehealth practice in an era of digital disruption; (2) describe the people, training, processes, and tools needed for its successful implementation and sustainability; (3) examine health equity implications; and (4) critically review current telehealth policy as well as future policy needs. The American Academy of Pediatrics (AAP) is continuing to develop policy, specific practice tips, training modules, checklists, and other detailed resources, which will be available later in 2021.

'Candidatus Phytoplasma dypsidis', a novel taxon associated with a lethal wilt disease of palms in Australia.

A phytoplasma was initially detected in Dypsis poivriana by nested and real-time PCR from the botanical gardens in Cairns, Queensland, Australia in 2017. Further surveys in the Cairns region identified phytoplasma infections in eight additional dying ornamental palm species (Euterpe precatoria, Cocos nucifera, Verschaffeltia splendida, Brassiophoenix drymophloeodes, Burretiokentia hapala, Cyrtostachys renda, Reinhardtia gracilis, Carpoxylon macrospermum), a Phoenix species, a Euterpe species and two native palms (Archontophoenix alexandrae). Analysis of 16S rRNA gene sequences showed that this phytoplasma is distinct as it shared less than 97.5 % similarity with all other 'Candidatus Phytoplasma' species. At 96.3 % similarity, the most closely related formally described member of the provisional 'Ca. Phytoplasma' genus was 'Ca. Phytoplasma noviguineense', a novel taxon from the island of New Guinea found in monocotyledonous plants. It was slightly more closely related (96.6-96.8 %) to four palm-infecting strains from the Americas, which belong to strain group 16SrIV and which have not been assigned to a formal 'Candidatus Phytoplasma' species taxon. Phylogenetic analysis of the 16S rRNA gene and ribosomal protein genes of the phytoplasma isolate from a dying coconut palm revealed that the phytoplasma represented a distinct lineage within the phytoplasma clade. As the nucleotide identity with other phytoplasmas is less than 97.5 % and the phylogenetic analyses show that it is distinct, a novel taxon 'Candidatus Phytoplasma dypsidis' is proposed for the phytoplasma found in Australia. Strain RID7692 (GenBank accession no. MT536195) is the reference strain. The impact and preliminary aspects of the epidemiology of the disease outbreak associated with this novel taxon are described.

Factor analysis of the Home Handedness Questionnaire: Unimanual and role differentiated bimanual manipulation as separate dimensions of handedness.

Questionnaires are commonly used to measure handedness. However, popular measures do not capture hand preference by skill type, thus reducing handedness to a single dimension. An exception is the Home Handedness Questionnaire (HHQ), an action-based measure developed initially for children, which measures skills across two dimensions of handedness: unimanual actions and role differentiated bimanual manipulation (RDBM). The goal of the current study was to confirm the factor structure of the HHQ in a large sample of adults (N = 1051). A secondary goal was to measure RDBM hand preference in adults. To further validate the HHQ, participants also completed the Edinburgh Handedness Inventory (EHI). Confirmatory factor analysis verified the two-factor structure of the HHQ, and a one-factor solution was replicated for the EHI. Individuals that were classified as consistent on the EHI had stronger preferences for unimanual and RDBM hand use on the HHQ. Right hand patterning was reduced for RDBM compared to unimanual on the HHQ, and the EHI. The HHQ was found to be reliable and valid against the EHI. The HHQ offers researchers a tool to examine individual differences across manual skills that comprise the neuropsychological phenomenon handedness, and to more broadly examine laterality patterns with respect to cognition.

Evidence-based Medicine Simulation: A Novel and Practice-relevant Approach to Teaching Real-time Literature Searching to Emergency Medicine Residents.

INTRODUCTION: Evidence-based medicine (EBM) and literature searching skills are competencies within the emergency medicine (EM) residency curriculum. Previously in our residency program, a librarian taught literature searching instruction, including a classroom-based overview of search engines. Learners reported low engagement and poor retention. To improve engagement, interest, and skill retention, we used a novel approach: simulation to teach real-time literature searching. METHODS: Based on a needs assessment of our EM residents, we created a literature searching workshop using a flipped classroom approach and high-fidelity simulation. Goals of the session were to be interactive, engaging, and practice-relevant. With a librarian, we developed a brief list of EM-relevant databases, including tips for searching and links to sites/apps. Prereadings also covered the hierarchy of evidence and formulating a good clinical (PICO) question. Residents (12 junior residents) participated in a high-fidelity simulation involving a stable patient whose management required a literature search to inform decisions. Feedback was collected on the simulation experience. RESULTS: Residents received the list of EM-relevant databases 7 days prior and were instructed to set up and test the resources on their smartphones. The day of the session, one resident volunteered to lead the simulation; all residents participated in the search on their smart phones. Collectively, it took 4.5 minutes to find a study that adequately addressed the clinical question and to manage the patient accordingly. Feedback on the simulation was positive. Students found it "very real and practical" and "immediately institutable into practice." It helped residents learn to efficiently and effectively search the literature while managing a stable patient. CONCLUSION: A flipped-classroom simulation-based teaching strategy made learning literature searching more interesting, engaging, and applicable to EM practice. Based on popular demand, we will continue to use this teaching method.

Evaluation of trauma resources in rural northern Alberta identifies opportunities for improvement.

Background: The care of rural trauma patients in northern Alberta can be extremely challenging because of the vast geographic area, the limited access to health care facilities and the lack of adequate resources to manage severe injuries. Identifying gaps in equipment and personnel in rural centres can provide opportunities for improving the care of injured patients in these environments. We conducted a survey based on Canadian Accreditation Council quality indicators to evaluate trauma infrastructure and human resources in rural centres across northern Alberta. Methods: A standardized survey was developed to assess the availability of trauma-specific equipment and personnel across the prehospital and emergency department (ED) settings. The survey was distributed to 50 peripheral hospitals biannually from January 2017 to September 2018. Two-tailed paired t tests were used to evaluate changes in survey responses; a p value of less than 0.05 was considered statistically significant. Results: The survey response rate was 100%. By the end of the study period, there were significant improvements in the number of providers (p = 0.04), nurses (p = 0.01) and dedicated trauma resuscitation bays (p = 0.04) in the ED for managing injured patients. There were also significant increases in the availability of equipment, including advanced airway management tools (p = 0.02), rapid infusion devices (p = 0.02) and warmers (p = 0.04). Access to x-ray equipment (p = 0.03) and computed tomography (CT) scanners (p = 0.04) as well as equipment to support telehealth and teleconferencing (p = 0.04) increased during the study period. Access to, and supply of, blood products also increased significantly (p = 0.02) during the study period. Conclusion: Our study demonstrates that the trauma resources of rural health care centres may be evaluated in a standardized fashion centres, and the results point to opportunities to remedy gaps in equipment and personnel. Our methods may be applied to any trauma network that serves geographically large areas with a sparse distribution of health care facilities, to provide critical information for the optimization of resources in rural trauma.

Contexte: Les soins aux patients victimes de traumatismes en région rurale dans le nord de l'Alberta peuvent être très difficiles en raison de la superficie de la région, de l'accès limité aux établissements de santé et du manque de ressources pour soigner adéquatement les blessures graves. En repérant les lacunes en équipement et en personnel dans les établissements en région rurale, on peut créer des occasions d'améliorer les soins aux patients blessés dans ces milieux. Nous avons mené un sondage fondé sur les indicateurs de qualité du Conseil d'accréditation canadien pour évaluer les infrastructures et les ressources humaines en traumatologie dans les établissements des régions rurales du nord de l'Alberta. Méthodes: Un sondage standardisé a été créé pour évaluer la disponibilité des équipements et des ressources humaines en traumatologie en contexte préhospitalier et aux services d'urgence. Le sondage a été distribué 2 fois par année à 50 hôpitaux entre janvier 2017 et septembre 2018. Des tests t appariés ayant une hypothèse non nulle ont été utilisés pour évaluer les changements dans les réponses au sondage; les résultats ayant une valeur p < 0,05 étaient considérés comme statistiquement significatifs. Résultats: Le taux de participation au sondage était de 100 %. À la fin de la période étudiée, il y avait une amélioration significative du nombre de fournisseurs (p = 0,04), de personnel infirmier (p = 0,01) et d'espaces de réanimation réservés à la traumatologie (p = 0,04) dans les services d'urgence. Il y avait aussi une augmentation significative de la disponibilité de l'équipement, notamment des outils de prise en charge avancée des voies respiratoires (p = 0,02), des appareils de perfusion rapide (p = 0,02) et d'armoires chauffantes (p = 0,04). Les équipements de radiographie (p = 0,03) et de tomographie par ordinateur (p = 0,04) ainsi que les équipements facilitant la télémédecine et les téléconférences (p = 0,04) sont devenus plus accessibles pendant la période étudiée. Les réserves de produits sanguins et l'accès à ces produits a aussi augmenté de manière significative (p = 0,02). Conclusion: Notre étude montre que les ressources en traumatologie dans les établissements de santé en région rurale peuvent être évaluées de manière standardisée, et les résultats indiquent qu'il y a des occasions de combler les lacunes en équipement et en personnel. Notres méthodes peuvent être reproduites dans tout réseau de traumatologie couvrant un grand territoire où les établissements de santé sont dispersés, pour fournir des données critiques sur l'organisation des ressources de traumatologie en région rurale.

Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. OBJECTIVE: To describe how the skilled tele-intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. METHODS: We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele-intensive care unit nurses to work from home. RESULTS: Tele-intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele-intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. CONCLUSION: Tele-intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.

CAEP 2019 Academic Symposium: Got competence? Best practices in trainee progress decisions.

BACKGROUND: Competence committees play a key role in a competency-based system of assessment. These committees are tasked with reviewing and synthesizing clinical performance data to make judgments regarding residents' competence. Canadian emergency medicine (EM) postgraduate training programs recently implemented competence committees; however, a paucity of literature guides their work. OBJECTIVE: The objective of this study was to develop consensus-based recommendations to optimize the function and decisions of competence committees in Canadian EM training programs. METHODS: Semi-structured interviews of EM competence committee chairs were conducted and analyzed. The interview guide was informed by a literature review of competence committee structure, processes, and best practices. Inductive thematic analysis of interview transcripts was conducted to identify emerging themes. Preliminary recommendations, based on themes, were drafted and presented at the 2019 CAEP Academic Symposium on Education. Through a live presentation and survey poll, symposium attendees representing the national EM community participated in a facilitated discussion of the recommendations. The authors incorporated this feedback and identified consensus among symposium attendees on a final set of nine high-yield recommendations. CONCLUSION: The Canadian EM community used a structured process to develop nine best practice recommendations for competence committees addressing: committee membership, meeting processes, decision outcomes, use of high-quality performance data, and ongoing quality improvement. These recommendations can inform the structure and processes of competence committees in Canadian EM training programs.

Measuring infant handedness reliably from reaching: A systematic review.

Researchers have utilized reaching paradigms to measure infant handedness for more than a century. However, methods vary widely. Recent research has identified that the number of trials used in assessment is critical with the recommendation that at least 15 trials are necessary to reliably classify infants into handedness categories via statistical cutoffs. As a first step towards establishing best practices for the field, we identified, categorized, and synthesized findings according to trial number from studies that utilized reaching to index handedness in infants across the first two years of life using PRISMA guidelines. Database searches were conducted in PsycINFO, PubMed, and Ovid MEDLINE®. All articles published through May 2018 were included. Additional records were identified through other sources. After removing duplicates, 1,116 records were screened using the online software program Abstrackr. Of these records, 125 full-text articles were further assessed for eligibility, and 87 articles were included in the qualitative synthesis. Results revealed that the majority of papers published since 1890 (70%) do not meet the 15-trial minimum criterion for statistically reliable measurement of infant handedness. Broad themes from articles meeting the measurement criterion and implications for future research are discussed.