COVID-19 Pandemic Effects on Job Search and Employment of Graduates (2015-2020) of Canadian Dietetic Programmes.

Purpose: Self-reported coronavirus 2019 (COVID-19) pandemic effects on dietetic job search, employment, and practice of recent graduates were explored within a national workforce survey.Methods: Graduates (2015-2020) who were registered/licensed dietitians or eligible to write the Canadian Dietetic Registration Exam were recruited through dietetic programmes, Dietitians of Canada's communication channels, and social media. The online survey, available in English and French from August through October 2020, included questions about pandemic experiences. Descriptive statistics and thematic analysis were applied to closed and open-ended responses, respectively.Results: Thirty-four percent of survey respondents (n = 524) indicated pandemic effects on job search and described delayed entry into dietetics, fewer job opportunities, and challenges including restricted work between sites. The pandemic affected employment for 44% of respondents; of these, 45% indicated working from home, 45% provided virtual counselling, 7% were redeployed within dietetics, 14% provided nondietetic COVID-19 support, and 6% were furloughed or laid off. Changed work hours, predominantly reduced, were identified by 29%. Changes in pay, identified by 12%, included loss (e.g., raises deferred) or gain (e.g., pandemic pay). Fear of infection and stress about careers and finances were expressed.Conclusion: The COVID-19 pandemic profoundly affected both acquiring positions and employment in 2020 for recent dietetic graduates.

Eat, play, live: a randomized controlled trial within a natural experiment examining the role of nutrition policy and capacity building in improving food environments in recreation and sport facilities.

BACKGROUND: Recreation and sport facilities often have unhealthy food environments that may promote unhealthy dietary patterns among children. In response, some Canadian provinces have released voluntary nutrition guidelines for recreation and sport facilities, however implementation has been limited. Organizational capacity building may overcome barriers to implementing guidelines. Eat, Play, Live was a randomized controlled trial embedded within a natural experiment that tested the impact of an 18 month capacity building intervention (CBI) in enhancing implementation of provincial nutrition guidelines, and whether nutrition guidelines were associated with positive changes. Primary outcomes were facility capacity, policy development and food environment quality. METHODS: Recreation and sport facilities in three guideline provinces were randomized into a guideline + CBI (GL + CBI; n = 17) or a guideline only comparison condition (GL-ONLY; n = 15). Facilities in a province without guidelines constituted a second comparison condition (NO-GL; n = 17). Facility capacity, policy development, and food environment quality (vending and concession) were measured and compared at baseline and follow-up across conditions using repeated measures ANOVA and Chi-square statistics. Healthfulness of vending and concession items was rated as Do Not Sell (least nutritious), Sell Sometimes or Sell Most (most nutritious). RESULTS: There were significant time by condition effects, with significant increases in facility capacity (mean ± SD: 30.8 ± 15.6% to 62.3 ± 22.0%; p <  0.01), nutrition policy development (17.6% developed new policies; p = 0.049), overall quality of the concession food environment (14.7 ± 8.4 to 17.5 ± 7.2; p <  0.001), and in the proportion of Sell Most (3.7 ± 4.4% to 11.0 ± 9.0%; p = 0.002) and Sell Sometimes vending snacks (22.4 ± 14.4% to 43.8 ± 15.8%; p <  0.001) in GL + CBI facilities, with a significant decline in Do Not Sell vending snacks (74.0 ± 16.6% to 45.2 ± 20.1%; p <  0.001). CONCLUSIONS: Significant improvements in facility capacity, policy development and food environment quality occurred in recreation and sport facilities that were exposed to nutrition guidelines and participated in a CBI. Outcomes did not improve in facilities that were only passively or not at all exposed to guidelines. Ongoing capacity building may enhance implementation of voluntary nutrition guidelines, however food environments remained overwhelmingly unhealthy, suggesting additional scope to enhance implementation. TRIALS REGISTRATION: Clinical trials registration (retrospectively registered): ISRCTN14669997 Jul 3, 2018.

Adolescent perspectives of the recreational ice hockey food environment and influences on eating behaviour revealed through photovoice.

OBJECTIVE: Unhealthy dietary behaviours are prevalent among adolescents. This might relate, in part, to obesogenic environments, including recreation food facilities. The REFRESH Study (Recreation Environment and Food Research: Experiences from Hockey) aimed to explore, from the perspectives of adolescent ice hockey players and parents, broad social and physical environmental influences on adolescent food behaviours associated with hockey participation. DESIGN: Players used photovoice to describe their food experiences in relation to ice hockey. The approach included photos, individual interviews and focus groups. Exemplar photographs were exhibited for stakeholders, including five parents who were interviewed. Interview and focus group transcripts were thematically analysed. SETTING: Recreational ice hockey environment, Ontario, Canada, 2015-16. SUBJECTS: Ice hockey players (n 24) aged 11-15 years recruited from five leagues. RESULTS: Dominant influences among players included: their perceived importance of nutrients (e.g. protein) or foods (e.g. chocolate milk) for performance and recovery; marketing and branding (e.g. the pro-hockey aura of Tim Horton's®, Canada's largest quick-service restaurant); social aspects of tournaments and team meals; and moral values around 'right' and 'wrong' food choices. Both players and parents perceived recreational facility food options as unhealthy and identified that travel and time constraints contributed to less healthy choices. CONCLUSIONS: Results indicate recreation facilities are only one of a range of environments that influence eating behaviours of adolescent ice hockey players. Players' susceptibility to advertising/brand promotion and the value of healthy food choices for performance are findings that can inform policy and interventions to support healthy environments and behaviours.

The effect of emotion on articulation rate in persistence and recovery of childhood stuttering.

PURPOSE: This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering). METHODS: The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated. RESULTS: Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech. CONCLUSION: Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering.

What women want: convenient appointment times for cervical screening tests.

Little is known about women's preferred appointment times for cervical screening tests. Data from a postal questionnaire survey were used to compare preferred appointment times with those given. Although 33.4%[95% confidence intervals (CI) 31.8%-35.0%] of respondents received appointments between 10h00 and 11h55, only 17.0% (95% CI 15.3%-18.7%) wanted an appointment at that time. Nineteen per cent (95% CI 17.4%-21.0%) of respondents wanted appointments between 18h00 and 20h00, but only 4.4% (95% CI 3.7%-5.1%) received them. Saturday appointments for cervical screening are not given; however, overall approximately 13% of those surveyed would have preferred a Saturday appointment. Preferred times also varied significantly with age and deprivation category. Further research is required to determine whether appointment times for cervical screening can be tailored to meet these expressed needs, and the impact this has on service provision and uptake.

Information given to women invited for cervical screening: results of two postal surveys seven years apart.

In South Staffordshire, England, we compared women's views on information provided to them at different stages of the cervical screening program in 1994 with that provided in 2001. An age-stratified random sample of women aged 20-64 years who had a cervical smear taken between January and March 1994 (3856) or between January and March 2001 (4057) were sent postal questionnaires in June 1994 and July 2001, respectively. Response rates in 1994 (3124/3856, 81%) and 2001 (3288/4057, 81%) were similar. Compared to 1994, the proportion of women who thought the invitation letter was clear to read in 2001 increased (70% vs 98%, P < 0.0001); however, letters were thought to be less reassuring in 2001 compared to 1994 (P < 0.0001). In both study periods, 66% of women reported that the procedure was explained to them before the smear was taken. A greater proportion of women received their results by letter in 2001 compared to 1994 (57% vs 41%, P < 0.0001); however, 49% of women waited >4 weeks to receive their results in 2001 compared to 26% in 1994 (P < 0.0001). Bivariate analysis suggests that responses were age related, with older women (> or =45 years) experiencing poorer information provision. The issues highlighted by this study deserve further investigation in other areas.

Response patterns to a postal survey using a cervical screening register as the sampling frame.

This study compared different types of respondent to a postal survey. A random sample of women aged 20-64 years (n = 4057) was selected from a population-based cervical screening register to examine their information experience during the screening programme. The initial response rate was 57%, and this increased to 81% after one reminder. Respondents were older (P < 0.0001) than non-respondents, but both groups were comparable with regard to attendance history for cervical screening (respondents 89.3%; non-respondents 89.1%) and normal smear test results (respondents 84.0%; non-respondents 81.4%). Early and late respondents were similar in age. Compared with late respondents, early respondents were more likely to live in highly affluent (P < 0.0001) and rural areas (P = 0.026). They were also more likely to be non-attenders (P < 0.0001), but they were less likely to have had inadequate smear results (P = 0.030) than late respondents. These results suggest that consideration should be given to factors other than sociodemographic differences when examining response patterns to postal surveys.

The kinetics of the tanning response to tanning bed exposures.

No clinical studies have been published documenting the development of pigmentation following the use of the Food and Drug Administration (FDA) recommended exposures from a tanning bed. Panelists were exposed three times weekly for eight weeks (24 exposures) using the FDA recommended exposure schedule. The initial tan was noted after only six exposures and quantitatively increased through the remainder of the study.

The amyloid beta-protein precursor of Alzheimer's disease is degraded extracellularly by a Kunitz protease inhibitor domain-sensitive trypsin-like serine protease in cultures of chick sympathetic neurons.

The amyloid beta-protein precursor (APP) of Alzheimer's disease (AD) is cleaved either by alpha-secretase to generate an N-terminally secreted fragment, or by beta- and gamma-secretases to generate the beta-amyloid protein (Abeta). The accumulation of Abeta in the brain is an important step in the pathogenesis of AD. Alternative mRNA splicing can generate isoforms of APP which contain a Kunitz protease inhibitor (KPI) domain. However, little is known about the physiological function of this domain. In the present study, the metabolic turnover of APP was examined in cultured chick sympathetic neurons. APP was labelled by incubating neurons for 5 h with [35S]methionine and [35S]cysteine. Intracellular labelled APP decayed in a biphasic pattern suggesting that trafficking occurs through two metabolic compartments. The half-lives for APP in each compartment were 1.5 and 5.7 h, respectively. A small fraction (10%) of the total APP was secreted into the culture medium where it was degraded with a half-life of 9 h. Studies using specific protease inhibitors demonstrated that this extracellular breakdown was due to cleavage by a trypsin-like serine protease that was secreted into the culture medium. Significantly, this protease was inhibited by a recombinant isoform of APP (sAPP751), which contains a region homologous to the Kunitz protease inhibitor (KPI) domain. These results suggest that KPI forms of APP regulate extracellular cleavage of secreted APP by inhibiting the activity of a secreted APP-degrading protease.

Effect of patient age on tests of the acute-phase response.

Tests of the acute-phase response are used to screen for occult disease in the elderly, but there is little consensus as to their diagnostic value because of uncertainty as to the effect of age on reference ranges. We have therefore measured, as a function of age, the blood concentration of acute-phase proteins (C-reactive protein, alpha 1-acid glycoprotein, fibrinogen, albumin, and globulin) in parallel with three screening tests of the acute-phase response (erythrocyte sedimentation rate, plasma viscosity, and zeta sedimentation ratio). The study included 164 healthy individuals (age range, 25 to 84 years) plus 91 elderly ill but ambulant patients (age range, 65 to 84 years) from a family practitioner screening clinic. Reference ranges for the erythrocyte sedimentation rate, plasma viscosity, and zeta sedimentation ratio rose with age, with the erythrocyte sedimentation rate showing a particularly wide reference range. Healthy individuals aged 75 to 84 years, compared with those aged 65 to 74 years, showed a trend to a lower reference range for all three screening tests that may have reflected survival of the fittest individuals to the higher decade. Precise reference ranges are therefore required in the elderly; when these were used, the three screening tests showed a significant difference between elderly well and ill individuals.

Assessment of Diesse Ves-matic automated system for measuring erythrocyte sedimentation rate.

Measurement of the erythrocyte sedimentation rate (ESR) using a closed tube system reduces the biohazard risk to laboratory staff. The Diesse Ves-matic system offers manual or vacuum collection of blood into plastic tubes, automated mixing of the sample, and automated reading of the end point after 20 minutes of sedimentation. This system was compared with the 1977 Westergren ESR method of the International Council for Standardization in Haematology (ICSH) and with the 1988 ICSH undiluted ESR method. Manually collected Ves-matic samples showed good agreement with ICSH values, although there was a tendency to false low results at low ESR values which may represent dilution of plasma protein with excess citrate. Vacuum collected Ves-matic samples also showed good agreement with ICSH values, although there was a tendency to false high results which may reflect a change in the blood: citrate ratio caused by loss of anticoagulant diluent or vacuum from plastic tubes during storage. The Diesse Ves-matic system incorporates several improvements over previous technology and offers a safer, quicker, and more standardised ESR.

Evaluation of a 200 mm long vacuum aspiration tube for measurement of erythrocyte sedimentation rate.

The ESrT-system 200 comprises a 215 mm long vacuum aspiration venepuncture tube which contains anticoagulant diluent for the measurement of the erythrocyte sedimentation rate (ESR) without direct handling of the blood sample. This combines the advantage of a tube of "Westergren" length with a reduction in biohazard risk. Blood from 160 patients (ESR range 2-135 mm/first hour) was tested in parallel with the selected Westergren ESR method of the International Committee for Standardization in Haematology (ICSH) and a close correlation (r = 0.967) between the two methods was obtained. A second Westergren ESR, using anticoagulated but undiluted blood, was measured on 58 specimens to give an ICSH "expected" ESR. The ESrT-system 200 result was within 12 mm/first hour of the "expected" result for 91% of the specimens. This new ESR system is simple to use, does not require mathematical correction of the ESR reading for tube length, and gives results that are comparable with those obtained with the ICSH Westergren method.

Red cell membrane and cation deficiency in Rh null syndrome.

A 52-yr-old multiparous white female was found to have Rh null blood type. She had macrocytic anemia, with reticulocytosis (15%-20%), of long duration. Although stomatocytes in peripheral blood were numerous and osmotic fragility was increased, suggesting increased cell water, the RBC cation content, and thus cell water, was decreased. Cell dehydration was confirmed by an increased proportion of high density RBC on Stractan density gradients. The deformability of RBC from four gradient subpopulations was measured in the ektacytometer as a function of suspending medium osmolality. Analysis of these measurements showed an abnormal reduction in cell surface area with increasing cell density, thus explaining the increased osmotic fragility of whole blood. This was confirmed by a density-dependent reduction in cell cholesterol content, suggesting membrane instability in vivo. Rh null subpopulations showed a twofold increase in both ouabain-sensitive and -insensitive Na-K ATPase activity and 86Rb transport, even in the dense fraction with the fewest reticulocytes. No membrane protein or glycoprotein abnormality was detected by SDS-PAGE. The associated deficiencies of both membrane surface area and cation content in Rh null cells, as well as increased Na-K pump activity, suggest a pleiotropic functional interrelationship among Rh antigen, membrane stability, and cation regulation.