Not in the file: How competency committees work with undocumented contributions.

Introduction: Competence committees (CCs) centre their work around documentation of trainees' performance; undocumented contributions (i.e. informal, unrecorded material like personal judgements, experiential anecdotes and contextual information) evoke suspicion even though they may play a role in decision making.

Identifying leverage points for sustainable nutrient policy integration in Canada.

Addressing the 'wicked problem' of nutrient pollution requires coordinated policies spanning across diverse sectors and environmental systems. Using a case study of Canadian legislation, we apply semantic network analysis to identify thematic links across an inventory of 245 nutrient-related policies. Our analysis identifies twelve topics with unique types of connections across multiple facets of Canadian society.

A patienthood that transcends the patient: An analysis of patient research partners' narratives of involvement in a Canadian arthritis patient advisory board.

Objectives: Incorporating the perspectives of patients and public into the conduct of research has the potential to make scientific research more democratic. This paper explores how being a patient partner on an arthritis patient advisory board shapes the patienthood of a person living with arthritis.

Methods: An analysis was undertaken of the narratives of 22 patient research partners interviewed about their experiences on the Arthritis Patient Advisory Board (APAB), based in Vancouver, Canada.

Exploring Mistreatment of Medical Students by Patients: A Qualitative Study.

Purpose: Mistreatment of medical students by patients has not been qualitatively explored in the literature. The authors sought to develop a rich understanding of the impact and consequences of medical students' experiences of mistreatment by patients.

Method: This exploratory descriptive qualitative study was conducted at a large Canadian medical school from April-November 2020.

What do you mean, 'negotiating?': Patient, physician, and healthcare professional experiences of navigating hierarchy in networks of interprofessional care.

Interprofessional collaborative practice is a phenomenon that can be fraught with power dynamics between professions, within professions, and between professionals and patients. In the literature, the dominant notion is that conflicting viewpoints and interests arising from unequal power dynamics can be resolved through negotiation. This study examined COPD patients, health professionals, and physician experiences of negotiation within 10 interprofessional collaborative COPD care teams.

A new dietary guideline balancing sustainability and nutrition for China's rural and urban residents.

Diets have important but often complex implications for both environmental quality and nutrition. We establish a production-oriented life cycle model to quantify and compare the farm-to-gate environmental impacts and food nutritional qualities underlying rural and urban diets in China from 1980 to 2019, a period of rapid urbanization and socioeconomic changes. The environmental impacts of rural diets were generally higher than those of urban diets, but this gap reduced after 2000.

Untangling the role of social relationships for overcoming challenges in local food systems: a case study of farmers in Québec, Canada.

Unlabelled: Advocates for re-localizing food systems often encourage consumers to support local farmers and strengthen local food economies. Yet, local food systems hinge not only on consumers' willingness to buy local food but also on whether farmers have the social support networks to address diverse challenges during food production and distribution. This study characterizes the challenges and support systems of farmers selling to local markets in Québec, Canada, across multiple growing seasons using a mixed-methods research design.

A qualitative study of medical students' perceptions of resident feedback.

Context: Residents play a pivotal role in medical students' clinical education. From a feedback lens, the near-peer relationship between student and resident holds the potential to foster an educational alliance that could influence learning. We undertook the current qualitative study to explore medical students' perceptions of feedback experiences with residents, addressing when, how and why (and conversely when not and why not) resident feedback plays a role in their clinical education.

Imaging Modality and Frequency in Surveillance of Stage I Seminoma Testicular Cancer: Results From a Randomized, Phase III, Noninferiority Trial (TRISST).

Purpose: Survival in stage I seminoma is almost 100%. Computed tomography (CT) surveillance is an international standard of care, avoiding adjuvant therapy. In this young population, minimizing irradiation is vital.

Diverse adaptation strategies helped local food producers cope with initial challenges of the Covid-19 pandemic: Lessons from Québec, Canada.

The Covid-19 pandemic has demonstrated the vulnerability of food systems to disturbances. Advocates have promoted short food supply chains as more resilient and adaptable thanks to their embeddedness in local economic and ecological networks. As part of a broader case study on challenges facing farmers in local food supply chains in Québec, Canada, we asked farmers about the pandemic's impacts on food production and marketing in the province, including how food producers coped with these challenges.

Experiences of Wearable Technology by Persons with Knee Osteoarthritis Participating in a Physical Activity Counseling Intervention: Qualitative Study Using a Relational Ethics Lens.

Background: Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. However, recent evidence also identifies some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how persons with knee OA experience benefits or downsides using a wearable in their everyday lives.

Contractility of permeabilized rat vastus intermedius muscle fibres following high-fat, high-sucrose diet consumption.

Obesity is a worldwide health concern associated with impaired physical function. It is not clear if contractile protein dysfunction contributes to the impairment of muscle function observed with obesity. The purpose of this study was to examine if diet-induced obesity affects contractile function of chemically permeabilized vastus intermedius fibres of male Sprague-Dawley rats expressing fast myosin heavy chain (MHC) IIa or slow MHC I.

Macro and meso level influences on distributed integrated COPD care delivery: a social network perspective.

Background: Care guidelines for people with chronic obstructive pulmonary disease (COPD) recommend an integrated approach for holistic, flexible, and tailored interventions. Continuity of care is also emphasised. However, many patients with COPD experience fragmented care.

The persistent threat of emerging plant disease pandemics to global food security.

Plant disease outbreaks are increasing and threaten food security for the vulnerable in many areas of the world. Now a global human pandemic is threatening the health of millions on our planet. A stable, nutritious food supply will be needed to lift people out of poverty and improve health outcomes.

Challenging presentations of germ cell tumours in routine clinical practice.

Testicular cancer is the most common malignancy in young men. We discuss four cases of germ cell tumours (GCTs) presenting to general practitioners and physicians where there were notable preventable delays in the diagnosis and management. This diagnostic delay is associated with a more advanced stage of disease, and subsequent increased treatment-related morbidity and decreased survival.

The U.S. consumer phosphorus footprint: where do nitrogen and phosphorus diverge?

Phosphorus (P) and nitrogen (N) are essential nutrients for food production but their excess use in agriculture can have major social costs, particularly related to water quality degradation. Nutrient footprint approaches estimate N and P release to the environment through food production and waste management and enable linking these emissions to particular consumption patterns. Following an established method for quantifying a consumer-oriented N footprint for the United States (U.

Cardiac ventricular muscle mechanical properties through the first year of life in Sprague-Dawley rats.

Advanced age has been shown to result in decreased compliance, shortening velocity, and calcium sensitivity of the heart muscle. Even though cardiac health has been studied extensively in elderly populations, relatively little is known about cardiac health and age for the first part of adulthood. The purpose of this study was to compare cardiac contractile properties across the first year of life in rats (between 17-53 weeks), corresponding to early to mid-adulthood.

Testicular cancer: improving outcomes with national quality performance indicators.

Testicular cancer is the most common malignancy in young adult men. The prognosis is excellent in limited disease and cure is possible even in advanced disease. Quality performance indicators (QPI) are used in many developed countries as a measure of healthcare performance.

Mechanical adaptations of skinned cardiac muscle in response to dietary-induced obesity during adolescence in rats.

Childhood obesity is a major risk factor for heart disease during adulthood, independent of adulthood behaviours. Therefore, it seems that childhood obesity leads to partly irreversible decrements in cardiac function. Little is known about how obesity during maturation affects the mechanical properties of the heart.

Impact of age on host responses to diet-induced obesity: Development of joint damage and metabolic set points.

Background: Osteoarthritis is one of the leading causes of pain and disability worldwide, and a large percentage of patients with osteoarthritis are individuals who are also obese. In recent years, a series of animal models have demonstrated that obesity-inducing diets can result in synovial joint damage (both with and without the superimposition of trauma), which may be related to changes in percentage of body fat and a series of low-level systemic inflammatory mediators. Of note, there is a disparity between whether the dietary challenges commence at weaning, representing a weanling onset, or at skeletal maturity, representing an adult onset of obesity.

Definitive chemoradiotherapy for cervical cancer: A 11-year population-based study.

Purpose: To assess the recurrence pattern and survival in women treated with definitive chemoradiotherapy for cervical cancer.

Methods: A retrospective cohort study of women FIGO (2012) stage IB2 to IVA from the Grampian region of Scotland between February 2000 and March 2011. These women were followed up until April 2018.

Malignant spinal cord compression.

Malignant spinal cord compression (MSCC) is a potentially devastating consequence of cancer. Early recognition of the signs and symptoms of MSCC can allow diagnosis prior to the development of irreversible complications. Information provision to patients and doctors regarding the risk of MSCC and a streamlined pathway for further investigation are both key to improving the outcome for patients developing this condition.

High-Dose Chemotherapy in Relapsed or Refractory Metastatic Germ-Cell Cancer: The Scotland Experience.

Purpose: To report outcomes from high-dose chemotherapy (HDCT) and autologous stem-cell transplantation (ASCT) for metastatic germ-cell cancer in Scotland.

Patients And Methods: All patients who underwent this treatment between the years 2001 and 2016 at the Beatson West of Scotland Cancer Centre in Glasgow were identified. Information regarding baseline patient and tumor characteristics, prognostic features, HDCT delivery, and survival outcomes were obtained retrospectively from patients' medical records.