To evaluate Canadian student pharmacists' interactions with the pharmaceutical industry and their perceptions of potential bias, implications for future behavior as pharmacists, and conflicts of interest (COI). A national, cross-sectional survey was administered to students enrolled in accredited Canadian PharmD programs. The 31-item instrument examined acceptance of industry gifts, attendance at sponsored events, educational exposure to COI, and institutional policy awareness. Recruitment was conducted via email through student liaisons and associations. Of 4878 eligible students, 563 initiated and 483 completed the survey (response rate: 9.9%). A majority (88%) reported accepting small gifts, and 39% accepted larger gifts (eg, conference funding). Most students (75%) had attended pharmaceutical-sponsored educational or social events. Despite high participation, only a minority (6-17%) viewed these interactions as problematic regarding the impact on their behavior as future pharmacists. About one-third had never considered the implications of accepting gifts or awards. Over half of respondents believed pharmaceutical representatives were valuable information sources, and nearly one-third planned to meet with them in practice. Instruction on COI was inconsistent; only 31% received annual education, and over half were unaware whether their faculty had a COI policy. Observed behaviors of faculty and leaders appeared to normalize industry relationships for many students. Canadian student pharmacists report frequent interactions with the pharmaceutical industry and limited awareness of associated impacts on future professional behavior. These findings highlight the need for more robust, curriculum-based education on COI and industry influence to promote critical reflection and professional integrity.
To explore First Nations understandings of disability and exceptionality and the lived experiences of First Nations adults living with disabilities in Manitoba, Canada. Guided by community-based participatory research and Indigenous methodology, this study was led by a First Nations organization with oversight from an Advisory Circle. A modified grounded theory informed data collection and analysis. Twenty-one First Nations adults with disabilities and eleven family caregivers participated in conversational interviews. Findings were validated by participants, the Advisory Circle, Knowledge Keepers, and First Nations health and social experts. Six themes emerged: (1) Culture as Foundation; (2) Self-Determination and Person-Centered Care; (3) Caring for Caregivers; (4) Social Determinants of Health; (5) Inequitable On-Reserve Supports and Systemic Barriers; and (6) Research and Data. Culture, language, and ceremony were described as central to inclusion and well-being, while systemic inequities-poverty and other social determinants, inaccessible environments, and jurisdictional gaps-exacerbated exclusion and distress. Findings underscore the need to reframe disability supports for First Nations adults through Nation-led, culturally grounded, and life-course approaches. Advancing self-determination, caregiver supports, and data sovereignty is critical to achieving equitable and sustainable systems of care for First Nations adults with exceptionalities. Rehabilitation professionals should provide culturally grounded, strengths-based care that centers First Nations languages, ceremony, land-based practices, and relational approaches.Rehabilitation professionals should support self-determination by partnering with individuals and families across decisions and transitions in care.Rehabilitation professionals should recognize and support caregivers as essential partners in care.Rehabilitation assessment and planning should address social and environmental conditions that shape safety, autonomy, and meaningful participation in community life.
Delay of gratification in early childhood has long been associated with cognitive control and willpower. However, recent research has proposed an alternative perspective, emphasizing the role of habit formation in delaying gratification. We tested key predictions of this framework. Children's habits of waiting should not only increase their delay of gratification, but should decrease the work it takes for children to wait. In addition, the effects of children's habits of waiting should depend on contextual factors. A total of 149 Japanese children aged four to six years participated in a delay of gratification task, where they waited to eat a marshmallow or to open a wrapped gift, with an experimenter who behaved in a trustworthy or an untrustworthy manner. Children waited longer for food than for gifts, and children with stronger habits of waiting to eat waited longer for food but not gifts, consistent with prior work. Moreover, children tended to report that waiting for food took less work than waiting for gifts, and this effect was greater for children with stronger habits of waiting to eat. The trustworthiness of the experimenter did not significantly affect children's wait times, but children reported that waiting for the untrustworthy experimenter took more work than waiting for the trustworthy experimenter. The trustworthiness of the experimenter interacted with: a) children's habits of waiting to eat, with children with stronger habits waiting longer with the trustworthy experimenter only, and b) the strength of parent-child relationships, with children waiting longer with a trustworthy experimenter than with an untrustworthy one only if they had strong parent-child relationships. These findings suggest that cultural habits and social factors can interact and affect the work it takes for children to delay gratification, offering a clearer understanding of why childhood delay of gratification predicts future outcomes. SUMMARY: Cultural dining habits increase Japanese children's delay of gratification for food, reducing perceived effort. Japanese children with stronger eating habits waited longer for food, but not gifts. Waiting with an untrustworthy experimenter increased Japanese children's waiting workload. Strong parent-child relationships predict longer waiting with a trustworthy experimenter.
On-site oral health surveys conducted to epidemiologically assess dental diseases require strategies to prevent a decline in the number of participants and maintain data quality; however, few studies have examined measures to address this issue. This study aimed to identify the preferred conditions for promoting participation in on-site oral health surveys using conjoint analysis. A cross-sectional study using an online survey was conducted in Japan in January 2024. From a panel of an online research company, 1,260 individuals (420 residents of urban, intermediate, and rural areas) were randomly sampled. The participants were evaluated under 16 hypothetical scenarios for oral health surveys, each consisting of seven attributes and their respective levels. Monetary incentives were excluded as attributes, because such measures are typically not applicable to government-administered surveys. In total, 955 individuals were analysed (324 in urban areas; 333 in intermediate areas; and 298 in rural areas). Our conjoint analysis showed that in all three areas, the preferred conditions to promote participation in oral health surveys were nearby dental clinics, conducting the survey on a Saturday or Sunday, providing an explanation of oral health status by a dentist after the survey, and provision of small gifts such as toothbrushes. Conversely, the following conditions were rated unfavourably: location-home visits by investigators, and day of the week-weekdays. The modified Poisson regression analysis revealed that those who did not intend to participate in all 16 hypothetical scenarios were statistically significantly more likely to be older in urban and intermediate areas (prevalence ratio, urban, 60-69 years: 2.52; intermediate, 60-69 years: 2.19). Our findings suggest that an effective strategy to promote participation in on-site oral health surveys includes conducting a survey at nearby dental clinics on holidays, providing participants with an explanation of their oral health status by a dentist, and distributing small gifts such as toothbrushes after the survey. In addition, targeted approaches may be required to encourage participation among older adults, particularly in urban and intermediate areas.
The World Health Organization has recommended intermittent weekly iron-folic acid (IFA) supplementation as the most cost-effective intervention to reduce the burden of anemia among adolescents and women in child bearing age. Given the documented benefits of iron-folic acid supplementation, it goes with jurisdictional hurdles and motivators for uptake yet little is known in this regard in our study's settings. This study aimed to assess the challenges, motivators, and coping strategies for IFA tablets intake among beneficiaries in the Girls Iron-Folic Acid Tablet Supplementation (GIFTS) program of the Upper West region-Ghana. A convergent parallel mixed-methods design (n = 355; three focus group discussions) was used in this study. Semi-structured questionnaire was used to gather data on socio-demographic characteristics, motivators for IFA tablets intake, while focus group discussion was used to collect data on challenges, motivators and coping strategies for IFA tablets intake. Challenges to IFA tablets intake were reported under personal level (pharmacophobia, inadequate knowledge, experienced side effects, and forgetfulness), product level (negative sensory attributes), and school/distribution level (distribution failures and shortages). IFA tablets intake was motivated by perceived personal level benefits (nutritional and health benefits, appetite enhancement, menstrual benefits) derived from the IFA up-take. Participants adopted various coping strategies for personal and product level challenges, (Water therapy, massage therapy, medication, rest/reduced mobility, changed dressing style, avoiding tablets intake, and masking of tablets). The study also showed that participants had no specific coping mechanism for school/distribution level challenges (distribution failures and shortages). Varied challenges, motivators, and coping strategies for IFA intake were identified. Beneficiaries experienced shortages of IFA tablets distribution. It is thus recommended that implementers of the GIFTS program make the tablets readily available to schools to avoid shortages.
The aim of this study was to examine the temporal associations between feelings of emotional connectedness, jealousy, pro-relationship behaviors, and intimate partner violence (IPV) within adolescent and young adult romantic relationships. A cohort of late adolescent females (N = 144), aged 16 to 19, in a dating relationship with physical or psychological IPV, were recruited from public locations and a pediatric emergency department. Participants completed a daily Web-based survey for 4 months on partner-specific feelings of emotional connectedness (i.e., communication, trust, commitment, emotional security); emotional safety; jealousy; pro-relationship behaviors (i.e., had fun together, partner showed appreciation, partner did something that made her feel loved, gave/received a gift); sexual behavior, and experienced and use of psychological and physical IPV. The results of random effects models found previous- and same-day emotional connectedness decreased odds of experienced IPV; however, experienced IPV did not impact next-day emotional connectedness. Feeling less emotionally safe the previous day was associated with experiencing IPV, and both experiencing and using IPV were associated with feeling emotionally unsafe the next day. Made to feel loved and showing appreciation were protective against experienced IPV, while other pro-relationship behaviors were associated with increased risk (i.e., gifts, sex, and fun together). Findings highlight the need to develop prevention strategies that provide youth with meaningful skills to assist in navigating the emotional and behavioral challenges within their romantic relationships.
Iquitos, the most populated city in the Peruvian Amazon, is a hub in the regional supply chain of wild meat and supplies urban consumers. Studies on wild meat consumption have focused primarily on markets, limiting the scope of species considered to those that are economically valuable and potential inferences from those data. We conducted interviews with 1548 households in Iquitos across all four districts to assess wild meat consumption rates for 7831 people in those households. We used species- and source-specific conversion factors to estimate biomass consumed from different species and sources in the supply chain. We estimated that 1786 t (95% CI 636.48-3317.62) of wild mammal meat were consumed in 2019 in Iquitos, which is about 4.25 kg (95% CI 1.54-8.02) per person per year. Markets supplied 57.22% of all wild mammal meat, but 14.67% was purchased from other sources and 27.85% was not purchased. Paca (Cuniculus paca) and collared peccary (Dicotyles tajacu) were the most heavily consumed species, mostly from markets. The majority of meat from other species, such as the woolly monkey (Lagothrix lagotricha) and capybara (Hydrochoerus hydrochaeris), was traded outside markets. Our results indicated that wild mammal consumption rates may be much higher in Iquitos than previously reported, likely because social connections accounted for about half of the supply chain; consumers are receiving wild meat as gifts or were hunting themselves. The breadth of mammal meat consumption demonstrates the contributions of hunting to the food security and economic stability of consumers in Iquitos and the potential for sustainable supply chains of some mammals. Cadenas de suministro informales de carne silvestre procedente de la Amazonía rural y la seguridad alimentaria en un centro urbano Resumen Iquitos, la ciudad más poblada de la Amazonía peruana, es un centro neurálgico de la cadena de suministro regional de carne silvestre y abastece a los consumidores urbanos. Los estudios sobre el consumo de carne silvestre se han centrado principalmente en los mercados, lo que ha limitado el alcance de las especies consideradas a aquellas que tienen valor económico, así como las posibles conclusiones que se pueden extraer de esos datos. Realizamos entrevistas a 1,548 hogares de Iquitos en los cuatro distritos para evaluar las tasas de consumo de carne silvestre de 7,831 personas de esos hogares. Utilizamos factores de conversión específicos por especie y por fuente para estimar la biomasa consumida de diferentes especies y fuentes en la cadena de suministro. Estimamos que en 2019 se consumieron en Iquitos 1,786 t (IC del 95 %: 636.48 – 3,317.62) de carne de mamíferos silvestres, lo que equivale a unos 4.25 (IC del 95 %: 1.54 – 8.02) kg por persona al año. Los mercados suministraron el 57.22 % de toda la carne de mamíferos silvestres, pero el 14.67 % se compró en otras fuentes y el 27.85 % no fue comprado. La paca (Cuniculus paca) y el pecarí de collar (Dicotyles tajacu) fueron las especies más consumidas, principalmente en los mercados. La mayor parte de la carne de otras especies, como el mono lanudo (Lagothrix lagotricha) y el capibara (Hydrochoerus hydrochaeris), se comercializaba fuera de los mercados. Nuestros resultados indicaron que las tasas de consumo de mamíferos silvestres podrían ser mucho más altas en Iquitos de lo que se había informado con anterioridad, probablemente porque las conexiones sociales representaban aproximadamente la mitad de la cadena de suministro; los consumidores reciben carne silvestre como regalo o la cazan ellos mismos. La extensión del consumo de carne de mamíferos demuestra la contribución de la caza a la seguridad alimentaria y la estabilidad económica de los consumidores en Iquitos, así como el potencial de cadenas de suministro sostenibles de algunos mamíferos. 【摘要】 伊基托斯是秘鲁亚马逊地区人口最多的城市, 也是该地区野生肉类供应链的枢纽, 为城市消费者供应着野生肉类。目前, 关于野生肉类消费的研究主要集中在市场上, 导致研究仅关注具有经济价值的物种, 也限制了由此数据所能得出的推论。我们对伊基托斯四个行政区的1,548户家庭进行了访谈, 以评估这些家庭中7,831人的野生肉类消费量。我们使用了针对物种及来源特异的转换系数, 来估算供应链中不同物种和来源的生物量消费量。研究估计, 2019年伊基托斯地区消费了1,786吨(95%置信区间:636.48–3,317.62吨)野生哺乳动物肉类, 人均年消费量约为4.25千克(95%置信区间:1.54–8.02千克)。市场供应了全部野生哺乳动物肉类的57.22%, 还有14.67%由其他渠道购买, 而27.85%未通过购买获得。驼鼠(Cuniculus paca)和领西貒(Dicotyles tajacu)是被消费最多的物种, 主要来自市场。其他物种(如绒毛猴[Lagothrix lagotricha]和水豚[Hydrochoerus hydrochaeris])的大部分肉类是在市场外交易的。我们的研究结果表明, 伊基托斯的野生哺乳动物消费率可能远高于此前报告的水平, 这很可能是因为社交关系占据了供应链的一半左右;消费者可通过受赠或亲自狩猎获得野生肉类。哺乳动物肉类的广泛消费表明, 狩猎对伊基托斯消费者的粮食安全和经济稳定做出了贡献, 同时也显示出建立特定哺乳动物可持续供应链的潜力。【翻译:胡怡思;审校:聂永刚】.
Conflict-of-interest (COI) between doctors and the pharmaceutical industry is widespread and is present in the majority of practitioners. The effects of COI on how doctors prescribe and hence on the health of their patients is negative. This article first summarizes the widespread nature of COI and then examines what forms it takes and how doctors view COI. It next looks at the two ways that have been used to try and limit its influence - managing COI and avoiding COI - and shows that managing COI by limiting gifts to small amounts and relying on declaring COI are based on false assumptions and have little chance of producing any positive results. It then goes on to review the measures that have been shown to be beneficial, particularly policies and legislation restricting or prohibiting certain types of COI among medical students, residents and practicing doctors. Finally, this article looks at how to build upon the successes that have occurred and what more could be done.
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Communities of Practice (CoPs) offer a powerful framework for advancing faculty collaboration, professional identity formation, and the scholarship of teaching and learning (SoTL) in higher education. This article describes the design, implementation, and evolution of the Teaching, Learning, and Student Success (TLSS) Theme Team, a context-specific CoP established within the University of Tennessee Health Science Center College of Pharmacy to promote innovation in teaching and educational scholarship. The TLSS Theme Team was created to enhance collaboration across departments and campuses, mentor junior faculty, and align SoTL initiatives with institutional priorities. Guided by the core CoP constructs of domain, community, and practice, the team functions through shared goals, structured meetings, and dissemination of scholarly work. Key features include voluntary membership, rotating leadership, and minimal resource requirements supported by modest institutional funding. Activities such as quarterly meetings, annual retreats, and internal seed grants foster engagement, accountability, and shared productivity. Outcomes include increased collaboration, development of educational research skills, and scholarly dissemination. Implementation of the theme team was associated with increased cross-disciplinary collaboration, new joint projects, and an increase in scholarly publications over five years. This model demonstrates a feasible, scalable, and cost-effective approach to fostering SoTL and faculty development within pharmacy education. The theme team framework may be adapted by other institutions seeking to strengthen scholarly collaboration, align faculty development with accreditation and institutional goals, and build enduring cultures of teaching excellence and innovation.
Children with solid organ transplants (SOT) face higher risks of severe disease from varicella-zoster virus (VZV). Although some guidelines recommend live attenuated varicella vaccine (LAVV) for select children post SOT, further real-world vaccine immunogenicity and safety data are needed. A prospective observational study was conducted at 4 Canadian centres from 2020 to 2023. Children who were 1-19 years, VZV IgG negative, > 1 year post liver, kidney, or heart transplant, and were receiving LAVV as part of clinical care in accordance with centre-specific criteria were eligible for inclusion. Measurement of VZV IgG was recommended post-vaccination with LAVV. Adverse events following immunization (AEFIs) were captured via telephone survey and chart review. Fifty-six pediatric SOT recipients (51 liver, 3 kidney, and 2 heart) received ≥ 1 dose of LAVV. Serology after the last post-transplant dose of LAVV was available for 43/56 (77%) participants; 39/43 (91%) seroconverted to positive VZV IgG (12/16 after 1 post-transplant dose, 26/30 after 2 doses and 1/1 after 3 doses). Among 56 dose 1 recipients, 6 (11%) experienced an AEFI requiring medical attention. Four had rash: 3 with varicella-like rash (1/3 confirmed vaccine-strain varicella) and none required antivirals. Two had acute rejection 4-5 weeks after LAVV. Two of 38 (5%) dose 2 recipients had an AEFI requiring medical attention, with one serious AEFI 7 weeks after LAVV that was not deemed vaccine-related after careful review. LAVV was immunogenic and generally well tolerated in our cohort of patients. Post-SOT LAVV should be considered for select VZV seronegative children with close follow-up.
Flexible bronchoscopy (FB) is a key diagnostic and therapeutic procedure in the intensive care unit (ICU). However, significant heterogeneity exists regarding indications, peri-procedural management, training and safety practices across ICUs. Data on real-world practices remain limited. An international, online cross-sectional survey was conducted by the European Respiratory Society's Acute Critical Care Group between May and December 2023. The questionnaire, designed according to Checklist for Reporting Of Survey Studies (CROSS) and Academy of Critical Care: Development, Evaluation and Methodology (ACCADEMY) standards, targeted healthcare professionals performing FB in ICUs. It addressed procedural protocols, sedation, ventilation strategies, complications, microbiologic sampling, tracheostomy practices and training. Only fully completed responses were included in the analysis. Data from 266 respondents across 73 countries were analysed. Training in FB varied widely: 41% reported no formal training, and only 61% had access to a 24/7 bronchoscopy service. Sedation practices were heterogeneous. Ventilator settings were adjusted differently based on ICU certification, with ICU-certified physicians more likely to reduce positive end-expiratory pressure during FB (55% versus 42%; p=0.031). Bronchoalveolar lavage was the most common sampling method, with a median saline volume of 60-120 mL and a recovery rate of 48±18%. Microbiological findings led to therapeutic changes in 48±21% of cases. FB guidance during percutaneous tracheostomy was applied in only 56% of cases. Substantial variability exists in FB practices across ICUs, particularly in training, sedation, ventilation adjustments and microbiologic sampling. Despite frequent therapeutic consequences, standardised approaches are lacking. These findings underscore the need for international consensus guidelines and structured training programmes to harmonise FB practices in critical care settings.
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Respiratory viruses, frequently detected in asthma, are associated with worse outcomes. This meta-analysis systematically quantifies the prevalence of respiratory viruses in stable and acute asthma, across children and adults, and explores factors associated with increased viral burden through meta-regression. This prospectively registered meta-analysis (PROSPERO-CRD42023375108) included studies employing molecular techniques to assess respiratory virus prevalence in asthma. Three databases were searched in August 2024. Risk of bias and certainty of evidence were assessed. We performed random-effects meta-analysis of proportions. We included 111 eligible studies. Moderate-certainty evidence indicated a pooled prevalence of any respiratory virus of 33.9% (95% confidence interval 24.8-43.7%) in children and 23.0% (12.9-35.0%) in adults with stable asthma. In acute asthma, prevalence increased to 58.8% (52.5-65.0%) in children and 49.9% (41.2-58.5%) in adults (moderate certainty). Rhinovirus was the most frequently identified virus, especially in acute asthma (45.0% in children versus 21.2% in adults). Respiratory syncytial virus and bocavirus were more common in younger children, while coronavirus and influenza were more frequently detected in adults; respiratory syncytial virus peaked in older adults too. A higher prevalence of influenza virus B and adenovirus in children, and of influenza virus A and parainfluenza 2 in adults with severe versus non-severe acute asthma suggests a potential association with more severe acute attacks. Respiratory viruses are common in both stable and acute asthma. This suggests that the diagnostic value of a positive viral test during acute episodes may be limited and could benefit from complementary biomarkers to improve interpretation.
Observational evidence supports associations between higher consumption of omega-6 (n-6) polyunsaturated fatty acids (PUFAs) with reduced risks for cardiometabolic diseases. However, some have hypothesized that higher n-6 PUFA intake may be proinflammatory. The purpose of this cross-sectional analysis using baseline data from the Aegis cohort was to examine associations of serum total n-6 PUFA and linoleic acid concentrations with biomarkers of inflammation. Serum concentrations of high-sensitivity C-reactive protein (hs-CRP), glycoprotein acetyls, serum amyloid A (SAA), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were assessed as biomarkers of inflammation. Univariate Pearson correlation coefficients were calculated, and multivariate linear models were used to assess biomarker amounts across quintile categories of serum fatty acids with body mass index (BMI), age, sex, diabetes diagnosis, and n-3 PUFAs as covariates. Analyses included 2133 participants, of which 63.3% were female and mean (SD) age and BMI were 50.4 (16.7) y and 29.2 (6.68) kg/m2, respectively. Circulating n-6 PUFA and linoleic acid concentrations were inversely correlated with all biomarkers of inflammation, r = -0.049 to -0.455 (each P ≤ 0.03). Least squares geometric means (95% confidence intervals) for quintile categories of circulating concentrations of both n-6 PUFAs and linoleic acid showed that, as these fatty acid concentrations increased, there were statistically significant decreases (P < 0.001) in hs-CRP, glycoprotein acetyls, and sICAM-1 concentrations. Neither SAA nor sVCAM-1 showed any significant trends across quintile categories. A composite sum of Z-scores of all 5 biomarkers of inflammation showed a statistically significant (P < 0.001) inverse trend across increasing quintile categories of n-6 PUFAs and linoleic acid. These findings do not support the hypothesis that dietary n-6 PUFAs, including linoleic acid, are proinflammatory.
There is currently no national total shoulder arthroplasty (TSA) database in Canada. As a first step toward a national registry, a regional shoulder database was initiated in 2017. In this study, we describe the implementation of and initial findings from the shoulder database and patient-reported outcomes program. The registry is intended to capture all shoulder arthroplasty procedures in the province of Manitoba and includes surgeon-reported operative details and data on patient-reported outcome measures (PROMs). Every surgeon submits data. We included primary and revision procedures performed since 2017 in the retrospective case series study. We assessed registry coverage by the rate of return of surgeon-completed operative forms and patient-reported outcomes questionnaires, respectively. We determined the incidence of revision by the number of primary procedures linked to a revision within 1 year of surgery. A total of 1044 TSA procedures occurred during the study period. Overall, 65.0% were anatomic (n = 679) and 35.0% were reverse TSA procedures (n = 365). Of the 1044 surgeries that took place, the capture rate was 92.0% (n = 960) for operative data. The capture rate for PROM questionnaires was 78.6% preoperatively and 65.8% postoperatively. Four primary procedures were linked with a revision within 1 year of surgery (0.4%). The most frequent diagnosis reported was degenerative arthritis (n = 558/817). High satisfaction (n = 569/636) and improved joint-specific and general quality-of-life PROMs were reported at 1 year. The provincial shoulder database demonstrates the early stages of a registry, which contains useful, granular data and is an opportunity to fill an important gap in Canadian arthroplasty data. Il n’existe actuellement pas de base de données nationale sur les arthroplasties totales de l’épaule (ATE) au Canada. Une base de données régionale sur l’épaule a été mise en place en 2017 afin de servir de première étape à un registre national. Dans la présente étude, nous décrivons la mise en œuvre de la base de données sur l’épaule et d’un programme de résultats rapportés par la patientèle ainsi que les premiers résultats relatifs à ces initiatives. Le registre a pour objectif d’enregistrer toutes les arthroplasties de l’épaule effectuées au Manitoba ainsi que les détails relatifs à l’intervention chirurgicale rapportés par le chirurgien ou la chirurgienne et les données relatives aux mesures des résultats déclarés par les patients et patientes (MRDPP). Chaque chirurgien ou chirurgienne soumet ses données. Nous avons inclus dans cette étude de série de cas rétrospective les chirurgies primaires et de révision effectuées depuis 2017. Nous avons évalué la couverture du registre au moyen du taux de retour des formulaires d’intervention chirurgicale remplis par les chirurgiens et chirurgiennes et des questionnaires sur les résultats déclarés par la patientèle, respectivement. Nous avons déterminé l’incidence des chirurgies de révision au moyen du nombre de chirurgies primaires liées à une révision dans l’année suivant l’intervention chirurgicale. Au total, 1044 ATE ont été effectuées au cours de la période de l’étude. En tout, 65,0 % de celles-ci ont été réalisées au moyen d’une prothèse anatomique (n = 670) et 35,0 %, avec une prothèse inversée (n = 365). Parmi les 1044 interventions réalisées, le taux de saisie de données relatif à l’intervention chirurgicale était de 92,0 % (n = 960), et celui relatif aux questionnaires de MRDPP était de 78,6 % avant l’intervention et de 65,8 % après celle-ci. Quatre chirurgies primaires ont été liées à une révision dans l’année suivant l’intervention (0,4 %). Le diagnostic le plus souvent mentionné était l’arthrose (n = 558/817). On a noté une satisfaction élevée (n = 569/636) ainsi qu’une amélioration des MRDPP quant à l’articulation visée et de la qualité de vie en général 1 an après l’intervention chirurgicale. La base de données provinciale sur l’épaule constitue l’un des stades précoces d’un registre; elle contient des données granulaires et utiles et constitue une occasion de combler un besoin important quant aux données canadiennes sur l’arthroplastie.
Weight stigma represents a barrier to effective obesity management and to achieving health equity. Although most research has focused on high-income countries, data from Latin America remain scarce. This study aimed to examine perceptions, beliefs, and concerns about obesity among adults living with obesity in a middle-income country. This subanalysis used data from a nationally representative survey investigating perceptions of obesity among 2560 adults residing in Brazil. Responses from 653 people living with obesity (body mass index ≥ 30 kg/m2) were included in the present analysis. Analyses were stratified by gender and obesity class. Stigmatizing beliefs were prevalent: 27.5% of participants agreed that people living with obesity are personally responsible for their weight, with a significantly higher prevalence among men (35.5%, p < 0.001). Among those with Class II obesity, 42.8% of men and 15.0% of women endorsed this belief (p < 0.001). Leisure environments (48.2%) were the most frequently reported settings of discrimination, followed by workplaces (33.4%) and public transportation (33.1%). Healthcare settings were also cited by 11.6% of the responses. The most commonly reported sources of obesity-related information were healthcare professionals (50.3%) and those professionals active on social media (39.3%). Stigmatizing attitudes and the attribution of personal blame toward people living with obesity are widespread in Brazil. These findings underscore the need to integrate stigma awareness into medical education, public health communication, and clinical practice. Leveraging trusted sources, including healthcare professionals and influential social media communicators, may help mitigate weight stigma.
Osteoclast overactivation is a central driver of bone metabolic disorders such as osteoporosis, and novel drug targets for these diseases continue to be actively explored. Scaffold proteins, which enhance the specificity of deubiquitinase (DUB)-substrate interactions, have emerged as promising therapeutic targets for the sustained management of chronic diseases. Intraflagellar transport (IFT) proteins, recognized for their scaffolding roles in cellular signaling, are increasingly implicated in bone remodeling. However, their therapeutic potential for bone metabolic disorders remains to be fully elucidated. We systematically investigated the function of the core IFT protein, tetratricopeptide repeat protein 26 (TTC26), in osteoclastogenesis through clinical correlation analysis and mouse models (Ttc26 flox/flox , Lysm-Cre). Furthermore, through an integrated approach combining RNA sequencing, Western blotting, co-immunoprecipitation, in vitro osteoclast differentiation assays, and protein structural analysis, we elucidated the mechanistic role of TTC26 in regulating osteoclast differentiation. Ultimately, by osteoclast-targeted inhibition of Ttc26 (shTtc26) in ovariectomized (OVX) mice, we validated its therapeutic potential as a novel target for osteoporosis intervention. We identified TTC26 as a previously unrecognized regulator of osteoclast differentiation. Acting as a scaffold protein, TTC26 recruits the DUB ubiquitin carboxyl-terminal hydrolase-3 (MINDY3) to promote K48-linked deubiquitination of receptor for activated kinase C-1 (RACK1), thereby stabilizing RACK1 and activating nuclear factor of activated T cells 1 (NFATc1), the master transcription factor of osteoclastogenesis. Furthermore, structural analysis reveals that six critical TTC26 residues (N533, T534, E537, R541, K545, and K548) are essential for this scaffold activity. Notably, osteoclast-targeted inhibition of Ttc26 successfully alleviates trabecular bone loss in ovariectomized (OVX) mice. Our findings uncover a novel role for TTC26 in bone homeostasis and elucidate its molecular mechanism in driving osteoclastogenesis by scaffolding MINDY3-mediated deubiquitination of RACK1. This study holds clear clinical translational prospects: 1) TTC26 may serve as a novel biomarker for osteoporosis diagnosis; 2) Its functional residues provide precise targets for developing small-molecule inhibitors; 3) The scaffold protein regulatory paradigm offers a new model that can be referenced for treating other bone metabolic diseases.