Heat Shock Alters the Proteomic Profile of Equine Mesenchymal Stem Cells.

The aim of this research was to determine the impact of heat stress on cell differentiation in an equine mesenchymal stem cell model (EMSC) through the application of heat stress to primary EMSCs as they progressed through the cell specialization process. A proteomic analysis was performed using mass spectrometry to compare relative protein abundances among the proteomes of three cell types: progenitor EMSCs and differentiated osteoblasts and adipocytes, maintained at 37 °C and 42 °C during the process of cell differentiation. A cell-type and temperature-specific response to heat stress was observed, and many of the specific differentially expressed proteins were involved in cell-signaling pathways such as Notch and Wnt signaling, which are known to regulate cellular development. Furthermore, cytoskeletal proteins profilin, DSTN, SPECC1, and DAAM2 showed increased protein levels in osteoblasts differentiated at 42 °C as compared with 37 °C, and these cells, while they appeared to accumulate calcium, did not organize into a whorl agglomerate as is typically seen at physiological temperatures. This altered proteome composition observed suggests that heat stress could have long-term impacts on cellular development. We propose that this in vitro stem cell culture model of cell differentiation is useful for investigating molecular mechanisms that impact cell development in response to stressors.

A concept analysis of children with complex health conditions: implications for research and practice.

BACKGROUND: This concept analysis aimed to clarify the meaning of "children with complex health conditions" and endorse a definition to inform future research, policy, and practice. METHODS: Using Walker and Avant's (2011)'s approach, we refined the search strategy with input from our team, including family representatives. We reviewed the published and grey literature. We also interviewed 84 health, social, and educational stakeholders involved in the care of children with complex health conditions about their use/understanding of the concept. RESULTS: We provided model, borderline, related, and contrary cases for clarification purposes. We identified defining attributes that nuance the concept: (1) conditions and needs' breadth; (2) uniqueness of each child/condition; (3) varying extent of severity over time; 4) developmental age; and (5) uniqueness of each family/context. Antecedents were chronic physical, mental, developmental, and/or behavioural condition(s). There were individual, family, and system consequences, including fragmented services. CONCLUSIONS: Building on previous definitions, we proposed an iteration that acknowledges the conditions' changing trajectories as involving one or more chronic condition(s), regardless of type(s), whose trajectories can change over time, requiring services across sectors/settings, oftentimes resulting in a lower quality of life. A strength of this paper is the integration of the stakeholders'/family's voices into the development of the definition.

Evaluating the Wizards of Motion Cardiovascular Disease Prevention Module.

This study evaluated the level of change in students' knowledge of and attitudes toward healthy lifestyle behaviors and prevention of cardiovascular disease (CVD) following implementation of a Cardiovascular Disease Prevention Module in Grade 5 science classes. Two classes of students ( n1 = 39) were identified as the intervention group and two classes ( n2 = 31) were designated as controls. The intervention group participated in the module initially, whereas the control groups participated after the data collection was completed. A two-group, pre-post comparison design was used to evaluate results on both a knowledge test and an attitude questionnaire. The results indicated that although both the intervention and the control groups began with similar knowledge and attitudes toward CVD and healthy behaviors, the intervention group demonstrated an improved level of knowledge and attitudes. Further research is needed to determine whether this CVD module could provide a sustained impact on adoption of healthy behaviors among adolescents.

Ice Hockey Summit II: zero tolerance for head hits and fighting.

OBJECTIVE: To present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building on the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards; and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit includes the following: (1) eliminate head hits from all levels of ice hockey, (2) change body-checking policies, and (3) eliminate fighting in all amateur and professional hockey.

Ice Hockey Summit II: zero tolerance for head hits and fighting.

This study aimed to present currently known basic science and on-ice influences of sport-related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC. The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure for the science and discussion held during Summit II (Mayo Clinic, Rochester, MN, October 2013). Summit II focused on (1) Basic Science of Concussions in Ice Hockey: Taking Science Forward, (2) Acute and Chronic Concussion Care: Making a Difference, (3) Preventing Concussions via Behavior, Rules, Education, and Measuring Effectiveness, (4) Updates in Equipment: Their Relationship to Industry Standards, and (5) Policies and Plans at State, National, and Federal Levels To Reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were voted on subsequently for purposes of prioritization. The following proceedings include the knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. The Summit II evidence-based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. The highest-priority action items identified from the Summit include the following: (1) eliminate head hits from all levels of ice hockey, (2) change body checking policies, and (3) eliminate fighting in all amateur and professional hockey.

Skating crossovers on a motorized flywheel: a preliminary experimental design to test effect on speed and on crossovers.

Ice hockey requires frequent skater crossovers to execute turns. Our investigation aimed to determine the effectiveness of training crossovers on a motorized, polyethylene high-resistance flywheel. We hypothesized that high school hockey players training on the flywheel would perform as well as their peers training on ice. Participants were 23 male high-school hockey players (age 15-19 years). The study used an experimental prospective design to compare players who trained for 9 sessions on the 22-foot flywheel with players who trained for 9 sessions on a similarly sized on-ice circle. Both groups were compared with control subjects who were randomly selected from the same participant pool as those training on ice. All players were tested before and after their 3-week training regimens, and control subjects were asked to not practice crossovers between testing. Group 1 trained in a hockey training facility housing the flywheel, and group 2 trained in the ice hockey arena where testing occurred. Primary outcome measures tested in both directions were: (a) speed (time in seconds) required to skate crossovers for 3 laps of a marked face-off circle, (b) cadence of skating crossovers on the similarly sized circles, and (c) a repeat interval speed test, which measures anaerobic power. No significant changes were found between groups in on-ice testing before and after training. Among the group 1 players, 7 of 8 believed they benefited from flywheel training. Group 2 players, who trained on ice, did not improve performance significantly over group 1 players. Despite the fact that no significant on-ice changes in performance were observed in objective measures, players who trained on the flywheel subjectively reported that the flywheel is an effective cost-effective alternative to training on ice. This is a relevant finding when placed in context with limited availability of on-ice training.

Breastfeeding and Aboriginal women: validation of the Breastfeeding Self-Efficacy Scale-Short Form.

The purpose of this methodological investigation, part of a prospective cohort study, was to test the reliability and validity of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) among Aboriginal women.The sample comprised 130 breastfeeding Aboriginal women from the postpartum ward of an urban tertiary care hospital or a rural community hospital.The women provided baseline information while in hospital and were telephoned at 4 and 8 weeks postpartum for assessment of their method of infant feeding. The BSES-SF was found to be a valid and reliable tool for assessing breastfeeding self-efficacy among Aboriginal women. Significant differences were found in BSES-SF in-hospital scores among women who at 4 weeks postpartum were exclusively breastfeeding, combination feeding, or solely feeding formula (F(2) = 7.31, p = 0.001).The authors conclude that Aboriginal women with low breastfeeding self-efficacy in the early postpartum period may be at risk for early cessation and could benefit from additional breastfeeding support.

Selection and Validation of Reference Genes for Gene Expression Studies in an Equine Adipose-Derived Mesenchymal Stem Cell Differentiation Model by Proteome Analysis and Reverse-Transcriptase Quantitative Real-Time PCR.

Adipose-derived stem cells (ADSCs) are used in tissue regeneration therapies. The objective of this study is to identify stable reference genes (RGs) for use in gene expression studies in a characterized equine adipose-derived mesenchymal stem cell (EADMSC) differentiation model. ADSCs were differentiated into adipocytes (ADs) or osteoblasts (OBs), and the proteomes from these cells were analyzed by liquid chromatography tandem mass spectrometry. Proteins that were stably expressed in all three cells types were identified, and the mRNA expression stabilities for their corresponding genes were validated by RT-qPCR. PPP6R1, CCDC97, and then either ACTB or EPHA2 demonstrated the most stable mRNA levels. Normalizing target gene Cq data with at least three of these RGs simultaneously, as per MIQE guidelines (PPP6R1 and CCDC97 with either ACTB or EPHA2), resulted in congruent conclusions. FABP5 expression was increased in ADs (5.99 and 8.00 fold, p = 0.00002 and p = 0.0003) and in OBs (5.18 and 5.91 fold, p = 0.0011 and p = 0.0023) relative to ADSCs. RUNX2 expression was slightly higher in ADs relative to ADSCs (1.97 and 2.65 fold, p = 0.04 and p = 0.01), but not in OBs (0.9 and 1.03 fold, p = 0.58 and p = 0.91).

Predictors of Vaccine Hesitancy: Implications for COVID-19 Public Health Messaging.

OBJECTIVES: Successful immunization programs require strategic communication to increase confidence among individuals who are vaccine-hesitant. This paper reviews research on determinants of vaccine hesitancy with the objective of informing public health responses to COVID-19. METHOD: A literature review was conducted using a broad search strategy. Articles were included if they were published in English and relevant to the topic of demographic and individual factors associated with vaccine hesitancy. RESULTS AND DISCUSSION: Demographic determinants of vaccine hesitancy that emerged in the literature review were age, income, educational attainment, health literacy, rurality, and parental status. Individual difference factors included mistrust in authority, disgust sensitivity, and risk aversion. CONCLUSION: Meeting target immunization rates will require robust public health campaigns that speak to individuals who are vaccine-hesitant in their attitudes and behaviours. Based on the assortment of demographic and individual difference factors that contribute to vaccine hesitancy, public health communications must pursue a range of strategies to increase public confidence in available COVID-19 vaccines.

Constituent year: a new consideration for injury risk in Canadian youth ice hockey.

OBJECTIVE: To examine if chronological age within Canadian youth ice hockey's 2-year age bands influences the proportion of injury. DESIGN: Retrospective secondary data analyses. PARTICIPANTS: Information on 4736 injured youth ice hockey players (10-15 years old) reported by the Canadian Hospitals Injury Reporting Prevention Program (CHIRPP) and 4959 (12-15 years old) injured players reported by the Hockey Canada Insurance Database (HCID). MAIN OUTCOME MEASURES: Proportions of injuries according to constituent year (first vs second year of participation within 2-year youth ice hockey age bands). INDEPENDENT VARIABLES: The influence of age band (Atom, 10/11; Peewee, 12/13; Bantam, 14/15) and level of competitive play on constituent year injury proportions were examined. RESULTS: Injured Atom and Peewee players (CHIRPP) were more likely to be in constituent year 2 (Atom: odds ratio [OR], 1.72; 95% confidence interval [CI], 1.46-2.03; Peewee: OR, 1.25; 95% CI, 1.10-1.42). Injured players (HCID) at the highest tiers of competitive play were more likely to be in constituent year 2 (eg, Peewee: OR, 2.91; 95% CI, 1.92-4.41; Bantam: 1.89; 95% CI, 1.46-2.46). CONCLUSION: Constituent year may be a factor in determining injury risk and may be relevant to those managing the risk of injury for youth ice hockey players.

Identifying infants at risk for neonatal abstinence syndrome: a retrospective cohort comparison study of 3 screening approaches.

OBJECTIVE: The main objective of this study was to analyze the consistency in using a standardized newborn toxicology screening protocol to identify infants at risk of developing neonatal abstinence syndrome (NAS). DESIGN: A retrospective cohort comparison design was approved by the institutional review board at the regional hospital and used to gather data from the infants' medical records during the study period. SETTING: The data were collected for a period of 1 year from a regional hospital serving 100,000 patients per annum. PATIENTS/PARTICIPANTS: Data were based on expectant mothers who delivered between March 2006 and March 2007. METHOD: Data of maternal self-reported substance use, and urine toxicology results and meconium results were obtained through retrospective chart review of infants exhibiting signs of NAS as noted by nurses on the Finnegan Scoring Tool. RESULTS: In the absence of accurate prenatal screening, this study lends positively to support the use of toxicology screening protocols at birth to adequately assess and treat infants exposed to illicit substances. Toxicology screening in not intrusive and despite emotional discomfort experienced by mothers of the infants tested, the benefits of attaining accurate information regarding substance exposure is critical for the well-being of the infant. CONCLUSION: The use of a toxicology screening protocol at birth appears beneficial in determining the need for identifying infants with NAS. Early detection of substance exposure in newborns leads to timely assessment for NAS and subsequent treatment to reduce symptoms in newborns.

The use of the environmental scan in health services delivery research: a scoping review protocol.

INTRODUCTION: The environmental scan has been described as an important tool to inform decision-making on policy, planning and programme development in the healthcare sector. Despite the wide adoption of environmental scans, there is no consensus on a working definition within the health services delivery context and methodological guidance on the design and implementation of this approach is lacking in the literature. The objectives of this study are to map the extent, range and nature of evidence that describe the definitions, characteristics, conceptualisations, theoretical underpinnings, study limitations and other features of the environmental scan in the health services delivery literature and to propose a working definition specific to this context. METHODS AND ANALYSIS: This protocol describes a scoping review based on the methodology outlined by Khalil and colleagues. A comprehensive search strategy was developed by experienced health science librarians in consultation with the research team. A Peer Review of Electronic Search Strategies (PRESS) was completed. Two reviewers will independently screen titles, abstracts and full-text articles and select studies meeting the inclusion criteria from seven electronic databases: Academic Search Premier, Canadian Business & Current Affairs (CBCA), CINAHL, ERIC, Embase, MEDLINE and PsycINFO. The grey literature and reference lists of included articles will also be searched. The data will be analysed and presented in tabular format, and will include a descriptive numerical summary as well as a qualitative thematic analysis. ETHICS AND DISSEMINATION: This protocol provides an audit trail for a scoping review that will advance understanding about the environmental scan and its application in the health services delivery context. The review will propose a working definition and will inform future research to explore the development of a conceptual framework in this context. Findings will be disseminated through a peer-reviewed journal and conference presentations. The scoping review does not require ethics approval.

A Framework for Describing the Influence of Service Organisation and Delivery on Participation in Fetal Anomaly Screening in England.

Objective. The aim of this research was to explore the influence of service organisation and delivery on providers and users' interactions and decision-making in the context of Down's syndrome screening. Methods. A qualitative descriptive study involving online interviews conducted with a purposive sample of 34 community midwives, 35 pregnant women, and 15 partners from two maternity services in different health districts in England. Data were analysed using a combination of grounded theory principles and content analysis and a framework was developed. Results. The main emerging concepts were organisational constraints, power, routinisation, and tensions. Providers were concerned about being time-limited that encouraged routine, minimal information-giving and lacked skills to check users' understanding. Users reported their participation was influenced by providers' attitudes, the ambience of the environment, asymmetric power relations, and the offer and perception of screening as a routine test. Discordance between the national programme's policy of nondirective informed choice and providers' actions of recommending and arranging screening appointments was unexpected. Additionally, providers and users differing perceptions of emotional effects of information, beliefs, and expectations created tensions within them, between them, and in the antenatal environment. Conclusions. A move towards a social model of care may be beneficial to empower service users and create less tension for providers and users.

Identifying important factors for older adults' physical activity participation across individual/group, structured/unstructured contexts.

Most Canadian older adults do not meet physical activity recommendations. Researchers have investigated participation barriers and facilitators, with little consideration given to how specific factors influence activity participation for older adults. The purpose of this study was to identify unique factors that influence older adults' activity selection and to determine in which type of setting they are preferred. Using a two-phase methodology, identification of 25 factors affecting participation was followed by 45 older adults ranking the factors within four categories of activities: individual unstructured, group unstructured, individual structured, and group structured. Phase 1 analysis ranked each factor within each category. Further analysis found that there was a statistical difference between categories, indicating that older adults found different factors important, depending on the category of physical activity in question. This led to phase 2 analyses which identified three levels of factor groupings including the following factors: level A: fun, satisfaction, commitment, and energize; level B: safety, learning, awareness, internal motivation, and productive; and level C: meaningful contribution, intensity, and motivation. Additionally, some factors which were not identified in all categories were identified as unique to certain categories. These included creativity, hobbies, meaningful contribution, spiritual, competence, interaction casual, regularly scheduled, competition, self-efficacy physical, and team. This information can be used by individuals as well as program providers to nurture these factors within physical activity programs, which may lead to increased participation in this age cohort.

Ice hockey summit II: zero tolerance for head hits and fighting.

OBJECTIVE: To present currently known basic science and on-ice influences of sport related concussion (SRC) in hockey, building upon the Ice Hockey Summit I action plan (2011) to reduce SRC. METHODS: The prior summit proceedings included an action plan intended to reduce SRC. As such, the proceedings from Summit I served as a point of departure, for the science and discussion held during Summit II (Mayo Clinic, Rochester MN, October, 2013). Summit II focused on Basic Science of Concussions in Ice Hockey: Taking Science Forward; (2) Acute and Chronic Concussion Care: Making a Difference; (3) Preventing Concussions via Behavior, Rules, Education and Measuring Effectiveness; (4) Updates in Equipment: their Relationship to Industry Standards and (5) Policies and Plans at State, National and Federal Levels to reduce SRC. Action strategies derived from the presentations and discussion described in these sectors were subsequently voted on for purposes of prioritization. The following proceedings include the knowledge and research shared by invited faculty, many of whom are health care providers and clinical investigators. RESULTS: The Summit II evidence based action plan emphasizes the rapidly evolving scientific content of hockey SRC. It includes the most highly prioritized strategies voted on for implementation to decrease concussion. CONCLUSIONS: The highest priority action items identified from the Summit include: 1) eliminate head hits from all levels of ice hockey, 2) change body checking policies, and 3) eliminate fighting in all amateur and professional hockey.

Variability within individuals of plasma ionic magnesium concentrations.

BACKGROUND: With the invention of the ion-selective electrode (ISE), ionic magnesium (iMg) is a common blood assay. This could be advantageous, as iMg is the biologically active form of Mg. There is some evidence that iMg has considerable within subject variability. RESULTS: Individual ranges averaged.08 mmol/L (range.05 to.14). Coefficients of variation (CV) ranged from 3% to 7% (mean 4%) while analytical variation was determined to be 2.3%. Biological variability thus accounts for almost half of the variability, which is clinically significant, as 9 of the 13 subjects recorded at least one value below a reference range of.46 -.60 mmol/L. A significant within-day variation (p <.001) was noted, with differences between 7:00 and 10:00 as well as 10:00 and 22:00. Between day variations were not significant (p =.56). CONCLUSIONS: A plausible explanation of this data is that iMg has a circadian rhythm. Thus, cautious interpretation of single iMg values is warranted until future research determines the nature of iMg variability.

A mechanism for simultaneous suppression of tone burst-evoked otoacoustic emissions.

Tone burst-evoked otoacoustic emission (TBOAE) components in response to a 1 kHz tone burst are suppressed by the simultaneous presence of tone bursts at higher frequencies. To date, the underlying cause of this "simultaneous suppression" of TBOAEs is unclear. This paper describes a potential mechanism based on local nonlinear interactions between basilar membrane (BM) travelling waves, and tests the extent to which it is able to account for this specific suppression phenomenon. A simple mathematical model based on local nonlinear interactions was developed, and its predictions for a range of tone burst pairs were compared to corresponding TBOAE suppression data recorded from fourteen normally hearing human ears at a level of 60 dB p.e. SPL. Model predictions and mean TBOAE suppression data showed close agreement for all pairs of tone bursts. These results suggest that simultaneous suppression of TBOAEs can be explained solely in terms of the local nonlinear interaction-based mechanism. However, the involvement of other mechanisms, involving components generated at places basal to their characteristic place along the BM, cannot be excluded.

Validation of the FAST skating protocol to predict aerobic power in ice hockey players.

Few studies have reported a sport-specific protocol to measure the aerobic power of ice hockey players using a predictive process. The purpose of our study was to validate an ice hockey aerobic field test on players of varying ages, abilities, and levels. The Faught Aerobic Skating Test (FAST) uses an on-ice continuous skating protocol on a course measuring 160 feet (48.8 m) using a CD to pace the skater with a beep signal to cross the starting line at each end of the course. The FAST incorporates the principle of increasing workload at measured time intervals during a continuous skating exercise. Step-wise multiple regression modelling was used to determine the estimate of aerobic power. Participants completed a maximal aerobic power test using a modified Bruce incremental treadmill protocol, as well as the on-ice FAST. Normative data were collected on 406 ice hockey players (291 males, 115 females) ranging in age from 9 to 25 y. A regression to predict maximum aerobic power was developed using body mass (kg), height (m), age (y), and maximum completed lengths of the FAST as the significant predictors of skating aerobic power (adjusted R2 = 0.387, SEE = 7.25 mL.kg-1.min-1, p < 0.0001). These results support the application of the FAST in estimating aerobic power among male and female competitive ice hockey players between the ages of 9 and 25 years.

Injuries in Canadian youth ice hockey: the influence of relative age.

OBJECTIVE: The purpose of this study was to investigate the relationship between relative age and injury prevalence in Canadian youth ice hockey. METHODS: In study 1, youth ice hockey-related injuries (among children 10-15 years of age) collected by the Canadian Hospitals Injury Reporting and Prevention Program between 1995 and 2002 were analyzed. The relative ages of injured children were compared across different age groups and injury characteristics (mechanism of injury and severity of injury). In study 2, injuries reported in the Hockey Canada Insurance Database were analyzed. The relative ages of injured children at different levels of play (ie, representative versus house league teams) were compared. RESULTS: In study 1, the majority of injured players were of older relative age. However, relative age was not related to mechanism of injury or severity of injury. In study 2, approximately 40% of injured players at the highest level of play were relatively older, whereas only 20% to 25% of house league injured players were relatively older. CONCLUSION: Relatively older children within ice hockey age groups are at increased risk of injury compared with their younger peers. Furthermore, the risk of injury for relatively older players is greater at more competitive levels of play. This study proposes that the relative age advantage associated with selection to Canadian youth ice hockey teams is accompanied by an increased risk of injury.