Breastfeeding positions and techniques used by canadians with physical disabilities

BACKGROUND

Breastfeeding is recommended by both the World Health Organization and the Canadian Pediatric Society due to the numerous maternal and infant benefits. Current literature examining breastfeeding among people with physical disabilities is limited to the United States with limited information about the Canadian context.

OBJECTIVE

The primary aim of this study was to identify breastfeeding positions and techniques used by people with physical disabilities and explore their perceptions of effectiveness in a Canadian context where individuals had universal access to a lactation consultant.

METHODS

A cross-sectional interview-based study was undertaken. Individuals were eligible for the study if they breastfed within the last 10 years and a) used a mobility device or b) experienced dysmobility, weakness or pain due to a medical condition while breastfeeding. Interviews were semi-structured to allow in-depth exploration of breastfeeding techniques and perceptions of effectiveness. The interviews were audiotaped, professionally transcribed, and assessed for content surrounding the use and effectiveness of breastfeeding positions and techniques.

RESULTS

Eleven people participated in our study. Participants in our sample mentioned a variety of techniques used to breastfeed including a) accessories, b) assistance from others, c) breastfeeding positions, and d) location of feeding.

CONCLUSIONS

People with physical disabilities use a variety of breastfeeding techniques to overcome physical limitations. This practical advice may improve guidance for healthcare professionals, including lactation consultants, to better support people with physical disabilities meet their breastfeeding goals.

Associations between weight-related teasing and psychosomatic symptoms by weight status among school-aged youth

Objective

Weight‐related teasing (WT) is associated with poor mental health. This study examined whether weight status moderates the relationship between WT and psychosomatic symptoms within a representative sample of school‐aged youth.

Methods

Data are from the Canadian 2013/2014 Health Behaviour in School‐aged Children Survey, a nationally representative sample of youth in Grades 6–10. WT, psychosomatic symptoms and body mass index (BMI) were self‐reported.

Results

The final sample consisted of 20,277 youth (mean age = 14.2 years; 50.2% female). The prevalence who reported being WT at least once a week was 4.6%, 8.1% and 17.3% among youth with normal weight, overweight, and obesity, respectively (p < 0.001). There was a gradient relationship between the frequency of WT and psychosomatic symptoms (p < 0.001). By comparison to youth that were not WT, psychosomatic symptom z‐scores were significantly (p < 0.05) higher in youth that were WT one to two times in the past few months (0.47, 95% CI: 0.41–0.53), two to three times per month (0.65, 0.52–0.77), about once a week (0.82, 0.71–0.93) and several times a week (0.98, 0.84–1.12). However, the WT * BMI category interaction term was not significant (p = 0.86).

Conclusions

Victims of WT experienced more psychosomatic symptoms independent of BMI category; however, BMI category did not moderate the association between WT and psychosomatic symptoms.

Trace elements in Canadian field peas: a grain safety assurance perspective

Canada is a significant exporter of field peas and, thus, issues of food safety are important in all grain and food products within the international marketplace. Environmental contaminants, such as trace elements, may be present in all foods and, as a result, international standards have been established for a number of toxic trace elements, such as cadmium, lead, mercury and arsenic, in raw food commodities and food products. The Canadian Grain Commission has undertaken a baseline study of various trace elements in Canadian peas to ensure compliance with international food safety legislation. Mean total cadmium content was found to be 0.023 mg kg(-1); arsenic and lead mean values were below the method limit of quantification of 0.050 mg kg(-1) and the total mean mercury level was below the quantification level of 0.002 mg kg(-1). All measured values in the study were below the maximum residue levels (MRLs) established by the FAO and WHO in the Codex Alimentarius. The mean total selenium content was 0.331 mg kg(-1), with 56% of the measured values exceeding the MRL established by the People's Republic of China (PRC) of 0.3 mg kg(-1). No Codex MRL has been established for selenium as it is regarded as an essential trace element for human health and the PRC is currently reviewing its MRL for selenium in light of this fact. For those parts of the world where selenium-deficiency is of nutritional concern, the higher level of selenium in Canadian peas and their products may be of nutritional benefit.

Inheritance of Time to Flowering in Chickpea in a Short-Season Temperate Environment

Time to flowering is central in determining the adaptation and productivity of chickpea in short-season temperate environments. We studied the genetic control of this trait in three crosses, 272-2 x CDC Anna, 298T-9 x CDC Anna, and 298T-9 x CDC Frontier. From each cross, 180 F2 plants and parents were evaluated for time to flowering under greenhouse conditions. In summer 2004, multiple generations including P1, F1, P2, F2, and F2:3 (also called MG5) were evaluated for time to flowering under field conditions. The data on time to flowering in the F(2) populations were continuous in distribution but deviated from normal distribution. The F2:3 families derived from this showed a bimodal distribution for time to flowering, a typical case of major-gene inheritance model with duplicate recessive epistasis. A joint segregation analysis of MG5 also revealed that time to flowering in chickpea was controlled by two major genes along with other polygenes. Late flowering was dominant over early flowering for both major genes with digenic interaction between them, mainly an additive x additive type. This information can be used to formulate the most efficient breeding strategy for improvement of time to flowering in chickpea in short-season temperate environments.

Genetic diversity among varieties and wild species accessions of pea (Pisum sativum L.) based on molecular markers, and morphological and physiological characters

Random amplified polymorphic DNA, simple sequence repeat, and inter-simple sequence repeat markers were used to estimate the genetic relations among 65 pea varieties (Pisum sativum L.) and 21 accessions from wild Pisum subspecies (subsp.) abyssinicum, asiaticum, elatius, transcaucasicum, and var. arvense. Fifty-one of these varieties are currently available for growers in western Canada. Nei and Li's genetic similarity (GS) estimates calculated using the marker data showed that pair-wise comparison values among the 65 varieties ranged from 0.34 to 1.00. GS analysis on varieties grouped according to their originating breeding programs demonstrated that different levels of diversity were maintained at different breeding programs. Unweighted pair-group method arithmetic average cluster analysis and principal coordinate analysis on the marker-based GS grouped the cultivated varieties separately from the wild accessions. The majority of the food and feed varieties were grouped separately from the silage and specialty varieties, regardless of the originating breeding programs. The analysis also revealed some genetically distinct varieties such as Croma, CDC Handel, 1096M-8, and CDC Acer. The relations among the cultivated varieties, as revealed by molecular-marker-based GS, were not significantly correlated with those based on the agronomic characters, suggesting that the 2 systems give different estimates of genetic relations among the varieties. However, on a smaller scale, a consistent subcluster of genotypes was identified on the basis of agronomic characters and their marker-based GS. Furthermore, a number of variety-specific markers were identified in the current study, which could be useful for variety identification. Breeding strategies to maintain or enhance the genetic diversity of future varieties are proposed.

Quantitative trait loci for lodging resistance, plant height and partial resistance to mycosphaerella blight in field pea (Pisum sativum L.)

With the development of genetic maps and the identification of the most-likely positions of quantitative trait loci (QTLs) on these maps, molecular markers for lodging resistance can be identified. Consequently, marker-assisted selection (MAS) has the potential to improve the efficiency of selection for lodging resistance in a breeding program. This study was conducted to identify genetic loci associated with lodging resistance, plant height and reaction to mycosphaerella blight in pea. A population consisting of 88 recombinant inbred lines (RILs) was developed from a cross between Carneval and MP1401. The RILs were evaluated in 11 environments across the provinces of Manitoba, Saskatchewan and Alberta, Canada in 1998, 1999 and 2000. One hundred and ninety two amplified fragment length polymorphism (AFLP) markers, 13 random amplified polymorphic DNA (RAPD) markers and one sequence tagged site (STS) marker were assigned to ten linkage groups (LGs) that covered 1,274 centi Morgans (cM) of the pea genome. Six of these LGs were aligned with the previous pea map. Two QTLs were identified for lodging resistance that collectively explained 58% of the total phenotypic variation in the mean environment. Three QTLs were identified each for plant height and resistance to mycosphaerella blight, which accounted for 65% and 36% of the total phenotypic variation, respectively, in the mean environment. These QTLs were relatively consistent across environments. The AFLP marker that was associated with the major locus for lodging resistance was converted into the sequence-characterized amplified-region (SCAR) marker. The presence or absence of the SCAR marker corresponded well with the lodging reaction of 50 commercial pea varieties.

Genetics of resistance to anthracnose and identification of AFLP and RAPD markers linked to the resistance gene in PI 320937 germplasm of lentil (Lens culinaris Medikus)

Anthracnose, caused by Colletotrichum truncatum, is a major disease problem and production constraint of lentil in North America. The research was conducted to examine the resistance to anthracnose in PI 320937 lentil and to identify molecular markers linked to the resistance gene in a recombinant inbred line (RIL) population developed from a cross of Eston lentil, the susceptible parent, and PI 320937, the resistant parent. A total of 147 F(5:6) RILs were evaluated for resistance to anthracnose in the greenhouse using isolate 95B36 of C. truncatum. Bulked segregant analysis (BSA) strategy was employed and two contrasting DNA bulks were constructed based on greenhouse inoculation of F(5)-derived F(6) RILs. DNA from the parents and bulks were screened with 700 RAPD primers and seven AFLP primer combinations. Analysis of segregation data indicated that a major dominant gene was responsible for resistance to anthracnose while variations in the resistance level among RILs could be the influences of minor genes. We designate the major gene as LCt-2. MapMaker analysis produced two flanking RAPD markers OPEO6(1250) and UBC-704(700) linked to LCt-2 locus in repulsion (6.4 cM) and in coupling (10.5 cM), respectively. Also, three AFLP markers, EMCTTACA(350) and EMCTTAGG(375) in coupling, and EMCTAAAG(175) in repulsion, were linked to the LCt-2 locus. These markers could be used to tag the LCt-2 locus and facilitate marker-assisted selection for resistance to anthracnose in segregating populations of lentil in which PI 320937 was used as the source of resistance. Also, a broader application of the linked RAPD markers was also demonstrated in Indianhead lentil, widely used as a source of resistance to anthracnose in the breeding program at the Crop Development Centre, University of Saskatchewan. Further selection within the few F(5:6) lines should be effective in pyramiding one or several of the minor genes into the working germplasm of lentil, resulting in a more durable and higher level of resistance.

Failure of pulse high-dose dexamethasone in chronic idiopathic immune thrombocytopenia

Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by increased platelet destruction in the setting of normal megakaryopoiesis. Approximately 20% of patients with ITP are refractory to corticosteroids and splenectomy. Recently, pulse high-dose dexamethasone was reported to be effective in the treatment of chronic ITP in adult patients. We treated 9 patients with severe chronic ITP with monthly high-dose dexamethasone. None of the 9 patients responded with a sustained increase in platelet count. Five of these patients were unable to tolerate the regimen. The failure of high-dose dexamethasone in our hands contrasts with the good results of an earlier publication and suggests that there could be a subset of responders who will require better identification.

Splenectomy done during hematologic remission to prevent relapse in patients with thrombotic thrombocytopenic purpura

OBJECTIVE

To assess whether splenectomy done during hematologic remission reduces the relapse rate in patients with relapsing thrombotic thrombocytopenic purpura.

DESIGN

Consecutive case series.

SETTING

Tertiary care teaching hospital.

PATIENTS

6 consecutive patients seen during a 10-year period who had had one or more relapses of thrombotic thrombocytopenic purpura.

INTERVENTIONS

All patients had elective splenectomy while in hematologic remission and were followed after surgery for as long as 8.0 years.

MEASUREMENTS

Attack rates (events per year) were calculated for each patient from time of presentation to time of splenectomy and from time of splenectomy to January 1996.

RESULTS

A total of 26 episodes of thrombotic thrombocytopenic purpura occurred over 22.3 patient-years before splenectomy. After splenectomy, 3 acute episodes occurred over 22.7 patient-years. The attack rate (+/-1 SD) decreased from 2.3 +/- 2.0 events per year to 0.1 +/- 0.1 events per year.

CONCLUSION

In patients who have had one or more relapses of thrombotic thrombocytopenic purpura, splenectomy done during hematologic remission reduces the frequency of acute relapse and the resulting need for medical therapy.