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Background: The COVID-19 pandemic has had a negative impact on the mental health of people with intellectual and developmental disabilities. Numerous pandemic-related stressors experienced by people with intellectual and developmental disabilities may have impacted their ability to thrive, which has been linked to mental health outcomes. The current study examined the associations among COVID-19 stressors, thriving, and mental health problems among youth and adults with intellectual and developmental disabilities. Method: Caregivers of 159 people with intellectual and developmental disabilities between 12 and 35 years of age from Canada completed an online questionnaire. Results: A mediation analysis revealed that COVID-19 stressors were positively associated with mental health problems, and that thriving partially mediated this association. Conclusion: Our findings suggest that experiences of thriving may be an important target for mental health support for people with intellectual and developmental disabilities.

Children and youth with autism spectrum disorder engage in less physical activity than neurotypically developing peers. This may be due to factors associated with autism spectrum disorder at the individual and environmental level that can make physical activity participation more challenging. Parent support is a known determinant of physical activity among children and youth; however, limited research has explored the relationship between parent physical activity support behaviour and child physical activity behaviour within the autism spectrum disorder population. Guided by the multi-process action control framework, this study examined the relationship between parent physical activity support behaviour and physical activity levels of children and youth with autism spectrum disorder. Parents (n = 201) of school-aged children and youth with autism spectrum disorder completed measures of parent physical activity support (intentions, behavioural regulation, support behaviour), as well as their child's physical activity behaviour. Congruent with the multi-process action control model, intentions to provide physical activity support were significantly associated with parent physical activity support behaviour. Behavioural regulation of physical activity support mediated this relationship, which in turn significantly predicted child physical activity behaviour. Findings suggest parents play an instrumental role in the physical activity behaviour of children and youth with autism spectrum disorder. Family-level interventions targeting parents' behavioural regulation strategies to provide physical activity support may be an effective strategy to increase physical activity in children and youth with autism spectrum disorder.

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the utility of the six quality participation (QP) elements developed for physical activity programs for individuals with disability (autonomy, belongingness, challenge, engagement, mastery and meaning) within the context of dance movement therapy for individuals with Parkinson's Disease. This is a single-case study with semistructured interviews that involved eight participants (six women and two men) from a dance movement therapy program for individuals with Parkinson's Disease, to explore participants' experiences within the context of the QP elements. Data were analyzed using reflexive thematic analysis. Autonomy, engagement, and belongingness were identified as contributors to QP experiences. Insights were gained on the relevancy of the QP elements to assess QP among individuals with Parkinson's Disease in a dance movement therapy physical activity program. Findings also highlight potential nuances in the understanding and application of the QP elements for different populations with disabilities. In this case study, three of the QP elements had utility in situ and advanced our understanding of the multidimensional nature of QP for individuals with Parkinson's Disease. [ABSTRACT FROM AUTHOR]

Physical activity (PA) promotion messages are typically framed in terms of the gains or losses associated with PA. However, the impact of gain and loss messages is affected by the message recipient's understanding of the risks associated with PA. PA risk is reinforced by the representation of aging as a risk factor of physical decline. Messages that promote PA as a strategy to mitigate aging-related risks of physical decline may have unintended consequences for aging anxiety (AA); however, this association is unexamined. This experiment examined if aging-related risk information and/or message framing impact PA intention and AA. 253 participants completed a randomized set of tasks that exposed them to different levels of aging-related risk information (high vs. low risk) and framed PA messages (gain vs. loss), resulting in a 2 × 2 factorial between-groups design. Outcome variables were lifespan PA intentions and AA. High-risk aging information promoted PA intentions more than low-risk information. Loss-framed PA messages resulted in greater AA than gain-framed messages. Low-risk aging information increased AA when paired with loss-framed PA messages, and high-risk aging information increased AA when paired with gain-framed PA messages. Including aging-related risk information with PA messages increases lifespan PA intentions as well as AA. PA messages that do not include aging-related risk information, but focus on the consequences of inactivity with age, also increase AA. Thus, there appears to be a paradoxical trade-off between promoting lifespan PA intentions and inducing AA through high-risk and loss-framed PA promotion approaches. [ABSTRACT FROM AUTHOR]

Aim: The management of anastomotic leak after sigmoid colectomy for diverticular disease has not been well defined. Specifically, there is a lack of literature on optimal types of reoperations for leaks. The aim of this study was to describe and compare reoperative approaches and their postoperative outcomes. Methods: We performed a retrospective cohort study using the NSQIP Colectomy Module (2012–2019) and single‐institution chart review. Patients with diverticular disease who underwent elective sigmoid colectomy were included. Primary outcomes were anastomotic leak requiring reoperation and management of anastomotic leak. Results: Of 37,471 patients who underwent sigmoid colectomy for diverticular disease, 1003 (2.7%) suffered an anastomotic leak, of whom 583 underwent reoperation. Of the 572 patients who were not initially diverted and underwent reoperation for leak, 302 (52.8%) were managed with stoma creation – 200 (35.0%) with colostomy and 102 (17.8%) with ileostomy. The remaining 47.2% underwent colectomy with reanastomosis, suturing of large bowel, and drainage. There were no differences in length of stay, readmission, or mortality between patients who underwent ileostomy or colostomy at reoperation (p > 0.05). Single‐institution analysis demonstrated that 100% of patients with ileostomies underwent subsequent ileostomy closure, compared to 60% of patients with colostomies. Conclusions: In patients who suffer anastomotic leaks after sigmoid colectomy for diverticular disease and undergo reoperations, ileostomy at the time of reoperation appears to be safe, with comparable results to colostomy. Ileostomies were more frequently closed than colostomies. When faced with a colorectal anastomotic leak, ileostomy creation may be considered. [ABSTRACT FROM AUTHOR]

A lack of disability-specific knowledge among practitioners poses a significant barrier to physical activity (PA) participation for persons with physical disabilities (PWPDs). This study aimed to identify perceived training needs of health and fitness practitioners to support PA for PWPDs. Canadian health and fitness practitioners (n = 115; 81% female) completed an online survey. More specialized training and access to information about PA for PWPDs are needed. In-person training, webinars, and lived experiences of PWPDs are recommended. [ABSTRACT FROM AUTHOR]

This article describes a laparoscopic-assisted endoscopic procedure called a "clean sweep" for removing small bowel polyps in patients with Peutz Jeghers Syndrome (PJS). The technique combines laparoscopy and intra-operative enteroscopy to completely remove hamartomas from the entire small bowel, reducing the risk of future recurrences. The procedure is minimally invasive, safe, and has good postoperative outcomes. It is intended for patients with PJS who have extensive, symptomatic, and endoscopically-unreachable or unresectable small bowel hamartomas. The article provides detailed technical instructions and includes visual aids to illustrate the procedure. [Extracted from the article]

Physical activity (PA) among children and youth with disabilities (CYD) has been negatively impacted by the COVID-19 pandemic. Parent PA support and parent PA modelling (i.e., parents engaging in PA themselves) have been shown to be associated with PA in CYD. However, parents' influence on the PA behaviours of CYD during the pandemic remains unknown. The purpose of this study was to examine the relationship between parent PA support and parent PA modelling (i.e., parent moderate-to-vigorous PA (MVPA)) and the PA behaviours of CYD. It was hypothesized that higher levels of parent PA support and parent PA modelling would significantly relate to both child MVPA and child PA at any intensity. An online survey was sent to parents of CYD in November 2020 (i.e., during the second wave of the COVID-19 pandemic in Canada) that assessed the MVPA and total PA (any intensity), parent PA support (e.g., encouraging PA, providing transportation for PA), and parent MVPA. Separate linear regression models assessed the relationships between parent PA support and parent PA modelling with (a) child MVPA and (b) child PA at any intensity. Parent and child age, child gender and disability group, marital status, and household type were controlled for in all analyses. A total of 86 parents (Mage = 43 years, SD = 5.9; 93% mothers) of CYD (Mage = 11 years, SD = 3.3; 20% girls; 77% with a developmental disability) completed the survey. Parent PA support was significantly associated with child MVPA (β = 0.30, CI = 0.067–0.438, p = 0.008) but not child PA at any intensity. No significant relationship was shown between parent PA modelling and either child MVPA or child PA at any intensity. Findings suggest that parent PA support, but not parent PA modelling, was associated with PA in CYD, at least during the acute period of the pandemic. Greater efforts must be directed towards developing effective parent PA support interventions to reduce the detrimental effects of the COVID-19 pandemic on PA in CYD. [ABSTRACT FROM AUTHOR]

To advance the understanding of perceived social isolation among persons with spinal cord injury (SCI), the objectives of the present study were to explore: (1) experiences of perceived social isolation and (2) factors that contribute to perceived social isolation. Interpretive description qualitative methodology was used to conduct semi-structured interviews with 30 individuals with SCI from across Ontario (Canada) from November 2016 to August 2017. Data were analyzed using thematic analysis. Participants identified disruption to social networks that seemed to impact perceived social isolation. Five major themes were identified: (1) impact on structure and frequency of social network; (2) importance of feeling heard; (3) importance of employment, hobbies, and sports; (4) need to improve physical accessibility and built environment; and (5) individual characteristics. Changes in quality of social networks, rather than size, contributed to greater feelings of perceived social isolation. The built environment, maintenance of employment, hobbies, and sports, social media, and technology use, as well as individual traits, were also found to impact perceived social isolation. Future research should focus on the development of programs to help maintain or improve social network quality for persons with SCI to minimize the impact of perceived social isolation. Perceived social isolation, resulting from physical and environmental barriers, is a challenge that is faced by many individuals who are living in the community with a spinal cord injury (SCI). Rehabilitation and community programs should utilize an individualized approach to find solutions to challenges faced by this population to prevent the effects of perceived social isolation. Education on how to adapt to changes in social network, together with the provision of access to peer-to-peer support groups, and SCI specific return to work or leisure programs, is recommended as an essential component of rehabilitation. [ABSTRACT FROM AUTHOR]

When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity. [ABSTRACT FROM AUTHOR]

To describe objective social disconnectedness and perceived social isolation post-spinal cord injury/dysfunction (SCI/D), and to examine associations among social disconnectedness and social isolation by sociodemographic and clinical characteristics. A telephone-based questionnaire was administered to 170 community dwelling individuals with a SCI/D. Social disconnectedness was measured by social network size, composition, and frequency of contact. Social isolation was measured using the revised three item UCLA Loneliness Scale. Of the 170 participants, the majority were men (n = 136, 80%), had a traumatic injury (n = 149, 87.6%), and had incomplete tetraplegia (n = 58, 34%). The mean network size was 3.86 (SD = 2.0) of a maximum seven. The mean loneliness score for the sample was 4.93 (SD = 1.87). Factors associated with lower feelings of loneliness included being married, living with a higher proportion of network members, and being employed. Size of networks was not significantly associated with feelings of loneliness. This study highlights the vulnerability for perceived social isolation among persons with SCI/D. The size of network does not seem to matter as much as the frequency and quality of social interactions. Findings reinforce the complexity of social disconnectedness and the importance in understanding the various indicators of social disconnectedness as they relate to social isolation. Social relationships have been shown to be a vital component of optimal health and well-being. Individuals with a spinal cord injury/dysfunction are faced with a number of challenges in developing and maintaining social relationships and community participation. Rehabilitation professionals should encourage opportunities for social inclusion, employment and community participation to optimize health and well-being for this population. [ABSTRACT FROM AUTHOR]

"Real-world" initiatives represent an important source of information for evidence-based practice; however, accessing information about initiatives is often challenging. Casebooks are an innovative knowledge translation (KT) tool for researchers, practitioners, and end-users to address "research-to-implementation gaps" through sharing "real-world" experiences. Several casebooks have been published; yet, they remain inconsistent in their methodological approach for identifying "real-world" initiatives. The purpose of this project is to describe and apply systematic scoping study methods for the identification of "real-world" initiatives relevant for the development of KT tools. Specifically, systematic scoping study methods were developed to identify community-based physical activity (PA) programs for persons with physical disabilities across Canada. To identify PA programs, a search strategy was developed and included five distinct search approaches: (i) peer-reviewed literature databases, (ii) grey literature databases, (iii) customized Google search engines, (iv) targeted websites, and (v) consultation with content experts. Title screening and hand searching identified 478 potentially relevant PA programs. Full record review identified 72 PA programs that met KT tool criteria. The most comprehensive search approach was targeted websites, which identified 25 (35%) unique PA programs, followed by content experts (n = 12; 17%). Only four (5.6%) unique PA programs were identified via custom Google searching. No PA programs were uniquely identified through peer- or grey literature database searches. This study describes and applies a systematic scoping study methodology that serves as a basis for identifying and selecting "real-world" initiatives that are central to the development of evidence-based KT tools. [ABSTRACT FROM AUTHOR]

Introduction: Laparoscopic fundoplication is the gold standard treatment for gastroesophageal reflux disease (GERD) refractory to medical management. Although many studies have compared Nissen fundoplication (NF) to Toupet fundoplication (TF), it is unclear which operation provides the best long-term reflux control. The objective of this study was to evaluate long-term quality-of-life (QoL) outcomes after NF versus TF.Methods: Clinical data from our single academic institutional foregut database were used to identify patients who underwent NF or TF (June 2010 to May 2016). Postoperative QoL was assessed through telephone at 1, 3, or 5 years postsurgery, using GERD-health related quality of life (GERD-HRQL), Gastroparesis Cardinal Symptom Index (GCSI), and Eckardt Dysphagia scores. Proton pump inhibitor (PPI) use and satisfaction with surgery were also obtained. Trends in outcomes over time were analyzed by logistic regression or Cochran-Armitage trend test.Results: Our cohort included 155 TF and 161 NF patients. TF patients reported baseline dysphagia at higher rates (42.6% versus 19.9%; P < .001) and had worse preoperative esophageal dysmotility than NF patients. There were no significant differences in GERD-HRQL or GCSI scores between TF and NF patients at any time point postoperatively. Long-term satisfaction was equivalent between TF and NF patients 5 years postoperatively (70.0% versus 77.4%; P = .67). NF patients had higher Eckardt dysphagia scores 1 year after surgery compared to TF patients, but this difference was not present at 3 or 5 years postoperatively. Over time, PPI use increased and there was a trend toward increased GERD-HRQL scores in the TF group.Conclusions: Both TF and NF provide excellent long-term satisfaction for patients with GERD. NF and TF patients reported similar postoperative QoL scores. Our finding of increasing PPI use and a trend toward worsening GERD scores following TF warrants additional investigation regarding the long-term durability of TF. [ABSTRACT FROM AUTHOR]

Few people with multiple sclerosis engage in physical activity. Messaging interventions may motivate more physical activity among these individuals. The purpose of this online study was to evaluate an intervention presenting participants with multiple sclerosis (N = 237) with risk information (i.e., information demonstrating people with multiple sclerosis are more likely to experience certain health issues) or no risk information followed by gain- or loss-framed physical activity messages. Participants completed questionnaires on Days 1, 6, and 28 and received information material on Days 2–5. The dependent variables were as follows: physical activity intentions and behavior, response and task efficacy, perceived threat (i.e., perception of threat to health issues relevant to people with multiple sclerosis), and avoidance (i.e., avoiding thinking about/doing something about the health issues presented in the messages). Analyses indicated physical activity and response efficacy increased over time. Also, participants receiving risk information had higher levels of physical activity and perceived threat. However, manipulation checks showed no differences between participants regarding perceptions of risk information or gain/loss-framed messages. Despite the lack of impact of the framing intervention, this study suggests that a brief informational intervention can positively influence physical activity and certain correlates of physical activity among people with multiple sclerosis. [ABSTRACT FROM PUBLISHER]

Background: Transitioning to parenthood is a major life event that may impact parents’ personal lifestyles, yet there is an absence of theory-based research examining the impact of parenthood on motives for dietary behaviour. As a result, we are unaware of the social cognitive variables that predict eating behaviour among those transitioning to parenthood. The purpose of the study was to examine eating behaviour motives across 12 months within the framework of the theory of planned behavior (TPB) and compare these across groups of new parents, non-parents, and established parents. Methods: Non-parents (n = 92), new parents (n = 135), and established parents (n = 71) completed TPB questionnaires assessing attitudes, subjective norms, perceived behavioral control (PBC), and intentions and three day food records at baseline, and 6- and 12-months post-delivery (for parents) and 6- and 12-months post-baseline (for non-parents). Results: Repeated measures ANOVAs revealed that among men, new- and established-parents had greater intentions to eat healthy compared to non-parents, F(2) = 3.59, p = .03. Among women, established parents had greater intentions than new- and non-parents, F(2) = 5.33, p = .01. Among both men and women during the first 6-months post-delivery, new-parents experienced decreased PBC, whereas established parents experienced increased PBC. Overall, affective attitudes were the strongest predictor of intentions for men (β = 0.55, p < .001) and women (β = 0.38, p < .01). PBC predicted changes in fruit and vegetable consumption for men (β = 0.45, p = .02), and changes in fat consumption for men (β = −0.25, p = .03) and women (β = −.24, p < .05), regardless of parent status. Conclusion: The transition to parenthood for new and established parents may impact motivation for healthy eating, especially PBC within the framework of TPB. However, regardless of parental status, affective attitudes and PBC are critical antecedents of intentions and eating behaviour. Interventions should target affective attitudes and PBC to motivate healthy eating and may need to be intensified during parenthood. [ABSTRACT FROM AUTHOR]