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The financial crisis associated with the COVID-19 pandemic has exacerbated food insecurity in the United States. The emergency provides an opportunity to re-think the American nutrition-assistance system. In this paper, we describe findings from a community-based project conducted in urban Alaska before the pandemic in collaboration with a local food pantry. We conducted semi-structured interviews with nineteen food recipients, half of them twice, about how they procure food and prepare their meals in the context of juggling other expenses and demands on their time. What participants in our study do fits mainstream American patterns. Our study adds to the knowledge base by focusing on how families think strategically about their situations in context. In addition to cost, participants take nutrition and flavor into account. Most importantly, they do not think about assistance programs in isolation but holistically.

Mycobacterium abscessus is a fast-growing environmental organism and an important emerging pathogen. It is highly resistant to many antibiotics and undergoes a smooth to rough colony morphology change that appears to be important for pathogenesis. Smooth environmental strains have a glycopeptidolipid (GPL) on the surface, while certain types of clinical strains are often rough and lack this GPL, due to mutations in biosynthetic genes or the mmpL4b transporter gene. We report here the development and evaluation of an allelic exchange system for unmarked alleles in M. abscessus ATCC19977, using a suicide vector bearing the E. coli galK gene and 2-deoxygalactose counterselection. We describe here two variant galK suicide vectors, and demonstrate their utility in constructing a variety of mutants with deletion alleles of the mmpL4b GPL transporter gene, the mbtH GPL biosynthesis gene, the known β-lactamase gene MAB_2875 and a putative β-lactamase gene, MAB_2833. We also show that a novel allele of the E. coli aacC4 gene, conferring apramycin resistance (aacC41), can be used as a selectable marker in M. abscessus ATCC19977 at single copy.

Background: This media content analysis explored the Canadian newspapers reporting on men's health, and their contribution to public understanding of the social determinants of men’s health and lifestyles. Methods: A media content analysis of 44 news articles on boys’, youth’s and men’s health,published from 2010 to 2014 by three national newspapers (The Globe and Mail, National Post,and Metro News). Results: Data indicated that the predominant discourse consists of informative and awareness messages, mostly about men’s prostate and sexual health. Very little health news content referred to working conditions, education and income, all of which are significant social determinants of health (SDH). This may reflect the current state of health research, which does not adequately incorporate the effects of these determinants. It may also indicate a reproduction of dominant health knowledge and understanding of masculinity. Little content was found on policy solutions to other publicized health issues, such as limited access to health services or inter-sectoral collaborations; this reflects a lack of government action and a lack of citizen engagement toward the creation of a concerted men’s health policy. Conclusion: Despite the acknowledged importance of the media in promoting access to health information and indirectly contributing to improve the general public’s level of health literacy, it is also necessary to remember that there must be a greater attention to the structural constraints imposed by socioeconomic inequalities. Future studies should explore media discourses about men’s unequal access to health care services and citizens’ awareness of ways to overcome those inequalities shortcomings.

BACKGROUND: Inguinal hernia repair is the most common general surgery procedure and can be performed under local or general anesthesia. We hypothesized that using local rather than general anesthesia would improve outcomes, especially for older adults. METHODS: This is a retrospective review of 97,437 patients in the Veterans Affairs Surgical Quality Improvement Program who had open inguinal hernia surgery under local or general anesthesia. Outcomes included 30-day postoperative complications, operative time, and recovery time. RESULTS: Our cohort included 22,333 (23%) Veterans who received local and 75,104 (77%) who received general anesthesia. Mean age was 62 years. Local anesthesia was associated with a 37% decrease in the odds of postoperative complications (95% CI 0.54–0.73), a 13% decrease in operative time (95% CI 17.5–7.5), and a 27% shorter recovery room stay (95% CI 27.5–25.5), regardless of age. CONCLUSIONS: Using local rather than general anesthesia is associated with a profound decrease in complications (equivalent to “de-aging” patients by 30 years) and could significantly reduce costs for this common procedure.

Highlights • Haemobilia is a rare complication of laparoscopic cholecystectomy. • Pancreatitis is not usually caused be an obstructing thrombus. • Advances in surgical practise predisposes to haemobilia occurring as a complication. • Surgeons must be aware of spectrum of complications related to modern techniques., Introduction Haemobilia is an uncommon entity even though its frequency has increased with hepato-biliary instrumentation and procedures. It can be associated with obstructive jaundice and pancreatitis (Green et al., 2001) [1]. Haemobilia following cholecystectomy has frequently been reported in association with hepatic artery pseudo-aneurysm (Curet et al., 1981; Ribeiro et al., 1998) [2,3]. The authors wish to report a case of haemobilia due to a porto-biliary fistula presenting as acute pancreatitis. Presentation of case A 34-year-old female admitted as an urgency with upper abdominal pain for 3 weeks. She had, in the preceding days, been admitted to another hospital with acute pancreatitis. She reported an episode of rectal bleeding during that admission and possessed an abdominal ultrasound scan (USS) and magnetic resonance cholangiopancreatography (MRCP) which suggested the presence of a biliary tract neoplasm. The patient was also found to be jaundiced and the diagnosis of a porto-biliary fistula was made at operation. Conclusion The diagnosis in this case was found to be a portal vein-biliary tract fistula occurring post cholecystectomy. An awareness of the spectrum of complications related to modern surgical techniques may aid timely diagnosis and the achievement of favourable outcomes.

A strategy to rapidly determine if a matched unrelated donor (URD) can be secured for allograft recipients is needed. We sought to validate the accuracy of (1) HapLogic match predictions and (2) a resultant novel Search Prognosis (SP) patient categorization that could predict 8/8 HLA-matched URD(s) likelihood at search initiation. Patient prognosis categories at search initiation were correlated with URD confirmatory typing results. HapLogic-based SP categorizations accurately predicted the likelihood of an 8/8 HLA-match in 830 patients (1530 donors tested). Sixty percent of patients had 8/8 URD(s) identified. Patient SP categories (217 very good, 104 good, 178 fair, 33 poor, 153 very poor, 145 futile) were associated with a marked progressive decrease in 8/8 URD identification and transplantation. Very good to good categories were highly predictive of identifying and receiving an 8/8 URD regardless of ancestry. Europeans in fair/poor categories were more likely to identify and receive an 8/8 URD compared with non-Europeans. In all ancestries very poor and futile categories predicted no 8/8 URDs. HapLogic permits URD search results to be predicted once patient HLA typing and ancestry is obtained, dramatically improving search efficiency. Poor, very poor, andfutile searches can be immediately recognized, thereby facilitating prompt pursuit of alternative donors.

This article reviews the qualitative research on men’s self-management of mental and physical chronic diseases, with emphasis on strategies for dealing with risks and promoting wellness. Using Bardin’s method of document analysis, it was focused on the findings of Canadian qualitative studies published in French or English from 2005 to 2011. Boltanski’s theory on social uses of the body inspired the analysis. Living with a chronic disease threatens men’s sense of masculinity and self-image, as well as their perceived ability to fulfill expected social roles. Social images of men’s bodies influence how men express their emotions, attributes, and attitudes, or acknowledge the need for and seek social affirmation. Self-management has been documented in Canadian qualitative literature as a complex phenomenon influenced by the social environment, personal capacities, feelings, perceptions, and potentials. The extent of how all these features interact within the scope of men’s mental and physical health and illness experiences was partially revealed in this study. The findings underscore the social invisibility of men’s bodies, especially those of men facing social inequities. Attending to principles of social justice can ensure that future research on men’s health will amplify the range of men’s voices and allow them to be heard. Recommendations address also the international scientific community interested in advancing men’s health research, especially in those countries that lack a national men’s health policy.