Copyright© the College of Family Physicians of Canada.in French OBJECTIF Examiner les problèmes de l’isolement social, de la solitude et de la vulnérabilité sociale chez les adultes plus âgés, de même que les risques qui leur sont associés, et aider les professionnels des soins primaires à identifier les patients à risque et à recommander des interventions efficaces. SOURCES DE L’INFORMATION Une recherche documentaire a été effectuée dans PubMed et PsycINFO en se servant des expressions aged, social isolation, loneliness, screening et interventions, de même que des mots clés associés pour trouver des articles pertinents en anglais. Les références des articles cernés ont aussi fait l’objet d’une recherche manuelle. Une recension distincte dans la littérature grise à l’aide de Google a aussi été faite pour trouver des documents de politiques et du matériel de transfert des connaissances provenant d’organisations appropriées. La recherche portait sur les articles publiés durant les 10 années précédant juin 2019. MESSAGE PRINCIPAL L’isolement social, la solitude et iaires de soins de longue durée et des aidants plus âgés, doivent être évalués de manière plus approfondie. CONCLUSION L’isolement social, la solitude et la vulnérabilité sociale sont des problèmes fréquents chez les adultes plus âgés, et ils ont des répercussions importantes sur la santé. Les médecins de famille sont bien placés pour identifier les aînés esseulés ou socialement isolés et enclencher l’amorce des services voulus.OBJECTIVE To investigate the experiences of family caregivers who participated in an innovative model of interprofessional team-based care specifically designed for elderly patients with complex care needs. DESIGN Qualitative study. SETTING Large academic family practice in Toronto, Ont. PARTICIPANTS Family caregivers of elderly patients who had attended the IMPACT (Interprofessional Model of Practice for Aging and Complex Treatments) clinic (N = 13). METHODS Individual semistructured interviews, which were conducted face-to-face, audiorecorded, transcribed verbatim, and analyzed using the constant comparative method. MAIN FINDINGS Family caregivers who attended the IMPACT clinic believed it enhanced caregiver experience and capacity. Caregivers experienced increased validation and engagement with the treatment team. Feelings of isolation were reduced, resulting in increased confidence and greater feelings of empowerment in their caregiver role. CONCLUSION While the needs and value of caregivers are increasingly acknowledged, health care teams continue to struggle with how to relate to and engage with family caregivers-how best to support them and work with them in the context of their family members' care. Interprofessional teams who adopt the IMPACT model-providing synchronous, real-time interventions that include the caregiver-can facilitate increased caregiver capacity, confidence, and empowerment. Copyright© the College of Family Physicians of Canada.Question I have several patients with autism spectrum disorder (ASD) who experience difficulties with sleep, affecting the quality of life of both the child and the family. Is melatonin an effective treatment for sleep problems in children with this condition?Answer Autism spectrum disorder is prevalent among children in Canada and globally, with most affected children experiencing troubles with sleep. Behavioural therapy is the first-line treatment for sleep problems in children with ASD, and melatonin has been reported to be effective and safe in this population as an alternative or adjunctive treatment. A new pediatric, prolonged-release formulation of melatonin is not yet available in Canada, but initial studies in Europe have indicated that it is a potentially effective treatment for sleep problems in children with ASD. Copyright© the College of Family Physicians of Canada.OBJECTIVE To review the problems of social isolation, loneliness, and social vulnerability in older adults and the associated risks, and to help primary care providers identify patients at risk and recommend effective interventions. SOURCES OF INFORMATION PubMed and PsycINFO searches were conducted using the terms aged, social isolation, loneliness, screening, and interventions and associated key words for relevant English-language articles. References of identified articles were also hand searched. A separate search of the gray literature using Google was conducted to find policy documents and knowledge translation materials from relevant organizations. The search covered relevant articles from the 10 years before June 2019. MAIN MESSAGE Social isolation, loneliness, and social vulnerability are very common in older adults and are associated with considerable morbidity and mortality, comparable to established risk factors such as smoking, alcohol consumption, obesity, and frailty. Numerous interventions addranada.Accumulating evidence suggests that metabolic reprogramming has a critical role in carcinogenesis and tumor progression. The usefulness of formalin-fixed paraffin-embedded (FFPE) tissue material for metabolomics analysis as compared with fresh frozen tissue material remains unclear.  https://www.selleckchem.com/products/oprozomib-onx-0912.html  Liquid chromatography tandem mass spectrometry-based metabolomics analysis was performed on 11 pairs of matched tumor and normal tissues in both FFPE and fresh frozen tissue materials from colorectal carcinoma patients. Permutation t-test was applied to identify metabolites with differential abundance between tumor and normal tissues. A total of 200 metabolites were detected in the FFPE samples and 536 in the fresh frozen samples. The preservation of metabolites in FFPE samples was diverse according to classes and chemical characteristics, ranging from 78% (energy) to 0% (peptides). Compared with the normal tissues, 34 (17%) and 174 (32%) metabolites were either accumulated or depleted in the tumor tissues derived from FFPE and fresh frozen samples, respectively. Among them, 15 metabolites were common in both FFPE and fresh frozen samples. Notably, branched chain amino acids were highly accumulated in tumor tissues. Using KEGG pathway analyses, glyoxylate and dicarboxylate metabolism, arginine and proline, glycerophospholipid, and glycine, serine and threonine metabolism pathways distinguishing tumor from normal tissues were found in both FFPE and fresh frozen samples. This study demonstrates that informative data of metabolic profiles can be retrieved from FFPE tissue materials. Implications Our findings suggest potential value of metabolic profiling using FFPE tumor tissues and may help to shape future translational studies through developing treatment strategies targeting metabolites. Copyright ©2020, American Association for Cancer Research.