This dietary intervention did not improve non-allergic nut ingestion by nut allergic children. Hospital challenge increased introduction rates, whilst parentally reported child concern about a reaction reduced success. Non-allergic nut ingestion did not change quality of life or sensitization.

Background  Perley Health has implemented SeeMe™: Understanding frailty together (www.perleyhealth.ca), a comprehensive approach to care that integrates the assessment and management of frailty, with an emphasis on goals of care planning.  Methods  Program evaluation over the first year of SeeMe™ used a mixed-methods approach involving quantitative data from surveys, goals of care preferences, hospital transfers, and qualitative data from interviews.  Results  The SeeMe™ training is an effective way to educate nurses and physicians in long-term care about frailty. For residents with documented care preferences prior to SeeMe™, there was a 15% reduction in the number of residents who preferred to be transferred to hospital post-SeeMe™ implementation. There was no significant decrease in hospital transfers during the first year the program was introduced.  Conclusion  After the roll-out of SeeMe™, nurses, physicians, and families reported high satisfaction with the program, and nurses reported an increase in knowledge and confidence. There was also a reduction in the number of residents and families selecting to transfer to hospital. This suggests that the education from SeeMe™ influenced residents and families to choose less invasive interventions in the context of frailty and quality of life goals.