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Capsaicin: Vegetation with the Genus Chili peppers and Optimistic Effect of China Spruce on Epidermis Wellness.
The items within the scale showed high construct validity. Reliability was also excellent for the instrument. The applicability of this tool in supporting quality improvement initiatives is discussed. Copyright © 2019 Longwoods Publishing.BACKGROUND First Nations (FN) have unique perspectives and experiences of health and healthcare services, which are critical to the provision of effective community-based primary healthcare (CBPHC). OBJECTIVE This paper shares FN perspectives on primary healthcare (PHC), taking geographical, cultural and historical realities into account, to elucidate opportunities to improve current healthcare services. METHODS Semi-structured in-depth qualitative interviews were completed with 183 residents of 8 Manitoba FN communities. Grounded theory-guided data analysis was conducted. RESULTS Improving PHC performance requires delivering timely and holistic healthcare that integrates traditional health knowledge, comprehensive CBPHC increasing services such as healthcare and medical transportation, healthy food as an important preventative measure and a culturally informed workforce backed by local leadership and promoting cultural respect. CONCLUSION The relationship between self-determination and health is a critical factor in the implementation of CBPHC. FN must be respected to decide healthcare priorities that reflect the needs and visions of each community. Copyright © 2019 Longwoods Publishing.OBJECTIVES Of the several barriers associated with uptake and adherence to hearing services, cost is the most commonly identified barrier in Canada. This study evaluated health insurance plans for hearing care coverage within Alberta, Canada, and subsequent out-of-pocket expenses that would result if an individual chose to pursue treatment. METHODS An investigation of eight companies that provide supplementary health coverage in Alberta was conducted. Categories of health service coverage included hearing, vision, speech-language pathology (S-LP), physical therapy related (PT-R; including massage therapy and chiropractic therapy) and alternative medicine related (AM-R; including osteopathy, acupuncture and naturopathy). All coverage amounts were corrected to a four-year term for comparison purposes. RESULTS For a four-year term, the coverage amounts for hearing services were CAD 300-750; for vision services were CAD 0-900; for S-LP services were CAD 0-2,400; for PT-R services were CAD 1,400-10,200; and for AM-R services were CAD 0-10,200 per four-year term. The expected out-of-pocket expense for vision ranged from CAD 0 to CAD 2,766, whereas for hearing, it ranged from CAD 250 to CAD 11,700. CONCLUSION A considerable range and discrepancy were reported between hearing care and most paramedical services. In addition, the coverage amounts for hearing care were inconsistent with treatment costs, resulting in considerable out-of-pocket expenses for most consumers. The potential implications of such cost-related barriers on public health are an important consideration as our understanding of the impact of untreated hearing impairment continues to increase. Copyright © 2019 Longwoods Publishing.BACKGROUND The UK's publicly provided National Health Service (NHS) is primarily publicly funded but treats some private-pay patients (PPPs). Little is known about impacts of treating PPPs within publicly provided health systems. This study explores NHS health professionals' experiences and understanding of this phenomenon. METHODS Semi-structured interviews were carried out with NHS clinicians. The interview transcripts were then thematically analyzed. RESULTS A total of 17 clinicians highlighted potential impacts in five areas (1) availability of resources for non-urgent, publicly funded patients, (2) patient safety for publicly funded patients and PPPs, (3) health professional training, (4) NHS finances, and (5) NHS direction setting and values. CONCLUSIONS In a publicly provided health service that is increasingly treating PPPs, clinicians had limited knowledge of policies for PPP care. Clinicians were concerned about patient safety impacts of prioritizing PPPs over publicly funded patients. Potential cross-subsidies from public to private funding were mooted. The issues raised here require further exploration and may inform research and policy development in the UK and other countries. Copyright © 2019 Longwoods Publishing.BACKGROUND Advances in genomics and epidemiology can foster the implementation of a risk-based approach to current age-based breast cancer screening programs. This personalized approach would challenge the trajectory for women in the healthcare system by adding both a risk-assessment step (including a genomic test) and screening options. OBJECTIVE The aim of this study is to explore, from an organizational perspective, the acceptability of different proposals for each step of the trajectory for women in the healthcare system should a personalized approach be implemented in the province of Quebec. METHODS We interviewed 20 professional stakeholders who are either involved in the current breast cancer screening program in Quebec or who are likely to play a role in the future implementation of a personalized risk-based approach. RESULTS|DISCUSSION Preferences are split between proposals supporting self-management by the women themselves (e.g., solicitation through media campaign, self-collection of information and sample and results provided by letter) and proposals prioritizing more interaction between women and healthcare providers (e.g., solicitation by health professionals, collection of information and samples by a nurse and results provided by health professionals). Copyright © 2019 Longwoods Publishing.Canadian medical assistance in dying (MAiD) legislation was introduced in 2016. Although Bill C-14 attempted to balance patient autonomy and the protection of the vulnerable, recent court challenges suggest that an ideal balance has not been achieved. Numerous advocacy initiatives as well as a parliamentary review currently focus on three specific populations mature minors, patients requesting MAiD via an advance directive and patients with a mental illness as the sole underlying condition. This article approaches these issues from an ethical and legal lens. We first outline a policy review on existing MAiD legislation in 11 jurisdictions. We then use the Oakes test (a critical assessment tool in the Carter v Canada case) to determine whether the restrictions on the three above-mentioned groups are consistent with the Canadian Charter of Rights and Freedoms. Finally, we consult our literature review to propose reasonable solutions that would be more consistent with the Charter. Copyright © 2019 Longwoods Publishing.A population's health is dependent on the availability of skilled health professionals. We know little about retirement decision-making among publicly employed Canadian registered nurses (RNs) and allied health professionals (AHPs). We identified and compared factors reported to influence early versus 65+ retirement decisions among RNs (n = 794) and AHPs (n = 393). RNs, on average, retired at 58.1 years and AHPs at 59.4 years. More than two thirds retired before age 65. Among RNs, caregiving demands predict early retirement - policies supporting employed RN caregivers may reduce early workforce exits among publicly employed RNs. Copyright © 2019 Longwoods Publishing.Patient-oriented research (POR) aims to increase patient engagement in health research to improve health research and health services. In Canada, the Strategies for Patient-Oriented Research (SPOR) framework provides guidance for conducting POR. We critically review the SPOR framework through the lens of public health systems and services research. The SPOR framework is primarily focused on engaging individual patients in health research without attention to broader structural forces that shape health and participation in healthcare systems. Shifting from patient to public involvement and from patient to community engagement and being explicit about the range of health research that SPOR encompasses would enhance the framework and strengthen the potential of SPOR to improve health systems through health protection, promotion and prevention of disease and injury. Copyright © 2019 Longwoods Publishing.It has been a fantastic opportunity to be the editor for this journal over the last decade. I have very much enjoyed being exposed to the broad range of health services and policy research papers that have been submitted to the journal - more than 1,000 manuscripts that reflect a diverse set of questions, approaches, contributors and conclusions. The articles in this issue exemplify that diversity. Some themes continue to resonate strongly health human resources, primary healthcare, and healthcare financing have been important topics since the journal was founded, for instance. But there have been changes too. Some topics - such as medical assistance in dying - have emerged as central questions in healthcare policy. We now see more research being undertaken with patients and communities. And the ratio of qualitative and mixed-methods research to quantitative analysis has risen. Copyright © 2019 Longwoods Publishing.The mechanism through which developmental programming of offspring overweight/obesity following in utero exposure to maternal overweight/obesity operates is unknown but may operate through biologic pathways involving offspring anthropometry at birth. Thus, we sought to examine to what extent the association between in utero exposure to maternal overweight/obesity and childhood overweight/obesity is mediated by birth anthropometry. Analyses were conducted on a retrospective cohort with data obtained from one hospital system. A natural effects model framework was used to estimate the natural direct effect and natural indirect effect of birth anthropometry (weight, length, head circumference, ponderal index, and small-for-gestational age [SGA] or large-for-gestational age [LGA]) for the association between pre-pregnancy maternal body mass index (BMI) category (overweight/obese vs normal weight) and offspring overweight/obesity in childhood. Models were adjusted for maternal and child socio-demographics. Three thousand nine hundred and fifty mother-child dyads were included in analyses (1467 [57.8%] of mothers and 913 [34.4%] of children were overweight/obese). Results suggest that a small percentage of the effect of maternal pre-pregnancy BMI overweight/obesity on offspring overweight/obesity operated through offspring anthropometry at birth (weight 15.5%, length 5.2%, head circumference 8.5%, ponderal index 2.2%, SGA 2.9%, and LGA 4.2%). There was a small increase in the percentage mediated when gestational diabetes or hypertensive disorders were added to the models. Our study suggests that some measures of birth anthropometry mediate the association between maternal pre-pregnancy overweight/obesity and offspring overweight/obesity in childhood and that the size of this mediated effect is small.BACKGROUND Resistance to glucocorticoid (GC)-induced apoptosis in acute lymphoblastic leukemia (ALL), is considered one of the major prognostic factors for the disease. Prednisolone is a corticosteroid and one of the most important agents in the treatment of acute lymphoblastic leukemia. The mechanics of GC resistance are largely unknown and intense ongoing research focuses on this topic. AIM The aim of the present study is to review some aspects of GC resistance in ALL, and in particular of Prednisolone, with emphasis on previous and present knowledge on gene expression and signaling pathways playing a role in the phenomenon. METHODS An electronic literature search was conducted by the authors from 1994 to June 2019. Original articles and systematic reviews selected, and the titles and abstracts of papers screened to determine whether they met the eligibility criteria, and full texts of the selected articles were retrieved. RESULTS Identification of gene targets responsible for glucocorticoid resistance may allow discovery of drugs, which in combination with glucocorticoids may increase the effectiveness of anti-leukemia therapies.
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