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Canada’s Truth and Reconciliation Commission Final Report (2015) highlighted the necessity of Indigenous self-determination in addressing the legacy of residential schools, yet Indigenous aging research remains dominated by Settlers. This Indigenist study by a Cree/Settler research team asked Indigenous Elders what is needed to support the wellness of the older adults in their communities. Elders shared that the healing of older survivors comes from reconnecting to the cultural knowledges that residential schools sought to eradicate. In resuming their traditional roles as transmitters of knowledge, older adults not only support their own healing, but also that of their whole communities. This understanding of the profoundly interrelational nature of Indigenous communities means that older adults’ wellness depends on first reclaiming their cultural identity and then on their roles as intergenerational transmitters of knowledge.
Society is undergoing a shift in gender politics. Science and medicine are part of this conversation, not least as women's representation and pay continue to drop as one progresses through more senior academic and clinical levels. Naming and redressing these inequalities needs to be a priority for us all.
Acute psychological stress is positively associated with a cold/flu. The present randomised, double-blind, placebo-controlled study examined the effect of three potentially probiotic bacteria on the proportion of healthy days over a 6-week period in academically stressed undergraduate students (n 581) who received Lactobacillus helveticus R0052, Bifidobacterium longum ssp. infantis R0033, Bifidobacterium bifidum R0071 or placebo. On each day, participants recorded the intensity (scale: 0 = not experiencing to 3 = very intense) for nine cold/flu symptoms, and a sum of symptom intensity >6 was designated as a day of cold/flu. B. bifidum resulted in a greater proportion of healthy days than placebo (P≤ 0·05). The percentage of participants reporting ≥ 1 d of cold/flu during the 6-week intervention period was significantly lower with B. bifidum than with placebo (P< 0·05). There were no effects of B. infantis or L. helveticus compared with placebo on either outcome. A predictive model accounted for influential characteristics and their interactions on daily reporting of cold/flu episodes. The proportion of participants reporting a cold on any given day was lower at weeks 2 and 3 with B. bifidum and B. infantis than with placebo for the average level of stress and the most commonly reported number of hours of sleep. Daily intake of bifidobacteria provides benefit related to cold/flu outcomes during acute stress.
In Ontario, clinical decision units (CDUs) were implemented as a pilot project in 2008 by the Ministry of Health and Long-Term Care as part of its strategy to reduce emergency department (ED) waiting times. Our objective was to describe general characteristics of the program at each of the participating sites and to examine barriers and facilitators to integrating CDUs into practice.
On-site small-group interviews were conducted in two phases with ED and hospital staff at participating sites, first at 8 to 12 weeks and again at 12 months postimplementation. Interview data were analyzed using the framework approach. Unstructured field notes and CDU clinical care protocols and documentation were also reviewed.
The qualitative analysis identified 10 key themes related to integrating CDUs into EDs: shift in clinical and operational practice; administrative aspects of implementation; team building and stakeholder involvement; use of clinical care protocols; physical or virtual model of care; responsive ancillary services; involvement of specialist services; coordination with hospital and community supports; appropriate use of the CDU; and ongoing evaluation and monitoring. Each theme represents an important insight from the perspective of clinical and administrative staff at participating sites.
The implementation of CDUs is a complex process, with no single preferred clinical care or operational model. This study identifies a number of key considerations relevant to the future implementation of CDUs.
In order to characterize the nature and extent of neuropsychological dysfunction in primary lateral sclerosis (PLS), we studied prospectively cognitive, emotional, and behavioral functioning in PLS, and compared performances to functioning in amyotrophic lateral sclerosis (ALS).
Eighteen patients with PLS and 13 patients with ALS completed a neuropsychological test battery assessing both cognitive skills and emotional/behavioral functioning.
Both PLS and ALS groups scored broadly within normal limits (mean T-scores greater than 40) on all cognitive measures and no significant between-group differences were found with the exception of one variable. However, when examined on a case by case basis, the data revealed considerable heterogeneity amongst patients in both groups. Overall, 39% of PLS patients and 31% of ALS patients were considered cognitively impaired. A higher than expected frequency of abnormal scores was noted for several tests of executive function in both groups, and a majority of PLS patients also exhibited abnormal behavioural symptoms. There was no relationship in PLS or ALS groups between cognitive functioning and disease duration, current site of disease, site of onset, functional status, and respiratory variables. Comparison between the PLS and ALS groups indicated virtually no differences in cognitive test scores and overall emotional/behavioural symptoms.
We observed deficits in cognition and behaviour in a significant proportion of PLS patients which were comparable to those observed in ALS cases. Although deficits were not in the range of frontotemporal dementia, both ALS and PLS cases demonstrated deficits most prominently on tests of executive functioning.
Last fall, we had the opportunity to return to the classroom as students. We were invited by the American Political Science Association to take a course titled Congress and the Making of Foreign Policy at the Johns Hopkins School of Advanced International Studies (SAIS) in Washington, D.C. The course, which was taught by professor Charles Stevenson, met twice weekly during September and October, prior to the start of APSA's Congressional Fellowship Program in November. The course was designed to give APSA Congressional Fellows and SAIS students an overview of the role that Congress plays in the foreign policymaking process. Since both of us teach a course on Congress, much of the course was an excellent refresher for us. But it also differed in important ways from the courses we teach at our respective schools. It is these differences that deepened our understanding of Congress and the foreign policymaking process and provided an important introduction to our work as APSA fellows on Capitol Hill.
This paper reports on a study examining the effects of undertaking population-based health needs assessment (HNA) on the knowledge, views and working practices of health visitors. Data were generated through indepth interviews with health visitors who had all utilized a standard mechanism for needs assessment. This was analysed to assess the impact of this work on the research respondents’ knowledge base, their attitudes and approaches to health visiting and their everyday practice. Findings suggest that undertaking health needs assessment increased understanding of public health concepts, enabled a profound reflection on current working practices and increased respondent’s desire to practise differently. However, despite these forces for change, the practitioners in this study found it very difficult to refocus their work in the way they desired due to a combination of inhibiting factors, including custom and practice and the perceptions and demands of others. If health visitors are to expand the scope of their work to incorporate an increased amount of community based activity as the UK Government is proposing, this study would suggest that these inhibiting factors must be addressed not only by health visitors themselves, but also by their employers and other primary care professionals.
Paleocene spatangoids are unknown from the Antilles, apart from evidence from trace fossils. The peak of spatangoid diversity was the Eocene. Jamaican Oligo-Miocene spatangoids have a relatively low diversity compared with that of the Antillean region. Plio-Pleistocene spatangoids are poorly known from the Antilles (four genera), in contrast to the Oligo-Miocene (16 genera) and Holocene (17 genera). The depauperate Paleocene and Plio-Pleistocene spatangoid faunas are probably in part artifacts of incomplete sampling, facies-related absences, outcrop area effects and the relative brevity of these stratigraphic intervals.
To the large echinoid fauna of the Swanswick Formation (Middle-Upper Eocene) of Jamaica is added the schizasterid Aguayoaster schickleri new species. This is the first record of this genus outside Cuba; it is distinctly more elongate than all other known specimens of this genus. The schizasterid Caribbaster loveni (Cotteau, 1875) is recorded from the Swanswick Formation for the first time, the youngest occurrence of this genus in Jamaica. The coeval Claremont Formation has not previously yielded spatangoid echinoids; the brissid Eupatagus cf. antillarum (Cotteau) from a new locality is the first spatangoid known from a lagoonal unit of the White Limestone Group.
To determine the prevalence of influenza vaccination in patients who present to the emergency department (ED) who meet current guidelines for its use. To evaluate the feasibility of an ED-based program to provide influenza vaccine to at-risk patients.
A survey of ED patients and their family physicians, using a convenience sample.
Participants and setting:
Consecutive patients presenting to the emergency department of Prince George Regional Hospital, Prince George, BC, a regional hospital in Northern British Columbia, during designated shifts between Nov. 6, 1997, and Dec. 10, 1997.
Age, gender, family physician (FP), eligibility for influenza vaccine, vaccination status, willingness to receive vaccine in the ED, and FP methods for ensuring use of influenza vaccine.
935 patients were interviewed; 816 met study eligibility criteria. Of 214 patients eligible for influenza vaccine, 113 (52.8%) had not been vaccinated. Fifty-three (46.9%) agreed to vaccination, and 49 were vaccinated in the ED. A survey of the patients’ FPs revealed that 85% used callback lists, but that only 49% of vaccine-eligible patients identified in the study were on a callback list. Positive associations were found between the presence of an FP and the likelihood of having been vaccinated (odds ratio [OR] = 8.8), being on a callback list and having been vaccinated (OR = 4.1), and age >64 and being on a callback list (OR = 2.1).
Up to 50% of patients eligible for influenza vaccine are not adequately immunized. Administering influenza vaccine in the ED is acceptable to patients and should reduce influenza rates in at-risk populations. There is a role for administering influenza vaccine in the ED.