Tendances et déterminants de l’utilisation de l’aide à domicile subventionnée par le gouvernement par les personnes âgées au Canada, 1996-1997 à 2009-2010

Il est connu que le vieillissement de la population canadienne va augmenter la demande d’aide à domicile et qu’un soutien insuffisant du secteur public accroît l’implication des réseaux informels et privés. En s’appuyant sur les données de l’Enquête nationale sur la santé de la population (ENSP) et de l’Enquête sur la santé dans les collectivités canadiennes (ESCC), cette recherche analyse les tendances et déterminants de l’utilisation de l’aide à domicile subventionnée par le gouvernement au Canada et en Ontario entre 1996-1997 et 2009-2010. Il en ressort que la proportion de bénéficiaires âgés de 65 ans et plus est en diminution, passant de 9,9% à 9,2% au Canada (1996-1997 à 2005) et de 10,2% à 8,8% puis 9,6% en Ontario (1996-1997, 2005, 2009-2010). Les compressions sont particulièrement ressenties dans les services de maintien à domicile, dont l’aide pour les travaux ménagers (de 51% à 34% en Ontario). Les personnes âgées, les femmes, les gens vivant seuls ou qui ont besoin d’assistance pour accomplir certaines activités de la vie quotidienne (AVQ) ou activités instrumentales de la vie quotidienne (AIVQ) reçoivent de moins en moins d’aide publique à domicile. En conclusion, le présent système de santé, qui semble se concentrer sur les soins de santé plutôt que sur les services de maintien, ne répond pas aux besoins des personnes âgées. Par ailleurs, le cas ontarien évoque l’impact que peuvent avoir les décisions politiques sur l’utilisation de l’aide à domicile. Les résultats suggèrent qu’entre 1996-1997 et 2005, ce sont surtout les personnes âgées de 18 à 64 ans et ceux nécessitant des soins qui bénéficièrent des programmes publics. Durant la période suivante (2005 à 2009-2010), il semble y avoir un intérêt plus marqué pour les 65 ans et plus dont la proportion d’utilisateurs s’accroît plus rapidement.It is known that the aging of the Canadian population will increase the demand for home care and that insufficient support from the public sector increases the implication of the informal and private networks. Using cross-sectional data from the National Population Health Survey (NPHS) and the Canadian Community Health Survey (CCHS), this research analyzes the trends and predictors of subsidized home care in Canada and Ontario between 1996/97 and 2009/10. It shows that the proportion of care receivers aged 65 and older is decreasing, going down from 9.9% to 9.2% in Canada (1996/97 to 2005) and from 10.2% to 8.8% then 9.6% in Ontario (1996/97, 2005, 2009/10). Government cuts are particularly felt in terms of home support services, like support for housework (from 51% to 34% in Ontario). Older persons, women, people living alone or those who need assistance to perform some activities of daily living (ADLs) or instrumental activities of daily living (IADLs) are receiving less and less subsidized home care. In conclusion, the actual health system, that appear to focus on health care instead of home support services, do not meet the needs of older persons. Furthermore, the Ontario case evokes the effect that policies can have on home care utilization. Results suggest that between 1996/97 and 2005, it is mostly persons aged from 18 to 64 years old or needing health care that benefited from the public program. During the next period (2005 to 2009/10), there seems to be a greater interest for the 65 and older, whose proportion of users increases more rapidly

Integration of oral health into primary care : a scoping review protocol

Integrated care has been introduced as a means of improving health outcomes and access to care, and reducing the cost of healthcare. Despite its importance, the integration of oral health into primary care is still an emerging healthcare pathway. This scoping review protocol has been developed and funded by the Canadian Institutes of Health Research to provide an evidence-based synthesis on a primary oral healthcare approach and its effectiveness in improving oral health outcomes

Scribing Method for Carbon Perovskite Solar Modules

The fully printable carbon triple-mesoscopic perovskite solar cell (C-PSC) has already demonstrated good efficiency and long-term stability, opening the possibility of lab-to-fab transition. Modules based on C-PSC architecture have been reported and, at present, are achieved through the accurate registration of each of the patterned layers using screen-printing. Modules based on this approach were reported with geometric fill factor (g-FF) as high as 70%. Another approach to create the interconnects, the so-called scribing method, was reported to achieve more than 90% g-FF for architectures based on evaporated metal contacts, i.e., without a carbon counter electrode. Here, for the first time, we adopt the scribing method to selectively remove materials within a C-PSC. This approach allowed a deep and selective scribe to open an aperture from the transparent electrode through all the layers, including the blocking layer, enabling a direct contact between the electrodes in the interconnects. In this work, a systematic study of the interconnection area between cells is discussed, showing the key role of the FTO/carbon contact. Furthermore, a module on 10 × 10 cm2 substrate with the optimised design showing efficiency over 10% is also demonstrated

Eliciting Awe in the Spectator: The Case of a Dhrupad-Based Dance Performance

This paper describes “Kalos, eîdos, skopeîn,” an immersive Dhrupad-based dance installation designed to elicit feelings of awe in the spectators, in a real-life artistic context. This study used a mixed-methods approach in order to explore spectators’ awe experience (N=45), using specific scales and interpretative phenomenological analysis. Results suggested that “Kalos, eîdos, skopeîn,” with its combination of nature motifs and the slow dance-walk associated with the Dhrupad music in the choreography, was able to produce awe-related moments in some spectators and inspire a degree of positive emotions. Our qualitative results viewed awe explicitly as a positive emotion and showed that generally the spectator narratives, involving the whole performance, were based on modified states of consciousness. Three themes emerged: the main theme is “A rich experience of modified states of consciousness” involving the whole performance, and two interconnected sub-themes “Captivated by the slowness of the dancers” associated with the slow movement and “I can still hear the mantra in my head” in rapport with Dhrupad music. This study was carried out as part of the Canadian FRQSC/FCI Project (2019-RC2-260306)

Eliciting Awe in the Spectator: The Case of a Dhrupad-Based Dance Performance

This paper describes “Kalos, eîdos, skopeîn,” an immersive Dhrupad-based dance installation designed to elicit feelings of awe in the spectators, in a real-life artistic context. This study used a mixed-methods approach in order to explore spectators’ awe experience (N=45), using specific scales and interpretative phenomenological analysis. Results suggested that “Kalos, eîdos, skopeîn,” with its combination of nature motifs and the slow dance-walk associated with the Dhrupad music in the choreography, was able to produce awe-related moments in some spectators and inspire a degree of positive emotions. Our qualitative results viewed awe explicitly as a positive emotion and showed that generally the spectator narratives, involving the whole performance, were based on modified states of consciousness. Three themes emerged: the main theme is “A rich experience of modified states of consciousness” involving the whole performance, and two interconnected sub-themes “Captivated by the slowness of the dancers” associated with the slow movement and “I can still hear the mantra in my head” in rapport with Dhrupad music. This study was carried out as part of the Canadian FRQSC/FCI Project (2019-RC2-260306)

Exploring use of unsupervised clustering to associate signaling profiles of GPCR ligands to clinical response.

Signaling diversity of G protein-coupled (GPCR) ligands provides novel opportunities to develop more effective, better-tolerated therapeutics. Taking advantage of these opportunities requires identifying which effectors should be specifically activated or avoided so as to promote desired clinical responses and avoid side effects. However, identifying signaling profiles that support desired clinical outcomes remains challenging. This study describes signaling diversity of mu opioid receptor (MOR) ligands in terms of logistic and operational parameters for ten different in vitro readouts. It then uses unsupervised clustering of curve parameters to: classify MOR ligands according to similarities in type and magnitude of response, associate resulting ligand categories with frequency of undesired events reported to the pharmacovigilance program of the Food and Drug Administration and associate signals to side effects. The ability of the classification method to associate specific in vitro signaling profiles to clinically relevant responses was corroborated using β2-adrenergic receptor ligands.This research was supported by a research contract from Pfizer Inc. and grants from the Natural Sciences and Engineering Research Council of Canada (Grant 311997 to G.P.) and the Canadian Institutes of Health Research MOP 324876 (to G.P.), MOP 102630 (to M.B. and O.L.) and Foundation grant (FDN-148431) to MB. MB holds a Canada Research Chair in Signal Transduction and Molecular Pharmacology. Dr Lichtarge’s research was supported by National Institutes of Health (NIH 2R01 GM066099; NIH 5R01 GM079656). B.B. was supported by a studentship from Fonds de Recherche en Santé du Québec. P.D. was supported by a MITACS fellowship

PeRL:A circum-Arctic Permafrost Region Pond and Lake database

Ponds and lakes are abundant in Arctic permafrost lowlands. They play an important role in Arctic wetland ecosystems by regulating carbon, water, and energy fluxes and providing freshwater habitats. However, ponds, i.e., waterbodies with surface areas smaller than 1. 0 × 104ĝ€m2, have not been inventoried on global and regional scales. The Permafrost Region Pond and Lake (PeRL) database presents the results of a circum-Arctic effort to map ponds and lakes from modern (2002-2013) high-resolution aerial and satellite imagery with a resolution of 5ĝ€m or better. The database also includes historical imagery from 1948 to 1965 with a resolution of 6ĝ€m or better. PeRL includes 69 maps covering a wide range of environmental conditions from tundra to boreal regions and from continuous to discontinuous permafrost zones. Waterbody maps are linked to regional permafrost landscape maps which provide information on permafrost extent, ground ice volume, geology, and lithology. This paper describes waterbody classification and accuracy, and presents statistics of waterbody distribution for each site. Maps of permafrost landscapes in Alaska, Canada, and Russia are used to extrapolate waterbody statistics from the site level to regional landscape units. PeRL presents pond and lake estimates for a total area of 1. 4 × 106ĝ€km2 across the Arctic, about 17ĝ€% of the Arctic lowland ( < ĝ€300ĝ€mĝ€a.s.l.) land surface area. PeRL waterbodies with sizes of 1. 0 × 106ĝ€m2 down to 1. 0 × 102ĝ€m2 contributed up to 21ĝ€% to the total water fraction. Waterbody density ranged from 1. 0 × 10 to 9. 4 × 101ĝ€kmĝ'2. Ponds are the dominant waterbody type by number in all landscapes representing 45-99ĝ€% of the total waterbody number. The implementation of PeRL size distributions in land surface models will greatly improve the investigation and projection of surface inundation and carbon fluxes in permafrost lowlands. Waterbody maps, study area boundaries, and maps of regional permafrost landscapes including detailed metadata are available at https://doi.pangaea.de/10.1594/PANGAEA.868349

From theoretical concepts to policies and applied programmes: the landscape of integration of oral health in primary care

Background: Despite its importance, the integration of oral health into primary care is still an emerging practice in the field of health care services. This scoping review aims to map the literature and provide a summary on the conceptual frameworks, policies and programs related to this concept. Methods: Using the Levac et al. six-stage framework, we performed a systematic search of electronic databases, organizational websites and grey literature from 1978 to April 2016. All relevant original publications with a focus on the integration of oral health into primary care were retrieved. Content analyses were performed to synthesize the results. Results: From a total of 1619 citations, 67 publications were included in the review. Two conceptual frameworks were identified. Policies regarding oral heath integration into primary care were mostly oriented toward common risk factors approach and care coordination processes. In general, oral health integrated care programs were designed in the public health sector and based on partnerships with various private and public health organizations, governmental bodies and academic institutions. These programmes used various strategies to empower oral health integrated care, including building interdisciplinary networks, training nondental care providers, oral health champion modelling, enabling care linkages and care coordinated process, as well as the use of e-health technologies. The majority of studies on the programs outcomes were descriptive in nature without reporting long-term outcomes. Conclusions: This scoping review provided a comprehensive overview on the concept of integration of oral health in primary care. The findings identified major gaps in reported programs outcomes mainly because of the lack of related research. However, the results could be considered as a first step in the development of health care policies that support collaborative practices and patient-centred care in the field of primary care sector

Ceacam1 separates graft-versus-host-disease from graft-versus-tumor activity after experimental allogeneic bone marrow transplantation.

BACKGROUND: Allogeneic bone marrow transplantation (allo-BMT) is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT) activity are limited by graft-versus-host-disease (GVHD). Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1) is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models. METHODS: We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT) in mouse models. In vivo, Ceacam1(-/-) T cells caused increased GVHD mortality and GVHD of the colon, and greater numbers of donor T cells were positive for activation markers (CD25(hi), CD62L(lo)). Additionally, Ceacam1(-/-) CD8 T cells had greater expression of the gut-trafficking integrin α(4)β(7), though both CD4 and CD8 T cells were found increased numbers in the gut post-transplant. Ceacam1(-/-) recipients also experienced increased GVHD mortality and GVHD of the colon, and alloreactive T cells displayed increased activation. Additionally, Ceacam1(-/-) mice had increased mortality and decreased numbers of regenerating small intestinal crypts upon radiation exposure. Conversely, Ceacam1-overexpressing T cells caused attenuated target-organ and systemic GVHD, which correlated with decreased donor T cell numbers in target tissues, and mortality. Finally, graft-versus-tumor survival in a Ceacam1(+) lymphoma model was improved in animals receiving Ceacam1(-/-) vs. control T cells. CONCLUSIONS: We conclude that Ceacam1 regulates T cell activation, GVHD target organ damage, and numbers of donor T cells in lymphoid organs and GVHD target tissues. In recipients of allo-BMT, Ceacam1 may also regulate tissue radiosensitivity. Because of its expression on both the donor graft and host tissues, this suggests that targeting Ceacam1 may represent a potent strategy for the regulation of GVHD and GVT after allogeneic transplantation

Aldo Keto Reductase 1B7 and Prostaglandin F2α Are Regulators of Adrenal Endocrine Functions

Prostaglandin F2α (PGF2α), represses ovarian steroidogenesis and initiates parturition in mammals but its impact on adrenal gland is unknown. Prostaglandins biosynthesis depends on the sequential action of upstream cyclooxygenases (COX) and terminal synthases but no PGF2α synthases (PGFS) were functionally identified in mammalian cells. In vitro, the most efficient mammalian PGFS belong to aldo-keto reductase 1B (AKR1B) family. The adrenal gland is a major site of AKR1B expression in both human (AKR1B1) and mouse (AKR1B3, AKR1B7). Thus, we examined the PGF2α biosynthetic pathway and its functional impact on both cortical and medullary zones. Both compartments produced PGF2α but expressed different biosynthetic isozymes. In chromaffin cells, PGF2α secretion appeared constitutive and correlated to continuous expression of COX1 and AKR1B3. In steroidogenic cells, PGF2α secretion was stimulated by adrenocorticotropic hormone (ACTH) and correlated to ACTH-responsiveness of both COX2 and AKR1B7/B1. The pivotal role of AKR1B7 in ACTH-induced PGF2α release and functional coupling with COX2 was demonstrated using over- and down-expression in cell lines. PGF2α receptor was only detected in chromaffin cells, making medulla the primary target of PGF2α action. By comparing PGF2α-responsiveness of isolated cells and whole adrenal cultures, we demonstrated that PGF2α repressed glucocorticoid secretion by an indirect mechanism involving a decrease in catecholamine release which in turn decreased adrenal steroidogenesis. PGF2α may be regarded as a negative autocrine/paracrine regulator within a novel intra-adrenal feedback loop. The coordinated cell-specific regulation of COX2 and AKR1B7 ensures the generation of this stress-induced corticostatic signal