Health outcomes, health services utilization, and costs consequences of medicare uninsurance among migrants in Canada: a systematic review

Abstract Background Medically uninsured groups, many of them migrants, reportedly delay using healthcare services due to costs and often face preventable health consequences. This systematic review sought to assess quantitative evidence on health outcomes, health services use, and health care costs among uninsured migrant populations in Canada. Methods OVID MEDLINE, Embase, Global Health, EconLit, and grey literature were searched to identify relevant literature published up until March 2021. The Cochrane Risk of Bias in Non-randomized Studies – of Interventions (ROBINS-I) tool was used to assess the quality of studies. Results Ten studies were included. Data showed that there are differences among insured and uninsured groups in reported health outcomes and health services use. No quantitative studies on economic costs were captured. Conclusions Our findings indicate a need to review policies regarding accessible and affordable health care for migrants. Increasing funding to community health centers may improve service utilization and health outcomes among this population

Correlative Study on the Hepatorenal and Hormonal Alterations in Perimenopausal Women in Enugu, South East of Nigeria

Background: The term perimenopause refers to a woman's shift from a reproductive to a nonreproductive stage. Many hormonal and biochemical changes accompany this transformation. There is insufficient information in the association between hormonal changes, Liver enzymes activities, and renal functions in perimenopause. This study evaluated the hormonal and hepatorenal alterations in perimenopausal and premenopausal women in Enugu State, Nigeria. Methods: A total of 180 apparently healthy women were recruited for this cross-sectional study. 90 perimenopausal women (mean age = 49 years) and 90 premenopausal women (mean age = 29 years) served as test and control subjects. Subjects' anthropometric indices (blood pressure, waist circumference (WC), height, and weight) were measured. five milliliters of fasting blood was collected from the subjects to test for Estradiol (E2), Luteinizing hormone (LH), Follicle stimulating hormone (FSH), Alanine transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALP), Protein, Urea, Creatinine, and Fasting blood glucose (FBG) using standard biochemical procedures. Results: Blood pressure, FBG, WC, FSH, LH, ALT, AST, Creatinine levels were substantially higher and Estradiol was lower in perimenopausal women when compared to premenopausal women (P<0.05). There exist significant positive correlations among perimenopausal women in FSH and LH with AST and ALT, Estradiol with protein, Urea vs Creatinine, while Estradiol was negatively associated with ALT, AST, ALP and FSH. Conclusion: Perimenopausal women are likely prone to a higher risk of liver and renal dysfunction. Therefore, the need for regular evaluation of liver and kidney parameters during perimenopause is encouraged