"Me, I'm Living It": The Primary Health Care Experiences of Women who use Drugs in Vancouver’s Downtown Eastside: Summary of Findings from the VANDU Women's Clinic Action Research for Empowerment Study

First paragraph: Preventing and reducing the harmful consequences of drug use has been identified as a key priority in Canada at all levels of government. Initiatives to reduce barriers to care for marginalized women who use drugs are currently underway. However, despite the significant national and international attention paid to the health and social conditions of women in Vancouver's Downtown Eastside (DTES), women who use drugs in this community report persistent health inequities and barriers to accessing a wide range of services, including primary health care, harm reduction services, mental health care, and addictions treatment. These inequities and barriers to care result from a complex interplay of social, political and economic factors. In order to provide effective, empowering, compassionate, and respectful care for women who use drugs it is crucial to understand how these factors influence health and well-being

Examination of a new mobile intermittent pneumatic compression device in healthy adults

Aim: Intermittent pneumatic compression (IPC) is an alternative method of compression treatment designed to compress the leg and mimic ambulatory pump action to actively promote venous return. This study explores the efficacy of a new portable IPC device on tissue oxygenation (StO2) in two sitting positions. Methods: Twenty-nine participants were screened and recruited using (PAR-Q, CA). All data conformed to the Declaration of Helsinki and ethical principles. Participants attended two separate one-hour sessions to evaluate StO2 in a chair-sitting and long-sitting position. StO2 was recorded for 20-minutes pre-, during and post- a 20-minute intervention of the IPC unit (VenaproTM, DJO Global, CA). Results: A significant difference was seen between the two seating positions (p=0.003) with long-sitting showing a 12% higher StO2 level than chair-sitting post intervention. A similar effect was seen in both seating positions when analysing data over three, time points (p=0.000). Post-hoc pairwise comparisons showed that significant improvements in StO2 (p≤0.000) were seen from baseline, throughout the intervention, continuing up to 15 minutes post intervention, indicating a continued effect of the device after a short intervention. Conclusion: Post-operative care poses huge demands and cost to health services worldwide, so promotion of portable rehabilitation tools that facilitate community rehabilitation affords immense potential. Increasing StO2 through short-intervention sessions with this portable device within various health and sports-based practices, improving tissue health, potentially reducing post-operative DVT risk or inflammation. Such devices lend themselves to wide self-management implementation

Plasma contactor technology for Space Station Freedom

Hollow cathode plasma contactors were baselined for Space Station Freedom (SSF) to control the electrical potentials of surfaces to eliminate/mitigate damaging interactions with the space environment. The system represents a dual-use technology which is a direct outgrowth of the NASA electric propulsion program and in particular the technology development effort on ion thruster systems. Specific efforts include optimizing the design and configuration of the contactor, validating its required lifetime, and characterizing the contactor plume and electromagnetic interference. The plasma contact or subsystems include the plasma contact or unit, a power electronics unit, and an expellant management unit. Under this program these will all be brought to breadboard and engineering model development status. New test facilities were developed, and existing facilities were augmented, to support characterizations and life testing of contactor components and systems. The magnitude, scope, and status of the plasma contactor hardware development program now underway and preliminary test results on system components are discussed

Gasdermin E Does Not Limit Apoptotic Cell Disassembly by Promoting Early Onset of Secondary Necrosis in Jurkat T Cells and THP-1 Monocytes

During the progression of necroptosis and pyroptosis, the plasma membrane will become permeabilized through the activation of mixed lineage kinase domain like pseudokinase (MLKL) or gasdermin D (GSDMD), respectively. Recently, the progression of apoptotic cells into secondary necrotic cells following membrane lysis was shown to be regulated by gasdermin E (GSDME, or DFNA5), a process dependent on caspase 3-mediated cleavage of GSDME. Notably, GSDME was also proposed to negatively regulate the disassembly of apoptotic cells into smaller membrane-bound vesicles known as apoptotic bodies (ApoBDs) by promoting earlier onset of membrane permeabilisation. The presence of a process downstream of caspase 3 that would actively drive cell lysis and limit cell disassembly during apoptosis is somewhat surprising as this could favor the release of proinflammatory intracellular contents and hinder efficient clearance of apoptotic materials. In contrast to the latter studies, we present here that GSDME is not involved in regulating secondary necrosis in human T cells and monocytes, and also unlikely in epithelial cells. Furthermore, GSDME is evidently not a negative regulator of apoptotic cell disassembly in our cell models. Thus, the function of GSDME in regulating membrane permeabilization and cell disassembly during apoptosis may be more limited

Moving beyond size and phosphatidylserine exposure: evidence for a diversity of apoptotic cell-derived extracellular vesicles in vitro

Apoptosis is a form of programmed cell death that occurs throughout life as part of normal development as well as pathologic processes including chronic inflammation and infection. Although the death of a cell is often considered as the only biological outcome of a cell committed to apoptosis, it is becoming increasingly clear that the dying cell can actively communicate with other cells via soluble factors as well as membrane-bound extracellular vesicles (EVs) to regulate processes including cell clearance, immunity and tissue repair. Compared to EVs generated from viable cells such as exosomes and microvesicles, apoptotic cell-derived EVs (ApoEVs) are less well defined and the basic criteria for ApoEV characterization have not been established in the field. In this study, we will examine the current understanding of ApoEVs, in particular, the ApoEV subtype called apoptotic bodies (ApoBDs). We described that a subset of ApoBDs can be larger than 5 μm and smaller than 1 μm based on flow cytometry and live time-lapse microscopy analysis, respectively. We also described that a subset of ApoBDs can expose a relatively low level of phosphatidylserine on its surface based on annexin A5 staining. Furthermore, we characterized the presence of caspase-cleaved proteins (in particular plasma membrane-associated or cytoplasmic proteins) in samples enriched in ApoBDs. Lastly, using a combination of biochemical-, live imaging- and flow cytometry-based approaches, we characterized the progressive lysis of ApoBDs. Taken together, these results extended our understanding of ApoBDs

How much is too much? Examining the relationship between digital screen engagement and psychosocial functioning in a confirmatory cohort study

Objective Previous studies have offered mixed results regarding the link between digital screen engagement and the psychosocial functioning of young people. In this study, we aimed to determine the magnitude of this relation, to inform the discussion regarding whether amount of digital screen time has a subjectively significant impact on the psychosocial functioning of children and adolescents. Method We analyzed data from primary caregivers participating in the National Survey of Children’s Health (NSCH), an annual nationally representative survey fielded by the US Census Bureau between June 2016 and February 2017. NSCH uses an address-based sampling frame and both Web- and paper-based data collection instruments to measure psychosocial functioning and digital engagement, including a modified version of the Strengths and Difficulties questionnaire and caregiver estimates of daily television- and device-based engagement, respectively. Results The expected parabolic inverted-U-shaped relationship linking digital screen engagement to psychosocial functioning was found. These results replicated past findings suggesting that moderate levels of screen time (1-2 hours a day) were associated with slightly higher levels of psychosocial functioning compared to lower or higher levels of engagement. Furthermore, it indicated that children and adolescents would require 4 hours 40 minutes of television-based engagement and 5 hours 8 minutes of daily device-based engagement before caregivers would be able to notice subjectively significant variations in psychosocial functioning. Conclusion The possible influence of digital screen engagement is likely smaller and more nuanced than we might expect. These findings do not rule out the possibility that parents might only notice very high levels of screen time when their child manifests pronounced psychosocial difficulties. Future work should be guided by transparent and confirmatory programs of research

Bereavement help-seeking following an 'expected' death: a cross-sectional randomised face-to-face population survey

© 2008 Currow et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background : This study examines the prevalence and nature of bereavement help-seeking among the population who experienced an "expected" death in the five years before their survey response. Such whole population data are not limited by identification through previous access to specific services nor practitioners. Methods : In a randomised, cross-sectional, state-wide population-based survey, 6034 people over two years completed face-to-face interviews in South Australia by trained interviewers using piloted questions (74.2% participation rate). Respondent demographics, type of grief help sought, and circumstantial characteristics were collected. Uni- and multi-variate logistic regression models were created. Results : One in three people (1965/6034) had experienced an 'expected' death of someone close to them in the last five years. Thirteen per cent sought help for their grief from one or more: friend/family members (10.7%); grief counselors (2.2%); spiritual advisers (1.9%); nurses/doctors (1.5%). Twenty five respondents (1.3%) had not sought, but would have valued help with their grief. In multi-variate regression modeling, those who sought professional help (3.4% of the bereaved) had provided more intense care (OR 5.39; CI 1.94 to14.98; p < 0.001), identified that they were less able to 'move on' with their lives (OR 7.08; CI 2.49 to 20.13; p = 0.001) and were more likely not to be in full- or part-time work (OR 3.75; CI 2.31 – 11.82; p = 0.024; Nagelkerke's R2 = 0.33). Conclusion : These data provide a whole-of-population baseline of bereavement help-seeking. The uniquely identified group who wished they had sought help is one where potentially significant health gains could be made as we seek to understand better any improved health outcomes as a result of involving bereavement services

Experiences of coordinated care for people in the UK affected by rare diseases: cross-sectional survey of patients, carers, and healthcare professionals

BackgroundPoorly coordinated care can have major impacts on patients and families affected by rare conditions, with negative physical health, psychosocial and financial consequences. This study aimed to understand how care is coordinated for rare diseases in the United Kingdom.MethodsWe undertook a national survey in the UK involving 760 adults affected by rare diseases, 446 parents/carers of people affected by rare diseases, and 251 healthcare professionals who care for people affected by rare diseases.ResultsFindings suggested that a wide range of patients, parents and carers do not have coordinated care. For example, few participants reported having a care coordinator (12% patients, 14% parents/carers), attending a specialist centre (32% patients, 33% parents/carers) or having a care plan (10% patients, 44% parents/carers). A very small number of patients (2%) and parents/carers (5%) had access to all three—a care coordinator, specialist centre and care plan. Fifty four percent of patients and 33% of parents/carers reported access to none of these. On the other hand, a higher proportion of healthcare professionals reported that families with rare conditions had access to care coordinators (35%), specialist centres (60%) and care plans (40%).ConclusionsCare for families with rare conditions is generally not well coordinated in the UK, with findings indicating limited access to care coordinators, specialist centres and care plans. Better understanding of these issues can inform how care coordination might be improved and embrace the needs and preferences of patients and families affected by rare conditions