Alternative health care consultations in Ontario, Canada: A geographic and socio-demographic analysis

<p>Abstract</p> <p>Background</p> <p>An important but understudied component of Canada's health system is alternative care. The objective of this paper is to examine the geographic and socio-demographic characteristics of alternative care consultation in Ontario, Canada's largest province.</p> <p>Methods</p> <p>Data is drawn from the Canadian Community Health Survey (CCHS Cycle 3.1, 2005) for people aged 18 or over (n = 32,598) who had a consultation with an alternative health care provider. Four groups of consultations are examined: (1) all consultations (2) massage therapy (3) acupuncture, and (4) homeopath/naturopath. Descriptive statistics, mapping and logistic regression modeling are employed to analyze the data and to compare modalities of alternative health care use.</p> <p>Results</p> <p>In 2005, more than 1.2 million adults aged 18 or over consulted an alternative health care provider, representing about 13% of the total population of Ontario. The analysis revealed a varied geographic pattern of consultations across the province. Consultations were fairly even across the urban to rural continuum and rural residents were just as likely to consult a provider as their urban counterparts. From a health perspective, people with a chronic condition, lower health status and self-perceived unmet health care needs were more likely to see an alternative health provider. Women with chronic conditions such as fibromyalgia, high blood pressure, chronic fatigue syndrome and chemical sensitivities were more likely to see an alternative provider if they felt their health care needs were not being met.</p> <p>Conclusions</p> <p>The analysis revealed that geography is not a factor in determining alternative health care consultations in Ontario. By contrast, there is a strong association between these consultations and socio-demographic characteristics particularly age, sex, education, health and self-perceived unmet health care needs. The results underscore the importance of women's health needs as related to alternative care use. The paper concludes that there is a need for more place-specific research that explores the reasons why people use specific types of alternative health care as tied to socio-economic status, health, place of residence, and knowledge of these treatments.</p

Dysphagia secondary to dermatomyositis treated successfully with intravenous immunoglobulin: a case report

A 46 year old woman presented with a one month history of rash and mylagia. The history, clinical findings and blood tests all supported a diagnosis of dermatomyositis. The patient later developed dysphagia and was successfully treated with intravenous immunoglobulin. Investigations and treatment of dysphagia in the context of dermatomyositis are discussed

Nadine Gordimer: 01-24-1986

Gordimer calls herself a natural writer and speaks about the influence that growing up in a South African mining town had on her writing. She responds to questions about voice, rhythm, audience, narrative techniques, and her composition process for the short story and the novel. Gordimer says that the short story taught her how important getting to the essence of things is to her writing. She also considers the effect of gender on her writing. The language of politics vs. the language of art is discussed as the distinction between nonfiction and fiction. The theme of betrayal in her latest collection is examined, as well as the political efficacy of literature to effect change in human rights issues, including apartheid. Gordimer calls her essays the one thing I can do for my nation.https://digitalcommons.brockport.edu/writers_videos/1034/thumbnail.jp

Developments in Earth observation for the assessment and monitoring of inland, transitional, coastal and shelf-sea waters

The Earth's surface waters are a fundamental resource and encompass a broad range of ecosystems that are core to global biogeochemical cycling and food and energy production. Despite this, the Earth's surface waters are impacted by multiple natural and anthropogenic pressures and drivers of environmental change. The complex interaction between physical, chemical and biological processes in surface waters poses significant challenges for in situ monitoring and assessment and often limits our ability to adequately capture the dynamics of aquatic systems and our understanding of their status, functioning and response to pressures. Here we explore the opportunities that Earth observation (EO) has to offer to basin-scale monitoring of water quality over the surface water continuum comprising inland, transition and coastal water bodies, with a particular focus on the Danube and Black Sea region. This review summarises the technological advances in EO and the opportunities that the next generation satellites offer for water quality monitoring. We provide an overview of algorithms for the retrieval of water quality parameters and demonstrate how such models have been used for the assessment and monitoring of inland, transitional, coastal and shelf-sea systems. Further, we argue that very few studies have investigated the connectivity between these systems especially in large river-sea systems such as the Danube-Black Sea. Subsequently, we describe current capability in operational processing of archive and near real-time satellite data. We conclude that while the operational use of satellites for the assessment and monitoring of surface waters is still developing for inland and coastal waters and more work is required on the development and validation of remote sensing algorithms for these optically complex waters, the potential that these data streams offer for developing an improved, potentially paradigm-shifting understanding of physical and biogeochemical processes across large scale river-sea continuum including the Danube-Black Sea is considerable

Multicentury Fire and Forest Histories at 19 Sites in Utah and Eastern Nevada

Our objective is to provide site-specific fire and forest histories from Utah and eastern Nevada that can be used for land management or additional research. We systematically sampled fire scars and tree-recruitment dates across broad gradients in elevation and forest type at 13 sites in Utah and 1 in eastern Nevada to characterize spatial and temporal variation in historical fire regimes as well as forest structure and composition. We collected similar data non-systematically at five additional sites in Utah. These 19 sites include a broad range of forest types (from pinyon-juniper woodlands to spruce-fir forests) and fire regime types. In this report, we summarize local-scale spatial and temporal variation with site-specific details of historical fire regimes and forests that will be useful for local natural resource and fire management of the individual sites. For each site, we report topography, chronologies of fire and tree recruitment, and properties derived from those chronologies such as time-averaged fire regime parameters (mean fire interval and fire severity) and changes in forest composition and structure that have occurred since the late 1800s

Dynamics of direct inter-pack encounters in endangered African wild dogs

Aggressive encounters may have important life history consequences due to the potential for injury and death, disease transmission, dispersal opportunities or exclusion from key areas of the home range. Despite this, little is known of their detailed dynamics, mainly due to the difficulties of directly observing encounters in detail. Here, we describe detailed spatial dynamics of inter-pack encounters in African wild dogs (Lycaon pictus), using data from custom-built high-resolution GPS collars in 11 free-ranging packs. On average, each pack encountered another pack approximately every 7 weeks and met each neighbour twice each year. Surprisingly, intruders were more likely to win encounters (winning 78.6% of encounters by remaining closer to the site in the short term). However, intruders did tend to move farther than residents toward their own range core in the short-term (1 h) post-encounter, and if this were used to indicate losing an encounter, then the majority (73.3%) of encounters were won by residents. Surprisingly, relative pack size had little effect on encounter outcome, and injuries were rare (<15% of encounters). These results highlight the difficulty of remotely scoring encounters involving mobile participants away from static defendable food resources. Although inter-pack range overlap was reduced following an encounter, encounter outcome did not seem to drive this, as both packs shifted their ranges post-encounter. Our results indicate that inter-pack encounters may be lower risk than previously suggested and do not appear to influence long-term movement and ranging

Current tobacco use and susceptibility to using tobacco among non-users of tobacco: A cross-sectional study among school-going adolescents in Sierra Leone.

From PubMed via Jisc Publications RouterHistory: received 2022-03-20, revised 2022-12-02, accepted 2022-12-05Publication status: epublishTobacco use is a global health threat associated with a high disease burden and death. Current tobacco use and susceptibility to using tobacco products among adolescents who are potential adult tobacco users have not been explored in Sierra Leone. Thus, we aimed to estimate the prevalence and correlates of current tobacco use and tobacco non-users susceptibility to using tobacco amongst high school students in Sierra Leone. We used data obtained from the 2017 Sierra Leone Global Youth Tobacco Survey (GYTS), which presented information collected from 6680 students aged 11-17 years nationwide. Gender-based correlates of current use and susceptibility to using tobacco among non-tobacco users were determined by complex sample logistic regression analyses. Adjusted odds ratios (AOR) and respective 95% confidence intervals (CIs) are reported. A p<0.05 was considered significant. The prevalence of current tobacco use among high school adolescents in Sierra Leone was 24.6%, higher in males (27.9%) than in females (18.6%). Male (AOR=1.50; 95% CI: 1.18-1.91), parental smoking (AOR=1.73; 95% CI: 1.32-2.26) exposure to household secondhand smoke (AOR=1.82; 95% CI: 1.27-2.62), having peers who smoke (AOR=2.24; 95% CI: 1.51-3.31) were more likely to be currently using tobacco. The overall tobacco non-users susceptibility to using tobacco among adolescents in Sierra Leone was 18.2% (males 18.0%, females 18.5%). Exposure to tobacco promotion (AOR=1.50; 95% CI: 1.06-2.10) and non-exposure to anti-smoking education (AOR=1.39; 95% CI: 1.05-1.86) were significantly associated with tobacco non-users' susceptibility to using tobacco. Our study suggests that one in four school-going adolescents currently uses tobacco, with nearly one in five non-users susceptible to using tobacco. Given the high prevalence of tobacco product use among adults in Sierra Leone, our findings highlight the need for policies and interventions to prevent tobacco use behavior among adolescents, aimed at averting tobacco use in adulthood. [Abstract copyright: © 2023 James P.B. et al.]pubpu

The association between time of in hospital cardiac arrest and mortality:a retrospective analysis of two UK databases

Aims: The incidence of in hospital cardiac arrest (IHCA) varies throughout the day. This study aimed to report the variation in incidence of IHCA, presenting rhythm and outcome based on the hour in which IHCA occurred. Methods: We conducted a retrospective analysis of the National Cardiac Arrest Audit (NCAA) including patients who suffered an IHCA from 1st April 2011 to 31st December 2019. We then linked the NCAA and intensive care Case Mix Programme databases to explore the effect of time of IHCA on hospital survival in the subgroup of patients admitted to intensive care following IHCA. Results: We identified 115,690 eligible patients in the NCAA database. Pulseless electrical activity was the commonest presenting rhythm (54.8%). 66,885 patients died in the immediate post resuscitation period. Overall, hospital survival in the NCAA cohort was 21.3%. We identified 13,858 patients with linked ICU admissions in the Case Mix Programme database; 37.0% survived to hospital discharge. The incidence of IHCA peaked at 06.00. Rates of return of spontaneous circulation, survival to hospital discharge and good neurological outcome were lowest between 05.00 and 07.00. Among those admitted to ICU, no clear diurnal variation in hospital survival was seen in the unadjusted or adjusted analysis. This pattern was consistent across all presenting rhythms. Conclusions: We observed higher rates of IHCA, and poorer outcomes at night. However, in those admitted to ICU, this variation was absent. This suggests patient factors and processes of care issues contribute to the variation in IHCA seen throughout the day

Active-Optical Reflectance Sensing Evaluated for Red and Red-Edge Waveband Sensitivity

Uncertainty exists with corn (Zea mays L.) N management due to year-to-year variation in crop N need, soil N supply, and N loss from leaching, volatilization, and denitrification. Active-optical reflectance sensing (AORS) has proven effective in some fields for generating N fertilizer recommendations that improve N use efficiency. However, various sensors utilize different wavebands of light to calculate N fertilizer recommendations making it difficult to know which waveband is most sensitive to plant health. The objective of this research was to evaluate across the US Midwest Corn Belt the performance and sensitivity of the red (R) and red-edge (RE) wavebands. Forty-nine N response trials were conducted across eight states and three growing seasons. Reflectance measurements were collected and topdress N rates (40 to 240 lbs N ac-1 on 40 lbs ac-1 increments) applied at approximately V9 corn development stage. Both R and RE wavebands were compared to the at-planting N fertilizer rate, V5 soil nitrate-N, and end-of-season calculated relative yield. In every comparison the RE waveband demonstrated higher coefficient of determination values over the R waveband. These findings suggest the RE waveband is most sensitive to variations in N management and would work best for in-season AORS management over a geographically-diverse soil and weather region