Disability Related Sources of Income and Expenses: An Examination Among the Elderly in Canada

The primary purpose of this paper is to examine disability-related sources of income and expenses among high and low income older Canadians. Specifically, the paper attempts to answer three questions: Do low and high income seniors experience disability equally? Do low and high income seniors incur equal disability- related non-reimbursed expenses? And, Do low and high income seniors receive equal disability-related pensions and tax credits? The analysis is based on the Health and Activity Limitation Surveys of 1986 and 1991. Both surveys were cross-sectional, designed to gather information on disabilities and their impact on daily living. Among the seniors (those 65 and over), between 10.3% (men in 1986) and 23.2% (women in 1991) were classified as low income and about 40% reporting having at least one disability, compared to one-quarter of women and men of all ages. The analysis indicates that low income seniors are disadvantaged in that they experience more disability, incur more non-reimbursed expenses, and receive less in terms of disability- related pensions and credits than do high income seniors. It thus appears that interventions should be policy based rather than individual based.elderly; disability; income

Developing Tautai Lavea‘i, a Breast Cancer Patient Nativation Program in American Samoa

This article focuses on development of the psychosocial-cultural components of a breast cancer patient navigation program (PNP) in the medically underserved, albeit culturally-rich Territory of American Samoa. Efforts to reduce cancer morbidity and mortality in American Samoa must necessarily consider the territory’s limited cancer resources and indigenous culture, as well as the individuals at risk for poor health outcomes and premature death. Within this complex set of challenges resides the prospect of health equity and opportunities for advancing service innovations that meaningfully plait native ways of knowing with Western evidence- based practice. Increasing adherence to diagnostic and treatment procedures is of significant concern to the American Samoa Cancer Community Network who initiated this inquiry to assess patients lost to follow-up, describe treatment-seeking influences, and identify cultural preferences for inclusion in a PNP tailored on fa‘aSamoa or the Samoan worldview

Natural Variation in Fc Glycosylation of HIV-Specific Antibodies Impacts Antiviral Activity

While the induction of a neutralizing antibody response against HIV remains a daunting goal, data from both natural infection and vaccine-induced immune responses suggest that it may be possible to induce antibodies with enhanced Fc effector activity and improved antiviral control via vaccination. However, the specific features of naturally induced HIV-specific antibodies that allow for the potent recruitment of antiviral activity and the means by which these functions are regulated are poorly defined. Because antibody effector functions are critically dependent on antibody Fc domain glycosylation, we aimed to define the natural glycoforms associated with robust Fc-mediated antiviral activity. We demonstrate that spontaneous control of HIV and improved antiviral activity are associated with a dramatic shift in the global antibody-glycosylation profile toward agalactosylated glycoforms. HIV-specific antibodies exhibited an even greater frequency of agalactosylated, afucosylated, and asialylated glycans. These glycoforms were associated with enhanced Fc-mediated reduction of viral replication and enhanced Fc receptor binding and were consistent with transcriptional profiling of glycosyltransferases in peripheral B cells. These data suggest that B cell programs tune antibody glycosylation actively in an antigen-specific manner, potentially contributing to antiviral control during HIV infection

Core principles to reduce current variations that exist in grading of midwifery practice in the United Kingdom.

Aim To reduce variations in grading of midwifery practice and enhance reliability of assessment. Background The first phase of a national project showed there to be widely ranging interpretation and application of professional educational standards in relation to grading of practice in midwifery. This raised concerns about reliability and equity of professional assessment. The second phase therefore sought to achieve consensus on a set of core principles. Methods A participatory action research process in two stages, using a Mini-Delphi approach. Educational leads from all 55 institutions delivering midwifery programmes nationally were invited to participate. Stage one: Questionnaire comprising 12 statements drawn from the findings of the initial phase of the project. Stage two: Face-to-face discussion. Findings Statements were categorised based on questionnaire responses: 1) Consensus, 2) Staged consensus, 2) Minor modifications, 4) Controversial. Consensus was achieved on 11 core principles through group discussion; only one was omitted from the final set. Recommendations All midwifery programmes nationally to incorporate the agreed core principles. Findings should be disseminated to the regulatory body to help inform changes to midwifery and nursing educational standards. The core principles may also contribute to curriculum development in midwifery and other professions internationally

Assessing fitness-to-practice of overseas-trained health practitioners by Australian registration & accreditation bodies

Assessment of fitness-to-practice of health professionals trained overseas and who wish to practice in Australia is undertaken by a range of organisations. These organisations conduct assessments using a range of methods. However there is very little published about how these organisations conduct their assessments. The purpose of the current paper is to investigate the methods of assessment used by these organisations and the issues associated with conducting these assessments

A Young Girl Reading: Martha’s Quest through Literature and Realism in Martha Quest

This paper examines the young heroine’s ambivalent relationship with books in Doris Lessing’s coming-of-age novel Martha Quest. Martha, a young British girl growing up in the British colony of Southern Rhodesia (now Zimbabwe) in the wake of World War II, is a voracious young reader who reads extensively in order to make sense of the world in which she is living. Sometimes the books she reads lead her to think critically and challenge the canonical authorities and patriarchal society; however, at times her reading experience is also unsettling and frustrating because the books she reads are mostly produced within a biased system she intends to go beyond. The paper analyzes how Martha relies on books to reshape her national identity and personal life, and how she deals with the discrepancy between the world represented in books and reality in terms of Benedict Anderson’s concept of an ‘imagined community’. Furthermore, this paper also discusses how Martha’s portrait as a bewildered reader of realist literature mirrors Lessing’s own ambiguous relationship with her realist narratives

How effective is low vision service provision? A systematic review

Visual impairment is a large and growing socioeconomic problem. Good evidence on rehabilitation outcomes is required to guide service development and improve the lives of people with sight loss. Of the 478 potentially relevant articles identified, only 58 studies met our liberal inclusion criteria, and of these only 7 were randomized controlled trials. Although the literature is sufficient to confirm that rehabilitation services result in improved clinical and functional ability outcomes, the effects on mood, vision-related quality of life (QoL) and health-related QoL are less clear. There are some good data on the performance of particular types of intervention, but almost no useful data about outcomes in children, those of working age, and other groups. There were no reports on cost effectiveness. Overall, the number of well-designed and adequately reported studies is pitifully small; visual rehabilitation research needs higher quality research. We highlight study design and reporting considerations and suggest a future research agenda