Building a children's health and environment research agenda in Alberta, Canada: A multi-stakeholder engagement process

As new environmental exposures are continuously identified, environmental influences on health are of growing concern. Knowledge regarding the impacts of environmental exposures is constantly evolving and is often incomplete. In this paper, we describe a multi-phased, multi-stakeholder engagement initiative involving diverse stakeholders with an interest in building a children's environmental health research agenda which would link with and support local practices and policies. The intent of this initiative was to identify priority research issues, themes and questions by implementing a tested Research Planning Model that encompassed the engagement of diverse stakeholders. Here, we describe the model application, which was specifically focused on children's health and the environment. A key component of the model was the ongoing stakeholder engagement process. This included two stakeholder forums, during which participants identified three main research themes (social determinants of health, environmental exposures and knowledge translation) and a short list of research questions. Other key components of the model included the development of a Global Sounding Board of key stakeholders, an Advisory Board and a Scientific Panel with mandates to review and prioritise the research questions. In our case, the Advisory Board and Scientific Panel prioritised questions that focused on environmental exposures related to children's respiratory outcomes. The stakeholder engagement described here is an evolving process with frequent changes of context, sustained by the commitment and dedication of the Children's Environment and Health Research planning team and the Advisory Board. In this article, we share the engagement process, outcomes, successes, challenges and lessons learned from this ongoing experience. Keywordsstakeholder engagement, children's health, environmental health, health researc

Direct cardiac and peripheral vascular effects of intracoronary and intravenous nifedipine

The hemodynamic effects of a new parenteral formulation of nifedipine administered by the intravenous (1 mg) and intracoronary (IC) (0.1 and 0.2 mg) routes were studied in 10 patients with symptomatic coronary artery disease undergoing diagnostic right- and left-sided cardiac catheterization. Intravenous nifedipine (1 mg) reduced systemic vascular resistance by 34% (p < 0.01), increased cardiac output by 28% (p < 0.01) and decreased mean arterial pressure by 10% (p < 0.01). It had less effect on peak positive dP/dt (-8% p < 0.025) and on peak negative dP/dt (-15% p < 0.01). Coronary blood flow increased 20% (p < 0.025). In contrast, IC nifedipine (0.2 mg) increased coronary blood flow 46% (p < 0.025), depressed contractility as assessed by peak positive dP/dt (-26% p < 0.01) and prolonged diastolic relaxation time. The effect of 0.1 mg was similar but less pronounced. These data suggest that the primary therapeutic effect of nifedipine administered systemically to patients at rest results from an increase in coronary blood flow and, to a lesser extent, from afterload reduction; its myocardial depressant effects are small, transient and masked by reflex catecholamine release. IC nifedipine increases coronary blood flow, has a transient negative inotropic effect and prolongs relaxation. The relative importance of these myocardial effects in preventing myocardial ischemia is not known.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26108/1/0000184.pd

Effects of CI-914 in congestive heart failure due to coronary artery disease or idiopathic cardiomyopathy

The hemodynamic effects of CI-914, a phosphodiesterase inhibitor, were studied in 12 patients with left ventricular (LV) dysfunction who were undergoing diagnostic cardiac catheterization. CI-914 was infused intravenously at a rate of 0.8 to 7.0 [mu]g/kg/min for 30 to 60 minutes; hemodynamic values were measured every 10 minutes. No effect was seen in the patient receiving 0.8 [mu]g/kg/min. At infusion rates of 1.2 to 2.4 [mu]g/kg/min, cardiac index increased by 14% (p 2, cardiac index increased by 50% (p 2 (group A). Although systemic vascular resistance decreased in all 8 patients by 26% (p 2; the double product fell from 101 +/- 31 to 91 +/- 23 (NS). In all 12 patients, a linear correlation between peak venous blood concentration and peak effect on cardiac index, systemic vascular resistance and pulmonary artery wedge pressure was observed. The increase in cardiac index associated with a decrease in systemic vascular resistance suggests that part of the favorable hemodynamic effect is attributable to afterload reduction. Nonetheless, the increase in peak +dP/dt in all patients suggests that CI-914 also has a positive inotropic effect. This combination of effects may be of value in the treatment of severe congestive heart failure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26044/1/0000117.pd

Larvisida Dan Pupisida Isotearil Alkohol Etoksilat Terhadap Larva Dan Pupa Aedes Aegypti

Isotearil alkohol etoksilat merupakan larvasida yang bekerja sebagai barier fisik bagi pertumbuhan nyamuk. Larvasida ini membentuk lapisan yang sangat tipis (monomolecular surface film) dan menurunkan tegangan permukaan air. Permasalahan penelitian adalah bagaimana efektifitas isotearil alkohol etoksilat dalam membunuh larva dan pupa nyamuk vektor DBD Ae. aegypti. Tujuan penelitian ingin mengetahui efektifitas isotearil alkohol etoksilat dalam membunuh larva dan pupa nyamuk vektor DBD Ae. aegypti. Metode penelitian dengan pengujian efikasi isotearil alkohol etoksilat terhadap larva Aedes aegypti. Penelitian menggunakan 5 dosis, yaitu 0,5 ml/m2, 0,75 ml/m2, 1,0 ml/m2, 1,5 ml/m2 dan 2 ml/m2 serta kontrol. Hasil penelitian menunjukkan bahwa isotearil alkohol etoksilat selama satu minggu membunuh larva dan pupa Ae. aegypti ± 75%. Hasil analisis data menggunakan Anova menunjukkan tidak ada perbedaan jumlah kematian larva Ae. aegypti pada dosis yang berbeda (p=0,999). Simpulan penelitian adalah isotearil alkohol etoksilat dosis 0,5, 0,75, 1,0, 1,5 dan 2 ml/m2 kurang efektif digunakan untuk membunuh larva dan pupa nyamuk vektor DBD Ae. aegypti. Isotearil alcohol ethoxylate is larvicide who works as a physical barrier to mosquito\u27s growth. This larvicides form is very thin layer (monomolecular surface film) and lowers the surface tension of water. The research problem was how effectiveness of alcohol ethoxylate isotearil for killing mosquito larvae and pupae dengue vector Aedes aegypti. Research purpose was to determine the effectiveness of alcohol ethoxylate isotearil for killing larvae and pupae of dengue mosquitoes vector Aedes aegypti. Research methods used to test the efficacy of alcohol ethoxylate isotearil against Aedes aegypti larvae. Research used 5 doses, 0.5ml/m2, 0.75ml/m2, 1.0ml/m2, 1.5ml/m2, and 2ml/m2, and control. The results showed that the alcohol ethoxylate isotearil for a week to kill the larvae and pupae of Aedes aegypti ± 75 %. Data analysis using ANOVA showed no difference in mortality of larvae of Aedes aegypti at different doses (p=0.999). Therefore, isotearil alcohol ethoxylate dose of 0.5 , 0.75 , 1.0 , 1.5 and 2 ml/m2 were not effective used to kill mosquito larvae and pupae dengue vector Aedes aegypti

Point-of-Care Tests to Strengthen Health Systems and Save Newborn Lives: The Case of Syphilis

Rosanna Peeling and colleagues describe their experience of introducing point-of-care testing to screen for syphilis in pregnant women living in low- and middle-income countries

Consensus Statement on the Terminology and Classification of Central Neck Dissection for Thyroid Cancer

Background: The primary goals of this interdisciplinary consensus statement are to review the relevant anatomy of the central neck compartment, to identify the nodal subgroups within the central compartment commonly involved in thyroid cancer, and to define a consistent terminology relevant to the central compartment neck dissection. Summary: The most commonly involved central lymph nodes in thyroid carcinoma are the prelaryngeal (Delphian), pretracheal, and the right and left paratracheal nodal basins. A central neck dissection includes comprehensive, compartment-oriented removal of the prelaryngeal and pretracheal nodes and at least one paratracheal lymph node basin. A designation should be made as to whether a unilateral or bilateral dissection is performed and on which side (left or right) in unilateral cases. Lymph node plucking or berry picking implies removal only of the clinically involved nodes rather than a complete nodal group within the compartment and is not recommended. A therapeutic central compartment neck dissection implies that nodal metastasis is apparent clinically (preoperatively or intraoperatively) or by imaging (clinically N1a). A prophylactic/elective central compartment dissection implies nodal metastasis is not detected clinically or by imaging (clinically N0). Conclusion: Central neck dissection at a minimum should consist of removal of the prelaryngeal, pretracheal, and paratracheal lymph nodes. The description of a central neck dissection should include both the indication (therapeutic vs. prophylactic/elective) and the extent of the dissection (unilateral or bilateral).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78103/1/thy.2009.0159.pd

Improving tumor budding reporting in colorectal cancer : a Delphi consensus study

Tumor budding is a long-established independent adverse prognostic marker in colorectal cancer, yet methods for its assessment have varied widely. In an effort to standardize its reporting, a group of experts met in Bern, Switzerland, in 2016 to reach consensus on a single, international, evidence-based method for tumor budding assessment and reporting (International Tumor Budding Consensus Conference [ITBCC]). Tumor budding assessment using the ITBCC criteria has been validated in large cohorts of cancer patients and incorporated into several international colorectal cancer pathology and clinical guidelines. With the wider reporting of tumor budding, new issues have emerged that require further clarification. To better inform researchers and health-care professionals on these issues, an international group of experts in gastrointestinal pathology participated in a modified Delphi process to generate consensus and highlight areas requiring further research. This effort serves to re-affirm the importance of tumor budding in colorectal cancer and support its continued use in routine clinical practice.Peer reviewe