A Framework to Determine the Extent to Which Regional Primary Healthcare Organisations Are Comprehensive or Selective in Their Approach.

Background: There is an increasing emphasis on the importance of comprehensive primary healthcare (CPHC) in improving population health and health equity. There is, therefore, a need for a practical means to determine how comprehensive regional primary healthcare organisations (RPHCOs) are in their approach. This paper proposes a framework to provide such a means.

The Use of Vasopressor Agents in Free Tissue Transfer for Head and Neck Reconstruction: Current Trends and Review of the Literature.

Background/objectives: Microvascular free tissue transfer has become essential to head and neck reconstruction and recent advancements in microvascular surgery have led to excellent surgical outcomes. However, there continues to be controversy and a stigma associated with the use of perioperative intravenous vasopressor agents among both surgeons and anesthesiologists. Due to concern for vasoconstriction of peripheral vasculature flowing to the denervated tissue flap, there remains concerns about potential thrombosis, decreased tissue perfusion and ultimately flap failure.

Lack of evidence for the effectiveness or safety of over-the-counter cannabidiol products.

Over the past 5 years, public interest in the potential health benefits of cannabidiol (CBD) has increased exponentially, and a wide range of over-the-counter (OTC) preparations of CBD are now available. A substantial proportion of the population appears to have used these products, yet the extent to which they are effective or safe is unclear. We reviewed the evidence for whether CBD has significant pharmacological and symptomatic effects at the doses typically found in OTC preparations.

Single mothers by choice: Parenting and child adjustment in middle childhood.

Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8-10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students.

College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. This study evaluated the mediating role of coping styles (i.

In a Time of Need: A Grassroots Initiative in Response to PPE Shortage in the COVID-19 Pandemic.

Setting: Primary care is the first line of defence in healthcare, particularly during the coronavirus disease 2019 (COVID-19) pandemic. In the London-Middlesex region of Ontario, a critical shortage of personal protective equipment (PPE) was identified among primary care physicians (PCPs).

Intervention: With the help of the London-Middlesex Primary Care Alliance, volunteer administrators, physicians and medical students coordinated the acquisition and redistribution of community-donated PPE to PCPs across London-Middlesex.

The acute effects of cannabidiol on the neural correlates of reward anticipation and feedback in healthy volunteers.

Background: Cannabidiol has potential therapeutic benefits for people with psychiatric disorders characterised by reward function impairment. There is existing evidence that cannabidiol may influence some aspects of reward processing. However, it is unknown whether cannabidiol acutely affects brain function underpinning reward anticipation and feedback.

Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial.

Unlabelled: Background A substantial and unmet clinical need exists for pharmacological treatment of cannabis use disorders. Cannabidiol could offer a novel treatment, but it is unclear which doses might be efficacious or safe. Therefore, we aimed to identify efficacious doses and eliminate inefficacious doses in a phase 2a trial using an adaptive Bayesian design.

High-dose methotrexate-based regimens with or without vincristine for the treatment of primary central nervous system lymphoma.

Background: Primary central nervous system lymphoma (PCNSL) is a rare malignancy with few treatment options. One regimen used for induction is rituximab, high-dose methotrexate (HD-MTX), procarbazine, and vincristine (R-MPV). A common institutional practice is removing vincristine (VCR) from this regimen due to its poor CNS penetration and associated toxicities.

Tracking Changes in SARS-CoV-2 Spike: Evidence that D614G Increases Infectivity of the COVID-19 Virus.

A SARS-CoV-2 variant carrying the Spike protein amino acid change D614G has become the most prevalent form in the global pandemic. Dynamic tracking of variant frequencies revealed a recurrent pattern of G614 increase at multiple geographic levels: national, regional, and municipal. The shift occurred even in local epidemics where the original D614 form was well established prior to introduction of the G614 variant.

Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea.

Papua New Guinea (PNG) has the highest malaria transmission outside of Africa. Long-lasting insecticidal nets (LLINs) are believed to have helped to reduce average malaria prevalence in PNG from 16% in 2008 to 1% in 2014. Since 2015 malaria in PNG has resurged significantly.

Targeting the NLRP3 Inflammasome in Severe COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a member of the genus within the family . It is an enveloped single-stranded positive-sense RNA virus. Since December of 2019, a global expansion of the infection has occurred with widespread dissemination of coronavirus disease 2019 (COVID-19).

Global health activists' lessons on building social movements for Health for All.

Background: The People's Health Movement (PHM) was formed in 2000 and drew inspiration from the Alma Ata Declaration on Primary Health Care's 'Health for All' (1978). Since then PHM has been an active part of a global counter-hegemonic social movement. This study aimed to gain insights on social movement building, drawing on the successes and failures reported by activists over their experiences of working in the Health for All social movement to improve health, justice and equity.

The transcriptional signature associated with human motile cilia.

Cilia are complex microtubule-based organelles essential to a range of processes associated with embryogenesis and tissue homeostasis. Mutations in components of these organelles or those involved in their assembly may result in a diverse set of diseases collectively known as ciliopathies. Accordingly, many cilia-associated proteins have been described, while those distinguishing cilia subtypes are poorly defined.

Cannabis knowledge and implications for health: Considerations regarding the legalization of non-medical cannabis.

Cannabis contains over a hundred of different cannabinoids, of which Δ-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most well studied. The use of high-potency cannabis, containing high concentrations of THC and low concentrations of CBD, has been linked to adverse health outcomes, particularly for adolescents and young adults. Recently, an increase in cannabis potency has been observed in jurisdictions that legalized the sale of cannabis for non-medical purposes.

β-Blockers and angiotensin-converting enzyme inhibitors with sublingual immunotherapy: are risks related to individual product safety profile?

Purpose Of Review: The objective of this article is to review the available literature regarding the risks associated with sublingual immunotherapy and angiotensin-converting enzyme (ACE) inhibitors or β-blocker use. It also evaluates for any differences in these risks among the available sublingual immunotherapy (SLIT) tablets.

Recent Findings: A literature search was conducted in PubMed to identify peer-reviewed articles using the following keywords: anaphylaxis, ACE inhibitor, β-blocker, and sublingual immunotherapy.

"How do online and offline sampling compare in a multinational study of drug use and nightlife behaviour?".

Background: Online sampling is widely used to recruit hard to reach samples such as drug users at nightlife events. We conducted the first study comparing differences in demographics, drug use and nightlife behaviour between an online sample of young adults engaging with the European nightlife scene, and an offline sample recruited at nightclubs and festivals in Europe.

Methods: Online participants who attended at least six nightlife events in the past 12 months were recruited using social media advertising (May-November 2017).

Two-Dimensional Analysis of Horizontal and Vertical Pursuit in Infantile Nystagmus Reveals Quantitative Deficits in Accuracy and Precision.

Purpose: Infantile nystagmus (IN) presents with continuous, predominantly horizontal eye oscillations. It remains controversial whether those with IN have normal horizontal pursuit, while vertical pursuit has rarely been studied. We examined whether there are pursuit deficits associated with IN by investigating the effect of target direction, velocity, and amplitude.

Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence.

Importance: Cannabis use is consistently linked to poorer mental health outcomes, and there is evidence that use of higher-potency cannabis increases these risks. To date, no studies have described the association between cannabis potency and concurrent mental health in a general population sample or addressed confounding using longitudinal data.

Objective: To explore the association between cannabis potency and substance use and mental health outcomes, accounting for preceding mental health and frequency of cannabis use.

Do AKT1, COMT and FAAH influence reports of acute cannabis intoxication experiences in patients with first episode psychosis, controls and young adult cannabis users?

Epidemiological and biological evidence support the association between heavy cannabis use and psychosis. However, it is unclear which cannabis users are susceptible to its psychotogenic effect. Therefore, understanding genetic factors contributing to this relationship might prove an important strategy to identify the mechanisms underlying cannabis-associated psychotic experiences.

Simultaneous Sacroiliac Joint Fusion in Patients with Long Lumbosacral Constructs: Case Report and Operative Technique.

Background: Literature data on the frequency and pathogenesis of sacroiliac joint (SIJ) pain and arthropathy following lumbosacral fusion with long constructs combined with sacroiliac fixation remains scarce. From clinical experience, we noticed that many patients undergoing these surgeries develop SIJ disease postoperatively.

Case Description: We report a clinical observation of no occurrence or remission of SIJ pain following simultaneous SIJ fusion in cases of long-construct lumbosacral fusion and sacropelvic fixation with S2-alar-iliac screws.