A Case of Lymphocytic Myocarditis With Complete Heart Block Requiring Permanent Pacemaker Implantation.

Lymphocytic myocarditis (LM) is a rare condition with a broad spectrum of clinical presentations. Complete heart block (CHB) is an uncommon sequela. We present a case of a young man with biopsy-proven LM who presented with cardiogenic shock and went on to develop nonresolving CHB, requiring permanent pacemaker implantation.

Risk of malignancy in papillary neoplasms of the breast.

Purpose: In recent years, routine excision of papillary neoplasms (PN) of the breast has been questioned and controversy exists over when excision is necessary. The aim of this study was to evaluate the upstage rate to malignancy of core needle biopsy (CNB) diagnosed PNs from multiple diagnostic centers in our area and to identify factors predictive of malignancy.

Methods: Patients presenting to our surgical center between 2013 and 2017 for excision of CNB PN were evaluated.

Iatrogenic embolization following cardiac intervention: postmortem analysis of 110 cases.

Introduction: Iatrogenic embolization following cardiac investigative procedures may result from hydrophilic polymer emboli (HPE) from catheter valve and vessel wall calcifications, and air embolism from open heart surgery. This retrospective clinical pathologic analysis was undertaken to ascertain the frequency and extent of these potentially fatal complications.

Methods: This retrospective clinical pathologic autopsy analysis with premortem diagnostic imaging correlation identified 110 individuals who had undergone endovascular procedures between 2010 and 2016 within 90 days of death and followed by hospital autopsy.

Metastatic breast carcinoma to the urinary bladder-a report of 11 cases including a tumor to tumor metastasis.

Metastatic breast carcinoma to the urinary bladder is rare. Eleven cases of metastatic breast carcinoma to the bladder are described in this report, including one case with a tumor to tumor metastasis. The patients ranged from 51 to 83 years of age.

Air pollution, neighbourhood and maternal-level factors modify the effect of smoking on birth weight: a multilevel analysis in British Columbia, Canada.

Background: Maternal smoking during pregnancy negatively impacts fetal growth, but the effect is not homogenous across the population. We sought to determine how the relationship between cigarette use and fetal growth is modified by the social and physical environment.

Methods: Birth records with covariates were obtained from the BC Perinatal Database Registry (N = 232,291).

Hospital support services and the impacts of outsourcing on occupational health and safety.

Background: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors.

Objectives: This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach.

The reduction of birth weight by fine particulate matter and its modification by maternal and neighbourhood-level factors: a multilevel analysis in British Columbia, Canada.

Background: The purpose of this research was to determine the relationship between modeled particulate matter (PM2.5) exposure and birth weight, including the potential modification by maternal risk factors and indicators of socioeconomic status (SES).

Methods: Birth records from 2001 to 2006 (N = 231,929) were linked to modeled PM2.

A survey of food bank operations in five Canadian cities.

Background: Food banks have emerged in response to growing food insecurity among low-income groups in many affluent nations, but their ability to manage this problem is questionable. In Canada, in the absence of public programs and policy interventions, food banks are the only source of immediate assistance for households struggling to meet food needs, but there are many indications that this response is insufficient. The purpose of this study was to examine the factors that facilitate and limit food bank operations in five Canadian cities and appraise the potential of these initiatives to meet food needs.

Exploring Public Health's roles and limitations in advancing food security in British Columbia.

Objectives: This research analyzes the roles and limitations of Public Health in British Columbia in advancing food security through the integration of food security initiatives into its policies and programs. It asks the question, can Public Health advance food security? If so, how, and what are its limitations?

Methods: This policy analysis merges findings from 38 key informant interviews conducted with government and civil society stakeholders involved in the development of food security initiatives, along with an examination of relevant documents. The Population Health Template is used to delineate and analyze Public Health roles in food security.

The privileged normalization of marijuana use - an analysis of Canadian newspaper reporting, 1997-2007.

The objective of this study was to systematically examine predominant themes within mainstream media reporting about marijuana use in Canada. To ascertain the themes present in major Canadian newspaper reports, a sample ( = 1999) of articles published between 1997 and 2007 was analyzed. Drawing from Manning's theory of the symbolic framing of drug use within media, it is argued that a discourse of 'privileged normalization' informs portrayals of marijuana use and descriptions of the drug's users.

Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people.

Transcatheter aortic valve replacement with a new self-expanding transcatheter heart valve and motorized delivery system.

Objectives: The aim of this study was to demonstrate feasibility and short- and midterm clinical outcomes with a new self-expanding transcatheter heart valve and motorized delivery system.

Background: Refining transcatheter aortic valve replacement with newly designed bioprostheses and delivery systems is anticipated to facilitate the procedure, reduce the risk of complications, improve outcomes, and widen applicability.

Methods: The CENTERA valve (Edwards Lifesciences, Irvine, California) was implanted in 15 patients with symptomatic severe aortic stenosis via femoral or axillary arterial percutaneous access.

Integrating food security into public health and provincial government departments in British Columbia, Canada.

Food security policy, programs, and infrastructure have been incorporated into Public Health and other areas of the Provincial Government in British Columbia, including the adoption of food security as a Public Health Core Program. A policy analysis of the integration into Public Health is completed by merging findings from 48 key informant interviews conducted with government, civil society, and food supply chain representatives involved in the initiatives along with relevant documents and participant/direct observations. The paper then examines the results within the context of historic and international trends and theoretical models of food policy, community food security, and applied policy research.

A double-blind randomised controlled trial of gloved versus ungloved merocel middle meatal spacers for endoscopic sinus surgery.

Background: Middle meatal spacers are commonly used following endoscopic sinus surgery to prevent post-operative bleeding and lateralization of the middle turbinates. The effects of nasal packing on post-operative sinonasal mucosal healing remain unknown in humans.

Objective: This study aims to compare the histopathalogical effects of Merocel and Merocel covered with a finger glove on mucosal healing, and patients` discomfort immediately post-operatively after endoscopic sinus surgery and at removal of the nasal packing.

Job strain and shift work influences on biomarkers and subclinical heart disease indicators: a pilot study.

This pilot study is one of the first to examine the impact of job strain and shift work on both the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis using two salivary stress biomarkers and two subclinical heart disease indicators. This study also tested the feasibility of a rigorous biological sampling protocol in a busy workplace setting. Paramedics (n = 21) self-collected five salivary samples over 1 rest and 2 workdays.

Pathology of transcatheter valve therapy.

Objectives: This study sought to report on the pathology of transcatheter aortic valves explanted at early and late time points after transcatheter aortic valve implantation.

Background: Information on pathological findings following transcatheter aortic valve implantation is scarce, particularly late after transcatheter aortic valve implantation.

Methods: This study included 20 patients (13 men, median age 80 years [interquartile range: 72 to 84] years) with previous transcatheter aortic valve implantation with a valve explanted at autopsy (n = 17) or surgery (n = 3) up to 30 months after implantation (10 transapical and 10 transfemoral procedures).

Psychosocial and other working conditions: variation by employment arrangement in a sample of working Australians.

Background: The evidence linking precarious employment with poor health is mixed. Self-reported occupational exposures in a population-based Australian sample were assessed to investigate the potential for differential exposure to psychosocial and other occupational hazards to contribute to such a relationship, hypothesizing that exposures are worse under more precarious employment arrangements (EA).

Methods: Various psychoscial and other working conditions were modeled in relation to eight empirically derived EA categories with Permanent Full-Time (PFT) as the reference category (N = 925), controlling for sex, age, and occupational skill level.

Injury risk associated with physical demands and school environment characteristics among a cohort of custodial workers.

Few epidemiological studies have investigated the relationship between work exposures and injury risk among custodians. The relationship between injury risk and occupational physical demands (e.g.

Double-blinded, randomized, controlled trial of medicated versus nonmedicated merocel sponges for functional endoscopic sinus surgery.

Objective: This study aimed to compare differences between medicated and nonmedicated Merocel middle meatal spacers (MMSs) on sinonasal mucosal healing (histopathologic and endoscopic difference), patient discomfort, and pain on removal of the MMS following functional endoscopic sinus surgery.

Methods: Forty-eight patients with chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery were enrolled in a prospective study. Patients were randomized and blinded to receive a medication-soaked Merocel MMS (either one of budesonide, gentamicin, or manuka honey) in one nostril and a nonmedicated Merocel MMS in the contralateral side.

Mental health differences among middle-aged sawmill workers in rural compared to urban British Columbia.

The study sought to determine whether differences in mental health outcomes were observable in a cohort of workers living in rural compared to urban places in the Canadian province of British Columbia. The study was based on a cohort of male sawmill workers. The cohort was probabilistically linked to the BC Linked Health Database in order to yield objective mental health outcomes.

Work disability prevention in rural healthcare workers.

Introduction: Approximately 20% of healthcare workers in high-income countries such as Australia, Canada and the USA work in rural areas. Healthcare workers are known to be vulnerable to occupational injury and poor work disability outcomes; given their rural-urban distribution, it is possible to compare work disability prevention in rural and urban areas. However, little attention has been paid to work disability prevention issues specific to rural workers, including rural healthcare workers.

A health and nutritional evaluation of changes in agriculture in the past quarter century in British Columbia: implications for food security.

This paper describes change in local food production in British Columbia with a focus on changes in the production of foods recommended for increased consumption by nutritionists. We determine, in one of the most productive agricultural provinces in Canada, whether secular trends in agricultural land use and food production, over the past quarter century, have resulted in increased production of foods recommended by nutritionists as more healthy and nutritious. In particular we are concerned with estimating the extent to which changes in agriculture and food production are congruent with official nutrition advice to avoid less healthy foods and to consume more vegetables, fruit, and whole grains.

Publically funded recreation facilities: obesogenic environments for children and families?

Increasing healthy food options in public venues, including recreational facilities, is a health priority. The purpose of this study was to describe the public recreation food environment in British Columbia, Canada using a sequential explanatory mixed methods design. Facility audits assessed policy, programs, vending, concessions, fundraising, staff meetings and events.

Climate change and health in british columbia: projected impacts and a proposed agenda for adaptation research and policy.

This is a case study describing how climate change may affect the health of British Columbians and to suggest a way forward to promote health and policy research, and adaptation to these changes. After reviewing the limited evidence of the impacts of climate change on human health we have developed five principles to guide the development of research and policy to better predict future impacts of climate change on health and to enhance adaptation to these change in BC. We suggest that, with some modification, these principles will be useful to policy makers in other jurisdictions.