Medication misuse in India: a major public health issue in India.

Background: In India, it has been estimated that 50% of family spending on healthcare is on unnecessary medications or investigations. This, combined with the wide availability of medications, has seemingly contributed to increasing rates of antibiotic resistance and further impoverishment. In this literature review, we aim to characterize the extent of misuse and describe underlying factors contributing to the misuse of medication in India.

Choosing Wisely Canada cancer list: ten low-value or harmful practices that should be avoided in cancer care.

Purpose: Choosing Wisely Canada, modeled after Choosing Wisely in the United States, is intended to identify low-value or potentially harmful practices relevant to the Canadian health care environment. Our objective was to use multidisciplinary, pan-Canadian, physician-based consensus to identify a list of low-value or harmful cancer practices frequently used in Canada.

Methods: A Task Force convened by the Canadian Partnership Against Cancer included physician representation from the Canadian Society of Surgical Oncology, Canadian Association of Medical Oncologists, and Canadian Association of Radiation Oncology, and an expert advisor.

Optical properties and residual stress in Nb-Si composite films prepared by magnetron cosputtering.

This paper investigates Nb-Si metal composite films with various proportions of niobium in comparison to pure Nb films. Films were prepared by two-target RF-DC magnetron cosputtering deposition. The optical properties and residual stress were analyzed.

Cell death disguised: The mitochondrial permeability transition pore as the c-subunit of the F(1)F(O) ATP synthase.

Ion transport across the mitochondrial inner and outer membranes is central to mitochondrial function, including regulation of oxidative phosphorylation and cell death. Although essential for ATP production by mitochondria, recent findings have confirmed that the c-subunit of the ATP synthase also houses a large conductance uncoupling channel, the mitochondrial permeability transition pore (mPTP), the persistent opening of which produces osmotic dysregulation of the inner mitochondrial membrane and cell death. This review will discuss recent advances in understanding the molecular components of mPTP, its regulatory mechanisms and how these contribute directly to its physiological as well as pathological roles.

Patterns of health care utilization preceding a colorectal cancer diagnosis are strong predictors of dying quickly following diagnosis.

Background: Understanding the predictors of a quick death following diagnosis may improve timely access to palliative care. The objective of this study was to explore whether factors in the 24 months prior to a colorectal cancer (CRC) diagnosis predict a quick death post-diagnosis.

Methods: Data were from a longitudinal study of all adult persons diagnosed with CRC in Nova Scotia, Canada, from 01Jan2001-31Dec2005.

A novel method for the photographic recovery of fingermark impressions from ammunition cases using digital imaging.

The photographic preservation of fingermark impression evidence found on ammunition cases remains problematic due to the cylindrical shape of the deposition substrate preventing complete capture of the impression in a single image. A novel method was developed for the photographic recovery of fingermarks from curved surfaces using digital imaging. The process involves the digital construction of a complete impression image made from several different images captured from multiple camera perspectives.

Proctitis following stereotactic body radiation therapy for prostate cancer.

Background: Proctitis after radiation therapy for prostate cancer remains an ongoing clinical challenge and critical quality of life issue. SBRT could minimize rectal toxicity by reducing the volume of rectum receiving high radiation doses and offers the potential radiobiologic benefits of hypofractionation. This study sought to evaluate the incidence and severity of proctitis following SBRT for prostate cancer.

Initiation of electron transport chain activity in the embryonic heart coincides with the activation of mitochondrial complex 1 and the formation of supercomplexes.

Mitochondria provide energy in form of ATP in eukaryotic cells. However, it is not known when, during embryonic cardiac development, mitochondria become able to fulfill this function. To assess this, we measured mitochondrial oxygen consumption and the activity of the complexes (Cx) 1 and 2 of the electron transport chain (ETC) and used immunoprecipitation to follow the generation of mitochondrial supercomplexes.

Self-reported practice patterns and knowledge of rectal cancer care among Canadian general surgeons.

Background: Our objective was to examine the knowledge and treatment decision practice patterns of Canadian surgeons who treat patients with rectal cancer.

Methods: A mail survey with 6 questions on staging investigations, management of low rectal cancer, lymph node harvest, surgical margins and use of adjuvant therapies was sent to all general surgeons in Canada. Appropriate responses to survey questions were defined a priori.

Breast and cervical cancer screening behaviours among colorectal cancer survivors in Nova Scotia.

Purpose: We analyzed patterns and factors associated with receipt of breast and cervical cancer screening in a cohort of colorectal cancer survivors.

Methods: Individuals diagnosed with colorectal cancer in Nova Scotia between January 2001 and December 2005 were eligible for inclusion. Receipt of breast and cervical cancer screening was determined using administrative data.

Bcl-xL in neuroprotection and plasticity.

Accepted features of neurodegenerative disease include mitochondrial and protein folding dysfunction and activation of pro-death factors. Neurons that experience high metabolic demand or those found in organisms with genetic mutations in proteins that control cell stress may be more susceptible to aging and neurodegenerative disease. In neurons, events that normally promote growth, synapse formation, and plasticity are also often deployed to control neurotoxicity.

Is axillary sonographic staging less accurate in invasive lobular breast cancer than in ductal breast cancer?

Objectives: The purpose of this study was to determine whether axillary sonography is less accurate in invasive lobular breast cancer than in ductal breast cancer.

Methods: Patients with invasive breast cancer were retrospectively identified from histologic records from 2010 to 2012. Staging axillary sonograms from 96 patients with primary breast cancer in each of 2 subgroups, invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), were reviewed.

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting.

Background: The implementation of innovations (i.e., new tools and practices) in healthcare organizations remains a significant challenge.

Acquired von Willebrand's disease associated with epithelial myoepithelial carcinoma of the parotid salivary gland.

This is the first case report of a patient with acquired von Willebrand's disease (AvWD) secondary to epithelial myoepithelial carcinoma (EMC) of the parotid salivary gland. This patient presented to haematology following an abnormal bleeding episode with von Willebrand factor Ristocetin cofactor (VWF:RCo) <5% and VWF:Ag 13%. He was diagnosed with AvWD.

Rates of breast cancer surgery in Canada from 2007/08 to 2009/10: retrospective cohort study.

Background: Surgery is a common and important component of breast cancer treatment. We assessed the rates of breast cancer surgery across Canada from 2007/08 to 2009/10.

Methods: We used hospital and day surgery data from the Canadian Institute for Health Information to assemble a cohort of women who had undergone breast cancer surgery.

Networking between community health programs: a team-work approach to improving health service provision.

Background: Networking between non-government organisations in the health sector is recognised as an effective method of improving service delivery. The Uttarakhand Cluster was established in 2008 as a collaboration of community health programs in rural north India with the aim of building capacity, increasing visibility and improving linkages with the government. This qualitative research, conducted between 2011-2012, examined the factors contributing to formation and sustainability of this clustering approach.

General practice and public health: who is my patient?

Background: General practitioners (GPs) tend to focus most of their energies on providing primary healthcare to individuals, with less attention to the overall population health issues in their community. In contrast, public health practitioners tend to focus on the health needs of entire populations, by addressing the social determinants of health, with less attention to individual patient care.

Objective: This article seeks to provide a practical approach for GPs to incorporate a public health perspective in their everyday work.

An uncoupling channel within the c-subunit ring of the F1FO ATP synthase is the mitochondrial permeability transition pore.

Mitochondria maintain tight regulation of inner mitochondrial membrane (IMM) permeability to sustain ATP production. Stressful events cause cellular calcium (Ca(2+)) dysregulation followed by rapid loss of IMM potential known as permeability transition (PT), which produces osmotic shifts, metabolic dysfunction, and cell death. The molecular identity of the mitochondrial PT pore (mPTP) was previously unknown.

Survey of American and Canadian general surgeons' perceptions of margin status and practice patterns for breast conserving surgery.

Although breast conservation surgery (BCS) is commonly performed, several aspects of the procedure remain controversial. We undertook a cross-sectional survey to compare Canadian (CDN) and American (AM) general surgeons' reported BCS practice patterns to better understand the cross-border differences in early-stage breast cancer surgery care. A modified Dillman Method survey was mailed to 1,447 AM and 1,443 CDN surgeons.

CONTEXT MATTERS: FOSTERING, ORPHANHOOD AND SCHOOLING IN SUB-SAHARAN AFRICA.

A growing body of research suggests that orphanhood and fostering might be (independently) associated with educational disadvantage in sub-Saharan Africa. However, literature on the impacts of orphanhood and fostering on school enrolment, attendance and progress produces equivocal, and often conflicting, results. This paper reports on quantitative and qualitative data from sixteen field-sites in Ghana and Malawi, highlighting the importance of historical and social context in shaping schooling outcomes for fostered and orphaned children.

The current state of pancreatic cancer in Canada: incidence, mortality, and surgical therapy.

Objective: This study aimed to evaluate the trends in the incidence, survival, and surgical therapy for Canadian patients affected by pancreatic cancer (PC).

Methods: The incidence, mortality, number of resections, and outcomes of patients with PC stratified by year, sex, and province were extracted from Canadian cancer databases.

Results: In 2012, PC was diagnosed in 4600 Canadians and it was responsible for 4300 deaths.