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Objectives: Group antenatal care (G‐ANC) is an innovative model in which antenatal care is delivered to a group of 8–12 women of similar gestational age. Evidence from high‐income countries suggests G‐ANC is particularly effective for women from marginalised populations, including adolescents. The objective of this study was to examine the experiences of Senegalese adolescents engaged in group antenatal care. Methods: This convergent parallel mixed‐methods study is derived from a larger effectiveness–implementation hybrid pilot study conducted in Kaolack district, Senegal. Quantitative data for adolescent participants were collected through baseline and postnatal surveys and descriptively analysed. One‐on‐one interviews and focus‐group discussions were conducted with adolescent participants, and qualitative data were analysed using qualitative descriptive analysis. Results: Forty‐five adolescents aged 15–19 participated in G‐ANC, with a median age of 18 years. The majority (93.3%) were married, and 64.4% were nulliparous. Findings indicated similar levels of G‐ANC participation for adolescent and adult women. The majority (93.1%) of participants who had previously attended individual ANC indicated they would prefer G‐ANC to individual care for a future pregnancy. Qualitative findings indicated key facets of consideration relevant to G‐ANC for adolescents include social connectedness, the influence of social norms and the opportunity for engagement in healthcare. Conclusions: This study suggests that G‐ANC has the potential to be an adolescent‐responsive and culturally appropriate method of delivering antenatal care in Senegal. [ABSTRACT FROM AUTHOR]

Introduction: Sickle cell disease (SCD) is an inherited, multi-system, chronic disease with the highest prevalence affecting people of Sub-Saharan African descent. While major advances in SCD care have occurred over the last few decades in many African countries these advances are not readily available. Prior literature from Ghana and Kenya describe stigma, despair, and economic burden as well as hope when a child has SCD. When people migrate to North America with a child with SCD it is unknown whether their perception of the disease changes. We asked, "How do immigrant parents of children with SCD from Sub-Saharan Africa perceive, and manage the disease in the context of western medical care?" Methods: The research question was explored with qualitative methodology, specifically focused ethnography. Semi-structured interviews were conducted with parent(s). The interviews were audio recorded, transcribed, and open coded. Rigor was determined through methodological coherence, appropriate and sufficient sampling, and iterative data collection and analysis. Results: Twelve interviews were conducted. Identified themes are as follows: memories of SCD in Africa, the emotional journey towards acceptance, and parental approach to care for their child. Conclusions: Healthcare providers should be responsive to an immigrant families' needs and not expect linear progression of emotional acceptance to the diagnosis. Healthcare providers patience with the process helps establish trust, works to facilitate and encourage hope and acknowledges the strength of the families, and their dedication to their family member. Healthcare providers should acknowledge parents' sources of support (religion/family) and ensure parents are aware of medical advances. [ABSTRACT FROM AUTHOR]

BACKGROUND: Skunk currant is widely dispersed across North America and a feature of some traditional North American indigenous diets. Whereas many wild and cultivated berries have attracting interest related to their antioxidant phenolic metabolites and putative health benefits in humans, very few data are available concerning skunk currant phytochemistry. OBJECTIVE: Provide the first metabolic profile of skunk currant fruits with a focus on phenolic and polyphenolic compounds, owing to their emerging implications in human health. METHODS: Skunk currants were harvested in Nunavik, Québec. Flavonols, flavan-3-ols, and phenolic acids were characterized using a targeted approach with reverse-phase ultra-high pressure liquid chromatography coupled with tandem mass spectrometry. Ellagitannins and anthocyanins were measured using reverse-phase HPLC following acid hydrolysis and employing diode array detection. Proanthocyanidins and sugars were detected with normal-phase HPLC. RESULTS: A total of 11 phenolic acids and 11 flavonoids, including three cyanidins and three quercetin glycosides were identified. Both condensed (proanthocyanidins) and hydrolysable (ellagitannins) tannins were also detected at 162 mg and 75 mg per 100 g extract, respectively. The cumulative amount of detected phenolic and polyphenolic metabolites totaled 622.6 mg/100 g extract (63.4 mg/100 g berry FW). CONCLUSIONS: Skunk currant is a source of many bioactive phenolic and polyphenolic compounds. Appearing richer in phenolics than some cultivated varieties, the wild northern varieties of North America warrant additional study. [ABSTRACT FROM AUTHOR]

There is a paucity of published literature on the epidemiology of childhood acute leukemias and lymphomas in Canada. This study was designed to describe children and youth (age <20 years) diagnosed with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL) in Alberta, Canada, during 22 fiscal years. The Alberta Cancer Registry was used to extract data all ALL, AML, HL, and NHL cases diagnosed between April 1, 1982, and March 31, 2004. Population data for Alberta were also obtained. Descriptive statistics and cluster detection tests were used. During 22 years, 525, 117, 257, and 111 children (total == 1010) were diagnosed with ALL, AML, HL, and NHL, respectively. The median ages at diagnosis were 4, 11, 16, and 12 years for ALL, AML, HL, and NHL, respectively. The majority were male for ALL (287/525, 55%%), AML (64/117, 55%%), and NHL (81/111, 73%%), and female for HL (133/257, 52%%). The crude rates per 100,000 children were variable, without significant trends, over time and for each diagnosis; the median annual rates, per 100,000 children, were 3.00 (ranging from 1.87 to 3.75) for ALL, 0.62 (ranging from 0.26 to1.27) for AML, 1.42 (ranging from 0.76 to 2.67) for HL, and 0.54 (ranging from 0.24 to 1.40) for NHL. A few potential spatiotemporal clusters were identified. They are likely due to small number of cases and plausibly clinically insignificant. Overall, childhood leukemia and lymphoma rates in Alberta have remained relatively stable, with no clear epidemiological trends and no significant spatiotemporal clustering. Further investigations are warranted to see if such stability continues and if spatiotemporal patterns arise from longer studies and studies in larger geographic regions with a larger sample size, whilst analyzing for other causal/associated factors, individual susceptibilities, and disease outcomes. [ABSTRACT FROM AUTHOR]

AbstractWe sought to identify whether deficits in selective attention are present in pediatric brain tumor patients. Selective attention was assessed with covert-orienting, filtering, and visual-search tasks in 54 patients with either (1) posterior fossa (PF) tumors treated with cranial radiation and surgery (n= 22); (2) PF tumors treated with surgery alone (n= 17); or (3) non-CNS tumors (n= 15), who served as a patient control group. To account for normal development, patient performance was also compared with that of healthy age-matched controls (n= 10). We found that in PF tumor patients selective attention was impaired, regardless of whether they were treated with cranial radiation and surgery or surgery alone. However, patients treated with cranial radiation were most impaired. These patients may have greater damage to posterior brain regions know to mediate selective attention as the result of tumor location, effects of surgery, and higher doses of radiation to the posterior regions of the brain. These findings help to elucidate the potential impact of pediatric brain tumors and their treatment on discrete attentional skills. (JINS, 2009, 15, 205?216.) [ABSTRACT FROM AUTHOR]

Concerns regarding a child's sleep, identified by a caregiver or by the health care practitioner, are commonly raised but often left unexplored. Families in geographically isolated areas, with limited access to specialty services such as pediatric sleep medicine, are at increased risk for unmet treatment needs. Telehealth is a potential vehicle for delivery of these specialty services and overcoming barriers in diagnosing and treating sleep disorders in children by improving access and enhancing support for the families in their communities. This article describes the initiation of a pilot program in the delivery of multidisciplinary pediatric sleep medicine services via telehealth in Alberta, Canada. [ABSTRACT FROM AUTHOR]

Neurobehavioral functioning of 50 Canadian children diagnosed with Fetal Alcohol Spectrum Disorder (FASD) was evaluated. The aims of this study were to identify specific areas of weakness in neurobehavioral functioning, to examine whether neurobehavioral functioning was related to various predictor variables, and to determine which measures differentiated between children given a brain score of 2 (possible dysfunction) and 3 (probable dysfunction). Participants displayed difficulties with many aspects of intelligence, memory, executive functioning, and attention. Measures of Full scale and Verbal IQ, as well as memory for faces and numbers differentiated between children with a brain 2 and 3 ranking. An interesting pattern of strengths and weaknesses emerged as well as significant differences related to ethnic background, gender, and age. Aboriginal children and Caucasian children with FASD do not appear to show the same pattern of strengths and weaknesses in neurobehavioral functioning. [ABSTRACT FROM AUTHOR]

Examines the pre- and postinjury patterns of alcohol and illicit drug use of 87 young persons with traumatic brain injury. Primal effects of brain injury on neurobehavioral functioning; Clinical implications.

This paper presents a study assessing the possible application of seven clay substrates of various particle compositions and plasticity, sampled locally in rural regions, as materials allowing affordable construction of the waste landfill liners, which meet the main principles of sustainability, utilize locally available materials and limit the environmental threats posed by landfill leachate to water, public health and arable land. The researched substrates were tested according to their long-term sealing properties by their saturated hydraulic conductivity after compaction, swelling and shrinkage characteristics and ability to sustain their sealing capability after repeated drying and rewetting. The basic characteristics of soils were determined by the standard methods. Saturated hydraulic conductivity after compaction and after repeated shrinking and swelling were tested in laboratory falling head permeameters. Shrinkage characteristics were based on dimensionless indicators of the geometry and linear extensibility. The obtained results showed that the tested clay substrates were found applicable to construction of compacted clay liner for sustainable waste landfill. The environmental sustainability of a local, rural waste landfill, isolated by compacted earthen liners utilizing local materials is, in our opinion possible, but strongly related to the compaction parameters applied during liner construction for the given clay substrate. [ABSTRACT FROM AUTHOR]

Information regarding traumatic brain injury sequelae in a sample of 503 traumatic brain injury patients was obtained using the Neurobehavioral Functioning Inventory (NFI). Data revealed that motor dysfunction was more frequently reported than somatic difficulties. Analyses of variance indicated that unemployed patients experienced significantly more motor problems than patients working 40 or more hours per week. No differences in the incidence of somatic complaints, headaches, or muscular pain were found between employed and unemployed patients. Data suggests that long-term, interdisciplinary rehabilitation may be cost effective, especially when viewed in the context of successful employment.

The present investigation assessed 38 family members' perceptions of unmet, partly met and met needs following the brain injury of a relative. Follow-up data was collected at two time intervals averaging 6 and 24 months post-injury. There was no significant difference between the proportion of needs rated as important or very important at time I or II. Highly ranked needs included requests for information, clear and honest explanations from professionals, reassurance, respite care, educational and social activities for the patient, emotional support, financial counseling, and advice about community resources. Relatives rated nearly half of the 40 needs as not met at either time. A significant difference was noted in the proportion of un met/partly met needs within each factor scale at time I and II. A larger number of Emotional Support and Involvement with Care needs were reported as not met at time II. Needs for Professional Support were more frequently reported as met at time II. For both time periods, Health information needs were generally perceived as met while needs relating to Instrumental Support were largely unmet. The findings are discussed in light of implications for treatment and long term adjustment to injury related changes.

During the early stages of recovery from severe brain injury many patients are comatose or minimally responsive. Rehabilitation for these low-functioning survivors traditionally includes acute medical care and transfer to a skilled nursing facility or acute rehabilitation. Concerns have been expressed that customary treatment options are ineffective, costly, or both. In response, 'intermediate'-level programmes designed to provide effective, cost-efficient rehabilitation have emerged. The purpose of this paper is to provide information regarding outcome of severe brain injury and the early rehabilitation needs of survivors. Common characteristics, advantages, and disadvantages of various intermediate programmes, including 'subacute' and 'transitional' rehabilitation, are discussed and contrasted.

Professionals have suggested that aggressiveness, substance abuse, and criminality contribute to poor outcomes after brain injury. There is considerable research regarding post-injury aggressive behaviour, but limited information concerning criminal behaviour and alcohol use patterns. With a sample of 327 patients varying in severity of traumatic brain injury, the present investigation examined alcohol use patterns, arrest histories, behavioural characteristics, and psychiatric treatment histories. Relative to the uninjured population, analysis revealed relatively high incidence of heavy drinking, both pre- and post-injury, among patients with a history of arrest. Increases in abstinence rates were found regardless of arrest history. In addition, a history of arrest was associated with a greater likelihood of psychiatric treatment. Findings also indicated relatively high levels of aggressive behaviours. Discussion focuses on implications for evaluation, rehabilitation, and future research.

Outcome of 295 rehabilitation patients with mild, moderate, and severe brain injury was investigated prospectively at five regional medical centers using the Neurobehavioral Rating Scale. Mean factor scale scores were generally low. with the cognition mean highest and the excitement mean lowest. Regardless of scale, the most significant neurobehavioral difficulties were related to memory, insight, attention, alertness, fatigue, and blunted affect. Conversely, problems rated as least severe included hallucinations, guilt, excitement and lability of mood. Approximately 9% of the sample had at least a moderate problem with agitation, an item on the excitement scale. The general pattern of mean factor scale elevations was consistent with other studies. No relationship was found between injury severity and neurobehavioral characteristics. The relatively low incidence of neurobehavioral problems may reflect recovery and effective interdisciplinary management.