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ObjectiveTo develop an index to assess the nutritional quality of household food purchases based on food expenditures only.DesignA database of monthly food purchases of a convenience sample of low-income households was used to develop the Healthy Purchase Index (HPI). The HPI is the sum of two sub-scores based on expenditure shares of food categories in total household food expenditure: the purchase diversity sub-score and the purchase quality sub-score. The first was adapted from an existing diversity score. The second integrated those food categories identified as the best predictors of the nutritional quality of purchases based on associations between expenditure shares of food categories and two nutritional quality indicators: the mean adequacy ratio (MAR) and the mean excess ratio (MER). Correlation between the HPI and a score assessing adherence to French dietary guidelines (PNNS-GSmod) was performed as a first validation.Setting/ParticpantsFood purchases of 112 households from deprived neighbourhoods of Marseille (France), participating in the Opticourses and Jassur projects (2012–2015).ResultsThe purchase diversity sub-score reflects the presence in food purchases of five food categories: fruits, vegetables, starches, dairy products, and meat, fish & eggs. The purchase quality sub-score is based on expenditure shares for fruit & vegetables, added fats & seasonings, sweet snacks, cheese, sugary drinks, refined grains and fish, as these were identified as predictors of the nutritional quality of purchases. The HPI was positively associated with the PNNS-GSmod(rs=0·378;PConclusionsThe HPI helps assess the healthiness of household food purchases.

Glucose-regulated protein 78 (GRP78) is a chaperone protein that has a high frequency in tumor cells. Normally it is found in the endoplasmic reticulum to assist in protein folding, but under cellular stress, GRP78 influences proliferative signaling pathways at the cell surface. The increased expression elicits autoantibody production, providing a biomarker of ovarian cancer, as well as other types of cancer. This study aims to determine the epitope recognition of GRP78 autoantibodies isolated from serum of ovarian cancer patients and use the identified antibodies to design new drug delivery systems to specifically target cancer cells. We first confirmed that the membrane GRP78 levels are increased in ovarian cancer cells and positively correlate with proliferation. However, the level of circulating GRP78 autoantibodies did not correlate with membrane GRP78 expression in ovarian cancer cells and was lower, although not significantly, compared to control patients. We then determined the epitope recognition of GRP78 autoantibodies and showed that treatment with paclitaxel-loaded nanoparticles coated with anti-GRP78 antibodies significantly decreased tumor development in chick embryo culture of ovarian cancer cell tumors compared to paclitaxel treatment alone. This evidence suggests that nanoparticle drug delivery systems coupled with antibodies against GRP78 has potential as a powerful therapy against ovarian cancer.

The purpose of this study was to establish audiology referral protocols for post meningitis paediatric populations in two academic hospitals in Gauteng, South Africa. Specific objectives of this study included determining if audiological assessment referrals were made following infection; determining the time of referral post meningitis diagnosis; establishing what audiological assessments were conducted on this population, as well as determining any correlations between signs and symptoms of meningitis and referrals for audiology assessments. Medical records of 47 children admitted to hospital with a diagnosis of meningitis between the ages of birth and 6 years were reviewed following a retrospective record review design. Data relevant to the current study were obtained from hospital records and this was captured in a data spreadsheet. Both descriptive and inferential statistics were implemented in analysis of the data. Inferential statistics in the form of logistic regression analysis was used to establish any significant factor that may predict referral for audiological assessment. The findings indicated that almost half (40%) of the cases were not referred for audiological services. Of those cases referred for assessment, 89% were referred as in-patients before hospital discharge, with minimal referrals occurring after discharge from hospital. Screening, rather than diagnostic audiology measures were conducted on a majority of the cases. Logistic regression analysis identified fever as the only predictor variable (p

The development of close relationships between public health and clinic services, particularly those provided by primary care family physicians, is supported in all western healthcare systems. Collaborations leading to such interface are supposed to have positive impacts on the quality of care, the burden of diseases and the equity in the healthcare system. If players in both fields accept the relevance of the interface and support in principle its development, there are still many barriers that impede the collaborations in reality. That said, little is known about the barriers in the Quebec healthcare system. The purpose of this study is to answer to this lack of information by studying the interface from an organizational perspective. Two conceptual frameworks have been used: the Lasker's typology (1997) and the Hinings and Greenwood archetypes (1988).The analysis highlights two of the six forms of collaboration proposed by the typology used: the coordination of services provided to individuals and the use of clinic visits for the purpose of public health. Activities associated to these forms of collaboration, which are important with regard to the public health mandate, are of interest essentially for public health and are practically unilaterally determined by public health. Moreover, the lack of coordination in activities involving a collaboration with physicians is an obstacle for the development of such activities and generates irritants for the physicians. Thus, in the Quebec healthcare system there are opportunities for the development of the interface where the collaboration occurs also at the benefit of the clinic practice and where it takes into account the constraints of the clinic sector.

Homeless persons are numerous, carry a significant burden of illness and face challenges in accessing care. A search of the literature revealed insufficient empirical sources to permit the use of standard systematic review methodology to determine the most effective way to deliver point-of-first-contact healthcare to homeless people. Instead, we used a policy analysis approach. We found that the dominant model of primary care in Canada performs poorly when assessed on 13 evaluation criteria. While there is variable performance on individual measures, the three alternative models – targeted standard facility/clinic site, fixed outreach site and mobile outreach service – all perform well. Our findings suggest that some factor other than performance on the specified measures, such as costs, feasibility, geographical fit or local preferences, should be used to choose a specific model. Our analysis clearly indicates that the status quo model of primary care is inadequate to meet the needs of homeless people.

Cet article rend compte d’une étude de cas portant sur le mémoire que les CPE doivent soutenir lors de leur seconde année de master MEEF. Ce mémoire est emblématique de l’ambition des réformes qui se sont succédé de 1990 à 2013, qui se donnaient pour but d’« universitariser » et de professionnaliser la formation de ces professionnels de l’éducation. L’étude de cas montre que les formateurs se sont efforcés de mettre en place les conditions pour que le mémoire contribue efficacement à la formation des CPE, mais qu’il ne conduit pas systématiquement aux effets escomptés., This paper relates a case study about the research paper that the Principal Educational Advisers must produce cursing the second year of the MEEF master’s degree. This research paper is representative of the ambitiousness of successive reforms from 1990 to 2013, which aimed to strengthen the academic and vocational dimensions of the training of these professionals. This case study shows that trainers endeavored to implement the necessary conditions to allow the research paper to be effective but it doesn’t always have the expected impacts.