Search

Jalil Safaei Department of Economics, University of Northern British Columbia, Prince George, BC, CanadaBackground: There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM), patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care.Objective: This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries.Method: Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care.Results: Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature.Conclusion: Seeking deliberative democracy in health care is both challenging and rewarding. The challenges have been more or less identified. However, its prospects are potentially significant. Such prospects are more likely to materialize if deliberative democracy is pursued more systematically in the broader sociopolitical domains.Keywords: citizen juries, patient engagement, shared decision-making, decision aids, public participation

The effective utilization of solar energy for hydrogen production requires an abundant supply of thermodynamically active photo-electrons; however, the photocatalysts are generally impeded by insufficient light absorption and fast photocarrier recombination. Here, we report a multiple-regulated strategy to capture photons and boost photocarrier dynamics by developing a broadband photocatalyst composed of defect engineered g-C3N4 (DCN) and upconversion NaYF4:Yb3+,Tm3+ (NYF) nanocrystals. Through a precise defect engineering, the S dopants and C vacancies jointly render DCN with defect states to effectively extend the visible light absorption to 590 nm and boost photocarrier separation via a moderate electron-trapping ability, thus facilitating the subsequent re-absorption and utilization of upconverted photons/electrons. Importantly, we found a promoted interfacial charge polarization between DCN and NYF has also been achieved mainly due to Y-N interaction, which further favors the upconverted excited energy transfer from NYF onto DCN as verified both theoretically and experimentally. With a 3D architecture, the NYF@DCN catalyst exhibits a superior solar H2 evolution rate among the reported upconversion-based system, which is 19.3 and 1.5 fold higher than bulk material and DCN, respectively. This work provides an innovative strategy to boost solar utilization by using defect engineering and building up interaction between hetero-materials.

Studies of health have recognized the influence of socioeconomic position on health outcomes. People with higher socioeconomic ranking, in general, tend to be healthier than those with lower socioeconomic rankings. The effect of political environment on population health has not been adequately researched, however. This study investigates the effect of democracy (or lack thereof) along with socioeconomic factors on population health. It is maintained that democracy may have an impact on health independent of the effects of socioeconomic factors. Such impact is considered as the direct effect of democracy on health. Democracy may also affect population health indirectly by affecting socioeconomic position. To investigate these theoretical links, some broad measures of population health (e.g., mortality rates and life expectancies) are empirically examined across a spectrum of countries categorized as autocratic, incoherent, and democratic polities. The regression findings support the positive influence of democracy on population health. Incoherent polities, however, do not seem to have any significant health advantage over autocratic polities as the reference category. More rigorous tests of the links between democracy and health should await data from multi-country population health surveys that include specific measures of mental and physical morbidity. [ABSTRACT FROM AUTHOR]

Objectives: The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries., Methods: To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022)., Results: The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification., Conclusions: The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic's adverse health impacts, more so than emergency containment measures and social restrictions.

This study seeks to identify the impact of social determinants and lifestyle factors on life expectancy and self-perceived health as two measures of objective and subjective health, respectively, using data from Canadian provinces during 2007-21. Through a simple conceptual model, it lays out the direct and indirect pathways through which social and lifestyle determinants affect health. The conceptual model guides the formulation of empirical models, which are used to estimate the effects of social and lifestyle factors on health. The study uses 'panel-corrected standard errors' estimation method to obtain reliable results. The findings confirm that social determinants contribute directly and indirectly (through lifestyle) to life expectancy. For self-perceived health, however, the contributions of both social and lifestyle determinants are only direct. The latter result may be explained by the immediacy of lifestyle and its impact on health in individuals' minds, a notion that is constantly reinforced by the mainstream discourse on health promotion. Our study indicates that lifestyle factors should be addressed within the context of broader social determinants. In other words, an individual agency should be understood within the larger enveloping social structure. The study recognizes redistributive measures aimed at reducing social gradients in health as effective health promotion policies., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Two-dimensional (2D) nanofluidic membranes have shown great promise in harvesting osmotic energy from the salinity difference between seawater and fresh water. However, the output power densities are strongly hampered by insufficient membrane permselectivity. Herein, we demonstrate that vacancy engineering is an effective strategy to enhance the permselectivity of 2D nanofluidic membranes to achieve high-efficiency osmotic energy generation. Phosphorus vacancies were facilely created on NbOPO 4 (NbP) nanosheets, which remarkably enlarged their negative surface charge. As verified by both experimental and theoretical investigations, the vacancy-introduced NbP (V-NbP) exhibited fast transmembrane ion migration and high ionic selectivity originating from the improved electrostatic affinity of cations. When applied in a natural river water|seawater osmotic power generator, the macroscopic-scale V-NbP membrane delivered a record-high power density of 10.7 W m -2 , far exceeding the commercial benchmark of 5.0 W m -2 . This work endows the remarkable potential of vacancy engineering for 2D materials in nanofluidic energy devices.

Membrane cleaning is critical for economic and scientific reasons in wastewater treatment systems. Sodium docusate is a laxative agent and removes cerumen (ear wax). Docusate penetrates the hard ear wax, making it softer and easier to remove. The same concept could be applied to soften and remove fouling layers on the membrane surface. Once softened, the foulants can be easily flushed with water. This innovative approach can address the challenge of developing superior methods to mitigate membrane fouling and material degradation. In this study, we evaluated the efficiency of sodium docusate for cleaning fouled forward osmosis membranes with real landfill leachate wastewater. Experiments were conducted to examine the impact of dose rate, contact time, flow or static conditions, and process configuration (forward osmosis (FO) or pressure retarded osmosis (PRO) upon fouling created by landfill leachate dewatering. A remarkable (99%) flux recovery was achieved using docusate at a small concentration of only 0.1% for 30 min. Furthermore, docusate can also effectively restore flux with static cleaning without using pumps to circulate the cleaning solution. Furthermore, cleaning efficiency can be achieved at neutral pH compatible with most membrane materials. From an economic and energy-saving perspective, static cleaning can almost achieve the same cleaning efficiency as kinetic cleaning for fouled forward osmosis membranes without the expense of additional pumping energy compared to kinetic cleaning. Since pumping energy is a major contributor to the overall energy of the forward osmosis system, it can be minimized to a certain degree by using a static cleaning approach and can bring good energy savings when using larger membrane areas. Studies of the contact angle on the membrane surface indicated that the contact angle was decreased compared to the fouled membrane after cleaning (e.g. 70.3° to 63.2° or FO mode and static cleaning). Scanning Electron Microscopy revealed that the cleaning strategy was successful. Infrared Spectroscopy showed that a small amount of sodium docusate remained on the membrane surface. Docusate is more environmentally friendly than acid or alkaline solutions from an environmental perspective. Furthermore, the cleaning solution can be reused for several cycles without discarding it due to the surfactant properties of docusate., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Rechargeable multivalent metal (e.g., zinc (Zn) and aluminum (Al)) batteries are ideal choices for large-scale energy storage owing to their intrinsic low cost and safety. However, the poor compatibility between metallic anodes and electrolytes strongly hampers their practical applications. Herein, it is demonstrated that confining multivalent metals in a biomimetic scaffold (Bio-scaffold) can achieve highly efficient multivalent metal plating/stripping. This Bio-scaffold is well-tailored through the synergy of a parallel-aligned array of fractal copper branches and a CaTiO 3 (CTO)-based coating layer. By virtue of this design strategy, the as-developed Bio-scaffold-based Zn- and Al-metal anodes exhibited dendrite-free morphologies with high reversibility and long lifespan, as well as excellent performance for Zn and Al full batteries. Theoretical modeling and experimental investigations reveal that the fractal copper array not only facilitates multivalent ion diffusion and electrolyte wetting but also effectively reduces the local current densities during cycling; Meanwhile, the CTO-based coating layer effectively blocks interfacial side reactions and enables a homogeneous ionic flux. This work opens a new avenue for developing multivalent metal batteries., (© 2022 The Authors. Advanced Materials published by Wiley-VCH GmbH.)

Osmotic energy stored between seawater and freshwater is a clean and renewable energy source. However, developing high-efficiency and durable permselective membranes for harvesting osmotic energy remains a longstanding bottleneck. Herein, we report that a nanocomposite membrane with a biological serosa-mimetic structure can achieve high-performance osmotic energy generation through the coupling of two-dimensional (2D) sulfonated covalent organic framework (COF) nanosheets and anion-grafted aramid nanofibers (ANFs). As verified by theoretical calculations and experimental investigations, the 2D COF nanosheets not only provide abundant one-dimensional (1D)/2D nanofluidic channels to synergistically benefit an ultrafast ion migration but also enable high cation permselectivity via the covalently tethered anions. The grafted ANFs increase the mechanical strength of the membrane and further improve the ion diffusion/rectification. When it was applied in an osmotic power generator, the biomimetic membrane delivered a power density of 9.6 W m -2 , far surpassing the commercial benchmark of 5.0 W m -2 . This work could boost the viability of osmotic energy conversion toward a sustainable future.

Water-in-salt (WIS) electrolytes using super-concentrated organic lithium (Li) salts are of interest for aqueous Li-ion batteries. However, the high salt cost, high viscosity, poor wettability, and environmental hazards remain a great challenge. Herein, we present a localized water-in-salt (LWIS) electrolyte based on low-cost lithium nitrate (LiNO 3 ) salt and 1,5-pentanediol (PD) as inert diluent. The addition of PD maintains the solvation structure of the WIS electrolyte, improves the electrolyte stability via hydrogen-bonding interactions with water and NO 3 - molecules, and reduces the total salt concentration. By in situ gelling the LWIS electrolyte with tetraethylene glycol diacrylate (TEGDA) monomer, the electrolyte stability window can be further expanded to 3.0 V. The as-developed Mo 6 S 8 |LWIS gel electrolyte|LiMn 2 O 4 (LMO) batteries delivered outstanding cycling performance with an average Coulombic efficiency of 98.53 % after 250 cycles at 1 C., (© 2021 Wiley-VCH GmbH.)

The regulation of anions and cations at the atomic scale is of great significance in membrane-based separation technologies. Ionic transport regulation techniques could also play a crucial role in developing high-performance alkali metal batteries such as alkali metal-sulfur and alkali metal-selenium batteries, which suffer from the non-uniform transport of alkali metal ions (e.g., Li + or Na + ) and detrimental shuttling effect of polysulfide/polyselenide anions. These drawbacks could cause unfavourable growth of alkali metal depositions at the metal electrode and irreversible consumption of cathode active materials, leading to capacity decay and short cycling life. Herein, we propose the use of a polypropylene separator coated with negatively charged Ti 0.87 O 2 nanosheets with Ti atomic vacancies to tackle these issues. In particular, we demonstrate that the electrostatic interactions between the negatively charged Ti 0.87 O 2 nanosheets and polysulfide/polyselenide anions reduce the shuttling effect. Moreover, the Ti 0.87 O 2 -coated separator regulates the migration of alkali ions ensuring a homogeneous ion flux and the Ti vacancies, acting as sub-nanometric pores, promote fast alkali-ion diffusion.

Defect engineering is increasingly recognized as a viable strategy for boosting the performance of photoelectrochemical (PEC) water splitting using metal oxide-based photoelectrodes. However, previously developed methods for generating point defects associated with oxygen vacancies are rather time-consuming. Herein, high density oxygen deficient α-Fe 2 O 3 with the dominant (110) crystal plane is developed in a very short timescale of 10 minutes by employing aerosol-assisted chemical vapor deposition and pure nitrogen as a gas carrier. The oxygen-defective film exhibits almost 8 times higher photocurrent density compared to a hematite photoanode with a low concentration of oxygen vacancies which is prepared in purified air. The existence of oxygen vacancies improves light absorption ability, accelerates charge transport in the bulk of films, and promotes charge separation at the electrolyte/semiconductor interface. DFT simulations verify that oxygen-defective hematite has a narrow bandgap, electron-hole trapped centre, and strong adsorption energy of water molecules compared to pristine hematite. This strategy might bring PEC technology another step further towards large-scale fabrication for future commercialization.

The formation of sodium (Na) dendrites during cycling has impeded the practical application of Na metal anodes. Herein, we developed a flexible graphene-based matrix, e.g., a porous reduced graphene oxide (PRGO) film, to support dendrite-free Na nucleation and plating, contributing to high-performance Na metal batteries. The PRGO film possessed outstanding merits of sodiophilicity and flexibility. The sodiophilic PRGO film enabled uniform Na nucleation in the initial electroplating stage. Furthermore, the flexible PRGO film with a small Young's modulus effectively alleviated the texture deformation of electrodeposited Na, leading to a compact and dendrite-free Na deposition layer. The well-maintained Na metal anodes on the PRGO film exhibited superior cyclability, high Coulombic efficiency, and improved energy density in both half-cell and full-cell testing. This work illustrates the great significance of mechanical properties of the supporting matrix for the Na electroplating, which provides a new strategy to develop high-performance dendrite-free Na metal batteries.

Habituation is a ubiquitous form of non-associative learning observed as a decrement in responding to repeated stimulation that cannot be explained by sensory adaptation or motor fatigue. One of the defining characteristics of habituation is its sensitivity to the rate at which training stimuli are presented-animals habituate faster in response to more rapid stimulation. The molecular mechanisms underlying this interstimulus interval (ISI)-dependent characteristic of habituation remain unknown. In this article, we use behavioural neurogenetic and bioinformatic analyses in the nematode Caenorhabiditis elegans to identify the first molecules that modulate habituation in an ISI-dependent manner. We show that the Caenorhabditis elegans orthologues of Ca 2+ /calmodulin-dependent kinases CaMK1/4, CMK-1 and O-linked N-acetylglucosamine (O-GlcNAc) transferase, OGT-1, both function in primary sensory neurons to inhibit habituation at short ISIs and promote it at long ISIs. In addition, both cmk-1 and ogt-1 mutants display a rare mechanosensory hyper-responsive phenotype (i.e. larger mechanosensory responses than wild-type). Overall, our work identifies two conserved genes that function in sensory neurons to modulate habituation in an ISI-dependent manner, providing the first insights into the molecular mechanisms underlying the universally observed phenomenon that habituation has different properties when stimuli are delivered at different rates., (© 2018 The Author(s).)

The reversible phosphorylation of proteins catalyzed by protein kinases in eukaryotes supports an important role for eukaryotic protein kinases (ePKs) in the emergence of nucleated cells in the third superkingdom of life. Choline kinases (ChKs) could also be critical in the early evolution of eukaryotes, because of their function in the biosynthesis of phosphatidylcholine, which is unique to eukaryotic membranes. However, the genomic origins of ePKs and ChKs are unclear. The high degeneracy of protein sequences and broad expansion of ePK families have made this fundamental question difficult to answer. In this study, we identified two class-I aminoacyl-tRNA synthetases with high similarities to consensus amino acid sequences of human protein-serine/threonine kinases. Comparisons of primary and tertiary structures supported that ePKs and ChKs evolved from a common ancestor related to glutaminyl aminoacyl-tRNA synthetases, which may have been one of the key factors in the successful of emergence of ancient eukaryotic cells from bacterial colonies., (© 2016 by The American Society for Biochemistry and Molecular Biology, Inc.)

This study uses data from the Organisation for Economic Co-operation and Development countries over the 2008-2010 period to construct indicators of "pro-primary" and "pro-secondary" distributions. The former is concerned with the original distribution of income through the market, whereas the latter is concerned with the redistribution efforts of the government. The study ranks these countries along these dimensions to create a distributional orientation map for such countries. It finds that the Scandinavian countries occupy the top rankings in terms of equity in pro-primary distribution, followed by countries with a Bismarckian welfare state regime. The Scandinavian countries also rank very high on equity in pro-secondary distribution, along with some of the top-ranking Bismarckian countries. More significantly, the study finds that the countries' health outcomes are associated more strongly with the pro-primary distributional stance than with the pro-secondary distributional stance. A key policy implication is that to achieve better and more equitable health, it is more effective to design a level playing field for market participants in the first place, than to try to mend inequities after the fact through remedial social policy., (© The Author(s) 2015.)

Significant improvements in human rights and democracy have been made since the adoption of the Universal Declaration of Human Rights by the United Nations in 1948. Yet, human rights, especially women's rights, are still being violated in many parts of the developing world. The adverse effects of such violations on women's and children's health are well known, but they are rarely measured. This study uses cross-national data from over 145 countries to estimate the impact of democracy and respect for human rights on various measures of women's health while controlling for confounding socio-economic factors such as income, education, fertility and healthcare. It finds that democracy and regards for human rights contribute positively to women's health outcomes, as do socio-economic variables.

Background: Complex intracellular signaling networks monitor diverse environmental inputs to evoke appropriate and coordinated effector responses. Defective signal transduction underlies many pathologies, including cancer, diabetes, autoimmunity and about 400 other human diseases. Therefore, there is high impetus to define the composition and architecture of cellular communications networks in humans. The major components of intracellular signaling networks are protein kinases and protein phosphatases, which catalyze the reversible phosphorylation of proteins. Here, we have focused on identification of kinase-substrate interactions through prediction of the phosphorylation site specificity from knowledge of the primary amino acid sequence of the catalytic domain of each kinase., Results: The presented method predicts 488 different kinase catalytic domain substrate specificity matrices in 478 typical and 4 atypical human kinases that rely on both positive and negative determinants for scoring individual phosphosites for their suitability as kinase substrates. This represents a marked advancement over existing methods such as those used in NetPhorest (179 kinases in 76 groups) and NetworKIN (123 kinases), which consider only positive determinants for kinase substrate prediction. Comparison of our predicted matrices with experimentally-derived matrices from about 9,000 known kinase-phosphosite substrate pairs revealed a high degree of concordance with the established preferences of about 150 well studied protein kinases. Furthermore for many of the better known kinases, the predicted optimal phosphosite sequences were more accurate than the consensus phosphosite sequences inferred by simple alignment of the phosphosites of known kinase substrates., Conclusions: Application of this improved kinase substrate prediction algorithm to the primary structures of over 23, 000 proteins encoded by the human genome has permitted the identification of about 650, 000 putative phosphosites, which are posted on the open source PhosphoNET website (http://www.phosphonet.ca).

New research on broader determinants of health has culminated into the new paradigm of social determinants of health. The fundamental view that underlies this new paradigm is that socioeconomic and political contexts in which people live have significant bearing upon their health and well-being. Unlike a wealth of research on socioeconomic determinants, few studies have focused on the role of political factors. Some of these studies examine the role of political determinants on health through their mediation with the labour environments and systems of welfare state. A few others study the relationship between polity regimes and population health more directly. However, none of them has a focus on women's health. This study explores the interactions, both direct and indirect, between democracy and women's health. In doing so, it identifies some of the main health vulnerabilities for women and explains, through a conceptual model, how democracy and respect for human rights interacts with women's health.

Objectives: This study examines the long-term unemployment rate and various health outcomes across Canadian communities to estimate employment-related health inequalities in these communities., Methods: The study uses cross-sectional community-level health data along with data on the long-term employment rate for various communities across Canada to quantify health inequalities among these communities. The health outcomes that are considered in this study include total and disease specific mortality rates; health conditions such as high blood pressure, diabetes, injuries, and self rated health; and life expectancies at birth and at age 65. Health inequalities are estimated using the concentration index, which is used to measure health inequalities along socioeconomic dimensions. The concentration index is estimated by a regression of weighted relative health (ill health) over weighted cumulative relative rank of the populations. All the estimates are provided separately for males and females., Results: The findings of the study support the existence of inequalities in community health outcomes as related to the long-term employment rates in those communities. Communities with lower long term employment rates (higher unemployment rates) have poorer health outcomes in terms of higher mortality rates, worse health conditions, and shorter life expectancies., Conclusion: Health inequalities related to long-term employment have important policy implications. They call for policies that would increase and maintain long term employment rates as part of a broader socioeconomic approach to health. Long term employment ensures income security and prevents the psychosocial experiences leading to mental and physical ill health.