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Journal Cover   UBC Medical Journal
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 1920-7425 - ISSN (Online) 1920-7417
   Published by University of British Columbia Homepage  [3 journals]
  • The role of BDNF in Huntington’s Disease: A Targeted Analysis of 12
           Microarray Studies

    • Authors: Ronald Xie, Sharon Yang, Felix Ma, Eric Yang Zhao
      Abstract: Objectives Huntington’s disease (HD) is a common hereditary neurodegenerative disorder. Pathogenesis is strongly associated with mutation of the protein huntingtin (HTT). This study focuses on the REST/BDNF pathway and provides statistical analysis on expression levels of many genes involved in this pathway in HD and normal subjects. Methods We systematically selected 12 recent microarray studies from the Gene Expression Omnibus (GEO) and conducted over-representation analysis on all assayed genes. Detailed analysis of genes involved in BDNF expression, delivery, and response was performed and Fischer’s combined probability test was applied to combine findings across studies. Results Our findings suggest down-regulation of BDNF expression with up-regulation of REST expression in HD-affected compared to controls. Analysis of the BDNF receptor NTRK2 displayed a possible trend of decreased expression, with down-regulation of genes involved in the downstream AKT pathway. Conclusions Changes in expression of BDNF, REST, NTRK2, and ATK2 in HD suggest that impairment of the expression, delivery, and downstream effects of BDNF may play a role in HD pathogenesis.
      PubDate: 2015-03-27
      Issue No: Vol. 6, No. 2 (2015)
       
  • Health Advocacy

    • Authors: Carolyn Bennett
      Pages: 6 - 7
      Abstract: Not Applicable
      PubDate: 2015-03-16
      Issue No: Vol. 6, No. 2 (2015)
       
  • How and why you could become an advocate for health: an interview
           conducted with Erica Frank

    • Authors: Sian Hsiang-Te Tsuei
      Pages: 8 - 10
      Abstract: Not Applicable
      PubDate: 2015-03-16
      Issue No: Vol. 6, No. 2 (2015)
       
  • A SURVEY OF PARENTAL BARRIERS TO USING PAIN-REDUCTION STRATEGIES DURING
           CHILDHOOD VACCINATIONS

    • Authors: Alex Zhao, Renata Leong, William Watson
      Pages: 11 - 14
      Abstract: Objective: Childhood immunizations represent the most significant source of iatrogenic pain in otherwise healthy children. Consequently, children make correlations between the doctor’s office and the anticipated pain from immunizations and these have long-term consequences such as procedural anxiety, needle phobias, and non-compliance with immunization schedules. Clinical guidelines exist for reducing pain during childhood immunizations. Our study analyzed the use of pain reduction strategies and assessed the barriers that parents face in a family practice setting. Methods: We surveyed parents at academic family practice units at St. Michael’s Hospital. A survey was developed based on a literature search and utilizing current pain reduction guidelines. Results: 62 surveys were recorded and most parents were moderately concerned about their child’s pain. A minority of parents had experience with any of the strategies and the major barriers related to a lack of knowledge and perceptions that pain is a normal part of the immunization experience. Conclusions: We report multiple barriers that parents face when utilizing pain reduction strategies during immunizations. While knowledge, perceptions about pain, and time represent major barriers, healthcare providers should take responsibility in playing an active role in advocating for children while working together with parents.
      PubDate: 2015-03-16
      Issue No: Vol. 6, No. 2 (2015)
       
  • Length of family medicine training and readiness for independent practice:
           Residents’ perspectives at one Canadian university

    • Authors: Kristyn Jewell, Christie Newton, Shafik Dharamsi
      Pages: 15 - 19
      Abstract: Objectives: There is ongoing debate in North America around the appropriate length of training for family physicians. This pilot study presents the results of a qualitative exploration of the viewpoints of family medicine residents at one Canadian university who were asked to reflect on their level of readiness for practice following the standard two years of training. Methods: Twenty-three family medicine residents completed an online qualitative survey that asked them to rank their self-perceived level of preparedness around the key CanMEDS-FM roles and competencies. Six residents participated in a follow-up focus group interview. A qualitative analysis of written responses to the survey and focus group data provided an insight into the residents’ viewpoints. Results: There was a sense that two years is not enough to adequately prepare for independent practice. Residents reported feeling well prepared around competencies related to communication skills and addressing psychosocial issues, however, they indicated that they would feel better prepared in their role as generalists if they had greater exposure to a broader spectrum of clinical domains and issues around practice management. Conclusions: Lengthening training in family medicine continues to receive mixed reviews. Canadian family medicine residents appear to have to master a wider breadth of knowledge within a shorter training period compared to their peers in other specialties. The new competency-based curriculum (Triple C) in family medicine may influence the residents’ sense of readiness for practice.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • The clinical presentation and diagnosis of Vogt-Koyanagi-Harada Disease

    • Authors: Bhupinder Johal, Herman Johal, Andrew Lukaris
      Pages: 20 - 22
      Abstract: Vogt Koyanagi Harada Syndrome (VKH) is a rare systemic disease (1.5 people per 1 million) involving melanocyte containing organs. It is a granulomatous inflammatory disorder that affects the eyes, auditory system, meninges, skin and may present with neurological findings.[1] VKH occurs in certain ethnic groups that possess darker skin pigmentation such as Native Americans, Asians, Hispanics, and those from the Middle East.[2] Women are usually affected more commonly than men (3:1) and incidence occurs in the third or fourth decade of life.[2] Treatment for this disease is systemic corticosteroids. Herein, we describe a previously healthy 34 year old Metis woman with a three week history of bilateral uveitis presenting with tinnitus and skin pigment changes.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Case Report: Appendiceal mucoceles, an uncommon answer to common symptoms.

    • Authors: Andrew Devlin Wilson, Thomas L Perry, Ormond N Panton
      Pages: 23 - 25
      Abstract: A 49 year old man presented with abdominal pain, fatigue, tachycardia, and anemia three weeks after sphenopalatine artery ligation for massive epistaxis. A misleading constellation of symptoms delayed the diagnosis and treatment of a large appendiceal mucocele. Although this may have been an incidental finding, all symptoms have resolved since surgery. This case illustrates the importance of timely diagnosis in patients with vague yet persistent symptoms. An uncommon condition can have potentially serious consequences if missed.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Early Interprofessional Collaboration Through Student-Run Clinics

    • Authors: Diana Kim, Newvick Lee
      Pages: 26 - 27
      Abstract: The current BC primary care system is challenged with an increasing number of patients with chronic and complex comorbidities. Interprofessional collaborative care has demonstrated positive outcomes for patients, providers and the system. However, interprofessional education for UBC health science students is still at its infancy. Student-driven community service learning projects and student-run clinics are able to offer a solution in enhancing the educational opportunities for UBC students. Although there are recognized challenges, these student initiatives may offer an engaging learning opportunity if UBC, educators and student leaders can collaborative effectively.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • An Introduction to Health Professionals’ Role in Addressing Human
           Trafficking

    • Authors: Riley Golby
      Pages: 28 - 29
      Abstract: It is estimated that 2.4 million individuals around the world are trafficked each year. Human trafficking continues to be a complex issue mostly affecting those who are female, socioeconomically disadvantaged, and from marginalized ethnicities. Despite 28% to 50% of trafficked individuals presenting to health providers, health professionals are not well equipped to clinically assist these individuals. This paper discusses the current training opportunities and interventional paradigms in the Lower Mainland, and proposes improvements necessary for health providers to effectively tackle this issue.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Workplace Psychological Health Among Canadian Nurses

    • Authors: Constanza Berrios, Yayuk Joffres, Louis Wang
      Pages: 30 - 32
      Abstract: Due to the demanding nature of their work, nurses in Canada are at high risk of developing psychological distress compared to the general Canadian workforce. Nurses experience high levels of physical and psychological injury, job burnout, and depression. This has been found to result in increased levels of absenteeism, disability claims, and compromise the quality of patient care. We advocate for improvements to workplace psychological health for Canadian nurses at an organizational level. This is a matter of occupational health and safety that has the potential to enhance both nurse and patient health.  
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Physician Leadership: Learning from Dr. Bill Cavers, President of Doctors
           of BC

    • Authors: Alvin Ip
      First page: 33
      Abstract: n/a
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Health Advocacy in Canada: Past, Present and Future

    • Authors: Andrea Marie Jones
      First page: 34
      Abstract: None. Its a news article.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Facing down the threat: What should be Canada’s role in fighting
           global health crises'

    • Authors: Stephanie Lake
      Pages: 35 - 36
      Abstract: N/A
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Esophageal cancer and management of localized disease: a review.

    • Authors: Matthew Chan
      Pages: 37 - 40
      Abstract: Esophageal cancer is often diagnosed in its late stages with a 5-year overall survival rate of approximately 28% in British Columbia. It frequently presents as either squamous cell carcinoma or adenocarcinoma. The most common presenting complaint is dysphagia, typically characterized by a worsening tolerance to solid foods. Esophagogastroduodenoscopy with biopsy is the gold standard for diagnosis. CT scan of the chest and abdomen, FDG-PET scan, and endoscopic ultrasound are useful staging investigations. Esophageal cancer is a heterogeneous disease with no single optimal treatment algorithm. Esophagectomy is the preferred treatment modality in Tis-T1 disease. Neoadjuvant chemoradiotherapy prior to definitive surgery should always be considered in T2 disease and is recommended in ≥T3 or N+ disease. There is controversial evidence against the survival benefit and potential added morbidity of neoadjuvant chemoradiotherapy in the treatment of early esophageal cancer. Unresectable and cervical tumors should be treated with definitive chemoradiotherapy. The optimal treatment of adenocarcinomas of the distal esophagus and gastro-esophageal junction is under investigation but likely includes peri-operative chemotherapy. Current research in esophageal cancer includes the use of early FDG-PET scans to assess response to chemotherapy, which could have important implications in prognostication and treatment decisions. Keywords: localized esophageal cancer, management, chemoradiotherapy, FDG-PET
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Childhood Poverty and Parental Stress: Important Determinants of Health

    • Authors: Jennifer Anne Kalil
      Pages: 41 - 43
      Abstract: The following is a review of child development literature that attempts to elucidate what early-life stress and poverty does to an individual, how it does so, and what we can do to try and prevent and/or minimize this damage. First, we provide a snap shot of the research that demonstrates that early-life experiences affect the cognitive abilities, behaviour, and health of an individual for the rest of their life. Next, we explain the mechanisms by which these long lasting stable changes occur, including toxic stress mediated dysregulation of the HPA axis and epigenetics. Finally we touch on some of the up and coming evidence that early-childhood interventions targeting education, family stress relief, and the parent-child relationship can reverse and/or prevent the negative effects of toxic stress on cognition and health.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
  • Anatomy of a Stem Cell Drive: An Evidence-Based Approach to Stem Cell
           Drive Organization

    • Authors: Warren Fingrut
      Pages: 44 - 46
      Abstract: Many patients with blood diseases require a stem cell transplant from a genetically-matched donor. However, 70% of patients do not have a suitable match in their family. Canada’s stem cell donor database, OneMatch Stem Cell and Marrow Network, is used to match potential unrelated donors to patients in need, worldwide. Individuals age 17-35 can register online or at stem cell drives, where they provide consent and a tissue sample (cheek-swab). To the knowledge of this author, no published guidelines recommend a process for stem cell donor recruitment at drives. This article outlines an evidence-based approach to stem cell drive organization.
      PubDate: 2015-03-20
      Issue No: Vol. 6, No. 2 (2015)
       
 
 
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