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Primary care in Caribbean Small Island Developing States

Abstract Caribbean Small Island Developing States (SIDS) made good process on improving the health of their populations; but concerns exist when it comes to meeting changing health needs. Due to remoteness and limited resources it is difficult to respond to high rates of non-communicable diseases (NCDs). Furthermore, little is known about how primary care (PC) is organised and how this responds to current health issues. This study focused on gaining insights in the organisation of PC of Caribbean SIDS based on currently available literature. This literature review was an explorative multiple case study, where structure of PC and health status of 16 Caribbean SIDS were reviewed using available scientific and grey literature between the years 1997 and 2014. Thirty documents were used to analyse 20 indicators for the dimensions “Structure of Primary Care” and “Health Status”. Results were mapped in order to identify if there is a possible relation between structures of PC to the health of the populations. When reviewing the structure of PC, the majority of information was available for “Economic conditions of PC” (78%) and the least information was available for “Governance of PC” (40%). With regards to health status, all islands show improvements on “Life expectancy at birth” since 2007. In contrast, on average, the mortality due to NCDs did not improve. Saint Lucia performs best on “Structure of PC”. The British Virgin Islands have the best health status. When both dimensions were analysed, Saint Lucia performs best. There is still little known on the responsiveness of PC of Caribbean SIDS to NCDs. There is a need for elaborate research on: (1) If and how the functioning of these health systems relate to the health status; (2) What islands can learn from an analysis over time and what they can learn from cross-island analysis; and (3) Filling the gaps of knowledge which currently exist within this field of research.

Disrupting the subscription journals’ business model for the necessary large-scale transformation to open access

This paper makes the strong, fact-based case for a large-scale transformation of the current corpus of scientific subscription journals to an open access business model. The existing journals, with their well-tested functionalities, should be retained and developed to meet the demands of 21st century research, while the underlying payment streams undergo a major restructuring. There is sufficient momentum for this decisive push towards open access publishing. The diverse existing initiatives must be coordinated so as to converge on this clear goal. The international nature of research implies that this transformation will be achieved on a truly global scale only through a consensus of the world’s most eminent research organizations. All the indications are that the money already invested in the research publishing system is sufficient to enable a transformation that will be sustainable for the future. There needs to be a shared understanding that the money currently locked in the journal subscription system must be withdrawn and re-purposed for open access publishing services. The current library acquisition budgets are the ultimate reservoir for enabling the transformation without financial or other risks. The goal is to preserve the established service levels provided by publishers that are still requested by researchers, while redefining and reorganizing the necessary payment streams. By disrupting the underlying business model, the viability of journal publishing can be preserved and put on a solid footing for the scholarly developments of the future.

Review of ‘Production and characterization of cyclodextrin glycosyltransferase from Bacillus.sp isolated from Cuban Soil.’

ScienceOpen SO Reviews Review    Rated 3 of 5. Zhaofeng Li on 2015-06-30 (2014)

This manuscript reports the production and characterization of a cyclodextrin glycosyltransferase from Bacillus sp., which is isolated from Cuban soil. Some places which were not indicated clearly are listed as follows.

1. The authors should provide the image of SDS-PAGE gel to show the …

Review of ‘Intersubject information mapping: revealing canonical representations of complex natural stimuli’

ScienceOpen SO Reviews Review    Rated 4.5 of 5. JUSSI TOHKA on 2015-06-18 (2015)
Very interesting proposal for data analysis of fMRI acquired using naturalistic stimuli

Lipoprotein (a) upregulates ABCA1 in liver cells via scavenger receptor-B1 through its oxidized phospholipids[S]

     Review now
Elevated levels of lipoprotein (a) [Lp(a)] are a well-established risk factor for developing CVD. While Lp(a) levels are thought to be independent of other plasma lipoproteins, some trials have reported a positive association between Lp(a) and HDL. Whether Lp(a) has a direct effect on HDL is not known. Here we investigated to determine whether Lp(a) had any effect on the ABCA1 pathway of HDL production in liver cells. Incubation of HepG2 cells with Lp(a) upregulated the PPARγ protein by 1.7-fold and the liver X receptor α protein by 3-fold. This was accompanied by a 1.8-fold increase in ABCA1 protein and a 1.5-fold increase in cholesterol efflux onto apoA1. We showed that Lp(a) was internalized by HepG2 cells, however, the ABCA1 response to Lp(a) was mediated by the selective uptake of oxidized phospholipids (oxPLs) from Lp(a) via the scavenger receptor-B1 and not by Lp(a) internalization per se. We conclude that there is a biological connection between Lp(a) and HDL through the ability of Lp(a)’s oxPLs to upregulate HDL biosynthesis.

Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study

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Background: Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. Aim: We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners. Design: Mindfulness-Based Stress Reduction is a training in which mindfulness practices are combined with psycho-education to help participants cope with distress. In this mixed methods pilot study, questionnaires on psychological distress and quality of life were administered before, directly after and 3 months after the Mindfulness-Based Stress Reduction training, in combination with semi-structured interviews. Setting/participants: Patients with lung cancer and partners were recruited at one tertiary care academic medical centre. A total of 19 lung cancer patients and 16 partners participated in the Mindfulness-Based Stress Reduction training. Results: Most patients were diagnosed with advanced stage lung cancer. Vast majority completed the training. Those receiving anti-cancer treatment did not miss more sessions than patients who were not currently treated. Patients and partners felt positive about participating in a peer group and with their partner. Among participants no significant changes were found in psychological distress. Caregiver burden in partners decreased significantly after following Mindfulness-Based Stress Reduction. The qualitative analysis showed that the training seemed to instigate a process of change in participants. Conclusion: The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners. A randomized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners.