Questions regarding psychological distress (question 46) were adapted from the CCHS-MH and are originally sourced from the Kessler Psychological Distress Scale.[38] No special permissions were required for use of this instrument. Questions regarding positive mental health (question 45) were adapted from the CCHS-MH and are originally sourced from the Mental Health Continuum-Short Form (Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207-222). No special permissions were required for use of this instrument. NOTE: The full survey questionnaire included questions regarding burnout that were adapted from the Maslach Burnout Inventory (questions 28-31) and used with express consent and under the appropriate licensing agreement with the copyright holders of the Maslach Burnout Inventory (Maslach, C., Jackson S.E., & Leiter, M. P. Maslach Burnout Inventory Manual. 3rd ed. 1996). These questions cannot be reproduced under the conditions of this instrument's licensing agreement and have, therefore, been removed from this questionnaire. For copies of the full questionnaire, please contact the authors. NOTE: The full survey questionnaire included questions regarding resilience that were adapted from the Connor-Davidson Resilience Scale (question 32) and used with express consent and under the appropriate licensing agreement with the copyright holders of the Connor-Davidson Resilience Scale (Davidson JRT, Connor KM. Connor-Davidson Resilience Scale Manual. Unpublished 2014. Personal communication from the authors; Connor, K, & Davidson, J. Depression and Anxiety 2003 18:76-82). These questions cannot be reproduced under the conditions of this instrument's licensing agreement and have, therefore, been removed from this questionnaire. For copies of the full questionnaire, please contact the authors. Consent Canadian Federation of Medical Students (CFMS) & Fédération médicale étudiante du Québec (FMEQ) Health and Wellbeing SurveyDear Colleague, As a physician-in-training, you know that your own health is subject to factors and forces similar to those that impact your patients, and that you are not immune to stressors on your mental and physical health. Therefore, the Canadian Federation of Medical Students (CFMS) and the Fédération médicale étudiante du Québec (FMEQ) are collecting new information on the health and behaviours of medical students studying undergraduate medicine at institutions across Canada, so that we can develop and advocate for programs to improve our health. The total approximate time for completion of this survey is 15 minutes.We ask that any student that has been significantly involved in the creation or piloting of this survey (i.e. CFMS and FMEQ Executive members) please do not complete this survey. As well, if you are currently on leave from your medical studies, and have been so for greater than four consecutive weeks, please do not complete this survey. By participating, you are verifying that you do not meet any ...

BACKGROUND AND PURPOSE:Pre-eclampsia is a serious clinical gestational disorder occurring in 3%-5% of all human pregnancies and characterized by endothelial dysfunction and vascular complications. Offspring born of pre-eclamptic pregnancies are reported to exhibit deficits in cognitive function, higher incidence of depression, and increased susceptibility to stroke. However, no brain imaging reports exist on these offspring. We aimed to assess brain structural and vascular anatomy in 7-to 10-year-old offspring of pre-eclamptic pregnancies compared with matched controls.

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This cross-sectional study investigates the national prevalence of tobacco, alcohol, cannabis, and nonmedical prescription stimulant use among Canadian medical students.

Background Despite increasing global attention to non-communicable diseases (NCDs) and their incorporation into universal health coverage (UHC), the factors that determine whether and how NCDs are prioritized in national health agendas and integrated into health systems remain poorly understood. Childhood cancer is a leading non-communicable cause of death in children aged 0–14 years worldwide. We investigated the political, social, and economic factors that influence health system priority-setting on childhood cancer care in a range of low- and middle-income countries (LMIC). Methods and findings Based on in-depth qualitative case studies, we analyzed the determinants of priority-setting for childhood cancer care in El Salvador, Guatemala, Ghana, India, and the Philippines using a conceptual framework that considers four principal influences on political prioritization: political contexts, actor power, ideas, and issue characteristics. Data for the analysis derived from in-depth interviews ( n = 68) with key informants involved in or impacted by childhood cancer policies and programs in participating countries, supplemented by published academic literature and available policy documents. Political priority for childhood cancer varies widely across the countries studied and is most influenced by political context and actor power dynamics. Ghana has placed relatively little national priority on childhood cancer, largely due to competing priorities and a lack of cohesion among stakeholders. In both El Salvador and Guatemala, actor power has played a central role in generating national priority for childhood cancer, where well-organized and -resourced civil society organizations have disrupted legacies of fragmented governance and financing to create priority for childhood cancer care. In India, the role of a uniquely empowered private actor was instrumental in creating political priority and establishing sustained channels of financing for childhood cancer care. In the Philippines, the childhood cancer community has capitalized on a window of opportunity to expand access and reduce disparities in childhood cancer care through the political prioritization of UHC and NCDs in current health system reforms. Conclusions The importance of key health system actors in determining the relative political priority for childhood cancer in the countries studied points to actor power as a critical enabler of prioritization in other LMIC. Responsiveness to political contexts–in particular, rhetorical and policy priority placed on NCDs and UHC–will be crucial to efforts to place childhood cancer firmly on national health agendas. National governments must be convinced of the potential for foundational health system strengthening through attention to childhood cancer care, and the presence and capability of networked actors primed to amplify public sector investments and catalyze change on the ground.

Background Infections are common and are a major cause of morbidity and mortality during treatment of childhood leukemia. We evaluated the cost effectiveness of levofloxacin antibiotic prophylaxis, compared to no prophylaxis, in children receiving chemotherapy for acute myeloid leukemia (AML) or relapsed acute lymphoblastic leukemia (ALL). Procedures A cost‐utility analysis was conducted from the perspective of the single‐payer health care system using a lifetime horizon. A comprehensive literature review identified available evidence for effectiveness, safety, costs of antibiotic prophylaxis in children with leukemia, and health utilities associated with the relevant health states. The effects of levofloxacin prophylaxis on health outcomes, quality‐adjusted life‐years (QALY), and direct health costs were derived from a combined decision tree and state‐transition model. One‐way deterministic and probabilistic sensitivity analyses were performed to test the sensitivity of results to parameter uncertainty. Results The literature review revealed one randomized controlled trial on levofloxacin prophylaxis in childhood AML and relapsed ALL, by Alexander et al, that showed a significant reduction in rates of fever and neutropenia (71.2% vs 82.1%) and bacteremia (21.9% vs 43.4%) with levofloxacin compared to no prophylaxis. In our cost‐utility analysis, levofloxacin prophylaxis was dominant over no prophylaxis, resulting in cost savings of $542.44 and increased survival of 0.13 QALY. In probabilistic sensitivity analysis, levofloxacin prophylaxis was dominant in 98.8% of iterations. Conclusions The present analysis suggests that levofloxacin prophylaxis, compared to no prophylaxis, is cost saving in children receiving intensive chemotherapy for AML or relapsed ALL.

Background:The JunB transcription factor is a key mediator of proliferation, apoptosis, differentiation, and the immune response. Results: JunB is a caspase substrate. Conclusion: Caspase-mediated cleavage of JunB generates a C-terminal fragment, that when overexpressed, functions as an inhibitor of AP-1-dependent transcription. Significance: We demonstrate a novel regulatory mechanism for an important transcription factor.

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