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Salmon A.,Womens Health Research Institute | Salmon A.,University of British Columbia
Critical Public Health | Year: 2011

Over the past 25 years, Aboriginal leaders, community advocates, children's and women's health specialists and Canadian government agencies have drawn increasing attention to the perceived need to undertake targeted initiatives to prevent fetal alcohol spectrum disorder (FASD) in indigenous communities. In pursuit of this goal, a range of prevention campaigns have been undertaken - generally with funding from the State - urging pregnant women to abstain from alcohol. Because both risk and protective factors for FASD are intimately connected to the social conditions in which women become pregnant, give birth to and mother their children, FASD prevention campaigns targeting Aboriginal communities suggest possibilities that are both provocative and problematic for advancing movements for social justice, decolonisation and improved maternal and child health. In this essay, I consider how the gendered and racialised legacies of colonisation emerge alongside concerns for improved health and well-being of indigenous children to inform contemporary, state-funded efforts to prevent FASD. In so doing, I examine the ways that neoliberal economic and political trajectories of Canadian state formation intersect with some aspects of decolonisation movements to raise important questions about when, how and under what conditions colonial states support FASD prevention efforts among indigenous peoples. © 2011 Taylor & Francis.

Pugash D.,University of British Columbia | Hendson G.,University of British Columbia | Dunham C.P.,University of British Columbia | Dewar K.,Womens Health Research Institute | And 2 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2012

Objectives Prenatal development of the brain is characterized by gestational age-specific changes in the laminar structure of the brain parenchyma before 30 gestational weeks. Cerebral lamination patterns of normal fetal brain development have been described histologically, by postmortem in-vitro magnetic resonance imaging (MRI) and by in-vivo fetal MRI. The purpose of this study was to evaluate the sonographic appearance of laminar organization of the cerebral wall in normal and abnormal brain development. Methods This was a retrospective study of ultrasound findings in 92 normal fetuses and 68 fetuses with abnormal cerebral lamination patterns for gestational age, at 17-38 weeks' gestation. We investigated the visibility of the subplate zone relative to the intermediate zone and correlated characteristic sonographic findings of cerebral lamination with gestational age in order to evaluate transient structures. Results In the normal cohort, the subplate zone-intermediate zone interface was identified as early as 17 weeks, and in all 57 fetuses examined up to 28 weeks. In all of these fetuses, the subplate zone appeared anechoic and the intermediate zone appeared homogeneously more echogenic than did the subplate zone. In the 22 fetuses between 28 and 34 weeks, there was a transition period when lamination disappeared in a variable fashion. The subplate zone-intermediate zone interface was not identified in any fetus after 34 weeks (n = 13). There were three patterns of abnormal cerebral lamination: (1) no normal laminar pattern before 28 weeks (n = 32), in association with severe ventriculomegaly, diffuse ischemia, microcephaly, teratogen exposure or lissencephaly; (2) focal disruption of lamination before 28 weeks (n = 24), associated with hemorrhage, porencephaly, stroke, migrational abnormalities, thanatophoric dysplasia, meningomyelocele or encephalocele; (3) increased prominence and echogenicity of the intermediate zone before 28 weeks and/or persistence of a laminar pattern beyond 33 weeks (n = 10), associated with Type 1 lissencephaly or CMV infection. There was a mixed focal/diffuse pattern in two fetuses. In CMV infection, the earliest indication of the infection was focal heterogeneity and increased echogenicity of the intermediate zone, which predated the development of microcephaly, ventriculomegaly and intracranial calcification. Conclusions The fetal subplate and intermediate zones can be demonstrated reliably on routine sonography before 28 weeks and disappear after 34 weeks. These findings represent normal gestational age-dependent transient laminar patterns of cerebral development and are consistent with histological studies. Abnormal fetal cerebral lamination patterns for gestational age are also visible on sonography, and may indicate abnormal brain development. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

Sklepkiewicz P.,York College | Shiomi T.,York College | Kaur R.,York College | Sun J.,York College | And 7 more authors.
Circulation: Heart Failure | Year: 2015

Background-The Wnt/β-catenin signaling pathway plays a central role during cardiac development and has been implicated in cardiac remodeling and aging. However, the role of Wnt modulators in this process is unknown. In this study, we examined the role of the Wnt signaling inhibitor secreted frizzled-related protein-1 (sFRP-1) in aged wild-type and sFRP-1-deficient mice. Methods and Results-sFRP-1 gene deletion mice were grossly normal with no difference in mortality but developed abnormal cardiac structure and dysfunction with progressive age. Ventricular dilation and hypertrophy in addition to deterioration of cardiac function and massive cardiac fibrosis, all features present in dilated cardiomyopathy, were observed in the aged sFRP-1 knockout mice. Loss of sFRP-1 led to increased expression of Wnt ligands (Wnt1, 3, 7b, and 16) and Wnt target genes (Wisp1 and Lef1) in aged hearts, which correlated with increased protein levels of β-catenin. Cardiac fibroblasts lacking endogenous sFRP-1 showed increased φ-smooth muscle actin expression, higher cell proliferation rates, and increased collagen production consistent with the cardiac phenotype exhibited in aged sFRP-1 knockout mice. The clinical relevance of these findings was supported by the demonstration of decreased sFRP-1 gene expression and increased Wisp-1 levels in the left ventricles of patients with ischemic dilated cardiomyopathy and dilated cardiomyopathy. Conclusions-This study identifies a novel role of sFRP-1 in age-related cardiac deterioration and fibrosis. Further exploration of this pathway will identify downstream molecules important in these processes and also suggest the potential use of Wnt signaling agents as therapeutic targets for age-related cardiovascular disorders in humans. © 2015 American Heart Associations, Inc.

Riddell L.,Womens Hospital and Health Center | Varto H.,Vancouver Coastal Health Research Institute | Hodgson Z.G.,Womens Health Research Institute
Canadian Journal of Human Sexuality | Year: 2010

This exploratory, descriptive study investigated the motivations and practices behind the phenomenon of pubic hair removal among women. A final sample of 660 women aged 16-50 years who had ever removed their pubic hair completed surveys asking about their reasons for, methods of, and side effects associated with this practice. Based on their usual practices for areas of hair removal, bikini line was reported by about 50% of participants and whole pubic area by about 30%. Shaving, salon waxing, and trimming with scissors were the most common usual methods although many more reported having ever tried more than one of these or other methods. Appearance in a bathing suit was the most common reason given for pubic hair removal followed by feeling attractive and by the notion that pubic hair removal is cleaner. Side effects ever experienced were common and included razor bump and ingrown hairs but also rash, pimples, and cuts among other less common types of pubic skin traumatization. Further research is proposed to better understand the social constructs of pubic hair removal and to develop best practice guidelines for health professionals in relation to this phenomenon.

Swigris J.J.,Autoimmune Lung Center and Interstitial Lung Disease Program | Lee H.-S.,University of South Florida | Cohen M.,Womens Health Research Institute | Inoue Y.,National Hospital Organization Kinki Chou Chest Medical Center | And 4 more authors.
Chest | Year: 2013

Background: Lymphangioleiomyomatosis (LAM) is an uncommon, progressive, cystic lung disease that causes shortness of breath, hypoxemia, and impaired health-related quality of life (HRQL). Whether St. George's Respiratory Questionnaire (SGRQ), a respiratory-specific HRQL instrument, captures longitudinal changes in HRQL in patients with LAM is unknown. Methods: Using data from the Multicenter International Lymphangioleiomyomatosis Efficacy and Safety of Sirolimus trial, we performed analyses to examine associations between SGRQ scores and values for four external measures (anchors). Anchors included (1) FEV1, (2) diffusing capacity of the lung for carbon monoxide, (3) distance walked during the 6-min walk test, and (4) serum vascular endothelial growth factor-D. Results: SGRQ scores correlated with the majority of anchor values at baseline, 6 months, and 12 months. Results from longitudinal analyses demonstrated that SGRQ change scores tracked changes over time in values for each of the four anchors. At 12 months, subjects with the greatest improvement from baseline in FEV1 experienced the greatest improvement in SGRQ scores (Symptoms domain, -13.4 ± 14.6 points; Activity domain, -6.46 ± 8.20 points; Impacts domain, -6.25 ± 12.8 points; SGRQ total, -7.53±10.0 points). Plots of cumulative distribution functions further supported the longitudinal validity of the SGRQ in LAM. Conclusions: In LAM, SGRQ scores are associated with variables used to assess LAM severity. The SGRQ is sensitive to change in LAM severity, particularly when change is defined by FEV1, perhaps the most clinically relevant and prognostically important variable in LAM. The constellation of results here supports the validity of the SGRQ as capable of assessing longitudinal change in HRQL in LAM. © 2013 American College of Chest Physicians.

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