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1.
In a previous article we reported that mutations favoring cancer at adulthood seemed to improve fertility and limit miscarriages. Because spontaneous abortion may result from anomalies in embryo, we questioned if an increased frequency of congenital malformation could be evidenced among cancer-prone families. Oncogenetics database (≈193 000 members) of the comprehensive cancer center Jean Perrin was crossed with regional registry of congenital malformations (≈10 000). Among children born between 1986 and 2011, 176 children with malformation matched in both databases. In breast/ovaries cancer-prone families, the risk for malformations was multiplied by 2.4 [1.2-4.5] in case of a BRCA1 mutation. Frequencies of malformation in BRCA2 and MMR mutated families were similar to families without a cancer syndrome. In comparison to malformations concerning a unique anatomical system, multimalformations were significantly more frequent in case of BRCA or MMR mutations: compared to families without cancer syndrome, the risk of multimalformations was multiplied by 4.1 [0.8-21.7] for cancer-prone families but with no known deleterious mutation, by 6.9 [1.2-38.6] in families with a known mutation but an unknown parental mutational status and by 10.4 [2.3-46.0] when one parent carried the familial mutation. No association with the type of anatomical system was found, nor with multiple births. These results suggest that BRCA and MMR genes play an important role in human embryogenesis and that if their function is lowered because of heterozygote mutations, congenital malformations are either more likely (BRCA1 mutations) and/or more susceptible to concern several anatomical systems.  相似文献   
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Background

One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine.

Objective

This study investigates the perspectives of Ontario pharmacy patrons, who had not recently received this vaccine from a pharmacist, regarding this pharmacist service.

Methods

A survey was administered in six Ontario community pharmacies to pharmacy patrons who had not received an influenza vaccination from a pharmacist during the previous year. The instrument included questions about influenza vaccination, and knowledge of and attitudes toward vaccines and pharmacist-administered immunization.

Results

A total of 541 pharmacy patrons completed the survey (53.9% response rate). About one-third (30.5%) of respondents were not aware that pharmacists could give the influenza vaccine, with younger individuals being less likely to be aware (OR 0.48, 95% CI 0.29–0.77, p?<?0.05) and less likely to receive the vaccine annually (OR 0.28, 95% CI 0.19–0.42, p?<?0.05). Leading reasons respondents gave as to why they did not receive their influenza vaccine from a pharmacist included not wanting or feeling they needed to be immunized (41.6%) and being used to receiving the vaccine from a physician (16.5%). Concerns about the experience and training of pharmacists and lack of privacy in a community pharmacy were uncommon.

Conclusion

Reduced awareness of the availability of pharmacist-provided influenza vaccine is still common. Pharmacists have a significant opportunity to address lack of awareness and vaccine hesitancy issues. They can promote this service to increase influenza vaccination rates among pharmacy patrons who do not utilize this professional service.  相似文献   
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Familial Cancer - The risk of radiotherapy-induced malignancies (RIMs) is a concern when treating Li–Fraumeni syndrome (LFS) or Li–Fraumeni Like (LFL) patients. However, the type of...  相似文献   
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Rates of smoking during pregnancy remain high in Canada, and cessation rates are low among women who are younger than 24 years and who are socially disadvantaged, that is, have few social and economic resources because of poverty, violence, or mental health issues. On the basis of findings from literature reviews and consultation with policy makers, we developed and operationalized four approaches that can be used by health care providers to tailor interventions for tobacco use in pregnancy. These four approaches are woman centered, trauma informed, harm reducing, and equitable. Public health initiatives that address smoking in young and socially disadvantaged women could be more sharply focused by shifting to such tailored approaches that are grounded in social justice aims, span pre- and postpregnancy periods, and can be used to address women’s social contexts and concerns.  相似文献   
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Using the SF-12 to measure physical and mental functioning, the authors examine the intra-individual changes in health-related quality of life (HRQOL) 6 months post-discharge for depressed older adults. In addition, they examine three sets of predictors that might influence these changes. The sample of depressed older adults was recruited from an inpatient geropsychiatry unit. Although their physical and mental health scores on the SF-12 were lower than comparable norms, the sample showed an average increase in their mental functioning but a decrease in the physical functioning over the 6 months. Negative life-events were significant predictors of people who reported no change in their mental health functioning and decreases in their physical health functioning. Interestingly, those who experienced positive life events were more likely to report declines and younger participants were more likely to report no change in their physical functioning. The findings indicate that the effects of depression on HRQOL can have enduring effects on a sample of previously hospitalized older adults. The significance of life event changes might signify the importance of taking into account non-traditional areas of medical interventions. Further, the findings indicate the usefulness of the SF-12 quantifying HRQOL outcomes.  相似文献   
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