Letter to the Editor -- Who benefits from the professionalization of health promotion? / Lettre à la rédaction -- À qui profite la professionnalisation de la promotion de la santé?

In 2007, Health Promotion Ontario (HPO) began working to advance the "profession" of health promotion (HP) in Canada through development of national competencies for health promoters. Their work was continued by the Pan-Canadian Network for Health Promoter Competencies ("the Network"). Funded by the Public Health Agency of Canada, the Network aimed to address (1) the recommendation made by the Canadian Joint Task Group on Public Health Human Resources for function specific competencies (including "HP Specialists"); and (2) the marginalization health promoters face in practice. The current health promoter competencies were released in November 2015, following a series of literature reviews and practitioner consultations.

INTRODUCTION: En 2007, Health Promotion Ontario (HPO) a entrepris de faire progresser la « profession ¼ de praticien en promotion de la santé (PS) au Canada en établissant des compétences nationales à l'intention des promoteurs de la santé. Ce travail a été poursuivi par le Réseau pancanadien pour les compétences des promoteurs de la santé (« le Réseau ¼). Avec le financement de l'Agence de la santé publique du Canada, le Réseau a eu pour mandat, premièrement, de donner suite à la recommandation formulée par le Groupe de travail conjoint sur les ressources humaines en santé publique à propos des compétences spécifiques (notamment pour les « spécialistes de la promotion de la santé ¼) et, deuxièmement, de lutter contre la marginalisation que subissent les promoteurs de la santé dans l'exercice de leurs fonctions. Les compétences des promoteurs de la santé en vigueur actuellement ont été publiées en novembre 2015 à la suite d'une série de revues de la littérature et de consultations auprès de praticiens.

Discovery and spectroscopy of the young jovian planet 51 Eri b with the Gemini Planet Imager.

Directly detecting thermal emission from young extrasolar planets allows measurement of their atmospheric compositions and luminosities, which are influenced by their formation mechanisms. Using the Gemini Planet Imager, we discovered a planet orbiting the ~20-million-year-old star 51 Eridani at a projected separation of 13 astronomical units. Near-infrared observations show a spectrum with strong methane and water-vapor absorption. Modeling of the spectra and photometry yields a luminosity (normalized by the luminosity of the Sun) of 1.6 to 4.0 × 10(-6) and an effective temperature of 600 to 750 kelvin. For this age and luminosity, "hot-start" formation models indicate a mass twice that of Jupiter. This planet also has a sufficiently low luminosity to be consistent with the "cold-start" core-accretion process that may have formed Jupiter.

A review of the otological aspects of whiplash injury.

Approximately 10% of patients who have suffered with whiplash injury will develop otological symptoms such as tinnitus, deafness and vertigo. Some of these are purely subjective symptoms; nevertheless, for the majority there are specific tests that can be undertaken. These tests can quantify the extent and severity of the symptoms as well as provide guidance as to the correct rehabilitation pathway. This article reviews the body of literature relating to the otological aspects of whiplash injury and gives an overview for medical and legal professionals.

Myotonic dystrophy associated expanded CUG repeat muscleblind positive ribonuclear foci are not toxic to Drosophila.

Myotonic dystrophy type 1 is an autosomal dominant disorder associated with the expansion of a CTG repeat in the 3' untranslated region (UTR) of the DMPK gene. Recent data suggest that pathogenesis is predominantly mediated by a gain of function of the mutant transcript. In patients, these expanded CUG repeat-containing transcripts are sequestered into ribonuclear foci that also contain the muscleblind-like proteins. To provide further insights into muscleblind function and the pathogenesis of myotonic dystrophy, we generated Drosophila incorporating CTG repeats in the 3'-UTR of a reporter gene. As in patients, expanded CUG repeats form discrete ribonuclear foci in Drosophila muscle cells that co-localize with muscleblind. Unexpectedly, however, foci are not observed in all cell types and muscleblind is neither necessary nor sufficient for their formation. The foci are dynamic transient structures with short half-lifes that do not co-localize with the proteasome, suggesting they are unlikely to contain mis-folded proteins. However, they do co-localize with non-A, the human orthologs of which are implicated in both RNA splicing and attachment of dsRNA to the nuclear matrix. Muscleblind is also revealed as having a previously unrecognized role in stabilizing CUG transcripts. Most interestingly, Drosophila expressing (CUG)162 repeats has no detectable pathological phenotype suggesting that in contrast to expanded polyglutamine-containing proteins, neither the expanded CUG repeat RNA nor the ribonuclear foci are directly toxic.

Methylation target array for rapid analysis of CpG island hypermethylation in multiple tissue genomes.

Hypermethylation of multiple CpG islands is a common event in cancer. To assess the prognostic values of this epigenetic alteration, we developed Methylation Target Array (MTA), derived from the concept of tissue microarray, for simultaneous analysis of DNA hypermethylation in hundreds of tissue genomes. In MTA, linker-ligated CpG island fragments were digested with methylation-sensitive endonucleases and amplified with flanking primers. A panel of 468 MTA amplicons, which represented the whole repertoire of methylated CpG islands in 93 breast tumors, 20 normal breast tissues, and 4 breast cancer cell lines, were arrayed on nylon membrane for probe hybridization. Positive hybridization signals detected in tumor amplicons, but not in normal amplicons, were indicative of aberrant hypermethylation in tumor samples. This is attributed to aberrant sites that were protected from methylation-sensitive restriction and were amplified by PCR in tumor samples, while the same sites were restricted and could not be amplified in normal samples. Hypermethylation frequencies of the 10 genes tested in breast tumors and cancer cell lines were 60% for GPC3, 58% for RASSF1A, 32% for 3OST3B, 30% for HOXA5, 28% for uPA, 25% for WT1, 23% for BRCA1, 9% for DAPK1, and 0% for KL. Furthermore, hypermethylation of 5 to 7 loci of these genes was significantly correlated with hormone receptor status, clinical stages, and ages at diagnosis of the patients analyzed. This novel approach thus provides an additional avenue for assessing clinicopathological consequences of DNA hypermethylation in breast cancer.

Assembly and annotation of human chromosome 2q33 sequence containing the CD28, CTLA4, and ICOS gene cluster: analysis by computational, comparative, and microarray approaches.

Human chromosome 2q33 is an immunologically important region based on the linkage of numerous autoimmune diseases to the CTLA4 locus. Here, we sequenced and assembled 2q33 bacterial artificial chromosome (BAC) clones, resulting in 381,403 bp of contiguous sequence containing genes encoding a NADH: ubiquinone oxidoreductase, the costimulatory receptors CD28, CTLA4, and ICOS, and a HERV-H type endogenous retrovirus located 366 bp downstream of ICOS in the reverse orientation. Genomic microarray expression analysis using differentially activated T-cell RNA against a subcloned CTLA4/ICOS BAC library revealed upregulation of CTLA4 and ICOS sequences, plus antisense ICOS transcripts generated by the HERV-H, suggesting a potential mechanism for ICOS regulation. We identified four nonlinked, polymorphic, simple repetitive sequence elements in this region, which may be used to delineate genetic effects of ICOS and CTLA4 in disease populations. Comparative genomic analysis of mouse genomic Icos sequences revealed 60% sequence identity in the 5' UTR and regions between exon 2 and the 3' UTR, suggesting the importance of ICOS gene function.

Ethnic and gender differences in mental health utilization: the case of Muslim Jordanian and Moroccan Jewish Israeli out-patient psychiatric patients.

A sample of 148 (87 Jordanian [61 male, 26 female] and 61 Israeli [26 male, 35 female]) was selected from a psychiatric clinic in Ashdod Israel and Zarka Jordan, using convenience sampling methodology over a 12 month period in late 1997 and early 1998. A revised Hopkins Symptom Checklist: A Self-Report Symptom Inventory (HSCL) was translated into Arabic and Hebrew and distributed to subjects; additional questions explored demographic characteristics, forms of received treatment, patient perceptions of treatment efficacy, patient use of traditional healers, and patient explanation of etiology. Data revealed that there were differences in dimensions between the 2 groups based on nationality and gender. More Jordanians than Israelis expected medications as the main treatment, and unlike Israelis, no Jordanian patients received individual psychotherapy. Israelis expected medications, advice, directions, and instructions from psychiatrists. Both ethnic groups consulted a wide array of traditional healers, although precise types of healers varied according to gender and ethnicity. Israeli subjects gave more diverse explanations of mental health etiologies: physical, family, divorce, economic, unemployment; whereas Jordanians tended to emphasize divine and spiritual sources. Implications for psychiatric practice are discussed.

Use of the MMPI-A to detect substance abuse in a juvenile correctional setting.

In this study, we examined the ability of the MMPI-A (Butcher et al., 1992) to detect substance abuse problems in a juvenile correctional setting. Specifically, we evaluated the Alcohol/Drug Problem Acknowledgment scale (ACK; Weed, Butcher, & Williams, 1994), the Alcohol/Drug Problem Proneness scale (PRO; Weed et al., 1994), and the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992) in the prediction of substance abuse. In addition, the incremental validity of ACK in comparison to PRO was evaluated, as was the incremental validity of PRO in comparison to ACK. The sample consisted of 123 boys and girls from ajuvenile correctional facility in Northeastern Ohio. Results indicate that ACK and PRO, but not MAC-R, were related to interviewer ratings of substance abuse. Results point to the superiority of ACK over PRO in substance abuse identification.

Gendered utilization differences of mental health services in Jordan.

A revised Hopkins Symptom Checklist (HSCL), translated into Arabic, was distributed to a sample of 87 nonpsychotic mental health out-patients in Zarka, Jordan (male = 61, female = 26). Findings revealed no significant gendered differences, but higher responses among women in all dimensions. Regardless of gender, patients also expected and were satisfied with medicinal treatment; explained etiologies as having supernatural origins; and utilized informal community traditional healing and religious healing systems. The supernatural explanations and community healing systems varied by gender. Findings emphasize future treatment and programme development strategies that take into account the biomedical/traditional interface, culturally appropriate treatment modalities, different gendered patient needs, and the potential stigma of professional treatment.

Development of an Infrequency-Psychopathology scale for the MMPI-A: the Fp-A Scale.

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

Detection of coached general malingering on the MMPI-2.

The current study examined the effects of validity-scale coaching on one's ability to feign general psychopathology. College students were coached on malingering strategies and completed the MMPI-2. Their responses were compared with students asked to malinger psychopathology without validity-scale coaching and with psychiatric inpatients completing the MMPI-2 under standard instructions. In accordance with previous research (e.g., J. R. Graham, D. Watts, & R. E. Timbrook, 1991), uncoached malingerers were adequately discriminated from patients by using the Infrequency (F) scale. However, as suggested by previous research (R. Rogers, R. M. Bagby, & D. Chakraborty, 1993), the F scale was not as effective at classifying coached malingerers. It was found that other validity indicators, such as the Infrequency Psychopathology Scale were more accurate at discriminating between coached malingerers and hospitalized patients.

Culturally sensitive social work practice with Arab clients in mental health settings.

Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.

Gender and biomedical/traditional mental health utilization among the Bedouin-Arabs of the Negev.

Twenty Bedouin-Arab non-psychotic subjects in Israel (10 male, 10 female) utilized biomedical and traditional healing mental health care systems. Common patterns of utilization were observed: first to family/friends, then to a general practitioner, next to a traditional healer, and finally to a psychiatrist. Men were more familiar with the biomedical system, and women with the traditional. Women, more than men, made group utilization decisions; men, more than women, saw traditional healers outsider their home communities. Gender differences were found in symptomatology and in patient construction of etiology. The biomedical system successfully addressed physical symptoms. The traditional system struck a stronger therapeutic alliance, tended to diagnose more comprehensibly, and was perceived by many patients as being more clinically beneficial. Biomedical practitioners can learn from traditional healers how to read a client's ecological map, incorporate the family/community in treatment, and communicate in the patient's cultural idiom. In their search for models of traditional/biomedical system integration, scholars should turn to patients themselves, who are currently living such integration.

Social work intervention with Bedouin-Arab children in the context of blood vengeance.

Blood vengeance is a culturally specific phenomenon that can place Bedouin-Arab children at high risk of neglect. This case study examines the psychological and social implications of vengeance on children, the children's coping strategies, and the role of social work. The social work function includes nonauthoritarianism, strategies for forming a positive helping alliance, and various forms of culturally sensitive assessment and intervention. The study therefore yields insight into bridging the emic-etic gap in conceptualizing and responding to child neglect in a non-Western society.

Effects of nutrient intake and number of oestrous cycles on in vitro development of preimplantation pig embryos.

The effects of nutrient intake and insemination of gilts at first versus third oestrus on the in vitro development of preimplantation pig embryos were investigated. Standard swine management involves ad libitum feeding of gilts at first oestrus and restricted feeding of gilts at third oestrus. According to previous research, gilts inseminated at first oestrus demonstrate greater embryonic mortality than gilts inseminated at third oestrus, and it is possible that differences in nutrient intake between gilts inseminated at first versus third oestrus affect the viability of eggs or embryos. In the present study, experimental gilts were assigned to three treatments: animals designated 1A were inseminated at first oestrus and fed ad libitum; animals designated 3R were inseminated at third oestrus and were fed a restricted diet; and 3A animals were inseminated at third oestrus and fed ad libitum. Embryos collected from each treatment group were cultured in vitro, and data were evaluated according to cell stage at collection. Comparison of treatments 1A and 3R supported the contention of increased embryo mortality in gilts inseminated at first oestrus under normal management conditions. When cultures were initiated at the one- to two-cell or two- to four-cell stages, the percentage of 1A embryos developing to the morula stage (50.9%, 68.0%) was significantly lower than that of 3R embryos (88.9%, 90.9%; P < 0.05). Comparison of treatments 1A and 3A addressed effects due to the number of oestrous cycles. Significantly more two- to four-cell embryos from gilts inseminated at third oestrus and fed ad libitum reached the morula and expanded blastocyst stages of development (87.0%, 41.3%) compared with embryos from gilts inseminated at first oestrus and fed ad libitum (68.0%, 20.3%; P < 0.05). Finally, the effects of ad libitum feeding were determined by comparing treatments 3A and 3R. These data were inconclusive, as both positive and negative effects were observed. More one- to two-cell embryos from treatment 3R developed to the morula stage (88.9%) compared with 3A embryos collected at the same stage (64.7%), whereas a greater number of 3A embryos in the two- to four-cell category reached the expanded blastocyst stage (41.3%) than 3R embryos (21.2%; P < 0.05). These results support the hypothesis of lower in vitro developmental capacity for embryos collected from gilts inseminated at first oestrus. Furthermore, the findings indicate that differences in embryo viability between gilts inseminated at first versus third oestrus are related to the number of oestrous cycles and possibly to differential nutrition.

Long-term stability of MMPI-A scales.

Adolescents (24 boys, 37 girls) from public school settings were given the MMPI-A on 2 occasions with approximately 1 year between testing sessions. Long-term stability of validity, clinical, content, supplementary, and the new Psychopathology Five scales are examined and correlation coefficients are presented. The reliabilities of the MMPI-A scales are consistent with previously reported data. In addition, improvements made during development of the MMPI-A may have led generally to modest increases in stability of the clinical scales for adolescents. Given the importance of both short-term and long-term test-retest data in the evaluation of the validity of an assessment instrument, this study represents an important step in evaluating the validity of the MMPI-A for assessment of personality.