Community Pharmacists and Influenza Vaccination: Opportunities and Challenges From a Public Health Perspective.

Context: In Quebec, Bill 31, adopted on March 18, 2020, extended vaccination to pharmacists. Despite many advantages, this new practice comes with public health issues reinforced in the context of COVID-19. Therefore, it is essential to understand the opportunities and challenges of the participation of community pharmacists in influenza vaccination, from a public health perspective by (i) describing the year of 2020-2021 influenza vaccination offer, (ii) its opportunities and challenges, and (iii) its impact on the accessibility of this service newly offered by pharmacists to the most vulnerable people. Methods: This research is a case study from one of the most affected areas by COVID-19 in Canada: Laval. Our method combines documentary analysis and semi-structured interviews with health professionals and public health actors (n = 23). Researchers used a thematic analysis to analyze these results. Results: Most partners (pharmacists, public health administrators) underlined multiple opportunities of this new practice, ie, pharmacists who can vaccinate, particularly for chronically ill patients. However, structural and strategical challenges remain. More specifically, vaccination seemed to only rely on a "first come, first served" basis, which questions public health objectives of vaccination, such as equitable access. Conclusion: The introduction of new actors, such as pharmacists, represents a major opportunity to improve vaccination coverage and reduce the burden of COVID-19 on the health system. However, this delegation of a public health activity to the private sector undoubtedly requires closer coordination with public health institutions.

Diagnosis, Prevalence, Awareness, Treatment, Prevention, and Control of Hypertension in Cameroon: Protocol for a Systematic Review and Meta-Analysis of Clinic-Based and Community-Based Studies.

BACKGROUND: Hypertension holds a unique place in population health and health care because it is the leading cause of cardiovascular disease and the most common noncommunicable condition seen in primary care worldwide. Without effective prevention and control, raised blood pressure significantly increases the risk of stroke, myocardial infarction, chronic kidney disease, heart failure, dementia, renal failure, and blindness. There is an urgent need for stakeholders-including individuals and families-across the health system, researchers, and decision makers to work collaboratively for improving prevention, screening and detection, diagnosis and evaluation, awareness, treatment and medication adherence, management, and control for people with or at high risk for hypertension. Meeting this need will help reduce the burden of hypertension-related disease, prevent complications, and reduce the need for hospitalization, costly interventions, and premature deaths. OBJECTIVE: This review aims to synthesize evidence on the epidemiological landscape and control of hypertension in Cameroon, and to identify elements that could potentially inform interventions to combat hypertension in this setting and elsewhere in sub-Saharan Africa. METHODS: The full search process will involve several steps, including selecting relevant databases, keywords, and Medical Subject Headings (MeSH); searching for relevant studies from the selected databases; searching OpenGrey and the Grey Literature Report for gray literature; hand searching in Google Scholar; and soliciting missed publications (if any) from relevant authors. We will select qualitative, quantitative, or mixed-methods studies with data on the epidemiology and control of hypertension in Cameroon. We will include published literature in French or English from electronic databases up to December 31, 2016, and involving adults aged 18 years or older. Both facility and population-based studies on hypertension will be included. Two reviewers of the team will independently search, screen, extract data, and assess the quality of selected studies using suitable tools. Selected studies will be analyzed by narrative synthesis, meta-analysis, or both, depending on the nature of the data retrieved in line with the review objectives. RESULTS: This review is part of an ongoing research program on disease prevention and control in the context of the dual burden of communicable and noncommunicable diseases in Africa. The first results are expected in 2017. CONCLUSIONS: This review will provide a comprehensive assessment of the burden of hypertension and control measures that have been designed and implemented in Cameroon. Findings will form the knowledge base relevant to stakeholders across the health system and researchers who are involved in hypertension prevention and control in the community and clinic settings in Cameroon, as a yardstick for similar African countries. TRIAL REGISTRATION: PROSPERO registration number: CRD42017054950; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42017054950 (Archived by WebCite at http://www.webcitation.org/6qYSjt9Jc).

[Alternative medicine, from North America to East Asia: between persistent exclusion and embodied pluralism]. / Médecines alternatives, du continent nord-américain à l'Asie orientale - Entre exclusion réitérée et pluralisme incorporé.

At a time of growing interest in integrative approaches to health and care, this article examines, from a historical perspective, the factors underlying the global popularity of so-called complementary and alternative medicines (CAM). Focusing on the multiple and changing meanings of the concepts used with reference to CAM since the nineteenth century, it emphasizes the agency of CAM practitioners' and calls into question a linear progression from outright exclusion to gradual inclusion into mainstream health care systems. This analysis concludes that biomedicine and "other" medical systems have mutually defined each other in a process of co-production that has had a significant impact on the medicalization of contemporary societies from North America to East Asia.

Understanding Vaccine Hesitancy in Canada: Results of a Consultation Study by the Canadian Immunization Research Network.

"Vaccine hesitancy" is a concept now frequently used in vaccination discourse. The increased popularity of this concept in both academic and public health circles is challenging previously held perspectives that individual vaccination attitudes and behaviours are a simple dichotomy of accept or reject. A consultation study was designed to assess the opinions of experts and health professionals concerning the definition, scope, and causes of vaccine hesitancy in Canada. We sent online surveys to two panels (1- vaccination experts and 2- front-line vaccine providers). Two questionnaires were completed by each panel, with data from the first questionnaire informing the development of questions for the second. Our participants defined vaccine hesitancy as an attitude (doubts, concerns) as well as a behaviour (refusing some / many vaccines, delaying vaccination). Our findings also indicate that both vaccine experts and front-line vaccine providers have the perception that vaccine rates have been declining and consider vaccine hesitancy an important issue to address in Canada. Diffusion of negative information online and lack of knowledge about vaccines were identified as the key causes of vaccine hesitancy by the participants. A common understanding of vaccine hesitancy among researchers, public health experts, policymakers and health care providers will better guide interventions that can more effectively address vaccine hesitancy within Canada.

Colonised and neurasthenic: from the appropriation of a word to the reality of a malaise de civilisation in urban French Vietnam.

Neurasthenia remains an important health problem in certain Asian populations, both in Asia as well as in a diasporic context. An anachronistic disease for Western observers, it has become an exotic culture-bound syndrome as well as a somatoform disorder too often hiding much more serious issues of depression. This article approaches this 'problematic' health issue from a historian's point of view and offers a colonial genealogy that will discuss neurasthenia's outline in French Vietnam. By retracing and analysing the different mentions, definitions, and uses of the term neurasthenia in the interwar period, it aims to better understand certain historical realities that might have shaped the local identity and spatiality of this problem (concentrated in colonial cities in which social change and modernity were expressed in their most salient forms), and perhaps even identify reasons that facilitated its post-colonial survival.

[Comment on the perception of risk and its relationship to advancements in health knowledge]. / Comment l'analyse profane du risque peut-elle contribuer à l'avancement des savoirs en santé?

Since World War II, industrialized Western societies have been making significant public investments that have yielded spectacular improvements in the health status of their populations. Yet despite such considerable strides, it is nonetheless evident that lay peoples are expressing both more scepticism than in the past and greater mistrust toward medical science and biomedicine, even as they show increasing concern about health risks. In this article we intend to discuss some of the broader opportunities that the analysis of lay risk perceptions offers for appreciating the concerns of lay peoples about health-related issues as well as to provide new insights in population health.