Beneficial Effects of Multi-Micronutrient Supplementation with Collagen Peptides on Global Wrinkles, Skin Elasticity and Appearance in Healthy Female Subjects.

INTRODUCTION: With ageing, collagen production slows down, leading to wrinkle appearance and loss of elasticity. Replenishing key structural molecules through oral supplementation is a promising strategy that complements the topical delivery of cosmetic products and creates a holistic skincare regimen. The present study assessed the effectiveness of a food supplement with collagen peptides, vitamins and minerals in improving the quality of the skin and general wellbeing of healthy women. METHODS: This was an open-label study of 135 women aged between 45 and 65 years. A 3-month treatment phase followed a 4-week washout phase, with visits scheduled at baseline and after each month of treatment. Subjects received three tablets of Richelet Skin Renewal daily. The primary outcome was change from baseline to month 3 in global wrinkles score by expert grader analysis. Secondary outcomes included changes in skin elasticity and other skin attributes, product assessment via self-perception questionnaires and total antioxidant status. RESULTS: A total of 116 subjects completed the study. The mean global wrinkles score indicated a statistically significant decrease from 5.9 at baseline to 5.0 at month 3 (p < 0.0001), with 83.6% of subjects showing an improvement; significant changes were reported at all intermediate visits. The increase in skin elasticity was also statistically significant (R2 score 0.74 at month 3; p < 0.0001). All subjects (100%) demonstrated significant improvements in skin texture, skin tone evenness, skin radiance and overall skin quality at the month 3 visit. CONCLUSIONS: The study product achieved statistically significant, noticeable effects on global wrinkles, skin elasticity and a range of skin attributes after 3 months of use in healthy women. These results strengthen the evidence for supplementation of collagen peptides and other micronutrients as an effective component of anti-ageing skincare.

Towards an evolutionary approach to learning from assumptions: Lessons from the evaluation of Dancing with Parkinson's.

This paper highlights how learnings from exploring assumptions can be strengthened by taking an evolutionary approach to theory building and analysis. We discuss theory-driven evaluation applied to a community-based intervention implemented by Dancing With Parkinson's in Toronto, Canada, targeting Parkinson's disease (PD), a neurodegenerative condition affecting movement. A major gap in the literature is understanding the mechanisms by which dance might make a difference in the daily lives of people living with PD. This study was an early exploratory evaluation to better understand mechanisms and short-term outcomes. Conventional thinking generally favors "permanent" over "transitory" changes, and "long-term" over "short-term" effects. Yet, for people living with degenerative conditions (and also people experiencing chronic pain and other chronic symptoms), transitory and short-term changes may be highly valued and welcomed relief. In order to study and link multiple longitudinal events to explore key linkages in the theory of change, we piloted the use of diaries, with brief entries filled out daily by participants. The aim was to better understand the short-term experiences of participants using their daily routines as a means of learning about potential mechanisms, what matters to participants, and to see if small effects could be observed on days when participants danced versus days when they did not dance and also longitudinally over several months. Our initial theoretical stance began with a view of dance as exercise and the well-established benefits of exercise; yet, we explored through the diary data collected, as well as client interviews and literature review, potential other mechanisms of dancing (such as group interaction, touch, stimulation by the music, and esthetics including "feeling lovely"). This paper does not develop a full, comprehensive theory of dance but moves towards a more comprehensive view that locates dance within the routine activities of participants' daily lives. We argue that given the challenges of evaluating complex interventions comprising multiple, interacting components, there is a need for an evolutionary learning process to understand heterogeneities in mechanisms -- what works for whom -- when faced with knowledge incompleteness in the theory of change.

Nothing about me without me: The central role of program beneficiaries in developing theories of change.

This paper discusses the central importance of involving program recipients in the initial development of the theory of change. Through an example of a drop-in located in the inner-city of Toronto, we describe how, first, theories of change based on funder and even staff perspectives may have program goals that do not connect with the lives and values of clients. Second, engagement with clients should surface heterogeneities in their expectations; many theories of change, even when they are developed with clients, assume there is a 'homogenous' clientele. Third, programs that address the needs of marginalized individuals need to pay attention to the dynamics of marginalization. These points have consequences for the development of the initial theories of change.

Successes and challenges of speech language therapy service provision in Western Kenya: Three case studies.

BACKGROUND: The need for communication-related services in sub-Saharan Africa to support individuals experiencing communication disability is a longstanding and well-documented situation. We posit the inequities highlighted by coronavirus disease 2019 (COVID-19) make this a relevant time for speech language therapists and the professional bodies that govern us to broadly consider our roles and practices in education, health and disability in local, national and global contexts. OBJECTIVE: To illustrate what services developed with local knowledge can look like in Kenya in order to promote dialogue around alternative speech language therapy models, particularly in contexts where there are insufficient services, few trained speech language therapists and limited structures to support the emerging profession. METHOD: This article examines three clinical case studies from Western Kenya, using a conceptual framework for responsive global engagement. RESULTS: Service needs in Western Kenya well exceed a direct one-on-one model of care that is common in the minority world. The service delivery models described here emphasise training, skills sharing and engaging the myriad of communication partners available to individuals with communication disabilities. CONCLUSION: We offer up these case studies of collaborative practice as contextual realities that may be present in any speech language therapy programming in under-resourced communities. We dispel the idea that success in this work has been linear, progressed on planned time frames or come to fruition with targeted goal attainment. The fact that our relationships have endured in these communities since 2007 is our primary success.

Speech-language pathology and ethical practice in global contexts.

Given the growing professional interest of speech-language pathologists (SLP) in global development work and the opportunities for minority world health providers to use their skills internationally, conversations about what SLPs do when working in majority world settings, and how they do it are imperative. This paper presents case studies of speech-language pathology work in global settings examined within the context of ethical frameworks developed by: The American Speech-Language-Hearing Association, Speech-Language and Audiology Canada, and Speech Pathology Australia. These case studies drawn from personal experiences working as SLPs in majority world contexts are used to discuss the following issues: (1) the need for honest and reflective conversations about SLPs' motivations for engagement in global work; (2) the need to consider how funds are used to have the biggest and most sustainable impact on emerging professional contexts; (3) the necessity of long-term mutually beneficial global partnerships; (4) critical examination of culturally appropriate speech-language pathology services and recommendations; (5) learning to listen to majority world colleagues; (6) creating opportunities for majority world colleagues to represent themselves at conferences, meetings and in the literature, and; (7) the crucial role university staff play in fostering ethical and sustainable speech-language pathology practices.

Evaluating Dancing With Parkinson's: Reflections from the perspective of a community organization.

In 2015, Dancing With Parkinson's (DWP), a Toronto-based community organization, participated in the Ontario Brain Institute's (OBI) newly launched Evaluation Support Program. This paper reflects on that experience. In particular, we identify the key lessons derived from the OBI initiative, discuss how these lessons have informed DWP practice going forward, and highlight what we consider to be the most valuable aspects of the Evaluation Support Program. While we now recognize the need to establish an evaluation culture within DWP, we find that there are significant challenges associated with both building and sustaining evaluation capacity in the context of a small community-based organization. Whereas DWP has built considerable strengths in terms of informal evaluation capacity, on its own, such capacity is insufficient to, for example, demonstrate DWP's impact to outside audiences or successfully scale up the program.

Towards an understanding of the multilevel factors associated with maternal health care utilization in Uttar Pradesh, India.

BACKGROUND: This paper explores the multilevel factors associated with maternal health utilization in India's most populous state, Uttar Pradesh. 3 key utilization practices: registration of pregnancy, receipt of antenatal care, and delivery at home are examined for district and individual level predictors. The data is based on 5666 household surveys conducted as part of a baseline evaluation of the Uttar Pradesh Technical Support Unit (UPTSU.) program. OBJECTIVES: This intervention aims to assist the Government of Uttar Pradesh in increasing the efficiency, effectiveness, and equity of service delivery across a continuum of reproductive, maternal, new-born, child, and adolescent health (RMNCH+A) outcomes. METHODS: The paper employs multilevel models that control for individuals being nested within districts in order to understand the predictors of maternal health care utilization. RESULTS: The study identifies several individual-level predictors of health care utilization, including: literacy of the woman, the husband's schooling, age at marriage, and socio-economic factors. Key predictors of pregnancy registration include husband's schooling (OR 1.49, 95% CI 1.26-1.76), having a bank account (OR 1.36, 95% CI 1.11-1.68), and owning a house (OR 2.28, 95% CI 1.85-2.80). Factors affecting antenatal care include the woman's literacy (OR 1.49, 95% CI 1.28-1.73), the respondent having had a job in the last year (OR 1.39, 95% CI 1.10-1.77), and owning a house (OR 2.83, 95% CI 2.27-3.53). Home delivery tends to be associated with woman's literacy (OR 0.62, 95% CI 0.54-0.72) and marriage age of 15 and younger (OR 1.48, 95% CI 1.26-1.73). CONCLUSIONS: Interventions having equity considerations need to disrupt existing patterns of the health gradient. Successful implementation of such interventions, necessitate understanding the mechanisms that can disrupt the unequal utilization patterns and target domains of disadvantage. Knowledge of key predictors of utilization can aid in the implementation of such complex interventions.