The experiences of Indigenous people with cancer in Saskatchewan: a patient-oriented qualitative study using a sharing circle.

BACKGROUND: Although disparities in cancer rates, later diagnoses and lower survival rates between Indigenous and non-Indigenous people have been documented, little is known about how Indigenous patients with cancer encounter the health care system. We explored perceptions and experiences of Indigenous patients with cancer and their families to understand better how 2 key concepts - trust and world view - influence cancer care decisions. METHODS: In this patient-oriented study that included participation of 2 patient partners, qualitative data were collected from Indigenous patients with cancer and their families using an Indigenous method of sharing circles. The sharing circle occurred at a culturally appropriate place, Wanuskewin Heritage Park, Saskatoon, on Sept. 22, 2017. The first patient partner started the sharing circle by sharing their cancer journey, thus engaging the Indigenous methodology of storytelling. This patient partner was involved in selecting the data collection method and recruiting participants through snowballing and social media. Trust and world view were employed as meta themes to guide our examination of the data. In keeping with Indigenous methodology, interview transcripts were analyzed using narrative analysis. The themes were reviewed and verified by a second Indigenous patient partner. RESULTS: There were 14 participants in the sharing circle. The 2 meta themes, trust and world view, comprised 8 subthemes. The meta theme trust included mistrust with diagnosis and Western treatment after cancer therapy, protection of Indigenous medicine and physician expertise with treatment recommendations. The world view meta theme included the following subthemes: best of both worlds, spiritual beliefs, required to be strong for family and importance of knowing Indigenous survivors. INTERPRETATION: This study displayed complex relations between trust and world view in the cancer journeys of Indigenous patients and their families. These findings may assist health care providers in gaining a better understanding of how trust and world view affect the decision-making of Indigenous patients regarding cancer care.

Decisions on cancer care by Indigenous peoples in Alberta and Saskatchewan: a narrative analysis.

INTRODUCTION: The prevalence of cancer is increasing among Indigenous peoples in Canada. To enhance quality of life of those Indigenous people affected by cancer, their decision-making experiences must be understood. This article presents the findings of a qualitative study exploring the treatment decision-making practices among Indigenous peoples with cancer in rural and remote Alberta and Saskatchewan, Canada. METHODS: This study employed a qualitative narrative-based approach using the Indigenous research method of storytelling. Seventeen Indigenous participants (14 women, three men) with various forms of cancer were interviewed. Open-ended questions were used that were designed to understand participants' decision-making processing regarding their cancer treatment. RESULTS: Keeping with Indigenous methodology, the interview transcripts were analysed by a narrative method, with the intent that the data would be presented in story format. Eight vignettes relating to decision making were created: being strong for family; family support; strength and independence; denial and not wanting to know; fear-based decision making; finding the blessing; the spiritual journey; and traditional medicine and doctors. Participants were involved in validating the analysis to ensure that data were accurately interpreted. CONCLUSION: The vignettes demonstrate the similarities and differences among Indigenous people with cancer from other countries. A primary feature is that family members play a central role in participants' cancer treatment decisions. While some participants embraced and relied upon traditional medicines, others were supported by the providers of Western health care. A healthcare system that provides access to both traditional and Western medicine can be essential to culturally safe, high-quality cancer care for Indigenous peoples.

Development of PLGA nanoparticles for sustained release of a connexin43 mimetic peptide to target glioblastoma cells.

Effective therapeutic delivery of peptide and protein drugs is challenged by short in vivo half-lives due to rapid degradation. Sustained release formulations of αCT1, a 25 amino acid peptide drug, would afford lower dosing frequency in indications that require long term treatment, such as chronic wounds and cancers. In this study, rhodamine B (RhB) was used as a model drug to develop and optimize a double emulsion-solvent evaporation method of poly(lactic-co-glycolic acid) (PLGA) nanoparticle synthesis. Encapsulation of αCT1 in these nanoparticles (NPs) resulted in a sustained in vitro release profile over three weeks, characterized by an initial burst release of approximately 50% of total encapsulated drug over the first three days followed by sustained release over the remaining two and a half weeks. NP uptake by glioblastoma stem cells was through endocytosis and RhB and αCT1 were observed in cells after at least 4 days.

Collection of airborne ultrafine cellulose nanocrystals by impinger with an efficiency mimicking deposition in the human respiratory system.

As cellulose nanocrystals (CNCs) are increasing in production, establishing safe workplace practices in industry will be paramount to their continued use and growth. Particles other than CNCs with similar high aspect ratios have exhibited toxicity on inhalation. Safeguards are needed to monitor concentrations of CNCs in air in industrial and laboratory settings to protect workers. However, because of their size, morphology, and chemical makeup, CNCs are difficult to characterize and differentiate from other dust and cellulose products. This work is focused on developing an effective method of characterizing the concentration of airborne ultrafine CNCs that may deposit in the respiratory tract. CNCs were tagged with rhodamine b (RhB-CNCs) for improved visualization and characterized using UV-vis spectroscopy (UV-vis), transmission electron microscopy (TEM), and dynamic light scattering (DLS), then aerosolized and collected via a novel method using plastic impingers. Concentration of RhB-CNCs was measured using UV-vis and scanning mobility particle sizer (SMPS). The plastic impinger with 3D-printed nozzle collected airborne CNCs at an efficiency that improves upon commercially available impingers for relevant particle sizes.

Current characterization methods for cellulose nanomaterials.

A new family of materials comprised of cellulose, cellulose nanomaterials (CNMs), having properties and functionalities distinct from molecular cellulose and wood pulp, is being developed for applications that were once thought impossible for cellulosic materials. Commercialization, paralleled by research in this field, is fueled by the unique combination of characteristics, such as high on-axis stiffness, sustainability, scalability, and mechanical reinforcement of a wide variety of materials, leading to their utility across a broad spectrum of high-performance material applications. However, with this exponential growth in interest/activity, the development of measurement protocols necessary for consistent, reliable and accurate materials characterization has been outpaced. These protocols, developed in the broader research community, are critical for the advancement in understanding, process optimization, and utilization of CNMs in materials development. This review establishes detailed best practices, methods and techniques for characterizing CNM particle morphology, surface chemistry, surface charge, purity, crystallinity, rheological properties, mechanical properties, and toxicity for two distinct forms of CNMs: cellulose nanocrystals and cellulose nanofibrils.

Effective cellulose nanocrystal imaging using transmission electron microscopy.

Characterization of cellulose nanocrystals (CNCs) is often complex and tedious. With their increased use for biological materials, polymer reinforcing agents, and other applications, better characterization methods of CNCs are needed to ensure product quality. However, because of their small size, hydrogen bonding, and low electron density, individual CNCs are difficult to image with high resolution and magnification using electron microscopy. Methods to help counter these challenges include staining for increased contrast and techniques to increase dispersion. This work tested several stains, dispersing agents, and sample supports to find a consistent method of individualizing CNCs and providing good contrast for imaging in transmission electron microscopy (TEM). The most consistent method found uses a low concentration of CNCs, bovine serum albumin as a dispersing agent, and Nanovan® as the contrasting stain on a silicon monoxide-coated Formvar TEM grid.

Reconceptualizing determinants of health: barriers to improving the health status of First Nations peoples.

Comparing the key determinants of health articulated by the Public Health Agency of Canada (the Agency) with the spiritual and cultural knowledge systems of First Nations peoples, as expressed by the Four Worlds International Institute for Human and Community Development (Four Worlds) and their 14 determinants of well-being and health, reveals differing philosophical perspectives. The key determinants of health can be interpreted as lacking a holistic and inclusive approach to public health services. As a result, many public health programs in Canada marginalize, ignore and suppress the needs of First Nations communities and people. Incorporating the Four Worlds guiding principles and its 14 health determinants model within the context of Canadian public health services geared towards First Nations populations provides the opportunity to develop a deeper understanding of social determinants of health. Therefore, when implementing public health initiatives to address the health status of First Nations people in Canada, it is important that the Agency incorporate the guiding principles of the Four Worlds: Development Comes from Within; No Vision, No Development; Individual and Community Transformations Must Go Hand in Hand; and Holistic Learning is the Key to Deep and Lasting Change. Reconceptualizing the key determinants of health to encompass the worldview expressed by the Four Worlds acknowledges the cultural wisdom of First Nations people and offers the potential to develop more inclusive public health services.

Individual differences in sentence memory.

Results from an experiment with two parts are presented in this paper. In part one, participants listened to sentences containing two, three, four, or five clauses, and were asked questions about the content of the sentences. The results of part one demonstrate that an important unit of representation in sentence memory is the clause, and not some other component of discourse structure. In part two, the same group of participants performed eight different short-term storage/working memory tasks. A composite complex span score was computed for each participant based on three working memory tasks closely based on Daneman & Carpenter's (1980) reading span task. This working memory measure was significantly correlated with the participants' performance on the sentence memory task in part one. A second working memory measure--N-back--was also significantly correlated with the participants' performance on the sentence memory task, and there was no correlation between their performance on the complex span task and the N-back task. It is therefore concluded that (i) working memory consists of a number of dissociable components; and (ii) memory for sentences taps into more than one of these working memory components. Furthermore, the high correlations of sentence memory with the complex span and the N-back tasks (neither of which are language processing tasks) suggests that memory for sentences is not simply a result of linguistic experience; rather, it is likely that an independent working memory component contributes to participants' performance on the sentence memory task.