Summary of an environmental scan of HIV and Hepatitis C programs, projects and initiatives in Saskatchewan

Background

In 2019, the human immunodeficiency virus (HIV) and hepatitis C (HCV) diagnosis rates in Saskatchewan (SK) were approximately twice the national rate. To address these high levels, Saskatchewan Stories, a community-based digital database, was developed to make information on Saskatchewan-based HIV and HCV programs, projects and initiatives (PPI) centrally and freely available. To begin populating this database, we conducted an environmental scan representing HIV and HCV PPI from January 1, 1980 to May 31, 2020.

Methods

MedLine, ERIC, ProQuest One Literature, Public Health Information database, SCOPUS and CINAHL were searched for both HIV and HCV articles. In addition, Bibliography of Native North Americans was searched for HIV and EMBSE (Ovid) and Indigenous studies portal (iPortal) were searched for HCV articles. Google Canada, Government of Saskatchewan, and Government of Canada websites were also searched.

Results

In total, 139 HIV-specific PPI and 29 HCV-specific PPI were found in the environmental scan (n=168). Among HIV PPI, 27% (n=38) were from academic literature while 73% (n=101) were from grey literature. Among HCV PPI, 41% (n=12) were from academic literature, while 59% (n=17) were from grey literature. HIV accounted for 83% of total PPI, compared to 17% for HCV.

Conclusion

This environmental scan is an important contribution to evidence-based practice and research in SK. It is particularly useful for organizations, researchers, policymakers and people living with HIV/HCV to develop new evidence-based PPI, to secure funding for PPI and to support individuals and communities in SK affected by HIV and HCV.

Contemporary nutrition-based interventions to reduce risk of infection among elderly long-term care residents: A scoping review

Background

Elderly long-term care residents (ELTCRs) face considerable burden of infection, especially evident during the COVID-19 pandemic. The nutritional status of the host can influence susceptibility to infection by altering immune system integrity, therefore, nutrition-based interventions may be a viable complement to existing infection prevention measures.

Objective

This scoping review sought to identify nutritional interventions and factors that have the strongest evidence to benefit ELTCRs, and thus best poised for rigorous clinical trial evaluation and subsequent implementation.

Methods

A database search of OVID-Medline, OVID-Embase, and Web of Science was performed from 2011 to 2021 to identify nutritional intervention studies which attribute to changes in infection in contemporary ELTCR settings. Articles were screened in duplicate and data extraction completed by a single reviewer, while a second reviewer verified the data which was fitted to identify evidence for nutritional interventions related to reducing rates of infection among ELTCRs.

Results

The search identified 1018 studies, of which 11 (nine clinical trials and two observational cohort studies) satisfied screening criteria. Interventions that significantly reduced risk of infection included whey protein (any infection), Black Chokeberry (urinary tract infection), and vitamin D (acute respiratory tract infection, skin and soft tissue infection). Both zinc and a dedicated meal-plan significantly improved lymphocyte parameters. Vitamin D deficiency was associated with the development of respiratory tract infections. Probiotic and soy-based protein interventions did not significantly affect risk of infection or lymphocyte parameters, respectively.

Conclusion

The current scoping review was effective in identifying the use of nutrition-based interventions for infection prevention among ELTCRs. In this study, some nutrition-based interventions were observed to significantly influence the risk of infection among ELTCRs. Nutritional interventions such as vitamin D (preventing deficiency/insufficiency), Black Chokeberry juice, zinc gluconate, whey protein, and varied and nutrient dense meal plans may be suitable for future rigorous clinical trial evaluation.

"Every One of Us Is a Strand in That Basket": Weaving Together Stories of Indigenous Wellness and Resilience From the Perspective of Those With Lived and Living Experience With HIV/Hepatitis C Virus

ABSTRACT

This article primarily focuses on the stories shared by Indigenous women with living and/or lived experiences of HIV/hepatitis C virus from the Vancouver Downtown East Side who attended the "Awakening our Wisdom" retreat. Weaving together the story of an Indigenous approach to research that informed the design of the retreat and the findings that emerged, a basket is formed that highlights the ways settler-colonialism within Canada has produced a system of health care that has neglected the Indigenous experience. The emerging themes of Connection, Disconnection, and Reconnection offers teachings for Indigenous journeys of resilience and wellness for those living with HIV/hepatitis C virus. These findings may help health care practitioners identify health care places and spaces that are in need of decolonization and offer, from an Indigenous perspective, the next steps forward for a health care system that promotes Indigenous engagement and retention in care.

An environmental scan of impacts and interventions for women with methamphetamine use in pregnancy and their children

BACKGROUND

Indigenous women are overrepresented among people who use (PWU) methamphetamine (MA) due to colonialism and intergenerational trauma. Prenatal methamphetamine exposure (PME) is increasing as the number of PWUMA of childbearing age grows. Yet impacts of MA in pregnancy and effective interventions are not yet well understood.

OBJECTIVE

We conducted an environmental scan of published and grey literature (2010-2020) to determine effects of MA use in pregnancy for mothers and their offspring, effective interventions and implications for Indigenous women.

SEARCH STRATEGY

A strategic search of Ovid Medline, Embase, ProQuest-Public Health and CINAHL databases identified academic literature, while Google and ProQuest-Public Health identified grey literature.

SELECTION CRITERIA

Article selection was based on titles, abstracts and keywords. The time frame captured recent MA composition and excluded literature impacted by coronavirus disease 2019.

DATA COLLECTION AND ANALYSIS

Data extracted from 80 articles identified 463 results related to 210 outcomes, and seven interventions. Analysis focused on six categories: maternal, neonatal/infant, cognitive, behavioral, neurological, and interventions.

MAIN RESULTS

Maternal outcomes were more congruent than child outcomes. The most prevalent outcomes were general neonatal/infant outcomes.

CONCLUSION

A lack of Indigenous-specific research on PME and interventions highlights a need for future research that incorporates relevant historical and sociocultural contexts.

Video Modeling and Video Feedback to Reduce Time to Perform Intravenous Cannulation in Medical Students: A Randomized-Controlled Mixed-Methods Study

PURPOSE

Combined video modeling (VM) and video feedback (VF) may be more beneficial than traditional feedback when teaching procedural skills. This study examined whether repeated VM and VF compared with VM alone reduced the time required for medical students to perform peripheral intravenous (IV) cannulation.

METHODS

Twenty-five novice medical students were randomly assigned to groups in a one-way blinded embedded mixed-methods study to perform IV cannulation. Participants received standardized instruction and performed IV cannulation on each other while being audio-video recorded. They were assigned to review a video of an expert performing IV cannulation (VM alone), or both the expert video and a video of their own most recent IV cannulation (VM+VF), before returning to perform another IV cannulation. This was repeated for a total of four IV cannulation encounters and three video reviews. A post-test interview was also conducted and analyzed qualitatively using thematic content analysis.

RESULTS

The median [interquartile range] time required to perform IV cannulation in the final encounter was significantly different between the VM+VF group vs VM alone group (126 [93-226] sec vs 345 [131-537] sec, respectively; median difference, 111 sec; 95% confidence interval, 8 to 391; P = 0.02). There was no significant difference in IV cannulation success between VM alone and VM+VF in the final encounter (75% vs 85% respectively; P = 0.65). For the VM+VF group, the time to perform IV cannulation was reduced after the final encounter compared with the baseline encounter (P = 0.002), which was not true of the VM alone group (P = 0.35).

CONCLUSION

Video modeling and feedback shortened time to IV skill completion, reduced complications, and improved satisfaction in novice medical students.

Risk Factors Associated with Self-reported Sexually Transmitted Infections among Postsecondary Students in Canada

Background:

Despite major public health efforts in addressing the burden of disease caused by sexually transmitted infections (STIs), rates among young adults continue to rise in Canada. The purpose of the study was to examine the prevalence and risk factors associated with acquiring STIs among postsecondary students in Canada.

Methods:

A secondary analysis of the American College Health Association-National College Health Assessment II-C Spring 2016 survey data (n = 43,780) was conducted. Sexually active participants (n = 28,831) were examined for their demographics, sexual behavior, alcohol and marijuana use, testing for human immunodeficiency virus (HIV), and human papillomavirus vaccination history. These factors were analyzed to help identify their possible association with acquiring an STI using logistic regression and multivariate modeling.

Results:

Among the study participants, 3.88% had an STI, with the highest rates observed among females and individuals aged 21–24 years old. Multivariate logistic analysis showed that participants who engaged in anal intercourse within the past 30 days (odds ratio [OR] = 1.634; 95% confidence interval [CI], 1.343–1.988), had four or more sexual partners in the last 12 months (OR = 4.223; 95% CI, 3.595–4.962), used marijuana within the past 30 days (OR = 1.641; 95% CI, 1.387–1.941), and had ever been tested for HIV (OR = 3.008; 95% CI, 2.607–3.471) had greater odds of acquiring an STI.

Conclusions:

The findings of this study highlight certain high-risk behaviors that are strongly associated with acquiring an STI among postsecondary students. Thus, efforts to design and deliver relevant educational programming and health promotion initiatives for this particular population are of utmost importance.

Safety, specificity and immunogenicity of a PrP(Sc)-specific prion vaccine based on the YYR disease specific epitope

Prions are a novel form of infectivity based on the misfolding of a self-protein (PrP(C)) into a pathological, infectious isomer (PrP(Sc)). The current uncontrolled spread of chronic wasting disease in cervids, coupled with the demonstrated zoonotic nature of select livestock prion diseases, highlights the urgent need for disease management tools. While there is proof-of-principle evidence for a prion vaccine, these efforts are complicated by the challenges and risks associated with induction of immune responses to a self-protein. Our priority is to develop a PrP(Sc)-specific prion vaccine based on epitopes that are uniquely exposed upon misfolding. These disease specific epitopes (DSEs) have the potential to enable specific targeting of the pathological species through immunotherapy. Here we review outcomes of the translation of a prion DSE into a PrP(Sc)-specific vaccine based on the criteria of immunogenicity, safety and specificity.

Nanopore analysis of tethered peptides

Peptides of 12 amino acids were tethered via a terminal cysteine to mono-, di-, tri-, and tetrabromomethyl-substituted benzene to produce bundles of one to four peptide strands (CY12-T1 to CY12-T4, respectively). The interaction of the bundles with the α-hemolysin pore was assessed by measuring the blockade currents (I) and times (T) at an applied potential of - 50, - 100, and - 150 mV. Three types of events could be distinguished: bumping events, with small I and short T where the molecule transiently interacts with the pore before diffusing away; translocation events, where the molecule threads through the pore with large I and the value of T decreases with increasing voltage; and intercalation events, where the molecule transiently enters the pore but does not translocate with large I and the value of T increases with increasing voltage. CY12-T1 and CY12-T2 gave only bumping and translocation events; CY12-T3 and CY12-T4 also gave intercalation events, some of which were of very long duration. The results suggest that three uncoiled peptide strands cannot simultaneously thread through the α-hemolysin pore and that proteins must completely unfold in order to translocate.