Doctors' Professional and Personal Reflections: A Qualitative Exploration of Physicians' Views and Coping during the COVID-19 Pandemic.

Numerous studies have examined the risks for anxiety and depression experienced by physicians during the COVID-19 pandemic. Still, qualitative studies investigating physicians' views, and their discovered strengths, are lacking. Our research fills this gap by exploring professional and personal reflections developed by physicians from various specialties during the pandemic. Semi-structured interviews were conducted with physicians practicing in the province of Saskatchewan, Canada, during November 2020-July 2021. Thematic analysis identified core themes and subthemes. Seventeen physicians, including nine males and eight females, from eleven specialties completed the interviews. The pandemic brought to the forefront life's temporality and a new appreciation for life, work, and each other. Most physicians found strength in values, such as gratitude, solidarity, and faith in human potential, to anchor them professionally and personally. A new need for personal fulfilment and hybrid care emerged. Negative feelings of anger, fear, uncertainty, and frustration were due to overwhelming pressures, while feelings of injustice and betrayal were caused by human or system failures. The physicians' appreciation for life and family and their faith in humanity and science were the primary coping strategies used to build adaptation and overcome negative emotions. These reflections are summarized, and implications for prevention and resilience are discussed.

Indigenous Community-Directed Needs Assessment for Rehabilitation Therapy Services.

The eleven Indigenous communities served by the File Hills Qu'Appelle Tribal Council (FHQTC) in Saskatchewan, Canada have experienced a progressive reduction in access to physical and occupational therapy services. A community-directed needs assessment facilitated by FHQTC Health Services was undertaken in the summer of 2021 to identify experiences and barriers of community members in accessing rehabilitation services. Sharing circles were conducted according to FHQTC COVID-19 policies; researchers connected to community members via Webex virtual conferencing software. Community stories and experiences were collected via sharing circles and semi-structured interviews. Data was analysed using an iterative thematic analysis approach with NVIVO qualitative analysis software. An overarching theme of culture contextualised five primary themes: 1) Barriers to Rehabilitation Care, 2) Impacts on Family and Quality of Life, 3) Calls for Services, 4) Strength Based Supports, and 5) What Care Should Look Like. Each theme is comprised of numerous subthemes amassed by stories from community members. Five recommendations were developed to enhance culturally responsive access to local services in FHQTC communities: 1) Rehabilitation Staffing Requirements, 2) Integration with Cultural Care, 3) Practitioner Education and Awareness, 4) Patient and Community-Centered Care, and 5) Feedback and Ongoing Evaluation.

A guiding framework for needs assessment evaluations to embed digital platforms in partnership with Indigenous communities.

INTRODUCTION: In community-based research projects, needs assessments are one of the first steps to identify community priorities. Access-related issues often pose significant barriers to participation in research and evaluation for rural and remote communities, particularly Indigenous communities, which also have a complex relationship with academia due to a history of exploitation. To bridge this gap, work with Indigenous communities requires consistent and meaningful engagement. The prominence of digital devices (i.e., smartphones) offers an unparalleled opportunity for ethical and equitable engagement between researchers and communities across jurisdictions, particularly in remote communities. METHODS: This paper presents a framework to guide needs assessments which embed digital platforms in partnership with Indigenous communities. Guided by this framework, a qualitative needs assessment was conducted with a subarctic Métis community in Saskatchewan, Canada. This project is governed by an Advisory Council comprised of Knowledge Keepers, Elders, and youth in the community. An environmental scan of relevant programs, three key informant interviews, and two focus groups (n = 4 in each) were conducted to systematically identify community priorities. RESULTS: Through discussions with the community, four priorities were identified: (1) the Coronavirus pandemic, (2) climate change impacts on the environment, (3) mental health and wellbeing, and (4) food security and sovereignty. Given the timing of the needs assessment, the community identified the Coronavirus pandemic as a key priority requiring digital initiatives. CONCLUSION: Recommendations for community-based needs assessments to conceptualize and implement digital infrastructure are put forward, with an emphasis on self-governance and data sovereignty.

A wastewater-based risk index for SARS-CoV-2 infections among three cities on the Canadian Prairie.

Wastewater surveillance (WWS) is useful to better understand the spreading of coronavirus disease 2019 (COVID-19) in communities, which can help design and implement suitable mitigation measures. The main objective of this study was to develop the Wastewater Viral Load Risk Index (WWVLRI) for three Saskatchewan cities to offer a simple metric to interpret WWS. The index was developed by considering relationships between reproduction number, clinical data, daily per capita concentrations of virus particles in wastewater, and weekly viral load change rate. Trends of daily per capita concentrations of SARS-CoV-2 in wastewater for Saskatoon, Prince Albert, and North Battleford were similar during the pandemic, suggesting that per capita viral load can be useful to quantitatively compare wastewater signals among cities and develop an effective and comprehensible WWVLRI. The effective reproduction number (Rt) and the daily per capita efficiency adjusted viral load thresholds of 85 × 106 and 200 × 106 N2 gene counts (gc)/population day (pd) were determined. These values with rates of change were used to categorize the potential for COVID-19 outbreaks and subsequent declines. The weekly average was considered 'low risk' when the per capita viral load was 85 × 106 N2 gc/pd. A 'medium risk' occurs when the per capita copies were between 85 × 106 and 200 × 106 N2 gc/pd. with a rate of change <100 %. The start of an outbreak is indicated by a 'medium-high' risk classification when the week-over-week rate of change was >100 %, and the absolute magnitude of concentrations of viral particles was >85 × 106 N2 gc/pd. Lastly, a 'high risk' occurs when the viral load exceeds 200 × 106 N2 gc/pd. This methodology provides a valuable resource for decision-makers and health authorities, specifically given the limitation of COVID-19 surveillance based on clinical data.

Where past meets present: Indigenous vaccine hesitancy in Saskatchewan.

In Canada, colonisation, both historic and ongoing, increases Indigenous vaccine hesitancy and the threat posed by infectious diseases. This research investigated Indigenous vaccine hesitancy in a First Nation community in Saskatchewan, ways it can be overcome, and the influence of a colonial history as well as modernity. Research followed Indigenous research methodologies, a community-based participatory research design, and used mixed methods. Social media posts (interventions) were piloted on a community Facebook page in January and February (2022). These interventions tested different messaging techniques in a search for effective strategies. The analysis that followed compared the number of likes and views of the different techniques to each other, a control post, and community-developed posts implemented by the community's pandemic response team. At the end of the research, a sharing circle occurred and was followed by culturally appropriate data analysis (Nanâtawihowin Âcimowina Kika-Môsahkinikêhk Papiskîci-Itascikêwin Astâcikowina procedure). Results demonstrated the importance of exploring an Indigenous community's self-determined solution, at the very least, alongside the exploration of external solutions. Further, some sources of vaccine hesitancy, such as cultural barriers, can also be used to promote vaccine confidence. When attempting to overcome barriers, empathy is crucial as vaccine fears exist, and antivaccine groups are prepared to take advantage of empathetic failures. Additionally, the wider community has a powerful influence on vaccine confidence. Messaging, therefore, should avoid polarising vaccine-confident and vaccine-hesitant people to the point where the benefits of community influence are limited. Finally, you need to understand people and their beliefs to understand how to overcome hesitancy. To gain this understanding, there is no substitute for listening.

The role of the HLA allelic repertoire on the clinical severity of COVID-19 in Canadians, living in the Saskatchewan province.

AIMS: The HLA system has been implicated as an underlying determinant for modulating the immune response to SARS-CoV-2. In this study, we aimed to determine the association of patients' HLA genetic profiles with the disease severity of COVID-19 infection. METHODS: Prospective study was conducted on COVID-19 patients (n = 40) admitted to hospitals in Saskatoon, Canada, between March and December 2020. Next-generation sequencing was performed on the patient samples to obtain high-resolution HLA typing profiles. The statistical association between HLA allelic frequency and disease severity was examined. The disease severity was categorized based on the length of hospital stay and intensive care needs or demise during the hospital stay. RESULTS: HLA allelic frequencies of the high and low-severity cohorts were normalized against corresponding background allelic frequencies. In the high-severity cohort, A*02:06 (11.8-fold), B*51:01 (2.4-fold), B*15:01(3.1-fold), C*01:02 (3.3-fold), DRB1*08:02 (31.2-fold), DQ*06:09 (11-fold), and DPB1*04:02(4-fold) were significantly overrepresented (p < 0.05) making these deleterious alleles. In the low-severity cohort, A*24:02 (2.8-fold), B*35:01 (2.8-fold), DRB1*04:07 (5.3-fold), and DRB1*08:11 (22-fold) were found to be significantly overrepresented (p < 0.05) making these protective alleles. These above alleles interact with NK cell antiviral activity via the killer immunoglobulin-like receptors (KIR). The high-severity cohort had a higher predilection for HLA alleles associated with KIR subgroups; Bw4-80I (1.1-fold), and C1 (1.6-fold) which promotes NK cell inhibition, while the low-severity cohort had a higher predilection for Bw4-80T (1.6-fold), and C2 (1.6-fold) which promote NK cell activation. CONCLUSION: In this study, the HLA allelic repository with the distribution of deleterious and protective alleles was found to correlate with the severity of the clinical course in COVID-19. Moreover, the interaction of specific HLA alleles with the KIR-associated subfamily modulates the NK cell-mediated surveillance of SARS-CoV-2. Both deleterious HLA alleles and inhibitory KIR appear prominently in the severe COVID-19 group focusing on the importance of NK cells in the convalescence of COVID-19.

Equity Analysis of Repeated Cross-Sectional Survey Data on Mental Health Outcomes in Saskatchewan, Canada during COVID-19 Pandemic.

This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.

Lessons learned developing and deploying a provincial virtual mental health support during the COVID-19 pandemic.

Significant efforts have been put into implementing virtual forms of healthcare and supports since the beginning of the pandemic. However, limited information has been shared with health leaders about how this has taken place, and what can be learned from this to move forward into the future. The purpose of this article is to describe lessons learned co-designing and developing a virtual health support during the COVID-19 pandemic in the province of Saskatchewan. In this article, we anchor these lessons learned on a specific virtual health service support, "SaskWell," which offers a digital service, and aims to connect residents of the province to digital mental health supports and resources.

Characteristics Associated with the Dual Behavior of Mask Wearing and Vaccine Acceptance: A Pooled Cross-Sectional Study among Adults in Saskatchewan.

While the dual behavior of consistent mask wearing and vaccine acceptance represents an effective method of protecting oneself and others from COVID-19, research has yet to directly examine its predictors. A total of 3347 responses from a pooled cross-sectional survey of adults living in Saskatchewan, Canada, were analyzed using a multinomial logistic regression model. The outcome variable was the combined behavior of mask-wearing and vaccine intention in four combinations, while covariates consisted of socio-demographic factors, risk of exposure to coronavirus, mitigating behaviors, and perceptions of COVID-19. Those who were 65 years and older, financially secure, consistently practiced social distancing and had no or very few contacts with people outside their households, were concerned about spreading the virus, and perceived they would be seriously sick if infected were likely to engage in both mask wearing and vaccine acceptance, rather than one or the other, with adjusted odds ratios ranging from 2.24 to 27.54. Further, within mask wearers, these factors were associated in a graded manner with vaccine intent. By describing the characteristics of those who engage in both mask wearing and vaccine acceptance, these results offer a specific set of characteristics for public health authorities to target and, therefore, contribute to the rapidly evolving body of knowledge on protective factors for COVID-19.

COVID-19 vaccine hesitancy and refusal and associated factors in an adult population in Saskatchewan, Canada: Evidence from predictive modelling.

BACKGROUND: A high population level of vaccination is required to control the COVID-19 pandemic, but not all Canadians are convinced of the value and safety of vaccination. Understanding more about these individuals can aid in developing strategies to increase their acceptance of a COVID-19 vaccine. The objectives of this study were to describe COVID-19 vaccine acceptance, hesitancy and refusal rates and associated factors in Saskatchewan, Canada. METHODS: This is a cross-sequential study that consisted of pooled responses from weighted samples of 9,252 Saskatchewan adults (≥18 years) across nine rounds of data collection between May 4, 2020 and April 3, 2021. The outcome variable was vaccine intention: vaccine acceptance, hesitancy, and refusal. The independent variables were layered into socio-demographic factors, risk of exposure to coronavirus, mitigating behaviours, and perceptions of COVID-19. Data were analyzed using multinomial logistic regression and a classification and regression tree. RESULTS: Seventy-six percent of the respondents indicated that they had been or were willing to be vaccinated, 13% had not yet decided, and the remaining 11% said they would not be vaccinated. Factors that increased the likelihood of vaccine refusal and hesitancy were lower education level, financial instability, Indigenous status, and not being concerned about spreading the coronavirus. Perceiving COVID-19 to be more of a threat to one's community and believing that one had a higher risk of illness or death from COVID-19 decreased the likelihood of both vaccine refusal and hesitancy. Women and newcomers to Canada were more likely to be unsure about getting vaccinated. Respondents who did not plan to be vaccinated were less likely to wear face masks and practice physical distancing. CONCLUSION: While many Canadians have voluntarily and eagerly become vaccinated already, reaching sufficient coverage of the population is likely to require targeted efforts to convince those who are resistant or unsure. Identifying and overcoming any barriers to vaccination that exist within the socio-demographic groups we found were least likely to be vaccinated is a crucial component.

Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members.

BACKGROUND: The aging of rural populations contributes to growing numbers of people with dementia in rural areas. Despite the key role of primary healthcare in rural settings there is limited research on effective models for dementia care, or evidence on sustaining and scaling them. The purpose of this study was to identify factors influencing sustainability and scale-up of rural primary care based memory clinics from the perspective of healthcare providers involved in their design and delivery. METHODS: Participants were members of four interdisciplinary rural memory clinic teams in the Canadian province of Saskatchewan. A qualitative cross-sectional and retrospective study design was conducted. Data were collected via 6 focus groups (n = 40) and 16 workgroup meetings held with teams over 1 year post-implementation (n = 100). An inductive thematic analysis was used to identify themes. RESULTS: Eleven themes were identified (five that influenced both sustainability and scale-up, three related to sustainability, and three related to scale-up), encompassing team, organizational, and intervention-based factors. Factors that influenced both sustainability and scale-up were positive outcomes for patients and families, access to well-developed clinic processes and tools, a confident clinic leader-champion, facilitation by local facilitators and the researchers, and organizational and leadership support. Study findings revealed the importance of particular factors in the rural context, including facilitation to support team activities, a proven ready-to-use model, continuity of team members, and mentoring. CONCLUSIONS: Interdisciplinary models of dementia care are feasible in rural settings if the right conditions and supports are maintained. Team-based factors were key to sustaining and scaling the innovation.

Developing a patient-oriented realist evaluation for COVID-19 vaccine implementation in Saskatchewan: a methodologic framework.

BACKGROUND: There is an urgent need to inform decision-making and safe delivery of vaccines in a timely manner. Our objective is to describe the methods we used to perform a patient-oriented realist evaluation of COVID-19 vaccination implementation in Saskatchewan, Canada, in order to understand the underlying mechanisms and contexts of vaccination implementation and vaccine uptake. METHODS: This methodology paper describes a patient-oriented, realist, mixed-method evaluation to assess COVID-19 vaccination implementation in Regina, Saskatoon and Prince Albert, Saskatchewan. The study comprised 3 iterative phases guided by Realist And Meta-narrative Evidence Synthesis: Evolving Standards II (RAMESES II). In phase 1 (January-February 2021), we developed the initial program theory, in phase 2 (March-May 2021), we tested and refined the initial program theory, and in phase 3 (June-July 2021), we established the final program theory. Three patient and family partners with different backgrounds and experiences were selected purposively from various locations (urban and rural) in Saskatchewan to engage collaboratively in the evaluation. Data analysis and synthesis occurred at all 3 phases of the project. We analysed qualitative data from phases 2 and 3 using a "retroductive" approach. We used quantitative data to compare outcomes from the 3 sites. INTERPRETATION: This protocol describes how we developed a final program theory for COVID-19 vaccination implementation with patient and family partners to show for whom, under what circumstances, how and why Saskatchewan's COVID-19 vaccination program has led to vaccine uptake. With patient and family partners' engagement, the evaluation findings will be shared with the Saskatchewan Health Authority and provincial government policy-makers and communications departments, published in peer-reviewed journals, presented at provincial or national conferences, and disseminated through any additional media identified by the patient and family partners.

Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study.

INTRODUCTION: The global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic. METHODS AND ANALYSIS: This study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods. ETHICS AND DISSEMINATION: This study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee.

Evaluation of a Social Media Campaign in Saskatchewan to Promote Healthy Eating During the COVID-19 Pandemic: Social Media Analysis and Qualitative Interview Study.

BACKGROUND: The beginning of the COVID-19 pandemic presented many sudden challenges regarding food, including grocery shopping changes (eg, reduced store hours, capacity restrictions, and empty store shelves due to food hoarding), restaurant closures, the need to cook more at home, and closures of food access programs. Eat Well Saskatchewan (EWS) implemented a 16-week social media campaign, #eatwellcovid19, led by a dietitian and nutrition student that focused on sharing stories submitted by the Saskatchewan public about how they were eating healthy during the COVID-19 pandemic. OBJECTIVE: The goal of this study was to describe the implementation of the #eatwellcovid19 social media campaign and the results from the evaluation of the campaign, which included campaign performance using social media metrics and experiences and perspectives of campaign followers. METHODS: Residents of Saskatchewan, Canada, were invited to submit personal stories and experiences to EWS about how they were eating healthy during the COVID-19 pandemic from April to August 2020. Each week, one to three stories were featured on EWS social media platforms-Facebook, Instagram, and Twitter-along with evidence-based nutrition information to help residents become more resilient to challenges related to food and nutrition experienced during the COVID-19 pandemic. Individuals who submitted stories were entered into a weekly draw for a Can $100 grocery gift card. Social media metrics and semistructured qualitative interviews of campaign followers were used to evaluate the #eatwellcovid19 campaign. RESULTS: In total, 75 stories were submitted by 74 individuals on a variety of topics (eg, grocery shopping, traditional skills, and gardening), and 42 stories were featured on social media. EWS shared 194 #eatwellcovid19 posts across social media platforms (Facebook: n=100; Instagram: n=55; and Twitter: n=39). On Facebook, #eatawellcovid19 reached 100,571 followers and left 128,818 impressions, resulting in 9575 engagements. On Instagram, the campaign reached 11,310 followers, made 14,145 impressions, and received 823 likes and 15 comments. On Twitter, #eatwellcovid19 made 15,199 impressions and received 424 engagements. Featured story submission posts had the best engagement on Facebook and the most likes and comments on Instagram. The EWS social media pages reported increases in their following during the campaign (Instagram: +30%; Facebook: +14%; and Twitter: +12%). Results from the interviews revealed that there were two types of campaign followers: those who appreciated hearing the stories submitted by followers, as it helped them to feel connected to the community during social isolation, and those who appreciated the evidence-based information. CONCLUSIONS: Numerous stories were submitted to the #eatwellcovid19 social media campaign on various topics. On Instagram and Facebook, posts that featured these stories had the highest engagement. During this campaign, EWS's social media following increased by more than 10% on each platform. The approach used for the #eatwellcovid19 campaign could be considered by others looking to develop health promotion campaigns.

The Role of Uncertainty in the Experiences of Nurses During the Covid-19 Pandemic: A Phenomenological Study.

BACKGROUND: The novel coronavirus (Covid-19) has spread quickly to all corners of the globe and caused high rates of morbidity and mortality. Nurses have been at the centre of this experience managing the outbreak through direct bedside care, managing hospital units, providing Covid-19 testing, and contact tracing. PURPOSE: The aim of this article is to examine the role that nurses played in the early stages of the Covid-19 pandemic through the voices of the participants. METHODS: Using a phenomenological methodology thirty-one interviews were completed via phone and thematic analysis was completed. RESULTS: The major themes that emerged from this phenomenological study were: emotional challenges, uncertainty, and protective factors. Emotional challenges included, stress, anxiety, exhaustion, frustration, guilt, and loneliness. These challenges were magnified by uncertainty through leadership and communication challenges, needs of the pandemic versus needs of the patient, and Covid-19 and best practice. In this study, emotional challenges were mitigated by the protective factors of: education, ability to contribute, team cohesiveness, and community support. CONCLUSIONS: Nurses are challenged during this time but by limiting uncertainty and providing protective factors, nurses can be less affected by emotional challenges and able to provide nursing care and manage the outbreak effectively.

Where in the world is Florence Nightingale's medicine chest?

BACKGROUND: In the 121st anniversary year of the birth of Florence Nightingale, and during the COVID-19 pandemic, it is both interesting and salient to be reminded of the foundational work of this famous woman who began modern nursing. Her work in nursing care and nursing, health and public policy has been a continuing strong foundation to practices in societies around the world. METHODS: In this short communication about historical research, various aspects of Florence's life and work are described, as well as the locations, memorials and museum significant to our remembrance of her. RESULTS: A particular focus of this paper is the description of a larger but little-known medicine chest located at the College of Nursing, University of Saskatchewan, in Saskatoon, SK, Canada, and attributed as belonging to Florence. CONCLUSION: Best known to this point in time is a smaller medicine chest at the Florence Nightingale Museum in London.

Modeling of municipal waste disposal rates during COVID-19 using separated waste fraction models.

Municipal waste disposal behaviors in Regina, the capital city of Saskatchewan, Canada have significantly changed during the COVID-19 pandemic. About 7.5 year of waste disposal data at the Regina landfill was collected, verified, and consolidated. Four modeling approaches were examined to predict total waste disposal at the Regina landfill during the COVID-19 period, including (i) continuous total (Baseline), (ii) continuous fraction, (iii) truncated total, and (iv) truncated fraction. A single feature input recurrent neural network model was adopted for each approach. It is hypothesized that waste quantity modeling using different waste fractions and separate time series can better capture disposal behaviors of residents during the lockdown. Compared to the baseline approach, the use of waste fractions in modeling improves both result accuracy and precision. In general, the use of continuous time series over-predicted total waste disposal, especially when actual disposal rates were less than 50 t/day. Compared to the baseline approach, mean absolute error (MAE), mean absolute percentage error (MAPE), and mean square error (MSE) were reduced. The R value increased from 0.63 to 0.79. Comparing to the baseline, the truncated total and the truncated fraction approaches better captured the total waste disposal behaviors during the COVID-19 period, probably due to the periodicity of the weeklong data set. For both approaches, MAE and MAPE were lower than 70 and 22%, respectively. The model performance of the truncated fraction appears the best, with an MAPE of 19.8% and R value of 0.92. Results suggest the uses of waste fractions and separated time series are beneficial, especially if the input set is heavily skewed.

Identification of behaviour patterns in waste collection and disposal during the first wave of COVID-19 in Regina, Saskatchewan, Canada.

The novel coronavirus (2019-nCov) has had significant impacts on almost every aspect of daily life. From 'stay-at-home' orders to the progressive lifting of restrictions, the COVID-19 pandemic has had unprecedented effects on consumer behaviours and waste disposal habits. The purpose of this short communication is to examine time series waste collection and disposal data in a mid-sized Canadian city to understand how behavioural changes have affected municipal waste management. The results suggest that private waste disposal increased during the pandemic. This may be due to people doing home renovations in order to accommodate working from home. Furthermore, it appears that changes in consumer habits destabilized the consistency of waste disposal tonnage when compared to the same time period in 2019. When considering curbside residential waste collection, there was also an increase in tonnage. This may be the result of more waste being generated at home due to changes in eating and cooking habits, and cleaning routine. Finally, the ratio of residential waste collection to total disposal is examined. More residential waste is being generated, which may have environmental and operational effects, especially related to collection and transportation. The results from this study are important from an operational perspective, and will help planners and policy makers to better prepare for changes in the waste stream due to pandemics or other emergencies.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on university students' dietary intake, physical activity, and sedentary behaviour.

University students are a vulnerable group for poor dietary intake, insufficient physical activity and sedentary behaviour. The purpose of this study was to examine the impact of coronavirus disease (COVID-19) on university students' dietary intake, physical activity, and sedentary behaviour. Participants were students (n = 125) from the Universities of Saskatchewan and Regina. An online questionnaire was administered retrospectively (for prepandemic) and prospectively (during the pandemic) to examine students' dietary intake, physical activity, and sedentary behaviour. Overall, nutrient and caloric intakes were significantly reduced (p < 0.05) during the pandemic, and alcohol intake increased (p = 0.03). Before the pandemic, 16% and 54% of the participants were meeting the Canadian 24-Hour Movement Guidelines for Adults (18-64 years) of 150 min of moderate-vigorous physical activity and 8 h or less of sedentary activity, respectively. Only 10% met the guidelines for physical activity while 30% met the guidelines for sedentary behaviour during the pandemic. The minutes per week spent engaging in moderate to vigorous physical activity during the pandemic decreased by approximately 20% (p < 0.001). The hours spent in sedentary activities increased by 3 h per day (p < 0.001). Our findings confirm that during the pandemic, students' inadequate dietary intake, high alcohol consumption, low physical activity, and high sedentary behaviour were significantly compounded. Novelty: During COVID-19, the nutrient and caloric intakes of university students decreased, and alcohol intake increased significantly. University students' physical activity levels decreased, and sedentary activity increased significantly during COVID-19. During COVID-19 students did not engage in sufficient physical activity to offset the increased sedentary behaviour.