Healthcare Service Utilization and Perceived Gaps: The Experience of French-Speaking 2S/LGBTQI+ People in Manitoba.

Ethnolinguistically diverse 2S/LGBTQI+ (two-spirit, lesbian, gay, bisexual, transgender, queer and intersex) populations have unique healthcare needs and experience health inequities compared to their cisgender or heterosexual peers. This community-based participatory study sought to describe the profile and healthcare needs and experiences of official language minority French-speaking 2S/LGBTQI+ adults in Manitoba. Participants (N = 80) reported that gender and sexual identity were often concealed from service providers; many respondents faced discrimination based on their ethnolinguistic and sexual identities. Service gaps are identified pertaining to mental and sexual health; locating 2S/LGBTQI+-friendly, patient-centred care in French is difficult. Policy and practice should address systemic inequity and discrimination experienced by this equity-seeking population.

Recreational Cannabis Legislation: substance use and impaired driving among Canadian rural and urban postsecondary students.

BACKGROUND: Investigation of cannabis use trends among emerging adults (EA, aged between 18 and 24 years) following 2018 Canadian Recreational Cannabis Legislation (RCL) is critical. EAs report the heaviest cannabis use in Canada and are particularly vulnerable to the onset of problematic substance use. OBJECTIVES: To describe and compare post-RCL use of cannabis and other state-altering substances, as well as the prevalence of impaired driving, among EA postsecondary students in both rural and urban settings, studying on one of five campuses in either Manitoba, Ontario, or Quebec. METHODS: For this quantitative cross-sectional study, a self-report survey was administered to 1496 EA postsecondary students in the months following RCL (2018-2019). Multiple logistic regression analyses were conducted to explore the influence of provincial and urban/rural living contexts on recreational cannabis use, other state-altering substance use and impaired driving behaviours, adjusting for sociodemographic variables. RESULTS: Statistically significant differences were observed between cohorts in almost all measures. Quebec students were more likely to have consumed cannabis during their lifetime (AOR = 1.41, 95% CI [1.05, 1.90]) than all other cohorts. Rural cohorts all had greater odds of reporting consumption of cannabis during the previous year compared to urban cohorts (AOR = 1.32, 95% CI [1.04, 1.67]). However, the relation between cannabis use in the last month and operating a motor vehicle after using cannabis (lifetime and past month) and living context differed between subjects in Quebec and those in the two other provinces. Quebec's students having lived mostly in urban contexts had greater odds of using cannabis in the past month and operating a motor vehicle after using cannabis (lifetime and past month) than those in rural contexts; the opposite was observed in Manitoba and Ontario. Differing interprovincial prohibitive/permissive legislation and licit cannabis infrastructure appeared to have little impact on post-RCL substance use. CONCLUSIONS: In Manitoba and in Ontario, rural/urban living context seems to better predict substance use and related road-safety practices, suggesting these trends supersede permissive/prohibitive provincial legislation and licit cannabis-related infrastructures. Further investigation into sociodemographic factors influencing state-altering substance use and impaired driving, and maintaining tailored cannabis misuse prevention campaigns, is warranted on Canadian campuses.

Living in a liminal space: Experiences of 2SLGBTQ + official language minority Canadians during the COVID-19 pandemic.

The intersecting identities of those identifying with multiple minorities, such as 2SLGBTQ + and ethnolinguistic minorities, bring individuals to have unique experiences, especially concerning health and wellness. This topic is particularly poorly understood among French-speaking official language minority 2SLGBTQ + populations in Canada. Hence, this study was conducted to generate insights into their needs and experiences, through the lens of intersectionality. This quantitative community-based study, a first of its kind in Western Canada, describes the sociodemographic profile, experiences of discrimination and stigmatisation, and needs and challenges pertaining to mental health and social supports of this double minority group. Data were obtained by an online survey conducted in the Canadian province of Manitoba in June 2020. The participant sample was largely homogenous: most were under the age of 55 years, white, educated, and from urban areas. Many reported experiencing dual marginalisation, feeling unaccepted by both of their minority communities (Francophone and 2SLGBTQ+). A sense of isolation, as well as a lack of social connectedness and psychological support, were often reported. Social initiatives and mental health support within environments proactively affirming of the official language of the minority and inclusive of diverse 2SLGBTQ + identities are needed.

Management strategies to improve French language service coordination and continuity for official language Francophone seniors in Canada.

Evidence suggests that language barriers present obstacles to healthcare access and quality for Francophone seniors in official language minority communities across Canada. Addressing language barriers and providing continuity is challenging, as French language services (FLSs) rely heavily on bilingual providers and the practice of active offer by all staff. This qualitative research used semi-structured group and individual interviews to explore mechanisms supporting FLS coordination and continuity in two Canadian provinces. Identification of the language variable in health records, virtual healthcare, and FLS directories are conducive to FLS continuity, but financial and resource limitations present major obstacles. Management strategies to facilitate continuity of FLS across health organizations are discussed.

Evidence of commitment to research partnerships? Results of two web reviews.

BACKGROUND: Partnerships between academic researchers and health system leadership are often promoted by health research funding agencies as an important strategy in helping ensure that funded research is relevant and the results used. While potential benefits of such partnerships have been identified, there is limited guidance in the scientific literature for either healthcare organisations or researchers on how to select, build and manage effective research partnerships. Our main research objective was to explore the health system perspective on partnerships with researchers with a focus on issues related to the design and organisation of the health system and services. Two structured web reviews were conducted as one component of this larger study. METHODS: Two separate structured web reviews were conducted using structured data extraction tools. The first review focused on sites of health research bodies and those providing information on health system management and knowledge translation (n = 38) to identify what guidance to support partnerships might be available on websites commonly accessed by health leaders and researchers. The second reviewed sites from all health 'regions' in Canada (n = 64) to determine what criteria and standards were currently used in guiding decisions to engage in research partnerships; phone follow-up ensured all relevant information was collected. RESULTS: Absence of guidance on partnerships between research institutions and health system leaders was found. In the first review, absence of guidance on research partnerships and knowledge coproduction was striking and in contrast with coverage of other forms of collaboration such as patient/community engagement. In the second review, little evidence of criteria and standards regarding research partnerships was found. Difficulties in finding appropriate contact information for those responsible for research and obtaining a response were commonly experienced. CONCLUSION: Guidance related to health system partnerships with academic researchers is lacking on websites that should promote and support such collaborations. Health region websites provide little evidence of partnership criteria and often do not make contact information to research leaders within health systems readily available; this may hinder partnership development between health systems and academia.

Substance use and impaired driving prevalence among Francophone and Anglophone postsecondary students in Western Canada.

INTRODUCTION: Substance use and impaired driving increase risk of motor vehicle crashes and deaths. Individual, socio-economic and -cultural factors are associated with these at-risk behaviors; however, little is known if differences exist between the Anglophone majority and minority Francophone populations in Canada. This article describes prevalence of substance use, impaired driving and driving practices by postsecondary student and compares Francophones and Anglophones with respect to these behaviors. METHODS: Postsecondary students between 18 and 24 years attending a Francophone university in Western Canada completed a paper-based survey during class-time. RESULTS: Prevalence of alcohol consumption, binge drinking and marijuana use in the past month were 88.6%, 64.2% and 22.7% respectively. Francophone participants were more likely to consume more alcohol, participate in drinking games, and consume marijuana during the past month than Anglophones. They were also more likely to report impaired-driving, speeding, distracted driving and being passenger in a motor vehicle driven by an impaired driver. CONCLUSION: Awareness campaigns on campus highlighting the risks of substance use and unsafe driving practices should be strengthened and target Francophone students in linguistic minority communities.

Impact of Language Barriers on Quality of Care and Patient Safety for Official Language Minority Francophones in Canada.

INTRODUCTION: The risks to patient safety and quality of care faced by members of linguistic minority groups have been well-documented. However, little research has focused on the experience of official language minorities in Canada. METHODS: This multiple method study (online and paper-based surveys combined with semi-structured individual interviews with patients and interpreters-health navigators) explored the experience of minority Francophones living in 4 Canadian provinces. RESULTS: Patients and interpreters-navigators described experiences where language barriers contributed to poorer patient assessment, misdiagnosis and/or delayed treatment, incomplete understanding of patient condition and prescribed treatment, and impaired confidence in services received. Reliance on Google Translate and ad hoc, untrained interpreters are commonly reported, in spite of evidence highlighting the risks associated with such practice. CONCLUSION: Increased awareness that the risks of language barriers apply to official language minorities is essential.

Impact of language barriers on access to healthcare for official language minority Francophones in Canada.

While there is strong international evidence that language barriers present obstacles to healthcare access, quality and safety, little research has been conducted on the experience of official language minorities in Canada. This multiple method research used on-line and paper-based surveys, combined with semi-structured individual interviews to explore the experience with access to care of Francophone minorities living in four Canadian provinces. The majority of Francophones surveyed reported limited access to French language services and described an environment where low importance is given to addressing language barriers within the health system. Even when services are available, the lack of services in French sometimes results in avoidance of care. Results confirm that many Francophones face similar barriers to care as other language minorities in Canada. Strategies to improve access for official language minorities are discussed.

[Not Available]. / Les comportements sexuels et le harcèlement sexuel en milieu postsecondaire dans l'Ouest canadien.

OBJECTIVES: Risky sexual behaviour associated with sexually transmitted infections (STI) and sexual harassment are important topics in university environments and public health. This article compares these behaviours between student cohorts in 2005 and 2012 from a Western Canadian university. The sexual habits of young adults with multiple partners are also examined. METHODS: Researchers conducted a comparative study of sexual behaviour among approximately 400 students per cohort. Estimates of prevalence and adjusted odds for age group and sex were used to analyze associations between the two cohorts and their sexual behaviours. RESULTS: Trends in sexual behaviour of young adults are maintained with respect to the proportion of those who are sexually active and their number of partners. A reduction in sexual harassment is observed, especially towards women. The condom remains the most frequently used method of contraception, but its use is erratic, particularly among respondents with multiple sexual partners. Drinking and the use of drugs predisposes to unplanned sexual relations and to non-use of means to prevent STIs and pregnancy, particularly among respondents with multiple sexual partners. CONCLUSIONS: The postsecondary student population should be informed of the risks associated with multiple sexual partners and alcohol and drug consumption leading to unplanned sexual acts. A sexual harassment policy contributes to reduction of incidents of harassment within a postsecondary institution.

Akwaton, polyhexamethylene-guanidine hydrochloride-based sporicidal disinfectant: a novel tool to fight bacterial spores and nosocomial infections.

Bacterial spores are of continuing interest to the food and medical industries. In efforts to eliminate bacterial spore contamination, a number of sporicidal agents have been developed. Most of these compounds must be used carefully in very specific circumstances as they are toxic to humans. The sporicidal activity of Akwaton, a polyhexamethylene-guanidine hydrochloride (PHMGH)-based disinfectant, was tested against Bacillus subtilis spores. PHMGH is a colourless, odourless, non-corrosive and non-irritating antimicrobial biocide of the guanidine family. Spores suspended in distilled water and spores placed on solid surfaces (stainless steel and glass) were used to determine the log(10) reduction after exposure to varying concentrations of Akwaton. The minimum sporostatic concentration, the minimum sporicidal concentration and the time required for sporicidal activity corresponded to 0.06% (w/v), 0.08 % (w/v) and 8.5 min, respectively. Disinfectant concentrations of 0.24 % (w/v) and 0.44 % (w/v) killed all spores suspended in distilled water within 3 min and 90 s, respectively. The sporicidal activity against suspended spores was linearly dependent with respect to the concentration of PHMGH and contact time (y(3 min) = 40x-1.6 and y(90 s) = 20x-0.8 thus y(3 min) = 2y(90 s)). Spores placed on surfaces were more resistant to the effect of the disinfectant and the positive linear correlation between the sporicidal activity and concentration was not observed. The concentration required to kill all spores placed on a surface (stainless steel or glass) corresponded to 0.52 % (w/v) for 90 s of contact and 0.36 % (w/v) for 3 min. This study demonstrated that PHMGH is an effective sporicidal disinfectant with great potential for use in hospitals, laboratories, food industries and households.

A conserved glutamate residue exhibits multifunctional catalytic roles in D-fructose-1,6-bisphosphate aldolases.

The aldolase catalytic cycle consists of a number of proton transfers that interconvert covalent enzyme intermediates. Glu-187 is a conserved amino acid that is located in the mammalian fructose-1,6-bisphosphate aldolase active site. Its central location, within hydrogen bonding distance of three other conserved active site residues: Lys-146, Glu-189, and Schiff base-forming Lys-229, makes it an ideal candidate for mediating proton transfers. Point mutations, Glu-187--> Gln, Ala, which would inhibit proton transfers significantly, compromise activity. Trapping of enzymatic intermediates in Glu-187 mutants defines a proton transfer role for Glu-187 in substrate cleavage and Schiff base formation. Structural data show that loss of Glu-187 negative charge results in hydrogen bond formation between Lys-146 and Lys-229 consistent with a basic pK(a) for Lys-229 in native enzyme and supporting nucleophilic activation of Lys-229 by Glu-187 during Schiff base formation. The crystal structures also substantiate Glu-187 and Glu-189 as present in ionized form in native enzyme, compatible with their role of catalyzing proton exchange with solvent as indicated from solvent isotope effects. The proton exchange mechanism ensures Glu-187 basicity throughout the catalytic cycle requisite for mediating proton transfer and electrostatic stabilization of ketamine intermediates. Glutamate general base catalysis is a recurrent evolutionary feature of Schiff base0forming aldolases.