Ontario's Healthy Babies Healthy Children Screen tool: identifying postpartum families in need of home visiting services in Ottawa, Canada.

INTERVENTION: Across Ontario, the Healthy Babies Healthy Children (HBHC) postpartum screening tool is routinely used to identify families with potential risk of negative development outcomes for children. RESEARCH QUESTION: To identify screening questions associated with subsequent high-risk in-depth assessment (IDA) in order to prioritize services. METHODS: Ottawa families who gave birth (2013-2016) consented to the postpartum HBHC Screen (N = 29,162). Maternal socio-demographics, perinatal indicators, and 36 questions assessing pregnancy/birth, family, parenting, infant development, and health professional observations were analyzed for association with a high-risk IDA using regression analysis. RESULTS: Upon first screen, 51% of families scored two or more risks. Most commonly, labour/delivery complications (27%), previous loss (26%), health professional concerns (22%), and mental illness (17%) were identified. Among IDA completions, 41% were assessed as high risk and this proportion increased when screened with 4+ risks. Characteristics associated with high-risk IDA among families scoring two or three included the following: maternal age ≤ 19 years (aRR = 2.0, 95% CI 1.50-2.80), 20-29 years (1.3, 1.12-1.53), ≥ 35 years (1.2, 1.04-1.45); combination breast and formula feeding on discharge (1.2, 1.03-1.37); < 18 years old at birth of first child (1.7, 1.13-2.43); single parent and no partner involved (1.6, 1.07-2.33); high school incomplete (1.8, 1.45-2.35); newcomer support needed (1.8, 1.43-2.17); financial concerns (1.6, 1.27-2.14); history of mental illness (1.2, 1.01-1.33); and parent disability (1.7, 1.09-2.78). CONCLUSION: While offering the IDA when scoring 2+ risks is a provincial requirement, practices of increasing effort toward contacting families screened with 4+ risks are substantiated. An adapted approach to prioritize families screened with two or three risks is described.

Social Marginalization and Internal Exclusion: Gay Men's Understandings and Experiences of Community.

A total of 27 gay and bisexual men were interviewed about how they perceived the criminal prosecution of persons living with HIV who do not disclose their HIV status. The stories that emerged from the interviews raise questions about the nature of the gay community. The findings centre on the participants' descriptions of (1) the heterosexual meta-culture, (2) the locales of gay life, and (3) unsupportive elements in the gay community. Analysis of the interview data situates the gay community as a place of both inclusion and exclusion and as a heterogeneous environment.

Des entrevues ont été menées auprès de 27 hommes gais et bisexuels afin de sonder leurs perceptions à l'égard des poursuites criminelles intentées contre les personnes vivant avec le VIH/sida qui n'ont pas divulgué leur état. Les récits qui en découlent soulèvent des questions sur la nature de la communauté gaie. Les données touchent aux descriptions des participants concernant 1) la méta-culture hétérosexuelle; 2) les lieux de la culture gaie; 3) les éléments non solidaires au sein de la communauté gaie. L'analyse des données d'entrevue situe celle-ci comme un espace à la fois d'inclusion et d'exclusion et comme un milieu hétérogène.

Get Tested Why Not? A novel approach to internet-based chlamydia and gonorrhea testing in Canada.

OBJECTIVE: The objective of the Get Tested Why Not campaign is to increase access to chlamydia and gonorrhea testing and sexual health information, with specific focus on youth. PARTICIPANTS: Individuals between the ages of 15-29 are most affected by chlamydia and gonorrhea infections in Ottawa and were identified as the target population. Youth from the target population were engaged in the development and launch of the campaign. SETTING: Development of the campaign began in 2009 and led to a launch on March 21, 2011. Social media promotion as well as traditional advertising approaches developed awareness of the campaign within the target population. INTERVENTION: The campaign consists of a bilingual, youth-friendly website and texting service. After assessing appropriateness of testing, clients can download a requisition form for urine-based chlamydia and gonorrhea testing and submit a sample at one of 26 laboratories across Ottawa. OUTCOMES: During year 1 of the campaign, there were 13,385 website hits and 104 specimens submitted for chlamydia and gonorrhea testing. The majority (57.6%, n=60) of requisitions were submitted by members of the target population (age 15-29). Of the requisitions submitted, 95 (91.3%) were negative, 4 (3.9%) were positive and 5 (4.8%) were cancelled due to lab errors. CONCLUSION: The campaign is reaching the target population and has demonstrated a positive impact on knowledge and intended behaviours of users. The use of technology has expanded testing options, thereby potentially broadening Ottawa Public Health's reach to clients who may be less likely to test through traditional testing approaches.

Nondisclosure prosecutions and population health outcomes: examining HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following nondisclosure prosecution media releases in Ottawa, Canada.

BACKGROUND: During the past decade, the intersection of HIV and criminal law has become increasingly discussed. The majority of studies to date have approached this topic from a sociological or legal perspective. As a result, the potential effect of nondisclosure prosecutions on population health and HIV prevention work remains mostly unknown. METHODS: A descriptive quantitative-qualitative study was undertaken to examine HIV testing, HIV diagnoses, and the attitudes of men who have sex with men following regional media releases about a local nondisclosure prosecution. As part of this study, first, we reviewed the trends in HIV testing and HIV diagnoses from 2008 through 2011 in Ottawa, Canada. Second, we explored the attitudes and beliefs of local MSM about HIV, HIV prevention, HIV serostatus disclosure, nondisclosure prosecutions, and public health. RESULTS: Quantitatively, the findings of this study revealed that, in comparison to the period preceding the media releases about a local nondisclosure prosecution, HIV testing and HIV diagnoses among men who have sex with men did not significantly change after the media releases of interest. Qualitatively, a subgroup of 27 men who have sex with men (12 HIV-positive, 15 HIV-negative) noted their beliefs that the local public health department openly shares information about people living with HIV with the police. Moreover, some HIV-positive participants stated that this perceived association between the local public health department and police services caused them to not access public health department services, notwithstanding their desires to seek assistance in maintaining safer sexual practices. CONCLUSIONS: Nondisclosure prosecutions likely undermine HIV prevention efforts.

RnaPredict--an evolutionary algorithm for RNA secondary structure prediction.

This paper presents two in-depth studies on RnaPredict, an evolutionary algorithm for RNA secondary structure prediction. The first study is an analysis of the performance of two thermodynamic models, Individual Nearest Neighbor (INN) and Individual Nearest Neighbor Hydrogen Bond (INN-HB). The correlation between the free energy of predicted structures and the sensitivity is analyzed for 19 RNA sequences. Although some variance is shown, there is a clear trend between a lower free energy and an increase in true positive base pairs. With increasing sequence length, this correlation generally decreases. In the second experiment, the accuracy of the predicted structures for these 19 sequences are compared against the accuracy of the structures generated by the mfold dynamic programming algorithm (DPA) and also to known structures. RnaPredict is shown to outperform the minimum free energy structures produced by mfold and has comparable performance when compared to sub-optimal structures produced by mfold.

Comparison of P-RnaPredict and mfold--algorithms for RNA secondary structure prediction.

MOTIVATION: Ribonucleic acid is vital in numerous stages of protein synthesis; it also possesses important functional and structural roles within the cell. The function of an RNA molecule within a particular organic system is principally determined by its structure. The current physical methods available for structure determination are time-consuming and expensive. Hence, computational methods for structure prediction are sought after. The energies involved by the formation of secondary structure elements are significantly greater than those of tertiary elements. Therefore, RNA structure prediction focuses on secondary structure. RESULTS: We present P-RnaPredict, a parallel evolutionary algorithm for RNA secondary structure prediction. The speedup provided by parallelization is investigated with five sequences, and a dramatic improvement in speedup is demonstrated, especially with longer sequences. An evaluation of the performance of P-RnaPredict in terms of prediction accuracy is made through comparison with 10 individual known structures from 3 RNA classes (5S rRNA, Group I intron 16S rRNA and 16S rRNA) and the mfold dynamic programming algorithm. P-RnaPredict is able to predict structures with higher true positive base pair counts and lower false positives than mfold on certain sequences. AVAILABILITY: P-RnaPredict is available for non-commercial usage. Interested parties should contact Kay C. Wiese (wiese@cs.sfu.ca).

P-RnaPredict--a parallel evolutionary algorithm for RNA folding: effects of pseudorandom number quality.

This paper presents a fully parallel version of RnaPredict, a genetic algorithm (GA) for RNA secondary structure prediction. The research presented here builds on previous work and examines the impact of three different pseudorandom number generators (PRNGs) on the GA's performance. The three generators tested are the C standard library PRNG RAND, a parallelized multiplicative congruential generator (MCG), and a parallelized Mersenne Twister (MT). A fully parallel version of RnaPredict using the Message Passing Interface (MPI) was implemented on a 128-node Beowulf cluster. The PRNG comparison tests were performed with known structures whose sequences are 118, 122, 468, 543, and 556 nucleotides in length. The effects of the PRNGs are investigated and the predicted structures are compared to known structures. Results indicate that P-RnaPredict demonstrated good prediction accuracy, particularly so for shorter sequences.