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Experiences of African immigrant/refugee women with prenatal and maternal health care services and treatment adherence in Winnipeg, Manitoba
Get PDFIn recent years, the number of immigrants who come to Canada seeking health care has increased. The study had three objectives: (1) describe how some African immigrant/refugee women living in Manitoba access perinatal and maternal health care services; (2) describe their interactions with health care providers and (3) describe how their experience impacts their treatment adherence. The study utilized principles of community-based participatory research in partnership with Sexuality Education Resources Centre Manitoba (SERC) representative leaders. Purposive and snowball sampling methods were used to recruit 16 women from SERC and local African community organizations. Data collection included in-depth interviews, and analysis was based on interpretative phenomenological analysis (IPA) and intersectionality from a black feminist tradition. IPA facilitated the description of meanings provided by the women of their experiences and intersectionality enabled to highlight issues such as how perceived racism can intersect with being immigrants/refugees facing unique challenges while accessing health care. The participants shared accessing these services through Mom and Me program, clinics, and family doctors. The women who arrived while pregnant or became pregnant within the first two years of their stay in Winnipeg experienced barriers such as language differences and lack of social support. Some of the main themes that emerged from the women’s experiences with accessing care included: it was tough, trying to understand and left hanging. The women described positive and negative experiences with health care providers. The lack of understanding of the health care system led the women feeling unsure if their experience was due to racism/discrimination or to structural barriers. The women also shared not following some recommendations due to their traditional/cultural way of caring for a newborn. To our knowledge this is the first study that focused on African immigrant/refugee women’s experience with prenatal and maternal services in Manitoba. The findings from the study may help health care professionals to provide more holistic care. The study may also inform policy and advocacy actions to improve health services to this population.Dr. Michelle Driedger’s research project (Changing the patient-PCP dialogue: Fostering trust through joint clinical decision making) supported by the Canadian Institutes of Health Research (grant number 156052)May 202
The role of innovation and adaptation technologies in climate change-induced disaster risk reduction: enhancing resilience in Satkhira communities of Bangladesh
Get PDFClimate-induced disasters, exacerbated by the changing climate, pose significant threats to the coastal communities of Bangladesh. This thesis investigates the multifaceted strategies of innovation, adaptation technology, and institutional processes to respond to and mitigate the impacts of climatic disasters and strengthen local communities' resilience. The required field data were collected from December 2022 to February 2023 in two coastal Unions of Bangladesh using various Participatory Rural Appraisal (PRA) tools such as key informant interviews, household surveys, and focus group discussions.
The research findings revealed that innovation and adaptation technologies emerge as critical components to minimize vulnerability and enhance preparedness in the face of catastrophic events. Innovations such as the Cyclone Preparedness Programme (CPP) help vulnerable communities by disseminating warning information and evacuating them to safer locations with the help of the CPP volunteers. The households avail loans and/or credit from various microfinance institutions (MFIs) to “bounce back” from climatic disasters. Such financial assistance has proven instrumental in facilitating timely repairs and reconstruction of houses in the aftermath of extreme climatic events, while also assisting in restoring livelihood activities and income generation. Adoption of adaptation technology is another strategy that is being widely practiced in the study area to cope with the shocks and stresses arising from climate change.
The formal, quasi-formal, and informal institutions were found to be deeply engaged locally in promoting climatic risk reduction efforts. These institutions facilitate the development of livelihood strategies, provide access to credit services, and help in mitigating climatic risks through knowledge sharing within the local community. The policy recommendations from the research underscore the necessity of a comprehensive framework for enhancing the resilience and adaptive capacity of coastal communities. Furthermore, it also emphasizes the integration of innovation and adaptation technologies at the local level for sustainable development.May 202
Numerical modelling of drying processes in a mixed-flow grain dryer based on coupled discrete element and computational fluid dynamics method
No full textThe main objective of this research was to develop a numerical model to simulate the transport phenomena involved in the grain drying processes in mixed-flow grain dryers by coupling the discrete element method (DEM) and computational fluid dynamics (CFD), and utilize the proposed model for the design assessment and optimization of mixed-low grain dryers. The formation of the grain bed and the movement of the grain kernels were simulated by the proposed DEM model which was developed using a commercial software package PFC3D (Particle Flow Code in Three Dimension, Itasca Consulting Group, Inc. Minneapolis, MN). Heat and mass transfer, as well as the air flow pattern were solved in the proposed CFD model, which was developed in ANSYS Fluent 2022. The coupling between the DEM and CFD models was realized by custom-coded algorithms in Matlab (Version 8.4) following a quasi-static fashion, i.e., each simulation was run incrementally in the time domain and the simulation results (data) were transferred between the CFD and DEM models after each time increment. The coupled CFD-DEM, as well as component DEM and CFD models, was validated against experimental data extracted from the literature in terms of grain temperature and moisture content distribution, as well as grain movement and airflow pattern. Close agreements were achieved between simulated results of the coupled CFD-DEM model and published experimental data, with an average difference of 4.3% for grain temperature and 2.5% for grain moisture content.
The model revealed the detailed distribution patterns of grain movement, temperature and moisture content. Specifically, the grain movement was slowed down by the air ducts and dryer walls, causing nonuniform distribution of grain velocity across the dryer, with the lowest velocity at about 43% of the highest velocity. The low-velocity zones were found underneath the air ducts. This nonuniform distribution of grain velocity resulted in large disparities in the residence time of drying, with the longest residence time (66 min) being 3.3 times the shortest one (20 min) while the median time was 36 min. There were considerable variations in grain temperature within the drying column, with the highest grain temperature underneath the inlet air ducts, while “cold zones” existed in the near-wall region. The grain moisture content was not uniform across the dryer, with the lowest moisture content underneath the inlet air duct and the higher moisture near the dryer walls.
Using empirical models in the literature, the potential reduction in grain quality during drying was estimated in terms of risks of germination reduction and fissure (stress cracking) of grain kernels, which were predicted based on the grain temperature and moisture simulated by the coupled CFD-DEM model. A valuable function of the model was the ability to predict the zones within the dryer where grain could potentially experience quality losses. These zones were generally located underneath the inlet air ducts.
The model was also applied to assessment of different duct designs and layouts in mixed-flow grain dryers. It was found that the air ducts with 60-degree angles resulted in the best drying performance among the five duct geometries that were simulated. The best layout had the ratio of vertical distance to duct height of 1.35 and the ratio of horizontal distance to duct width of 1.5.February 202
Management of agricultural pesticide rinsate using a biobed under Manitoba conditions
No full textA dual-celled biobed was built at the Ian Morrison N. Research farm in Carman, MB to degrade and retain the pesticides from pesticide rinsate derived at the farm. The biobed was designed for Manitoba conditions with considerations taken from existing biobeds in the Province of Saskatchewan. Temperature and moisture of the biomixture contained within the biobed was monitored using probes for the duration of the study. Three pesticides (2,4-DB, dicamba, and metrafenone) were detected in the biomixture prior to pesticide input from rinsing in 2020 but had degraded by the end of the season and were no longer detected. The Influent of the biobed was analyzed for a suite of pesticides and 23 pesticides and one pesticide metabolite were detected. In Effluent One only 11 of the 24 compounds were detected, and six compounds were detected in Effluent Two. Total pesticide concentrations significantly decreased for Influent > Effluent One > Effluent Two. Pesticides detected in the effluents tended to have higher GUS or Koc values. In 2021, a large influx of prepared spraying liquid containing glufosinate (approximately 680L) overburdened the biobed and resulted in reduced degradation and increasing mean concentrations from Influent > Effluent One > Effluent Two. Glufosinate and seven other pesticides detected in the influent were not measured in biomix due to method limitations. There were three pesticides (bifenthrin, trifloxystrobin, and diuron) detected in the biomixture samples in 2021, and only diuron, which had the highest GUS and Koc values, was still detected at the end of the season.Natural Science and Engineering Research Council of Canada (NSERC)
Canadian Agricultural Partnership (CAP)May 202
Perspectives on research and health of individuals with lived experience of opioid use in pregnancy
No full textOpioid use in Canada has been on the rise over the past two decades, and many individuals who use opioids are of child-bearing age. Although significant research exists on the effects of opioid use in pregnancy for both the pregnant individual and the child, few studies to date have engaged individuals with lived experience of opioid use in pregnancy to determine research priorities that are important to this population. From November 2022 to August 2023, twelve interviews were conducted with individuals who have used opioid in pregnancy. Participants were given space to share their story and questioned on research priorities that were meaningful to them. Data were coded and analyzed with Dedoose, using a hermeneutic phenomonelogical framework.
Relative to personal experience and research guidance shared by birth parents, five themes were identified: 1) addiction and mental health; 2) impact of Child and Family Services; 3) lack of knowledge within the healthcare system; 4) stigmatizing interactions with the health care system; and 5) recommendations for future research. Individuals articulated the need for positive, trusting, and non-judgemental relationships between researchers, health care practitioners, and patients with opioid-affected pregnancies. Participants expressed the need for detailed information on best practices in opioid use and pregnancy, resources available to parents, and short and long-term effects of opioid use in pregnancy. Majority of participants expressed a desire for further clinical and social research on opioid-affected pregnancies. Future research and health care interactions with individuals with opioid-affected pregnancies must be founded in principles of non-judgemental care, harm reduction, relationship-building and reducing stigma.February 202
Together At Last: An Academic and Public Library Leisure Reading Partnership
No full textThe creation of leisure reading collections in health sciences libraries is a growing trend, due in part to research that has shown the connection between recreational reading and both academic achievement and personal and cultural enrichment.
This presentation will highlight the partnership process undertaken by Winnipeg Public Library and the University of Manitoba to create a leisure reading collection for faculty, staff, students, and patients and their families housed at the Neil John Maclean Health Sciences Library.
Included will be a discussion of the specific model used to create the collection; the creation of a partnership document outlining roles, responsibilities, desired outcomes and evaluation; and the challenges faced by the project. A preliminary evaluation of usage data will be presented, as well as future directions for the collection
Telling stories of resistance – calling to ancestral strength: an exploration of mental health support service access and adequacy for Indigenous mothers in Manitoba
No full textBackground. Indigenous mothers in Canada experience disproportionate adversity related to mental health with increased risk of anxiety and depression (Black et al., 2019; Owais et al., 2020). The mental health disparity between Indigenous and non-Indigenous mothers reveals the need to provide mental health support services that are culturally aligned and meet the specific needs of this community. A subset of Indigenous identifying individuals who participated in a family mental health program for mothers of young children were contacted and invited to participate in an individual interview to share their experiences and provide their perspectives on mental health support service seeking. Research Objective and Questions. The aim of this study was to build knowledge surrounding the experiences of Indigenous mothers with mental health support service seeking and participation to inform improvements in mental health programming. This objective was framed around two central research questions. 1. What are the experiences and motivations of Indigenous mothers seeking and participating in mental health programs starting in the perinatal period? 2. How can improvements be made to existing programs? Methods. The research team conducted seven virtual interviews with individual participants. Data was analyzed using a narrative and interpretive meaning making approach, situating results within social, cultural, kinship, and individual contexts. Results. Findings illustrated key storylines across sub-samples of Anishinaabe (n=3) and Métis (n=4) participants. Within the stories shared by participants across sub-samples, key recommendations for program improvement were made including offering weekly hybrid program sessions, integrating traditional teachings from Elders into program content, providing childcare for children of participants, implementing mandatory cultural sensitivity training for facilitators, offering free programming, and increasing opportunities for relationship building among participants. Discussion. Results highlight the value of relationality in the wellbeing of Indigenous mothers, as well as the importance of culturally responsive and trauma informed care in program delivery. This research will offer guidance for future studies and service providers aiming to incorporate Indigenous perspectives into program development and implementation. Findings may be used to create novel, culturally appropriate interventions to support Indigenous women and families.October 202
The role of thioredoxin-interacting protein in corticosterone-impaired neurite outgrowth
No full textBackground: Glucocorticoid is produced in response to stress. Chronic stress is a high risk factor for developing psychiatric disorders. Many studies have shown that chronic stress and chronic treatment with stress hormone corticosterone cause oxidative damage in the brain. Thioredoxin is an oxidoreductase that reduces protein cysteine oxidation. Thioredoxin also facilitates peroxiredoxin-induced scavenging of H2O2, preventing protein cysteine oxidation and carbonylation. Trx can also bind to apoptosis signal-regulating kinase 1 (ASK1) and inhibit apoptosis. Thioredoxin-interacting protein (Txnip) is an endogenous thioredoxin inhibitor, promoting protein cysteine oxidation and carbonylation, and activating ASK1 apoptotic signaling. Previously, our laboratory found that chronic corticosterone treatment had no effect on thioredoxin levels, but increased Txnip levels in cultured mouse neurons, indicating that corticosterone may upregulate Txnip and cause oxidative damage to neurons.
Objective: Establishing if chronic corticosterone treatment increases Txnip, causing oxidative protein damage and impairing neurite outgrowth.
Methods and Results: Using immunoblotting analysis we found that although chronic treatment with corticosterone for 5 days had no effect on Trx, this treatment dose-dependently increased Txnip levels in primary cultured mouse cerebrocortical neurons. Using dimedone conjugation, biotin hydrazide conjugation and biotin-switch methods respectively, we also found that chronic corticosterone treatment increased protein cysteine sulfenylation and protein carbonylation, but had no effect on protein cysteine nitrosylation. We also found that chronic corticosterone had no effects on ASK phosphorylation, cell viability. Cultured neurons were stained by microtubule-associated protein 2 antibody using immunocytochemistry to analyze neurite outgrowth. We found that chronic corticosterone treatment reduced length and number of neurite branches. To determine the role of Txnip in corticosterone-induced neurite damage, Txnip genes were knocked down by CRISPR/Cas9/Txnip sgRNA technique. We found that knocking down Txnip prevented corticosterone-reduced length and number of neurite branches.
Conclusion: Our findings suggest that chronic corticosterone treatment upregulates Txnip, promoting protein oxidative damage and impairing neurite outgrowth; and also suggest that Txnip may be a potential target for the treatment of psychiatric disorders.October 202
Ascertaining the Francophone population in Ontario: validating the language variable in health data
No full textBackground
Language barriers can impact health care and outcomes. Valid and reliable language data is central to studying health inequalities in linguistic minorities. In Canada, language variables are available in administrative health databases; however, the validity of these variables has not been studied. This study assessed concordance between language variables from administrative health databases and language variables from the Canadian Community Health Survey (CCHS) to identify Francophones in Ontario.
Methods
An Ontario combined sample of CCHS cycles from 2000 to 2012 (from participants who consented to link their data) was individually linked to three administrative databases (home care, long-term care [LTC], and mental health admissions). In total, 27,111 respondents had at least one encounter in one of the three databases. Language spoken at home (LOSH) and first official language spoken (FOLS) from CCHS were used as reference standards to assess their concordance with the language variables in administrative health databases, using the Cohen kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV).
Results
Language variables from home care and LTC databases had the highest agreement with LOSH (kappa = 0.76 [95%CI, 0.735–0.793] and 0.75 [95%CI, 0.70–0.80], respectively) and FOLS (kappa = 0.66 for both). Sensitivity was higher with LOSH as the reference standard (75.5% [95%CI, 71.6–79.0] and 74.2% [95%CI, 67.3–80.1] for home care and LTC, respectively). With FOLS as the reference standard, the language variables in both data sources had modest sensitivity (53.1% [95%CI, 49.8–56.4] and 54.1% [95%CI, 48.3–59.7] in home care and LTC, respectively) but very high specificity (99.8% [95%CI, 99.7–99.9] and 99.6% [95%CI, 99.4–99.8]) and predictive values. The language variable from mental health admissions had poor agreement with all language variables in the CCHS.
Conclusions
Language variables in home care and LTC health databases were most consistent with the language often spoken at home. Studies using language variables from administrative data can use the sensitivity and specificity reported from this study to gauge the level of mis-ascertainment error and the resulting bias
COVID-19 vaccinations among incarcerated populations in North America: a mixed-methods systematic review
No full textCorrectional facilities are susceptible to infectious disease outbreaks, as evidenced during the COVID-19 pandemic. Achieving a high and sustained rate of COVID-19 vaccination is essential to control future outbreaks and safely resume normal activities within correctional facilities. This mixed-methods systematic review synthesized the literature on the associated social determinants of health, the facilitators, and the barriers of COVID-19 vaccination in incarcerated populations in North America. A search of five databases was performed on October 11th, 2023. Peer-reviewed, primary quantitative, qualitative, and mixed-methods studies published in English in the years following 2020, focusing on COVID-19 vaccination in incarcerated populations in North America were included in the review. A total of 15 studies were included in the review. Data from the included studies was extracted and synthesized using a segregated approach to data synthesis. The quantitative findings include two individual and group-level determinants, three health-related determinants, four correctional determinants, and one policy-level determinant of COVID-19 vaccination. According to the review’s findings, target groups for COVID-19 vaccination interventions should include younger and healthier adults, Black/African American and Indigenous individuals, those who recently refused the Influenza vaccine and who report low medical trust, individuals in jail facilities who are single-celled and have a medium to maximum-security classification, and populations not prioritized for early vaccination in vaccination policies. The qualitative findings include seven synthesized findings on the barriers and facilitators of vaccination in incarcerated populations and the correctional setting. Barriers of vaccination include vaccination-programme related factors, a lack of vaccine knowledge, social pressure and negative social norms, universal distrust, risk perceptions, beliefs about health and immunity rendering vaccination unimportant, and not perceiving one’s vaccination as impactful. Facilitators of vaccination include the right type of vaccine recommendation, positive social norms, belief in the protective benefits of vaccination, and vaccine incentives.University of Manitoba, Doris Irene Wilton Memorial Scholarship, Award # 43517
University of Manitoba, Foundation for Registered Nurses of Manitoba Inc. Graduate Award
University of Manitoba, Christina Gow Community Health Nursing Scholarship, Award # 43980
University of Manitoba, Manitoba Training Program for Health Services Research Award
Irene E. Nordwich Foundation, Irene E. Nordwich Foundation Award
University of Manitoba, Mona McLeod Award, Award # 44397
Winnipeg Regional Health Authority, WRHA Education FundMay 202