Spatial analysis of discarded needles and dropbox locations in Calgary, Canada

Concomitant with the rise in the number of people who inject drugs has been an increase in unsafely discarded needles and injection debris. While the scholarly literature indicates that harm reduction programs reduce needle debris, the news media often report otherwise. Using geographic information systems (GIS) software ArcGIS Desktop 10.8 (Esri 2020), we analyzed geospatial data pertaining to needle debris in Calgary (Canada), correlating debris with available needle dropboxes, outreach education, overdoses, and changes over the COVID pandemic. Needle debris was most dense in two central neighbourhoods: Beltline and Downtown Commercial Core. The city’s central neighbourhoods contributed to 83% of all needle discards, which accounted for 73% of discrete locations. Additionally, 51% of discarded needles were collected from the Beltline (40%) and Downtown Commercial Core (11%) neighbourhoods, accounting for 85% of clusters and 71% of hotspots. Overdoses were positively correlated with needle debris. COVID-19 pandemic restrictions were linked to a spike in the number of discards. Needle debris is a complex social, environmental and public health issue that requires a multifaceted approach. GIS mapping is a powerful tool that can locate hotspots so that resources can be deployed.Parallèlement à l’augmentation du nombre de personnes qui s’injectent des drogues, il y a eu une augmentation des aiguilles et des débris d’injection mis au rebut de manière non sécuritaire. Alors que la littérature scientifique indique que les programmes de réduction de risques réduisent les débris d’aiguilles, les médias rapportent souvent le contraire. À l’aide du logiciel de système d’information géographique (SIG), nous avons analysé les données géo-spatiales relatives aux débris d’aiguilles à Calgary (Canada), en corrélant les débris avec les boîtes de dépôt d’aiguilles disponibles, programme de sensibilisation et d’éducation, les surdoses et les changements au cours de la pandémie de COVID. Les débris d’aiguilles étaient les plus denses dans deux quartiers centraux : Beltline et Downtown Commercial Core. Les quartiers centraux de la ville ont contribué à 83 % de tous les rejets d’aiguilles, qui représentent 73 % des emplacements discrets. De plus, 51 % des aiguilles jetées ont été recueillies dans les quartiers Beltline (40 %) et les quartiers de Downtown Commercial Core (11 %), représentant 85 % des grappes et 71 % des points chauds. Les surdoses étaient positivement corrélées avec les débris d’aiguilles. Les restrictions liées à la pandémie de COVID-19 étaient liées à une augmentation du nombre de rejets d’aiguilles. Les débris d’aiguilles sont un problème social, environnemental et de santé publique complexe qui nécessite une approche multidimensionnelle. La cartographie SIG est un outil puissant qui peut localiser les points chauds afin que les ressources puissent être déployées

Community health nursing practice education: preparing the next generation

Sherpa Romeo yellow journal. Permission to archive final published versionUndergraduate nursing practice rotations today are quite different from what many practicing nurses experienced during their own education. This is especially true of community health practice rotations. Increasingly, non-traditional community health sites are being used as practice sites—sites such as schools, homeless shelters, non-profit agencies, and even churches. Increasingly, non-traditional practice experiences are eclipsing traditional practice experiences involving home care and public health. Why has this shift occurred, and what do these experiences offer students? Do these experiences actually prepare nursing students for clinical practice once they graduate? What does preparing the next generation of community health nurses entail?Ye

Nursing students achieving community health competencies through undergraduate clinical experiences: a gap analysis

Sherpa Romeo yellow journal. Permission to archive final published versionIn Canada, it is widely believed that nursing practice and health care will move from acute care into the community. At the same time, increasing numbers of nursing students are engaged in non-traditional clinical experiences for their community health rotation. These clinical experiences occur at agencies not organizationally affiliated with the health care system and typically do not employ registered nurses (RNs). What has yet to be established is the degree to which nursing students are actually being prepared for community health nursing roles through their community health clinical rotations. In this paper we report the findings of a mixed method study that explored the gap between desired and observed levels of competence in community health of senior nursing students and new graduates. The gap was quantified and then the nature of the gap further explored through focus groups.Ye

Restoring the blessings of the morning star: childbirth and maternal-infant health for First Nations near Edmonton, Alberta

Open access article.It is not only remote Aboriginal communities in Canada that have poorer maternalinfant health status than Canadian averages; residents of First Nation communities located close to large urban centres also experience this health status gap. Alexander, Alexis, Enoch, and Paul First Nations are located within an hour of healthcare services in greater Edmonton. The narratives of 75 predominantly Cree and Stoney women from these communities were gathered through seven talking circles and five semi-structured interviews. The participants described their experiences of loss and separation as pregnancy care and childbirth moved out of the community and into the hospital over the last two generations. This shift was not only a geographic relocation; it also disconnected the childbirth experience from elders, family and community, traditional teachings, and spiritual meaning. Conversely, the participants’ hospital experiences were characterized by a limited sense of cultural safety. Participants highlighted the urgent need to reintegrate culturally based community support and health perspectives into the childbirth experience. The implementation of such a culturally integrated healthcare model in all Aboriginal communities—remote, rural, suburban, and urban—may be the key finally to closing the gap between Aboriginal and non-Aboriginal maternal and infant health status in Canada.Ye

Pitch Comparisons between Electrical Stimulation of a Cochlear Implant and Acoustic Stimuli Presented to a Normal-hearing Contralateral Ear

Four cochlear implant users, having normal hearing in the unimplanted ear, compared the pitches of electrical and acoustic stimuli presented to the two ears. Comparisons were between 1,031-pps pulse trains and pure tones or between 12 and 25-pps electric pulse trains and bandpass-filtered acoustic pulse trains of the same rate. Three methods—pitch adjustment, constant stimuli, and interleaved adaptive procedures—were used. For all methods, we showed that the results can be strongly influenced by non-sensory biases arising from the range of acoustic stimuli presented, and proposed a series of checks that should be made to alert the experimenter to those biases. We then showed that the results of comparisons that survived these checks do not deviate consistently from the predictions of a widely-used cochlear frequency-to-place formula or of a computational cochlear model. We also demonstrate that substantial range effects occur with other widely used experimental methods, even for normal-hearing listeners

The role of disease characteristics in the ethical debate on personal genome testing

Background: Companies are currently marketing personal genome tests directly-to-consumer that provide genetic susceptibility testing for a range of multifactorial diseases simultaneously. As these tests comprise multiple risk analyses for multiple diseases, they may be difficult to evaluate. Insight into morally relevant differences between diseases will assist researchers, healthcare professionals, policy-makers and other stakeholders in the ethical evaluation of personal genome tests. Discussion. In this paper, we identify and discuss four disease characteristics - severity, actionability, age of onset, and the somatic/psychiatric nature of disease - and show how these lead to specific ethical issues. By way of illustration, we apply this framework to genetic susceptibility testing for three diseases: type 2 diabetes, age-related macular degeneration and clinical depression. For these three diseases, we point out the ethical issues that are relevant to the question whether it is morally justifiable to offer genetic susceptibility testing to adults or to children or minors, and on what conditions. Summary. We conclude that the ethical evaluation of personal genome tests is challenging, for the ethical issues differ with the diseases tested for. An understanding of the ethical significance of disease characteristics will improve the ethical, legal and societal debate on personal genome testing

Does soil pyrogenic carbon determine plant functional traits in Amazon Basin forests?

Amazon forests are fire-sensitive ecosystems and consequently fires affect forest structure and composition. For instance, the legacy of past fire regimes may persist through some species and traits that are found due to past fires. In this study, we tested for relationships between functional traits that are classically presented as the main components of plant ecological strategies and environmental filters related to climate and historical fires among permanent mature forest plots across the range of local and regional environmental gradients that occur in Amazonia. We used percentage surface soil pyrogenic carbon (PyC), a recalcitrant form of carbon that can persist for millennia in soils, as a novel indicator of historical fire in old-growth forests. Five out of the nine functional traits evaluated across all 378 species were correlated with some environmental variables. Although there is more PyC in Amazonian soils than previously reported, the percentage soil PyC indicated no detectable legacy effect of past fires on contemporary functional composition. More species with dry diaspores were found in drier and hotter environments. We also found higher wood density in trees from higher temperature sites. If Amazon forest past burnings were local and without distinguishable attributes of a widespread fire regime, then impacts on biodiversity would have been small and heterogeneous. Alternatively, sufficient time may have passed since the last fire to allow for species replacement. Regardless, as we failed to detect any impact of past fire on present forest functional composition, if our plots are representative then it suggests that mature Amazon forests lack a compositional legacy of past fire