Cryptosporidiosis Outbreak Investigation in a Canadian Correctional Facility Using Novel Case Finding Tools.

Eliminating Cryptosporidium oocysts is particularly challenging in prison environments, and limited information is available on best practices for outbreak control. This report aims to expand the evidence base through the lessons learned from an outbreak at a Canadian federal penitentiary in 2013. The outbreak investigation methods included inmate and staff case finding, hypothesis-generating questionnaires, and environmental investigation. A clear source of Cryptosporidium into the facility could not be identified; however, there were a number of possible sources of ongoing propagation within the facility. There were difficulties obtaining valid data on inmate and staff cases and exposures. This report discusses the novel epidemiological tools used in this investigation to address the complex challenges of a correctional setting.

The CARE model of social accountability: promoting cultural change.

On the 10th anniversary of Health Canada and the Association of Faculties of Medicine of Canada's publication in 2001 of Social Accountability: A Vision for Canadian Medical Schools, the authors review the progress at one Canadian medical school, the College of Medicine at the University of Saskatchewan, in developing a culture of social accountability. They review the changes that have made the medical school more socially accountable and the steps taken to make those changes possible. In response to calls for socially accountable medical schools, the College of Medicine created a Social Accountability Committee to oversee the integration of these principles into the college. The committee developed the CARE model (Clinical activity, Advocacy, Research, Education and training) as a guiding tool for social accountability initiatives toward priority health concerns and as a means of evaluation. Diverse faculty and student committees have emerged as a result and have had far-reaching impacts on the college and communities: from changes in curricula and admissions to community programming and international educational experiences. Although a systematic assessment of the CARE model is needed, early evidence shows that the most significant effects can be found in the cultural shift in the college, most notably among students. The CARE model may serve as an important example for other educational institutions in the development of health practitioners and research that is responsive to the needs of their communities.