COVID-19 among Black people in Canada: a scoping review. / La COVID-19 chez les personnes noires au Canada : un examen de la portée.

INTRODUCTION: The COVID-19 pandemic exacerbated health inequities worldwide. Research conducted in Canada shows that Black populations were disproportionately exposed to COVID-19 and more likely than other ethnoracial groups to be infected and hospitalized. This scoping review sought to map out the nature and extent of current research on COVID-19 among Black people in Canada. METHODS: Following a five-stage methodological framework for conducting scoping reviews, studies exploring the effects of the COVID-19 pandemic on Black people in Canada, published up to May 2023, were retrieved through a systematic search of seven databases. Of 457 identified records, 124 duplicates and 279 additional records were excluded after title and abstract screening. Of the remaining 54 articles, 39 were excluded after full-text screening; 2 articles were manually picked from the reference lists of the included articles. In total, 17 articles were included in this review. RESULTS: Our review found higher rates of COVID-19 infections and lower rates of COVID-19 screening and vaccine uptake among Black Canadians due to pre-COVID-19 experiences of institutional and structural racism, health inequities and a mistrust of health care professionals that further impeded access to health care. Misinformation about COVID-19 exacerbated mental health issues among Black Canadians. CONCLUSIONS: Our findings suggest the need to address social inequities experienced by Black Canadians, particularly those related to unequal access to employment and health care. Collecting race-based data on COVID-19 could inform policy formulation to address racial discrimination in access to health care, quality housing and employment, resolve inequities and improve the health and well-being of Black people in Canada.

Equity, diversity, and exclusion? A national mixed methods study of "belonging" in Canadian undergraduate medical education.

Equity, diversity, and inclusion remain a prominent focus in medical schools, yet the phenomenon of "belonging" has arguably been overlooked. Little is known regarding how belonging is experienced by medical students from groups that face systemic oppression and exclusion. We employed a sequential explanatory mixed methods design to explore how students from equity-deserving groups (EDGs) experience belonging during medical school, including those who are women, racialized, Indigenous, disabled, and 2SLGBTQIA+. First, we conducted a national cross-sectional survey of medical students (N = 480) measuring four constructs: belonging, imposter syndrome, burnout, and depression. Belonging scores were overall lower for students from EDGs and, more specifically, significantly lowest amongst racialized students. Structural equation models show that poor sense of belonging precedes imposter syndrome and further exacerbates burnout and depression. Next, we sampled and interviewed students (N = 16) from the EDG whose belonging scores were significantly lowest. Participants described the essence of belonging as being able to exist as one's "true self" while emphasizing feelings of acceptance, comfort, and safety as well as being valued and seen as an equal - yet described how routine experiences of "othering" inhibited a sense of belonging, often due to differences in social identity and structural privilege. Poor sense of belonging negatively affected learners' well-being and career trajectory. We illuminate the range of psychological and professional consequences associated with diminished sense of belonging and highlight the need to expand traditional notions of equity, diversity, and inclusion to consider structural barriers to belonging.

Sternal plate fixation for sternal wound reconstruction: initial experience (retrospective study).

BACKGROUND: Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4-5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. METHODS: A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate (Titanium Sternal Fixation System®, Synthes). Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean±SD, Median (range) or number (%). Statistical analyses were made by using Excel 2003 for Windows (Microsoft, Redmond, WA, USA). RESULTS: There were 40 consecutive patients, 31 males and 9 females. Twenty two patients (55%) were diagnosed with sternal dehiscence alone and 18 patients (45%) with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. CONCLUSION: Sternal plating appears to be an effective option for the treatment of sternal wound dehiscence associated with sternal instability. Long-term follow-up and further larger studies are needed to address the indications, benefits and complications of sternal plating.

The effects of short- vs. long-bout exercise on mood, VO2max, and percent body fat.

BACKGROUND: To compare the ACSM-CDC physical activity accumulation recommendation to the traditional recommendation, for impact on mood and physiological markers of fitness. METHODS: Randomized controlled trial with sedentary male (n = 21) and female (n = 19) subjects assigned to walk either long bouts (LB; 30 min/day), short bouts (SB; 3 x 10 min/day), or a nonexercise control (CTL) group for 8 weeks. Pre- and post-measures were collected for V02max and percent body fat. Pre-, mid-, and post-measures were collected for the Profile of Mood States (POMS). RESULTS: VO2max increased in the SB group (+7.2%) and LB (+6.7%; P < or = 0.05). Percent body fat decreased in the LB group (-6.7%; P < or = 0.05). Total mood disturbance (TMD) decreased in the LB and SB groups (P < or = 0.05); only the LB group showed reductions compared to the CTL group (P < or = 0.05). Tension-anxiety and vigor-activity were altered in the LB group compared to the other two groups (P < or = 0.05). Reductions in percent body fat correlated with TMD (r = 0.38; P < or = 0.05) and Tension-anxiety reduction (r = 0.40; P < or = 0.05). CONCLUSIONS: LB and SB walking produced similar and significant improvements in VO2max LB walking was more effective at reducing percent body fat, tension-anxiety and total mood disturbance, and increasing vigor compared to the control group.

Carpal tunnel syndrome and workers' compensation: A cross-Canada comparison.

Carpal tunnel syndrome (CTS) is the source of substantial workers' compensation claims in industrialized countries. Its pathogenesis, however, continues to be questioned. The purpose of the present study was to assess the attitudes of Canadian plastic surgeons toward Workers' Compensation Board (WCB)-supported claims for CTS and to assess patterns of resource allocation across Canada. Sixty-seven plastic surgeons were asked to read a clinical scenario and respond whether they would support a WCB claim for CTS. Provincial WCB offices were contacted and asked to provide statistics surrounding CTS claims for 1997 to 2001. Fifty-eight per cent (39 of 67) of surgeons surveyed felt that CTS should be covered as a WCB claim, while 42% (28 of 67) felt that it should not be covered by WCB. In British Columbia, 50% (six of 12) of surgeons were in support of the claim compared to 92% (11 of 12) of those from Alberta, 55% (17 of 31) of those from the Central Provinces and 42% (five of 12) of those from the Maritime Provinces. Trends of resource allocation and number of CTS claims per year are presented for the individual provinces for 1997 to 2001. An extensive literature review revealed that there is minimal to no evidence to support the view that CTS should be a compensated claim. As defined by the WCB of Canada, a compensated claim is one that "arises out of, and in the course of, employment and that results from causes and conditions peculiar to the trade, occupation or industry." The ambiguity in the beliefs of Canadian plastic surgeons in supporting CTS as a WCB claim reflects a situation where many of the decisions to cover CTS as a WCB claim are not evidence based.

Le syndrome du canal carpien (SCC) est la source d'importantes réclamations d'indemnisations de la part des travailleurs des pays industrialisés. Sa pathogenèse continue toutefois d'être remise en question. La présente étude vise à évaluer les attitudes des plasticiens canadiens par rapport aux réclamations reliées au SCC auprès de la Commission de la santé et de la sécurité du travail (CSST) ainsi que les schèmes d'attribution des ressources au Canada.Soixante-sept plasticiens ont été invités à lire un scénario clinique et à répondre s'ils soutiendraient une réclamation reliée au SCC auprès de la CSST. On a communiqué avec les bureaux de la CSST des provinces pour qu'ils fournissent des statistiques au sujet des réclamations reliées au SCC entre 1997 et 2001. Cinquante-huit pour cent (39 des 67) chirurgiens sondés pensaient que le SCC devrait être couvert par la CSST, tandis que 42 % (28 des 67) d'entre eux pensaient qu'il ne devrait pas l'être. En Colombie-Britannique, 50 % (six des 12) des plasticiens soutenaient la réclamation, par rapport à 92 % (11 des 12) des plasticiens de l'Alberta, à 55 % (17 des 31) de ceux des provinces centrales et à 42 % (cinq des 12) de ceux des Maritimes. Les tendances d'attribution des ressources et le nombre de réclamations reliées au SCC par année sont présentés pour chacune des provinces entre 1997 et 2001.Une analyse bibliographique fouillée révèle qu'il existe peu de données probantes, sinon aucune, pour soutenir une réclamation reliée au SCC. Telle qu'elle est définie par la CSST du Canada, une indemnisation découle de l'emploi et résulte de causes et de troubles propres au métier, à l'emploi ou à l'industrie. L'ambiguïté des convictions des plasticiens canadiens quant au soutien d'une réclamation reliée au SCC auprès de la CSST reflète le fait que bon nombre des décisions pour que la CSST indemnise les cas de SCC ne sont pas fondées sur des faits probants.