The Winnipeg Regional Health Authority (WRHA; French: Office régional de la santé de Winnipeg, ORSW) is the governing body for healthcare regulation for the City of Winnipeg, the northern community of Churchill, and the Rural Municipalities of East and West St. Paul, in the Canadian province of Manitoba. The WRHA also provides health-care support and specialty referral services to those Manitobans who live out of these boundaries, as well as residents of northwestern Ontario and Nunavut.The Winnipeg health region is divided into 12 community areas for the purpose of aiding the delivery of health services. Operating or funding more than 200 health service facilities and programs, the WRHA is the largest of the five Regional Health Authorities (RHAs) in Manitoba. More particularly, the WRHA consists of 35 personal care homes, 12 community health agencies, 20 community health offices, 2 tertiary hospitals, 4 community hospitals, and 4 long-term care centres.In October 2008, the Winnipeg Free Press announced that WRHA was named one of Manitoba's Top Employers; and, as of 2021, it employs over 14,000 people.As of 2009, the WRHA also publishes a bi-monthly health and wellness magazine, called Wave. Beginning publication in 2009, Wave moved to being an online-only magazine in 2017. Brian Cole was the editor of the magazine at the time.
BACKGROUND:Pediatric surgical societies in high-income countries (HICs) have historically offered travel fellowships to surgeons from low- and middle-income countries (LMICs) to attend annual meetings. The value and return on investment of these programs have recently been questioned. We surveyed the experiences and outcomes of these fellows. METHODS:We conducted a sequential, explanatory, mixed-methods study of travel fellows who attended APSA, BAPS, CAPS, or PAPS annual meetings. Participants completed an anonymous online survey exploring their experience, outcomes, and feedback. Amenable participants completed virtual semi-structured interviews, that were transcribed for thematic analysis. RESULTS:Of 65 fellows contacted, 35 (54 %) provided complete survey responses, including 24 men (69 %) and 11 women (31 %), from 26 LMICs. Fellows' self-reported outcomes were highly favorable with respect to the fellowship's impact on their knowledge, skill acquisition, professional development, networking, and local practice environment. All but one fellow found the fellowship worthwhile, and all would recommend it to a colleague. Currently, most alumni (71 %) hold an academic position at the rank of associate professor or higher. Thematic analysis of the 20 interviews revealed both strengths (international community-building, exposure to a different practice environment) and weaknesses (lack of direct patient care, short fellowship duration, and visa difficulties). CONCLUSION:Travel fellowships awarded by HIC pediatric surgical societies to LMIC pediatric surgeons are highly valued by recipients, and foster important collaborations, practice enhancement, and career advancement, albeit not without logistical hurdles. Feedback from recipients can further improve host associations' return on investment. LEVEL OF EVIDENCE:Not Applicable.
Many studies have investigated the relationship between vaginal and cesarean births and child developmental outcomes. However, evidence on whether mode of delivery influences long-term academic performance remains inconsistent, especially within Nigerian primary school populations. The present study assessed whether mode of delivery (vaginal vs. cesarean section) influences academic performance among primary school pupils in Ogbomoso, Oyo State, Nigeria. This descriptive school-based cross-sectional study recruited 481 pupils using a multistage sampling technique. Data were collected using a structured, pretested questionnaire and validated academic records. Sociodemographic and perinatal variables were obtained from parents/guardians. Academic performance was calculated using weighted continuous assessments and end-of-term examinations. Statistical analysis was conducted using SPSS v26. Chi-square tests and multivariable logistic regression assessed associations, with significance set at 5
Objective: The median sternotomy remains the most common surgical approach in most centers performing cardiac surgery. Patients are traditionally required to undergo 6 to 8 weeks of postoperative sternal precautions, placing significant limitations on their daily activities. The aim of this study was to determine the safety of an evidence-based movement strategy (Moving Safely) with and without the use of a wearable external sternal support device on patient quality of life after cardiac surgery. Methods: A total of 150 patients at high risk for sternal complications were recruited prospectively between 2017 and 2018 at a single tertiary cardiac center. Patients were divided into 3 groups: standard sternal precautions, Moving Safely, and Moving Safely with a wearable external sternal support device. The primary outcome was patient health-related quality of life, assessed using the EuroQol 5-dimension 5-level and the EuroQoL visual analogue scale, preoperatively, at discharge, and at 8 weeks postsurgery. Simple spirometry was also performed to assess respiratory function at these time points. Results: All patients reported better health-related quality of life on the EuroQol 5-dimension 5-level and EuroQoL visual analogue scale at time of follow-up compared with time of discharge (P < .001, respectively). Similar improvements were seen in forced expiratory volume in 1 second and forced vital capacity (P < .001, respectively). No significant differences were observed in the incidence of sternal complications among the 3 treatment groups. Conclusions: The use of a Moving Safely protocol after cardiac surgery was not associated with adverse events and improved patient health-related quality of life compared with traditional sternal precautions. The support provided by a wearable external sternal support device did not improve patient health-related quality of life after cardiac surgery.
OBJECTIVE:To evaluate the integration of Indigenous healing practices within an interprofessional team-based primary care clinic. DESIGN:Guided by the Two-Eyed Seeing and Eco-Normalization frameworks, a developmental evaluation was conducted from November 2023 to July 2024, and included surveys, semistructured interviews, and a facilitated sharing circle. Quantitative data were analyzed descriptively. Deductive content analysis-using the Eco-Normalization Framework and the Empathy Map analysis-was used for qualitative data analysis. SETTING:An interprofessional team-based primary care clinic in Winnipeg, Man, in Canada. PARTICIPANTS:Indigenous and non-Indigenous patients (n=9) and health care providers (n=14). METHODS:An Indigenous Elder, Knowledge Keeper, and mental health counsellor were integrated into the study to embed Indigenous ways of knowing into care. Perspectives of patients and health care providers regarding the perceived value of integrating Indigenous ways of knowing and healing were explored. MAIN FINDINGS:Nine themes emerged: valuing Indigenous ways of knowing and healing; culturally relevant, holistic care; incorporating Indigenous healing practices; whole-person care; collaboration within a team-based model; relationship building; barriers to health care access; lost traditional knowledge and continuation of intergenerational trauma; and centrality of emotional health. Patients and providers reported improved cultural safety, enhanced trust, and deeper engagement. Key facilitators included interdisciplinary collaboration, community partnerships, and integration of ceremony and land-based healing. Challenges included systemic barriers beyond the clinic and sustainability concerns. CONCLUSION:Integrating Indigenous knowledge into team-based primary care can advance culturally safe, holistic, and equity-oriented health services. Structural transformation, sustainable funding, Indigenous governance, and embedding Indigenous ways of knowing into health professional education are critical for scaling and sustaining such models. Our findings support the Truth and Reconciliation Commission of Canada's Calls to Action.
Indigenous women, two-spirit, transgender, and gender-diverse people in Canada experience disproportionate HIV and sexually transmitted and blood-borne infection (STBBI) inequities shaped by colonial violence and systemic racism. While Indigenous doula work is resurging as reproductive justice, its application to HIV/STBBI prevention and care remains underexplored. We examined how Indigenous HIV/STBBI doula care is envisioned and what competencies are needed to support implementation.This community-based study was guided by an Indigenous Community Guiding Circle of people living with HIV/STBBI and anchored in cultural protocols and ceremony. We conducted 40 in-depth interviews with Indigenous community members living with HIV/STBBI (n = 20), relatives (n = 7), helpers/service providers (n = 8), and Elders/Knowledge Holders (n = 5). Interviews were analyzed using thematic analysis guided by Indigenous storywork principles.Participants described doulas as kin and "helpers" who: (1) provide sustained, nonjudgmental presence across diagnosis, parenting, substance use, and grief; (2) reconnect people to culture, land-based healing, and ceremony; (3) offer peer mentorship rooted in lived experience; (4) deliver practical HIV/STBBI education and stigma reduction; and (5) enact structural advocacy across healthcare, justice, housing, and child welfare systems.Indigenous HIV/STBBI doula care offers a culturally grounded, peer-led model with potential to strengthen engagement across the HIV/STBBI care cascade.
