ObjectiveTo evaluate the safety and efficacy of first trimester “No Touch” medication abortion programs at two clinics in Toronto, Ontario during their early implementation in response to the COVID-19 pandemic.MethodsThis retrospective study included all patients who underwent virtual consultation for mifepristone-misoprostol medication abortion between April 2020 - August 2022 at two reproductive health clinics. In response to the pandemic, “No Touch” abortion protocols had been developed that align with the Canadian Protocol for the Provision of Medical Abortion via Telemedicine. Records were reviewed for demographic information, clinical course, investigations required, confirmation of complete abortion and adverse events. The primary outcome was complete medication abortion, defined as expulsion of the pregnancy without requiring uterine aspiration.ResultsA total of 277 patients had abortions initiated in the “No Touch” or “Low Touch” care pathways and had sufficient follow-up to determine outcomes. Of these patients, 92.8% (95%CI 89.7%-95.8%) had a complete medication abortion (n=257) and 76.1% (n=159) remained “No Touch” throughout their care. Investigations were performed for 102 participants before or after their abortion, classifying them as “Low Touch”. Nineteen patients (6.9%) underwent uterine aspiration. The rate of adverse events was low with one case of a missed ectopic pregnancy and one patient requiring hospitalization for endometritis.Conclusion“No Touch” provision of mifepristone-misoprostol medication abortion care was safe and effective with outcomes comparable to previous studies.These results provide evidence for the efficacy and safety of a “No Touch” approach in the Canadian context, which has the potential to reduce barriers in accessing abortion care.

OBJECTIVES:This qualitative study aimed to explore the perspectives of Canadian global surgeons with experience developing surgical education partnerships with low- and middle-income countries (LMICs) for the purpose of identifying factors for success. DESIGN:A purposive sample of leaders from global surgery programmes at Canadian Faculties of Medicine participated in virtual semi-structured interviews. A six-phase thematic analysis was performed using a constructivist lens on verbatim transcripts by three independent researchers. Key factors for success were thematically collated with constant comparison and inter-investigator triangulation in NVivo software until theoretical saturation was reached. PARTICIPANTS:Fifteen surgeons, representing 11 subspecialties at 6 Canadian academic institutions and a combined experience across 6 continents, were interviewed between January and June 2022. RESULTS:Four facilitators for success of global surgery training programmes were identified, with a strong undertone of relationship-building permeating all subthemes: (1) facilitative skill sets and infrastructure, (2) longitudinal engagement, (3) local ownership and (4) interpersonal humility. Participants defined facilitative skill sets to include demonstrated surgical competence and facilitative infrastructure to include pre-existing local networks, language congruency, sustainable funding and support from external organisations. They perceived longitudinal engagement as spanning multiple trips, enabled by strong personal motivation and arrangements at their home institutions. Ownership of projects by local champions, including in research output, was noted as key to preventing brain drain and catalysing a ripple effect of surgical trainees. Finally, interviewees emphasised interpersonal humility as being crucial to decolonising the institution of global surgery with cultural competence, reflexivity and sustainability. CONCLUSIONS:The interviewed surgeons perceived strong cross-cultural relationships as fundamental to all other dimensions of success when working in low-resource capacity-building. While this study presents a comprehensive Canadian perspective informed by high-profile leadership in global surgery, a parallel study highlighting LMIC-partners' perspectives will be critical to a more complete understanding of programme success.

Indigenous men around the world hold expertise over their own lives. Informed by this perspective, this study centres this experience to better understand what is needed to improve sexual health outcomes among a group of men with a history of incarceration. Semi-structured interviews were conducted with 10 Indigenous men with such a history. Through thematic analysis the study identified two major themes: 1) the impacts of systemic oppression; 2) the value of guidance in walking the right path. Men identified colonial trauma and the associated mental, physical, emotional and spiritual wounds stemming from systemic oppression as continuing to impact their wellbeing. Men also described the systems of support necessary to help guide them on their journeys through incarceration, rehabilitation and building strong and nurturing relationships. Findings from the study provide important guidance from Indigenous men for future more holistic sexual health intervention programming.

Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provide equitable health care for Indigenous peoples. Keywords: Indigenous health, health professions, curricula, faculty perspectives, barriers, Canada

The sexual health of Indigenous Peoples in Canada has been identified as an important community and public health concern; however, there is a lack of research on the sexual health needs of Indigenous boys and men. This article shares results from interviews conducted with six stakeholders to explore pathways for sexual health promotion and considers the impacts of colonialism and other socio-political contextual factors on Indigenous boys’ and men’s sexual health. The study employed thematic analysis, and the findings indicate the following three pathways for sexual health promotion of Indigenous boys and men: (1) developing healthy relationships and highlighting role models, (2) providing access to comprehensive sexual health information, and (3) fostering open communication among Indigenous boys and men. Sexual health promotion with Indigenous boys and men in Atlantic Canada should include addressing the impacts of colonization and their unique socio-cultural contexts.

Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys' and men's sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men.

The purpose of this article is to explore the scope of available evidence regarding the use of interactive e-texts and their relationship to student learning experiences in post-secondary education. Following the framework of Arksey and O’Malley, this scoping review identified and reported on 33 articles. Study characteristics are presented alongside four themes that were found across the included articles: (1) the effect of interactive e-texts on student learning experiences; (2) the relationship between interactive e-texts and academic performance; (3) factors influencing student adoption and experience of interactive e-texts; and (4) roles, responsibilities, and recommendations. While the adoption of interactive e-texts is becoming increasingly common in post-secondary education, their effect on student learning experiences remains complex. This review emphasizes the importance of user-friendliness, affordability, accessibility, portability, and the role of educators. Using interactive e-texts shows promise, though future research should explore how barriers might be minimized and benefits might be maximized to have the strongest impact on student learning experiences. Keywords: interactive e-text, student experience, scoping review, post-secondary education

ABSTRACT Objective: The objective of this review is to identify the characteristics of Indigenous healing strategies in Canada and approaches to improving cultural relevance to local Indigenous contexts. Introduction: In the previous 150 years, Indigenous peoples of Canada have experienced colonization, forced assimilation, cultural oppression and violence, and these are associated with high rates of social distress and health disparities. Today, legacies of colonization continue to marginalize Indigenous peoples, creating healthcare institutions devoid of Indigenous worldviews. Despite the growing number of Indigenous healing strategies currently in existence, literature describing these strategies has not been systematically scoped. To address this gap, this scoping review will identify characteristics of Indigenous healing strategies in Canada, and explore culturally relevant approaches used in research process. Inclusion criteria: This review will consider literature that describes Indigenous healing strategies in Canada and will include First Nations, Inuit and Métis as the population of interest. Strategies may include, but are not limited to, health services and programs, policies and guidelines, models and frameworks, and Indigenous narratives and expert opinions. Healing strategies delivered in all service settings are eligible for inclusion. Methods: The databases/sources to be searched will include: CINAHL, Sociological Abstracts, PsycINFO, MEDLINE and Academic Search Premier. Searches for gray literature will be conducted in iPortal, Canadian Electronic Library, and a list of Canadian government and Indigenous organization websites. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Findings will be summarized in tabular forms accompanied by narrative text.

Evidence suggests that the use of educational technologies may promote positive learning environments and contribute to students' success. The following mixed methods study examined the impact of Top Hat in a blended learning environment on undergraduate students' sense of belongingness, engagement, and self-confidence in a Canadian post-secondary institution. A survey study measured students' sense of belongingness, engagement, and self-confidence before and after the course, which used Top Hat. The results show a significant increase in belongingness and self-confidence, but a decrease in engagement. Contrarily, focus groups revealed that using Top Hat may improve the overall learning experience. Limitations and future recommendations are discussed.