No abstract

Community arts projects have long been used in community development. Nevertheless, despite many liberatory tales that have emerged, scholars caution that well-meaning organizations and artists may inadvertently become complicit in efforts that distract from fundamental inequities, instrumentalizing creative expression as a means to transform potentially dissident youth into productive and cooperative ‘citizens’. This article examines how social circus – using circus arts with equity-seeking communities – has been affecting personal and community development among youth with marginalized lifestyles in Quebec, Canada. Employing a ‘critical mixed methods’ design, we analysed the impacts of the social circus methodology and partnership model deployed on transformation at the personal and community level. Our analysis suggests that transformation in this context is grounded in principles of using embodied play to re-forge habits and fortify an identity within community and societal acceptance through recognizing individual and collective creative contributions. The disciplinary dimension of the programme, however, equally suggests an imprinting of values of ‘productivity’ by putting marginality ‘to work’. In the social circus programmes studied, tensions between the goal of better coping within the existing socioeconomic system and building skills to transform inequitable dynamics within dominant social and cultural processes, are navigated by carving out a space in society that offers alternative ways of seeing and engaging.

The article adds to the burgeoning literature examining the macro‐level influence of income inequalities and electoral turnout by evaluating the relationship between the two variables across a global sample of 161 presidential elections from 1990 to 2010. Controlling for compulsory voting, semi‐presidentialism, federalism, regime type, development, population size, and the closeness of the election, we find that dispersions in income neither directly nor indirectly influence macro‐level electoral participation in presidential political systems. Rather, the variable's impact on electoral turnout is statistically insignificant and empirically nonsubstantial. In this sense, our article rejects both the power and the conflict theories' predictions on the supposed relationship between the two concepts at the macro‐level.

Health care workers in sub-Saharan Africa are at high risk of acquiring bloodborne diseases. A training program was launched to build the capacity of occupational health nurses to design and implement workplace-based projects. The study assessed the knowledge, attitudes, and practices of health care workers regarding blood and body fluid exposures in a small district hospital in a rural area of the Free State in South Africa. Under the guidance of two experienced mentors, an occupational health nurse designed a knowledge, attitudes, and practices questionnaire and distributed itto 101 health care workers at risk throughout the hospital; 88% of questionnaires were returned in sealed envelopes.Limited knowledge and ineffective practices were documented. For example, only 54.3% of the respondents reported that needles should never be recapped. A significant correlation (p < .001) was found between limited knowledge and recent blood and body fluid exposure. The study results provided the occupational health nurse with data to address the knowledge, attitudes, and practices deficits by implementing an injury prevention educational intervention. Such training initiatives can decrease the burden of occupational disease among health care workers in rural low-resourced areas.

Participatory theatre techniques may offer a useful, culturally appropriate supplement to existing educational approaches to the prevention and management of occupational TB. Given the limitations in resources and our assessment of feasibility, training existing health care educators in such techniques would be a promising next step.

IntroductionMany women living with hepatitis C (HCV) are of childbearing age. While the risk of vertical HCV transmission has been well established, the impact of HCV on pregnancy outcomes are equivocal, with some studies reporting risks of preterm birth, low gestational weight, gestational diabetes and hypertension, while other studies report no such risks. With the shift of the HCV treatment landscape to more effective, tolerable and shorter medications, understanding pregnancy outcomes of women living with HCV are an important consideration in order to provide a baseline from which to consider the usefulness and safety of HCV treatment for this population. The objective of this systematic review will be to investigate pregnancy outcomes associated with maternal HCV infection.Methods and analysisThis systematic review will incorporate articles relevant to pregnancy outcomes among women living with HCV (eg, gestational diabetes and caesarean delivery). Articles will be retrieved from academic databases including MEDLINE, EMBASE, CINAHL, clinicaltrial.gov and the Cochrane Library and hand searching of conference proceedings and reference lists. A database search will not be restricted by date, and conference abstract will be restricted to the past 2 years. The Newcastle-Ottawa Quality Assessment Scale will be used to assess the quality of the retrieved studies. Data will be extracted and scored independently by two authors. A narrative account will synthesise the findings to answer the objectives of this review.Ethics and disseminationThis systematic review will synthesise the literature on the pregnancy outcomes of women living with HCV. Results from this review will be disseminated to clinical audiences, community groups and policy-makers, and may support clinicians and decision-makers in developing guidelines to promote best outcomes for this population.

Background Hospital readmission 30 days after discharge is associated with adverse health outcomes, and people living with HIV(PLWH) experience elevated rates of hospital readmission. While continuity of care with a healthcare provider is associated with lower rates of 30-day readmission among the general population, little is known about this relationship among PLWH. The objective of this study is to examine whether engaging with the same provider, defined as patient-provider attachment, is associated with 30-day readmission for this population. Setting Data derived from the Seek and Treat for Optimal Prevention of HIV in British Columbia, cohort. Methods Using generalized estimating equation with a logit link function, we examined the association between patient-provider attachment and 30-day hospital readmission. We determined whether readmission was due to all cause or to similar cause as the index admission. Results 7013 PLWH were hospitalized during the study period. 921 (13.1%) were readmitted to hospital for all cause, and 564 (8.0%) for the similar cause as the index admission. Patient-provider attachment was negatively associated with 30-day readmission for all causes [adjusted odds ratio (AOR)=0.85, confidence interval (CI)=0.83–0.86]. A second multivariable model indicated that patient-provider attachment was also negatively associated with 30-day readmission for a similar cause (AOR=0.86, CI= 0.84–0.88). Conclusion Our results indicate that a higher proportion of patient-provider attachment was negatively associated with 30-day hospital readmission among PLWH. Our study findings support the adoption of interventions that seek to build patient-provider relationships in order to optimize outcomes for people living with HIV, and enhance healthcare sustainability.

Background British Columbia (BC) is in the midst of an opioid overdose crisis. Since 2017, smoking illicit drugs has been the leading mode of drug administration causing overdose death. Yet, little is known about people who smoke opioids, and factors underlying choice of mode of administration. The study objectives are to identify the prevalence and correlates associated with smoking opioids. Methods The Harm Reduction Client Survey is a monitoring tool used by the BC Centre for Disease Control since 2012. This survey is disseminated to harm reduction sites across BC to understand drug use trends and drug-related harms. We examined data from the survey administered October–December 2019 and performed descriptive, univariate, and multivariate analyses to better understand factors associated with smoking opioids. Results A total of 369 people who used opioids in the past 3 days were included, of whom 251 (68.0%) reported smoking opioids. A total of 109 (29.5%) respondents experienced an overdose in the past 6 months; of these 79 (72.5%) smoked opioids. Factors significantly associated with smoking opioids were: living in a small community (AOR =2.41, CI =1.27–4.58), being a woman (AOR = 1.84, CI = 1.03–3.30), age under 30 (AOR = 5.41, CI = 2.19–13.40) or 30–39 (AOR = 2.77, CI = 1.33–5.78) compared to age ≥ 50, using drugs alone (AOR = 2.98, CI = 1.30–6.83), and owning a take-home naloxone kit (AOR = 2.01, CI = 1.08–3.72). Reported use of methamphetamines within the past 3 days was strongly associated with smoking opioids (AOR = 6.48, CI = 3.51–11.96). Conclusions Our findings highlight important correlates associated with smoking opioids, particularly the recent use of methamphetamines. These findings identify actions to better respond to the overdose crisis, such as targeted harm reduction approaches, educating on safer smoking, advocating for consumption sites where people can smoke drugs, and providing a regulated supply of opioids that can be smoked.