Saskatchewan Health Authority

Conducted in 2024at the time of the Government of Canada's announcement about a new National School Food Program (NSFP), this study explores parents' and educators' perspectives on food, funding, and preferred attributes of an NSFP. Using an Equity, Diversity, Inclusion and Accessibility (EDIA) lens, we consider how to create socially just School Food Programs (SFPs). We conducted a mixed-methods study in publicly funded primary schools in two urban regions of Ontario, Canada. Parents/caregivers completed an online survey about family socio-demographics and views on SFPs with 267 valid responses. Twenty-seven parents participated in six focus groups and six primary school educators were interviewed. Equitable accessibility, cultural food, and including interest holders and community partners were organizing themes from qualitative findings that were compared to quantitative survey data. Equitable accessibility to SFPs was conceptualized as universally affordable but not necessarily universally free. Accessibility for students with dietary requirements was considered with concerns about logistical challenges. Consideration of cultural food in SFPs encompassed student representation, educational benefits, and challenges for incorporating it. Some parents advocated for the inclusion of key interest holders - students and parents - in planning and implementation along with broader community partners. Many participants envisioned SFPs that consider universal accessibility, cultural food diversity, and inclusive participation. Embedding EDIA in program design is key to socially just SFPs but questions remain about how to achieve this. We recommend that local level data are collected with interest holder consultation.

Pre-treatment thrombocytosis and elevated C-reactive protein have been linked to poor prognosis in endometrial cancer, although findings are inconsistent. We aimed to study the prognostic significance of C-reactive protein and platelet count in a contemporary single-center endometrial cancer cohort. A retrospective study was conducted at a single tertiary referral center. We included consecutive patients with endometrial cancer who underwent staging surgery between January 2010 and December 2022. Pre-operative C-reactive protein and platelet counts were recorded. Receiver operating characteristic curve analysis and Kolmogorov-Smirnov statistics were applied. Kaplan-Meier curves and Cox regression were calculated for progression-free survival and overall survival. Overall, 797 patients were included. The median age was 64 years (interquartile range [IQR]; 57-70), and the mean body mass index was 32.4 kg/m2 (IQR 26.0-37.1). The median follow-up time was 53 months (IQR 31-75). Endometrioid carcinoma was the most common histologic sub-type, comprising 75.4% of cases (n = 601), including grade 1 (46.3%, n = 369), grade 2 (22.1%, n = 176), and grade 3 (7.0%, n = 56)]. The median age was 64 years, and 71% of patients had stage I disease. Thrombocytosis (platelet ≥400,000) was observed in 5.6% of patients, and the median C-reactive protein was 3.2 mg/L. Thrombocytopenia (platelet <150,000) occurred in 24 (3.0%) patients. Receiver operating characteristic analysis showed limited predictive performance for recurrence (area under the curve: 0.434 for platelet, 0.506 for C-reactive protein) and modest performance for death (area under the curve: 0.513 and 0.613, respectively). Using a C-reactive protein cutoff of 2.45 mg/L, patients with elevated C-reactive protein had significantly worse overall survival (p <.001). In multi-variable Cox analysis, C-reactive protein remained independently associated with overall survival (adjusted hazard ratio [HR] 2.37, 95% confidence interval [CI ] 1.23 to 4.55), along with age (HR 1.05, 95% CI 1.02 to 1.08), stage IV disease (HR 5.82, 95% CI 3.06 to 11.08), and P53 mutated (HR 2.69, 95% CI 1.06 to 6.79). Platelet was not prognostic. Pre-treatment C-reactive protein is an independent predictor of survival in endometrial cancer, whereas platelet count shows limited prognostic relevance. C-reactive protein may serve as an accessible biomarker to refine risk stratification, particularly in low-resource settings where molecular profiling is not routinely available.

The CLSA is a national data platform for aging research that used epidemiology-based sampling methods and explicitly excluded people living on First Nations Reserves and other provincial First Nations settlements as possible CLSA participants. As such, the CLSA research approach did not use Indigenous community engagement. Nevertheless, the CLSA sample includes a sizeable subsample of participants who self-identified as First Nations, Métis, or Inuit. This project seeks to describe the self-identified Indigenous subsample of the CLSA from the baseline data collection and interpret that description with the aid of an Elder Advisory Circle. We conducted a descriptive analysis of the self-identified Indigenous subsample of the CLSA from the baseline data collection. The analysis was presented to an Elder Advisory Circle for consultation. The lack of community-engaged approaches to Indigenous research and sampling approaches appears to have resulted in a sociodemographic profile of older Indigenous Peoples that does not match the lived experience of the Elder Advisory Circle and contrasts with other data available on Indigenous Peoples in Canada. We feel the existing CLSA data does not reflect the sociodemographic profile of older Indigenous Peoples. We use this community consultation process to provide recommendations for the appropriate use of the Indigenous-identified data in the CLSA, and we conclude by recommending great caution when using the data from the Indigenous subsample in the CLSA data.

Coping strategies are essential for psychological well-being and healthy survivorship experience of patients with breast cancer. However, there is a research gap in the understanding of coping strategies and their associated factors among patients with breast cancer in Nigeria. This study aimed to investigate coping strategies, focusing on disengagement coping and its relationship with sociodemographic and illness-related factors in a sample of patients with breast cancer in South-South, Nigeria. A cross-sectional study was conducted among 240 breast cancer patients at a tertiary hospital in the South‒South region of Nigeria. The participants completed a clinico-sociodemographic questionnaire to gather their background information and the 32-item Coping Strategies Inventory (CSI-32) to assess coping. The mean age of the participants was 46.8 years (SD = 13.4), and most participants were employed (89.2%), married (62.1%), and had children (74.6%). Most participants (n = 179, 74.6%) presented with advanced breast cancers (stage 3 and 4) and reported poor treatment adherence (n = 185, 77.1%). The findings on CSI-32 revealed a significantly greater reliance on disengagement coping (61.25%, n = 147) strategies (e.g., wishful thinking and social withdrawal) compared with engagement coping (38.75%, n = 93). Disengagement coping was significantly associated with those with fewer children, χ2(1, N = 240) = 4.93, p = .03; post-primary education level, χ2(1, N = 240) = 5.71, p = .01; being employed, χ²(1, N = 240) = 6.38, p = .01; early cancer stage, χ2(1, N = 240) = 2.94, p = .03; and poor treatment adherence, χ2(1, N = 240) = 3.22, p = .03. Following regression analysis, individuals with disengagement coping were more likely to be employed, have post-primary education, and report poor treatment adherence. There is a need for psychosocial interventions to bolster healthy coping strategies amongst patients with breast cancer in this region, preferably by reducing a reliance on disengagement coping and ultimately improving psychological well-being. Such interventions need to be holistic and tailored to the unique attributes of individual patient using a patient-centered care model. Our study findings also highlight the need for future research with robust methodology, especially prospective studies, to better understand the trajectory of coping strategies in patients with breast cancer and the impacts on their wellbeing.

Purpose: The purpose of this study was to explore the perceptions of parents/guardians regarding school food policy (SFP) and food fundraisers in Regina elementary schools. Methods: A 41-item survey was distributed electronically to a school division superintendent to send to their principals to share with parents/guardians. Results: Eighty-four percent (n=67/80) of respondents that completed the survey were parents/guardians. The majority strongly agreed/agreed that children's nutrition should be a priority for schools (78%; n=61/80). Thirty-two percent were aware that an SFP existed (32%; n=22/67), 40% agreed SFP is important (n=27/67), and 46% (n=31/67) agreed they could influence SFP. Sixty-five percent (n=52/80) identified School Community Councils (made up of parents and staff) as the primary fundraising organizers. The majority (68%; n=52/76) strongly agreed/agreed it is important for fundraisers to support the health of students, staff, and families; however, 57% (n=45/78) felt it is okay to offer highly processed foods because it only happens occasionally. Fifty-seven percent (n=45/78) strongly agreed/agreed that non-food and healthy food fundraisers are viable in making as much of a profit as highly processed foods. Conclusions: The results suggest dietitians should engage parents/guardians in SFP and food fundraising to influence health and learning.

The number of new HIV infections in young adults is increasing in Canada. Research is lacking on the awareness and acceptability of HIV pre-exposure prophylaxis (PrEP) amongst Canadian university students. We conducted this study to assess awareness and attitudes towards PrEP amongst University of Saskatchewan students. A cross-sectional web-based survey was sent to 22,004 actively enrolled university students. The survey explored students’ perceived risk of HIV, awareness of PrEP, and attitudes towards PrEP use. Statistical analyses were performed on all completed responses and the following subgroups: visible minorities, Indigenous women, gay men and bisexual men to assess differences in attitudes amongst groups. 3,005 complete responses were included in data analysis. Respondents were predominantly undergraduate students (79%), 28 years old or younger, female (66%), heterosexual (77%) and Caucasian (63%). Only 30% had heard of PrEP prior to the survey and 3% had used it. 84% were comfortable accessing PrEP on campus. Only 34% were likely to talk to their health care provider about PrEP and 30% were likely to take PrEP. However, 94% were willing to take PrEP if recommended by their health care provider. 68% were likely to recommend PrEP to others. In contrast, 94% of gay men were aware of PrEP, 35% had taken it, 73% were likely to talk to their health care provider about it, 69% were likely to take it and 83% were likely to recommend it to others. PrEP awareness was low in our study cohort with the exception of gay men. Willingness to use PrEP was also low but increased on the recommendation of health care provider. Comfort in accessing PrEP at campus health center was also high. Results from this survey could inform strategies for scaling up PrEP uptake on campus.

To assess the efficacy of the addition of a hysteroscopic fundal block on patient's perception of intra-operative pain during NovaSure endometrial ablation in an ambulatory setting. Single centre, randomized, double-blind, placebo-controlled trial with a parallel design and a 1:1 treatment allocation ratio. Canadian gynecologic ambulatory-care clinic. A total of 100 premenopausal female patients with abnormal uterine bleeding undergoing an ambulatory NovaSure endometrial ablation. Hysteroscopic fundal injections with 10 mL 1% lidocaine (treatment group) or hysteroscopic fundal injections with normal saline (placebo group). There was no difference in Numeric Rating Scale (NRS) for pain scores at 30 seconds, 60 seconds, and 1-hour postprocedure in the placebo and fundal block groups (p = .08; p = .28; p = .09). Secondary subgroup analysis revealed significantly higher NRS scores in those with a self-reported history of dysmenorrhea (NRS score >5) who received placebo compared to the lidocaine fundal block at 30 and 60 seconds (p = .02; p = .03). The procedure was found to be acceptable to the majority of participants and 95.6% would recommend the procedure to someone else with no difference between groups. There was no difference in use of intraoperative analgesics and sedatives, postoperative pain, or adverse events between the groups. When using parenteral conscious sedation and a paracervical block, the addition of a hysteroscopic fundal block during ambulatory NovaSure endometrial ablation does not improve NRS pain scores. Select patients, including those with dysmenorrhea, may benefit from the addition of a hysteroscopic fundal block.

ABSTRACTIntroductionThis article shares insights from the Learning Health Systems Symposium, “Charting the Future of Saskatchewan Healthcare: Generating Value within our Health Systems.”MethodsPatient Partners and over 100 professionals in the fields of research, healthcare, and policy joined the Saskatchewan Centre for Patient‐Oriented Research (SCPOR) in Regina, Saskatchewan Canada, for a day filled with knowledge about learning health systems (LHSs). Attendees provided key insights on how to build provincial capacity in LHSs and thereby improve the health of people in Saskatchewan.ResultsKey insights from the symposium included strengthening meaningful partnerships with patients and the community; establishing a shared vision for LHSs; harmonizing conflicting priorities; removing silos; recognizing the natural tensions between academia and the healthcare system; and building on and aligning infrastructure to support LHSs development.ConclusionThe LHSs symposium provided a way for health system leaders, Patient Partners, researchers, clinicians, and students to develop a common understanding of LHSs and envision a future for LHSs in Saskatchewan, Canada. Key next steps were to strengthen patient and community engagement, work collaboratively to establish a shared vision of LHSs, better understand existing assets to support LHSs, and identify opportunities to build future LHSs infrastructure.