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As part of the University of Manitoba Libraries Outreach Services, the Winnipeg Regional Health Authority (WRHA) Virtual Library provides library services to hospitals, health centres, community health agencies, and personal care homes throughout the city of Winnipeg, Manitoba. All services of the WRHA Virtual Library, including the collection, are entirely virtual, though staff are physically located in the University’s health library. In March 2020, shortly after the World Health Organization declared the novel coronavirus disease (COVID-19) pandemic, libraries around the world started closing their doors and staff were required to work from home. The virtual infrastructure of our services and collections required no changes in how our patrons accessed the Virtual Library and a smooth transition was expected, but the sudden shift to working from home revealed gaps. This article discusses the unique experience of the WRHA Virtual Library transitioning to a completely virtual environment, the previous reliance on the University’s physical infrastructure, and the inequities identified between librarians and library technicians.

Background: Outcomes of national policy change impact all levels of the organizational hierarchy. The medical education literature is sparse on how reflections from program directors (PDs) on past large-scale policy changes can inform future policy initiatives. To fill this gap, we conducted a national survey on PDs’ perceptions of, and reflections on, decision-making in medical education, accreditation procedures, and the CanMEDS framework implementation. Methods: The survey was distributed to former Canadian specialty medicine PDs (N = 684). Descriptive analysis was performed on quantitative data, thematic analysis was performed on qualitative comments, and comparisons between the quantitative and qualitative findings were performed to identify areas of convergence and/or divergence. Results: A total of 265 (38.7%) former PDs participated. Quantitative analysis revealed that 52.8% of respondents did not feel involved in decision-making regarding policy changes, 45.1% of respondents did not feel prepared to assess the CanMEDS Roles, and PDs were divided on the reasonableness of accreditation documentation. Qualitative analysis produced four themes: communication, resources, expectations of outcomes, and buy-in. Nine sub-themes were also identified. A high level of convergence was identified across the content, with only four areas of divergence identified. Conclusions: Our findings have the potential to inform future policy and/or accreditation changes. Without the lens of those charged with overseeing the implementation, policy evaluation and quality improvement will remain uninformed. PDs, therefore, bring unique insights into our understanding of national policy changes, and without the voices of these frontline implementers, the true success of policy change implementation will be hindered.

Implication Statement Longitudinal global health experiences promote cultural competency and a commitment to caring for underserved populations beyond residency. This paper describes a longitudinal, co-curricular local global health experience. Obstetrics and gynaecology residents have partnered with the Family Medicine-led Halifax Newcomer Health Clinic to provide education and clinical well woman care to refugee women. This resident-led initiative meets the care needs of an underserved population while promoting resident engagement in health advocacy.

INTRODUCTION: The World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologically-confirmed TB when using Xpert MTB/RIF. METHODS: From 08/12-11/2014, all people living with HIV were recruited at 22 clinics. For patients screened positive using the four TB symptoms their sputa were tested by Xpert MTB/RIF and smear. Laboratorians assessed and recorded sputum appearance and volume. The yield of bacteriologically-positive sputum evaluated using Xpert MTB/RIF and smear, likelihood-ratios were calculated. RESULTS: Among 6,041 patients enrolled 2,296 were presumptive TB, 1,305 (56.8%) had 1 sputa collected and 644/1,305 (49.3%) had both Xpert MTB/RIF and smear results. Since 1 sputa collected from 644 patients 954 sputa were tested by Xpert MTB/RIF and smear. Bacteriologically-positive sputum was two-fold higher with Xpert MTB/RIF 11.4% versus smear 5.3%, p = 0.001. Sputum appearance and quantity were not predictive of bacteriologically-positive results, except volume of 2ml to 3ml, tested by Xpert MTB/RIF LR+=1.26 (95% CI, 1.05,1.50). CONCLUSION: Xpert MTB/RIF test yield to bacteriologically-positive sputum was superior to smear. Sputum quality and quantity, however, were not consistently predictive of bacteriologically-positive results by Xpert MTB/RIF or smear.

The purpose of this study was to determine the degree to which students from an American-style Business School in Lebanon expect the managerial behaviors that they are taught in the classroom to actually be applied by managers in the Lebanese workplace. Broadly categorized as accountability, gender equity, religious tolerance, consultation and transparency, the authors found little indication that such expectations existed. Even when they could be identified such as with racial equality, their relative strength was so weak that they were barely above neutral on a 10-point scale. What was perhaps most troubling was that expectation for the elimination of bribery and corruption actually declined as students matriculated through the curriculum. At least for the time being, it appears that Lebanese business students do not anticipate encountering American-style management practices, which have formed the core of the Business courses, when they enter the workforce.