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The Canadian academy is dominated by Western epistemologies that devalue Indigenous ways of knowing and marginalize Indigenous communities, cultures, and histories (Louie et al., 2017). This paper draws on a cross-disciplinary, interprofessional collaboration between a School of Public Health Sciences and School of Social Work to develop an online graduate course that sought to advance knowledge and practice in Indigenous wellbeing and health through a social justice lens. We explore key considerations, strategies, and challenges undertaken by an interdisciplinary group of non-Indigenous professors to create a learning experience for students that challenges colonial ways of seeing, being, knowing, and doing in the professional practice fields of public health and social work and that serves to elevate and sustain Indigenous voices, knowledges, sciences, and practices within the academy. In doing so, we centre the process of course development, including working with an Indigenous Advisory Circle and Indigenous contributors of content, guest lecture videos, and artwork. The paper describes the creation of a relational teaching and learning community, while raising concerns about the institutionalization of this approach to Indigenous-focused course development in the absence of the structural changes needed to enhance the presence of Indigenous faculty and Elders in academic institutions.

Introduction The North American toxic drug crisis has been framed as an epidemic primarily affecting white people. However, evidence suggests that deaths are rising among racialised people. Accordingly, we sought to describe and compare characteristics and circumstances of opioid toxicity deaths across ethno-racial groups.Methods We conducted a population-based, descriptive cross-sectional study of all individuals who died of accidental opioid toxicity in Ontario, Canada between 1 July 2017 and 30 June 2021. Decedents were categorised as Asian, black, Latin American or white. We summarised decedents’ sociodemographic characteristics, circumstances surrounding death and patterns of healthcare utilisation preceding death by ethno-racial group, and used standardised differences (SDs) to draw comparisons.Results Overall, 6687 Ontarians died of opioid toxicity, of whom 275 were Asian (4.1%), 238 were black (3.6%), 53 were Latin American (0.8%), 5222 were white (78.1%) and 899 (13.4%) had an unknown ethno-racial identity. Black people (median age: 35 years; SD: 0.40) and Asian people (median age: 37 years; SD: 0.30) generally died younger than white people (median age: 40 years), and there was greater male predominance in deaths among Asian people (86.2%; SD: 0.30), Latin American people (83.0%; SD: 0.21) and black people (80.3%; SD: 0.14) relative to white people (74.6%). Cocaine contributed to more deaths among black people (55.9%; SD: 0.37) and Asian people (45.1%; SD: 0.15) compared with white people (37.6%). Racialised people had a lower prevalence of opioid agonist treatment in the 5 years preceding death (black people: 27.9%, SD: 0.73; Asian people: 51.1%, SD: 0.22; white people: 61.9%).Conclusions There are marked differences in the risk factors, context and patterns of drug involvement in opioid toxicity deaths across ethno-racial groups, and substantial disparities exist in access to harm reduction and treatment services. Prevention and response strategies must be tailored and targeted to racialised people.

Abstract Background The Canadian drug supply has significantly increased in toxicity over the past few years, resulting in the worsening of the overdose crisis. A key initiative implemented during this crisis has been data monitoring and reporting of substance use-related harms (SRH). This literature review aims to: (1) identify strategies used for the meaningful engagement of people who use drugs (PWUD) in local, provincial, and national SRH data system planning, reporting, and action and (2) describe data monitoring and reporting strategies and common indicators of SRH within those systems. Methods We searched three academic and five gray literature databases for relevant literature published between 2012 and 2022. Team members who identify as PWUD and a librarian at Public Health Ontario developed search strings collaboratively. Two reviewers screened all search results and applied the eligibility criteria. We used Microsoft Excel for data management. Results Twenty-two articles met our eligibility criteria (peer-reviewed n = 10 and gray literature reports n = 12); most used qualitative methods and focused on the Canadian context (n = 20). There were few examples of PWUD engaged as authors of reports on SRH monitoring. Among information systems involving PWUD, we found two main strategies: (1) community-based strategies (e.g., word of mouth, through drug sellers, and through satellite workers) and (2) public health-based data monitoring and communication strategies (e.g., communicating drug quality and alerts to PWUD). Substance use-related mortality, hospitalizations, and emergency department visits were the indicators most commonly used in systems of SRH reporting that engaged PWUD. Conclusion This review demonstrates limited engagement of PWUD and silos of activity in existing SRH data monitoring and reporting strategies. Future work is needed to better engage PWUD in these processes in an equitable manner. Building SRH monitoring systems in partnership with PWUD may increase the potential impact of these systems to reduce harms in the community.

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

This case report describes a patient with post-neurosurgical infection and bacteremia caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae. There is limited evidence to guide antibiotic treatment decisions for such infections. The patient was treated with meropenem-vaborbactam (MEV). MEV monotherapy was associated with bacteremia clearance.

In this multimedia report we introduce our ongoing collaborative archival project to organize, describe, and provide access to digitized audio files from the long-running Indigenous radio broadcast called Smoke Signals, produced and hosted by Indigenous activists, community leaders, educators, and Elders Dan Smoke and Mary Lou Smoke.

IMPORTANCE:. COVID-19 can cause serious illness requiring multimodal treatment and is associated with secondary infections. Studies have suggested an increased risk of fungal infections, including candidemia following severe COVID-19 though understanding of risk factors and clinical outcomes remains unclear. OBJECTIVES:. To describe clinical characteristics, outcomes and risk factors of candidemia among patients hospitalized with severe COVID-19. DESIGN, SETTING, AND PARTICIPANTS:. A multicenter, case-control study of patients with severe COVID-19 was conducted to evaluate risk factors and clinical outcomes in patients who developed candidemia between August 2020 and August 2021. MAIN OUTCOMES AND MEASURES:. Chart review evaluating institutional and patient demographics, clinical and mycological characteristics, concomitant interventions (antibiotics, immunosuppressive agents, parenteral nutrition, degree of oxygen support, mechanical ventilation, surgery), treatment regimens, and outcomes (length of stay and discharge disposition) RESULTS:. A total of 275 patients were enrolled in the study, including 91 patients with severe COVID-19 and subsequent candidemia and 184 with severe COVID-19 without candidemia. Most patients received antibiotics prior to candidemia episode (93%), while approximately one-quarter of patients received biologic for COVID-19. In-hospital mortality was significantly higher in the cases compared with the controls (68% vs 40%; p < 0.01). Candida albicans was the most common (53%), followed by C. glabrata (19%). Use of central lines, biologic, and paralytics were independent risk factors for candidemia. CONCLUSIONS AND RELEVANCE:. Candidemia following COVID-19 infection is a concern that requires clinical consideration and patient monitoring. Risk factors for the development of candidemia in the setting of COVID-19 infection are largely consistent with traditional risk factors for candidemia in hospitalized patients.

The article discusses the key principles for clinical pharmacists on how to discuss, critique, and approach the use of artificial intelligence (AI) tools in clinical pharmacy. Topics include the need of pharmacists for a basic understanding of AI, not expertise in AI, ways that AI has the potential to benefit pharmacy practice, and the need of pharmacists to understand the limitations of AI tools.