Continuity of routine immunization programs in Canada during the COVID-19 pandemic

IntroductionIn Canada, the COVID-19 pandemic has interrupted many routine health services, placed additional strain on the health care system, and resulted in many Canadians being either unable or unwilling to attend routine immunization appointments. We sought to capture and synthesize information about changes to routine immunization programs in response to the pandemic and plans to catch-up any missed immunizations.MethodsProvincial/territorial (P/T) public health leaders were interviewed via teleconference between August-October 2020 to collect information on the following topics: how routine immunization delivery was affected during and after initial lockdown periods, plans to catch-up missed doses, and major challenges and achievements in continuing routine immunization programs. Data were coded and categorized according to common responses and descriptive analysis was performed.ResultsInterviews occurred with participants from 11 of 13 P/Ts. School immunization programs were reported to be most negatively affected by the pandemic (n=9). In the early pandemic period, infant, preschool, and maternal/prenatal programs were prioritized, with most P/Ts continuing these services with adaptations for COVID-19. After the initial lockdown period, all routine programs were continuing with adaptations in most P/Ts. Infant, preschool, and school programs were most often targeted for catch-up through measures such as appointment rebooking and making additional clinics and/or providers available. Major challenges included resource limitations (e.g., staff shortages, PPE shortages, limited infrastructure) (n=11), public health restrictions (n=8), and public hesitancy to attend appointments (n=5).ConclusionsCanadian routine immunization programs faced some disruptions due to the COVID-19 pandemic, particularly the school, adult, and older adult programs. Further research is needed to determine the measurable impact of the pandemic on routine vaccine coverage levels.

Assessing Shared Decision-Making in Cystic Fibrosis Care Using collaboRATE: A Cross-Sectional Study of 159 Programs

There are numerous opportunities for shared decision-making (SDM) in cystic fibrosis (CF) care, yet little is known about patients’ SDM experiences. This study evaluated SDM across 159 CF care programs (4024 participants) in the United States. Shared decision-making was assessed using the patient-reported collaboRATE measure, which was included in the CF Foundation’s Patient and Family Experience of Care Survey over 18 months. Overall, 69% of respondents reported experiencing SDM. Respondents at pediatric programs were more likely to experience SDM than those at adult programs (72% vs 67%, P < .001). Multivariable logistic regression analyses showed a relationship between SDM and patient age, whereby SDM was less likely to occur with patients aged 18 to 24 years, compared to some younger and older age groups ( P = .02-<.001). Shared decision-making was more likely to occur at pediatric programs when patients had better general health ( P = .02-<.01), and at pediatric and adult programs when patients had better mental health ( P = .02-<.001). Disparities in SDM experiences highlight a need to improve decision-making processes in CF care. Interventions tailored for improving SDM among specific patient populations may be particularly advantageous.

142 Providing an experiential learning opportunity through an Extension animal science internship

Summer is a busy time for Extension programs and includes several activities, such as 4-H youth programs and producer meetings. Three years ago, the Arkansas Extension Animal Science Department started offering an internship opportunity for students. The internship occurs for 12 weeks with salary compensation and housing (if needed). Monies for the internship are provided by both the department and Extension ANR Associate Director. Applications are accepted in the spring (resume, cover letter, and 3 references), interviews are held for the top 3–5 applicants, and then an intern is selected. Year 1 and 2 yielded 11 applicants each year and year 3 generated 22. Interns spend the summer assisting faculty with youth programs, adult programs, and research projects. They are not assigned to one particular faculty member, but have the opportunity to gain experiences from all faculty members.Mid-way through the internship and at the end of the internship, an evaluation is sent to both the intern and faculty members to assess the mid- and overall performance of the intern. Some notable results from the intern evaluations include: 75% had moderate or large improvement in written and oral communication skills and 100% had a large improvement in general knowledge of Extension. All interns indicated that tasks assigned were challenging, but attainable; they believe the internship was excellent and would definitely recommend to others; they are more interested to work for Extension as a result of the internship; and believe the internship is a very valuable educational experience. From the faculty perspective, having an intern is very valuable. An intern allows for more things to get done in a timely manner. Suggestions for improvement are for more interns to be hired. Internships are a great way to expose students to Extension and what the Animal Science Department offers.

Sarcoma as a Model for Adolescent and Young Adult Care

Sarcomas occur across all ages and are relatively abundant in the adolescent and young adult populations compared with older adults. Because of an overall rarity combined with a broad diversity of diagnoses, expertise is often concentrated in comprehensive cancer centers. The sarcoma model of care is an excellent model for overall adolescent and young adult care. We summarize some of the natural advantages of the field for developing adolescent and young adult programs, review management and referral touchpoints, and summarize recent biologic and clinical trial insights that have affected sarcoma management recently.

From Territory to Human Resources: A History of Colonial Adult Education in the Central Arctic

This article narrates the history of state-organized adult education in the Central Arctic (Kitikmeot region) from the 1950s through the early 1990s. Prior to 1960, little formal adult education was delivered in the region, as relationships between Inuit and Euro-Canadians centred on the exchange of fox furs for external products. In the 1960s and 1970s, adult programs focused on housing, education, literacy, and home management, teaching groups of Inuit how to live in the permanent settlements that had recently been constructed by the federal government. In the 1980s, adult programs focused on employment preparation and life skills, moulding individual Inuit into employable citizens. This article addresses an important silence in existing scholarship regarding Canadian educational history, and sheds light upon the evolving priorities of Euro-Canadian colonizers in the Arctic; whether for purposes of territorial sovereignty or human resource development, adult education served as an important medium for the communication of colonial messages.RésuméCet article raconte l’histoire de l’éducation aux adultes organisée par l’État dans l’Arctique central (région de Kitikmeot), depuis les années 1950 jusqu’au début des années 1990. Avant 1960, peu de programmes d’éducation aux adultes étaient offerts dans la région, puisque les relations entre Inuits et Euro-Canadiens étaient alors centrées sur l’échange de fourrures de renard contre des produits venant de l’extérieur. Dans les années 1960 et 1970, les programmes pour adultes se sont concentrés sur le logement, l’éducation, l’alphabétisation et l’économie familiale, enseignant aux Inuits comment vivre dans les établissements permanents récemment construits par le gouvernement fédéral. Dans les années 1980, les programmes pour adultes se sont concentrés sur la préparation à l’emploi et les compétences de la vie quotidienne, façonnant les individus Inuits en citoyens aptes à l’emploi. Cet article comble un manque important dans la littérature sur l’histoire de l’éducation canadienne, et met en lumière l’évolution des priorités des colonisateurs Euro-Canadiens dans l’Arctique. Que ce soit à des fins de souveraineté territoriale ou de développement des ressources humaines, l’éducation aux adultes a servi comme un important moyen de communication des messages coloniaux.

Supernatural Creatures, Accidents, and War

This study explored preschool children’s television-related fears through a general study of children’s television-viewing habits. Based on semi-structured interviews with eighteen Estonian preschoolers, the results showed that young children’s fears were represented not only in adult programs but also in seemingly child-friendly cartoons through which children tended to see the fictional story as real. However, children were not passive victims: they took an active role in diminishing their television-related fears by using various coping strategies, including peer mediation. These results support the notion that children are second-level mediators who share with their peers both their own experiences and what their parents have taught them about television.