Mosquitoes Seeing Red

“Beating the bite of mosquitoes this spring and summer could hinge on your attire and your skin. New research led by scientists at the University of Washington indicates that a common mosquito species — after detecting a telltale gas that we exhale — flies toward specific colors, including red, orange, black and cyan. The mosquitoes ignore other colors, such as green, purple, blue and white. The researchers believe these findings help explain how mosquitoes find hosts, since human skin, regardless of overall pigmentation, emits a strong red-orange “signal” to their eyes.

‘Mosquitoes appear to use odors to help them distinguish what is nearby, like a host to bite,’ said Jeffrey Riffell, a UW professor of biology. ‘When they smell specific compounds, like CO2 from our breath, that scent stimulates the eyes to scan for specific colors and other visual patterns, which are associated with a potential host, and head to them.’

The results, published Feb. 4 in Nature Communications, reveal how the mosquito sense of smell — known as olfaction — influences how the mosquito responds to visual cues. Knowing which colors attract hungry mosquitoes, and which ones do not, can help design better repellants, traps and other methods to keep mosquitoes at bay.”

More on Mosquitoes are seeing red: Why new findings about their vision could help you hide from these disease vectors via UW.

Canada: Testing Wastewater for Polio

“After new reports of polio cases abroad, and virus samples in the wastewater of several other developed countries, Canada intends to start testing wastewater from a number of cities ‘as soon as possible,’ CBC News has learned.

The Public Health Agency of Canada (PHAC) already works to monitor polio activity around the world, a spokesperson said in an email response to CBC News questions.

Currently, PHAC’s National Microbiology Laboratory in Winnipeg does have the diagnostic tools available to test samples for poliovirus. Any suspected positive Canadian samples of poliovirus will be sent to that lab for further laboratory analysis and confirmation, with results shared with the respective local health authorities “so appropriate public health measures can be taken if necessary.”

According to the statement, PHAC has been communicating with national and international partners who are experts in this field to finalize a wastewater testing strategy. It will be testing wastewater samples that were collected earlier this year from ‘key high-risk municipalities’ to determine if polio was present prior to the reported international cases.

Read more on Wastewater tests will focus on ‘key high-risk municipalities,’ says Public Health Agency of Canada via CBC.

Sepsis Awareness Is Good

Sepsis Steps. Training tool for teaching the progression of sepsis stages via Wikipedia.

“Despite significant progress over the last 20 years in increasing awareness of sepsis (infection induced organ dysfunction) among healthcare providers (HCPs), the public, and patients/families, there remains much to be accomplished, with sepsis morbidity and mortality remaining unacceptably high. For HCPs, early identification of sepsis is paramount for initiating early appropriate therapy. For the lay person, recognizing when they or a family member are at significant risk for sepsis requiring prompt evaluation by a HCP may be life-saving. And for patients hospitalized with sepsis, patient and family understanding of the sepsis disease process is important not only for the provider patient/family relationship but also for the postdischarge period since repeat admission after discharge is common. The primary reason for hospital readmission after a sepsis diagnosis is infection, often resulting in poor outcomes. In this issue of Critical Care Medicine, Fiest et al. provide the reader with a scoping review of the literature to establish what is known as to the degree of sepsis awareness and education among the three aforementioned groups, as well as the vehicles that provide that awareness and education.”

More on Sepsis Awareness Is Good, Please Do Not Let It Be Misunderstood* via Critical Care Medicine.

Art Museum-Based Teaching

J. Bond Francisco, The Sick Child, 1893, oil on canvas, via Smithsonian American Art Museum, Museum Purchase, 1991.9

The Association of American Medical Colleges recently launched an initiative to explore the role of the arts and humanities in physician development, a topic gaining recognition in health professions education. This Last Page focuses on the most established and studied of the art museum-based teaching methods: visual thinking strategies (VTS), an open-ended facilitated discussion centered around a preselected work of art, such as painting.

Learn more here Art Museum-Based Teaching: Visual Thinking Strategies via Academic Medicine.

Hybrid Brains & Ethics

Leonardo da Vinci depiction of the cavities of the brain.

“In a darkened room in a laboratory in London, a group of students and researchers watch a clump of human brain cells settle into their new home: a living mouse brain. On a computer monitor next to a microscope, the human cells light up in flashes of simultaneous activity. Over time, the cells sprout new connections a few centimetres long, and form networks with each other. It’s captivating viewing for his students, says Vincenzo De Paola, who runs the lab at Imperial College London. ‘It’s all they want to do. I can’t tear them away,’ he says.

They have front-row seats to an unusual show. De Paola’s group is one of just a handful of labs able to study human neural cells at work in a live, developing brain — a system that is otherwise largely off limits for both ethical and technical reasons. ‘We cannot study these processes as they unfold in a fetal human brain,’ he says. ‘Instead, we wanted to watch human cortical neurons mature and form active networks in a live animal.’”

More on Hybrid brains: the ethics of transplanting human neurons into animals via Nature.

Health Effects of Electronic Cigarettes

ABSTRACT: The use of electronic cigarettes (e-cigarettes) is rapidly growing. Recent surveys demonstrate particularly high uptake among young never-smokers and a possible association with increased uptake of combustible cigarette smoking. E-cigarettes may be associated with increased risk of cardiovascular disease, including myocardial infarction, stroke, coronary artery disease, hypertension, and elevated heart rate. However, there is a paucity of long-term clinical data to show the cardiovascular disease implications of these changes. With regard to pulmonary disease, e-cigarettes appear to be strongly implicated in the recent outbreak of acute e-cigarette, or vaping, product use–associated lung injury. The relationship between e-cigarettes and chronic pulmonary disease is less clear, though possible associations with obstructive spirometric changes, chronic obstructive pulmonary disease, asthma, and chronic cough have been demonstrated. Nonetheless, the literature suggests that e-cigarettes are likely less harmful to the cardiovascular and respiratory systems than combustible cigarettes, and emerging evidence suggests that e-cigarettes can be an effective smoking cessation aid for smokers who are motivated to quit.

Quality Improvement and Patient Safety (QIPS)

Providing training in quality improvement and patient safety (QIPS) is an important consideration for all of our residency programs. This has been fortified by its specific inclusion in the new accreditation standards. PGME’s aim is to provide a foundational QIPS curriculum to supplement what already exists and for the curriculum to be integrated into each residency program as needed.

Residents

You can access the Intro to PS Primer and QI Project Guide through the Quality Improvement and Patient Safety community in Entrada. To access the community, follow the two steps outlined below:

Step One: Log into Entrada using CWL

Step Two: Copy and paste the following link: https://entrada.med.ubc.ca/community/qips into the address bar. Press Enter on your keyboard.

For visual step-by-step instructions, click here.
Please Note: Entrada is not mobile friendly.

Learn more here.

Monkeypox Declared a Global Emergency

“Over the weekend, the World Health Organization (WHO) declared that the monkeypox outbreak spreading globally is a ‘public health emergency of international concern’ (PHEIC). Researchers hope that the declaration — the agency’s highest alarm — might serve as a wake-up call for countries as they struggle to contain the spread of the virus that causes monkeypox.

Since the first cases were detected outside Africa in May, more than 16,500 people have been confirmed infected in nearly 80 countries that don’t typically see cases. Monkeypox has been circulating in parts of Africa for decades.

This is the seventh time since the alarm system originated in 2005 that the WHO has declared a PHEIC — a step it reserves for events that pose a risk to multiple countries, and that require a coordinated international response (see ‘The highest alarm’). Two of those warnings, for COVID-19 and polio, are still in place.”

More on Monkeypox declared a global emergency: will it help contain the outbreak? via Nature.

Patient Perceptions of Quality of Care through Telemedicine

“Telemedicine can be broadly defined as the use of electronic information and telecommunications technologies to facilitate health care services, with a common form being virtual care. Prior to the COVID-19 pandemic, telemedicine was used primarily to bridge the gap for rural or remote locations where there is lack of transport, mobility, or funding. While there has been increasing patient demand for telemedicine, many barriers existed with regard to governance of compensation mechanisms, licensure restrictions, and technology infrastructure across health care platforms and facilities. At the start of the COVID-19 pandemic, the use of telemedicine was expanded due to the necessity to limit vectors of disease spread. Primary care has been significantly impacted by this change. In-person visits have been limited to those deemed necessary, and telemedicine has been widely used as a tool to provide patient care while maintaining social distancing. Throughout this rapid period of change, there has been limited literature on patient perceptions of their quality of care with the widespread use of telemedicine. In this study, we aimed to identify the proportion of patients who received telemedicine versus in-person appointments during the pandemic, and the number who required in-person follow-up after a phone consultation. In addition, we aimed to identify patient perceptions of their health care experience via telemedicine versus an in-person appointment. With this information, in conjunction with current technological capabilities of health care delivery, we aim to inform the projected need for telemedicine and identify potential areas of improvement during and beyond the COVID-19 pandemic. From a policy and technology perspective, we believe this information could help improve the delivery of health care, both locally and remotely, thereby improving access to primary care across Canada.”

Learn more on Evaluating patient perceptions of quality of care through telemedicine during the COVID-19 pandemic via BCMJ.

Refugee Health Care: Ukraine

KEY POINTS

  • Canada has launched a 3-year temporary visa pathway to shelter nationals fleeing from Ukraine, which may allow for more rapid approval and integration than regular refugee pathways, but may also leave gaps in access to essential medications and social and refugee protection services.
  • Clinical considerations for practitioners caring for people fleeing conflict in Ukraine include screening for noncommunicable and infectious diseases, anticipating mental health conditions and offering available vaccinations as needed.
  • Key gaps in the health system in Canada include lack of universal access to interpreters and lack of supports for coordination of care across health services; addressing these will require a multistakeholder approach and multisectoral partnerships.
  • Health care providers and civil society should take a trauma-and violence-informed care approach when engaging with people fleeing the war in Ukraine.

The war in Ukraine has driven global counts of displaced people and refugees to an all-time high, with numbers expected to continue to increase as a result of global instability and the impacts of climate change. As of May 25, 2022, 8 million people were internally displaced from Ukraine and more than 6.6 million had fled the country. Most have entered neighbouring Eastern European countries, but Western European countries, the United States and Canada have also accepted people fleeing from Ukraine. Canada has granted 112,035 temporary visas for Ukrainians; 241,620 people have applied; and as of May 18, 2022, 32,201 had arrived. Refugees fleeing traumatic situations face socioeconomic stressors and barriers to services after arrival and are more likely to transition to poor health than other immigrants, but this can be mitigated by supportive resettlement services. Although Canada has a long history of welcoming and integrating refugee groups and other humanitarian migrants, the concurrent arrival of Ukranians displaced by the war and refugees from Afghanistan into health systems strained by COVID-19 requires an examination of current refugee health practices and programs and demands creative solutions. We outline clinical considerations for health providers caring for people displaced by the war in Ukraine, based on available evidence and guidance, and discuss how Canada can strengthen its measures to provide health care to currently arriving refugees and prepare for future refugee waves.

The war in Ukraine and refugee health care: considerations for health care providers in Canada via CMAJ.