Intervention en santé publique à un cas nouvellement diagnostiqué d’hépatite C associé à une lacune dans les pratiques de prévention et de contrôle des infections dans un établissement dentaire en Ontario, Canada

Contexte : La Circonscription sanitaire du district d’Haliburton, Kawartha, Pine Ridge a étudié une exposition dans un établissement dentaire opérationnel de l’Ontario à une infection par le virus de l’hépatite C (VHC) nouvellement diagnostiquée causée par un virus ayant un génotype de l’hépatite C rare. Des lacunes dans la prévention et le contrôle des infections (PCI) et un deuxième cas lié de manière épidémiologique (avec le même génotype inhabituel de l’hépatite C) ont été identifiés, ce qui a entraîné une intervention plus large en santé publique et une enquête sur les éclosions. Objectifs : a) Décrire l’enquête sur un cas d’hépatite C nouvellement diagnostiqué; b) décrire l’intervention en santé publique dans son ensemble, et c) remédier à la pénurie de documentation sur le risque de transmission de la maladie dans les établissements dentaires en raison de lacunes de PCI. Méthodes : Une approche de collaboration avec deux cabinets dentaires, des partenaires en santé publique et des organismes de réglementation a été utilisée. Une inspection de PCI a été effectuée afin de déterminer et d’atténuer le risque de transmission d’infection par le sang dans les installations. Des protocoles appropriés ont été suivis pour l’enquête de PCI et l’intervention en santé publique. Résultats : L’enquête a révélé un risque de transmission potentielle du VHC entre deux cas liés à la même installation dentaire. Aucun autre cas de VHC lié à l’épidémiologie n’a été signalé. Les défis comprenaient le manque de respect des normes de PCI dans l’un des milieux dentaires et la sensibilisation de la communauté dentaire à la transmission du VHC, la coordination avec les organismes de réglementation et les experts en santé publique et la faible participation des patients aux tests de laboratoire. Conclusion : Malgré les défis uniques associés à l’enquête, la Circonscription sanitaire du district d’Haliburton, Kawartha, Pine Ridge a mené avec succès une enquête sur les lacunes de PCI et une intervention en santé publique. Les services de santé publique doivent maintenir des approches de collaboration avec les professionnels de la santé réglementés, leurs organismes de réglementation et les experts en santé publique.

EPICS Lakota: Promoting Food Sovereignty on Pine Ridge Indian Reservation

EPICS Team Lakota was started as a way for students to help promote food sovereignty and combat loss of cultural knowledge as felt by the residents of Pine Ridge Reservation, which is located in one of the poorest counties in the United States and is a food desert. In partnership with EPICS students at Oglala Lakota College (OLC) and South Dakota School of Mines (SDSM), students at Purdue came up with the idea of putting up a greenhouse on the Rapid City Campus of OLC. This greenhouse was meant not as a direct solution to food scarcity, but as a blueprint to be implemented across the reservation in the future. The greenhouse will be a resource for students, teachers, residents, and community elders to come together and preserve the knowledge of culturally significant plants and herbs, as well as a place to learn how to grow the fresh produce that is so hard to find on the reservation. Students at all schools worked together to figure out the optimal size and construction of the greenhouse, and also worked with residents to determine what should be grown and how to meet the needs of each plant. Consideration was given to the sustainability of the project as this was important to the Lakota stakeholders, including ways to lighten the load on any water and electric utilities. The greenhouse was also designed to be ADA accessible, so that community elders and all who needed such accommodations would have no trouble taking part. Throughout the project, students kept in contact with each other and the affected community. This continuous communication both aided and impeded the progress of the project. Care was taken at each point in the project to make sure that the final deliverable was the most effective it could be. This paper will explore the successes of the project and how the students addressed concerns as they arose.

Development of a Culturally Valid Instrument Examining HPV Knowledge and Beliefs of Lakota Women on the Pine Ridge Reservation

Introduction The aim of this article is to describe the modification of an instrument to secure cultural validity using cognitive interviewing to adequately examine and address health issues in a diverse population. Method Cultural experts ( n = 8) on the Lakota reservation were identified to provide input on cultural items of an instrument. Two rounds of cognitive interviewing ensued with each expert. The instrument items ( n = 40) were reviewed and revised as indicated. Results The results of this project were twofold; a culturally valid instrument was developed, and a process was delineated to ensure cultural validity. Content validity was supported by the 100% consensus among the Lakota cultural experts on every item. Discussion This article describes how cognitive interviewing was applied for instrument modification to obtain cultural validity resulting in a relevant instrument which may useful to researchers when working with diverse populations that have unique needs.

From Urban Core to Vacant Terrain

In Chapter 5, Eleanor Harrison-Buck and colleagues describe their use of drones to quickly and economically map roughly 7 km2 of plowed fields at the site of Saturday Creek in the middle Belize River Valley. They argue that Saturday Creek was a central node on the landscape from Preclassic to Colonial times, serving as an important crossroads between east-west and north-south transportation routes. The authors consider the dense settlement around the site core of Saturday Creek to be part of a larger monumental landscape and consider activities taking place in the vacant terrain on the fringes of the peri-urban settlement—what they refer to as the “heterotopia” (borrowing from Foucault). These spaces were separate from the settlement, but integral to its operation and included environments such as the pine ridge that served as an important transportation corridor, vast tracts of wetlands with ditched and drained agricultural fields, and broad floodplains with rich alluvial soils, which were likely places of cacao cultivation. The authors conclude that these “heterotopian” spaces in the monumental landscape are important to consider in settlement studies because they played a vital role in maintaining long-term, dense populations in urban and peri-urban centers like Saturday Creek.