Influence of Geographical Origin and Ethnicity on Mortality in Patients on Antiretroviral Therapy in Canada, Europe, and the United States

Our objective was to assess differences in all-cause mortality, as well as AIDS and non-AIDS death rates, among patients started on antiretroviral therapy (ART) according to their geographical origin and ethnicity/race in Europe, Canada, and the United States. METHODS: This was a collaboration of 19 cohort studies of human immunodeficiency virus-positive subjects who have initiated ART (ART Cohort Collaboration) between 1998 and 2009. Adjusted mortality hazard ratios (AHRs) were estimated using Cox regression. A competing risk framework was used to estimate adjusted subdistribution hazard ratios for AIDS and non-AIDS mortality. RESULTS: Of 46 648 European patients, 16.3% were from sub-Saharan Africa (SSA), 5.1% Caribbean and Latin America, 1.6% North Africa and Middle East, and 1.7% Asia/West; of 1371 patients from Canada, 14.9% were First Nations and 22.4% migrants, and of 7742 patients from North America, 55.5% were African American and 6.6% Hispanic. Migrants from SSA (AHR, 0.79; 95% confidence interval [CI], .68-.92) and Asia/West (AHR, 0.62; 95% CI, .41-.92) had lower mortality than Europeans; these differences appeared mainly attributable to lower non-AIDS mortality. Compared with white Canadians, mortality in Canadian First Nations people (AHR, 1.48; 95% CI, .96-2.29) was higher, both for AIDS and non-AIDS mortality rates. Among US patients, when compared with whites, African Americans had higher AIDS and non-AIDS mortality, and hazard ratios for all-cause mortality increased with time on ART. CONCLUSIONS: The lower mortality observed in migrants suggests "healthy migrant" effects, whereas the higher mortality in First Nations people and African Americans in North America suggests social inequality gaps. KEYWORDS: HIV infection, antiretroviral therapy, ethnic minorities, migrants Comment in Addressing disparities in HIV mortality: antiretroviral therapy is necessary but not sufficient. [Clin Infect Dis. 2013]

The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.

Cleverer than we thought: the change in discourse of the Georgian Orthodox Church

This paper will focus on three episodes of contemporary church-state relations in Georgia, in particular, the conflicting interaction between law and religion in the public space. The first episode will be an open confrontation between the church and the state over the law on Registration of Religious Minority organizations (2011) which allowed the religious minorities to freely register; second: the Law on Self-governance (2013) which Georgian Orthodox Church considered “a threat to territorial integrity of Georgia”; and lastly: the Law on Anti-discrimination (2014) which was deemed “legitimization of Sodomic sin”. By reflecting on the three examples where for the first time after the collapse of Soviet Union, the Georgian state openly confronted the church and made a decision notwithstanding its position, I will attempt to argue that the role of the Orthodox Church in influencing the law making process is in gradual decline. However, on the other hand, by presenting the results of an ethnographic study conducted in 23 eparchies and perishes in 7 regions of Georgia in 2014, I will also show that church has adapted to its declining role over policy making, and to regain its political influence it gradually started to employ a civic rather than ethno nationalist discourse on matters of religious freedom while engaging with government. The paper will suggest that both unilateral decision-making of the state and civic shift in the discourse of the church constitute an important change in understanding church-state dynamics in the post-communist Orthodox Christianity dominated society.

Educational Systems and Gender Segregation in Education: A Three-Country Comparison of Germany, Norway and Canada

How do institutional settings and their embedded policy principles affect gender-typed enrolment in educational programmes? Based on gender-sensitive theories on career choice, we hypothesised that gender segregation in education is higher with a wider range of offers of vocational programmes. By analysing youth survey and panel data, we tested this assumption for Germany, Norway and Canada, three countries whose educational systems represent a different mix of academic, vocational and universalistic education principles. We found that vocational programmes are considerably more gender-segregated than are academic (e.g. university) programmes. Men, more so than women, can avoid gender-typed programmes by passing on to a university education. This in turn means that as long as their secondary school achievement does not allow for a higher education career, they have a higher likelihood of being allocated to male-typed programmes in the vocational education and training (VET) system. In addition, social background and the age at which students have to choose educational offers impact on the transition to gendered educational programmes. Overall, gender segregation in education is highest in Germany and the lowest in Canada. We interpret the differences between these countries with respect to the constellations of educational principles and policies in the respective countries.