5 on 5: Fertility

October’s 5 0n 5 came in by request! Here are 5  basic fertility resources to support healthcare providers and patients.

  1. HealthLinkBC. Fertility. 2021.
  1. Society for Women’s Health Research. Clinician resource guide to fertility health care. 2022.
  1. Canadian Fertility and Andrology Society. Guidelines and Resources.
  1. American Society for Reproductive Medicine. Practice Documents.
  1. Jung C, Hunter A, Saleh M, Quinn G, Nippita S. Breaking the binary: How clinicians can ensure everyone receives high quality reproductive health services. Open Access Journal of Contraception. 2023; 14:23-39.

Up next month, also by request, 5 resources on Harm Reduction.

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5 on 5 Blastomycosis

For September’s 5 on 5 we have 5 resources on Blastomycosis.

  1. Government of Canada. Blastomycosis. Includes causes, symptoms, risks, treatment, prevention, surveillance, and for health professionals.
  1. Miceli A, Krishnamurthy K. Blastomycosis. 2023.

“Blastomycosis is a fungal infection caused by the organism Blastomyces dermatitidis, which is endemic in the soils of the Ohio and Mississippi River Valleys, Great Lakes region, and the southeastern United States.[1] It most commonly presents as a pulmonary infection following the inhalation of spores, which may be asymptomatic and, therefore, undetectable, though severe, life-threatening complications like acute respiratory distress syndrome can occur. Extrapulmonary disease occurs in approximately 25% to 30% of patients after hematogenous dissemination from the lungs, with the skin being the most common site of extrapulmonary disease.[2] Primary cutaneous blastomycosis, though rare, can occur due to direct inoculation after trauma to the skin. Unlike other deep fungal infections that occur predominantly in immunocompromised patients, blastomycosis also occurs in immunocompetent hosts.”

  1. Merck Manual. Blastoycosis (Gilchrist Disease; North American Blastomycosis)

“Blastomycosis is a pulmonary disease caused by inhaling spores of the dimorphic fungus Blastomyces dermatitidis. Occasionally, the fungi spread hematogenously, causing extrapulmonary disease. Symptoms result from pneumonia or from dissemination to multiple organs, most commonly the skin. Diagnosis is clinical, by chest x-ray, or both and is confirmed by laboratory identification of the fungi. Treatment is with itraconazole, fluconazole, or amphotericin B.”

  1. National Collaborating Centre for Infectious Diseases. Blastomycosis Disease Debrief.

“Questions Addressed in this debrief: What are important characteristics of Blastomycosis? What is happening with current outbreaks of Blastomycosis? What is the current risk for Canadians from Blastomycosis? What measures should be taken for a suspected Blastomycosis case or contact?”

  1. Tat J, Nadarajah J, Kus J. Blastomycosis. CMAJ. 2023; 195(29): E984.

“Although rates of blastomycosis in Canada remain low outside of historically endemic areas, the range for Blastomyces now includes Quebec, Manitoba, Saskatchewan, Ontario — the Kenora area has the highest global rates — and the eastern United States.13 Changes in climate and land use are hypothesized to be causing the expansion.2 Although a travel and exposure history remains important to differential diagnosis, cases are increasingly described in patients who have not travelled to traditional endemic areas.”

 

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5 on 5 Cybersecurity

July’s 5 0n 5 is by request! Here are 5 resources on cybersecurity in healthcare and how to keep electronic information safe.

  1. The Canadian Medical Protective Association. Electronic records: 10 tips to improve safety.

 

  1. The HIPAA Journal

The HIPAA password requirements and the best way to comply with them. 2023.

               For more articles go to https://www.hipaajournal.com/

 

  1. Canadian Centre for Cyber Security. Cyber security for healthcare organizations: protecting yourself against common cyber attacks.

 

  1. InfoLAW: Mobile devices in the workplace. Canadian Nurses Protective Society.

 

  1. Canadian Centre for Cyber Security. Don’t take the bait: Recognize and avoid phishing attacks.

 

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5 on 5: 2SLGBTQI+ Health

In honour of Pride month we are showcasing 5 resources for 2SLGBTQI+ health!

  1. American Psychological Association. Lesbian, Gay, Bisexual, and Transgender Health.

Among the APA’s goals is to expand psychology’s role in advancing health and in decreasing health disparities. The introductory summary of the Institute of Medicine’s 2011 report, “The Health of Lesbian, Gay, Bisexual and Transgender People: Building a Foundation for a Better Understanding,” states:

“Lesbian, gay, bisexual and transgender individuals experience unique health disparities. Although the acronym LGBT is used as an umbrella term, and the health needs of this community are often grouped together, each of these letters represents a distinct population with its own health concerns. Furthermore, among lesbians, gay men, bisexual men and women, and transgender people, there are subpopulations based on race, ethnicity, socioeconomic status, geographic location, age and other factors.”

Compounding this is that there are at present no large scale population data sets that include information about sexual orientation and gender identity, and LGBT people have been the subject of relatively little health research. In addition to these issues, LGBT people face barriers to equitable health care that profoundly affects their overall well-being.

 

  1. GLMA: Health Professionals Advancing LGBTQ Equality

Educating health professionals on the latest in LGBTQ+ health is key to GLMA’s mission of ensuring health equity for all LGBTQ+ people and equality for LGBTQ+ health professionals. GLMA provides practice-changing continuing education for health professionals and resources to educate and empower LGBTQ+ patients.

 

  1. National Collaborating Centre for Indigenous Health. An Introduction to the Health of Two-Spirit People: Historical, contemporary and emergent issues. 2016.

Two-Spirit is a term that encompasses a broad range of sexual and gender identities of Aboriginal peoples, including those who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). This paper, authored by Dr. Sarah Hunt, introduces the historical, contemporary and emergent issues related to Two-Spirit health. Integral to this discussion is that Two-Spirit health is understood within the context of colonialism and heteropatriarchy, as well as in the current resurgence of Two-Spirit peoples’ gender roles and sexual identities.

 

4. National LGBTQIA+ Health Education Center. Learning Resources.

This list of resources includes webinars, toolkits, videos, and publications for healthcare professionals.

 

  1. Substance Abuse and Mental Health Services Administration. Moving beyond change efforts: Evidence and action to support and affirm LGBTQI+ Youth. 2023.

This report provides behavioral health professionals, researchers, policymakers and other audiences with a comprehensive research overview and accurate information about effective and ineffective therapeutic practices related to youth of diverse sexual orientation and gender identity.

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5 on 5: Dermatology

For May’s 5 on 5 we have 5 resources on dermatology.

1. American Academy of Dermatology Association. Clinical Guidelines.

“The Academy is dedicated to promoting and encouraging dermatology research and the application of these findings to improving patient care. This includes the development of rigorous, evidence-based guidelines of care for dermatologic conditions. Learn more about the guideline development process. Review current clinical guidelines, those in development, and guidelines that the AAD has collaborated on.”

2. JAMA Dermatology

“JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications.”

3. The Royal College of General Practitioners. Dermatology Toolkit.

“Skin conditions are the most common reason for patients to present in primary care. Around one in four patients visit their GP with skin problems each year. Many skin conditions are long term, with significant morbidity and requiring high levels of self-care. Skin cancer incidence and dermatology referrals are rising with high demands on secondary care services and increasingly long delays for dermatology specialist review.”

4. Brady J, Kashlan R, Ruterbusch J, Farshchian M, Moossavi M. Racial Disparities in Patients with Melanoma: A Multivariate Survival Analysis. Clin Cosmet Investig Dermatol. 2021;14:547-550.

“Purpose: As the most common cause of skin cancer death, incidence and mortality of melanoma vary widely between ethnic and racial groups. Methods: Surveillance, Epidemiology, and End Results (SEER) data were used to examine the incidence and survival in patients with melanoma concerning race and ethnicity in Wayne County, Michigan between 2000 and 2016. Results: Analysis of data revealed significantly higher melanoma-specific death in non-Hispanic black patients compared to their non-Hispanic white counterparts (p <0.001). However, no increased risk of death due to melanoma was observed following adjustment of data for the stage, age, and sex (H.R. = 1.00, 95% CI 0.64-1.56). Conclusion: Non-Hispanic black patients have the highest percentage of late-stage melanoma. Increased incidence of melanoma mortality in non-Hispanic black patients is likely a consequence of late-stage diagnosis.”

For more research on disparities in dermatology here is a list of articles indexed in Pubmed.

5. DermNet

“ The world’s leading free dermatology resource. We help thousands of people make informed, evidence-based decisions on how to care for skin conditions, by providing reliable information at the click of a button.”

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5 on 5 Remote Healthcare

In CADTH’s 2022 Health Technology Trends to Watch: top 10 list, Remote Diagnostics, Remote Monitoring and Remote Care Management is listed as the number one trend.  As a result, this month we are featuring 5 resources related to remote healthcare!

1. CADTH reports on Remote Monitoring

2. Canada Health Infoway. Providing safe and high-quality virtual care: A guide for new and experienced users: Clinician Change Virtual Care Toolkit. 2022.

3. Lim C, Rosenfeld L, Nissen N, Wang P, Patel Pharm N, Powers B, Huang H. Remote care management for older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness: A systematic review. Journal of the Academy of Consultation-Liaison Psychiatry. 2022;63(1):198-212.

Background: Comorbidity of psychiatric and medical illnesses among older adult populations is highly prevalent and associated with adverse outcomes. Care management is a common form of outpatient support for both psychiatric and medical conditions in which assessment, care planning, and care coordination are provided. Although care management is often remote and delivered by telephone, the evidence supporting this model of care is uncertain.  Objective: To perform a systematic review of the literature on remote care management programs for older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness.  Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A multidatabase search was performed. Articles were included for review if they studied fully remote care management for older adult populations with elevated prevalence of depression or anxiety and chronic medical illness or poor physical health. A narrative synthesis was performed. Results: A total of 6 articles representing 6 unique studies met inclusion criteria. The 6 studies included 4 randomized controlled trials, 1 case-matched retrospective cohort study, and 1 pre-post analysis. Two studies focused on specific medical conditions. All interventions were entirely telephonic. Five of 6 studies involved an intervention that was 3 to 6 months in duration. Across the 6 studies, care management demonstrated mixed results in terms of impact on psychiatric outcomes and limited impact on medical outcomes. No studies demonstrated a statistically significant impact on health care utilization or cost.  Conclusions: Among older adult populations with elevated prevalence of depression or anxiety and comorbid chronic medical illness, remote care management may have favorable impact on psychiatric symptoms, but impact on physical health and health care utilization is uncertain. Future research should focus on identifying effective models and elements of remote care management for this population, with a particular focus on optimizing medical outcomes.

4. Cardile D, Corallo F, Cappadona I, lelo A, Bramanti P, Buono V, Ciurleo R, De Cola M. Auditing the audits: A systematic review on different procedures in telemedicine. International journal of environmental research and public health. 2023;20(5):4484.

Telemedicine is a process of delivering health care using information and communication technologies. Audit and feedback (A&F) constitute a systematic intervention that is aimed at collecting data, which are subsequently compared with reference standards and then returned to health care operators through feedback meetings. The aim of this review is to analyse different audit procedures on and by mean of telemedicine services and to identify a practice that is more effective than the others. Systematic searches were performed in three databases evaluating studies focusing on clinical audits performed on and by means of telemedicine systems. Twenty-five studies were included in the review. Most of them focused on telecounselling services with an audit and a maximum duration of one year. Recipients of the audit were telemedicine systems and service users (general practitioners, referring doctors, and patients). Data resulting from the audit were inherent to the telemedicine service. The overall data collected concerned the number of teleconsultations, service activity, reasons for referral, response times, follow-up, reasons why treatment was not completed, technical issues, and other information specific to each telemedicine service. Only two of the considered studies dealt with organizational aspects, and of these, only one analysed communicative aspects. The complexity and heterogeneity of the treatments and services provided meant that no index of uniformity could be identified. Certainly, some audits were performed in an overlapping manner in the different studies, and these show that although attention is often paid to workers’ opinions, needs, and issues, little interest was shown in communicative/organizational and team dynamics. Given the importance and influence that communication has in teamwork and care settings, an audit protocol that takes into account intra- and extra-team communication processes could be essential to improving the well-being of operators and the quality of the service provided.

5. Asrar F, Saint-Jacques D, Williams D. Outer space assets offer benefits to health care: Family doctors play a key role in supporting innovative work. Canadian Family Physician. 2022;68(11):797-798, 800.

“Technological requirements of spaceflight drive innovation and economic growth. Outer space assets, such as satellites, have played roles in Canadians’ daily and digital lives for decades, but most do not realize it. The Global Positioning System that we use for navigation and the weather forecasts and traffic reports that we check as we plan our activities all involve space technology.1 Similarly, benefits that space technology can offer health care are not well known.”

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5 on 5 Women’s Health

In honour of International Women’s Day on March 8, 2023 we have 5 resources that look at disparities in women’s health.

1. BIPOC Women’s Health Network

Resources for Healthcare Professionals

Resources for Patients

“The BIPOC Women’s Health Network aims to provide healthcare resources for serving racialized women in local Canadian communities. We believe providing information that is culturally-sensitive, anti-oppressive, multilingual, feminist, and pro-choice is crucial to addressing healthcare disparities faced by BIPOC women. Our organization is dedicated to accomplishing these goals by providing education for health care providers, medical students, and patients. We are committed to improving healthcare access, advocating for patients, and empowering women to take control of their health.”

2. World Health Organization – Women’s Health

“Being a man or a woman has a significant impact on health, as a result of both biological and gender-related differences. The health of women and girls is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors. For example, women and girls face increased vulnerability to HIV/AIDS.

Some of the sociocultural factors that prevent women and girls to benefit from quality health services and attaining the best possible level of health include:

  • unequal power relationships between men and women;
  • social norms that decrease education and paid employment opportunities;
  • an exclusive focus on women’s reproductive roles; and
  • potential or actual experience of physical, sexual and emotional violence.

While poverty is an important barrier to positive health outcomes for both men and women, poverty tends to yield a higher burden on women and girls’ health due to, for example, feeding practices (malnutrition) and use of unsafe cooking fuels (COPD).”

3. Prioritizing gender equity and intersectionality in Canadian global health institutions and partnerships.

Carducci B, Keats EC, Amri M, Plamondon KM, Shoveller J, Ako O, et al. (2022). PLOS Glob Public Health 2(10): e0001105.

“Despite governmental efforts to close the gender gap and global calls including Sustainable Development Goal 5 to promote gender equality, the sobering reality is that gender inequities continue to persist in Canadian global health institutions. Moreover, from health to the economy, security to social protection, COVID-19 has exposed and heightened pre-existing inequities, with women, especially marginalized women, being disproportionately impacted. Women, particularly women who face bias along multiple identity dimensions, continue to be at risk of being excluded or delegitimized as participants in the global health workforce and continue to face barriers in career advancement to leadership, management and governance positions in Canada. These inequities have downstream effects on the policies and programmes, including global health efforts intended to support equitable partnerships with colleagues in low- and middle- income countries. We review current institutional gender inequities in Canadian global health research, policy and practice and by extension, our global partnerships. Informed by this review, we offer four priority actions for institutional leaders and managers to gender-transform Canadian global health institutions to accompany both the immediate response and longer-term recovery efforts of COVID-19. In particular, we call for the need for tracking indicators of gender parity within and across our institutions and in global health research (e.g., representation and participation, pay, promotions, training opportunities, unpaid care work), accountability and progressive action.”

4. The Silence and the Stigma: Menopause in Canada. (2022).

“The Menopause Foundation of Canada’s landmark research of Canadian women aged 40 to 60 shows that among those going through perimenopause/menopause, more than half (54%) believe the topic is still taboo. A shocking one in two women (46%) feel unprepared for this stage of life. Even more remarkable, four in 10 women report feeling alone. How can something that happens to more than 50% of the population be such a mystery?”

5. Global Gender Gap Report 2022: Insight Report. (2022).

“The Global Gender Gap Index benchmarks the current state and evolution of gender parity across four key dimensions (Economic Participation and Opportunity, Educational Attainment, Health and Survival, and Political Empowerment). It is the longest-standing index which tracks progress towards closing these gaps over time since its inception in 2006. This year, the Global Gender Gap Index benchmarks 146 countries, providing a basis for robust crosscountry analysis. Of these, a subset of 102 countries have been represented in every edition of the index since 2006, further providing a large constant sample for time series analysis. The Global Gender Gap Index measures scores on a 0 to 100 scale and scores can be interpreted as the distance covered towards parity (i.e. the percentage of the gender gap that has been closed). The cross-country comparisons aim to support the identification of the most effective policies to close gender gaps.”

For more information you can also see The World Economic Forum’s page “Health equity for women and girls: Here’s how to get there

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5 on 5 Cancer Care

  1. Improving Indigenous Cancer Journeys in BC: A Road Map

“Improving Indigenous Cancer Journeys: A Road Map is the result of a multi-year partnership between BC Cancer, First Nations Health Authority (FNHA), Métis Nation British Columbia (MNBC) and the BC Association of Aboriginal Friendship Centres (BCAAFC). Only the second of its kind in the country, its priorities are in line with the calls to action for health by the Truth and Reconciliation Commission of Canada.  The strategy addresses all aspects of cancer, from prevention through to survivorship with a focus on delivering culturally safe cancer care.”

  1. LGBTQI Inclusive Cancer Care: A Discourse Analytic Study of Health Care Professional, Patient and Carer Perspectives

Ussher, J. M., Power, R., Perz, J., Hawkey, A. J., & Allison, K. (2022). Frontiers in oncology12, 832657.

“This study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers.”

  1. Cancer Care: Advancing Health Equity

EQUIP Health Care’s cancer care project resources. “The main goal of the EQUIP cancer care project is to improve cancer care for people who are experiencing significant health and social inequities. As a first step, we will improve our understanding of the factors that impact the uptake of equity-oriented healthcare strategies within cancer care.”

  1. Rapid Synthesis: Identifying Educational Approaches and Resources to Support Seamless Transitions Between Cancer Programs and Primary Care. (2021).

“It is estimated that nearly one in two Canadians will develop some form of cancer over their lifetimes. In supporting the growing number of individuals transitioning to survivorship care, there is a need to improve the coordination between cancer care and the primary- and community-care sectors. The transition in care following treatment into survivorship requires survivors and their families to adjust how they interact with the healthcare system. Additional supports are required to meet the needs of cancer survivors in this transition, as well as to enhance the capacity of primary- and community-care sectors in providing optimal care during and beyond the care transition.”

  1. CDC Cancer Resource Library

Resources for both Healthcare Professionals and Patients.

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5 on 5 Nutrition

For January’s 5 on 5 we are featuring resources on nutrition.

1. Indigenous Nutritional Knowledge Information Network

“We have learned through time honored tradition, the role and responsibilities we carry in our connection to food and water. We know these to be medicines and therefore family to the generations that have come before and the faces that are yet to come to this world. When we think of food and water as family, we honour a kinship that can be shared with our clients and our personal and professional development.” This page also includes recipes and webinars on Indigenous nutrition.

2. Canada Malnutrition Task Force – Resources

Nutrition resources for hospital care, primary care, pediatrics, long term care, changing practice, and subjective global assessment (SGA) – Diagnosing malnutrition.

3. UnlockFood.ca

“UnlockFood.ca is a bilingual, award-winning website brought to you by Dietitians of Canada. UnlockFood.ca is here to help Canadians connect with a dietitian and find the nutrition and food information that they need when they need it.”

“On UnlockFood.ca, you will find information on nutrition, food and healthy eating, as well as recipesvideos and online tools. There is information on hundreds of topics from A-Z.”

4. Ontario Dieticians in Public Health – Resources

“ODPH members work together and with other experts to create helpful resources and position statements related to public health nutrition. These resources can be used as a basis for public health-related programs, policies and health promotion strategies.”

5. Canada’s dietary guidelines for health professionals and policy makers

“Canada’s Dietary Guidelines set out Health Canada’s guidelines and considerations on healthy eating. The objectives of the guidelines are to promote healthy eating and overall nutritional well-being, and support improvements to the Canadian food environment”

Do you have a suggestion for future 5 on 5 topics? Let us know with an email to mhiknet@umanitoba.ca

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5 on 5 Human Rights in Healthcare

For our December 5 on 5 we are highlighting human rights in healthcare and featuring resources in support of Human Rights Day on December 10th.

1.Survey on Experiences of Racism in the Manitoba Health Care System 2021. Southern Chiefs’ Organization.

“In Manitoba, the statistics are damning. Health disparities between First Nations and other Manitobans is wide and widening, resulting in lower life expectancies at birth, higher suicide attempts, and poorer access to health services, to name a few (Manitoba Centre for Health Policy and the First Nations Health and Social Secretariat of Manitoba, 2019). In a recent southern First Nation Health Director Forum, experiences of systemic racism were identified by southern communities.

Discussion of racism and attempts to reform First Nations’ health gave impetus to the creation of a survey to investigate the extent and type of racism being experienced and observed by participating First Nation citizens in Manitoba. This report shares the results from the SCO Survey on Racism in Health Care and summarizes a snapshot of how racism is experienced in Manitoba’s health care system. It provides examples of experiences that First Nation people have had when facing racism in health care and the range of effects that racism in health care has had on First Nation people.”

For more Anti-Racism resources from Southern Chiefs’ Organization.

2. Health and Human Rights Journal

Health and Human Rights focuses rigorous scholarly analysis on the conceptual foundations and challenges of rights discourse and action in relation to health. The journal is dedicated to empowering new voices from the field — highlighting the innovative work of groups and individuals in direct engagement with human rights struggles as they relate to health. We seek to foster engaged scholarship and reflective activism. In doing so, we invite informed action to realize the full spectrum of human rights.” Health and Human Rights Journal is an open access publication.

3. Privacy and Security Considerations for Virtual Health Care Visits: Guidelines for the Health Sector.  Information and Privacy Commissioner of Ontario.

“The delivery of virtual health care has become an integral part of Ontario’s health system. Virtual health care can include secure messaging, telephone consultation, and videoconferencing. These forms of digital communication offer significant convenience for health information custodians (custodians) and their patients where physical distance poses a challenge. However, virtual health care also raises unique privacy and security concerns because it depends on technologies, communication infrastructures, and remote environments. Virtual health care raises new kinds of cybersecurity risks that are not as prevalent in the analog world.”

4. Sexual Health, Human Rights and the Law. World Health Organization.

“Sexual health today is widely understood as a state of physical, emotional, mental and social wellbeing in relation to sexuality. It encompasses not only certain aspects of reproductive health – such as being able to control one’s fertility through access to contraception and abortion, and being free from sexually transmitted infections (STIs), sexual dysfunction and sequelae related to sexual violence or female genital mutilation – but also, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. Indeed, it has become clear that human sexuality includes many different forms of behaviour and expression, and that the recognition of the diversity of sexual behaviour and expression contributes to people’s overall sense of well-being and health.”

5. A Human Rights Based Approach to the COVID-19 Pandemic: Principles and Actions. The Manitoba Human Rights Commission.

“As the COVID-19 pandemic sweeps across the globe, it has touched all Manitobans in some way and led to innovative and unprecedented responses from governments. Extensive public health campaigns, restrictions on social interaction and freedom of movement, and economic stimulus are just a few of the steps governments have taken in response to the virus. However, protecting public health can have implications for human rights, including the right to non-discrimination, education, employment and freedom of movement and assembly.”

Do you have a suggestion for future 5 on 5 topics? Let us know with an email to mhiknet@umanitoba.ca

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