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The present report describes the first known case of an otherwise healthy child who developed a soft tissue infection due to Mycobacterium senegalense - a pathogen usually found in east Africa that is responsible for infecting various animals. The patient presented with nonhealing wounds after sustaining facial lacerations from the shattered glass of a fish tank. The patient responded well to scar revision and antibiotics, with no subsequent relapse.

BackgroundIt is estimated that approximately one-third of pregnancies in Canada are unintended, meaning they were either mistimed (the woman wanted to be pregnant at a different point in time) or undesired (the woman did not want to be pregnant). This study aimed to assess the impact of socioeconomic variables and method of contraception on the decision to either terminate or continue and unintended pregnancy.MethodsData were obtained from two contemporaneous studies in Calgary Canada– a cross-sectional study involving women seeking abortion services (n = 577) and a longitudinal cohort study involving women with continuing pregnancies (n = 3552) between 2008 and 2012. Chi square tests and logistic regression were used to examine the association between socioeconomic variables, use of contraception and pregnancy intention.Results96.5 % of women seeking an abortion and 19.6 % of women with ongoing pregnancies reported having an unintended pregnancy. Women with unintended pregnancies were significantly younger (p < 0.001), less educated (p < 0.001), had a lower household income (p < 0.001), were less likely to be in a stable relationship (p < 0.001), and less likely to speak English in the home (p < 0.002). 20.2 % reported not using any form of birth control despite their desire to not get pregnant. Among women with unintended pregnancies, the only significant demographic predictor of not using any form of contraception was low educational attainment (OR = 1.7, 95 % CI: 1.2–2.4).ConclusionsLow educational attainment was associated with not using any form of contraception among women with unintended pregnancies. However, as unintended pregnancy occurs across all socio-demographic groups, care providers are encouraged to have an open discussion regarding fertility goals and contraception with all patients and refer them to appropriate resource materials.

Objective To guide clinicians working in a range of primary care clinical settings on how to provide effective care and support for refugees and newcomers during and after the coronavirus disease 2019 (COVID-19) pandemic. Sources of informationThe described approach integrates recommendations from evidence-based clinical guidelines on refugee health and COVID-19, practical lessons learned from Canadian Refugee Health Network clinicians working in a variety of primary care settings, and contributions from persons with lived experience of forced migration. Main messageThe COVID-19 pandemic has amplified health and social inequities for refugees, asylum seekers, undocumented migrants, transient migrant workers, and other newcomers. Refugees and newcomers face front-line exposure risks, difficulties accessing COVID-19 testing, exacerbation of mental health concerns, and challenges accessing health care, social, and settlement supports. Existing guidelines for clinical care of refugees are useful, but creative case-by-case strategies must be employed to overcome additional barriers in the context of COVID-19 and new care environments, such as the need for virtual interpretation and digital literacy skills. Clinicians can address inequities and advocate for improved services in collaboration with community partners. ConclusionThe COVID-19 pandemic is amplifying structural inequities. Refugees and newcomers require and deserve effective health care and support during this challenging time. This article outlines practical approaches and advocacy priorities for providing care in the COVID-19 context. This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link. This article has been peer reviewed.

Révision clinique Exclusivement sur le webCet article donne droit à des crédits d'autoapprentissage certifiés Mainpro+. Pour obtenir des crédits, rendez-vous à www.cfp.ca et cliquez sur le lien Mainpro+. Cet article a fait l'objet d'une révision par des pairs.