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Moral panics are moments of intense and widespread public concern about a specific group, whose behaviour is deemed a moral threat to the collective. We examined public health guidelines in the first months of the COVID-19 pandemic in Canadian newspaper editorials, columns and letters to the editor, to evaluate how perceived threats to public interests were expressed and amplified through claims-making processes. Normalization of infection control behaviours has led to a moral panic about lack of compliance with preventive measures, which is expressed in opinion discourse. Following public health guidelines was construed as a moral imperative and a civic duty, while those who failed to comply with these guidelines were stigmatized, shamed as "covidiots," and discursively constructed as a threat to public health and moral order. Unlike other moral panics in which there is social consensus about what needs to be done, Canadian commentators presented a variety of possible solutions, opening a debate around infection surveillance, privacy, trust, and punishment. Public health communication messaging needs to be clear, to both facilitate compliance and provide the material conditions necessary to promote infection prevention behaviour, and reduce the stigmatization of certain groups and hostile reactions towards them., Competing Interests: The authors have declared that no competing interests exist.

Background: The COVID-19 pandemic brought the production of scientific knowledge onto the public agenda in real-time. News media and commentators analysed the successes and failures of the pandemic response in real-time, bringing the process of scientific inquiry, which is also fraught with uncertainty, onto the public agenda. We examine how Canadian newspapers framed scientific uncertainty in their initial coverage of the COVID-19 pandemic and how journalists made sense of the scientific process., Methods: We conducted a framing analysis of 1143 news stories and opinion during the first two waves of the COVID-19 pandemic. Using a qualitative analysis software, our analysis focused, first, on how scientific uncertainty was framed in hard news and opinion discourse (editorial, op-ed). Second, we compared how specialist health and science reporters discussed scientific evidence versus non-specialist reporters in hard news and columns., Results: Uncertainty emerged as a "master frame" across the sample, and four additional framing strategies were used by reporters and commentators when covering the pandemic: (1), evidence -focusing on presence or absence of it-; (2) transparency and leadership -focusing on the pandemic response-; (3) duelling experts - highlighting disagreement among experts or criticizing public health decisions for not adhering to expert recommendations-; and (4) mixed messaging -criticizing public health communication efforts. While specialist journalists understood that scientific knowledge evolves and the process is fraught with uncertainty, non-specialist reporters and commentators expressed frustration over changing public health guidelines, leading to the politicization of the pandemic response and condemnation of elected officials' decisions., Conclusions: Managing scientific uncertainty in evolving science-policy situations requires timely and clear communication. Public health officials and political leaders need to provide clear and consistent messages and access to data regarding infection prevention guidelines. Public health officials should quickly engage in communication course corrections if original messages are missing the intended mark, and clearly explain the shift. Finally, public health communicators should be aware of and more responsive to a variety of media reporters, who will bring different interpretative frames to their reporting. More care and effort are needed in these communication engagements to minimize inconsistencies, uncertainty, and politicization., (© 2021. The Author(s).)

Due to shared modes of exposure, HIV-HBV co-infection is common worldwide. Increased knowledge of the demographic and clinical characteristics of the co-infected population will allow us to optimize our approach to management of both infections in clinical practice. The Canadian Hepatitis B Network Cohort was utilized to conduct a cross-sectional evaluation of the demographic, biochemical, fibrotic and treatment characteristics of HIV-HBV patients and a comparator HBV group. From a total of 5996 HBV-infected patients, 335 HIV-HBV patients were identified. HIV-HBV patients were characterized by older median age, higher male and lower Asian proportion, more advanced fibrosis and higher anti-HBV therapy use (91% vs. 30%) than the HBV-positive / HIV seronegative comparator group. A history of reported high-risk exposure activities (drug use, high-risk sexual contact) was more common in HIV-HBV patients. HIV-HBV patients with reported high-risk exposure activities had higher male proportion, more Caucasian ethnicity and higher prevalence of cirrhosis than HIV-HBV patients born in an endemic country. In the main cohort, age ≥60 years, male sex, elevated ALT, the presence of comorbidity and HCV seropositivity were independent predictors of significant fibrosis. HIV seropositivity was not an independent predictor of advanced fibrosis (adj OR 0.75 [95%CI: 0.34-1.67]). In conclusion, Canadian co-infected patients differed considerably from those with mono-infection. Furthermore, HIV-HBV-infected patients who report high-risk behaviours and those born in endemic countries represent two distinct subpopulations, which should be considered when engaging these patients in care., (© 2020 John Wiley & Sons Ltd.)

In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants' acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants' relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.

Background: Obesity rates have reached epidemic levels with over 300 million obese individuals worldwide. Laparoscopic sleeve gastrectomy (LSG) as a primarily restrictive bariatric surgical procedure has been shown to be effective in producing marked weight loss. However, LSG-associated gastric leakage and hemorrhages remain the most important challenges postoperatively. Staple line buttress reinforcement has been suggested to reduce these postoperative complications. Our objective was to assess staple line buttress reinforcement via the Duet™ tissue reinforcement stapler system in morbidly obese patients undergoing LSG as part of a comprehensive weight management strategy, focusing on postoperative complications., Methods: Between January 2008 and April 2011, we retrospectively reviewed the medical records of 116 consecutive patients that underwent LSG with staple line buttress reinforcement at an academic teaching hospital with advanced bariatric fellowship., Results: The mean age of patients was 44.3 ± 9.5 years, with mean preoperative BMI of 44 ± 7 kg/m2. The mean operative time to perform LSG was 96 ± 25 min. Postoperative weight was significantly lower following LSG at 1-year follow-up compared to baseline (104 ± 25 vs. 125 ± 27 kg, P < 0.05). There were no postoperative gastric leaks observed. Postoperative bleeding from the gastric staple line occurred in one patient (0.9%) and was treated with conservative management., Conclusions: In LSG, staple line buttress reinforcement limits postoperative gastric leakage and bleeding in morbidly obese patients.