At least 60% of First Nation communities in Manitoba, including the Lake Manitoba First Nation, are in wetland areas.47% of First Nations communities in Manitoba served by facultative lagoons failed to achieve the total phosphorus (TP) concentration of 1 mg/L in proposed regulations for effluent discharge into the environment. The Lake Manitoba First Nation community facultative lagoon system treats domestic wastewater and seasonally discharges effluent into a wetland that connects to Lake Manitoba. This research was performed to estimate phosphorus removal efficiency through the natural wetland during the vegetation growing season.The average TP concentration reduction utilizing the natural treatment area of 1.3 ha was more than 70%, achieving the desired total phosphorus below 1 mg/L.These short-term study results indicate the potential of natural wetland treatment applications under cold continental climate conditions, as an effluent polishing step to satisfy regulatory requirements for phosphorus reduction in smaller First Nations communities. / February 2017

Methicillin-resistant Staphylococcus aureus (MRSA) is a growing concern in Canada especially in Aboriginal communities in remote regions. The northern and remote communities possess some or many of the risk factors that are identified in previous research to be associated with Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections such as overcrowding, challenges in maintaining personal hygiene and limited access to healthcare. CA-MRSA spreads rapidly in the communities. It is known to not only affect young and healthy individuals, but it is also associated with high morbidity and mortality rates. Furthermore, antibiotic resistance in CA-MRSA is increasing in Canada. It is known that inappropriate and greater use of antibiotics is associated with increased antibiotic resistance. Resistant CA-MRSA infections are more difficult to treat. To reduce and to control the antibiotic resistance, monitoring the prevalence of CA-MRSA and the changing antibiotic susceptibility profiles at the population level, especially in highly affected communities, is crucial. By monitoring this trend, it will enable healthcare practitioners to provide more adequate and appropriate treatment. To our knowledge, there was no community-based study that examined the epidemiology of CA-MRSA skin and soft-tissue infections (SSTIs) in First Nations communities in Canada at large scale, and the knowledge on the risk factors, outcomes and antibiotic susceptibility profiles is still very limited. This study aimed to describe the local epidemiology of SSTIs at the community level in selected First Nations communities as well as to describe the antibiotic use to treat SSTIs and the antibiotic susceptibility patterns of CA-MRSA. A retrospective chart review was conducted in 12 nursing stations in the First Nations communities across 5 provinces in Canada. The charts of individuals over 18 years of age who had received service at the nursing station in the previous 12 months, starting retrospectively from the date of collection, were reviewed in this study. Each antibiotic prescription that was noted in the chart in this period prior to chart review was recorded in the antibiotic tracking case report form. Data collected included demographics, indication for antibiotic use, antibiotic prescription parameters and patient outcomes. In total, of 372 patient charts reviewed, 224 patient charts contained at least one case (an encounter that resulted in an antibiotic prescription during the study period). Of those 224 charts, 459 cases were recorded and, of those, 137 cases had a diagnosis of an SSTI. In the 65 patients accounting for all cases of SSTI patients, more than 80% of the study population were under the age of 50. The prevalence of impaired renal function was low, diabetes was present in 20% of cases, cardiac disease was present in 15% of cases, and reported alcohol misuse was present in 30% of cases. The presence of indwelling devices was very rare. There were 137 cases of SSTIs over 372 charts reviewed in total. The prevalence of SSTI among the selected First Nations communities in 2012-2013 was estimated at almost 37% (137 cases of SSTIs / 372 charts reviewed). In the 137 SSTI cases, 55 cases were identified as MRSA infections either by laboratory test such as wound culture or by history of colonization documented in the chart. The overall prevalence of MRSA in all SSTI cases was estimated at 40.1% (55 confirmed MRSA positive cases / 137 cases of SSTIs). The majority of SSTIs were purulent infections and wounds. We also found that a wound culture and susceptibility test were performed only in 29% of all SSTI cases. An orally administered antibiotic was most frequently used (in 71.5% of treatments). Topical antibiotics were used in 18.3% and IV antibiotics were used in 8.8%. Other than the antibiotic treatment, wound care was performed in 49% of the SSTI cases and incision and drainage (I&D) procedure in 9%. The majority of MRSA isolates in this study were susceptible to clindamycin and co-trimoxazole (90.5% and 95.2%), but only 29% were susceptible to erythromycin. In general, higher rates of SSTIs were seen in communities where overcrowding and poor access to running water are more prevalent. In this study, we found that the diagnostic tests such as wound culture and sensitivity test was not ordered very often and there was also lack of follow-up or lack of documentation of the follow-up. More research is needed to better understand some of the challenges and risk factors associated with CA-MRSA infections in remote communities. Developing a national-level surveillance system that can help with monitoring the epidemiology of SSTIs and the antibiotic susceptibility test results of CA-MRSA at community level would be essential for better prevention, control, and management. Furthermore, adopting other initiatives such as antibiotic stewardship programs at community and healthcare settings as well as addressing the socio-environmental factors such as housing and access to water would be all very important in the steps to curb antibiotic resistance.

have altered the context and practices of the First Nations culture and by so doing, compromised their will and capacity to implement traditional education policies, a situation that must be linked to realization of the Education Action Plan’s goals. The goal of the study was to assist policy makers, community leaders, and educators in recognizing the attitudes, social norms, and practices that are interwoven with post-colonial trust issues at the community level and to focus on the viability of preservation of First Nations heritage and culture. The inquiry documented and analyzed, in a case study approach, the dynamics of colonialism on two First Nations communities. Interviews and questionnaires, utilized in communities, were based on a matrix that directed comments to areas associated with traditional knowledge, remnants of colonialism and areas of will and capacity. The focus of the inquires referred to curriculum content, funding, school and community structure, as well as traditional knowledge, communication, participation, and the role of members in shaping the community values and school curricula. In all, 32 people were formally interviewed including teachers, Elders, education council members, principals, and community leaders. The study comprised 14 interviews and 17 questionnaires in Two Rivers, and 18 interviews and 8 questionnaires in Round Rock. The study intended to establish whether colonialism would play out in the implementation of the traditional knowledge aspect of the Education Action Plan and if so, in what areas and in what manner. Through research, it was

have altered the context and practices of the First Nations culture and by so doing, compromised their will and capacity to implement traditional education policies, a situation that must be linked to realization of the Education Action Plan’s goals. The goal of the study was to assist policy makers, community leaders, and educators in recognizing the attitudes, social norms, and practices that are interwoven with post-colonial trust issues at the community level and to focus on the viability of preservation of First Nations heritage and culture. The inquiry documented and analyzed, in a case study approach, the dynamics of colonialism on two First Nations communities. Interviews and questionnaires, utilized in communities, were based on a matrix that directed comments to areas associated with traditional knowledge, remnants of colonialism and areas of will and capacity. The focus of the inquires referred to curriculum content, funding, school and community structure, as well as traditional knowledge, communication, participation, and the role of members in shaping the community values and school curricula. In all, 32 people were formally interviewed including teachers, Elders, education council members, principals, and community leaders. The study comprised 14 interviews and 17 questionnaires in Two Rivers, and 18 interviews and 8 questionnaires in Round Rock. The study intended to establish whether colonialism would play out in the implementation of the traditional knowledge aspect of the Education Action Plan and if so, in what areas and in what manner. Through research, it was