Cross-Cultural Translation of the Adolescent Menstrual Bleeding Questionnaire (AMBQ).

Aim: Heavy menstrual bleeding (HMB) affects up to 37% of adolescents. Given the paucity of available tools to assess health-related quality of life (HRQoL) in adolescents with HMB, we developed the adolescent menstrual bleeding questionnaire (aMBQ), a valid and reliable measure of bleeding-related quality of life. The aim of this study was cross-cultural translation and adaptation of the English aMBQ into French to ensure accessibility for more Canadian adolescents who menstruate.

Uptake of guideline-based testing for chronic viral hepatitis in Australian primary care: retrospective analysis of electronic medical record data.

Background Diagnosis is essential for engagement in care for chronic hepatitis B (CHB) and chronic hepatitis C (CHC), however, many Australians remain undiagnosed, especially for CHB. Primary care represents an important setting for testing, and this study sought to examine coverage in a large representative cohort of patients. Methods We analysed retrospective data from the electronic medical records of active patients visiting 566 primary care clinics in Victoria, Australia.

Does admission to intensive care post total joint arthroplasty result in poorer outcomes 12-months after surgery?

Background: It is unknown if total joint arthroplasty (TJA) patients admitted to the intensive care unit (ICU) benefit from the surgery. This impedes clinical decision-making, resource allocation and patient informed consent. This study aims to identify whether admission to ICU post-TJA surgery is associated with poorer quality of life, pain and function, compared to those not requiring ICU admission.

Guest Editorial - Moral injury in acute medicine.

Recently I had to have a few minutes in my office to regroup after I'd seen a patient. I didn't quite know how to process my feelings. I was feeling ashamed and upset.

The WeThrive App and Its Impact on Adolescents Who Menstruate: Qualitative Study.

Background: Heavy menstrual bleeding (HMB) affects up to 37% of adolescents. Without recognition, HMB can lead to other medical conditions resulting in diminished health-related quality of life. WeThrive, a new mobile health (mHealth) app, implements the pictorial bleeding assessment chart to identify HMB, and the adolescent Menstrual Bleeding Questionnaire to measure the effects of HMB on adolescents' health-related quality of life.

Resource use and disease severity of children hospitalized for COVID-19 versus multisystem inflammatory syndrome in children (MIS-C) in Canada.

Background: Direct comparisons of paediatric hospitalizations for acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) can inform health system planning. We describe the absolute and relative hospital burden of acute paediatric COVID-19 and MIS-C in Canada.

Methods: This national prospective study was conducted via the Canadian Paediatric Surveillance Program from March 2020-May 2021.

Society for Acute Medicine undergraduate syllabus for Acute Internal Medicine.

This syllabus is intended to act as a guide for students and their instructors in medical schools. It describes the range of clinical presentations that they should be able to recognize and the underlying conditions that they should know how to treat. It also includes knowledge of the practice of Acute Internal Medicine and systems of care.

Innovations in genomic antimicrobial resistance surveillance.

Whole-genome sequencing of antimicrobial-resistant pathogens is increasingly being used for antimicrobial resistance (AMR) surveillance, particularly in high-income countries. Innovations in genome sequencing and analysis technologies promise to revolutionise AMR surveillance and epidemiology; however, routine adoption of these technologies is challenging, particularly in low-income and middle-income countries. As part of a wider series of workshops and online consultations, a group of experts in AMR pathogen genomics and computational tool development conducted a situational analysis, identifying the following under-used innovations in genomic AMR surveillance: clinical metagenomics, environmental metagenomics, gene or plasmid tracking, and machine learning.

Enterococcus faecalis Strains with Compromised CRISPR-Cas Defense Emerge under Antibiotic Selection for a CRISPR-Targeted Plasmid.

Enterococcus faecalis is a Gram-positive bacterium that natively colonizes the human gastrointestinal tract and opportunistically causes life-threatening infections. Multidrug-resistant (MDR) E. faecalis strains have emerged that are replete with mobile genetic elements (MGEs).

Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids.

Study Objective: The purpose of this study is to rank the factors that are most and least important to patients with symptomatic uterine fibroids when considering surgical treatment options.

Materials And Methods: Using a best worst scaling (BWS) preference elicitation approach, participants completed an online survey to rank factors associated with fibroid surgical treatments. Survey content was based on a literature review and included the following factors: symptom relief; surgical complications; repeat treatment; recovery time; cosmetic effects; risk of spreading undiagnosed cancer; sexual outcomes; maintenance of child-bearing; continuation of menses; unpredictable menses; and location of procedure.

Mechanical and leakage integrity testing considerations for evaluating the performance of tissue containment systems.

Tissue containment systems (TCS) are medical devices that may be used during morcellation procedures during minimally invasive laparoscopic surgery. TCS are not new devices but their use as a potential mitigation for the spread of occult malignancy during laparoscopic power morcellation of fibroids and/or the uterus has been the subject of interest following reports of upstaging of previously undetected sarcoma in women who underwent a laparoscopic hysterectomy. Development of standardized test methods and acceptance criteria to evaluate the safety and performance of these devices will speed development, allowing for more devices to benefit patients.

Fat mass, weight and body shape changes at menopause - causes and consequences: a narrative review.

In addition to age-related weight gain, menopause adds additional challenges for women with the occurrence of significant metabolic alterations and central and visceral fat redistribution. The changes in body composition then influence risks of cardiovascular disease, metabolic disruption, cancer, fracture, lung disease, sexual dysfunction, mental health disorders and dementia. They may also heighten the severity of vasomotor symptoms.

A systematic review of economic evaluations of whole-genome sequencing for the surveillance of bacterial pathogens.

Whole-genome sequencing (WGS) has unparalleled ability to distinguish between bacteria, with many public health applications. The generation and analysis of WGS data require significant financial investment. We describe a systematic review summarizing economic analyses of genomic surveillance of bacterial pathogens, reviewing the evidence for economic viability.

Analysis of Rates of Completion, Delays, and Participant Recruitment in Randomized Clinical Trials in Surgery.

Importance: Discontinuation and nonpublication are established sources of avoidable waste among surgical trials, but rates of delayed completion and recruiting shortfalls remain unclear.

Objectives: To examine the rate of delayed completion, incomplete enrollment, and discontinuation among randomized clinical trials in surgical populations and the duration of delays and extent of recruiting shortfalls among these trials.

Design, Setting, And Participants: This cross-sectional study examined randomized clinical trials in surgical populations registered on ClinicalTrials.

Defining ferritin clinical decision limits to improve diagnosis and treatment of iron deficiency: A modified Delphi study.

Background: Iron deficiency is highly prevalent worldwide and is an issue of health inequity. Despite its high prevalence, uncertainty on the clinical applicability and evidence-base of iron-related lab test cut-offs remains. In particular, current ferritin decision limits for the diagnosis of iron deficiency may not be clinically appropriate nor scientifically grounded.

Estimating the impact of menstrual poverty on adolescents in Nova Scotia.

Background: Menstrual poverty is defined as the inability of people who menstruate to obtain menstrual products due to financial burden. The impact of menstrual poverty is not well studied in developed countries.

Objectives: This study aims to estimate the impact of menstrual poverty on adolescents who reside in Nova Scotia (NS), Canada.

Development of a core minimum data set to advance real-world evidence generation for uterine fibroids treatment technologies.

Objectives: The accumulation of data through a prospective, multicenter coordinated registry network (CRN) is a robust and cost-effective way to gather real-world evidence on the performance of uterine fibroids treatment technologies for device-based and intervention-based studies. To develop the CRN, a group of uterine fibroids experts, consisting of representatives from professional societies, the US Food and Drug Administration, academia, industry, and the patient community, was convened to discuss the role and feasibility of the CRN and to identify the core data elements needed to assess uterine fibroid treatment technologies.

Design: A Delphi method approach was employed to achieve consensus on a core minimum data set for the CRN.

Developing and validating a prediction model of adolescent major depressive disorder in the offspring of depressed parents.

Background: Parental depression is common and is a major risk factor for depression in adolescents. Early identification of adolescents at elevated risk of developing major depressive disorder (MDD) in this group could improve early access to preventive interventions.

Methods: Using longitudinal data from 337 adolescents at high familial risk of depression, we developed a risk prediction model for adolescent MDD.

Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020-May 2021.

Background: Children living with chronic comorbid conditions are at increased risk for severe COVID-19, though there is limited evidence regarding the risks associated with specific conditions and which children may benefit from targeted COVID-19 therapies. The objective of this study was to identify factors associated with severe disease among hospitalized children with COVID-19 in Canada.

Methods: We conducted a national prospective study on hospitalized children with microbiologically confirmed SARS-CoV-2 infection via the Canadian Paediatric Surveillance Program (CPSP) from April 2020-May 2021.

Possible futures of acute medical care in the NHS: a multispecialty approach.

Changing population demographics and needs are resulting in a continual rise in acute medical admissions. This review draws on the observations of the NHS GIRFT programme across England. Fundamental aspects of acute medical care are not universally provided, resulting in preventable hospitalisation and over-use of emergency departments.

Whole-genome sequencing enhances existing pathogen and antimicrobial-resistance surveillance schemes within a neonatal unit.

In some neonatal units, the screening of isolates for antimicrobial-resistant organisms is a matter of routine, with theoretical benefits including the prevention or early detection of outbreaks. This study sought to use whole-genome sequencing (WGS) retrospectively to characterize the genomic epidemiology of Gram-negative organisms obtained from a screening programme in a 32-bed unit providing intensive, high-dependency and special care at City Hospital, Birmingham, UK, identifying occult transmission events and clinically important antimicrobial-resistance (AMR) genes. WGS was performed for 155 isolates collected from rectal and umbilical screening swabs over a 2 month period from 44 individual neonates.

Developing priorities for quality improvement in acute medicine using a modified Delphi method A consensus process hosted by the Society for Acute Medicine Quality Improvement Committee (SAM-QI).

Introduction: The SAM Quality Improvement Committee (SAM-QI), set up in 2016, has worked over the last year to determine the priority Acute Medicine QI topics. They have also discussed and put forward proposals to improve QI training for Acute Medicine professionals.

Methods: A modified Delphi process was completed over four rounds to determine priority QI topics.

Pediatric Benign Neutropenia: Assessing Practice Preferences in Canada.

Pediatric benign neutropenia is a self-limited condition with a benign clinical course. An approach to this condition is not well-defined in the literature. Our objective was to use a case-based survey to elucidate trends in the diagnosis and management of benign neutropenia among pediatric hematology/oncology practitioners in Canada.