Adapting the design of the ongoing RAMPART trial in response to external evidence: An example for trials which take many years to run and report.

Clinical trials to establish the efficacy of new agents in the adjuvant cancer setting typically take many years to complete. During that time, external factors can impact recruitment and reporting plans. An example is a new standard of care becoming available during the recruitment period.

Effect of body mass index on survival after spinal cord injury.

Introduction: Increased mortality after acute and chronic spinal cord injury (SCI) remains a challenge and mandates a better understanding of the factors contributing to survival in these patients. This study investigated whether body mass index (BMI) measured after acute traumatic SCI is associated with a change in mortality.

Methods: A prospective longitudinal cohort study was conducted with 742 patients who were admitted to the Acute Spine Unit of the Vancouver General Hospital between 2004 and 2016 with a traumatic SCI.

'They treat us like machines': migrant workers' conceptual framework of labour exploitation for health research and policy.

Background: The exploitation of migrant workers ranks high on global political agendas including the Sustainable Development Goals. Research on exploited workers, using assessment tools where exploitation is defined by professional experts, indicates serious health concerns and needs. Yet, migrant workers are rarely asked about their understanding of a phenomenon they may experience.

Nationwide emergency department visits for pediatric traumatic spinal cord injury in the United States, 2016-2020.

Introduction: Traumatic spinal cord injury (tSCI) is a debilitating neurological condition resulting in lifelong disability for many individuals. The primary objectives of our study were to describe national trends in incident emergency department (ED) visits for tSCI among children (less than 21 years) in the United States, and to determine the proportion of visits that resulted in immediate hospitalization each year, including stratified by age and sex. Secondary objectives were to examine associations between select characteristics and hospitalization following tSCI, as well as to assess sports-related tSCIs over time, including by individual sport and geographic region.

Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data.

Introduction: Incidence and prevalence data are needed for the planning, funding, delivery and evaluation of injury prevention and health care programs. The objective of this study was to estimate the Canadian traumatic spinal cord injury (TSCI) incidence, prevalence and trends over time using national-level health administrative data.

Methods: ICD-10 CA codes were used to identify the cases for the hospital admission and discharge incidence rates of TSCI in Canada from 2005 to 2016.

Spinal Cord Injury Community Personal Opinions and Perspectives on Spinal Cord Stimulation.

Background: Spinal cord stimulation (SCS) clinical trials are evaluating its efficacy and safety for motor, sensory, and autonomic recovery following spinal cord injury (SCI). The perspectives of people living with SCI are not well known and can inform the planning, delivery, and translation of SCS.

Objectives: To obtain input from people living with SCI on the top priorities for recovery, expected meaningful benefits, risk tolerance, clinical trial design, and overall interest in SCS.

"We should be at the table together from the beginning": perspectives on partnership from stakeholders at four research institutions in sub-Saharan Africa.

Background: Global health research partnerships have been scrutinised for how they operate and criticised for perpetuating inequities. Guidance to inform fair partnership practice has proliferated and the movement to decolonise global health has added momentum for change. In light of this evolving context, we sought in this study to document contemporary experiences of partnership from the perspective of stakeholders in four sub-Saharan African research institutions.

Building a better understanding of labour exploitation's impact on migrant health: An operational framework.

Background: There is limited evidence on labour exploitation's impact on migrant health. This population is, however, often employed in manual low-skilled jobs known for poor labour conditions and exploitation risks. The lack of a common conceptualisation of labour exploitation in health research impedes the development of research measuring its effects on migrant health and, ultimately, our understanding of migrants' health needs.

Surgical resection of giant extrasellar thyrotropinoma: Use of orbitozygomatic and endoscopic endonasal approach.

Background: Thyrotropinomas (TSHoma) are rare pituitary adenomas.

Case Description: A 34-year-old female presented with mild bitemporal field defect in third trimester with intact pituitary function. MRI demonstrated an enhancing lesion from the posterior planum to suprasellar, interpeduncular and prepontine cisterns with chiasmal compression and right fetal posterior communicating artery encasement.

Spinal Cord Stimulation Research in the Restoration of Motor, Sensory, and Autonomic Function for Individuals Living With Spinal Cord Injuries: A Scoping Review.

Objective: To describe the status of spinal cord stimulation (SCS) research for the improvement of motor, sensory, and autonomic function for individuals living with a spinal cord injury (SCI).

Data Sources: This scoping review identified original research published before March 31, 2021, via literature searches using MEDLINE, Embase, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health, Sport Discus, and Web of Science, as well as a targeted search for well-known principal investigators. Search terms included permutations of "spinal cord stimulation," "epidural spinal cord stimulation," "transcutaneous spinal cord stimulation," "magnetic spinal cord stimulation," and "neuromodulation.

Pediatric Traumatic Spinal Cord Injury in the United States: A National Inpatient Analysis.

Background: Traumatic spinal cord injury (tSCI) is a debilitating neurological condition often associated with lifelong disability. Despite this, there are limited data on pediatric tSCI epidemiology in the United States.

Objectives: Our primary objective was to estimate tSCI hospitalization rates among children, including by age, sex, and race.

What makes working together work? A scoping review of the guidance on North-South research partnerships.

At their best, research partnerships provide a mechanism to optimize each partner's strengths, make scientific discoveries and achieve development goals. Each partner stands to gain from the relationship and perceives it to be fair. However, partnerships between institutions in the global North and the global South have been beleaguered by structural inequalities and power imbalances, and Northern stakeholders have been criticized for perpetuating paternalistic or neo-colonial behaviours.

RAMPART: A phase III multi-arm multi-stage trial of adjuvant checkpoint inhibitors in patients with resected primary renal cell carcinoma (RCC) at high or intermediate risk of relapse.

Background: 20-60% of patients with initially locally advanced Renal Cell Carcinoma (RCC) develop metastatic disease despite optimal surgical excision. Adjuvant strategies have been tested in RCC including cytokines, radiotherapy, hormones and oral tyrosine-kinase inhibitors (TKIs), with limited success. The predominant global standard-of-care after nephrectomy remains active monitoring.

RAMPART: A model for a regulatory-ready academic-led phase III trial in the adjuvant renal cell carcinoma setting.

The development of therapeutics in oncology is a highly active research area for the pharmaceutical and biotechnology industries, but also has a strong academic base. Many new agents have been developed in recent years, most with specific biological targets. This has mandated the need to look at different ways to streamline the evaluation of new agents.

Development of priorities for a Canadian strategy to advance activity-based therapies after spinal cord injury.

Study Design: Participatory design.

Objectives: Activity-based therapies (ABT) have physical and psychosocial benefits for individuals with spinal cord injury (SCI). A Canadian ABT summit was held to: (1) identify methods used in stroke rehabilitation that may be appropriate for SCI; (2) understand the current state of ABT activities in Canada; and (3) identify priorities for ABT research and care for the next five years.

Parents as carers on a neonatal unit: Qualitative study of parental and staff perceptions in a low-income setting.

Unlabelled: Aim To determine parents' experiences on a neonatal unit in a low-income country, how they and staff perceive the role of parents and if parents' role as primary carers could be extended.

Background: A busy, rural district hospital in Rwanda. Rwandan neonatal mortality is falling, but achieving Sustainable Development Goal target is hampered by trained staff shortage.

The recovery experience of people who were sex trafficked: the thwarted journey towards goal pursuit.

Background: In 2010, a shelter programme was established in the Netherlands to provide social and health services for trafficked people. This article describes how service users in this programme conceptualized and experienced their own process of recovery.

Methods: In 2012, 14 people of non-Dutch nationality who had been trafficked for the purpose of sexual exploitation were interviewed at all three shelters of the programme.

Supporting ALL victims of violence, abuse, neglect or exploitation: guidance for health providers.

Smaller groups of victims of violence, abuse, neglect or exploitation - such as male victims of intimate partner violence (IPV), victims of elder abuse, victims of abuse by carers, victims of parent abuse, victims of human trafficking, girls and boys below 18 years engaging in sex work, victims of sexual exploitation by gangs or groups and victims of honour based violence (such as forced marriages and female genital mutilation) - are often in contact with the health care system without being identified as such and frequently do not receive appropriate treatment. To address this problem, two things need to happen: 1) that ALL groups of victims of violence, abuse, neglect or exploitation are explicitly listed in policies and protocols, and 2) that both the similarities as well as the differences between the groups with regard to identification, support and referral - described in this article - are explained, so that health providers are appropriately supported in this important function.

Treatment fidelity in the Camden Weight Loss (CAMWEL) intervention assessed from recordings of advisor-participant consultations.

Background: Variations in the delivery of content and process can alter the effectiveness of complex interventions. This study examined the fidelity of a weight loss intervention (Camden Weight Loss) from recorded consultations by assessing advisors' delivery of content, use of motivational interviewing approach and therapeutic alliance.

Methods: A process evaluation was conducted of advisor-participant consultations in a 12-month randomised controlled trial of an intervention for adult volunteers with a body mass index categorised as overweight or obese.

Characteristics of Non-traumatic Spinal Cord Dysfunction in Canada Using Administrative Health Data.

There is a paucity of studies using administrative health data to examine the epidemiology, health care utilization, and outcomes for non-traumatic spinal cord dysfunction (NTSCD). The purpose of this study is to characterize discrete NTSCD cohorts using decision algorithms with Canadian health administrative databases. Data were provided by the Canadian Institute for Health Information that included all acute care hospital, day surgery, ambulatory, and inpatient rehabilitation records of patients with neurological impairment between April 1, 2004 and March 31, 2011.

Creation of an Algorithm to Identify Non-traumatic Spinal Cord Dysfunction Patients in Canada Using Administrative Health Data.

The lack of consensus on the best methodology for identifying cases of non-traumatic spinal cord dysfunction (NTSCD) in administrative health data limits the ability to determine the burden of disease and provide evidence-informed services. The purpose of this study is to develop an algorithm for identifying cases of NTSCD with Canadian health administrative databases using a case-based approach. Data were provided by the Canadian Institute for Health Information that included all acute care hospital and day surgery (Discharge Abstract Database), ambulatory (National Ambulatory Care Reporting System), and inpatient rehabilitation records (National Rehabilitation Reporting System) of patients with neurological impairment (paraplegia, tetraplegia, and cauda equina syndrome) between April 1, 2004 and March 31, 2011.

Mental health impact of social capital interventions: a systematic review.

Purpose: Mental disorders are a major contributor to the global burden of disease and disability, and can be extremely costly at both individual and community level. Social capital, (SC) defined as an individual's social relationships and participation in community networks, may lower the risk of mental disorders while increasing resilience capacity, adaptation and recovery. SC interventions may be a cost-effective way of preventing and ameliorating these conditions.

Evaluation of a Clinical Protocol to Assess and Diagnose Neuropathic Pain During Acute Hospital Admission: Results From Traumatic Spinal Cord Injury.

Objectives: A clinical protocol was developed for clinicians to routinely assess and initiate treatment for patients with neuropathic pain (NP) in an acute care setting. The objectives of this study were to: (1) determine the incidence and onset of NP in patients with traumatic spinal cord injury during acute care and (2) describe how the implementation of a clinical protocol impacts the assessment and diagnosis of NP.

Materials And Methods: The study was a cohort analysis with a pre-post-test utilizing a historical control.