Competency based medical education (CBME) in CCFP(EM) programs.

Introduction: It is postulated that implementation of Competency by Design (CBD) in Royal College of Physicians and Surgeons of Canada (RCPSC) programs has helped enhanced skills programs in emergency medicine (CCFP(EM)) move towards a more competency-based residency. The objectives of the study were to identify major competency-based medical educational (CBME) components of CCFP(EM) programs across the country; and determine how programs are delivering these components.

Methods: After a rigorous development process (expert content development, and pilot testing), a survey questionnaire was administered to all 17 CCFP(EM) program directors using a modified Dillman technique.

Hyperbaric oxygen therapy for treatment of a late presenting ischaemic complication from hyaluronic acid cosmetic filler injection.

Vascular compromise and resulting ischaemic injury are known rare complications of cosmetic filler injections. Most hyaluronic acid vascular compromises present early and can be treated effectively by hyaluronidase. Here we present a case of ischaemic wound and mucosal necrosis after cosmetic facial hyaluronic acid injection that appeared within hours of injection but was not diagnosed and treated for 5 days.

Personalised multicomponent interventions for tobacco dependence management in low socioeconomic populations: a systematic review and meta-analysis.

Background: There remains a disproportionally high tobacco smoking rate in low-income populations. Multicomponent tobacco dependence interventions in theory are effective. However, which intervention components are necessary to include for low socioeconomic status (SES) populations is still unknown.

Adverse Events Associated with Immune Checkpoint Inhibitors: Overview of Systematic Reviews.

Background: Recognition and management of adverse events (AEs) associated with immune checkpoint inhibitor (ICI) use by cancer patients requires expertise from multiple disciplines. Greater awareness of potential AEs may result in earlier recognition, appropriate management, and better patient outcomes.

Objective: The primary objective of this overview of systematic reviews was to synthesize and consolidate systematic review evidence describing the incidence proportion and severity of AEs associated with various ICI therapies across different cancers.

A Community Prenatal Intervention in Social Nutrition: Evaluating the Impact on Pregnancy and Birthweight Outcomes.

This study aims to assess the associations between structural features of the Montreal Diet Dispensary's social nutrition intervention and pregnancy (i.e., anemia, gestational diabetes mellitus (GDM), gestational weight gain (GWG), hypertension) and birthweight outcomes (i.

Increased Mortality and Costs Associated with Adverse Events in Intensive Care Unit Patients.

Adverse events (AEs) are defined as unintended complications occurring to patients as a result of medical care. AEs are especially prevalent in the intensive care unit (ICU) setting and may lead to negative patient outcomes. Although many studies have examined the impact of AEs on patient outcomes, few have investigated their associated costs.

Scoping review of evidence for managing postnatal hypoglycaemia.

Objectives: To identify what is known empirically about the screening, treatment and harm of exposure to neonatal hypoglycaemia.

Design: Scoping review that applied a preregistered protocol based on established frameworks.

Data Sources: Medline and Embase, up to 12 May 2020.

Factors to Consider During Identification and Invitation of Individuals in a Multi-stakeholder Research Partnership.

Background: Health research teams increasingly partner with stakeholders to produce research that is relevant, accessible, and widely used. Previous work has covered stakeholder group identification.

Objective: We aimed to develop factors for health research teams to consider during identification and invitation of individual representatives in a multi-stakeholder research partnership, with the aim of forming equitable and informed teams.

Interfacility Transport of Mechanically Ventilated Patients with Suspected COVID-19 in the Prone Position.

Objective: Prone positioning during mechanical ventilation in patients with severe respiratory failure is an important intervention with both physiologic and empiric rationale for its use. This study describes a consecutive cohort of patients with severe hypoxemic respiratory failure due to COVID-19 who were transported in the prone position in order to determine the incidence of serious adverse events (SAEs) during transport.

Methods: This retrospective study used prospectively collected data from a provincial air and land critical care transport system where specially trained critical care paramedic crews transported intubated and mechanically ventilated patients with COVID-19 in the prone position.

Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial.

Background: The role of remdesivir in the treatment of patients in hospital with COVID-19 remains ill defined in a global context. The World Health Organization Solidarity randomized controlled trial (RCT) evaluated remdesivir in patients across many countries, with Canada enrolling patients using an expanded data collection format in the Canadian Treatments for COVID-19 (CATCO) trial. We report on the Canadian findings, with additional demographics, characteristics and clinical outcomes, to explore the potential for differential effects across different health care systems.

Reducing low-value testing in the emergency department through cost-effective physician education and personalised audit and feedback scorecards.

Objectives: Delivery of low-value healthcare impacts patients, resources, and overall healthcare sustainability. In Canada, an estimated 30% of tests, treatments, and procedures are unnecessary. As primary decision-makers, physicians have a major influence on healthcare utilisation.

Synthetic vaccine affords full protection to mice against lethal challenge of influenza B virus of both genetic lineages.

A quarter of all seasonal influenza cases are caused by type B influenza virus (IBV) that also dominates periodically. Here, we investigated a recombinant adenovirus vaccine carrying a synthetic HA2 representing the consensus sequence of all IBV hemagglutinins. The vaccine fully protected mice from lethal challenges by IBV of both genetic lineages, demonstrating its breadth of protection.

Executive Summary: Debridement: Canadian Best Practice Recommendations for Nurses Developed by Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC).

Debridement is described in the literature as having a high level of clinical risk and may result in patient harm when performed by untrained nurses. As a result, specialized knowledge, skills, and competencies are required to initiate, direct, and perform safe and effective debridement. This executive summary provides an overview of Debridement: Canadian Best Practice Recommendations for Nurses from the Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC).

Mapping multicenter randomized controlled trials in anesthesiology: a scoping review.

Background: Evidence suggests that there are substantial inconsistencies in the practice of anesthesia. There has not yet been a comprehensive summary of the anesthesia literature that can guide future knowledge translation interventions to move evidence into practice. As the first step toward identifying the most promising interventions for systematic implementation in anesthesia practice, this scoping review of multicentre RCTs aimed to explore and map the existing literature investigating perioperative anesthesia-related interventions and clinical patient outcomes.

Predictors of methacholine challenge testing results in subjects without airflow obstruction.

Objective: Methacholine challenge testing (MCT) is considered when asthma remains clinically suspected despite normal spirometry. Few studies have attempted to determine the predictive factors of MCT results. We aimed to establish which demographic data, clinical symptoms, pulmonary function testing results, and laboratory values were associated with abnormal MCT (provocation concentration causing a 20% decrease in FEV (PC20) ≤ 16 mg/mL) in subjects without airflow obstruction on spirometry.

Factors Associated with Condom Knowledge, Attitude, and Use among Black Heterosexual Men in Ontario, Canada.

African, Caribbean, and Black (ACB) men living in Canada share a heightened risk of HIV infection and the associated risk factors such as suboptimal use of family planning services such as condom use. In this study, we assessed the factors associated with knowledge, attitude, and condom use among ACB men in Ontario. .

Predictors of neurologists confirming or overturning emergency physicians' diagnosis of TIA or stroke.

Background: Transient ischemic attack (TIA) and non-disabling stroke are common emergency department (ED) presentations. Currently, there are no prospective multicenter studies determining predictors of neurologists confirming a diagnosis of cerebral ischemia in patients discharged with a diagnosis of TIA or stroke. The objectives were to (1) calculate the concordance between emergency physicians and neurologists for the outcome of diagnosing TIA or stroke, and (2) identify characteristics associated with neurologists diagnosing a stroke mimic.

NCLEX-RN preparation resources available online in French: An integrative review.

Aim: This review describes the availability of online French NCLEX-RN preparation resources for candidates BACKGROUND: One entry to practice requirement for Canadian nurses is to successfully pass a licensing exam upon graduation from their educational program. In 2015, the American NCLEX-RN replaced the Canadian entry to practice licensing examination which was offered in Canada's two official languages: English and French. The NCLEX-RN was developed in English and later translated to French.

Improving primary care access to respirologists using eConsult.

Background: Patients and primary care providers (PCPs) can experience frustration about poor access to specialist care. The Champlain Building Access to Specialists through eConsultation (BASETM) is a secure online platform that allows PCPs to ask a clinical question to 142 different specialty groups. The specialist is expected to respond within 7 days.