Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement framework.

Background: Many clinicians feel uncomfortable with de-labelling penicillin allergies despite ample safety data. Point of care tools effectively support providers with de-labelling. This study's objective was to increase the number of providers intending to pursue a penicillin oral challenge by 15% by February 2023.

A mixed-methods exploration of the Real-Time Virtual Support pathway Child Health Advice in Real-Time Electronically in Northwestern BC.

Objectives: To explore the implementation of a provincial virtual paediatric consulting service, Child Health Advice in Real-Time Electronically (CHARLiE), integrated into the paediatric on-call schedule in Northwestern British Columbia.

Methods: Healthcare providers in Northwestern British Columbia responded to a survey (n = 72) and participated in focus groups (n = 35) and key informant interviews (n = 4) to share their experiences engaging in a healthcare model that incorporated virtual paediatric consultants in lieu of in-person local paediatrician coverage over a 28-month period. Survey data was analyzed using descriptive statistics.

Non-specific myocardial fibrosis in young competitive athletes: clinical significance and risk prediction by a powerful machine learning-based model.

Background: Non-specific myocardial fibrosis (NSMF) is a heterogeneous entity. We aimed to evaluate young athletes with and without NSMF to establish potentially clinically significance.

Methods: We analysed data from 328 young athletes.

Temporal Trends in Spinal Imaging in Ontario (2002-2019) and Manitoba (2001-2011), Canada.

Background Several studies have reported the overuse of spinal imaging, which, in Canada, led to several provincial pathways aimed at optimizing the use of imaging. We assessed temporal trends in spine imaging in two Canadian provinces. Methods We explored the use of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations of the cervical, thoracic, and lumbar spine regions among adults in Ontario (April 1, 2002, to March 31, 2019) and in Manitoba, Canada (April 1, 2001, to March 31, 2011) using linked Ontario Health Insurance Plan administrative databases and data from Manitoba Health.

Pathologist workload, burnout, and wellness: connecting the dots.

No standard tool to measure pathologist workload currently exists. An accurate measure of workload is needed for determining the number of pathologists to be hired, distributing the workload fairly among pathologists, and assessing the overall cost of pathology consults. Initially, simple tools such as counting cases or slides were used to give an estimate of the workload.

open repair of renal artery aneurysm in 43-year-old with solitary kidney: a case report.

Renal artery aneurysms are rare. Indications for management include size > 3 cm, female gender within childbearing age, pain, hematuria, medically refractory hypertension, thromboembolism, dissection, and rupture. Management options include endovascular, open repair, and ex vivo approaches.

Multimodality imaging review of ulnar nerve pathologies.

The ulnar nerve is the second most commonly entrapped nerve after the median nerve. Although clinical evaluation and electrodiagnostic studies remain widely used for the evaluation of ulnar neuropathy, advancements in imaging have led to increased utilization of these newer / better imaging techniques in the overall management of ulnar neuropathy. Specifically, high-resolution ultrasonography of peripheral nerves as well as MRI has become quite useful in evaluating the ulnar nerve in order to better guide treatment.

An audit of the carbon footprint of travel for the Canadian Anesthesiologists' Society International Education Foundation partnerships.

Purpose: International partnerships have an important role in capacity building in global health, but frequently involve travel and its associated carbon footprint. The environmental impact of global health partnerships has not previously been quantified.

Methods: We conducted a retrospective internal audit of the environmental impact of air travel for the international education programs of the Canadian Anesthesiology Society's International Education Fund (CASIEF).

Supporting consulting paediatrics in rural, remote, or vulnerable communities in British Columbia: Time for national collaboration.

Rural consultant paediatricians in Canada are in short supply. Rural communities across the country could benefit from the implementation of strategies to ensure access to consistent, local consultant paediatric care. Compared to their urban counterparts, rural paediatricians face unique challenges, including significant call requirements, potential risk of burnout and difficulty in recruitment.

Corrigendum to: Supporting consulting paediatrics in rural, remote or vulnerable communities in British Columbia: Time for national collaboration.

[This corrects the article DOI: 10.1093/pch/pxab043.].

Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation.

Background: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity.

Perceptions of Independent Pharmacist Prescribing among Health Authority- and Community-Based Pharmacists in Northern British Columbia.

Pharmacists across Canada have varying degrees of ability to prescribe medications depending on their jurisdiction of licensure. The purpose of this study was to the evaluate attitudes, beliefs, and perceptions of independent pharmacist prescribing among health authority- and community-based pharmacists. This prospective, cross-sectional online survey assessed the perceptions of independent pharmacist prescribing of health authority and community pharmacists practising in northern British Columbia (BC), which was defined as within the geographical boundaries of Northern Health.

Assessing Use of a Standardized Allergy History Questionnaire for Patients with Reported Allergy to Penicillin.

Background: Inappropriate allergy labelling is associated with significant clinical and pharmacoeconomic implications. Detailed antimicrobial allergy assessments represent a key component of antimicrobial stewardship and aid in identifying true type I (immediate hypersensitivity) reactions. The allergy history form currently used at the University Hospital of Northern British Columbia (UHNBC), in Prince George, relies on the assessor's ability to ask appropriate prompting questions to obtain a thorough history, but it may not be sufficient to accurately identify true allergies.

Adaptations of transfusion systems to the COVID-19 pandemic in British Columbia, Canada: Early experiences of a large tertiary care center and survey of provincial activities.

Background: In March 2020, a state of emergency was declared to facilitate organized responses to the coronavirus disease 2019 (COVID-19) pandemic in British Columbia, Canada. Emergency blood management committees (EBMCs) were formed regionally and provincially to coordinate transfusion service activities and responses to possible national blood shortages.

Study Design And Methods: We describe the responses of transfusion services to COVID-19 in regional health authorities in British Columbia through a collaborative survey, contingency planning meeting minutes, and policy documents, including early trends observed in blood product usage.

Understanding physical literacy in the context of health: a rapid scoping review.

Background: Physical literacy is a multidimensional concept that describes a holistic foundation for physical activity engagement. Understanding the utilization and effectiveness of physical literacy in the context of health and the health care setting will support clinical and population health programming. The purpose of this rapid scoping review was to: 1) map the conceptualization of physical literacy as it relates to health; 2) identify and describe the utilization of physical literacy in the context of health and engagement of health care providers; and 3) better understand the relationship between physical literacy, physical activity, and health.

Implementation of Physical Activity Interventions in Rural, Remote, and Northern Communities: A Scoping Review.

Compared with urban centers, rural, remote, and northern communities face substantial health inequities and increased rates of noncommunicable disease fuelled, in part, by decreased participation in physical activity. Understanding how the unique sociocultural and environmental factors in rural, remote, and northern communities contribute to implementation of physical activity interventions can help guide health promotion policy and practice. A scoping review was conducted to map literature describing the implementation of physical activity interventions in rural, remote, and/or northern communities.

The relationship between no-flow interval and survival with favourable neurological outcome in out-of-hospital cardiac arrest: Implications for outcomes and ECPR eligibility.

Background: The "no flow" interval is the time from out-of-hospital cardiac arrest (OHCA) to cardiopulmonary resuscitation (CPR). Its prognostic value is important to define for prehospital resuscitation decisions, post-resuscitation care and prognostication, and extracorporeal cardiopulmonary resuscitation (ECPR) candidacy assessment.

Methods: We examined bystander-witnessed OHCAs without bystander CPR from two Resuscitation Outcomes Consortium datasets.

What lies downstream? A case of superior vena cava syndrome presenting in the dermatology clinic: A case report.

A 75-year-old female presented with a 1 year history of a firm, diffusely swollen, and erythematous facial plaque. She had preceding unsuccessful investigations and treatment for angioedema. Full-skin examination revealed multiple prominent varicosities on the chest and abdomen.

Sleep Disturbance in Adjustment Disorder and Depressive Episode.

In this paper, we aimed to examine the patterns of sleep disturbance in adjustment disorder (AD) and depressive episode (DE), to examine the variables associated with sleep disturbance in AD and DE and associated impairment in functioning. This is a multi-centre case-control study of 370 patients: 185 patients with AD and 185 patients with a diagnosis of DE, recruited from the liaison psychiatry services of three Dublin hospitals. We examined the participants' sleep pathology using the sleep disturbance items on the Schedule for Clinical Assessment in Neuropsychiatry, and the Inventory of Depressive Symptoms-Clinician-rated-30.

Twelve tips for clinicians dealing with uncertainty when assessing learners.

Clinician educators often experience distress caused by uncertainty regarding how effectively to participate in assessment practices in a way that supports both their programs and their students. Uncertainty is a common state for clinicians, particularly for those who see patients with early or ill-defined illness presentations. While clinicians often feel ill at ease when facing uncertainty in the clinical realm, becoming comfortable with uncertainty and learning to manage such states are now recognized as vital components of clinical practice.

Improving Communication Between Surgery and Critical Care Teams: Beyond the Handover.

Background: Structured communication tools for postoperative surgical handover to the intensive care unit (ICU) have shown promise, yet little work has addressed ongoing daily communication between the surgery and ICU teams thereafter.

Objectives: Evaluation of a novel, 2-part communication intervention between surgery and ICU teams focused on postoperative handover and ongoing daily communication.

Methods: A mixed-methods, pre- and postintervention survey study was conducted in a closed quaternary medical-surgical ICU.

Is Twice-Daily Skin Moisturizing More Effective Than Routine Care in the Prevention of Skin Tears in the Elderly Population?

Background: Skin-moisturizing routines are part of a bundle of interventions designed to prevent skin tears.

Objective: This Evidence-Based Report Card reviews the effect of twice-daily moisturization of the skin on skin tear occurrence versus occurrence rates using routine skin care.

Search Strategy: The literature was systematically reviewed for studies that evaluated the use of standardized skin moisturizers on the rate of skin tears in the older adults (>60 years of age).