Pathologic classification of a late-onset peripheral neuropathy in a spontaneous Labrador retriever dog model.

Late-onset peripheral neuropathy (LPN) is a heritable canine neuropathy commonly found in Labrador retrievers and is characterized by laryngeal paralysis and pelvic limb paresis. Our objective was to establish canine LPN as a model for human hereditary peripheral neuropathy by classifying it as either an axonopathy or myelinopathy and evaluating length-dependent degeneration. We conducted a motor nerve conduction study of the sciatic and ulnar nerves, electromyography (EMG) of appendicular and epaxial musculature, and histologic analysis of sciatic and recurrent laryngeal nerves in LPN-affected and control dogs. LPN-affected dogs exhibited significant decreases in compound muscle action potential (CMAP) amplitude, CMAP area, and pelvic limb latencies. However, no differences were found in motor nerve conduction velocity, residual latencies, or CMAP duration. Distal limb musculature showed greater EMG changes in LPN-affected dogs. Histologically, LPN-affected dogs exhibited a reduction in the number of large-diameter axons, especially in distal nerve regions. In conclusion, LPN in Labrador retrievers is a common, spontaneous, length-dependent peripheral axonopathy that is a novel animal model of age-related peripheral neuropathy that could be used for fundamental research and clinical trials.

An mHealth Design to Promote Medication Safety in Children with Medical Complexity.

BACKGROUND: Children with medical complexity (CMC) are uniquely vulnerable to medication errors and preventable adverse drug events because of their extreme polypharmacy, medical fragility, and reliance on complicated medication schedules and routes managed by undersupported family caregivers. There is an opportunity to improve CMC outcomes by designing health information technologies that support medication administration accuracy, timeliness, and communication within CMC caregiving networks. OBJECTIVES: The present study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a codesign process to identify: (1) medication safety challenges experienced by CMC caregivers and (2) design requirements for a mobile health application to improve medication safety for CMC in the home. METHODS: Study staff recruited family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program to participate in virtual codesign sessions. During sessions, the facilitator-guided codesigners in generating and converging upon medication safety challenges and design requirements. Between sessions, the research team reviewed notes from the session to identify design specifications and modify the prototype. After design sessions concluded, each session recording was reviewed to confirm that all designer comments had been captured. RESULTS: A total of N = 16 codesigners participated. Analyses yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines. Supporting quotations from codesigners and prototype features associated with each design requirement are presented. CONCLUSION: This study generated design requirements for a tool that may improve medication safety by creating distributed situation awareness within the caregiving network. The next steps are to pilot test tools that integrate these design requirements for usability and feasibility, and to conduct a randomized control trial to determine if use of these tools reduces medication errors.

Reproductive healthcare in prison: A qualitative study of women's experiences and perspectives in Ontario, Canada.

OBJECTIVE: To explore women's experiences and perspectives of reproductive healthcare in prison. METHODS: We conducted a qualitative study using semi-structured focus groups in 2018 with women in a provincial prison in Ontario, Canada. We asked participants about their experiences and perspectives of pregnancy and contraception related to healthcare in prison. We used a combination of deductive and inductive content analysis to categorize data. A concept map was generated using a reproductive justice framework. RESULTS: The data reflected three components of a reproductive justice framework: 1) women have limited access to healthcare in prison, 2) reproductive safety and dignity influence attitudes toward pregnancy and contraception, and 3) women in prison want better reproductive healthcare. Discrimination and stigma were commonly invoked throughout women's experiences in seeking reproductive healthcare. CONCLUSIONS: Improving reproductive healthcare for women in prison is crucial to promoting reproductive justice in this population. Efforts to increase access to comprehensive, responsive, and timely reproductive healthcare should be informed by the needs and desires of women in prison and should actively seek to reduce their experience of discrimination and stigma in this context.

Evaluating Trends in COVID-19 Research Activity in Early 2020: The Creation and Utilization of a Novel Open-Access Database.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has been unprecedented in recent history. The rapid global spread has demonstrated how the emergence of a novel pathogen necessitates new information to advise both healthcare systems and policy-makers. The directives for the management of COVID-19 have been limited to infection control measures and treatment of patients, which has left physicians and researchers alone to navigate the massive amount of research being published while searching for evidence-based strategies to care for patients. To tackle this barrier, we launched CovidReview.ca, an open-access, continually updated, online platform that screens available COVID-19 research to determine higher quality publications. This paper uses data from this review process to explore the activity and trends of COVID-19 research worldwide over time, while specifically looking at the types of studies being published. Materials and Methods The literature search was conducted on PubMed. Search terms included "COVID-19", "severe acute respiratory syndrome coronavirus 2", "coronavirus 19", "SARS-COV-2", and "2019-nCoV". All articles captured by this strategy were reviewed by a minimum of two reviewers and categorized by type of research, relevant medical specialties, and type of publication. Criteria were developed to allow for inclusion or exclusion to the website. Due to the volume of research, only a level 1 (title and abstract) screen was performed. Results The time period for the analysis was January 17, 2020, to May 10, 2020. The total number of papers captured by the search criteria was 10,685, of which 2,742 were included on the website and 7,943 were excluded. The greatest increase in the types of studies over the 16 weeks was narrative review/expert opinion papers followed by case series/reports. Meta-analyses, systematic reviews, and randomized controlled trials remained the least published types of studies. Conclusions The surge of research that accompanied the COVID-19 pandemic is unparalleled in recent years. From our analysis, it is clear that case reports and narrative reviews were the most widely published, particularly in the earlier days of this pandemic. Continued research that falls higher on the evidence pyramid and is more applicable to clinical settings is warranted.

Scholarly activity as a selection criterion in the Canadian Residency Matching Service (CaRMS): A review of published criteria by internal medicine, family medicine, and pediatrics programs.

BACKGROUND: Undergraduate medical students seek as much information as possible as to how residency programs select candidates. The Canadian Residency Matching Service (CaRMS) website is one of their primary sources of information. Students may be more competitive in the match if they know whether scholarly activity is used in the selection process by their preferred programs, as described on the CaRMS website. METHODS: For all 17 Canadian faculties of medicine, 2019 R1 entry internal medicine, family medicine and pediatrics program descriptions were reviewed on the CaRMS website looking for keywords related to scholarly activity. RESULTS: Forty-one percent of family medicine, 65% of internal medicine and 71% of pediatric programs explicitly stated having interest in applicants with scholarly experience. In Western Canada, 80% of internal medicine and 60% of pediatrics programs included scholarly activity in their CaRMS description of criteria considered in ranking applications. Similarly, in Ontario, 66% of internal medicine and 83% of pediatrics programs mentioned scholarly activity as a valuable quality. In Quebec 100% of family medicine and 50% of pediatrics programs include scholarly activity in their descriptions. Pediatrics and family medicine programs (100%) in Atlantic Canada mentioned scholarly activities but neither of the two Atlantic Canada internal medicine programs mentioned scholarly activities. CONCLUSION: Undergraduate medical students can use this project to prioritize extracurricular activities and scholarly work to be competitive for application to family medicine, internal medicine and pediatrics residency programs.

CONTEXTE: Les étudiants de premier cycle en médecine cherchent autant de renseignements que possible sur la manière dont les programmes de résidence sélectionnent les candidats. Le site Web du Service canadien de jumelage des résidents (CaRMS) représente l'une de leur principale source de renseignements. Les étudiants peuvent être plus compétitifs dans le jumelage s'ils savent comment les activités d'érudition sont utilisées dans le processus de sélection par leurs programmes préférés, comme il est décrit sur le site Web de CaRMS. MÉTHODES: Pour l'ensemble des 17 facultés de médecine canadiennes, les descriptions des programmes d'entrée R1 de 2019 en médecine interne, en médecine familiale et en pédiatrie ont été examinées sur le site Web du CaRMS pour la recherche de mots clés liés aux activités d'érudition. RÉSULTATS: 41 % des programmes de médecine familiale, 65 % de ceux en médecine interne et 71 % de ceux en pédiatrie énonçaient explicitement avoir un intérêt pour les candidats avec une expérience en érudition. Dans l'Ouest canadien, 80 % des programmes en médecine interne et 60 % de ceux en pédiatrie comportaient une activité d'érudition dans leur description CaRMS des critères dont ils tenaient compte dans le classement des demandes. De même, en Ontario, 66 % des programmes en médecine interne et 83 % de ceux en pédiatrie mentionnaient que les activités d'érudition représentaient une qualité importante. Au Québec, 100 % des programmes en médecine familiale et 50 % de ceux en pédiatrie présentent une activité d'érudition dans leur description. Les programmes de pédiatrie et de médecine familiale (100 %) dans le Canada atlantique mentionnent les activités scientifiques, mais aucun des deux programmes de médecine interne du Canada atlantique ne mentionnait des activités scientifiques. CONCLUSION: Les étudiants de premier cycle en médecine peuvent utiliser le présent projet pour prioriser leurs activités extracurriculaires et le travail d'érudition pour être compétitifs lors de leurs applications dans des programmes de médecine familiale, de médecine interne et de pédiatrie.

Reliability of the Crossed-Hands Deficit in Tactile Temporal Order Judgements.

Crossing the hands over the midline impairs performance on a tactile temporal order judgement (TOJ) task, resulting in the crossed-hands deficit. This deficit results from a conflict between two reference frames - one internal (somatotopic) and the other external (spatial) - for coding stimulus location. The substantial individual differences observed in the crossed-hands deficit highlight the differential reliance on these reference frames. For example, women have been reported to place a greater emphasis on the external reference frame than men, resulting in a larger crossed-hands deficit for women. It has also been speculated that individuals with an eating disorder place a greater weight on the external reference frame. Further exploration of individual differences in reference frame weighing using a tactile TOJ task requires that the reliability of the task be established. In Experiment 1, we investigated the reliability of the tactile TOJ task across two sessions separated by one week and found high reliability in the magnitude of the crossed-hands deficit. In Experiment 2, we report the split-half reliability across multiple experiments (both published and unpublished). Overall, tactile TOJ reliability was high. Experiments with small to moderate crossed-hands deficits showed good reliability; those with larger deficits showed even higher reliability. Researchers should try to maximize the size of the effect when interested in individual differences in the use of the internal and external reference frames.