Michener Institute

Objectives/Goals: Using secure systems for sharing documents with external collaborators is essential for all researchers. These documents may include protected health information (PHI) or sensitive materials like protocols, study reports, DSMB reports, publications, presentations, abstracts, and statistical analysis plans (SAPs). Methods/Study Population: We surveyed the ACTS Biostatistics, Epidemiology, and Research Design Special Interest Group (BERD-SIG) to gather information about the systems they are currently using or have used in the past for document sharing with external collaborators. The survey focused on the security of these systems, particularly in relation to sharing documents containing PHI. In addition, the survey included questions about various system features of interest. These features included version control, simultaneous editing by multiple users, and access rights management, such as the ability to assign different permissions (e.g., read-only, write, and download) to different individuals. We also invited participants to provide feedback on any additional positive or negative aspects of the systems they use. Results/Anticipated Results: We received 28 completed survey responses. Respondents had an option for choosing more than one system. The top current systems reported were Microsoft Teams (OneDrive, SharePoint) (n = 16), Box (n = 11), Google Docs/Drive (n = 10), and Dropbox (n = 6). Among other systems listed individually were Filelocker, REDCap, Slack, Website, Significant Media Shuttle, and Zulip. Notably, 15 responses indicated the respondents were unsure if their system is secure for sharing documents containing PHI. Respondents also offered feedback on both the positive and negative aspects of these systems. For example, a key advantage of Box was its password-controlled access. However, its incompatibility with office tools and the challenges for external collaborators attempting to access the system were noted as drawbacks. Discussion/Significance of Impact: Utilizing secure institutional document-sharing systems and understanding their features significantly affects the effectiveness and security of collaborations among researchers, particularly with external partners. This knowledge is especially crucial when sharing documents containing sensitive patient and study data.

Ectopic pregnancy occurs when a fertilized ovum implants outside the endometrial lining of the uterine cavity. Ectopic pregnancy is most commonly found in the fallopian tube but may also occur in the cervix, cesarean scar, ovary, or abdominal cavity. Ectopic pregnancy accounts for up to 13% of pregnancy-related deaths. Given the high degree of maternal mortality, recognizing an ectopic pregnancy is crucial for patient management. Clinical signs and symptoms can be nonspecific, but history of pelvic pain, vaginal bleeding, and no visualization of an intrauterine gestational sac in a patient with positive beta-human chorionic gonadotropin should raise the suspicion of an ectopic pregnancy. The place of implantation ultimately dictates treatment. Ultrasound is the imaging modality of choice for diagnosing ectopic pregnancy. This article explores the various subtypes of ectopic pregnancy and their concomitant sonographic appearances.

To review a practical and scientifically sound application of the wound bed preparation model for communities without ideal resources. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Summarize issues related to wound assessment.2. Identify a class of drugs for the treatment of type II diabetes mellitus that has been shown to improve glycemia, nephroprotection, and cardiovascular outcomes.3. Synthesize strategies for wound management, including treatment in resource-limited settings.4. Specify the target time for edge advancement in chronic, healable wounds.

IntroductionFoot ulcers are one of the most devastating complications of diabetes mellitus leading to leg amputations. In Canada, systematically marginalised and racialised populations are more prone to developing foot ulcers and at higher risk of limb amputations. Shortages of regulated healthcare have hindered efforts to provide foot care. Upskilling unregulated care providers (UCPs) to deliver foot screening seems a reasonable solution to reduce limb loss. UCPs can advocate for health equity and deliver appropriate care. There is a need, however, to understand how and why an educational intervention for UCPs providing foot screening for these high-risk groups may or may not work.Methods and analysisThis realist review will follow the Realist And Meta-narrative Evidence Syntheses: Evolving Standards standards. First, we will develop an initial programme theory (PrT) based on exploratory searches and discussions with experts and stakeholders. Then, we will search MEDLINE, Embase, PsycINFO, ERIC, CINAHL and Scopus databases along with relevant sources of grey literature. The retrieved articles will be screened for studies focusing on planned educational interventions for UCPs related to diabetic foot assessment. Data regarding contexts, mechanisms and outcomes will be extracted and analysed using a realist analysis through an iterative process that includes data reviewing and consultation with our team. Finally, we will use these results to modify the initial PrT.Ethics and disseminationEthical approval is not required for this review. The main output of this research will be an evidence-based PrT for upskilling programmes for UCPs. We will share our final PrT using text, tables and infographics to summarise our results and draw insights across papers/reports. For academic, clinical, social care and educational audiences, we will produce peer-reviewed journal articles, including those detailing the process and findings of the realist review and establishing our suggestions for effective upskilling programmes.PROSPERO registration numberCRD42022369208.

BACKGROUND As new technologies emerge, there is a significant shift in the way care is delivered on a global scale. Artificial intelligence (AI) technologies have been rapidly and inexorably used to optimize patient outcomes, reduce health system costs, improve workflow efficiency, and enhance population health. Despite the widespread adoption of AI technologies, the literature on patient engagement and their perspectives on how AI will affect clinical care is scarce. Minimal patient engagement can limit the optimization of these novel technologies and contribute to suboptimal use in care settings. OBJECTIVE We aimed to explore patients’ views on what skills they believe health care professionals should have in preparation for this AI-enabled future and how we can better engage patients when adopting and deploying AI technologies in health care settings. METHODS Semistructured interviews were conducted from August 2020 to December 2021 with 12 individuals who were a patient in any Canadian health care setting. Interviews were conducted until thematic saturation occurred. A thematic analysis approach outlined by Braun and Clarke was used to inductively analyze the data and identify overarching themes. RESULTS Among the 12 patients interviewed, 8 (67%) were from urban settings and 4 (33%) were from rural settings. A majority of the participants were very comfortable with technology (n=6, 50%) and somewhat familiar with AI (n=7, 58%). In total, 3 themes emerged: cultivating patients’ trust, fostering patient engagement, and establishing data governance and validation of AI technologies. CONCLUSIONS With the rapid surge of AI solutions, there is a critical need to understand patient values in advancing the quality of care and contributing to an equitable health system. Our study demonstrated that health care professionals play a synergetic role in the future of AI and digital technologies. Patient engagement is vital in addressing underlying health inequities and fostering an optimal care experience. Future research is warranted to understand and capture the diverse perspectives of patients with various racial, ethnic, and socioeconomic backgrounds.