Background  In the early developmental phase of a postmortem rapid tissue donation (RTD) program for patients with metastatic cancer, we surveyed health care professionals (HCPS) and oncology patients at the McGill University Health Centre (MUHC) to assess their knowledge and attitudes pertaining to RTD from metastatic cancer patients for research purposes.Methods   A 23-item survey was developed and distributed to hcps at tumour board meetings, and a related 26-item survey was developed and distributed to oncology patients at the MUHC Cedars Cancer Centre.Results   The survey attracted participation from 73 HCPS, including 37 attending physicians, and 102 oncology patients. Despite the fact that 88% of hcps rated their knowledge of RTD as none or limited, 42% indicated that they would feel comfortable discussing RTD with their cancer patients. Of the responding hcps, 67% indicated that their current knowledge of RTD would affect their decision to discuss such a program with patients, which implies the importance of education for hcps to facilitate enrolment of patients into a RTD program. Of responding patients, 78% indicated that they would not be uncomfortable if their doctor discussed RTD with them, and 61% indicated that they would like it if their doctor were to discuss RTD with them. The hcps and patients felt that the best time for patients to be approached about consenting to a RTD program would be at the transition to palliative care when no treatment options remain.Conclusions   At the MUHC, hcps and patients are generally enthusiastic about adopting a RTD program for patients with metastatic cancer. Education of hcps and patients will be an important determinant of the program’s success.

Background Translational research is an ideology focussed on streamlining the transition of novel research into clinical practice to ultimately benefit populations. Central to this approach is overcoming barriers to research involvement and interdisciplinary collaboration. Identifying barriers has been the subject of several studies focused on communities with large academic hospitals. The Windsor-Essex region is currently built around community hospitals which have less of an emphasis on research, employ fewer physicians holding academic appointments and generally do not provide incentivised time for research and training. In this study, we surveyed clinicians and researchers working in Windsor-Essex to gain insight into barriers to translational research important to those working in smaller sized, community-based research networks. Methods Using an anonymous close-ended Qualtrics survey distributed via email, we surveyed faculty members from The University of Windsor and clinical care providers from Windsor-Essex (n = 68). This included 24 physicians, 14 allied health professionals, and 30 non-clinician researchers. Results Managing competing interests, lack of time, funding, infrastructure, and networks were identified by greater than 75% of participants as barriers to research involvement. 62% of physicians identified the lack of permanent post-graduate medical trainees as a barrier. Clinicians were consistently less experienced in research skills compared to others; particularly in publishing results and applying for funding (p < 0.001). Schedule incompatibility, funding issues and identifying interested collaborators with overlapping interests were identified as barriers to interdisciplinary collaboration by 80% of participants. Moreover, 46% of those surveyed were unhappy with their research involvement and these individuals were 13% more likely to perceive research as important for their career progression (p = 0.244). Conclusions This study identifies several important barriers to translational research in Windsor-Essex and suggests that many motivated researchers are unhappy with their current involvement. These results will inform decision making in the research community of Windsor-Essex and provides insight for communities of similar size and research capacity. Ultimately, enabling the translation of clinical research in all communities is required to ensure equitable access to cutting edge care.

Background Systemic amyloidosis is group of disorders characterized by the accumulation of insoluble proteins in tissues. The most common form of systemic amyloidosis is light chain amyloidosis, which results from the accumulation of misfolded immunoglobulins. The disease is progressive, with treatment targeted at the underlying plasma cell dyscrasia. Since essentially any organ system can be affected, the presentation is variable and delays in diagnosis are common. Given this diagnostic difficulty, we discuss four different manifestations of light chain amyloidosis. Case presentations In this case series, we discuss four cases of light chain amyloidosis. These include cardiac, hepatic, and gastrointestinal as well as autonomic and peripheral nerve involvement with amyloidosis. The patients in our series are of Caucasian background and include a  69-year-old female, a 29-year-old female, a 68-year-old male, and a 70-year-old male, respectively. The case discussions highlight variability in presentation and diagnostic challenges. Conclusions Amyloidosis is a rare but serious disease that is often complicated by long delays in diagnosis. Morbidity and mortality can sometimes be limited if diagnosed earlier. We hope our real life cases will contribute to understanding and to early suspicion that can lead to early diagnosis and management.

The COVID-19 pandemic started in China in late 2019 and has since caused social and economic disruption across the globe. While children seem to be less severely affected by the disease, indirect factors may be affecting children’s physical and mental wellbeing. Countries have adopted social distancing policies, including school closures, in an attempt to slow the spread of the disease. Children were forced to be socially isolated from agemates during prolonged home-stay at an unprecedented scale. In addition, the pandemic is causing economic decline surpassing that of the Great Recession in 2008-2009. Other than some preliminary reports, it is unknown how the current situation will affect child health. To estimate how these drastic changes may impact children, we examine previous studies on social isolation and economic recession. Social isolation in the context of infectious disease is understudied, but the limited literature does show a correlation with increased post-traumatic stress scores and need for mental health services.  Studies from the 2008 recession show how economic decline may be related to higher rates of infant and child mortality, obesity, mental health concerns, suicide related behaviours and child maltreatment. Potential increases in child maltreatment are of concern because reporting has decreased in a variety of jurisdictions after the onset of the pandemic. Parents and those who work with children should be aware of these indirect consequences during and after the pandemic.

BackgroundTranslational research is an ideology focussed on streamlining the transition of novel research into clinical practice to ultimately benefit populations. Central to this approach is overcoming barriers to research involvement and interdisciplinary collaboration. While these have been the subject of several studies, the research community of Windsor-Essex lacks the large tertiary institution typical of the communities that are the usually the subject of this research. In this study, we surveyed clinicians and researchers working in Windsor-Essex to gain insight into barriers to translational research important to those working in smaller sized, community-based research networks. MethodsUsing an anonymous close-ended Qualtrics survey distributed via email, we surveyed faculty members from The University of Windsor and clinical care providers from Windsor-Essex (n=68). This included 24 physicians, 14 allied health professionals, and 30 non-clinician researchers. Results Managing competing interests, lack of time, funding, infrastructure, and networks were identified by greater than 75% of participants as barriers to research involvement. 62% of physicians identified the lack of permanent post-graduate medical trainees as a barrier. Clinicians were consistently less experienced in research skills compared to others; particularly in publishing results and applying for funding (p<0.001). Schedule incompatibility, funding issues and identifying interested collaborators with overlapping interests were identified as barriers to interdisciplinary collaboration by 80% of participants. Moreover, 54% of those surveyed were unhappy with their research involvement and these individuals were 9% more likely to perceive research as important for their career progression (p=0.046). ConclusionsThis study identifies several important barriers to translational research in Windsor-Essex and suggests that many motivated researchers are unhappy with their current involvement. These results will inform decision making in the research community of Windsor-Essex and provides insight for communities of similar size and research capacity. Ultimately, enabling the translation of clinical research in all communities is required to ensure equitable access to cutting edge care.