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OBJECTIVES: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. METHODS: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. RESULTS: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. CONCLUSION: The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions. [ABSTRACT FROM AUTHOR]

The author reflects on the altitudinal range of Mosses in Aberdeenshire. He stated that two of the species of Andraea grow near the sea and not 100 feet above sea level such as the Andraea Rupestris and Andrae Rothii. Meanwhile, species of polytrichum such as undulatum, hercynicum and piliferum grow in the immediate vicinity of Aberdeen.

Gene therapy has the potential to transform patients' lives and appropriate assessment methods are needed to capture the benefits of this type of treatment. The objective of this research was to characterize the current use of clinical outcome assessments (COAs) for U.S. Food and Drug Administration (FDA)- and European Medicines Agency (EMA)-approved gene therapies to describe ways in which the gene therapy patient experience is captured. [Extracted from the article]

Background: Short bowel syndrome (SBS) is a malabsorptive condition that can result in intestinal failure (SBS‐IF). Many patients with SBS‐IF require home parenteral nutrition (PN) for survival. However, PN has profound effects on patients and their family members. The present study aimed to understand the lived experience of SBS‐IF for patients and their families. Methods: In‐depth semi‐structured qualitative interviews were conducted with 15 patients with SBS‐IF and five adult family members living with someone with SBS‐IF. A patient‐centric approach was taken, with a patient steering group providing input and guidance to develop the interview guide. Key concepts were identified using thematic analysis of interview transcripts. Results: Patients' lives were dominated by having SBS‐IF. They described physical impacts that included patient‐reported signs and symptoms and physical restrictions comprising of restrictions on daily life, actives of daily living and physical functioning. In addition, they encountered emotional impacts with a plethora of negative feelings and social impacts, such as difficulties socialising and maintaining relationships. Patients coped by adapting their life around SBS‐IF, having support and adopting an attitude of gratitude and acceptance. Family members were also affected and, along with patients, appreciated the respite of a night off from infusions. Conclusions: Patients and families face many difficulties with SBS‐IF. Healthcare professionals can support patients by facilitating them explore what others have found beneficial; adapting their life around PN, viewing PN with acceptance and trying to cultivate gratitude. Further research into the support required for families may be beneficial. [ABSTRACT FROM AUTHOR]

Background: AGITG DOCTOR was a randomised phase 2 trial of pre-operative cisplatin, 5 fluorouracil (CF) followed by docetaxel (D) with or without radiotherapy (RT) based on poor early response to CF, detected via PET, for resectable oesophageal adenocarcinoma. This study describes PROs over 2 years.Methods: Participants (N = 116) completed the EORTC QLQ-C30 and oesophageal module (QLQ-OES18) before chemotherapy (baseline), before surgery, six and 12 weeks post-surgery and three-monthly until 2 years. We plotted PROs over time and calculated the percentage of participants per treatment group whose post-surgery score was within 10 points (threshold for clinically relevant change) of their baseline score, for each PRO scale. We examined the relationship between Grade 3+ adverse events (AEs) and PROs. This analysis included four groups: CF responders, non-responders randomised to DCF, non-responders randomised to DCF + RT, and "others" who were not randomised.Results: Global QOL was clinically similar between groups from 6 weeks post-surgery. All groups had poorer functional and higher symptom scores during active treatment and shortly after surgery, particularly the DCF and DCF + RT groups. DCF + RT reported a clinically significant difference (-13points) in mean overall health/QOL between baseline and pre-surgery. Similar proportions of patients across groups scored +/- 10 points of baseline scores within 2 years for most PRO domains. Instance of grade 3+ AEs were not related to PROs at baseline or 2 years.Conclusions: By 2 years, similar proportions of patients scored within 10 points of baseline for most PRO domains, with the exception of pain and insomnia for the DCF + RT group. Non-responders randomised to DCF or DCF + RT experienced additional short-term burden compared to CF responders, reflecting the longer duration of neoadjuvant treatment and additional toxicity. This should be weighed against clinical benefits reported in AGITG DOCTOR. This data will inform communication of the trajectory of treatment options for early CF non-responders.Trial Registration: Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN12609000665235 . Registered 31 July 2009. [ABSTRACT FROM AUTHOR]

Objective: To evaluate a curriculum for teaching family physicians (FPs) in rural and underserviced areas about children's mental health, and to evaluate a collaborative model of teaching using child psychiatrists and FPs. Methods: A child psychiatrist and a rural FP provided training to rural FPs in attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs). Training consisted of a half-day workshop in 11 communities located in southwestern Ontario. Workshops included didactic teaching, observation of standardized videos demonstrating interviewing skills, and interactive discussion. Participants completed pre- and posttraining questionnaires about their confidence in managing these conditions, and completed standardized questionnaires on the effectiveness of the workshop and videos. One month after the training, participants were randomly assigned to receive individual interviews. Three months later 2 questionnaires were mailed to participants for evaluation of their confidence after their training and for evaluation of the impact on their practice. Results: Fifty-six FPs attended the workshops and, of these, 80% completed the study. Family physicians reported improved confidence in their abilities to diagnose and treat ADHD and DBDs after the training. Conclusion: Didactic presentations by child psychiatrists and FPs, followed by video examples of interviewing skills, and informal discussions with small groups, was found to be an effective curriculum for teaching rural FPs about children's mental health. [ABSTRACT FROM AUTHOR]