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Harry Benjamin (1885–1986) was a German-American physician who played a significant role in the early history of transgender medicine. He wrote the groundbreaking book "The Transsexual Phenomenon" in 1966 and advocated for compassionate treatment of transgender individuals. Benjamin initially focused on geriatrics in his medical practice but became interested in the therapeutic possibilities of endocrine glands. He had connections with Magnus Hirschfeld, a German physician and activist for homosexual rights, and was willing to use medical tools to help transgender individuals align their bodies with their gender identity. Benjamin's approach was cautious, urging patients to proceed slowly and only change their bodies as a last resort. He provided hormone therapy and practical aid, such as testifying on his patients' behalf in court and helping them obtain identification papers. Benjamin's work influenced a generation of transgender people and health professionals, and he became the physician to over a thousand transgender individuals. While his approach may seem old-fashioned by today's standards, Benjamin's compassionate and respectful treatment of his patients eased their suffering and opened up a new field of care. [Extracted from the article]

We appreciate and have carefully considered Dr. Jain's response.[1] We opted to reduce (not eliminate) bias caused by the unequal distribution of medical risk factors by type of most responsible provider (MRP) using a validated weighted risk score to group birthers into prenatal risk groups. We appreciate the etiological consideration Dr. Jain suggested and can also think of factors that might predispose midwifery clients to worse outcomes. With respect to MRP assignment, MRP is a mandatory data field, is clearly defined in our paper and, in our view, is the best variable to use when describing outcomes of midwife-led care. [Extracted from the article]

The article discusses the results of the 2014 National Physical Survey (NPS). Results mentioned include 21.3 percent of physicians reporting using only paper charts to enter and retrieve clinical patient notes, 29.4 percent of physicians reporting that they exclusively use electronic records, and how the switch from paper to electronic medical records (EMR) has become a standard of practice in the modern primary health care clinic.

Background: Understanding the complex interaction of risk factors that increase the likelihood of developing common diseases is challenging. The Canadian Partnership for Tomorrow Project (CPTP) is a prospective cohort study created as a population-health research platform for assessing the effect of genetics, behaviour, family health history and environment (among other factors) on chronic diseases.Methods: Volunteer participants were recruited from the general Canadian population for a confederation of 5 regional cohorts. Participants were enrolled in the study and core information obtained using 2 approaches: attendance at a study assessment centre for all study measures (questionnaire, venous blood sample and physical measurements) or completion of the core questionnaire (online or paper), with later collection of other study measures where possible. Physical measurements included height, weight, percentage body fat and blood pressure. Participants consented to passive follow-up through linkage with administrative health databases and active follow-up through recontact. All participant data across the 5 regional cohorts were harmonized.Results: A total of 307 017 participants aged 30-74 from 8 provinces were recruited. More than half provided a venous blood sample and/or other biological sample, and 33% completed physical measurements. A total of 709 harmonized variables were created; almost 25% are available for all participants and 60% for at least 220 000 participants.Interpretation: Primary recruitment for the CPTP is complete, and data and biosamples are available to Canadian and international researchers through a data-access process. The CPTP will support research into how modifiable risk factors, genetics and the environment interact to affect the development of cancer and other chronic diseases, ultimately contributing evidence to reduce the global burden of chronic disease. [ABSTRACT FROM AUTHOR]

The article offers information about the interwoven history of mercury poisoning among indigenous people in Ontario, Canada and the 20th century industrial incident in Minamata, Japan. It discusses issues concerning Dryden Chemical Co.'s pulp and paper mill, which generated mercury waste from bleaching paper, and methylmercury, a lipid-soluble compound.

That date marks the expiry of Bill C-7's exception for MAiD in circumstances where a mental disorder is the sole underlying medical condition. Another recent paper by the same group complements this work by leveraging the European experience in another way - the iterative development of an expert consensus-based set of criteria for MAiD in circumstances where a mental disorder is the sole underlying medical condition.[2] The current MAiD reporting requirements[3] are insufficient to address the crucial upcoming questions regarding MAiD in the context described above. The recent article by van Veen and colleagues[1] provides a window into a possible future for Canadian practice regarding medical assistance in dying (MAiD) among people for whom a mental disorder is the sole underlying medical condition. [Extracted from the article]

Background: Meta-analyses of continuous outcomes typically provide enough information for decision-makers to evaluate the extent to which chance can explain apparent differences between interventions. The interpretation of the magnitude of these differences - from trivial to large - can, however, be challenging. We investigated clinicians' understanding and perceptions of usefulness of 6 statistical formats for presenting continuous outcomes from meta-analyses (standardized mean difference, minimal important difference units, mean difference in natural units, ratio of means, relative risk and risk difference).Methods: We invited 610 staff and trainees in internal medicine and family medicine programs in 8 countries to participate. Paper-based, self-administered questionnaires presented summary estimates of hypothetical interventions versus placebo for chronic pain. The estimates showed either a small or a large effect for each of the 6 statistical formats for presenting continuous outcomes. Questions addressed participants' understanding of the magnitude of treatment effects and their perception of the usefulness of the presentation format. We randomly assigned participants 1 of 4 versions of the questionnaire, each with a different effect size (large or small) and presentation order for the 6 formats (1 to 6, or 6 to 1).Results: Overall, 531 (87.0%) of the clinicians responded. Respondents best understood risk difference, followed by relative risk and ratio of means. Similarly, they perceived the dichotomous presentation of continuous outcomes (relative risk and risk difference) to be most useful. Presenting results as a standardized mean difference, the longest standing and most widely used approach, was poorly understood and perceived as least useful.Interpretation: None of the presentation formats were well understood or perceived as extremely useful. Clinicians best understood the dichotomous presentations of continuous outcomes and perceived them to be the most useful. Further initiatives to help clinicians better grasp the magnitude of the treatment effect are needed. [ABSTRACT FROM AUTHOR]

Some nights turned into most nights, and, soon enough, she was spending them lying in bed, gazing upon our constellations on the ceiling, her bright but tired eyes peeking from beneath the blanket. The glow of a flashlight shone through the cracks, and I spotted a book on her knees, a tiny finger trailing along the pages. Placing the paper in front of the flashlight, I pointed it toward the ceiling. [Extracted from the article]

Recent clinical trials have shed new light on treatments for coronavirus disease 2019 (COVID-19), but retractions of COVID-19 papers have also sparked concerns about data quality and "science by press release." My institution specifically set up a board to ensure that the highest quality studies were approved because very quickly when a patient came in with COVID-19, you had study coordinators lining up outside the patient's room. [Extracted from the article]

2019;129:49-57. 5 Mubarak A, Benninga MA, Broekaert I. Diagnosis, management, and prevention of button battery ingestion in childhood: a European Society for Paediatric Gastroenterology Hepatology and Nutrition position paper. If the battery does not pass, or if symptoms develop, imaging should be repeated (at 48 h if the battery is > 20 mm; at 10-14 d if < 20 mm) and endoscopic removal considered.[3] Honey or sucralfate should be administered after battery ingestion Honey should be administered before the patient reaches the hospital, and sucralfate when in hospital within 12 hours of battery ingestion, to mitigate tissue injury while awaiting possible definitive management. Between 1999 and 2019, the United States National Poison Data System reported a 66.7% increase in yearly ingestion of button batteries (6.98 to 10.46 per million population) and a 10-fold increase in complications (0.77% [ I n i = 76] to 7.53% [ I n i = 551]).[1] Button batteries can cause substantial tissue damage within 2 hours of ingestion.[2] The type and size of the ingested battery influence the likelihood of complications Lithium batteries (given their high voltage) and those 20 mm or larger (which are likely to become lodged in the esophagus) are most dangerous, especially in children younger than 6 years.[2] Complications include gastrointestinal perforation, aortoesophageal fistulas and strictures.[2],[3] Urgency of management depends on the location of the battery Anterior-posterior and lateral radiographs of the chest and abdomen can determine the location of the button battery. [Extracted from the article]

Similarly, despite World Health Organization guidelines suggesting only 10%-15% of women require cesarean section, the researchers found that 29% of physicians giving birth had the procedure, a rate only slightly below that of other patients (31%). Graph: The cesarean rate among physician and nonphysician patients was similar in a recent analysis of US military data. One lesson physicians can learn from this paper, said Jena, is that providing information to a patient about their health and treatments is just one step in providing them with appropriate care. [Extracted from the article]

The article reflects on the lawsuit filed against Jameda, an online platform with ratings for German physicians, by a dermatologist demanding the removal of references that could injure her reputation. Switzerland-based medical bioethicist Stuart McLennan notes that physicians fear over online ratings may be overblown anyway. It notes a paper by McLennan and his colleagues which concluded that recommendations from friends, family members, and referrals remain more important than online rating.

The article reports on a discussion paper released by the Patented Medicine Prices Review Board which asks Canadians, physicians, and pharmaceutical companies to review the drug-pricing system in Canada, with the aim of modernizing and simplifying the regulatory framework on patented drug pricing. It highlights statistics which compare the cost of medicines in the country with others. The discussion paper is said to be a part of a consultation process designed to focus drug-pricing problems.

The article focuses on the effort of the U.S. Food and Drug Administration (FDA) to get stakeholders to set a voluntary tampon standard in light of tampons' alleged association with toxic shock syndrome. Topics include the withdrawal of Rely tampons, produced by Protector & Gamble, from the market following its implication as the single most contributing to the onset of toxic shock syndrome, creation of the Tampon Task Force by the FDA, and the findings of the task force regarding the issue.

The article highlights two medical research papers. The first paper analyzes the risk of acute kidney injury and acute interstitial nephritis in Ontario residents aged 66 years and older. The second paper showed that the composite risk for life-threatening maternal outcomes was higher among women planning vaginal birth compared with cesarean birth, both with and without a prior vaginal birth.

The article discusses a study that examined the benefits of the online social media, Twitter to journal clubs, particularly the International Urology Journal Club. It references a research published in the journal "European Urology." Topics discussed include the origin of the club as detailed in the initial Twitter account blog post in October 2012 and the rationale behind its format and the club's focus on papers selected within four weeks of publication online.

The article reports on the formation of the Advancing Rural Family Medicine Canadian Collaboration Taskforce to support rural physicians. Topics discussed include an overview of the taskforce, information on the rural family medicine in the country, and the background paper released by the taskforce outlining guidelines on how to help family physicians in rural areas.

The article stresses the importance of social determinants, such as income, on health outcomes and the role of physicians in addressing them. Topics discussed include the policy papers of the Canadian Medical Association (CMA) on the role of physicians in addressing the social determinants and health equity and a series of public town meetings across Canada on what makes people sick hosted by the CMA.

This section offers news briefs relating to the health industry in Canada as of March 20, 2015. A research paper published in the "Canadian Medical Association Journal (CMAJ)" reveals that a national pharmacare plan can reduce spending on prescription drugs in Canada. A report from Fraser Institute reveals that more than 52,000 Canadians received non-emergency medical care outside Canada in 2014. Decentralized health care system will again be used in Alberta, Canada.

The article focuses on issues concerning the cardiology journal "Experimental & Clinical Cardiology," formerly owned by Pulsus Group. It noted that after Pulsus Group sold the journal in 2013, it has been sending spam to physicians asking for research papers. Also cited is the estimated amount of profits generated by the journal from requested articles in July 2014.

The article discusses the sanctions of scientists to speak freely abut their works by the Liberal government of Canada. It notes the 2013 survey of trade union Professional Institute of the Public Service of Canada (PIPSC) which reported the highest rates of interference by management with manuscripts and conference presentations among members of government department Health Canada. It also notes the call of PIPSC and Evidence for Democracy for a legacy of draconian communication policies.