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Our professional organizations have prepared this paper as part of an integrated, multidisciplinary plan to ensure the availability of well-trained practitioner teams to sustain safe, effective and high-quality rural surgical and operative delivery services. Without these robust local (or nearby) surgical services, sustaining rural maternity care is much more difficult. This paper describes the "network model" as a health human resources solution to meet the surgical needs, including operative delivery, of rural residents; outlines necessary policy directions for achieving this solution; and poses a series of enabling recommendations. [ABSTRACT FROM AUTHOR]

The article offers information on a paper of the Society of Rural Physicians of Canada, focusing on the issue of the rural health service closures. It explores the main causes behind the hospital closures including quality concerns, economic matters and highlights the impact of the step. After studying different aspects of the topic, it concludes that the decision of closing rural hospitals is not backed by proper reasons.

A review of the current literature on issues of maternity care relevant to rural populations underpins 14 recommendations prepared and approved by 5 national physician, midwifery and nursing organizations. This review and these recommendations are intended to help rural obstetric care providers to continue to provide quality care for women in their communities. [ABSTRACT FROM AUTHOR]

Presents a joint position paper on training for rural family practitioners in Canada in advanced maternity skills and cesarean section. Paper prepared by the College of Family Physicians of Canada, the Society of Rural Physicians of Canada and the Society of Obstetricians and Gynecologists of Canada; Benefits to rural women and their infants.

Presents a study on rural obstetrical analgesia and anesthesia in Canada. Aim of the study; Side effects of intrathecal opiates; List of propositions and recommendations on obstetrical regional analgesia.

Focuses on regionalization of health care services in all provincial governments in Canada except Ontario. Divergence of health care services in the provinces; Impact of health care services in rural communities; Essentiality of regionalization in solving health care system problems; Principles involved in health care regionalization.

Background: Dedicated quality-improvement (QI) initiatives within health care systems are of clear benefit, and physicians respond to financial incentivization. The Canadian health care system often lacks this lever, and many financially incentivized QI programs rely on traditional economic principles. We describe our evaluation of financial incentivization for the implementation of QI process metrics in a department of surgery at a Canadian academic hospital system and its impact over a 4-year period.Methods: Quality-improvement processes informed by extant QI incentivization literature and guided by the principles of behavioural economics were implemented within our institution's Department of Surgery. Disbursement of supplemental government funding was modified to be contingent on the ability of divisions within the department to meet predefined QI metrics, including regular multidisciplinary meetings, morbidity and mortality rounds with documented feedback of systemic issues to division members, reviews of adverse events, and implementation of annual patient experience projects. We evaluated the effect of the QI processes from 2015/16 to 2018/19.Results: There was a significant increase in the number of divisions that satisfied all the QI metrics over the study period, from 2 (28%) in 2015/16, to 5 (71%) in 2016/17, to 7 (100.0%) in 2017/18 and 2018/19 (p < 0.01). The application of behavioural economics principles, such as reward versus penalty payoff, loss aversion, payment separation, aligning of values, and relative social ranking, was important to the outcome of the study.Conclusion: Incentivizing QI activities in the Canadian health care system is possible and led to improvement in QI processes as a whole in our department. This paper lays out a method of financial reimbursement to facilitate engagement of physicians and establishment of a foundation of important QI processes and measures within a department. [ABSTRACT FROM AUTHOR]

Abdominal aortic aneurysms (AAAs) remain a major risk to patients, despite level 1 evidence for screening to prevent rupture events and decrease mortality. In 2007, the Canadian Society for Vascular Surgery (CSVS) published a review and position statement for AAA screening in Canada. Since that publication, there have been a number of updates in the published literature affecting screening recommendations. In this paper, we present a review of some of the controversies in the AAA screening literature to help elucidate differences in the various published screening guidelines. This article represents a review of the data and updated recommendations for AAA screening in the Canadian population on behalf of the CSVS. Les anévrismes de l'aorte abdominale (AAA) continuent de poser un risque majeur pour les patients, malgré des données probantes de niveau 1 à l'appui du dépistage pour prévenir les ruptures et réduire la mortalité. En 2007, la Société canadienne de chirurgie vasculaire (SCCV) a publié une revue et un énoncé de position sur le dépistage de l'AAA au Canada. Depuis lors, plusieurs mises à jour ont paru dans la littérature et elles ont un impact sur les recommandations relatives au dépistage. Dans le présent article, nous présentons une synthèse de quelques controverses soulevées dans la littérature sur le dépistage de l'AAA afin d'expliquer les différences entre les diverses lignes directrices publiées à ce sujet. Cet article propose au nom de la SCCV une revue des données probantes et des recommandations à jour sur le dépistage de l'AAA dans la population canadienne. [ABSTRACT FROM AUTHOR]

The article focuses on article, published by Nousiainen and colleagues, which evaluates surgical fellowship training in Canada. It evaluates the kind of guidance which is available from the Royal College of Physicians and Surgeons of Canada. It puts emphasis on several concepts and questions which papers by Nousiainen and colleagues have brought forward for detailed examinations.

Reports that a physician involved in an Israeli assassination attempt in Jordan was carrying a forged Canadian passport.

Studies of clinical populations that combine MRI data generated at multiple sites are increasingly common. The Canadian Biomarker Integration Network in Depression (CAN-BIND; www.canbind.ca) is a national depression research program that includes multimodal neuroimaging collected at several sites across Canada. The purpose of the current paper is to provide detailed information on the imaging protocols used in a number of CAN-BIND studies. The CAN-BIND program implemented a series of platform-specific MRI protocols, including a suite of prescribed structural and functional MRI sequences supported by real-time monitoring for adherence and quality control. The imaging data are retained in an established informatics and databasing platform. Approximately 1300 participants are being recruited, including almost 1000 with depression. These include participants treated with antidepressant medications, transcranial magnetic stimulation, cognitive behavioural therapy and cognitive remediation therapy. Our ability to analyze the large number of imaging variables available may be limited by the sample size of the substudies. The CAN-BIND program includes a multimodal imaging database supported by extensive clinical, demographic, neuropsychological and biological data from people with major depression. It is a resource for Canadian investigators who are interested in understanding whether aspects of neuroimaging — alone or in combination with other variables — can predict the outcomes of various treatment modalities. [ABSTRACT FROM AUTHOR]

The author reflects on the series of white papers written by Royal College of Physicians and Surgeons of Canada (RCPSC) on various topics. It states that RCPSC stated that the in-training assessment must be the dominant method to determine competence. It mentions that RCPSC wants to move toward more assessment exams and it misses the reason why In-training Evaluation Report (ITER) has failed.

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]

Introduction: Rural recruitment and retention continues to present challenges to health workforce planners. This paper reports and analyzes the results of a survey sent to physicians in Manitoba, eliciting their opinions regarding rural jobs. Methods: A survey was sent to all physicians in Manitoba. Part 1 of the survey included questions about background and demographic information; part 2 was a set of job satisfaction questions regarding respondents' current job; and part 3 included 2 sets of stated-choice questions eliciting preferences for a set of attributes relevant to rural recruitment and retention. Results: Of the 2487 physicians who received surveys, 561 (22.6%) responded. Respondents indicated that income, hours worked and on-call frequency are very important: overall job satisfaction increased with income and decreased with hours worked. Income, hours and on-call frequency were ranked "very important" by the largest proportions of physicians. The estimated compensation for on-call more frequent than 1-in-4 was very high (82% of average income), and additional hours worked were worth $183 per hour. Other attributes that were important included professional interaction, housing availability and community incentives during the first year, which were valued at 11%-31% of annual income. Conclusion: Work--life balance is a key consideration for rural jobs, and there are incentives that can compensate for less desirable attributes. . [ABSTRACT FROM AUTHOR]

Introduction: This paper briefly describes the use of Canada Post Unaddressed Admail and a geographic information system (GIS) for survey distribution to a specific target population in a large, sparsely populated geographic area, and the effectiveness of this approach. Methods: Surveys were sent as Unaddressed Admail via Canada Post to a target population of people livingwithin 5 km of awind turbine in southwestern Ontario. Results: The overall response rate from 8 wind farms (in 8 counties) was 8.1%. Conclusion: This approach has the potential to save time and money, but low response rates are common, distribution is not precise and there is potential for selection bias. Despite these flaws, Unaddressed Admail is worth consideration for delivery of information, study-recruitment materials and surveys to rural, remote and specific target populations. [ABSTRACT FROM AUTHOR]

Background: Prospective cohorts have the potential to support multifactorial, health-related research, particularly if they are drawn from the general population, incorporate active and passive follow-up and permission is obtained to allow access by researchers to data repositories. This paper describes Phase I of the Alberta’s Tomorrow Project cohort, a broad-based research platform designed to support investigations into factors that influence cancer and chronic disease risk. Methods: Adults aged 35–69 years living in Alberta, Canada, with no previous cancer diagnosis other than nonmelanoma skin cancer were recruited to the project by telephone-based random digit dialling. Participants were enrolled if they returned a Health and Lifestyle Questionnaire. Past year diet and physical activity questionnaires were mailed 3 months after enrolment. Consent was sought for active follow-up and linkage with administrative databases. Depending on enrolment date, participants were invited to complete up to 2 follow-up questionnaires (2004 and 2008). Results: Between 2001 and 2009, 31 072 (39% men) participants (mean age 50.2 [± 9.2] yr) were enrolled and 99% consented to linkage with administrative databases. Participants reported a wide range of educational attainment and household income. Compared with provincial surveillance data from the Canadian Community Health Survey, Alberta’s Tomorrow Project participants had higher body mass index, lower prevalence of smoking and similar distribution of chronic health conditions. Follow-up questionnaires were completed by 83% and 72% of participants in 2004 and 2008, respectively. Robust quality control measures resulted in low frequencies of missing data. Interpretation: Alberta’s Tomorrow Project provides a robust platform, based on a prospective cohort design, to support research into risk factors for cancer and chronic disease. [ABSTRACT FROM AUTHOR]

This paper describes a functional approach to the definition of rural populations for purposes of rural health care research. Rather than define ‘rural’ directly, we created a definition of urban populations and our research target became the non-urban component. Using Geographic Information Systems technology, isochrones (drivetime zones) were created that attached suburban populations to urban centres and mapped non-urban populations into rural hospital catchment areas. For population-based analyses, we have proposed a methodology for constructing catchment areas attached to Rural, Regional and Metropolitan services. We have developed a model for calculation of travel time for patients required to travel for care. We successfully applied these methodologies to the disparate regions of rural Alberta and Northern Ontario in 2 papers that investigated the delivery of rural surgical services. This methodology represents a durable and portable designation of ‘rural’ with potential for research applications in other areas of health research. By defining ‘urban’ rather than ‘rural,’ we avoided many of the methodological conundrums in this research field. [ABSTRACT FROM AUTHOR]

Introduction: A major goal of the Faculty of Medicine at the Memorial University of Newfoundland is to produce physicians who will return to rural areas that are currently underserviced. Research shows that the strongest indicator of practice in a rural area is a rural background, and thus it is important that rural students apply to medical school. We investigated what high school students believe to be preventing them from pursuing medical education. Methods: Between September 2013 and June 2014, we administered a paper survey to high school students in Newfoundland and Labrador, New Brunswick and Prince Edward Island. Results: A total of 665 participants completed the survey. We found that fewer rural students (75.6%) than urban students (98.6%) believed that they could gain admission to medical school (p < 0.01) and that medicine was promoted as a career choice in fewer rural schools (55.7%) than urban schools (69.7%). Also, 55.4% of urban students, but only 44.4% of rural students, believed that rural students were disadvantaged when applying to medical school. Conclusion: In our study, rural students believed they were less likely to be accepted into medical school than urban students, and fewer rural students felt that medicine was promoted as a potential career choice. Our results may be explained by a lack of role models or perhaps by financial barriers, although further research is needed. [ABSTRACT FROM AUTHOR]

Summary: Rural western Canada relies heavily on family physicians with enhanced surgical skills (ESS) for surgical services. The recent decision by the College of Family Physicians of Canada (CFPC) to recognize ESS as a "community of practice" section offers a potential home akin to family practice anesthesia and emergency medicine. To our knowledge, however, a skill set for ESS in Canada has never been described formally. In this paper the Curriculum Committee of the National ESS Working Group proposes a generic curriculum for the training and evaluation of the ESS skill set. [ABSTRACT FROM AUTHOR]

Introduction: This paper quantifies the proportion of family physicians in rural practice and, in particular, initial rural practice. It examines differences between graduates of Canadian and international medical schools. Methods: The Canadian Medical Association postal code master file was used to determine the distribution in rural practice of Canadian and international medical school graduates for every other year from 2000 to 2011. The master file maps practice postal codes into a census metropolitan area or census agglomeration; physicians practising outside these areas are considered rural. Initial practices were estimated based on year of undergraduate medical degree. Results: Two-thirds of family physicians practising rural medicine in 2011 were graduates of Canadian medical schools. However, between 2000 and 2011, a greater proportion of international medical graduates were practising in rural areas than graduates of Canadian medical schools. International graduates were more likely to initially locate in a rural area, but the drop-off rate was greater among them than with graduates of Canadian medical schools. The proportion of international medical graduates setting up rural practices was decreased among more recent graduation cohorts. The proportion of Canadian medical school graduates initially practising in rural areas was steady. Conclusion: The results of this study suggest that graduates of international and Canadian medical schools treat rural practice differently. International graduates may decide on a rural location as a means to set up practice in Canada or fulfill a return-of service obligation, whereas graduates of Canadian medical schools may make a conscious choice to practise in rural locations. Decreasing proportions of international medical graduates in rural practice may be a result of increased opportunities for Canadian postgraduate training and full licensure. [ABSTRACT FROM AUTHOR]

This article reports on the discussion paper, It's About Access! Informing the Debate on Public and Private Health Care, which was released by the Canadian Medical Association (CMA). Attendees at the CMA Annual Meeting will be asked to use the discussion paper to address the split between the private and public health care. The possible scenarios for the changes in the Canadian health care system are highlighted. The paper was co-authored by Dr. Robert Hollinshead.

This paper examines current issues concerning surgical fellowship training in Canada. Other than information from a few studies of fellowship training in North America, there are scant data on this subject in the literature. Little is known about the demographic characteristics of those who pursue fellowship training in Canada, what the experiences and expectations are of fellows and their supervisors with respect to the strengths and weaknesses of this level of training, or how this level of education fits in with Canadian undergraduate and postgraduate medical training. We summarize current knowledge about fellowship training in Canada as it pertains to demographic characteristics, finances, work hours, residency training, preparation for clinical and research work and satisfaction with training. Most information on surgical fellowship training comes from the United States. As such, we used information from American studies to supplement the Canadian data. Because a surgical fellowship experience in Canada may be different from that in the United States, we propose that Canadian surgical fellows and their supervisors should be surveyed to gain an understanding of such information. This knowledge could be used to improve surgical fellowship training in Canada. [ABSTRACT FROM AUTHOR]

Tactical Combat Casualty Care (TCCC) is intended to treat potentially preventable causes of death on the battlefield, but acknowledges that application of these treatments may place the provider and even the mission in jeopardy if performed at the wrong time. Therefore, TCCC classifies the tactical situation with respect to health care provision into 3 phases (care under fire, tactical field care and tactical evacuation) and only permits certain interventions to be performed in specific phases based on the danger to the provider and casualty. In the 6 years that the Canadian Forces (CF) have been involved in sustained combat operations in Kandahar, Afghanistan, more than 1000 CF members have been injured and more than 150 have been killed. As a result, the CF gained substantial experience delivering TCCC to wounded soldiers on the battlefield. The purpose of this paper is to review the principles of TCCC and some of the lessons learned about battlefield trauma care during this conflict. [ABSTRACT FROM AUTHOR]

Information on several papers discussed at the Canadian Society for Vascular Surgery 2011 Annual Meeting held from September 23 to 24 is presented. It discusses the use of endovascular therapy for elective and ruptured abdominal aortic aneurysm processes across Canada. It also highlights the differences in aneurysm surgery between rural and urban patients. Also explored are the medical education activities taken by vascular specialists.

The decision of the physician to practise in a rural setting involves a multitude of personal and professional preferences, ideals and values. However, among these many factors, there is little dispute that Canadian medical schools, with the ability to directly influence the career choices of their graduating students, have an important societal responsibility to strive to address the issues facing rural medicine. The aim of this paper is to summarize the evidence for interventions that are feasible and that may be used by Canadian medical schools to increase the number of graduates who will become rurally oriented physicians. We outline several interventions and make recommendations to improve the recruitment of rurally minded medical students and the rural training of all medical students. [ABSTRACT FROM AUTHOR]

The article provides an explanation on the professionalism of surgeons in Canada. It discusses the development of professionalism, its meaning, as well as the essence of teaching professionalism. The author also highlights how the Committee on Professionalism developed the code of professionalism for Canadian surgeons. The position paper through the effort of Canadian Association of General Surgeons, which focuses on professionalism for the general surgeon is also presented.

The origins of neurosurgical services in Atlantic Canada are tied to the individual efforts of William D. Stevenson. Born in Hamilton, Ontario, Stevenson completed his senior matriculation in Dunnville, Ontario, before studying medicine at the University of Toronto. He completed the Gallie surgical course in Toronto and then spent 1 year training with Edward Archibald at McGill University. After working for 2 years with the Canadian Mobile Neurosurgical Unit in Europe during the Second World War, Stevenson undertook formal neurosurgical training with Kenneth G. McKenzie, Canada's first neurosurgeon. Stevenson was thereafter recruited to Halifax to start the neurosurgical service at the Victoria General Hospital in January 1948, and he remained head of the division for the next 26 years. His pioneering work laid the foundations for the establishment of a major academic neurosurgical service at Dalhousie University and was crucial for the establishment of neurosurgery in Atlantic Canada. After his retirement, Stevenson moved back to Ontario and began his second career, transferring his passion for neurosurgery to oil painting. His legacy to neurosurgery in Atlantic Canada will be remembered in perpetuity with the annual Neurosurgery Resident Research Award at Dalhousie University, established and named in his honour. This paper focuses on Stevenson's life and work in neurosurgery as Atlantic Canada's first neurosurgeon. [ABSTRACT FROM AUTHOR]

In 2002, Osteoporosis Canada published clinical practice guidelines for the diagnosis and management of osteoporosis. The current paper supplements that guideline and provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men. [ABSTRACT FROM AUTHOR]

In this short paper, I present my 3-year experience, from January 2000 to September 2002, with a neurosurgery consultation outreach clinic in Huntsville, Ont. I describe the logistics, advantages, disadvantages and implications for surgeons of outreach clinics and their patients. The clinic was highly successful for the area physicians and the patients, but was discontinued in September 2002 owing to restrictions on my time available for the clinic. New surgical outreach clinics should be carefully planned. The specialist surgeon must have adequate flexibility and time for this activity and the success of the clinic must be assessed regularly. [ABSTRACT FROM AUTHOR]

Clark Noble was one of the first members of the University of Toronto insulin team and came within a coin toss of replacing Charles Best as Frederick Banting's assistant during the summer of 1921. Noble performed important early studies helping to characterize insulin's action, and he co-authored many of the original papers describing insulin. Because mass production of insulin from livestock pancreata had proved elusive throughout 1922, J.J.R. Macleod hired Noble during the summer of 1923 to help him test and develop a new method for producing commercial quantities of insulin that Macleod believed would revolutionize insulin production. However, commercial production of insulin from fish proved impractical and was dropped by 1924, as methods to produce large quantities of mammalian insulin had improved very rapidly. Noble later played a small but critical role in the most important Canadian contribution to cancer chemotherapy research: the discovery of vinca alkaloids by his brother Robert Laing Noble. Although one might expect that a physician involved in 2 of Canada's most important medical discoveries during the 20th century must be famous, such was not Clark Noble's fate. He died without so much as an obituary in CMAJ. INSET: From our files. [ABSTRACT FROM AUTHOR]

The Oregon Health Plan (OHP) has been widely heralded as an important innovation in medical care policy and rationing. Oregon's pioneering method of prioritizing funding for health care through systematic and public ranking of medical services has drawn substantial international interest. This paper reviews the experience of the Oregon plan since it began operation in 1994. We argue that widespread misconceptions persist about the significance of the OHP. In particular, there is little evidence that the OHP has operated as a model of explicit rationing. In reality, Oregon has not rationed services, nor has its policy of cutting public coverage for services produced substantial savings. These findings have important implications regarding the desirability and feasibility of adopting a policy of removing items from the list of insured medicare services in Canada. Oregon's experience suggests that drawing the line on medicare coverage would be more difficult and less financially rewarding than advocates claim. [ABSTRACT FROM AUTHOR]

Clinicians are exposed to numerous hypertension guidelines. However, their enthusiasm for these guidelines, and the impact of the guidelines, appears modest at best. Barriers to the successful implementation of a guideline can be identified at the level of the clinician, the patient or the practice setting; however, the shortcomings of the guidelines themselves have received little attention. In this paper, we review the hypertension guidelines that are most commonly encountered by Canadian clinicians: the "1999 Canadian Recommendations for the Management of Hypertension," "The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" in the United States and the "1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension." The key points of these guidelines are compared and the shortcomings that may impede their ability to influence practice are discussed. The main implications for future guideline developers are outlined. [ABSTRACT FROM AUTHOR]

Background: The results of randomized trials show that breast cancer screening by mammography reduces breast cancer mortality by up to 40% in women aged 50-69 years. Because of these results, by 1998, 22 countries, including Canada, had established population-based organized screening programs. This paper presents the results of screening mammography in 1996 for 7 provincially organized breast cancer screening programs in Canada. [ABSTRACT FROM AUTHOR]

AbstractBackground: In 1996 the number of deaths and admissions to hospital in Canada that could be attributed to the use of alcohol, tobacco and illicit drugs were estimated from 1992 data. In this paper we update these estimates to the year 1995.Methods: On the basis of pooled estimates of relative risk, etiologic fractions were calculated by age, sex and province for 90 causes of disease or death attributable to alcohol, tobacco or illicit drugs; the etiologic fractions were then applied to national mortality and morbidity data for 1995 to estimate the number of deaths and admissions to hospital attributable to substance abuse.Results: In 1995, 6507 deaths and 82 014 admissions to hospital were attributed to alcohol, 34 728 deaths and 194 072 admissions to hospital were attributed to tobacco, and 805 deaths and 6940 admissions to hospital were due to illicit drugs.Interpretation: The use and misuse of alcohol, tobacco and illicit drugs accounted for 20.0% of deaths, 22.2% of years of potential life lost and 9.4% of admissions to hospital in Canada in 1995. [ABSTRACT FROM AUTHOR]

Surgeons caring for severely injured patients have witnessed tremendous change over the past 2 decades with the rapid evolution of trauma systems. This paper describes the evolution of trauma systems in Canada, using the one in Calgary as a model. Canadian system guidelines were produced by the Trauma Association of Canada in 1993. Participation in Canadian accreditation is accelerating as increasingly more centres across the country undergo external review each year. Reporting of trauma outcomes, including standardized mortality and a variety of performance measures, is becoming the norm. Injury is being treated as a disease with comprehensive control strategies aimed at reducing death and disability rates through prevention, treatment and rehabilitation. [ABSTRACT FROM AUTHOR]

Focuses on the question of whether active euthanasia should sometimes be allowed. The difference between passive and active euthanasia; The acceptance of passive euthanasia by the Canadian Medical Association (CMA); The cases against Dr. Claudio Alberto de la Rocha and Dr. Nancy Morrison, both of Canada, and their participation in acts of euthanasia; Mention of the papers `Active and passive euthanasia,' by James Rachels and `Killing and letting die,' by Philippa Foot.

Presents a paper that reports on the first study in Canada to use physician records to assess the use of prostate-specific antigen (PSA) testing. Methods; Results; Conclusions.

The author discusses the role of the Society of Rural Physicians of Canada (SRPC) as a catalyst that promotes excellent care close to home for Canada's rural population. Members of SRPC work at the coal face of rural health care. They have worked with several medical organizations since 1992 to promote and improve health care, including the College of Family Physicians of Canada. They produced the joint position paper on rural surgery and operative delivery.

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 reports on the proposal of Health Canada for a new regulatory regime for drugs. Under its paper, "The Progressive Licensing Framework Concept Paper for Discussion," Health Canada proposes to lower the threshold for initial market authorization licenses in exchange for more safety and efficacy studies as a condition for selling a drug. The institution's proposed regime involves the incorporation of post-market surveillance in its oversight of drugs.

The authors look into the vulnerable populations as the magazine's fourth area of focus, alongside sepsis, health services and mental health. It notes a paper that calls the Canadian government to reform health care delivery for groups like prisoners, drug users, and refugees. It cites a commentary which considers vulnerability as conceived in health research and health care. It also cites a study that calls the economic burden of health care inequalities and of disease attributable to poverty.

Presents information on the planned introduction of reduced ignition propensity (RIP) cigarettes in Canada by 2005. Market reach of Merit, the first RIP cigarette in the world manufactured by Philip Morris; Statistics on fires caused by careless smoking in Canada, as of 2003; Objection regarding the level of toxicity of RIP cigarettes.

The article focuses on Canadian initiatives on driving competency among older patients. It states that the family driving agreements of Keeping Us Safe allow older drivers to designate a companion to inform them when to stop driving. It says that a paper by Paige Moorhouse and colleagues has found that 30% of Canadians with dementia still drive despite their condition. It also discusses the Independent Transportation Network America program that allows people to trade vehicles to pay for rides.

The article reports on the potential benefits of medical research projects on actual patients that may improve clinical settings. According to doctor Alain Beaudet, Canadian Institutes of Health Research (CIHR) president, Canada needs to focus more on patient-oriented researches to improve medial research. It states that CIHR discussion paper "Strategy for Patient-Oriented Research" includes activities that need to be address after the research such as translation and dissemination.

The article reports on the call of family physicians to develop medical homes in the U.S. It states that U.S. President Barack Obama has shown interest to fund a medical home to oversee the conditions of chronically ill patients in the country. It cites that joining the agenda is the College of Family Physicians of Canada (CFPC) that released a discussion paper and called on governments to establish a medical home. The move of CFPC is not only intended for ill patients but for every Canadian.

Information about several papers discussed during a conference sponsored by the Physicians for Global Survival in Canada on April 17, 2009 is presented. Topics highlighted the recommendation of the Canadian affiliate of International Physicians for the Prevention of Nuclear War for doctors to use diagnostic alternatives to reactor-produced isotopes in health care. Attendees in the event include mathematician and physicist Gordon Edwards, Dr. Christopher O'Brien and Dr. Nancy Covington.

Information about several papers discussed during the meeting of the Health Canada-commissioned expert panel on the health risks of chrysotile asbestos in Canada is presented. Topics include the strong potential relationship on the exposure to chrysotile asbestos on the occurrence of lung cancer, pleural mesothelioma and peritoneal mesothelioma. Among the featured health experts during the meeting include Health Canada Chairman Trevor Ogden, officer Christelle Legault, and Alex Burdorf.

The article provides information on the journal "Revue d'art canadienne/ Canadian Art Review" (RACAR). It cites that the said journal provides scholarly papers about medical aesthetic and anatomy in the 19th century. The journal serves as the Universities Art Association of Canada's publication produced with language variation.

The article offers world news briefs on medicine. The U.S. government funded $31 million into the ongoing development of a national Drug Safety and Effectiveness Network. Lung transplants in Canada rose more than 3 times faster than that of solid organ transplants. The Department for Work and Pensions has announced that paper-based sick notes will be replaced with electronic fit notes in the Great Britain in 2010.

The article reports on the health policies of Canadian Liberal party candidate Stéphane Dion. Dion has not issued any health policy paper. His position on access to health care remains vague. In his campaign, he expressed his desire to improve Aboriginal health, increase health research, promote healthy lifestyles and sports activities and strengthen the public health agency. Details of Dion's plans for health research are mentioned.