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Background: A total of 18%-30% of Canadians live in a rural area and are served by 8% of the country's general surgeons. The demographic characteristics of Canada's population and its geography greatly affect the health outcomes and needs of the population living in rural areas, and rural general surgeons hold a unique role in meeting the surgical needs of these communities. Rural general surgery is a distinct area of practice that is not well understood. We aimed to define the Canadian rural general surgeon to inform rural health human resource planning. Methods: A scoping review of the literature was undertaken of Ovid, MEDLINE, and Embase using the terms 'rural,' 'general surgery,' and 'workforce.' We limited our review to articles from North America and Australia. Results: The search yielded 425 titles, and 110 articles underwent full-text review. A definition of rural general surgery was not identified in the Canadian literature. Rurality was defined by population cut-offs or combining community size and proximity to larger centres. The literature highlighted the unique challenges and broad scope of rural general surgical practice. Conclusion: Rural general surgeons in Canada can be defined as specialists who work in a small community with limited metropolitan influence. They apply core general surgery skills and skills from other specialties to serve the unique needs of their community. Surgical training programs and health systems planning must recognize and support the unique skill set required of rural general surgeons and the critical role they play in the health and sustainability of rural communities. Contexte : En tout, 18%-30% de la population canadienne vit en milieu rural et est desservie par 8% des effectifs en chirurgie g n rale au pays. Les caract ristiques d mographiques de sa population et la g ographie du Canada influent grandement sur l' tat de sant et les besoins de la population rurale, et la chirurgie g n rale en milieu rural joue un r le central en r pondant aux besoins chirurgicaux de ces communaut s. La chirurgie g n rale en milieu rural est un domaine de pratique part, et elle n'est pas bien comprise. Nous avons voulu d finir la chirurgie g n rale en milieu rural au Canada pour en faciliter la planification des ressources humaines. M thodes : Nous avons proc d une synth se exploratoire de la litt rature aupr s des bases de donn es Ovid, MEDLINE, et Embase partir des termes anglais <>, <>, et <>. Nous avons limit notre interrogation aux articles provenant de l'Am rique du Nord et de l'Australie. R sultats : L'interrogation a g n r 425 titres, et 110 articles ont fait l'objet d'une revue du texte int gral. Nous n'avons trouv aucune d finition de la chirurgie g n rale en milieu rural dans la litt rature canadienne. La ruralit tait d finie par des seuils de population ou le rapport entre la taille d'une communaut et sa proximit d'un grand centre. La litt rature a fait ressortir les d fis particuliers et la port e du champ de pratique de la chirurgie g n rale en milieu rural. Conclusion : La chirurgie g n rale en milieu rurale au Canada peut se d finir comme un champ de sp cialit qui dessert une petite communaut et qui subit peu l'influence de la m tropole. Elle applique les techniques fondamentales de la chirurgie g n rale et emprunte certains actes m dicaux d'autres sp cialit s pour r pondre aux besoins particuliers des communaut s. Les programmes de formation en chirurgie et la planification des syst mes de sant devraient reconna tre et soutenir l'ensemble unique des habilet s requises pour exercer en chirurgie g n rale en milieu rurale et son r le dans la sant et la pr servation des communaut s rurales., According to the Canadian Institute for Health Information, 8% of general surgeons in Canada work in a rural setting, whereas 18%-30% of the population lives in rural areas, which are [...]

To determine if microetching the mandibular premolars and first molars prior to acid-etching reduced bracket failures during the first six months of orthodontic treatment.

To compare the clinical failure rates over six months of indirectly bonded brackets with and without methyl methacrylate monomer (MMM) conditioned custom bases.

To compare the effectiveness of a self-ligating (SL) porcelain bracket with a conventional porcelain (CP) bracket tied with ligatures for initial alignment in the upper arch, to compare the discomfort of both bracket – archwire combinations and to compare the times taken (both assisted and unassisted) to untie and ligate both bracket – archwire combinations.

Background: The scope of practice of general surgeons in Canada is highly variable. The objective of this study was to examine the demographic characteristics of general surgeons in Canada and compare surgical procedures performed across community sizes and specialties. Methods: Data from the Canadian Institute for Health Information's National Physician Database were used to analyze fee-for-service (FFS) care provided by general surgeons and other providers across Canada in 2015/16. Results: Across 8 Canadian provinces, 1669 general surgeons provided FFS care. The majority of the surgeons worked in communities with more than 100 000 residents (71%), were male (78%), were aged 35-54 years (56%) and were Canadian medical graduates (76%). Only 7% of general surgeons practised in rural areas and 14% in communities with between 10 000 and 50 000 residents. Rural communities were significantly more likely to have surgeons who were international medical graduates or who were older than 65 years. The surgical procedures most commonly performed by general surgeons were hernia repairs, gallbladder and biliary tree surgery, excision of skin tumours, colon and intestine resections and breast surgery. Many general surgeons performed procedures not listed in their Royal College of Physicians and Surgeons of Canada training objectives. Conclusion: Canadian general surgeons provide a wide array of surgical services, and practice patterns vary by community size. Surgeons practising in rural and small communities require proficiency in skills not routinely taught in general surgery residency. Opportunities to acquire these skills should be available in training to prepare surgeons to meet the care needs of Canadians. Contexte : La pratique des chirurgiens generalistes au Canada varie grandement. Cette etude vis ait a examiner les caracteristiques demographiques des chirurgiens generalistes au Canada et a comparer les interventions realisees selon la specialite et la taille des collectivites. Methodes : Des donnees de la Base de donnees nationale sur les medecins de l'Institut canadien d'information sur la sante ont ete utilisees pour analyser les soins remuneres a Facte dispenses par des chirurgiens generalistes et d'autres fournisseurs de soins au Canada en 2015-2016. Resultats : Dans 8 provinces canadiennes, 1669 chirurgiens generalistes ont fourni des soins remuneres a Facte. La majorite d'entre eux travaillaient dans des collectivites de plus de 100 000 residents (71 %), etaient des hommes (78%), avaient entre 35 et 54 ans (56 %) et avaient obtenu leur diplome de medecine au Canada (76 %). Seuls 7 % des chirurgiens generalistes travaillaient en region rurale et 14 %, dans des collectivites comptant entre 10 000 et 50 000 residents. En region rurale, la probabilite que les chirurgiens soient des diplomes internationaux en medecine ou aient plus de 65 ans etait significativement plus elevee. Les interventions les plus frequent es etaient la reparation d'une hernie, la chirurgie de la vesicule biliaire et des voies biliaires, le re trait de tumeurs de la peau, la resection du colon ou de Fintestin et la chirurgie mammaire. De nombreux chirurgiens generalistes ont realise des procedures ne faisant pas partie des objectifs de formation du College royal des medecins et chirurgiens du Canada. Conclusion : Les chirurgiens generalistes canadiens realisent une large gamme d'interventions chirurgie ales et leur pratique varie selon la taille de la collectivite dans laquelle ils travaillent. Les chirurgiens exercant en milieu rural et dans les petites collectivities doivent avoir des competences qui ne sont habituellement pas enseignees durant la residence en chirurgie generale. La formation devrait integrer des occasions d'acquerir ces competences pour preparer les chirurgiens a repondre aux besoins en matiere de soins des Canadiens., The scope of practice of general surgeons in Canada is highly variable. (1) Despite having vastly different practice profiles, all graduates must meet the training objectives set forth by the [...]

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. Nos organisations professionnelles ont prepare cet article dans le cadre d'un plan multidisciplinaire integre visant a assurer la disponibilite d'equipes soignantes bien formees pour offrir des services obstetricaux interventionnels et chirurgicaux securitaires, efficaces et de grande qualite en milieu rural. Sans de tels solides services chirurgicaux locaux (ou de proximite), il est beaucoup plus difficile d'assurer les soins obstetricaux en milieu rural. Cet article decrit le << modele en reseau >> comme une solution au chapitre des ressources humaines en sante pour repondre aux besoins chirurgicaux des populations rurales, y compris pour les services obstetricaux interventionnels. On y decrit aussi les orientations politiques necessaires a l'application de cette solution et on formule une serie de recommandations preparatoires., OVERVIEW The precipitous attrition of small-volume surgical programs in rural Canada over the past 2 decades has led to the need for rural residents to travel for even the most [...]

The term aphid refers to any member of the Aphidoidea in a broad sense, but feeding strategies may vary significantly between families, although there is much similarity in salivary function within the family. Sedentary, gall-forming aphids may have salivary functions distinct from those of aphidids. The physical and chemical nature of the salivary secretions, methods of analysis of aphid saliva, similarities and differences in saliva composition, are considered. The stylet sheath of aphidids is mostly protein and appears to inhibit necrotic responses in plants. Watery saliva contains free amino acids and is secreted intermittently during feeding. It is concluded that aphids saliva mediates both choice of food plant and effects on the plant.