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Page 363, affiliations section, “On behalf of the ICARA Study Group” should instead read “and the ICARA study group”.

Introduction: In the context of rapid population ageing and the increase in number of activity of daily living (ADL) limitations with age, the number of older persons requiring human assistance in Singapore is likely to grow. To promote informed planning for the needs of these elderly, we project the number of resident Singaporeans 60 years of age and older with 1 or more ADL limitations requiring human assistance through 2030. Materials and Methods: The proportion of community-dwelling older adults with ADL limitations requiring human assistance, stratified by gender and age group, was calculated utilising a recent nationally-representative survey of older Singaporeans. The proportion of older adults in nursing homes with ADL limitations was estimated based on available literature. Together, these prevalence estimates were applied to a simulation of the future population of older adults in Singapore to derive an estimate of the number of individuals with ADL limitations requiring human assistance through 2030. Results: By 2030, the number of resident Singaporeans aged 60 years or older with 1 or more ADL limitations requiring human assistance is projected to be 82,968 persons (7% of the total population aged 60 years or older). Of this number, 38,809 (47%) are estimated to have 1 or 2 ADL limitations, and 44,159 (53%) are estimated to have 3 or more. Conclusion: The number of elderly Singaporeans with activity limitations is expected grow rapidly from 31,738 in 2010 to 82,968 in 2030. Estimates of the number of older individuals with ADL limitations requiring human assistance are of value for policymakers as well as acute and long-term care capacity planners as they seek to meet demand for health and social services in Singapore. Key words: Ageing, Activities of daily living, Forecasting, Long-term care, Singapore

PROBLEM BEING ADDRESSED: Traditional continuing medical education (CME) approaches do not work well in changing physicians' behaviour, but some promising strategies and technologies might help. Our program sought to meld small-group learning with an Internet e-mail approach. OBJECTIVE OF PROGRAM: In 1994, the Family medicine Education and Research Network (FERN) was developed to support on-line discussion among London, Ont, and area family physicians. To support educational, moderated case discussions using e-mail, FERN Dissemination (FERN-D) was introduced to a subgroup of participants. We hoped to increase awareness and use of evidence-based research in clinical practice and to increase use of Internet-based resources for CME. The target group was family physicians in the London area. MAIN COMPONENTS OF PROGRAM: Forty volunteers were recruited and were e-mailed one case every 2 weeks; 34 completed the study. Each case was followed by further postings and, at the end of 2 weeks, by a summary of the group's discussion. Background material for each case was researched and was evidence-based. Evaluation was conducted using preintervention and postintervention mailed surveys combined with an e-mail feedback questionnaire and a modified focus group. CONCLUSION: On-line case-based discussion is a promising strategy for encouraging family physicians to access current research. More research is needed to determine whether it can be effectively used to change physicians' practice.

OBJECTIVE: To determine the prevalence of neonatal circumcision immediately following delisting of the procedure in Ontario and to examine parents' knowledge, attitudes, and behaviours regarding circumcision. DESIGN: Cross-sectional survey. SETTING: Perinatal tertiary care centre in southwestern Ontario. PARTICIPANTS: Of the 151 mothers approached, three were excluded because they did not speak English and two declined participation; 112 of 146 mothers of healthy male newborns responded for a response rate of 77%. MAIN OUTCOME MEASURES: Circumcision status of infant and parents' knowledge, attitudes, and behaviour. RESULTS: The circumcision rate before delisting had been 56.2%; in the months immediately after, the rate was 59.8% (95% confidence interval was 51%, 69%). Mothers of infants in the outcome groups did not differ significantly in any demographic feature other than education, where the group deciding against circumcision reported higher education levels (Wilcoxon nonparametic two-sample test: zeta = 2.29, P = 0.02). Mothers who chose circumcision listed medical (59%) and sociocultural considerations (40%) a most important to their decision. Father's circumcision status was strongly associated with the infant's (chi 2[df 1] = 25.13, P = 0.0001). Although 74% discussed circumcision with their family physicians, many parents were not well informed about risks or benefits. Anesthetic use during circumcision was reported by 29%, but 48% did not know whether any had been used. CONCLUSIONS: The prevalence of neonatal circumcision did not change after delisting. Informed consent was often lacking. Sociocultural issues are important to some parents and need to be addressed in the consultation process.

The authors report on an international collaboration that uses the Internet for medical education. In addition to introducing the students to electronic communication, the project aims to further international collaboration and understanding and to emphasize the importance of a population perspective for health and disease. Students and professors in Canada, England and Hungary participated.

The economy of Hungary is undergoing a major transition. The prevalence of behavioural and environmental risk factors is high. The population's health status is among the worst in Europe, and has declined in recent years. The Prussian-style curriculum in the medical universities was rigid and dictated from Budapest and Moscow. The teaching of public health was didactic, there was an emphasis on subjects such as dialectic materialism and hygiene. "Development of Medical Education for a New Public Health in Hungary", a three-year project funded by the European Community's TEMPUS program, is established to develop undergraduate and graduate education. It is a joint program between the five Hungarian medical schools and ten universities in Western countries including Canada. The reformation includes a shift from didactic teaching methods to problem-based learning techniques and greater emphasis on health promotion and population health. Communication within the project is facilitated through an electronic 'list server' based in London, Ontario.