Editors’ Blog

is Deputy Editor at CMAJ

 

Today, February 27th 2015, marks the tenth anniversary of the coming into force of the (). To mark the historic treaty's first decade the WHO's Director-General, , gave in which she called the FCTC the 'single most powerful preventive instrument available to public health'. She wasn't exaggerating. I'll tell you why.

The FCTC was the first, and remains the only, legally binding multilateral agreement ratified by WHO member states. Most of WHO's directives are delivered with the all the authority of a global governance institution but with none of the legal teeth that multilateral trade agreements, for example, enjoy. ...continue reading

This week:

Interview with , interventional cardiologist at Sunnybrook Health Sciences Centre in Toronto and senior scientist with the Institute of Clinical Evaluative Sciences. Dr. Ko and colleagues found that patients discharged after an emergency department visit for chest pain were less likely to be seen within 30 days by a primary care physician or cardiologist if they had known cardiac or cerebrovascular conditions, as well as other comorbidities. The paradoxical finding that patients at higher risk for adverse events were less likely to receive follow-up suggests the need for a better strategy to improve transition of care in this context.

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The February 17th issue summary podcast is presented by Dr. Kirsten Patrick, deputy editor, and Dr. Matthew Stanbrook, deputy editor.

Dr. Patrick and Dr. Stanbrook discuss the following:

  • Adverse outcomes among patients co-prescribed clarithromycin and statins
  • Cost-effectiveness of screening for hepatitis C
  • Sofosbuvir to treat hepatitis C
  • Unsanctioned travel restrictions related to Ebola
  • Caring for Aboriginal patients
  • Lung-protective ventilation
  • Alicia Priest (1953-2015) on living with ALS

And more...

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Subscribe to CMAJ Podcasts on , , Overcast, Instacast, or your favourite aggregator. You can also follow us directly on our. Our podcasts are also released on and here on the blogs.

This week:

Interview with Dr. Raza Naqvi, assistant professor of geriatrics at Western University. In their systematic review and meta-analysis published in CMAJ, Dr. Naqvi and colleagues found that the RUDAS, a brief and freely available tool, compares well with standard tools assessing cognitive deficits. It was developed for particular use among patients whose first language is not English, which makes it useful in settings where patient groups are diverse.

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Subscribe to CMAJ Podcasts on , , Overcast, Instacast, or your favourite aggregator. You can also follow us directly on our. Our podcasts are also released on and here on the blogs.

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK, recently returned from attending in Ottawa.

 

Myth busters could be a regular session at any medical conference. But sports medicine seems particularly susceptible to suggestion, quackery or placebo as everyone looks for an easy answer. took us on an entertaining trip around the dubious evidence base surrounding interventions such as functional movement prediction of injury; managing muscle soreness; glucosamine and chondroitin; ice baths in recovery and many others. I was delighted to hear praise for my colleague ’s work. And, indeed, mention of the .

Should my child play contact sports? It is a question asked by many parents following the discussions about trauma in professional sport. outlined many of the arguments, focusing on the short and long term risks associated with concussion. My view of Delaney's talk is that the evidence is unclear- and it can be difficult, even for you as the doctor, to be objective. ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. This week he is attending the in Ottawa.

 

Edu-tainment is how we need engage audiences, according to , chair of the opening session of the CASEM-OMA 2015 meeting in Ottawa. And what a superb opening session. and introduced their five key sports medicine papers and debates of the last year. From a CMAJ perspective, it was great to hear Ian cite on arthroscopic surgery for degenerative tears of the meniscus as a key paper. He made a very important point that the outcome was the minimally important difference to patients. The authors had used the average but, looking at the minimally important difference distribution, this may not be entirely reflective, and some people may have had a benefit in the short term although, in the long term, there was no effect.

Concussion is a major issue and Pierre reminded us of a paper emphasising that concussion should include cervicovestibular evaluation ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Concussion is in the news again. In the first of the Six Nations Championship matches, George North of Wales suffered two blows to the head during the game against England. Peter Robinson, whose son Ben died in 2011 at age 14 after a schools match in Northern Ireland, was quoted in the “We are using these players as guinea pigs. I thought Ben’s death was the tipping point when they realised they had to do something, but I don’t think anything drastic will happen until there is a tragedy involving a famous star live on TV. We need a culture change.” Since the weekend, the medics, the coaching team, the concussion protocols and the rugby hierarchy have all been criticized. ...continue reading

This week's author interviews:

Interview with Dr. Christopher Parshuram, critical care specialist with the Hospital for Sick Children in Toronto. He is the lead author of a randomized trial published in CMAJ looking at patient safety, resident well-being and continuity of care for three resident duty schedules in the ICU. Work schedules incorporating shorter periods of continuous duty affected neither doctors' daytime sleepiness nor adverse outcomes in patients.

Interview with Dr. Thomas Maniatis, internal medicine training program director and clinical ethicist at McGill. Dr. Maniatis is the author of a commentary published in CMAJ. He argues that resident duty-hour reform must be further evaluated in order to design systems that provide maximal benefit and minimal harms for all involved.

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is Deputy Editor at CMAJ

 

Today is a momentous day for physicians in Canada. No matter what your opinion about whether or not physician assisted dying is morally right, it will be a human right henceforth under certain circumstances.

We have aired a broad spectrum of views on this forum in the lead up to the Supreme Court of Canada’s , released this morning. Even CMAJ’s editors are divided in their personal opinions. We have discussed our personal views in many an editorial meeting, and CMAJ’s Editor-In-Chief, John Fletcher, put me on the spot to declare my position publicly when we were recording the of the journal.

Many Canadian physicians will feel unhappy about the decision, perhaps even angry ...continue reading

is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

French general practitioners today. It’s part of an that includes refusing to process paperwork and a number of planned medical centre closures. Not every GP could participate today, however, due to a flu epidemic sweeping across France. Doctors had already closed their offices during December but there was little response from Marisol Touraine, the Minister for Health, and this was part of their planned efforts to maintain pressure.

Money is one problem. The agreed fees paid by l'Assurance Maladie . Doctors are paid €23 euro per consultation with for 2013 of just over ...continue reading