All studies that provide follow-up information for workers more than 35 years after initial exposure to asbestos show a declining ratio of observed to expected lung cancer deaths at the end of follow-up. The most parsimonious explanation of this finding is that relative risk for lung cancer begins to decline sometime after cessation of asbestos exposure.
Urinary incontinence (UI) is a significant psychological, social and healthcare problem across the lifespan. Although there is evidence of physical therapy (PT) efficacy, no literature was located pertaining to UI in PT curricula. The aim was to compare curricular content on UI (of non-neuropathic origin) in PT programmes in Canada, the UK and the USA. The study subjects were PT educators in entry-level programmes.
All Canadian PT programmes (13) were surveyed. Stratification was used to make random samples of PT programmes: 50% of UK (13/26) and 50% of USA (69/136). A questionnaire was used to obtain information on: degree level, programme length, specific courses, time allotted, UI topics, teaching method(s), the professional teaching patients with UI and reasons for non-inclusion in the study. One follow-up letter was sent. Results are presented as frequencies and percentages.
Overall, the response rate was 62.8%; country response rates were: Canada 92.3%; UK 76.9% and USA 53.6%. UI was taught in 80% of Canadian, 90% of UK (which gave the most time to teaching on UI: 70% > 60 minutes) and 78.4% of USA PT programmes. Kegel exercises were taught in all three countries (> 81.1%) and electrical stimulation in > 65%. Theory only was the primary method of teaching in all countries (> 64.9%). Physical therapists were reported to have a major role in treating patients with UI (Canada > 75%; UK 100%; USA 70.3%).
With Kegel exercises and electrical stimulation taught in two-thirds of all programmes physical therapy graduates may have some knowledge of UI management. However, for the UK and USA programmes data are from only 38.5% and 27% respectively. As the common method of teaching on UI was by theory only, graduating physical therapists may lack the clinical skills to apply assessment and treatment techniques.
Retrospective study of data from annual surveys and hospital records over 23 years confirmed the 1950 report of a high prevalence of congenital hip disease (CHD) in the Cree-Ojibwa population of Island Lake, Man. Annual ascertainment rates ranged from 35 to 600 cases per 1000 live births; 5-year rates for dislocation or subluxation were the highest reported for any population. The minimally declining rates of CHD may reflect upgrading in criteria for hip abnormality as well as decreasing isolation and increasing outbreeding of the population. The preponderance of females (female:male ratio, 1.90:1) was low compared with that found in other studies. For all diagnoses bilateral hip involvement exceeded unilateral in frequency; laterality differences were not significant when the sexes were studied separately. Function in everyday activities was impaired little.
The European League Against Rheumatism/EULAR Scleroderma Trials and Research group (EULAR/EUSTAR) has published recommendations for the management of systemic sclerosis (SSc). Members of the Scleroderma Clinical Trials Consortium and the Canadian Scleroderma Research Group were surveyed regarding their level of agreement with the recommendations.
A survey containing the 14 EULAR/EUSTAR recommendations asked participants to indicate their level of agreement with each on a 10-point scale, from 0 (not at all) to 9 (completely agree). The survey was sent to 117 people, and 66 replies were received (56% response rate).
Exceptions to generally high agreement included the use of iloprost and bosentan for digital vasculopathy, methotrexate for skin involvement, and bosentan and epoprostenol for pulmonary arterial hypertension (PAH; all
Numerous studies have assessed the significance of meconium-stained amniotic fluid (MSAF) at term. However, to date, there has been very little documentation on the incidence and significance of meconium in the preterm population. Our objective was to define the incidence of MSAF in patients delivering prematurely (
Financial incentives are the only form of compensation that will motivate surgeons at an academic health sciences center to perform the tasks outlined in the hospital's mission statement.
A questionnaire divided into 5 sections: demographics, compensation, time allocation, benefits and incentives, and motivational factors.
The Department of Surgery, The Toronto Hospital, Toronto, Ontario.
All academic surgeons (N=64) practicing at The Toronto Hospital in July 1997.
Of the 64 eligible mailed surveys, there were responses for 59. Of these 59 surgeons, 48 (81%) receive compensation through a fee-for-service method. However, only 32 (54%) of the surgeons prefer the fee-for-service method, while 18 (31%) prefer salary and 9 (15%) prefer an alternative system. On average, these academic surgeons spend 44% of their time teaching or performing research, for which they receive 14% of their total income. Of the motivational factors assessed, financial bonuses are a positive motivational factor for all "surgeon tasks." In addition, task-specific motivational factors were established for research, teaching, and operating, including research facilities, mentorship and prestige, and interesting case types, respectively.
Surgeons are not appropriately renumerated for time spent on academic activities, and many would prefer an alternative form of compensation to the fee-for-service method. Knowledge that surgeons are receptive to tasks supporting the hospital's mission statement leads us to conclude that appropriate motivation can shape the activity of academic surgeons. Financial rewards ranked the highest as a motivational factor for all surgeon tasks; however, task-specific motivational factors were identified. Overall, multiple factors, specifically targeted to the individual, will serve to motivate. Thus, compensation packages based on individual preferences and personal motivational factors will be the most successful.
Operational fighter squadrons frequently find themselves deployed to semi-isolated stations in the Arctic. This paper discusses the major issues necessary for flight surgeon consideration. In particular, the areas of pre-deployment planning, preparing for the worst, routine operations, and post deployment actions are discussed. A recent month-long deployment of a 12-ship squadron of F18s with support elements from Bagotvi le, Canada, to Evenes, Norway, is examined. A proposed kit list to support a similar deployment to a semi-isolated station is provided.
1,3-Butadiene was included in the second list of Priority Substances to be assessed under the Canadian Environmental Protection Act. Potential hazards to human health were characterized on the basis of critical examination of available data on health effects in experimental animals and occupationally exposed human populations, as well as information on mode of action. Based on consideration of all relevant data identified as of April 1998, butadiene was considered highly likely to be carcinogenic to humans, and likely to be a somatic and germ cell genotoxicant in humans. In addition, butadiene may also be a reproductive toxicant in humans. Estimates of the potency of butadiene to induce these effects have been derived on the basis of quantitation of observed exposure-response relationships for the purposes of characterization of risk to the general population in Canada exposed to butadiene in the ambient environment.