CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Representatives of international, national and scientific organizations met in Bellagio, Italy, in June 1995 to examine the implications of global trends in tobacco production and consumption. The 22 participants agreed that a growing pandemic of tobacco use poses a major threat to sustainable and equitable development in low-income countries. The international Development Research Centre was invited to lead a roundtable consultative process to devise a broad-based funding strategy to promote action on tobacco control.
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One of the main conclusions of the World Bank's World Development Report 1993--Investing in Health was that equitable access to a package of essential clinical and public health services could significantly reduce the overall burden of disease in low-income countries. The report argued that more rational and effective decisions with regard to the allocation of limited resources could be made on the basis of burden-of-disease and cost-effectiveness analyses. In collaboration with the Canadian International Development Agency and several other organizations, the International Development Research Centre has developed the Essential Health Interventions Project to test the feasibility of this approach in a few districts in Tanzania. Outcome assessment wil focus on improved planning at the district level and on changes to the health status of the study population.
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Comparative Study
Comparison of activity level and service intensity of male and female physicians in five fields of medicine in Ontario.
To examine the extent to which physician's sex explains variation in the activity level and service intensity of a cohort of physicians in each of five medical fields after other sources of variation are taken into account. ⋯ Although physician's sex explained much of the variation in activity level and service intensity, even after other important correlates were controlled for, the type and extent of differences observed between female and male physicians depended on the particular medical field examined. To understand the effect of the large increase in the number of women on the physician workforce, more detailed analyses by medical field are needed of the volume, mix and intensity of services provided by men and women, with adjustment for any possible differences in the patients seen in their practices.
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Comparative Study
Comparison of sexual assaults by strangers and known assailants in an urban population of women.
To examine the characteristics of sexual assaults by strangers and those by people known to the victims in an urban community-based population of women. ⋯ Two thirds of the sexual assaults in this urban population were committed by people known to the victims, and over two thirds of these assaults were associated with physical trauma. Improved victim services and prevention strategies should be built on this knowledge.
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During the CMA's recent annual meeting in Winnipeg, General Council delegates agreed that as far as Canada's health care system is concerned, maintenance of the status quo is impossible. Some delegates were motivated by the principle of professional autonomy, while others approached the issue from a public-policy perspective. ⋯ But delegates barely resisted the pull of a vocal group of physicians who favour giving Canadians the right to choose regulated private insurance for all medical services. The compromise position, for now at least, is that delegates want the CMA to lead a public debate on the future of health care.