CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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A mandatory cardiopulmonary resuscitation (CPR) program that started as a pilot project in Ottawa-area high schools is expanding to other Canadian schools. Besides CPR techniques, Grade 9 students are being taught about healthy lifestyles and how to recognize cardiac arrest. Emergency physician Justin Maloney, the program's principal architect, believes that in a decade this mandatory training will translate into increased bystander-initiated CPR and improved chances of survival for victims of cardiac arrest.
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There was much more to this summer's international AIDS conference in Vancouver than reports by researchers. Richard Cairney says the $15-million conference attracted a mix of activists, demonstrators, physicians and business representatives, and they coexisted somewhat uneasily.
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In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patient should always be preferred. Clinicians can minimize the impact of controlling factors on patients' decisions by promoting awareness of available choices, inviting questions and ensuring that decisions are based on an adequate, unbiased disclosure of the relevant information.
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To describe potential therapeutic uses of calcitonin in the prevention and treatment of osteoporosis. ⋯ Calcitonin in both intramuscular and intranasal forms can reduce the pain of acute osteoporotic vertebral fractures and may be effective in treating that associated with chronic vertebral osteoporotic fractures. Calcitonin may also prevent postmenopausal bone loss and increase bone density in those with established osteoporosis. Current evidence for long-term prevention of fractures is limited and does not support the use of calcitonin as a first-line treatment for established osteoporosis. Most side effects can be avoided with nasal administration. Further trials are needed to assess fracture prevention and effective dose ranges for treating pain and increasing bone mineral density and to determine the long-term efficacy of calcitonin in secondary osteoporosis, in premenopausal women, in men and in elderly people.