CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Of the 5551 confirmed measles cases reported in 1995 in the Americas, 2301 (41%) occurred in Canada. In this issue (see pages 1407 to 1413) Drs. Penny A. ⋯ Their findings support the use of a two-dose measles vaccination strategy. In this editorial the author explains how a two-dose strategy lowers the incidence of primary and secondary vaccine failures and thus reduces the number of susceptible people to below the outbreak threshold. Two-dose programs in Finland, Sweden and the United States have dramatically reduced the incidence rates of measles in those countries, and it is expected that the implementation of two-dose programs and "catch-up" campaigns in Canada and the remaining countries of the Americas will eliminate measles from the Western Hemisphere by the year 2000.
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Medical research and practice have always posed many ethical dilemmas for scientists and physicians, but technologic advances mean that the questions are becoming even more difficult. That is why an exhibit, A Question of Truth, that is being prepared at Toronto's Ontario Science Centre is so timely. It examines the biases and political climates in which science operates, as well as the relative subjectivity of truth, knowledge and reality.
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Reforms involving the National Health Service (NHS) have greatly reduced the length of waiting lists in the United Kingdom. The key to the reductions was additional funding from the government, the chief executive of the NHS said during a recent visit to Ottawa. Decreasing the size of the waiting lists created intense stress for NHS personnel, who had to work longer hours, and it also lowered demand for private-sector care.
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Dr. Kenneth Rothman, a critic of the use of placebos in clinical trials, recently discussed the issue with Health Canada employees. Some researchers insist this is not a black-and-white issue, and that in some cases patients who receive a placebo are the lucky ones.