CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Review Meta Analysis
Does bed rest after cervical or lumbar puncture prevent headache? A systematic review and meta-analysis.
Headache after cervical or lumbar puncture has long been attributed to early mobilization; however, there is little evidence for this. We performed a systematic literature review and meta-analysis of randomized controlled trials to assess whether longer bed rest is better than immediate mobilization or short bed rest in preventing headache. ⋯ There was no evidence that longer bed rest after cervical or lumbar puncture was better than immediate mobilization or short bed rest in reducing the incidence of headache.
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Review Case Reports
Clinical nutrition: 1. Protein-energy malnutrition in the inpatient.
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Comparative Study
Primary health care services provided by nurse practitioners and family physicians in shared practice.
Collaborative practice involving nurse practitioners (NPs) and family physicians (FPs) is undergoing a renaissance in Canada. However, it is not understood what services are delivered by FPs and NPs working collaboratively. One objective of this study was to determine what primary health care services are provided to patients by NPs and FPs working in the same rural practice setting. ⋯ For the practices in this study NPs were underutilized with regard to curative and rehabilitative care. Referral patterns indicate little evidence of bidirectional referral (a measure of shared care). Explanations for the findings include medicolegal issues related to shared responsibility, lack of interdisciplinary education and lack of familiarity with the scope of NP practice.