CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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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.
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To document the criteria used to declare brain death in a pediatric critical care unit (PCCU). ⋯ Pediatricians in this large tertiary care referral centre are using clinical criteria based on the 1987 guidelines of the CMA to diagnose brain death in pediatric patients, including neonates. When clinical criteria cannot be fully applied, ancillary methods of investigation are consistently used. Although the soundness of this pattern of practice is established for adults and older children, its applicability to neonates and infants still needs to be validated.
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In a controversial decision, the General Medical Council has found a consultant anesthetist guilty of serious professional misconduct for giving a painkilling suppository without forewarning the patient and obtaining consent. Even though the suppository was misplaced in the patient's vagina, this was accepted as a mistake, at issue was whether a specific separate consent was required for insertion of the suppository.