Canadian family physician Médecin de famille canadien
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To define pregnancy-related cardiovascular risk indicators and their association with developing future cardiovascular disease (CVD), and to provide guidance on how primary care providers can help lower future CVD risk through early identification and intervention. ⋯ Women with 1 or more of these pregnancy complications should be identified at the time of delivery and have formalized postpartum follow-up, including a thorough history, a physical examination, biochemical screening, counseling around lifestyle modification, and possible therapeutic intervention. The link between pregnancy complications and future CVD affords the earliest opportunity for CVD risk assessment for health preservation and disease prevention.
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To compare the national health systems of Canada and Brazil and how both countries have addressed similar challenges in their primary care sectors. ⋯ The Brazilian and Canadian primary care systems are faced with similar challenges, including geography, demographic changes, population health inequities, and gaps in universal access to comprehensive primary care services. Although the approaches to addressing these challenges are different in both settings, they highlight the central importance of family physicians in both systems. Both countries continue to face considerable challenges in the context of mental health services in primary care. It remains important for Canada to draw lessons from the primary care systems and reforms of other countries, such as Brazil.
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To summarize information on the effects of opioid use in pregnancy on subsequent pediatric development and behaviour. ⋯ The effect of maternal opioid use on pediatric development is unclear and the evidence is inconsistent. However, opioid exposure in pregnancy does define these children as a population at risk. They might experience developmental delays compared with their peers, yet remain within population norms in cognition, fine-motor skills, hand-eye coordination, executive function, and attention and impulsivity levels.
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To systematically review the literature for studies comparing the efficacy of opioid analgesics for older adults (≥ 65 years) presenting to the emergency department (ED) with acute pain. ⋯ The lack of published research in this area demonstrates a considerable gap in knowledge of the comparative efficacy of opioid analgesics in the growing older adult patient population. Physicians are often uncertain in their choice of analgesia, potentially contributing to the undertreatment of pain. It is clear that well designed RCTs are urgently needed.