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January-March 2020 Volume 25 | Issue 1
Page Nos. 3-50
Online since Thursday, December 19, 2019
Accessed 55,565 times.
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EDITORIALS / ÉDITORIAUX |
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The ‘Brokenness’ of postgraduate medical education |
p. 3 |
Peter Hutten-Czapski DOI:10.4103/CJRM.CJRM_85_19 PMID:31854333 |
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La fragmentation de l'éducation médicale de deuxième cycle |
p. 5 |
Peter Hutten-Czapski DOI:10.4103/1203-7796.273541 PMID:31854334 |
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President's Message.
Care delayed is care denied |
p. 7 |
Margaret Tromp DOI:10.4103/CJRM.CJRM_89_19 PMID:31854335 |
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Message du Président.
Les soins retardés sont des soins refusés |
p. 9 |
Margaret Tromp DOI:10.4103/1203-7796.273543 PMID:31854336 |
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PODIUM |
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Research funding by the Canadian Institutes of Health Research: More rural needed! |
p. 11 |
James Rourke, Ruth Wilson DOI:10.4103/CJRM.CJRM_82_19 PMID:31854337 |
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RURAL RECOMMENDATIONS |
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Progress made on access to rural healthcare in Canada |
p. 14 |
C Ruth Wilson, James Rourke, Ivy F Oandasan, Carmela Bosco DOI:10.4103/CJRM.CJRM_84_19 PMID:31854338 |
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SYSTEMATIC REVIEW |
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A systematic review of reviews: Recruitment and retention of rural family physicians |
p. 20 |
Shabnam Asghari, Megan C Kirkland, Jillian Blackmore, Sarah Boyd, Alison Farrell, James Rourke, Kris Aubrey-Bassler, Marshall Godwin, Ivy Oandasan, Aleksandra Walczak DOI:10.4103/CJRM.CJRM_4_19 PMID:31854339Abstract
Introduction: The recruitment and retention of family physicians in rural and remote communities has been the topic of many reviews; however, a lack of consensus among them with regard to which factors are most influential makes it difficult for setting priorities. We performed a systematic review of reviews which helped to establish an overall conclusion and provided a set of fundamental influential factors, regardless of the consistency or generalisability of the findings across reviews. This review also identified the knowledge gaps and areas of priority for future research.
Methods: A literature search was conducted to find the review articles discussing the factors of recruitment or retention of rural family physicians. Results were screened by two independent reviewers. The number of times that each factor was mentioned in the literature was counted and ordered in terms of frequency.
Results: The literature search identified 84 systematic reviews. Fourteen met the inclusion criteria, from which 158 specific factors were identified and summarised into 11 categories: personal, health, family, training, practice, work, professional, pay, community, regional and system/legislation. The three categories referenced most often were training, personal and practice. The specific individual factors mentioned most often in the literature were 'medical school characteristics', 'longitudinal rural training' and 'raised in a small town'.
Conclusion: The three most often cited categories resemble three distinct phases of a family physician's life: pre-medical school, medical school and post-medical school. To increase the number of physicians who choose to work in rural practice, strategies must encompass and promote continuity across all three of these phases. The results of this systematic review will allow for the identification of areas of priority that require further attention to develop appropriate strategies to improve the number of family physicians working in rural and remote locations.
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REVIEW ARTICLE |
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Impact of telemedicine on diagnosis, clinical management and outcomes in rural trauma patients: A rapid review |
p. 31 |
Luc Lapointe, Marie-Helene Lavallee-Bourget, Alexia Pichard-Jolicoeur, Catherine Turgeon-Pelchat, Richard Fleet DOI:10.4103/CJRM.CJRM_8_19 PMID:31854340Abstract
Introduction: Rural trauma patients are at increased risk of morbidity and mortality compared to trauma patients treated in urban facilities. Factors contributing to this disparity include differences in resource availability and increased time to definitive treatment for rural patients. Telemedicine can improve the early management of these patients by enabling rural providers to consult with trauma specialists at urban centres. The purpose of this study was to assess the impact of telemedicine utilisation on the diagnosis, clinical management and outcomes of rural trauma patients.
Materials and Methods: A rapid review of the literature was performed using the concepts 'trauma', 'rural' and 'telemedicine'. Fifteen electronic databases were searched from inception to 29th June 2018. Manual searches were also conducted in relevant systematic reviews, key journals and bibliographies of included studies.
Results: The literature search identified 187 articles, of which 8 articles were included in the review. All 8 studies reported on clinical management, while the impact of telemedicine use on diagnosis and outcomes was reported in 4 and 5 studies, respectively. Study findings suggest that the use of telemedicine may improve patient diagnosis, streamline the process of transferring patients and reduce length of stay. Use of telemedicine had minimal impact on mortality and complications in rural trauma patients.
Conclusions: The evidence identified by this rapid review suggests that telemedicine may improve the diagnosis, management and outcomes of rural trauma patients. Further research is required to validate these findings by performing large and well-designed studies in rural areas, ideally as randomised clinical trials.
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PROCEDURE |
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The occasional bougie-assisted cricothyroidotomy |
p. 41 |
Tyler M C. Johnston, Philip J Davis DOI:10.4103/CJRM.CJRM_50_19 PMID:31854341 |
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LETTER TO EDITOR |
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Erysipelothrix rhusiopathiae and contact with snow crab |
p. 49 |
Sora Yasri, Viroj Wiwanitkit DOI:10.4103/CJRM.CJRM_80_19 PMID:31854342 |
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AUTHORS’ REPLY |
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Authors' Reply |
p. 50 |
Nathan Wilson DOI:10.4103/1203-7796.273537 PMID:31854343 |
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