CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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To ascertain the prevalence of HIV infection among people entering provincial adult prisons in British Columbia and to study associations between HIV infection and specific demographic and behavioural characteristics. ⋯ Unlinked, voluntary HIV antibody testing of inmates can achieve high participation rates. The overall prevalence rate of 1.1% and the rate among the female inmates of 3.3% confirm that HIV infection is a reality in prisons and that the virus has established a clear foothold in inmate populations. Harm-reduction interventions should include a comprehensive education program for inmates on infectious diseases, the availability of condoms throughout prisons and the distribution of bleach for sterilizing needles and syringes. From a public health perspective, these data suggest an urgent need for access to sterile injection equipment in addition to other preventive measures.
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Practice Guideline Guideline
Management of the woman with threatened birth of an infant of extremely low gestational age. Fetus and Newborn Committee, Canadian Paediatric Society, Maternal-Fetal Medicine Committee, Society of Obstetricians and Gynaecologists of Canada.
To offer guidelines for parents, physicians and other members of the health-care team for management of the probable birth of an infant with a gestational age of 26 completed weeks or less. ⋯ Members of the Fetus and Newborn Committee of the Canadian Paediatric Society (CPS) were involved in the preparation of this article, which was reviewed and modified by the Ethics Committee of the CPS and the Maternal-Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC). A draft was circulated to Canadian university-based perinatal programs and members of the Section on Neonatal-Perinatal Medicine of the CPS. Comments from physicians and bioethicists were incorporated, when possible, into the final version. There are no similar guidelines in North America.
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How reasonable are expectations that patients will participate in care decisions? The previous article in this series reviewed models of the patient-physician relationship and views on the extent to which patients want to be informed; it also described one information tool--the interactive videodisc. This article reviews literature on the extent to which patients wish to be involved in making decisions about their care. ⋯ The author suggests a distinction between two elements of choice: problem solving and decision making. This distinction helps in identifying appropriate roles for patient and provider, thereby leading to genuine shared decision making.
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To examine the extent prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) are used by elderly people in Alberta as well as the degree of concurrent use of multiple NSAIDs, of peptic ulcer medications and of certain medications known to have clinically significant adverse interactions with NSAIDs. ⋯ NSAIDs are prescribed frequently for elderly people and are associated with an increased likelihood of concurrent prescription of peptic ulcer medication and medications that could have adverse drug interactions with NSAIDs. Additional study is required to evaluate the appropriateness of NSAID use in elderly patients, to determine the degree of actual patient consumption of these medications, to document the true prevalence of clinically significant drug interactions and to formulate educational strategies to reach physicians with this information.
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Practice Guideline Guideline
Periodic health examination, 1994 update: 3. Primary and secondary prevention of neural tube defects. Canadian Task Force on the Periodic Health Examination.
To make recommendations on nutritional interventions and screening manoeuvres to prevent the birth of infants with neural tube defects (NTDs). ⋯ These guidelines were developed and endorsed by the Canadian task force, which funded by Health Canada.