Depression and mortality in a longitudinal study: 1952-2011.

Background: Many studies have shown that depression increases mortality risk. We aimed to investigate the duration of time over which depression is associated with increased risk of mortality, secular trends in the association between depression and mortality, and sex differences in the association between depression and mortality.

Methods: We conducted a cohort study of 3410 adults enrolled in 3 representative samples of a county in Atlantic Canada in 1952 ( = 1003), 1970 ( = 1203) or 1992 ( = 1402) (the Stirling County Study).

Experiences in feeding and gastrointestinal dysfunction in children with CHARGE syndrome.

Feeding issues are very common in individuals with CHARGE syndrome and can lead to increased morbidity and mortality. The aim of this study was to expand upon the limited knowledge base of feeding and gastrointestinal issues in individuals with CHARGE syndrome. Parents of individuals (age range 1-18 years) with CHARGE syndrome, with or without feeding/gastrointestinal issues, were recruited through international CHARGE syndrome associations and CHARGE syndrome Facebook pages.

Adolescent narrative comments in assessing medical students.

Background: Adolescent medical interviewing is a difficult topic to teach and assess. Programmatic assessment has been gaining interest in medical teaching, and shifts the mode of assessment from the traditional assessment of learning (e.g.

A Video-Based Introductory EEG Curriculum for Neurology Residents and Other EEG Learners.

Introduction: It is difficult to provide standardized formal education in EEG because of time limitations and the availability of expert teachers. Video-based miniature lectures are a useful way to standardize the foundational principles of EEG and support learning during EEG/epilepsy rotations.

Methods: A curriculum of 10 EEG teaching videos was developed based on concepts outlined in the Accreditation Council for Graduate Medical Education Neurology Milestones.

CHARGE syndrome gastrointestinal involvement: from mouth to anus.

CHARGE syndrome is an autosomal dominant disorder that occurs as a result of a heterozygous loss-of-function mutation in the chromodomain helicase DNA-binding (CHD7) gene, which is important for neural crest cell formation. Gastrointestinal (GI) symptoms and feeding difficulties are highly prevalent but are often a neglected area of diagnosis, treatment, and research. Cranial nerve dysfunction, craniofacial abnormalities, and other physical manifestations of this syndrome lead to gut dysmotility, sensory impairment, and oral-motor function abnormalities.

The future of financing for HIV services in Uganda and the wider sub-Saharan Africa region: should we ask patients to contribute to the cost of their care?

Whilst multi-lateral funding for HIV/AIDS dramatically increased from 2004 to 2008, it has largely plateaued in the last 8 years. Across sub-Saharan Africa, up to 20 % of total spending on health is used for HIV services, and of this over 85 % is estimated to come from international funding rather than in-country sources. In Uganda, the fiscal liability to maintain services for all those who are currently receiving it is estimated to be as much as 3 % of Gross Domestic Product (GDP).

Patient preferences in early glottic cancer treatment.

Patients with early-stage glottic cancer are primarily treated with one of three options: endoscopic laser excision, external-beam radiation, or open conservation surgery. We sought to determine patient preferences for treatment when presented with a choice between CO2 laser resection and radiation (open conservation surgery was not offered because the endoscopic approach is preferred at our institution). This prospective cohort study was conducted at the Dalhousie University Faculty of Medicine in Halifax, Canada.

Extending Aromatase-Inhibitor Adjuvant Therapy to 10 Years.

Background: Treatment with an aromatase inhibitor for 5 years as up-front monotherapy or after tamoxifen therapy is the treatment of choice for hormone-receptor-positive early breast cancer in postmenopausal women. Extending treatment with an aromatase inhibitor to 10 years may further reduce the risk of breast-cancer recurrence.

Methods: We conducted a double-blind, placebo-controlled trial to assess the effect of the extended use of letrozole for an additional 5 years.

Aggression, Violence and Injury in Minor League Ice Hockey: Avenues for Prevention of Injury.

Background: In North America, more than 800,000 youth are registered in organized ice hockey leagues. Despite the many benefits of involvement, young players are at significant risk for injury. Body-checking and aggressive play are associated with high frequency of game-related injury including concussion.

Physician-assisted death: A Canada-wide survey of ALS health care providers.

Objective: To survey amyotrophic lateral sclerosis (ALS) health care providers to determine attitudes regarding physician-assisted death (PAD) after the Supreme Court of Canada (SCC) invalidated the Criminal Code provisions that prohibit PAD in February 2015.

Methods: We conducted a Canada-wide survey of physicians and allied health professionals (AHP) involved in the care of patients with ALS on their opinions regarding (1) the SCC ruling, (2) their willingness to participate in PAD, and (3) the PAD implementation process for patients with ALS.

Results: We received 231 responses from ALS health care providers representing all 15 academic ALS centers in Canada, with an overall response rate for invited participants of 74%.

Achieving the World Health Organization's vision for clinical pharmacology.

Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence-based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co-morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline.

Sociomateriality: a theoretical framework for studying distributed medical education.

Distributed medical education (DME) is a type of distance learning in which students participate in medical education from diverse geographic locations using Web conferencing, videoconferencing, e-learning, and similar tools. DME is becoming increasingly widespread in North America and around the world.Although relatively new to medical education, distance learning has a long history in the broader field of education and a related body of literature that speaks to the importance of engaging in rigorous and theoretically informed studies of distance learning.

Restraint in police use of force events: examining sudden in custody death for prone and not-prone positions.

Little is understood about the incidence of sudden death, its underlying pathophysiology, or its actual relationship to subject positioning. We report data from 4828 consecutive use of force events (August 2006-March 2013) in 7 Canadian police agencies in Eastern and Western Canada. Consecutive subjects aged >18 years who were involved in a police use of force event were included regardless of outcome.

Health technology assessment and personalized medicine: are economic evaluation guidelines sufficient to support decision making?

Background: Many jurisdictions delivering health care, including Canada, have developed guidance for conducting economic evaluation, often in the service of larger health technology assessment (HTA) and reimbursement processes. Like any health intervention, personalized medical (PM) interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. However, current approaches to economic evaluation to support decision making have been largely developed from population-based approaches to therapy-that is, evaluating the costs and consequences of single interventions across single populations.

Interplay of proliferation and proapoptotic and antiapoptotic factors is revealed in the early human inner ear development.

Hypothesis: Spatiotemporal interplay of factors controlling proliferation, differentiation and apoptosis within the developing human inner ear is essential for labyrinth morphogenesis and development of vestibular and cochlear functions.

Background: Studies on the early human inner ear development are scarce and insufficient.

Methods: The immunolocalization of Ki-67, Bcl-2, caspase-3, and IGF-1 was analyzed in 6 human inner ears, 5 to 10 gestational weeks old.

The expression of long-term potentiation: reconciling the preists and the postivists.

Long-term potentiation (LTP) of excitatory synaptic transmission in the hippocampus has been investigated in great detail over the past 40 years. Where and how LTP is actually expressed, however, remain controversial issues. Considerable evidence has been offered to support both pre- and postsynaptic contributions to LTP expression.

Psychosis in children and youth: focus on early-onset schizophrenia.

On the basis of strong research evidence (1)(3) very early onset (VEOS) and early onset schizophrenia (EOS) carry significant morbidity and mortality risks for children and adolescents. On the basis of strong research evidence, the pathogenesis of EOS is linked to a dysregulation of dopamine and morphologic brain changes. (6)(7) On the basis of some research evidence and consensus, development of schizophrenia is the result of the interplay between genetic and environmental risk factors.

Discovery of blood transcriptomic markers for depression in animal models and pilot validation in subjects with early-onset major depression.

Early-onset major depressive disorder (MDD) is a serious and prevalent psychiatric illness in adolescents and young adults. Current treatments are not optimally effective. Biological markers of early-onset MDD could increase diagnostic specificity, but no such biomarker exists.

Role of skeletal muscle in lung development.

Skeletal (striated) muscle is one of the four basic tissue types, together with the epithelium, connective and nervous tissues. Lungs, on the other hand, develop from the foregut and among various cell types contain smooth, but not skeletal muscle. Therefore, during earlier stages of development, it is unlikely that skeletal muscle and lung depend on each other.

Complete revascularization is compromised in off-pump coronary artery bypass grafting.

Objective: Patients who undergo off-pump coronary artery bypass grafting (OPCAB) commonly receive fewer bypass grafts and are more often incompletely revascularized compared with those receiving conventional coronary artery bypass (CCAB) recipients. Because this can compromise survival, we sought to determine whether patients undergoing OPCAB are incompletely revascularized and whether this affects long-term survival and freedom from cardiac events.

Methods: OPCAB cases (n = 411) performed from January 1, 1997 to June 30, 2003 were considered for inclusion and matching with 874 randomly selected, contemporary CCAB cases.

Developing nervous systems in molluscs: navigating the twists and turns of a complex life cycle.

Molluscs constitute a richly diversified phylum, containing abundant species that have successfully invaded a variety of habitats. Despite the long-standing importance of its various members as model species for neurobiology, research on the development of the molluscan nervous system has lagged behind that on several other phyla. Recent studies, however, have begun to sketch an overview of neural development during the complex life cycles of these animals, involving multiple larval and postlarval stages and often including processes of torsion and occasionally detorsion affecting the entire body plan.