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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 25 | Issue 1
Page Nos. 3-50

Online since Thursday, December 19, 2019

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EDITORIALS / ÉDITORIAUX  

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 Top

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 Top

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 Top

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:31854339
Abstract 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 Top

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:31854340
Abstract 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 Top

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 Top

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 Top

Authors' Reply p. 50
Nathan Wilson
DOI:10.4103/1203-7796.273537  PMID:31854343
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