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   Table of Contents - Current issue
Coverpage
April-June 2021
Volume 26 | Issue 2
Page Nos. 51-90

Online since Tuesday, March 30, 2021

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EDITORIALS / ÉDITORIAUX  

Looking back and looking forward p. 51
Peter Hutten-Czapski
DOI:10.4103/CJRM.CJRM_7_21  PMID:33818528
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Regarder en arrière et droit devant p. 52
Peter Hutten-Czapski
DOI:10.4103/1203-7796.312617  PMID:33818529
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President's Message. Striving for excellence in continuing education on indigenous health p. 53
Gabe Woollam
DOI:10.4103/CJRM.CJRM_6_21  PMID:33818530
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Message du président. Viser l'excellence en Formation Continue Sur La Santé Autochtone p. 54
Gabe Woollam
DOI:10.4103/1203-7796.312613  PMID:33818531
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ORIGINAL ARTICLE / ARTICLE ORIGINAUX Top

New obesity treatment: Fasting, exercise and low carb diet - The NOT-FED study Highly accessed article p. 55
Terry O'Driscoll, Robert Minty, Denise Poirier, Jenna Poirier, Wilma Hopman, Hannah Willms, Aidan Goertzen, Sharen Madden, Len Kelly
DOI:10.4103/CJRM.CJRM_1_20  PMID:33818532
Introduction: Due to high rates of obesity in Canada, weight loss is an important primary care challenge. Recent innovations in strategies include intermittent fasting and low-carbohydrate diets, with limited research in a rural setting. Methods: This prospective 1-year observational study provided patients in Sioux Lookout, Northwestern Ontario with information on fasting and low-carbohydrate diets. Patients were recommended to attend every 3 months for measurements of weight, waist circumference, body mass index (BMI) and blood pressure. Initial and 6-month bloodwork included A1c and Lipids. A survey of health status and diet was administered at 6 months. Results: Of the 94 initial registrants, 36 participants completed 1 year and achieved a 9% weight loss and an 8.6% decrease in BMI and waist circumference. Most participants were female with an average age of 60 years. Clinically insignificant changes in blood pressure and serology were observed. Participants reported few side effects and good compliance with intermittent fasting, averaging 15 h/day, 6 days/week. As in other dietary studies, the dropout rate was high at 62%. Conclusion: This low-resource initiative was successful in assisting self-selected patients at a rural primary care clinic to achieve significant weight loss at 1-year. This approach is practical and is fertile ground for ongoing research.
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What makes a healthy rural community? p. 61
Ilona Hale, Stefan Grzybowski, Zoe Ramdin
DOI:10.4103/CJRM.CJRM_22_20  PMID:33818533
Introduction: Health outcomes in rural populations are known to be generally worse than in urban populations but there are some exceptions to this trend. Most research evaluating these disparities has focused on rural communities with poor health outcomes. The current study set out to explore the factors that make some rural communities healthier than others. Methods: Semi-structured interviews were conducted with a purposive sample of 12 key informants in a rural community within a healthy outlier region. The interview guide was based on the Social-Ecological Model of health and the focus was on community – as opposed to facility-based health. Interview data were analysed using directed content analysis. Results: Five main themes were identified: (1) availability of amenities, (2) healthy lifestyle as a shared value, (3) transition from a mining community, (4) geographic location and (5) challenges. Conclusion: Many of the findings challenge traditional assumptions about determinants of health in rural communities. The phenomenon of 'amenity migration' from urban to rural areas which may increase in coming years, is one that can have important implications for health.
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Healthcare utilisation among Canadian adults in rural and urban areas – The Canadian Longitudinal Study on Aging p. 69
Kirsten Clark, Philip St John, Verena Menec, Denise Cloutier, Nancy Newall, Megan O'Connell, Robert Tate
DOI:10.4103/CJRM.CJRM_43_20  PMID:33818534
Objective: The objective is to determine the use of health-care services (physician visits, emergency department use and hospitalisations) in rural areas and examine differences in four geographic areas on a rural to urban spectrum. Methods: We conducted a secondary analysis of cross-sectional data from a population-based prospective cohort study, the Canadian Longitudinal Study on Aging (CLSA). Participants included community-dwelling adults aged 45–85 years old from the tracking cohort of the CLSA (n = 21,241). Rurality was classified based on definitions from the CLSA sampling frame and similar to the 2006 census. Main outcome measures included self-reported family physician and specialist visits, emergency department visits and hospitalisations within the previous 12 months. Results were compared for four geographic areas on a rural-urban continuum. Univariate and bivariate analyses were performed on data from the 'tracking cohort' of the CLSA, Chi-square tests were used for categorical variables. Logistic regression models were created for the main outcome measures. Results: Participants in rural and mixed rural and urban areas were less likely to have seen a family physician or a specialist physician compared to urban areas. Those living in rural and peri-urban areas were more likely to visit an emergency department compared to urban areas. These differences persisted after adjusting for sociodemographic and health-related variables. There were no significant rural-urban differences in hospitalisations. Conclusion: Rural-urban differences were found in visits to family physicians, specialists and emergency departments.
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PROCEDURAL ARTICLE Top

The occasional eyelid lesion p. 80
Mitchell Crozier, Sarah M Giles
DOI:10.4103/CJRM.CJRM_66_20  PMID:33818535
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CASE REPORT Top

Survival of Boerhaave syndrome against all odds at a rural Emergency Department p. 87
Mohammed Abrahim, Janna AbdelAziz
DOI:10.4103/CJRM.CJRM_69_20  PMID:33818536
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