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   Table of Contents - Current issue
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October-December 2020
Volume 25 | Issue 4
Page Nos. 135-158

Online since Monday, September 28, 2020

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EDITORIALS / ÉDITORIAUX  

Reflections on Summer 2020 p. 135
Peter Hutten-Czapski
DOI:10.4103/CJRM.CJRM_59_20  PMID:33004695
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Réflections sur l'été 2020 p. 136
Peter Hutten-Czapski
DOI:10.4103/1203-7796.296488  PMID:33004696
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President's Message. A rural lens on physician credentialing p. 137
Gabe Woollam
DOI:10.4103/CJRM.CJRM_62_20  PMID:33004697
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Message du Président. Dérive des titres de compétence p. 138
Gabe Woollam
DOI:10.4103/1203-7796.296490  PMID:33004698
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ORIGINAL ARTICLES / ARTICLES ORIGINAUX Top

Diabetes prevalence and demographics in 25 First Nations communities in northwest Ontario (2014–2017) p. 139
Cai-Lei Matsumoto, Sheldon Tobe, Yoko S Schreiber, Natalie Bocking, Janet Gordon, Sharen Madden, Josh Hopko, Len Kelly
DOI:10.4103/CJRM.CJRM_99_19  PMID:33004699
Introduction: First Nations communities are known to have high rates of diabetes. The rural First Nations communities in northwest (NW) Ontario are particularly affected. Regional studies in 1985 and 1994 found a high prevalence of diabetes. More recently, they are estimated to have the highest prevalence in Ontario at 19%, double the provincial norm. The purpose of this study is to examine the epidemiology and prevalence of diabetes in the total population and cardiovascular comorbidities in the adult population of 25 First Nations communities in NW Ontario. Methods: This retrospective diabetes prevalence study used primary care electronic medical record data for a 3-year period, 1 August 2014–31 July 2017. Diabetes prevalence was calculated for both the total and the adult (18+) populations and comorbid hypertension and dyslipidaemia were identified in adults. Results: The age-adjusted diabetes prevalence for the total population was 15.1% versus a Canadian prevalence of 8.8%. The age-adjusted adult prevalence was 14.1%, double Canada's average of 7.1%. The average age of adults with diabetes was 52 years (±14.9); 57% were female. Comorbid hypertension (58%) and dyslipidaemia (73%) were common. Metformin was the most commonly used medication (58%), followed by insulin/analogues (23%) and sulphonylureas (13%). Conclusion: The diabetes prevalence in the First Nations population of NW Ontario is double Canada's norm. Addressing it will require addressing relevant social determinants of health, including poverty and food security.
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Defining rural teaching hospitals in Canada: Developing and testing a new definition p. 145
Aaron Johnston, Julia Haber, Rebecca Malhi, Darren Nichols, Rylen Williamson
DOI:10.4103/CJRM.CJRM_21_20  PMID:33004700
Introduction: The current definition of 'teaching hospital' provided by Canadian Institute of Health Information (CIHI) focuses on large academic teaching hospitals. High-quality rural training experiences have been identified as a key component of training the future rural medical workforce. Identifying communities and hospitals where this training is currently available and taking place is important in understanding the current landscape of available rural training but is hampered by the lack of an agreed upon definition of 'rural teaching hospital'. This limits the understanding of current rural training landscapes, comparison across regions and research in this area. We propose a definition of a 'rural teaching hospital'. Methods: Using the CIHI definition of rural as an initial reference point, we used accessible data from the University of Calgary and University of Alberta Distributed Medical Education (DME) programs to develop a definition of a 'rural teaching hospital'. We then identified rural Alberta hospitals to show how this definition would work in practice. Results: Our definition of a rural teaching hospital is a hospital situated in a town of <30,000 people, teaching occurs at least 36 h a week and that teaching includes at least Family Medicine clerkship OR Family Medicine residency rotations. We identified 104 Alberta rural hospitals. The University of Calgary and University of Alberta DME programs included 70 communities and 44 of these communities met all three proposed criteria for rural teaching hospitals. Conclusion: Creating a working definition of a 'rural teaching hospital' is of high importance for both research and for day-to-day operations of rural educational units.
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PROCEDURAL SERIES Top

The occasional low-flow priapism p. 150
Andrew Baker, Christopher Patey, Hasan Al-Obaidi
DOI:10.4103/CJRM.CJRM_97_19  PMID:33004701
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CASE REPORT Top

Bacterial endocarditis diagnosed with point-of-care ultrasound in a rural emergency department p. 154
Taft Micks, Kyle Sue
DOI:10.4103/CJRM.CJRM_75_19  PMID:33004702
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BOOK REVIEW Top

Deep Water Dream p. 158
Stacy Desilets
DOI:10.4103/CJRM.CJRM_19_19  
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