The Role of the Practising Physician in Medical Student Recruitment

The role that the practitioner of medicine can play in assisting recruitment to medical schools is examined. Although the total enrolment in universities has increased sharply in the past decade, the group applying to enter medicine has decreased. The output of Canada''s 12 schools of medicine—850 graduates per year-falls significantly short of the number of new physicians required to maintain the present physician:population ratio. With the expanded output of physicians required in future, an active program of recruitment will be necessary. The recruitment program organized by the practising physicians of British Columbia and the Faculty of Medicine at the University of British Columbia is outlined.     

Accuracy of registration of invasive cervical cancer.

The quality of the data recorded by the British Columbia Cancer Registry for 521 new cases of invasive cervical cancer was evaluated. The registry''s pathological diagnosis in all new registrations of invasive cervical cancer diagnosed in British Columbia between 1977 and 1979 was compared with a best estimate of the true diagnosis, which was determined from the results of the provincial cervical cytology screening program and the clinical charts at the Cancer Control Agency of British Columbia. The registry''s data overestimated the true incidence of invasive cervical cancer by approximately 55%, since 184 (35%) of the cases were incorrectly registered. Of the 184, 141 (77%) were cases of preinvasive cervical cancer, 26 (14%) did not meet the criteria for a true case (i.e., they were not newly diagnosed in British Columbia between 1977 and 1979) and 17 (9%) were cases of invasive cancer of another primary site. In addition, 28 cases of invasive cervical cancer diagnosed in the province during the study period had not been reported to the registry. Thus, both over-reporting and under-reporting occurred. There is a need for constant evaluation of registry data if cancer registries are to fulfil their potential contribution to cancer control programs and research.     

Organisation and results of the cervical cytology screening programme in British Columbia, 1955-85

A screening programme to detect preinvasive carcinoma of the cervix was started in British Columbia in 1949. Since 1970 the number of women who have been screened at least once has been maintained at about 85% of the population at risk. More than 500 000 cervical smears are being examined each year in the central laboratory. There has been an appreciable increase in the number of cases and rates of carcinoma in situ seen since 1970, particularly in women between 20 and 30 years of age. Since the programme started over 26 000 cases of squamous carcinoma in situ have been detected and treated. The incidence of clinically invasive squamous carcinoma of the cervix has fallen by 78% during the period under review, and mortality from squamous carcinoma of the cervix has fallen by 72%. A colposcopy programme, introduced throughout British Columbia over the past 12 years, has been important in reducing the problems of managing preinvasive lesions, particularly in younger women.It is concluded that the reduction in morbidity and mortality from invasive squamous cancer of the cervix in British Columbia over the past 30 years is directly attributable to the province wide screening programme and that a large potential increase in invasive cervical cancer rates among younger women is being prevented.     

Incidence rates for cleft lip and palate in British Columbia 1952-71 for North American Indian, Japanese, Chinese and total populations: secular trends over twenty years

The incidence of cleft lip and/or cleft palate was examined for the 1952-71 period for the Province of British Columbia. Although there were some fluctuations, some of which were significant, there was no general trend which indicated that the rates were either increasing or decreasing. These rates are important for a background calculation when investigating new invironment teratogens. The total rate of 1.97 per 1,000 live birth is comparable with other Caucasian populations where there is good ascertainment and adequate follow-up period. This study also confirmed the previously reported high rate for North American Indians in British Columbia (3.74 per 1,000 live births) and established rates for the Japanese (3.36 per 1,000 live births) and Chinese (1.76 per 1,000 live births) of British Columbia. Since these three sub-populations are relatively small in relation to the total population, they do not influence the overall total rate to any great extent.     

Confirmation of genital herpes simplex viral infection by an immunoperoxidase technique

Over the 12-month period from April 1984 to April 1985, 512,000 gynecologic (Papanicolaou) smears were examined in the Provincial Screening Program in British Columbia. During this time, 307 patients were found to have smears that contained cells consistent with, or suggestive of, a herpes simplex viral (HSV) infection. The Papanicolaou-stained smears from these 307 cases were subsequently restained, without prior destaining, using an immunoperoxidase technique specific for type 2 HSV (HSV-2) and cross reactive with HSV-1. Of the 205 smears containing cells considered to be consistent with a herpes infection, 187 were positive using the immunoperoxidase technique. Of the 102 smears showing reactive cell changes though unlikely to be causes by an HSV infection, only 5 were positive using the immunoperoxidase technique. The results show that the immunoperoxidase technique is a rapid and reliable method of confirming a suspected diagnosis of herpetic infection and that it is particularly useful in those patients in whom the Papanicolaou smear findings are equivocal.     

Dystocia and cesarean section

We performed an anonymous seroprevalence survey of human immunodeficiency virus (HIV) type 1 infection through HIV antibody testing of blood samples from 22,512 women aged 15 to 44 years receiving prenatal care in British Columbia and the Yukon Territory from Mar. 15 to Sept. 30, 1989. Of the samples six were confirmed to be HIV positive; this yielded a crude overall seroprevalence rate of 2.7 per 10,000 pregnant women (95% confidence interval [CI] 1.0 to 5.8). All of the positive samples were from women 20 to 29 years of age; four were from Vancouver, one was from Victoria, and one was from elsewhere. The highest seroprevalence rates were among women aged 15 to 29 years in Vancouver and Victoria (7.2 and 9.4 per 10,000 pregnant women respectively). Thus, 1 in 1300 pregnant women in that age group in the metropolitan areas of British Columbia was HIV positive. Application of seroprevalence rates to the total female population in British Columbia and the Yukon Territory revealed that as many as 401 women had HIV infection in 1989. Our estimates likely represent the minimum. As a subset of women of childbearing age pregnant women are likely at lowest risk of HIV infection, and so the true number of women 15 to 44 years of age with HIV infection is probably several times higher. Our study has provided a baseline assessment and will be repeated annually to analyse trends in HIV seroprevalence among pregnant women in British Columbia and the Yukon Territory.     

The Medical Library Service of the College of Physicians and Surgeons of British Columbia

A unique provincial medical library service has been established in British Columbia. Under the direction of professional librarians, the central library in Vancouver is building an extensive, largely clinical collection while 30 smaller branch libraries in hospitals throughout the province are establishing basic, up-to-date collections. Financial support comes from an annual fee of $25.00 per doctor paid to the College of Physicians and Surgeons of British Columbia. Photoduplication, mail and telephone services meet many reference needs. Reading is vital to continuing medical education. The library works closely with the University of British Columbia''s Department of Continuing Medical Education to bring current medical knowledge to every doctor in British Columbia.     

Program for licensure for international medical graduates in British Columbia: 7 years' experience

British Columbia has funded a program for licensure for international medical graduates since 1992, providing 2 entry positions per year for postgraduate training. Each year 25-35 candidates are eligible for the program, 13-16 enter the evaluation process, 4 go on to a clinical evaluation and 2 are offered funding by the Ministry of Health. Other candidates may access community funding if they meet the requirements of the program. Twenty of 26 candidates have successfully completed the postgraduate training and achieved full licensure; 6 are still in training. In this article we describe the development of the program, the evaluation and selection process, characteristics of the candidates and the outcomes of the program.     

Five-year follow-up of women with borderline and mildly dyskaryotic cervical smears

This study investigated the 5-year follow-up status of women with cervical smears showing borderline nuclear changes (BNC) or mild dyskaryosis and the effect of koilocytosis on the outcome. Thirteen per cent of women with cervical smears showing BNC had high-grade cervical intraepithelial neoplasia (CIN). In contrast, 28% of women with cervical smears showing mild dyskaryosis had high-grade CIN. The presence of koilocytosis (24% for borderline smears and 34% for mild dyskaryotic smears) did not appear to influence the risk of developing high-grade CIN. Our results suggest that the simultaneous implementation of the British Society for Clinical Cytology proposed terminology and the colposcopy guidelines from the British Society for Colposcopy and Cervical Pathology could have an impact on colposcopy services.     

High genetic diversity in the blue-listed British Columbia population of the purple martin maintained by multiple sources of immigrants

To assess genetic diversity in the blue-listed purple martin (Progne subis) population in British Columbia, we analysed mitochondrial control region sequences of 93 individuals from British Columbia and 121 individuals collected from seven localities of the western and eastern North American subspecies P. s. arboricola and P. s. subis, respectively. Of the 47 haplotypes we detected, 34 were found exclusively in western populations, and 12 were found only in eastern populations. The most common eastern haplotype (25) was also found in three nestlings in British Columbia and one in Washington. Another British Columbia nestling had a haplotype (35) that differed by a C to T transition from haplotype 25. Coalescent analysis indicated that these five nestlings are probably descendents of recent immigrants dispersing from east to the west, because populations were estimated to have diverged about 200,000–400,000 ybp, making ancestral polymorphism a less likely explanation. Maximum likelihood estimates of gene flow among all populations detected asymmetrical gene flow into British Columbia not only of rare migrants from the eastern subspecies in Alberta but also a substantial number of migrants from the adjacent Washington population, and progressively lower numbers from Oregon in an isolation-by distance pattern. The influx of migrants from different populations is consistent with the migrant-pool model of recolonization which has maintained high genetic diversity in the small recovering population in British Columbia. Thus, the risk to this population is not from genetic erosion or inbreeding following a severe population crash, but from demographic stochasticity and extinction in small populations.     

Population structure of lake‐type and river‐type sockeye salmon in transboundary rivers of northern British Columbia

The population structure of 'lake‐type' and 'river‐type' sockeye salmon Oncorhynchus nerka , primarily in transboundary rivers in northern British Columbia, was examined with a survey of microsatellite variation. Variation at 14 microsatellite loci was surveyed from c . 3000 lake‐type and 3200 river‐type sockeye salmon from 47 populations in six river drainages in British Columbia. The mean F _ST for the 14 microsatellite loci and 47 populations was 0·068, and 0·034 over all river‐type populations. River‐type sockeye salmon were more genetically diverse than lake‐type sockeye salmon, with expected heterozygosity of river‐type sockeye salmon 0·72 and with an average 12·7 alleles observed per locus, whereas expected heterozygosity of lake‐type sockeye salmon was 0·65 with and average 10·5 alleles observed per locus. River drainage of origin was a significant unit of population structure. There was clear evidence of genetic differentiation among river‐type populations of sockeye salmon from different drainages over a broad geographic range in British Columbia.     

The Chilliwack Respiratory Survey, 1963: Part II. Aerometric Study

A study of the quality of the ambient air at Chilliwack, British Columbia, was conducted from May 1963 to April 1964. Measurements of dustfall, soiling, sulfation, hydrogen sulfide, oxidants and total hydrocarbons were made by a network of five sampling stations. The results of this survey indicated that Chilliwack was relatively free from any air pollution and would therefore be a suitable control for a study of the relationship between community air pollution and respiratory disease.     

Ecological factors drive differentiation in wolves from British Columbia

Aim Limited population structure is predicted for vagile, generalist species, such as the grey wolf (Canis lupus L.). Our aims were to study how genetic variability of grey wolves was distributed in an area comprising different habitats that lay within the potential dispersal range of an individual and to make inferences about the impact of ecology on population structure. Location British Columbia, Canada – which is characterized by a continuum of biogeoclimatic zones across which grey wolves are distributed – and adjacent areas in both Canada and Alaska, United States. Methods We obtained mitochondrial DNA control region sequences from grey wolves from across the province and integrated our genetic results with data on phenotype, behaviour and ecology (distance, habitat and prey composition). We also compared the genetic diversity and differentiation of British Columbia grey wolves with those of other North American wolf populations. Results We found strong genetic differentiation between adjacent populations of grey wolves from coastal and inland British Columbia. We show that the most likely factor explaining this differentiation is habitat discontinuity between the coastal and interior regions of British Columbia, as opposed to geographic distance or physical barriers to dispersal. We hypothesize that dispersing grey wolves select habitats similar to the one in which they were reared, and that this differentiation is maintained largely through behavioural mechanisms. Main conclusions The identification of strong genetic structure on a scale within the dispersing capabilities of an individual suggests that ecological factors are driving wolf differentiation in British Columbia. Coastal wolves are highly distinct and representative of a unique ecosystem, whereas inland British Columbia grey wolves are more similar to adjacent populations of wolves located in Alaska, Alberta and Northwest Territories. Given their unique ecological, morphological, behavioural and genetic characteristics, grey wolves of coastal British Columbia should be considered an Evolutionary Significant Unit (ESU) and, consequently, warrant special conservation status. If ecology can drive differentiation in a highly mobile generalist such as the grey wolf, ecology probably drives differentiation in many other species as well.     

Regional-scale impact of the weed biocontrol agent Mecinus janthinus on Dalmatian toadflax (Linaria dalmatica)

Dalmatian toadflax (Linaria dalmatica (L.) Mill.) is an important invasive plant on rangelands throughout western North America. In 1991, the stem-mining weevil, Mecinus janthinus Germar, was introduced into Canada from Europe as a classical biological control agent to reduce toadflax densities and improve rangelands, particularly in British Columbia. To determine if the program was a success at a regional level, this paper answers three key questions: (1) has M. janthinus spread throughout the study area, (2) is M. janthinus causing a decline in toadflax plant size or density at the regional scale, and (3) has the distribution of toadflax plants changed following M. janthinus introduction? These questions are answered by combining historical survey data and mensurative experimental data on plant and weevil densities across a 40,000 km² area in southern British Columbia. The results show that through a combination of intentional redistribution and natural dispersal weevils have spread throughout the study area. Stem densities at naturally colonized sites and historical release sites were equally low. Across weevil populations between 3 and 10 years old, weevil densities peaked in the eighth year, and there was a negative relationship between weevil density and stem length. Between 2000 and 2007, toadflax patches were found to both decrease in density and become more fragmented over time, with 15% of patches disappearing completely. These findings show that M. janthinus has had a significant negative impact on both the density and distribution of Dalmatian toadflax throughout a large part of its range in British Columbia.     

Small RNAs tell big stories in Whistler

The Keystone Symposium on RNAi, microRNA and non-coding RNA convened on March 25-30 at Whistler Resort in Whistler, British Columbia, Canada. Researchers with backgrounds in different biochemical disciplines came together to exchange ideas on short RNAs and their roles in a host of biological processes.     

Practice patterns of family physicians with 2-year residency v. 1-year internship training: do both roads lead to Rome?

Are there differences in patterns of practice between actively practising physicians who have been certified after a 2-year family practice residency and matched physicians without certification who have completed the standard 1-year internship? With the use of billing files prepared by the British Columbia Medical Association a group of 65 family practice certificants in active practice in British Columbia was compared with a control group of 130 internship trainees matched by year and school of graduation, category of billing (i.e., solo or group) and region. A wide range of practice features was assessed for the fiscal years 1984-85, 1985-86 and 1986-87. No differences were detected between the groups in 1986-87 for the following practice variables: number of patients (1888 and 1842 respectively), number of personal services billed for (7265 and 7173), number of personal services per patient (3.9), amount of funding for personal services ($140,192 and $140,100) and amount per patient for personal services ($77 and $79). Age-adjusted costs for male and female patients were similar in the two groups. Of six services thought to be influenced by type of training, only maternity care generated a significantly higher number of billings in the study group (341 v. 249). These results suggest that there is no demonstrable effect of training on patterns of practice. However, the question of the effect of training on quality of care and whether the 2-year residency may have a longer effect on practice patterns should be the focus of future research.     

Population Structure and Stock Identification of Eulachon (Thaleichthys pacificus), an Anadromous Smelt, in the Pacific Northwest

The genetic structure of eulachon (Thaleichthys pacificus) populations was examined in an analysis of variation of 14 microsatellite loci representing approximately 1900 fish from 9 sites between the Columbia River and Cook Inlet, Alaska. Significant genetic differentiation occurred among the putative populations. The mean F_ST for all loci was 0.0046, and there was a significant correlation between population genetic differentiation (F_ST) and geographic distance. Simulated mixed-stock samples comprising populations from different regions suggested that variation at microsatellite loci provided reasonably accurate estimates of stock composition for potential fishery samples. Marine sampling indicated that immature eulachons from different rivers, during the 2 to 3 years of prespawning life in offshore marine waters, do not mix thoroughly. For eulachons captured incidentally in offshore trawl fisheries, there was a clear geographic cline in relative abundance of eulachons from different geographic areas. The sample from northern British Columbia was dominated by northern and central coastal populations of British Columbia, the sample from central British Columbia was composed of eulachons from all regions, and the sample from southern British Columbia was dominated by Columbia River and Fraser River populations. These results have implications for the management of trawl fisheries and conservation of spawning populations in some rivers where abundance is at historically low levels.     

Indicators for demonstrating sustainable forest management in British Columbia,Canada: An international review

Many organizations and individuals are developing sustainable forestry criteria and indicator (C&I) research and monitoring initiatives at various scales. In support of Canada's international commitments, the Canadian Council of Forest Ministers (CCFM) recently (2003) revised a set of national C&I, broadly based on the Montreal Process. Meanwhile, the Province of British Columbia, Canada, has implemented new, results-based, legislation, the Forest and Range Practices Act 2003, which sets objectives for 11 public ‘Values’ that require appropriate C&I for effectiveness evaluation. At the local-level, British Columbia's forest industry requires indicators to achieve third-party certification. Each of these parties seeks to assess and report on performance. There is, therefore, a recognized desire to define a collaborative approach to C&I research and monitoring frameworks in British Columbia. This paper discusses the results of a rigorous review of indicators related to sustainable forest management (SFM) in British Columbia. Based on the 6 CCFM indicators, 47 SFM questions were developed to guide the selection of potential indicators for British Columbia. A hierarchical framework of proposed SFM indicators was then proposed to provide trend information on resource condition at both the macro (landscape) and local (management unit) levels of forest management. However, a number of key challenges remain for British Columbia as it continues towards a scientifically sound, useful, and effective indicator framework that will demonstrate progress towards SFM at the provincial level. These include stakeholder consultation, practicality, data interpretation and long-term commitment.     

The 8th International Conference of the Canadian Proteomics Initiative

The 8th International Conference of the Canadian Proteomics Initiative (CPI) was held at the Hilton Vancouver Metrotown Hotel in Burnaby, British Columbia from 3–5 May, 2008. With nearly 200 delegates, 32 speakers and more than 50 poster presentations, CPI 2008 covered a wide range of topics, including novel technologies, human and clinical proteomics, structural proteomics, bioinformatics, post-translational modifications, membrane and receptor proteomics, and plant and animal proteomics. This year’s conference was also highlighted by hands-on proteomics workshops at the University of Victoria Genome BC Proteomics Centre and the University of British Columbia, an inaugural meeting of the British Columbia Proteomics Network and focus meetings exploring opportunities for the formation of a nationwide association for Canadian proteomics and Genome British Columbia’s efforts towards large-scale global genomics and proteomics projects.     

Redefining the Ethnographic Object: An Anthropology Museum Turns Fifty

Exhibit A: Objects of Intrigue. Museum of Anthropology, University of British Columbia, Vancouver, March 9, 1999–March 31, 2000.
Objects and Expressions: Celebrating the Collections of the Museum of Anthropology at the University of British Columbia. Vancouver: Museum of Anthropology, University of British Columbia, 1999.