University acknowledges special risks,introduces drug program for anesthetists.

Anesthetists are at special risk for becoming addicted to some of the drugs they work with. The problem was highlighted by the recent death of a physician in Comox, BC, and a doctor''s brush with death at a hospital near Ottawa. The University of Ottawa has responded with a program, the professional Assistance Program for the Impaired or Disabled Physician, that is in the final stages of approval. Although it will be aimed initially at anesthetists and anesthesia residents in the university''s teaching hospitals, there are hopes the program will spread eventually to other medical departments.     

The private sector invades medicare's home town

If Canada''s medicare system has a home town it is probably Ottawa, where the system was first welded together 30 years ago. Charlotte Gray reports that there is a certain irony now that examples of private health care are sprouting up in the nations''s capital.     

Jane Fulton: Cat among the pigeons?

Few bureaucratic appointments have raised as many eyebrows as the announcement that controversial health economist Jane Fulton would become Alberta''s deputy minister of health. A staunch supporter of private health care, Fulton joins the Alberta ministry just as Premier Ralph Klein''s Progressive Conservatives gear up for a battle with Ottawa over two-tier medicine.     

Will hospital closures mean physician unemployment in Ontario?

Dr. Duncan Sinclair, the former dean of medicine who heads the commission charged with restructuring Ontario''s health care system, said something dramatic was needed to revamp the system. He wasn''t kidding. His commission recently called for the closure of 3 hospitals in Ottawa and 10 more in Toronto. In a wideranging interview with Charlotte Gray he talks about the commission''s goals and their potential impact on physicians.     

Prevention should be the preferred insurance program for all physicians.

Recent fee increases announced to the Canadian Medical Protective Association (CMPA) and the Ontario government''s plan to stop its CMPA rebate program for the province''s physicians have put the spotlight on medical liability insurance. In this examination of the role played by the CMPA, Ottawa lawyer Karen Capen notes that quality service and attention to physician-patient communication will in most cases ensure a litigation-free professional life.     

Humane handling of end-of-life issues the aim of program at U of O medical schools.

The University of Ottawa medical school has launched a program to help students deal with end-of-life issues. One of its speakers is a cancer patient upset with a physician''s handling of his case. Organizers hope to gauge the impact of the program through a study of its effectiveness.     

Furious passion confronts the cool logic behind a CEO's hospital appointment

First, Ontario decided it would close or reduce the operations of 3 Ottawa hospitals and combine 2 others. When the board for the combined hospital named a Parti Québécois confidant the new hospital''s CEO, it hoped David Levine''s background would go unnoticed. As Charlotte Gray reports, it didn''t, and Levine became the lightning rod for a lot of anger.     

CMA conference to look at role research plays when critical policy decisions are being made

Physician leaders will meet in Ottawa Feb. 28 and Mar. 1 for the CMA''s 9th Annual Leadership Conference to examine how evidence, research and data influence health policy. For information or to register contact CMA Meetings and Travel Department, 800 663-7336, ext. 2274; fax 613 731-8047.     

The National Forum on Health is talking,but is anybody listening?

The federal government''s National Forum on Health is organizing a series of discussion groups across the country to focus on problems facing Canada''s health care system. Although a great deal of time and money is being spent on this and other forum projects, Charlotte Gray asks whether anyone is listening. She says many provincial governments are treating the forum with “elaborate disdain” and the only governments that appear willing to give it a chance to work are found in have-not provinces that rely on Ottawa for handouts in the form of transfer payments.     

Ottawa researchers enter home stretch in race to produce artificial heart

An Ottawa team is in a fierce race to produce an artificial heart. If it wins, the prize will be huge: a worldwide market worth billions of dollars. The team, led by Dr. Tofy Mussivand, brings together scientists and entrepreneurs. The goal is to produce a heart that improves patients'' quality of life and doesn''t leave them tethered to a machine in hospital. Current plans are to complete clinical tests by 2000 and to have a commercial product ready for market in 2001-2. Several other groups are also racing the clock.     

Tailoring family medicine residency programs to meet community needs

This paper describes how members of the Department of Family Medicine of the University of Ottawa developed lists of problems and procedures common and important in family practice in Canada and, on the basis of these lists, drew up guidelines for content in the 2-year residency program for family medicine. A computerized data retrieval system is used to monitor every resident''s practice to ensure that he or she gains appropriate exposure to common problems and procedures.     

A multi-century eastern white pine tree-ring chronology developed from salvaged river logs and its utility for dating heritage structures in Canada's National Capital Region

The early settlement history of Canada's National Capital Region, including Ottawa (Ontario) and Gatineau (Québec), was shaped in large part by the towering eastern white pine (Pinus strobus) forests that once covered the Ottawa Valley and fuelled a lucrative lumber export industry spanning the 19th and much of the 20th century. Some of the first dwellings and farmsteads of this era are still standing and serve as reminders of this history. A crucial piece of information in the assessment of a structure's heritage value is its date of construction. Unfortunately, this information is not always known and is approximated based on construction styles and other sources of information. In this study, dendroarchaeology methods are applied to constrain the construction dates of six historic structures in the National Capital Region of 19th century vintage. A multi-century (AD 1670–2009) eastern white pine ring-width chronology was developed for dating the study structures using cross sections from sunken logs recovered from the Ottawa River and cores from live trees from the Petawawa Research Forest. The tree-ring inferred construction dates for the six structures ranged from 1830 to 1878. For most structures, historical records about the property or first inhabitants were available to corroborate the results. The ring-width chronologies of the individual structures were well correlated with the regional chronology (r_avg = 0.63, p ≤ 0.01), and this regional coherence clearly demonstrates the value of tree-rings for heritage structure assessments and reconstructing the settlement history of this region.     

Primary malignant lymphoma cutis.

Between 1934 and 1975, 16 patients with primary malignant lymphoma cutis were seen at the Ottawa clinic of the Ontario Cancer Foundation. The lesions were purplish, firm, dermal or hypodermal (or both) nodules, tumours and plaques. In all 16 the histopathologic diagnosis was diffuse non-Hodgkin''s lymphoma; 12 were considered to have prognostically bad lymphomas. However, the prognosis of primary malignant lymphoma cutis is significantly more favourable than is implied by the stage IV designation that such localized extranodal involvement would have required under the Rye clinical staging classification.     

An artificial heart with the right connection.

Led by Dr. Tofy Mussivand at the University of Ottawa Heart Institute, a team of Canadian medical scientists, engineers, economists, physicians and medical devices manufacturers is working to bring a prototype artificial heart closer to clinical trials. Key to this effort is the development of an electrical connector that can function for a long period in the harsh environment of the human body. Such a connector will enable various components of the artificial heart, such as the internal battery, to be replaced independently. As well as being of obvious benefit to people with end-stage heart disease, a Canadian-made artificial heart has export potential that should help to redress the country''s large trade deficit in medical devices.     

Medical fund took off like a rocket,but will budget bring it down to earth?

In 18 months the Canadian Medical Discoveries Fund (CMDF) has attracted investments worth $180 million to spend on biotechnology and medical research. Although eight initial investments totalled only $9.7 million, Dr. Cal Stiller, chair and CEO of the fund''s management corporation, says there are many good Canadian-based technology firms and research projects that merit investment. Examples include a London, Ont., firm that is bringing a 3-D ultrasound-imaging system to market, and world-class genetics research at the University of Ottawa. However, the federal government recently changed tax rules for venture-capital funds, making them less attractive to investors. How will this affect the effort to build a health-research industry in Canada?     

Use of NDVI dataset for a GIS based analysis: A sample study of TAR Creek superfund site

Tar Creek is an Environmental Protection Agency (EPA) designated superfund site in Ottawa County, Oklahoma that is heavily polluted with acid mine drainage (AMD) and pollutant deposits in the form of mine tailings (chat piles). Among several residual heavy metal contaminants, zinc and lead are most prevalent in these chat piles. Approximately 50 million cubic yards or 75 million tons of chat remained in Ottawa County as a result of excessive mining in early 1900's to 1960's. This chat is in addition to the pollution that is leached from open mine shafts that drain contaminants into the groundwater, some of which flows directly into streams and creeks. This paper discusses a methodology for incorporating satellite data (MODIS NDVI) within a GIS framework to perform time series analysis in areas near Tar Creek. GIS functions in Map Algebra and Zonal Statistics were implemented to study changes in spectral reflectance due to vegetation at two locations. One of the locations is a sample plot where remedial action consisted of cleaning up of the chat pile and growing native grass. The second location is along Tar Creek and Elm Creek. The paper describes one of the methods that can be used to combine remotely sensed imagery data and spatial feature data within the GIS framework. The main advantages of combining the two datasets using the described process is that, powerful geoprocessing functions within GIS can be easily applied to remote sensing data and the analysis of vector and raster data can be performed in unison.     

1st International Symposium on Ecosystem Health and Medicine: New Goals for Environmental Management

Symposium Announcement and Call for Presentations

1st International Symposium on Ecosystem Health and Medicine: New Goals for Environmental ManagementJune 19–22, 1994 · Ottawa Congress Centre Ottawa, Ontario, Canada     

Production and turnover ratio of Pisidium casertanum (Pelecypoda: Sphaeriidae) in the Ottawa River near Ottawa-Hull,Canada

Production of the sphaeriid clam Pisidium casertanum (Poli) was measured at several locations in the Ottawa River. Maximum production occurred in locations where sediment grain size was 3–4 phi units (0.250–0.0625 mm diameter, fine sand to very fine sand) and current velocity was near 0.1 m/sec. The turnover ratio of P. casertanum in the Ottawa River is a constant 3.8.     

Cervical cancer screening: are the 1989 recommendations still valid? National Workshop on Screening for Cancer of the Cervix.

Although screening for cervical cancer has been shown to be effective in reducing the morbidity and mortality associated with this disease, and despite many attempts to encourage the development of provincial programs, as of 1995 no province had a comprehensive screening program for cervical cancer. Participants at the Interchange ''95 workshop, held in Ottawa in November 1995, reviewed the recommendations of the 1989 National Workshop on Screening for Cancer of the Cervix and identified factors that have impeded their implementation. Participants discussed the need for comprehensive information systems, quality control and strategies to increase recruitment of unscreened and underscreened women. They concluded that the formation of a Cervical Cancer Prevention Network involving key stakeholders will facilitate the development and implementation of provincial programs to ensure optimal screening. They agreed that, in the interim, recommendations for practising physicians should remain as they were following the 1989 workshop.     

Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review

ObjectiveTo summarise the evidence on accuracy of the Ottawa ankle rules, a decision aid for excluding fractures of the ankle and mid-foot.DesignSystematic review.Results32 studies met the inclusion criteria and 27 studies reporting on 15 581 patients were used for meta-analysis. The pooled negative likelihood ratios for the ankle and mid-foot were 0.08 (95% confidence interval 0.03 to 0.18) and 0.08 (0.03 to 0.20), respectively. The pooled negative likelihood ratio for both regions in children was 0.07 (0.03 to 0.18). Applying these ratios to a 15% prevalence of fracture gave a less than 1.4% probability of actual fracture in these subgroups.ConclusionEvidence supports the Ottawa ankle rules as an accurate instrument for excluding fractures of the ankle and mid-foot. The instrument has a sensitivity of almost 100% and a modest specificity, and its use should reduce the number of unnecessary radiographs by 30-40%.

What is already known on this topic

Although most patients with ankle sprains who present to emergency departments undergo radiography, less than 15% have a fractureThe Ottawa ankle rules is a clinical decision aid designed to avoid unnecessary radiography

What this paper adds

The Ottawa ankle rules is highly accurate at excluding ankle fractures after sprain injury