Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

The declaration of Alma Ata, over forty years ago, was a key milestone in the development of general practice. Generations of physicians may remember how it defined their career. Dr Shannon Barkley, World Health Organisation Technical Officer for Primary Health Care Services and Family medicine, described the changes that have occurred since then, leading to the 2018 Declaration of Astana. Looking back, we can see why the Declaration of Alma Ata was so important and how the principles outlined are still as fresh and relevant as they then were. There has been progress although different countries move at different speeds. “Health for all by the year 2000” wasn’t achieved but the Millennium Development Goals” were quite successful and the focus has been, more recently, on universal health coverage. I asked Shannon to tell us a little more about the Declaration ...continue reading

Beatrice Preti is an R2 in internal medicine at the Queen's University.

 

 

 

 

It was a childhood dream, one that I loved well,

A fairy-tale story I’d heard someone tell

I replayed it at nights, as I lay in my bed

While visions of stethoscopes danced ins my head ...continue reading

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Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. He recently attended the Society for Academic Primary Care annual conference in Exeter, England.

 

Resources for primary care in the United Kingdom are under increasing pressure, as Dr. Jennifer Dixon, Chief Executive of the Health Foundation, outlined in her keynote address to the  Society for Academic Primary Care meeting in Exeter last week. A healthy growth in spending from about 1990 until 2008 was followed by a rather dismal change in the funding landscape: the proportion of overall health spending allocated to primary care gradually declined and has now been flat for the last 6 years at roughly 9%. Overall, however, spending on health as a percentage of GDP is about average within the EU and despite austerity policies, spending on health has been relatively well preserved compared to education, for example. When it comes to public satisfaction with primary care, the main problem mirrors what we see in Canada - access. ...continue reading

Anser Daud is a medical student at the University of Toronto. He enjoys writing about health advocacy and human rights issues.

 

“We’re dealing with a situation that’s not far from here, this is serious,” said Toronto Raptors sportscaster Matt Devlin as he interrupted the proceedings of the championship ceremony at Toronto’s Nathan Phillips Square on June 17. Those present—perhaps 2 million people by some estimates—began to wonder if their worst fears were beginning to materialize. Videos on social media show ...continue reading

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor. Follow his writing instagram: @_kenkan.

 

 

plastic plants in the dentist clinic
that you haven’t visited since you were a child
wearing a yellow smile and proud stain of mustard on your shirt
that has followed every laundromat you’ve ever been to ...continue reading

Caitlin Dunne is a Co-Director at the Pacific Centre for Reproductive Medicine (PCRM) in Vancouver and a Clinical Assistant Professor at the University of British Columbia.

 

A new study published in the Journal of the American Medical Association (JAMA) Pediatrics has linked fertility treatment with a risk of childhood cancer. The researchers linked data on babies from an American fertility database with birth and cancer registry data from 14 states. Their study spanned an eight-year time period, including 275 686 children conceived by in vitro fertilization (IVF) and 2 266 847 children who were conceived naturally. The focus was on young children, up to four and a half years old. ...continue reading

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Imagine yourself as a family physician seeing a 68-year-old woman with type 2 diabetes, chronic obstructive pulmonary disease, hypertension, and chronic knee pain. While these medical concerns are well-managed, things for your patient are tough socially. She has become increasingly isolated since her husband passed. Her apartment is in an older building with good heating but no air-conditioning and near to no sidewalks, green spaces, or public transit routes in the area. She often requires friends or a cab to drive her around.

How can you assess and mitigate the acute and chronic environment-related health risks faced by this woman, and other patients like her? ...continue reading

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Geraldine Huynh is a medical student in the Class of 2020 at the University of Alberta.

 

After “catching the flu” and falling down in his own home, Marion Chomik distinctly remembers in October 1960 the embarrassment of his dad carrying him as a 13-year-old boy into the car to a local hospital in Viking, AB, where he would awake the next day to the shocking realization that he could no longer move his arms or legs.

Marion Chomik was one of the patients I interviewed. ...continue reading

Nigel Rawson is President at Eastlake Research Group

 

The 2019 federal budget announced that the federal government will take initial steps towards implementing national pharmacare to improve the affordability and accessibility of prescription drugs across Canada. The government's plan includes the development of "three foundational" elements - a national Canadian Drug Agency (CDA), a comprehensive national drug formulary, and a national strategy for high-cost rare-disorder medicines. ...continue reading

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Noni MacDonald is a Professor at Dalhousie University

Shawn Harmon is a Policy Analyst at Dalhousie University

 

A recent family arbitration case that saw the arbitrator side with a mother who did not wish to vaccinate her two children is concerning. Their father, who shares custody of the children, wanted the children to be vaccinated. Arbitrator Herschel Fogelman appears to have given insufficient weight to the compelling evidence presented by the father and too much weight to questionable evidence presented by the mother and an expert witness whose expertise has been called into question. ...continue reading