Cal Robinson is a PGY2 Pediatrics resident at McMaster University interested in how social determinants of health impact Canadian children.
On November 22nd, 2018, Ontario’s Progressive Conservative government unveiled their planned reforms of provincial social assistance programs, including changing the definition of disability for the Ontario Disability Support Program (ODSP). These announcements have been met with criticism from political and advocacy groups who argue that these represent further cuts to social assistance. Further policy announcements last year included a reduction of the planned 3% increase in social assistance to 1.5% and cancellation of the Ontario Basic Income Pilot, one of the largest minimum income studies ever developed. The Ontario Basic Income Pilot had already enrolled 4,000 low-income individuals across the province. These intended cuts to Ontario’s social assistance programs will have a substantial negative impact on the health of Ontarians, and will particularly threaten the physical, psychological and social wellbeing of Canadian children and their families. ...continue reading →
Denis Daneman is Professor and Chair Emeritus in the Department of Paediatrics at the University of Toronto, and Paediatrician-in-Chief Emeritus at the Hospital for Sick Children in Toronto
Here’s a strong recommendation for all paediatricians and paediatricians-in-training: if you are going to read only one book in 2018, seriously consider Ghost Boy: The miraculous escape of a misdiagnosed boy trapped inside his own body, the autobiography of Martin Pistorius, co-written with Megan Lloyd Davies. The book was given to me by a colleague aware of my bibliophilia, my South African roots and my advocacy for child health: “Read this!” she said, simply and forcefully. I obeyed, picking it up a couple of days later. I could not put it down until I’d read it cover to cover.
The story is pretty simple: a 12 year old, previously well boy in South Africa, develops an undiagnosed neurological illness, which leaves him mute and quadriplegic ...continue reading →
Interview with Dr. Brett Thombs, professor in the Faculty of Medicine at McGill University and senior investigator of the Lady Davis Institute, Jewish General Hospital in Montreal. He is also chair-elect of the Canadian Task Force on Preventive Health Care and chair of the tobacco guideline working group.
In their clinical guideline published in the CMAJ (open access), Dr. Thombs and the Task Force reviewed the evidence supporting behavioural interventions for prevention and treatment of smoking in children and youth. He explains their findings in this podcast.
Interview with Dr. Ian Kitai, tuberculosis specialist with the Hospital for Sick Children and associate professor in the Department of Pediatrics at the University of Toronto School of Medicine. Dr. Kitai co-authored a review article (subscription required) on the diagnosis and management of tuberculosis in children. Tuberculosis is generally uncommon in children and adolescents in Canada, but among some populations we still find high rates of the disease. A high index of suspicion is required to ensure timely diagnosis.
Diagnostic delay of central nervous system tumours in children has serious implications for the children and their families. Dr. Ran Goldman, Pediatrician at BC Children's Hospital, Professor of Pediatrics at the University of British Columbia and Chief Medical Officer for the website medschoolforparents.com, discusses how practitioners can maintain a high index of suspicion for these rare tumours, yet not overinvestigate benign conditions.
Dr. Goldman co-authored a review article (subscription required) on pediatric central nervous system tumours published in CMAJ.
Dr Rod Bergh is a general pediatrician who has practiced medicine since the early 1960s.
I have practiced Pediatrics for most of the 59 years since I graduated from Medical School and I have seen tremendous changes in our knowledge. For the past 16 years, I have restricted my practice to children with ADHD and have experienced the great satisfaction of seeing in this period about 3000 children turn their lives around.
Change is based on knowledge gained by research. However, I would like to point out an area where I believe we have ignored evidence, which has resulted in some less-than-optimal therapy for ADHD. ...continue reading →
Laura Stymiest is a paediatrics resident at Dalhousie University. She previously trained at the Coady International Institute and has researched in the area of Social Paediatrics. She writes with...
Elizabeth Lee-Ford Jones, an expert adviser with EvidenceNetwork.ca, and Prof of Paediatrics at SickKids in Toronto.
I remember being a second year medical student working in a paediatric clinic.
I see a young girl who has been referred for inability to pay attention in the classroom. The child’s teacher is concerned she has attention deficit hyperactivity disorder (ADHD), and possibly, a learning disability.
I am just beginning to establish my approach to patient problems and complex medical illness.
As I make my way through the medical history, the child’s parents tell me they are struggling to make ends meet. Despite their best efforts combined with collections from a nearby food bank, the little girl often goes to school hungry. ...continue reading →
Interview with Dr. Jocelyn Gravel, pediatric emergency physician and research director at Sainte-Justine hospital in Montreal. In a research article published in CMAJ, Dr. Gravel and colleagues derived and validated a clinical decision rule to identify skull fracture following minor head trauma in young children. The rule should make it possible to identify about 90% of skull fractures in young children with mild head trauma and reduce the use of radiologic investigations by about 60% compared with current practice.
Interview with Dr. Matthew Johnson, Associate Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. Renewed interest in the use of psychedelic drugs as treatments for illnesses such as anxiety, addiction and post-traumatic stress disorder has led to small controlled studies. In association with psychotherapy some psychedelic drugs have shown good effects with adequate safety. In an analysis article published in CMAJ, Dr. Johnson and colleagues look at new emerging evidence.
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