Author Archives: CMAJ

4 Comments

Martin Kaminski is a resident in internal medicine at Cambridge Health Alliance in Cambridge, Massachusetts and a clinical fellow in medicine at Harvard Medical School

Peter Kaminski is an advanced heart failure hospitalist and clinical instructor at UCSF Medical Center, San Francisco

 

Over the last decade, it has become widely accepted that chest compressions during Cardiopulmonary Resuscitation (CPR) should be done to the beat of the Bee Gees’ 1977 hit, “Stayin’ Alive”, to help save lives. The United Kingdom's Resuscitation Council advises that chest compressions during CPR should be between 100 to 120 beats per minute based on the consensus of the 2015 International Liaison Committee on Resuscitation. Meanwhile, “Stayin’ Alive” clocks in at 104 beats per minute. Case closed some would say. But the real question is, can we do better? The tools of medicine are constantly evolving. Furthermore, we question whether a song approaching its 41st year remains at the forefront of medical science. As both a senior millennial (MK, 35 years old) and a slightly less senior millennial (PK, 30 years old) we feel that “the times they are a changin’.” Therefore, we embarked on a serious, rigorous search for the best song to which to perform CPR.

You Ain’t Seen Nothing Yet  ...continue reading

Christopher Miller is an Investigator at the VA Boston Healthcare System Center for Healthcare Organization and Implementation Research (CHOIR), and an Assistant Professor of Psychology at the Harvard Medical School Department of Psychiatry

 

Abstract

Objectives:

(1) To empirically determine common grant-writing challenges; and (2) to compile the most common and frustrating challenges into a Christmas-themed song

Design:

Rapid qualitative analysis

Setting:

A health services research center in the northeastern United States

Participants:

Eight health services research staff with grant submission experience

Results:

Participants revealed common challenges in writing and submitting grants, including: the need for increased caffeine consumption; the rapid pace at which grant guidelines and requirements change; difficulties accommodating limited budgets; attempting to obtain responses from non-responsive co-investigators (Co-Is); developing and formatting seemingly endless appendices; fitting the grant text into page limits; formatting and finalizing letters of support; meeting obscure font size and line spacing requirements; formatting tables and figures; managing problems related to computer malfunctions or network disconnections; dealing with sleep deprivation; and responding to, or anticipating, reviews written by disgruntled grant reviewers.

Conclusions:

The resulting parody song, entitled The Twelve Days of Grants-mas, may provide some measure of comfort, good cheer, and humor to those research staff unfortunate enough to be writing or submitting grants during or near the holiday season.

...continue reading

2 Comments

Maggie Keresteci is a caregiver to her sibling who lives with a life altering disease and is committed to advocating for solutions that will improve the lives of Canadian patients and their caregivers.

 

 

"Coming together is a beginning;

keeping together is progress;

working together is success."

These words of Henry Ford, that bastion of business innovation, have been taking up space in my mind for the last few weeks, as I have contemplated the emerging world of patient and caregiver partnership in Canada. ...continue reading

2 Comments

Dan Small is a medical anthropologist and lecturer at the University of British Columbia.

 

Since 2018, British Columbia has been pursuing legal action against pharmaceutical companies for their involvement in the opioid crisis. Within the wider context of North America, there have been over 2600 such lawsuits against the pharmaceutical companies including Purdue, Johnston and Johnson, Teva Pharmaceutical and Endo International. The Purdue pharmaceutical company, the maker of OxyContin, has recently filed for bankruptcy in response to the lawsuits. I believe a suitable strategy for examining the wider variables that have contributed to the opioid crisis: a Royal Commission. This is needed in order to widen public scrutiny beyond the role of pharmaceutical companies to include investigation of the overarching causes of Canada’s overdose epidemic.

...continue reading

13 Comments

Maureen Topps is the Executive Director and CEO of the Medical Council of Canada.

 

Nothing matters more in my role than helping Canadian and international medical graduates succeed as they prepare to practice medicine in Canada. But what does success look like and how do we measure it?

...continue reading

1 Comment

Marika Warren is an Assistant Professor in the Department of Bioethics, Dalhousie University.

 

In early July The College of Physicians and Surgeons of British Columbia dismissed a complaint against Dr. Ellen Wiebe made by the Louis Brier Home and Hospital, an Orthodox Jewish long term care facility. Dr. Wiebe had provided medical assistance in dying (MAiD) to a patient who resided in Louis Brier who had requested it. She thereby contravened the Home's policy. Cases such as these are increasingly likely as the policies of institutions exercising conscientious objection conflict with both patients’ interests in accessing MAiD (and other services) and providers’ interests in practicing with integrity. One way to resolve such conflicts would be to recognize a claim to conscientious provision of health care services that parallels the claims of individuals and organizations to conscientious objection. ...continue reading

CMAJ’s Holiday Reading is back! CMAJ Blogs will host the popular Holiday Reading series online in December 2019.

We’re seeking witty, offbeat, whimsical stories grounded in medicine. Have ideas? Email blogs@cmaj.ca 

Need inspiration? Check out some popular stories from previous years:

Pathology in the Hundred Acre Wood

Limitations

Diving into the ice bucket challenge

1 Comment

Neil Chanchlani is a CMAJ Associate Editor and clinical research fellow at the University of Exeter, UK. He recently attended the 8th EBMLive conference in Oxford, England.

 

All healthcare practitioners are encouraged to make decisions that are based on strong evidence. But often we don’t – sometimes because the evidence is poor and conflicting, other times because we are ignorant and unaware and, rarely, because we aren’t comfortable with updating our practice. So we need to keep Evidence-Based Medicine (EBM) on the frontline and not on the (academic) shelves  - we need to remind clinicians, researchers, and patients that decisions should be based on the best possible data. ...continue reading

2 Comments

Eleftherios Diamandis is Professor and Head, Division of Clinical Biochemistry, Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto

 

In the 1970s, my mentor and Professor at the University of Athens, Greece, Dr. Themistokles Hadjiioannou, asked me periodically to go to the library and check his citation record. I remember grabbing from library shelves printed volumes of the “Science Citation Index”, which were as heavy as 5 kg each, going through the pages and then recording manually as to who cited his work. This task required many days of intellectual and physical work ...continue reading

16 Comments

Arundhati Dhara is an Assistant Professor at Dalhousie University in the Department of Family Medicine

Saroo Sharda is an Anesthesiologist in Oakville and an Assistant Clinical Professor at McMaster University

 

There are few data available on the racial make-up of Canadian female physicians. What data exist suggests that South Asian and East Asian groups are over-represented relative to their proportion of the general population and Black and Indigenous people remain underrepresented.

There is also evidence that non-white physicians experience discrimination from colleagues and patients ranging from daily microaggressions to more overt acts. While organizational anti-discrimination policies often exist, we are generally ill-prepared to deal with incidents when they occur and in their immediate aftermath. The clinicians experiencing bias are often left to act, and must weigh power dynamics against speaking up. The damaging effects of physician discrimination based on race or gender are clear, and yet we know little about the ways in which gender and race intersect to further marginalize women physicians of colour. ...continue reading