Physical activity prescription by Canadian Emergency Medicine Physicians.

An increase in physical activity has been shown to improve outcomes in many diseases. An estimated 600 000 Canadians receive their primary health care from emergency departments (ED). This study aims to examine physical activity prescription by emergency medicine physicians (EPs) to determine factors that influence decisions to prescribe physical activity. A survey was distributed to EPs via email using the Canadian Association of Emergency Physicians (CAEP) survey distribution protocol. Responses from 20% (n = 332) of emergency physician/residents in Canada were analyzed. Of the EPs, 62.7% often/always counsel patients about preventative medicine (smoking, diet, and alcohol). Only 12.7% (42) often/always prescribe physical activity. The CCFP-trained physicians (College of Family Physicians Canada) were significantly more likely to feel comfortable than CCFP-EM-trained physicians (Family Physicians with Enhanced Skills in Emergency Medicine) prescribing physical activity (p = 0.0001). Both were significantly more likely than the FRCPC-trained EPs (Fellows of the Royal College of Physicians of Canada). Of the EPs, 73.4% (244) believe the ED environment does not allow adequate time for physical activity prescription. Family medicine-trained EPs are more likely to prescribe physical activity; the training they receive may better educate them compared with FRCPC-trained emergency medicine. Further education is required to standardize an approach to ED physical activity prescription.

Medical school outreach and mentorship for rural secondary school students: a pilot of the Southwestern Ontario Medical Mentorship Program.

INTRODUCTION: Rural communities in Canada face challenges with physician recruitment. Physicians from rural backgrounds are more likely to practise in rural areas; however, rural students are underrepresented in medical schools. To address this, the Southwestern Ontario Medical Mentorship Program (SWOMMP) was created to expose rural secondary school students to medical careers. METHODS: This pilot project involved a school-based interactive session run by rural medical students on paths to medicine, medical specialties and skills workshops of roughly 2.5 hours targeted to grades 10-12 university-level students in rural southwestern Ontario. Two sessions were held, 1 in a town with a population of 20 000 and the other in a town with a population of 5000. A survey was administered before and after the session to assess changes in interest in medical careers and in perceived barriers. RESULTS: Forty-five students participated in the sessions. After the sessions, 32 students (71%) were considering a career in health care, compared to 26 (58%) before the sessions. Almost all students (43 [96%]) found the session helpful or extremely helpful, and all reported they would recommend it to other classes. Finances, grades and length of schooling were the most commonly perceived barriers to pursuing a career in medicine; fewer students had concerns about finances and length of schooling after the sessions. Twenty-nine students (64%) enrolled in longitudinal mentorship with a medical student. CONCLUSION: This pilot project showed that a rural secondary school outreach program run by medical students can increase high school students' interest in medical careers. The project will continue and aims to expand and improve using the pilot study's data.

INTRODUCTION: Les régions rurales au Canada ont de la difficulté à recruter des médecins et les médecins qui viennent eux-mêmes de milieux ruraux sont plus susceptibles d'exercer en région rurale. Cependant, les étudiants de régions rurales sont sous-représentés au sein des écoles de médecine. Pour aborder ce problème, le programme SWOMMP (Southwestern Ontario Medical Mentorship Program) a été créé afin de présenter des carrières en médecine aux élèves du secondaire de régions rurales. METHODS: Le projet pilote comprenait une séance interactive en milieu scolaire d'une durée d'environ 2.5 heures tenue par des étudiants en médecine de milieux ruraux. Les séances portaient sur le cheminement de carrière d'un médecin généraliste ou d'un médecin spécialiste et des ateliers sur les compétences ciblant les élèves de 10e, 11e et 12e année de régions rurales du sud-ouest de l'Ontario qui envisagent poursuivre des études universitaires. Deux séances ont été organisées, l'une dans une ville de 20 000 habitants et l'autre dans une localité de 5000 habitants. Un sondage a été mené avant et après la séance pour déterminer les changements d'intérêt pour une carrière de médecin et des obstacles perçus. RESULTS: Quarante-cinq élèves ont participé aux séances. À la suite de celles-ci, 32 élèves (71 %) envisageaient une carrière en soins de santé, comparativement à 26 (58 %) avant les séances. Presque tous les élèves (43 [96 %]) étaient d'avis que la séance leur avait été utile ou extrêmement utile et tous les élèves ont signalé qu'ils la recommanderaient aux élèves d'autres classes. Les ressources financières, les résultats scolaires et la durée des études étaient les obstacles perçus les plus courants à la poursuite d'une carrière de médecin. Moins d'élèves se préoccupaient des ressources financières et de la durée des études à la fin des séances. Vingt-neuf élèves (64 %) se sont inscrits à un mentorat longitudinal auprès d'un étudiant en médecine. CONCLUSION: Le projet pilote a permis de démontrer qu'un programme d'approche des écoles secondaires rurales, dirigé par des étudiants en médecine, peut accroître l'intérêt des élèves du secondaire pour une carrière en médecine. Le projet se poursuivra dans un but d'expansion et d'amélioration à l'aide des données de l'étude pilote.

Reversible Deafness and Blindness in a Patient with Cryptococcal Meningitis in Tanzania.

Cryptococcal meningitis is a common and devastating complication of advanced HIV, and is most prevalent in low resource settings in sub Saharan Africa. Raised intracranial pressure is one of the hallmarks of the disease, which can lead to visual and hearing loss and ultimately death. We present the case of a patient with visual and hearing impairment secondary to Cryptococcal meningitis successfully managed by serial cerebrospinal fluid drainage. This case highlights some of the challenges of managing this severe opportunistic infection in a low resource setting.