The purpose of this study was to analyse the consistency and extent of palliative content across high-level guiding documents related to the care of persons residing in Canadian long-term care homes. A systematic search was conducted examining documents at the national level and across five provinces (Alberta, Ontario, Saskatchewan, Manitoba, and Quebec). Twenty-five documents were selected based on inclusion criteria from 273 documents identified in the systematic search. The majority of these documents were created nationally (48%) or in Ontario (28%). Documents varied in palliative topics discussed, and long-term care was discussed minimally. A minimal number of palliative care guiding documents were found. Long-term care specific documents were absent, and all documents lacked consistency on palliative topics. It is imperative that palliative principles are present and consistent in high-level documents in order to improve the quality of life and care for long-term care residents across Canada.

Tetanus is a life-threatening clinical syndrome that commonly presents with muscular spasms, rigidity, and autonomic instability. It is considered rare in industrialized countries, and tetanus occurring secondary to dental abscesses, procedures, or infections has been infrequently reported. We describe the case of a patient inadequately immunized for tetanus, who presented to the emergency department with muscular spasms, rigidity, and autonomic instability in the setting of an odontogenic infection. A clinical diagnosis of tetanus was made and subsequently managed successfully.

Despite a dramatic decline in transfusion-associated AIDS, increased safety of the national blood supply, and voluntary efforts to find alternatives to homologous blood sources, Americans remain fearful about the possibility of acquiring AIDS through a blood transfusion. Numerous states have initiated legislative efforts that would require explicit warnings about blood safety and that would direct patients to alternative sources of blood. These proposed laws—known as MANTRA bills, for “mandatory notification of transfusion alternatives”—would require physicians to advise patients of blood transfusion options prior to any surgery. Many would mandate the development of new informed consent documents and involve health departments in the implementation of new regulations regarding transfusions. This article concludes that MANTRA legislation is primarily a symbolic attempt to reassure the public about AIDS. It mandates practices that are being adopted voluntarily; it will not make the blood supply safer; it will increase the cost of health care to individuals and in the aggregate; it may diminish the number of donors to the voluntary blood supply system; and it is likely to intensify public fear about the risk of a blood transfusion.

A growing body of literature has explored the influence of physical activity on brain structure and function. While the mechanisms of this relationship remain largely speculative, recent research suggests that one of the effects of physical exercise is an increase in synaptic long-term potentiation (LTP). This has not yet been explored directly in humans due to the difficulty of measuring LTP non-invasively. However, we have previously established that LTP-like changes in visual-evoked potentials (VEPs) can be measured in humans. Here, we investigated whether physical fitness status affects the degree of visual sensory LTP. Using a self-report measure of physical activity, participants were split into two groups: a high-activity group, and a low-activity group. LTP was measured and compared between the two groups using the previously established electroencephalography-LTP paradigm, which assesses the degree to which the N1b component of the VEP elicited by a sine grating is potentiated (enhanced) following a rapid “tetanic” presentation of that grating. Both groups demonstrated increased negativity in the amplitude of the N1b component of the VEP immediately after presentation of the visual “tetanus,” indicating potentiation. However, after a 30-min rest period, the N1b for the high-activity group remained potentiated while the N1b for the low-activity group returned to baseline. This study presents the first evidence for the impact of self-reported levels of physical activity on LTP in humans, and sheds light on potential neurological mechanisms underlying the relationship between physical fitness and cognition. (JINS, 2015, 21, 831–840)

Over the last few years there has been considerable progress in linking the published scholarly literature with on-line data. This will greatly help with data discovery and aid the efforts to the VO.

Quick Response Programs (QRP) have been instituted to contain hospital costs by reducing unnecessary hospital admissions through the prompt co-ordination of Home Care Services. No formal economic evaluation of the impact of this redirection of services has been conducted. This paper describes a randomized controlled trial designed to compare the costs and effects between comparable emergency department patients (ED) serviced by the QRP versus the usual department services. Patients were assessed at baseline and 10 days following discharge from the ED specifically for their health status, caregiver burden, satisfaction with health care services and expenditures. QRP was an acceptable alternative to ED services for a small percentage of patients and was not more expensive in total care costs although there was a shift in expenditures from hospital to Home Care services. Due to the small sample size the power to detect the clinically important differences in health status was 60 per cent.