Biomedical subjects
Publications and source records attributed to J Strachan.
Infants are in negative iodine balance on current standard regimens of total parenteral nutrition, with a mean iodine intake of 3 micro g/kg/day (150 ml/kg/day). The recommended enteral intake of iodine for preterm infants is 30 micro g/kg/day. Gastrointestinal absorption of iodine is high, suggesting that parenteral intakes should approach enteral recommendations.
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OBJECTIVE: The aim of this study is to examine the frequency and severity of hyponatraemia in a psychogeriatric inpatient population taking selective serotonin re-uptake inhibitors (SSRIs). METHOD: Casenotes for 1 year were reviewed and 53 patients with 55 admissions were identified. Eighteen were treated with fluoxetine and 37 with paroxetine. Five (28%) of the patients on fluoxetine and eight (22%) on paroxetine were, or became, hyponatraemic. RESULTS: The SSRI was discontinued in two symptomatic patients. Serum sodium returned to normal in nine patients maintained on the SSRI. Two patients maintained on an SSRI remained hyponatraemic but asymptomatic. CONCLUSIONS: Hyponatraemia may be a relatively common early asymptomatic side effect of SSRIs, especially in older women. Serum sodium should be measured before commencing an SSRI and monitored during the first month. Any patient who exhibits symptoms of hyponatraemia, or whose depression apparently worsens, while on an SSRI must have their serum sodium measured. Discontinuation of the SSRI may be avoidable if serum sodium levels can be closely monitored.
OBJECTIVE: To determine whether location of postgraduate medical training and other factors are associated with the emigration of physicians from Canada to the United States. DESIGN: Case-control study, physicians were surveyed with the use of a questionnaire mailed in May 1994 (with a reminder sent in September 1994), responses to which were accepted until Dec. 31, 1994. PARTICIPANTS: Physicians randomly selected from the CMA database, 4000 with addresses in Canada and 4000 with current addresses in the United States and previous addresses in Canada. OUTCOME MEASURES: Sex, age, location of undergraduate and postgraduate medical training, qualifications, practice location, opinions concerning residence decisions, current satisfaction and plans. RESULTS: The overall response rate was 49.6% (50.0% among physicians in the United States and 49.2% among those in Canada). Age and sex distributions were similar among the 8000 questionnaire recipients and the nearly 4000 respondents. Physicians living in the United States were more likely to be older (mean 53.2 v. 49.6 years of age), male (87% v. 75%) and specialists (79% v. 52%) than those practising in Canada. Postgraduate training in the United States was associated with subsequent emigration (odds ratio 9.2, 95% confidence interval 7.8 to 10.7). However, in rating the importance of nine factors in the decision to emigrate or remain in Canada, there was no significant difference between the two groups in the rating assigned to location of postgraduate training. Professional factors rated most important by most physicians in both groups were professional/clinical autonomy, availability of medical facilities and job availability. Remuneration was considered an equally important factor by those in Canada and in the United States. Six of seven personal/family factors were rated as more important to their choice of practice location by respondents in Canada than by those in the United States. Current satisfaction was significantly higher among respondents in the United States. Most physicians in each group planned to continue practising at their current location. Of Canadian respondents, 22% indicated that they were more likely to move to the United States than they were a year beforehand, whereas 4% of US respondents indicated that they were more likely to return to Canada. CONCLUSIONS: Factors affecting the decision to move to the United States or remain in Canada can be categorized as "push" factors (e.g., government involvement) and "pull" factors (e.g., better geographic climate in the US). Factors can also be categorized by whether they are amenable to change (e.g., availability of medical facilities) or cannot be managed (e.g., proximity of relatives). An understanding of the reasons why physicians immigrate to the United States or remain in Canada is essential to planning physician resources nationally.
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Rapid population growth has put family planning on personal and political agendas in the Solomon Islands. With the release of a population policy in 1988, national leaders sanctioned the concept of family planning as a key strategy in reducing the rate of population growth. On a personal level, Solomon Islanders share their government's concern about population problems. There is a shortage of arable land, health services are stretched, and there are limited places in school for children. A study in Choiseul Province, a rural area in Solomon Islands, suggests that people want smaller families but have limited means to control their fertility. Meagre resources and infrastructure, compounded by geography, climate, culture and religion, constrain the development of family planning services.
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This paper mainly describes levels and trends of marriages and rates and its relationship with demographic and social conditions in Canada from 1921 to 1990. In Canada, the propensity to marry was much higher in the 1960s and early 1970s than in the 1980s. A similar tendency was observed for a few years prior to, and at the beginning of, World War II and a couple of years after. The number of marriages peaked at an all time high of 200,470 in 1972 with a rate of 44.3 per 1,000 unmarried population aged 15-59. By 1986 the number of marriages had declined by 12.4% and the rate by 33.2%, but both the number of marriages and the rate increased marginally in the following three years. Since 1921 the average age at marriage has increased by 3.6 years for brides and 1.7 years for grooms. The proportion of marriages by previously divorced persons increased sharply after 1968. The changes in marriage rates in Canada parallel those exhibited in the United States and other developed countries in the western hemisphere.
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