skip to main content
Menu
Back to Top
May 1, 2016 | Editorial 

From the Editors 2016

Lazar Milovanovic

Preface

New and emerging clinicians and scientists have a daunting task ahead of them: treading in the footsteps of pioneers carving a new path for future discovery. The McMaster University Medical Journal (MUMJ) was established in 2003 as a means to gather and share innovative ideas, perspectives and promote discussions within the field of health and wellness. Our issue this year presents a diverse series of original research, educational program implementations and commentaries.​

Downloadables

May 1, 2016 | Original Research 

Obstacle Course Racing: An analysis of Eastern Canada Spartan Race Injury Rates

Jillian L. Coleby, BSc, MD Candidate (McMaster University, Class of 2016), Émilie I. Thibeault-Rivard, MPT, BHSc.

ABSTRACT:

Objective: Obstacle course racing (OCR) has stormed the athletic community over the past five years. Little has been published about injury rates at OCR and thus the actual risk associated with participation in OCR is unknown. The publication of the injury rates from the 2014 Eastern Canada Spartan Race (ECSR) series will form a baseline for future research that will enable North American OCR medical planners to ensure adequate preparation for anticipated injuries.

Methods: 165 patient encounters from 12 summer events during the 2014 ECSR series were analyzed.

Results: A total of 40 123 participants raced the ECSR series. 0.4% of athletes required medical attention. 4.2% of assessed injuries required transport to area hospital by ambulance. The majority of injuries assessed could be treated onsite (83.0%, n=137). Musculoskeletal injuries (59.4%, n=98), exertional injuries, (18.8%, n=31), and lacerations/burns (12.1%, n=20) were the most prevalent conditions assessed.

Conclusion: Based on data from 12 events, there appears to be a predictable pattern of injury at ECSR events. More information is required to further establish this pattern and determine if this is similar at other North American OCR events. Trauma and exertional injuries were the most common. Until more findings are published, we suggest that event medical planners expect a casualty rate of 0.5-2% of competitors, and an ambulance transfer rate of approximately 4% of patients.

Downloadables

May 1, 2016 | Original Research 

Towards GIM 2.0

Hugh Fuller, Chandak Upagupta, Lori MacBeth

ABSTRACT:

Healthcare is dynamic, a field that is continuously trying to provide the best care for all. General Internal Medicine (GIM) is a major component of healthcare, particularly in the hospital setting and is an area suffering from an increase in numbers of patients and an increase in the complexity of illness and disease in those patients. We report the implementation of a Disruptive Innovation (DI) initiative at St. Joseph’s Healthcare Hamilton within the GIM Program with the aim of improving the processes of care sufficiently that the new Program could be referred to as “GIM 2.0”. Data was collected from participants in two groups, one with clinical experience and one with LEAN Process improvement experience. Participants identified issues in GIM and proposed solutions based on their professional expertise and experiences. There were similarities between the identified issues from both groups, particularly in workload and communication. Through the remodeling of existing healthcare elements, a number of innovations were described. On review of the definition of DI, however, these innovations were not bold enough to fit the description of DI but rather were examples of sustaining innovation, with changes that were not substantial enough to justify the term “GIM 2.0”. These sustaining innovations were contrasted with truly disruptive innovations that were made in response to a major flood at the hospital, improvements that were in every way worthy of the term “GIM 2.0”.

Downloadables

May 1, 2016 | Clinical Review 

Recognizing aneurysmal subarachnoid hemorrhage and understanding management

Victor Lam Shin Cheung, Alim P. Mitha MD, SM, FRCSC

ABSTRACT:

Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency resulting from the accumulation of blood in the subarachnoid space. The incidence of aSAH is approximately 9 per 100 000 person-years and trauma represents the most common cause of SAH followed by cerebral aneurysm rupture. A sudden and severe headache is the cardinal feature of aSAH. Investigations include non-contrast computed tomography (CT) of the head followed by a lumbar puncture in patients with a negative CT scan but a high index of suspicion. Unfortunately, recent evidence suggests that the frequency of non-traumatic SAH misdiagnosis may be between 12% to 50% in the primary care setting and data has shown that patients who are misdiagnosed are at an increased risk of complications and poor outcomes. Management is intensive and involves multiple considerations for the complications associated with aSAH. Treatment of an aneurysm rupture includes endovascular coiling or neurosurgical clipping. Despite available treatment options the case-fatality rate is approximately 50%. This review will summarize the epidemiology, diagnosis and management of aneurysmal subarachnoid hemorrhages in order to help clinicians recognize the presentation of aSAH in a primary care setting and understand its management.

Downloadables

May 1, 2016 | Commentary 

Cultural Competency in Epidemic Responses: A Missing Lesson from the Ebola Outbreak

Sarah L Silverberg B.Arts.Sc., Dan Poenaru MD

In late December, 2013, in a remote village in southern Guinea, a boy contracted a mysterious virus identified months later as Ebola. As it spread through family and community members to other regions, outbreaks developed throughout Guinea as well as in neighbouring Liberia and Sierra Leone, resulting in over 28,000 cases and over 11,000 deaths to date1. The epidemic highlighted many challenges on a global scale, from delayed response to inadequate local health systems. In the aftermath of the Ebola outbreak in West Africa, many reports have come out as to what lessons the international
community can learn from the delayed, and originally inadequate, global response to the outbreak. Many are focusing on care coming too little and too late, the WHO’s apparent lack of leadership, the importance of strengthening existing health systems, increasing
surveillance protocols, and speeding up the international response to emerging pathogens.

Downloadables

May 1, 2016 | Commentary 

Adopting Service-learning as part of the undergraduate medical curriculum: A review of benefits and challenges

Humaira Saeed, Christian Kraeker, MD, FRCPC

It is widely known that the Royal College of Physicians and Surgeons of Canada identifies health advocacy as a core competency in the CanMEDS framework. According to CanMEDS, health advocacy entails contributing “expertise and influence to improve health by working with the patients, communities, or populations they serve to determine and understand needs, develop partnerships, speak on behalf of others when needed, and support the mobilization of resources to effect change.”1 In essence, health advocacy encompasses ‘health equity’ and ‘determinants of health’ perspectives rather than biomedical ones.

Downloadables

May 1, 2016 | Commentary 

HIV prevention may require merging educational strategies with vaccines

Daniel Moldaver, BSc

ABSTRACT:

Human immunodeficiency virus (HIV) infects an estimated 35 million people, worldwide, causing unimaginable damage to quality of life and drastically reducing life expectancy for the infected in developing areas of the world. Globally, but especially in underdeveloped countries, anti-retroviral therapy can be cost-prohibitive, thereby making the discovery of a prophylactic HIV vaccine extremely desirable. To date, three phase III clinical trials of prophylactic HIV vaccines have been attempted, and only one has shown modest efficacy (RV144). Efficacy was only detectable in low-risk individuals, which raises the concern that prophylactic vaccination may be unable to cope with the high viral titers encountered by high-risk individuals. This fear has been corroborated by subsequent analyses of the RV144 trial, that demonstrated that a single high-risk behaviour after vaccine treatment can markedly reduce vaccine efficacy. Clinical studies over the past two decades have demonstrated that social and behavioural interventions effectively reduce HIV transmission and high-risk behaviour that can lead to HIV transmission, thereby comprising the only currently efficacious strategy capable of combating HIV transmission. Regrettably, HIV remains a problem world-wide and evidence is beginning to accumulate suggesting that persistent reductions in HIV infection rates will only be observed once extensive, continual social interventions are established. Here, current and future strategies for prevention of HIV infection are discussed and the importance of melding social strategies with vaccine prophylaxis is highlighted.

Downloadables

May 1, 2016 | In Memoriam 

A Tribute to Dr. John Evans – Founder of the McMaster School of Medicine

Elizabeth Simms

In this issue of the McMaster University Medical Journal we remember and pay tribute to Dr. John Evans, founder of the McMaster School of Medicine. Dr. Evans passed away at the age of 85 on February 13, 2015, after a long struggle with Parkinson’s disease.

Dr. John Evans received the Rhodes Scholarship, completed his medical degree at the University of Toronto, and specialized in internal medicine and cardiology at Oxford before...

Downloadables

May 1, 2016 | In Memoriam 

A tribute to Dr. David Sackett – A Giant of Evidence-Based Medicine

Lazar Milovanovic, BASc

On May 13, 2015, Dr. David Sackett – physician, founder of the McMaster department of clinical epidemiology and biostatistics, and pioneer of evidence-based medicine passed away at the age of 80. Although he had retired from clinical teaching and undergraduate
medical education for several years, his presence and impact continues to be felt throughout the medical school curriculum, the work of faculty and staff and the research being conducted.

Downloadables

May 1, 2016 | Presentation Medical Education 

MMSRD 2016 Recap and Winners

Isabel Kim, Roman Reznikov

McMaster Medical Student Research Day (MMSRD) was first founded in 2010 to highlight the importance of research in bridging the bench-to-bedside gap. By providing a platform for interdisciplinary dialogue, critical appraisal and networking, MMSRD became an avenue to promote educational values that extended beyond the classroom, encouraging participants and attendees to harness both the scientific method and creative thinking to solve medical issues in all domains of health care.

MMSRD has now grown in scope and capacity, building upon previous years of experience. This year’s event showcased over 80 abstract presentations in all avenues of research including the basic sciences, clinical research, medical education, population health, and health policy. This year, the MMSRD committee recognized McMaster students’ penchant for quality improvement research and introduced a separate award category for these projects given the distinct nature of this work and accessibility to medical students. 

Moving forward, MMSRD will hopefully continue to grow and provide important cross-talk opportunities for medical students and the broader community.

Downloadables

© 2015 McMaster University  |  1280 Main Street West  |  Hamilton, Ontario L8S4L8  |  905-525-9140  |  Contact Us  | Terms of Use & Privacy Policy

More than one Google Analytics scripts are registered. Please verify your pages and templates.