Although emergency departments (EDs) inCanada’s rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged.



Approximately 20% of the Canadian population lives in rural or remote areas.1 Providing sustainable access to emergency care in these areas is challenging.2 In the context of limited resources and increased costs, there have been increased efforts to regionalise and centralise healthcare services in rural Canada.3–6 This has resulted in local service cuts and hospital closings.5 6 Therefore, the current level of services offered in rural hospitals in Canada is unclear.



Emergency departments are important safety nets for people who live in rural areas.Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health
and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency de...


We have previously reported that 35% CO2 challenge induced myocardial ischemia in 81% of coronary artery disease (CAD) patients with comorbid panic disorder (PD) and previous positive nuclear exercise stress tests. However, it is yet unclear whether this is the case among CAD patients with PD and normal nuclear exercise stress test results. We hypothesized that a potent mental stressor such as a panic challenge among CAD
patients with PD would also induce ischemia in patients with normal exercise stress tests.



Efforts at cost containment through regionalization have led to reduced services in several
rural emergency departments (EDs) in Canada. As a result, questions have been raised about patient safety and equitable access to care, compelling physicians to advocate for their patients. Few published reports on physicians’ advocacy experiences pertaining to rural EDs exist. We describe our experience of patient advocacy after major service cuts at Kootenay Lake Hospital in Nelson, BC. Despite mixed results, we suggest increased physician involvement in patient advocacy.



Little is known about factors influencing the professionals' use of wiki's. We developed and validated two questionnaires to asses health care professionals' intention to use wiki-based

reminders for the management of trauma patients.



Panic-like anxiety ( panic attacks with or without panic disorder), a highly treatable condition, is the most prevalent condition associated with unexplained chest pain in the emergency department. Panic-like anxiety may be responsible for a significant portion of the negative consequences of unexplained chest pain, such as functional limitations and chronicity. However, more than 92% of panic-like anxiety cases remain undiagnosed at the time of
discharge from the emergency department. The 4-item Panic Screening Score (PSS) questionnaire was derived in order to increase the identification of paniclike anxiety in emergency...


In describing family medicine research, Dr Wendy Norman, Chair of the 2013 Family Medicine Forum (FMF) Research Committee, invited us to substitute the word research with innovation or creativity. Dr Norman suggested that, whereas research might cause  one’s eyes to glaze over or one to quickly turn his or her attention to another topic, innovation and creativity conjure up a vision of something new, interesting, and even, perhaps, exciting.



This study evaluates the impacts of seasonal and lunar cycles on anxiety and mood disorders, panic and suicidal ideation in patients consulting the emergency department (ED) with a complaint of unexplained chest pain (UCP).



The objective of this paper is to present Cirque du Soleil’s social circus program, Cirque du Monde, to explore its potential as a primary health care tool for family physicians.


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