Highlights of this issue

Pay-for-performance incentives

Do pay-for-performance incentives improve processes of care and patient outcomes? Millett and colleagues report on their study of the impact such incentives have on the documentation of smoking status and the delivery of smoking cessation advice to a population of patients with diabetes in the United Kingdom. They found that the pay-for-performance incentive increased the provision of smoking cessation advice and was associated with a reduction in smoking prevalence in the study population. In a related commentary, Bell and Levinson discuss the challenges of implementing pay-for-performance incentives in Canada.

See pages 1705 and 1717

Parental divorce and methylphenidate use in children

To determine whether parental divorce is a predictor of methylphenidate use among Canadian children, Strohschein analyzed data from the National Longitudinal Survey of Children and Youth. She included data for children who remained in the survey from 1994 to 2000 and whose parents were married in 1994. Methylphenidate use was significantly higher among the children whose parents subsequently divorced than among those whose parents remained married.

See page 1711

Encouraging medical students to do research

A senior clinician and a medical student team up to offer advice on helping students and trainees to participate successfully in research.

See page 1719

Embryo donation for stem cell research

In this commentary, Caulfield and colleagues consider 2 unresolved issues surrounding embryo donation for stem cell research: Who should obtain consent? and Does the donor have the right to withdraw consent?

See page 1722

Global health

The Jean Chrétien Pledge to Africa Act came into force in 2005, promising to bring cheaper drugs to poor, epidemic-ridden developing countries. Attaran lays harsh criticism on this law, noting that the only result so far has been “zero treatments for zero patients.” In another commentary on global health, Simms reviews the inadequate leadership role the World Bank played in responding to Africa's HIV/AIDS crisis.

See pages 1726 and 1728

Practice

“The great imitator” is making a comeback in Canada. A Teaching Case Report outlines the symptoms and diagnostic clues that led to the correct diagnosis of 2 cases of meningovascular syphilis (page 1699).

In Clinical Vistas, electromyography helps diagnose a rare but treatable source of pain, spasm and stiffness that persisted years after a whiplash neck injury (page 1702).