Highlights

Inguinal hernia in infants and young children

Longer wait times for the surgical repair of an inguinal hernia in infants and young children mean more emergency visits and a greater risk of incarcerated hernia. Zamakhshary and colleagues, who used linked data from administrative databases, found that waiting for surgery for more than 14 days doubled the risk of incarcerated hernia. See Research, page 1001

Children have been largely ignored in the debate on surgical wait times, says Blair. See Commentary, page 983

Chronic kidney disease among Aboriginal people

Aboriginal people with severe kidney disease were 43% less likely than non-Aboriginal people to visit a nephrologist. Aboriginal people were also almost twice as likely to be admitted to hospital for a condition that can be effectively managed with ambulatory care. See Research, page 1007

Peiris and colleagues say that we need to understand the underlying causes of the disparities in access to health care among Aboriginal people and make collaborative changes. Such change is often resisted by institutional, political, structural, social and cultural forces. See Commentary, page 985

Poor exchange of information in health care

Van Walraven and colleagues report that information from a previous visit with another physician was available at the current visit 22% of the time in a multicentre prospective cohort study involving patients discharged from hospital. See Research, page 1013

Traditional ways of transferring information among professionals are inadequate for health care to be continuous, say Reid and Wagner. See Commentary, page 987

Wrongful birth litigation

According to clinical practice guidelines issued in 2007, all pregnant women must be offered prenatal screening. Pioro and colleagues caution that successful litigation may increase if clinicians do not practise according to the new standard of care. See Analysis, page 1027

Postpartum thunderclap headache

A 31-year-old woman presented with a severe thunderclap headache and seizures 2 days after giving birth. See Practice, page 1033

Pneumopericardium

A 21-year-old man with a mediastinal tumour and respiratory distress developed a pneumopericardium. See Clinical images, page 1087

Public–private partnership hospitals

Debate over the merits of public–private partnership hospitals is highly polarized in Canada. The points of contention are cost, flexibility, transparency and the public interest. See News, page 991