Briefly

Pay gap widens: The differential wage gap between newly trained male and female doctors is widening rather than narrowing in the United States, according to a new study. The average starting salary for a female doctor was US$174 000 in 2008, as compared with US$209 300 for men. The differential rose to an average US$16 819 or 17%, as compared with an average $3600, or 12.5% in 1999, states the study (Health Affairs 2011;30:2193–201). But the differential is not necessarily discriminatory, or a bad thing, the study adds. Women are more likely to enter primary care fields such as family practice, pediatrics or internal medicine, than specialties. Many also opt to work fewer hours so as to lead a more balanced life. — Wayne Kondro, CMAJ

CMAJ oversight: Dr. Jean Gray has assumed the helm of CMAJ’s Journal Oversight Committee. Gray, professor emeritus of medical education, medicine and pharmacology at Dalhousie University in Halifax, Nova Scotia, has agreed to a two-year term at the helm of the committee. She replaces Dr. Peter Tugwell, professor of medicine at the University of Ottawa in Ontario, who was appointed chair in 2006 after the committee was restructured as an independent body to protect the CMAJ editor-in-chief from interference and unfair dismissal by journal owner, the Canadian Medical Association, as well as resolve disputes between the journal and its owner (www.cmaj.ca/cgi/doi/10.1503/cmaj.060917). Gray’s lengthy credentials include stints as the associate dean of postgraduate medical education and the associated dean of continuing medical education at Dalhousie. She is also a fellow of the Order of Canada. — Wayne Kondro, CMAJ

Allergen labels: In a bid to protect people with food allergies or celiac disease, the Canadian government has unveiled new food-labelling regulations that will require manufacturers to make clear which foods contain “hidden” allergens, gluten sources and added sulphites. Such substances will also have to be identified on the labels in commonly used words such as “milk” and “wheat” (www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2011/2011_23bk-eng.php). In the future, it will also be mandatory that some ingredients used in prepackaged food products (i.e. components of margarine or flour) appear on the list of ingredients (www.hc-sc.gc.ca/fn-an/label-etiquet/allergen/index-eng.php). “These changes to food labels will make it easier for parents of children with food allergies to identify potentially harmful, if not fatal, ingredients in foods,” Minister of Health Leona Aglukkaq said in the press release. Health Canada estimates that 5%–6% of young children, and 3%–4% of adults, suffer from food allergies, while nearly 1% of the population is affected by celiac disease. The department hopes the changes will better inform consumers, reduce the number of food recalls, and standardize labelling requirements for manufacturers, (www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2011/2011_23bk-eng.php). Food processors have until Aug. 4, 2012 to comply with the regulations. — Jennie Russell, Ottawa, Ont.

Pandemic responses: It’s preferable to have wholesale closure of schools during a pandemic than to keep some of them open and overrun the intensive care units of hospitals, according to a British study (http://rspb.royalsocietypublishing.org/content/early/2011/01/25/rspb.2010.2688.full?sid=6eeebdec-020d-4968-aad2-0a47522ff2fb). But the advice comes with two caveats: “The first is that a large number of schools must close in a coordinated way if there is to be a substantial impact on the peak epidemic size. It is probably that individual schools may need to close owing to the impact of the epidemic on staff availability, however, these closures are unlikely to be sufficiently coordinated to offer protection to the surrounding population. Second, such closures must be carefully timed to start just before the expected epidemic peak, prediction of this optimal timing requires well-parametrized mathematical models that can account for the true number of cases and the pre-existing levels of susceptibility within the population.” — Wayne Kondro, CMAJ

Circumpolar health: Arctic health ministers have approved an Arctic Health Declaration to bolster collaboration “in health promotion, disease surveillance and culturally appropriate health care delivery,” while also promoting “increased participation in health research by indigenous peoples and other Arctic residents.” The declaration was signed by seven Arctic states — Canada, Denmark, Iceland, Norway, Russia, Sweden, and the United States — along with the governments of the Faroe Islands and Greenland (http://arctic-council.org/filearchive/The_Arctic_Health_Declaration_16_February_2011.pdf). It also commits the governments to “enhance mental health and prevention of substance abuse and suicides through exchange of experience” and extended use of ehealth applications such as telemedicine. — Wayne Kondro, CMAJ

Data mining: Searching for health information has become the third most popular online activity among United States Internet users, according to a new study by the Pew Research Center and the California HealthCare Foundation (http://www.pewinternet.org/~/media//Files/Reports/2011/PIP_HealthTopics.pdf). Nearly 80% of American Internet users look for health information online. The extent to which specific health information is sought varies substantially, with information on a specific disease or medical problem leading the way (66%). That was followed by information on: specific medical treatment or procedure (56%); specific doctors and other health professionals (44%); specific hospitals or medical facilities (36%); health insurance (33%); environmental health hazards (22%); food safety or recalls (29%); drug safety or recalls (24%); pregnancy and childbirth (19%); memory loss and dementia (17%); medical test results (16%); chronic pain (14%); long-term care for the elderly or disabled (12%); and end-of-life decisions (7%). — Wayne Kondro, CMAJ

Unprofessional conduct: The vast majority of sexual misconduct complaints made against physicians in Saskatchewan are made against international medical graduates, according to a study conducted for the College of Physicians and Surgeons of Saskatchewan. Between 2006 and 2010, 38 of 41 sexual misconduct complaints that were filed with the college and formally investigated were against doctors who had completed their education outside Canada, as were 46 of 47 investigated between 1985–2005 (study available upon request from cpss{at}quadrant.net). Slightly more than half of Saskatchewan’s doctors are foreign trained, the report says, noting that international medical graduates are “significantly over represented” in the number of sexual misconduct complaints. It also notes that “there isn’t an indication of a statistically significant correlation between number of years of practice and complaints of sexual misconduct.” — Jennie Russell, Ottawa, Ont.

Intervenor status: An international coalition of harm reduction experts will appear before the Supreme Court of Canada to support Insite, a supervised injection site in Vancouver, British Columbia, against the Canadian government’s appeal to shut the site down. In a landmark 2010 decision, the British Columbia Court of Appeal ruled that Insite fell within provincial jurisdiction and as such did not violate federal health or drug laws — a decision the federal government has appealed. The coalition is composed of experts from the International Harm Reduction Association, the Canadian HIV/AIDS Legal Network and CACTUS Montreal, a Quebec-based nonprofit organization that aids the homeless, sex workers and people who use illicit drugs. “Insite abides by international law, by our own Canadian Charter of Rights and Freedoms, and by the law of the province of British Columbia,” said Richard Elliott, executive director of Canadian HIV/AIDS Legal Network, in a news release (http://aidslaw.ca/publications/interfaces/downloadFile.php?ref=1818). “Insite is also an international success story. Yet the government continues to ignore not only scientific evidence, but legal precedent as well.” — Lauren Vogel, CMAJ

Controlling salvia: The Canadian government plans to label Salvia divinorum, a mint plant that induces hallucinations when smoked, as a controlled substance. Health Canada has published an outline of its proposal to add the plant, commonly known as salvia, as well as its active ingredient, salvinorin A, to the Controlled Drugs and Substances Act. This would make it illegal to possess, sell, import, export or produce the plant. Several countries, including Australia and Belgium, have already banned Salvia divinorum. There is no scientific evidence, however, to suggest it has any long-term, negative health effects. Some researchers worry that bans will thwart research into salvinorin A, the most potent naturally occurring hallucinogen, that could lead to better treatments for mental illness (www.cmaj.ca/cgi/doi/10.1503/cmaj.109-3080). — Roger Collier, CMAJ