Pertussis vaccine: Can we do better?
In 1997/98, all provinces and territories in Canada changed from using a whole-cell pertussis vaccine to an acellular vaccine. Vickers and colleagues took the opportunity to see if the change had a positive effect on the incidence of pertussis among infants and young children in Saskatoon. Their analysis revealed unexpected results and prompted them to suggest the need for an improved acellular pertussis vaccine or perhaps a mixed schedule of whole-cell and acellular vaccines, as used in Europe. In a related commentary, Halperin and De Serres offer alternative explanations for the findings and argue that the reintroduction of whole-cell pertussis vaccine has no merit.
Prevention of droplet transmission of infections in households
The Canadian outbreak of severe acute respiratory syndrome (SARS) in 2003 provided a rare opportunity to study the transmission of an infectious disease in households at a time when little was known about the illness. In a retrospective cohort study, Wilson-Clark and colleagues studied SARS-affected households to determine risk factors for household transmission. Their results indicate measures that can be taken to minimize the spread of serious infections through droplet transmission.
See page 1219
Female urinary incontinence: A correct diagnosis is key
Up to two-thirds of all women experience female urinary incontinence in the form of stress, urge or mixed incontinence. Currently available treatment options can be expected to give satisfactory relief in most cases. However, the key to successful treatment is a correct diagnosis — not always easy. In this review, Smith and coauthors give primary care practitioners an overview of the current understanding of the pathophysiology, evaluation and treatment of female urinary incontinence.
See page 1233
Liability risk of members of research ethics boards
In this commentary, Hutt discusses liability risks for members of research ethics boards (REBs) at public institutes in Canada. Arguments that might be marshalled against indemnification for board members are reviewed, and members are encouraged to engage with their institutes about this issue. Hutt notes that the trend in the United States toward suing individual REB members is likely to spill into Canada, where protective insurance and legislation are currently inadequate.
See page 1229
Analysis • Practice
Research reported by pediatrician Clara Marie Davis in 1939 threw the child-feeding dogma of the time into full reverse. Strauss looks at this dramatic change from a modern perspective (page 1199).
Videofluorography provides a novel view of a diagnostic test in an adult experiencing dysphagia with a sudden onset (page 1203).
Persistent pulmonary opacity in a chronic smoker — don't jump to conclusions. In Clinical Vistas, family history and a chest CT scan provide an unexpected answer (page 1206).
Poulin takes a look at problem gambling from a public health perspective and gives a list of measures that provincial governments could use for harm reduction strategies (page 1208).