Family physicians can play an important role in providing lifestyle advice that aims to prevent or delay chronic disease. Given the vast amount of evidence that regular physical activity improves health and wellbeing, providing brief tailored advice in a clinic setting has the potential to make a positive impact on population health. Working side by side with physicians, the Health Promotion Board has developed the Physical Activity Advice Tool (PAAT) to enable physicians to quickly and accurately provide evidence-based tailored physical activity advice.

Biofilms are the source of vascular catheter infections and arefound uniformly on central venous catheters after 3 days.Only about half of these biofilms are culture positive.Of those that are culture positive the timing of initial colonization varies by catheter site:subcutaneous segment (average:5.1 days),tip segment (8.6d),and lumen (13.1d).The more organisms that come to reside on a catheter,the greater the likelihood that the catheter will have associated purulence or bloodstream infection.The risk of catheter-related bloodstream infection ranges considerably from≤2/1 000 patient days (peripheral venous catheters,peripherally inserted central catheters (PICC)),cuffed central venous catheters,ports,10/1 000 patient days (arterial and Wwan-Ganz catheters)to 30-50/1 000 patient days (multilumen,hemodialysis).Intrinsic factors that affect the risk of vascular catheter infection include host factors,type of organism,catheter material,and the manufacturing process.Humans are quite susceptible to Saureus,rabbits are not.S.epidermidis requires a polysaccharide adhesin to produce catheter infections.Silicone catheters have a greater risk of infection than polyurethane,polyvinylchloride,or teflon,and this increased risk is related to excess complement activation.Extrinsic factors that can affect the risk of infection include the use of maximal sterile barriers,chlorhexidine skin preparation,insertion by inadequately trained personnel,the number of line breaks,hyperalimentation fluid (favors yeasts),5% dextrose (favors gram-negative organisms),and lipid emulsions (favors Malassezia).

Health services managers are responsible for management and financing of health care in a variety of delivery models. This article provides information about the profession of health services management. It includes a brief historical overview of the profession, describes the various job roles that health service managers can assume, and outlines the educational curriculum to prepare and qualify for a career as health services manager. Educational preparation is available at the baccalaureate, masters, and doctoral levels. Finally, the article discusses future prospects for employment in the profession.

No abstract available.
Aviation* ; Emergencies* ; Medical Assistance*

Delivery of Health Care ; ethics ; Ethics, Medical ; Ethics, Research ; Humans ; Physicians ; ethics

Adolescent* ; Humans ; Insulin Resistance* ; Insulin* ; Polycystic Ovary Syndrome*

Glioblastoma multiforme (GBM) is the most aggressive form of primary brain tumours known collectively as gliomas. Gliomas are graded by their microscopic appearance. As a rule, their behaviour can be predicted from histology: Grade I (pilocytic astrocytomas) and Grade II (benign astrocytomas) tumours are of low grade and grow slowly over many years. Grade IV tumours (GBM) are the most aggressive and, unfortunately, also the most common in humans, growing rapidly, invading and altering brain function. These tumours arise from the supporting glial cells of the brain during childhood and in adulthood. These growths do not spread throughout the body like other forms of cancer, but cause symptoms by invading the brain. Untreated GBMs are rapidly lethal. Most patients with GBM die of their disease in less than a year and none have long term survival. Extracranial metastases from GBM are extremely rare, with a reported frequency of only 0.44% because of the absence of lymphatics in the brain and the difficulty of tumours to penetrate blood vessels. A case of glioblastoma multiforme with the rare features of extensive liver and bone metastases is presented in this paper.