Alan Abelsohn

Marital cohesion and ambulatory blood pressure in early hypertension

One hundred thirty-four men and seventy-one women, unmedicated mild hypertensives, underwent 24-h ambulatory blood pressure (BP) monitoring (ABP) and completed standardized questionnaires measuring marital and job stress. Of these, 44.8% had daytime diastolic BP < 90 mm Hg; 96.1% had left ventricular mass index in the normal range (N = 176). Lower marital cohesion (Cohesion, subscale of the Dyadic Adjustment Scale) was related to elevated nighttime ABP (P < or = .05) and 24-h diastolic BP (P < .05). With low Cohesion (N = 83), more reported spousal contact was associated with elevated nighttime ABP (P < .031). The 7.3% of subjects with very low Cohesion demonstrated approximately 6 mm Hg elevation of all ABP variables, controlling for other significant variables (P < .05, except for nighttime SBP). This study shows an association between marital cohesion and ABP and suggests that marital factors may have a role in sustaining BP in early hypertension.

Design, delivery and evaluation of an email-based Continuing Professional Development course on outdoor air pollution and health

The authors designed an email-based discussion forum with the objective of promoting and supporting peer discussion on the health effects of outdoor air pollution, linked to a recently published review article. Clinical cases served as stimulus material and participants were provided with an online toolbox of resources. Message postings from 27 participants were most frequent (92) during the first of four weeks and lowest (17) during the second, suggesting that some participants were overwhelmed by the initial volume. Evaluation of short-term impact completed by 16 participants indicated that the course was successful in improving some participants’ knowledge. Evaluation three months after course completion by 20 participants revealed an impact on clinical practice. As an alternative to email, requiring participants to visit a web page to view and submit postings may avoid problems related to volume of messages. Controlled delivery of small portions of information tied to specific self-directed tasks is also recommended.

Beyond Alcohol and Tobacco Smoke: Are We Doing Enough to Reduce Fetal Toxicant Exposure?

Eric Crighton, Alan Abelsohn, Jennifer Blake, Joanne Enders, Katrina Kilroy, Bruce Lanphear, Lynn Marshall, Erica Phipps, Graeme Smith Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, ON Department of Family and Community Medicine, University of Toronto, Toronto, ON Dali Lana School of Public Health, University of Toronto, Toronto, ON Society for Obstetricians and Gynecologist of Canada, Ottawa, ON Reproductive Health Workgroup, Ontario Public Health Association, Waterloo, ON Reproductive Health & Healthy Family Dynamics Program, Healthy Living Division, Region of Waterloo Public Health, Waterloo, ON Canadian Association of Midwives, Toronto, ON Child & Family Research Institute, BC Children’s Hospital, Vancouver, BC Clinical Sciences Division, Northern Ontario School of Medicine, Sudbury, ON Canadian Partnership for Children’s Health and Environment, Toronto, ON Obstetrics & Gynecology, Kingston General Hospital, Queens University, Kingston, ON

Heat-induced illness

The European heat wave of 2003 resulted in more than 70 000 deaths, 28.9% of which were attributed to heatstroke, hyperthermia or dehydration.[1][1] Extreme heat recently contributed to 106 deaths in Montreal, Quebec, and 156 deaths in Vancouver, British Columbia.[2][2] Extreme heat events are

General Practitioners’ responses to global climate change - lessons from clinical experience and the clinical method

BackgroundClimate change is a global public health problem that will require complex thinking if meaningful and effective solutions are to be achieved. In this conceptual paper we argue that GPs have much to bring to the issue of climate change from their wide-ranging clinical experience and from the principles underpinning their clinical methods. This experience and thinking calls forth particular contributions GPs can and should make to debate and action.DiscussionWe contend that the privileged experience and GP way of thinking can make valuable contributions when applied to climate change solutions. These include a lifetime of experience, reflection and epistemological application to first doing no harm, managing uncertainty, the ability to make necessary decisions while possessing incomplete information, an appreciation of complex adaptive systems, maintenance of homeostasis, vigilance for unintended consequences, and an appreciation of the importance of transdisciplinarity and interprofessionalism.SummaryGeneral practitioners have a long history of public health advocacy and in the case of climate change may bring a way of approaching complex human problems that could be applied to the dilemmas of climate change.