Planned home births are safe for women who are at low risk of complications, are cared for by a qualified midwife and can be transferred quickly to hospital if problems arise. This has been confirmed by a British Columbia study that compared the outcomes from planned home births with a midwife in attendance with planned hospital births attended by either a midwife or a physician. The research led by researchers from the University of British Columbia evaluated the 2889 home births that took place in the province between 2000 and 2004 and the 10,000 planned hospital births that took place over the same period. They found the perinatal death rate was very low in both groups. Home births also had a complication rate that was comparable or lower than those that took place in hospital. Helen McLachlan (PhD) and Della Forster (PhD) from Mother and Child Research at La Trobe University, Melbourne, Australia, commented on the study and said the findings match those from other studies conducted to date. However, they said it is important to note that the study involved women who chose to give birth at home and so were self-selected to be at low risk for having problems.

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Development of a city-wide program in Calgary to rapidly treat heart attack patients and a collaborative project involving the University of Manitoba and the University of Nairobi, that was one of the first to identify the association between male circumcision and the risk of HIV infection, are two of the top eight Canadian projects selected as having had a substantive impact on health and health care. The projects were identified in a collaborative venture between the Canadian Institutes of Health Research (CIHR) and CMAJ to acknowledge the best in Canadian health research. CIHR is the major federal funding agency for health research in Canada. Among the other projects selected was research by Dr. Fred Possmayer from the University of Western Ontario, conducted in the 1970s showing how an extract from cow lungs can help save lives in newborns with acute respiratory distress and work by Geoffrey Fong, the founder of the International Tobacco Control Policy Evaluation Project at the University of Waterloo, that evaluates the impact of policy to help control tobacco use.

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Giving a one-month intensive education program about asthma to children with asthma and their parents can significantly reduce the number of visits they make to the emergency department in the following year. That finding comes from a study conducted at the Children’s Hospital of Winnipeg. Almost 400 children with asthma who had visited emergency were randomly divided to receive either the usual care from their family physician or participate in the intensive education program. The program was delivered by a nurse educator and a respiratory therapist and took place in small group sessions lasting approximately 90 minutes a week. In the following year, the researchers found the likelihood of a child in the education group requiring emergency care was reduced by 38% although there was no difference between the two groups in hospital admissions. Dr. Christopher Cates, an asthma expert from St. George’s University of London, UK, said the study findings suggest families of children with asthma who visit the emergency department could benefit from the offer of supportive, group-oriented education.

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If you are 50 years old or older and suffer a hip fracture you have a one-in-four chance of dying within a year of the fracture and you also have three times the risk of dying compared with people of similar age who have not had a fracture. The negative impact of having a hip or vertebral fracture persists even when other factors such as general health are taken into account. These concerning findings come from a study of 7753 randomly selected people who participated in the Canadian Multicentre Osteoporosis Study conducted over a five-year period. Participants reported any fractures that occurred and all deaths in the group were recorded. While hip and vertebral factures were associated with a markedly increased risk of death, the same was not true of fractures of the wrist, forearm or ribs. No difference was seen between men and women. Maureen Ashe (PhD) and Dr. Karim Khan, from the Centre for Hip Health and Mobility in Vancouver, commented on the study. They said more must be done to prevent fractures in the elderly and this can be achieved by preventing falls and also by using the best preventive medical treatments, such as oral bisphosphonates, calcium and vitamin D, as well as balance and strength training.

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