Cowal Community Hospital

PROBLEM BEING ADDRESSED: Colorectal cancer (CRC) is a substantial cause of death and morbidity in Canada. Endoscopy screening by colonoscopy has been recommended, but widespread implementation is impossible because it is difficult to obtain, especially in rural areas. OBJECTIVE OF PROGRAM: To screen for CRC safely and effectively using colonoscopy performed by non-specialist endoscopists in rural areas. PROGRAM DESCRIPTION: Health providers and community organizations were informed about the screening program. Patients between the ages of 50 and 75 and those at high risk of CRC based on family history were screened. Measures of safety and effectiveness were monitored. In 2 years of screening, one of 152 patients was found to have CRC, and 23.7% had adenomatous polyps. There were no complications. Rates of CRC and adenoma detection and cecal intubation were similar to rates found in other screening studies. CONCLUSION: It was not difficult to design and implement a CRC screening program in our small rural community. Colonoscopies performed by family physicians have been effective, and there have been no serious complications.

Open hostilities in the Korean War ended on the 27th of July 1953. The armistice that was signed at that time remains the poignant symbol of an incomplete conclusion – of a war that retains a distinct possibility of resuming at short notice. So what did Australia contribute to the Korean War from June 1950 to July 1953? What were the Australians doing there? How significant

BACKGROUND: Screening for colon cancer by colonoscopy is increasingly recommended in the medical literature. There are few, if any, reports in the medical literature regarding the provision of colonoscopy services in small rural hospitals by non-specialist endoscopists. OBJECTIVE: This study, carried out in a small rural hospital in northern Ontario, tracks the development of a colonoscopy service provided by a general practitioner with some basic colonoscopy training. It compares the GP's past and present level of expertise with literature-derived benchmarks and gauges the safety and effectiveness of the procedure. METHODS: A retrospective chart review of 616 colonoscopies performed by this GP between April 1992 and September 2003. RESULTS: The results of the study support the idea that colonoscopy in a rural setting can be provided safely and effectively. CONCLUSION: Colonoscopy has a high safety profile when provided by general practitioners, and training in the procedure should be available to interested family practitioners and family practice residents.

Grimmia anomala is reported from seven sites in Scotland and Ireland. Confusion in the past with Grimmia hartmanii has meant that this species has been overlooked. Its occurrence in Scandinavia and the Faroes means that its sites in Scotland are not unexpected but the Irish localities for this boreal-montane species are noteworthy.

This paper is concerned to reinforce the case for the use of analytical techniques in historical cartography. The need for such analysis is conditioned by the requirements of authenticity and accuracy. A few simple analytical techniques are discussed including chemical analysis, dating by magnetic variation, geometric identification of projections and style assessment.

A 60-year old male with right scrotal hernia was assaulted with a brick on the right groin leading to swelling of right scrotum. He had been treated for scrotal contusion at the local hospital and died on the third day.