The Commonwealth Fund Survey of Primary Care Physicians Reveals Challenges Experienced by Family Doctors and Emphasizes the Need for Interoperability of Health Information Technologies.

Electronic health information that is easily accessible and shareable among healthcare providers and their patients can provide substantial improvements in Canada's primary care system and population health outcomes. The Commonwealth Fund's (CMWF's) 2022 International Health Policy Survey of Primary Care Physicians (CIHI 2023) highlights the views and experiences of primary care doctors in 10 developed countries, including Canada. The survey covered various topics related to physician workload, the use of information technology and coordination of care. While the COVID-19 pandemic contributed to an increased physician workload that may have impacted the ability to efficiently coordinate care with other healthcare providers, Canadian family doctors did close the gap with other countries as 93% of family doctors are now using electronic medical records (EMRs) in their practices. The CMWF's 2022 survey revealed challenges faced by Canadian family doctors in their practices. However, international comparisons provide opportunities to learn from other countries and build on the implementation of EMRs as part of Canada's shared health priorities.

Signaling events for metallothionein induction.

Metallothioneins (MTs) are low molecular weight, cysteine-rich metal-binding proteins found in a wide variety of organisms including bacteria, fungi and all eukaryotic plant and animal species. They are the single most abundant group of intracellular zinc-binding proteins in eukaryotic cells [Prog. Food Nutr. Sci. 14 (1990) 193]: 5-10% of zinc in human hepatocytes is bound to MTs [Methods Enzymol. 205 (1991) 613; FEBS Lett. 39 (1974) 229]. A critical physiological role for MTs has been suggested to encompass control of zinc availability to proteins requiring zinc for activity, but has not been definitively described. Nevertheless, a hallmark of MT gene regulation is their pattern of expression in different cell types and tissues, and their inducibility by a host of chemical and physical agents acting directly or indirectly on multiple cis-acting motifs in the regulatory regions of MT genes [Prog. Nucleic Acid. Res. Mol. Biol., 66 (2001) 357]. The pattern of physical and chemical events regulating basal MT gene transcription, and induction or repression of MT gene activity, provides valuable insight into the potential functions of MTs. In this review, we describe the transcriptional regulatory processes involved in MT gene expression.