Fatal Second Impact Syndrome in Rowan Stringer, A 17-Year-Old Rugby Player.

Second impact syndrome (SIS) is associated with malignant brain swelling and usually occurs in young athletes with one or more prior, recent concussions. SIS is rare and some dispute its existence. We report a case of SIS in Rowan Stringer, age 17, a rugby player who sustained a fatal brain injury despite prompt medical therapy including decompression surgery. The cause of the massive brain swelling was initially unknown. An inquest revealed Rowan's text messages to friends describing symptoms from two prior, recent rugby brain injuries, likely concussions, within 5 days of the fatal blow and confirming the diagnosis of SIS.

Health research involving First Nations, Inuit and Métis children and their communities.

Canadian and international guidelines address the ethical conduct of health research in general and the issues affecting Indigenous populations in particular. This statement summarizes, for clinicians and researchers, relevant ethical and practical considerations for health research involving Aboriginal children and youth. While not intended to duplicate findings arising from lengthy collaborative processes, it does highlight 'wise practices' that have successfully generated knowledge relevant to, respectful of and useful for Aboriginal children, youth and their communities. Further research on current health issues and inequities should lead to practical, effective and culturally relevant applications. Expanding our knowledge of ways to address the health disparities facing Canada's Aboriginal children and youth can inform health policy and the provision of services. Community-based participatory research is proposed as a means to achieve this goal.

Les lignes directrices canadiennes et internationales portent sur la tenue éthique de la recherche en santé en général et les problèmes touchant les populations autochtones en particulier. Le présent document de principes contient un résumé des considérations éthiques et pratiques pertinentes liées à la recherche en santé auprès des enfants et des adolescents autochtones, à l'intention des cliniciens et des chercheurs. Il ne vise pas à dédoubler les résultats découlant de longs processus coopératifs, mais il expose les « pratiques judicieuses ¼ qui ont suscité des connaissances pertinentes, respectueuses et utiles pour les enfants, les adolescents et les communautés autochtones. D'autres recherches sur les enjeux et les inégalités en matière de santé devraient donner lieu à des applications pratiques, efficaces et pertinentes sur le plan culturel. Le fait d'accroître nos connaissances sur les moyens d'éliminer les disparités en santé dont sont victimes les enfants et les adolescents autochtones du Canada peut étayer les politiques en santé et la prestation des services. Les recherches participatives menées dans les communautés sont présentées comme un moyen de réaliser cet objectif.

Unmet need for the treatment of depression in Atlantic Canada.

OBJECTIVE: Most people with depression do not receive treatment, even though effective interventions are available. Population-based data can assist health service planners to improve access to mental health services. This study aimed to examine the determinants of untreated depression in Canada's Atlantic provinces. METHOD: This study used data from the Canadian Community Health Survey Cycle 1.1. Logistic regression models explored the prevalence of depression and associated patterns of mental health service use among population subgroups. RESULTS: Of the respondents, 7.3% experienced major depression in the previous year, as measured by the Composite International Diagnostic Interview Short Form. Individuals with the following characteristics were at increased risk for depression: female sex; widowed, separated, or divorced marital status; low income; and 2 or more comorbid medical conditions. Only 40% of respondents with probable depression reported any consultation about their condition with a general practitioner or mental health specialist. Less than one-quarter of Atlantic Canadians with depression reported receiving levels of care consistent with practice guidelines. Vulnerable groups, including older individuals, people with low levels of education, and those living in rural areas, were significantly less likely to receive treatment in either primary or specialty care. CONCLUSIONS: These findings suggest inequitable access to services and the need to target interventions to at-risk populations by raising awareness among the public and health care providers. Health systems in the Atlantic region must work toward achieving consistent longitudinal care for a larger proportion of individuals suffering from depression by studying the underlying factors for service use among underserved groups.