Although BC has been experiencing an outbreak of infectious syphilis (IS; primary, secondary, and early latent syphilis) since 1997, there have been recent important changes in the epidemic. Prior to 2003, British Columbia was unique worldwide because the outbreak was focused primarily in the Downtown Eastside heterosexual population[1] while elsewhere, the epidemic was based in men who have sex with men (MSM). Here, prior to 2003, fewer than 5% of individuals with infectious syphilis identified themselves as MSM.
The cover story on acupuncture and the treatment of fibromyalgia raises many questions related to the basics of experimental design. Unfortunately, the trial as presented in January/February’s issue of the BCMJ (2004;46[1]:21-23) does not appear to be a valid test of the effectiveness of acupuncture. Several serious, indeed fatal, flaws render this trial useless from a scientific perspective:
Over the last decade there has been a distinct and alarming shift away from the travail of family practice as a discipline of medicine. Family practitioners are quitting in droves. New graduates are extremely reluctant to commit themselves to our specialty upon graduation. Currently a full and running practice cannot be given away, let alone sold. It is undeniable that there is no other specialty that encompasses the scope of what we do in fulfilling the long-term health care needs of individuals.
An estimated 2285 people live in the Bella Coola Valley, a remote coastal community in British Columbia. Approximately 46% of these are of aboriginal descent,[1-3] compared with an estimated provincial aboriginal population of 3.6%.[3] Bella Coola is one of the most isolated communities in British Columbia. The closest referral hospital is more than 450 km away by road in Williams Lake or 2 hours away by air in Vancouver. Bella Coola is served by three physicians at any given time.[4]
