Our findings suggest that randomized control trials published in journal supplements are generally of inferior quality compared with articles published in the parent journal. The review process surrounding the publication of journal supplements should be consistent with that of the parent journal.

The automated paging system reduced the length of time physicians took to respond to critical laboratory values, but this difference was not statistically significant. Future reseach should evaluate the effects of alerts for conditions that currently do not generate a phone call and the addition of real-time decision support to the critical value alerts.

This paper has been substantially revised by the Canadian Psychiatric Association's Research Committee and approved for republication by the CPA's Board of Directors on May 3, 2017. The original policy paper was developed by the Scientific and Research Affairs Standing Committee and approved by the Board of Directors on November 10, 2008.

Media reporting on suicide may have harmful and/or protective effects on deaths by suicide, depending on the nature of the coverage. Canada's first forum on this important issue was held in Toronto on November 6, 2015. Participating in the forum were public health policy-makers, mental health and suicide prevention experts and senior media representatives. This commentary summarizes the content of the forum and highlights the need for ongoing collaboration between suicide prevention experts and media professionals aimed at safe and respectful reporting that maintains the public's need to be informed.KEY WORDS: Suicide; mass media; imitative behavior La traduction du résumé se trouve à la fin de l'article.

Purpose: Ischemic preconditioning (IPC) through purposeful circulatory occlusion may enhance exercise performance. The value of IPC for improving performance is controversial owing to challenges with employing effective placebo controls. This study examines the efficacy of IPC versus a deceptive sham protocol for improving performance to determine whether benefits of IPC are attributable to true physiological effects. It was hypothesized that IPC would favorably alter performance more than a sham treatment and that physiological responses to exercise would be affected only after IPC treatment. Methods: In a randomized order, 16 participants performed incremental exercise to exhaustion on a cycle ergometer in control conditions and after sham and IPC treatments. Participants rated their belief as to the efficacy of each treatment compared with control. Results: Time to exhaustion was greatest after IPC (control = 1331 [270] s, IPC = 1429 [300] s, sham = 1343 [255] s, P = .02), despite negative performance expectations after IPC and positive expectation after sham. Maximal aerobic power remained unchanged after both SHAM and IPC (control = 42.0 [5.2], IPC = 41.7 [5.5], sham = 41.6 [5.5] mL·kg−1·min−1, P = .7), as did submaximal lactate concentration (control = 8.9 [2.6], sham = 8.0 [1.9], IPC = 7.7 [2.1] mmol, P = .1) and oxygen uptake (control = 37.8 [4.8], sham = 37.5 [5.3], IPC = 37.5 [5.5] mL·kg−1·min−1, P = .6). Conclusions: IPC before cycling exercise provides an ergogenic benefit that is not attributable to a placebo effect from positive expectation and that was not explained by traditionally suggested mechanisms.

E ffective communication between health care providers is essential to patient safety and quality of care. 1-6 A retrospective study of 14 000 admissions found that communication failures were the most common cause of preventable disability or death and were nearly twice as common as those due to inadequate medical skill. 6 A major type of communication failure is sending a page to the wrong physician. Prior studies have described paging problems such as paging the wrong physician, unanswered pages, and delayed responses but do not quantify the extent of the problem. 3 Our primary aim was to quantify the frequency of pages sent to the wrong physician in 2 academic teaching hospitals and to examine the potential clinical importance of these errors. Methods. Sunnybrook Health Sciences Centre (SHSC) and the Toronto General Hospital (TGH) are tertiary care academic teaching hospitals affiliated with the

Objective: To apply the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) to determine the prevalence of mental health symptoms in a cohort of university student athletes over an academic year. A secondary objective was to explore the internal consistency of the screening tools from the SMHAT-1. Design: Cross-sectional design with 3 repeated measurements over an academic year. Setting: A large university multisport program. Participants: Five hundred forty-two university-level student athletes from 17 sports. Intervention: N/A. Main Outcome Measures: On 3 occasions, the participants completed the SMHAT-1, which consists of the Athlete Psychological Strain Questionnaire. If an athlete's score was above the threshold ($17), the athlete completed step 2, consisting of (1) Generalized Anxiety Disorder-7; (2) Patient Health Questionnaire-9; (3) Athlete Sleep Screening Questionnaire; (4) Alcohol Use Disorders Identification Test Consumption; (5) Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers Adapted to Include Drugs; and (6) Brief Eating Disorder in Athletes Questionnaire. Internal consistency of the SMHAT-1 was also measured. Results: Participants reported mental health symptoms with prevalence of 24% to 40% for distress, 15% to 30% for anxiety, 19% to 26% for depression, 23% to 39% for sleep disturbance, 49% to 55% for alcohol misuse, 5% to 10% for substance use, and 72% to 83% for disordered eating. Female athletes were more likely to suffer psychological strain, depression, and sleep disturbance; male athletes were more likely to report substance use. Conclusions: The SMHAT-1 was feasible to implement with good internal consistency. University-level athletes suffer from a variety of mental health symptoms underscoring the necessity for team physicians to have the clinical competence to recognize and treat mental health symptoms.

Cannabis is widely used for both recreational and medicinal purposes on a global scale. There is accumulating interest in the use of cannabis and its constituents for athletic recovery, and in some instances, performance. Amidst speculation of potential beneficial applications, the effects of cannabis and its two most abundant constituents, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), remain largely un-investigated. The purpose of this review is to critically evaluate the literature describing the effects of whole cannabis, THC, and CBD, on athletic performance and recovery. While investigations of whole cannabis and THC have generally shown either null or detrimental effects on exercise performance in strength and aerobic-type activities, studies of sufficient rigor and validity to conclusively declare ergogenic or ergolytic potential in athletes are lacking. The ability of cannabis and THC to perturb cardiovascular homeostasis warrants further investigation regarding mechanisms by which performance may be affected across different exercise modalities and energetic demands. In contrast to cannabis and THC, CBD has largely been scrutinized for its potential to aid in recovery. The beneficial effects of CBD on sleep quality, pain, and mild traumatic brain injury may be of particular interest to certain athletes. However, research in each of these respective areas has yet to be thoroughly investigated in athletic populations. Elucidating the effects of whole cannabis, THC, and CBD is pertinent for both researchers and practitioners given the widespread use of these products, and their potential to interact with athletes’ performance and recovery.