Health-care system constraints combined with a lack of a uniform referral process are leaving Ontario physicians brokering which patients are in greatest need of hip and knee replacement, a study led by a St. Michael's Hospital researcher funded by the Canadian Institutes of Health Research has revealed.

The study, conducted by a team of researchers from across the University of Toronto and published in Medical Decision Making, examined the impact of patient characteristics, including age, weight/obesity, comorbidity and perioperative risk, and gender and caretaker roles in the decision-making process of 18 family physicians, 15 rheumatologists and 17 orthopedic surgeons from across Ontario.

The variability in this process means not everyone who needs this surgery will actually get surgery.

When six day care centers imposed a fine on parents who picked their children up late, tardiness doubled and it stayed high even when the fine was removed.

How can it be that a financial penalty made the problem worse? Parents, it seems, stopped seeing lateness as an imposition on teachers, and instead saw it as something that could be purchased with no moral failing.

A basic tenet of economics is that people always behave selfishly, or as the 18th century philosopher economist David Hume put it, "every man ought to be supposed to be a knave."

Information gleaned from a Greenland ice core by an international science team shows that two huge Northern Hemisphere temperature spikes prior to the close of the last ice age some 11,500 years ago were tied to fundamental shifts in atmospheric circulation.

The ice core showed the Northern Hemisphere briefly emerged from the last ice age some 14,700 years ago with a 22-degree-Fahrenheit spike in just 50 years, then plunged back into icy conditions before abruptly warming again about 11,700 years ago. Startlingly, the Greenland ice core evidence showed that a massive "reorganization" of atmospheric circulation in the Northern Hemisphere coincided with each temperature spurt, with each reorganization taking just one or two years, said the study authors.

The new findings are expected to help scientists improve existing computer models for predicting future climate change as increasing anthropogenic greenhouse gases in the atmosphere drive up Earth's temperatures globally.

Since September 11, U.S. politicians have repeatedly reminded us that the journalists in the Arab world are biased against America and the West. A new study in the July 2008 issue of International Journal of Press/Politics says that is not the case.

To provide a snapshot of journalists' attitudes and to create a benchmark for future studies, the researchers surveyed 601 mainstream professional Arab journalists with the goal of understanding how they view both their profession and the events they cover. (1)

While still subject to censorship, Arab journalists have growing aspirations for independence fed by their access to more than 300 free-to-air Arab satellite channels and the rise of blogging on the internet.

Are senior doctors who help drug companies sell their drugs independent experts or just drug representatives in disguise, asks Ray Moynihan from the University of Newcastle in Australia, in this week's BMJ.

Pharmaceutical companies regularly sponsor leading specialists with "generous fees to peddle influence" and promote drugs to the profession and the public, writes Moynihan.

Drug companies will pay influential doctors up to $400 an hour to act as key opinion leaders, and some doctors earn more than $25 000 a year in advisory fees.

To mark the launch of the Pet Health Information website ( http://www.pethealthinfo.org.uk), a nationwide search for 'it shouldn't happen to a pet' anecdotes to highlight the lack of awareness of pet health issues amongst owners has revealed some howlers.

Enactment of the Genetic Information Nondiscrimination Act (GINA) of 2008 is a boon to individual patients and for genetic research, write Kathy Hudson, M.K. Holohan, and Francis Collins in the June 19 issue of the New England Journal of Medicine. But the bill is not a panacea, they note: Employers, health insurers, patients, and doctors now must be educated about its provisions, gaps remain in genetic testing oversight, and there still may be opportunities to misuse genetic information.

Hudson, director of the Pew Charitable Trusts-funded Genetics and Public Policy Center, and co-authors Holohan and Collins of the National Human Genome Research Institute, reflect on GINA's slow path through the legislative process.

The 2007 Intergovernmental Panel on Climate Change report was wrong, say a group of researchers, but not about whether there was global warming. Rather, the report underestimated its effects concerning ocean temperature and associated sea level increases between 1961 and 2003 - by 50 percent.

The report in the June 19 edition of Nature compared climate models with observations that show sea levels rose by 1.5 millimeters per year in the period from 1961-2003. That equates to an approximately 2 inch increase in ocean levels in a 42-year span.

Not exactly WaterWorld but not insignificant either.

A new mass spectrometry test can help sports anti-drug doping officials to detect whether an athlete has used drugs that boost naturally occurring steroid levels. The test is more sensitive compared to previous alternatives, more capable of revealing specific suspicious chemical in the body, faster to perform, and could be run on standard drug-screening laboratory equipment.

The new test was announced in a special issue of the Journal of Mass Spectrometry that concentrates on detecting drugs in sports.

One of the roles of the masculinising hormone testosterone is to increase muscle size and strength. Taking extra testosterone, or taking a chemical that the body can use to create extra testosterone, could therefore enhance an athlete's performance. For this reason taking it is banned by the World Anti-Doping Agency (WADA).