By Chaim M. Bell and Wendy Levinson

Most doctors feel that they provide good to above-average patient care. However, Canadian physicians rarely receive feedback about their clinical performance or patient outcomes. Although both of us believe that we provide excellent patient care, we have never received any data on our clinical performance or patient outcomes compared with other physicians or benchmarks. How can we learn to improve our provision of care without objective measures of our performance?

By Christopher Millett, Jeremy Gray, Sonia Saxena, Gopalakrishnan Netuveli and Azeem Majeed

Many people with diabetes continue to smoke despite being at high risk of cardiovascular disease. We examined the impact of a pay-for-performance incentive in the United Kingdom introduced in 2004 as part of the new general practitioner contract to improve support for smoking cessation and to reduce the prevalence of smoking among people with chronic diseases such as diabetes.

Like hobos on a train, HIV, the virus that causes AIDS, uses a pre-existing transport system to leave one infected cell and infect new ones, Hopkins scientists have discovered. Their findings, published in the June issue of Plos Biology, counter the prevailing belief that HIV and other retroviruses can only leave and enter cells by virus-specific mechanisms.

In head-to-head trials of two drugs, the one deemed better appears to depend largely on who is funding the study, according to an analysis of nearly 200 statin-drug comparisons carried out between 1999 and 2005.

UCSF researchers examined 192 published results of trials comparing one cholesterol-lowering statin drug to another, or to a non-statin drug.

Radical steps to engineer Earth’s climate by blocking sunlight could drastically cool the planet, but could just as easily worsen the situation if these projects fail or are suddenly halted, according to a new computer modeling study.

The experiments, described in the June 4 early online edition of The Proceedings of the National Academy of Sciences, look at what might happen if we attempt to slow climate change by “geoengineering” a solar filter instead of reducing carbon dioxide emissions. The researchers used a computer model to simulate a decrease in solar radiation across the entire planet, but assumed that that the current trend of increasing global carbon dioxide emissions would continue for the rest of this century.

Commonly used by around 10 million people in east Africa and countries in the Arabian peninsula, chewing khat for its stimulant properties has also become popular in the UK among immigrants of the Somali, Yemeni and Ethiopian communities. Whilst it is reported to have cultural functions, it is also increasingly reported to be associated with social and medical problems including anti-social behaviour, unemployment, psychoses, depression, and self-neglect.