Objective: Patient satisfaction surveys are primarily conducted in English and thus exclude respondents who cannot read or are not proficient in the English language. This study used a language and culture-specific questionnaire to explore potential barriers to health care among Chinese patients and to determine their satisfaction with health care services received at their visit to the Toronto Western Hospital (TWH), University Health Network. Methods: A cross-sectional survey design was used. Patients were recruited from the General Internal Medicine inpatient ward and Tuberculosis, Liver and Angiography ambulatory care clinics at TWH. A questionnaire was administered by an interviewer to patients who self-identified as Chinese. The interviewer administered the questionnaire in English, Cantonese and Mandarin. The questionnaire explored three main topics which included language barriers, cultural barriers and patient satisfaction. Results: A total of 138 patients were approached to participate in the study over a six week period. There was a 97.1% response rate. Of the 134 patients who participated in the study, 52% reported having difficulty speaking English but only 24% utilized the hospital’s interpretation and translation service. Barriers to health care identified by patients included: limited discussion of use of Chinese medical therapies with physicians, difficulty understanding explanations provided by physicians and nurses, and difficulty finding a hospital staff member who could talk with them about their illness in their preferred language. Conclusion: Language and culture-specific questionnaires can reveal barriers to health care in patients with limited English proficiency. These barriers need to be addressed to ensure delivery of quality health care in a culturally responsive manner.
{"title":"Linguistic and cultural barriers to health care among Chinese patients at the Toronto Western Hospital","authors":"E. Lam, E. Heathcote","doi":"10.5015/UTMJ.V87I3.1173","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1173","url":null,"abstract":"Objective: Patient satisfaction surveys are primarily conducted in English and thus exclude respondents who cannot read or are not proficient in the English language. This study used a language and culture-specific questionnaire to explore potential barriers to health care among Chinese patients and to determine their satisfaction with health care services received at their visit to the Toronto Western Hospital (TWH), University Health Network. \u0000Methods: A cross-sectional survey design was used. Patients were recruited from the General Internal Medicine inpatient ward and Tuberculosis, Liver and Angiography ambulatory care clinics at TWH. A questionnaire was administered by an interviewer to patients who self-identified as Chinese. The interviewer administered the questionnaire in English, Cantonese and Mandarin. The questionnaire explored three main topics which included language barriers, cultural barriers and patient satisfaction. \u0000Results: A total of 138 patients were approached to participate in the study over a six week period. There was a 97.1% response rate. Of the 134 patients who participated in the study, 52% reported having difficulty speaking English but only 24% utilized the hospital’s interpretation and translation service. \u0000Barriers to health care identified by patients included: limited discussion of use of Chinese medical therapies with physicians, difficulty understanding explanations provided by physicians and nurses, and difficulty finding a hospital staff member who could talk with them about their illness in their preferred language. \u0000Conclusion: Language and culture-specific questionnaires can reveal barriers to health care in patients with limited English proficiency. These barriers need to be addressed to ensure delivery of quality health care in a culturally responsive manner.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"18 1","pages":"174-176"},"PeriodicalIF":0.7,"publicationDate":"2010-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73124015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
NOTE: This is a History of Medicine submission and does not have an abstract. As such the Introduction section has been pasted here as an "abstract". Obstructive sleep apnea (OSA) is a condition characterized by repeated occlusion of the upper airway (UA) during sleep. From OSA’s initial clinical description less than 50 years ago to present day, progression in respiratory sleep medicine has vastly expanded the scope of our knowledge of OSA. What was once regarded as a rare affliction that simply led to daytime hypersomnelence1 is now recognized as a common and serious condition capable wreaking havoc in the cardiovascular system, independently promoting heart failure, stroke, hypertension and likely atherosclerosis.At the beginning of a new decade, the field of OSA research finds itself at yet another frontier as a radically new etiological perspective emerges. This new paradigm of the cause of OSA promises the possibility of novel OSA treatments and prophylaxes. This article will follow the progression of OSA research, from the condition's initial discovery, on to the current widely-accepted view of OSA and finally to the future of respiratory sleep medicine.
{"title":"Historical changes in perspective of the etiology, pathophysiology and treatment of obstructive sleep apnea","authors":"J. Gabriel","doi":"10.5015/UTMJ.V87I3.1175","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1175","url":null,"abstract":"NOTE: This is a History of Medicine submission and does not have an abstract. As such the Introduction section has been pasted here as an \"abstract\". \u0000 \u0000 \u0000Obstructive sleep apnea (OSA) is a condition characterized by repeated occlusion of the upper airway (UA) during sleep. From OSA’s initial clinical description less than 50 years ago to present day, progression in respiratory sleep medicine has vastly expanded the scope of our knowledge of OSA. What was once regarded as a rare affliction that simply led to daytime hypersomnelence1 is now recognized as a common and serious condition capable wreaking havoc in the cardiovascular system, independently promoting heart failure, stroke, hypertension and likely atherosclerosis.At the beginning of a new decade, the field of OSA research finds itself at yet another frontier as a radically new etiological perspective emerges. This new paradigm of the cause of OSA promises the possibility of novel OSA treatments and prophylaxes. This article will follow the progression of OSA research, from the condition's initial discovery, on to the current widely-accepted view of OSA and finally to the future of respiratory sleep medicine.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"42 1","pages":"177-180"},"PeriodicalIF":0.7,"publicationDate":"2010-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85817766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rheumatic fever and rheumatic heart disease continue to be the most common form of cardiovascular disease in low-income countries. Poor diagnostic and treatment capacity and limited patient understanding of disease etiology have kept both disease recognition and patient adherence to treatment low. In rural and remote areas, this is worsened as a result of poorer access to health facilities for diagnosis, treatment and monitoring. As recommended by the World Health Organization, to treat the chronic effects of rheumatic heart disease, patients must adhere to strict monthly treatment regimes of secondary prophylaxis with penicillin. However, adherence to treatment remains difficult for poor populations who struggle to meet the travel, economic and opportunity costs associated with seeking care. To address these challenges, lessons from Ethiopia suggest that a community-based primary healthcare approach that offers follow-up treatment and care through satellite health centres with health officers can be a sustainable and effective strategy for rheumatic fever and rheumatic heart disease management.
{"title":"Managing the Growing Burden of Rheumatic Heart Disease in Low-Income Countries: A Primary Healthcare Approach in Ethiopia","authors":"Kadia Petricca","doi":"10.5015/UTMJ.V87I3.1176","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1176","url":null,"abstract":"Rheumatic fever and rheumatic heart disease continue to be the most common form of cardiovascular disease in low-income countries. Poor diagnostic and treatment capacity and limited patient understanding of disease etiology have kept both disease recognition and patient adherence to treatment low. In rural and remote areas, this is worsened as a result of poorer access to health facilities for diagnosis, treatment and monitoring. As recommended by the World Health Organization, to treat the chronic effects of rheumatic heart disease, patients must adhere to strict monthly treatment regimes of secondary prophylaxis with penicillin. However, adherence to treatment remains difficult for poor populations who struggle to meet the travel, economic and opportunity costs associated with seeking care. To address these challenges, lessons from Ethiopia suggest that a community-based primary healthcare approach that offers follow-up treatment and care through satellite health centres with health officers can be a sustainable and effective strategy for rheumatic fever and rheumatic heart disease management.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"R-26 1","pages":"170-173"},"PeriodicalIF":0.7,"publicationDate":"2010-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84745171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guilt and Time: My Enemies","authors":"Jay M. Baruch","doi":"10.5015/UTMJ.V87I2.1258","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I2.1258","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"1 1","pages":"106-108"},"PeriodicalIF":0.7,"publicationDate":"2010-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74420815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"For David: After Words","authors":"S. Cox","doi":"10.5015/UTMJ.V87I2.1257","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I2.1257","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"6 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74079291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Motivational Interviewing: Preparing People for Change","authors":"S. Dabbo, Nader Dabbo","doi":"10.5015/utmj.v87i2.1178","DOIUrl":"https://doi.org/10.5015/utmj.v87i2.1178","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"225 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77285925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr. Karel terBrugge, MD, FRCPC, is a Professor at the University of Toronto and Chief of Neuroradiology at the Toronto Western Hospital. As an internationally recognized interventional neuroradiologist, he specializes in treatment of brain aneurysms, arterio-venous malformations, and acute stroke.
Dr. Karel terBrugge，医学博士，FRCPC，多伦多大学教授，多伦多西部医院神经放射学主任。作为一名国际公认的介入神经放射学家，他擅长治疗脑动脉瘤、动静脉畸形和急性中风。
{"title":"Interventional Neuroradiology: An Interview with Dr. Karel terBrugge","authors":"C. Woodford","doi":"10.5015/utmj.v87i2.1254","DOIUrl":"https://doi.org/10.5015/utmj.v87i2.1254","url":null,"abstract":"Dr. Karel terBrugge, MD, FRCPC, is a Professor at the University of Toronto and Chief of Neuroradiology at the Toronto Western Hospital. As an internationally recognized interventional neuroradiologist, he specializes in treatment of brain aneurysms, arterio-venous malformations, and acute stroke.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"96 1","pages":"75-78"},"PeriodicalIF":0.7,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79183501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr. David J. Mikulis is a staff neuroradiologist at Toronto Western Hospital and Senior Scientist at the Toronto Western Research Institute, part of the University Health Network. He met with the UTMJ to discuss his career as a clinician-scientist and his lab's novel method of generating maps of cerebrovascular reactivity.
David J. Mikulis博士是多伦多西部医院的神经放射科医生，也是多伦多西部研究所的高级科学家，该研究所是大学健康网络的一部分。他会见了UTMJ，讨论了他作为临床科学家的职业生涯，以及他的实验室生成脑血管反应性图的新方法。
{"title":"Neuroradiology: An Interview with Dr. David J. Mikulis","authors":"R. Vanner","doi":"10.5015/utmj.v87i2.1255","DOIUrl":"https://doi.org/10.5015/utmj.v87i2.1255","url":null,"abstract":"Dr. David J. Mikulis is a staff neuroradiologist at Toronto Western Hospital and Senior Scientist at the Toronto Western Research Institute, part of the University Health Network. He met with the UTMJ to discuss his career as a clinician-scientist and his lab's novel method of generating maps of cerebrovascular reactivity.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"47 1","pages":"79-82"},"PeriodicalIF":0.7,"publicationDate":"2010-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72863101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A significant proportion of patients who sufferfrom heart disease have both these predisposing factors andother comorbidities, making their management more difficult.While medical treatment of heart conditions has helped toextend the durability of the native heart, many patients willeventually reach a point where invasive surgical manoeuvreshave to be considered.Fortunately, there is an emerging field in cardiovascular med -icine that can provide a new alternative for these patients: per-cutaneous cardiac therapies. These procedures are minimallyinvasive and are often associated with fewer peri-proceduralcomplications than a coronary-artery bypass graft (CABG), lead -ing to fewer subsequent morbidities.
{"title":"Curing the Heart Under the Wire","authors":"T. Soeyonggo","doi":"10.5015/UTMJ.V87I2.1171","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I2.1171","url":null,"abstract":"A significant proportion of patients who sufferfrom heart disease have both these predisposing factors andother comorbidities, making their management more difficult.While medical treatment of heart conditions has helped toextend the durability of the native heart, many patients willeventually reach a point where invasive surgical manoeuvreshave to be considered.Fortunately, there is an emerging field in cardiovascular med -icine that can provide a new alternative for these patients: per-cutaneous cardiac therapies. These procedures are minimallyinvasive and are often associated with fewer peri-proceduralcomplications than a coronary-artery bypass graft (CABG), lead -ing to fewer subsequent morbidities.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"14 1","pages":"70-73"},"PeriodicalIF":0.7,"publicationDate":"2010-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75513860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Molecular imaging is a rapidly evolving field that aims to develop novel technologies and methods to image specific biological processes in the living organism at the cellular and molecular level. This review discusses several novel imaging strategies that exploit the unique biological properties of atherosclerosis to detect key aspects of the disease. Among the approaches, targeting macrophage activity, protease activity, apoptosis and angiogenesis for in vivo molecular imaging of atherosclerosis have demonstrated the greatest potential for translation into the clinical setting.
{"title":"Molecular Imaging of Atherosclerosis","authors":"Danny L. Costantini","doi":"10.5015/UTMJ.V87I2.1172","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I2.1172","url":null,"abstract":"Molecular imaging is a rapidly evolving field that aims to develop novel technologies and methods to image specific biological processes in the living organism at the cellular and molecular level. This review discusses several novel imaging strategies that exploit the unique biological properties of atherosclerosis to detect key aspects of the disease. Among the approaches, targeting macrophage activity, protease activity, apoptosis and angiogenesis for in vivo molecular imaging of atherosclerosis have demonstrated the greatest potential for translation into the clinical setting.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"58 1","pages":"87-90"},"PeriodicalIF":0.7,"publicationDate":"2010-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77253479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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