Pub Date : 2024-01-04DOI: 10.5206/uwomj.v91i1.15682
Ahmad Khan, Omar Taboun
Short Term Experiences in Global Health (STEGH) are becoming increasingly prevalent, where students and volunteers predominately from high income countries travel to lower income countries to work with local community organizations. Although the benefits of STEGHs have been touted, they have also been increasingly criticized as representing a new form of colonialism and have been shown to harm host communities in a number of ways. Can the enterprise of STEGHs be ethically justified? We argue that STEGHs must incorporate principles of bi-directionality, continuity, cultural humility and decolonization in order to be equitable and sustainable.
{"title":"Short Term Experiences in Global Health (STEGH)","authors":"Ahmad Khan, Omar Taboun","doi":"10.5206/uwomj.v91i1.15682","DOIUrl":"https://doi.org/10.5206/uwomj.v91i1.15682","url":null,"abstract":"Short Term Experiences in Global Health (STEGH) are becoming increasingly prevalent, where students and volunteers predominately from high income countries travel to lower income countries to work with local community organizations. Although the benefits of STEGHs have been touted, they have also been increasingly criticized as representing a new form of colonialism and have been shown to harm host communities in a number of ways. Can the enterprise of STEGHs be ethically justified? We argue that STEGHs must incorporate principles of bi-directionality, continuity, cultural humility and decolonization in order to be equitable and sustainable.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"47 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139384788","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}
Pub Date : 2024-01-04DOI: 10.5206/uwomj.v91i1.15684
Jay Shah
Antimicrobial resistance is a global issue that threatens to alter the treatment and management of infections. For many decades, antibiotics have successfully kept numerous bacterial pathogens at bay and have reduced post-surgery infection rates. This article presents research and projections on the economic implications of antimicrobial resistance. Development of new antibiotics comes at a substantial cost. The economic incentives of different stakeholders affected by antimicrobial resistance are also discussed.
{"title":"Primer on the Economics of Antimicrobial Resistance","authors":"Jay Shah","doi":"10.5206/uwomj.v91i1.15684","DOIUrl":"https://doi.org/10.5206/uwomj.v91i1.15684","url":null,"abstract":"Antimicrobial resistance is a global issue that threatens to alter the treatment and management of infections. For many decades, antibiotics have successfully kept numerous bacterial pathogens at bay and have reduced post-surgery infection rates. This article presents research and projections on the economic implications of antimicrobial resistance. Development of new antibiotics comes at a substantial cost. The economic incentives of different stakeholders affected by antimicrobial resistance are also discussed.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387250","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":"Contraception Access in Global Health Policies and Programs","authors":"Riana Sihota, Shaily Brahmbhatt, Rachel DuCharme, Keran Gao, Apoorv Pant, Lakshmi Venkatesan","doi":"10.5206/uwomj.v91i1.15630","DOIUrl":"https://doi.org/10.5206/uwomj.v91i1.15630","url":null,"abstract":"","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"45 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385052","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}
Pub Date : 2023-06-15DOI: 10.5206/uwomj.v90i2.14834
Victoria P Sanderson, Retage Al Bader
Dr Hamm was the first oncologist to receive an academic appointment in Windsor and has since spearheaded the development of Windsor oncology into an academic program. She completed her fellowship training in hematology and stem cell transplant in Detroit and has since returned to her hometown of Windsor. We had the opportunity to talk with Dr Hamm about the impact of social medicine on cancer prognosis, chemotherapy hesitancy, critical care for migrant workers and coping with death. “We’re really grateful to have had this talk with someone working in oncology because I’m now realizing just how much social medicine plays an important and visible role, maybe especially in oncology, because of cancer’s chronic nature, and the social aspect of people’s lives shapes so much of the supports a person can access and rely on.” – Retage “Social medicine plays a unique role in each specialty of medicine but it’s really interesting hearing about social considerations from the oncology perspective where the biology aspect is so complex that the social factors are often overlooked but play at least, if not greater, of a role on outcomes and patient experience.” – Victoria
{"title":"An Oncologist's Perspective on Social Medicine","authors":"Victoria P Sanderson, Retage Al Bader","doi":"10.5206/uwomj.v90i2.14834","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14834","url":null,"abstract":"Dr Hamm was the first oncologist to receive an academic appointment in Windsor and has since spearheaded the development of Windsor oncology into an academic program. She completed her fellowship training in hematology and stem cell transplant in Detroit and has since returned to her hometown of Windsor. We had the opportunity to talk with Dr Hamm about the impact of social medicine on cancer prognosis, chemotherapy hesitancy, critical care for migrant workers and coping with death. \u0000 \u0000“We’re really grateful to have had this talk with someone working in oncology because I’m now realizing just how much social medicine plays an important and visible role, maybe especially in oncology, because of cancer’s chronic nature, and the social aspect of people’s lives shapes so much of the supports a person can access and rely on.” – Retage \u0000 \u0000“Social medicine plays a unique role in each specialty of medicine but it’s really interesting hearing about social considerations from the oncology perspective where the biology aspect is so complex that the social factors are often overlooked but play at least, if not greater, of a role on outcomes and patient experience.” – Victoria","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90250974","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.14735
A. Sivajohan, Sarah Krause
Many women refuse an epidural during delivery, despite most women perceiving labour pain as the most excruciating event of their lifetime. This can be baffling to a physician involved in their care, but there are many historical and personal factors at play that must be taken into account. Use of obstetric anaesthesia began in 1847 and was met with controversy. In a time when childbirth physiology was poorly understood, physicians disagreed over the utility of labour pain and pain was even used as an indicator to guide delivery. Religious justification also perpetuated the reservations regarding obstetric anaesthesia. Despite initial overwhelming opposition to obstetric anaesthesia within the medical community, attitudes began to shift in favour of obstetric anaesthesia as a result of clinical observations and feminist advocacy. Obstetric anaesthesia has since been well-studied and routinely used, but historical misconceptions have endured and epidural refusal continues to linger in childbirth communities. Furthermore, there are some evidence-based concerns voiced by patients, including the risk of instrumental delivery and low risk for adverse events, which must be carefully addressed by physicians involved in patient care. In addition to concerns regarding safety of obstetric anaesthesia, pain is a subjective experience that may add meaning/fulfilment to childbirth for some patients. In conclusion, there are many historical and personal factors at play when it comes to refusal of obstetric anaesthesia, which must be understood by physicians to optimise patient care.
{"title":"Examining the choice behind refusal of obstetric anaesthesia","authors":"A. Sivajohan, Sarah Krause","doi":"10.5206/uwomj.v90i2.14735","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14735","url":null,"abstract":"Many women refuse an epidural during delivery, despite most women perceiving labour pain as the most excruciating event of their lifetime. This can be baffling to a physician involved in their care, but there are many historical and personal factors at play that must be taken into account. Use of obstetric anaesthesia began in 1847 and was met with controversy. In a time when childbirth physiology was poorly understood, physicians disagreed over the utility of labour pain and pain was even used as an indicator to guide delivery. Religious justification also perpetuated the reservations regarding obstetric anaesthesia. Despite initial overwhelming opposition to obstetric anaesthesia within the medical community, attitudes began to shift in favour of obstetric anaesthesia as a result of clinical observations and feminist advocacy. Obstetric anaesthesia has since been well-studied and routinely used, but historical misconceptions have endured and epidural refusal continues to linger in childbirth communities. Furthermore, there are some evidence-based concerns voiced by patients, including the risk of instrumental delivery and low risk for adverse events, which must be carefully addressed by physicians involved in patient care. In addition to concerns regarding safety of obstetric anaesthesia, pain is a subjective experience that may add meaning/fulfilment to childbirth for some patients. In conclusion, there are many historical and personal factors at play when it comes to refusal of obstetric anaesthesia, which must be understood by physicians to optimise patient care.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81311645","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.14736
Amy Basilious
N/A
N/A
{"title":"Challenges in transition to practice","authors":"Amy Basilious","doi":"10.5206/uwomj.v90i2.14736","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14736","url":null,"abstract":"<jats:p>N/A</jats:p>","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89404923","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.15007
Aileen Liang
We present a case of 43-year-old African American man, MS, who was diagnosed with hypertension at his barbershop after getting his blood pressure taken by a pharmacist team during his haircut. He was started on blood pressure medications and made several lifestyle modifications. He continued to get his blood pressure checked weekly during haircuts for the next six months and was able to lower his blood pressure to heathy levels. MS was then able to manage his blood pressure solely through lifestyle changes. We further discuss the significance of “barbershop medicine” and its role in combating the racial disparities in usual sources of care, as well as other non-traditional sources of health care particularly for the hypertension management.
{"title":"Cutting-edge medicine: A case of hypertension managed at the barbershop","authors":"Aileen Liang","doi":"10.5206/uwomj.v90i2.15007","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.15007","url":null,"abstract":" We present a case of 43-year-old African American man, MS, who was diagnosed with hypertension at his barbershop after getting his blood pressure taken by a pharmacist team during his haircut. He was started on blood pressure medications and made several lifestyle modifications. He continued to get his blood pressure checked weekly during haircuts for the next six months and was able to lower his blood pressure to heathy levels. MS was then able to manage his blood pressure solely through lifestyle changes. We further discuss the significance of “barbershop medicine” and its role in combating the racial disparities in usual sources of care, as well as other non-traditional sources of health care particularly for the hypertension management.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"6 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79797921","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.14847
Lotus Alphonsus, T. D. De Silva
Commentary - Both authors contributed equally
评论-两位作者贡献相同
{"title":"Falling Through the Cracks: COVID-19 disproportionately affects refugee communities","authors":"Lotus Alphonsus, T. D. De Silva","doi":"10.5206/uwomj.v90i2.14847","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14847","url":null,"abstract":"Commentary - Both authors contributed equally","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88859620","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.14870
Maud Ahmad, Zahra Taboun
Cardiovascular disease incidence and risk profiles vary substantially across ethnicities within Canada, with South Asians carrying a disproportionately high burden of disease. South Asians exhibit high incidences of modifiable risk factors that predispose them to cardiovascular disease: dyslipidemia, hypertension, diabetes, and physical inactivity. As well as a genetic predisposition through elevated lipoprotein(a) levels. Dietary and physical activity prescriptions must consider South Asian culture and barriers they face. These include culturally tailored dietary guidelines and women-only fitness centres. Lipoprotein(a), an atherogenic molecule, is genetically determined and elevated in South Asians but may be modified with antisense oligonucleotide therapy. This therapy warrants consideration as part of the treatment algorithms for South Asians with elevated lipoprotein(a) levels. Introducing these practices into primary and secondary prevention guidelines may reduce the cardiovascular disease burden seen in South Asians.
{"title":"Cardiovascular disease in South Asian Canadians: using risk factors to target primary and secondary prevention","authors":"Maud Ahmad, Zahra Taboun","doi":"10.5206/uwomj.v90i2.14870","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.14870","url":null,"abstract":"Cardiovascular disease incidence and risk profiles vary substantially across ethnicities within Canada, with South Asians carrying a disproportionately high burden of disease. South Asians exhibit high incidences of modifiable risk factors that predispose them to cardiovascular disease: dyslipidemia, hypertension, diabetes, and physical inactivity. As well as a genetic predisposition through elevated lipoprotein(a) levels. Dietary and physical activity prescriptions must consider South Asian culture and barriers they face. These include culturally tailored dietary guidelines and women-only fitness centres. Lipoprotein(a), an atherogenic molecule, is genetically determined and elevated in South Asians but may be modified with antisense oligonucleotide therapy. This therapy warrants consideration as part of the treatment algorithms for South Asians with elevated lipoprotein(a) levels. Introducing these practices into primary and secondary prevention guidelines may reduce the cardiovascular disease burden seen in South Asians.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85784232","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}
Pub Date : 2023-06-11DOI: 10.5206/uwomj.v90i2.15073
Hongdao Dong, C. Symonette, N. Merritt, Jacob Davidson
Background: The COVID-19 pandemic had accelerated the adoption of virtual care as an extension of routine clinical practice. In addition, pre-clinical undergraduate medical education was affected by the transition to both synchronous and asynchronous online learning. The objective of this study was to assess the current experience and knowledge of medical students with regards to virtual care. A secondary objective was to identify opportunities for improvement in the undergraduate medical curriculum. Methods: An electronic survey was distributed to undergraduate medical students in Canadian medical schools. Main sections of the survey addressed experience with virtual care encounters and perceived impact of virtual learning on medical education. Result: Out of our 53 respondents, the majority (80%) of medical students perceived high educational importance of virtual care encounters. 91% of the students recognized the developing role of virtual care in current and future medical practices. 55% of the surveyed showed readiness to conduct virtual care in the current curriculum. 94% of the responses stated the preferred feedback method for clinical learning was immediate faculty assessment following the encounter. Discussion: The results from this study provided insight on the medical learner’s experience while navigating virtual care and identified areas of improvements at an institutional level. Effective medical training that integrates the advantages of virtual care is crucial.
{"title":"Virtual Care and Virtual Medical Education: A Canadian Medical Student Perspective","authors":"Hongdao Dong, C. Symonette, N. Merritt, Jacob Davidson","doi":"10.5206/uwomj.v90i2.15073","DOIUrl":"https://doi.org/10.5206/uwomj.v90i2.15073","url":null,"abstract":" \u0000Background: The COVID-19 pandemic had accelerated the adoption of virtual care as an extension of routine clinical practice. In addition, pre-clinical undergraduate medical education was affected by the transition to both synchronous and asynchronous online learning. The objective of this study was to assess the current experience and knowledge of medical students with regards to virtual care. A secondary objective was to identify opportunities for improvement in the undergraduate medical curriculum. \u0000Methods: An electronic survey was distributed to undergraduate medical students in Canadian medical schools. Main sections of the survey addressed experience with virtual care encounters and perceived impact of virtual learning on medical education. \u0000Result: Out of our 53 respondents, the majority (80%) of medical students perceived high educational importance of virtual care encounters. 91% of the students recognized the developing role of virtual care in current and future medical practices. 55% of the surveyed showed readiness to conduct virtual care in the current curriculum. 94% of the responses stated the preferred feedback method for clinical learning was immediate faculty assessment following the encounter. \u0000Discussion: The results from this study provided insight on the medical learner’s experience while navigating virtual care and identified areas of improvements at an institutional level. Effective medical training that integrates the advantages of virtual care is crucial.","PeriodicalId":87852,"journal":{"name":"University of Western Ontario medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91271127","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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