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1. Socioeconomic disparities and their effect on medical student academic attainment Sudanese Universities

Author

Mohammed Hammad Jaber, Ibrahim Abusufian Dafallah, Ayat Yousif Mohammed, Reel Eltahir Eltahir, Mohammed Awad Mohamed, Tarteel Abdalla Mohamed, Moayad Hussein Mudawi, Duha Osman Tayfour, Sana Esmail Mastor Mohammed Ali, Eman Mohammed Ali Mohammed Ahmed, Asma Mohammedelbagir Osman, Hala Abdallah Kakoum, Mawada Mohammed Bagadi, and Ahmed Osman Mohammed

Subjects
Socioeconomic status, Academic performance, Education, Medical school, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Background Socioeconomic status (SES) is a social classification factor that takes into account income, parental education and occupation. SES has been shown to play an important role in shaping students’ academic performance, including in medical schools, but there still remains significant variation in findings around SES and academic achievement worldwide. We aim to assess and explore socioeconomic disparities and their effects on medical school performance at Sudanese public and private universities. Objectives The objective of our study was to assess the effects of age, sex, living conditions, parental education and income level on the academic achievement of medical students from universities in Sudan. Methods This cross-sectional study was conducted among undergraduate medical students at ten public universities in Sudan between September and December 2023. Participants were included if they were older than 18 years and were studying in their 2nd year or older. The data were collected using an online questionnaire with open- and closed-ended questions measuring age, living conditions, parental income level and education. A convenience sampling method was used to recruit participants from universities. The data were analyzed using SPSS v28.0.0, and a p value less than 0.05 was used to indicate statistical significance. Results We received 832 responses, 516 (62%) from females and 307 (36.9%) from males. The median age was 23 years. Most students lived with their families (61.1%), followed by student housing (28.2%). This study revealed age (p = .024) (95% Cl: 0.025- 0.023) andhigh family income (p = .019) (95% Cl: 0.018- 0.02) are associated with academic achievement in the long term, as demonstrated through cumulative grade point average (cGPA). Conclusion The findings underscore the importance of targeted support systems to bridge the socioeconomic gaps that exist among medical students, allowing all students to thrive academically regardless of their background. Clinical trial number None.

Published
2024
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2. #COVID19 and #Breastcancer: a qualitative analysis of tweets

Author

Bilgen, İdil, Naganathan, G.; Cleland, J.; Reel, E.; Cil, T., School of Medicine, Bilgen, İdil, Naganathan, G.; Cleland, J.; Reel, E.; Cil, T., and School of Medicine

Abstract

Rapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool., NA

Published
2022

3. General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

Author

Odor, P. M., Bampoe, S., Moonesinghe, S. R., Andrade, J., Pandit, J. J., Lucas, D. N., A’Court, A., Abdel-Gadir, D., Abdu, A., Abisogun, C., Aboud, Z., Abrams, J., Ackerman, A., Adamson, C., Addison, R., Adeyeye, A., Adler, R., Aduse-Poku, M., Adyanthaya, S., Ahmad, N., Ahmed, D., Ahmed, A., Akindele, B., Akindele, O., Akrimi, S., Al-Rawi, S., Ali, Y., Allam, J., Allana, A., Allen, K., Allen, O., Amaradasa, N., Amarasekara, L., Amoakwa-adu, F., Anandageetha, P., Anandakrishnan, S., Anandanadesan, R., Anderson, M., Apps, S., Aquilina, A., Arbane, G., Arch, A., Armstrong, S., Arya, R., Ashiru, G., Ashpole, K., Atkinson, C., Atkinson, F., Auer, E., Avery, B., Babio-Galan, M., Bader, H., Badham, G., Bagchi, S., Bailey, S., Baird, Y., Balaka, C., Baldwin, M., Balfour, P., Bali, S., Banks, S., Barclay, P., Barnes, L., Barnes, T., Barot, N., Barrett, S., Barrett, V., Barrett, K., Bates, L., Batte, K., Baytug, B., Behravesh, M., Bell, S., Benloch, R., Bentley, R., Berg, J., Berwick, C., Berwick, R., Bhadange, R., Bhattacharyya, S., Bielskute, E., Birch, S., Bird, S., Bird, Ruth, Birts, William, Black, Becky, Blagova, Tatyana, Blake, Holly, Blightman, Oliver, Blunden, Susara, Bolton, R., Borkett-Jones, C., Boselli, J., Bowen, M., Bowen, R., Bowyer, J., Boyle, H., Brar, Z., Bray, J., Brayshaw, S., Bressington, C., Brewer, A., Brice, N., Bridge, L., Briscoe, J., Brocklesby, S., Brown, H., Brown, S., Brunnen, D., Burijintichenna, K., Burnard, S., Burtt, A., Buswell, V., Bykar, H., Cairney, M., Calvert, C., Camarasa, L., Campbell, N., Campbell-Jones, F., Cantliffe, J., Carrol, W., Carvalho, J., Cashell, C., Cassie, S., Cassim, K., Chandler, M., Chapman, R., Charles, R., Chen, P., Cheyne, D., Chima, K., Chin, F., Chirvasuta, R., Shao Chong, M., Choudhury, S., Chowdhury, P., Christmas, T., Chughwani, S., Ciechanowicz, S., Clarey, E., Coe, R., Cohen, J., Coker, N., Collins, K., Collis, L., Comar, J., Conroy, M., Constantin, K., Corfe, J., Coulborn, E., Cowie, V., Crone, R., Cronin, J., Crooks, J., Crowther, N., Crowther, E., Cruz, C., Curtis, A., Curtis, S., Dabrowicz, A., Daines, N., Dalal, V., Dannatt, P., Das, D., Dash, J., Davidson, K., Davies, S., Davis, Y., Dawson, J., Dean, J., Dean, C., Denman, J., Desai, N., Dewan, P., Dimont, S., Donovan, C., Doraiswami, M., Doughty, K., Douglass, J., Dower, M., Downing, S., Duberry, W., Duckham, E., Dudgeon, L., Dukes, S., Dunn, L., Duraiswamy, V., Dwyer, A. O., Dyer, K., Eapen, S., Earl, M., Eason, S., Edwards, K., Edwards, Z., Egole, O., Ekpa, J., el-Amin, O., el-Boghdadly, K., Elbasir, O., Eldridge, J., Elgie, L., Ellington, M., Elliott, K., Elliott, J., Elmi, M., Elnoumeir, R., Emeakaraoha, E., Evans, M., Everett, M., Fabb, P., Farooq, H., Farrimond, R., Faulds, F., Fawcett, E., Feneley, A., Fernando, D., Ferns, J., Finlay, C., Fitzgerald, S., O’Flaherty, D., Fleet, M., Fletcher, L., Fludder, V., Follet, T., Forbes, J., Forth, M., Foster, G., Francis, J., Fraser, K., Friedman, L., Fruggeri, L., Fulton, L., Funnell, S., Gadre, A., Gandhi, A., Gardiner, H., Garner, Z., Garvey, G., Gately, T., George, R., Gillespie, S., Glover, S., Goddard, J., Goodman, B., Gopal, T., Graham, G., Green, D., Griffin, D., Griffith, J., Grigsby, S., Grindey, J., Griffiths, H., Groome, J., Grother, C., Grounds, G., Groves, A., Guha, A., Gunawardhana, A., Gupta, A., Gupta, R., Gutsell, J., Haddon, R., Hadi, D., Hadjipavlou, N., Hammerbeck, H., Hammon, L., Hammond, S., Hampanna, H., Hancock, H., Handapangoda, H., Haroon-Mowahed, Y., Harpham, D., Harris, G., Harrison, A., Harshan, D., Hartopp, A., Harty, E., Haslam, N., Hawkins, G., Hawkins, E., Hawksey, S., Hays, C., Hazelton, T., Heavyside, A., Hemeson, C., Henderson, K., Henry, O., Herbert, L., Higgins, N., Hilton, J., Hindmoor, C., Hitchcock, R., Hobbs, L., Homsy, M., Honeywell, C., Hoque, N., House, K., Howle, R., Tiller, A., Huniak, M., Hunte, J., Husain, T., Huson, C., Hussain, C., Hussain, T., Hussein, Z., Hyams, J., Hyde, E., Laverdino, M., Ignacka, A., Innes, E., Ioannidis, S., Iqbal, R., Ismail, F., Jackson, J., Jackson, M., Jackson, G., Jacobs, R., Jadhav, P., Jalaly, A., James, L., James, M., Jani, S., Jeganathan, C., Joannides, C., Johnson, R., Johnson, T., Johnston, C., Jones, R., Jones, T., Kadr, M., Kainth, R., Kane, J., Kanji, R., Kannanparambil, S., Kar, G., Kasianandan, T., Kaskos, H., Kavanagh, L., Kaye, R., Kelliher, L., Kelliot, S., Kelly, J., Kenyon, C., Kessack, L., Kestner, S., Khaku, M., Khaleeq, S., Khan, P., Khan, S., Kidwai, U., King, C., King, H., Kingston, E., Kok, W., Konig, R., Konstantinova, Z., Krishnan, P., Kua, J., Kuntumalla, K., Kursumovic, E., Kurzatkowski, K., Kuttambakam, H., Lane, K., Lane, S., Langton, A., Latif, H., Lau, N., Laxman, S., Laycock, H., Lee, R., Leonardi, S., Light, K., Lightfoot, H., Liu, S., Liyanage, S., Lowe, J., Lucas, N., Lungu, M., Lunn, M., Lynes, H., Machavarapu, K., Mackenzie, M., Magee, D., Major, J., Male, V., Malik, Z., Manso, K., Maquinana, M., Marciniak, K., Maronge, L., Marsh, C., Martella, C., Martin, N., Martins, N., Marway, J., Mason, L., Masood, N., Masters, J., Maton-Howarth, M., Mazzola, F., McAllister, T., McCarthy, R., McCormick, C., McCready, S., McDougall, S., Mcewan, L., McGarry, J., McKevitt, H., Mckinley, S., Mckskeane, A., McMaster, E., McMonagle, M., McNamara, H., McPhee, H., McRae, L., Mead, D., Meadows, E., Mehta, M., Meikle, J., Metodiev, Y., Michael, C., Millar, V., Miller, S., Miller, G., Milne, S., Miltsios, K., Misquita, L., Misquita, S., Mittal, M., Mohamed, M., Powell Monaghan, K., Monk, J., Monkhouse, A., Monks, D., Montague, L., Moon, A., Moran, J., Moreton, A., Morgan, E., Morgan, O., Morland, D., Morosan, M., Morris, K., Morris, A., Moser, C., Mount, M., Muir, C., Mupudzi, M., Murali, M., Murdoch, I., Murray, H., Murray, T., Murrell, K., Narasimha Murthy, G., Neeley, D., Nei, H., Neil, K., Nejim, T., Nel, M., Nicholson, A., Nicklin, A., Nolan, C., Nolan, T., Nurmi, E., O’Neill, B., Oakes, C., Oakes, N., Ochoa-Ferraro, M., Odeleye, N., Oliver, K., Oliver, M., Onslow, J., Onwochei, D., Oommen, T., Orr, T., Osagie, O., Osborn, H., Overend, J., Owston, H., Pack, E., Padhi, P., Palani, P., Pandey, R., Pandya, D., Panesar, N., Papageorgiou, C., Papanastasiou, G., Papoutsos, C., Pararajasingham, S., Parry, J., Patel, H., Patel, J., Patel, K., Patel, M., Patel, R., Patel, N., Pathak, S., Pearson, F., Peciulene, V., Peers, B., Peirce, B., Pepper, S., Perinpanayagam, J., Perry, H., Petrova, N., Phillips, T., Phillips, S., Phylactides, L., Pilkington, F., Plumb, J., Poimenidi, E., Sau Kuk Poon, A., Potter, T., Poultney, U., Powell, L., Prenter, A., Preston, K., Price, A., Pritchard, N., Pullen, J., Purohit, M., Quamina, C., Qureshi, J., Rajput, Z., Ramage, S., Ramanathan, T., Ranasinghe, U., Ranatunga, K., Rand, A., Randive, S., Rangarajan, D., Rao, C., Rao Pelluri, S., Ratnasingham, A., Razzaque, J., Reddy, A., Redington, K., Reel, E., Remeta, P., Ricco, F., Riccoboni, A., Rice, P., Rich, M., Richards, N., Riches, J., Ripoll, S., Roberts, F., Roberts, K., Robins, K., Robinson, S., Roche, S., Rojo, M., Carmela Romano, N., Rosser, H., Roughley, L., Routley, C., Rowley, C., Rudra, P., Russell, R., Ryan, C., Saad, C., Sadeghi, A., Salberg, A., Salota, V., Samuel, M., Samuels, R., Sanapala, S., Sanusi, S., Sarao, S., Sathyabhama, S., Saunders, Z., Sawarzynska-ryszka, B., Sceales, P., Schumacher, N., Schwartz, N., Sellers, C., Sellers, H., Sellick, J., Sen, S., Senaratne, D., Senbeto, S., Seneviratna, D., Setty, T., Shah, R., Shah, S., Shambly, J., Sharafudeen, S., Sharieff, I., Sharifi, L., Sharpe, L., Shaw, M., Sheldrake, I., Shinde, P., Shonfeld, A., Short, J., Siah, J., Sibug, S., Siddique, O., Siew, S., Simpson, M., Singleton, G., Sinha, K., Sinha, A., Sinnott, M., Sivadhas, H., Sivakumar, S., Sivarajan, B., Sivarajan, S., Skeoch, C., Slade, S., Slater, P., Smith, C., Smith, E., Smith, J., Smith, L., Smith, A., Smith, R., Smith, S., Smith, T., Smithers, H., Smolen, S., Smyth, C., Snel, T., Snipe, C., Soltanifar, S., Sonawane, N., Soundararaja, A., Spence, E., Spiliopoulos, M., Srivastava, C., Stacey, K., Stafford, H., Staines, N., Stead, R., Stevens, E., Stilwell, A., Stocks, G., Stokes, A., Stone, C., Straughan, B., Subbarathnam, V., Sudunagunta, S., Sultan, P., Suppiah, P., Surve, P., Sutherland, A., Swanton, R., Swarbrick, C., Swinson, A., Syrrakou, E., Tadbiri, S., Tamhane, P., Tamilselvan, P., Tan, A., Tanna, S., Tarft, H., Tarry, L., Taylor, I., Taylor, S., Tebbot, J., Theron, S., Thomas, M., Todd, S., Tolliday, H., Topham, C., Tovell, N., Traves, M., Trodd, D., Tufchi, A., Turley, K., Turnbull, M., Turnbull, C., Turner, O., Turner, W., Turney, S., Tyagi, E., Uncles, D., Unsworth, V., Vadnere, P., Varadan, R., Vasishta, V., Veal, A., Vedham, L., Venkaya, J., Verghese, M., Veronica, I., Vidanagamage, D., Vincent, R., Vyapury, V., Wain, H., Walbridge, F., Walker, E., Walsh, P., Walshe, E., Walters, M., Wan, Y., Wang, C., Wankhade, K., Waters, G., Watts, C., Webber, A., Wedgwood, T., Wee, M., Wellstead, S., White, A., Whitear, M., Whitefield, L., Wilkinson, S., Williams, L., Williams, R., Wilson, D., Wilson, S., Wimble, K., Winkley, E., Winslow, L., Winwright, P., Wloch, K., Wong, G., Wong, H., Man Wong, J., Wood, T., Wray, S., Wrench, I., Wu, J., Wynn, K., Yap, Y., Kuan Yeow, C., Young, E., Yusaf, A., Uz Zafar, S., Zeinali, D., Zhang, S., Zope, S., Zucco, L., Anwar, S., Blunt, N., Grover, V., Grailey, K., Gray, M., Highton, D., Hopkins, P., Kemp, H., Lo, Q., Martin, D., Morkane, C., O’Carroll, J., Oliver, C., Post, B., Visram, A., Wickham, A., General Paediatrics, Graduate School, Adult Psychiatry, and Pulmonology

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Caesarean section, General anaesthesia, general anaesthesia, 030212 general & internal medicine, Rocuronium, General anaesthetic, education, Neuromuscular Blockade, education.field_of_study, airway management, obstetrics, business.industry, Tracheal intubation, Surgery, Anesthesiology and Pain Medicine, caesarean section, Airway management, business, medicine.drug
Abstract

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%).

Published
2020

7. The Impact of COVID-19 on Breast Cancer Care: A Qualitative Analysis of Surgeons' Perspectives.

Author

Ko G, Naganathan G, Reel E, Cleland J, Covelli A, Wright FC, and Cil TD

Subjects
Humans, Female, Ontario epidemiology, Attitude of Health Personnel, Middle Aged, Adult, Healthcare Disparities, COVID-19 epidemiology, Breast Neoplasms psychology, Breast Neoplasms therapy, Breast Neoplasms surgery, Surgeons psychology, Surgeons statistics & numerical data, Qualitative Research, SARS-CoV-2
Abstract

Introduction: While studies have documented delays in breast cancer (BC) care during the COVID-19 pandemic due to healthcare restrictions, there have been no studies on the experiences, and, particularly, the challenges with providing care faced by breast surgeons during this unprecedented time. This paper aims to understand the perspectives of breast surgeons regarding the impact of the COVID-19 pandemic on BC care., Methods: We used purposeful and snowball sampling to identify breast surgeons in Ontario, Canada. One-on-one qualitative semi-structured interviews were conducted exploring the impact of the pandemic on BC treatment, psychosocial well-being of patients and providers, and the future state of BC care. Audio-recorded interviews were transcribed verbatim and analyzed using Thematic Analysis., Results: A total of 10 breast surgeons (5 community and 5 academic) were interviewed. Breast surgeons reported that the pandemic led to increased multidisciplinary collaboration and innovations in delivery of BC surgery (e.g., increased use of regional anesthesia). Multiple surgeons identified that the pandemic created disparities in BC care based geographic location and that existing disparities in care based on ethnicity or marginalization were exacerbated. Last, surgeons identified that virtual care improved, but also created some challenges to how BC care was delivered, with many hoping for this to be continued after the pandemic was over., Conclusions: In this study, breast surgeons identified unique challenges and solutions to BC care delivery during the pandemic. Concerns regarding disparities in care based on geographic location and marginalized patients require further study to improve future BC care., (Copyright © 2024. Published by Elsevier Inc.)

Published
2024
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8. 2023 Canadian Surgery Forum: Sept. 20-23, 2023.

Author

Brière R, Émond M, Benhamed A, Blanchard PG, Drolet S, Habashi R, Golbon B, Shellenberger J, Pasternak J, Merchant S, Shellenberger J, La J, Sawhney M, Brogly S, Cadili L, Horkoff M, Ainslie S, Demetrick J, Chai B, Wiseman K, Hwang H, Alhumoud Z, Salem A, Lau R, Aw K, Nessim C, Gawad N, Alibhai K, Towaij C, Doan D, Raîche I, Valji R, Turner S, Balmes PN, Hwang H, Hameed SM, Tan JGK, Wijesuriya R, Tan JGK, Hew NLC, Wijesuriya R, Lund M, Hawel J, Gregor J, Leslie K, Lenet T, McIsaac D, Hallet J, Jerath A, Lalu M, Nicholls S, Presseau J, Tinmouth A, Verret M, Wherrett C, Fergusson D, Martel G, Sharma S, McKechnie T, Talwar G, Patel J, Heimann L, Doumouras A, Hong D, Eskicioglu C, Wang C, Guo M, Huang L, Sun S, Davis N, Wang J, Skulsky S, Sikora L, Raîche I, Son HJ, Gee D, Gomez D, Jung J, Selvam R, Seguin N, Zhang L, Lacaille-Ranger A, Sikora L, McIsaac D, Moloo H, Follett A, Holly, Organ M, Pace D, Balvardi S, Kaneva P, Semsar-Kazerooni K, Mueller C, Vassiliou M, Al Mahroos M, Fiore JF Jr, Schwartzman K, Feldman L, Guo M, Karimuddin A, Liu GP, Crump T, Sutherland J, Hickey K, Bonisteel EM, Umali J, Dogar I, Warden G, Boone D, Mathieson A, Hogan M, Pace D, Seguin N, Moloo H, Li Y, Best G, Leong R, Wiseman S, Alaoui AA, Hajjar R, Wassef E, Metellus DS, Dagbert F, Loungnarath R, Ratelle R, Schwenter F, Debroux É, Wassef R, Gagnon-Konamna M, Pomp A, Richard CS, Sebajang H, Alaoui AA, Hajjar R, Dagbert F, Loungnarath R, Sebajang H, Ratelle R, Schwenter F, Debroux É, Wassef R, Gagnon-Konamna M, Pomp A, Santos MM, Richard CS, Shi G, Leung R, Lim C, Knowles S, Parmar S, Wang C, Debru E, Mohamed F, Anakin M, Lee Y, Samarasinghe Y, Khamar J, Petrisor B, McKechnie T, Eskicioglu C, Yang I, Mughal HN, Bhugio M, Gok MA, Khan UA, Fernandes AR, Spence R, Porter G, Hoogerboord CM, Neumann K, Pillar M, Guo M, Manhas N, Melck A, Kazi T, McKechnie T, Jessani G, Heimann L, Lee Y, Hong D, Eskicioglu C, McKechnie T, Tessier L, Archer V, Park L, Cohen D, Parpia S, Bhandari M, Dionne J, Eskicioglu C, Bolin S, Afford R, Armstrong M, Karimuddin A, Leung R, Shi G, Lim C, Grant A, Van Koughnett JA, Knowles S, Clement E, Lange C, Roshan A, Karimuddin A, Scott T, Nadeau K, Macmillan J, Wilson J, Deschenes M, Nurullah A, Cahill C, Chen VH, Patterson KM, Wiseman SM, Wen B, Bhudial J, Barton A, Lie J, Park CM, Yang L, Gouskova N, Kim DH, Afford R, Bolin S, Morris-Janzen D, McLellan A, Karimuddin A, Archer V, Cloutier Z, Berg A, McKechnie T, Wiercioch W, Eskicioglu C, Labonté J, Bisson P, Bégin A, Cheng-Oviedo SG, Collin Y, Fernandes AR, Hossain I, Ellsmere J, El-Kefraoui C, Do U, Miller A, Kouyoumdjian A, Cui D, Khorasani E, Landry T, Amar-Zifkin A, Lee L, Feldman L, Fiore J, Au TM, Oppenheimer M, Logsetty S, AlShammari R, AlAbri M, Karimuddin A, Brown C, Raval MJ, Phang PT, Bird S, Baig Z, Abu-Omar N, Gill D, Suresh S, Ginther N, Karpinski M, Ghuman A, Malik PRA, Alibhai K, Zabolotniuk T, Raîche I, Gawad N, Mashal S, Boulanger N, Watt L, Razek T, Fata P, Grushka J, Wong EG, Hossain I, Landry M, Mackey S, Fairbridge N, Greene A, Borgoankar M, Kim C, DeCarvalho D, Pace D, Wigen R, Walser E, Davidson J, Dorward M, Muszynski L, Dann C, Seemann N, Lam J, Harding K, Lowik AJ, Guinard C, Wiseman S, Ma O, Mocanu V, Lin A, Karmali S, Bigam D, Harding K, Greaves G, Parker B, Nguyen V, Ahmed A, Yee B, Perren J, Norman M, Grey M, Perini R, Jowhari F, Bak A, Drung J, Allen L, Wiseman D, Moffat B, Lee JKH, McGuire C, Raîche I, Tudorache M, Gawad N, Park LJ, Borges FK, Nenshi R, Jacka M, Heels-Ansdell D, Simunovic M, Bogach J, Serrano PE, Thabane L, Devereaux PJ, Farooq S, Lester E, Kung J, Bradley N, Best G, Ahn S, Zhang L, Prince N, Cheng-Boivin O, Seguin N, Wang H, Quartermain L, Tan S, Shamess J, Simard M, Vigil H, Raîche I, Hanna M, Moloo H, Azam R, Ko G, Zhu M, Raveendran Y, Lam C, Tang J, Bajwa A, Englesakis M, Reel E, Cleland J, Snell L, Lorello G, Cil T, Ahn HS, Dube C, McIsaac D, Smith D, Leclerc A, Shamess J, Rostom A, Calo N, Thavorn K, Moloo H, Laplante S, Liu L, Khan N, Okrainec A, Ma O, Lin A, Mocanu V, Karmali S, Bigam D, Bruyninx G, Georgescu I, Khokhotva V, Talwar G, Sharma S, McKechnie T, Yang S, Khamar J, Hong D, Doumouras A, Eskicioglu C, Spoyalo K, Rebello TA, Chhipi-Shrestha G, Mayson K, Sadiq R, Hewage K, MacNeill A, Muncner S, Li MY, Mihajlovic I, Dykstra M, Snelgrove R, Wang H, Schweitzer C, Wiseman SM, Garcha I, Jogiat U, Baracos V, Turner SR, Eurich D, Filafilo H, Rouhi A, Bédard A, Bédard ELR, Patel YS, Alaichi JA, Agzarian J, Hanna WC, Patel YS, Alaichi JA, Provost E, Shayegan B, Adili A, Hanna WC, Mistry N, Gatti AA, Patel YS, Farrokhyar F, Xie F, Hanna WC, Sullivan KA, Farrokhyar F, Patel YS, Liberman M, Turner SR, Gonzalez AV, Nayak R, Yasufuku K, Hanna WC, Mistry N, Gatti AA, Patel YS, Cross S, Farrokhyar F, Xie F, Hanna WC, Haché PL, Galvaing G, Simard S, Grégoire J, Bussières J, Lacasse Y, Sassi S, Champagne C, Laliberté AS, Jeong JY, Jogiat U, Wilson H, Bédard A, Blakely P, Dang J, Sun W, Karmali S, Bédard ELR, Wong C, Hakim SY, Azizi S, El-Menyar A, Rizoli S, Al-Thani H, Fernandes AR, French D, Li C, Ellsmere J, Gossen S, French D, Bailey J, Tibbo P, Crocker C, Bondzi-Simpson A, Ribeiro T, Kidane B, Ko M, Coburn N, Kulkarni G, Hallet J, Ramzee AF, Afifi I, Alani M, El-Menyar A, Rizoli S, Al-Thani H, Chughtai T, Huo B, Manos D, Xu Z, Kontouli KM, Chun S, Fris J, Wallace AMR, French DG, Giffin C, Liberman M, Dayan G, Laliberté AS, Yasufuku K, Farivar A, Kidane B, Weessies C, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan SK, Kidane B, Nasralla A, Safieddine N, Gazala S, Simone C, Ahmadi N, Hilzenrat R, Blitz M, Deen S, Humer M, Jugnauth A, Buduhan G, Kerr L, Sun S, Browne I, Patel Y, Hanna W, Loshusan B, Shamsil A, Naish MD, Qiabi M, Nayak R, Patel R, Malthaner R, Pooja P, Roberto R, Greg H, Daniel F, Huynh C, Sharma S, Vieira A, Jain F, Lee Y, Mousa-Doust D, Costa J, Mezei M, Chapman K, Briemberg H, Jack K, Grant K, Choi J, Yee J, McGuire AL, Abdul SA, Khazoom F, Aw K, Lau R, Gilbert S, Sundaresan S, Jones D, Seely AJE, Villeneuve PJ, Maziak DE, Pigeon CA, Frigault J, Drolet S, Roy ÈM, Bujold-Pitre K, Courval V, Tessier L, McKechnie T, Lee Y, Park L, Gangam N, Eskicioglu C, Cloutier Z, McKechnie T (McMaster University), Archer V, Park L, Lee J, Patel A, Hong D, Eskicioglu C, Ichhpuniani S, McKechnie T, Elder G, Chen A, Logie K, Doumouras A, Hong D, Benko R, Eskicioglu C, Castelo M, Paszat L, Hansen B, Scheer A, Faught N, Nguyen L, Baxter N, Sharma S, McKechnie T, Khamar J, Wu K, Eskicioglu C, McKechnie T, Khamar J, Lee Y, Tessier L, Passos E, Doumouras A, Hong D, Eskicioglu C, McKechnie T, Khamar J, Sachdeva A, Lee Y, Hong D, Eskicioglu C, Fei LYN, Caycedo A, Patel S, Popa T, Boudreau L, Grin A, Wang T, Lie J, Karimuddin A, Brown C, Phang T, Raval M, Ghuman A, Candy S, Nanda K, Li C, Snelgrove R, Dykstra M, Kroeker K, Wang H, Roy H, Helewa RM, Johnson G, Singh H, Hyun E, Moffatt D, Vergis A, Balmes P, Phang T, Guo M, Liu J, Roy H, Webber S, Shariff F, Helewa RM, Hochman D, Park J, Johnson G, Hyun E, Robitaille S, Wang A, Maalouf M, Alali N, Elhaj H, Liberman S, Charlebois P, Stein B, Feldman L, Fiore JF Jr, Lee L, Hu R, Lacaille-Ranger A, Ahn S, Tudorache M, Moloo H, Williams L, Raîche I, Musselman R, Lemke M, Allen L, Samarasinghe N, Vogt K, Brackstone M, Zwiep T, Clement E, Lange C, Alam A, Ghuman A, Karimuddin A, Phang T, Raval M, Brown C, Clement E, Liu J, Ghuman A, Karimuddin A, Phang T, Raval M, Brown C, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, James N, Zwiep T, Van Koughnett JA, Laczko D, McKechnie T, Yang S, Wu K, Sharma S, Lee Y, Park L, Doumouras A, Hong D, Parpia S, Bhandari M, Eskicioglu C, McKechnie T, Tessier L, Lee S, Kazi T, Sritharan P, Lee Y, Doumouras A, Hong D, Eskicioglu C, McKechnie T, Lee Y, Hong D, Dionne J, Doumouras A, Parpia S, Bhandari M, Eskicioglu C, Hershorn O, Ghuman A, Karimuddin A, Brown C, Raval M, Phang PT, Chen A, Boutros M, Caminsky N, Dumitra T, Faris-Sabboobeh S, Demian M, Rigas G, Monton O, Smith A, Moon J, Demian M, Garfinkle R, Vasilevsky CA, Rajabiyazdi F, Boutros M, Courage E, LeBlanc D, Benesch M, Hickey K, Hartwig K, Armstrong C, Engelbrecht R, Fagan M, Borgaonkar M, Pace D, Shanahan J, Moon J, Salama E, Wang A, Arsenault M, Leon N, Loiselle C, Rajabiyazdi F, Boutros M, Brennan K, Rai M, Farooq A, McClintock C, Kong W, Patel S, Boukhili N, Caminsky N, Faris-Sabboobeh S, Demian M, Boutros M, Paradis T, Robitaille S, Dumitra T, Liberman AS, Charlebois P, Stein B, Fiore JF Jr, Feldman LS, Lee L, Zwiep T, Abner D, Alam T, Beyer E, Evans M, Hill M, Johnston D, Lohnes K, Menard S, Pitcher N, Sair K, Smith B, Yarjau B, LeBlanc K, Samarasinghe N, Karimuddin AA, Brown CJ, Phang PT, Raval MJ, MacDonell K, Ghuman A, Harvey A, Phang PT, Karimuddin A, Brown CJ, Raval MJ, Ghuman A, Hershorn O, Ghuman A, Karimuddin A, Raval M, Phang PT, Brown C, Logie K, Mckechnie T, Lee Y, Hong D, Eskicioglu C, Matta M, Baker L, Hopkins J, Rochon R, Buie D, MacLean A, Ghuman A, Park J, Karimuddin AA, Phang PT, Raval MJ, Brown CJ, Farooq A, Ghuman A, Patel S, Macdonald H, Karimuddin A, Raval M, Phang PT, Brown C, Wiseman V, Brennan K, Patel S, Farooq A, Merchant S, Kong W, McClintock C, Booth C, Hann T, Ricci A, Patel S, Brennan K, Wiseman V, McClintock C, Kong W, Farooq A, Kakkar R, Hershorn O, Raval M, Phang PT, Karimuddin A, Ghuman A, Brown C, Wiseman V, Farooq A, Patel S, Hajjar R, Gonzalez E, Fragoso G, Oliero M, Alaoui AA, Rendos HV, Djediai S, Cuisiniere T, Laplante P, Gerkins C, Ajayi AS, Diop K, Taleb N, Thérien S, Schampaert F, Alratrout H, Dagbert F, Loungnarath R, Sebajang H, Schwenter F, Wassef R, Ratelle R, Debroux É, Cailhier JF, Routy B, Annabi B, Brereton NJB, Richard C, Santos MM, Gimon T, MacRae H, de Buck van Overstraeten A, Brar M, Chadi S, Kennedy E, Baker L, Hopkins J, Rochon R, Buie D, MacLean A, Park LJ, Archer V, McKechnie T, Lee Y, McIsaac D, Rashanov P, Eskicioglu C, Moloo H, Devereaux PJ, Alsayari R, McKechnie T, Ichhpuniani S, Lee Y, Eskicioglu C, Hajjar R, Oliero M, Fragoso G, Ajayi AS, Alaoui AA, Rendos HV, Calvé A, Cuisinière T, Gerkins C, Thérien S, Taleb N, Dagbert F, Sebajang H, Loungnarath R, Schwenter F, Ratelle R, Wassef R, Debroux E, Richard C, Santos MM, Kennedy E, Simunovic M, Schmocker S, Brown C, MacLean A, Liberman S, Drolet S, Neumann K, Stotland P, Jhaveri K, Kirsch R, Alnajem H, Alibrahim H, Giundi C, Chen A, Rigas G, Munir H, Safar A, Sabboobeh S, Holland J, Boutros M, Kennedy E, Richard C, Simunovic M, Schmocker S, Brown C, MacLean A, Liberman S, Drolet S, Neumann K, Stotland P, Jhaveri K, Kirsch R, Bruyninx G, Gill D, Alsayari R, McKechnie T, Lee Y, Hong D, Eskicioglu C, Zhang L, Abtahi S, Chhor A, Best G, Raîche I, Musselman R, Williams L, Moloo H, Caminsky NG, Moon JJ, Marinescu D, Pang A, Vasilevsky CA, Boutros M, Al-Abri M, Gee E, Karimuddin A, Phang PT, Brown C, Raval M, Ghuman A, Morena N, Ben-Zvi L, Hayman V, Hou M (University of Calgary), Nguyen D, Rentschler CA, Meguerditchian AN, Mir Z, Fei L, McKeown S, Dinchong R, Cofie N, Dalgarno N, Cheifetz R, Merchant S, Jaffer A, Cullinane C, Feeney G, Jalali A, Merrigan A, Baban C, Buckley J, Tormey S, Benesch M, Wu R, Takabe K, Benesch M, O'Brien S, Kazazian K, Abdalaty AH, Brezden C, Burkes R, Chen E, Govindarajan A, Jang R, Kennedy E, Lukovic J, Mesci A, Quereshy F, Swallow C, Chadi S, Habashi R, Pasternak J, Marini W, Zheng W, Murakami K, Ohashi P, Reedijk M, Hu R, Ivankovic V, Han L, Gresham L, Mallick R, Auer R, Ribeiro T, Bondzi-Simpson A, Coburn N, Hallet J, Cil T, Fontebasso A, Lee A, Bernard-Bedard E, Wong B, Li H, Grose E, Brandts-Longtin O, Aw K, Lau R, Abed A, Stevenson J, Sheikh R, Chen R, Johnson-Obaseki S, Nessim C, Hennessey RL, Meneghetti AT, Bildersheim M, Bouchard-Fortier A, Nelson G, Mack L, Ghasemi F, Naeini MM, Parsyan A, Kaur Y, Covelli A, Quereshy F, Elimova E, Panov E, Lukovic J, Brierley J, Burnett B, Swallow C, Eom A, Kirkwood D, Hodgson N, Doumouras A, Bogach J, Whelan T, Levine M, Parvez E, Ng D, Kazazian K, Lee K, Lu YQ, Kim DK, Magalhaes M, Grigor E, Arnaout A, Zhang J, Yee EK, Hallet J, Look Hong NJ, Nguyen L, Coburn N, Wright FC, Gandhi S, Jerzak KJ, Eisen A, Roberts A, Ben Lustig D, Quan ML, Phan T, Bouchard-Fortier A, Cao J, Bayley C, Watanabe A, Yao S, Prisman E, Groot G, Mitmaker E, Walker R, Wu J, Pasternak J, Lai CK, Eskander A, Wasserman J, Mercier F, Roth K, Gill S, Villamil C, Goldstein D, Munro V, Pathak A (University of Manitoba), Lee D, Nguyen A, Wiseman S, Rajendran L, Claasen M, Ivanics T, Selzner N, McGilvray I, Cattral M, Ghanekar A, Moulton CA, Reichman T, Shwaartz C, Metser U, Burkes R, Winter E, Gallinger S, Sapisochin G, Glinka J, Waugh E, Leslie K, Skaro A, Tang E, Glinka J, Charbonneau J, Brind'Amour A, Turgeon AF, O'Connor S, Couture T, Wang Y, Yoshino O, Driedger M, Beckman M, Vrochides D, Martinie J, Alabduljabbar A, Aali M, Lightfoot C, Gala-Lopez B, Labelle M, D'Aragon F, Collin Y, Hirpara D, Irish J, Rashid M, Martin T, Zhu A, McKnight L, Hunter A, Jayaraman S, Wei A, Coburn N, Wright F, Mallette K, Elnahas A, Alkhamesi N, Schlachta C, Hawel J, Tang E, Punnen S, Zhong J, Yang Y, Streith L, Yu J, Chung S, Kim P, Chartier-Plante S, Segedi M, Bleszynski M, White M, Tsang ME, Jayaraman S, Lam-Tin-Cheung K, Jayaraman S, Tsang M, Greene B, Pouramin P, Allen S, Evan Nelson D, Walsh M, Côté J, Rebolledo R, Borie M, Menaouar A, Landry C, Plasse M, Létourneau R, Dagenais M, Rong Z, Roy A, Beaudry-Simoneau E, Vandenbroucke-Menu F, Lapointe R, Ferraro P, Sarkissian S, Noiseux N, Turcotte S, Haddad Y, Bernard A, Lafortune C, Brassard N, Roy A, Perreault C, Mayer G, Marcinkiewicz M, Mbikay M, Chrétien M, Turcotte S, Waugh E, Sinclair L, Glinka J, Shin E, Engelage C, Tang E, Skaro A, Muaddi H, Flemming J, Hansen B, Dawson L, O'Kane G, Feld J, Sapisochin G, Zhu A, Jayaraman S, Cleary S, Hamel A, Pigeon CA, Marcoux C, Ngo TP, Deshaies I, Mansouri S, Amhis N, Léveillé M, Lawson C, Achard C, Ilkow C, Collin Y, Tai LH, Park L, Griffiths C, D'Souza D, Rodriguez F, McKechnie T, Serrano PE, Hennessey RL, Yang Y, Meneghetti AT, Panton ONM, Chiu CJ, Henao O, Netto FS, Mainprize M, Hennessey RL, Chiu CJ, Hennessey RL, Chiu CJ, Jatana S, Verhoeff K, Mocanu V, Jogiat U, Birch D, Karmali S, Switzer N, Hetherington A, Verhoeff K, Mocanu V, Birch D, Karmali S, Switzer N, Safar A, Al-Ghaithi N, Vourtzoumis P, Demyttenaere S, Court O, Andalib A, Wilson H, Verhoeff K, Dang J, Kung J, Switzer N, Birch D, Madsen K, Karmali S, Mocanu V, Wu T, He W, Vergis A, Hardy K, Zmudzinski M, Daenick F, Linton J, Zmudzinski M, Fowler-Woods M, He W, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Lee Y, Doumouras A, Molnar A, Nguyen F, Hong D, Schneider R, Fecso AB, Sharma P, Maeda A, Jackson T, Okrainec A, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, MacVicar S, Dang J, Mocanu V, Verhoeff K, Jogiat U, Karmali S, Birch D, Switzer N, McLennan S, Verhoeff K, Purich K, Dang J, Kung J, Mocanu V, McLennan S, Verhoeff K, Mocanu V, Jogiat U, Birch DW, Karmali S, Switzer NJ, Jeffery L, Hwang H, Ryley A, Schellenberg M, Owattanapanich N, Emigh B, Nichols C, Dilday J, Ugarte C, Onogawa A, Matsushima K, Martin MJ, Inaba K, Schellenberg M, Emigh B, Nichols C, Dilday J, Ugarte C, Onogawa A, Shapiro D, Im D, Inaba K, Schellenberg M, Owattanapanich N, Ugarte C, Lam L, Martin MJ, Inaba K, Rezende-Neto J, Patel S, Zhang L, Mir Z, Lemke M, Leeper W, Allen L, Walser E, Vogt K, Ribeiro T, Bateni S, Bondzi-Simpson A, Coburn N, Hallet J, Barabash V, Barr A, Chan W, Hakim SY, El-Menyar A, Rizoli S, Al-Thani H, Mughal HN, Bhugio M, Gok MA, Khan UA, Warraich A, Gillman L, Ziesmann M, Momic J, Yassin N, Kim M, Makish A, Walser E, Smith S, Ball I, Moffat B, Parry N, Vogt K, Lee A, Kroeker J, Evans D, Fansia N, Notik C, Wong EG, Coyle G, Seben D, Smith J, Tanenbaum B, Freedman C, Nathens A, Fowler R, Patel P, Elrick T, Ewing M, Di Marco S, Razek T, Grushka J, Wong EG, Park LJ, Borges FK, Nenshi R, Serrano PE, Engels P, Vogt K, Di Sante E, Vincent J, Tsiplova K, Devereaux PJ, Talwar G, Dionne J, McKechnie T, Lee Y, Kazi T, El-Sayes A, Bogach J, Hong D, Eskicioglu C, Connell M, Klooster A, Beck J, Verhoeff K, Strickland M, Anantha R, Groszman L, Caminsky NG, Watt L, Boulanger N, Razek T, Grushka J, Di Marco S, Wong EG, Livergant R, McDonald B, Binda C, Luthra S, Ebert N, Falk R, and Joos E

Published
2023
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9. Profiles of Burnout and Response to the COVID-19 Pandemic Among General Surgery Residents at a Large Academic Training Program.

Author

Nguyen MA, Castelo M, Greene B, Lu J, Brar S, Reel E, and Cil TD

Subjects
Humans, Pandemics, Surveys and Questionnaires, Internship and Residency, COVID-19 epidemiology, Burnout, Professional epidemiology, Burnout, Professional psychology, General Surgery education
Abstract

Background: COVID-19 has placed demands on General Surgery residents, who are already at high risk of burnout. This study examined the pandemic's impact on burnout and wellness among General Surgery residents at a large training program., Methods: General Surgery residents at our institution completed a survey focused on self-reported burnout, mental health, perceptions of wellness resources, and changes in activities during the pandemic. Burnout was measured using the Maslach Burnout Inventory (MBI). Unsupervised machine learning ( k-means clustering) was used to identify profiles of burnout and comparisons between profiles were made., Results: Of 82 eligible residents, 51 completed the survey (62% response rate). During COVID-19, 63% of residents had self-described burnout, 43% had depression, 18% acknowledged binge drinking/drug use, and 8% had anxiety. There were no significant differences from pre-pandemic levels ( p all >.05). Few residents perceived available wellness resources as effective (6%). Based on MBI scores, the clustering analysis identified three clusters, characterized as "overextended", "engaged", and "ineffective". Engaged residents had the least concerning MBI scores and were significantly more likely to exercise, retain social contact during the pandemic, and had less self-reported anxiety or depression. Research residents were overrepresented in the ineffective cluster (46%), which had high rates of self-reported burnout (77%) and was characterized by the lowest personal accomplishment scores. Rates of self-reported burnout for overextended and engaged residents were 73% and 48%, respectively., Conclusion: Surgical residents have high rates of self-reported burnout and depression during the COVID-19 pandemic. Clusters of burnout may offer targets for individualized intervention.

Published
2023
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10. High Risk Breast Cancer Screening is a Double Edged Sword: A Qualitative Study of Patient Perspectives on the Ontario High Risk Breast Cancer Screening Program.

Author

Deng SX, Castelo M, Reel E, Naganathan G, Eisen A, Muradali D, Grunfeld E, and Scheer AS

Subjects
Female, Humans, Adult, Ontario, Mammography, Breast pathology, Mass Screening, Magnetic Resonance Imaging, Early Detection of Cancer, Breast Neoplasms diagnostic imaging, Breast Neoplasms genetics
Abstract

Background: MRI-based breast cancer screening for high-risk women has been associated with false positives. This study explored the benefits and drawbacks of MRI-based screening using in-depth patient interviews., Methods: This was a qualitative study of interviews with women participating in the High Risk Ontario Breast Screening Program. Women enrolled at two centers who had completed at least one round of screening were invited to participate. Recruitment was suspended when thematic saturation was reached. Semi-structured telephone interviews were conducted and transcribed verbatim. Emergent themes were identified and a coding framework established., Results: 21 women (median age 41 years) participated in telephone interviews. Women had been in the program a median of 4 years (IQR 1-5), and 71% had experienced at least one abnormal screen. Eight participants (38%) had undergone biopsies. Six women (29%) were BRCA mutation carriers. MRIs were described as intimidating, uncomfortable, and claustrophobic. Participants were concerned about long-term exposure to gadolinium contrast. Compared to MRI, mammography alone was viewed as painful, less sensitive, and a "useless…waste of time." MRI provided a "psychological safety net" that outweighed the distress associated with abnormal screens. Many women accepted this trade-off as a "two-edged sword" that was "worth it" and provided a sense of control. Suggestions for improvement included more information regarding the risks of MRI, and access to counselling., Conclusions: Women participating in MRI-based screening strongly value reassurance from a highly sensitive screening test. This outweighed the distress of abnormal screens. There are areas for improvement around patient communication and psychosocial support., Competing Interests: Competing interests None to declare., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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11. #COVID19 and #Breastcancer: A Qualitative Analysis of Tweets.

Author

Naganathan G, Bilgen I, Cleland J, Reel E, and Cil T

Subjects
Humans, United States, Female, Pandemics, COVID-19 epidemiology, Social Media, Breast Neoplasms therapy
Abstract

Rapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool.

Published
2022
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12. Challenges in Cross-Cultural Communication in Breast Cancer Surgery: Is there a Gender Gap?

Author

Hu SY, Reel E, Nisenbaum R, and Scheer AS

Subjects
Canada, Communication, Communication Barriers, Cross-Cultural Comparison, Female, Humans, Sex Factors, Breast Neoplasms surgery
Abstract

The aim of this study is to identify [1] facilitators and barriers to cross-cultural communication with Canadian immigrants during the breast cancer (BC) surgical consultation and [2] the impact of cultural sensitivity training on the perception of cross-cultural communication barriers. A 29-item questionnaire mailed to 450 surgeons was developed based on the Ottawa Decision Support Framework, informed by interviews with BC practitioners and a literature review. The inclusion criteria are English-speaking general surgeons practicing in Vancouver, Montréal, and Toronto, home to > 60% of Canada's immigrant population. The association between surgeon characteristics and barriers to communication was assessed using the chi-square or Fisher's exact test. Univariate and multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between frequent perception of each barrier to communication and gender, career stage, and percentage of foreign-born patients. Between June and September 2017, 130 surveys were returned for a 29% response rate. The majority of practitioners reported experiencing language barriers in consultation with immigrant patients (71.4%). In the patient-provider relationship, the most commonly reported barrier was the patient's lack of medical understanding (81.4%). At the system level, the absence of a relative for translation was the most frequently encountered challenge (77.1%). On multivariable analysis adjusting for career stage and percentage of foreign-born patients, female gender of a surgeon was associated with more frequent perception of barriers related to language (OR 4.91, [95% CI 1.43, 16.82; p = 0.0114]), the patient's desired role in decision-making (OR 3.000 [95% CI 1.116-8.059; p = 0.0294]), and poor access to interpreters (OR 3.63 [95% CI 1.24, 10.64; p = 0.0189]). Furthermore, on multivariable analysis adjusting for gender and career stage, surgeons identified as having < 25% foreign-born patients in their practice were less likely to identify communication barriers due to the patients' perception and understanding of their healthcare (OR 0.32 [95% CI 0.11, 0.95; p = 0.041]). Cultural sensitivity training did not appear to be an influential factor though this may be due to the low number of surgeons who received training (5.7%). There are multiple cross-cultural communication challenges. Gender, years in practice, and the cultural diversity of a practice might play significant roles in the identification and perception of these barriers., (© 2021. American Association for Cancer Education.)

Published
2022
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13. Axillary surgery and complication rates after mastectomy and reconstruction for breast cancer: an analysis of the NSQIP database.

Author

Bogach J, Cordeiro E, Reel E, and Cil TD

Subjects
Axilla pathology, Female, Humans, Lymph Node Excision adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Sentinel Lymph Node Biopsy adverse effects, Breast Neoplasms pathology, Mastectomy adverse effects
Abstract

Purpose: Some series have shown increased complications with extended nodal surgery and immediate breast reconstruction (IBR) with implants. We aim to explore complications associated with axillary dissection compared to sentinel lymph node biopsy at a population level., Methods: American College of Surgeons National Surgical Quality Improvement Program participant user files from 2008-2018 were searched to create a cohort of female patients undergoing unilateral mastectomy with IBR and axillary surgery for non-metastatic breast cancer. Patients were classified as having sentinel lymph node biopsy (SLNB), axillary dissection (ALND), or sentinel lymph node biopsy and axillary dissection (SLNB + ALND). Baseline demographics were compared, and multivariable logistic regression was to assess for independent predictors of the primary outcome of 30-day morbidity., Results: Between 2008 and 2018, 18,232 patients had mastectomy and IBR with axillary surgery; 12,632 patients underwent SLNB, 3727 had ALND and 1,873 underwent SLNB + ALND. Mean age of patients in the cohort was 52.5 (SD 11). There was no difference in 30-day morbidity between groups (SLNB: 4.3%, ALND: 4.9%, SLNB + ALND: 4.2%, p = 0.207). Multivariable regression showed that type of axillary surgery was not an independent predictor of 30-day complications (OR 0.78 (95% CI 0.52-1.15) for ALND, and OR 0.87 (95% CI 0.52-1.45) for ALND + SLNB vs SLNB alone). Significant independent predictors for complications were increased BMI (OR 1.06 (95%CI 1.04-1.08)) and increased operative time (OR 1.003 (95% CI 1.001-1.005))., Conclusions: ALND does not increase 30-day morbidity in patients undergoing IBR when compared to SLNB. This supports concurrent axillary dissection for IBR patients when indicated., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2022
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14. Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise.

Author

McManus IC, Harborne AC, Horsfall HL, Joseph T, Smith DT, Marshall-Andon T, Samuels R, Kearsley JW, Abbas N, Baig H, Beecham J, Benons N, Caird C, Clark R, Cope T, Coultas J, Debenham L, Douglas S, Eldridge J, Hughes-Gooding T, Jakubowska A, Jones O, Lancaster E, MacMillan C, McAllister R, Merzougui W, Phillips B, Phillips S, Risk O, Sage A, Sooltangos A, Spencer R, Tajbakhsh R, Adesalu O, Aganin I, Ahmed A, Aiken K, Akeredolu AS, Alam I, Ali A, Anderson R, Ang JJ, Anis FS, Aojula S, Arthur C, Ashby A, Ashraf A, Aspinall E, Awad M, Yahaya AA, Badhrinarayanan S, Bandyopadhyay S, Barnes S, Bassey-Duke D, Boreham C, Braine R, Brandreth J, Carrington Z, Cashin Z, Chatterjee S, Chawla M, Chean CS, Clements C, Clough R, Coulthurst J, Curry L, Daniels VC, Davies S, Davis R, De Waal H, Desai N, Douglas H, Druce J, Ejamike LN, Esere M, Eyre A, Fazmin IT, Fitzgerald-Smith S, Ford V, Freeston S, Garnett K, General W, Gilbert H, Gowie Z, Grafton-Clarke C, Gudka K, Gumber L, Gupta R, Harlow C, Harrington A, Heaney A, Ho WHS, Holloway L, Hood C, Houghton E, Houshangi S, Howard E, Human B, Hunter H, Hussain I, Hussain S, Jackson-Taylor RT, Jacob-Ramsdale B, Janjuha R, Jawad S, Jelani M, Johnston D, Jones M, Kalidindi S, Kalsi S, Kalyanasundaram A, Kane A, Kaur S, Al-Othman OK, Khan Q, Khullar S, Kirkland P, Lawrence-Smith H, Leeson C, Lenaerts JER, Long K, Lubbock S, Burrell JMD, Maguire R, Mahendran P, Majeed S, Malhotra PS, Mandagere V, Mantelakis A, McGovern S, Mosuro A, Moxley A, Mustoe S, Myers S, Nadeem K, Nasseri R, Newman T, Nzewi R, Ogborne R, Omatseye J, Paddock S, Parkin J, Patel M, Pawar S, Pearce S, Penrice S, Purdy J, Ramjan R, Randhawa R, Rasul U, Raymond-Taggert E, Razey R, Razzaghi C, Reel E, Revell EJ, Rigbye J, Rotimi O, Said A, Sanders E, Sangal P, Grandal NS, Shah A, Shah RA, Shotton O, Sims D, Smart K, Smith MA, Smith N, Sopian AS, South M, Speller J, Syer TJ, Ta NH, Tadross D, Thompson B, Trevett J, Tyler M, Ullah R, Utukuri M, Vadera S, Van Den Tooren H, Venturini S, Vijayakumar A, Vine M, Wellbelove Z, Wittner L, Yong GHK, Ziyada F, and Devine OP

Subjects
Female, Humans, Male, United Kingdom, Schools, Medical standards, Students, Medical statistics & numerical data
Abstract

Background: Medical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors., Method: Aggregated data were collected for 50 measures across 29 UK medical schools. Data include institutional history (e.g. rate of production of hospital and GP specialists in the past), curricular influences (e.g. PBL schools, spend per student, staff-student ratio), selection measures (e.g. entry grades), teaching and assessment (e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores, Foundation satisfaction, postgraduate examination performance and fitness to practise (postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail., Results: Medical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant with p < 0.05, and 201 (16.4%) reached a Tukey-adjusted criterion of p < 0.0025. Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools. A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning. Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs., Conclusions: Medical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.

Published
2020
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15. The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning.

Author

Devine OP, Harborne AC, Horsfall HL, Joseph T, Marshall-Andon T, Samuels R, Kearsley JW, Abbas N, Baig H, Beecham J, Benons N, Caird C, Clark R, Cope T, Coultas J, Debenham L, Douglas S, Eldridge J, Hughes-Gooding T, Jakubowska A, Jones O, Lancaster E, MacMillan C, McAllister R, Merzougui W, Phillips B, Phillips S, Risk O, Sage A, Sooltangos A, Spencer R, Tajbakhsh R, Adesalu O, Aganin I, Ahmed A, Aiken K, Akeredolu AS, Alam I, Ali A, Anderson R, Ang JJ, Anis FS, Aojula S, Arthur C, Ashby A, Ashraf A, Aspinall E, Awad M, Yahaya AA, Badhrinarayanan S, Bandyopadhyay S, Barnes S, Bassey-Duke D, Boreham C, Braine R, Brandreth J, Carrington Z, Cashin Z, Chatterjee S, Chawla M, Chean CS, Clements C, Clough R, Coulthurst J, Curry L, Daniels VC, Davies S, Davis R, De Waal H, Desai N, Douglas H, Druce J, Ejamike LN, Esere M, Eyre A, Fazmin IT, Fitzgerald-Smith S, Ford V, Freeston S, Garnett K, General W, Gilbert H, Gowie Z, Grafton-Clarke C, Gudka K, Gumber L, Gupta R, Harlow C, Harrington A, Heaney A, Ho WHS, Holloway L, Hood C, Houghton E, Houshangi S, Howard E, Human B, Hunter H, Hussain I, Hussain S, Jackson-Taylor RT, Jacob-Ramsdale B, Janjuha R, Jawad S, Jelani M, Johnston D, Jones M, Kalidindi S, Kalsi S, Kalyanasundaram A, Kane A, Kaur S, Al-Othman OK, Khan Q, Khullar S, Kirkland P, Lawrence-Smith H, Leeson C, Lenaerts JER, Long K, Lubbock S, Burrell JMD, Maguire R, Mahendran P, Majeed S, Malhotra PS, Mandagere V, Mantelakis A, McGovern S, Mosuro A, Moxley A, Mustoe S, Myers S, Nadeem K, Nasseri R, Newman T, Nzewi R, Ogborne R, Omatseye J, Paddock S, Parkin J, Patel M, Pawar S, Pearce S, Penrice S, Purdy J, Ramjan R, Randhawa R, Rasul U, Raymond-Taggert E, Razey R, Razzaghi C, Reel E, Revell EJ, Rigbye J, Rotimi O, Said A, Sanders E, Sangal P, Grandal NS, Shah A, Shah RA, Shotton O, Sims D, Smart K, Smith MA, Smith N, Sopian AS, South M, Speller J, Syer TJ, Ta NH, Tadross D, Thompson B, Trevett J, Tyler M, Ullah R, Utukuri M, Vadera S, Van Den Tooren H, Venturini S, Vijayakumar A, Vine M, Wellbelove Z, Wittner L, Yong GHK, Ziyada F, and McManus IC

Subjects
Female, Humans, Male, Surveys and Questionnaires, United Kingdom, Curriculum standards, Education, Medical, Undergraduate organization & administration
Abstract

Background: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL)., Method: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times., Results: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content., Discussion: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.

Published
2020
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