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Dimitropoulos G.,University of Toronto | Tran A.F.,University of Toronto | Agarwal P.,Toronto East General Hospital | Woodside B.,University of Toronto
International Journal of Eating Disorders | Year: 2012

Objective: This study aims to conduct qualitative research on the perspectives of service providers regarding the transition process from pediatric to adult specialized eating disorder tertiary care programs. Method: Two focus groups with a diverse group of clinicians in pediatric and adult eating disorder programs and five qualitative interviews with clinicians in the community were conducted. Results: Three themes were identified as challenges during the transition process: (1) illness related factors (ambivalence and denial); (2) the interruption of normative adolescent developmental processes by the illness; and, (3) the impact of decreased parental involvement in the adult compared to pediatric eating disorder programs. Discussion: These themes were compared with empirical evidence on other chronic mental or physical health concerns for the purpose of identifying ways to facilitate a more successful service transition for young adults with anorexia nervosa. Future research and clinical implications are delineated. © 2011 by Wiley Periodicals, Inc.

Wright S.,Toronto East General Hospital | Wright S.,Center for Ambulatory Care Education
Advances in Health Sciences Education | Year: 2015

Students from state schools are underrepresented in UK medical schools. Discussions often focus on deficient academic and motivational traits of state school students, rather than considering the effects of student support during the admissions process. This qualitative study explored student experiences of support from schools and families during the medical school admissions process with particular focus on the personal statement. Interviews were conducted with thirteen medical students at a British medical school who had each attended a different secondary school (classified as private or state funded). A thematic analysis was performed. Bourdieu’s concepts of capital and field were used as a theoretical lens through which to view the results. Interviews revealed substantial differences in support provided by private and state funded schools. Private schools had much more experience in the field of medical school admissions and had a vested interest in providing students with support. State schools were lacking by comparison, offering limited support that was often reactive rather than proactive. Students from private schools were also more likely to have social contacts who were knowledgeable about medical school admissions and who could help them gain access to work experience opportunities that would be recognised as legitimate by selectors. While medical schools endeavour to make fair admissions policies, there is an unintended link between a student’s access to capital and ability to demonstrate commitment and motivation on personal statements. This helps explain why academically capable but financially or socially challenged students are less likely to be recognised as having potential during the admissions process. Medical schools need to be challenged to review their admissions policies to ensure that the do not inadvertently favour cultural privilege rather than student potential. © 2014, Springer Science+Business Media Dordrecht.

Szkorla P.,Toronto East General Hospital
Canadian Journal of Respiratory Therapy | Year: 2010

This report suggests a potential practice implication for controlling MRSA colonization. It was observed with one patient that in addition to the hospitals protocol for decolonization, changing a patient's tracheostomy tube to one that had an inner cannula resulted in negative culture results at the tracheostomy site. Other sites also tested negative including the nose, G-tube and groin. This would suggest that further study of the use of tracheostomy tubes with and without inner cannulas in long term tracheostomized patients colonized for MRSA.

Newman D.E.,Toronto East General Hospital
Rural and remote health | Year: 2010

The Department of Loreto, one of the poorest regions of Peru, has an insufficient number of physicians, particularly specialists, needed to provide adequate health care for its population. The majority of Loreto physicians are GPs who have completed a one-year internship after medical school, followed by a mandatory year of rural service, with no subsequent training. Currently there are no residency training programs available in Loreto. The Loreto Ministry of Health recognizes the value in retaining its own medical school graduates and is, therefore, considering building residency programs in the 4 'basic specialties': internal medicine, pediatrics, general surgery, and obstetrics/gynecology. The objectives of this study were to: (1) characterize the population of currently practicing GPs in Iquitos and Requena in terms of demographics, current medical practice, and educational goals; (2) determine the obstacles faced by general physicians in Loreto, Peru in pursuing residency training; (3) provide baseline information to be used by medical academic institutions to develop specialization programs in Loreto. A survey of 55 questions was created in Spanish encompassing demographics, current medical practice, education, training, and professional goals. Of the total 416 GPs in Loreto, 55 were identified in 2 locations: Iquitos and Requena. The goal was to administer the survey to each of these 55 physicians. Consent was given verbally, and 49 surveys were self-administered. Survey responses were translated into English, data were entered in EpiData and analyzed using SPSS software (SPSS Inc; Chicago, IL, USA). A total of 49 surveys were completed by GPs in Iquitos and Requena. Of the respondents, 84% were male, the majority were either married or in common-law relationships, with at least one child. Their average age was 37.6 years. Sixty-five percent were born in Loreto and most currently lived in Iquitos. Almost all respondents reported that they intended to pursue further training, the majority (59%) intending to pursue residency. Of those intending to complete a residency in the future, 40% specified a desired specialty from among the basic four, 22% a more specialized residency, and 37% did not specify any. The location of training sites, cost of moving to and living in Lima, and/or personal or family reasons were each identified by approximately 50% of respondents as obstacles to their pursuit of residency. Less common obstacles were: not passing the entrance exam, lack of job stability, and not knowing English. Fifty percent of the respondents only identified one obstacle, while 35% identified two and 15% identified three. Cost and location were the most significant factors preventing physicians from pursuing residency; overall, 83% of the physicians surveyed identified one or both of these as a factor that prevented them from pursuing residency. This suggests that there would be interest among the local physician population in residency programs established in Loreto.

Kell J.S.,Toronto East General Hospital
The Canadian journal of urology | Year: 2010

Prostate cancer is a highly prevalent malignancy. Using serum prostatic-specific antigen (PSA) levels to screen for prostate cancer has led to a greater detection of this cancer, at earlier stages. However, screening for prostate cancer by determining PSA levels remains controversial. Concerns include the risk of overdiagnosis and conversely, the failure to detect all prostate cancers. This article, aimed at primary care practitioners, reviews the characteristics of an ideal screening test, in relation to the characteristics of the PSA test. It then discusses the implications of recent findings from two large, randomized, prospective screening trials: the American Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) screening trial and the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial. The latter trial demonstrated a modest survival benefit from PSA screening. Lastly, the article summarizes recommendations from recently updated guidelines about PSA testing from the American Urological Association (AUA), and it discusses when a primary care practitioner might refer a patient to a urologist.

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