Canadian Medical Association journal最新文献

{"title":"Correction to \"Generalized pitting edema in a patient with dilated cardiomyopathy secondary to hypothyroidism\".","authors":"","doi":"10.1503/cmaj.240833","DOIUrl":"10.1503/cmaj.240833","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ce n’est pas au service des urgences que devrait être annoncé un diagnostic de cancer.","authors":"Keerat Grewal, Catherine Varner","doi":"10.1503/cmaj.240612-f","DOIUrl":"10.1503/cmaj.240612-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lived experiences of transgender and gender-diverse people in accessing publicly funded penile-inversion vaginoplasty in Canada.","authors":"Gianni R Lorello, Aradhana Tewari, Marudan Sivagurunathan, Emery Potter, Yonah Krakowsky, Janice Du Mont, David R Urbach","doi":"10.1503/cmaj.231250","DOIUrl":"10.1503/cmaj.231250","url":null,"abstract":"<p><strong>Background: </strong>Canada's health care systems underserve people who are transgender and gender diverse (TGD), leading to unique disparities not experienced by other patient groups, such as in accessing gender-affirmation surgery. We sought to explore the experiences of TGD people seeking and accessing gender-affirmation surgery at a publicly funded hospital in Canada to identify opportunities to improve the current system.</p><p><strong>Methods: </strong>We used hermeneutic phenomenology according to Max van Manen to conduct this qualitative study. Between January and August 2022, we conducted interviews with TGD people who had undergone penile-inversion vaginoplasty at Women's College Hospital, Toronto, Ontario, since June 2019. We conducted interviews via Microsoft Teams and transcribed them verbatim. We coded the transcripts using NVivo version 12. Using inductive analysis, we constructed themes, which we mapped onto van Manen's framework of lived body, lived time, lived space, and lived human relations.</p><p><strong>Results: </strong>We interviewed 15 participants who had undergone penile-inversion vaginoplasty; they predominantly self-identified as transgender women (<i>n</i> = 13) and White (<i>n</i> = 14). Participants lived in rural (<i>n</i> = 4), suburban (<i>n</i> = 5), or urban (<i>n</i> = 6) locations. Their median age was 32 (range 27-67) years. We identified 11 themes that demonstrated the interconnected nature of TGD peoples' lived experiences over many years leading up to accessing gender-affirmation surgery. These themes emphasized the role of the body in experiencing the world and shaping identity, the lived experience of the body in shaping human connectedness, and participants' intersecting identities and emotional pain (lived body); participants' experiences of the passage of time and progression of events (lived time); environments inducing existential anxiety or fostering affirmation, the role of technology in shaping participants' understanding of the body, and the effect of liminal spaces (lived space); and finally, the role of communication and language, empathy and compassion, and participants' experiences of loss of trust and connection (lived human relations).</p><p><strong>Interpretation: </strong>Our findings reveal TGD patients' lived experiences as they navigated a lengthy and often difficult journey to penile-inversion vaginoplasty. They suggest a need for improved access to gender-affirmation surgery by reducing wait times, increasing capacity, and improving care experiences.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compassion need not be a scarce resource in health care for transgender and gender-diverse people.","authors":"Kirsten Patrick","doi":"10.1503/cmaj.240878","DOIUrl":"10.1503/cmaj.240878","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projection du fardeau du cancer au Canada en 2024.","authors":"Darren R Brenner, Jennifer Gillis, Alain A Demers, Larry F Ellison, Jean-Michel Billette, Shary Xinyu Zhang, JiaQi Leon Liu, Ryan R Woods, Christian Finley, Natalie Fitzgerald, Nathalie Saint-Jacques, Lorraine Shack, Donna Turner","doi":"10.1503/cmaj.240095-f","DOIUrl":"10.1503/cmaj.240095-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV postexposure prophylaxis-in-pocket.","authors":"Maxime Billick, Isaac I Bogoch","doi":"10.1503/cmaj.240064","DOIUrl":"10.1503/cmaj.240064","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycétome pulmonaire à <i>Pseudallescheria</i> chez une femme de 48 ans souffrant de bronchiectasie.","authors":"Chanhee Seo, Dina A Fisher, Elaine Dumoulin, Christina S Thornton","doi":"10.1503/cmaj.231618-f","DOIUrl":"10.1503/cmaj.231618-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple-site primary extramammary Paget disease in a 77-year-old man.","authors":"Ming-Che Chiang, Ying-Yi Chiang","doi":"10.1503/cmaj.240188","DOIUrl":"10.1503/cmaj.240188","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “May 2024 obituaries”","authors":"","doi":"10.1503/cmaj.240838","DOIUrl":"https://doi.org/10.1503/cmaj.240838","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study.","authors":"Hilary MacCormick, Les T Johnson, Drew Burchell, Allana Munro, Gianni R Lorello, Ronald B George, M Dylan Bould","doi":"10.1503/cmaj.240061","DOIUrl":"10.1503/cmaj.240061","url":null,"abstract":"<p><strong>Background: </strong>Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes.</p><p><strong>Results: </strong>We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals.</p><p><strong>Interpretation: </strong>Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":null,"pages":null},"PeriodicalIF":9.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}