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The 2004 Canadian recommendations for the management of hypertension: Part II--Therapy.

https://arctichealth.org/en/permalink/ahliterature181498
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Publication Type
Article
Date
Jan-2004
Author
Nadia A Khan
Finlay A McAlister
Norman R C Campbell
Ross D Feldman
Simon Rabkin
Jeff Mahon
Richard Lewanczuk
Kelly B Zarnke
Brenda Hemmelgarn
Marcel Lebel
Mitchell Levine
Carol Herbert
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada.
Source
Can J Cardiol. 2004 Jan;20(1):41-54
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - administration & dosage
Blood Pressure Determination - standards
Canada - epidemiology
Cardiovascular Diseases - prevention & control
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Evidence-Based Medicine - standards
Female
Humans
Hypertension - diagnosis - drug therapy - epidemiology
Male
Middle Aged
Prognosis
Risk assessment
Severity of Illness Index
Societies, Medical
Treatment Outcome
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For patients who require pharmacological therapy for hypertension, a number of antihypertensive agents may be used. Randomized trials evaluating first-line therapy with diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), alpha-blockers, centrally acting agents or angiotensin receptor antagonists were reviewed. Also, randomized trials evaluating other agents, such as statins or acetylsalicylic acid, in patients with hypertension were reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. In addition, other relevant outcomes such as development of end-stage renal disease or changes in blood pressure were examined where appropriate.
MEDLINE searches were conducted from November 2001 to October 2003 to update the 2001 Recommendations for the management of hypertension. Reference lists were scanned, experts were contacted, and the personal files of the subgroup members and authors were used to identify additional published studies. All relevant articles were reviewed and appraised independently, using prespecified levels of evidence by content and methodology experts.
This document contains detailed recommendations and supporting evidence on treatment thresholds, target blood pressures and choice of agents for hypertensive patients with or without comorbidities. Lifestyle modifications are a key component of any antiatherosclerotic management strategy and detailed recommendations are contained in a separate document. Key recommendations for pharmacotherapy include the following: treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbidities, with particular attention to systolic blood pressure; blood pressure should be lowered to 140/90 mmHg or less in all patients, and 130/80 mmHg or less in those with diabetes mellitus or renal disease (125/75 mmHg or less in those with nondiabetic renal disease and more than 1 g of proteinuria per day); most adults with hypertension require more than one agent to achieve target blood pressures; for adults without compelling indications for other agents, initial therapy should include thiazide diuretics; other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), ACE inhibitors (in non-Blacks), long-acting dihydropyridine CCBs or angiotensin receptor antagonists; other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine CCBs or angiotensin receptor antagonists; certain comorbidities provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or thiazides in patients with diabetes mellitus without albuminuria) are appropriate first-line therapies; and in patients with mild to moderate nondiabetic renal disease, ACE inhibitors are recommended; all hypertensive patients should have their fasting lipids screened and those with dyslipidemia should be treated using the thresholds, targets and agents as per the Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease; and selected patients with hypertension should also receive statin and/or acetylsalicylic acid therapy.
All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually.
PubMed ID
14968142 View in PubMed
Less detail

The 2005 Canadian Hypertension Education Program recommendations for the management of hypertension: part II - therapy.

https://arctichealth.org/en/permalink/ahliterature173954
Source
Can J Cardiol. 2005 Jun;21(8):657-72
Publication Type
Article
Date
Jun-2005
Author
Nadia A Khan
Finlay A McAlister
Richard Z Lewanczuk
Rhian M Touyz
Raj Padwal
Simon W Rabkin
Lawrence A Leiter
Marcel Lebel
Carol Herbert
Ernesto L Schiffrin
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Jacques DeChamplain
George Pylypchuk
Alexander G Logan
Norm Gledhill
Robert Petrella
Norman R C Campbell
Malcolm Arnold
Gordon Moe
Micharl D Hill
Charlotte Jones
Pierre Larochelle
Richard I Ogilvie
Sheldon Tobe
Robyn Houlden
Ellen Burgess
Ross D Feldman
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, Canada.
Source
Can J Cardiol. 2005 Jun;21(8):657-72
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Canada
Diet
Evidence-Based Medicine
Exercise
Humans
Hypertension - therapy
Patient Education as Topic
Weight Loss
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence from randomized controlled trials and systematic reviews of trials was preferentially reviewed. While changes in cardiovascular morbidity and mortality were the primary outcomes of interest, for lifestyle interventions, blood pressure lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field, and for certain comorbid conditions, other relevant outcomes, such as development of proteinuria or worsening of kidney function, were considered.
MEDLINE searches were conducted from November 2003 to October 2004 to update the 2004 recommendations. Reference lists were scanned, experts were contacted, and the personal files of the subgroup members and authors were used to identify additional published studies. All relevant articles were reviewed and appraised independently, using prespecified levels of evidence, by content and methodology experts. As per previous years, only studies that had been published in the peer-reviewed literature were included; evidence from abstracts, conference presentations and unpublished personal communications was not included.
Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise on four to seven days of the week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 units per week in men or nine units per week in women; follow a reduced fat, low cholesterol diet with an adequate intake of potassium, magnesium and calcium; restrict salt intake; and consider stress management (in selected individuals). Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and any comorbid conditions. Blood pressure should be lowered to 140/90 mmHg or less in all patients, and to 130/80 mmHg or less in those with diabetes mellitus or chronic kidney disease. Most adults with hypertension require more than one agent to achieve target blood pressures. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (except in black patients), long-acting calcium channel blockers and angiotensin receptor antagonists. Other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers and angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or thiazides in patients with diabetes mellitus without albuminuria) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy.
All recommendations were graded according to the strength of the evidence and voted on by the 43 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
PubMed ID
16003449 View in PubMed
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The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy.

https://arctichealth.org/en/permalink/ahliterature168976
Source
Can J Cardiol. 2006 May 15;22(7):583-93
Publication Type
Article
Date
May-15-2006
Author
N A Khan
Finlay A McAlister
Simon W Rabkin
Raj Padwal
Ross D Feldman
Norman Rc Campbell
Lawrence A Leiter
Richard Z Lewanczuk
Ernesto L Schiffrin
Michael D Hill
Malcolm Arnold
Gordon Moe
Tavis S Campbell
Carol Herbert
Alain Milot
James A Stone
Ellen Burgess
B. Hemmelgarn
Charlotte Jones
Pierre Larochelle
Richard I Ogilvie
Robyn Houlden
Robert J Herman
Pavel Hamet
George Fodor
George Carruthers
Bruce Culleton
Jacques Dechamplain
George Pylypchuk
Alexander G Logan
Norm Gledhill
Robert Petrella
Sheldon Tobe
Rhian M Touyz
Author Affiliation
Division of General Internal Medicine, University of British Columbia, Vancouver, BC, Canada.
Source
Can J Cardiol. 2006 May 15;22(7):583-93
Date
May-15-2006
Language
English
Publication Type
Article
Keywords
Advisory Committees
Alcohol Drinking
Antihypertensive Agents - therapeutic use
Calcium, Dietary - administration & dosage
Canada
Cerebrovascular Disorders - therapy
Diabetes Mellitus - therapy
Diet
Exercise
Humans
Hypertension - therapy
Hypertrophy, Left Ventricular - therapy
Kidney Diseases - therapy
Life Style
Magnesium - administration & dosage
Myocardial Ischemia - therapy
Patient compliance
Potassium, Dietary - administration & dosage
Sodium, Dietary - administration & dosage
Stress, Psychological - prevention & control
Weight Loss
Abstract
To provide updated, evidence-based recommendations for the management of hypertension in adults.
For lifestyle and pharmacological interventions, evidence from randomized, controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. For lifestyle interventions, blood pressure (BP) lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field. For treatment of patients with kidney disease, the development of proteinuria or worsening of kidney function was also accepted as a clinically relevant primary outcome.
MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by content and methodological experts using prespecified levels of evidence.
Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 standard drinks per week in men or nine standard drinks per week in women; follow a diet that is reduced in saturated fat and cholesterol and that emphasizes fruits, vegetables and low-fat dairy products; restrict salt intake; and consider stress management in selected individuals. Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbid conditions. BP should be lowered to less than 140/90 mmHg in all patients, and to less than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease (regardless of the degree of proteinuria). Most adults with hypertension require more than one agent to achieve these target BPs. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (in nonblack patients), long-acting calcium channel blockers or angiotensin receptor antagonists. Other agents for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers or angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or in patients without albuminuria, thiazides or dihydropyridine calcium channel blockers) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy.
All recommendations were graded according to strength of the evidence and voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.
Notes
Cites: N Engl J Med. 2000 Jan 20;342(3):145-5310639539
Cites: Lancet. 2006 Jan 21;367(9506):209; author reply 21016427487
Cites: Can J Cardiol. 2000 Sep;16(9):1094-10211021953
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Cites: Am J Med. 2001 Nov;111(7):553-811705432
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PubMed ID
16755313 View in PubMed
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Better doctor efficiency is the real key to better productivity.

https://arctichealth.org/en/permalink/ahliterature148442
Source
Med Educ. 2009 Oct;43(10):1019
Publication Type
Article
Date
Oct-2009
Author
Farah Manji
Iva Vukin
Barbara Lent
Carol Herbert
Source
Med Educ. 2009 Oct;43(10):1019
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Canada
Education, Medical - trends
Efficiency
Female
Humans
Male
Physician's Practice Patterns
Physicians, Women - trends
Sex Distribution
Sex Factors
Notes
Comment In: Med Educ. 2010 Apr;44(4):42920444078
Comment On: Med Educ. 2009 May;43(5):442-819422491
PubMed ID
19769652 View in PubMed
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Complementary therapy use by cancer patients. Physicians' perceptions, attitudes, and ideas.

https://arctichealth.org/en/permalink/ahliterature179323
Source
Can Fam Physician. 2004 Jun;50:882-8
Publication Type
Article
Date
Jun-2004
Author
Maeve O'Beirne
Marja Verhoef
Elan Paluck
Carol Herbert
Author Affiliation
Department of Family Medicine, University of Calgary, AB. obeirne@ucalgary.ca
Source
Can Fam Physician. 2004 Jun;50:882-8
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adult
Alberta
Anecdotes as Topic
Attitude of Health Personnel
British Columbia
Complementary Therapies - utilization
Family Practice - standards
Female
Humans
Male
Middle Aged
Neoplasms - therapy
Patient Acceptance of Health Care
Patient Education as Topic - methods
Patient Participation - statistics & numerical data
Patient-Centered Care - organization & administration
Physician's Practice Patterns
Physician-Patient Relations
Pilot Projects
Questionnaires
Rural Population - statistics & numerical data
Urban Population - statistics & numerical data
Abstract
To explore family physicians' perceptions of their cancer patients' use of complementary therapy.
Qualitative pilot study.
British Columbia and Alberta.
Rural and urban family physicians.
Five focus groups were conducted with a total of 28 participants. Content analysis of focus group transcripts.
Eight themes were identified: definition of complementary therapies, importance of holistic health, role of evidence, attitudes toward complementary therapies, perceptions of cancer patients' use of complementary therapies, patient-physician communication, perceptions of family physicians' role with respect to complementary therapies, and concerns about complementary therapies. Family physicians believed that many of their patients were using complementary therapies and that patients and physicians needed to communicate about this practice.
The study increased understanding of physicians'perspectives on communication about complementary therapies and exposed issues that need to be addressed through education and research.
Notes
Cites: Can Fam Physician. 1995 Jun;41:1005-117780312
Cites: Cancer Prev Control. 1999 Jun;3(3):181-710474765
Cites: Arch Intern Med. 2002 May 27;162(10):1176-8112020190
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Cites: BMJ. 2001 Jan 20;322(7279):154-811159576
Cites: Complement Ther Med. 2000 Dec;8(4):248-5211098200
Cites: Eur J Cancer. 2000 Oct;36(16):2090-511044646
Cites: JAMA. 1999 Dec 22-29;282(24):2356-710612326
Cites: CMAJ. 1996 Dec 15;155(12):1679-858976333
Cites: J Health Serv Res Policy. 1997 Apr;2(2):112-2110180362
Cites: Arch Intern Med. 1998 Nov 23;158(21):2303-109827781
Cites: Acad Med. 1998 Dec;73(12):1234-409883197
Cites: J Okla State Med Assoc. 1999 May;92(5):219-2610432781
Cites: CMAJ. 1995 May 1;152(9):1423-337728691
PubMed ID
15233371 View in PubMed
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The Haida Gwaii Diabetes Project: planned response activity outcomes.

https://arctichealth.org/en/permalink/ahliterature3143
Source
Health Soc Care Community. 1999 Nov;7(6):379-386
Publication Type
Article
Date
Nov-1999
Author
Clare Heffernan
Carol Herbert
Garry D. Grams
Stefan Grzybowski
Mary Ann Wilson
Betty Calam
Diane Brown
Author Affiliation
Queen Charlotte Islands Health Care Society, Queen Charlotte City, British Columbia, Canada,Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada,Skidegate Health Centre, Skidegate, British Columbia, Canada.
Source
Health Soc Care Community. 1999 Nov;7(6):379-386
Date
Nov-1999
Language
English
Publication Type
Article
Abstract
A 1992 chart review in the Haida Village of Skidegate, Haida Gwaii/Queen Charlotte Islands, Canada, revealed that 17% of the unscreened population aged 35 or over have been diagnosed with diabetes. The Haida Gwaii Diabetes Project was designed to develop a culturally sensitive community-based participatory action approach to the management of noninsulin-dependent diabetes (NIDDM). Phase One included obtaining community support, conducting a chart review, holding clinics to measure biophysical indicators, conducting focus groups, and planning response activities with the communities. A list of activities was developed, based on the focus group results. In addition, the project team developed a set of operating principles that ensured and reinforced collaboration. Phase Two included implementing and monitoring planned response activities, and holding exit clinics. The best attended activities were trials of traditional herbal medicine and traditional diet, and an exercise programme. While participation levels were not high enough for causal conclusions, a significant decrease in total cholesterol (0.45; P = 0.005) and rise in HDL (-0.097; P = 0.05) was found for participants for whom paired values were available. Diabetes intervention research in First Nations settings involves small numbers of participants, making it difficult to quantitatively assess outcomes. To increase participation it is advisable to open activities to the whole community, to tie planned activities into other scheduled community events, and to share findings concerning managing illnesses of acculturation with other communities.
PubMed ID
11560654 View in PubMed
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It's a matter of values: partnership for innovative change.

https://arctichealth.org/en/permalink/ahliterature133680
Source
Healthc Pap. 2011;11(2):31-7; discussion 64-7
Publication Type
Article
Date
2011
Author
Carol Herbert
Allan Best
Author Affiliation
Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario.
Source
Healthc Pap. 2011;11(2):31-7; discussion 64-7
Date
2011
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - organization & administration - standards
Evidence-Based Practice - organization & administration - standards
Health Services Research - organization & administration - standards
Humans
Organizational Innovation
Public-Private Sector Partnerships
Abstract
We need new ways of thinking and of working in order to accommodate the complexity of the challenges in and urgent need for health system innovation and change. Solution seeking must begin with the convergence of two driving imperatives: the need to ground partnership in shared values and the need for systems thinking. The authors see three core value perspectives as central to partnerships for change: a patient- and family-centred social responsibility and equity paradigm, a commitment to changing outcomes and an evidence-informed strategy that integrates needs for research and knowledge translation. These imperatives can be expressed as a simple value stream: (1) articulate the shared values foundation of key partners; (2) express a common vision for changes needed; (3) develop a governance framework articulating roles, accountability and decision-making; (4) collaborate on an integrated intervention plan that takes complexity into account; and (5) ensure continuous improvement based on measured outcomes. The authors link this value stream to a six-point framework of guiding principles for innovation and implementation and discuss these six principles: values, systems, thinking, leadership, governance, learning networks and innovation research. Working partnerships among government, health services researchers and academic health science networks are essential if innovative change is to be implemented and sustained.
Notes
Comment On: Healthc Pap. 2011;11(2):10-2421677513
PubMed ID
21677515 View in PubMed
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Seeking balance: the complexity of choice-making among academic surgeons.

https://arctichealth.org/en/permalink/ahliterature131859
Source
Acad Med. 2011 Oct;86(10):1288-92
Publication Type
Article
Date
Oct-2011
Author
Judith Belle Brown
Meghan Fluit
Barbara Lent
Carol Herbert
Author Affiliation
Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. jbbrown@uwo.ca
Source
Acad Med. 2011 Oct;86(10):1288-92
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adult
Career Choice
Choice Behavior
Female
General Surgery - education
Humans
Job Satisfaction
Male
Middle Aged
Ontario
Physicians - psychology
Questionnaires
Retrospective Studies
Abstract
This study describes the experiences of academic surgeons in seeking a balance between their personal and professional lives.
This phenomenological study, conducted in 2009-2010 at the University of Western Ontario, used in-depth individual semistructured interviews to explore the ideas, perceptions, and experiences of 17 recently recruited academic surgeons (nine women/eight men) about seeking balance between their personal and professional lives. All the interviews were audiotaped and transcribed verbatim. The data analysis was both iterative and interpretative.
All the participants expressed a passion and commitment to academic surgery, but their stories revealed the complexity of making choices in seeking a balance between their personal and professional lives. This process of making choices was filtered through influential values in their lives, which in turn determined how they set boundaries to protect their personal and family time from the demands of their professional obligations. Intertwined in this process were the trade-offs they had to make in order to seek balance. Some choices, boundary-setting strategies, and trade-offs were dictated by gender. Finally, the process of making choices was not static; instead, the data revealed how it was both dynamic and cyclical, requiring reexamination over the life cycle, as well as their career trajectory. Thus, seeking a balance was an ever-changing process.
Understanding how members of an academic department of surgery navigate the balance between their personal and professional worlds may provide new insights for other disciplines seeking to enhance the development of the next generation of academics.
PubMed ID
21869660 View in PubMed
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Surgical culture in transition: gender matters and generation counts.

https://arctichealth.org/en/permalink/ahliterature115641
Source
Can J Surg. 2013 Jun;56(3):153-8
Publication Type
Article
Date
Jun-2013
Author
Judith Belle Brown
Meghan Fluit
Barbara Lent
Carol Herbert
Author Affiliation
The Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont., Canada. jbbrown@uwo.ca
Source
Can J Surg. 2013 Jun;56(3):153-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Academic Medical Centers
Adult
Age Factors
Attitude of Health Personnel
Canada
Career Choice
Faculty, Medical - organization & administration
Female
General Surgery - education - organization & administration
Humans
Intergenerational Relations
Male
Middle Aged
Organizational Culture
Personnel Management
Sex Factors
Abstract
We sought to study the impact of the change in gender balance and the shift in generational beliefs on the practice of surgery.
We used in-depth, individual, semistructured interviews to explore the ideas, perceptions and experiences of recently recruited academic surgeons regarding the role of gender and the influence of the changing attitudes of this generation on the work environment. All the interviews were audiotaped and transcribed verbatim. The data analysis was both iterative and interpretative.
Nine women and 8 men participated in the study. All participants stated that departmental expectations regarding their performance as clinicians and as academics were not influenced by gender. However, further exploration revealed how gender did influence the way they sought to balance their personal and professional lives. Women in particular struggled with attaining this balance. While maternity leave was endorsed by both men and women, the challenging logistics associated with such leave were noted. Our data also revealed a generational shift among men and women in terms of the importance of the balance between their personal and professional lives. Participants saw this priority as radically different from that of their senior colleagues.
Gender and the shift in generational attitudes are changing the culture of academic surgery, often described as the prototypical male-dominated medical environment. These changes may reflect the changing face of medicine.
Notes
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PubMed ID
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