People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowledge and access varied among South-Asian patients. Participants were South-Asian cardiac patients receiving treatment at hospitals in Ontario, Canada. Each hospital refers to CR via one offour methods: automatically through paper or electronically, through discussion with allied health professionals (liaison referral), or through referral at the physician's discretion. Data were collected via interviews and analyzed using interpretive-descriptive analysis. Four themes emerged: the importance of predischarge CR discussions with healthcare providers, limited knowledge of CR, ease of the referral process for facilitators of CR attendance, and participants'needs for personal autonomy regarding their decision to attend CR. Liaison referral was perceived to be the most suitable referral method for participants. It facilitated communication between patients and providers, ensuring improved understanding of CR. Automatic referral may not be as well suited to this population because of reduced patient-provider communication.
BACKGROUND: This paper describes a study that explores the experiences of internationally educated nurses (IENs) in their efforts to gain entry to practice as Registered Nurses (RNs) in the province of Ontario, Canada. AIM: The aim was to uncover, in part, the issues related to professional nursing credentialling. METHODS: This study was guided by a biographical narrative (qualitative) research methodology. A convenience sample of 12 IEN students volunteered for this study representing the Philippines, Mainland China, Korea, Ukraine and India. FINDINGS: The findings were that the IENs progress through a three-phase journey in their quest for licensure in Ontario. These phases include: (1) hope - wanting the Canadian dream of becoming an RN in Ontario; (2) disillusionment - discovering that their home-country nursing qualifications do not meet Ontario RN entry to practice; and (3) navigating disillusionment - living the redefined Canadian dream by returning to nursing school to upgrade their nursing qualifications. CONCLUSIONS: Professional regulatory nursing bodies and nursing educators, as well as practising nurses, must be aware of the potentially confusing and unpleasant processes IENs go through as they qualify for the privilege of practising nursing in Ontario.
PURPOSE: There is very little data available on adaptation at adolescence after "visible adoptions" (children adopted from abroad), in terms of mental health, risk-taking and problem behaviour in comparison with nonadopted adolescents. This study describes such an outcome. MATERIAL AND METHOD: Data derived from self-reports from 125 adolescents aged 13-18 years who identified themselves as adopted, and who participated in two epidemiological surveys of 9329 adolescents. Their number was representative for children adopted from abroad. The other adolescents served as controls. RESULTS: Family life styles showed no differences between groups. Health was similar to that of the controls. Foreign adopted adolescents significantly often evaluated themselves as shorter and with early puberty. The proportion of adopted girls with suicidal thoughts was significantly larger, they also reported school truancy, not using safety belts, sexual intercourse, unpleasant sexual encounters, and contact with illicit drugs more often than the controls. The stress of early puberty could only partly explain this. CONCLUSIONS: Girls adopted from abroad, representing "visible adoptions", need additional attention and study during adolescence to expose causes for maladaption among some of them.
The demographic profile of the patient receiving coronary artery bypass graft (CABG) surgery in Canada has changed significantly over the past 20 years from mainly white (i.e., English, Irish, Scottish) to non-white (i.e., Indian or Chinese). To support individuals who have recently undergone a CABG procedure, patient education is provided to guide performance of self-care behaviours in the home environment. The relevance of this education, when applied to the current CABG surgery population, is questionable, as it was designed and tested using a white, homogenous sample. Thus, the number and type of self-care behaviours performed by persons of Indian and Chinese origin has not been investigated. These individuals may have varying self-care needs that are not reflected in the current self-care patient education materials.
The intent of this study was to examine the difference in the type and number of self-care behaviours performed between white and non-white patients following CABG surgery.
This study is a sub-study of a descriptive, exploratory design that included a convenience sample. Ninety-nine patients were recruited, representing three cultural groups (White, Indian, and Chinese). Descriptive data were used to describe the sample and identify specific self-care behaviours performed in the home environment.
Results indicate statistically significant differences between white and non-white individuals related to use of incentive spirometer (p = 0.04), deep breathing and coughing exercises (p = 0.04), and activity modification (p
The question of whether South Africans approve of drinking and drunkenness was researched. It seems that although they evaluate both drinking and drunkenness in general negatively, and particularly more negatively than for example Finns and Swedes do, substantial proportions accept drinking and drunkenness in certain situations, especially when these are of a non-work nature.
Celiac disease is thought to be a genetically based disorder reported mainly from European countries as well as countries to which Europeans have emigrated, including North America. This report documents a clinical experience of biopsy-defined celiac disease in 14 Asians diagnosed since 1988 in a single Canadian teaching hospital. Eleven were Indo-Canadians, including 10 of Punjabi descent. Other ethnic groups were also represented, including two Japanese and one Chinese patient. Abdominal pain was the most frequent presenting symptom. Anemia, particularly associated with a deficiency of iron was common, along with diarrhea and weight loss. Endoscopic studies documented lymphocytic gastric and colonic mucosal changes in over one-third of the cases while antibodies for tissue transglutaminase were positive in all patients tested. Dermatitis herpetiformis, diabetes mellitus and autoimmune liver disease were also documented. These findings indicate for the first time that adult celiac disease occurs in Asian populations living in North America, particularly in those of Punjabi descent.
Department of Paediatrics (Schwartz), University of Toronto, Toronto, Ont.; Division of Infectious Diseases (Schwartz), The Hospital for Sick Children, Toronto, Ont.; Workplace Safety and Insurance Board of Ontario (Giga), Toronto, Ont.; Tropical Disease Unit, Division of Infectious Diseases (Boggild), Department of Medicine, University Health Network and University of Toronto, Toronto, Ont.; Laboratory Services (Boggild), Public Health Ontario, Toronto, Ont.