Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial
Sex differences in thromboprophylaxis of the critically ill: a secondary analysis of a randomized trial.
Venous thromboembolism (VTE) is a common complication of critical illness. Sex- or gender-based analyses are rarely conducted and their effect on outcomes is unknown. We assessed for an effect modification of thromboprophylaxis (dalteparin or unfractionated heparin [UFH]) by sex on thrombotic (deep venous thrombosis [DVT], pulmonary embolism [PE], VTE) and mortality outcomes in a secondary analysis of the Prophylaxis for Thromboembolism in Critical Care Trial (PROTECT). ⋯ We found an effect modification by sex of thromboprophylaxis on VTE in critically ill patients that requires confirmation. Our findings highlight the need for sex- and gender-based analyses in acute care research.
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Microaggressions are subtle verbal or nonverbal insults that convey derogatory and negative messages to and about people who belong to oppressed groups. Microaggressions reflect structurally and historically perpetuated societal values, which advantage some groups of people by considering them to be inherently more worthy than others, while simultaneously disadvantaging others. ⋯ In this narrative review, we provide examples of microaggressions towards physicians and learners working in anesthesia and critical care, and offer individual and institutional approaches to managing such incidents. Concepts of privilege and power are introduced to ground interpersonal interventions within the larger context of systemic discrimination, and to encourage anesthesia and critical care physicians to contribute to systemic solutions.
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Queer theory is a disruptive lens that can be adopted by researchers, educators, clinicians, and administrators to effect transformative social change. It offers opportunities for anesthesiologists, critical care physicians, and medical practitioners to more broadly understand what it means to think queerly and how queering anesthesiology and critical care medicine spaces improves workplace culture and patient outcomes. This article grapples with the cis-heteronormative medical gaze and queer people's apprehensions of violence in medical settings to offer new ways of thinking about structural changes needed in medicine, medical language, and the dehumanizing application of medical modes of care. Using a series of clinical vignettes, this article outlines the historical context underlying queer peoples' distrust of medicine, a primer in queer theory, and an understanding of how to begin to "queer" medical spaces using this critical framework.
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We aimed to evaluate the representation of women and persons of colour (POC) authors of COVID-19 manuscripts submitted to, accepted in, and rejected from the Journal and to evaluate trends in their representation during the pandemic. ⋯ The proportion of women authors of COVID-19 manuscripts was lower than men's representation. Further research is required to determine the factors that account for the higher proportion of POC authors across rejected manuscripts.
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This continuing professional development module aims to elucidate the current demographics of anesthesiology in Canada and the experience of anesthesiologists from equity-seeking groups. This module will also identify and describe factors impacting the health care experience of patients from equity-seeking groups who receive perioperative, pain, and obstetric care. ⋯ Discrimination and inequity persist in the Canadian health care system. It is incumbent upon us to actively work against these inequities every day to create a kinder and more just health care system in Canada.