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Surgical missions

Michelle White, Dennis Alcorn, Kirsten Randall, Stephanie Duncan, Heather Klassen, Mark Shrime
BACKGROUND: Billions of people worldwide lack access to safe affordable surgery. Surgical missions and non-governmental organisations (NGO) are vital in meeting this need, but long-term outcomes are rarely reported. Mercy Ships is a surgical NGO, and we aimed to measure disability-free survival, impact and patient satisfaction in Madagascar after a 7-month mission. METHOD: We aimed to evaluate 346 patients. Primary outcome measure was the World Health Organisation Disability Assessment Schedule 2...
October 11, 2016: World Journal of Surgery
Aviram M Giladi, Kavitha Ranganathan, Kevin C Chung
Understanding the global burden of trauma, particularly upper extremity trauma, is necessary in addressing the need for surgical services. Critical to that mission is to understand, and accurately measure, disability and related disability-adjusted life-years from massive upper extremity trauma. The impact of these injuries is magnified when considering that they frequently occur to young people in prime working years. This article discusses these social and medical system issues and reviews components of a comprehensive approach to measuring outcomes after these injuries...
November 2016: Hand Clinics
Mary K Mulcahey, Brian R Waterman
In its brief 10-year existence, the Arthroscopy Association of North America Advanced Arthroscopy Traveling Fellowship has quickly established itself as the paramount educational experience for aspiring young surgeons in sports medicine and arthroscopy. The Traveling Fellowship is structured as a 10-day experience with visits to 3 host sites and culminates at the AANA Annual Meeting. With 4 selected fellows and an honorary "Godfather," the Traveling Fellowship affords a unique and invaluable opportunity to forge enduring friendships and rare mentorships with established leaders in the field of Arthroscopy...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mei-Ling Lin, Chuen-Teng Huang, Ching-Huey Chen
AIMS AND OBJECTS: The aim of this study was to inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. BACKGROUND: Making a patient the center of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking...
September 29, 2016: Journal of Clinical Nursing
Julielynn Y Wong, Andreas C Pfahnl
INTRODUCTION: The first space-based fused deposition modeling (FDM) 3D printer became operational in 2014. This study evaluated whether Mars simulation crewmembers of the Hawai'i Space Exploration Analog and Simulation (HI-SEAS) II mission with no prior surgical experience could utilize acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments FDM 3D printed on Earth to complete simulated surgical tasks. METHODS: This study sought to examine the feasibility of using 3D printed surgical tools when the primary crew medical officer is incapacitated and the back-up crew medical officer must conduct a surgical procedure during a simulated extended space mission...
September 2016: Aerospace Medicine and Human Performance
Matthieu Komorowski, Sarah Fleming, Jochen Hinkelbein
PURPOSE OF REVIEW: Missions to the Moon or more distant planets are planned in the next future, and will push back the limits of our experience in providing medical support in remote environments. Medical preparedness is ongoing, and involves planning for emergency surgical interventions and anaesthetic procedures. This review will summarize what principles of ambulatory anaesthesia on Earth could benefit the environment of a space mission with its unique constraints. RECENT FINDINGS: Ambulatory anaesthesia relies on several principles such as improved patient pathway, correct patient selection, optimized procedural strategies to hasten recovery and active prevention of postoperative complications...
August 31, 2016: Current Opinion in Anaesthesiology
Caroline A Yao, Jordan Swanson, Meghan McCullough, Trisa B Taro, Ricardo Gutierrez, Allison Bradshaw, Alex Campbell, William P Magee, William P Magee
BACKGROUND: The emphasis on cultural competency for physicians and surgeons is increasingly important, as communication with both patients and other providers significantly affects individual and system-wide outcomes. International surgical training has been shown to improve leadership skills, cultural competency, and technical proficiency of participants in short-term follow-up. This study explores the long-term impact of international surgical mission experiences on developing participants' core competencies, professional outcomes, and commitment to global health...
September 2016: Plastic and Reconstructive Surgery
Elysée Nouvet, Elizabeth Chan, Lisa J Schwartz
In this paper, we present findings from a qualitative study that gathered Nicaraguans' perceptions of short-term foreign medical missions, towards deepening the understanding of what Nicaraguans value or find limited in the work of such foreign missions operating in their country. Fifty-two interviews were conducted with patients, relatives of patients, Nicaraguan physicians and nurses who partnered with or observed missions at work, 'beneficiary' community leaders, and individuals who were unable or unwilling to access mission-provided healthcare...
August 20, 2016: Global Public Health
Charlotte Richardson, Nadine Hachach-Haram, Michael Billingsley, Norma Timoney, Will Grant, Paul Gerarchi, Jonathon Collier, Simon Eccles, Richard Young, Niall Kirkpatrick
BACKGROUND: Education and training of local healthcare staff is a crucial component of a surgical mission. Facing The World (FTW) is a UK-based craniofacial charity that provides facial reconstructive surgery to children with complex, craniofacial anomalies. As part of its global initiative, FTW has developed a training outreach program in Vietnam. The aim of this study was to analyze feedback data to evaluate the educational value of the training program and identify areas for improvement...
October 2016: Journal of Craniofacial Surgery
Chenfei Rao, Junzhe Du, Xi Li, Jing Li, Heng Zhang, Yan Zhao, Shengshou Hu, Lixin Jiang, Zhe Zheng
OBJECTIVES: The benefits of secondary preventive drugs after coronary artery bypass grafting have been thoroughly established. However, the prescription rates of these drugs are low at discharge in China. We sought to evaluate the effectiveness of continuous quality improvement with mobile-based interventions for clinicians on improving the guideline-adherence of secondary preventive drugs prescription. METHODS AND RESULTS: The quality MISSION-1 study is a cluster-randomized controlled trial...
August 2016: American Heart Journal
W Thomas Lawrence
The American Association of Plastic Surgeons was founded in 1921 and is the oldest of the plastic surgery societies. It was born out of the enthusiasm of reconstructive surgeons who had recently increased in numbers and expanded the scope of their activities as a result of the challenges posed by battle-injured soldiers during World War I. Early meetings were small, focused exclusively on the head and neck, and often included live surgical demonstrations. The Association has grown in size and scope with time, but it has maintained its academic focus...
July 2016: Plastic and Reconstructive Surgery
Mikito Kawamata
Physician anesthesiologists should ensure a future leadership position in perioperative medicine and pain medicine. In order to establish the missions, anesthesiologists need to know how to relieve pain in surgical patients, critically ill patients and patients with cancer and non-cancer chronic pain. Thus, anesthesiologists should realize physiology of pain representation from pain management I will review physiological basis of pain mechanisms in this manuscript which includes 1) evolutional aspect of pain perception, 2) transduction of noxious stimuli, 3) the types of nociceptors and conduction of noxious stimuli, 4) the ascending pathway of pain and central modulation of pain, 5) the descending inhibitory pain system, and 6) various types of pain...
May 2016: Masui. the Japanese Journal of Anesthesiology
Christopher A Devine, Amy Yu, Rachel G Kasdin, Laura M Bogart, Aileen M Davis, Luis Alcántara Abreu, Roya Ghazinouri, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: U.S. practitioners have prescribed opioid analgesics increasingly in recent years, contributing to what has been declared an opioid epidemic by the U.S. Centers for Disease Control and Prevention (CDC). Opioids are used frequently in the preoperative and postoperative periods for patients undergoing total joint replacement in developed countries, but cross-cultural comparisons of this practice are limited. An international medical mission such as Operation Walk Boston, which provides total joint replacement to financially vulnerable patients in the Dominican Republic, offers a unique opportunity to compare postoperative pain management approaches in a developed nation and a developing nation...
June 15, 2016: Journal of Bone and Joint Surgery. American Volume
Casey J Allen, Richard J Straker, Clark R Murray, William M Hannay, Mena M Hanna, Jonathan P Meizoso, Ronald J Manning, Carl I Schulman, Jason M Seery, Kenneth G Proctor
U.S. Army Forward Surgical Teams (FSTs) are elite, multidisciplinary units that are highly mobile, and rapidly deployable. The mission of the FST is to provide resuscitative and damage control surgery for stabilization of life-threatening injuries in austere environments. The Army Trauma Training Center began in 2001 at the University of Miami Ryder Trauma Center under the direction of COL T. E. Knuth, MC USA (Ret.), as a multimodality combination of lectures, laboratory exercises, and clinical experiences that provided the only predeployment mass casualty and clinical trauma training center for all FSTs...
June 2016: Military Medicine
Mairin A Jerome, Justin Gillenwater, Donald R Laub, Turner Osler, Anna Y Allan, Carolina Restrepo, Alex Campbell
OBJECTIVE:   To compare anthropometric z-scores with incidence of post-operative complications for patients undergoing primary cleft lip or palate repair. DESIGN:   This was a retrospective observational analysis of patients from a surgical center in Assam, India, and includes a cohort from a single surgical mission completed before the opening of the center. SETTING:   Patients included in the study underwent surgery during an Operation Smile mission before the opening of Operation Smile's Guwahati Comprehensive Cleft Care Center in Guwahati, India...
May 31, 2016: Cleft Palate-craniofacial Journal
Hanon Sadoni, Hamidreza Arti
INTRODUCTION: Femoral shaft fracture is one of the typical bone fractures due to high energy trauma and may occur as an open fracture. Some foreign materials may enter the fracture site such as sand, cloth particles and so on. CASE PRESENTATION: A 28-year-old motorcycle riding military member and his collaborator were received in the hospital because of multiple traumas due to a fall in a hollow during a surveillance mission. His collaborator died because of head trauma and multiple severe open fractures...
February 2016: Trauma Monthly
John E Wilson, William P Barras
Lessons learned over the past decade and a half of combat casualty management has brought about numerous advances in trauma anesthesia practice. In the post-Vietnam era, deployable anesthesia equipment centered on the capability to provide a balanced anesthetic technique, utilizing a combination of volatile gas and intravenous anesthetic adjuncts. The evolution of the modern battlefield has forced anesthesia providers across the military to adapt to mission requirements that often dictate a surgical capability that is more rapidly mobile and less reliant on logistical support...
April 2016: U.S. Army Medical Department Journal
Aimee K Gardner, Marc A DeMoya, Glen H Tinkoff, Kimberly M Brown, George D Garcia, Geoffrey T Miller, Bernice W Zaidel, James R Korndorffer, Daniel J Scott, Ajit K Sachdeva
BACKGROUND: As it addresses both technical and nontechnical skills, simulation-based training is playing an increasingly important role in surgery. In addition to the focus on skill acquisition, it is also important to ensure that surgeons are able to perform a variety of tasks in unique and challenging situations. These situations include responding to mass casualties, dealing with disease outbreaks, and preparing for wartime missions. Simulation-based training can be a valuable training modality in these situations, as it allows opportunities to practice and prepare for high-risk and often low-frequency events...
September 2016: Surgery
Charles Scott Hultman
INTRODUCTION: Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. METHODS: We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption...
June 2016: Annals of Plastic Surgery
Charles Scott Hultman
PURPOSE: Portfolio planning in health care represents the strategic prioritization of services that permits an organization to better achieve its goals of margin and mission. Because of recent volatility in the economy, declining reimbursement, and rising costs of providing care, such strategic planning has become increasingly important if physicians want to remain leaders in health care. This project assesses the financial impact of procedural portfolio planning on an academic plastic surgery practice from the physician's perspective...
June 2016: Annals of Plastic Surgery
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