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Surgical inequality

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https://www.readbyqxmd.com/read/28904639/a-comparison-of-functional-outcome-between-amputation-and-extension-prosthesis-in-the-treatment-of-congenital-absence-of-the-fibula-with-severe-limb-deformity
#1
P Calder, S Shaw, A Roberts, S Tennant, I Sedki, R Hanspal, D Eastwood
PURPOSE: Complete fibula absence often presents with significant lower-limb deformity. Parental counselling regarding management is paramount in achieving the optimum functional outcome. Amputation offers a single surgical event with minimal complications. This study compares outcomes with an amputation protocol to those using an extension prosthesis. METHOD: Thirty-two patients were identified. Nine patients (2 males, 7 females; median age at assessment of 23...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28876674/an-analysis-of-the-inequalities-between-the-public-and-private-sector-in-south-africa
#2
A J Dell, D Kahn, J Klopper
BACKGROUND: The full extent of the global burden of surgical disease is largely unknown; however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compounds inequitable access to surgical care. METHOD: This study involved a descriptive analysis of surgical resources and included the total number of hospitals, hospital beds, surgical beds, general surgeons (specialist and nonspecialist), and the number of functional operating theatres in South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876568/an-analysis-of-the-inequalities-between-the-public-and-private-sector-in-south-africa
#3
A Dell, D Kahn, J Klopper
BACKGROUND: The full extent of the global burden of surgical disease is largely unknown, however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compounds inequitable access to surgical care. METHOD: This study involved a descriptive analysis of surgical resources and included the total number of hospitals, of hospital beds, the number of surgical beds, the number of general surgeons (specialist and non-specialist), and the number of functional operating theatres in South Africa...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28859056/persistent-inequalities-in-90-day-colon-cancer-mortality-an-english-cohort-study
#4
H Fowler, A Belot, E N Njagi, M A Luque-Fernandez, C Maringe, M Quaresma, M Kajiwara, B Rachet
BACKGROUND: Variation in colon cancer mortality occurring shortly after diagnosis is widely reported between socio-economic status (SES) groups: we investigated the role of different prognostic factors in explaining variation in 90-day mortality. METHODS: National cancer registry data were linked with national clinical audit data and Hospital Episode Statistics records for 69 769 adults diagnosed with colon cancer in England between January 2010 and March 2013...
August 31, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28833452/boys-have-better-short-term-and-long-term-survival-rates-after-intensive-care-admissions-than-girls
#5
E Johansson Frigyesi, P Andersson, A Frigyesi
AIM: We investigated possible gender differences in paediatric intensive-care morbidity-adjusted mortality. METHODS: In this study, data on all 21,972 paediatric intensive-care admissions in Sweden between 2008 and 2015 were analysed regarding morbidity-adjusted survival, using Cox regression, with age, gender and estimated mortality ratio as dependent variables and using the standardised mortality ratio at 90 days after admission. The data was obtained from the Swedish Intensive Care Registry...
August 22, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28693395/an-ideal-hospital
#6
Singithi Sidney Chandrasiri
Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform...
July 3, 2017: Leadership in Health Services
https://www.readbyqxmd.com/read/28658852/severe-puerperal-sepsis-a-simmering-menace
#7
Sheeba Marwah, Sonam R Topden, Manjula Sharma, Ritin Mohindra, Pratima Mittal
INTRODUCTION: Even decades after the development of effective low-cost antibiotics, sepsis persists as the foremost cause of preventable maternal death worldwide. In developing countries like India, where the paramount impediment to intervention is poverty, maternal mortality due to sepsis is a continuing representation of maternal health inequality. AIM: To determine the incidence, risk factors and mortality in women presenting with puerperal sepsis in a tertiary care health facility in India...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658340/surgery-in-brazilian-health-care-funding-and-physician-distribution
#8
Nivaldo Alonso, Benjamin B Massenburg, Rafael Galli, Lucas Sobrado, Dario Birolini
Objective: to analyze demographic Brazilian medical data from the national public healthcare system (SUS), which provides free universal health coverage for the entire population, and discuss the problems revealed, with particular focus on surgical care. Methods: data was obtained from public healthcare databases including the Medical Demography, the Brazilian Federal Council of Medicine, the Brazilian Institute of Geography and Statistics, and the National Database of Healthcare Establishments...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28647446/social-and-geographic-determinants-of-hysterectomy-in-ontario-a-population-based-retrospective-cross-sectional-analysis
#9
Innie Chen, Michelle R Wise, Sheila Dunn, Geoffrey Anderson, Naushaba Degani, Guylaine Lefebvre, Arlene S Bierman
OBJECTIVES: This study sought to determine whether social factors (neighbourhood education and income) and geographic factors (urban or rural dwelling and local service area) are associated with hysterectomy rates, proportion of hysterectomies performed minimally invasively, and hysterectomy complication and readmission rates in Ontario. METHODS: The Canadian Institute for Health Information Discharge Abstract Database was used to perform a population-based retrospective cross-sectional study on women who had an abdominal, vaginal, and laparoscopic hysterectomy in 2007 for benign gynaecologic conditions in hospitals in Ontario, Canada...
June 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28580824/addressing-health-workforce-inequities-in-the-mindanao-regions-of-the-philippines-tracer-study-of-graduates-from-a-socially-accountable-community-engaged-medical-school-and-graduates-from-a-conventional-medical-school
#10
Servando 'Ben' Halili, Fortunato Cristobal, Torres Woolley, Simone J Ross, Carole Reeve, A-J Neusy
Developing and retaining a high-quality medical workforce in low-resource countries is a worldwide challenge. The Filipino Ateneo de Zamboanga University-School of Medicine (ADZU-SOM) has adopted a strong focus on socially accountable health professional education (SAHPE) in order to address the shortage of physicians across rural and urban communities in the Western Mindanao region. A cross-sectional survey of graduates from two Philippines medical schools: ADZU-SOM in the Mindanao region and a medical school with a more conventional curriculum, found ADZU-SOM graduates were more likely to have joined the medical profession due to a desire to help others (p = 0...
June 5, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28564674/association-of-a-policy-mandating-physician-patient-communication-with-racial-ethnic-disparities-in-postmastectomy-breast-reconstruction
#11
Elham Mahmoudi, Yiwen Lu, Allan K Metz, Adeyiza O Momoh, Kevin C Chung
Importance: With the stabilization of breast cancer incidence and substantial improvement in survival, more attention has focused on postmastectomy breast reconstruction (PBR). Despite its demonstrated benefits, wide disparities in the use of PBR remain. Physician-patient communication has an important role in disparities in health care, especially for elective surgical procedures. Recognizing this, the State of New York enacted Public Health Law (NY PBH Law) 2803-o in 2011 mandating that physicians communicate about reconstructive surgery with patients undergoing mastectomy...
August 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28433398/multi-state-survey-of-healthcare-associated-infections-in-acute-care-hospitals-in-brazil
#12
C Magno Castelo Branco Fortaleza, M C Padoveze, C R Veiga Kiffer, A L Barth, Irna C do Rosário Souza Carneiro, H I Garcia Giamberardino, J L Nobre Rodrigues, L Santos Filho, M J Gonçalves de Mello, M Severino Pereira, P Pinto Gontijo Filho, M Rocha, E A Servolo de Medeiros, A C Campos Pignatari
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds)...
March 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28410637/the-influence-of-physician-and-patient-gender-on-risk-assessment-for-lung-cancer-resection
#13
Mark K Ferguson, Megan Huisingh-Scheetz, Katherine Thompson, Kristen Wroblewski, Jeanne Farnan, Julissa Acevedo
BACKGROUND: Women do not receive appropriate surgical therapy for lung cancer as often as men. Patient gender may influence treatment recommendations; less is known about the effect of physician gender on recommendations. METHODS: Gender-neutral vignettes representing low-risk, average-risk, and high-risk candidates for lung resection were paired with concordant videos of standardized patients (SPs). Cardiothoracic trainees and practicing thoracic surgeons read a vignette, provided an initial estimate of the percentage risk of major adverse events after lung resection, viewed a video (randomized to male or female SP), provided a final estimate of risk, and ranked the importance of the video in the final risk estimate...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28341282/the-state-of-the-surgical-workforce-in-brazil
#14
Mário C Scheffer, Aline G A Guilloux, Alicia Matijasevich, Benjamin B Massenburg, Saurabh Saluja, Nivaldo Alonso
BACKGROUND: A critical insufficiency of surgeons, anesthesiologists, and obstetricians exists around the world, leaving billions of people without access to safe operative care. The distribution of the surgical workforce in Brazil, however, is poorly described and rarely assessed. Though the surgical workforce is only one element in the surgical system, this study aimed to map and characterize the distribution of the surgical workforce in Brazil in order to stimulate discussion on future surgical policy reforms...
February 2017: Surgery
https://www.readbyqxmd.com/read/28337730/current-concepts-of-shared-decision-making-in-orthopedic-surgery
#15
REVIEW
Kevin Klifto, Christopher Klifto, James Slover
PURPOSE OF REVIEW: The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes...
June 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28299257/cleft-lip-and-palate-parental-experiences-of-stigma-discrimination-and-social-structural-inequalities
#16
Wasiu Lanre Adeyemo, Olutayo James, Azeez Butali
BACKGROUND: Cleft lip and palate (CLP) are the most common craniofacial birth impairment and one of the most common congenital impairments in humans. Anecdotal evidence suggests that stigmatization, discrimination, and sociocultural inequalities are common "phenomenon" experienced by families of children with CLP in Nigeria. This study aimed to explore the stigmatization, discrimination, and sociocultural inequalities experiences of families with children born with CLP. MATERIALS AND METHODS: The study was carried out at the surgical outpatient cleft clinic of the Lagos University Teaching Hospital, Lagos, Nigeria...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28249047/effective-cataract-surgical-coverage-an-indicator-for-measuring-quality-of-care-in-the-context-of-universal-health-coverage
#17
Jacqueline Ramke, Clare E Gilbert, Arier C Lee, Peter Ackland, Hans Limburg, Allen Foster
OBJECTIVE: To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome). METHODS: All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated...
2017: PloS One
https://www.readbyqxmd.com/read/28228412/inequality-in-cataract-blindness-and-services-moving-beyond-unidimensional-analyses-of-social-position
#18
Jacqueline Ramke, Anthony B Zwi, Arier C Lee, Ilse Blignault, Clare E Gilbert
OBJECTIVE: Inequalities in cataract blindness are well known, but data are rarely disaggregated to explore the combined effects of a range of axes describing social disadvantage. We examined inequalities in cataract blindness and services at the intersection of three social axes. METHODS: Three dichotomous social variables (sex (male/female); place of residence (urban/rural); literacy (literate/illiterate)) from cross-sectional national blindness surveys in Pakistan (2001-2004; n=16 507) and Nigeria (2005-2007; n=13 591) were used to construct eight subgroups, with disadvantaged subgroups selected a priori (ie, women, rural dwellers, illiterate)...
April 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28223043/socio-economic-status-influences-the-likelihood-of-undergoing-surgical-treatment-for-pancreatic-cancer-in-the-netherlands
#19
Maikel J A M Bakens, Valery E P P Lemmens, Ignace H J T de Hingh
Surgical resection offers the only prospect of cure in pancreatic cancer patients. The probability of undergoing surgery is determined by several factors. The influence of socio-economic status (SES) on surgical treatment and survival was investigated in the Netherlands, a country with a widely accessible healthcare system. METHODS: Data on all patients with non-metastasised pancreatic cancer between 2005-2013 were analysed in the Eindhoven Cancer Registry (ECR). SES was categorized as low, intermediate or high...
February 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28193221/the-publication-gender-gap-in-us-academic-surgery
#20
Claudia Mueller, Robert Wright, Sabine Girod
BACKGROUND: Terms such as "glass ceiling" and "sticky floor" are still commonly used to describe women's role in academic surgery. Despite continued efforts to address disparities between men and women in the field, gender inequalities persist. METHODS: In this investigation we highlight gender differences in published surgical literature by both quantity and impact. Websites for departments of surgery of three academic centers were reviewed to assess the bibliometrics of publications by gender over a two-week period...
February 14, 2017: BMC Surgery
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