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Surgical inequality

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https://www.readbyqxmd.com/read/28341282/the-state-of-the-surgical-workforce-in-brazil
#1
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
#2
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...
March 23, 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
#3
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
#4
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
#5
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)...
February 22, 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
#6
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
#7
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
https://www.readbyqxmd.com/read/28179415/factors-related-to-receipt-of-non-cancer-related-transurethral-prostatectomy-findings-from-a-large-prospective-study-of-106%C3%A2-769-middle-aged-and-older-australian-men
#8
Grace Joshy, Kay Soga, Rosemary J Korda, Manish I Patel, Emily Banks
BACKGROUND: Transurethral prostatectomy (TURP) is a common surgical intervention for chronic lower urinary tract symptoms (LUTS). Little large-scale evidence exists on factors related to receipt of non-cancer-related TURP. METHODS: A prospective study of men aged ≥45 years participating in the 45 and Up Study, a large Australian cohort study, without prior prostatectomy and/or bowel/genital/urinary-tract cancer; questionnaire data were linked to hospitalisations and deaths...
February 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28140615/unsettling-the-fistula-narrative-cultural-pathology-biomedical-redemption-and-inequities-of-health-access-in-niger-and-ethiopia
#9
Alison Heller, Anita Hannig
Obstetric fistula, a maternal childbirth injury that results in chronic incontinence, affects an estimated one million women in the global south. In the course of media and donor coverage on this condition, fistula sufferers have been branded as 'child brides' who, following the onset of their incontinence, become social pariahs and eventually find physical and social redemption through surgical repair. This narrative framing pits the violence of 'culture' against the potency of biomedical salvation. Based on over two years of ethnographic research at fistula repair centres in Niger and Ethiopia, this paper challenges this narrative and argues that most women with obstetric fistula remain embedded in social relations, receive continued familial support, and, unexpectedly, experience ambiguous surgical outcomes...
April 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28105299/geographic-variation-in-selected-hospital-procedures-and-services-in-the-israeli-health-care-system
#10
Joseph Mendlovic, Ethel-Sherry Gordon, Ziona Haklai, Jill Meron, Arnon Afek
BACKGROUND: Medical practice variation refers to differences in health service utilization among regions in the same country. It is used as a tool for studying health inequities. In 2011, the OECD launched a Medical Practice Variation Project which examines regional differences within countries and explores the sources of the inter-regional differences. The aim of this study is to examine the patterns and trends in geographic variation for selected health services in Israel. METHODS: The analysis is based on data from the National Hospital Discharges Database (NHDD) of the Israeli Ministry of Health...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28035298/thoracic-and-cardiovascular-surgeons-perception-of-the-concentration-of-cardiovascular-operations-in-seoul-metropolitan-area-s-hospitals
#11
Hyo Seon Jeong, Kun Sei Lee, Hyun Keun Chee, Hye Mi Ahn, Sung Bo Sim
BACKGROUND: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. METHODS: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27900509/conversion-of-hip-fusion-to-total-hip-arthroplasty-clinical-radiological-outcomes-and-complications-in-40-hips
#12
Mustafa Celiktas, Ozkan Kose, Adil Turan, Ferhat Guler, Cagri Ors, Emre Togrul
OBJECTIVE: The purpose of this retrospective study is to report the clinical and radiological outcome of total hip arthroplasty in patients with previous hip arthrodesis. PATIENTS AND METHODS: We retrospectively reviewed 28 (40 hips) prospectively followed patients in whom ankylosed hips were converted to total hip arthroplasty (THA) between 2010 and 2014 in our institution. The average age at the time of the conversion operation was 40.8 ± 9.8 years (range 24-62)...
January 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27876245/perioperative-medicine-and-taiwan-national-health-insurance-research-database
#13
REVIEW
C C Chang, C C Liao, T L Chen
"Big data", characterized by 'volume', 'velocity', 'variety', and 'veracity', being routinely collected in huge amounts of clinical and administrative healthcare-related data are becoming common and generating promising viewpoints for a better understanding of the complexity for medical situations. Taiwan National Health Insurance Research Database (NHIRD), one of large and comprehensive nationwide population reimbursement databases in the world, provides the strength of sample size avoiding selection and participation bias...
September 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27832174/the-impact-of-socioeconomic-status-surgical-resection-and-type-of-hospital-on-survival-in-patients-with-pancreatic-cancer-a-population-based-study-in-the-netherlands
#14
Margijske H G van Roest, Maaike A van der Aa, Lydia G M van der Geest, Koert P de Jong
The influence of socioeconomic inequalities in pancreatic cancer patients and especially its effect in patients who had a resection is not known. Hospital type in which resection is performed might also influence outcome. Patients diagnosed with pancreatic cancer from 1989 to 2011 (n = 34,757) were selected from the population-based Netherlands Cancer Registry. Postal code was used to determine SES. Multivariable survival analyses using Cox regression were conducted to discriminate independent risk factors for death...
2016: PloS One
https://www.readbyqxmd.com/read/27785671/a-crosswalk-between-ucla-and-lower-extremity-activity-scales
#15
Hassan M K Ghomrawi, Yuo-Yu Lee, Christina Herrero, Amethia Joseph, Douglas Padgett, Geoffrey Westrich, Michael Parks, Stephen Lyman
BACKGROUND: The University of California, Los Angeles (UCLA) activity scale and the Lower Extremity Activity Scale (LEAS) are the two most-widely used and rigorously developed scales for assessing activity level in patients having joint replacement. However, the two scales are not convertible, and the level of correlation between the two is not clear. Creating a crosswalk between these scales; that is, a concordance table to convert scores from one scale to the other and vice versa, will help compare results from existing studies using either scale, and pool those results for meta-analyses...
February 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27748675/physeal-bar-equivalent
#16
Hamlet A Peterson, William J Shaughnessy, Anthony A Stans
Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27579265/the-role-of-plastic-surgeons-in-advancing-development-global
#17
REVIEW
P Niclas Broer, Hillary E Jenny, Joshua S Ng-Kamstra, Sabrina Juran
In September 2015, the international community came together to agree on the 2030 Agenda for Sustainable Development, a plan of action for people, the planet, and prosperity. Ambitious and far-reaching as they are, they are built on three keystones: the elimination of extreme poverty, fighting climate change, and a commitment to fighting injustice and inequality. Critical to the achievement of the Agenda is the global realization of access to safe, affordable surgical and anesthesia care when needed. The landmark report by the Lancet Commission on Global Surgery estimated that between 28 and 32 percent of the global burden of disease is amenable to surgical treatment...
May 2016: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/27548584/complications-associated-with-epiphysiodesis-for-management-of-leg-length-discrepancy
#18
Marina R Makarov, Samuel H Dunn, Dustin E Singer, Karl E Rathjen, Brandon A Ramo, Chukwudi K Chukwunyerenwa, John G Birch
BACKGROUND: Epiphysiodesis is well-established surgical treatment for the management of leg length discrepancy (LLD) in children; however, a variety of complications may occur. This study evaluates the nature, rate, and potential risk factors of complications associated with epiphysiodesis in a large patient population treated in 1 institution. METHODS: We evaluated the medical and radiographic records of 863 children who had lower extremity epiphysiodesis to manage LLD between 1980 and 2011...
August 19, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27534822/overcoming-the-tyranny-of-distance-an-audit-of-process-and-outcomes-from-a-pilot-telehealth-spinal-assessment-clinic
#19
Matthew Beard, Joseph F Orlando, Saravana Kumar
INTRODUCTION: There is consistent evidence to indicate people living in rural and remote regions have limited access to healthcare and poorer health outcomes. One way to address this inequity is through innovative models of care such as telehealth. The aim of this pilot trial was to determine the feasibility, appropriateness and access to a telehealth clinic. In this pilot trial, the telehealth clinic outcomes are compared with the outreach clinic. Both models of care are commonly utilised means of providing healthcare to meet the needs of people living in rural and remote regions...
August 17, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27447656/geographical-inequalities-in-surgical-treatment-for-localized-female-breast-cancer-queensland-australia-1997-2011-improvements-over-time-but-inequalities-remain
#20
Peter D Baade, Paramita Dasgupta, Philippa H Youl, Christopher Pyke, Joanne F Aitken
The uptake of breast conserving surgery (BCS) for early stage breast cancer varies by where women live. We investigate whether these geographical patterns have changed over time using population-based data linkage between cancer registry records and hospital inpatient episodes. The study cohort consisted of 11,631 women aged 20 years and over diagnosed with a single primary invasive localised breast cancer between 1997 and 2011 in Queensland, Australia who underwent either BCS (n = 9223, 79%) or mastectomy (n = 2408, 21%)...
2016: International Journal of Environmental Research and Public Health
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