Seminars in Pediatric Surgery最新文献_第10页

Global children's surgery: Economic and policy priorities 全球儿童外科:经济和政策重点

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-20 DOI: 10.1016/j.sempedsurg.2023.151347

Justina Onyioza Seyi-Olajide , Isaac Chukwu

{"title":"Global children's surgery: Economic and policy priorities","authors":"Justina Onyioza Seyi-Olajide , Isaac Chukwu","doi":"10.1016/j.sempedsurg.2023.151347","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151347","url":null,"abstract":"<div><p>An estimated two-thirds of the world's children and adolescents, most of whom live in low- and middle- income countries lack access to safe, quality, and timely surgical care. While much efforts have been made in the last decade to advocate for children’ surgery, several economic and policy gaps remain, hampering progress and investments. These gaps range from lack of adequate data on costs and cost-effectiveness, high rate of out-of-pocket payments and limited health insurance coverage, to non-inclusion of children's surgical care in public child health policies and surgical plans. Given the magnitude of the limitations, actions and initiatives need to be prioritised to facilitate coordinated investments. Urgent investments are required to generate reliable and convincing data on costs of children's surgical care, as well as costs of equipment and supplies. To support actions and initiatives, children's surgery should be included in any existing and planned child public health initiatives and surgical plans. Integration of injury prevention and early identification of surgical conditions into school health initiatives would also strengthen care. The overall return on investment in children's surgical care are enormous with implications for child survival, family, and society stability as well as country workforce and economy. Investments should be well coordinated at country, regional and global levels to avoid waste of resources and duplication of efforts, while encouraging convergence of efforts.</p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151347"},"PeriodicalIF":1.7,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138436606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Civil Society and the Voluntary Sector in Children's Global Surgery 民间社会和志愿部门在儿童全球外科手术中的作用

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-19 DOI: 10.1016/j.sempedsurg.2023.151351

Leigh Selesner , Marilyn W. Butler

引用次数: 0

The global challenges of surgical congenital anomalies: Evidence, models, and lessons 外科先天性异常的全球挑战:证据、模型和教训

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-19 DOI: 10.1016/j.sempedsurg.2023.151348

Salimah R Walani , Norgrove Penny , Doreen Nakku

{"title":"The global challenges of surgical congenital anomalies: Evidence, models, and lessons","authors":"Salimah R Walani , Norgrove Penny , Doreen Nakku","doi":"10.1016/j.sempedsurg.2023.151348","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151348","url":null,"abstract":"<div><p><span>The treatment of </span>congenital anomalies<span><span> (structural birth defects) is common to all the surgical sub-specialties dealing with children. Globally more than 90 % of all babies born with a congenital anomaly are born in middle-and-low-income countries where there is often limited access to needed surgical care. Challenges include lacks of early identification, registry and surveillance systems, missing referral pathways, shortage of trained surgical expertise and insufficient surgical infrastructure. Poverty, transportation logistics, financial constraints and social stigma<span> are also serious barriers for families. There is, however, growing recognition of the priority to expand services, encouraged by the World Health Organization and other global players, and examples of successful models of care. Registry programs are growing, especially in Latin America. The Ponseti method of </span></span>clubfoot care has been revolutionary on a global scale. The role of not-for-profit non-governmental-organizations has been instrumental in fundraising, training and logistical support as exemplified in the care of oro-facial clefts. Specialized “niche” hospitals are providing needed sub-specialist expertise. The way forward includes the need for effective partnerships, innovative methods to distribute care out from referral hospitals into the districts and the development of national plans embedded in national health policy.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151348"},"PeriodicalIF":1.7,"publicationDate":"2023-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gaps and priorities in innovation for children's surgery 儿童外科创新的差距和重点

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-08 DOI: 10.1016/j.sempedsurg.2023.151352

Tamara N Fitzgerald , Alan Zambeli-Ljepović , Bolusefe T. Olatunji , Abdullah Saleh , Emmanuel A. Ameh

{"title":"Gaps and priorities in innovation for children's surgery","authors":"Tamara N Fitzgerald , Alan Zambeli-Ljepović , Bolusefe T. Olatunji , Abdullah Saleh , Emmanuel A. Ameh","doi":"10.1016/j.sempedsurg.2023.151352","DOIUrl":"10.1016/j.sempedsurg.2023.151352","url":null,"abstract":"<div><p><span>Lack of access to pediatric </span>medical devices<span> and innovative technology contributes to global disparities in children's surgical care. There are currently many barriers that prevent access to these technologies in low- and middle-income countries (LMICs). Technologies that were designed for the needs of high-income countries (HICs) may not fit the resources available in LMICs. Likewise, obtaining these devices are costly and require supply chain infrastructure. Once these technologies have reached the LMIC, there are many issues with sustainability and maintenance of the devices. Ideally, devices would be created for the needs and resources of LMICs, but there are many obstacles to innovation that are imposed by institutions in both HICs and LMICs. Fortunately, there is a growing interest for development of this space, and there are many examples of current technologies that are paving the way for future innovations. Innovations in simulation-based training with incorporated learner self-assessment are needed to fast-track skills acquisition for both specialist trainees and non-specialist children's surgery providers, to scale up access for the larger population of children. Pediatric laparoscopy and imaging are some of the innovations that could make a major impact in children's surgery worldwide.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151352"},"PeriodicalIF":1.7,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addressing health equity in pediatric surgical care in the United States– Progress and challenges 解决在美国儿科外科护理卫生公平-进展和挑战。

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-08 DOI: 10.1016/j.sempedsurg.2023.151354

Stephen Trinidad , Matthew Goldshore , Meera Kotagal

{"title":"Addressing health equity in pediatric surgical care in the United States– Progress and challenges","authors":"Stephen Trinidad , Matthew Goldshore , Meera Kotagal","doi":"10.1016/j.sempedsurg.2023.151354","DOIUrl":"10.1016/j.sempedsurg.2023.151354","url":null,"abstract":"<div><p><span>There are notable inequities in health outcomes for children based on their social determinants of health<span> (SDOH), including where they are born and live, their primary language, their race and ethnicity, socioeconomic status, and more. These health inequities are not restricted to resource limited settings; here we highlight three broad topics that are relevant to pediatric surgeons in the United States (US): access to care and disparities, and examples of inequities in firearm-related injuries and </span></span>appendicitis.</p><p>Most of our patients will at some point require operative interventions, yet there can be significant challenges in accessing this care and navigating our health systems<span><span>, particularly around complex perioperative care. There are significant opportunities to improve equitable care by helping patients navigate our health systems and connecting them with additional resources, including screening for </span>primary care services.</span></p><p>Firearm-related injuries are now the leading cause of death in children in the US, with significant associated morbidity for non-fatal injuries. There are notable inequities in the risk of injury and types of injuries experienced by children based on their SDOH. Appendicitis is one of the most common pathologies managed by pediatric surgeons, with similar inequities in the rates of perforated appendicitis based on a child's SDOH.</p><p>For both issues, addressing the inequities our patients experience requires moving upstream and working towards prevention. Key opportunities include better research and data to understand the drivers for observed inequities, multidisciplinary collaboration, community engagement, and public health<span> advocacy among others. As a profession, we have a responsibility to work to address the health inequities our patients experience.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151354"},"PeriodicalIF":1.7,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Anatomy and lessons of partnerships in global pediatric surgery” “全球儿科外科伙伴关系的剖析和经验教训”

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-08 DOI: 10.1016/j.sempedsurg.2023.151353

Rovine Naluyimbazi , Stella Nimanya , Phyllis Kisa

{"title":"“Anatomy and lessons of partnerships in global pediatric surgery”","authors":"Rovine Naluyimbazi , Stella Nimanya , Phyllis Kisa","doi":"10.1016/j.sempedsurg.2023.151353","DOIUrl":"10.1016/j.sempedsurg.2023.151353","url":null,"abstract":"<div><p>Partnerships in Global Surgery have evolved over several decades and continue to do so based on reports from different experiences and collaborations. These should be characterised by their objectives, leadership and “championship,” communication, ethics and equity. Partnerships take the form of academic collaborations or clinical support<span> whose details vary with the different stakeholders involved. Over time, these have evolved based on challenges, successes, and failures. Recently, quality improvement activities have been increasingly initiated with locally derived information. This has come from local databases in low and middle income country (LMIC) settings whose maintenance and analysis have been done through academic collaborations. For many sites in LMICs, there would be very little advance in paediatric surgery without collaborations. Despite this, problems still arise from collaborations due to failure to learn from past problems, lack of local championship, poor communication, and externally driven objectives. For success and longevity, the collaboration must pay attention to unique the needs of the site, champions and equity.</span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 6","pages":"Article 151353"},"PeriodicalIF":1.7,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135514594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anorectal malformations in low and middle-income countries- spectrum, burden and management 低收入和中等收入国家的肛肠畸形——范围、负担和管理

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-11-08 DOI: 10.1016/j.sempedsurg.2023.151349

Shilpa Sharma , Dennis Mazingi , Md Sharif Imam , Tanvir Kabir Chowdhury , Lily J. Saldaña , Noxolo Z Mashavave , Maricarmen Olivos , Md. Tameem Shafayat Chowdhury , Mozammel Hoque , Catalina Correa , Tahmina Banu

引用次数: 0

Critical elements of pediatric liver cancer surgery 小儿肝癌手术的关键要素

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-10-01 DOI: 10.1016/j.sempedsurg.2023.151340

Zachary J. Kastenberg , Reto M. Baertschiger , Alex G. Cuenca , Nhu Thao Nguyen Galvan , Caroline P. Lemoine , Jonathan P. Roach , Ashley E. Walther , Stephen P. Dunn , John A. Goss , Patrick J. Healey , Jonathan Karpelowsky , Eugene S. Kim , Max R. Langham , Rebecka L. Meyers , Riccardo A. Superina , Greg M. Tiao , Christopher B. Weldon , Alex J. Bondoc , Kimberly J. Riehle , Sanjeev A. Vasudevan

{"title":"Critical elements of pediatric liver cancer surgery","authors":"Zachary J. Kastenberg , Reto M. Baertschiger , Alex G. Cuenca , Nhu Thao Nguyen Galvan , Caroline P. Lemoine , Jonathan P. Roach , Ashley E. Walther , Stephen P. Dunn , John A. Goss , Patrick J. Healey , Jonathan Karpelowsky , Eugene S. Kim , Max R. Langham , Rebecka L. Meyers , Riccardo A. Superina , Greg M. Tiao , Christopher B. Weldon , Alex J. Bondoc , Kimberly J. Riehle , Sanjeev A. Vasudevan","doi":"10.1016/j.sempedsurg.2023.151340","DOIUrl":"https://doi.org/10.1016/j.sempedsurg.2023.151340","url":null,"abstract":"<div><p><span><span><span>The appropriate management of pediatric liver </span>malignancies, primarily </span>hepatoblastoma and hepatocellular carcinoma, requires an in depth understanding of contemporary preoperative </span>risk stratification<span>, experience with advanced hepatobiliary surgery<span>, and a good relationship with one’s local or regional liver transplant<span> center. While chemotherapy regimens have become more effective, operative indications more well-defined, and overall survival improved, the complexity of liver surgery in small children provides ample opportunity for protocol violation, inadequate resection, and iatrogenic morbidity. These guidelines represent the distillation of contemporary literature and expert opinion as a means to provide a framework for preoperative planning and intraoperative decision-making for the pediatric surgeon.</span></span></span></p></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"32 5","pages":"Article 151340"},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Critical elements of pediatric testicular germ cell tumors surgery 小儿睾丸生殖细胞肿瘤手术的关键要素

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-10-01 DOI: 10.1016/j.sempedsurg.2023.151343

Amanda F. Saltzman , Patrick Hensley , Jonathan Ross , Lynn Woo , Deborah Billmire , Frederick Rescorla , Dhruv Puri , Sunil Patel , Phillip Pierorazio , Aditya Bagrodia , Clint Cary , Nicholas G. Cost

引用次数: 0

Critical elements of pediatrics sacrococcygeal germ cell tumor surgery 小儿骶尾骨生殖细胞瘤手术的关键因素

IF 1.7 3区医学

Seminars in Pediatric Surgery Pub Date : 2023-10-01 DOI: 10.1016/j.sempedsurg.2023.151344

Frederick Rescorla , Bryan Dicken , Deborah Billmire , Brent Weil , Rebecca Stark , Arin Madenci , Akila Ramaraj

引用次数: 0