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Memba R, Puyana JC, Grayling M, Climent C, Martínez P, Blanco E, Rigueiro J, Suárez D, Viscasillas G, Fortea E, Roman O, Gracia D, Feliu F, Nve S, Jorba R. The Use of a Theory of Change Model to Guide the Implementation of a Comprehensive Surgical Specialty Training Program in Equatorial Guinea. Ann Glob Health 2024; 90:43. [PMID: 39036647 PMCID: PMC11259116 DOI: 10.5334/aogh.4477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/07/2024] [Indexed: 07/23/2024] Open
Abstract
Background: Equatorial Guinea (EG) is located on the African west coast, with only 0.4 trained physicians per 1,000 resident population. The country has one medical school and there is no specialist training program. From 2000 to 2022, 524 doctors have received their medical degree. However, the number of national surgical specialists in the entire country is currently 42. Objective: Formación Especializada Sanitaria en Guinea Ecuatorial (FES Guinea) is a program specifically aimed at designing and implementing a long-term national surgical specialist training program. Methods: Más Que Salud (+QS), which means "More than Health" in Spanish, is a nonprofit organization leading the FES Guinea program. We used the theory of change (ToC) framework to evaluate the work accomplished and implement subsequent phases. The initial phase (A) included a needs assessment and mapping of available resources. An intermediate phase (B) started with a memorandum of understanding to implement a Train the Trainer program. The consolidation phase (C) consists of educational interventions and future advanced training projects. Findings: The ToC model allowed us an analyses of initial and intermediate phases. The needs assessments and resources mapping were executed while several scientific meetings and workshops were given. Scholarships to support specialist training abroad benefited six physicians in a diverse set of surgical disciplines. A regulatory commission to implement the FES Guinea program and the National Medical Council of EG were created. Working directly with the EG Ministry of Health, +QS codesigned a National Health Development Plan that began implementation in 2021 to continue until 2025. Conclusions: The ToC model allowed us to predict the current and future potential effects of FES Guinea on surgical workforce development in EG. This is a unique surgical training program, which combined effective initiatives spearheaded initially by an NGO that successfully incorporated both local health and academic authorities, ensuring sustainability.
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Affiliation(s)
- Robert Memba
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- General Surgery Department, University Hospital of Tarragona Joan XXIII, Spain
- Rovira i Virgili University (URV), Pere Virgili Institute for Health Research (IISPV)
| | - Juan Carlos Puyana
- Global Health Surgery Department, University of Pittsburgh, US
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin
| | - Martha Grayling
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
| | - Carme Climent
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Pediatrics Department, University General Hospital of Catalonia, Spain
| | - Patrícia Martínez
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Orthopedics and Trauma Surgery Department, Parc Taulí University Hospital, Spain
| | - Eunice Blanco
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Social Work Department, Vall d'Hebron University Hospital, Spain
| | - Jordi Rigueiro
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- INnGEAUDIO (Innovation and Engineering for Hearing), Spain
| | - David Suárez
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
| | - Guillem Viscasillas
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Otorhinolaryngology Department, Althaia Manresa University Healthcare Network, Spain
| | - Emma Fortea
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Dentistry Department, Dentalògic Dental Clinic, Spain
| | - Olga Roman
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
- Gynecology and Obstetrics Department, Manacor Hospital, Spain
| | - Daniel Gracia
- Más Que Salud (More than Health), Non-Governmental Organization, Spain
| | - Francesc Feliu
- General Surgery Department, University Hospital of Tarragona Joan XXIII, Spain
- Rovira i Virgili University (URV), Pere Virgili Institute for Health Research (IISPV)
| | - Silvano Nve
- Anesthesiology Department, Bata General Hospital, Equatorial Guinea
| | - Rosa Jorba
- General Surgery Department, University Hospital of Tarragona Joan XXIII, Spain
- Rovira i Virgili University (URV), Pere Virgili Institute for Health Research (IISPV)
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Krakauer KN, Wong LY, Tobias J, Majekodunmi O, Balumuka D, Bravo K, Ameh E, Finlayson S, Nwomeh B, Sifri Z, Charles A, Krishnaswami S. Evaluating Global Surgery Partnerships From Low and Middle Income Country Perspectives. J Surg Res 2024; 296:681-688. [PMID: 38364695 DOI: 10.1016/j.jss.2024.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Little is known about perceptions of low-income and middle-income country (LMIC) partners regarding global surgery collaborations with high-income countries (HICs). METHODS A survey was distributed to surgeons from LMICs to assess the nature and perception of collaborations, funding, benefits, communication, and the effects of COVID-19 on partnerships. RESULTS We received 19 responses from LMIC representatives in 12 countries on three continents. The majority (83%) had participated in collaborations within the past 5 y with 39% of collaborations were facilitated virtually. Clinical and educational partnerships (39% each) were ranked most important by respondents. Sustainability of the partnership was most successfully achieved in domains of education/training (78%) and research (61%). The majority (77%) of respondents reported expressing their needs before HIC team arrival. However, 54% of respondents were the ones to initiate the conversation and only 47% said HIC partners understood the overall environment well at arrival to LMIC. Almost all participants (95%) felt a formal process of collaboration and a structured partnership would benefit all parties in assessing needs. During the COVID-19 pandemic, 87% of participants reported continued collaborations; however, 44% of partners felt that relationships were weaker, 31% felt relationships were stronger, and 25% felt they were unchanged. CONCLUSIONS Our study provides a snapshot of LMIC surgeons' perspectives on collaboration in global surgery. Independent of location, LMIC partners cite inadequate structure for long-term collaborations. We propose a formal pathway and initiation process to assess resources and needs at the outset of a partnership.
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Affiliation(s)
- Kelsi N Krakauer
- Department of Surgery, Oregon Health And Science University, Portland, Oregon
| | - Lye-Yeng Wong
- Department of Surgery, Oregon Health And Science University, Portland, Oregon.
| | - Joseph Tobias
- Department of Surgery, Oregon Health And Science University, Portland, Oregon
| | - Olubunmi Majekodunmi
- Department of Surgery, National Hospital Abuja, Abuja, Federal Capital Territory, Nigeria
| | - Darius Balumuka
- Department of Surgery, Oregon Health And Science University, Portland, Oregon
| | - Kali Bravo
- Department of Surgery, Oregon Health And Science University, Portland, Oregon
| | - Emmanuel Ameh
- Department of Surgery, National Hospital Abuja, Abuja, Federal Capital Territory, Nigeria
| | | | - Benedict Nwomeh
- Department of Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Ziad Sifri
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Anthony Charles
- Department of Surgery, University Of North Carolina At Chapel Hill, Chapel Hill, North Carolina
| | - Sanjay Krishnaswami
- Department of Surgery, Oregon Health And Science University, Portland, Oregon
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Nwagbata A, Dutta R, Jayaram A, Thivalapill N, Jain S, Faria I, Alty IG, Gadgil A, Roy N, Raykar NP. Beyond the Ivory Tower: Perception of academic global surgery by surgeons in low- and middle-income countries. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002979. [PMID: 38483892 PMCID: PMC10939292 DOI: 10.1371/journal.pgph.0002979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024]
Abstract
Interest in global surgery has surged amongst academics and practitioners in high-income countries (HICs), but it is unclear how frontline surgical practitioners in low-resource environments perceive the new field or its benefit. Our objective was to assess perceptions of academic global surgery amongst surgeons in low- and middle-income countries (LMICs). We conducted a cross-sectional e-survey among surgical trainees and consultants in 62 LMICs, as defined by the World Bank in 2020. This paper is a sub-analysis highlighting the perception of academic surgery and the association between practice setting and responses using Pearson's Chi-square test. Analyses were completed using Stata15. The survey received 416 responses, including 173 consultants (41.6%), 221 residents (53.1%), 8 medical graduates (1.9%), and 14 fellows (3.4%). Of these, 72 responses (17.3%) were from low-income countries, 137 (32.9%) from lower-middle-income countries, and 207 (49.8%) from upper-middle-income countries. 286 respondents (68.8%) practiced in urban areas, 34 (8.2%) in rural areas, and 84 (20.2%) in both rural and urban areas. Only 185 (44.58%) were familiar with the term "global surgery." However, 326 (79.3%) agreed that collaborating with HIC surgeons for research is beneficial to being a global surgeon, 323 (78.8%) agreed that having an HIC co-author improves likelihood of publication in a reputable journal, 337 (81.6%) agreed that securing research funding is difficult in their country, 195 (47.3%) agreed that their institutions consider research for promotion, 252 (61.0%) agreed that they can combine research and clinical practice, and 336 (82%) are willing to train HIC medical students and residents. A majority of these LMIC surgeons noted limited academic incentives to perform research in the field. The academic global surgery community should take note and foster equitable collaborations to ensure that this critical segment of stakeholders is engaged and has fewer barriers to participation.
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Affiliation(s)
- Arinzechukwu Nwagbata
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Rohini Dutta
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Anusha Jayaram
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Neil Thivalapill
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Samarvir Jain
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Isabella Faria
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Isaac G. Alty
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Anita Gadgil
- The George Institute for Global Health, New Delhi, India
| | - Nobhojit Roy
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- The George Institute for Global Health, New Delhi, India
- Karolinska Institutet, Stockholm, Sweden
| | - Nakul P. Raykar
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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Sasani AR, Soffer JM, Abdurrob A, Marston AP. Publishing Trends in International Humanitarian Cleft Lip and Palate Care: A Systematic Review. Facial Plast Surg Aesthet Med 2024; 26:91-97. [PMID: 37358592 DOI: 10.1089/fpsam.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Background: Humanitarian outreach delivers essential cleft lip and palate (CLP) care in low- and middle-income countries. Objective: To review the literature regarding humanitarian CLP care and determine if a shift toward more sustainable care delivery is observed. Methods: A systematic review was performed on articles describing CLP repair in humanitarian settings from 1985 to 2020. Publications were categorized into trip reports, outcomes, teaching, and public health. Articles were stratified into three 12-year intervals (T1-T3) for analysis. Results: A total of 246 publications were included. Average annual publications increased 15.4-fold from T1 to T3 (p < 0.001). Among publications focused on delivering CLP-related care, descriptive trip report articles trended downward (58% in T1 vs. 42% in T3), whereas outcome-focused publications trended upward (42% in T1 vs. 58% T3). Public health research represented the greatest percentage of publications in T3 (50%). There were 22 teaching-related publications in T3 and only one in prior years. Conclusion: Research trends demonstrate a shift away from focusing solely on the number of surgical cases completed and toward more sustainable models of care delivery that address barriers to receiving longitudinal care.
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Affiliation(s)
- Ali R Sasani
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Justin M Soffer
- Tufts University School of Medicine, Boston, Massachusetts, USA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Alexander P Marston
- Tufts University School of Medicine, Boston, Massachusetts, USA
- Dr. Elie E. Rebeiz Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA
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Are C, Murthy SS, Sullivan R, Schissel M, Chowdhury S, Alatise O, Anaya D, Are M, Balch C, Bartlett D, Brennan M, Cairncross L, Clark M, Deo SVS, Dudeja V, D'Ugo D, Fadhil I, Giuliano A, Gopal S, Gutnik L, Ilbawi A, Jani P, Kingham TP, Lorenzon L, Leiphrakpam P, Leon A, Martinez-Said H, McMasters K, Meltzer DO, Mutebi M, Zafar SN, Naik V, Newman L, Oliveira AF, Park DJ, Pramesh CS, Rao S, Subramanyeshwar Rao T, Bargallo-Rocha E, Romanoff A, Rositch AF, Rubio IT, Salvador de Castro Ribeiro H, Sbaity E, Senthil M, Smith L, Toi M, Turaga K, Yanala U, Yip CH, Zaghloul A, Anderson BO. Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide. Lancet Oncol 2023; 24:e472-e518. [PMID: 37924819 DOI: 10.1016/s1470-2045(23)00412-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 11/06/2023]
Abstract
The first Lancet Oncology Commission on Global Cancer Surgery was published in 2015 and serves as a landmark paper in the field of cancer surgery. The Commission highlighted the burden of cancer and the importance of cancer surgery, while documenting the many inadequacies in the ability to deliver safe, timely, and affordable cancer surgical care. This Commission builds on the first Commission by focusing on solutions and actions to improve access to cancer surgery globally, developed by drawing upon the expertise from cancer surgery leaders across the world. We present solution frameworks in nine domains that can improve access to cancer surgery. These nine domains were refined to identify solutions specific to the six WHO regions. On the basis of these solutions, we developed eight actions to propel essential improvements in the global capacity for cancer surgery. Our initiatives are broad in scope, pragmatic, affordable, and contextually applicable, and aimed at cancer surgeons as well as leaders, administrators, elected officials, and health policy advocates. We envision that the solutions and actions contained within the Commission will address inequities and promote safe, timely, and affordable cancer surgery for every patient, regardless of their socioeconomic status or geographic location.
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Affiliation(s)
- Chandrakanth Are
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Shilpa S Murthy
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, King's College London, London, UK
| | - Makayla Schissel
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sanjib Chowdhury
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Olesegun Alatise
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Daniel Anaya
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Madhuri Are
- Division of Pain Medicine, Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Charles Balch
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, Global Cancer Surgery: pragmatic solutions to improve USA
| | - David Bartlett
- Department of Surgery, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - Murray Brennan
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lydia Cairncross
- Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Matthew Clark
- University of Auckland School of Medicine, Auckland, New Zealand
| | - S V S Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Dudeja
- Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Domenico D'Ugo
- Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome, Italy
| | | | - Armando Giuliano
- Cedars-Sinai Medical Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Satish Gopal
- Center for Global Health, National Cancer Institute, Washington DC, USA
| | - Lily Gutnik
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andre Ilbawi
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Pankaj Jani
- Department of Surgery, University of Nairobi, Nairobi, Kenya
| | | | - Laura Lorenzon
- Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Rome, Italy
| | - Premila Leiphrakpam
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Augusto Leon
- Department of Surgical Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Kelly McMasters
- Division of Surgical Oncology, Hiram C Polk, Jr MD Department of Surgery, University of Louisville, Louisville, KY, USA
| | - David O Meltzer
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | - Syed Nabeel Zafar
- Department of Surgery, University of Wisconsin Hospitals and Clinics, Madison, WI, USA
| | - Vibhavari Naik
- Department of Anesthesiology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | - Lisa Newman
- Department of Surgery, New York-Presbyterian, Weill Cornell Medicine, New York, NY, USA
| | | | - Do Joong Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - C S Pramesh
- Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Saieesh Rao
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - T Subramanyeshwar Rao
- Department of Surgical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India
| | | | - Anya Romanoff
- Department of Global Health and Health System Design, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain
| | | | - Eman Sbaity
- Division of General Surgery, Department of Surgery, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maheswari Senthil
- Division of Surgical Oncology, Department of Surgery, University of California, Irvine, Irvine, CA, USA
| | - Lynette Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Masakazi Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Kiran Turaga
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Ujwal Yanala
- Surgical Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Cheng-Har Yip
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
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Bansal S, Sherif YA, Nuchtern JG, Rosengart TK, Davis RW. A comprehensive curriculum for the American academic global surgery trainee: Addressing an educational need. Am J Surg 2023; 226:721-725. [PMID: 37468385 DOI: 10.1016/j.amjsurg.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Sukriti Bansal
- Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Youmna A Sherif
- Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Jed G Nuchtern
- Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA; Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA
| | - Todd K Rosengart
- Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Rachel W Davis
- Michael E. DeBakey Department of General Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA; Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA
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Ameh EA. Aligning Global Surgical Research Collaborations with Local Priorities in Low- and Middle-Income Countries. World J Surg 2023; 47:2328-2329. [PMID: 37493830 DOI: 10.1007/s00268-023-07119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Emmanuel A Ameh
- Division of Paediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria.
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8
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Wen T, Liu D, Li X, Zhang Y, Jia Z, Wu Y, Li W. How international are the editorial boards in the field of hand research? A cross-sectional study of leading subspecialty hand journals. J Orthop Surg Res 2023; 18:576. [PMID: 37550717 PMCID: PMC10405437 DOI: 10.1186/s13018-023-04068-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 08/02/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Although low- and middle-income countries (LMIC) have great disease burden, but the lack of studies from LMIC have been shown in several fields. Multiple researchers from LMIC perceive editorial bias against their studies. Editorial board members (EBMs) from LMIC are under-represented across many medical journals. It is still unclear whether this phenomenon exists in the field of hand research. The purpose of this study was to investigate the composition of EBMs in leading subspecialty hand journals, and to reveal the international representation of EBMs in the field of hand research. METHODS This cross-sectional study included seven leading subspecialty hand journals. The EBMs were obtained from the journals' websites. The country affiliations of EBMs were categorized based on their locations and economy status. The composition of EBMs was investigated. RESULTS There were 211 EBMs in the seven journals. A total of 185 EBMs (87.7%) were affiliated with high-income countries (HIC), 18 (8.5%) with upper middle-income countries, and 8 (3.8%) with lower middle-income countries. None EBMs were affiliated with low income countries. The EBMs were affiliated with 30 countries. The biggest number of EBMs were affiliated with the USA 74 (35.07%), followed by the United Kingdom (45, 21.33%), and France (13, 6.16%). Most of EBMs were based in Europe and Central Asia (86, 40.8%) and North America (81, 38.4%). CONCLUSIONS The EBMs of leading subspecialty hand journals are dominated by HIC with a very low representation of LMIC. There is a need to make the editorial boards more international in the field of hand research.
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Affiliation(s)
- Tianlin Wen
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Donghua Liu
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xingxuan Li
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Zhang
- Department of TCM Orthopedics, Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Zhiwei Jia
- Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Yaohong Wu
- Department of Spine Surgery, Ganzhou People's Hospital, Ganzhou, China.
| | - Wei Li
- Department of Sports Medicine, Fourth Medical Center of PLA General Hospital, Beijing, China.
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Poor Representation of Developing Countries in Editorial Boards of Leading Obstetrics and Gynaecology Journals. Asian Bioeth Rev 2023. [PMCID: PMC9902818 DOI: 10.1007/s41649-023-00241-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Evidence suggests a limited contribution to the total research output in leading obstetrics and gynaecology journals by researchers from the developing world. Editorial bias, quality of scientific research produced and language barriers have been attributed as possible causes for this phenomenon. The aim of this study was to understand the prevalence of editorial board members based out of low and lower-middle income countries in leading journals in the field of obstetrics and gynaecology. The top 21 journals in the field of obstetrics and gynaecology were selected based on their impact factor, SCImago ranking and literature search. The composition of the editorial boards of these journals was studied based on World Bank Income Criteria to understand the representation status of researchers from low and lower-middle income countries. A total of 1315 board members make up the editorial composition of leading obstetrics and gynaecology journals. The majority of these editors belong to high-income countries (n = 1148; 87.3%). Low (n = 6; 0.45%) and lower-middle income (n = 55; 4.18%) countries make up for a very minuscule proportion of editorial board members. Only a meagre 9 out of 21 journals have editorial board members from these countries (42.85%). Low and low-middle countries have poor representation in the editorial boards of leading obstetrics and gynaecology journals. Poor representation in research from these countries has grave consequences for a large proportion of the global population and multidisciplinary collaborative efforts must be taken to rapidly change this statistic with immediate effect.
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10
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Academic Global Surgery: Creating Opportunities, Equity, and Diversity. Ann Glob Health 2023; 89:12. [PMID: 36819966 PMCID: PMC9936913 DOI: 10.5334/aogh.3972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/11/2022] [Indexed: 02/16/2023] Open
Abstract
A workforce trained in the development and delivery of equitable surgical care is critical in reducing the global burden of surgical disease. Academic global surgery aims to address the present inequities through collaborative partnerships that foster research, education, advocacy and training to support and increase the surgical capacity in settings with limited resources. Barriers include a deficiency of resources, personnel, equipment, and funding, a lack of communication, and geographical challenges. Multi-level partnerships remain fundamental; these types of partnerships include a wide range of trainees, professionals, institutions, and nations, yet care must be taken to avoid falling into the trap of surgical "voluntourism" and undermining the expertise and practice of long-standing frontline providers. Academic global surgery has the benefit of developing a community of surgeons who possess the tools needed to collaborate on individual, institutional, and international levels to address inequities in surgery that are spread variously across the globe. However, challenges for surgeons pursuing a career in global surgery include balancing clinical responsibilities while integrating global surgery as a career during training. This is due in part to the lack of mentorship, research time, grant funding, support to attend conferences, and a limitation of resources, all of which are significantly more pronounced for surgeons from low-resource countries.
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Paradie E, Warman PI, Waguia-Kouam R, Seas A, Qiu L, Shlobin NA, Carpenter K, Hughes J, von Isenburg M, Haglund MM, Fuller AT, Ukachukwu AEK. The Scope, Growth, and Inequities of the Global Neurosurgery Literature: A Bibliometric Analysis. World Neurosurg 2022; 167:e670-e684. [PMID: 36028109 DOI: 10.1016/j.wneu.2022.08.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Here, we evaluate the evolution and growth of global neurosurgery publications over time, further focusing on the contributions and impact of authors in low- and middle-income countries (LMICs). METHODS In this systematic bibliometric analysis, we conducted a two-stage blinded screening process of global neurosurgery publications from 5 databases from inception through July 2021. Articles involving multi-national/multi-institutional research collaborations, detailing any area of global neurosurgery collaboration, or influencing global neurosurgery practice were included. Statistical hypothesis testing was conducted to analyze trends and hypotheses of LMIC authorship contributions. RESULTS The number of global neurosurgery publications has soared in the last decade. Overall, authors from HIC countries were most commonly from the US (41.1%), Canada (4.0%), and the UK (3.9%), while authors from LMIC countries were most commonly from Uganda (4.2%), Tanzania (2.6%), Cameroon (1.8%), and India (1.8%). Over a quarter (28%) of publications had no LMIC authors, while only 11% had 3 or more LMIC authors. The proportion of LMIC authors (LMIC-R) was not correlated with the citation rate of individual articles or with the year of publication, and a positive trend emerged when the LMIC-R of top-publishing LMICs was individually examined and compared to the year of publication. CONCLUSIONS Despite recent growth, the number of global neurosurgery publications arising from LMICs pales in comparison to those from HICs. Collaborative efforts between certain HICs and LMICs have likely contributed to the observed increase in LMIC author independence over time.
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Affiliation(s)
- Emma Paradie
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Pranav I Warman
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Romaric Waguia-Kouam
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Andreas Seas
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Liming Qiu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Singapore General Hospital, Singhealth, Singapore, Singapore
| | - Nathan A Shlobin
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kennedy Carpenter
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA
| | - Jasmine Hughes
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Megan von Isenburg
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA.
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Lozada-Martinez ID, Carvajal-Bautista J, Picón-Jaimes YA, Dominguez-Alvarado G, Cabrera-Vargas LF, Torregrosa-Almonacid L, Guevara-Cruz O, Narvaez-Rojas AR. Surgical research in Colombia part 1: Scientific and academic productivity of the Colombian research groups in surgery. Ann Med Surg (Lond) 2022; 77:103667. [PMID: 35638019 PMCID: PMC9142555 DOI: 10.1016/j.amsu.2022.103667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Global surgery has become the undisputed starting point for addressing a myriad of problems in surgery today. Therefore, it is necessary to constantly evaluate the scientific productivity in surgery, its behavior, validity and impact. In Latin America, specifically in Colombia, there are no studies that have analyzed this production. Methods A retrospective cross-sectional bibliometric study was carried out, in which the Colombian Ministry of Science database was consulted with the validated results up to July 2021. In the search section for research groups, the key word “Surgery” was used, and all associated GrupLAC (platform where the information of the research groups can be found) and their registered products were reviewed. Results 40 groups were included. Only 5 (12.5%) were registered in surgery as main line of research. The great majority of the groups were in the medium-low category, 50% in category C and 22.5% in category B. The vast majority of surgical groups are located in Bogotá (19; 47.5%). The first surgery group in the country was created in 1994 and the last one in 2017. In 27 years of surgical research, a total of 4121 registered scientific articles were found, 83 books, 713 book chapters, 2891 products associated with participation in scientific events, 1221 theses directed, and 1670 projects in colombian surgical research groups. There was evidence of a high rate of underreporting of data, due to duplication of products and incomplete registration of data. Conclusions There is a high rate of underreporting of products and data in the GrupLAC of Colombian surgical research groups. Most of the production is located in the Andes region (Antioquia, Valle del Cauca and Bogotá), and is predominantly composed of scientific articles and products associated with participation in scientific events. There is a high rate of underreporting of data in the Colombian surgical research groups. Most of the production is composed of articles and participation in scientific events. Surgical production in Colombia is centralized in the Andean region.
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Affiliation(s)
- Ivan David Lozada-Martinez
- Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Cartagena, Colombia.,Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia
| | | | | | - Gonzalo Dominguez-Alvarado
- Grupo de Innovación e Investigación en Cirugía, Semillero de Innovación e Investigación Quirúrgica, Bucaramanga, Colombia
| | | | | | | | - Alexis Rafael Narvaez-Rojas
- Department of Surgery, Hospital Carlos Roberto Huembes, Universidad Nacional Autonoma de Nicaragua, Managua, Nicaragua
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OUP accepted manuscript. Br J Surg 2022; 109:645-646. [DOI: 10.1093/bjs/znac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/11/2022] [Accepted: 03/15/2022] [Indexed: 11/15/2022]
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Sebopelo LA, Bourcier AJ, Dada OE, Adegboyega G, Nteranya DS, Kanmounye US. Retrospective review of Google Trends to gauge the popularity of global surgery worldwide: A cross-sectional study. Ann Med Surg (Lond) 2021; 71:102950. [PMID: 34703591 PMCID: PMC8524754 DOI: 10.1016/j.amsu.2021.102950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction Global surgery is a growing movement worldwide, but its expansion has not been quantified. Google Search is the most popular search engine worldwide, and Google Trends analyzes its queries to determine popularity trends. We used Google Trends to analyze the regional and temporal popularity of global surgery (GS). Furthermore, we compared GS with global health (GH) to understand if the two were correlated. Methods This is a retrospective cross-sectional study examining Google Trends of GS and GH. We searched the terms "global surgery" and "global health" on Google Trends (Google Inc., CA, USA) from January 2004 to May 2021. We identified time trends and compared the two search terms using SPSS v26 (IBM, WA, USA) to run summary descriptive analyses and Wilcoxon rank-sum tests. Results The ten countries most interested in GS were India (5.0%), the United Kingdom (5.0%), Ireland (4.0%), the United States (4.0%), Australia (3.0%), Canada (3.0%), New Zealand (3.0%), Germany (2.0%), South Africa (2.0%), and Nigeria (1.0%). GS became more popular after 2015 (2.3% vs. 1.3%, P < 0.001) and was consistently less popular than GH (1.6% vs. 45.3%, P = 0.04). The difference between GS and GH interest levels increased after 2015 (45.4% vs. 42.9%, P = 0.04). Conclusion GS is less popular than GH, more popular in high-income countries, and has become more popular after 2015 when the Lancet Commission on Global Surgery published its seminal report. The World Health Organization passed resolution WHA 68.15. Future advocacy efforts should target low- and middle-income countries primarily.
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Davison EJ, Singh SK, Jemec B. Global Surgery Fellowships-An Investigation of Opportunities, Outcomes, and Applicants. J Hand Microsurg 2021; 13:196-201. [PMID: 34511839 PMCID: PMC8426046 DOI: 10.1055/s-0041-1726672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Following the Lancet Commission on Global Surgery in 2015, the Global Surgery Fellowships have risen in popularity, advertised as formalized opportunities for surgical trainees who have an interest in international surgical care. There is currently no up-to-date review of all fellowships available and an urgently needed overview of these opportunities is presented, including critical appraisal of their accessibility, funding, and outcomes. Detailed searches were conducted on the web engine Google, using the term "global surgery fellowship" and iterations. From the 547 resulting links, after applying exclusion criteria, 69 relevant fellowships were included in analysis. The majority of fellowships based in the United States (55%) and arranged by non-governmental organizations (NGOs) or universities (>70%). Also, 60% of fellowships had a duration of 1 year or longer. Only a quarter of the fellowships was open solely to trainees from low- or middle-income countries (LMIC), with over 80% of these being full funded. But 40% of the fellowships were advertised as open to trainees from any country, though only one-third of these provided full funding. Key themes across the fellowships' outcomes included "Professional Development," "Research," and "LMIC Quality Improvement." Almost all of the fellowships (95%) stated international travel opportunities. Twelve of the fellowships offered higher degrees, with the most common being a Masters of Public Health. The global distribution of fellowships and reduced funding opportunities for trainees from LMIC limit accessibility of the Global Surgery Fellowships. It is, however, still promising that most of key themes and high rates of international work are in line with The Lancet Commission's recommendations. This overview of the Global Surgery Fellowships highlights the need for collaboration between institutions and has illustrated points for consideration when introducing new and the value of established fellowships.
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Affiliation(s)
- Eliza J. Davison
- Department of Plastic Surgery, Royal Free London National Health Service Foundation Trust, Royal Free Hospital, London, United Kingdom
| | - Satyendra K. Singh
- Department of Burns, Plastic and Reconstructive Surgery, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
| | - Barbara Jemec
- Department of Plastic Surgery, Royal Free London National Health Service Foundation Trust, Royal Free Hospital, London, United Kingdom
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Patterson RH, Xu MJ, Okerosi S, Bhutta MF, Der C, Alkire B, Njogu R, Vendra V, Tamir SO, Fagan JJ. Research Equity in Otolaryngology-Head and Neck Surgery. OTO Open 2021; 5:2473974X211024145. [PMID: 34212124 PMCID: PMC8216382 DOI: 10.1177/2473974x211024145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
Equitable research collaborations benefit the quality and relevance of global otolaryngology-head and neck surgery research. However, analyses of existing global health literature have shown disproportionate representation by foreign authors. To avert this inequity and improve global otolaryngology-head and neck surgery research, we propose a framework that emphasizes local representation and capacity building in research.
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Affiliation(s)
- Rolvix Harlan Patterson
- Department of Head and Neck Surgery and Communication Sciences, School of Medicine, Duke University, Durham, North Carolina, USA
| | - Mary Jue Xu
- Department of Otolaryngology–Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Samuel Okerosi
- Department of Otolaryngology, Machakos Level Five Hospital, Machakos, Kenya
| | - Mahmood F. Bhutta
- University Hospitals Sussex, Brighton, UK
- Brighton and Sussex Medical School, Brighton, UK
| | - Carolina Der
- School of Medicine, Clínica Alemana, Universidad del Desarrollo; Otorhinolaryngology Department, Dr Luis Calvo Mackenna Children’s Hospital, Santiago, Chile
| | - Blake Alkire
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Center for Global Surgery Evaluation, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Global Health Equity, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Rose Njogu
- SH:24 Sexual and Adolescent Reproductive Health, London, UK
| | - Varun Vendra
- Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sharon Ovnat Tamir
- Department of Otolaryngology–Head and Neck Surgery, Faculty of Health Sciences, Samson Assuta Ashdod University Hospital, Ben Gurion University, Ashdod, Israel
| | - Johannes J. Fagan
- Division of Otolaryngology, University of Cape Town, Cape Town, South Africa
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Veerappan VR, Jindal RM. Community participation in global surgery. BMJ Glob Health 2021; 6:e005044. [PMID: 33827792 PMCID: PMC8031061 DOI: 10.1136/bmjgh-2021-005044] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Rahul M Jindal
- Department of Surgery, Uniformed Services University, Bethesda, Maryland, USA
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Long KL, Galukande M, Kyamanywa P, Tarpley MJ, Dodgion C. Developing Research Potential and Building Partnerships: A Report of the Fundamentals of Surgical Research Course at the College of Surgeons of East, Central, and Southern Africa. J Surg Res 2020; 259:34-38. [PMID: 33278795 DOI: 10.1016/j.jss.2020.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/05/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Approximately a decade after the inaugural Fundamentals of Surgical Research Course (FSRC) at the West African College of Surgeons meeting (2008), the Association for Academic Surgery expanded the course offering to the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA). After the second annual offering of the course in 2019, participants were surveyed to assess the impact of the course. METHODS A survey was distributed to the attendees of the 2019 second COSECSA FSRC course, held in December 2019 in Kampala, Uganda. Approximately 80 people attended at least a portion of the full-day course. Forty-nine participants completed the voluntary survey questionnaire distributed to assess each session of the course at course completion. RESULTS Ten different countries were represented among the attendees. Of the 49 evaluations, 35 respondents were male and six were female. Eight respondents did not identify a gender. Surgical residents comprised 19 of the 49 attendees, and one of the 49 attendees was a medical student. Thirty-five respondents indicated that their views of surgical research had changed after attending the course. CONCLUSIONS The second annual FSRC at COSECSA confirmed significant interest in building research skills and partnerships in sub-Saharan Africa. A wide variety of learners attended the course, and a majority of the sessions received overwhelmingly positive feedback. Multiple conference attendees expressed interest in serving as faculty for the course moving forward, highlighting a viable path for sustainability as the Association for Academic Surgery develops an international research education platform.
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Affiliation(s)
- Kristin L Long
- Division of Endocrine Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
| | | | - Patrick Kyamanywa
- Department of Surgery, Kampala International University Western Campus, Kampala, Uganda
| | - Margaret J Tarpley
- Department of Surgery, Vanderbilt University, Nashville, Tennessee; Department of Medical Education, University of Botswana, Gaborone, Botswana
| | - Christopher Dodgion
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Padmanaban V, DaCosta A, Tran A, Kunac A, Swaroop M, Zhang WW, Sifri ZC. Closing the Gender Gap in Global Surgery: Trends at the Academic Surgical Congress. J Surg Res 2020; 257:389-393. [PMID: 32892135 DOI: 10.1016/j.jss.2020.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/22/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Female researchers are underrepresented in academic surgery. While they are increasingly producing original research, they lag male researchers in productivity. This disparity is not well understood within the nascent field of global surgery. The following study examines gender parity in global surgery research presented at the Academic Surgical Congress and within subsequent publications. METHODS Abstracts presented at the Academic Surgical Congress (ASC) between 2015 and 2019 in "Global Surgery" sessions were reviewed to obtain title, the first author (FA) and senior author (SA). The authors were classified by gender. The Scopus database was queried by two reviewers for abstracts with corresponding publications, citations, and journal impact factors. Statistical analysis was conducted using chi-square analysis and t-tests where appropriate. RESULTS Of a total of 6635 abstracts, 218 global surgery abstracts over a 5-year period were identified. Of these abstracts, 96 (44%) had female FAs, while 56 (26%) had female SAs. When comparing gender, female (44%) FAs and male (56%) FAs were equally represented. While SAs were significantly less likely to be female (26% versus 74%, P < 0.0001), female senior authorship increased significantly within the study period. Output with respect to publications, citations, and journal impact factors were equal by gender. CONCLUSIONS This study presents 5 y of gender trends in global surgery scholarly work presented at the ASC. Despite an overall predominance of male senior authors, the paradigm is shifting with a recent trend to gender parity. Male and female authors have equal output and are equally impactful. Findings of gender equity in academic global surgery are encouraging, and further study of other disciplines are warranted.
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Affiliation(s)
- Vennila Padmanaban
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
| | - Angela DaCosta
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ashley Tran
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Anastasia Kunac
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Mamta Swaroop
- Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Wei Wei Zhang
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ziad C Sifri
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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Rosenberg A, Uwitonze JM, Dworkin M, Kabagema I, Dushime T, Nkeshimana M, Riviello R, Jayaraman S. Fostering Trauma and Emergency Research Capacity in Rwanda Through Collaboration. JOURNAL OF SURGICAL EDUCATION 2020; 77:1018-1023. [PMID: 32713743 DOI: 10.1016/j.jsurg.2020.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Access to effective emergent care would prevent 45% of all deaths in LMICs, however, trauma and emergency care remain largely neglected. Our collaboration in Rwanda to build prehospital trauma care led us to create a research mentorship program to enhance the ability of the local team to evaluate their system. METHODS NIH grant funding had been previously obtained to establish standards for prehospital trauma care in Rwanda and build local research capacity. We created a research mentorship program that involved a surgical resident embedded locally tasked with 1) giving lectures on research, study design, interpretation, and writing, 2) providing mentorship for data interpretation and 3) supporting the development of abstracts, presentations, and publications. RESULTS Four research teams identified high priority areas for quality improvement research. Research group meetings were held and involved mentored literature searches, critical review of published works, basics of study design, abstract writing and manuscript development. Abstracts were submitted and accepted to three international conferences. At this time 3 manuscripts have been accepted and are in production, 2 abstracts and 1 manuscript has been published. Eleven staff enrolled in master's degree programs in critical and nursing, epidemiology, public health and global health equity across three institutions. CONCLUSIONS Responsive health care systems need capacity for ongoing quality improvement and research. This is especially true to address the massive global burden of disease of trauma and emergency conditions. US academic surgical collaborations have tremendous research expertise that can contribute to improving health system capacity globally. Such collaborations offer the opportunity to set up the foundations of future academic productivity.
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Affiliation(s)
- Ashley Rosenberg
- Division of Acute Care Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
| | - J M Uwitonze
- Service d'Aide Medicale Urgente, Rwanda Ministry of Health, Kigali, Rwanda.
| | - Myles Dworkin
- Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania.
| | - Ignace Kabagema
- Service d'Aide Medicale Urgente, Rwanda Ministry of Health, Kigali, Rwanda.
| | - Theophile Dushime
- Service d'Aide Medicale Urgente, Rwanda Ministry of Health, Kigali, Rwanda.
| | - Menelas Nkeshimana
- Department of Accident and Emergency, University Teaching Hospital of Kigali, Kigali, Rwanda.
| | - Robert Riviello
- Department of Surgery, Harvard University, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Sudha Jayaraman
- Division of Acute Care Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
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Rees CA, Keating EM, Dearden KA, Haq H, Robison JA, Kazembe PN, Bourgeois FT, Niescierenko M. Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study. Am J Trop Med Hyg 2020; 102:649-657. [PMID: 31933470 PMCID: PMC7056414 DOI: 10.4269/ajtmh.19-0555] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Academic global health collaborations have the potential to improve joint understanding of health issues in low- and middle-income countries (LMICs). Our objective was to elucidate perceptions of benefits and challenges of academic global health collaborations as well as areas for improving collaborative research conducted in LMICs. This cross-sectional, mixed-methods study surveyed investigators' perceptions of benefits and challenges of pediatric academic global health collaborations. Authors of articles from four pediatric journals reporting pediatric research conducted in LMICs published between 2006 and 2015 were surveyed. Responses of LMIC investigators were compared with those of investigators in high-income countries (HICs). Responses to open-ended questions were analyzed using a combined thematic and content analysis approach. Of 1,420 potential respondents, 252 (17.7%) responded to the survey. Collaborative research with investigators from other countries was perceived as beneficial by 88.5% of respondents (n = 223), although this perception was more common among HIC respondents (n = 110, 94.0%) than LMIC respondents (n = 113, 83.7%) (p = 0.014). Sixty-seven percent (n = 170) of respondents perceived that HIC investigators had set the research agenda in work conducted in a LMIC. Respondents identified several critical factors to improve academic global health collaborations, including research capacity building, communication, and early involvement of LMIC investigators with shared decision-making during study conception and grant writing. Pediatric academic global health collaboration was widely perceived as positive. However, despite calls for capacity building and locally generated research ideas, many respondents felt that HIC investigators set the research agenda for work conducted in LMICs. This study provides suggestions for improving collaboration among pediatric academicians globally.
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Affiliation(s)
- Chris A Rees
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth M Keating
- Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, Utah
| | | | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jeff A Robison
- Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, Utah
| | - Peter N Kazembe
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - Florence T Bourgeois
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michelle Niescierenko
- Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Hedt-Gauthier BL, Jeufack HM, Neufeld NH, Alem A, Sauer S, Odhiambo J, Boum Y, Shuchman M, Volmink J. Stuck in the middle: a systematic review of authorship in collaborative health research in Africa, 2014-2016. BMJ Glob Health 2019; 4:e001853. [PMID: 31750000 PMCID: PMC6830050 DOI: 10.1136/bmjgh-2019-001853] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 11/04/2022] Open
Abstract
Background Collaborations are often a cornerstone of global health research. Power dynamics can shape if and how local researchers are included in manuscripts. This article investigates how international collaborations affect the representation of local authors, overall and in first and last author positions, in African health research. Methods We extracted papers on 'health' in sub-Saharan Africa indexed in PubMed and published between 2014 and 2016. The author's affiliation was used to classify the individual as from the country of the paper's focus, from another African country, from Europe, from the USA/Canada or from another locale. Authors classified as from the USA/Canada were further subclassified if the author was from a top US university. In primary analyses, individuals with multiple affiliations were presumed to be from a high-income country if they contained any affiliation from a high-income country. In sensitivity analyses, these individuals were presumed to be from an African country if they contained any affiliation an African country. Differences in paper characteristics and representation of local coauthors are compared by collaborative type using χ² tests. Results Of the 7100 articles identified, 68.3% included collaborators from the USA, Canada, Europe and/or another African country. 54.0% of all 43 429 authors and 52.9% of 7100 first authors were from the country of the paper's focus. Representation dropped if any collaborators were from USA, Canada or Europe with the lowest representation for collaborators from top US universities-for these papers, 41.3% of all authors and 23.0% of first authors were from country of paper's focus. Local representation was highest with collaborators from another African country. 13.5% of all papers had no local coauthors. Discussion Individuals, institutions and funders from high-income countries should challenge persistent power differentials in global health research. South-South collaborations can help African researchers expand technical expertise while maintaining presence on the resulting research.
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Affiliation(s)
- Bethany L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Nicholas H Neufeld
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Sara Sauer
- Department of Biostatistics, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Yap Boum
- Epicentre, Médecins Sans Frontières, Yaoundé, Cameroon
| | - Miriam Shuchman
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jimmy Volmink
- Department of Global Health and Dean's Office, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Hagander L, Leather A. A realized vision of access to safe, affordable surgical and anaesthesia care. Br J Surg 2019; 106:e24-e26. [PMID: 30620073 DOI: 10.1002/bjs.11068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/20/2022]
Abstract
Where is the funding?
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Affiliation(s)
- L Hagander
- WHO Collaborating Centre for Surgery and Public Health, Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Department of Paediatric Surgery, Skåne University Hospital Children's Hospital, Lund, Sweden
| | - A Leather
- King's Centre for Global Health and Health Partnership, School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, Room 2.13, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
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