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Accepting the baton at the Journal: a moment to celebrate success, science, diversity, and future opportunities. Can J Anaesth 2020; 68:1-7. [PMID: 33174165 PMCID: PMC7654843 DOI: 10.1007/s12630-020-01841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022] Open
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Orser BA, Wilson CR, Rotstein AJ, Iglesias SJ, Spain BT, Ranganathan P, MacDonald WA, Ng V, O'Leary S, Lafontaine A. Improving Access to Safe Anesthetic Care in Rural and Remote Communities in Affluent Countries. Anesth Analg 2020; 129:294-300. [PMID: 30855341 DOI: 10.1213/ane.0000000000004083] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. This report summarizes the challenges facing the provision of anesthesia services in rural and remote regions. The current landscape of anesthesia providers and their training is described. We also explore innovative strategies and emerging technologies that could better support physician-led anesthesia care teams working in rural and remote areas. Ultimately, we believe that it is the responsibility of specialist anesthesiologists and academic health sciences centers to facilitate access to high-quality care through partnership with other stakeholders. Professional medical organizations also play an important role in ensuring the quality of care and continuing professional development. Enhanced collaboration between academic anesthesiologists and other stakeholders is required to meet the challenge issued by the World Health Organization to ensure access to essential anesthesia and surgical services for all.
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Affiliation(s)
- Beverley A Orser
- From the Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
| | - C Ruth Wilson
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Stuart J Iglesias
- Department of Family Medicine, University of British Columbia, Bella Bella, British Columbia, Canada
| | - Brian T Spain
- Department of Anaesthesia and Perioperative Medicine, Royal Darwin Hospital, Flinders University, Darwin, Australia
| | - Pavithra Ranganathan
- Department of Anesthesiology, West Virginia University, Morgantown, West Virginia
| | - William A MacDonald
- Faculty of Medicine, Discipline of Family Medicine, Memorial University, St John's Newfoundland, Canada
| | - Victor Ng
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan O'Leary
- Department of Anesthesia and Pain Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alika Lafontaine
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
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Musings from an Unlikely Clinician-Scientist: 2018 American Society of Anesthesiologists Excellence in Research Award. Anesthesiology 2019; 131:795-800. [PMID: 31335546 DOI: 10.1097/aln.0000000000002881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article, which stems from the 2018 American Society of Anesthesiologists Excellence in Research Award Lecture, aims to encourage young investigators, offer advice, and share several early life experiences that have influenced the author's career as an anesthesiologist and clinician-scientist. The article also describes key discoveries that have increased understanding of the role of γ-aminobutyric acid type A (GABAA) receptors in health and disease. The author's research team identified the unique pharmacologic properties of extrasynaptic GABAA receptors and their role in the anesthetic state. The author's team also showed that extrasynaptic GABAA receptors expressed in neuronal and nonneuronal cells contribute to a variety of disorders and are novel drug targets. The author's overarching message is that young investigators must create their own unique narratives, train hard, be relentless in their studies and-most important-enjoy the journey of discovering new truths that will ultimately benefit patients.
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