Barriers to Surgical Innovation Research: A Canadian Study on Public Funding Trends

Background

A decline in research funding has been cited as a potential cause for limited surgical innovation in the United States. We aim to understand if this is a North American phenomenon and explore whether a lack of public funding is a barrier to surgical innovation in Canada.

Methods

Publicly available funding data from Canadian Institutes of Health Research (CIHR) were reviewed from 2008 to 2019 to determine the yearly funding distributed to surgical departments. Surgical innovation studies were identified and total yearly funding was calculated. All amounts were adjusted for inflation to reflect 2019 Canadian dollar value.

Results

From 2008 to 2019, surgical departments were granted 1.82–4.70% of total CIHR funding. In total, 902 grants were allocated to surgical departments and 126 (14.0%) met criteria for surgical innovation. Surgical innovation research was allocated a total annual amount ranging from 1.52 to 9.01 million CAD. There appears to be an upward trend in public funding for surgical innovation over this time period.

Discussion

Contrary to the landscape in the United States, there is no evidence of decreasing trends in public funding for surgical innovation in Canada. Considerations should be given to other potential barriers precluding surgeons from participating in innovation.

Conclusion

Only a small percentage of research dollars to departments in Canada are spent on innovation research, despite an overall increasing trend in total public research funding over the past 10 years. We need to foster an environment in which surgical innovation is encouraged through medical curriculum changes, multidisciplinary collaboration opportunities, and dedicated faculty resources.

Assessing the prevalence and correlates of prenatal cannabis consumption in an urban Canadian population: a cross-sectional survey

BACKGROUND

Recreational cannabis use was legalized in Canada in October 2018. We aimed to determine the prevalence and correlates of cannabis consumption among pregnant individuals in a single Canadian city following national legalization.

METHODS

Over the period May to October 2019, we distributed an anonymous cross-sectional survey to pregnant patients attending family practice, midwifery, and low-risk and high-risk obstetrics clinics in Hamilton, Ontario. Eligibility was based on English literacy and current pregnancy. The survey included questions regarding lifetime and in-pregnancy cannabis use, intent for postpartum use and patterns of use. We also collected demographic information. We calculated descriptive statistics and performed logistic regression analyses to explore the relations between cannabis consumption and demographic characteristics.

RESULTS

Of 531 pregnant individuals approached, 478 agreed and were able to participate, for a 90% participation rate. Among these 478 respondents, 54 (11%) reported consuming cannabis at some point during the pregnancy and 20 (4%) reported currently consuming cannabis. Among the 460 respondents who intended to breastfeed, 23 (5%) planned to consume cannabis during the postpartum period. Of 20 current users, 13 (65%) reported consuming cannabis at least weekly and 19 (95%) reported nausea, sleep problems or anxiety as reasons for use. Respondents without postsecondary education had 10.0-fold (95% confidence interval [CI] 4.6-23.5) greater odds of prenatal cannabis consumption than university-educated respondents. In addition, respondents who reported that their partners used cannabis had 3.9-fold (95% CI 2.2-7.3) greater odds of prenatal cannabis consumption than those who reported that their partners did not use cannabis.

INTERPRETATION

Lower educational attainment and partners' cannabis consumption were associated with greater odds of inpregnancy cannabis use. These results may help to inform early intervention strategies to decrease cannabis consumption during this vulnerable period of fetal and neonatal development.