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Alvares LTDEA, Rangel AG, Campos LN, Viana SW, Kim AWS, Sampaio NZ, Ferreira R, Silva JB, Mooney DP, Camargo CP. Expanding Global Surgery Education in Brazil: Perspectives after the 35th Brazilian Surgical Congress. Rev Col Bras Cir 2024; 51:e20243667. [PMID: 38324886 PMCID: PMC10826473 DOI: 10.1590/0100-6991e-20243667-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/15/2023] [Indexed: 02/09/2024] Open
Abstract
The 35th Brazilian Congress of Surgery marked a turning point for surgical education in the country. For the first time, the Brazilian College of Surgeons included Global Surgery on the main congressional agenda, providing a unique opportunity to rethink how surgical skills are taught from a public health perspective. This discussion prompts us to consider why and how Global Surgery education should be expanded in Brazil. Although Brazilian researchers and institutions have contributed to the fields expansion since 2015, Global Surgery education initiatives are still incipient in our country. Relying on successful strategies can be a starting point to promote the area among national surgical practitioners. In this editorial, we discuss potential strategies to expand Global Surgery education opportunities and propose a series of recommendations at the national level.
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Affiliation(s)
| | - Ayla Gerk Rangel
- - Harvard Medical School, Program in Global Surgery and Social Change - Boston - Massachusetts - Estados Unidos
| | | | | | | | | | - Roseanne Ferreira
- - McMaster University, Department of Health Research Methods, Evidence and, Impact - Hamilton - Ontario - Canadá
| | | | - David P Mooney
- - Boston Children's Hospital - Boston - Massachusetts - Estados Unidos
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Campos LN, Naus A, Rangel AG, Brandão GR, Faria I, Pierre TAJ, Freire CVS, Schlindwein SS, Feres B, Wagemaker S, Salgado LS, Ferreira R, Ferreira JL. Women Representation on Editorial Boards in Latin America Journals: Promoting Gender Equity in Academic Surgery, Anesthesia, and Obstetrics. World J Surg 2023; 47:845-853. [PMID: 36587176 DOI: 10.1007/s00268-022-06872-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Inequitable representation in journal editorial boards may impact women's career progression across surgical, anesthesia, and obstetric (SAO) specialties. However, data from Latin America are lacking. We evaluated women's representation on editorial boards of Latin America SAO journals in 2021. METHODS We conducted a cross-sectional analysis, retrieving journals through Scimago Journal and Country Rank 2020. Journals were included if active, focused on SAO topics, and publicly provided information on editorial board staff. Editorial board member names and positions were extracted from journals' websites. Members were classified into senior (e.g., editor-in-chief), academic (e.g., reviewer), and non-academic roles (e.g., administrative office). Women's representation was predicted from first names using Genderize.io. The number of women SAO physicians per country was obtained from articles and governmental reports. RESULTS We included 19 of 25 identified journals and analyzed 1,318 names. Three anesthesiology, seven obstetric, and nine surgical journals represented five Latin American countries. Women held 17% (224/1,318) of board positions [p < 0.0001; 95% CI(0.14, 0.19)]. Women held fewer academic roles (14.3%, 155/1,084) compared to senior [28.9%, 64/221 (p < 0.001)] and non-academic roles [38.4%, 5/13 (p = 0.042)]. Surgical journals had fewer women (7.7%, 58/752) compared to anesthesia [25.5%, 52/204 (p = 0.006)] and obstetrics [31.5%, 114/362 (p < 0.001)]. Women's proportion on editorial boards increased according to the number of women SAO physicians per country (p < 0.001). CONCLUSIONS Our study assessed the composition of editorial boards from Latin America SAO journals and demonstrated that women remain underrepresented. Our findings highlight the need for regional strategies to advance women's careers across SAO specialties.
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Affiliation(s)
- Letícia Nunes Campos
- Faculty of Medical Sciences, Universidade de Pernambuco, Rua Arnóbio Marquês, 310, Recife, Pernambuco, Brazil. .,Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA, USA.
| | - Abbie Naus
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA, USA
| | - Ayla Gerk Rangel
- Faculty of Medical Sciences, Universidad Católica Argentina, Buenos Aires, Argentina
| | | | - Isabella Faria
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA, USA
| | | | | | | | - Brenda Feres
- School of Medicine, Kursk State Medical University, Kursk, Kurskaya Oblast, Russia
| | - Sofia Wagemaker
- School of Medicine, Kursk State Medical University, Kursk, Kurskaya Oblast, Russia
| | | | - Roseanne Ferreira
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Júlia Loyola Ferreira
- McGill University, Montreal, Canada.,Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Canada
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Truche P, Campos LN, Marrazzo EB, Rangel AG, Bernardino R, Bowder AN, Buda AM, Faria I, Pompermaier L, Rice HE, Watters D, Dantas FLL, Mooney DP, Botelho F, Ferreira RV, Alonso N. Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil: a modeling study. ACTA ACUST UNITED AC 2021; 3:100056. [PMID: 34725652 PMCID: PMC8552244 DOI: 10.1016/j.lana.2021.100056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 12/01/2022]
Abstract
Background The impact of public health policy to reduce the spread of COVID-19 on access to surgical care is poorly defined. We aim to quantify the surgical backlog during the COVID-19 pandemic in the Brazilian public health system and determine the relationship between state-level policy response and the degree of state-level delays in public surgical care. Methods Monthly estimates of surgical procedures performed per state from January 2016 to December 2020 were obtained from Brazil's Unified Health System Informatics Department. Forecasting models using historical surgical volume data before March 2020 (first reported COVID-19 case) were constructed to predict expected monthly operations from March through December 2020. Total, emergency, and elective surgical monthly backlogs were calculated by comparing reported volume to forecasted volume. Linear mixed effects models were used to model the relationship between public surgical delivery and two measures of health policy response: the COVID-19 Stringency Index (SI) and the Containment & Health Index (CHI) by state. Findings Between March and December 2020, the total surgical backlog included 1,119,433 (95% Confidence Interval 762,663–1,523,995) total operations, 161,321 (95%CI 37,468–395,478) emergent operations, and 928,758 (95%CI 675,202–1,208,769) elective operations. Increased SI and CHI scores were associated with reductions in emergent surgical delays but increases in elective surgical backlogs. The maximum government stringency (score = 100) reduced emergency delays to nearly zero but tripled the elective surgical backlog. Interpretation Strong health policy efforts to contain COVID-19 ensure minimal reductions in delivery of emergent surgery, but dramatically increase elective backlogs. Additional coordinated government efforts will be necessary to specifically address the increased elective backlogs that accompany stringent responses.
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Affiliation(s)
- Paul Truche
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | | | - Enzzo Barrozo Marrazzo
- Institute of Biological Sciences, Faculty of Medicine Pontifícia Universidade Católica de Minas Gerais Poços de Caldas, MG, Brazil
| | - Ayla Gerk Rangel
- Faculty of Medical Sciences, Universidad Católica Argentina, Buenos Aires, Argentina
| | - Ramon Bernardino
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Alexis N Bowder
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Alexandra M Buda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Isabella Faria
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Laura Pompermaier
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| | - Henry E Rice
- Duke University Medical Center and Duke Global Health Institute, Durham, NC, United States
| | - David Watters
- Deakin University and Barwon Health, Melbourne, Australia
| | | | | | | | | | - Nivaldo Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
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