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- Davies, J. I., et al.
(författare)
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Global surgery, obstetric, and anaesthesia indicator definitions and reporting: An Utstein consensus report
- 2021
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Ingår i: Plos Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 18:8
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Tidskriftsartikel (refereegranskat)abstract
- Background Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees. Conclusions To track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.
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- Holmer, H., et al.
(författare)
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Evaluating the collection, comparability and findings of six global surgery indicators
- 2019
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 106:2, s. 138-150
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates. Methods: Nationally representative data were compiled for all WHO member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases. Availability, comparability and utility were assessed for each indicator: access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality, and protection against impoverishing and catastrophic expenditure. Where feasible, imputation models were developed to generate global estimates. Results: Of all WHO member states, 19 had data on the proportion of the population within 2h of a surgical facility, 154 had data on workforce density, 72 reported number of procedures, and nine had perioperative mortality data, but none could report data on catastrophic or impoverishing expenditure. Comparability and utility were variable, and largely dependent on different definitions used. There were sufficient data to estimate that worldwide, in 2015, there were 2 038 947 (i.q.r. 1 884 916–2 281 776) surgeons, obstetricians and anaesthetists, and 266·1 (95 per cent c.i. 220·1 to 344·4) million operations performed. Conclusion: Surgical and anaesthesia indicators are increasingly being adopted by the global health community, but data availability remains low. Comparability and utility for all indicators require further resolution.
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- Juran, S., et al.
(författare)
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The Development and Inclusion of Questions on Surgery in the 2018 Zambia Demographic and Health Survey
- 2021
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Ingår i: Global Health-Science and Practice. - : Johns Hopkins School Bloomberg School of Public Health, Center for Communication Programs. - 2169-575X. ; 9:4, s. 905-914
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Tidskriftsartikel (refereegranskat)abstract
- Background: While primary data on the unmet need for surgery in low- and middle-income countries is lacking, household surveys could provide an entry point to collect such data. We describe the first development and inclusion of questions on surgery in a nationally representative Demographic and Health Survey (DHS) in Zambia. Method: Questions regarding surgical conditions were developed through an iterative consultative process and integrated into the rollout of the DHS survey in Zambia in 2018 and administered to a nationwide sample survey of eligible women aged 15-49 years and men aged 15-59 years. Results: In total, 7 questions covering 4 themes of service delivery, diagnosed burden of surgical disease, access to care, and quality of care were added. The questions were administered across 12,831 households (13,683 women aged 15-49 years and 12,132 men aged 15-59 years). Results showed that approximately 5% of women and 2% of men had undergone an operation in the past 5 years. Among women, cesarean delivery was the most common surgery; circumcision was the most common procedure among men. In the past 5 years, an estimated 0.61% of the population had been told by a health care worker that they might need surgery, and of this group, 35% had undergone the relevant procedure. Conclusion: For the first time, questions on surgery have been included in a nationwide DHS. We have shown that it is feasible to integrate these questions into a large-scale survey to provide insight into surgical needs at a national level. Based on the DHS design and implementation mechanisms, a country interested in including a set of questions like the one included in Zambia, could replicate this data collection in other settings, which provides an opportunity for systematic collection of comparable surgical data, a vital role in surgical health care system strengthening.
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- Miller, J.F., et al.
(författare)
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Proposed stratotype for the base of the highest Cambrian stage at the first appearance datum of Cordylodus andresi, Lawson Cove section, Utah, USA
- 2006
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Ingår i: Palaeoworld. - : Elsevier BV. - 1871-174X .- 1875-5887. ; :15, s. 384-405
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Tidskriftsartikel (refereegranskat)abstract
- We propose a candidate for the Global Standard Stratotype-section and Point (GSSP) for the base of the highest stage of the Furongian Series of the Cambrian System. The section is at Lawson Cove in the Ibex area of Millard County, Utah, USA. The marker horizon is the first appearance datum (FAD) of the conodont Cordylodus andresi Viira et Sergeyeva in Kaljo et al. [Kaljo, D., Borovko, N., Heinsalu, H., Khazanovich, K., Mens, K., Popov, L., Sergeyeva, S., Sobolevskaya, R., Viira, V., 1986. The Cambrian-Ordovician boundary in the Baltic-Ladoga clint area (North Estonia and Leningrad Region, USSR). Eesti NSV Teaduste Akadeemia Toimetised. Geologia 35, 97-108]. At this section and elsewhere this horizon also is the FAD of the trilobite Eurekia apopsis (Winston et Nicholls, 1967). This conodont characterizes the base of the Cordylodus proavus Zone, which has been recognized in many parts of the world. This trilobite characterizes the base of the Eurekia apopsis Zone, which has been recognized in many parts of North America. The proposed boundary is 46.7 m above the base of the Lava Dam Member of the Notch Peak Formation at the Lawson Cove section. Brachiopods, sequence stratigraphy, and carbon-isotope geochemistry are other tools that characterize this horizon and allow it to be recognized in other areas. ?? 2006 Nanjing Institute of Geology and Palaeontology, CAS.
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- Zhang, Zhifei, et al.
(författare)
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An early Cambrian agglutinated tubular lophophorate with brachiopod characters
- 2014
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 4:4682, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- The morphological disparity of lophotrochozoan phyla makes it difficult to predict the morphology of the last common ancestor. Only fossils of stem groups can help discover the morphological transitions that occurred along the roots of these phyla. Here, we describe a tubular fossil Yuganotheca elegans gen. et sp. nov. from the Cambrian (Stage 3) Chengjiang Lagersta¨tte (Yunnan, China) that exhibits an unusual combination of phoronid, brachiopod and tommotiid (Cambrian problematica) characters, notably a pair of agglutinated valves, enclosing a horseshoe-shaped lophophore, supported by a lower bipartite tubular attachment structure with a long pedicle with coelomic space. The terminal bulb of the pedicle provided anchorage in soft sediment. The discovery has important implications for the early evolution of lophotrochozoans, suggesting rooting of brachiopods into the sessile lophotrochozoans and the origination of their bivalved bauplan preceding the biomineralization of shell valves in crown brachiopods.
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- Abrahamsson, L., et al.
(författare)
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Behöver arbetslinjen inte forskning?
- 2007
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Ingår i: Svenska Dagbladet Brännpunkt (debattinlägg). ; :2007-11-28
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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