Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2022
ReviewRacial and ethnic disparities in access to gynecologic care.
Despite efforts to minimize patient barriers to equitable care, health disparities persist in gynecology. This paper seeks to highlight racial and ethnic disparities in gynecologic care as represented by recent literature. ⋯ As we identify these social disparities in healthcare, we gain valuable knowledge of where our efforts are lacking and where we can further improve the health of women. Future research should focus on identifying and combating such disparities with measurable changes in health outcomes.
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Curr Opin Anaesthesiol · Jun 2022
ReviewSafe surgery for every child, implementation of paediatric anaesthesia training in Nigeria.
Nigeria is the most populous country in Africa and 43.5% of its population is under 15 years. Most of these children do not have access to specialized paediatric anaesthesia care when needed, as there are only few paediatric anaesthetists in the country. We highlight the barriers to safe anaesthesia in children, present training opportunities in paediatric anaesthesia and the need for additional, more extensive training in Nigeria. ⋯ To solve the urgent problem of acute shortage of paediatric anaesthetists in Nigeria, general anaesthetists should be empowered through short courses to provide safe anaesthesia for children. A comprehensive Fellowship programme is urgently needed to train specialists in paediatric anaesthesia. Equipment upgrade, creation of children's hospitals and empowerment for research are important end points that require governmental support.
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Curr Opin Anaesthesiol · Jun 2022
ReviewA pragmatic approach to quality improvement in pediatric anesthesia.
The concept of quality improvement (QI) is well implemented in pediatric anesthesia. Conductance, reporting and publishing of QI projects and -results is well described and promoted. However, the perception of quality might differ between stakeholders and beneficiaries. Based on measures of quality as perceived by healthcare professionals and pediatric patients, a pragmatic approach to choosing the relevant quality measure is suggested. ⋯ In an attempt to embrace both perspectives of quality in pediatric anesthesia care, it is suggested to choose quality items for improvement based on patient safety, professional excellency and benignancy. By following this approach, QI is expected to remain relevant to both healthcare professionals and patients.
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Curr Opin Anaesthesiol · Jun 2022
ReviewGlobal pediatric surgery and anesthesia inequities: how do we have a global effort?
The SARS-CoV-2 (COVID-19) pandemic has highlighted the inequities in access to healthcare while also revealing our global connectivity. These inequities are emblematic of decades of underinvestment in healthcare systems, education, and research in low-middle income countries (LMICs), especially in surgery and anesthesiology. Five billion people remain without access to safe surgery, and we must take appropriate action now. ⋯ Research that determines ethical and acceptable partnership development between high- and low-resourced settings focusing on education and capacity building needs to be standardized and followed.
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Curr Opin Anaesthesiol · Jun 2022
ReviewAddressing comorbidities in the perioperative setting and optimizing perioperative medicine education.
Preoperative clinics and patient optimization are examples of collaborative, multidisciplinary care pathways that create value. This article reviews current literature to demonstrate the importance of preoperative enhancement of patients' cognitive and functional status. This article underscores the importance of formal training in multidisciplinary topics, such as frailty, brain health, and shared decision-making for anesthesiology house staff. ⋯ Anesthesiologists as perioperative physicians are in a unique position to lead and coordinate interdisciplinary conversations that incorporate patient goal concordant care and realistic assessment of perioperative complications. Formal house staff training in early recognition and management of patients at risk of adverse outcomes in the short and long term postoperatively improves patient outcomes and decreases healthcare spending.