Abstract:
BACKGROUND:Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. METHODS:A two-day workshop was held in Kigali, Rwanda in May 2019 with representation from health providers, academia, and government. A four delays model (delays to seeking, reaching, receiving, and remaining in care) was applied to injury care. Participants identified barriers at each delay and graded, through consensus, their relative importance. Following an iterative voting process, the four highest priority barriers were identified. Based on workshop findings and a scoping review, a map was created to visually represent injury care access as a complex health-system problem. RESULTS:Initially, 42 barriers were identified by the 34 participants. 19 barriers across all four delays were assigned high priority; highest-priority barriers were "Training and retention of specialist staff", "Health education/awareness of injury severity", "Geographical coverage of referral trauma centres", and "Lack of protocol for bypass to referral centres". The literature review identified evidence relating to 14 of 19 high-priority barriers. Most barriers were mapped to more than one of the four delays, visually represented in a complex health-system map. CONCLUSION:Overcoming barriers to ensure access to quality injury care requires a multifaceted approach which considers the whole patient journey from injury to rehabilitation. Our results can guide researchers and policymakers planning future interventions.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Odland ML,Whitaker J,Nepogodiev D,Aling' CA,Bagahirwa I,Dushime T,Erlangga D,Mpirimbanyi C,Muneza S,Nkeshimana M,Nyundo M,Umuhoza C,Uwitonze E,Steans J,Rushton A,Belli A,Byiringiro JC,Bekele A,Davies Jdoi
10.1007/s00268-020-05571-6subject
Has Abstractpub_date
2020-09-01 00:00:00pages
2903-2918issue
9eissn
0364-2313issn
1432-2323pii
10.1007/s00268-020-05571-6journal_volume
44pub_type
杂志文章abstract::The geographic distribution of duodenal ulcer and its characteristics in rural areas of high incidence in developing countries are reviewed. The choice of surgical procedures is discussed in light of the bulky diet and nutritional problems of these countries. A vagotomy procedure is advised for duodenal ulcer and a B...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01654731
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Surgeon performed ultrasound (US) is being increasingly embraced by breast surgeons worldwide as an integral part of patient assessment. The extent of its application within Australia and New Zealand is not well documented. The present study aimed to evaluate its current usage patterns and to determine suita...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2076-8
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Efficient DNA damage repair by MutL-homolog DNA mismatch repair (MMR) enzymes, MLH1, MLH3, PMS1 and PMS2, are required to maintain thyrocyte genomic integrity. We hypothesized that persistent oxidative stress and consequent transcriptional dysregulation observed in thyroid follicles will lead to MMR deficien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4299-6
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Prior studies have examined the use of liver function tests (LFT) for predicting the presence of common bile duct (CBD) stones in chronic cholecystitis (CC) patients. It is currently unclear whether LFT are also useful for predicting CBD stones in patients with acute cholecystitis (AC). METHODS:Of 1059 pati...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3517-y
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Scarce data are available on the characteristics of postoperative organ failure (POF) and mortality after gastrectomy. We aimed to describe the causes of organ failure and mortality related to gastrectomy for gastric cancer and to identify patients with POF who are at a risk of failure to rescue (FTR). METH...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05382-9
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS:The outcome of patients who underwe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9504-1
更新日期:2008-06-01 00:00:00
abstract::A randomized, double-blind multicenter trial was performed to compare the safety and efficacy of a new low-molecular-weight heparin (LMWH) (LU 47311, Clivarine) and standard unfractionated heparin for the prophylaxis of postoperative venous thromboembolism. Altogether 1351 patients scheduled to undergo abdominal surge...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s002689900185
更新日期:1997-01-01 00:00:00
abstract::Patients with early-stage non-small-cell lung cancer (NSCLC) should be treated with complete surgical resection whenever possible. Incomplete resections do not cure, and the optimal pulmonary resection is anatomic lobectomy. Limited resections (wedge resection and segmentectomy) are associated with a threefold increas...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680020017
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the per...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3659-y
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Surgical care is not uniformly available worldwide. Inequities in surgical care and access may also vary within countries, and the present study aimed to explore these disparities in Pakistan. METHODS:The National Health Survey of Pakistan was analyzed. The proportion of people with a history of abdominal s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1732-8
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Von Hippel-Lindau disease (VHL) is a dominantly inherited multi-system syndrome. Although pheochromocytoma is the hallmark endocrine neoplasm, pancreatic lesions occur frequently, and their management can be complex. This report describes 26 patients from a single institution with pancreatic or adrenal les...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0359-4
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:We assessed whether the simultaneous sequential strategy could (1) achieve additional sinus restoration for those patients who were not in sinus rhythm while coming off bypass after modified left maze procedure and (2) attain the same long-term success rates as the bi-atrial maze procedure in patients with p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0382-0
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3222-2
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Five billion people lack access to surgery. Accurate and complete data have been identified as essential to the global scale-up of perioperative care. This study retrospectively validates the Mbarara Surgical Services Quality Assurance Database (SQUAD), an electronic outcomes database at a Ugandan secondary ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05537-8
更新日期:2020-08-01 00:00:00
abstract::Evaluation of prognostic factors of adenocarcinoma of Vater's ampulla is still a matter of debate. The aim of this study was to evaluate retrospectively factors that influence early and long-term outcomes in a 20-year single-institution experience on ampullary carcinoma. A total of 94 consecutive patients with ampulla...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7498-x
更新日期:2005-04-01 00:00:00
abstract::Nineteen consecutive patients receiving renal transplants underwent prospective evaluation of their calcium homeostasis for 1 year after transplantation to characterize indices of hyperparathyroidism (HPT) amelioration. All but one underwent dialysis, and six had vitamin D supplementation before grafting. The rapid fa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900446
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Parathyroid glands (PGs) can be particularly hard to distinguish from surrounding tissue and thus can be damaged or removed during thyroidectomy. Postoperative hypoparathyroidism is the most common complication after thyroidectomy. Very recently, it has been found that the parathyroid tissue shows near-infra...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3571-5
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:It has been reported that the paraesophagogastric devascularization with esophageal transection procedure, also known as the modified Sugiura procedure, was effective in the treatment of variceal bleeding. However, it was not widely accepted by other surgeons because of the high rate of rebleeding, complicat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2478-2
更新日期:2014-08-01 00:00:00
abstract::Calcium oxalate is a major component of renal stones, and its urinary concentration plays an important role in stone formation. Even a small increase in urinary oxalate has a significant impact on calcium oxalate saturation. Although primary hyperoxaluria is relatively uncommon, patients with calcium oxalate stones ha...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010193
更新日期:2000-10-01 00:00:00
abstract:INTRODUCTION:Gastroesophageal reflux disease is common in Western societies, although the prevalence of reflux symptoms in the community is not well described. In this study we determined the prevalence of symptoms of gastroesophageal reflux and other "esophageal" symptoms, and the consumption of medication for reflux ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9780-9
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Frailty is a customized marker of biological age that helps to gauge an individual's functional physiologic reserve and ability to react to stress and is associated with increased postoperative morbidity and mortality. In order to mitigate frailty preoperatively, the concept of prehabilitation has entered th...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-020-05658-0
更新日期:2020-11-01 00:00:00
abstract::Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7040-6
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:In patients with well-differentiated thyroid cancer, the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50%. Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients, even if there are no clinically...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1507-2
更新日期:2012-06-01 00:00:00
abstract::The imaging characteristics of diagnostic ultrasound (US) are determined by the ultrasonic properties of tissue. The velocity of propagation of US and the attenuation are the 2 most important parameters. These determine the frequency with which the tissues may be imaged, which in turn sets a fundamental limit on the a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910026
更新日期:2000-02-01 00:00:00
abstract::The purpose of this study was to evaluate the surgical outcome of completion thyroidectomy in patients with presumed unilateral well-differentiated thyroid cancer (WDTC). The medical records of all patients having had unilateral thyroid lobectomy for WDTC, who subsequently underwent completion thyroidectomy, were revi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067365
更新日期:1992-07-01 00:00:00
abstract::The epidermal growth factor receptor family consists of four closely related transmembrane receptors: epidermal growth factor receptor (EGF-R), c-erbB-2, c-erbB-3, and c-erbB-4. Overexpression of each receptor may lead to cell transformation and contributes to tumor progression in various malignancies. Although these ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900616
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Linitis plastica-type gastric carcinoma remains a disease with poor prognosis despite an aggressive surgical approach. Although a prominent pattern of disease failure is peritoneal carcinomatosis, some patients experience rapid disease progression without signs of the peritoneal disease. METHODS:Clinicopath...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9672-z
更新日期:2008-09-01 00:00:00
abstract::In the original article Dennis Den Hartog's name was tagged incorrectly. It is correct as reflected here. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-019-04957-5
更新日期:2019-05-01 00:00:00
abstract::Surgery is the most effective therapeutic intervention available for the treatment of breast cancer. It has been responsible for obtaining local control and long-term disease-free intervals in more patients over the past century than any other treatment modality. Trends toward earlier stage at diagnosis are likely to ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0010-y
更新日期:2001-06-01 00:00:00
abstract::A new technique for ligating vessels and similar structures that offers more security is described. The aim of the study was to test whether this hypothesis was correct. Six different types of knots, including the one described in this article were compared by a strength-testing study. The knots were tied on a silicon...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7675-6
更新日期:2005-10-01 00:00:00