Global pediatric surgery and anesthesia inequities: how do we have a global effort?
Purpose of review
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.
Recent findings
The pediatric perioperative mortality in low-resourced settings may be as high as 100 times greater than in high-resourced settings, and a pediatric surgery w...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Christiane Beck Source Type: research
Safe surgery for every child, implementation of paediatric anaesthesia training in Nigeria
Purpose of review
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.
Recent findings
The Nigerian paediatric anaesthesia workforce is minimal with a dismal paediatric anaesthetist to child density of 0.028 per 100 000 children (Sour...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Christiane Beck Source Type: research
After nectarine: how should we provide anesthesia for neonates?
Purpose of review
Neonates have a high risk of perioperative morbidity and mortality. The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) investigated the anesthesia practice, complications and perioperative morbidity and mortality in neonates and infants (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Christiane Beck Source Type: research
Safe in the first attempt: teaching neonatal airway management
Purpose of review
Quick and precise facemask ventilation and tracheal intubation are critical clinical skills in neonatal airway management. In addition, this vulnerable population requires a thorough understanding of developmental airway anatomy and respiratory physiology to manage and anticipate potential airway mishaps. Neonates have greater oxygen consumption, increased minute ventilation relative to functional residual capacity, and increased closing volumes compared to older children and adults. After a missed airway attempt, this combination can quickly lead to dire consequences, such as cardiac arrest. Keeping ...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Christiane Beck Source Type: research
Editorial: Safe anesthesia for every child
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Christiane Beck Source Type: research
Workforce solutions to address health disparities
Purpose of review
This review focuses on physician workforce racial & ethnic diversity as a solution to improve perioperative and peripartum health equity.
Recent findings
Black, Indigenous, and Hispanic physicians remain underrepresented in medicine (URiM) and anesthesiology, and efforts to expand this workforce have had limited impact. Psychological forces, including implicit bias, aversive racism, outgroup bias, racial attention bias, stereotype threat, and imposter syndrome all act to reinforce structural racism and decrease opportunity for advancement. Evidence based solutions are emerging, but require inst...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Health equity research in obstetric anesthesia
Purpose of review
Health equity is an important priority for obstetric anesthesia, but describing disparities in perinatal care process and health outcome is insufficient to achieve this goal. Conceptualizing and framing disparity is a prerequisite to pose meaningful research questions. We emphasize the need to hypothesize and test which mechanisms and drivers are instrumental for disparities in perinatal processes and outcomes, in order to target, test and refine effective countermeasures.
Recent findings
With an emphasis on methodology and measurement, we sketch how health systems and disparity research may ad...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Perinatal quality collaboratives and birth equity
Purpose of review
The purpose of this review is to discuss how state perinatal quality collaboratives are addressing birth equity to reduce disparities in maternal morbidity and mortality.
Recent finding
Perinatal quality collaboratives are adopting core practices to advance birth equity, reduce disparities and confront racism and bias in obstetric care including securing leadership commitments to equity, providing education on the causes of inequities and mitigation strategies, collecting accurate race/ethnicity data, addressing social determinants of health, and integrating patient and community knowledge, exp...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
LGBTQ+ health and anaesthesia for obstetric and gynaecological procedures
Purpose of review
People who self-identify as lesbian, gay, bisexual, transgender, queer, two-spirited and intersex (LGBTQ2SI) make up approximately 10% of the US population. Black, Native American and Latino/a/x communities are known to have a higher percentage of people who self-identify as LGBTQ2SI than white communities. Despite growing acceptance of LGBTQ2SI communities in the USA, these populations continue to experience health inequities. This review article will provide a narrative review of recent publications that discuss topics of LGBTQ2SI health and anaesthetic care during obstetric and gynaecological proce...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Limited English proficiency in the labor and delivery unit
Purpose of review
Limited English proficiency (LEP) impacts patient access to safe and comprehensive care during the antepartum, intrapartum, and postpartum periods. In this review, we explore disparities in care delivery and outcomes that LEP women experience, and discuss the importance of providing language concordant care and using interpretation services appropriately.
Recent findings
The number of individuals with LEP is steadily increasing in the United States. Pregnant women with LEP suffer disparities in obstetric care and are at risk for postpartum depression, breastfeeding difficulties, and substandard...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Causes of health inequities
Purpose of review
A renewed focus on U.S. racial and ethnic maternal health disparities has arisen following high-profile incidents of police violence and antiracism protests which coincided with the coronavirus disease 2019 pandemic, which has exerted a disproportionate effect on minority communities. Understanding the causes of disparities is pivotal for developing solutions.
Recent findings
Social determinants of health must be addressed during clinical care; however, race must be used with caution in clinical decision-making. Medicaid expansion has been associated with a decrease in severe maternal morbidity...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Do racial and ethnic disparities lead to the undertreatment of pain? Are there solutions?
Purpose of review
The current review aims to empower anesthesiologists, specifically pain medicine specialists, to become leaders in ensuring equitable care.
Recent findings
Disparities in both acute and chronic pain medicine lead to increased morbidity for patients of color. Gaps in care include misdiagnosis or under diagnosis of chronic pain disease states, undertreatment of sickle cell disease and other conditions that are common in minorities, under prescription of opioids, and lack of access to novel opioid sparing treatments. While the causes of these disparities are multifactorial, care team implicit bias...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Racial and ethnic disparities in access to gynecologic care
Purpose of review
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.
Recent findings
Disparities exist among many areas including preventive screenings, vaccination rates, contraception use, infertility, and oncologic care. These can be identified at the patient, physician, and institutional levels.
Summary
As we identify these social disparities in healthcare, we gain valuable knowledge of where our efforts are lacking and where we can...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Obstetric and perinatal racial and ethnic disparities
Purpose of review
Healthcare disparities are health differences that adversely affect disadvantaged populations. In the United States, research shows that women of color, in particular Black and Hispanic women and their offspring, experience disproportionately higher mortality, severe maternal morbidity, and neonatal morbidity and mortality. This review highlights recent population health sciences and comparative effectiveness research that discuss racial and ethnic disparities in maternal and perinatal outcomes.
Recent findings
Epidemiological research confirms the presence of maternal and neonatal disparities ...
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
Editorial: Justice, equity, diversity and inclusion in obstetric and gynecological anesthesia
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - June 1, 2022 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research
