Anaesthesia global health programmes in North America: organisational structures and impact of the COVID-19 pandemic.
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ABSTRACT:
SUBMITTER: Pakala S
PROVIDER: S-EPMC9868363 | biostudies-literature | 2023 Apr
REPOSITORIES: biostudies-literature
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Anaesthesia global health programmes in North America: organisational structures and impact of the COVID-19 pandemic.
Pakala Swetha S Brouillette Mark M Thom DeSean D Hargett Mary J MJ Reddy Niyam N Gbaje Ejiro E Thakkar Niharika N
British journal of anaesthesia 20230123 4
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Project description:BackgroundThe COVID-19 pandemic has drastically changed healthcare systems and training around the world. The Training Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition sought to understand how COVID-19 has affected pediatric gastroenterology fellowship training.MethodsA 21 question survey was distributed to all 77 pediatric gastroenterology fellowship program directors (PDs) in the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition program director database via email on April 7. Responses collected through April 19, 2020 were analyzed using descriptive statistics.ResultsFifty-one of 77 (66%) PDs from the United States, Canada, and Mexico responded to the survey. Forty-six of 51 (90%) PDs reported that they were under a "stay-at-home" order for a median of 4 weeks at the time of the survey. Two of the 51 (4%) programs had fellows participating in outpatient telehealth before COVID-19 and 39 of 51 (76%) at the time of the survey. Fellows stopped participating in outpatient clinics in 22 of 51 (43%) programs and endoscopy in 26 of 51 (52%) programs. Changes to inpatient care included reduced fellow staffing, limiting who entered patient rooms, and rounding remotely. Fellows in 3 New York programs were deployed to adult medicine units. Didactics were moved to virtual conferences in 47 of 51 (94%) programs, and fellows used various online resources. Clinical research and, disproportionately, bench research were restricted.ConclusionsThis report provides early information of the impact of COVID-19 on pediatric fellowship training. Rapid adoption of telehealth and reduced clinical and research experiences were important changes. Survey information may spur communication and innovation to help educators adapt.
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Project description:RationaleThe COVID-19 pandemic has wreaked havoc on lives around the globe. In addition to the primary threat of infection, widespread secondary stressors associated with the pandemic have included social isolation, financial insecurity, resource scarcity, and occupational difficulties.ObjectiveThe current study examined the impact of these disruptions on psychological distress during the initial adjustment phase to the pandemic in North America.MethodA sample of 2463 residents of the US and Canada completed both baseline and follow-up surveys across several weeks between March and May 2020.ResultsThose participants perceiving stress related to higher levels of personal threat to health and to the well-being of family members at baseline reported higher levels of depressive symptoms at follow-up, even after controlling for baseline depressive symptoms. In addition, pandemic-related secondary stressors (social isolation, financial insecurity, occupational difficulty, and resource scarcity) were all independently associated with depressive symptoms at follow-up, controlling for both baseline depression and perceived health threats. The results were robust and held up after controlling for demographic factors. Women, young adults, and those who reported lower income were all at higher risk for subsequent depressive symptoms.ConclusionFindings from the present study can help to identify key groups at risk for mental health problems during the pandemic, and indicate actionable areas for targeted intervention.
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Project description:During summer 2021, Western North America (WNA) experienced an unprecedented heatwave with record-breaking high temperatures associated with a strong anomalous high-pressure system, i.e., a heat dome. Here, we use a flow analog method and find that the heat dome over the WNA can explain half of the magnitude of the anomalous temperature. The intensities of hot extremes associated with similar heat dome-like atmospheric circulations increase faster than background global warming in both historical change and future projection. Such relationship between hot extremes and mean temperature can be partly explained by soil moisture-atmosphere feedback. The probability of 2021-like heat extremes is projected to increase due to the background warming, the enhanced soil moisture-atmosphere feedback and the weak but still significantly increased probability of the heat dome-like circulation. The population exposure to such heat extremes will also increase. Limiting global warming to 1.5 °C instead of 2 °C (3 °C) would lead to an avoided impact of 53% (89%) of the increase in population exposure to 2021-like heat extremes under the RCP8.5-SSP5 scenario.
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Project description:PurposeOrthopaedic residents are increasingly seeking international health electives (IHEs) during training, many of which involve providing paediatric orthopaedic care. However, little is known about the availability of IHEs during orthopaedic fellowship training. Our study sought to assess the global health opportunities available to North American paediatric orthopaedic fellows.MethodsWe conducted an online, REDCap-based survey of paediatric orthopaedic fellowship programme directors (PDs) in the United States and Canada. The survey link was sent by the Pediatric Orthopaedic Society of North America (POSNA) Evidence-Based Medicine Committee to all POSNA-approved paediatric orthopaedic fellowship PDs. Follow-up reminder emails were delivered at set time intervals.ResultsThe overall response rate was 55% (26/47). Only three of 26 responding programmes (11.5%) offered a structured global health programme but 42.3% of programmes (11/26) reported fellow IHE participation within the last ten years. In all, 91% of PDs reported that fellows were extremely satisfied with their IHE, and 91% agreed that IHEs are valuable for trainees. Perceived barriers to fellow participation in IHEs included lack of funding, lack of established partner sites, lack of interest among fellows and concerns related to time away compromising clinical/call coverage. In all, 65.4% of PDs agree that IHE participation during training plays a major role in shaping fellows' future volunteer activities.ConclusionThere are limited global health opportunities among North American paediatric orthopaedic fellowship programmes, with only 11.5% offering a structured global health programme. Greater efforts to establish sustainable funding and international partnerships may increase opportunities for IHEs during paediatric orthopaedic fellowship training.Level of evidenceLevel II.
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