scholarly journals Availability of global health opportunities in North American Paediatric Orthopaedic Fellowship Programmes

2018 ◽  
Vol 12 (6) ◽  
pp. 640-646
Author(s):  
A. B. Siy ◽  
L. A. Lins ◽  
J. S. Dahm ◽  
J. T. Shaw ◽  
N. M. Simske ◽  
...  
Keyword(s):  
Global Health ◽  
North American ◽  
International Health ◽  
The United States ◽  
Fellowship Training ◽  
Level Of Evidence ◽  
Orthopaedic Care ◽  
Paediatric Orthopaedic ◽  
Orthopaedic Society ◽  
Health Programme

Purpose Orthopaedic 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. Methods We 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. Results The 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. Conclusion There 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 Evidence Level II

scholarly journals Global Health Training During Residency: The Weill Cornell Tanzania Experience

2011 ◽  
Vol 3 (3) ◽  
pp. 421-424 ◽  
Author(s):  
Duncan K Hau ◽  
Jennifer I DiPace ◽  
Robert N Peck ◽  
Warren D Johnson
Keyword(s):  
Internal Medicine ◽  
Global Health ◽  
Overall Response Rate ◽  
Medical Center ◽  
International Health ◽  
The United States ◽  
Full Time ◽  
Medical College ◽  
Positive Experiences ◽  
Positive Effect

Abstract Background In 2007, Weill Cornell Medical College (WCMC) began annually to send approximately 30 residents in internal medicine and pediatrics to Bugando Medical Center in Mwanza, Tanzania, where they were supervised and mentored by 2 full-time WCMC faculty physicians. Objective To describe the components of the WCMC global health elective and to evaluate the experiences of the participants. Methods Subjects were WCMC residents in internal medicine and pediatrics from the graduating classes of 2007–2009. Electronic surveys were sent to all participants (n  = 57) and to a group of nonparticipants (n  =  57). Results Overall response rate was 58%. The most-selected, primary reasons for participation in the program were an interest in global health and a desire to serve an underprivileged population. Participants rated use of routine laboratory tests in the United States as more overused than did nonparticipants (P  =  .01). After the elective, 62% of participants reported a reduced use of laboratory and/or radiologic tests. All participants (100%; 39 of 39) reported the elective as having a positive effect on their knowledge of international health and tropical medicine. More than 90% of participants (36 of 39) reported the elective as having a positive effect on their physical examination skills. Conclusions Participants of the WCMC global health elective report positive experiences from our multidimensional global health collaboration.

scholarly journals Status of global health fellowship training in the United States and Canada

2019 ◽  
Vol 10 (4) ◽  
pp. e80-e95
Author(s):  
Ann Evensen ◽  
Sean Duffy ◽  
Russell Dawe ◽  
Andrea Pike ◽  
Brett Nelson
Keyword(s):  
Global Health ◽  
Program Directors ◽  
The United States ◽  
Fellowship Training ◽  
Web Based ◽  
Training Requirements ◽  
Median Size ◽  
Fellowship Programs ◽  
Program Characteristics ◽  
Clear Objective

Background: Increasing numbers of residency graduates desire global health (GH) fellowship training. However, the full extent of training options is not clear. Objective: To identify clinical GH fellowships in all specialties in the U.S. and Canada and to describe their demographics, innovative features, and challenges. Methods: The authors surveyed program directors or designees from GH fellowships with a web-based tool in 2017. Program directors reported demographics and program characteristics. Results: The authors identified 85 potential programs. Fifty-four programs (63.5%) responded confirming 50 fellowships. The number of U.S. GH fellowship programs increased by 89.7% since 2010. One-third of fellowships accepted graduates from more than one specialty. The most common single-specialty programs were Emergency Medicine or Family Medicine. Fellowship duration was most commonly 24 months. Median size was one fellow per year. Funding and lack of qualified applicants were significant challenges. Most programs were funded through fellow billing for patient care or other means of self-support.   Conclusions: The number of U.S. and Canadian GH fellowship programs has nearly doubled since 2010. Programs reported lack of funding and qualified applicants as their most significant challenges. Consensus amongst stakeholders regarding training requirements may improve outcomes for future fellows, their employers, and the patients they serve.

scholarly journals Global Health Fellowships: A National, Cross-Disciplinary Survey of US Training Opportunities

2012 ◽  
Vol 4 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Brett D. Nelson ◽  
Rasa Izadnegahdar ◽  
Lauren Hall ◽  
Patrick T. Lee
Keyword(s):  
Global Health ◽  
The United States ◽  
Fellowship Training ◽  
Snowball Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Fellowship Programs ◽  
Training Activities ◽  
Training Opportunities

Abstract Introduction Medical trainee interest and participation in global health programs have been growing at unprecedented rates, and the response has been increasing opportunities for medical students and residents. However, at the fellowship level, the number and types of global health training opportunities across specialties have not previously been characterized. Methods A cross-sectional survey was conducted between November and December 2010 among all identified global health fellowship programs in the United States. Programs were identified through review of academic and institutional websites, peer-reviewed literature, web-based search engines, and epidemiologic snowball sampling. Identified global health fellowship programs were invited through e-mail invitation and follow-up telephone calls to participate in the web-based survey questionnaire. Results The survey identified 80 global health fellowship programs: 31 in emergency medicine, 14 in family medicine, 11 in internal medicine, 10 in pediatrics, 8 interdisciplinary programs, 3 in surgery, and 3 in women's health. Of these, 46 of the programs (57.5%) responded to the survey. Fellowship programs were most commonly between 19 and 24 months in duration and were nearly equally divided among 2 models: (1) fellowship integrated into residency, and (2) fellowship following completion of residency. Respondents also provided information on selection criteria for fellows, fellowship training activities, and graduates' career choices. Nearly half of fellowship programs surveyed were recently established and had not graduated fellows at the time of the study. Conclusion Institutions across the nation have established a significant, diverse collection of global health fellowship opportunities. A public online database (www.globalhealthfellowships.org), developed from the results of this study, will serve as an ongoing resource on global health fellowships and best practices.

scholarly journals Increased incidence of acute patellar dislocations and patellar instability surgical procedures across the United States in paediatric and adolescent patients

2021 ◽  
Vol 15 (2) ◽  
pp. 149-156
Author(s):  
Kelly H. McFarlane ◽  
Ryan P. Coene ◽  
Lanna Feldman ◽  
Patricia E. Miller ◽  
Benton E. Heyworth ◽  
...  
Keyword(s):  
United States ◽  
Surgical Procedures ◽  
Patellar Instability ◽  
Patellofemoral Instability ◽  
Sports Participation ◽  
The United States ◽  
Significant Rise ◽  
Level Of Evidence ◽  
Adolescent Patients ◽  
Paediatric Orthopaedic

Purpose Patellofemoral instability is a common cause of knee pain and dysfunction in paediatric and adolescent patients. The purpose of the study was to evaluate the frequency of patellar dislocations seen in emergency departments (EDs) and the rates of surgical procedures for patellar instability at paediatric hospitals in the United States between 2004 and 2014. Methods The Pediatric Health Information System database was queried for all paediatric patients who underwent surgery for patellar instability or were seen in the ED for acute patellar dislocation between 2004 and 2014. This was compared with the annual numbers of overall orthopaedic surgical procedures. Results Between 2004 and 2014, there were 3481 patellar instability procedures and 447 285 overall orthopaedic surgical procedures performed at the included institutions, suggesting a rate of 7.8 per 1000 orthopaedic surgeries. An additional 5244 patellar dislocations treated in EDs were identified. Between 2004 and 2014, the number of patellar instability procedures increased 2.1-fold (95% confidence interval (CI) 1.4 to 3.0), while orthopaedic surgical procedures increased 1.7-fold (95% CI 1.3 to 2.0), suggesting a 1.2-fold relative increase in patellar instability procedures, compared with total paediatric orthopaedic surgeries. Conclusion This study shows a significant rise in the rate of acute patellar instability treatment events in paediatric and adolescent patients across the country. Surgery for patellar instability also increased over the study period, though only slightly more than the rate of all paediatric orthopaedic surgical procedures. This may suggest that increasing youth sports participation may be leading to a spectrum of increasing injuries and associated surgeries in children. Level of Evidence IV

scholarly journals Diagnostic and treatment preferences for developmental dysplasia of the hip: a survey of EPOS and POSNA members

2018 ◽  
Vol 12 (3) ◽  
pp. 236-244 ◽  
Author(s):  
C. Alves ◽  
W. H. Truong ◽  
M. V. Thompson ◽  
J. R. Suryavanshi ◽  
C. L. Penny ◽  
...  
Keyword(s):  
Developmental Dysplasia ◽  
Diagnosis And Treatment ◽  
Treatment Preferences ◽  
Level Of Evidence ◽  
Hip Abduction ◽  
Frequent Response ◽  
Radiology Technicians ◽  
Paediatric Orthopaedic ◽  
Orthopaedic Society ◽  
Dysplasia Of The Hip

Purpose The aim of this study was to elucidate developmental dysplasia of the hip (DDH) diagnosis and treatment preferences among members of the Pediatric Orthopaedic Society of North America (POSNA) and European Paediatric Orthopaedic Society (EPOS). Methods A 54-question survey on DDH diagnosis and treatment preferences was distributed to POSNA and EPOS members. Descriptive statistics were performed. Results A total of 459 responses were analyzed. Ultrasound was the preferred modality for diagnosing DDH in infants less than six months old; few surgeons preferred radiographs. In all, 57% of POSNA members had radiology technicians perform ultrasounds, only 7% of EPOS members did. The percent coverage defining a dislocated hip varied greatly, the most frequent response being < 20% for POSNA and < 40% for EPOS members. Pavlik harnesses were the most popular harness/brace, used by 90% of POSNA and 71% of EPOS members. POSNA members were more likely than EPOS members to use a rigid abduction brace following initial harness/brace failure. For residual acetabular dysplasia, POSNA members were twice as likely as EPOS members to institute hip abduction bracing. Most surgeons would not perform closed reduction at less than three months of age or open reduction at less than six months of age. Most EPOS ­members used traction prior to reduction; few POSNA members did. Few POSNA and EPOS members believed that reduction should be delayed until the ossific nucleus was visible. Conclusion There is great variation in the preferred methods for diagnosing and treating DDH. This survey is the largest transcontinental survey to compile diagnostic and treatment preferences for DDH. With wide variations in practice, there is room for quality improvement. Level of Evidence II

scholarly journals Trends in Leadership Within Orthopedic Foot and Ankle Fellowships

2021 ◽  
Vol 6 (3) ◽  
pp. 247301142110332
Author(s):  
Joshua P. Weissman ◽  
Cody Goedderz ◽  
Muhammad Y. Mutawakkil ◽  
Peter R. Swiatek ◽  
Erik B. Gerlach ◽  
...  
Keyword(s):  
Surgical Training ◽  
Asian American ◽  
The United States ◽  
Fellowship Training ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
H Index ◽  
Training Time ◽  
Race Ethnicity ◽  
American Orthopaedic

Background: No study in the orthopedic literature has analyzed the demographic characteristics or surgical training of foot and ankle fellowship directors (FDs). Our group sought to illustrate demographic trends among foot and ankle fellowship leaders. Methods: The American Orthopaedic Foot & Ankle Society (AOFAS) Fellowship Directory for the 2021 to 2022 program year was queried in order to identify all foot and ankle fellowship leaders at programs currently offering positions in the United States and Canada. Data points gathered included age, sex, race/ethnicity, location of surgical training, time since training completion until FD appointment, length in FD role, and individual research H-index. Results: We identified 68 fellowship leaders, which consisted of 48 FDs and 19 co-FDs. Sixty-five individuals (95.6%) were male, and 3 (4.4%) were female. As regards race/ethnicity, 88.2% of the leadership was Caucasian (n = 60), 7.4% was Asian American (n = 5), 1.5% was Hispanic/Latino (n = 1), and 1.5% was African American (n = 1). The average age was 51.5 years, and the calculated mean Scopus H-index was 15.28. The mean duration from fellowship training to fellowship leader position was 11.23 years. Conclusion: Leaders within foot and ankle orthopedic surgery are characterized by research prowess and experience, but demographic diversity is lacking. Level of Evidence: Level III.

scholarly journals An International Health Track Is Associated With Care for Underserved US Populations in Subsequent Clinical Practice

2011 ◽  
Vol 3 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Andrew W. Bazemore ◽  
Linda M. Goldenhar ◽  
Christopher J. Lindsell ◽  
Philip M. Diller ◽  
Mark K. Huntington
Keyword(s):  
United States ◽  
Global Health ◽  
Rural Areas ◽  
Health Care Services ◽  
Underserved Populations ◽  
Insurance Coverage ◽  
International Health ◽  
The United States ◽  
Global Health Education ◽  
The Impact

Abstract Background Recent efforts to increase insurance coverage have revealed limits in primary care capacity, in part due to physician maldistribution. Of interest to policymakers and educators is the impact of nontraditional curricula, including global health education, on eventual physician location. We sought to measure the association between graduate medical education in global health and subsequent care of the underserved in the United States. Methods In 2005, we surveyed 137 graduates of a family medicine program with one of the country's longest-running international health tracks (IHTs). We compared graduates of the IHT, those in the traditional residency track, and graduates prior to IHT implementation, assessing the anticipated and actual involvement in care of rural and other underserved populations, physician characteristics, and practice location and practice population. Results IHT participants were more likely to practice abroad and care for the underserved in the United States in the first 5 years following residency than non-IHT peers. Their current practices were more likely to be in underserved settings and they had higher percentages of uninsured and non–English-speaking patients. Comparisons between pre-IHT and post-IHT inception showed that in the first 5 years following residency, post-IHT graduates were more likely to care for the underserved and practice in rural areas and were likely to offer volunteer community health care services but were not more likely to practice abroad or to be in an academic practice. Conclusions Presence of an IHT was associated with increased care of underserved populations. After the institution of an IHT track, this association was seen among IHT participants and nonparticipants and was not associated with increased long-term service abroad.

scholarly journals The covid-19 Pandemic, Geopolitics, and International Law

2020 ◽  
Vol 11 (2) ◽  
pp. 237-248
Author(s):  
David P Fidler
Keyword(s):  
Cold War ◽  
Global Health ◽  
International Law ◽  
International Health ◽  
Balance Of Power ◽  
The United States ◽  
Power Politics ◽  
Post Cold War ◽  
The Cold War ◽  
The Impact

Abstract Balance-of-power politics have shaped how countries, especially the United States and China, have responded to the covid-19 pandemic. The manner in which geopolitics have influenced responses to this outbreak is unprecedented, and the impact has also been felt in the field of international law. This article surveys how geopolitical calculations appeared in global health from the mid-nineteenth century through the end of the Cold War and why such calculations did not, during this period, fundamentally change international health cooperation or the international law used to address health issues. The astonishing changes in global health and international law on health that unfolded during the post-Cold War era happened in a context not characterized by geopolitical machinations. However, the covid-19 pandemic emerged after the balance of power had returned to international relations, and rival great powers have turned this pandemic into a battleground in their competition for power and influence.

Benjamin Henry Latrobe and the nomenclature of two North American fishes

1987 ◽  
Vol 14 (1) ◽  
pp. 85-88
Author(s):  
CHARLOTTE M PORTER
Keyword(s):  
United States ◽  
North American ◽  
The United States ◽  
American Shad ◽  
New Name ◽  
The Common ◽  
Fish Louse

A curious error affects the names of three North American clupeids—the Alewife, American Shad, and Menhaden. The Alewife was first described by the British-born American architect, Benjamin Henry Latrobe in 1799, just two years after what is generally acknowledged as the earliest description of any ichthyological species published in the United States. Latrobe also described the ‘fish louse’, the common isopod parasite of the Alewife, with the new name, Oniscus praegustator. Expressing an enthusiasm for American independence typical of his generation, Latrobe humorously proposed the name Clupea tyrannus for the Alewife because the fish, like all tyrants, had parasites or hangers-on.

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