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1.

Background

The Lancet Commission on Global Surgery highlighted global surgical need but offered little insight into the specific surgical challenges of children in low-resource settings. Efforts to strengthen the quality of global pediatric surgical care have resulted in a proliferation of partnerships between low-and middle-income countries (LMICs) and high-income countries (HICs). Standardized tools able to reliably measure gaps in delivery and quality of care are important aids for these partnerships. We undertook a systematic review (SR) of capacity assessment tools (CATs) focused on needs assessment in pediatric surgery.

Methods

A comprehensive search strategy of multiple electronic databases was conducted per PRISMA guidelines without linguistic or temporal restrictions. CATs were selected according to pre-defined inclusion criteria. Articles were assessed by two independent reviewers. Methodological quality of studies was appraised using the COSMIN checklist with 4-point scale.

Results

The search strategy generated 16,641 original publications, of which three CATs were deemed eligible. Eligible tools were either excessively detailed or oversimplified. None used weighted scores to identify finer granularity between institutions. No CATs comprehensively included measures of resources, outcomes, accessibility/impact and training.

Discussion

The results of this study identify the need for a CAT capable of objectively measuring key aspects of surgical capacity and performance in a weighted tool designed for pediatric surgical centers in LMICs.

Type of Study

Systematic Review.

Level of Evidence

II.  相似文献   
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Effects of capsaicin in temporomandibular joint arthritis in rats   总被引:8,自引:0,他引:8  
Temporomandibular joint (TMJ) arthritis was induced in female Lewis rats by unilateral injection of a suspension of heat-killed Mycobacterium butyricum in paraffin oil into the TMJ. Control rats received paraffin oil by the same route. Arthritic and control rats were pretreated either with capsaicin or denervation of the mandibular branch of the trigeminal nerve. Tissues were collected for neuropeptide extraction and analysed by radioimmunoassay and reverse-phase high-performance liquid chromatography. In all groups, the levels of substance P- (SP), calcitonin gene-related peptide- (CGRP) and neuropeptide Y- (NPY) like immunoreactivity (LI) were higher in the trigeminal ganglia than in the TMJs. In control rats, capsaicin significantly lowered the levels of SP-LI in the trigeminal ganglia and TMJ, but not CGRP-LI and NPY-LI. In the arthritic rats, capsaicin pretreatment significantly lowered the SP-LI and CGRP-LI in the trigeminal ganglia and TMJ, but not the NPY-LI. In the trigeminal ganglia the unilateral denervation significantly lowered SP-LI in control rats, and in arthritic rats SP-LI and CGRP-LI. On the denervated side of the arthritic TMJ, NPY-LI, SP-LI and CGRP- LI were significantly lowered as compared to the arthritic control rats and to the contralateral side. In this rat model, pretreatment with capsaicin and surgical denervation decreased the neuropeptide content in the trigeminal ganglia and the TMJ. The results clearly demonstrate a close interaction between increased neuropeptide release from sensory and sympathetic neurones after induction of arthritis in the rat.  相似文献   
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Indoor gamma radiation measurement at dwellings of Riyadh city in Saudi Arabia using TLD has been performed. Measurements were carried out from October 2004 to June 2005. The city was divided into five sectors, for four categories of bed rooms, living rooms, bathrooms and kitchens. The indoor gamma annual absorbed dose of Riyadh city is in the range from 303+/-57 to 700+/-38microGyy(-1) with an average value of 455.1+/-45microGyy(-1). The calculated corresponding annual effective dose to the adult population of the locations will vary from 212+/-40 to 490+/-27microSvy(-1) with an average value of 318.57+/-31microSvy(-1).(222)Rn concentration was measured at dwellings of Riyadh city in Saudi Arabia to estimate effective annual dose to the public from (222)Rn and its progeny. The (222)Rn concentrations were measured using CR-39 detector. The range of annual mean (222)Rn concentrations for all sites was 2-69Bqm(-3) with an average of 18.4Bqm(-3). The effective annual dose was estimated to be 0.46mSvy(-1).  相似文献   
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This paper introduces the design and implementation of a generic wireless and Real-time Multi-purpose Health Care Telemedicine system applying Bluetooth protocol, Global System for Mobile Communications (GSM) and General Packet Radio Service (GPRS). The paper explores the factors that should be considered when evaluating different technologies for application in telemedicine system. The design and implementation of an embedded wireless communication platform utilising Bluetooth protocol is described, and the implementation problems and limitations are investigated. The system is tested and its telecommunication general aspects are verified. The results showed that the system has (97.9 +/- 1.3)% Up-time, 2.5 x 10(-5) Bit Error Rate, 1% Dropped Call Rate, 97.4% Call Success Rate, 5 second transmission delay in average, (3.42 +/- 0.11) kbps throughput, and the system may have application in electrocardiography.  相似文献   
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The hepatocyte growth factor (HGF) has been crucially implicated in the development of proliferative retinal diseases; however, it is unclear whether retinal glial cells express or respond to HGF. Therefore, we examined the expression of HGF and of the receptor for HGF, c-Met, by immunohistochemical costaining with glial fibrillary acidic protein (GFAP) in epiretinal membranes of patients with proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR), respectively. Furthermore, it was determined whether cells of the human retinal glial cell line, MIO-M1, secrete HGF protein, and whether HGF stimulates proliferation and chemotaxis, and secretion of the vascular endothelial growth factor (VEGF). Neuroretinas of patients with PVR express elevated mRNA level for HGF in comparison to control retinas. In epiretinal membranes of patients with PVR or PDR, immunoreactivity for HGF and for c-Met, respectively, partially colocalized with immunoreactivity for GFAP. Fetal bovine serum and basic fibroblast growth factor, but not heparin-binding epidermal or platelet-derived growth factors, evoked HGF secretion by cultured retinal glial cells. HGF displayed only a marginal effect on cell proliferation while it stimulated chemotaxis. HGF promoted the secretion of VEGF, via activation of the phosphatidylinositol-3 kinase. It is concluded that glial cells in epiretinal membranes express both HGF protein and c-Met receptors. The results suggest an autocrine/paracrine role of HGF in glial cell responses during proliferative vitreoretinal disorders as well as in retinal neovascularization, by stimulating of VEGF release.  相似文献   
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