Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice. Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value \u3c 0.05 was considered to be statistically significant. Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category. Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group

Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study.

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice. Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant. Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category. Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group

Effet de recours aux bases de données féminines sur la dérivation du t-score chez les hommes

Le recours à une base de données normative masculine (BDNM) ou féminine (BDNF) lors de la dérivation des T-scores en vue du diagnostic d’ostéoporose chez les hommes demeure matière à controverse à l’heure actuelle. Notre étude a pour but d’évaluer l’impact de l’option d’une BDNF (au lieu de la BDNM) lors de la dérivation des T-scores chez les hommes ainsi que la classification diagnostique de la densité minérale osseuse (DMO), lorsque l’on applique les critères de l’OMS, dans une cohorte de 1200 hommes âgés de 20 à 90 ans (moyenne 50.1 ± 16.2) chez lesquels l’indication d’une absorptiométrie biphotonique à rayons X (DXA) était posée. Cette étude couvre la période allant de Mai 2004 à Septembre 2008 et a pour cadre l’Hôpital Militaire Mohammed V de Rabat. L’indice de masse corporelle (IMC) moyen (kg/m2) était de 24.8 ± 3.9 (13,0 à 37,5). La DMO au rachis lombaire et au col fémoral fut obtenue sur un densitomètre GE Lunar Prodigy. Initialement, la BDNM marocaine fut utilisée pour calculer les T-scores. Par la suite, les scans étaient analysés de nouveau par la BDNF. Les DMO (DS) moyennes aux niveaux du rachis lombaire, du col fémoral et de la hanche totale étaient respectivement de 1,098 (0,17), 0,974 (0,17) et 1,006 (0,16) g/cm2. Lorsque les scans étaient analysés de nouveau par le biais de la BDNF, les T-scores étaient plus bas au niveau de tous les sites (p < 0,0001). Quand on avait recours à la BDNF, un nombre plus réduit de patients (p < 0,0001) était classé comme « ostéoporotique », et ce au niveau de tous les sites. De même, la proportion d’hommes classés comme ayant une ostéoporose à n’importe quel site qu’il soit diminuait de 14,8 à 11,2 %. Lors de la seconde analyse par le biais de la BDNF, les T-scores augmentaient (p < 0,0001), avec des biais positifs respectifs de 0,45 ; 0,90, et de 0,45 aux niveaux du rachis L1-L4, du col fémoral et de la hanche totale. En conclusion, le recours à une BDNF génère des T-scores plus élevés que lors de l’usage de la BDNM. Comme supposé, il en résulte un nombre plus réduit d’hommes qui sont diagnostiqués comme ostéoporotiques et ce d’après le système de classification de l’OMS

Global neurosurgery over a 60-year period : Conceptual foundations, time reference, emerging Co-ordinates and prospects for collaborative interventions in low and middle income countries

Introduction: We evaluated salient initiatives invested in global neurosurgery over a 60-year period. Research question: What are the Phases, Achievements, Challenges, and Lessons of Global Neurosurgery. Methods: A 60-year retrospective study from 1960 to 2020 analyzing the major phases, lessons, and progress notes. We reviewed the foundational need questions and innovated tools used to answer them. Results: Three phases defining our study period were identified. In the early phase, birthing academic units and the onset of individual volunteerism were dominant concepts. The 2nd phase is summarized by the rise of volunteerism and surgical camps. The third phase is heralded by advocacy and strategies for achieving care equity.The defining moment is the Lancet commission for global surgery summit in 2015. Lessons include the need for evaluation of the resources of recipient and donor locations using novel global surgery tools. Conclusion: Global neurosurgery over the 60-year study period is summarized by indelible touchstones of personal and group efforts as well as triumphs derived from innovations in the face of formidable challenges