Radical Listening, Action, and Reflection at the Boundaries of Youth Violence Prevention

The purpose of this article is to make visible collaborative pedagogical and research practices that opened space for community members to be co-educators and researchers with students and a professor on a youth violence assessment. We use Third Generation Cultural Historical Activity Theory (CHAT) as a conceptual framework to examine the learning that occurred in the boundary zone of our eight differently situated organizations. As we demonstrate through the inclusion of boundary dialogue excerpts, this process generated more authentic understandings of why racial inequity has persisted in youth violence outcomes. The assessment questions we asked, the key informants we engaged, the data analysis process we undertook, and the substantially different types of findings that emerged were a function of relationship building and radical listening in the boundary zone of our collaboration. We conclude that practices that foster radical listening in boundary work can reframe experiential learning for racial justice

Radical Listening, Action, and Reflection at the Boundaries of Youth Violence Prevention

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Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially