Neurosurgery and Global Health

Description

This book is a combination of ideas and experiences from over 100 dedicated and brilliant neurosurgeons around the world. Their common goal is to provide data for a deeper understanding of the multi-faceted aspects of neurosurgery and, by doing so, to better serve patients across the globe. Scientific curiosity, deep dedication, incredible work ethics, entrepreneurship, and creativity are the common traits among all neurosurgeons, and not the exception. By allowing readers to see the field of neurosurgery from the perspectives of surgeons spanning five continents, this book serves to provide multiple, diverse viewpoints and to build a foundation for future collaborations. The book’s 24 chapters are organized into 3 parts. Part I provides the reader with an overview of the role of neurosurgery in worldwide health care, its evolution over the past decades, the current state and future directions of each neurosurgical subspecialty across the five continents. Over the years, the overarching goal for neurosurgeons has been to develop new, more effective and high-end solutions for complex diseases and to provide access to neurosurgical services for all patients. Part II discusses the differences and similarities of neurosurgery education and training across the globe, providing a snapshot of how new tools, technology, and paradigms reduce inequality and increase access to neurosurgical education. Educational accomplishments and challenges still present for the in different regions of the world are reviewed. Part III focuses on economic aspects influencing neurosurgery globally, including how to make efficient decisions in the face of scarcity, yet demand. The authors provide theories, models, and tools helpful to apply when planning to allocate resources, not just financial, but also human and intellectual. A deeper understanding of economics does not necessarily provide the answer to the problem; rather it provides the tools to find an answer, or, ideally, multiple possible solutions. Neurosurgery and Global Health is the first comprehensive guide to the role of neurosurgery in the global health care sphere, providing an in-depth compendium about the understanding of the neurosurgical role within global health, its efforts in the education of tomorrow’s workforce, and the economic aspects driving the field. Preface Contents Contributors Part I: The Role of Neurosrugery in Global Health References Chapter 1: The Role of Neurosurgery in Worldwide Health Care and Its Disparities: An Overview References Chapter 2: Historical Perspective: The History of Neurosurgery References Chapter 3: The Role of Neurosurgery in Global Health Head Trauma Brief Historical Background Traumatic Brain Injury (TBI): Current Status Prevention Pre-Hospital Care Neuroimaging Surgery Neurocritical Care Rehabilitation Future Opportunities and Unmet Needs References Chapter 4: The Role of Neurosurgery in Global Health Pediatrics Introduction Defining the Pediatric Neurosurgery Specialty Through History The Modern Era and the Birth of Organized Pediatric Neurosurgery Pediatric Neurosurgical Training The Current Status of the Pediatric Neurosurgical Workforce Around the Globe Africa Asia Australia Europe Latin America North America (USA and Canada) Middle Eastern Asia Future Opportunities/Unmet Needs References Chapter 5: The Role of Neurosurgery in Global Health Cerebrovascular Surgery Introduction Brief History of Cerebrovascular Neurosurgery Current Status of Vascular Neurosurgery AVM Surgery Aneurysm Surgery Cavernous Angioma Surgery Carotid Surgery Acute Ischemic Stroke Current Status of Cerebrovascular Surgery Across the Globe References Chapter 6: The Role of Neurosurgery in Global Health Oncology Introduction Neuro-oncology Across the Globe Africa The Neuro-oncology Disease Burden in Africa Limitations in the Accurate Assessment of the Neuro-oncology Disease Burden Neuro-oncology Education and the Way Forward Asia The Neuro-oncology Disease Burden in Asia Brief History of Neuro-oncology in Japan The Japanese Brain Tumor Registry Neuro-oncology Care in Japan Neuro-oncology Education Europe The Neuro-oncology Disease Burden in Europe Average Estimated Brain Tumor Economic Burden Neuro-oncology Training in Europe North America The Neuro-oncology Disease Burden in North America Training in Neuro-oncology in North America Latin America The Neuro-oncology Disease Burden in Latin America Neuro-oncology Care in Latin America Neuro-oncology Education Australia Neuro-oncology Education Conclusion References Chapter 7: The Role of Neurosurgery in Global Spine Health Introduction Brief Historical Background Decompression Techniques Stabilization Techniques Deformity Correction Minimally Invasive Spinal Surgery Current Status of Spinal Neurosurgery Spinal Neurosurgery Clinical Practice Spinal Neurosurgery Research Spinal Neurosurgery Publications Guidelines and Recommendations Spinal Neurosurgery Education The Evolution of Spine Neurosurgery Education Spinal Neurosurgery Education in Latin American: A Pioneer Example Global Spinal Neurosurgery Education Benefits of Global Spinal Neurosurgery Education Spinal Neurosurgery and Community Education Spinal Neurosurgery and Residents’ Training Interactive Spinal Neurosurgery Learning, e-Learning, and Digital Technology Education via Spine Neurosurgery Simulation and Virtual Reality Future Plans and Recommendations Global Spine Health Neurosurgery Spine Education Conclusions Clinical Spine Neurosurgery Spinal Neurosurgery Education References Chapter 8: The Role of Neurosurgery in Global Health Epilepsy, Movement Disorders, and Psychiatric Diseases Introduction Global Stereotactic Radiosurgery Global Epilepsy Surgery Functional and Stereotactic Neurosurgery for Movement Disorders Functional and Stereotactic Neurosurgery for Psychiatric Disorders Conclusion References Chapter 9: The Role of Neurosurgery in Global Health Integrating Mass Casuality Disaster Response Introduction The United Nations (UN) and Disaster Mitigation What Constitutes a Disaster? How Can We Improve Mass Casualty Disaster Response? Chapter Outline Current Status of Mass Casualty Disaster Response Evolution of Disasters Worldwide Current Status of Disaster Response Worldwide Examples of Disaster Response at the Country Level Examples of Disaster Response at the International Level Current Status of Mass Casualty Disaster Response: Summary Resources for Mass Casualty Disaster Response Trauma/Stroke Centers Personnel for Mass Casualty Disaster Response Resilient and Mobile Equipment Telemedicine and Telepresence Information Technology (IT) Drones and Robots Mass Casualty Disaster Response: Improving Global Health Daily The Cost of “Routine” (I.E., Non-disaster) Care: Trauma and Otherwise Integration for Global Health: Across Specialties, Across Countries, and Across Continents Never Let a Disaster Go to Waste References Chapter 10: The Role of Neurosurgery Quality of Care and Patients Safety in Global Health Quality of Care and Patient Safety in Medicine: Historical Background Concepts and Definitions: Quality, Complication, Incident, and Error Access to Healthcare Inequality and Socioeconomic Disparities Global Health Non-governmental Efforts in Quality of Care and Safety Policies Quality of Care and Patients’ Safety Initiatives in Neurosurgery Future Opportunities to Improve Quality of Care and Patients’ Safety Simulation-Based Training Medicine New Therapeutic Frontiers and Artificial Intelligence Telemedicine and Global Access to Care References Chapter 11: Ethical and Legal Consideration in Global Neurosurgery Introduction Ethics, Clinical Ethics, and Values-Based Medicine A Basic Introduction to Ethics Clinical Ethics and Principle-Based Approaches Evidence-Based Medicine and Values-Based Medicine The Definition of Law Implementation of Ethics in Daily Neurosurgical Practice Mental Capacity and Substitute Decision-Making for Informed Consent Illustrative Case Ethical and Legal Perspective on Consent and Consent Without Patient’s Capacity Withdrawal and/or Withholding of Futile Treatment Illustrative Case Ethical and Legal Perspective on Clinical Decision-Making and Withdrawal of Treatment Unconventional Interventions and Patient’s Best Interests Illustrative Case Innovation and Clinical Research Illustrative Case Ethical and Legal Perspective About the Fine Line between Innovation and Clinical Research Transparency in Obtaining Informed Consent Illustrative Case Ethical and Legal Perspective on Transparency Obtaining Informed Consent Ethical Considerations for the Neurosurgery Trainer and Trainee Conflict of Interest: Incentives, Gifts, and Presents “Does the End Justify the Means?” Illustrative Case Ethical and Legal Perspective on Conflict of Interest Public and Private Industry Agreements Conclusion References Chapter 12: The Role of Neurosurgery in Global Health: Future Directions Brief Historical Background Current Status Future Opportunities and Unmet Needs References Part II: Neurosurgery Education Around the World References Chapter 13: Neurosurgery Education Around the World: Africa Introduction Historical Background The African Legacy The Dawn of African Neurosurgery The Neurosurgical Workforce Distribution in Africa: Past and Present Minimizing the Paucity of Neurosurgeons in Africa: From the WFNS Residency Training Center (RTC) to a Widespread African Effort The Impact of Local Training on the Growth of African Neurosurgery The African Neurosurgery Training Curriculum The Current Challenges of Neurosurgical Training in Africa Future Opportunities and Unmet Needs Conclusion References Chapter 14: Neurosurgery Education Around the World: Asia Introduction Neurosurgical Education Japan India China Russia Novosibirsk Research Institute of Traumatology and Orthopedics, Novosibirsk Bangladesh Malaysia Indonesia Pakistan The Philippines Other Asian Countries Neurosurgical Training and Care in Asia: Challenges and Opportunities Conclusion References Suggested Reading Chapter 15: Neurosurgery Education Around the World: Australasia Introduction Historical Background The Royal Australasian College of Surgeons The Neurosurgical Society of Australasia Modern Neurosurgical Training Current Status and Controversies of Neurosurgical Education in Australasia Current Status of Neurosurgical Education Selection of Neurosurgical Trainees Accreditation of Neurosurgical Training Units Controversies in Neurosurgical Education Future Opportunities and Unmet Needs Diversity in the Neurosurgical Workforce Flexible Neurosurgical Training Research in Neurosurgical Training Innovation in Operative Training Conclusion References Chapter 16: Neurosurgery Education Around the World: Europe Historical Background Current Status: What Was Accomplished Until Present Future Opportunities/Unmet Needs References Chapter 17: Neurosurgery Education Around the World: Central and South America Introduction Brief Historical Background Current Status: What Was Accomplished Until the Present Future Opportunities and Unmet Needs References Chapter 18: Neurosurgery Education Around the World: North America Introduction Brief Historical Background Canada The United States Mexico Current Status: What Was Accomplished Till Present Canada The United States Mexico Future Opportunities and Unmet Needs Canada The United States Mexico References Part III: The Economics of Neurosurgery Chapter 19: The Neurosurgery Enterprise and Its Stakeholders Introduction Defining the Neurosurgery Enterprise and Its Complexity Defining the Forces Shaping Neurosurgery Healthcare Delivery Worldwide Externality Government Insurance Medical and Pharmacological Industry Nonprofit and Academic Organizations Uncertainty Conclusion References Chapter 20: Medical Technology Innovation and Entrepreneurship in Neurosurgery Ultrasound-Induced Blood-Brain Barrier Opening: The Neurosurgeon’s SonoCloud Solution Step 1: The Vision Step 2: Preclinical Research Step 3: Translation from “Proof of Concept” to Clinical Trials Step 4: Clinical Trials Step 5: User Adoption Saving Lives by Other Means: Enabling Radiosurgery for Two Million Patients per Year Step 1: My Serendipitous Path Step 2: Leverage Your Environment Step 3: The Business Plan Step 3: User Adoption and Academia Step 4: The Impact of Historic Financial Market Events Step 5: Doing It All Over Again! Conclusions References Chapter 21: Digital Technology in Neurosurgery: A Successful Entrepreneurship Story The Problem The Dawn of New Ideas The Challenge: Creating a Team and a Developing Process The Times and the Spaces: Evolving Toward a Company What Is UpSurgeOn Now and Where Is It Going to? Conclusion and Perspectives References Chapter 22: The Role of Nonprofit and Academic Institutions in Global Neurosurgery Brief Historical Background Current Status Surgical Camps Education Training Research Health System Strengthening, Health Policy, and Advocacy Future Opportunities and Unmet Needs Surgical Camps Education Training Research Health System Strengthening, Health Policy, and Advocacy Conclusion References Chapter 23: The World Health Organization and Neurosurgery Historical Background Modern History Current Status Partnerships with WHO Surgery WHO and Neurosurgery Children’s Neurosurgery Health Facilities Health Systems Medical Equipment Essential Medicines Health Workforce/Training Programs Catastrophic Expenditures National Health Policy Future Opportunities/Unmet Needs References Chapter 24: The Impact of the COVID-19 Pandemic on Neurosurgery Worldwide COVID-19 Impact on Clinical Neurosurgery Prioritization Preoperative Measures and Transformation of the OR Intraoperative Considerations in Neurosurgery Redeployment The Rise in Telehealth for Outpatient Assessment and Postoperative Follow-Up Future Directions: Lessons Learned COVID-19 Impact on Neurosurgery Education and Training Loss of Training Opportunities Adaptations Under Fire Other Concerns of Trainees COVID-19’s Impact on Neurosurgery Research Conclusion References Index