John G Meara
Dados Biográficos
| ID | 1961565 |
|---|---|
| NOME | John G Meara |
| PRENOMES | John G |
| SOBRENOME | Meara |
| ASSINATURA | MEARA J G |
| AFILIAÇÕES | Boston Children's Hospital |
| ORCID | 0000-0003-4369-3209 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 24 |
| TOTAL DE CITAÇÕES | 0 |
| TOTAL COMO AUTOR | 24 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2015 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 0 |
Burn injuries among paediatric patients treated at Mexican public hospitals
INTRODUCTION: Paediatric burns are a leading cause of mortality among Mexican children, yet comprehensive national data are scarce. This retrospective cohort study provides an epidemiological analysis of paediatric burn injuries in Mexico using a nationwide hospitalisation database. METHODS: We conducted a retrospective cohort analysis of all paediatric burn patients aged 0-18 years (ICD-10 codes: T200-T329) who were hospitalised in the Mexican p…
‘Climate Change and Health Indicators’ and ‘Surgical System Strengthening’
Climate change is a public health emergency. Yet, incongruously, the healthcare sector is a significant source of global greenhouse gas emissions. Surgical systems are uniquely situated to address this public health crisis due to the high carbon footprint associated with surgical care delivery and the ability of strong surgical systems to foster broader climate resilience. There is an urgent need for climate change and health indicators (CCHIs) s…
Integrating comprehensive surgical, intensive, and emergency care systems into the Pan American Health Organization’s health agenda
In October 2024, the Pan American Health Organization (PAHO) formally integrated surgical, intensive, and emergency care into its health agenda. This followed important events, including the June 2024 endorsement of the Strategy on Integrated Emergency, Critical and Operative Care 2025-2030 by the PAHO Executive Committee. This strategy builds on the 2015 World Health Assembly (WHA) Resolution 68.15, which recognized surgery as essential to unive…
Energy security as a crucial component of health infrastructure
Energy security, defined as the availability of reliable, clean, and sustainable energy necessary to ensure the continuous operation of health-care facilities, is essential for delivering safe and effective health care. Yet, it is rarely measured, financed, or governed as a component of core health infrastructure. Evidence from nearly a thousand hospitals shows that power outages were common, especially in lower-income settings, disrupting surger…
Task-sharing spinal anaesthesia care in three rural Indian hospitals
BACKGROUND: Task-sharing of spinal anaesthesia care by non-specialist graduate physicians, termed medical officers (MOs), is commonly practised in rural Indian healthcare facilities to mitigate workforce constraints. We sought to assess whether spinal anaesthesia failure rates of MOs were non-inferior to those of consultant anaesthesiologists (CA) following a standardised educational curriculum. METHODS: We performed a randomised, non-inferiority…
Health systems strengthening through surgical and perioperative care pathways
Global health has traditionally focused on the primary health development with disease-specific focus such as HIV, malaria and non-communicable diseases (NCDs). As such, surgery has traditionally been neglected in global health as investment in them is often expensive, relative to these other priorities. Therefore, efforts to improve surgical care have remained on the periphery of initiatives in health system strengthening. However, today, many w…
Building resilient surgical systems that can withstand external shocks
When surgical systems fail, there is the major collateral impact on patients, society and economies. While short-term impact on patient outcomes during periods of high system stress is easy to measure, the long-term repercussions of global crises are harder to quantify and require modelling studies with inherent uncertainty. When external stressors such as high-threat infectious disease, forced migration or climate-change-related events occur, th…
Scalable policy adoption and sustainable implementation of surgical care in the Americas
On September 29, 2023, the Republic of Ecuador convened a meeting to address surgical system strengthening and urge political leaders to invest in surgical infrastructure. The meeting included experts in health diplomacy, innovative financing, implementation strategy and national surgical plans. The event occurred in parallel with the Sixtieth Directing Council of the Pan American Health Organization, Seventy-fifth session of the World Health Org…
Ecuador’s National Surgical Strengthening Plan
Context matters for disability and priority setting for musculoskeletal diseases
Health metrics have evolved with increasing sophistication. The disability-adjusted life-year (DALY) has emerged as a widely used metric. While DALYs vary between countries, the global disability weights (DWs) that are integral to the DALY ignore the potential impact of local factors on the burden of disease. Developmental dysplasia of the hip (DDH), a spectrum of hip pathologies, typically develops during early childhood and is a leading cause o…
A new approach to sustainable surgery
Estimating access to surgical care
Pakistan is a lower middle-income country in South Asia with a population of 225 million. No estimate for surgical care access exists for the country. We postulate the estimated access to surgical care is less than the minimum 80% to be achieved by 2030. We conducted a randomized, stratified two-stage cluster household survey. A sample of 770 households was selected using 2017 census frames from the Pakistan Bureau of Statistics. Data was collect…
Estimating the economic impact of interpersonal violence in Mexico in 2021
Objective. To calculate the economic impact of violence across Mexico in 2021 and project costs for 2021–2030. Methods. Incidence data was obtained from the Executive Secretariat of the National Public Security System, (SESNSP), National Population Council (CONAPO), National Institute of Statistics and Geography (INEGI), and the National Survey of Victimization and Perception of Public Safety (ENVIPE). Our model incorporates incidence estimates o…
Access to paediatric surgery
BACKGROUND: About 96.3 million children and adolescents aged 0-19 years reside in Nigeria, comprising 54% of the population. Without adequate access to surgery for commonly treatable diseases, many face disability and increased risk of mortality. Due to this population's unique perioperative needs, increasing access to paediatric surgical care requires a situational evaluation of the distribution of paediatric surgeons and anaesthesiologists. Thi…
Building safe surgery knowledge and capacity in Cambodia
BACKGROUND: Working in partnership with the Cambodian Ministry of Health, the Safe Surgery 2020 initiative (SS2020) supports the prioritization of surgery and mobilization of resources to target limited workforce capacity. An evaluation study was conducted to assess the impact of SS2020 on intervention hospitals in Cambodia. OBJECTIVE: To understand the impact of the SS2020 program on intervention hospitals in Cambodia by assessing the changes in…
Surgical data strengthening in Ethiopia
Study results are largely positive and make evident that surgical data capture is feasible in low-resource settings and warrants more investment in global surgery efforts. This type of training and mentorship model can be successful in changing individual behavior and institutional culture regarding surgical data collection and reporting. Use of the Kirkpatrick Framework for evaluation of a surgical DQI is an innovative contribution to literature…
The impact of physician migration on mortality in low and middle-income countries
Background: The WHO estimates a global shortage of 2.8 million physicians, with severe deficiencies especially in low and middle-income countries (LMIC). The unequitable distribution of physicians worldwide is further exacerbated by the migration of physicians from LMICs to high-income countries (HIC). This large-scale migration has numerous economic consequences which include increased mortality associated with inadequate physician supply in LMI…
Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries
Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand…
Surgery and universal health coverage
Globalization of national surgical, obstetric and anesthesia plans
Efforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for …
How Should We Decide Whether and When Some Care Is Better Than No Care
This case of cleft lip and palate repair by a surgical mission team is common. Low-risk, single-procedure surgical interventions requiring minimal follow-up with substantial quality of life improvement are well suited for this type of mission. However, cleft repair can also be quite complex and require multiple surgeries and other care over time, postoperative surveillance, and speech therapy. These benefits and burdens prompt us to investigate, …
High-quality health systems in the Sustainable Development Goals era
and respecting all workers to deliver the best care possible. Fourth, governments and civil society should ignite demand for quality in the population to empower people to hold systems accountable and actively seek high-quality care. Additional targeted actions in areas such as health financing, management, district-level learning, and others can complement these efforts. What works in one setting might not work elsewhere, and improvement efforts…
The evolving role of surgery in the international public health agenda
In 2015, the entry of surgery into the public health agenda was marked by three key events. Firstly, the first volume of Disease Control Priorities-3 1 was published by the World Bank -an entire volume devoted to surgery -, showing that despite significant variation in surgical care quality, tackling surgery could be amongst the most cost-effective public health measures to improve the population's health. Secondly, the Lancet Commission on Globa…
Global Surgery 2030
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Global Surgery 2030
The evolving role of surgery in the international public health agenda
In 2015, the entry of surgery into the public health agenda was marked by three key events. Firstly, the first volume of Disease Control Priorities-3 1 was published by the World Bank -an entire volume devoted to surgery -, showing that despite significant variation in surgical care quality, tackling surgery could be amongst the most cost-effective public health measures to improve the population's health. Secondly, the Lancet Commission on Globa…
High-quality health systems in the Sustainable Development Goals era
and respecting all workers to deliver the best care possible. Fourth, governments and civil society should ignite demand for quality in the population to empower people to hold systems accountable and actively seek high-quality care. Additional targeted actions in areas such as health financing, management, district-level learning, and others can complement these efforts. What works in one setting might not work elsewhere, and improvement efforts…
How Should We Decide Whether and When Some Care Is Better Than No Care
This case of cleft lip and palate repair by a surgical mission team is common. Low-risk, single-procedure surgical interventions requiring minimal follow-up with substantial quality of life improvement are well suited for this type of mission. However, cleft repair can also be quite complex and require multiple surgeries and other care over time, postoperative surveillance, and speech therapy. These benefits and burdens prompt us to investigate, …
The impact of physician migration on mortality in low and middle-income countries
Background: The WHO estimates a global shortage of 2.8 million physicians, with severe deficiencies especially in low and middle-income countries (LMIC). The unequitable distribution of physicians worldwide is further exacerbated by the migration of physicians from LMICs to high-income countries (HIC). This large-scale migration has numerous economic consequences which include increased mortality associated with inadequate physician supply in LMI…
Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries
Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand…
Surgery and universal health coverage
Globalization of national surgical, obstetric and anesthesia plans
Efforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for …
Access to paediatric surgery
BACKGROUND: About 96.3 million children and adolescents aged 0-19 years reside in Nigeria, comprising 54% of the population. Without adequate access to surgery for commonly treatable diseases, many face disability and increased risk of mortality. Due to this population's unique perioperative needs, increasing access to paediatric surgical care requires a situational evaluation of the distribution of paediatric surgeons and anaesthesiologists. Thi…
Building safe surgery knowledge and capacity in Cambodia
BACKGROUND: Working in partnership with the Cambodian Ministry of Health, the Safe Surgery 2020 initiative (SS2020) supports the prioritization of surgery and mobilization of resources to target limited workforce capacity. An evaluation study was conducted to assess the impact of SS2020 on intervention hospitals in Cambodia. OBJECTIVE: To understand the impact of the SS2020 program on intervention hospitals in Cambodia by assessing the changes in…
Surgical data strengthening in Ethiopia
Study results are largely positive and make evident that surgical data capture is feasible in low-resource settings and warrants more investment in global surgery efforts. This type of training and mentorship model can be successful in changing individual behavior and institutional culture regarding surgical data collection and reporting. Use of the Kirkpatrick Framework for evaluation of a surgical DQI is an innovative contribution to literature…
Context matters for disability and priority setting for musculoskeletal diseases
Health metrics have evolved with increasing sophistication. The disability-adjusted life-year (DALY) has emerged as a widely used metric. While DALYs vary between countries, the global disability weights (DWs) that are integral to the DALY ignore the potential impact of local factors on the burden of disease. Developmental dysplasia of the hip (DDH), a spectrum of hip pathologies, typically develops during early childhood and is a leading cause o…
A new approach to sustainable surgery
Estimating access to surgical care
Pakistan is a lower middle-income country in South Asia with a population of 225 million. No estimate for surgical care access exists for the country. We postulate the estimated access to surgical care is less than the minimum 80% to be achieved by 2030. We conducted a randomized, stratified two-stage cluster household survey. A sample of 770 households was selected using 2017 census frames from the Pakistan Bureau of Statistics. Data was collect…
Estimating the economic impact of interpersonal violence in Mexico in 2021
Objective. To calculate the economic impact of violence across Mexico in 2021 and project costs for 2021–2030. Methods. Incidence data was obtained from the Executive Secretariat of the National Public Security System, (SESNSP), National Population Council (CONAPO), National Institute of Statistics and Geography (INEGI), and the National Survey of Victimization and Perception of Public Safety (ENVIPE). Our model incorporates incidence estimates o…
Task-sharing spinal anaesthesia care in three rural Indian hospitals
BACKGROUND: Task-sharing of spinal anaesthesia care by non-specialist graduate physicians, termed medical officers (MOs), is commonly practised in rural Indian healthcare facilities to mitigate workforce constraints. We sought to assess whether spinal anaesthesia failure rates of MOs were non-inferior to those of consultant anaesthesiologists (CA) following a standardised educational curriculum. METHODS: We performed a randomised, non-inferiority…
Health systems strengthening through surgical and perioperative care pathways
Global health has traditionally focused on the primary health development with disease-specific focus such as HIV, malaria and non-communicable diseases (NCDs). As such, surgery has traditionally been neglected in global health as investment in them is often expensive, relative to these other priorities. Therefore, efforts to improve surgical care have remained on the periphery of initiatives in health system strengthening. However, today, many w…
Building resilient surgical systems that can withstand external shocks
When surgical systems fail, there is the major collateral impact on patients, society and economies. While short-term impact on patient outcomes during periods of high system stress is easy to measure, the long-term repercussions of global crises are harder to quantify and require modelling studies with inherent uncertainty. When external stressors such as high-threat infectious disease, forced migration or climate-change-related events occur, th…
Scalable policy adoption and sustainable implementation of surgical care in the Americas
On September 29, 2023, the Republic of Ecuador convened a meeting to address surgical system strengthening and urge political leaders to invest in surgical infrastructure. The meeting included experts in health diplomacy, innovative financing, implementation strategy and national surgical plans. The event occurred in parallel with the Sixtieth Directing Council of the Pan American Health Organization, Seventy-fifth session of the World Health Org…
Ecuador’s National Surgical Strengthening Plan
Burn injuries among paediatric patients treated at Mexican public hospitals
INTRODUCTION: Paediatric burns are a leading cause of mortality among Mexican children, yet comprehensive national data are scarce. This retrospective cohort study provides an epidemiological analysis of paediatric burn injuries in Mexico using a nationwide hospitalisation database. METHODS: We conducted a retrospective cohort analysis of all paediatric burn patients aged 0-18 years (ICD-10 codes: T200-T329) who were hospitalised in the Mexican p…
‘Climate Change and Health Indicators’ and ‘Surgical System Strengthening’
Climate change is a public health emergency. Yet, incongruously, the healthcare sector is a significant source of global greenhouse gas emissions. Surgical systems are uniquely situated to address this public health crisis due to the high carbon footprint associated with surgical care delivery and the ability of strong surgical systems to foster broader climate resilience. There is an urgent need for climate change and health indicators (CCHIs) s…
Integrating comprehensive surgical, intensive, and emergency care systems into the Pan American Health Organization’s health agenda
In October 2024, the Pan American Health Organization (PAHO) formally integrated surgical, intensive, and emergency care into its health agenda. This followed important events, including the June 2024 endorsement of the Strategy on Integrated Emergency, Critical and Operative Care 2025-2030 by the PAHO Executive Committee. This strategy builds on the 2015 World Health Assembly (WHA) Resolution 68.15, which recognized surgery as essential to unive…
Energy security as a crucial component of health infrastructure
Energy security, defined as the availability of reliable, clean, and sustainable energy necessary to ensure the continuous operation of health-care facilities, is essential for delivering safe and effective health care. Yet, it is rarely measured, financed, or governed as a component of core health infrastructure. Evidence from nearly a thousand hospitals shows that power outages were common, especially in lower-income settings, disrupting surger…
Medicine (21 obras) · Global Health and Surgery (19 obras) · Global Health Workforce Issues (12 obras) · Health care (9 obras) · Nursing (9 obras) · Political science (8 obras) · Business (7 obras) · Economic growth (7 obras) · Environmental health (6 obras) · Public health (6 obras)