Conceptualising sustainability in the surgical work of non-governmental organisations in low and middle-income countries : a scoping review protocol.

INTRODUCTION: Sustainability remains poorly defined in global surgery, yet is, nevertheless, crucial to the work of non-governmental organisations (NGOs) in low- and middle-income countries (LMICs) aimed at strengthening access to, and quality of, surgical and anaesthesia care. The objective of this protocol is to outline a scoping review that maps what is known in the literature about sustainability in NGO surgical work in LMICs. METHODS: The application of Arksey and O'Malley's six-stage methodological framework is described: identifying research questions; identifying relevant publications; selecting publications; charting the data; reporting results; and stakeholder consultation. The review will include all study designs, as well as editorials, commentaries, sources of unpublished studies and grey literature. Three electronic databases will be searched. Two reviewers will use predefined and iteratively refined selection criteria based on the 'Population-Concept-Context' framework to independently screen titles and abstracts of citations from the search. Disagreements will be resolved together by the reviewers. Full-text screening will also be carried out independently by two reviewers. Disagreements at this stage will be resolved with a third party. The search strategy for grey literature will include searching in ProQuest Dissertations and Theses and the websites listed in a surgical NGO database. Further relevant citations will be identified by screening the reference lists of the included papers. ETHICS AND DISSEMINATION: This review will undertake a secondary analysis of data already collected and does not require ethical approval. The results will be disseminated through journals and conferences targeting surgical NGO stakeholders and global health academics.

"It's all interconnected like a spider web": a qualitative study of the meanings of food and healthy eating in an Indigenous community.

Canadian Indigenous populations are disproportionately affected by rising rates of diet-related chronic disease and have been experiencing rapid lifestyle changes affecting diet. In recognition of these issues, this study aimed to obtain greater understanding of attitudes and meanings around healthy eating in a semi-remote community in Eeyou Istchee. A qualitative study design used semi-structured interviews and observational field notes to explore local accounts of food and health. Two distinct versions of "healthy eating" were identified: one relating to traditional food and preparation methods; the other reflecting medicalised accounts of illness and diagnosed conditions. The latter links with "southern" modes of accessing and preparing food, demonstrating local capacity to adapt to the rapid changes in body, lifestyle and environment being experienced. New connections, associating non-native ways with traditional practices, are being formed where traditional ways of living on the land have been severed. These local accounts show how people are continually negotiating different constructs of "healthy eating." These findings expand current understandings of the context of food and healthy eating in Eeyou Istchee, emphasising present-day and historical experiences of the land. Future research and diet-related health interventions must continue to acknowledge and incorporate local understandings of health to help address the broader socio-political factors that shape Indigenous lifestyles, environments and health.

Delivering genomic medicine in the United Kingdom National Health Service: a systematic review and narrative synthesis.

PURPOSE: We sought to assess the readiness of the United Kingdom (UK) National Health Service to implement a Genomic Medicine Service. We conducted a systematic literature review to identify what is known about factors related to the implementation of genomic medicine in routine health care and to draw out the implications for the UK and other settings. METHODS: Relevant studies were identified in Web of Science and PubMed from their date of inception to April 2018. The review included primary research studies using quantitative, qualitative, or mixed methods, and systematic reviews. A narrative synthesis was conducted. RESULTS: Fifty-five studies met our inclusion criteria. The majority of studies reviewed were conducted in the United States. We identified four domains: (1) systems, (2) training and workforce needs, (3) professional attitudes and values, and (4) the role of patients and the public. CONCLUSION: Mainstreaming genomic medicine into routine clinical practice requires actions at each level of the health-care system. Our synthesis emphasized the organizational, social, and cultural implications of reforming practice, highlighting that demonstration of clinical utility and cost-effectiveness, attending to the compatibility of genomic medicine with clinical principles, and involving and engaging patients are key to successful implementation.

Correction: Delivering genomic medicine in the UK National Health Service: a systematic review and narrative synthesis.

In subsection "Genetics/genomics specialists" sentence beginning "Five…" cited reference 32 (Schwarze et al. 2018) and should have been reference 34 (Carroll et al. 2016). While in subsection "The value of genomic medicine" sentence beginning "V…" should have read "'Vassy et al…." Finally, in the same subsection, sentence beginning "Christensen and," should have read "Christensen and Green." The PDF and HTML versions of the Article have been modified accordingly.