Haitian State Hospital Orthopedic Grand Rounds Series: A Virtual Curriculum to Address Global Surgery Needs.

Background: Orthopedic Relief Services International (ORSI), in partnership with the Foundation for Orthopedic Trauma and the department of Orthopedic Surgery of La Paix University Hospital in Haiti, has developed a year-round Orthopedic Grand Round series. This series is moderated by Haitian faculty, features presentations by American orthopedic surgeons, and is broadcast to major state hospitals in Haiti for residents and attendings. Objective: To introduce clinical concepts and increase knowledge in an area that is medically underserved, especially in the field of orthopedics, through lectures that tailor to the educational needs of Haiti. Methods: Topics for lecture series are requested by Haitian attending orthopedic surgeons and residents in collaboration with American orthopedic surgeons to meet the educational needs of the residents in Haiti. These lectures reflect the case mix typically seen at state hospitals in Haiti and consider the infrastructural capacity of participating centers. Grand rounds are held an average of twice per month for an hour each, encompassing an educational lesson followed by an open forum for questions and case discussion. Feedback is taken from Haitian residents to ensure the sessions are beneficial to their learning. Findings and Conclusions: To date 95 sessions hosted by 32 lecturers have been completed over Zoom between the US and Haiti. The fourth year of the lecture series is currently ongoing with an expansion of topics. In an underserved medical area such as Haiti, programs that educate local surgeons are crucial to continuing the growth and development of the medical community. Programs like this have the potential to contribute to the educational infrastructure of countries in need, regardless of the specialty. The model of this program can be used to produce similar curricula in various specialties and areas around the world.

Sexual Health and Women Living With Spinal Cord Injury: The Unheard Voice.

Women's sexual health within the context of sexual function and psychosocial dimensions while living with a spinal cord injury (SCI) has rarely been discussed separately from men living with a SCI or from a collective with other chronic conditions. To date, over 64,000 women in the U.S. are currently living with SCI, with total numbers increasing each year, as well as the demographics shifting to include more diversity in race and incidences occurring later in life. On average, SCI tends to be acquired during the childbearing years (~30-50 years old), as well as when women experience other health concerns associated with aging, including perimenopause and menopause. Additionally, women's sexual health is often conceptualized from the position of the absence of disease and dysfunction. However, consistent with definitions furthered by the World Health Organization (WHO) and World Association of Sexual Health (WAS), we believe women's sexual health is multifaceted, moving beyond a focus on reproduction to also encompass sexual function and the psychosocial dimensions of sexual health both living with and without disabling conditions and diseases. Within this lens, we present prior research that has been conducted, conclusions from these studies, implications for practice, and recommendations for future research. Thus, the paper will expand the understanding of both sexual function and psychosocial dimensions for women living with SCI.

Problematic secondary health conditions among adults with spinal cord injury and its impact on social participation and daily life.

OBJECTIVE: This exploratory study describes the problematic secondary health conditions among adults with a spinal cord injury (SCI) and the impact these health concerns have on social participation and daily life. DESIGN: Cross-sectional survey design. SETTING: A community-based rehabilitation program within the United States. PARTICIPANTS: Fifty-six adults (33 males and 23 females; age 18 to 73 [M = 39.4, SD = 12.7]) with SCI participating in the community-based rehabilitation program. METHODS: Subjects identified the top five problematic secondary health conditions related to his/her SCI, belief about the impact these conditions have on social participation and daily life, and if they believed the secondary health condition(s) were avoidable. RESULTS: The top problematic areas identified were bladder control, pain, bowel control, and pressure ulcers, and 73% felt these problems were unavoidable. In addition, more than 66% had each of these problems continuously during the last 12 months. When examining the impact of the problematic secondary health conditions, 75% identified that the primary problem had a significant impact on social participation and 64% identified it significantly impacted daily life. CONCLUSION: Although the majority of the participants were actively participating in a community-based rehabilitation wellness program, it appears that they thought engagement in social participation and daily life were negatively impacted by the secondary health conditions and unavoidable. The results suggested unfulfilled goals despite the emphasized efforts of medical providers to help manage the secondary conditions. Future research should examine why individuals with SCI still have a difficult time managing secondary health conditions.

Examining How the Perception of Health Can Impact Participation and Autonomy Among Adults with Spinal Cord Injury.

Background: Studies examining participation as defined by the International Classification of Functioning, Disability and Health (ICF) as well as autonomy among the spinal cord injury population (SCI) are only starting to emerge. Little research has looked at how this population perceives their health status and the role this plays in active participation within their lives. Objective: This exploratory study was developed to determine whether the perception of health has an impact on participation and autonomy among adults with SCI. Methods: A convenience sample of adults with SCI currently receiving outpatient services from a rehabilitation hospital completed the online questionnaire. Forty-two subjects responded and were categorized into 2 groups: Group 1, positive perceived health, and Group 2, negative perceived health. The sample completed the Impact on Autonomy and Participation (IPA) that has 5 subscales (autonomy indoors, family role, autonomy outdoors, social life, and work/education) and demographic questions. Results: Multivariate analysis of variance (MANOVA) revealed that perceived health had a significant impact on family roles, autonomy outdoors, social life, and work/education. Perceived health did not have a significant impact on autonomy indoors. Conclusion: The perception of health may have an impact on participation and autonomy within the areas of family role, outdoors, work/education, and social life. Implications for rehabilitation are included.