Neuroscience Institute, Neurotrauma Group, El Bosque University, Avenue Carrera 9a, 131A-02, Edificio Fundadores, Bogotá, Colombia.
Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA.
Nature. 2015 Nov 19;527(7578):S193-7. doi: 10.1038/nature16035.
Traumatic injury to the brain or spinal cord is one of the most serious public health problems worldwide. The devastating impact of 'trauma', a term used to define the global burden of disease related to all injuries, is the leading cause of loss of human potential across the globe, especially in low- and middle-income countries. Enormous challenges must be met to significantly advance neurotrauma research around the world, specifically in underserved and austere environments. Neurotrauma research at the global level needs to be contextualized: different regions have their own needs and obstacles. Interventions that are not considered a priority in some regions could be a priority for others. The introduction of inexpensive and innovative interventions, including mobile technologies and e-health applications, focused on policy management improvement are essential and should be applicable to the needs of the local environment. The simple transfer of a clinical question from resource-rich environments to those of low- and middle-income countries that lack sophisticated interventions may not be the best strategy to address these countries' needs. Emphasis on promoting the design of true 'ecological' studies that include the evaluation of human factors in relation to the process of care, analytical descriptions of health systems, and how leadership is best applied in medical communities and society as a whole will become crucial.
颅脑或脊髓创伤是全球最严重的公共卫生问题之一。“创伤”一词用于定义与所有损伤相关的全球疾病负担，其具有破坏性的影响是全球范围内人类潜能丧失的主要原因，尤其是在低收入和中等收入国家。要想在全球范围内显著推进神经创伤研究，特别是在服务不足和艰苦环境中，必须应对巨大的挑战。全球层面的神经创伤研究需要具体情况具体分析：不同地区有其自身的需求和障碍。在某些地区不被视为优先事项的干预措施，在其他地区可能是优先事项。引入廉价且创新的干预措施，包括移动技术和电子健康应用程序，以改善政策管理，这是至关重要的，并且应该适用于当地环境的需求。简单地将一个临床问题从资源丰富的环境转移到缺乏复杂干预措施的低收入和中等收入国家，可能不是解决这些国家需求的最佳策略。强调促进真正“生态”研究的设计，包括评估与护理过程相关的人为因素、对卫生系统的分析描述，以及如何在医学社区和整个社会中最好地应用领导力，将变得至关重要。
