Interest In Global Health Research Articles

Factors influencing anesthesia residency selection: impact of global health opportunities.

There is growing evidence to suggest that the current generation of medical students and young physicians is interested in global health. However, there are few data on the interest in global health by students pursuing a career in anesthesiology. The objective of this survey was to evaluate the importance of global health opportunities in regard to applicants' choice of anesthesiology residency programs. Anesthesiology residency program directors in the United States were invited to distribute an online survey to recently matched residents. To reduce study bias, the survey included a wide selection of reasons for program choices in addition to global health. Participants were asked to rate independently, on a scale of 1 to 10 (1 = least important, 10 = most important), the importance that each factor had on their selection of an anesthesiology residency program. Of the 117 U.S. anesthesiology programs contacted, 87 (74%) distributed the survey. Completed surveys were obtained from 582 of 1,092 (53%) polled participants. All factors assessed were rated between 5 and 9 and the global health median [interquartile range] rating was 6 [3-7]. Nearly half of the survey respondents were interested in incorporating global health into future careers. More than three-quarters reported being interested in participating in, or reading about, global health activities during their residency. Responders with previous global health experience, or who were interested in an "in-country" experience, were more likely to choose programs that had global health opportunities available during residency. Anesthesia residency program applicants are interested in global health. Having a global health opportunity was an important reason for choosing a residency program, comparable to some more traditional factors. Regardless of previous global health experience, the majority of future anesthesia residents are either planning or considering participation in global health activities during or after training.

Status of vaccine research and development for norovirus

The global health community is beginning to gain an understanding of the global burden of norovirus-associated disease, which appears to have significant burden in both developed- and developing-country populations. Of particular importance is the growing recognition of norovirus as a leading cause of gastroenteritis and diarrhea in countries where rotavirus vaccine has been introduced. While not as severe as rotavirus disease, the sheer number of norovirus infections not limited to early childhood makes norovirus a formidable global health problem. This article provides a landscape review of norovirus vaccine development efforts. Multiple vaccine strategies, mostly relying on virus-like particle antigens, are under development and have demonstrated proof of efficacy in human challenge studies. Several are entering phase 2 clinical development. Norovirus vaccine development challenges include, but are not limited to: valency, induction of adequate immune responses in pediatric and elderly populations, and potential for vaccine-strain mismatch. Given current strategies and global health interest, the outlook for a norovirus vaccine is promising. Because a norovirus vaccine is expected to have a dual market in both developed and developing countries, there would likely be scale-up advantages for commercial development and global distribution. Combination with or expression by another enteric pathogen, such as rotavirus, could also enhance uptake of a norovirus vaccine.

Introduction of Thoracic CT-Guided Fine-Needle Aspiration to a Resource-Limited Radiology Department in Addis Ababa, Ethiopia

GLOBAL HEALTH AND RADIOLOGY Interest in global health has been on the rise over the past two decades, with a surge of involvement by the medical education community in recent years. In 2010, 30.8% of graduating medical students reported global health experience [1]. Opportunities for participation in international health programs by postgraduate medical trainees in many specialties are many, with 74% of pediatric residency programs, 69% of emergency medicine programs, and 67% of family medicine programs offering international electives according to the AMA’s FREIDA Online database [2]. Diagnostic radiology programs lag behind considerably, with the percentage of programs offering international experience reported at 4% in 2011 [3]. Although organized participation in global health is relatively low for radiology training programs compared with other medical specialties, there is a great need and ample opportunity for a larger presence on the global level. It is estimated that

Mass gatherings: A one-stop opportunity to complement global disease surveillance

Emerging infections including those resulting from the bioterrorist use of infectious agents have indicated the need for global health surveillance. This paper reviews multiple surveillance opportunities presented by mass gatherings (MGs) that align with fundamental questions in epidemiology (why, what, who, where, when and how). Some MGs bring together large, diverse population groups coming from countries with high prevalence of communicable diseases and disparate surveillance capacities. MGs have the potential to exacerbate the transmission dynamics of infectious diseases due to various factors including the high population density and rigor of events, increase in number of people with underlying diseases that predisposes them to disease acquisition, mixing of people from countries or regions with and without efficient disease control efforts, and varying endemicity or existence of communicable diseases in home countries. MGs also have the potential to increase the opportunities for mechanical and even heat-related injuries, morbidity or deaths from accidents, alcohol use, deliberate terrorist attacks with biological agents and/or with explosives and from exacerbation of pre-existing conditions. Responding to these wider range of events may require the use of novel bio-surveillance systems designed to collect data from different sources including electronic and non-electronic medical records from emergency departments and hospitalisations, laboratories, medical examiners, emergency call centres, veterinary, food processors, drinking water systems and even other non-traditional sources such as over-the-counter drug sales and crowd photographs. Well-structured, interoperable real-time surveillance and reporting systems should be integral to MG planning. The increase in magnitude of participants exceeding millions and diversity of people attending MGs can be proactively used to conduct active surveillance of communicable and non-communicable diseases or indicators of global and national public health interest during MGs than can collectively complement efforts to enhance global health security.

Determination of chemical quality parameters in surface water samples from rivers Sava, Danube, and Topciderka

Water quality is defined by numerous physical, chemical and biological parameters, the content of organic and inorganic substances, and its monitoring has become a global health, economic and legal interest in recent decades. In this paper, some of the most important indicators of chemical surface water quality were determined in samples from the river Sava (Ada i Ušće), Danube (Pristanište i Kej) and Topčiderka (Rakovica). Water samples from selected locations were collected in November 2014 and chemical parameters were determined using standard analytical procedures. The results were obtained in the following range: pH (5.71-6.40), content of dissolved oxygen (11.04-11.99 mg/dm3), chloride (20.89-32.82 mg/dm3), alkalinity (207.9-300.9 mg CaCO3/dm3), acidity (31.79-54.90 mg CaCO3/dm3), calcium (37.23-54.90 mg/dm3), magnesium (6.90-23.65 mg/dm3), total water hardness (137.6-235.8 mg CaCO3/dm3), chemical oxygen demand - COD (4.08-9.12 mg O2 /dm3). Tested parameters indicate no significant pollution of the surface water, but in order to perform the correct categorization of water in these rivers, it would be necessary to do further testing of physical, chemical and biological indicators of the water quality.

Building Networks for Global Clinical Research: The Basics.

Over the last several decades, interest in global health across all fields of medicine, including orthopaedic surgery, has grown markedly. Cross-national collaborations are an effective means of conducting high-quality clinical research and offer many advantages over single-center investigations. Successful collaboration requires a well-designed research protocol, development of an effective team structure, and the funding to ensure the project is sustained to completion. Equally important, investigators must consider the social, linguistic, and cultural context in which the study is being undertaken. Although randomized clinical trials are the highest level of evidence, study designs may have to be adapted to accommodate available resources, expertise, and local contextual factors. With appropriate planning, these collaborative endeavors can generate changes in clinical practice and positively impact health policy.

Development of a track in global and humanitarian health for neurology residents.

Neurology trainee interest in global health is rapidly increasing, but few neurology residency programs have formal opportunities for residents to pursue training in global health.1 Residents who participate in rotations abroad are at times inadequately prepared or insufficiently supported, which can lead to a detrimental burden on the host institution and negatively impact residents' experiences.2 We report the development of a track in global and humanitarian health aimed to provide a structured curriculum in the practice of neurology in resource-limited settings for neurology residents. The authors thank Dr. Farrah J. Mateen and Dr. Kate Brizzi for comments on this manuscript.

Global health training in US obstetrics and gynaecology residency programmes: perspectives of students, residents and programme directors

BackgroundBenefits of exposure to global health training during medical education are well documented and residents’ demand for this training is increasing. Despite this, it is offered by few US obstetrics...

Preparing for the Next Epidemic with Basic Virology.

Preparing for the Next Epidemic with Basic Virology.

Introducing global health into the undergraduate medical school curriculum using an e-learning program: a mixed method pilot study.

BackgroundPhysicians need global health competencies to provide effective care to culturally and linguistically diverse patients. Medical schools are seeking innovative approaches to support global health learning. This pilot study evaluated e-learning versus peer-reviewed articles to improve conceptual knowledge of global health.MethodsA mixed methods study using a randomized-controlled trial (RCT) and qualitative inquiry consisting of four post-intervention focus groups. Outcomes included pre/post knowledge quiz and self-assessment measures based on validated tools from a Global Health CanMEDS Competency Model. RCT results were analyzed using SPSS-21 and focus group transcripts coded using NVivo-9 and recoded using thematic analysis.ResultsOne hundred and sixty-one pre-clerkship medical students from three Canadian medical schools participated in 2012–2013: 59 completed all elements of the RCT, 24 participated in the focus groups. Overall, comparing pre to post results, both groups showed a significant increase in the mean knowledge (quiz) scores and for 5/7 self-assessed competencies (p < 0.05). These quantitative data were triangulated with the focus groups findings that revealed knowledge acquisition with both approaches. There was no statistically significant difference between the two approaches. Participants highlighted their preference for e-learning to introduce new global health knowledge and as a repository of resources. They also mentioned personal interest in global health, online convenience and integration into the curriculum as incentives to complete the e-learning. Beta version e-learning barriers included content overload and technical difficulties.ConclusionsBoth the e-learning and the peer reviewed PDF articles improved global health conceptual knowledge. Many students however, preferred e-learning given its interactive, multi-media approach, access to links and reference materials and its capacity to engage and re-engage over long periods of time.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0421-3) contains supplementary material, which is available to authorized users.

Training the next generation of global health advocates through experiential education: A mixed-methods case study evaluation

This case study evaluates a global health education experience aimed at training the next generation of global health advocates. Demand and interest in global health among Canadian students is well documented, despite the difficulty in integrating meaningful experiences into curricula. Global health advocacy was taught to 19 undergraduate students at McMaster University through an experiential education course, during which they developed a national advocacy campaign on global access to medicines. A quantitative survey and an analysis of social network dynamics were conducted, along with a qualitative analysis of written work and course evaluations. Data were interpreted through a thematic synthesis approach. Themes were identified related to students' learning outcomes, experience and class dynamics. The experiential education format helped students gain authentic, real-world experience in global health advocacy and leadership. The tangible implications for their course work was a key motivating factor. While experiential education is an effective tool for some learning outcomes, it is not suitable for all. As well, group dynamics and evaluation methods affect the learning environment. Real-world global health issues, public health practice and advocacy approaches can be effectively taught through experiential education, alongside skills like communication and professionalism. Students developed a nuanced understanding of many strategies, challenges and barriers that exist in advocating for public health ideas. These experiences are potentially empowering and confidence-building despite the heavy time commitment they require. Attention should be given to how such experiences are designed, as course dynamics and grading structure significantly influence students' experience.

Global Noncommunicable Disease Research: Opportunities and Challenges.

Opportunities for collaboration on global noncommunicable disease (NCD) research across international borders and scientific disciplines are increasingly available, coinciding with globalization of science and an unprecedented interest in global health among U.S. students, clinicians, and early-career investigators (1). However, challenges to developing and funding a global NCD research agenda remain. In September 2014, researchers representing 41 institutes, including universities, government agencies, private companies, journals, and foundations in the United States met to discuss the challenges and identify opportunities for moving forward on a global NCD research agenda. Four action items emerged from this conference.

Anesthesia for Children With Craniofacial Abnormalities in the Developing Countries

Interest in global health to provide safer pediatric surgical care in developing countries has increased during the last decade. A collaborative effort between surgeons and anesthesiologists has provided the opportunity to deliver specialized care to children, particularly in the areas of cleft lip and palate repair. However, medical resources, facilities, and adequately trained personnel, especially in pediatric anesthesia, are often limited in these countries. Challenges, educational efforts, and future directions for the globalization of anesthesia are discussed. Involvement of international entities may help raise awareness, channel efforts, expand programs and encourage volunteerism to ultimately provide safer care to pediatric patients, have better outcomes and reduced anesthesia-related morbidity and mortality.

Development of a Global Women's Health Curricular Addition to an Obstetrics and Gynecology Graduate Medical Education Program [83

INTRODUCTION: Interest in global health is growing among residents in obstetrics–gynecology programs; however, few programs have formal curricula in global health. Kacey (2014) found formal training in 34% of U.S. programs and a dedicated rotation in 27%. The goal of this needs-based assessment is to determine University of Vermont obstetrics–gynecology residents' interest and previous experiences in global health to guide the development of a competency-based global health curriculum, including an external rotation. METHODS: Exempt status was obtained from the University of Vermont institutional review board. A literature review of graduate medical education global health participation was conducted. University of Vermont obstetrics–gynecology residents completed a voluntary anonymous survey. Data were analyzed using descriptive statistics. RESULTS: Residents unanimously felt that global health was not included in the residency curriculum. Ninety-two percent of residents had moderate or above average interest in global health education and, interestingly, 69% intended to include global health in their careers. Seventy-six percent described their previous global health experience as minimal or none, but 53% had at least some prior experiences and 46% had formal training. Topics of interest included refugee health, sex trafficking, human immunodeficiency virus and acquired immune deficiency, and female genital mutilation. All residents would participate in an off-site rotation if offered. CONCLUSION AND IMPLICATIONS: Global health is not addressed in the University of Vermont obstetrics–gynecology residency. To meet this need, a competency-based, 2-year curriculum consisting of videos, lectures, and guest speakers will be developed. A Memorandum of Understanding between the University of Vermont and Makerere University (Uganda) will allow an international rotation for residents. Surveys will be administered postimplementation to judge effectiveness.

A Systematic Approach to Developing A Global Surgery Elective

Interest in global health has been increasing for years among American residents and medical students. Many residency programs have developed global health tracks or electives in response to this need. Our goal was to create a global surgery elective based on a synergistic partnership between our institution and a hospital in the developing world. We created a business plan and 1-year schedule for researching potential sites and completing a pilot rotation at our selected hospital. We administered a survey to general surgery residents at the University of Cincinnati and visited medical facilities in Sierra Leone, Cameroon, and Malawi. The survey was given to all general surgery residents. A resident and a faculty member executed the fact-finding trip as well as the pilot rotation. Our general surgery residents view an international elective as integral to residency training and would participate in such an elective. After investigating 6 hospitals in sub-Saharan Africa, we conducted a pilot rotation at our selected hospital and gained the necessary information to organize a curriculum. We will begin sending senior residents for 8-week rotations in the coming academic year. By systematically approaching the process of creating a global surgery elective, we were able to gain considerable insight into choosing a location and organizing the elective.

Resident Participation in International Surgical Missions is Predictive of Future Volunteerism in Practice.

BackgroundInterest in global health and international mission trips among medical student and resident trainees is growing rapidly. How these electives and international mission experiences affect future practice is still being elucidated. No study has identified if participation in international surgical missions during residency is a predictor of participation in international surgical missions in practice after training completion.MethodsAll trainees of our plastic surgery residency program from 1990 to 2011, during the implementation of optional annual international surgical missions, were surveyed to determine if the graduate had gone on a mission as a resident and as a plastic surgeon. Data were compared between graduates who participated in missions as residents and graduates who did not, from 1990 to 2011 and 1990 to 2007.ResultsOf Plastic Surgery graduates from 1990 to 2011 who participated in international missions as residents, 60% participated in missions when in practice, versus 5.9% of graduates participating in missions in practice but not residency (P<0.0001). When excluding last 5 years, graduates participating in international missions in practice after doing so as residents increases to 85.7%, versus 7.41% who participate in practice but not residency P<0.002.ConclusionsResults reveal plastic surgeons who participate in international surgical missions as residents participate in international surgical missions in practice at higher rates than graduates who did not participate in missions during residency. International missions have significant intrinsic value both to trainee and international communities served, and this opportunity should be readily and easily accessible to all plastic surgery residents nationwide.

A global health strategy to capitalize on proven-effective interventions for heart, lung, and blood diseases.

Global health research has historically been a high priority endeavor at the National Institutes of Health (NIH) and currently represents one of the five priorities of the NIH Director.1 Recognizing that science and disease have no national borders, NIH has encouraged its Institutes, Centers, and Offices to work with the Fogarty International Center to support biomedical research and research training across the globe.2, 3 In this effort, many Institutes including the National Institute of Allergy and Infectious Disease, National Cancer Institute, National Eye Institute and National Institute of Environmental Health Sciences, and others, have established or expanded their global health programs. More recently, the US Council on Foreign Relations (CFR) produced a report calling for a more robust US engagement in global health, especially for non-communicable diseases (NCDs).4, 5 In the report, a task force commissioned by CFR analyzed the case for increased U.S. focus on NCDs by examining countries that received significant U.S. health assistance and found that the premature burden of death and disability in many of these countries was heavily NCD-related.5 The CFR finds two compelling global health interests that justify increasing the US engagement with NCDs. First, NCDs undermine the effectiveness of existing U.S. global health investments. Second, NCDs represent an opportunity for the U.S. government to build on existing U.S. global health platforms that can achieve sustainable reductions in premature death and disability that disproportionately affect the poor.

International health electives in orthopaedic surgery residency training.

Residents in surgical training programs today demonstrate an increasingly strong interest in global health. Given the considerable need for specialists in underserved areas, some surgical residency programs offer international health electives in resource-poor settings to augment resident training. This study aims to quantify and to characterize international health elective opportunities among orthopaedic surgery residency programs across the United States. A web-based survey was distributed to program directors and program coordinators of the 154 U.S. orthopaedic surgery residency programs accredited by the Accreditation Council for Graduate Medical Education. Questions assessed the availability and characteristics of international health electives, the barriers to offering opportunities, and the opinions of program directors regarding the value of international health electives in orthopaedic surgery training. Seventy-three orthopaedic surgery residency programs (47.4% response rate) responded to the survey, with twenty-four responses from program directors and forty-nine responses from program coordinators. Nineteen programs (26.0%) offer international elective training opportunities. Fifty programs had notable barriers to offering international electives. These barriers included lack of training time (thirty-seven programs [74%]), lack of funding (thirty-five programs [70%]), and lack of an international partner to facilitate an international health elective (seventeen programs [34%]). Directors of programs that offer international health electives compared with directors of programs that do not offer these electives felt more strongly that international health electives are important in residency training (mean Likert scale score of 4.2 compared with 2.65; p = 0.00195), that international health electives are valuable for residents (mean Likert scale score of 4.6 compared with 3.53; p = 0.0265), and that exposure to international health care should be required during residency training (mean Likert scale score of 3.0 compared with 1.65; p = 0.0194). A minority of the orthopaedic surgery residency programs that participated in this study offers international health elective opportunities to trainees. Barriers such as time parameters and funding limit their availability. Our results characterize international health electives and highlight potential areas of intervention that could increase their availability to a greater number of residents.

Global Health Telemedicine Conferences: The System We Save May Be Our Own.

Global Health Telemedicine Conferences: The System We Save May Be Our Own.

"Polio Eradication" Game May Increase Public Interest in Global Health.

Interactive games that highlight global health challenges and solutions are a potential tool for increasing interest in global health. To test this hypothesis, we developed an interactive "Polio Eradication" (PE) game and evaluated whether playing or watching was associated with increased public interest in global health. The PE game is a life-size, human board game that simulates PE efforts. Four players-a researcher, a transportation expert, a local community coordinator, and a healthcare worker-collaborate as an interdisciplinary team to help limit ongoing and future polio outbreaks in Pakistan, represented on the game board. Participants who played or observed the game and those who did not participate in the game, but visited noninteractive global health exhibits, completed a survey on participation outcomes. We used relative risk regression to examine associations between cofactors and change in global health interest. Three variables predicted increased global health interest among the game participants: Having little or no previous global health knowledge prior to playing the game (risk ratio [RR]=1.28; 95 percent confidence interval [CI], 1.13-1.45), not currently being involved in global health (RR=1.41; 95 percent CI, 1.07-1.85), and visiting Seattle (RR=1.25; 95 percent CI, 1.04-1.51). Our results suggest that a hands-on, interactive game may increase the public's interest in global health, particularly among those with minimal previous knowledge of or involvement in global health activities.