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Item A Global Health Reciprocal Innovation grant programme: 5-year review with lessons learnt(BMJ Publishing, 2023) Ruhl, Laura J.; Kiplagat, Jepchirchir; O'Brien, Rishika; Wools-Kaloustian, Kara; Scanlon, Michael; Plater, David; Thomas, Melissa R.; Pastakia, Sonak; Gopal-Srivastava, Rashmi; Morales-Soto, Nydia; Nyandiko, Winstone; Vreeman, Rachel C.; Litzelman, Debra K.; Laktabai, Jeremiah; Medicine, School of MedicineUnilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as 'reciprocal innovation' (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core elements of RI, a concept informed by a 30-year partnership started between IU (Indiana) and Moi University (Kenya), which leverages knowledge sharing, transformational learning and translational innovations to address shared health challenges. In this paper, we describe the evolution and implementation of an RI grants programme, as well as the challenges faced. We aim to share the successes of our RI engagement and encourage further funding opportunities to promote innovations grounded in the RI core elements. From the complex series of challenges encountered, three major lessons have been learnt: dedicating extensive time and resources to bring different settings together; establishing local linkages across investigators; and addressing longstanding inequities in global health research. We describe our efforts to address these challenges through educational materials and an online library of resources for RI projects. Using perspectives from RI investigators funded by this programme, we offer future directions resulting from our 5-year experience in applying this RI-focused approach. As the understanding and implementation of RI grow, global health investigators can share resources, knowledge and innovations that have the potential to significantly change the face of collaborative international research and address long-standing health inequities across diverse settings.Item Assessing Global Kidney Nutrition Care(Wolters Kluwer, 2022) Wang, Angela Yee-Moon; Okpechi, Ikechi G.; Ye, Feng; Kovesdy, Csaba P.; Brunori, Giuliano; Burrowes, Jerrilynn D.; Campbell, Katrina; Damster, Sandrine; Fouque, Denis; Friedman, Allon N.; Garibotto, Giacomo; Guebre-Egziabher, Fitsum; Harris, David; Iseki, Kunitoshi; Jha, Vivekanand; Jindal, Kailash; Kalantar-Zadeh, Kamyar; Kistler, Brandon; Kopple, Joel D.; Kuhlmann, Martin; Lunney, Meaghan; Mafra, Denise; Malik, Charu; Moore, Linda W.; Price, S. Russ; Steiber, Alison; Wanner, Christoph; Wee, Pieter Ter; Levin, Adeera; Johnson, David W.; Bello, Aminu K.; Medicine, School of MedicineBackground and objectives: Nutrition intervention is an essential component of kidney disease management. This study aimed to understand current global availability and capacity of kidney nutrition care services, interdisciplinary communication, and availability of oral nutrition supplements. Design, setting, participants, & measurements: The International Society of Renal Nutrition and Metabolism (ISRNM), working in partnership with the International Society of Nephrology (ISN) Global Kidney Health Atlas Committee, developed this Global Kidney Nutrition Care Atlas. An electronic survey was administered among key kidney care stakeholders through 182 ISN-affiliated countries between July and September 2018. Results: Overall, 160 of 182 countries (88%) responded, of which 155 countries (97%) answered the survey items related to kidney nutrition care. Only 48% of the 155 countries have dietitians/renal dietitians to provide this specialized service. Dietary counseling, provided by a person trained in nutrition, was generally not available in 65% of low-/lower middle-income countries and "never" available in 23% of low-income countries. Forty-one percent of the countries did not provide formal assessment of nutrition status for kidney nutrition care. The availability of oral nutrition supplements varied globally and, mostly, were not freely available in low-/lower middle-income countries for both inpatient and outpatient settings. Dietitians and nephrologists only communicated "sometimes" on kidney nutrition care in ≥60% of countries globally. Conclusions: This survey reveals significant gaps in global kidney nutrition care service capacity, availability, cost coverage, and deficiencies in interdisciplinary communication on kidney nutrition care delivery, especially in lower-income countries.Item Call for papers: A special issue on tackling emerging infectious diseases(Elsevier, 2021-08-04) Frederickson, Robert M.; Herzog, Roland W.; Pediatrics, School of MedicineItem Creating the Map of Interactive Services Aiding and Assisting Persons With Disabilities (MSAADA) Project: Tutorial for the Novel Use of a Store Locator App(JMIR, 2022-12-08) Etling, Mary Ann; Musili, Michael; Eastes, Kaytlin; Oyungu, Eren; McHenry, Megan S.; Pediatrics, School of MedicineBackground: An estimated 15% of the global population is living with a disability. In Kenya, children with disabilities remain among the most vulnerable populations, experiencing substantial barriers to wellness and inclusion. Smartphone ownership and internet access have been increasing across sub-Saharan Africa, including in Kenya. Despite these advances, online or mobile resources remain limited and difficult to find and navigate. Objective: This paper aims to describe the novel use of a store locator app to develop an interactive map of organizations that provide medical, educational, and socioeconomic resources to individuals with disabilities in Kenya. The target audience is individuals with disabilities, medical professionals, and organization leaders. Methods: A comprehensive list of organizations, government county offices, educational assessment and resource centers, and institutions was compiled. Organizations were contacted via email, WhatsApp, or in person for semistructured interviews. Based on the services offered, each organization was assigned categorical search tags. The data were entered into a third-party store locator app. The resulting map was inserted into a page on the Academic Model Providing Access to Healthcare (AMPATH) website. Results: The Map of Interactive Services Aiding and Assisting Persons With Disabilities (MSAADA; this abbreviation is also Swahili for "help") was launched in July 2020 in both English and Swahili. The map included 89 organizations across Kenya. Of these, 51 were reached for an interview (for a 57% response rate). Interviewees cited limited paid staff and dependence on grant-based funding as primary challenges to growth and sustainability. Conclusions: MSAADA is an interactive, virtual map that aims to connect individuals with disabilities, medical professionals, and organization leaders to resources in Kenya. The novel use of a store locator app to compile resources in remote settings has the potential to improve access to health care for a wide variety of specialties and patient populations. Innovators in global health should consider the use of store locator apps to connect individuals to resources in regions with limited mapping.Item Daily Situational Brief, January 27, 2015(MESH Coalition, 1/27/2015) MESH CoalitionItem Emerging infections and pandemics: The critical importance of global health equity action(Elsevier, 2022) Sam-Agudu, Nadia A.; John, Chandy C.; Pediatrics, School of MedicineItem Enhancing narrative clinical guidance with computer-readable artifacts: Authoring FHIR implementation guides based on WHO recommendations(Elsevier, 2021) Shivers, Jennifer; Amlung, Joseph; Ratanaprayul, Natschja; Rhodes, Bryn; Biondich, Paul; Herron School of Art and DesignIntroduction: Narrative clinical guidelines often contain assumptions, knowledge gaps, and ambiguities that make translation into an electronic computable format difficult. This can lead to divergence in electronic implementations, reducing the usefulness of collected data outside of that implementation setting. This work set out to evolve guidelines-based data dictionaries by mapping to HL7 Fast Health Interoperability Resources (FHIR) and semantic terminology, thus progressing toward machine-readable guidelines that define the minimum data set required to support family planning and sexually transmitted infections. Material and methods: The data dictionaries were first structured to facilitate mapping to FHIR and semantic terminologies, including ICD-10, SNOMED-CT, LOINC, and RxNorm. FHIR resources and codes were assigned to data dictionary terms. The data dictionary and mappings were used as inputs for a newly developed tool to generate FHIR implementation guides. Results: Implementation guides for core data requirements for family planning and sexually transmitted infections were created. These implementation guides display data dictionary content as FHIR resources and semantic terminology codes. Challenges included the use of a two-dimensional spreadsheet to facilitate mapping, the need to create FHIR profiles and resource extensions, and applying FHIR to a data dictionary that was created with a user interface in mind. Conclusions: Authoring FHIR implementation guides is a complex and evolving practice, and there are limited examples for this groundbreaking work. Moving toward machine-readable guidelines by mapping to FHIR and semantic terminologies requires a thorough understanding of the context and use of terminology, an applied information model, and other strategies for optimizing the creation and long-term management of implementation guides. Next steps for this work include validation and, eventually, real-world application. The process for creating the data dictionary and for generating implementation guides should also be improved to prepare for this expanding work.Item Four Learner Categories in Global Health Experiences: A Framework for Successful Resident Engagement(Ubiquity Press, 2022-08-08) Guiles, Daniel A.; Nuwagira, Edwin; Stone, Geren S.; Medicine, School of MedicineAn increasing number of residency programs in the United States now offer global health experiences for trainees, yet many participating residents lack the behaviors and skills needed to engage effectively with local partners and colleagues. In the experience of the authors, trainees working in global settings fall into 1 of 4 learner categories determined by their degree of cultural humility and their willingness to engage with their hosts. This viewpoint proses the concept of "re-orientation," or ongoing structured mentorship, as a way to provide key opportunities for residents to mature in these two important areas during their global experiences. We propose that residencies should incorporate "re-orientation" as a component of their global health rotations in order to provide their trainees with the skills and behaviors to engage successfully with their local colleagues and partners.Item Identifying Gaps in Global Health Dermatology: A Survey of GLODERM Members(Oxford University Press, 2021) McMahon, Devon E.; Oyesiku, Linda; Amerson, Erin; Beltraminelli, Helmut; Chang, Aileen Y.; Forrestel, Amy; Hay, Roderick; Knapp, Alexia; Kovarik, Carrie; Maurer, Toby; Norton, Scott A.; Rehmus, Wingfield; Van Hees, Colette; Wanat, Karolyn A.; Williams, Victoria L.; Fuller, L. Claire; Freeman, Esther E.; Dermatology, School of MedicineItem International pediatric surgery partnerships in sub-Saharan Africa: a scoping literature review(Taylor & Francis, 2022) Woods, Alison; Shofner, Charles; Hodge, Bethany; Pediatrics, School of MedicineBackground: Sub-Saharan Africa (SSA) faces a critical shortage of pediatric surgical providers. International partnerships can play an important role in pediatric surgical capacity building but must be ethical and sustainable. Objective: The purpose of this study is to perform a scoping literature review of international pediatric surgery partnerships in SSA from 2009 to 2019. We aim to categorize and critically assess past partnerships to aid in future capacity-building efforts. Methods: We performed a scoping literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. We searched the PubMed and Embase databases for articles published from 2009 to 2019 using 24 keywords. Articles were selected according to inclusion criteria and assessed by two readers. Descriptive analyses of the data collected were conducted in Excel. Results: A total of 2376 articles were identified. After duplicates were removed, 405 articles were screened. In total, 83 articles were assessed for eligibility, and 62 were included in the review. The most common partnership category was short-term surgical trip (28 articles, 45%). A total of 35 articles (56%) included education of host country providers as part of the partnership. Only 45% of partnerships included follow-up care, and 50% included postoperative outcomes when applicable. Conclusions: To increase sustainability, more partnerships must include education of local health-care providers, and short-term surgical trips must be integrated into long-term partnerships. More partnerships need to report postoperative outcomes and ensure follow-up care. Educating peri-operative providers, training general surgeons in common pediatric procedures, and increasing telehealth use are other goals for future partnerships.
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