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Mascayano F, Lee J, Yang X, Li Z, Casanueva R, Hernández V, Burgos J, Florence AC, Yang LH, Susser E. Defining Urbanicity in the Context of Psychosis Research: A Qualitative Systematic Literature Review. Schizophr Bull 2024:sbae157. [PMID: 39393024 DOI: 10.1093/schbul/sbae157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2024]
Abstract
BACKGROUND AND HYPOTHESIS Numerous studies have found that being born or raised in urban environments increases the odds of developing psychosis in Northern and Western Europe. However, available research from Southern Europe, Latin America, and Asia has reported null results. A limitation in most studies to date is the inadequate characterization of urban and rural life components that may contribute to varying psychosis risk across regions. STUDY DESIGN To deepen our understanding of the different concepts and measures of urbanicity and related factors in psychosis research, we conducted a qualitative systematic literature review extracting information from studies published between 2000 and 2024. STUDY RESULTS Sixty-one articles met the inclusion and exclusion criteria and were used in the thematic analysis. The analysis revealed that urbanicity lacked a single, coherent definition across studies and regions. Three major categories of themes were developed from the analysis: (1) Urbanicity comprises several interconnected constructs, (2) Urbanicity measurements vary between countries from the Global North and the Global South, and (3) Urbanicity operates through key neighborhood-level mechanisms. CONCLUSIONS Future research on urbanicity and psychosis should consider the potential limitations of urbanicity's conceptualization and operationalization and aim to address these limitations by focusing on contextual, historical, and community-level factors, utilizing locally validated measures, and employing mixed-method designs.
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Affiliation(s)
- Franco Mascayano
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, NY, USA
- Global Mental Health Program, Institute of Public Health, Universidad Nacional Andres Bello, Santiago, Chile
| | - Jiwon Lee
- Center for the Treatment and Study of Anxiety, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xinyu Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Zeyu Li
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rodrigo Casanueva
- Global Mental Health Program, Institute of Public Health, Universidad Nacional Andres Bello, Santiago, Chile
| | - Viviana Hernández
- División de Prevención y Control de Enfermedades, Ministerio de Salud, Santiago, Chile
| | - Javiera Burgos
- División de Prevención y Control de Enfermedades, Ministerio de Salud, Santiago, Chile
| | - Ana Carolina Florence
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, NY, USA
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, NY, USA
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Foley S, Falconer Hall T, Bates D, Attridge K. Global health context for the military in Defence Engagement (Health). BMJ Mil Health 2024; 170:e59-e64. [PMID: 37536934 DOI: 10.1136/military-2023-002374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/09/2023] [Indexed: 08/05/2023]
Abstract
Global health practice is becoming a key enabler within UK Defence and foreign policy. The definition of global health remains debated, though some important themes have been identified including: the multidisciplinary nature of global health, its ethical foundation and the political nature of global health. This paper contributes to the ongoing rational discourse that this important discipline deserves and recommends a framework and principles to apply to military health and care system strengthening in the Defence Engagement (Health) (DE(H)) practitioner role. DE(H) involves complex multiorganisational relationships and processes, and while practitioners should be mindful of the political nature of their role, the broad aims of preventing conflict and building stability mean DE(H) should contribute positively to global health.This paper forms part of a special issue of BMJ Military Health dedicated to Defence Engagement.
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Affiliation(s)
- Sue Foley
- Medical Operational Support Unit (MOSU), British Army, York, UK
| | | | - D Bates
- Institute of Health, University of Cumbria, Carlisle, UK
| | - K Attridge
- Public Health, Royal Air Force Medical Service, Naphill, UK
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3
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Suarez-Herrera JC, Abeldaño Zúñiga RA, Díaz-Castro L. Strategic Alliances in Global Health: Innovative Perspectives in the Era of Sustainable Development. Healthcare (Basel) 2024; 12:1198. [PMID: 38921312 PMCID: PMC11204177 DOI: 10.3390/healthcare12121198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/23/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
This article discusses current challenges in the field of global health and the World Health Organization's (WHO) strategies to address them. It highlights the importance of measuring the health impacts of global recession and globalization and the need for human-centered approaches to sustainable development. Emphasis is placed on commitment to health equity and the use of strategic partnerships for health at global, national, and local levels. Improving the health and well-being of populations, as well as public health equity, are core principles of the 2030 Agenda for the Sustainable Development Goals (SDGs). These principles are expressed in SDG 3, which promotes universal access to health services and systems and recognizes global health as a basic human right. It highlights the importance of strategic partnerships to combat emerging health crises, improve public health indices, and address the burden of chronic disease. These partnerships are contemplated in SDG 17 and are manifested in different modalities, such as network governance, cross-sector collaboration, public-private partnership, and social participation. This diversity of alliances has played an important role in scaling up and strengthening universal health systems around the world, including in Latin America and the Caribbean. The text concludes by presenting the essential characteristics of these inter-organizational and inter-institutional alliances in the field of global health.
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Affiliation(s)
- José Carlos Suarez-Herrera
- Office of Research and Knowledge Transfer, Mid-Atlantic University, 35017 Las Palmas de Gran Canaria, Spain;
| | - Roberto Ariel Abeldaño Zúñiga
- Yhteiskuntadatatieteen Keskus, Valtiotieteellinen Tiedekunta, Helsingin Yliopisto, 00150 Helsinki, Finland
- Postgraduate Department, University of Sierra Sur, Oaxaca 70800, Mexico
| | - Lina Díaz-Castro
- Direction of Epidemiological and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, México City 14370, Mexico;
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Abimbola S, van de Kamp J, Lariat J, Rathod L, Klipstein-Grobusch K, van der Graaf R, Bhakuni H. Unfair knowledge practices in global health: a realist synthesis. Health Policy Plan 2024; 39:636-650. [PMID: 38642401 PMCID: PMC11145905 DOI: 10.1093/heapol/czae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
Unfair knowledge practices easily beset our efforts to achieve health equity within and between countries. Enacted by people from a distance and from a position of power ('the centre') on behalf of and alongside people with less power ('the periphery'), these unfair practices have generated a complex literature of complaints across various axes of inequity. We identified a sample of this literature from 12 journals and systematized it using the realist approach to explanation. We framed the outcome to be explained as 'manifestations of unfair knowledge practices'; their generative mechanisms as 'the reasoning of individuals or rationale of institutions'; and context that enable them as 'conditions that give knowledge practices their structure'. We identified four categories of unfair knowledge practices, each triggered by three mechanisms: (1) credibility deficit related to pose (mechanisms: 'the periphery's cultural knowledge, technical knowledge and "articulation" of knowledge do not matter'), (2) credibility deficit related to gaze (mechanisms: 'the centre's learning needs, knowledge platforms and scholarly standards must drive collective knowledge-making'), (3) interpretive marginalization related to pose (mechanisms: 'the periphery's sensemaking of partnerships, problems and social reality do not matter') and (4) interpretive marginalization related to gaze (mechanisms: 'the centre's learning needs, social sensitivities and status preservation must drive collective sensemaking'). Together, six mutually overlapping, reinforcing and dependent categories of context influence all 12 mechanisms: 'mislabelling' (the periphery as inferior), 'miseducation' (on structural origins of disadvantage), 'under-representation' (of the periphery on knowledge platforms), 'compounded spoils' (enjoyed by the centre), 'under-governance' (in making, changing, monitoring, enforcing and applying rules for fair engagement) and 'colonial mentality' (of/at the periphery). These context-mechanism-outcome linkages can inform efforts to redress unfair knowledge practices, investigations of unfair knowledge practices across disciplines and axes of inequity and ethics guidelines for health system research and practice when working at a social or physical distance.
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Affiliation(s)
- Seye Abimbola
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Judith van de Kamp
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Joni Lariat
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Lekha Rathod
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- Luxembourg Operational Research and Epidemiology Support Unit, Médecins Sans Frontières, Luxembourg City L-1617, Luxembourg
| | - Kerstin Klipstein-Grobusch
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Rieke van der Graaf
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
| | - Himani Bhakuni
- Department of Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands
- York Law School, University of York, York YO10 5GD, United Kingdom
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Smith SL, Cho A, Rosenberg SJ, Shiffman J, Shawar YR. Publishing priorities in global health: A framework and empirical analysis. Glob Public Health 2024; 19:2404662. [PMID: 39317420 DOI: 10.1080/17441692.2024.2404662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024]
Abstract
Though vital to health policymaking processes, little is known about the distribution of attention to issues global health journals focus on or their alignment with commitments to health equity. We developed a new framework and methods to help address these analytical gaps. We used content analysis to systematically identify and novel methods to measure attention to themes, subthemes and geographies represented in more than 2,000 research articles published in two of the longest-running multidisciplinary global health journals, Bulletin of the World Health Organization and Health Policy and Planning, between 2004 and 2018. We found four major themes-health systems and conditions received the most attention, followed by population groups and policy dynamics. Finer grained analysis shows that the broad-based journals feature many common themes and some, including subthemes like communicable diseases, financing and children, are heavily favoured over others, such as workforce and noncommunicable diseases. It reveals publishing gaps for some highly marginalised groups and shows attention to health equity fluctuates. The new framework and methods can be used to (1) check the distribution of publishing attention for consistency with global health and specific journal aims and (2) support inquiry into priority setting dynamics in the broader research publishing arena.
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Affiliation(s)
- Stephanie L Smith
- School of Public and International Affairs, Virginia Tech, Arlington, VA, USA
| | - Andrew Cho
- Department of Public Health Studies, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah J Rosenberg
- Department of Political Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy Shiffman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Yusra Ribhi Shawar
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Liwanag HJ, James O, Frahsa A. A review and analysis of accountability in global health funding, research collaborations and training: towards conceptual clarity and better practice. BMJ Glob Health 2023; 8:e012906. [PMID: 38084477 PMCID: PMC10711908 DOI: 10.1136/bmjgh-2023-012906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/21/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Accountability is a complex idea to unpack and involves different processes in global health practice. Calls for accountability in global health would be better translated to action through a better understanding of the concept and practice of accountability in global health. We sought to analyse accountability processes in practice in global health funding, research collaborations and training. METHODS This study is a literature review that systematically searched PubMed and Scopus for articles on formal accountability processes in global health. We charted information on processes based on accountability lines ('who is accountable to whom') and the outcomes the processes were intended for ('accountability for what'). We visualised the representation of accountability in the articles by mapping the processes according to their intended outcomes and the levels where processes were implemented. RESULTS We included 53 articles representing a wide range of contexts and identified 19 specific accountability processes for various outcomes in global health funding, research collaborations and training. Target setting and monitoring were the most common accountability processes. Other processes included interinstitutional networks for peer checking, litigation strategies to enforce health-related rights, special bodies that bring actors to account for commitments, self-accountability through internal organisational processes and multipolar accountability involving different types of institutional actors. Our mapping identified gaps at the institutional, interinstitutional and broader system levels where accountability processes could be enhanced. CONCLUSION To rebalance power in global health, our review has shown that analysing information on existing accountability processes regarding 'who is accountable to whom' and 'accountability for what' would be useful to characterise existing lines of accountability and create lines where there are gaps. However, we also suggest that institutional and systems processes for accountability must be accompanied by political engagement to mobilise collective action and create conditions where a culture of accountability thrives in global health.
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Affiliation(s)
- Harvy Joy Liwanag
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Oria James
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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7
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Younas MI, Iqbal MJ, Aziz A, Sodhro AH. Toward QoS Monitoring in IoT Edge Devices Driven Healthcare-A Systematic Literature Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:8885. [PMID: 37960584 PMCID: PMC10650388 DOI: 10.3390/s23218885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
Smart healthcare is altering the delivery of healthcare by combining the benefits of IoT, mobile, and cloud computing. Cloud computing has tremendously helped the health industry connect healthcare facilities, caregivers, and patients for information sharing. The main drivers for implementing effective healthcare systems are low latency and faster response times. Thus, quick responses among healthcare organizations are important in general, but in an emergency, significant latency at different stakeholders might result in disastrous situations. Thus, cutting-edge approaches like edge computing and artificial intelligence (AI) can deal with such problems. A packet cannot be sent from one location to another unless the "quality of service" (QoS) specifications are met. The term QoS refers to how well a service works for users. QoS parameters like throughput, bandwidth, transmission delay, availability, jitter, latency, and packet loss are crucial in this regard. Our focus is on the individual devices present at different levels of the smart healthcare infrastructure and the QoS requirements of the healthcare system as a whole. The contribution of this paper is five-fold: first, a novel pre-SLR method for comprehensive keyword research on subject-related themes for mining pertinent research papers for quality SLR; second, SLR on QoS improvement in smart healthcare apps; third a review of several QoS techniques used in current smart healthcare apps; fourth, the examination of the most important QoS measures in contemporary smart healthcare apps; fifth, offering solutions to the problems encountered in delivering QoS in smart healthcare IoT applications to improve healthcare services.
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Affiliation(s)
- Muhammad Irfan Younas
- Department of Computer System Engineering, Sukkur IBA University, Sukkur 65200, Pakistan;
- Institute of Space Science and Technology, University of Karachi, Karachi 75270, Pakistan;
| | - Muhammad Jawed Iqbal
- Institute of Space Science and Technology, University of Karachi, Karachi 75270, Pakistan;
| | - Abdul Aziz
- Department of Electrical Engineering, Sukkur IBA University, Sukkur 65200, Pakistan;
| | - Ali Hassan Sodhro
- Department of Computer Science, Kristianstad University, 29188 Kristianstad, Sweden
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Bahattab A, Caviglia M, Martini D, Hubloue I, Della Corte F, Ragazzoni L. Scenario-Based e-Simulation Design for Global Health Education: Theoretical Foundation and Practical Recommendations. J Med Internet Res 2023; 25:e46639. [PMID: 37902810 PMCID: PMC10644186 DOI: 10.2196/46639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/23/2023] [Accepted: 08/08/2023] [Indexed: 10/31/2023] Open
Abstract
Electronic simulation (e-simulation)-particularly scenario-based e-simulation (SBES)-is an increasingly used, promising educational strategy for global health education that can address gaps in training access, effectiveness, and cost. However, there is little guidance for educators on how to develop an SBES, and guidance is lacking outside the clinical context. Moreover, literature on medical education rarely uses the theoretical basis for e-simulation design and development, including for SBES. Hence, we aim to differentiate and describe the concept, design elements, and theoretical basis of SBES with examples from different topics in global health. In addition to enhancing the understanding of the potential of SBES for global health education, this manuscript also provides practical recommendations for global health educators in designing and developing SBESs based on the existing literature and authors' experiences. Overall, this manuscript will be useful for global health educators as well as other medical educators seeking to develop an SBES for similar skill sets.
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Affiliation(s)
- Awsan Bahattab
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
| | - Marta Caviglia
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Daniela Martini
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
| | - Ives Hubloue
- Research Group on Emergency and Disaster Medicine (ReGEDiM), Vrije Universiteit Brussel, Brussels, Belgium
| | - Francesco Della Corte
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Luca Ragazzoni
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università del Piemonte Orientale, Vercelli, Italy
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Zavaleta E, Ferrara F, Zovi A, Díaz-Madriz JP, Fallas-Mora A, Serrano-Arias B, Valentino F, Arguedas-Chacón S, Langella R, Trama U, Nava E. Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis. Cureus 2023; 15:e41414. [PMID: 37546059 PMCID: PMC10403152 DOI: 10.7759/cureus.41414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The increasing emergence and spread of drug-resistant pathogens resulting from inappropriate antibiotic usage have become more evident in recent years, particularly with the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Since joining the Organization for Economic Cooperation and Development (OECD), Costa Rica can now compare its healthcare system with other countries, and similarities have been noted with Italy regarding health indicators. Both nations have universal healthcare systems, covering their entire populations, and hold similar positions in the Human Development Index (HDI). Consequently, the goal is to compare antibiotic prescribing and consumption patterns to collaboratively develop strategies against bacterial resistance. METHODS In order to compare antibiotic consumption between regions, a standardized contrast was utilized, specifically using the defined daily dose (DDD). An Orthogonal Contrast test was performed to test the means, followed by the application of the Student's t-test on these contrasts. This analysis aimed to assess the potential influence of regions on DDD values. Antibiotic consumption data were collected between January 2021 and December 2022 from the Local Health Authority of Naples 3 South (LHANS) in Italy and IMS Health, Q Quintiles, and VIA by way of (IQVIA) reports in Costa Rica. RESULTS LHANS shows a considerable disparity in gross expenditure compared to Italy's overall expenditure, while the private sector of Costa Rica exhibits even lower gross expenditure than Italy. Antibiotic consumption in Italy exceeds that of Costa Rica, with Costa Rica's consumption amounting to 47.70% of Italy's total consumption. Additionally, LHANS exhibited a 22.43% higher gross expenditure compared to the Campania region, emphasizing the variability in antibiotic usage within the same country The results indicated no statistically significant differences in antibiotic consumption between the regions, as none of the null hypotheses were rejected. CONCLUSIONS The study provides valuable insights into expenditure patterns and antibiotic consumption, highlighting the need for improved prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings emphasize the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ugo Trama
- Pharmacy, Ministry of Health, Rome, ITA
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Bendezu-Quispe G, Caira-Chuquineyra B, Fernandez-Guzman D, Casanova-Pérez R, Bendezú-Martínez AG. Massive open online courses: learning opportunities about global health for Latin American countries. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:261-269. [PMID: 37433172 PMCID: PMC10555487 DOI: 10.7705/biomedica.6582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/02/2023] [Indexed: 07/13/2023]
Abstract
INTRODUCTION Massive open online courses provide the opportunity to train health professionals and researchers from Latin America in global health. OBJETIVES To determine the global offer of massive open online courses in global health and the characteristics of their content. MATERIAL AND METHODS We examined massive open online course platforms to compile the global health offerings. The search had no time restriction and was last conducted in November, 2021. The search strategy only included the descriptor “global health”. We obtained the characteristics of the courses, their content, and the global health domain covered. These data were analyzed using descriptive statistics, reporting absolute and relative frequencies. RESULTS Our search strategy identified 4,724 massive open online courses. Of these, only 92 were related to global health. Most of these courses (n=44; 47.8%) were offered through Coursera. More than half (n=50; 54.4%) of the MOOCs were conducted by U.S.A. institutions and in English language (n=90; 97.8%). Most courses focused on “globalization of health and healthcare” (n=24; 26.1%), followed by the domains “capacity building” (n=16; 17.4%), “global burden of disease” and “social and environmental determinants of health” (n=15; 16.3%). CONCLUSIONS We found a high offer of massive open online courses on global health. These courses covered the global health competencies required for health professionals.
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Pratt B, de Vries J. Where is knowledge from the global South? An account of epistemic justice for a global bioethics. JOURNAL OF MEDICAL ETHICS 2023; 49:325-334. [PMID: 36657964 PMCID: PMC10176400 DOI: 10.1136/jme-2022-108291] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/30/2022] [Indexed: 05/14/2023]
Abstract
The silencing of the epistemologies, theories, principles, values, concepts and experiences of the global South constitutes a particularly egregious epistemic injustice in bioethics. Our shared responsibility to rectify that injustice should be at the top of the ethics agenda. That it is not, or only is in part, is deeply problematic and endangers the credibility of the entire field. As a first step towards reorienting the field, this paper offers a comprehensive account of epistemic justice for global health ethics. We first introduce several different conceptions of justice and decolonisation in relation to knowledge, purposefully drawing on work emanating from the global South as well as the global North. We then apply those conceptions to the global health ethics context to generate a tripartite account of the layers of epistemic justice in the field: who is producing ethics knowledge; what theories and concepts are being applied to produce ethics knowledge; and whose voices are sought, recorded and used to generate ethics knowledge. These layers reflect that the field spans conceptual and empirical research. We conclude by proposing that, going forward, three avenues are key to achieve greater epistemic justice at each layer and to help decolonise global health ethics: namely, understanding the problem, dialogue and structural change.
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Affiliation(s)
- Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University - Brisbane Campus, Banyo, Queensland, Australia
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- The Ethics Lab, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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12
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Wu C, Yan LL, Long Q, Liu Y, Tan J, Lou Z, Tang S. Trends in global health research among universities in China: a bibliometric analysis. Glob Health Res Policy 2023; 8:10. [PMID: 37024983 PMCID: PMC10078049 DOI: 10.1186/s41256-023-00295-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND There has been considerable progress in developing global health education and research in China. Nevertheless, evidence of the progress of Chinese universities' contributions to global health research is limited. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health. This study aimed to examine Chinese universities' collective contributions to global health research by describing the longitudinal trends in global health research publications, uncovering research themes in global health, and exploring collaboration patterns. METHODS A comprehensive bibliometric analysis was conducted for original research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China. RESULTS We found that (1) the number of research publications in the field of global health has steadily increased from 2014 to 2020, (2) non-communicable disease was the most popular research topic, accounting for over one-third of total publications, followed by maternal and child health and neurological and mental disorders and diseases, (3) less than one-fifth of papers involved primary data collection, with the majority of the study populations from low-income and lower-middle-income countries in Asia and Africa, and (4) a sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one third from the US. CONCLUSIONS Despite a variety of challenges and barriers, Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications over the last decade. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.
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Affiliation(s)
- Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China.
| | - Lijing L Yan
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Qian Long
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Yunguo Liu
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Jie Tan
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
- School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Zhexun Lou
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
| | - Shenglan Tang
- Global Health Research Center, Duke Kunshan University, Academic Building 3038, No. 8 Duke Avenue, Kunshan, 215316, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Borst RAJ, Wehrens R, Bal R. "And when will you install the new water pump?": disconcerted reflections on how to be a 'good' Global Health scholar. Global Health 2023; 19:19. [PMID: 36944977 PMCID: PMC10029300 DOI: 10.1186/s12992-023-00919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND While critique on Global Health is not new, recent years show a surge of criticism on the field's colonial legacy and practices specifically. Such accounts argue that despite Global Health's strive for universality and equity in health, its activities regularly produce the opposite. The epistemic privileging of Northern academics and scientific method, further augmented by how Global Health funding is arranged, paints a picture of a fragmented field in which 'doing good' has become a normatively laden and controversial term. It is specifically this controversy that we seek to unpack in this paper: what does it take to be a 'good' Global Health scholar? RESULTS We used Helen Verran's notion of 'disconcertment' to analyse three auto-ethnographic vignettes of Robert's Global Health 'fieldwork'. We illustrate that disconcertment, a bodily and personalised experience of unease and conflicting feelings, may serve as an important diagnostic of conflicting imperatives in Global Health. Robert's fieldwork was entangled with incongruous imperatives which he constantly had to navigate through and that repeatedly produced disconcertment. The contribution that we seek to make here is that such disconcertment is not something to defuse or ignore, but to take seriously and stay with instead. CONCLUSION Staying with the disconcertment serves as a starting point for conversations about 'doing good' in Global Health fieldwork and creates opportunity for making Global Health teaching and projects more reflexive. The paper thereby positions itself in discussions about fair collaborations between the Global North and South and our analysis offers a set of considerations that can be used by Northern scholars to critically reflect on their own role within Global Health.
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Affiliation(s)
- Robert A J Borst
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam, 3000DR, the Netherlands.
| | - Rik Wehrens
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam, 3000DR, the Netherlands
| | - Roland Bal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam, 3000DR, the Netherlands
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Nguyen AXL, Xiang L, Chhibber R, Blanchard H, Tikhonova S, Zafran H, Miller CA, Bergevin Y. Student-led interprofessional global health course: learning impacts during a global crisis. BMC MEDICAL EDUCATION 2023; 23:166. [PMID: 36927580 PMCID: PMC10019388 DOI: 10.1186/s12909-023-04116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study assesses the impact of the Interprofessional Global Health Course (IPGHC) on students' fundamental global health knowledge and personal viewpoints on global health domains. It explores the evolution of students' understanding of global health specifically in relation to the COVID-19 pandemic. METHODS Ninety-nine students were selected from 123 McGill student applicants based on their motivation and commitment to take part in IPGHC's ten-week 2020 curriculum. These IPGHC students were eligible to participate in the study. The study's design is sequential explanatory mixed methods. The cross-sectional survey (quantitative phase) appraises students' global health learning outcomes using pre- and post-course surveys, with the use of 5-point Likert-scale questions. The descriptive qualitative survey (qualitative phase) further explores the impact of IPGHC on student's understanding of global health and the reflections of students on the COVID-19 pandemic after IPGHC. The post-course survey included a course evaluation for quality improvement purposes. RESULTS Of the 99 students, 81 students across multiple undergraduate and graduate disciplines participated in the study by completing the course surveys. Mean knowledge scores of the following 11 global health topics were increased between pre- and post-course survey: Canadian Indigenous health (P < 0.001), global burden of disease (P < 0.001), global surgery (P < 0.001), infectious diseases and neglected tropical diseases (P < 0.001), refugee and immigrant health (P < 0.001), research and development of drugs (P < 0.001), role of politics and policies in global health (P = 0.02), role of technology in global health (P < 0.001), sexual violence (P < 0.001), systemic racism in healthcare (P = 0.03), and trauma in the global health context (P < 0.001). A positive change in student viewpoints was observed in response to questions regarding their perception of the importance of global health education in their own professional health care programs (P < 0.001), and their understanding of the roles and responsibilities of other healthcare professionals (P < 0.001). In the post-course survey open-ended questions, students exemplified their knowledge gained during the course to create a more informed definition of global health. Several recurring themes were identified in the student reflections on the COVID-19 pandemic, notably policy and politics, followed by access to healthcare and resources. CONCLUSION This study emphasizes the need for interprofessional global health education at the university level and demonstrates how rapidly global health learners can apply their knowledge to evolving contexts like the COVID-19 pandemic.
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Affiliation(s)
- Anne Xuan-Lan Nguyen
- Faculty of Medicine and Health Sciences, McGill University, 3706 Peel St, H3A 1W9, Montreal, QC, Canada.
| | - Lucille Xiang
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Radhika Chhibber
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Hailey Blanchard
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Svetlana Tikhonova
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Hiba Zafran
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Catherine-Anne Miller
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Yves Bergevin
- Faculty of Medicine and Health Sciences, McGill University, 3706 Peel St, H3A 1W9, Montreal, QC, Canada
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Dosa NP, Ahmed YS, Alriksson-Schmidt A, Castillo H, Contepomi S, Locastro MM, Koning J, Koutsouras G, Kutwa E, Mahorta A, MacFarland S, Öhrvall AM, O’Neill P, Overvelde A, Peny-Dahlstrand M, Shaw A, Stockman J, Tovar-Spinoza Z, Castillo J. Spina Bifida Global Learning Collaborative: Educating the next generation of clinicians, researchers, and advocates. J Pediatr Rehabil Med 2023; 16:657-663. [PMID: 38143399 PMCID: PMC10789363 DOI: 10.3233/prm-230037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
PURPOSE This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees. METHODS Using a descriptive study design, a convenience sample of SB curricula were identified in 2022-23 by members of the Spina Bifida World Congress Outreach Committee and evaluated during a series of monthly Zoom calls to discuss SB education in a global health context. Participants included (1) leadership from the ReachAnother Foundation, (2) invited panelists from the Spina Bifida World Congress Global Health Symposium, and (3) global health students and preceptors. Education initiatives in Ethiopia, Sweden, Argentina, Ecuador, and the United States were evaluated vis-à-vis format and content. RESULTS All of the education initiatives referenced the framework of the World Health Organization International Classification of Functioning, Disability and Health. Formats varied and included both virtual and interactive workshops, print materials, videos, and guides for small group discussion. Content addressed four domains: Folate Prevention, Neurosurgical Training, After Care, and Data Collection. A multidisciplinary approach, partnerships with families, and workforce pipeline training were identified as guiding themes for educating the next generation of SB researchers and clinicians in global health settings. CONCLUSION The Spina Bifida Global Learning Collaborative is a transnational group of advocates, clinicians, and investigators whose mission is the advancement of SB-related global health education. Lessons learned from the collaborative are being leveraged to develop a global health curriculum for learners, which may improve services for individuals with SB around the globe.
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Affiliation(s)
- Nienke P. Dosa
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Yakob S. Ahmed
- ReachAnother Foundation, Bend, OR, USA; Addis Ababa, Ethiopia; and Delft, The Netherlands
| | | | - Heidi Castillo
- Developmental-Behavioral Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX; and Developmental Medicine, Department of Pediatrics, Children’s Nebraska, Omaha, NE, USA
| | | | - Mary M. Locastro
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jan Koning
- ReachAnother Foundation, Bend, OR, USA; Addis Ababa, Ethiopia; and Delft, The Netherlands
| | - George Koutsouras
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Elly Kutwa
- Maseno University School of Medicine and Surgery, Kisumu, Kenya
| | - Anjali Mahorta
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Shade MacFarland
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ann-Marie Öhrvall
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institute, Stockholm, Sweden
| | - Patricia O’Neill
- ReachAnother Foundation, Bend, OR, USA; Addis Ababa, Ethiopia; and Delft, The Netherlands
| | - Anneloes Overvelde
- ReachAnother Foundation, Bend, OR, USA; Addis Ababa, Ethiopia; and Delft, The Netherlands
| | - Marie Peny-Dahlstrand
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Occupational Therapy Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrea Shaw
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jessica Stockman
- Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Zulma Tovar-Spinoza
- Spina Bifida Center of Central New York, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jonathan Castillo
- Developmental-Behavioral Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX; and Developmental Medicine, Department of Pediatrics, Children’s Nebraska, Omaha, NE, USA
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16
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Le Louët H, Pitts PJ. Twenty-First Century Global ADR Management: A Need for Clarification, Redesign, and Coordinated Action. Ther Innov Regul Sci 2023; 57:100-103. [PMID: 35951160 PMCID: PMC9368697 DOI: 10.1007/s43441-022-00443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023]
Abstract
Adverse drug reactions (ADRs) are estimated to be between the fourth and sixth most common cause of death worldwide, taking their place among other prevalent causes of mortality such as heart disease, cancer, and stroke. ADRs impact a broad range of populations across a wide variety of global geography and demographics, with significant mortality and morbidity burden in vulnerable groups such as older people, pediatric populations, and individuals in low-income settings. Too large a share of medicines risk management remains limited to signal detection in big ADR databases (USFDA, EMA, WHO, etc.) This resource allocation is antiquated and applied statistical signal detection methodologies have reached their limits of usefulness. In addition, existing databases are designed for short-term reactions, closely related to medication use and, thus, can only partially assess important broader consequences across geography, time, and clinical relevance. There is an urgent need change the dynamic. We need to identify (earlier and more regularly) many of the important but often overlooked or missed ADRs. Rather than assigning blame, we need to identify the root causes of the problem so they can be clearly addressed and fixed. The public health implications are profound-particularly as we recognize the importance of predicting and mitigating the next pandemic. Consequently, medicines risk management must be integrated within a broader global public health vision. To accomplish this, we need to develop the new tools and methodologies critical to assessing these public health imperatives.
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Affiliation(s)
- Hervé Le Louët
- Council for International Organizations of Medical Sciences (CIOMS), Geneva, Switzerland
| | - Peter J. Pitts
- Center for Medicine in the Public Interest, New York, USA ,University of Paris School of Medicine, Paris, France
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17
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Radhuber IM, Fiske A, Galasso I, Gessl N, Hill MD, Morales ER, Olarte-Sánchez LE, Pelfini A, Saxinger G, Spahl W. Toward global citizenship? People (de)bordering their lives during COVID-19 in Latin America and Europe. Glob Public Health 2023; 18:2285880. [PMID: 38010427 DOI: 10.1080/17441692.2023.2285880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
The COVID-19 pandemic highlighted global interdependencies, accompanied by widespread calls for worldwide cooperation against a virus that knows no borders, but responses were led largely separately by national governments. In this tension between aspiration and reality, people began to grapple with how their own lives were affected by the global nature of the pandemic. In this article, based on 493 qualitative interviews conducted between 2020 and 2021, we explore how people in Argentina, Austria, Bolivia, Ecuador, Ireland, Italy and Mexico experienced, coped with and navigated the global nature of the pandemic. In dialogue with debates about the parameters of the 'global' in global health, we focus on what we call people's everyday (de)bordering practices to examine how they negotiated (dis)connections between 'us' and 'them' during the pandemic. Our interviewees' reactions moved from national containment to an increasing focus on people's unequal socio-spatial situatedness. Eventually, they began to (de)border their lives beyond national lines of division and to describe a new normal: a growing awareness of global connectedness and a desire for global citizenship. This newfound sense of global interrelatedness could signal support for and encourage transnational political action in times of crises.
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Affiliation(s)
| | - Amelia Fiske
- Department of Clinical Medicine, TUM School of Medicine and Health, Institute of History and Ethics in Medicine, Technical University of Munich, Munchen, Germany
| | - Ilaria Galasso
- Department of Clinical Medicine, TUM School of Medicine and Health, Institute of History and Ethics in Medicine, Technical University of Munich, Munchen, Germany
- University College Dublin, Dublin, Ireland
| | - Nicolai Gessl
- Department of Political Science, University of Vienna, Wien, Austria
| | - Michael D Hill
- Department of Anthropology, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Emma R Morales
- Department of Habitat and Urban Development, ITESO, Universidad Jesuita de Guadalajara, Tlaquepaque, Mexico
| | | | - Alejandro Pelfini
- Faculty of Social Sciences, Universidad del Salvador, Buenos Aires, Argentina
- Global Studies Programme, Facultad Latinoamericana de Ciencias Sociales FLACSO-Argentina, Buenos Aires, Argentina
| | - Gertrude Saxinger
- Department of Political Science, University of Vienna, Wien, Austria
| | - Wanda Spahl
- Department of Political Science, University of Vienna, Wien, Austria
- Division Biomedical and Public Health Ethics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
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18
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Shawar YR, Neill R, Kunnuji M, Manoj M, Shiffman J. Understanding resilience, self-reliance and increasing country voice: a clash of ideologies in global health. BMJ Glob Health 2023; 8:e010895. [PMID: 36634980 PMCID: PMC9843176 DOI: 10.1136/bmjgh-2022-010895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND 'Resilience', 'self-reliance' and 'increasing country voice' are widely used terms in global health. However, the terms are understood in diverse ways by various global health actors. We analyse how these terms are understood and why differences in understanding exist. METHODS Drawing on scholarship concerning ideology, framing and power, we employ a case study of a USAID-sponsored suite of awards called MOMENTUM. Applying a meta-ethnographic approach, we triangulate data from peer-reviewed and grey literature, as well as 27 key informant interviews with actors at the forefront of shaping these discourses and those associated with MOMENTUM, working in development agencies, implementing organisations, low-income and middle-income country governments, and academia. RESULTS The lack of common understanding of these three terms is in part a result of differences in two perspectives in global health-reformist and transformational-which are animated by fundamentally different ideologies. Reformists, reflecting neoliberal and liberal democratic ideologies, largely take a technocratic approach to understanding health problems and advance incremental solutions, working within existing global and local health systems to effect change. Transformationalists, reflecting threads of neo-Marxist ideology, see the problems as inherently political and seek to overhaul national and global systems and power relations. These ideologies shape differences in how actors define the problem, its solutions and attribute responsibility, resulting in nuanced differences among global health actors in their understanding of resilience, self-reliance and increasing country voice. CONCLUSIONS Differences in how these terms are employed and framed are not just linguistic; the language that is used is reflective of underlying ideological differences among global health actors, with implications for the way programmes are designed and implemented, the knowledge that is produced and engagement with stakeholders. Laying these distinct ideologies bare may be crucial for managing actor differences and advancing more productive discussions and actions towards achieving global health equity.
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Affiliation(s)
- Yusra Ribhi Shawar
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University Paul H. Nitze School of Advanced International Studies, Washington, DC, USA
| | - Rachel Neill
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Kunnuji
- Department of Sociology, University of Lagos, Akoka, Lagos, Nigeria
| | - Malvikha Manoj
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeremy Shiffman
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University Paul H. Nitze School of Advanced International Studies, Washington, DC, USA
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Furtado JP, Comparato BK, Reis AACD, Nakano AK, Souza LRD. Participation and diversity - the inclusive and multiepistemic construction of Global Health. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222711.06702022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The shaping of a new field to encompass health formulations and practices on a planetary scale must consider the multiple agents and territories involved and their differences and inequalities. The inclusion of different social segments in the decision-making processes and theoretical elaboration of Global Health, through participation, is presented as a strategic and necessary condition for facing transnational issues. This participation ensures political and epistemic diversity in establishing a global health committed to Global Health equity. The Latin American tradition that articulates research and action and the proposal for the Knowledge Meeting can contribute to participatory processes of constituting the field of Global Health in its practical and theoretical aspects.
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20
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Furtado JP, Comparato BK, Reis AACD, Nakano AK, Souza LRD. Participação e diversidade - a construção inclusiva e pluriepistêmica da Saúde Global. CIENCIA & SAUDE COLETIVA 2022; 27:4085-4090. [DOI: 10.1590/1413-812320222711.06702022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
Resumo A conformação de nova área para abarcar formulações e práticas de saúde em escala planetária deve considerar a multiplicidade de agentes e territórios envolvidos, bem como suas diferenças e desigualdades. A inserção dos diversos segmentos sociais nos processos decisórios e de elaborações teóricas da Saúde Global, por meio da participação, apresenta-se como condição estratégica e necessária ao enfrentamento de questões transnacionais. Uma participação que garanta diversidade política e epistêmica na constituição de uma Saúde Global comprometida com a equidade sanitária no plano mundial. A tradição latino-americana que articula pesquisa e ação e a proposta de Encontro de Saberes podem contribuir com processos participativos de constituição do campo da Saúde Global em seus aspectos práticos e teóricos.
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Stein DJ, Shoptaw SJ, Vigo DV, Lund C, Cuijpers P, Bantjes J, Sartorius N, Maj M. Psychiatric diagnosis and treatment in the 21st century: paradigm shifts versus incremental integration. World Psychiatry 2022; 21:393-414. [PMID: 36073709 PMCID: PMC9453916 DOI: 10.1002/wps.20998] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Psychiatry has always been characterized by a range of different models of and approaches to mental disorder, which have sometimes brought progress in clinical practice, but have often also been accompanied by critique from within and without the field. Psychiatric nosology has been a particular focus of debate in recent decades; successive editions of the DSM and ICD have strongly influenced both psychiatric practice and research, but have also led to assertions that psychiatry is in crisis, and to advocacy for entirely new paradigms for diagnosis and assessment. When thinking about etiology, many researchers currently refer to a biopsychosocial model, but this approach has received significant critique, being considered by some observers overly eclectic and vague. Despite the development of a range of evidence-based pharmacotherapies and psychotherapies, current evidence points to both a treatment gap and a research-practice gap in mental health. In this paper, after considering current clinical practice, we discuss some proposed novel perspectives that have recently achieved particular prominence and may significantly impact psychiatric practice and research in the future: clinical neuroscience and personalized pharmacotherapy; novel statistical approaches to psychiatric nosology, assessment and research; deinstitutionalization and community mental health care; the scale-up of evidence-based psychotherapy; digital phenotyping and digital therapies; and global mental health and task-sharing approaches. We consider the extent to which proposed transitions from current practices to novel approaches reflect hype or hope. Our review indicates that each of the novel perspectives contributes important insights that allow hope for the future, but also that each provides only a partial view, and that any promise of a paradigm shift for the field is not well grounded. We conclude that there have been crucial advances in psychiatric diagnosis and treatment in recent decades; that, despite this important progress, there is considerable need for further improvements in assessment and intervention; and that such improvements will likely not be achieved by any specific paradigm shifts in psychiatric practice and research, but rather by incremental progress and iterative integration.
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Affiliation(s)
- Dan J. Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape TownCape TownSouth Africa
| | - Steven J. Shoptaw
- Division of Family MedicineDavid Geffen School of Medicine, University of California Los AngelesLos AngelesCAUSA
| | - Daniel V. Vigo
- Department of PsychiatryUniversity of British ColumbiaVancouverBCCanada
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research DepartmentInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental PsychologyAmsterdam Public Health Research Institute, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Jason Bantjes
- Alcohol, Tobacco and Other Drug Research UnitSouth African Medical Research CouncilCape TownSouth Africa
| | - Norman Sartorius
- Association for the Improvement of Mental Health ProgrammesGenevaSwitzerland
| | - Mario Maj
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
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Målqvist M. Beyond global health: Redefining the ‘public’ in public health. Scand J Public Health 2022; 50:1059-1061. [PMID: 36114648 PMCID: PMC9578087 DOI: 10.1177/14034948221109712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The world has seen unprecedented changes over the last 50 years, with enormous gains in human health and living standards. Global public health has been a part of this transition to an interconnected and interdependent world, evolving from a medically based international health perspective to a global health discipline focusing on the social determinants of health and systems thinking. As we now face global challenges such as climate change, the loss of biodiversity and antimicrobial resistance, global public health needs to be transformed yet again. Public health needs to redefine its focus. To expand the scope beyond the anthropocentric – and to include nature and our planet as subjects and not merely resources for human well-being – is of the essence.
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Affiliation(s)
- Mats Målqvist
- Swedesd – Sustainability Learning and Research Center, Department of Women’s and Children’s Health, University Hospital, Uppsala, Sweden
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What is Global Health Equity? A Proposed Definition. Ann Glob Health 2022; 88:50. [PMID: 35860038 PMCID: PMC9266830 DOI: 10.5334/aogh.3754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022] Open
Abstract
The term “global health equity” has become more visible in recent years, yet we were unable to find a formal definition of the term. Our Viewpoint addresses this gap by offering a discussion of this need and proposing a definition. We define global health equity as mutually beneficial and power-balanced partnerships and processes leading to equitable human and environmental health outcomes (which we refer to as “products”) on a global scale. Equitable partnerships actively work against racism and supremacy. Such partnerships foster processes with these same dynamics; for example, sharing lead authorship responsibilities with meaningful roles for host country researchers to frame relevant questions and to provide context and interpretation for the research findings. Equitable products, such as access to technology and tailored delivery of interventions effective in the specific context, are the fruits of these partnerships and processes.
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Gomes BM, Rebelo CB, Alves de Sousa L. Public health, surveillance systems and preventive medicine in an interconnected world. One Health 2022. [DOI: 10.1016/b978-0-12-822794-7.00006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Garcia-Basteiro AL, Abimbola S. The challenges of defining global health research. BMJ Glob Health 2022; 6:bmjgh-2021-008169. [PMID: 34969684 PMCID: PMC8720987 DOI: 10.1136/bmjgh-2021-008169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Alberto L Garcia-Basteiro
- Centro de Investigação em Saude de Manhiça, Manhiça, Maputo, Mozambique .,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
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