Ethical challenges in global research on health system responses to violence against women: a qualitative study of policy and professional perspectives

BACKGROUND

Studying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of the global research projects on health system responses to VAW.

METHODS

We used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW.

RESULTS

We developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs' rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research.

CONCLUSIONS

The process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics.

The Global Framework for the Progressive Control of Transboundary Animal Diseases - Strengthening Infectious Disease Management and Veterinary Systems Across the Continents: Origins and Testimony

Transboundary animal diseases are defined by the Food and Agriculture Organization (FAO) of the United Nation's Emergency Prevention System as those diseases that are of significant economic, trade and/or food security importance, which can easily spread to other countries and reach epidemic proportions, and where control/management including exclusion requires cooperation among several countries. The Global Framework for the Progressive Control of Transboundary Animal Diseases represents a platform of the FAO and World Organisation for Animal Health to engage regional sub-regional organizations and national veterinary authorities in developing and monitoring progress in animal disease management efforts.

Considerations for establishing and maintaining international research collaboration: the example of chemotherapy-induced peripheral neurotoxicity (CIPN)-a white paper

PURPOSE

This white paper provides guidance regarding the process for establishing and maintaining international collaborations to conduct oncology/neurology-focused chemotherapy-induced peripheral neurotoxicity (CIPN) research.

METHODS

An international multidisciplinary group of CIPN scientists, clinicians, research administrators, and legal experts have pooled their collective knowledge regarding recommendations for establishing and maintaining international collaboration to foster advancement of CIPN science.

RESULTS

Experts provide recommendations in 10 categories: (1) preclinical and (2) clinical research collaboration; (3) collaborators and consortiums; (4) communication; (5) funding; (6) international regulatory standards; (7) staff training; (8) data management, quality control, and data sharing; (9) dissemination across disciplines and countries; and (10) additional recommendations about feasibility, policy, and mentorship.

CONCLUSION

Recommendations to establish and maintain international CIPN research collaboration will promote the inclusion of more diverse research participants, increasing consideration of cultural and genetic factors that are essential to inform innovative precision medicine interventions and propel scientific discovery to benefit cancer survivors worldwide.

RELEVANCE TO INFORM RESEARCH POLICY

Our suggested guidelines for establishing and maintaining international collaborations to conduct oncology/neurology-focused chemotherapy-induced peripheral neurotoxicity (CIPN) research set forth a challenge to multinational science, clinical, and policy leaders to (1) develop simple, streamlined research designs; (2) address logistical barriers; (3) simplify and standardize regulatory requirements across countries; (4) increase funding to support international collaboration; and (5) foster faculty mentorship.

EBRC: Enhancing bioeconomy through research and communication

On September 12, 2022, President Biden issued Executive Order 14081 to enable the progress of biomanufacturing and biotechnology. This timely initiative will help overcome many challenging issues, and its potential impacts will be huge. This article discusses eight recommendations to make this US national initiative successful, encourage other nations to consider similar initiatives, and create a better world for the next generations.

Time to establish an international vaccine candidate pool for potential highly infectious respiratory disease: a community's view

In counteracting highly infectious and disruptive respiratory diseases such as COVID-19, vaccination remains the primary and safest way to prevent disease, reduce the severity of illness, and save lives. Unfortunately, vaccination is often not the first intervention deployed for a new pandemic, as it takes time to develop and test vaccines, and confirmation of safety requires a period of observation after vaccination to detect potential late-onset vaccine-associated adverse events. In the meantime, nonpharmacologic public health interventions such as mask-wearing and social distancing can provide some degree of protection. As climate change, with its environmental impacts on pathogen evolution and international mobility continue to rise, highly infectious respiratory diseases will likely emerge more frequently and their impact is expected to be substantial. How quickly a safe and efficacious vaccine can be deployed against rising infectious respiratory diseases may be the most important challenge that humanity will face in the near future. While some organizations are engaged in addressing the World Health Organization's "blueprint for priority diseases", the lack of worldwide preparedness, and the uncertainty around universal vaccine availability, remain major concerns. We therefore propose the establishment of an international candidate vaccine pool repository for potential respiratory diseases, supported by multiple stakeholders and countries that contribute facilities, technologies, and other medical and financial resources. The types and categories of candidate vaccines can be determined based on information from previous pandemics and epidemics. Each participant country or region can focus on developing one or a few vaccine types or categories, together covering most if not all possible potential infectious diseases. The safety of these vaccines can be tested using animal models. Information for effective candidates that can be potentially applied to humans will then be shared across all participants. When a new pandemic arises, these pre-selected and tested vaccines can be quickly tested in RCTs for human populations.

Forging international collaboration and alliances to establish the largest transplant center in the north of Vietnam

Through collaboration with international experts, our institution established a highly active and successful hematopoietic stem cell transplant program, providing access to this potentially curative treatment modality for patients with a variety of benign and malignant hematological diseases. The initial development of an autologous stem cell transplant program provided our institution with the infrastructure, equipment, and expertise needed for the subsequent development of an allogeneic stem cell transplant program. Key transplant staff received training from international transplant experts at the NHLBI/NIH, the Mayo Clinic, the Johns Hopkins Hospital, and Nagoya Japan, providing them with the expertise to conduct a variety of different transplant approaches, including PBSC transplants from HLA-matched relatives, unrelated cord blood transplants, haploidentical transplants, and CD34 selected stem cell transplants. Patient characteristics were varied among all groups. The number of allogeneic and autologous transplants performed at the NIHBT has increased steadily every year since the initiation of our transplant program. By 2022, 547 transplant procedures had been performed, including 268 autologous and 279 allogeneic transplants. Allogeneic transplants were performed for both malignant and nonmalignant hematological diseases, with acute leukemia (AL) being the most common indication for allogeneic HCT. The majority of recipients undergoing allogeneic transplantation received G-CSF mobilized PBSC allografts from either HLA identical or haplo-identical relatives, with a smaller percentage of patients receiving a UCB transplant or a PBSC allograft that had been CD34+ selected. Amongst the 279 recipients of an allogeneic transplant, mortality rates within day 100 and beyond day 100 were 12.6% and 26.2% respectively. Overall survival (OS) and event-free survival at 5 years in benign and malignant subgroups were 81% and 73% vs 52% and 48% respectively. Through collaboration with international transplant experts, the National Institute of Hematology and Blood Transfusion in Hanoi has stood up the most active transplant center in the northern region of Vietnam. Patients coming from low-income financial backgrounds are now able to receive a variety of different state-of-the-art transplant approaches that are affordable and have been associated with excellent long-term outcomes.

The academic impact and value of an international online surgery lecture series

Due to the worldwide travel restrictions caused by the 2019 coronavirus disease pandemic, many universities and students lost opportunities to engage in international exchange over the past 2 years. Teleconferencing systems have thus been developed to compensate for severe travel restrictions. Kansai Medical University in Japan and Vilnius University in Lithuania have a collaborative research and academic relationship. The two universities have been conducting an online joint international surgery lecture series for the medical students of both universities. Fifteen lectures were given from October 2021 to May 2022. The lectures focused on gastrointestinal surgery, gastroenterology, radiology, pathology, genetics, laboratory medicine, and organ transplantation. A survey of the attendees indicated that they were generally interested in the content and satisfied with attending this lecture series. Our efforts were successful in providing Japanese and Lithuanian medical students with the opportunity to engage in international exchange through lectures held in each other's countries.

Impact of international collaboration on dentistry related papers published in Kingdom of Saudi Arabia

Objective

This bibliographic analysis was designed to review all dental publications in the Kingdom of Saudi Arabia (KSA) and evaluate the effect of international collaboration on the impact of published articles.

Methods

The Web of Science (WOS) database was used to extract all related published articles in the KSA from 1982 to 2021. The keywords were connected using Boolean Operators to download related articles. Downloaded articles were screened according to the following inclusion criteria: collaboration journal category, journal discipline, number of citations, number of authors, and impact factor. After applying the inclusion criteria and excluding single-author articles, 5,689 documents were included in the final analysis. The chi-square test and two-independent samples t-test were used to determine the statistical significance between the variables.

Results

A significantly higher proportion of articles with international collaboration (51.4%) were published in dental journals than those published nationally (43.3%) or within the institutional level (41.8%) (P < 0.0001). In addition, the average number of citations (9.28 ± 23.8) ranged from 0 to 749, received by an article and the impact factor of the journal in which the article was published, significantly higher in the case of internationally collaborative work compared with national or within institutional collaboration (P < 0.0001).

Conclusion

International collaboration positively affected the impact factor, number of citations, and quartile rank of published articles. Moreover, the number of co-authors in different countries contributes to the international collaboration effect.

The challenges of international collaboration in conflict and health research: experience from the Research for Health in Conflict-Middle East and North Africa (R4HC-MENA) partnership

BACKGROUND

Healthcare is a basic human right extending across all humanitarian contexts, including conflict. Globally, two billion people are living under conditions of insecurity and violent armed conflict with a consequent impact on public health. Health research in conflict-affected regions has been recognised as important to gain more understanding of the actual needs of such populations, to optimise healthcare delivery, as well as to inform advocacy and policy change. International collaborative research maximises the resources and skills available for dealing with global health issues, builds capacity and endeavours to ensure the research reflects real needs of the populations. Under the UK's Global Challenge Research Fund in 2017 a number of such international programs were created including the Research for Health in Conflict-Middle East and North Africa (R4HC-MENA) partnership to build capacity in conflict and health research as well as study specific areas, namely noncommunicable diseases in conflict (cancer & mental health) and the political economy of health in conflict.

METHODS

A qualitative study using semi-structured online interviews was conducted to explore researchers' and stakeholders' perspectives on the R4HC-MENA programme over its lifetime from 2017 to 2021. It aimed to understand the factors that influenced and accelerated international collaboration within the R4HC-MENA programme on conflict and health research, and to provide deeper insights into the implementation of the programme. Data collection was conducted from March 2022 to June 2022. Purposive and snowball sampling techniques were used for participant recruitment. Thematic analysis was applied for data analysis.

RESULTS

Twelve researchers/stakeholders participated in this study: four men and eight women. Four main themes were generated: Theme 1: Network building (personal and institutional levels); Theme 2: Hierarchies and power dynamics (power imbalance between different academic status, genders and institutions); Theme 3: Communication challenges; Theme 4: Career development (management, leadership, research, and teaching skills).

CONCLUSIONS

This study provided preliminary insights into perspectives on international collaboration in a major international programme of research on conflict and health. Several key challenges and outputs were generated by the researchers in this study. The findings are important for further developing effective strategies to tackle the challenge of power imbalance and ineffective communication in international research collaborations.

Data on donation behavior towards the conservation of migratory species

The data contains 716 individual decisions and responses from a lab-in-field experiment and an exit questionnaire that were conducted in Denmark, Spain, and Ghana. Individuals were initially asked to perform a small effort task (i.e., correctly counting the number of 1's and 0's in a page) to earn money and subsequently asked how much of their earnings they were willing to donate to BirdLife International to conserve Danish, Spanish, and Ghanaian habitats of the Montagu's Harrier, a migratory bird. The data is useful in understanding individual willingness-to-pay to conserve the habitats of the Montagu's Harrier along its flyway and could aid policymakers in having a clearer and more complete idea of support for international conservation. Among other things, the data can be used to look at the effect of individual socio-demographic characteristics and environmental and donation preferences on actual donation behavior.

Does being stricter mean doing better? Different effects of environmental policy stringency on quality of life, green innovation, and international cooperation

Nowadays, when we are facing several strict regulations, the question arises - does higher strictness lead to the desired results? This study addresses the fact that less research attention has focused on the effects of environmental policy stringency (EPS) on perceived health expressing quality of life, and on green international cooperation. In addition, previous research has provided rather mixed results on the impact of EPS on green innovation. Therefore, we fill an interesting research gap and help better understand the relationship between market-based and non-market-based EPS, perceived health, green innovations, and green international cooperation in OECD (Organization for Economic Co-operation and Development) countries. Using three complementary databases provided by OECD, Eurostat, and the World Bank and the classical linear regression model, we confirm hypotheses that strong market-based EPS and green international cooperation have positive effects on perceived health. Surprisingly, contrary to the findings of prior research, we do not confirm the positive effects of market-based and non-market-based EPS on green international cooperation. This study contributes to the literature on the Porter hypothesis, technological collaborations in green technological development, and environmental innovation theory. In addition, this study provides several practical implications for policymakers across OECD countries.

Evolution and optimization of therapies for acute lymphoblastic leukemia in infants

Acute lymphoblastic leukemia (ALL) in infants accounts for less than 5% of pediatric ALL and is biologically and clinically unique. Approximately 70% to 80% of cases present as an aggressive leukemia with KMT2A gene rearrangement (KMT2A-r), which is one of the most difficult-to-cure forms of pediatric leukemia. Owing to continuing global efforts through multicenter clinical trials since the mid-1990s, a standard of care for infant KMT2A-r ALL, including minimal residual disease-based risk stratifications, "hybrid chemotherapy" incorporating myeloid leukemia-like drugs (e.g., cytarabine) into the ALL chemotherapy backbone, and selective use of allogeneic hematopoietic stem cell transplantation, has now been established. However, there are still many concerns regarding treatment of infants with KMT2A-r ALL, including insufficient efficacy of the current standard therapies, limited pharmacokinetic/pharmacodynamic data on drugs in infants, and management of both acute and late toxicities. Refinements in risk stratification based on leukemia biology, as well as the introduction of emerging novel immunotherapies and molecular-targeted drugs to contemporary therapy, through international collaboration would provide key solutions for further improvement in outcomes.

Using the weighted Lorenz curve to represent balance in collaborations: the BIC indicator

This article aims to add to the body of indicators used to study collaboration in science. We propose a new indicator to measure balance in collaboration (BIC) which is based on the Gini evenness index for a weighted Lorenz curve. The new indicator of balance builds upon and extends the use of, our previously introduced indicator of relative intensity of collaboration (RIC). We present examples based on the collaboration network between the twenty largest countries contributing to science during 2000-2020.

Lessons learned during the COVID-19 pandemic using virtual basic laparoscopic training in Santa Cruz de la Sierra, Bolivia: effects on confidence, knowledge, and skill

BACKGROUND

An international surgical team implemented a virtual basic laparoscopic surgery course for Bolivian general and pediatric surgeons and residents during the COVID-19 pandemic. This simulation course aimed to enhance training in a lower-resource environment despite the challenges of decreased operative volume and lack of in-person instruction.

METHODS

The course was developed by surgeons from Bolivian and U.S.-based institutions and offered twice between July-December 2020. Didactic content and skill techniques were taught via weekly live videoconferences. Additional mentorship was provided through small group sessions. Participants were evaluated by pre- and post-course tests of didactic content as well as by video task review.

RESULTS

Of the 24 enrolled participants, 13 were practicing surgeons and 10 were surgery residents (one unspecified). Fifty percent (n = 12) indicated "almost never" performing laparoscopic surgeries pre-course. Confidence significantly increased for five laparoscopic tasks. Test scores also increased significantly (68.2% ± 12.5%, n = 21; vs 76.6% ± 12.6%, n = 19; p = 0.040). While challenges impeded objective evaluation for the first course iteration, adjustments permitted video scoring in the second iteration. This group demonstrated significant improvements in precision cutting (11.6% ± 16.7%, n = 9; vs 62.5% ± 18.6%, n = 6; p < 0.001), intracorporeal knot tying (36.4% ± 38.1%, n = 9; vs 79.2% ± 17.2%, n = 7; p = 0.012), and combined skill (40.3% ± 17.7%; n = 8 vs 77.2% ± 13.6%, n = 4; p = 0.042). Collectively, combined skill scores improved by 66.3% ± 10.4%.

CONCLUSION

Virtual international collaboration can improve confidence, knowledge, and basic laparoscopic skills, even in resource-limited settings during a global pandemic. Future efforts should focus on standardizing resources for participants and enhancing access to live feedback resources between classes.

Global trends in research on the effects of climate change on Aedes aegypti: international collaboration has increased, but some critical countries lag behind

Background

Mosquito-borne diseases (e.g., transmitted by Aedes aegypti) affect almost 700 million people each year and result in the deaths of more than 1 million people annually.

Methods

We examined research undertaken during the period 1951–2020 on the effects of temperature and climate change on Ae. aegypti, and also considered research location and between-country collaborations.

Results

The frequency of publications on the effects of climate change on Ae. aegypti increased over the period examined, and this topic received more attention than the effects of temperature alone on this species. The USA, UK, Australia, Brazil, and Argentina were the dominant research hubs, while other countries fell behind with respect to number of scientific publications and/or collaborations. The occurrence of Ae. aegypti and number of related dengue cases in the latter are very high, and climate change scenarios predict changes in the range expansion and/or occurrence of this species in these countries.

Conclusions

We conclude that some of the countries at risk of expanding Ae. aegypti populations have poor research networks that need to be strengthened. A number of mechanisms can be considered for the improvement of international collaboration, representativity and diversity, such as research networks, internationalization programs, and programs that enhance representativity. These types of collaboration are considered important to expand the relevant knowledge of these countries and for the development of management strategies in response to climate change scenarios.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05473-7.

Essential signals in publication trends and collaboration patterns in global Research Integrity and Research Ethics (RIRE)

Amid an increasingly demanding research environment, there has been a growing interest in studies concerning Research Integrity and Research Ethics (RIRE). Between 1990 and 2020, over 9700 publications were published to address problematic research conduct such as falsification, plagiarism, and related protocols and standards. In this work, country-level trends and collaborative structures are examined with respect to economic group. Our results showed that RIRE publications are predominantly led by the West, with North America and Western Europe contributing the most. While there is interest within growing economies such as China, the pace is not comparable to its overall publications. However, international collaborations on RIRE grew to account for nearly 30% of all publications on the subject in 2020. Although there is a stronger preference for high income countries to collaborate with other high income countries, we observe a rise in partnerships between high-/middle-income and middle-/lower-income co-authorship pairs in the last decade. These trends point to a maturing global community with distributed knowledge transfer, towards more unified international standards for research ethics and integrity.

COVID-19 convalescent plasma: Current status, lessons from the past and future perspectives

When the COVID-19 pandemic hit, blood transfusion services worldwide started collection of convalescent plasma as early as possible, as exemplified by the response in Norway. There were challenges related to donor selection, donor safety, testing for relevant antibodies and indications for and dosing of the convalescent plasma. As more knowledge became available, the product quality was more standardised. Multiple case reports, observational studies and some randomized studies were published during the pandemic, as well as laboratory studies reporting different approaches to antibody testing. The results were conflicting and the importance of convalescent plasma was disputed.

Even though there has been strong international collaboration with involvement of many key organisations, we may better prepare for the next pandemic. An even stronger, more formalised collaboration between these organisations could provide more clear evidence of the importance of convalescent plasma, based on the principles of passive immunisation.

Malaria from hyperendemicity to elimination along international borders in Yunnan, China during 2003‒2020: a case study

BACKGROUND

Border malaria is one of the most intractable problems hindering malaria elimination worldwide. Movement of both the human population and anopheline mosquitoes infected with Plasmodium spp. can cause cross-border malaria transmission. The Yunnan border area was still hyperendemic for malaria in the early part of this century. The objective of this case study was to analyze the strategies, interventions and impacts of malaria control and elimination in the Yunnan border area.

MAIN TEXT

A total of 10,349 malaria cases and 17.1 per 10,000 person-years of annual parasite incidence (API) were reported in the border area in 2003. Based on natural village-based stratification, integrated interventions, including mass drug administration for radical cures and preventive treatment, clinically presumptive treatment of all febrile patients for malaria and indoor residual spraying or dipping bed nets with insecticides were successfully carried out from 2003 to 2013. The overall API was reduced to 0.6 per 10,000 person-years by 2013, while effective cross-border collaboration interventions dramatically reduced the malaria burden in the neighbouring border areas of Myanmar. From 2014 forward, the comprehensive strategy, including universal coverage of surveillance to detect malaria cases, a rapid response to possible malaria cases and effective border collaboration with neighbouring areas, successfully eliminated malaria and prevented reintroduction of malaria transmission in the Yunnan border area.

CONCLUSIONS

In Yunnan malaria burden has successfully reduced by dynamically accurate stratification and comprehensive interventions; and then the region achieved elimination and prevented reintroduction of malaria transmission through intensive surveillance, rapid response and border collaboration. Other border areas should perform their own intervention trials to develop their own effective strategy.

Global research alliance in infectious disease: a collaborative effort to combat infectious diseases through dissemination of portable sequencing

Objective

To disseminate the portable sequencer MinION in developing countries for the main purpose of battling infectious diseases, we found a consortium called Global Research Alliance in Infectious Diseases (GRAID). By holding and inviting researchers both from developed and developing countries, we aim to train the participants with MinION’s operations and foster a collaboration in infectious diseases researches. As a real-life example in which resources are limited, we describe here a result from a training course, a metagenomics analysis from two blood samples collected from a routine cattle surveillance in Kulan Progo District, Yogyakarta Province, Indonesia in 2019.

Results

One of the samples was successfully sequenced with enough sequencing yield for further analysis. After depleting the reads mapped to host DNA, the remaining reads were shown to map to Theileria orientalis using BLAST and OneCodex. Although the reads were also mapped to Clostridium botulinum, those were found to be artifacts derived from the cow genome. An effort to construct a consensus sequence was successful using a reference-based approach with Pomoxis. Hence, we concluded that the asymptomatic cow might be infected with T. orientalis and showed the usefulness of sequencing technology, specifically the MinION platform, in a developing country.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-05927-2.

An Improved Bibliometric Analysis on Antibiotics in Soil Research

Antibiotic compounds can enter the environment and eventually into drinking water, when manure containing non-metabolized antibiotic residues is applied to agricultural land. In this study, the publication data was analyzed from the aspects of countries, subject categories and keywords during the period of 1946-2016 from Web of Science. The results indicated that, during the period of 2004-2016, the United States, followed by China, dominated the publication of antibiotics in soil. Three most representative subject categories were "Microbiology", "Environmental science and ecology" and "Chemistry". The most studied antibiotic was tetracycline. Antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs) with the fate and transport mechanisms such as degradation, adsorption and desorption were the hot research topics in this field. This study suggests that research on ARB, ARGs and antibiotics in soil should be paid more attention in the future research.

Internationalizing AI: evolution and impact of distance factors

International collaboration has become imperative in the field of AI. However, few studies exist concerning how distance factors have affected the international collaboration in AI research. In this study, we investigate this problem by using 1,294,644 AI related collaborative papers harvested from the Microsoft Academic Graph dataset. A framework including 13 indicators to quantify the distance factors between countries from 5 perspectives (i.e., geographic distance, economic distance, cultural distance, academic distance, and industrial distance) is proposed. The relationships were conducted by the methods of descriptive analysis and regression analysis. The results show that international collaboration in the field of AI today is not prevalent (only 15.7%). All the separations in international collaborations have increased over years, except for the cultural distance in masculinity/felinity dimension and the industrial distance. The geographic distance, economic distance and academic distances have shown significantly negative relationships with the degree of international collaborations in the field of AI. The industrial distance has a significant positive relationship with the degree of international collaboration in the field of AI. Also, the results demonstrate that the participation of the United States and China have promoted the international collaboration in the field of AI. This study provides a comprehensive understanding of internationalizing AI research in geographic, economic, cultural, academic, and industrial aspects.

Health professionals' attitudes toward religiosity and spirituality: a NERSH Data Pool based on 23 surveys from six continents

Background

In order to facilitate better international and cross-cultural comparisons of health professionals (HPs) attitudes towards Religiosity and/or Spirituality (R/S) using individual participant data meta-analysis we updated the NERSH Data Pool.

Methods

We performed both a network search, a citation search and systematic literature searches to find new surveys.

Results

We found six new surveys (N=1,068), and the complete data pool ended up comprising 7,323 observations, including 4,070 females and 3,253 males. Most physicians (83%, N=3,700) believed that R/S had “some” influence on their patients’ health (CI95%) (81.8%–84.2%). Similarly, nurses (94%, N=1,020) shared such a belief (92.5%–95.5%). Across all samples 649 (16%; 14.9%–17.1%) physicians reported to have undergone formal R/S-training, compared with nurses where this was 264 (23%; 20.6%–25.4%).

Conclusions

Preliminary analysis indicates that HPs believe R/S to be important for patient health but lack formal R/S-training. Findings are discussed. We find the data pool suitable as a base for future cross-cultural comparisons using individual participant data meta-analysis.

Measuring Post-training Activities Following a Veterinary Teaching Workshop in East Africa

A teaching workshop was delivered for faculty members of East African colleges of veterinary medicine to foster teaching development and reflection. The goal was for participants to use knowledge gained to improve teaching skills. The approach was to "train the trainer" so attendees could transfer new knowledge to colleagues at their institutions. Techniques were used to increase the likelihood that participants would apply the training. A culturally responsive survey was developed to assess training transfer 1 year later. Pilot survey results suggest that participants applied what they learned and shared with colleagues largely due to peer and supervisor support.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01428-2.

Challenges of evidence synthesis during the 2020 COVID pandemic: a scoping review

AIM

The objectives of this scoping review are to identify the challenges to conducting evidence synthesis during the COVID-19 pandemic and to propose some recommendations addressing the identified gaps.

METHODS

A scoping review methodology was followed to map the literature published on the challenges and solutions of conducting evidence synthesis using the Joanna Briggs Methodology of performing scoping review. We searched several databases from the start of the Pandemic in December 2019 until 10th June 2021.

RESULTS

A total of 28 publications was included in the review. The challenges cited in the included studies have been categorised into four distinct but interconnected themes including: upstream, Evidence synthesis, downstream and contextual challenges. These challenges have been further refined into issues with primary studies, databases, team capacity, process, resources, and context. Several proposals to improve the above challenges included: transparency in primary studies registration and reporting, establishment of online platforms that enables collaboration, data sharing and searching, the use of computable evidence and coordination of efforts at an international level.

CONCLUSION

This review has highlighted the importance of including artificial intelligence, a framework for international collaboration and a sustained funding model to address many of the shortcomings and ensure we are ready for similar challenges in the future.

Exploring the Experiences of Members of the International Food Safety Authorities Network: An Interpretative Phenomenological Analysis

ABSTRACT

The International Food Safety Authorities Network (INFOSAN) is a global network of national food safety authorities from 190 countries, managed jointly by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) that aims to facilitate the rapid exchange of information during food safety incidents. A three-phase study of INFOSAN was launched in 2019 to characterize and examine the network as a functional community of practice and determine its value systematically and rigorously from its members' perspectives. The first two phases of the study involved analyzing the INFOSAN Community Website and surveying of all of its members. The main objective of this third and final phase of the study was to understand the experiences of a small group of INFOSAN members as they relate to various dimensions of membership. A qualitative methodology was used to provide a deeper understanding of members' experiences and supplement the results from the first two quantitative study phases. Interviews were conducted with 10 INFOSAN members from 10 geographic regions, transcribed verbatim, and analyzed using interpretative phenomenological analysis. The results offer an understanding of INFOSAN members' experiences in the context of what participation in this global network means to them and relate to five themes concerning trust, learning, health protection, sense of community, and future potential. The findings suggest that focusing on outreach to sustain personal interest, training to improve technical capacity, and advocacy to obtain political buy-in are ways in which the INFOSAN Secretariat could enable participation and create value at the individual, organizational, and national level, respectively. Such engagement could translate into more effective international communication during urgent food safety incidents and fewer cases of foodborne illness worldwide.

HIGHLIGHTS

The Lake Erie HABs Grab: A binational collaboration to characterize the western basin cyanobacterial harmful algal blooms at an unprecedented high-resolution spatial scale

Monitoring of cyanobacterial bloom biomass in large lakes at high resolution is made possible by remote sensing. However, monitoring cyanobacterial toxins is only feasible with grab samples, which, with only sporadic sampling, results in uncertainties in the spatial distribution of toxins. To address this issue, we conducted two intensive "HABs Grabs" of microcystin (MC)-producing Microcystis blooms in the western basin of Lake Erie. These were one-day sampling events during August of 2018 and 2019 in which 100 and 172 grab samples were collected, respectively, within a six-hour window covering up to 2,270 km² and analyzed using consistent methods to estimate the total mass of MC. The samples were analyzed for 57 parameters, including toxins, nutrients, chlorophyll, and genomics. There were an estimated 11,513 kg and 30,691 kg of MCs in the western basin during the 2018 and 2019 HABs Grabs, respectively. The bloom boundary poses substantial issues for spatial assessments because MC concentration varied by nearly two orders of magnitude over very short distances. The MC to chlorophyll ratio (MC:chl) varied by a factor up to 5.3 throughout the basin, which creates challenges for using MC:chl to predict MC concentrations. Many of the biomass metrics strongly correlated (r > 0.70) with each other except chlorophyll fluorescence and phycocyanin concentration. While MC and chlorophyll correlated well with total phosphorus and nitrogen concentrations, MC:chl correlated with dissolved inorganic nitrogen. More frequent MC data collection can overcome these issues, and models need to account for the MC:chl spatial heterogeneity when forecasting MCs.

Alternatives to Student Outbound Mobility-Improving Students' Cultural Competency Skills Online to Improve Global Health Without Travel

Introduction

Student outbound mobility is a major element in internationalization of medical education and global health education. However, this approach is often criticized, as it is inherently inequitable. Internationalization at home is a newer concept that aims to provide students with international skills and experiences without exchange travel. We report detailed outcomes of an international online program during the COVID-19 pandemic, which aimed to include acquisition of cultural awareness and competency-similar to what the students would have obtained if they had travelled abroad.

Method

Sixty-eight students from 12 international universities participated in international small peer group collaborative work, and online networking. Perceived improvement of cultural competency using Likert scale and open-ended questions was used as a measure of success. Furthermore, students' definition of cultural competency in the different countries was obtained.

Results

Students improved their cultural competency skills. Data analysis supported statistically significant improvement of the above skills after the program, in comparison to the start of the program.

Discussion

Internationalization of medical education can be achieved at home-via structured online peer exchanges-and can provide students with intercultural skills and networking opportunities that are typically achieved via international in-person travel. The above represents a socially just and equitable way to reach all students and can result in improvement of their cultural competency, preparing them for their work in global health, and thereby resulting in improvement of global health.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-021-01332-9.

An international collaboration: Linguistic editing of scholarly work

English as an additional language scholars may be at a disadvantage when submitting manuscripts to most professional publications. This international collaboration between two Sigma chapters provided linguistic review of Jordanian nurses' manuscripts and dissertation chapters by American scholars. The background for the collaboration and the process are described. During the first year, formative evaluation was ongoing, allowing minor revisions to the program. Summative evaluation was completed after one year guided by Stufflebeam's (2014) context, input, process, and product (CIPP) model. Both authors and reviewers indicated satisfaction with the collaboration. All of the authors indicated that the feedback that they had received was clear. All of the reviewers indicated that they were willing to complete additional reviews. The evaluation also indicated areas of concern, including a reviewer's struggle to limit comments to linguistic changes rather than additional suggestions regarding content and discussion.

A brief history of the Italian-Korean symposium on relativistic astrophysics

The series of Italian-Korean Symposia on Relativistic Astrophysics began in 1987, well before the Astrophysics Division of the Korean Physical Society was established in 1995. The symposiums brought together young researchers and scientists of both nations and formed the foundation that would lead to the establishment of the astrophysics division. In this essay, I want to describe a brief history for the series. The series has been ongoing for more than 30 years, thanks to much effort put in by many motivated scientists. The most recent event was in 2019 at Pescara, Italy.

Education for future biobankers - The state-of-the-art and outlook

Biobanking as a quickly growing branch of personalised medicine has undergone enormous progress during last two decades. Nowadays it is a well developed and structured multidisciplinary field that reflects developments and advances of biomedical research based on principles of predictive, preventive and personalised medicine (PPPM/3PM). All these trends in PPPM progress have to be translated into practice and education of new generation of scientists and healthcare givers. The importance of biobanks for multitasking research, personalised treatment, and health care systems was emphasised by many scientists and health care experts. As biobanking carries multidisciplinary character currently including more professionals than ten—twenty years ago, new generation of professional biobankers is urgently needed. To create new generation of biobankers who are fully competent to answer more and more scientific and practical questions, new study programmes, novel university curricula, and topic-dedicated courses are essential. The aim of the review is to present basic forms, trends of biobanking education offered by various biobanking related bodies and to highlight future needs. The first step is to cover all activities and duties of biobanks: acquiring, collecting, storageing and sharing biological samples and associated data, using adequate assessment for both - materials and data, taking into consideration ethical, legal, and societal issues (ELSI), responding to all stakeholder needs including pharmaceutical and other related industries, patient organisations and many other interested groups, emerging technologies and innovations as well as current and future requirements of health care systems. To compile educational programmes is a comprehensive task for all actors involved in the field of biobanking who contribute to the harmonised process of creating high educational level for future generation of biobankers. The exchange of experience involving extensive international collaboration is the way how to facilitate the process of creating optimal biobanking education.

Cranioplasty Using Customized 3-Dimensional-Printed Titanium Implants: An International Collaboration Effort to Improve Neurosurgical Care

BACKGROUND

Evolutions in cranioplasty have allowed for the creation of customized implants via advances in 3-dimensional (3D) printing technology, although the high cost associated with this technique presents a barrier for low-income countries. Through an international collaboration, our team in Da Nang, Vietnam is able to create low-cost, customized titanium implants for patients with skull defects. We discuss the details of our collaboration and present our experience with this procedure.

METHODS

We conducted a retrospective review of 35 patients who underwent cranioplasty using custom-made titanium implants. The molding and implant making processes were performed by our neurosurgeons using a 3D printer donated by the United Kingdom-based nongovernmental organization Facing the World. We obtained demographic and preoperative data (reason for skull defect, location, surface area measurement of defect) and postoperative data (complications, cosmetic outcome, and patient satisfaction).

RESULTS

The median patient age was 27 years (range, 16-60 years). Primary indications for craniectomy included traumatic brain injury from motor vehicle accident (77.1%), cerebrovascular disease (11.4%), implant failure following previous cranioplasty (5.7%), and fall (5.7%). Postoperatively, all implants were found to have an excellent fit; at 6-month follow-up, none of the implants required removal. Complications included 4 postoperative hematomas and 1 surgical site infection. All the patients had improved aesthetic appearance and high satisfaction.

CONCLUSIONS

Cranioplasty using customized titanium implants yields excellent results for patients with skull defects, demonstrating the practicality of this technique for cranioplasty in low-income countries. Our experience highlights the importance of ongoing international collaboration to improve neurosurgical care in these countries.

Trends in funding research and international collaboration on greenhouse gas emissions: a bibliometric approach

The Web of Science Core Collection platform was used to withdraw the papers included in this study. The studied period comprised from inception till 2018. Trends in research, journals of publication, subject areas of research, keywords most frequently used, countries of publication, international collaboration, and trends of funding research were also analyzed. A total of 3902 articles were published, most of them (52.5%) during the five-year period 2014-2018. The area with the highest number of papers was environmental sciences (41%), followed by energy fuels (16.6%) and engineering environmental (15.7%). "Nitrous oxide emissions" was the most frequent word, followed by "Carbon dioxide emissions" and "Methane emissions". Other words that stood out were "Life cycle assessment", "Climate change" and "Environmental impacts". The United States was the country with the highest productivity (27.9%), followed by China (12.8%) and the United Kingdom (9.6%). There was a concentration of research in recent years, as more than 80% of the papers were published in the last 10 years. The journals that published the largest number of publications were devoted mainly to environmental studies (sciences and engineering), sustainable and green science and technology, energy and fuels, economics, and agriculture. Half of the works were published in Europe and the other half between North America and Asia. Two thirds of the works (67%) were financed compared to a third that were not financed. The percentage of funded works has been increasing over the last decade, which is seen as an indication of the importance of GHGE.

International collaboration during the COVID-19 crisis: autumn 2020 developments

After the initial shock of the early months of the global COVID-19 pandemic, international collaboration in COVID-19 research continues to show aberrant patterns compared to coronavirus research in pre-COVID times. The most affected nations tend to produce the greatest number of coronavirus articles, with output closely coupled to the rate of infection. COVID-19 research has fewer nations and smaller teams than pre-COVID research, a trend which intensifies throughout the pandemic. The United States remains the single largest contributor to the global publication output, but contrary to China's dominance in the initial months of the pandemic, China's contribution falls as the national COVID-19 caseload drops. China-USA collaborations drop as the pandemic continues, perhaps due to China's reduced rate of publication on the topic, and perhaps due to political obstacles, or a combination of these factors.

Assessing the Integration of Behavioral Health Services in Primary Care in Colombia

Integration of behavioral health care into primary care can improve health and economic outcomes. This study adapted the Behavioral Health Integration in Medical Care (BHIMC) index to the Colombian context and assessed the baseline level of behavioral health integration in a sample of primary care organizations. The BHIMC was able to detect the capacity to provide integrated behavioral care in Colombian settings. Results indicate a minimal to partial integration level across all sites, and that it is possible to measure the degree of integrated care capacity and identify improvement areas for better behavioral health care provision.

Exploring the International Food Safety Authorities Network as a Community of Practice: Results from a Global Survey of Network Members

ABSTRACT

The International Food Safety Authorities Network (INFOSAN) is a global network of national food safety authorities from 190 countries, managed jointly by the Food and Agriculture Organization of the United Nations and the World Health Organization, which facilitates the rapid exchange of information during food safety incidents. Until now, INFOSAN has not been characterized or examined as a functional community of practice, and its value, as understood from the perspective of its members, has not been determined in a systematic or rigorous way. The purpose of this study was to explore and describe the experiences and opinions of INFOSAN members to better understand the role of the network in improving food safety and mitigating the burden of foodborne illness globally. There were four main research questions: (i) How is the INFOSAN Community Website being used to support network activities? (ii) What are the barriers to active participation in INFOSAN? (iii) Do INFOSAN members believe that participation in the network prevents foodborne illness and saves lives? and (iv) Does participation in INFOSAN create value for members, and if so, through what mechanisms does this occur? To answer these questions, an online questionnaire was developed and adapted from English into French and Spanish before being disseminated to INFOSAN members. Responses were received from 239 INFOSAN members in 137 countries over a 10-week period between August and October 2019. This study represents the first to explore and describe the experiences of INFOSAN members with respect to their participation in network activities to improve global food safety and prevent foodborne diseases and to describe the characteristics of INFOSAN as a community of practice. The results suggest that INFOSAN is a valued tool, used globally to reduce the burden of foodborne illness and save lives. The INFOSAN Secretariat could use the results to prioritize future activities to further strengthen the network and support participation of members.

HIGHLIGHTS

International Collaboration and European Contributions to International Business Research

This study measures and ranks the performance of nations and academic institutions based on a 45-year analysis of international business (IB) publications, including 5853 academic authors from 1542 affiliated institutions. Examining authors’ academic origin and university of affiliation, and with a focus on the European nations that participated in the production of IB research, we make several novel contributions to the field: (1) identifying a unique internationalization process of IB research that consists of three distinct stages driven by international collaboration, (2) highlighting the role of international collaborations in overcoming publication barriers at the regional and country level, and (3) highlighting the role of both scale and scope of international collaborations in achieving a top-ranked position in the production of IB research.

AFHVS 2020 presidential address: pushing beyond the boundaries

In this 2020 AFHVS Presidential Address, Molly Anderson suggests that we must push beyond the boundaries imposed by our training, institutional reward systems, political system and comfort zones in order to solve global challenges. She lists five challenges facing those who are trying to build more sustainable food systems: overcoming the technocratic and productivist approach of industrial agriculture, avoiding future pandemics, restoring degraded and depleted systems and resources, remaining united as a movement while creating collaborations with other movements, and redistributing power across food system actors so that everyone can realize their human rights, including the right to food. She describes three ways that she has found to be effective in pushing beyond boundaries: international collaborations, interactions with global social movements, and anti-racist work. She links these "moments" of opportunity back to the five challenges, and concludes with advice to young scholars.

Looking Inside the International Food Safety Authorities Network Community Website

ABSTRACT

The International Food Safety Authorities Network (INFOSAN) was launched in 2004 by the World Health Organization (WHO) in collaboration with the Food and Agriculture Organization of the United Nations (FAO). Since then, this global network has aimed to halt the international spread of contaminated food, prevent foodborne disease outbreaks, and strengthen food safety systems globally to reduce the burden of foodborne illness. However, INFOSAN has never been examined as a functional community of practice and its value, according to members, has not been determined in a systematic or rigorous way. A three-phased, mixed-method study has explored the experiences of INFOSAN members with respect to their participation in collaborative network activities to improve global food safety and prevent foodborne illness. Results from phase 1 of this study are discussed here and relate to how the INFOSAN Community Website (ICW) is being used to support network activities. Overall, the descriptive analysis indicates that a small number of active INFOSAN members contribute most of information shared on the ICW. A much larger group of members participates passively, logging on to the site, reading content, but not sharing new information. Four hundred eighty-two food safety incidents are documented on the ICW, the majority of which have been caused by bacterial contamination, most commonly Salmonella enterica. The results from phase 1 of this study provide objective, foundational information about engagement of all members and were used to propose new ways to improve the ICW. Integration of these results with results from phases 2 and 3 will help determine whether and how members' reported attitudes and experiences reflect their online behaviors. This information can be used by the INFOSAN Secretariat to increase active participation and improve international information exchange to mitigate the impact of food safety emergencies and prevent foodborne diseases globally.

HIGHLIGHTS

International collaboration in Brazilian science: financing and impact

The study of international collaborations can help in understanding the benefits of such relationships and aid in developing national financing policies. In this paper, the international collaboration of Brazilian scientists was studied using SciVal^® and Incites^® database, looking at its effect on the universities, financing agencies and different areas of knowledge and research topic clusters. Cluster and principal component analyses of scientometric data were carried out. While the results confirmed known knowledge that international collaboration increases impact, this study shows that Brazilian researchers are contributing to prominent research topics worldwide, in all areas of knowledge. This finding is contrary to several points of view that identify Brazil as a regional and not an international partner in science. Important also to note the impact of Brazilian authors in international collaboration that is well above the world mean. The collaboration of Brazil with foreign partners brings benefits for both sides, creating the opportunity of Brazilian research access to financing from international agencies. Increases in measures of impact are also seen for both sides. Foreign partners likewise benefit from higher impact factors in the same topic cluster, when collaborating with Brazilian partners. Publishing open access in high impact journals is fundamental for maintaining Brazilian science at the forefront.

HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships

BACKGROUND

HIV/AIDS has attracted considerable research attention since the 1980s. In the current context of globalization and the predominance of cooperative work, it is crucial to analyze the participation of the countries and regions where the infection is most prevalent. This study assesses the participation of African countries in publications on the topic, as well as the degree of equity or influence existing in North-South relations.

METHODS

We identified all articles and reviews of HIV/AIDS indexed in the Web of Science Core Collection. We analyzed the scientific production, collaboration, and contributions from African and Middle Eastern countries to scientific activity in the region. The concept of leadership, measured through the participation as the first author of documents in collaboration was used to determine the equity in research produced through international collaboration.

RESULTS

A total of 68,808 documents published from 2010 to 2017 were analyzed. Researchers from North America and Europe participated in 82.14% of the global scientific production on HIV/AIDS, compared to just 21.61% from Africa and the Middle East. Furthermore, the publications that did come out of these regions was concentrated in a small number of countries, led by South Africa (41% of the documents). Other features associated with HIV/AIDS publications from Africa include the importance of international collaboration from the USA, the UK, and other European countries (75-93% of the documents) and the limited participation as first authors that is evident (30 to 36% of the documents). Finally, the publications to which African countries contributed had a notably different disciplinary orientation, with a predominance of research on public health, epidemiology, and drug therapy.

CONCLUSIONS

It is essential to foster more balance in research output, avoid the concentration of resources that reproduces the global North-South model on the African continent, and focus the research agenda on local priorities. To accomplish this, the global North should strengthen the transfer of research skills and seek equity in cooperative ties, favoring the empowerment of African countries. These efforts should be concentrated in countries with low scientific activity and high incidence and prevalence of the disease. It is also essential to foster intraregional collaborations between African countries.

The future of the forensic science providers - Time to re-think our structures?

The organisation of the forensic chain, from scene of crime up to the court house, has in most countries hardly evolved with the societal needs as well as with the scientific developments. It can be expected that the forensic possibilities will be strongly enlarged in the coming years, based on the current scientific evolution. This combined with the reduction of the operating funds most laboratories are experiencing highlights the need to reflect on the way the forensic chain and its providers are organized. In this paper, we will present a model based on a cost-balanced approach and distributed competences. Specialized forensic disciplines or techniques are either made available in single points of operation, through buying in services from external providers or through international collaboration with other forensic laboratories. Different ways for implementing the international exchange are discussed. A comparison is made with the collaboration of the metrological laboratories over the world which could serve as a template for the implementation of the forensic structure.

Short-term surgical trips: local collaboration and its effects on complications and patient satisfaction

PURPOSE

Short-term surgical missions can provide communities in need with desired expertise; however, it is uncertain who will manage the complications after visiting experts leave. Poor outcomes, decreased patient satisfaction, and tension on the healthcare system develop when local providers, often excluded from the initial patient care, are unable to cope with subsequent morbidity.

METHODS

Two-year retrospective review of pediatric general, plastic, and reconstructive surgery, and urology cases performed by a relief organization in the developing world. Case complexity and postoperative complications were analyzed. Phone interviews conducted with patients/families to quantify postoperative outcomes and satisfaction.

RESULTS

474 surgeries were performed on pediatric patients with 60% response rate. Respondents stratified into three levels of complexity: 159 simple, 72 intermediate, and 54 advanced surgeries. Six (2.1%) high-level complications occurred. No association between the complexity of the surgery and the occurrence of a complications. 83.5% were satisfied with outcomes and > 92% were happy with the provided support.

CONCLUSION

Facilitating visiting and local surgeons performing cases together increases the expertise of local providers, strengthens infrastructure, and establishes clear follow-up. Despite complications, patients and families continued to recommend care to family and friends by the relief organization and were happy with support from local providers. Engaging local providers is the gold-standard for short-term trips.

Scientific globalism during a global crisis: research collaboration and open access publications on COVID-19

This study sought to understand the nature of scientific globalism during a global crisis, particularly COVID-19. Findings show that scientific globalism occurs differently when comparing COVID-19 publications with non-COVID-19 publications during as well as before the pandemic. Despite the tense geopolitical climate, countries increased their proportion of international collaboration and open-access publications during the pandemic. However, not all countries engaged more globally. Countries that have been more impacted by the crisis and those with relatively lower GDPs tended to participate more in scientific globalism than their counterparts.

Scholar in the SEPR spotlight: Ian Douglas

In this reflective essay of intellectual autobiography, I respond to a series of questions the journal editor Wei-Ning Xiang asked about my 55-year journey from applied geography to socio-ecological practice research. These are (1) what and/or who had inspired your career most in geography and socio-ecological practice research? (2) Throughout your 55-year academic journey, did you ever reorient your ambitions in scholarly pursuit, or even reinvent yourself in your academic life? What motivated you in each of these instances? (3) How do you measure success in your work? Among many accomplishments, what are the top three that you are most proud of? (4) From your personal experience, what would be the most important attributes for a well-lived, fully realised, and meaningful life? Do you have any tips for maintaining work-life balance? (5) Do you have any specific advice for younger scholars in geography and socio-ecological practice research? (6) What are the three most interesting images reflecting turning points in your career? I hope that my experiences and insights showcased in this essay are helpful to the younger generations of geographers and socio-ecological practice researchers.

Improving capacity and access to neurosurgery in sub-Saharan Africa using a twinning paradigm pioneered by the Swedish African Neurosurgical Collaboration

BACKGROUND

The unmet need for neurosurgery in sub-Saharan Africa is staggering. Resolving this requires strategies that synergize salient local resources with tailored foreign help. This study is a trial of a twinning model adopted by the Swedish African Neurosurgical Collaboration (SANC).

METHODS

A multi-step neurosurgical twinning technique, International Neurosurgical Twinning Modeled for Africa (INTIMA), developed through a collaboration between African and Swedish neurosurgical teams was adopted for a neurosurgical mission in March 2019. The pioneering steps are evaluated together with data of treated patients prospectively acquired using SPSS Chicago Inc., Version 23. Associations were analyzed using chi-square tests, while inferences were evaluated at 95% level of significance.

RESULTS

The SANC global neurosurgery mission targeted microsurgical brain tumor resection. Fifty-five patients were operated on during the mission and subsequent 3 months. Patients' ages ranged from 3 months to 69 years with a mean of 30.6 ± 2.1 years 95% CL. Seven cases were performed during the first mission, while 48 were performed after the mission. Compared to 3 months before SANC when only 9 brain tumors were resected, more tumors were resected (n = 25) within the 3 consecutive months from the mission (X² = 14.2, DF = 1, P = 0.000). Thirty-day mortality following tumor resection was also lower, X² = 4.8, DF = 1, P = 0.028.

CONCLUSION

Improvements in capacity and short-term outcome define our initial pioneering application of a neurosurgical twinning paradigm pioneered by SANC.

Creating a community of researchers: Fostering global collaboration for doctoral prepared nurses and nursing students

BACKGROUND

Few publications have explored the role that professional organizations play in facilitating global partnerships; particularly regarding research and educational collaboration between doctoral prepared nurses and students residing in low- and middle-income countries with those from high-income countries.

OBJECTIVE

To describe a pilot Spotlight Project which was developed to foster communication and collaboration among global doctoral prepared nurses and nursing students within an international nursing organization.

METHODS

Twenty-seven members were identified and sent requests to complete the spotlight form created for this project. This form gave potential participants the option to do a 250 to 350-word write-up or develop a video describing their current research/educational initiatives, achievements, short and long -term goals.

RESULTS

Eight of the 27 spotlight requests were returned. Information was received from one recent graduate and 7 faculty members. It included descriptions of motivation to pursue doctoral education, future aspirations, and academic and career accomplishments.

DISCUSSION

The Spotlight Project could serve as an avenue for nursing students, researchers, and nursing schools; especially those from low- and middle-income countries that typically have limited funding and access to conferences and other professional opportunities to disseminate information about current projects, and a means of celebrating achievements of organization's members. This is also a potential avenue for international research and education collaboration between students and institutions.

How do new members affect the relationship between principal investigator's network position and academic output of granted funds?

The paper focuses on how to improve academic output of a granted fund when the adding of new members changes principal investigator's network position. This objective is refined by exploring how new members affect the relationship between principal investigator's network position and the academic output of granted funds, and whether this effect is similar in high-output and low-output collaboration networks. New members are divided into two groups, namely, international collaboration and inbound mobility. Using negative binomial regression on research funds supported by the National Natural Science Foundation of China, the results indicate that new members indeed have moderating effects on the relationship between principal investigator's network position and the academic output of granted funds. Moreover, we find that this moderating effect in high-output collaboration networks is larger than that in low-output collaboration networks. Our findings provide practical implications for the decision makers to design funding planning and for the principal investigators to improve academic output.

Improving Cross-Border Preparedness and Response: Lessons Learned from 3 Lassa Fever Outbreaks Across Benin, Nigeria, and Togo, 2017-2019

Long-standing cultural, economic, and political relationships among Benin, Nigeria, and Togo contribute to the complexity of their cross-border connectivity. The associated human movement increases the risk of international spread of communicable disease. The Benin and Togo ministries of health and the Nigeria Centre for Disease Control, in collaboration with the Abidjan Lagos Corridor Organization (a 5-country intergovernmental organization) and the US Centers for Disease Control and Prevention, sought to minimize the risk of cross-border outbreaks by defining and implementing procedures for binational and multinational public health collaboration. Through 2 multinational meetings, regular district-level binational meetings, and fieldwork to characterize population movement and connectivity patterns, the countries improved cross-border public health coordination. Across 3 sequential cross-border Lassa fever outbreaks identified in Benin or Togo between February 2017 and March 2019, the 3 countries improved their collection and sharing of patients' cross-border travel histories, shortened the time between case identification and cross-border information sharing, and streamlined multinational coordination during response efforts. Notably, they refined collaborative efforts using lessons learned from the January to March 2018 Benin outbreak, which had a 100% case fatality rate among the 5 laboratory-confirmed cases, 3 of whom migrated from Nigeria across porous borders when ill. Aligning countries' expectations for sharing public health information would assist in reducing the international spread of communicable diseases by facilitating coordinated preparedness and responses strategies. Additionally, these binational and multinational strategies could be made more effective by tailoring them to the unique cultural connections and population movement patterns in the region.

Laboratory biosafety in China: past, present, and future

The launch of the new journal, Biosafety and Health, presents me with a unique opportunity to recount the progress of laboratory biosafety (LB) in China and my contribution to this area over the past 30 years. Since the severe acute respiratory syndrome epidemic in 2003, China has constructed a primary network of high-level biosafety laboratories at different levels and established an expert team on LB. Furthermore, a series of LB management documents, including laws, regulations, standards, and guidelines, have been developed and published. This gradually maturing LB system has played a pivotal role in emerging infectious disease control and prevention, as well as in research, which in turn contributes to public health. In recent years, international collaboration between China and other countries has also been accelerated. Despite these achievements, we are still facing many challenges and opportunities in the field of LB. Sustainable LB development requires the joint efforts of the entire society and continuous international cooperation to safeguard global public health.

A Tale of Two Countries: Innovation and Collaboration Aimed at Changing the Culture of Medicine in Uruguay

This is a case study of a program to address professionalism at the Universidad de la República in Uruguay. We describe a five-year ongoing international collaboration. Relevant characteristics of the context, the program components, activities, and results were analyzed. The expected outcomes were to introduce standards of professional practices in the curricula of medical students and residents and the implementation of a program that might lead to a significant change in the culture of medicine in the University. Traditional didactics, interactive theater, and professional development workshops, issues such as teamwork and communication, professional behavior, and the culture of medicine, and physician wellness were addressed. A total of 359 faculty members, general practitioners, stakeholders, and other healthcare professionals (nurses, psychologists, social workers) participated in the intervention. The process led to specific achievements including new content in the curricula, the use of educational innovations to address issues of professionalism, a growing institutional culture of accountability, and the establishment of new rules and regulations. The strategies and interventions followed in the case of Uruguay can serve as a model to other developing countries to promote physician professionalism, wellness, and joy.