Establishing an infrastructure to optimize the integration of genomics into research: Results from a precision health needs assessment

Researchers across the translational research continuum have emphasized the importance of integrating genomics into their research program. To date capacity and resources for genomics research have been limited; however, a recent population-wide genomic screening initiative launched at the Medical University of South Carolina in partnership with Helix has rapidly advanced the need to develop appropriate infrastructure for genomics research at our institution. We conducted a survey with researchers from across our institution (n = 36) to assess current knowledge about genomics health, barriers, and facilitators to uptake, and next steps to support translational research using genomics. We also completed 30-minute qualitative interviews with providers and researchers from diverse specialties (n = 8). Quantitative data were analyzed using descriptive analyses. A rapid assessment process was used to develop a preliminary understanding of each interviewee's perspective. These interviews were transcribed and coded to extract themes. The codes included types of research, alignment with precision health, opportunities to incorporate precision health, examples of researchers in the field, barriers, and facilitators to uptake, educational activity suggestions, questions to be answered, and other observations. Themes from the surveys and interviews inform implementation strategies that are applicable not only to our institution, but also to other organizations interested in making genomic data available to researchers to support genomics-informed translational research.

COVID-19 infections, recoveries, and mortality: an ANOVA model of locations and administrative areas in Saudi Arabia

Background

Saudi Arabia has 13 administrative areas, all of which have been seriously affected by the COVID-19 epidemic regardless of their features. Being the largest and a prominent Arab country, epidemic intensity and dynamics have importance, especially in the era of Vision 2030 where infrastructure development and growth to enhance quality of life has of prime focus.

Aims

This analysis aims to trace the differentials in COVID-19 infections, recoveries, and deaths across the country depending upon various demographic and developmental dimensions and interactions.

Data and methods

This analysis used Saudi Arabia Ministry of Health data from March 15th, 2020 to August 31st, 2022, by classifying administrative areas and locations to build a generalized linear model (3 × 3): three types of administrative areas (major, middle-sized, and others) and localities (major, medium-sized, and others). Apart from two-way ANOVA, an one-way ANOVA also carried out in addition to calculating mean values of infections, recoveries, and deaths.

Results

A total of 205 localities were affected with varying severity, which are based on local demographics. Both the administrative areas and localities had a significant number of cases of infections, recoveries, and mortality, which are influenced by relationships and interactions, leading to differential mean values and proportional distributions across various types of administrative areas and localities.

Conclusion

There is dynamism that major administrative areas have lesser threats from the epidemics whereas medium-sized ones have serious threats. Moreover, an interaction of administrative areas and localities explains the dynamics of epidemic spread under varying levels of infrastructure preparedness. Thus, this study presents lessons learned to inform policies, programs, and development plans, especially for regional, urban, and infrastructure areas, considering grassroots level issues and diversity.

Experience with the Implementation of Continuous Medical Education among Mother-and-Child Healthcare Providers in Ukraine: A Case Study Based on Two International Collaboration Initiatives

BACKGROUND

Healthcare labor market shortages due to migration, inadequate investments, and lack of continuous training are essential concerns in the Eastern European region. This article aims to describe and reflect on the experience with the implementation of continuous medical education among mother-and-child healthcare providers in Ukraine, including achievements, challenges, and barriers. We analyze this case based on two international collaboration initiatives: the Swiss-Ukrainian program in mother-and-child health that ran from 2000 to 2015, supplemented by the recent Ukrainian-Swiss project "Medical education development" in 2018-2023.

METHODS

We use a case study approach as the methodology for our study. We collected data from documents (project reports reviews) and in-depth interviews with stakeholders. We apply the method of directed qualitative content analysis.

RESULTS

As a result of the Swiss-Ukrainian collaborations, the knowledge and awareness of medical personnel were greatly improved. Modern clinical concepts not well understood at the outset became commonplace and were incorporated into clinical activities. Nevertheless, obstacles to the implementation and rapid uptake of changes were found in the lack of knowledge of the English language among medical doctors, the fear of changes, and the lack of openness and readiness for novel evidence-based clinical practices. However, primary healthcare practitioners in this new project seem to be more inclined to change.

CONCLUSIONS

A modernized continuous medical education which is based on the values of openness, respect, dialogue, and professionalism can be implemented with the input of an international assistance program despite the resistance of the system towards change.

Building Critical Infrastructures: Evaluating the Roles of Governance and Institutions in Infrastructural Developments in Sub-Sahara African Countries

BACKGROUND

The Sub-Saharan African (SSA) region has notably been in the limelight of infrastructural deficit discussions over the decades. Although the region's infrastructural development is gradually improving, the levels and pace of development remain generally poor compared to the rest of the world.

OBJECTIVES

This study thus aims to empirically examine the roles of governance and institutions in infrastructural developments in the Sub-Sahara African (SSA) region toward addressing the pressing needs for critical infrastructures for the region.

RESEARCH DESIGNS

The empirical strategies utilized in the study include the Common Correlated Efficient Mean Group (CCEMG) and Dynamic CCEMG methods among others. These empirical approaches were applied to analyze data on governance and institutional quality proxies for the SSA region to achieve the study's objectives while controlling for the effects of industrial value-added, foreign capital inflow (FDI), and overall economic growth for the understudied period (1990-2019).

RESULTS

The results reflect the essence of governance and institutional quality as these variables significantly boost infrastructural development in SSA. In addition, industrialization and growth also show a favorable impact on the development of infrastructure thus reflecting that the transition from agrarian to industrial economies occurs in parallel with infrastructure development in the SSA. However, FDI inflows were not found to be significantly instrumental to infrastructural development in the region.

CONCLUSIONS

Hence, the SSA must strive to strengthen institutions and harmonize their industrial and economic push with infrastructural developments while encouraging potential foreign investors to diversify investments to infrastructural projects beyond the usual primary sector/resource-based activities.

Road networks predict human influence on Amazonian bird communities

Road building can lead to significant deleterious impacts on biodiversity, varying from direct road-kill mortality and direct habitat loss associated with road construction, to more subtle indirect impacts from edge effects and fragmentation. However, little work has been done to evaluate the specific effects of road networks and biodiversity loss beyond the more generalized effects of habitat loss. Here, we compared forest bird species richness and composition in the municipalities of Santarém and Belterra in Pará state, eastern Brazilian Amazon, with a road network metric called 'roadless volume (RV)' at the scale of small hydrological catchments (averaging 3721 ha). We found a significant positive relationship between RV and both forest bird richness and the average number of unique species (species represented by a single record) recorded at each site. Forest bird community composition was also significantly affected by RV. Moreover, there was no significant correlation between RV and forest cover, suggesting that road networks may impact biodiversity independently of changes in forest cover. However, variance partitioning analysis indicated that RV has partially independent and therefore additive effects, suggesting that RV and forest cover are best used in a complementary manner to investigate changes in biodiversity. Road impacts on avian species richness and composition independent of habitat loss may result from road-dependent habitat disturbance and fragmentation effects that are not captured by total percentage habitat cover, such as selective logging, fire, hunting, traffic disturbance, edge effects and road-induced fragmentation.

Patient-powered research networks: building capacity for conducting patient-centered clinical outcomes research

The Patient-Centered Outcomes Research Institute (PCORI) recently launched PCORnet to establish a single inter-operable multicenter data research network that will support observational research and randomized clinical trials. This paper provides an overview of the patient-powered research networks (PPRNs), networks of patient organizations focused on a particular health condition that are interested in sharing health information and engaging in research. PPRNs will build on their foundation of trust within the patient communities and draw on their expertise, working with participants to identify true patient-centered outcomes and direct a patient-centered research agenda. The PPRNs will overcome common challenges including enrolling a diverse and representative patient population; engaging patients in governance; designing the data infrastructure; sharing data securely while protecting privacy; prioritizing research questions; scaling small networks into a larger network; and identifying pathways to sustainability. PCORnet will be the first distributed research network to bring PCOR to national scale.

A Model for Sustainable Development of Child Mental Health Infrastructure in the LMIC World: Vietnam as a Case Example

Children and adolescents are among the highest need populations in regards to mental health support, especially in low and middle income countries (LMIC). Yet resources in LMIC for prevention and treatment of mental health problems are limited, in particular for children and adolescents. In this paper, we discuss a model for development of child and adolescent mental health (CAMH) resources in LMIC that has guided a ten year initiative focused on development of CAMH treatment and research infrastructure in Vietnam. We first review the need for development of mental health resources for children and adolescents in general, and then in Vietnam. We next present the model that guided our program as it developed, focused on the twin Capacity Development Goals of efficacy and sustainability, and the Capacity Development Targets used to move towards these goals. Finally we discuss our CAMH development initiative in Vietnam, the center of which has been development of a graduate program in clinical psychology at Vietnam National University, linking program activities to this model.