Mentoring the Mentors: Implementation and Evaluation of Four Fogarty-Sponsored Mentoring Training Workshops in Low-and Middle-Income Countries.

A growing body of evidence highlights the importance of competent mentoring in academic research. We describe the development, implementation, and evaluation of four regional 2-day intensive workshops to train mid- and senior-level investigators conducting public health, clinical, and basic science research across multiple academic institutions in low- and middle-income countries (LMICs) on tools and techniques of effective mentoring. Sponsored by the Fogarty International Center, workshops included didactic presentations, interactive discussions, and small-group problem-based learning and were conducted in Lima, Peru; Mombasa, Kenya; Bangalore, India; and Johannesburg, South Africa, from 2013 to 2016. Mid- or senior-level faculty from multiple academic institutions within each region applied and were selected. Thirty faculty from 12 South America-based institutions, 29 faculty from eight East Africa-based institutions, 37 faculty from 14 South Asia-based institutions, and 36 faculty from 13 Africa-based institutions participated, with diverse representation across disciplines, gender, and academic rank. Discussions and evaluations revealed important comparisons and contrasts in the practice of mentoring, and specific barriers and facilitators to mentoring within each cultural and regional context. Specific regional issues related to hierarchy, the post-colonial legacy, and diversity arose as challenges to mentoring in different parts of the world. Common barriers included a lack of a culture of mentoring, time constraints, lack of formal training, and a lack of recognition for mentoring. These workshops provided valuable training, were among the first of their kind, were well-attended, rated highly, and provided concepts and a structure for the development and strengthening of formal mentoring programs across LMIC institutions

Use of multivariate analysis in the non-genetic factors assessment of Creole goats

El peso al nacimiento en caprinos es un factor que siempre se pondera en los esquemas productivos por estar positivamente correlacionado con la tasa de crecimiento, con el tamaño del adulto, con el tiempo que tardan las crías en alcanzar peso de faena y con el tipo de alimentación que reciben. El peso al nacimiento varía en las distintas razas por ser determinado genéticamente. Hay productores que llegan a cambiar la raza de cabra buscando mejores pesos al nacimiento y desarrollos más precoces. Existen, sin embargo, factores no genéticos, que influyen en el peso al nacimiento y el desarrollo inicial que pueden llevar a confundir los resultados cuando se comparan diferentes razas buscando la producción de cabritos de mejores pesos al nacimiento y desarrollos más precoces. Sexo y número de camada son dos factores no genéticos relevantes en la determinación del peso al nacimiento y ya han sido demostrados en otras razas. En cabras Criollas, además de estos, se detecta que edad de la madre, número de parto de la madre, y mes de nacimiento también influyen. Se realizó un estudio de la influencia de todas estas variables en el peso al nacimiento y desarrollo inicial en un rebaño caprino de la Universidad Nacional de Santiago del Estero (UNSE), en el que se pesaron crías al nacimiento y en desarrollo inicial en cinco pariciones sucesivas. Se aplicó un análisis conjunto de todas las variables o multivariado, empleándose el método de componentes principales ACP, el cual detectó relaciones muy estrechas entre las variables en los tres ejes principales: 1) edad de la madre con número de parto, 2) peso con el tamaño de la camada y 3) otras relaciones, aunque débiles entre sexo y tamaño de camada. El ACP sirvió para sintetizar la información y mejorar la eficiencia en la interpretación de resultados, concentrando a los ejemplares en base a la influencia de las variables estudiadas con sus respectivos pesos al nacimiento, siendo los grupos 2 y 3 los de mayores pesos (3,18 kg y 3.4 kg respectivamente) y los bajos pesos para los grupos 1 y 4 (2,22 kg y 2,25 kg promedio, respectivamente).In goats, birth weight is a factor that is always taken into account in the production systems since it correlates positively with growth rate, with adult size, with the time required for the offspring reach slaughter weight and with the type of food they receive. Birth weight varies in different races to be genetically determined. There are breeders who change the race of goat focusing on the better birth weight and more early development. However, there are non-genetic factors that influence on the birth weight and early development that can lead to confusing results when comparing different races to looking offspring production of better birth weight and early development. Sex and number of litter are two non genetic factors relevant in determining birth weight, that in addition already it was demonstrated in other races. In Creole goats in addition to these, we found that age of mother, calving number of the mother, and birth month also have influence. A study of the influence of these variables on birth weight and initial development in a goat herd was conducted at the Na-tional University of Santiago del Estero. In this study the offspring were weighed at birth and during early developmental conducted in five successive calving. A pooled analysis of all variables or multivariate analyzes were applied, using the method of principal component ACP, which detect very close relations between the variables in the three major axis: 1) age of mother with calving number, 2) weight with the litter size and 3) other relationships, though weak between sex and litter size. This method, ACP, helped to summarize information and improving efficiency in the interpretation of results, bringing together animals based on the influence of the variables studied and their birth weight. Thus the groups 2 and 3 they presented the higher weights (3.18 kg and 3.4 kg respectively), and groups 1 and 4, lower weights (2.22 kg and 2.25 kg average respectively).Fil: David, R. N.. Universidad Nacional de Santiago del Estero. Facultad de Agronomía y Agroindustrias; ArgentinaFil: Abdala, G. C.. Universidad Nacional de Santiago del Estero. Facultad de Agronomía y Agroindustrias; ArgentinaFil: Abdala, María Eugenia. Universidad Nacional de Santiago del Estero. Facultad de Agronomía y Agroindustrias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lescano, J. A.. Universidad Nacional de Santiago del Estero. Facultad de Agronomía y Agroindustrias; Argentin

Strengthening Mentoring in Low- and Middle-Income Countries to Advance Global Health Research: An Overview.

Mentoring is a proven path to scientific progress, but it is not a common practice in low- and middle-income countries (LMICs). Existing mentoring approaches and guidelines are geared toward high-income country settings, without considering in detail the differences in resources, culture, and structure of research systems of LMICs. To address this gap, we conducted five Mentoring-the-Mentor workshops in Africa, South America, and Asia, which aimed at strengthening the capacity for evidence-based, LMIC-specific institutional mentoring programs globally. The outcomes of the workshops and two follow-up working meetings are presented in this special edition of the American Journal of Tropical Medicine and Hygiene. Seven articles offer recommendations on how to tailor mentoring to the context and culture of LMICs, and provide guidance on how to implement mentoring programs. This introductory article provides both a prelude and executive summary to the seven articles, describing the motivation, cultural context and relevant background, and presenting key findings, conclusions, and recommendations

Estudio estadístico del estado de conservación de pavimentos de hormigón del sector SE de Bahía Blanca (Buenos Aires)

En el presente trabajo se relevaron pavimentos de hormigón de la ciudad de Bahía Blanca con el propósito de determinar el estado de conservación y las causas de deterioro. Se presentan los resultados de 43 barrios del sector SE de la ciudad, que abarca una superficie de 13,4 km2. Se analizó el estado de las losas considerando las que necesitan reemplazo debido al avanzado estado de deterioro y el tipo de agregado que constituye el hormigón. Se determinó densidad, absorción y porosidad y se realizó un estudio petrográfico de los agregados y del estado del mortero, utilizando estereomicroscopio y microscopio óptico. Se realizó un estudio estadístico sobre un total de 32703 losas relevadas y se concluyó que el 40% presenta deterioro y de éstas, el 18% necesita reemplazo total. Las principales causas de falla están asociadas a defectos constructivos en la preparación de bases y a la falta de mantenimiento de juntas

Influencia de la aptitud natural de uso del suelo en la pobreza y desnutrición de la población rural en la provincia de Cotopaxi, Sierra Centro del Ecuador

It was taken as an antecedent the systematic primacy of the poverty of the rural population over the urbanpopulation, validated by the national statistics, to analyze how the natural aptitude of land use,inconsistentwith the current productive use, influences in poverty and undernourishment of the population of the ruralparishes of Cotopaxi province; under the premise that the main productive activity of this population is agriculture. The Spearman statistical method of correlation was applied to determine the relationship between the natural aptitude of land use and current land use, with poverty and undernourishment of the rural population. The correlation analysis was applied to the 33 rural parishes, excluding urban, since their productive activities are not the primary production. The results show that poverty and undernourishment of the rural population are directly correlated with the main activity of the population in primary production and the inappropriate use of land, contrary to the natural aptitude of use, which is not agriculture. In consequence, the highest rates of poverty and undernourishment are concentrated in areas with lowest natural aptitude of land use for agriculture, but at the same time, most of those areas are dedicated to agricultural activities (more than 60% in average). The main conclusion was that the primary production activities at majority of the rural areas of the Cotopaxi province, do not generate enough income to improve the life of the involved families and simultaneously cause environmental degradation, putting in threat the food security of the population and increasing their poverty and undernourishment.Se tomó como antecedente la preponderancia sistémica de la pobreza de la población rural sobre la urbana, avalada por las estadísticas nacionales y se propuso como objetivo central, determinar la correlación entre la aptitud natural de uso del suelo, incompatible con su uso productivo actual, con la pobreza y desnutrición de la población de las parroquias rurales de la provincia de Cotopaxi; bajo la premisa de que la principal actividad productiva de la población es la agricultura. Se aplicó el modelo de correlación de Spearman, dado que las variables utilizadas no garantizan normalidad para aplicar un modelo lineal; se trabajó con los datos de las 33 parroquias rurales de la provincia, excluyendo a las parroquias urbanas, por sus dinámicas productivas diferentes de la producción primaria. Los resultados revelaron que la pobreza y desnutrición de la población rural están en relación directa con la ocupación de la población en agricultura y el uso incorrecto del suelo, contrapuesto con la aptitud natural de uso. Efectivamente, los mayores niveles de pobreza y desnutrición se concentran en la población de las parroquias cuyos territorios muestran la menor aptitud natural para producir cultivos, pero que al mismo tiempo se ocupan mayoritariamente en la actividad agrícola, (más del 60%, en promedio de la población rural se ocupan de la agricultura). La conclusión principal fue que la actividad de producción primaria en la mayoría del territorio rural de la provincia de Cotopaxi, además de no generar los ingresos suficientes para garantizar una vida digna de las familias, produce una espiral de degradación ambiental en cada ciclo agrícola, que reduce la capacidad productiva de los suelos, con la consecuencia obvia del empobrecimiento sistemático de la población involucrada, amén de su inseguridad alimentaria

Statistical analyses in disease surveillance systems

The performance of disease surveillance systems is evaluated and monitored using a diverse set of statistical analyses throughout each stage of surveillance implementation. An overview of their main elements is presented, with a specific emphasis on syndromic surveillance directed to outbreak detection in resource-limited settings. Statistical analyses are proposed for three implementation stages: planning, early implementation, and consolidation. Data sources and collection procedures are described for each analysis

Mental health impact of social capital interventions: a systematic review.

PURPOSE: Mental disorders are a major contributor to the global burden of disease and disability, and can be extremely costly at both individual and community level. Social capital, (SC) defined as an individual's social relationships and participation in community networks, may lower the risk of mental disorders while increasing resilience capacity, adaptation and recovery. SC interventions may be a cost-effective way of preventing and ameliorating these conditions. However, the impact of these SC interventions on mental health still needs research. METHODS: We conducted a systematic review of SC-based interventions to investigate their effect on mental health outcomes from controlled, quasi-experimental studies or pilot trials. We searched twelve academic databases, three clinical trials registries, hand-searched references and contacted field experts. Studies' quality was assessed with the Cochrane Risk of Bias tools for randomized and non-randomized studies. RESULTS: Seven studies were included in the review, published between 2006 and 2016. There was substantial heterogeneity in the definitions of both SC and mental disorders among the studies, preventing us from calculating pooled effect sizes. The interventions included community engagement and educative programs, cognitive processing therapy and sociotherapy for trauma survivors, and neighbourhood projects. CONCLUSIONS: There are paucity of SC interventions investigating the effect on mental health outcomes. This study showed that both SC scores and mental health outcomes improved over time but there was little evidence of benefit compared to control groups in the long term. Further high-quality trials are needed, especially among adverse populations to assess sustainability of effect

Taenia solium Cysticercosis Hotspots Surrounding Tapeworm Carriers: Clustering on Human Seroprevalence but Not on Seizures

Cysticercosis is a parasitic disease caused by the tapeworm Taenia solium, common in areas with limited sanitation or with migration from these populations. The adult parasite is hosted in the human intestine and releases large numbers of eggs with the feces. Human beings sometimes ingest eggs due to poor hygiene, and then eggs sometimes lodge on the brain and after a few years can cause intense headaches and seizures. During a study in seven rural communities in Peru, individuals exposed to T. solium eggs were often tightly clustered at the homes or immediate surrounding of the carriers of the adult parasite. However, no aggregation of cases of seizures was found near carriers. It appears that seizures do not cluster around carriers because several years pass between exposure to T. solium eggs and the onset of seizures. During these years the adult parasite has probably died or people had moved within or even outside their communities. Therefore, only a partial understanding of the epidemiology of cysticercosis is gained by studying seizures cases

Acute complications of chronic liver diseases

As doenças hepáticas crônicas, em fases avançadas, cursam com graves complicações, responsáveis pela maioria das indicações de internações hospitalares e causas de morte dos pacientes. Neste capítulo, são discutidas as principais complicações das doenças hepáticas crônicas, que são a encefalopatia hepática, a peritonite bacteriana espontânea e a síndrome hepatorrenal. São apresentados os aspectos importantes, na prática médica, dessas três condições clínicas, com ênfase na abordagem diagnóstica e terapêutica.Advanced chronic liver diseases lead to severe complications that are responsible for the majority of indications of hospitalization and patients’ death. In this article the main complications of chronic liver diseases such as hepatic encephalopathy, spontaneous bacterial peritonitis and hepatorenal syndrome are discussed. The main aspects in practical clinic of these three clinical conditions with emphasis in the diagnostic and therapeutic approach are shown

Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010

ArticleMilitary personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2–36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries.The outbreak response was supported by the Peruvian Army Health Command COSALE and the Peruvian Ministry of Health through the General Epidemiology Directorate and the Health Directorate II, south Lima, and the. In addition, partial support was provided by grants CO497_11_L1 and CO466_11_L1 of the Global Emerging Infections Surveillance and Response System (AFHSC/GEIS) of the U.S. Department of Defense and the training grant 2D43 TW007393 awarded to the U.S. Naval Medical Research Unit No. 6 (NAMRU-6) by the Fogarty International Center of the National Institutes of Health (FIC/NIH). This study is part of the dissertation of Marianela Ore for a Masters in Epidemiological Research offered jointly by the Universidad Peruana Cayetano Heredia (UPCH) and NAMRU-6