Global Health Collaboration: Challenges and Lessons

This stimulating open access volume details the innovative work of the Pan Institution Network for Global Health in creating collaborative research-based answers to large-scale health issues. Equitable partnerships among member universities representing North America, Africa, Asia, and Europe reverse standard cross-national dynamics to develop locally relevant responses to health challenges as well as their underlying disparities. Case studies focusing on multiple morbidities and effects of urbanization on health illustrate open dialogue in addressing HIV, maternal/child health, diabetes, and other major concerns. These instructive examples model collaborations between global North and South as meaningful steps toward the emerging global future of public health. Included in the coverage: Building sustainable networks: introducing the Pan Institution Network for Global Health Fostering dialogues in global health education: a graduate and undergraduate approach Provider workload and multiple morbidities in the Caribbean and South Africa Project Redemption: conducting research with informal workers in New York City Partnership and collaboration in global health: valuing reciprocity Global Health Collaboration will interest faculty working within the field of global health; scholars within public health, health policy, and cognate disciplines; as well as administrators looking to develop international university partnerships around global health and graduate students in the areas of global health, health administration, and public health and related social sciences (e.g., sociology, anthropology, demography)

Lessons Learned: Feasibility of a Discussion Prompting Tool to Increase Fertility Risk Discussion Among Adolescent Oncology Families

The purpose of this study was to explore the feasibility of distributing a prompting tool (stress egg) in order to increase discussions about fertility risk and preservation (FP) among female adolescent oncology patients, parents, and healthcare providers (HCP). 200 eggs were distributed to four pediatric oncology centers. Qualitative interviews were completed with healthcare staff (N=7) after 6 months of distribution to newly diagnosed female oncology patients ages 12-18. Interviews showed that the main barriers to distribution of the prompt were: forgetting to distribute the eggs; uncertainty about the significance of fertility; and uncertainty about fertility issues in general for female adolescent cancer patients. The scientific community must continually explore effective avenues of communication to ensure such information is received. The stress egg has potential to impact a cancer survivor’s outlook on future partnering, family life, and self-concept when used in conjunction with policy

Assessing the Reproductive Concerns of Children and Adolescents with Cancer: Challenges and Potential Solutions

Infertility is often an expected side effect of cancer treatment, although the idea of fertility and sterility may be difficult for the child or adolescent patient to comprehend. Several established fertility preservation options exist for males and females, such as cryopreservation of sperm or embryos. Experimental therapies, which require institutional review board approval, are also being tested. While the science of fertility preservation for adolescents with cancer is advancing, the social science research in this area is lacking. Specifically, there are only a small number of studies about the psychological reproductive concerns in the pediatric oncology population. These studies have provided groundbreaking information for future research, but also illustrate the challenges in conducting research in this area. This article comments on those challenges and, when possible, presents solutions for confronting them

Assessing the Reproductive Concerns of Children and Adolescents with Cancer: Challenges and Potential Solutions

Infertility is often an expected side effect of cancer treatment, although the idea of fertility and sterility may be difficult for the child or adolescent patient to comprehend. Several established fertility preservation options exist for males and females, such as cryopreservation of sperm or embryos. Experimental therapies, which require institutional review board approval, are also being tested. While the science of fertility preservation for adolescents with cancer is advancing, the social science research in this area is lacking. Specifically, there are only a small number of studies about the psychological reproductive concerns in the pediatric oncology population. These studies have provided groundbreaking information for future research, but also illustrate the challenges in conducting research in this area. This article comments on those challenges and, when possible, presents solutions for confronting them

The effects of the Health Insurance Portability and Accountability Act privacy rule on influenza research using geographical information systems

The Health Insurance Portability and Accountability Act (HIPAA) privacy rule was enacted to protect patients’ personal health information from undue disclosure. Despite its intention to protect patients, recent reports suggest that HIPAA restrictions may be negatively impacting health research. Quantitative, visual geographical and statistical analysis of zip code geographical information systems (GIS) mapping, comparing 3-digit HIPAA-compliant and 5-digit HIPAA-non-compliant simulated data, was chosen to identify and describe the type of distortion that may result. It was found that unmitigated HIPAA compliance with HIPAA mapping rules distorted the GIS zip code data by 28% leading to erroneous results. Thus, compliance with HIPAA privacy rule when mapping may lead investigators to publish erroneous GIS maps

Factors Associated With Having A Medical Home For Children At-Risk Of Experiencing Negative Events: Results From A National Study

Objectives: Although the Patient Centered Medical Home is a considered an optimal model for care, some children still do not receive care in this model. Beyond the clinical and practitioner factors known to affect having a medical home, family and environmental risks [referred to as adverse childhood experiences (ACE)] may also be associated with having a medical home. This study’s purpose was to examine whether family and environment risks are associated with children having a medical home. Methods: Data from the nationally representative, cross-sectional 2011–2012 National Survey of Children’s Health telephone survey were used (N = 95,677). Analyses were conducted to describe the sample characteristics and determine the association between family and environmental risks and whether a child has a medical home. A subset of risks were modeled from the seminal study of ACEs. Results: Nearly one-quarter of parents reported that their children experienced at-least one ACE. Compared to children who experienced no ACEs, children who experienced at least one ACE, or other family and environmental risks, had lower odds of having a medical home than those whom did not. Logistic regressions showed that cumulative ACEs (odds ratio (OR) 0.76; 95 % confidence interval (CI) 0.65–0.90) as well as other family and environmental risks (OR 0.36, 95 % CI 0.26–0.51) were related to lower odds of having a medical home. Conclusions: This study suggests that family and environmental risks, including ACEs, impact parental report of a child having a medical home and that a dosage effect may exist. ACEs and other risk factors must be considered when providers care for children at-risk of experiencing negative events, particularly multiple negative events

The Comorbidity Of Physical, Mental, And Developmental Conditions Associated With Childhood Adversity: A Population Based Study

Objective Adverse childhood experiences (ACEs) are associated with myriad health conditions and risk behaviors in both adolescents and adults. In this study we examine the association between ACEs and specific physical, mental, and developmental conditions, as well as their comorbidity, in a nationally representative sample of children 0–17 years. Methods Data from the 2011–2012 National Survey for Child Health (NSCH) were used. A total of 95,677 random-digit-dial interviews with parents of children 0–17 years were conducted across all 50 states and the District of Columbia. Outcomes included singular condition domains (physical, mental, and developmental) as well as combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Results Twenty-three percent of parents reported that their child experienced 1 ACE; 9.2 % experienced 2 ACEs, and 10.3 % experienced three or more. Across all three condition domains and combinations of domains, children who experienced at least one ACE were more likely than children who experienced 0 ACEs to have at least one condition. Additionally, greater ACEs was associated with increased likelihood of at least one condition in each domain and in multiple domains. Conclusions for practice These findings support the extension of existing family environment screening tools in pediatric practices as well as the establishment of a system for monitoring ACEs in families with multiple or complex conditions

Adverse Childhood Experiences And Dental Health In Children And Adolescents

Objective This study seeks to explore the how specific toxic stressors, specifically adverse childhood experiences (ACEs), and their frequencies may be associated with tooth condition and the presence of caries. Methods Data from the 2011-12 National Survey for Child Health (NSCH), a nationally representative survey of child health, were used in this study. Pediatric dental health was measured using parent report of two characteristics: condition of teeth and having a toothache, decayed teeth, and/or unfilled cavities in the past 12 months. ACEs were measured by asking about a child\u27s exposure to the divorce of a parent, parental incarceration, domestic violence, neighborhood violence, drug and alcohol abuse, mental illness, and financial hardship. Analyses were adjusted by sociodemographic characteristics, healthcare access and utilization, and comorbid chronic conditions. Results The presence of even one ACE in a child\u27s life increased the likelihood of having poor dental health. Additionally, having multiple ACEs had a cumulative negative effect on the condition of their teeth and the presence of dental caries (Odds Ratios 1.61-2.55). Adjusted models show that racial and socioeconomic factors still play a significant role in dental health. Conclusions In addition to the known disparities in dental caries, this study demonstrates that there is significant association between childhood psychosocial issues and dental health. Preventive dental care should be considered incorporating the screening of multiple biological stressors, including ACEs, in routine dental visits as a means of identifying and reducing dental health inequities