A mixed methods study to develop a tool to assess institutional readiness to conduct knowledge translation activities in low-income and middle-income countries

Objective: This paper describes the development of a tool for assessing organisational readiness to conduct knowledge translation (KT) among academic institutions in low-income and middle-income countries (LMICs). // Design: A literature review and stakeholder consultation process were conducted to identify constructs relevant for assessing KT readiness in LMICs. These were face-validated with LMIC stakeholders and organised into a Likert-scale questionnaire. // Participants: The questionnaire was distributed to researchers based at six LMIC academic institutions and members of a global knowledge-to-action thematic working group. // Outcome measures: An exploratory factor analysis was used to identify underlying dimensions for assessing institutional readiness to conduct KT. // Results: 111 respondents with varied KT experiences from 10 LMICs were included in the analysis. We selected 5 factors and 23 items, with factor loadings from 0.40 to 0.77. These factors include (1) institutional climate, (2) organisation change efficacy, (3) prioritisation and cosmopolitanism, (4) self-efficacy, and (5) financial resources. These factors accounted for 69% of the total variance, with Cronbach’s alpha coefficients of 0.78, 0.73, 0.62, 0.68 and 0.52, respectively. // Conclusions: This study identifies a tool for assessing readiness of LMIC academic institutions to conduct KT and unique opportunities for building capacity. The organisational focus of these factors underscores the need for strategies that address organisational systems and structures in addition to individual skills. Future research will be conducted to understand determinants of these factors and develop a comprehensive set of capacity building strategies responsive to academic institutions in LMICs

An assessment of the learning styles of first year medical and dental students of North Bengal Medical College, Darjeeling, West Bengal, India

Background: Learning is the act of acquiring, modifying and reinforcing existing knowledge, behavior, skills and values. This phenomenon of learning is dominated by an individual’s learning style. Learning style is a popular concept in psychology and education, and it refers to how a person learns best. This study aims to identify the Learning Styles of the first year MBBS and BDS students at NBMC by administering the questionnaire of the VARK model.Methods: This cross-sectional study was performed in the Department of Physiology at North Bengal Medical College, West Bengal after. The VARK questionnaire 7.8 version was administered to 180 first year MBBS and BDS students from the 2017-2018 batch who had volunteered for the study. The Questionnaire consisted of 16 questions, along with a scoring chart. Students were allowed to choose more than one option. If in majority of the questions they opted for a single sensory modality they were considered as unimodal learners and if they chose multiple options, they were recognized as multimodal learners.Results: The study showed 57% of the students to be multimodal learners and 43% to be unimodal learners. Read/Write was the most preferred (31.22%) sensory modality followed by kinesthetic mode (29.57%).Conclusions: As majority of our students are multimodal learners teachers should incorporate active teaching and learning strategies to cater to all types of learners. Also, as the most preferred method is Read/Write which includes googling and the use of internet to browse for information, we must try and incorporate e-learning into our curriculum

Monogamy of quantum correlations reveals frustration in a quantum Ising spin system: Experimental demonstration

We report a nuclear magnetic resonance experiment, which simulates the quantum transverse Ising spin system in a triangular configuration and further show that the monogamy of quantum correlations can be used to distinguish between the frustrated and non-frustrated regimes in the ground state of this system. Adiabatic state preparation methods are used to prepare the ground states of the spin system. We employ two different multipartite quantum correlation measures to analyze the experimental ground state of the system in both the frustrated and non-frustrated regimes. In particular, we use multipartite quantum correlation measures generated by monogamy considerations of negativity, a bipartite entanglement measure, and that of quantum discord, an information-theoretic quantum correlation measure. As expected from theoretical predictions, the experimental data confirm that the non-frustrated regime shows higher multipartite quantum correlations compared to the frustrated one.Comment: Title in the published version is "Multipartite quantum correlations reveal frustration in a quantum Ising spin system", 7 pages, 4 figure

A Rare Case of Deep Vein Thrombosis Secondary to Protein S Deficiency and Antithrombin III Deficiency with MTHFR (C677T) Heterozygous Mutation, and Crohn’s Disease

Deep vein thrombosis is a condition wherein a thrombus develops in the deep veins of the body, most commonly in the legs, due to increasing tendency of the blood to coagulate. One such reason is the MTHFR gene mutation, wherein an increase in homocysteine levels causes irritation of the blood vessel endothelium, causing a disturbance in Virchow’s triad, hence triggering clot formation. [1] The MTHFR gene is responsible for instructing the body to produce an enzyme called methylene tetrahydrofolate reductase(MTHFR) [2]. MTHFR gene mutations can lead to a wide range of disorders, either as a result of the elevated levels of homocysteine in the blood, or due to folate deficiency. In about 25% of individuals globally, there is a mutation of MTHFR. The MTHFR 677C\u3eT mutation is predominantly seen in the Hispanic ethnicity, whereas the MTHFR 128A\u3eC is predominantly seen in the ethnicity groups belonging to south east Asia. In the Indian population, the MTHFR mutation prevails a low frequency of 2.9%. Diagnosis and treatment are required only in cases where secondary diseases occur as a result of MTHFR polymorphism, or if there is significant family history [4]. The treatment is along the same lines as that of another diagnosed individual without the mutation. In this case, the correlation between a genetic mutation of the MTHFR gene and Protein S and Antithrombin III deficiency, along with Crohn\u27s disease, which resulted in the development of DVT in a middle aged, male individual and its management is discussed

The influence of gender dynamics on polio eradication efforts at the community, workplace, and organizational level

Background: Globally, gender as a barrier or facilitator in achieving health outcomes is increasingly being documented. However, the role of gender in health programming and organization is frequently ignored. The Global Polio Eradication Initiative, one of the largest globally coordinated public health programs in history, has faced and worked to address gender-based challenges as they emerge. This paper seeks to describe the role of gender power relations in the polio program across global, national, subnational, and front-line levels to offer lessons learned for global programs. // Methods: We conducted qualitative key-informant interviews with individuals purposively selected from the polio universe globally and within seven country partners: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, and Nigeria. The interview tool was designed to explore nuances of implementation challenges, strategies, and consequences within polio eradication. All interviews were conducted in the local or official language, audio-recorded, and transcribed. We employed a deductive coding approach and used four gender analysis domains to explore data at the household, community, workplace, and organizational levels. // Results: We completed 196 interviews globally and within each partner country; 74.5% of respondents were male and 25.5% were female. Male polio workers were not allowed to enter many households in conservative communities which created demand for female vaccinators. This changed the dynamics of front-line program teams and workplaces and empowered many women to enter the workplace for the first time. However, some faced challenges with safety and balancing obligations at home. Women were less likely to receive promotions to managerial or supervisory roles; this was also reflected at the global level. Some described how this lack of diverse management and leadership negatively affected the quality of program planning, delivery and limited accountability. // Conclusions: Gender power relations play an important role in determining the success of global health programs from global to local levels. Without consideration of gender, large-scale programs may fail to meet targets and/or reinforce gender inequities. Global disease programs should incorporate a gender lens in planning and implementation by engaging men and boys, supporting women in the workplace, and increasing diversity and representation among leadership

Efficiency of Different Endodontic Irrigation and Activation Systems in Removal of the Smear Layer: A Scanning Electron Microscopy Study

Introduction: This in vitro study was designed to evaluate and compare different endodontic irrigation and activation systems for removal of the intracanal smear layer. Methods and Materials: Forty recently extracted, non-carious human intact single rooted premolars were selected and divided into five groups (n=10) according to the root canal irrigation systems; syringe and needle irrigation (CTR), sonic irrigation, passive ultrasonic irrigation (PUI) and EndoVac irrigation system. All groups were prepared to #40 apical size with K-files. Each sample was subjected to final irrigation by using four different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope (SEM). The irrigation systems were compared using the Fisher's exact test with the level of significance set at 0.05. Results: The four groups did not differ from each other in the coronal and mid-root parts of the canal. In the apical part of the canal none of the methods could completely remove all the smear layer but EndoVac system showed significantly better removal of smear layer and debris than the other methods. Conclusion: Within the limitations of the present study, the EndoVac system cleaned the apical part of the canal more efficiently than sonic, ultrasonic and syringe and needle irrigation.Keywords: EndoVac Irrigation System; Passive Ultrasonic Irrigation; Smear Layer; Sonic Irrigation Syste

Translating Implementation Experiences and Lessons Learned From Polio Eradication Into a Global Health Course: Insights From an International Consortium

Lessons learned from one global health program can inform responses to challenges faced by other programs. One way to disseminate these lessons is through courses. However, such courses are often delivered by and taught to people based in high-income countries and thus may not present a truly global perspective. The Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) is a consortium of 8 institutions in Afghanistan, Bangladesh, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, and the United States that seeks to carry out such a transfer of the lessons learned in polio eradication. This short report describes the collaborative process of developing content and curriculum for an international course, the learnings that emerged, the barriers we faced, and recommendations for future similar efforts. Various parts of our course were developed by teams of researchers from countries across South Asia and sub-Saharan Africa. We held a series of regional in-person team meetings hosted in different countries to improve rapport and provide a chance to work together in person. The course content reflects the diversity of team members’ knowledge in a variety of contexts. Challenges to this effort included team coordination (e.g., scheduling across time zones); hierarchies across and between countries; and the coronavirus disease (COVID-19) pandemic. We recommend planning for these hierarchies ahead of time and ensuring significant in-person meeting time to make the most of international collaboration

A multi-pronged scoping review approach to understanding the evolving implementation of the Smallpox and Polio eradication programs: what can other Global Health initiatives learn?

Background: Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this multi-pronged scoping review, we explored the evolution and learning from SEP and GPEI implementation over time at global and country levels to inform other global health programs. // Methods: Three related reviews of literature were conducted; we searched for documents on 1) the SEP and 2) GPEI via online database searches and also conducted global and national-level grey literature searches for documents related to the GPEI in seven purposively selected countries under the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) project. We included documents relevant to GPEI implementation. We conducted full text data analysis and captured data on Expert Recommendations for Implementing Change (ERIC) implementation strategies and principles, tools, outcomes, target audiences, and relevance to global health knowledge areas. // Results: 200 articles were included in the SEP scoping review, 1885 articles in the GPEI scoping review, and 963 documents in the grey literature review. M&E and engagement strategies were consistently translated from the SEP to GPEI; these evolved into newer approaches under the GPEI. Management strategies including setting up robust record systems also carried forward from SEP to GPEI; however, lessons around the need for operational flexibility in applying these strategies at national and sub-national levels did not. Similarly, strategies and lessons around conducting health systems readiness assessments prior to implementation were not carried forward from SEP to GPEI. Differences in the planning and communication strategies between the two programs included fidelity to implementation blueprints appeared to be higher under SEP, and independent monitoring boards and communication and media strategies were more prominent under GPEI. // Conclusions: Linear learning did not always occur between SEP and GPEI; several lessons were lost and had to be re-learned. Implementation and adaptation of strategies in global health programs should be well codified, including information on the contextual, time and stakeholders’ issues that elicit adaptations. Such description can improve the systematic translation of knowledge, and gains in efficiency and effectiveness of future global health programs

Rheology of Active-Particle Suspensions

We study the interplay of activity, order and flow through a set of coarse-grained equations governing the hydrodynamic velocity, concentration and stress fields in a suspension of active, energy-dissipating particles. We make several predictions for the rheology of such systems, which can be tested on bacterial suspensions, cell extracts with motors and filaments, or artificial machines in a fluid. The phenomena of cytoplasmic streaming, elastotaxis and active mechanosensing find natural explanations within our model.Comment: 3 eps figures, submitted to Phys Rev Let