MAKING REPRODUCTIVE HEALTH MEANINGFUL: AN ANTHROPOLOGICAL STUDY OF PLANNED PARENTHOOD PERSONNEL IN LEXINGTON, KY

This thesis focuses on how reproductive health is made meaningful in the context of a Planned Parenthood clinic in Kentucky. Using ethnographic field methods, including participant observation and semi-structured interviews, the paper explores how staff members negotiate definitions of reproductive health as employees of Planned Parenthood health center. The analysis addresses reproductive health discourse among the clinic staff and how reproductive health is used as a site of intervention. It also explores the sociocultural processes and interactions the staff members engage in at the national and local levels and the role these play in shaping the conceptualization of reproductive health and how it is deployed at the clinic level. This analysis illuminates the fluid nature of reproductive health meanings and the ways in which health care delivery is contextually and socially mediated

Transforming health professions\u27 education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative.

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning. METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These interviews were recorded, transcribed and coded to identify common themes. RESULTS: All of the consortia have prioritized efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilize limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalization of collaborative activities. CONCLUSIONS: The consortia described in this paper demonstrate a paradigm shift in the relationship between medical schools in four African countries. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding that was leveraged to form in-country partnerships has created a culture of collaboration, overriding the history of competition. The positive impact on the quality and efficiency of health workforce training suggests that future funding for global health education should prioritize such south-south collaborations

Transforming health professions\u27 education through in-country collaboration: examining the consortia among African medical schools catalyzed by the Medical Education Partnership Initiative.

BACKGROUND: African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning. METHODS: Semi-structured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These interviews were recorded, transcribed and coded to identify common themes. RESULTS: All of the consortia have prioritized efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilize limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalization of collaborative activities. CONCLUSIONS: The consortia described in this paper demonstrate a paradigm shift in the relationship between medical schools in four African countries. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding that was leveraged to form in-country partnerships has created a culture of collaboration, overriding the history of competition. The positive impact on the quality and efficiency of health workforce training suggests that future funding for global health education should prioritize such south-south collaborations

Transforming health professions\u27 education through in-country collaboration: Examining the consortia between African medical schools catalyzed by the medical education partnership initiative

Background African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning. Methods Semistructured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These interviews were recorded, transcribed and coded to identify common themes. Results All of the consortia have prioritized efforts to increase the quality of medical education, support new schools in-country and strengthen relations with government. These in-country partnerships have enabled schools to pool and mobilize limited resources creatively and generate locally-relevant curricula based on best-practices. The established schools are helping new schools by training faculty and using grant funds to purchase learning materials for their students. The consortia have strengthened the dialogue between academia and policy-makers enabling evidence-based health workforce planning. All of the partnerships are expected to last well beyond the MEPI grant as a result of local ownership and institutionalization of collaborative activities. Conclusions The consortia described in this paper demonstrate a paradigm shift in the relationship between medical schools in four African countries. While schools in Africa have historically worked in silos, competing for limited resources, MEPI funding that was leveraged to form in-country partnerships has created a culture of collaboration, overriding the history of competition. The positive impact on the quality and efficiency of health workforce training suggests that future funding for global health education should prioritize such south-south collaborations

Medical education departments: a study of four medical schools in Sub-Saharan Africa

Background Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. Methods In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Results Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. Conclusions The establishment of medical education departments in Sub-Saharan Africa is a strategy medical schools can employ to improve the quality of health professions education. The creation of communities of practice such as has been done by the MEPI project is a good way to expand the network of medical education departments in the region enabling the sharing of lessons learned across the continent

E-learning in medical education in resource constrained low- and middle-income countries

Background In the face of severe faculty shortages in resource-constrained countries, medical schools look to e-learning for improved access to medical education. This paper summarizes the literature on e-learning in low- and middle-income countries (LMIC), and presents the spectrum of tools and strategies used. Methods Researchers reviewed literature using terms related to e-learning and pre-service education of health professionals in LMIC. Search terms were connected using the Boolean Operators “AND” and “OR” to capture all relevant article suggestions. Using standard decision criteria, reviewers narrowed the article suggestions to a final 124 relevant articles. Results Of the relevant articles found, most referred to e-learning in Brazil (14 articles), India (14), Egypt (10) and South Africa (10). While e-learning has been used by a variety of health workers in LMICs, the majority (58%) reported on physician training, while 24% focused on nursing, pharmacy and dentistry training. Although reasons for investing in e-learning varied, expanded access to education was at the core of e-learning implementation which included providing supplementary tools to support faculty in their teaching, expanding the pool of faculty by connecting to partner and/or community teaching sites, and sharing of digital resources for use by students. E-learning in medical education takes many forms. Blended learning approaches were the most common methodology presented (49 articles) of which computer-assisted learning (CAL) comprised the majority (45 articles). Other approaches included simulations and the use of multimedia software (20 articles), web-based learning (14 articles), and eTutor/eMentor programs (3 articles). Of the 69 articles that evaluated the effectiveness of e-learning tools, 35 studies compared outcomes between e-learning and other approaches, while 34 studies qualitatively analyzed student and faculty attitudes toward e-learning modalities. Conclusions E-learning in medical education is a means to an end, rather than the end in itself. Utilizing e-learning can result in greater educational opportunities for students while simultaneously enhancing faculty effectiveness and efficiency. However, this potential of e-learning assumes a certain level of institutional readiness in human and infrastructural resources that is not always present in LMICs. Institutional readiness for e-learning adoption ensures the alignment of new tools to the educational and economic context

Gravimetric and density profiling using the combination of surface acoustic waves and neutron reflectivity

A new approach is described herein, where neutron reflectivity measurements that probe changes in the density profile of thin films as they absorb material from the gas phase have been combined with a Love wave based gravimetric assay that measures the mass of absorbed material. This combination of techniques not only determines the spatial distribution of absorbed molecules, but also reveals the amount of void space within the thin film (a quantity that can be difficult to assess using neutron reflectivity measurements alone). The uptake of organic solvent vapours into spun cast films of polystyrene has been used as a model system with a view to this method having the potential for extension to the study of other systems. These could include, for example, humidity sensors, hydrogel swelling, biomolecule adsorption or transformations of electroactive and chemically reactive thin films. This is the first ever demonstration of combined neutron reflectivity and Love wave-based gravimetry and the experimental caveats, limitations and scope of the method are explored and discussed in detail

Neural correlates of taste reactivity in autism spectrum disorder.

Selective or \u27picky\u27 eating habits are common among those with autism spectrum disorder (ASD). These behaviors are often related to aberrant sensory experience in individuals with ASD, including heightened reactivity to food taste and texture. However, very little is known about the neural mechanisms that underlie taste reactivity in ASD. In the present study, food-related neural responses were evaluated in 21 young adult and adolescent males diagnosed with ASD without intellectual disability, and 21 typically-developing (TD) controls. Taste reactivity was assessed using the Adolescent/Adult Sensory Profile, a clinical self-report measure. Functional magnetic resonance imaging was used to evaluate hemodynamic responses to sweet (vs. neutral) tastants and food pictures. Subjects also underwent resting-state functional connectivity scans.The ASD and TD individuals did not differ in their hemodynamic response to gustatory stimuli. However, the ASD subjects, but not the controls, exhibited a positive association between self-reported taste reactivity and the response to sweet tastants within the insular cortex and multiple brain regions associated with gustatory perception and reward. There was a strong interaction between diagnostic group and taste reactivity on tastant response in brain regions associated with ASD pathophysiology, including the bilateral anterior superior temporal sulcus (STS). This interaction of diagnosis and taste reactivity was also observed in the resting state functional connectivity between the anterior STS and dorsal mid-insula (i.e., gustatory cortex).These results suggest that self-reported heightened taste reactivity in ASD is associated with heightened brain responses to food-related stimuli and atypical functional connectivity of primary gustatory cortex, which may predispose these individuals to maladaptive and unhealthy patterns of selective eating behavior. Trial registration: (clinicaltrials.gov identifier) NCT01031407. Registered: December 14, 2009

Advances in SAW Gas Sensors Based on the Condensate-Adsorption Effect

A surface-acoustic-wave (SAW) gas sensor with a low detection limit and fast response for volatile organic compounds (VOCs) based on the condensate-adsorption effect detection is developed. In this sensor a gas chromatography (GC) column acts as the separator element and a dual-resonator oscillator acts as the detector element. Regarding the surface effective permittivity method, the response mechanism analysis, which relates the condensate-adsorption effect, is performed, leading to the sensor performance prediction prior to fabrication. New designs of SAW resonators, which act as feedback of the oscillator, are devised in order to decrease the insertion loss and to achieve single-mode control, resulting in superior frequency stability of the oscillator. Based on the new phase modulation approach, excellent short-term frequency stability (±3 Hz/s) is achieved with the SAW oscillator by using the 500 MHz dual-port resonator as feedback element. In a sensor experiment investigating formaldehyde detection, the implemented SAW gas sensor exhibits an excellent threshold detection limit as low as 0.38 pg

Robust Design of SAW Gas Sensors by Taguchi Dynamic Method

This paper adopts Taguchi’s signal-to-noise ratio analysis to optimize the dynamic characteristics of a SAW gas sensor system whose output response is linearly related to the input signal. The goal of the present dynamic characteristics study is to increase the sensitivity of the measurement system while simultaneously reducing its variability. A time- and cost-efficient finite element analysis method is utilized to investigate the effects of the deposited mass upon the resonant frequency output of the SAW biosensor. The results show that the proposed methodology not only reduces the design cost but also promotes the performance of the sensors