Advancing integrative “one-health” approaches to global health through multidisciplinary, faculty-led global health field courses

AbstractBackgroundSince 2003, the University of Wisconsin-Madison Global Health Institute, together with collaborating campus and in-country partners, has offered immersive, multidisciplinary, faculty-led, global health field courses in Ecuador and Thailand. These courses aim to help students to develop a working understanding of integrative one-health approaches and acquire the skills to work effectively across disciplines. That is, we aim to foster an appreciation of the role of culture in perceptions of health, disease, and health care; the complex interactions of animal-human-ecosystem health and disease; and the value of integrating cross-disciplinary and cross-cultural perspectives and skills to solve complex public health problems.MethodsStudents from various University of Wisconsin-Madison health faculties travelled, lived (accommodation included homestays in indigenous or rural communities), learnt, and engaged in community-health assessments or service-learning projects as a multidisciplinary team. We recruited students through annual presentations in each University of Wisconsin school or college and through recommendations from past participants. We recorded student reflections during the course, at course completion, and after graduation.FindingsBetween 2003 and 2014: 215 students from the University of Wisconsin have taken part in the global health field courses. Students came from the fields of human medicine (53 [25%]), veterinary medicine (35 [16%]), nursing (40 [19%]), pharmacy (41 [19%]), and other degree programs (46 [21%]). Results of the in-course and post course assessments consistently show strong student satisfaction with many aspects of the programme, including safety, faculty mentorship, the value of the multidisciplinary approach, depth of learning, and programme cost. Former participants also report use of cross-cultural skills in their professional practice, work with populations from cultures other than their own, positive effects on their decisions for career activities, and the belief that immersive cross-cultural experiences should be a required part of professional training for all health professional students. Finally, the courses undergo independent programme evaluations (including in-country observation and interviews with participants and stakeholders) approximately every 5 years.InterpretationProgramme directors continue to seek improvements related to: sustainable faculty engagement from various disciplines; development of increasingly specific course group learning objectives, competencies, and assessment tools; sustainability of impacts on community-level health and wellbeing; continuity between University of Wisconsin-Madison and in-country university and community partners; and scholarship support and other approaches so that cost does not exclude interested students from participating.FundingThe GHI is supported through a combination of university, grants, and philanthropic funding; these field courses do not have specific, separate funding. Students self-fund participation in the courses

An Anthropological Approach to Teaching Health Sciences Students Cultural Competency in a Field School Program

International immersion experiences do not, in themselves, provide students with the opportunity to develop cultural competence. However, using an anthropological lens to educate students allows them to learn how to negotiate cultural differences by removing their own cultural filters and seeing events through the eyes of those who are culturally different. Faculty at the University of Wisconsin-Madison’s Global Health Institute believed that an embedded experience, in which students engaged with local communities, would encourage them to adopt this cultural competency 2.0 position. With this goal in mind, they started the Field School for the Study of Language, Culture, and Community Health in Ecuador in 2003 to teach cultural competency to medical, veterinary, pharmacy, and nursing students. The program was rooted in medical anthropology and embraced the One Health initiative, which is a collaborative effort of multiple disciplines working locally, nationally, and globally to obtain optimal health for people, animals, and the environment. In this article, the authors identify effective practices and challenges for using a bio-cultural approach to educating students. In a semester-long preparatory class, students study the Spanish language, region-specific topics, and community engagement principles. While in Ecuador for five weeks, students apply their knowledge during community visits that involve homestays and service learning projects, for which they partner with local communities to meet their health needs. This combination of language and anthropological course work and community based service learning has led to positive outcomes for the local communities as well as professional development for students and faculty.This is a non-final version of an article. The article is copyrighted by The Association of American Medical Colleges and published by Lippincott Williams & Wilkins. It can be found as published in final form at: http://journals.lww.com/AcademicMedicine/pages/default.aspx under the doi:10.1097/ACM.0000000000000088

Characterization Of Supernate Samples From High Level Waste Tanks 13H, 30H, 37H, 39H, 45F, 46F and 49H

This document presents work conducted in support of technical needs expressed, in part, by the Engineering, Procurement, and Construction Contractor for the Salt Waste Processing Facility (SWPF). The Department of Energy (DOE) requested that Savannah River National Laboratory (SRNL) analyze and characterize supernate waste from seven selected High Level Waste (HLW) tanks to allow: classification of feed to be sent to the SWPF; verification that SWPF processes will be able to meet Saltstone Waste Acceptance Criteria (WAC); and updating of the Waste Characterization System (WCS) database. This document provides characterization data of samples obtained from Tanks 13H, 30H, 37H, 39H, 45F, 46F, and 49H and discusses results. Characterization of the waste tank samples involved several treatments and analysis at various stages of sample processing. These analytical stages included as-received liquid, post-dilution to 6.44 M sodium (target), post-acid digestion, post-filtration (at 3 filtration pore sizes), and after cesium removal using ammonium molybdophosphate (AMP). All tanks will require cesium removal as well as treatment with Monosodium Titanate (MST) for {sup 90}Sr (Strontium) decontamination. A small filtration effect for 90Sr was observed for six of the seven tank wastes. No filtration effects were observed for Pu (Plutonium), Np (Neptunium), U (Uranium), or Tc (Technetium); {sup 137}Cs (Cesium) concentration is ~E+09 pCi/mL for all the tank wastes. Tank 37H is significantly higher in {sup 90}Sr than the other six tanks. {sup 237}Np in the F-area tanks (45F and 46F) are at least 1 order of magnitude less than the H-Area tank wastes. The data indicate a constant ratio of {sup 99}Tc to Cs in the seven tank wastes. This indicates the Tc remains largely soluble in Savannah River Site (SRS) waste and partitions similarly with Cs. {sup 241}Am (Americium) concentration was low in the seven tank wastes. The majority of data were detection limit values, the largest being < 1.0E+04 pCi/mL. Measured values for Pu and U were generally well below solubility model predictions

Experimental Study of Informal Rewards in Peer Production

We test the effects of informal rewards in online peer production. Using a randomized, experimental design, we assigned editing awards or “barnstars” to a subset of the 1% most productive Wikipedia contributors. Comparison with the control group shows that receiving a barnstar increases productivity by 60% and makes contributors six times more likely to receive additional barnstars from other community members, revealing that informal rewards significantly impact individual effort

A Compton-vetoed germanium detector with increased sensitivity at low energies

The difficulty to directly detect plutonium in spent nuclear fuel due to the high Compton background of the fission products motivates the design of a Gamma detector with improved sensitivity at low energies. We have built such a detector by operating a thin high-purity Ge detector with a large scintillator Compton veto directly behind it. The Ge detector is thin to absorb just the low-energy Pu radiation of interest while minimizing Compton scattering of high energy radiation from the fission products. The subsequent scintillator is large so that forward scattered photons from the Ge detector interact in it at least once to provide an anti-coincidence veto for the Ge detector. For highest sensitivity, additional material in the line-of-sight is minimized, the radioactive sample is kept thin, and its radiation is collimated. We will discuss the instrument design, and demonstrate the feasibility of the approach with a prototype that employs two large CsI scintillator vetoes. Initial spectra of a thin Cs-137 calibration source show a background suppression of a factor of {approx}2.5 at {approx}100 keV, limited by an unexpectedly thick 4 mm dead layer in the Ge detector

Gender-Specific Effects of Unemployment on Family Formation: A Cross-National Perspective

This paper investigates the impact of unemployment on the propensity to start a family. Unemployment is accompanied by bad occupational prospects and impending economic deprivation, placing the well-being of a future family at risk. I analyze unemployment at the intersection of state-dependence and the reduced opportunity costs of parenthood, distinguishing between men and women across a set of welfare states. Using micro-data from the European Community Household Panel (ECHP), I apply event history methods to analyze longitudinal samples of first-birth transitions in France, Finland, Germany, and the UK (1994-2001). The results highlight spurious negative effects of unemployment on family formation among men, which can be attributed to the lack of breadwinner capabilities in the inability to financially support a family. Women, in contrast, show positive effects of unemployment on the propensity to have a first child in all countries except France. These effects prevail even after ontrolling for labour market and income-related factors. The findings are pronounced in Germany and the UK where work-family conflicts are the cause of high opportunity costs of motherhood, and the gender-specific division of labour is still highly traditional. Particularly among women with a moderate and low level of education, unemployment clearly increases the likelihood to have a first child

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