luni, 21 martie 2011

Advocating for Global Health through Evidence, Insight and Action

Student Voices: Advocating for Global Health through Evidence, Insight and Action

Steven J. Hoffman, Instructor, Faculty of Health Sciences, McMaster University Fellow, Munk School of Global Affairs,   University of Toronto

McMaster Health Forum, August 2010. Hamilton, Ontario, Canada - ISBN 978-1-894088-21-3
Available online [74p.] at: http://bit.ly/bvAjeU
 “……Global health efforts must be informed by the best available evidence and most creative insights. Today’s students have an important role to play in this enterprise for both their innovative ideas and future leadership of the global health sphere. This edited volume offers a student perspective on five pressing global health issues, namely internal displacement, disaster relief, water systems, gender-based violence and maternal health. Each chapter examines the global political context in which decisions on the particular health topic of focus are made, explores prevailing trends in the issue area, and considers advocacy strategies that concerned stakeholders can adopt to catalyze action. The authors are all undergraduate students at McMaster University in Hamilton, Ontario, Canada. Through this publication, it is hoped that the student voice can help shape some of today’s leading debates in global health as they prepare themselves to confront tomorrow’s greatest challenges…..”
Content

Chapter 1: Displacement and Health

Chapter 2: Disaster Relief Coordination

Chapter 3: Economics of the World Water Crisis

Chapter 4: Eliminating Gender-based Violence

Chapter 5: Advocating for Maternal Health
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Open medicine is approved for medline indexing View more documents from Dean Giustini.

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What's new at Open Medicine? August 2010

RESEARCH
Cardiovascular risk factors in ethnic populations within Canada: results from national cross-sectional surveys. Richard Liu, Lawrence So, Sailesh Mohan, Nadia Khan, Kathryn King  http://www.openmedicine.ca/article/view/372/343
CAST YOUR VOTE FOR OPEN MEDICINE

The legendary music festival South by Southwest has added a Health track to the Interactive portion of the fest in 2011. We've submitted a panel proposal called “Breaking Out of the Straitjacket” on the future of biomedical publishing. Your vote can help send Open Medicine to Austin.

To vote, visit: http://bit.ly/dbtiRD
BLOG Female doctors and students from “Across the World Unite”. A guest post from the 28th International Congress of the Medical Women
International Association in Munster, Germany http://blog.openmedicine.ca/node/276
OM IN THE NEWS

Claire Kendall, one of the founding editors of Open Medicine, is featured in a story on open-access pioneers at the University of Ottawa. Take a minute to get to know Claire. http://www.uottawa.ca/articles/open-access
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Female doctors & students from "Across the World Unite"

Kristin DeGirolamo and Pamela Verma reporting
"Globalization is not only out there, it is both here and there”. These remarks from keynote Speaker Dr. lona Kickbusch, Graduate Institute Geneva, set the tone for this year's formidable congress of women doctors and trainees regarding the scope of global medicine for developed and developing countries alike.
The 28th International Congress of the Medical Women International Association (MWIA) was hosted in Munster, Germany, from July 27th-31st. The quaint town attracted ~600 delegates to the conference from more than 15 countries with strong representation from Europe and Africa. Founded in 1919, MWIA is one of the oldest international medical bodies that remains active today. Its mandate is to provide a forum for the issues of women’s health and the existence of women in the profession.
The triennial meeting was themed Globalization in Medicine-Challenges and Opportunities and featured plenaries on Gender Strategies and Violence, Addiction, Epidemic Plagues, Health Care, and Nutrition. A highlight was the special program for students and young doctors which included a poster session, lectures and discussion meetings. Young women discussed issues such as work life balance, medical education, and current networks for dialogue in the profession.
With a rigorous scientific program of posters, lectures, and workshops the MWIA General Assembly discussed future activities for the society and the campaigns on Female Genital Mutilation and Cervical Cancer Screening and Prevention. “This meeting is not only an opportunity for great scientific information, but also for medical women from around the world to discuss common problems such as gender discrimination in the medical profession”, Secretary General Dr Shelley Ross said. Ross is a family practitioners who has been involved in Association since her days as a medical student.
For more information about MWIA (http://mwia.webtop.de/) and the Congress (http://www.mwia2010.net).
Kristin DeGirolamo and Pamela Verma
Faculty of Medicine, University of British Columbia
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Open Medicine supports 'The Vienna Declaration'

Open Medicine supports The Vienna Declaration, an official declaration of AIDS 2010, currently underway in Vienna. The statement supports the incorporation of scientific evidence into illicit drug policy, with the aim to improve community health. Canadian researchers, particularly those at the British Columbia Centre for Excellence in HIV/AIDS (www.cfenet.ubc.ca) and the International Centre for Science in Drug Policy (www.icsdp.org), were instrumental in developing this landmark statement.

Find out more—and join us in endorsing The Vienna Declaration at: http://www.viennadeclaration.com

Follow The Declaration onTwitter: http://twitter.com/vdecl

Follow The Declaration on Facebook: http://www.facebook.com/pages/The-Vienna-Declaration/108611532515232?ref=ts
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End of life 'quality' index

The Quality of Death: Ranking end-of-life care across the world
2010 The Economist Intelligence Unit

Available online PDF [39p.] at: http://bit.ly/9ToVuw
 “…………..“Quality of life” is a common phrase. The majority of human endeavours are ostensibly aimed at improving quality of life, whether for the individual or the community, and the concept ultimately informs most aspects of public policy and private enterprise.
Advancements in healthcare have been responsible for the most significant quality-of-life gains in the recent past: that humans are (on average) living longer, and more healthily than ever, is well established. But “quality of death” is another matter. Death, although inevitable, is distressing to contemplate and in many cultures is taboo.
Even where the issue can be openly discussed, the obligations implied by the Hippocratic oath—rightly the starting point for all curative medicine—do not fit easily with the demands of end-of-life palliative care, where the patient’s recovery is unlikely and instead the task falls to the physician (or, more often, caregiver) to minimise suffering as death approaches. Too often such care is simply not available: according to the Worldwide Palliative Care Alliance, while more than 100m people annually would benefit from hospice and palliative care (including family and carers who need help and assistance in caring), less than 8% of those in need access it.
Few nations, including rich ones with cutting-edge healthcare systems, incorporate palliative care strategies into their overall healthcare policy—despite the fact that in many of these countries, increasing longevity and ageing populations mean demand for end-of-life care is likely to rise sharply. Globally, training for palliative care is rarely included in healthcare education curricula. Institutions that specialise in giving palliative and end-of-life care are often not part of national healthcare systems, and many rely on volunteer or charitable status.
Added to this, the availability of painkilling drugs—the most basic issue in the minimisation of suffering—is woefully inadequate across much of the world, often because of concerns about illicit use and trafficking. The result of this state of affairs is an incalculable surfeit of suffering, not just for those about to die, but also for their loved ones. Clearly, the deeper inclusion of palliative care into broader health policy, and the improvement of standards of end-of-life care—raising the “quality of death”—will also yield significant gains for humanity’s quality of life……….”
Contents
Executive summary
Note on definitions
Introduction: new challenges in managing the end of life
1. The Quality of Death Index
Index methodology
A high quality of death
A low quality of death
2. Cultural issues in end-of-life care
Attitudes to death and dying
Levels of debate across the globe
The law and the decision to die
Three contrasting attitudes to death
3. The economics of end-of-life care
A variety of funding models
Romania: from last to leader
Kerala: the community model
Long-stay patients shift the balance
4. Policy issues in end-of-life care
Government recognition
The availability and use of opioids
Integration of care into mainstream services
Uganda: a beacon in Africa
Building capacity for home-based care
The importance of training
5. Conclusions
Appendix: Index methodology


This report and more information on the Quality of Death Index can be found at: www.eiu.com/sponsor/lienfoundation/qualityofdeath
More information on the Quality of Death Index is also available at the website created by the Lien Foundation, the sponsor of the research: www.qualityofdeath.org
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Men's Health - Canadian Consumer Information Portal

See also Men's Health Pathfinders and Women's Health (General guide) (also Canadian consumer health information (CHI) portal )
The purpose of these pathfinders is to point consumers and health professionals to leading men’s health initiatives (and digital sources of information) around the world. They are listed alphabetically (let me know if you want something added):
A to Z pathfinders
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First Conference for Open Access Publishers 2009

First Conference for Open Access Scholarly Publishers, 14-16 Sept 2009
The Open Access Scholarly Publishers Association, OASPA (www.oaspa.org), and the Directory of Open Access Journals (DOAJ) (www.doaj.org) are pleased to announce that they will jointly host the 1st Conference for Open Access Scholarly Publishers in Lund, Sweden from the 14th-16th September 2009 at the Scandic Star Hotel.
The conference is directed towards the interests of independent open access journals and professional publishing organizations, as well as librarians, suppliers and other stakeholders. Also those who are interested in learning more about open access publishing and exploring opportunities are welcome.
 Participants will have the opportunity to hear from many leading figures within the open access publishing movement, and to participate in workshops that will highlight a number of important issues related to open access publishing. A growing speakers list already includes: Lars Bjornshauge, Director Lund University Library Head Office/DOAJ, John Willinsky, Public Knowledge Project/OJS, Geoff Bilder, CrossRef, Kaitlin Thaney, Creative Commons and Jens Vigens, CERN/SCOAP3.
Additional information on the conference, registration and proposal submissions can found on the conference website at: www.oaspa.org/conference . Early bird fees will be available.
The organizing committee, the DOAJ and OASPA look forward to welcoming a broad and international spectrum of publishers and publishing suppliers to the first conference to specifically focus on open access and publishing.
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"Can improving access to information transform global health" April 21st, 2009



Here is the poster for the Open Medicine event at the University of Toronto on Tuesday April 21st, 2009. The entire emphasis is on improving access to information for healthcare. I encourage you to post this somewhere in your clinics or health organizations. If you attend, please introduce yourself to the OM editors.
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Swine Flu in Canada - Information Sources

See also Twitter "Swine flu" updates or Pat Andersen's iGoogle Swineflu tab
In April 2009, the Swine flu exploded onto the international scene with intense interest generated in the media and blogosphere. The U.S. Centers for Disease Control has taken a lead with respect to information dissemination, and with its international partners - including Health Canada and the Public Health Agency of Canada - explains what people can do to keep informed and to protect themselves when travelling.
In Canada, as of April 26th, there were 6 confirmed national cases, two in British Columbia and four in Nova Scotia. (For general information, see the PHAC Factsheet).
Canada
  • HealthLink BC at 8-1-1, 24 hours a day/seven days a week
Canadian news outlets
Google maps United States
The Center for Disease Control (CDC) maintains a web page on Swine Flu and is kept updated with recent facts.
Recent CDC articles on swine flu
Swine Influenza A (H1N1) infection in two children--Southern California, March-April 2009 MMWR Morb Mortal Wkly Rep. 2009 Apr 24;58(15):400-2. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm
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Guest Blogger - Dr. Farhan Asrar, part I, on "Dr. WW Keen"

William Williams Keen (January 19, 1837 – June 7, 1932)
by Dr. Farhan Asrar
Dr. W. W. Keen was an internationally renowned surgeon considered by many to be among the greatest of all time. An article in McGill University’s the Osler Library Newsletter in October 1972 by Professor G.E. Erikson of Brown University mentions three possible nominees for greatest surgeon of the early twentieth century (who could challenge Sir William Osler's achievements as a physician?). The three mentioned were Harvey Cushing, William Halsted and William W. Keen, all of whom were dear friends of Osler.
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William Williams Keen was born in Philadelphia in 1837 and went on to pursue both undergraduate and graduate studies at Brown University. He received his M.D. from Jefferson Medical College in 1862. In the Annals of Surgery in 1933, J.H. Gibbon called Keen America’s first brain surgeon as he had performed the U.S.A.’s first successful brain tumour surgery, removing a mass from a patient who lived for thirty years after the operation. Keen is credited with inventing several surgical procedures, including drainage of the cerebral ventricles. After hearing Joseph Lister’s views on antisepsis, Keen was among America's first surgeons to utilize antiseptic techniques and wrote the first American surgery text based on Listerian principles in 1892.
During Dr. Keen's career, it was estimated that he taught from between six to seven thousand medical students and wrote hundreds of articles, editorials and books. He edited an edition of Gray’s Anatomy and his 'System of Surgery' was considered to be the surgeon’s bible. He held countless honours and recognitions, including the president of several prestigious organizations such as the American Medical Association, the College of Physicians and Surgeons of Philadelphia, and the American Surgical Association. He was the first American to become President of the International Surgical Congress. Keen received honorary degrees from Toronto, Edinburgh, Paris, Yale, Harvard, Brown, Pennsylvania as well as others. He served during both the Spanish-American war and World War I.
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One of Keen's unknown achievements was being among a group of surgeons involved in operations to remove a malignant growth from the jaw of the then American President Grover Cleveland in 1893. Due to the national interests of the country, the operations were kept secret, the first of which was said to be performed on a yacht. Details of the surgeries came to light when Keen wrote about them in 1917. He noted "The entire operation was done within the mouth, without any external incision, by means of a cheek retractor”.
******************

The attached original letter was written by Keen to Dr. A.M. Eaton on December 11th, 1918. It mentions his work with the Medical reserve corps, as well as about a photograph that he is sending to Dr. Eaton.
William Osler and W.W. Keen shared a close friendship based on a delightful sense of humour. Professor G.E. Erikson wrote that Keen recalled how Osler would escort Keen’s prettiest daughter to functions and introduce her as his own wife with the straightest of faces. Another amusing incident is told through a post card at the Brown University archives; William Osler had sent the card to Keen, asking him not to buy a book which Osler himself was looking to purchase, stating “Please do not buy up all the incunabula you old greedy rascal. If you come across Servetus' Christianismi Restitutio - send it to me - 'twould not be a proper book for you! Love to the girls" (referring to Keen’s four daughters).
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Dr. William Williams Keen passed away in June 1932, leaving behind an unparalleled legacy in the field of surgery and medicine. Upon his death, the Canadian Medical Association Journal of August 1932 declared “One of the giants of our profession has passed. Among his contemporaries he was perhaps the only one who might be compared with Osler, in his range, his enthusiasm and his power of making friends”.
About the author and collector: Dr. Farhan M. Asrar is a resident physician (in the specialty of Community Medicine) at McMaster University. He has a keen interest in history as well as collecting arts and antiquities. The original letter of Dr. Keen is from his private collection in a specialized section entitled 'History of Medicine'.
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Guest Post - Richard Moyle, Mesothelioma Cancer Center

What is 'mesothelioma'?
Mesothelioma is a rare and aggressive cancer caused by exposure to asbestos, a naturally occurring mineral that was once widely used in a number of industrial applications. The substance was mainly used in insulation, brake lining, piping and flooring due to its durability and resistance to fire. Though harmless if left undisturbed, once asbestos is damaged the microscopic fibers are released into the air where they can then be inhaled or ingested. Once this happens, the fibers become lodged in the tissue surrounding organs like the lungs, heart or stomach.
The most common form of malignant mesothelioma affects the pleura or lining of the lungs, however mesothelioma has also been observed in the pericardium (heart lining) and peritoneum (stomach lining).
The biggest obstacle in the treatment of mesothelioma is the ability to detect the cancer early. The typical latency period of this type of cancer is anywhere from 25 to 50 years after initial exposure. Recognizable symptoms do not start to appear until about this time.
Known symptoms of pleural mesothelioma include:
  • Persistent dry or raspy cough (typically non-productive, meaning no phlegm)
  • Coughing up blood (hemoptysis)
  • Difficulty in swallowing (dysphagia)
  • Night sweats or fever
  • Unexplained weight loss of 10 percent or more
  • Fatigue
  • Persistent pain in the chest or rib area, or painful breathing
  • Shortness of breath (dyspnea) that occurs even when at rest
  • The appearance of lumps under the skin on the chest
Unfortunately, because symptoms take so long to exhibit and because symptoms are similar to other, less serious respiratory ailments, the cancer is not usually diagnosed until it is advanced. This makes treatment options limited and often inadequate to fight the cancer. The typical mesothelioma survival rate after diagnosis is about one year.
There are a few treatment options depending on how far along the cancer is at diagnosis.
  • Surgical – Curative surgical treatment is used to remove the cancer from the body. Unfortunately, this is only an option when the cancer is detected early, which is typically not the case.
  • Chemotherapy - Most forms of chemotherapy involve the intravenous administration of drugs such as Alimta and Cisplatin. Chemotherapeutic drugs are targeted to kill cells that are rapidly dividing by interfering with processes that occur during cell division. However, while cancer cells themselves divide rapidly, so do some types of healthy cells, causing some of the unpleasant side effects that are often associated with this form of treatment.
  • Radiation - used to kill cancer cells and to limit the spread of cancer. For patients with mesothelioma, radiation therapy is most often used in conjunction with surgery. in some cases radiation may be used as a stand-alone treatment to relieve pain and other symptoms associated with mesothelioma. In either case, it is rare for radiation therapy to provide more than short-term symptomatic relief.
  • Photodynamic Therapy - a highly specialized and specific form of treatment that is most often used to treat skin cancers, some types of lung cancer, and pleural mesothelioma. However, this treatment is usually unsuitable for patients with metastasized cancer; it is most effective in patients who have localized disease.
  • Gene Therapy - involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment.
Because early detection is a key factor in treating mesothelioma, if you are aware that you have had any exposure to asbestos in the past, it is important that you tell your doctor. Aside from military service, a few of the most common occupations that deal with asbestos include firefighters, electricians and auto mechanics.
Richard Moyle National Awareness Coordinator Mesothelioma Cancer Center - http://www.asbestos.com/
Other sources of information on 'Mesothelioma':
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CIHR "Knowledge Translation Learning Modules"

The Canadian Institutes of Health Research (CIHR) has published an excellent series of online Knowledge translation learning modules:
1. A Guide to Researcher and Knowledge-User Collaboration in Health Research
2. Introduction to Evidence-Informed Decision Making
3. Critical Appraisal of Intervention Studies
At CIHR, knowledge translation (KT) is defined as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.
A Guide to Researcher and Knowledge-User Collaboration in Health Research
This learning module will lead those engaged in collaborative health research - both researchers and knowledge users - through many of the key issues that should be considered and addressed when taking an integrated approach to creating knowledge and translating it into action. The module includes many real-life examples and case studies to illustrate learning points discussed in each section. This tutorial material was developed by Participatory Research at McGill (PRAM). For the full module, click here.
Module Sections 1. Introduction 2. Identify and recruit researcher partners 3. Taking stock of barriers and facilitators 4. Engaging in collaborative research design 5. Governance 6. Ethics 7. Maintaining partnerships over time 8. Identify Integrated Knowledge Translation (IKT) funding opportunities 9. Dissemination and knowledge to action
Introduction to Evidence-Informed Decision Making
This module has been developed to increase understanding about the components of evidence-informed decision making. It is built on a scenario that allows the learner to understand and apply each stage of the evidence-informed decision making process. The module was developed by Donna Ciliska, RN, PhD, Professor, McMaster University and Scientific Director, National Collaborating Centre for Methods and Tools. For the full module, click here.
Module Sections
What is evidence-informed decision making? Why bother?
Ask. How do I frame the question?
Acquire. How can I find the best evidence in five minutes or less?
Appraise. How can I decide if the particular study is good enough to apply?
Integrate. How do I decide which of multiple studies to use?
Adapt. How do I use the information from #5 in decision-making/policy brief?
Apply. How do I develop the implementation the plan?
Analyze. How do I evaluate if the plan worked?
Critical Appraisal of Intervention Studies
The objective of this module is to increase the learner's ability to decide if an intervention study is of sufficient quality that it can be applied to a particular situation. The module is built on a scenario that allows the learner to understand and apply each criterion for critical appraisal of an intervention study. The module was developed by Donna Ciliska, RN, PhD, Professor, McMaster University and Scientific Director, National Collaborating Centre for Methods and Tools. For the full module, click here.
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"Asynchronous telehealth: A scoping review of analytic studies" on our new wiki!

A new article was published this week by Amol Deshpande, Shariq Khoja, Julio Lorca, Ann Mckibbon, Carlos Rizo and Alejandro R Jadad entitled "Asynchronous telehealth: A scoping review of analytic studies" on Open Medicine's new wiki.
  This project explores the use of a wiki as an online collaborative tool for improving and updating peer-reviewed systematic reviews.
Posted on this wiki is a copy of the article: Asynchronous telehealth: A scoping review of analytic studies
Readers are invited to edit the article either by adding, deleting or modifying its contents.
Got a question or comment? Add it to the Discussion page.
Make sure to create an account so that any additions and edits that you contribute will be credited to your name rather than just your IP address.
This project is supported by the Canadian Agency for Drugs and Technology in Health (CADTH) and Open Medicine. The review was supported by CADTH and completed by Foresights Links.
Posted by Dean Giustini

Asynchronous telehealth: A scoping review of analytic studies

Posted on June 2, 2009 - 01:54
A new article was published this week by Amol Deshpande, Shariq Khoja, Julio Lorca, Ann McKibbon, Carlos Rizo and Alejandro R Jadad entitled "
Asynchronous telehealth: A scoping review of analytic studies" This project explores the use of a wiki as an online collaborative tool for improving and updating peer-reviewed systematic reviews.
Posted on this wiki is a copy of the article: Asynchronous telehealth: A scoping review of analytic studies
Readers are invited to edit the article either by adding, deleting or modifying its contents.
Got a question or comment? Add it to the Discussion page.
Make sure to create an account so that any additions and edits that you contribute will be credited to your name rather than just your IP address.
This project is supported by the Canadian Agency for Drugs and Technology in Health (CADTH) and Open Medicine. The review was supported by CADTH and completed by Foresights Links.
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Human Genome Resources



A challenge facing researchers today is that of piecing together and analyzing the plethora of data currently being generated through the Human Genome Project and scores of smaller projects. NCBI's Web site serves an an integrated, one-stop, genomic information infrastructure for biomedical researchers from around the world so that they may use these data in their research efforts. More...



Gene Database
A new database of genes and associated information is now available for searching in Entrez.

dbSNP
A database of single nucleotide polymorphisms (SNPs) and other nucleotide variations. 		  OMIM
A guide to human genes and inherited disorders maintained by Johns Hopkins University and collaborators.

dbGaP
The database of Genotypes and Phenotypes (dbGaP) was developed to archive and distribute the results of studies that have investigated the interaction of genotype and phenotype.


NIH Epigenomics Roadmap
Reference epigenomic maps and studies on new epigenetic mechanisms and their relevance to human health.
Roadmap Epigenomics Data
A comprehensive listing of all NIH Roadmap Epigenomics datasets submitted to GEO and SRA.


Download DNA sequence
Fifty years after the double helix, the reference DNA sequence of Homo sapiens is now available for downloading. 		BLAST the Genome
Compare your sequence to the genomic sequence and its products.

Clone Registry
A centralized registry of genomic clones, end-sequences, mapping data, and distributor information.


Map Viewer
An interactive viewer of physical and genetic maps, genomic sequence, genes, and other genomic annotations.

UniSTS
A non-redundant  collection of STSs with links to maps and sequence.

Electronic PCR
Check your sequence for STSs and view in genomic context.

Linkage Maps
deCODE Map
Marshfield Map
Genethon Map

Physical Maps
Stanford TNG RH Map
Stanford G3 RH Map
Whitehead YAC/RH Map



UniGene
A computational system for organizing transcribed sequences into gene-based clusters.

cDNA Sequencing Projects
A user's guide to sequences and clone reagents produced by full-length cDNA projects.

GEO
Gene Expression Omnibus, a public repository for gene expression and hybridization data.

SAGEmap
Gene expression results from SAGE tags mapped to mRNA sequences in GenBank.


Use of BAC clone CTD-3193o13 as a FISH probe in the analysis of chromosome aberrations associated with developmental abnormalities. Human BAC Resource
A cytogenetic resource of FISH-mapped, sequence-tagged BAC clones.

SKY/CGH
Spectral karyotyping and comparative genome hybridization data for studying chromosome abnormalities.
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