Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

Artificial Intelligence for Global Health: Difficulties and Challenges: A Narrative Review

Global health (GH) aims to improve healthcare for all people on the planet and eradicate all avoidable diseases and deaths. The inception of Artificial Intelligence (AI) is innovating healthcare practices and improving patient outcomes by shuffling enormous volumes of health data—from health records and clinical studies to genetic information analyzing it much faster than humans. AI also helps in the improvement of medical imaging and medical diagnosis. There is an increased optimism regarding the use of applications of AI locally but can these facets be translated globally in the advancement and delivery of healthcare with the help of AI. At present majority of AI developments and applications in health care provide to the needs of developed countries and there is little effort to develop programs which could help to improve healthcare delivery globally. We performed this narrative review to assess the difficulties and discrepancies in implementing AI in global health delivery and find ways to improve.

Monkeypox outbreak in the age of COVID‑19:a new global health emergency

Dear Editor,The World Health Organization recently declared monkeypox as a global emergency after reporting more than 57,000 new cases worldwide[1].Monkeypox is an orthopoxvirus similar in nature to the Variola virus,which is a causative agent for smallpox[2].Monkeypox virus presents as a unique challenge for global health and should be regarded with grave concern as the vast majority of cases are occurring in countries where the disease is not considered endemic.Furthermore,the spread of this pathogen is occurring concomitantly as the world is still engaged in a battle with the coronavirus disease 2019(COVID-19)pandemic,which has caused substantial damage to global healthcare infrastructure.If monkeypox continues its rapid spread,hospitals could be quickly overwhelmed by both COVID-19 and monkeypox cases.Now more than ever,early symptom recognition and use of all available treatments to contain monkeypox outbreaks are vital.Early precautions including early recognition of symptoms by physicians,use of currently available treatments,and promoting precautionary measures in at-risk populations may be vital in preventing hospital burden and further physician burnout.

Chromoblastomycosis:a tropical-subtropical fungal disease with pathognomonic features not to be neglected in a global health scenario

Chromoblastomycosis(CBM)is a fungal disease,distributed in tropical and subtropical regions,affecting mainly rural workers.It is characterized by chronic skin lesions that may vary from nodular,tumorous,verrucous or plaque type.Associated constitutional symptoms are rarely found.The histological presentation may yield a pathognomonic feature,the Medlar(sclerotic)bodies,in which a typical brown to black pigment is depicted,explaining“copper pennies”as its alias.In this article,the case of a 56-year-old woman in the countryside of Brazil is reported,whose main complaint was a chronic leg ulcer for the past 8 years.The left leg had a large,partially ulcerated plaque lesion was found.Microbiological cultures were positive for the pathogen.Histological analysis demonstrated pseudoepitheliomatous hyperplasia,lymphohistiocytic infiltrate and sclerotic bodies(“copper pennies”).CBM’s epidemiological panorama,once established uniquely by geographical distribution,is transitioning to a global health issue,influenced by immunosuppressive conditions,global warming and migration.This scenario demands CBM to be widely considered as a differential diagnosis and may represent a clinical challenge in regions whose professionals have little expertise in infectious tropical diseases.

Global health education in Chinese universities and potential for collaboration with schools of nursing: A qualitative study

Background: The Chinese Consortium of Universities for Global Health (CCUGH) was established within schools of public health in 2013 with the goal of enhancing global health in China.Expanding nursing students' exposure to global health curricula is important as nurses are essential actors in the health care system.However,information related to existing global health education within CCUGH-affiliated universities and the current engagement of Chinese schools of nursing in global health remains extremely limited.Objective: To identify and describe the current definitions and conceptualizations of global health education in Chinese universities,with a focus on schools of nursing,in order to explore potential opportunities for strengthened collaboration between global health initiative and schools of nursing in China.Methods: Purposive sampling with snowballing was used to recruit 19 key informants who were critical stakeholders in global health and nursing in China.Key informant interviews were conducted from July 2014 to February 2015,and data were updated in June 2016.Content analysis was used to analyze data via Atlas.ti 7.Results: There was a rapid growth in global health education within and beyond CCUGH-affiliated universities with nine universities establishing global health institutes.Translation and definition of global health lacked consistency in Chinese language.Though no course directly related to global health was offered,schools of nursing were gradually participating in global health education and research.Nursing was a critical component of global health,and global health and nursing mutually advanced each other.Nursing education should include global health contents,but at present independent global health curriculum in schools of nursing was not appropriate.Conclusion: Increasingly Chinese universities are promoting global health education through the platform of CCUGH.It is an ideal moment to promote and expand work across the fields of global health and nursing,specifically to highlight opportunities for collaboration across education,research and practice.

Global health governance for travel health: lessons learned from thecoronavirus disease 2019 (COVID-19) outbreaks in large cruise ships

Background: The outbreak and global pandemic of coronavirus disease 2019 (COVID-19) attracts a great deal ofattentions to the problem of travel health. Cruise tourism is increasingly popular, with an estimated 30 millionpassengers transported on cruise ships worldwide each year. Safeguarding the health of cruise travelers duringthe entire travel is of ultimate importance for both the industry and global public health.Objective: This study aimed to explore the challenges and opportunities in travel health from the perspective ofglobal health governance.Methods: The global governance framework including problems, values, tools or regulations, and actors relatedto travel health were used to analyze the issues involved.Results: Up to April 2020, nearly thirty cruise ship voyages reported COVID-19 cases. The Diamond Princess,Grand Princess and Ruby Princess cruise ship had over 1,400 total reported COVID-19 cases, and more than 30deaths. A community with a common future in travel health is the core value of global health governance fortravel health. The travel-related international regulations, including the International Health Regulation (IHR[2005]), United Nations Convention on the Law of the Sea (UNCLOS) and the International Maritime Organization(IMO) conventions should be further updated to deal with the travel health problems. The roles andresponsibilities and the cooperation mechanisms of different actors are not clear in relation to the public healthemergencies during the travel.Conclusion: Travel health transcends national borders and involves multilevel actors, thus needs globalcooperation and governance. Regulations and legislation at global and country level are required to preventlarge-scale humanitarian crisis on travel health. Multilateral coordination, cooperation and collaborationmechanisms between governments, intergovernmental organizations, non-governmental organizations andindustry are needed to build a better community of common destiny for travel health.

《中国医科大学学报》入选2008年英国《公共健康研究数据库》(Global Health)收录中国期刊名单

据中国高校自然科学学报研究会网站2009年3月30日报道,《中国医科大学学报》入选2008年英国《公共健康研究数据库》(Glbobal Health)收录中国期刊名单。Global

Disciplinary development of global health academic degree programs in China

This study aims to provide a brief overview of the history and development of global health education(GHE)as academic degree programs worldwide,and to identify GHE’s development opportunities and obstacles in China.This is a state-of-the-art review of published and unpublished information that described and evaluated disciplinary development of global health degree programs worldwide,written in English,and published or shared between 1990 and 2020.Data were derived from official websites of leading global health institutions,like“Google Scholar”,“PubMed”,and unpublished information such as presentation files and unpublished manuscripts collected from knowledgeable leaders in the field.We retrieved and reviewed a total of 35 articles and a large amount of unpublished information or sources on the internet.Global Health emerged as a new discipline around the end of the last millennium and proliferated in the last two decades in developed nations,especially the United States and the United Kingdom.The development of China’s GHE programs was built on China’s increasing engagement in global health affairs and research.In 2012,Wuhan University established the first official global health department in China.Several universities such as Peking University and Duke Kunshan University subsequently set up departments or programs to offer undergraduate and postgraduate majors and degrees.The first school-level global health unit was established in Shanghai in 2019.The Consortium of Chinese Universities for Global Health(CCUGH)grew from 10 founding members in 2013 to 25 in 2020.Major desirable attributes“unique”to students majoring in global health include global-mindedness,health interests,compassion,intercultural sensitivity,and adventurous spirit.Graduates from GHE programs have a diverse set of career choices spanning research,government,not-for-profit,and private sector occupations.We identified a number of strengths,weaknesses,opportunities,and threats to the future development of GHE in China.To ensure sustainable future growth,we advocate addressing the following key aspects:(1)clearer disciplinary distinctions;(2)multidisciplinary collaborations;(3)public-sector investments;and(4)non-public sectors participation.Amidst China’s increasing engagement in health affairs globally and the proliferation of GHE programs in developed nations,China has experienced fast growth in GHE degree programs since 2012 while a number of challenges remain for its future development.

Cultivating global health professionals: evaluation of a training course to develop international consulting service competence in China

Background:China’s accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick’s model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants’reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90%of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training(P<0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4%of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants’feedback,it is essential to develop and expand consulting training in the field of global health.

Global health education in U.K. universities

Background:The coronavirus disease 2019(COVID-19)pandemic has led to a paradigm shift in global health,casting a previously niche academic discipline into a headline dominating field of research.However,accurate information on the delivery of global health education(GHE)at a university level is lacking.This study aims to assess current GIIE practices in U.K.universities,by identifying the availability of dedicated global health qualifications,as well as the breadth of inclusion of GHE topics across university course content.Methods:Universities selected were the top 25 recipients of MRC funding in 2015-2016,as well as universi­ties who were included in previous iterations of the“Global Health League Table”.We used the Consortium of Universities for Global Health“GHE Competencies Toolkit”to identify the presence of global health content across university global health and other course offerings.Universities were additionally judged on opportunities available in global health and on the presence of sustainable partnerships.Results:Our results showed that 20 universities(74%)offer a post-graduate global health related course,with 9(33%)offering an undergraduate global health related course.13(48%)were identified as centers of global health excellence.Just 12(44%)universities had registered sustainable partnerships with Tropical Health and Education Trust.The London School of Hygiene and Tropical Medicine was identified as the top deliverer of GHE,with the Universities of Leicester and the Universities of Exeter joint bottom.We were unable to standardize quality assessments in this iteration of the project,but the release of student feedback to future assessors would help to improve the reliability of this study methodology.Additionally,much of our data was based on information available online,and thus some aspects of degree courses not published publicly may not have been accounted for in our scoring.Conclusion:Those institutions wishing to improve their delivery of GHE should consider the establishment of a postgraduate or undergraduate degree course.Breadth of global health content across curricular was a major discriminating factor between institutions,and we would advise universities to consider including more global health topics across their curricular-especially in light of the intersectional impacts of the COVID-19 pandemic.

Beyond the bedside:A review of translational medicine in global health

Translational research is a broad field of medicine with several key phases moving from scientific discovery to bench research and the hospital bedside,followed by evidence-based practice and population-level policy and programming. Understanding these phases is crucial when it comes to preventing and treating illness,especially in global health. Communities around the world struggle with a variety of health problems that are at some times similar and at others quite different. Three major world health issues help to outline the phases of translational research:vaccines,human immunodeficiency virus and acquired immunodeficiencysyndrome,and non-communicable diseases. Laboratory research has excelled in many of these areas and is struggling in a few. Where successful therapies have been discovered there are often problems with appropriate use or dissemination to groups in need. Also,many diseases would be better prevented from a population health approach. This review highlights successes and struggles in the arena of global health,from smallpox eradication to the impending epidemic of cardiovascular disease,in an attempt to illustrate of the various phases of translational research.

The power of the public purse: financing of global health partnerships and acienda setting for sustainability

Public-private partnerships(PPPs) have reshaped the institutional structure of global governance.They have advanced collaboration on core issues such as health, clean energy, the rights of women and children, and access to infrastructure, among others. But which actors create and finance public-private partnerships in global governance to advance such objectives? What are the implications of the agency behind such collaboration for influencing the global agenda on sustainable development? While some scholars and advocacy groups see the growing role of private actors as a powershift away from public institutions, others argue that such arrangements tend to be complementary to public mandates and indeed may provide a new means for international institutions to pursue such mandates. The article probes this debate by analyzing the type of actors that finance global health partnerships, an area in which the influence of hybrid initiatives is particularly prominent. It reveals that public financing remains a core and necessary condition for the emergence and functioning of PPPs. The growing share of private financing,nonetheless, has important implications for shaping partnerships agendas and steering global health and sustainability governance. Rather than a powershift or abdication of responsibilities by the state, there is rather a tendency of deliberate diffusion of power by donors toward hybrid structures.

A Brief Talk on How to Promote China Health and Quarantine at Points of Entry in the Framework of Global Health

Global health concerns about the health of the global population and the concepts of global health are gradually being accepted by all of the countries in the world.China health and quarantine at points of entry(POEs) is an integral part of global health,and its duty of prevention and control of the communicable diseases in POEs is consistent with the duty of global health to promote the health of global population.Under the principle of "prevention first",health and quarantine organ carries out the work of disease prevention and control and international travel health care,the reinforcement of core capacity at POEs,and focuses on human rights protection.All the same,there are some gaps with the requirements of global health,such as the inadequate of health promotion planning capacity,ethics awareness and legal protection.The future work of health and quarantine should change ideas on communicable diseases prevention at POEs,focus more on ethical consideration,and should optimize system architecture and human resources,strengthen cooperation,maintain core capacity at POEs,thus to build points of entry public health system with Chinese characteristics,meanwhile to apply the concepts of global health deeply into every aspects of health and quarantine at POEs.

Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Shaping global health promotion:a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences(1986-2021)Author links open overlay panel

Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing diverse health challenges that evolved over different periods.Methods The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986-2021.We summarized the themes and key achievements,and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.Results The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale.The primary purpose and goal are to promote health from regional to global.Significantly,our findings highlight a transition in the primary actors driving health promotion.It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization,governments,and international bodies,to a more inclusive approach involving non-governmental organizations and the general public.This development implies that health promotion has evolved into a collective global endeavor,demanding the proactive involvement of various stakeholders,and forging new alliances in public health.Meanwhile,the coronavirus disease 2019(COVID-19)pandemic has further shaped the landscape of health promotion,underscoring the need for intensified focus on areas including disease prevention,health education,and the integration of digital health technologies,and emphasizing the importance of a multidimensional,responsive approach in public health initiatives.Conclusions Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.Countries,together with public and private entities,should intensify cooperation.Multisectoral collaboration among partners such as healthcare,education,social security,and the industry is vital for health promotion and achieving global health goals.

Tackling global health security by building an academic community for One Health action

Background One Health approach is crucial to tackling complex global public health threats at the interface of humans, animals, and the environment. As outlined in the One Health Joint Plan of Action, the international One Health community includes stakeholders from different sectors. Supported by the Bill & Melinda Gates Foundation, an academic community for One Health action has been proposed with the aim of promoting the understanding and real-world implementation of One Health approach and contribution towards the Sustainable Development Goals for a healthy planet.Main text The proposed academic community would contribute to generating high-quality scientific evidence, distilling local experiences as well as fostering an interconnected One Health culture and mindset, among various stakeholders on different levels and in all sectors. The major scope of the community covers One Health governance, zoonotic diseases, food security, antimicrobial resistance, and climate change along with the research agenda to be developed. The academic community will be supported by two committees, including a strategic consultancy committee and a scientific steering committee, composed of influential scientists selected from the One Health information database. A workplan containing activities under six objectives is proposed to provide research support, strengthen local capacity, and enhance global participation.Conclusions The proposed academic community for One Health action is a crucial step towards enhancing communication, coordination, collaboration, and capacity building for the implementation of One Health. By bringing eminent global experts together, the academic community possesses the potential to generate scientific evidence and provide advice to local governments and international organizations, enabling the pursuit of common goals, collaborative policies, and solutions to misaligned interests.

Framework Construction and Application for Global Health Information Platform

In order to understand the global health related information rapidly and timely, a global health information platform based on big data from internet is constructed. In this paper, we introduce the framework and application of the global health information platform. The functions of information platform mainly include two aspects： to analyze and disseminate theoretical and technological progress of the main research fields in global health and to monitor real-time emergencies, epidemic situation and hot topics related to the field of global health. The objective of this research is to establish a Chinese-English bilingual information platform in the global health field. The platform would help academic researchers understand and master global health progress in time; acquire information of global health comprehensively, accurately and dynamically; and eventually help deal with the risk of global diseases, formulate appropriate health policies and actively participate in the international global health affairs.

Potential for broad-scale transmission of Ebola virus disease during the West Africa crisis:lessons for the Global Health security agenda

Background:The 2014-2016 Ebola crisis in West Africa had approximately eight times as many reported deaths as the sum of all previous Ebola outbreaks.The outbreak magnitude and occurrence of multiple Ebola cases in at least seven countries beyond Liberia,Sierra Leone,and Guinea,hinted at the possibility of broad-scale transmission of Ebola.Main text:Using a modeling tool developed by the US Centers for Disease Control and Prevention during the Ebola outbreak,we estimated the number of Ebola cases that might have occurred had the disease spread beyond the three countries in West Africa to cities in other countries at high risk for disease transmission(based on late 2014 air travel patterns).We estimated Ebola cases in three scenarios:a delayed response,a Liberia-like response,and a fast response scenario.Based on our estimates of the number of Ebola cases that could have occurred had Ebola spread to other countries beyond the West African foci,we emphasize the need for improved levels of preparedness and response to public health threats,which is the goal of the Global Health Security Agenda.Our estimates suggest that Ebola could have potentially spread widely beyond the West Africa foci,had local and international health workers and organizations not committed to a major response effort.Our results underscore the importance of rapid detection and initiation of an effective,organized response,and the challenges faced by countries with limited public health systems.Actionable lessons for strengthening local public health systems in countries at high risk of disease transmission include increasing health personnel,bolstering primary and critical healthcare facilities,developing public health infrastructure(e.g.laboratory capacity),and improving disease surveillance.With stronger local public health systems infectious disease outbreaks would still occur,but their rapid escalation would be considerably less likely,minimizing the impact of public health threats such as Ebola.Conclusions:The Ebola outbreak could have potentially spread to other countries,where limited public health surveillance and response capabilities may have resulted in additional foci.Health security requires robust local health systems that can rapidly detect and effectively respond to an infectious disease outbreak.

High-containment facilities and the role they play in global health security

Biological threats,whether naturally occurring or accidentally or deliberately released,have the potential to endanger lives and disrupt economies worldwide.Thus,high-containment protective measures should be implemented when handling bio-agents that can cause serious,highly contagious diseases,otherwise devastating pandemics can occur.In the fields of scientific investigation,healthcare,and product development,high-containment facilities play a critical role in preventing,detecting,and responding promptly and effectively to threats to global health security.In this paper,we present a summary of the main types of high-containment facilities,as well as their applications,challenges,and suggestions for the future.

Family medicine: Global health in practice

For nearly 40 years,family medicine has been providing guiding principles in major global health programs.This article has two aims:(1)to review past major global health campaigns with a specific focus on the roles of family medicine to illustrate its relevance in global health,and(2)to address practical approaches to attain health,which nurture sustainability of local health resources and resilience of the community.Regardless of the differences in the goals of past global health campaigns,three key approaches have emerged as essential interventions in the field based on family medicine principles,the so-called six Cs.The key approaches are(1)to protect families,(2)to train health care providers,and(3)to empower people.Family medicine continues to be a powerful tool to improve people’s health in our own communities and in global health practice.