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Global Health Education Day is an exciting opportunity to draw together global health researchers, educators, and students. Led by the Institute for Global Health's Center for Global Health Education, this year's event began with an online poster session where students, trainees, and faculty members presented posters on projects relevant to global health. All posters can be enlarged by clicking the link underneath each image.
The Surgical, Educational and Sustainability Outcomes of Short Term Surgical Trips in Otolaryngology- Head and Neck Surgery: A Systematic Review
While short term surgical trips (STSTs) have been used as a means to address unmet surgical needs within Otolaryngology- Head and Neck Surgery (Oto-HNS) in Low and Middle Income Countries (LMIC), net positive outcomes from these efforts are uncertain. As such, this systematic review aims to describe the surgical, educational, and sustainability-focused outcomes of STSTs that focus on Oto-HNS pathologies. focused on surgical, educational, and sustainability-focused goals.
Presenting author: Karina Yu
Poster 1
The Future of Sustainability at Clínica de Familia
As part of the Northwestern Access to Health Program, we worked on a feasibility study with Clínica de Familia (Clínica), a healthcare organization in La Romana, Dominican Republic. Given that Clínica is losing vital funding targeted toward programs serving female sex workers, men who have sex with men, and transwomen, we worked to provide Clínica with key recommendations about how to continue supporting these populations.
Presenting author: Michaella Baker
Poster 2
Antibiotics: How Immediate Care Centers Reduced Prescribing by 65%
Inappropriate use of antibiotics creates bacteria resistant to antibiotics, which increases community health risks, and exposes patients to unnecessary adverse effects. According to World Health Organization (WHO), antibiotic resistance is one of the biggest threats to global health, and there is an urgent need to change the way antibiotics are prescribed and used.4 Worldwide human antibiotics consumption is increasing at an alarming rate, an increase of 46% from 2000 to 2018, which adds to the urgency of combating antibiotic resistance.1 In the United States, outpatient settings are accountable for an estimated 80-90% of human antibiotic use.2 Furthermore, at least 28% of the antibiotic used in outpatient settings are unnecessary and account for greater than 60% of antibiotics expenditure in the United States.2 The problem of the inappropriate use of antibiotics is particularly magnified in urgent care settings. According to a recent study, 46% of the urgent care antibiotics were inappropriate for respiratory diagnoses.
Presenting author: Dharmesh Patel
Poster 3
Patient Family Experience of Limited English Proficiency and Immigrant Families at Lurie Children's Hospital
In the United States, 25% of children live in immigrant families, including children who are foreign-born and those with at least one foreign-born parent. In Illinois, 29% of households in Cook County include one or more immigrants. Immigration status serves an important social determinant of health, as children in immigrant families (CIF) are more likely to experience poverty, food and housing insecurity, and barriers to accessing healthcare. Parental limited English proficiency (LEP) is a risk factor for worse healthcare access and quality, as well as poor health outcomes among children. Prior studies have shown that cultural sensitivity affects the degree of trust and quality of patient care that immigrant families receive. Currently, data from patient family experience surveys at Lurie Children's demonstrate lower levels of satisfaction and feelings of courtesy and respect among LEP families when compared to English-speaking families. In the 2017 Healthy Chicago Survey, only 60% of Latinx respondents reported that they were very satisfied with care received in the prior year.
Objective: The aim is to identify potential areas of improvement in our care of CIF by surveying patient-facing providers and staff and conducting focus groups with families to understand the primary drivers of experience for families with LEP.
Presenting author: Aarabhi Rajagopal
Poster 4
The Impact of Virtual Programming in Expanding Boundaries
The benefits of community participation and exercise have been well documented in the literature. This is equally true for persons with disabilities. Benefits can include improved fitness, reduced risk for secondary health problems, self-esteem, improved social engagement, and reduced pain. However, the literature also is abundant in articles describing the barriers people with disabilities have in accessing fitness programs and activities. There have been multiple action plans to develop and encourage adoption, development, and support for sports activities for persons with disabilities. Despite all these advances, there remains a large disparity in access to fitness by persons with disability. Barriers include social perception, stigma, negative attitudes, lack of knowledge, fitness center inaccessibility, non-adjustable equipment, lack of support, and transportation. During the COVID pandemic, many programs had to rethink how to continue providing services to people and one medium that was popularized during this time period was virtual programming.
The Great Lakes Adaptive Sports Association (GLASA) is a non-profit social service organization located in north suburban Chicago. They aim to support individuals with a physical or visual disability through providing adaptive recreational, fitness and competitive sport activities, as well as education, leadership, training services and wellness programming. The objective of this study is to retrospectively compare the degree of enrollment and geographic reach of pre-pandemic, live, in person fitness/recreation/sports classes from GLASA with the degree of enrollment and geographic reach from GLASA after virtual programming was introduced and implemented. The study team anticipated that virtual programming would allow for greater access to organized fitness programming and could result in participation from a wider geographical location than previously possible.
Presenting author: Elizabeth Chan
Poster 5
Polypills for the Prevention of Cardiovascular Disease
Eighty percent of cardiovascular disease is preventable, and yet it remains the number one killer in the United States and globally. One solution to this problem is the polypill, which holds great promise for the primary and secondary prevention of cardiovascular disease, especially in low- and middle-income countries. A polypill is defined as a single fixed-dose combination pill containing at least one blood pressure-lowering drug and one lipid-lowering drug, with or without aspirin.
Presenting author: Daniel Underberg
Poster 6
Resident Linguistic Diversity and Its Impact on the Provision of Language-Concordant Care
Lurie Children's Hospital provides care to a diverse patient population including many patients and families with limited English proficiency (LEP) or families with a non-English preferred language. Throughout the hospital and its outpatient centers, there are a number of data-driven resources in place to ensure appropriate communication and equitable care. These interventions include in-person, video, and telephonic interpreters as well as discharge instructions and medical information translated into patients' preferred languages. Data show language barriers and health literacy barriers represent a significant healthcare disparity. Moreover, language concordance is a powerful influencer of patient outcomes, patient safety, and the subjective patient experience. Furthermore, providers who speak their patient's preferred language have been associated with increased perceived quality of care and improved patient outcomes as compared to interpreters or providers who do not speak this same language. In this light, this study consists of a survey to be completed by current residents in the Lurie Children's Department of Pediatrics.
Presenting author: Meaghan Mormann
Poster 7
Safe Opioid Prescribing in Primary Care
Opioids come with risks to patients, families and communities. They are not as safe as they were once thought to be and Illinoisans are increasingly dying of opioid overdoses. Nationally, the number of drug overdose deaths increased by nearly 5% from 2018 to 2019 according to the CDC. In Illinois there was a 33% increase of opioid overdose deaths in 2020 compared to 2019. At Northwestern Medical Group (NMG), a multi-specialty academic group practice which treated over 175,000 patients in primary care this past year, we noted that primary care is where the majority of chronic opioids are prescribed. There is noted variation among opioid prescribing practices across the practices. More specifically, Lake Forest Internal Medicine had 42% of chronic opioid therapy patients with high MME, 15% with concurrent opioid and benzodiazepine prescriptions and 5% percent of patients with pain agreements on file. This project focused on understanding what drivers and opportunities existed to improve patient safety around the use of opioids and implemented interventions to further to increase the safety of opioid prescribing at Lake Forest IM.
Presenting author: Mariam Eldeib
Poster 8
Impact of Primary Care-Embedded Pharmacists on Hemoglobin A1c Control in West Region African American and Hispanic/Latino Adults with Diabetes
Ethnic minorities, including African Americans (AA) and Hispanics/Latinos (HL), in the U.S. are disproportionately affected by most diabetes-related complications. 1) AA with diabetes are more likely to develop kidney disease and kidney failure requiring dialysis than non-Hispanic whites. 2) HL with type 2 diabetes exhibit poorer glycemic control, greater disease severity, and worse outcomes than non-Hispanic whites. 3) Hemoglobin A1c (HbA1c) is a widely used and accepted test for the diagnosis of prediabetes and diabetes and the assessment of glycemic control in patients with diabetes. The American Diabetes Association (ADA) goal for most adults with diabetes is a HbA1c of < 7%.
Presenting author: Imran Khan
Poster 9
Building a Public Health Leadership Curriculum
The COVID-19 pandemic has emphasized the importance of global health leadership. Public- and global health leaders took different approaches to reduce the spread of COVID-19. Leaders needed to effectively communicate effectively to the public and cooperate with stakeholders to reduce the spread of the COVID-19 virus. These are only two examples of skills for students to develop to prepare for a public health leadership position. Public health leadership skills are not yet being taught in the Northwestern University Master of Public Health curriculum. Therefore, essential public health leadership skills were investigated, and a course syllabus was developed.
Presenting author: Lotte Van der Pol
Poster 10
A Literature Review Examining the Perinatal Mental Health of a South Asian Diaspora Population
About 10% of pregnant women worldwide and 13% of women postpartum experience a mental health disorder. Studies have shown that 1 in 3 migrant women have experienced a perinatal mental health disorder with social support being a protective factor. As the South Asian diaspora population grows, little is about the perinatal mental health of this population. This review aims to examine the research on the prevalence and risk factors associated with the perinatal mental health disorders in this population.
Presenting author: Bushra Anis
Poster 11
Epidemiology and perceptions of unintentional injuries among select youth (aged 15-24 years) enrolled at vocational training institutes in Peshawar, Pakistan: A sequential explanatory mixed methods study
Youth (15–24 years of age) across the world are at a high risk of unintentional injuries compared to other age groups. The probability of death among youth before they reach age 25 years is 6 deaths per 1000 youth. [1]. A significant proportion (19%) of the global injury related deaths are occurring in the EMRO including Pakistan [2]. The incidence for all unintentional injuries in youth in Pakistan come from the 1st National Injury Survey of Pakistan (NISP) done in 1997 to be 45.6 per 1000 per year, while the incidence for road traffic injuries was 15 (CI: 13.7–16.5) per 1000 per year. [3]. The 1990-94 National Health Survey of Pakistan (NHSP) [4] provided the annual incidence of all unintentional injuries for the age group from 15-30 years in Pakistan as 46 injuries per 1000 population per year[4].
In the context of dated data this study undertakes assessing unintentional injury trends in the Pakistani youth population by selecting the youth enrolled at vocational training centers. By using a mixed method, the study will provide an extensive multi-level consideration of the topic.
Presenting author: Sarwat Masud
Poster 12
Creating a Regional Curriculum for Anesthesiologists in Daboase, Ghana: Challenges and Learning Points
There is a continuing need for access to surgical and anesthesia services in low- and middle-income countries. Lack of supplies (such as anesthesia machines, oxygen, and pulse oximeters) can be a barrier to safe care. Regional anesthesia techniques can allow providers to care for patients safely while reducing the need for the aforementioned equipment. Regional anesthesia education may be an important area of focus to build capacity for safe anesthesia care in the coming years. This is a qualitative review of a four-week virtual Global Health elective in January 2022 to create a regional anesthesia curriculum for a group of providers in Daboase, Ghana.
Presenting author: Amanda Johnson & Yujing Zhao
Poster 13
Historical Trends in Maternal Mortality: 1960s-1970s
Abortion, pre-eclampsia, puerperal sepsis, and peritonitis are all major causes of maternal mortality, known as such for well over a century. In the late 1960s to the early 1970s, however, there was a dramatic increase in the number of medical journal articles internationally having to do with these four causes of maternal mortality. This study sought to understand why this increase in medical journal articles occurred during this time by doing the following.
Presenting author: Ruba Memon
Poster 14
Community Cervical Cancer Screening in Jos, Nigeria
The reconstitution of immune status of people living with HIV following the use of ART and the natural history of cervical lesions is poorly understood. Persistent of HPV exposure with longer survival of women with HIV infection on antiretroviral therapy (ART) could lead to more abnormal cytology outcomes.
Objective: To determine whether cervical cytology outcomes among women differ by age at HIV diagnosis and viral suppression in Jos, Nigeria.
Presenting author: Francis Magaji
Poster 15
Adding (Ultra-)long-acting Insulin Analogues to the WHO Model List of Essential Medicines
Diabetes affected an estimated 463 million people in 2019, or 9.3% of the global population, of which 79% live in low and middle-income countries. Cost of insulin is a major barrier to care for many patients with diabetes. Only three companies currently control 96% of the insulin market by volume and 99% in terms of value, globally. Long-acting insulin analogues offer different pharmacokinetic profiles, adding more flexibility when designing insulin regimens (Table 1). Unfortunately these medications are often more expensive than intermediate-acting insulin.
The World Health Organization (WHO) defines the Model List of Essential Medicines (MLEM) as “the list of minimum medicine needs for a basic health-care system.” Adding a medication to the MLEM helps advocate for lowering cost and increasing access to this vital medication. Prior submissions in 2017 and 2019 proposing the addition of long-acting insulin analogues to the MLEM were rejected. The WHO Expert Committee recognized the benefits over human insulin, but reported that the price differences were too great for the documented magnitude of benefit.
Resarch Objective: To add long-acting and ultra-long-acting insulin analogues (specifically insulin glargine, insulin detemir, and insulin degludec, including similar biotherapeutic products) to the WHO MLEM for type 1 and type 2 diabetes mellitus for adults and children (aged 2 years and above).
Presenting author: Joshua Katz
Poster 16