Transformative Global Health Pedagogy: A Dinner Curriculum for Medical Students and Residents.

Introduction: The Hiatt Residency in Global Health Equity program at Brigham and Women's Hospital partnered with Loyola University Medical Center and the Stritch School of Medicine to build and share an innovative global health dinner curriculum (GHDC) based on the methodologies of transformative learning theory. This educational approach encourages trainees to critically analyze their frame of reference and has the potential to create practitioners equipped to advance health equity. Methods: The GHDC explored broad global health (GH) topics through facilitated discussions with faculty and an experienced guest discussant over dinner. Medical students and internal medicine residents attended sessions based on their availability and interest. Participants completed surveys before and after every dinner. Comprehensive post-curriculum surveys were collected after participants had been involved for at least 1 year. Results: In 2017-2018, 98% of the 37 participants preferred the dinner-style learning session to a didactic-style lecture (97% of the 37 participants in 2018-2019). Eighty-five percent (2017-2018) agreed or strongly agreed that dinners provided them with new knowledge on a GH topic (92% in 2018-2019). Seventy-two percent (2017-2018) agreed that the dinner introduced them to a new potential mentor in GH (66% in 2018-2019). Discussion: The GHDC has been particularly successful in introducing participants to unfamiliar areas of medicine and new mentors. A second strength is its accessibility to medical students and residents. Its dependence on local resources allows versatility and customization; however, this trait also makes it difficult to prepackage the curriculum for interested institutions.

Evidence for daily and weekly rhythmicity but not lunar or seasonal rhythmicity of physical activity in a large cohort of individuals from five different countries.

BACKGROUND: Biological rhythmicity has been extensively studied in animals for many decades. Although temporal patterns of physical activity have been identified in humans, no large-scale, multi-national study has been published, and no comparison has been attempted of the ubiquity of activity rhythms at different time scales (such as daily, weekly, monthly, and annual). METHODS: Using individually worn actigraphy devices, physical activity of 2,328 individuals from five different countries (adults of African descent from Ghana, South Africa, Jamaica, Seychelles, and the United States) was measured for seven consecutive days at different times of the year. RESULTS: Analysis for rhythmic patterns identified daily rhythmicity of physical activity in all five of the represented nationalities. Weekly rhythmicity was found in some, but not all, of the nationalities. No significant evidence of lunar rhythmicity or seasonal rhythmicity was found in any of the groups. CONCLUSIONS: These findings extend previous small-scale observations of daily rhythmicity to a large cohort of individuals from around the world. The findings also confirm the existence of modest weekly rhythmicity but not lunar or seasonal rhythmicity in human activity. These differences in rhythm strength have implications for the management of health hazards of rhythm misalignment.

Assessment of Reactive Catch Basin Larvicide Treatments Toward Improved Water Quality Using FourStar(®) Briquets and CocoBear™ Larvicide Oil.

Because it is often logistically impossible to monitor all catch basins within an operational area, local mosquito control programs will preemptively treat catch basins with larvicides each season. However, these larvicides can, ostensibly, be considered water quality pollutants. To experimentally reduce the use of larvicides toward improving water quality, 30 basins within a small 0.7-km(2) residential area were monitored weekly for the presence of larvae and pupae for 14 wk in the summer of 2013. Once a basin was found to reach a threshold of 12 mosquitoes per dip sample, it received a FourStar® Briquet (a 180-day briquet formulation of 6% Bacillus sphaericus and 1% B. thuringiensis israelensis). Each week a FourStar-treated basin surpassed this threshold, it was treated with an application of CocoBear™ oil (10% mineral oil). By the end of trials, all but one basin received a briquet and 13 required at least 4 treatments of CocoBear, suggesting that preemptive treatment is appropriate for the study area.

Daily activity patterns of 2316 men and women from five countries differing in socioeconomic development.

Daily rhythmicity in the locomotor activity of laboratory animals has been studied in great detail for many decades, but the daily pattern of locomotor activity has not received as much attention in humans. We collected waist-worn accelerometer data from more than 2000 individuals from five countries differing in socioeconomic development and conducted a detailed analysis of human locomotor activity. Body mass index (BMI) was computed from height and weight. Individual activity records lasting 7 days were subjected to cosinor analysis to determine the parameters of the daily activity rhythm: mesor (mean level), amplitude (half the range of excursion), acrophase (time of the peak) and robustness (rhythm strength). The activity records of all individual participants exhibited statistically significant 24-h rhythmicity, with activity increasing noticeably a few hours after sunrise and dropping off around the time of sunset, with a peak at 1:42 pm on average. The acrophase of the daily rhythm was comparable in men and women in each country but varied by as much as 3 h from country to country. Quantification of the socioeconomic stages of the five countries yielded suggestive evidence that more developed countries have more obese residents, who are less active, and who are active later in the day than residents from less developed countries. These results provide a detailed characterization of the daily activity pattern of individual human beings and reveal similarities and differences among people from five countries differing in socioeconomic development.