Medical Brigades to El Salvador and Honduras: Travel imaginaries and volunteer tourist recruitment

In this paper, I explore travel imaginaries in the recruitment of participants to short-term medical brigades in El Salvador and Honduras. I look in particular at how trip leaders and organization web sites frame the volunteer tourist experience, drawing on familiar, shared imaginaries of poor, backward international settings, and related performative interventions that echo white colonial relationships. Recruitment messaging offers little specific or informed sense of place, ignoring the national histories and socio-economic circumstances of the receiving countries. As a consequence, the health profiles and capacities of El Salvador and Honduras are finally obscured in favor of the valorized performance of visitors and externally-driven protocols and care. The efforts of some brigade sponsors and related organizations to improve health-care delivery to local communities, in particular fundraising among brigade participants and other donors, would seem to separate the link between travel and volunteerism. They continue, however, to reinforce broadly-held imaginaries of international poverty and economic backwardness and related rescue by the Global North. A more realistic understanding of Honduran and Salvadoran economies and politics remains elusive and requires a reorientation of voluntary engagement.

The effectiveness of supervision strategies to improve health care provider practices in low- and middle-income countries: secondary analysis of a systematic review

Background Although supervision is a ubiquitous approach to support health programs and improve health care provider (HCP) performance in low- and middle-income countries (LMICs), quantitative evidence of its effects is unclear. The objectives of this study are to describe the effect of supervision strategies on HCP practices in LMICs and to identify attributes associated with greater effectiveness of routine supervision. Methods We performed a secondary analysis of data on HCP practice outcomes (e.g., percentage of patients correctly treated) from a systematic review on improving HCP performance. The review included controlled trials and interrupted time series studies. We described distributions of effect sizes (defined as percentage-point [%-point] changes) for each supervision strategy. To identify attributes associated with supervision effectiveness, we performed random-effects linear regression modeling and examined studies that directly compared different approaches of routine supervision. Results We analyzed data from 81 studies from 36 countries. For professional HCPs, such as nurses and physicians, primarily working at health facilities, routine supervision (median improvement when compared to controls: 10.7%-points; IQR: 9.9, 27.9) had similar effects on HCP practices as audit with feedback (median improvement: 10.1%-points; IQR: 6.2, 23.7). Two attributes were associated with greater mean effectiveness of routine supervision (p < 0.10): supervisors received supervision (by 8.8–11.5%-points), and supervisors participated in problem-solving with HCPs (by 14.2–20.8%-points). Training for supervisors and use of a checklist during supervision visits were not associated with effectiveness. The effects of supervision frequency (i.e., number of visits per year) and dose (i.e., the number of supervision visits during a study) were unclear. For lay HCPs, the effect of routine supervision was difficult to characterize because few studies existed, and effectiveness in those studies varied considerably. Evidence quality for all findings was low primarily because many studies had a high risk of bias. Conclusions Although evidence is limited, to promote more effective supervision, our study supports supervising supervisors and having supervisors engage in problem-solving with HCPs. Supervision’s integral role in health systems in LMICs justifies a more deliberate research agenda to identify how to deliver supervision to optimize its effect on HCP practices.

Glimpse on the Second wave of COVID-19: A Situational Analysis of Bangladesh

The fatal COVID-19 has engulfed 220 countries globally. Up to 26 May 2021, 7,93,693 confirmed cases and 12458 deaths were reported in Bangladesh, whereas globally it counted 16,74,92,769 cases and 34,82,907 deaths. The beleaguered healthcare system has conducted 58,71,353PCR tests since 8 March 2020 and ranked Bangladesh as 33rd position in world. This paper sketched out overall scenario as a narrative including the impact on health system, economics and response from government to tackle the pandemic. It gathered secondary data from sources including journals, newspapers, and government info site to retrieve current information. Although the government took measures such as lockdown, social distancing, quarantine, and isolation from initial stage, misconceptions on vaccination, personal health hygiene, and lack of public responses are retributive to the robust COVID-19 surge. To mitigate the lethal impact of COVID-19, the government needs to expand its vaccination programs and improve health care system.

How does artificial intelligence in radiology improve efficiency and health outcomes?

Since the introduction of artificial intelligence (AI) in radiology, the promise has been that it will improve health care and reduce costs. Has AI been able to fulfill that promise? We describe six clinical objectives that can be supported by AI: a more efficient workflow, shortened reading time, a reduction of dose and contrast agents, earlier detection of disease, improved diagnostic accuracy and more personalized diagnostics. We provide examples of use cases including the available scientific evidence for its impact based on a hierarchical model of efficacy. We conclude that the market is still maturing and little is known about the contribution of AI to clinical practice. More real-world monitoring of AI in clinical practice is expected to aid in determining the value of AI and making informed decisions on development, procurement and reimbursement.

Podcasts for the Delivery of Medical Education and Remote Learning (Preprint)

UNSTRUCTURED Podcasts are increasingly being recognized as an effective platform for medical education. Compared with textbooks, face-to-face meetings, and other more traditional forms of medical education, podcasts are generally more engaging and less expensive to develop. Podcasts are at the cutting edge of digital education and can be an important element of a pharmaceutical company’s multichannel communications plan to improve health care professional (HCP) engagement and education in specific therapy areas. However, developing a successful podcast can have significant challenges. In this viewpoint paper, we provide our perspectives on medical podcasts as a medium for educating HCPs in the digital age. We describe our experience in developing a HIV-focused podcast for Australian HCPs, creating a series that has now expanded to other therapy areas in several countries. Practical considerations for developing podcasts and suggestions for how to overcome unique issues associated with industry-sponsored podcasts are outlined. Overall, we believe that the process of developing a podcast can be a challenging but rewarding experience, and medical education via podcasting should be more routinely considered by pharmaceutical companies.