Polarity Based Model for Guiding Medical School Strategy During Crisis - A Cross Sectional Qualitative Study

Background: Crises like the COVID pandemic in academia can best be dealt with as a polarity that needs to be leveraged rather than a problem that needs to be solved. This work aimed at utilizing the Polarity Approach for Continuity and Transformation (PACT)™ to establish a guide for medical schools during times of crisis to minimize the effect of crisis-driven decisions on strategic growth. Methods: A qualitative study followed the 5-Steps of the PACT process was conducted. A virtual mapping session was held with 108 medical educators from 22 countries to determine the upsides and downsides of strategic orientation and crisis management subsequently. Results: Four polarity maps were generated identifying four tension areas; University reputation, mission, teams, and individuals followed by a 72-item assessment and another mapping session to map the warning signs and action steps. A comparison between private school scores and the whole cohort of respondents showed that private schools had higher scores in all tension areas but still showed the least score for the “teams” tension. Conclusion: This study highlighted the importance of taking measures to communicate the mission and supporting team functions inside universities either by enhancing resources or utilizing time and effort-saving strategies.

Key Challenges Facing AMISOM in Military Diplomacy in the Horn of Africa

The world over, military diplomacy has not been always successful. This stems out of the fact that it could be faced by a plethora of challenges. This paper sets out to explore the key challenges facing AMISOM in military diplomacy in the Horn of Africa. The study adopted an exploratory and mixed methods research design. Data was obtained from a sample of 100 persons sampled from a population of 22,315 AMISOM Staff and Civilian contingent. The study employed a breadth of both primary and secondary sources for data collection. Primary data was being collected from study respondents by means of a research questionnaire and an interview schedule. The data analysis process involved both qualitative and quantitative techniques. Content analysis was mainly used to analyze the qualitative data and which would be reported normatively. Quantitative research findings were analyzed and reported using descriptive statistics, tables, graphs, charts and inferential statistics in Statistical Package for Social Sciences (SPSS v23). Moreover, the data analysis was structured objectively to address each of the study research questions. The findings show that while competing interests may have clouded the scene at regional level, partly alluded to lack of a common approach to deal with the Somalia issue among the various countries, military diplomatic engagements by AMISOM are the most agreeable way to address regional peace and security. The study highlights the greater need for revised strategies in military diplomacy efforts and novel approaches to address competing interests among troop contributing countries that comprise AMISOM. Based on the study findings, the following recommendations were made. Arguably, the most important dimension of its success is hinged on the strategic unity and partnership of the different troops. At present however, the inconsistency in unity and strategic alliance among these countries continue to challenge the seamless command and probably influence the implementation of different military diplomacy strategies based on competing interests. Further, while assets remain a critical component of military diplomacy, the success of such multidimensional peace operations is equally anchored on a civilian component and the need for civilian capabilities. The realization of effective peacemaking and peacekeeping calls for efficient management structures at the field and in Addis for strategic and support of mission teams. AMISOM currently experiences an insufficient institutional capacity and human resources required to effectively handle complex peace operations and peacemaking initiatives. Recent assessment reveals the institution bureaucratic processes are still weak.

Post-operative fever (POF) after cardiac surgery in a low- and middle-income-country: 7-year institutional experience

Background: Post-operative fever (POF) after cardiac surgery in a developing country is of great concern because of the associated morbidity and mortality. In our country, we experience this complication more because of a high rate of malaria infestations, gastroenteritis, and malnutrition. We also experience a low yield of positive diagnostic tests when POF develops; this is partly due to expense and the prioritisation of other essential items in our poorly equipped cardiac ICU. Aims/Objective: To assess the causes of POF after cardiac surgery and determine its impact on the outcome on patients. Materials and methods: International Cardiac Surgery Mission teams visited our centre for 7 years (2013–2019). During this period, a significant number of cardiac surgeries were performed. A retrospective study of patients with POF was performed with data from our hospital’s database, and included standard demographics; types of surgery performed, and management protocols being used in the peri-operative care. Results: A total of 242 patients were treated during the study period and underwent 266 surgeries. Of these, 151 (56.8%) and 115 (43.2%) were adult and paediatric cases respectively. Ages ranged between 0 and 90 years; 34 (14.1%) had POF. When we evaluated the clinical and associated laboratory findings, pyrexia (temp >38.0 °C) and elevated white blood cell count with differential neutrophilia were present in 10 patients (29.4%). The time of onset and duration of POF were between <24 and >144 hours. In the invasive procedure related to POF, sternotomy infections were present in seven patients (18.4%). Malaria infestations and breach in sterility protocol were predominant. Conclusion: The management of POF in the cardiac ICU was complicated by the requirement of co-operation from a larger number of specialties than is usually required in advanced centres with special expertise in malaria confirmation. We, therefore, introduced structured clinical, laboratory, and appropriate interventions to treat POF more aggressively. We found that more careful attention to peri-operative details to ensure strict observation of sterility protocol with anti-malaria prophylaxis led to improvements in our centre’s outcomes.

Interview with the Medicine Man: A Case Study of a Traditional Malian Healer

Pharmacists are commonly members of medical mission teams that provide health care services in underdeveloped countries. Although pharmacists and others often find their service on a mission trip to be positive and life changing, critics of such missions note that Western providers trained in biomedicine frequently lack the cultural awareness to practice effectively in such settings. This paper is a case study of one traditional healer who practices in rural Mali. Although the results of one case from one practice setting may not be generalizable to all cultures, a basic understanding of the healer's beliefs and practices concerning the etiology and treatment of disease, the role of magic and other supernatural therapies, his experience with Western trained providers and the regulatory environment in which he works should assist pharmacists who serve on mission trips to be better culturally prepared. Type: Case Study

Brief Introduction of Promoting the Chinese Program For Exploring the Martian System

Following the progress of Chinese deep space exploration step, since 2006 we started a Mars mission, Yinghuo-1, by join in the Phobos-Grunt mission of Russia. A satellite bus platform and onboard payloads as well as an innovative open-loop radio tracking system have been developed by mission team. Also, together with Russian and German colleagues, we developed a kind of in-beam tracking method for measuring the rotation and nutation of Phobos, and developed the 1st Phobos global gravity field for the mission. We are promoting the Chinese new mission for Mars exploration. Although the joint YH-1 & Phobos-Grunt mission failed, the new techniques and knowledge developed by mission teams may benifit the future missions. In fact, the open-loop technique have been applied into lunar and other planetary missions, and the method in developing Phobos global gravity field will be used in the study of Rosetta mission and future Chinese mission for small body.

Selection of Medications for the International Space Station: The Space Medicine Patient Condition Database

Medical care available to astronauts on the International Space Station has been affected by limitations on funding, space and weight availability, and crew training. A Space Medicine Patient Condition Database (PCDB) was designed to enhance inventory control, resource selection, protocol standardization, evidence-based medicine, on-orbit diagnostic skills, and materiel management. The first step in the PCDB creation was the identification of the medical conditions anticipated among the astronaut population in the flight environment. Military databases, previous spaceflight experience, and analog populations were used to create this listing. The PCDB then linked these individual conditions with the current resources available on orbit to treat them. Other features include a resource gauge, item location information, diagnosis coding, and built-in reference capabilities. Currently in the second phase of development, specific, evidence-based treatment protocols are being developed and evaluated in comparison with the terrestrial medicine standard of care. By documenting on-orbit medical systems and their associated terrestrial standards, the PCDB enables the prioritization and allocation of limited resources. In the final phase of the project, the PCDB will make use of decision support software to enhance diagnostic determination and provide an operational tool for the crew and mission teams.