This study found different levels of agreement between partners across economic regions of the world when compared with existing global health competencies. By gaining insight into host partners' perceptions of desired competencies, global health education programs in LMICs can be more collaboratively and ethically designed to meet the priorities, needs, and expectations of those stakeholders. This study begins to shift the paradigm of global health education program design by encouraging North-South/East-West shared agenda setting, mutual respect, empowerment, and true collaboration.
Background Thousands of students travel yearly from high-income countries (HICs) to low-income and middleincome countries (LMICs) for short-term experiences in global health, with much less travel by LMIC students to HICs. Little structured research has been done to seek host perspectives, particularly from LMICs, on what they would like to teach learners. By seeking LMIC host perspectives, we aimed to improve global health pedagogy, curriculum design, assessment, and experiential learning, better meeting host goals and expectations. Our additional aim was to improve mutual respect and trust, share power honestly and ethically, and facilitate more genuinely collaborative agenda setting between LMIC and HIC partners. MethodsWe previously did a hybrid quantitative and qualitative web-based survey from Sept 1, 2015, to Dec 31, 2015, exploring global health competencies with particular attention to LMIC hosts supervising and housing trainees in short-term experiences in global health. 274 host perspectives were gleaned from 38 countries speaking 22 languages. In this qualitative study, we analysed open-ended questions and responses not previously covered from the same survey data. 97 of 274 responses were selected for qualitative analysis, conducted via content analysis and coding, ensuring inter-rater reliability, and comparing HIC and LMIC responses. Findings Four core themes emerged in our content analysis regarding desired global health core competencies: most important global health core competencies; biggest mistakes students make; biggest challenges students face; and what students should remember most in experiential global health education.Interpretation Our qualitative study revealed intriguing comparative results addressing core controversies in global health, such as who "does global health" and where one must be to "do global health". Moving forward we hope this initial survey research will facilitate more genuinely collaborative agenda setting between North-South and East-West partners.
Background Competencies developed for global health education programmes that take place in low-income and middle-income countries have largely reflected the perspectives of educators and organisations in high-income countries. Consequently, there has been under-representation of voices and perspectives of host communities, where practical, experience-based global-health education occurs. In this study, we aimed to understand what global-health competencies are important in trainees who travel to work in other countries, seeking opinions from host community members and colleagues in low-income and middle-income countries.Methods We performed a literature review of current interprofessional global health competencies to inform our survey design. We used a web-based survey, available in English and Spanish, to collect data through Likert-scale and written questions. We piloted the survey in a diverse group of 14 respondents from high-income, middle-income, and low-income countries and subsequently refined the survey for greater clarity. We used convenience sampling to recruit participants from around the world and included a broad range of coauthors. A website was constructed in English and Spanish and the survey link added. This website and link were distributed as broadly as possible. It was mandatory for survey participants to list their country of birth and current work in order to confirm representation.
have recently called atteation to the fall of the concentration of the inorganic phosphate in the blood of human subjects and experimental animals following the use of insulin. In the course of various studies on diabetes, particularly in connection with the studies on the respiratory exchange of normal and diabetic subjects following the ingestion of glucose, glycerol, calcium hexose phosphate and calcium glycerophosphate' and the respiratory exchange following the administration of insulin and epinephrin4 data were accumulated on the changes of the inorganic phosphate in the blood and urine under the above enumerated experimental conditions. It was found that in normal human subjects the ingestion of 50-100 gm. of glucose and the intravenous injection of 3.5 units of insulin, also the subcutaneous injection of 0.5 cc. of 1 :lo00 solution of epinephrin caused a marked fall in the inorganic phosphate of the blood, and a simultaneous fall of the rate of excretion of phosphate in the urine. With the injection of epinephrin, however, in normal subjects the faltl of the blood phosphate was frequently accompanied by a rise in the rate of urinary excretion of phosphate. The excretion of phosphate was most singularly depressed by the IHarrop, G. A., and Benedict, E. M., Paw. SOC.
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