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The Declaration of Helsinki was adopted in 1964 and has been amended six times, most recently at the United Nations General Assembly in October 2008. This is now the only official version and it supersedes all previous ones, which should not be used or cited, except for historical purposes.
Testing treatments: Better research for better health care. This book, published by the James Lind Library, is a collection of essays addressing the question: How do we know whether a particular drug, therapy, or operation really works, and how well?
Pautas éticas internacionales sobre investigación en seres humanos (International Guidelines on Bioethics), Acta Bioethica 2004; 10(1), published in SciELO.
- Involving Human Subjects Guidelines for researchers on how to write a Research Protocol (Proposal)
- Progress (Interim) Report
- Final Report & Abstract
- Policy Recommendations
The Research Promotion and Development unit's Research Interest Group (RIG) is an informal and collegial discussion space fostering the exchange of information about research needs and interests. It is a space for discussing challenges, best practices, and novel ideas in research. Aimed towards inspiring innovation and collaboration in PAHO's work, the group seeks to tap into the network of diverse knowledge and experiences, both individual and collective, represented by PAHO staff.
Did you miss past RIG meetings? Here are some topics from previous discussions (Click on the year to see topics.) Don't miss the next one!
- 18 July. Topic: Photonovelas and Research Communication Methods to Reduce Health and Education Disparities for Low-Literacy
Speaker: Dr. Silvia Martinez (Howard University)
Summary: As communities, cultures, and health epidemics are becoming vastly global, the importance of knowledge translation and communication of health to those with communication disorders is ever-more important. On July 18th, Dr. Silvia Martinez came to speak at PAHO's Research Interest Group (RIG) for a discussion titled "Photonovelas and Research Communication Methods to Reduce Health and Education Disparities for Low-Literacy." Dr. Martinez is a bilingual speech and language pathologist, professor and researcher at Howard University, who has encouraged the use of stories to communicate and educate low-literate and immigrant populations on health prevention strategies. She analyses the use and impact of these photonovelas created by her research team in order to better understand prevention and control of illnesses, including both infectious (e.g. HIV/AIDS) and non-communicable diseases (e.g. diabetes, cardiovascular diseases and cancer and risk factor associated. These photonovelas are also instrumental in empowering vulnerable communities to take charge of their health education and feel autonomous in their health decisions. Through research and evaluation, Dr. Martinez and her team educate all age groups who are either illiterate or non-native English speakers on prevention of health challenges associated stroke, diabetes, cancer, obesity, and others. Check out more of her work and her website here.
- 30 May. Topic: Balancing Benefits & Harms: A Research Agenda on Quarantine.
Speaker: Dr. Rebecca Katz (Georgetown University Medical Center)
Summary: On 30 May 2017, a RIG discussion on global pandemic outbreaks took place at PAHO Headquarters. While it can be difficult to conduct research during an emergency health outbreak due to sensitivity of cultural customs, injuries, and other important factors, equally as challenging can be the decision to quarantine a community during these virulent situations. The 2014 Ebola crisis and the 2016 Zika outbreak emergencies tested the effectiveness of health systems globally. Unfortunately, some countries suffered fatal impacts from these outbreaks due to un-prepared health systems and others had more successful outcomes. While various perspectives exist on global health emergency preparedness, the PAHO Office of Knowledge Management, Bioethics, and Research and the Department of Public Health Emergencies invited Dr. Rebecca Katz, Professor of International Health at Georgetown University and Co-Director of the Georgetown University Center for Global Health Science and Security, to share her outlook on the issue. During the discussion, Dr. Katz shared with the audience various efforts of a comparative research study on Federal quarantining laws in the United States. She also clarified discrepancies between both federal and state level quarantine laws that affect how decisions to quarantine are made in the U.S. What she described to be of critical consideration was the decision to isolate individuals or communities during outbreaks, stating that people needed to be transparently aware of the decisions behind quarantining and current structures could benefit from lessening some of the many bureaucratic steps in order to make the process easier to understand and comply with. She defined a successful quarantine as one that effectively mitigates a disease concern during an outbreak. Deeper into the discussion, she stated that ultimately, no global database exists to review research evidence on quarantining. She suggested that having a database available might make the process of policy-making for quarantines much easier for lawmakers since it will be based on research evidence. Towards the end of the discussion, she shared three key concluding points with the audience for developing a research agenda on quarantining: 1) the importance of clarifying lessons learned from past global health outbreaks, 2) a need to focus on state and local laws for social distancing, and 3) giving primary consideration to making the social implications of quarantines less negative for communities focusing on adhering to civil liberties while maintaining trust. Overall, the RIG was a learning experience about how quarantine policy decisions are made and provided insight for future young professionals to consider research pertaining to global health emergency preparedness and policy-making.
- 18 April. Topic: Conducting Research in Emergency Situation
Speaker: Dr Daniel Lucey (Georgetown University, Washington DC)
Summary: Co-organized by PAHO Office of Knowledge Management, Bioethics and Research (Josselyn Mothe) and the PAHO Pan-American Health Emergency Department (Carolina Torres) under the guidance of Dr. Luis Gabriel Cuervo.
"Conducting research in health emergency situation is challenging and a rising topic. To give some perspectives on the subject, PAHO Office of Knowledge Management, Bioethics and Research and the PAHO Pan-American Health Emergency Department invited esteemed Dr. Daniel Lucey, an Adjunct Professor of Medicine and Infectious Diseases at Georgetown University Medical Center (GUMC) to bring his testimony. The 1 hour informal discussion took place at PAHO Headquarters on April, 18th 2017.
Building from his experience during the Ebola outbreak, Dr. Daniel Lucey shared with the audience his story in Africa as part as his work with Medecins Sans Frontières (MSF). These sort of intense situations often trigger innovation to overcome adversity and address gaps that can improve patient care. However due to the difficulties of the situation, these innovations are not always properly captured and therefore not replicated due to lack of proper data and evidence. This waste of "lessons learned" are a key challenge to be addressed.
The vivid illustration provided by Dr. Daniel Lucey comes from his own experience in West Africa during the Ebola outbreak. He observed that what was killing patients the most were not the hemorrhage but the dehydration. The dehydration was made worse by severe vomiting and diarrhea as well as profuse sweating in very hot tents. There were no intravenous fluids available and patients were too weak to drinks themselves. An idea was developed where basically patients that got better but that were still in remission were helping the other patients to drink. This experimentation was not measured though. He reminds the importance of separating the work of the clinician and the work of the researcher, especially during the acute emergency phase of an epidemic. Their roles are very different and the responsibilities vary. While the clinician is providing the necessary cares, the research is here to capture the data and generate knowledge. Therefore the research should be conducting by a separate person that doesn't have the responsibility of providing care but that is in the field with the patients. Working in close relationship with the country authority is also crucial."
- 18 October. Topic: Communicating Research Effectively: advancing the Vice President's Vision through engagement and communication
Speaker: Ms. Nelvis Castro (National Cancer Institute/National Institute of Health)
Summary: On October 18, 2016, another Research Interest Group (RIG) took place at PAHO's Headquarters in Washington, D.C., USA. The meeting was led by esteemed guest speaker Ms. Nelvis Castro, the Deputy Director of the Office of Communications and Public Liaison (OCPL) at the National Cancer Institute (NCI)/ National Institutes of Health (NIH). Ms. Castro shared her insights about the role of communications in supporting research to set up the Cancer Moonshot initiative. Announced by the President Barack Obama on January 12, 2016, the Moonshot aims to double the rate of progress of the fight against cancer, to accelerate research, to improve therapies available to those in need and to detect cancer at an early stage. Building on her experience, Ms. Castro presented how the NCI used communication strategies to engage different audiences and stakeholders (cancer researchers, patients' advocate organizations, agencies related to cancer, industries, patients, etc.). These were illustrated with explanations of how the OCPL responded to the need of a dynamic online presence, created specific engaging materials (e.g. fact sheets, blogs, videos) and organized listening sessions to engage stakeholders and to increase visibility of the project. Ms. Castro illuminated the audience to the creation of an online platform where the NCI asked the community to share their ideas on how to better address cancer related issues. Its successful implementation was highlighted by the over 1600 ideas the NCI received, which were reviewed and shared with the Blue Ribbon Panel, who then used the information to create the Task Force Report. Ms. Castro engaged with attendees about the importance of integrating communicators into research groups and shared practical tips with the audience on how to communicate research findings to the media. She also shared her insights on how to engage and build trust with reporters and advocacy organizations, emphasizing the importance of providing clear communication, in simple language. Overall, it was an excellent insight into the use of communication strategies to communicate research effectively.
- 4 August. Topic: Promoting Nursing Research and Nurse Scientists in the US and beyond
Speakers: Dr. Marguerite Kearney (NINR-NIH) and Dr. Rebecca Henry (NINR-NIH)
Summary: The Research Interest Group (RIG) took place on August 4th 2016 at PAHO Headquarters. The speakers, representing the National Institute of Nursing Research (NINR) - National Institutes of Health (NIH), discussed how researchers from different disciplines and countries interested not just in particular diseases, but globally, in patient centered outcomes can apply to different NIH grants in the realm of nursing research. Dr. Marguerite Kearney, Director of the Division of Extramural Science Programs, gave an overview on the different funding opportunities provided by the NINR. She mentioned that the NINR devotes 80% of its budget (146 million per year) to grants. Dr. Kearney explained the different types of grant mechanisms, highlighting that the largest grant mechanism has a limit of $500,000 per year, for a maximum of 5 years, and it is open to international applicants. Some grants are not open to international applicants, but international researchers can participate in the project as collaborators. Funding is open to different disciplines conducting basic, clinical and health services research, for example about what makes different interventions work and what motivates people to comply with treatments. The application review process takes approximately 7-8 months and consists of two review rounds. The key for a successful application is to present a project aligned with NINR's priorities, i.e. patients' outcomes in areas like Symptom Science and End of Life and Palliative Care. With regard to international projects, Dr. Rebecca Henry, Project Manager, reviewed some of the projects funded by the NINR outside the US, for instance in Malawi and South Africa, and other projects in the US aimed at immigrant communities, like translating flyers on palliative care into Spanish. She underlined that the NINR is interested in international projects and that the possibility of having projects in Latin America and the Caribbean is open; collaborations between institutions from the US and Latin American and the Caribbean could be a first step in that direction. The RIG ended with a series of Questions and Answers in which the speakers provided additional information, encouraging the audience to contact them for further information, in particular during the preparation of a grant proposal. Dr. Luis Gabriel Cuervo, PAHO's Senior Advisor for Research Promotion and Development, suggested including regional research agendas in the assessment of their grant applications.
- 2 June. Topic:Research for prevention of mosquito-borne diseases: Lessons of the application of an EcoHealth approach in Latin-America.
Speaker: Dr. Gabriel Carrasquilla
"If you want to walk fast, walk alone; but if you want to walk far, walk together."More...
Summary: Dr. Carrasquilla is an epidemiologist with more than 30 years of experience on research of tropical diseases prevention and control. During his presentation, he explained the main features of the EcoHealth approach: systemic approach, transdisciplinary, social and gender equity, social participation, and environmental sustainability. To illustrate how this approach can be used for control of mosquito-borne diseases, Dr. Carrasquilla showed the development over time of a research project to control the spread of Dengue in Girardot, Colombia. The project started by engaging researchers, government, technical cooperation agencies, civil society, and non-governmental organizations. The next step was identifying the main contributors to Dengue transmission and infection by using a complex system approach. Using an experimental design, the research team found around a significant reduction on the pupa per person index (PPI) in the intervention group compared to the control group (71% versus 25% reduction). The intervention comprised education of the population; introduction of long-lasting insecticide nets for windows, doors, and large water containers; and community engagement. The involvement of key stakeholders has resulted in appropriation by these, including civil society, thus resulting in better adherence and support behind the initiative.
The next phase comprises scaling up the intervention, measuring incidence of Dengue in the participating community, and adding costs to the effectiveness equation. Dr. Carrasquilla stressed the difficulties of carrying-out experimental studies within the community due to the risk of contamination, spill-over effect, and poor adherence to the intervention. American Sign Language (ASL) services were provided at the event.
Reference material: Gabriel Carrasquilla, LinkedIn
- Effectiveness and feasibility of long-lasting insecticide-treated curtains and water container covers for dengue vector control in Colombia: a cluster randomised trial (PDF)
- Ecobiosocial Community Intervention for Improved Aedes aegypti Control Using Water Container Covers to Prevent Dengue: Lessons Learned from Girardot Colombia (PDF)
- 5 May. Topic:Improvement of health and socio-economic outcomes in housing programs, using community engagement and research.
Speaker: Dr. Patricia O'Campo,
Summary: Dr. Patricia O'Campo is a social epidemiologist who has conducted policy-relevant intervention research addressing the social determinants of health and well-being of adults and children for over 25 years. During her presentation, she described the differences between participation, engagement, and consultation. She also pointed to the evidence of positive significant impacts in health and development of participation and engagement. In one of the examples, participation from communities for homelessness eradication proved significant health improvements, including saving $22,000 (per participant a year) in costs for the government and community to spend on the prevention of homelessness. She also tapped into how important community engagement was, including discussing her publications about bringing stakeholders together for urban health equity. An introduction to concept mapping as a participatory public health research method was also brought up by her. She stressed that building trust, partnership, and empowering people and organizations would help to develop better initiatives for homelessness prevention and other health issues. American Sign Language (ASL) services were provided at the event.
- Bringing stakeholders together for urban health equity: hallmarks of a compromised process
- 2. An introduction to concept mapping as a participatory public health research method
- 3 March. Topic: How Vaccines Overlay the Use of Research Promotion in Policy Making
Speaker: Dr. Jon Andrus, Executive Vice President of the Sabin Vaccine Institute.
Summary: Jon Andrus was invited as a special guest speaker to this Research Interest Group (RIG) to discuss his personal experience in the field of public health, including talking about his research related to vaccines, immunization, and accelerated control of vaccine-preventable diseases. Prior to joining the Sabin Vaccine Institute, Jon Andrus was also previously Deputy Director of the Pan American Health Organization (PAHO) and Lead Technical Advisor for PAHO's immunization program. His speech covered how his work overlaid the use of research promotion in policy-making and improving knowledge translation. During his presentation, Dr. Andrus tapped into three examples reflected in publications highlighting lessons learned and how barriers have been overcome to produce and use research. It included guiding the elimination of vector borne diseases and applying these to ongoing public health challenges such as Zika (See reference materials). There were a total of 27 attendees, including the guest speaker. This was also the first such event to offer American Sign Language (ASL).
Reference material: Jon Andrus' Linkedin
- Screening of cases of acute flaccid paralysis for poliomyelitis eradication: ways to improve specificity
- Risk of vaccine-associated paralytic poliomyelitis in Latin America, 1989-1991
- Direct Detection of Wild Poliovirus Circulation by Stool Surveys of Healthy Children and Analysis of Community Wastewater
- 21 October. Topic: Methods and Formats for Reporting on Research for Health
Speaker: Ms. Julia Belluz, Journalist.
Summary: Julia Belluz is a multiple award-winning journalist who currently covers stories about public health and medicine for Vox.com. Her work has been published in numerous newspapers, magazines and journals, including BMJ, The Globe and Mail, The Chicago Tribune, the LA Times and The Economist. She also founded "Science-ish", a blog dedicated to debunking popular health myths. Academically, she is a fellow and guest lecturer at McMaster University, and has held prior science journalism fellow positions at MIT and MBL. She is currently writing a book about "the misuses and abuses of science in policy, clinical practice and journalism". She received her MSc from the London School of Economics and holds a BA in journalism from Ryerson University.
Reference material: Twitter @JuliaOfToronto, or on her website www.juliabelluz.com
- 27 August. Topic: Knowledge Translation and the Criminal Justice System
Speaker: Dr. Anne S. Douds, Lawyer.
Summary: Dr. Douds builds upon her twenty years as a trial lawyer to inform her work as a professor of criminal and constitutional law at Penn State in Harrisburg, Pennsylvania. She specializes in practical application of empirical data to develop and improve policy and practices within courts and prisons. Presently, she is the principal investigator for two program evaluations of Pennsylvania veterans' courts and an assessment of media impact upon jury decision-making. Through these projects, she helps courts and prisons tailor their policies to better anticipate external influences. In the past, she has consulted with the Cochrane Justice Health Field on knowledge translation and the Georgia Department of Juvenile Justice on vaccination policies. Her forthcoming book, Teachings from Tartarus, synthesizes twelve firsthand accounts of prison experiences with analysis of prison health care and due process issues. Dr. Douds earned her bachelor's degree in political science from Duke University, her juris doctor degree from Emory University, and her doctorate in justice and crime policy from George Mason University.
Organizing interns: Chloe Adler and Michele Gilbert.
- 13 July. Topic: Knowledge translation and the how-to's of policy advising
Speaker: Dr. Tracey Perez Koehlmoos. Special Assistant to the Assistant Commandant of the Marine Corps
Summary: Dr. Tracey Perez Koehlmoos works as a senior representative of the Marine Corps on community health policy and research working groups at the interagency, Department of Defense and Department of the Navy levels.
As a health systems and policy scientist specializing in leading complex tasks, program development and capacity building, She has lived and worked in Saudi Arabia, Pakistan, Nepal, Bangladesh and Indonesia for more than 20 years. She has served as the head of the Health & Family Planning Systems Programme at ICDDRB in Bangladesh where she founded the Centre for Control of Chronic Diseases and the Centre for Systematic Review.
Dr. Koehlmoos has served as an adjunct professor in the College of Health & Human Services at George Mason University since 2005. She holds a Bachelor of Arts, a Master of Health Administration and Doctorate of Philosophy in Public Health and is a former Army Air Defense Artillery officer.
Organizing intern: Claudia Frankfurter.
- 4th June. Topic: Opening access to research and research involvement
Speaker: Ms. Hilda Bastian. Academic editor at the open access journal, PLOS Medicine, member of the PLOS One Human Research Ethics Advisory Group, and a member of Wikipedia's WikiProject Medicine
Summary: Ms. Bastian is editor of PubMed-related projects on clinical effectiveness and post-publication evaluation, PubMed Health and PubMed Commons. She also works at the National Institutes of Health (NIH) at the National Center for Biotechnology Information (NCBI) in the National Library of Medicine (NLM).
She was a long-time consumer advocate in Australia, whose career turned to analyzing evidence, communicating about it, and working to make it more accessible. She is a founding member of She is editor of PubMed-related projects on clinical effectiveness and post-publication evaluation, PubMed Health and PubMed Commons. She was a long-time consumer advocate in Australia, whose career turned to analyzing evidence, communicating about it, and working to make it more accessible. She is a founding member of Consumers' Health Forum of Australia, the Cochrane Collaboration and its Consumers and Communication Review Group. In 2004, she helped build the national Institute for Quality and Efficiency in Health Care (IQWiG) in Germany.
Organizing interns: Rita Lechuga and Julia Rodríguez.
- 21 May. Topic: Research to develop outcome measures that matter to patients
Speaker: Dr. Carolyn Wong Simpkins. Clinical Director and General Manager of the North America British Medical Journal (BMJ) Publishing Group.
Summary: Dr Simpkins is additionally the Global Lead for the BMJ Outcomes, aiming to improve the value of healthcare interventions by accelerating the development and use of outcomes measures that matter to patients. Dr. Simpkins is a board-certified, Duke and Johns Hopkins trained internist, previously practicing and teaching general internal medicine in the Greenville Hospital System. She was the founding medical director of the Barrier Islands Free Medical Clinic of Johns and Wadmalaw Islands, South Carolina, USA. She also worked as a health policy aide for the U.S. House of Representatives Ways and Means Subcommittee on Health. In addition to her medical degree, Dr. Simpkins holds a PhD in Pharmacology and Molecular Cancer Biology, along with a BS, in Biological Sciences from Stanford University.
Organizing interns: Rita Lechuga and Julia Rodríguez.
- 8 April. Topic: Continuing efforts being done to make the Cochrane Collaboration an emerging, inclusive organization using an original, infectious model.
Speaker: Dr. Jeremy Grimshaw. Co-chair of the Cochrane Collaboration and the Director of Cochrane Canada and the Coordinating Editor of the Cochrane Effective Practice and Organization of Care Group. He is also a Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute, a Full Professor in the Department of Medicine, University of Ottawa and a Tier 1 Canada Research Chair in Health Knowledge Transfer and Uptake.
Summary: Dr. Grimshaw is also the Principal Investigator of Knowledge Translation Canada (KT CANADA), a CIHR and CFI funded interdisciplinary network of over 50 knowledge translation researchers from six academic health science centers in three provinces. He has over 400 peer reviewed publications. His work focuses pretty much on bridging research evidence with public health and policy. Dr. Grimshaw talked about how an emergent and inclusive collaboration has inspired thousands of volunteers sharing common values and goals, to grow from the periphery, innovate, transform and lead on strategic developments that are bringing better production and use of research for health.
Organizing interns: Rita Lechuga and Julia Rodríguez.
- 8 December. Topic: How consumers and patients can influence in research for a better healthcare - and why that is all too often a difficult fight.
Speaker: Mr William Vaughan, Volunteer for Consumers United for Evidence-Based Healthcare (CUE), of the Cochrane Collaboration and a member of the Board of Directors of the National Committee to Preserve Social Security and Medicare.
Summary: Mr. Vaughan is currently a member of the Board of Directors of the National Committee to Preserve Social Security and Medicare. He is also a volunteer in the Consumers United for Evidence-Based Healthcare of the Cochrane Collaboration and is as well a volunteer with the Virginia State Health Insurance Counseling Program. He spoke about how consumers and patients can lobby for better health care-and why that is all too often a difficult fight. What influence can they have over the medical research that is carried out and what other ways can they advocate for an improved healthcare system?
Reference material: http://us.cochrane.org/CUE
Organizing interns: Pauline Obale, LinkedIn: https://www.linkedin.com/pub/pauline-obale/79/452/646
- 17 November. Topic: Research collaboration between institutions and countries to achieve quality research.
Speaker: Dr. Stephane Berghmans, Vice President of Academic & Research Relations for the European Union at Elsevier.
Summary: The interplay of academic, government, and private players in cooperating for quality research is one of the enduring challenges in our field. This collaboration is colored by many current issues, not the least of which is the current debate over open access data in research. Dr. Berghmans is the Vice President of Academic & Research Relations for the European Union at Elsevier. He has worked in biomedical research during his long career, first as a postdoctoral researcher at Harvard, then in his positions at Summit plc and Znomics Inc., Dr. Berghmans will speak to his role at Elsevier in stimulating cross-sectorial research, comparative research systems between the Americas and European Union, and the issue of open access data in research. A key take away message is that often, countries follow linguistic or cultural patterns in deciding other nations with which to cooperate in generating impactful research. .
Reference material: Dr. Berghmans' LinkedIn: http://be.linkedin.com/pub/stephane-berghmans/7/52/4a1
Organizing interns: Nick Hart (LinkedIn: www.linkedin.com/pub/nicholas-hart/59/a67/163/) and Pablo Rodríguez
- 19th June. Topic: Knowledge translation: How to make it useful
Speaker: Lisa Simpson, President and CEO of AcademyHealth
Summary: Lisa Simpson is the President and CEO of AcademyHealth, a leading national organization serving the fields of health services and policy research. As a health policy researcher, Lisa has a long experience in translation research into policy and practice. Guests will discuss the Organization's experience in making use of research in policy making and how to approach stakeholders.
Reference material: www.academyhealth.org
Organizing interns: Joanna Santos and Alanna Berdanier
- 12th June. Topic: Knowledge translation and implementation science at NIH/NCI
Speakers: Dr Cynthia Vinson and Mr Michael Sanchez
Summary: Implementation science is a public health tool that involves the use of evidence-based research in healthcare policy and practice. As a form of knowledge translation, implementation science bridges the gap between researchers and policy makers by helping governments make informed decisions that will positively impact health and health care systems.
Cynthia Vinson and Michael Sanchez are public health advisors within the division of cancer control and population sciences at the national cancer institute. As public health advisors, they specialize in implementation science. Their experience with evidence-based interventions and implementing dissemination strategies will greatly enhance this RIG presentation as they discuss personal experiences with implementation science and knowledge translation at the NIH, explaining the challenges they face and how they overcame these challenges.
Reference material: www.cancercontrol.gov/is Advancing global cancer research through coordination, collaboration, and communication. National institutes of health approaches to dissemination and implementation science: current and future directions
Organizing intern: Bridget Lee
- 9th May. Topic: Role of scientific research in Evidence Aid
Speaker: Claire Allen (Knowledge manager at Evidence Aid)
Summary: Evidence Aid is an international initiative formed in the wake of the Indian Ocean tsunami in December 2004. It provides timely access to organized reliable and up-to-date knowledge from evidence overviews and summaries of relevance to natural disasters and other humanitarian emergencies. Last year, Evidence Aid was awarded the Unorthodox Prize 2013.
Clare Allen is the Knowledge Manager at Evidence Aid and also works at the Cochrane Collaboration. She will discuss the circumstances that led to the development of Evidence Aid, how it evolved and the role of scientific research in the work of Evidence Aid. She will also speak about the vision and long term plans of the initiative.
This RIG was a collaboration with PAHO's department of Emergency preparedness and disaster relief.
- 7th April. Topic: Health inequalities and France's national health strategy: the case of stroke during and after acute care
Speaker: Olivier Grimaud, public health physician and Deputy Director of the Epidemiology Department at the National School of Public Health in France.
Summary: He discusses his current research on health inequalities regarding stroke onset and care, and a deliberation on the global challenge of tackling health inequalities with a specific focus on chronic disease management.
Reference material: Touraine, M. (2014). Comment: Health inequalities and France's national health strategy. The Lancet, 383(9923), March 29, DOI: 10.1016/S0140-6736(14)60423-2. http://www.sciencedirect.com/science/article/pii/S0140673614604232
Grimaud, O., Leray, E., Lalloué, B. et al. (2014). Mortality following stroke during and after acute care according to neighborhood deprivation: a disease registry study. Journal of Neurology, Neurosurgery & Psychiatry, JNNP. DOI:10.1136/jnnp-2013-307283. http://www.ncbi.nlm.nih.gov/pubmed/24648038
- 4th April. Topic: The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998 - 2010.
Speaker: Federico Guanais, Health specialist at the Inter-American Development Bank (IDB)
Summary: Discussions on his research on the combined effects of community based primary care expansion and conditional cash transferences in the reduction of infant mortality in Brazil between 1998 and 2010. This work underlines the importance of multi-sectorial public health public health approaches and describes mechanisms to advance towards effective universal health coverage.
Reference material: Guanais FC (2013). The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998 - 2010. American Journal of Public health, 103(11), 200-2006. DOI: 10.2105/AJPH.2013.301452
- 24th June. Topic: Testing Treatments-Interactive (TTI) Project
Speaker: Dr. Giordano Pérez-Gaxiola, editor of the project and Director of the Department of evidence-based medicine of the Pediatric hospital of Sinaloa.
Summary: Testing Treatments enables readers to better understand how to critically analyze: the research conditions in which treatments should be tested; the fairness and reliability of research; and the benefits and relevance of health treatments to their condition. The authors hope that an increased understanding of the conditions required for fair tests of treatments will improve healthcare, prevent unnecessary errors and promote public trust and engagement (as stressed by PAHO's Policy on Research for Health). It is available online and in Spanish.
Organizing Intern: Stephanie Soelling
- 15th August. Topic: Research on drug abuse and how the information can be used to design and implement policies and programs that directly confront the problem.
Speaker: Dr Francisco Cumsille, coordinator of the Inter-American Observatory on Drugs (OID) - the statistical branch of the Inter-American Drug Abuse Control Commission.
Summary: The OID provides technical assistance to the Member States, in particular for the collection and analysis of up-to-date drug-related data in the Americas. It will focus on what Member states can do or have already done to better understand drug abuse, and how this information can be used to design and implement policies and programs that directly confront the problem, with a special emphasis on drug-use in schools and prisons.
- 5th October. Topic: Evaluation within the UN System
Speakers: Dr Rosina Salerno and Dr Rocio Manchado Garabito
- 13 September: Biomedical sciences and the EU's upcoming Framework programme for research and innovation
Speaker: Declan Kirrane, Managing director at Intelligence in Science (ISC)
Reference material: www.iscintelligence.com (Partner & promoter, EU)
- 7th September. Topic: Using Research to strengthen Health Research Systems.
Speaker: Dr Diana Pinto, Health Lead Specialist, Inter-American Development Bank (IDB).
- 14th April. Topic: Science, Technology and Innovation at USAID
Speaker: Dr Norka Ruiz Bravo, Special advisor for Science and Technology Partnerships at USAID
- November 11. Topic: Stem Cell Research by Dr. John Tisdale.
- October 10. Topic: What Researchers Owe Research Participants- A Conversation on Ethics by Dr. Carla Saenz.
Elluminate link to the recording (Spanish only).
- August 4. Topic: Research priorities in Eduador- First International Research Interest Group.
Elluminate link to the recording (Spanish only).
- June 17. Topic: How to promote the sharing of knowledge and best practices among PAHO's programs, in order to translate research into practice?
- April 19. Topic: Data collection and analysis: Successes and Challenges.
- March 25. Topic: What research do you support, promote, and need to accomplish your goals?
Improving equitable access to Breast Cancer Screening for First Nations in Manitoba (Canada)
Imagine you are a woman living in the Canadian province of Manitoba as part of the First Nations indigenous population. Living in the rural North you have to travel long distances to access medical services. The costs for traveling in the North are very high. There are known benefits to screening for breast cancer. However, given your socio-economic barriers, how and when could you find the time to get screened for breast cancer?
What's the issue? Breast cancer in a Canadian First Nations Population
Within Manitoba there is a significant population of indigenous people in the northern part of the province. In 1996, 128,910 Aboriginal people lived in Manitoba, accounting for 11.7% of Manitoba's total population. The Aboriginal proportion of the population has been increasing rapidly over the past 20 years.1 Breast cancer is the most commonly diagnosed cancer among Manitoba women and the second most common cause of cancer-related deaths among women. From 1995 to 2004, the incidence of cancer among First Nations women doubled, from 178/100,000 to 391/100,000. During the same time, the incidence of cancer among non-First Nations women increased by just 1.5%.2
Research to Practice: Making Breast Cancer Screening Mobile
Manitoba has a publicly funded Breast Screening program which operates in four cities and towns. Breast cancer screening with a mammogram, a specialized x-ray of the breasts, is a way of detecting cancer. Access to breast cancer screening plays a major role in the timely detection and treatment of cancers in women. Monitoring breast screening participation rates showed the inequities for northern and rural women and the mobile program was introduced to address the disparities.
Ensuring Canada's First Nations have access to breast cancer screening, specifically the "geographically isolated" Manitoban Aboriginal women, and adapting it to cultural context is an example of how investment in research for health can be beneficial in promoting health equity with regards to gender, ethnicity, and socio-economic status. Mobile screening units have been created to reach women who live outside of the four cities and towns housing the screening program. To date, mobile screening programs operate in over 80 rural and northern communities every year and in 10 Winnipeg city locations.
The breast screening program works with First Nation communities to address cultural issues. The program developed posters that include aboriginal women and invitation letters are translated when needed. The local health workers arrange the appointments as some women don't have phones. The clinics are advertised over the local community radio station and the local health workers often visit women to explain the program.
This example makes clear that to achieve health equity, access to the products of research, such as cancer screening technologies, need to consider the social determinants of health. Outreach initiatives should be culturally appropriate, as shown in the example of the Aboriginal Cancer Strategy.3 The guiding principles include a physical, mental, emotional and spiritual approach to health in conjunction with a grass-roots approach that gives voice to the community.
What next: Improving Access to Breast Cancer Screening by Promoting Innovation
Despite the universal screening program, access remains a challenge. For example, mobile units have rigid schedules making it difficult to switch dates when bad winter weather or equipment failure interrupt schedules and it is not always possible to accommodate changes. The mobile unit may not return for another year or two, leading to wide variability in the use of mammograms among eligible Manitoba women. In the two year period from April 1, 2003 to March 31, 2004, just 60% of women aged 50 to 69 years had a mammogram. Women in the rural south were most likely (63%), and women in the north were least likely (53%), to have had a mammogram. In fact, all Regional Health Authorities in the rural south had higher participation rates in mammography than did Winnipeg (59%).4
These differences in breast screening participation can be related to income, jobs, children, high travel expenses and long travel times due to an inadequate infrastructure that make it difficult for northern women to travel, especially from isolated communities in the North. Thus, even reaching a mobile screening unit is perceived as an obstacle for some women. Also, competing socio-economic health issues and immediate needs such as daily bread and shelter are often considered more important. In addition, some women have family members affected by breast cancer. Such bias sometimes results in increased likelihood towards cancer screening, but sometimes also in aversion due to fear.
It is in the hands of the community health workers to raise awareness. The challenge for research is to find ways to expand equitable access to breast cancer screening for all under-screened indigenous women. This can be achieved by enhancing the favorable balance between the benefits and risks of screening and by finding ways to make the units more mobile and flexible. Looking into the future, new technologies such as more compact digitalized mammography or blood testing for cancerous cells should be at the forefront.
For further information:
- A gender and ethnicity analysis of cancer: Cancer in Manitoba, Canada
- PAHO's Gender Ethniciy and Health Unit
- All the data provided for this case study are from CancerCare Manitoba
- Province of Manitoba, Demographics,
- Cancer Care Manitoba. 2007. Custom Tabulation. in: PAHO; A gender and ethnicity analysis of cancer: Cancer in Manitoba, Canada, p.6,
- Ontario. Aboriginal Cancer Strategy. Honouring the Aboriginal Path to Well-being.
- Fransoo R, Martens P, Burland E. 2005. Sex differences in health status, health care use, and quality of care: A Population-Based analysis for Manitoba's Regional Health Authorities. Winnipeg: Manitoba Centre for Health Policy. 435 p, in: PAHO; A gender and ethnicity analysis of cancer: Cancer in Manitoba, Canada, p.16,
- Procedimientos normalizados de trabajo para presentar propuestas de investigación
Procedimientos Operacionais Padrão pela apresentaçâo das propostas de pesquisa
Standard Operating Procedures for submitting research proposals