Needs Assessment and Best Practices for Digital Trainings for Health Professionals in Ethiopia Using the RE-AIM Framework: COVID-19, Case Study.

OBJECTIVES: This study is aimed to assess the implementation science outcomes of the coronavirus disease (COVID-19) e-health educational intervention in Ethiopia targeting health care workers via the RE-AIM (Reach, Effectiveness, Adaption, Implementation, Maintenance) framework. METHODS: A series of three 1-hour medical seminars focused on COVID-19 prevention and treatment education were conducted between May and August 2020. Educational content was built from medical sites previously impacted by COVID-19. Post-seminar evaluation information was collected from physician and other participants by a survey instrument. Cross-sectional evaluation results are reported here by RE-AIM constructs. RESULTS: The medical seminars reached 324 participants. Key success metrics include that 90% reporting the information delivered in a culturally sensitive/tailored manner (effectiveness), 80% reporting that they planned to share the information presented with someone else (adoption and implementation), and 64% reporting using information presented in their daily clinical responsibilities 6 months after the first medical seminars (maintenance). CONCLUSION: Grounded in a theoretical framework and following evidence-based best practices, this intervention advances the field of dissemination and implementation science by demonstrating how to transition health care training and delivery from an in-person to digital medium in low-resource settings like Ethiopia.

Preoperative halo-gravity traction for severe spinal deformities at an SRS-GOP site in West Africa: protocols, complications, and results.

STUDY DESIGN: Retrospective analysis of a prospectively collected single-center database. OBJECTIVE: We describe a modified halo-gravity traction (HGT) protocol for patients with severe spinal deformities in West Africa, and assess the clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: Three-column osteotomies are frequently used in the correction of severe spinal deformities; however, these can be associated with high complication rates and significant risk for neurological injury. Preoperative traction is one modality used to obtain a partial correction prior to definitive fusion. Low numbers and variability of traction protocols, however, have limited previous reports of sustained HGT. METHODS: All patients who underwent HGT in Ghana from April 2012 to August 2013 were reviewed. HGT was started at 20% body weight and increased by 10% per week until 50% body weight was reached by 4 weeks or thereafter as tolerated. Demographic variables, operative data, radiographic parameters, and health-related quality of life scores were collected. A deformity reduction index was calculated at each time point by summing the scoliosis and abnormal kyphosis for each patient and reported as a percentage of the preoperative deformity. RESULTS: Twenty-nine patients underwent HGT for an average 107 days prior to definitive posterior spinal fusion (24 patients) or placement of growing rods (5 patients). The major curve improved from an average 131° to 90° (31%) after HGT, and to an average 57° (56%) postoperatively. Pure kyphotic curves were rigid (flexibility 22% after traction), with a correction index of 3.88, which is similar to historical controls. Deformity correction with HGT plateaued at 63 days. Overall Scoliosis Research Society-22 questionnaire scores improved significantly pretraction versus postoperatively, but there was no change after traction versus before traction. There were 11 pin tract infections, with no neurological complications. CONCLUSION: HGT is a safe method to partially correct severe spinal deformities prior to a definitive procedure, and may reduce the need for higher risk 3-column osteotomies. Importantly, kyphosis secondary to infection with spontaneous apical ankylosis is relatively resistant to HGT. LEVEL OF EVIDENCE: 4.

Nature and nurture in own-race face processing.

A standard visual preference task was used to examine 3-month-olds' looking times at own-race versus other-race faces as a function of environmental exposure to faces from the two categories. Participants were Caucasian infants living in a Caucasian environment, African infants living in an African environment, and African infants living in a predominantly Caucasian environment. The results indicate that preference for own-race faces is present as early as 3 months of age, but that this preference results from exposure to the prototypical facial environment.