How Should Food Offered by Health Care Organizations Meet Individual, Community, and Ecological Needs?

This commentary on a case suggests why health care organizations have responsibilities to serve food to their patients, guests, and employees that is ethically, nutritionally, culturally, and religiously appropriate. This article also investigates how inclusive, equitable, sustainable food services are key dimensions of health care organizations' civic and stewardship responsibilities to individuals and communities.

A Scoping Review on Resources, Tools, and Programs to Support Women's Leadership in Global Health: What Is Available, What Works, and How Do We Know?

Background: The unequal representation of women in global health leadership is a prevalent issue laterally across global health fields and vertically down experience levels. Although women compose much of the workforce, gender-based barriers prevent female talent from filling their appropriate leadership roles, which funnels unique expertise and problem-solving skills on a diversity of health topics out of positions of leadership. Currently, many calls to action have been proposed to raise awareness of the lack of women's global health leadership, with Women in Global Health as one of the more prominent movements. This paper evaluates how the priorities and strategies for leadership training and development set forth by such movements have changed the landscape of available programs and resources for women in global health, based on availability, success, and evaluation. Objectives: This manuscript maps existing programs and resources that support women's leadership in global health and describes available evaluations and documented outcomes. Methods: We used a dual approach of a peer-reviewed and gray literature search to build a comprehensive list of existing programs and resources designed to support women's leadership in global health. Out of 54 items included for full-text review and 22 gray literature items screened for inclusion, a total of 31 resources were processed in the final extraction. We used descriptive quantitative analysis for categorical and binary variables, while qualitative data from evaluations were analyzed for outcomes. Findings: Resources were in the form of conferences, supplemental resources to conferences, certificate programs, coursework, stand-alone documents, single-focus programs, and mostly multicomponent programs. Most resources did not have a global health focus area, and a third of the total resources identified women first authors from predominantly high-income countries. About half of the resources mention mentorship and networking as activities incorporated as part of the resource. Over half of the resources did not have a target audience, and most resources were free to users.While there is a lack of consistent and meaningful evaluation of the resources, the available captured metrics of success were described as the number of career-advancing opportunities after using the resources. Examples of opportunities include enrollment in graduate school, receiving academic promotions, participating in internships, presenting at conferences, and publications. Conclusion: While the supply of existing programming and resources to advance women's leadership in the global health field is limited in terms of quantity, it is rich in diverse formats, content, and implementation. This scoping review supports the notion that empowered female leadership in global health requires a complementary support system that encourages the unique needs and talents of female leaders. Such a support system needs inclusive targeting regardless of experience level, academic degree, or location. Furthermore, evaluations of resources will be critical in maintaining meaningful interventions that effectively dismantle the infrastructures that continue to limit the success of women leaders in global health.

Connectedness Is Critical: A Social Network Analysis to Support Emerging Women Leaders in Global Health.

Background: Global health networks serve to bring members together towards a specific objective. However, for myriad reasons, women often lack access to networks that facilitate leadership and career development. In 2020, the Johns Hopkins Center for Global Health launched Emerging Women Leaders in Global Health (EDGE) with a virtual seminar series featuring diverse women leaders followed by an online networking space. Objectives: The purpose of this paper is to use social network analysis (SNA) to describe the network, the connections within it, and the values placed on those connections to inform future programming. Methods: We asked EDGE participants to fill out a survey to collect network-specific data. Then, we developed a sociogram and calculated social network metrics based on region, type of organization, and professional career stage. Findings: The EDGE network had 103 unique connections, and each node, on average, was connected to two other nodes. Early professionals that work in Global North academic institutions were the most prevalent members and most efficiently connected with other members of the network. However, senior professionals from the Global South are key to bridging gaps between regions and across sectors. Conclusions: Early career professionals from the Global North and senior professionals from the Global South need to work in synergy to improve the connectedness of emerging women leaders around the world.

We Aren't Just 'Slack'ing Off: Utilizing a Digital Tool to Connect Emerging Women Leaders in Global Health.

Background: Investing in women leaders in global health catalyzes growth and positive outcomes for individuals and their communities, yet large gender disparities persist in leadership within the field due to several barriers. The use of digital tools facilitates cross-institutional and international collaborations to allow individuals or groups to create or share information, ideas, career interests, and other forms of expression via virtual communities. Digital tools can dramatically expand access to and the quantity and quality of opportunities for networking, mentoring, and collaboration to support women in their professional development. Objectives: The objective of this paper is to document tangible examples of positive experiences, connections, or collaborations resulting from connecting with other participants in a Slack network. We aimed to evaluate this network to understand how to better build, model, and scale advantageous digital networks of women leaders in global health moving forward. Methods: Semi-structured interviews were conducted virtually with seven members of the Slack network from Africa and North America who volunteered to share their experiences. Transcripts of six of these interviews were analyzed for key points using thematic analysis to derive short vignettes from each interview. Findings: The findings of this study indicate that Slack is a highly beneficial tool for women in global health to use for facilitating job searches, mentoring opportunities, promoting project collaborations, and proposing programming and outreach ideas in a remote environment. We found distinct recommendations for utilizing this digital networking tool in a way that best supports and engages women in global health. It is important to spread awareness and ensure visibility of the network to recruit and maintain members, design the network in a way that inspires internal motivation, encourage consistent and meaningful engagement, send weekly emails, and maintain accessibility for a global membership base. Conclusions: The Slack network provides an engaging digital tool that facilitates communication, opportunities, and growth among women in global health. Digital tools such as Slack can help to increase opportunities for participants from low- and-middle-income countries to engage in the same networking and leadership opportunities as individuals from high-income countries. It remains critical to continue to build, advance, and scale advantageous networks like Slack to promote equity and accessibility among women leaders in the global north and south into the post-pandemic world.

Strategies to Improve Women's Leadership Preparation for Early Career Global Health Professionals: Suggestions from Two Working Groups.

Background: Despite advances in gender equality, women still experience inequitable gaps in global health leadership, and barriers to women's advancement as leaders in global health have been well described in the literature. In 2021, the Johns Hopkins Center for Global Health conducted two virtual working groups for emerging women leaders to share challenges and suggest solutions to advance women's leadership in global health. In this paper, we present emerging themes from the working groups, provide a framework for the results, and discuss strategies for advancing women's leadership in global health. Objectives: The objective of this paper is to synthesize and share the themes of the two working group sessions to provide strategies for improving women's leadership training and opportunities in the field of global health. Methods: Approximately 182 women in the global health field participated in two virtual working group sessions hosted by the Johns Hopkins Center for Global Health using the Zoom platform. Participants were divided into virtual breakout rooms and discussed pre-assigned topics related to women's leadership in global health. The participants then returned to share their ideas in a plenary session. Notes from the breakout rooms and transcripts from the plenary session were analyzed through a participatory and iterative thematic analysis approach. Findings: We found that the working group participants identified two overarching themes that were critical for emerging women leaders to find success in global health leadership. First, the acquisition of individual essential skills is necessary to advance in their careers. Second, the institutional environments should be setup to encourage and enable women to enter and succeed in leadership roles. The participants also shared suggestions for improving women's leadership opportunities such as including the use of virtual technologies to increase training and networking opportunities, intersectionality in mentorship and sponsorship, combatting impostor syndrome, and the importance of work-life balance. Conclusions: Investing in women and their leadership potential has the promise to improve health and wealth at the individual, institutional, and community levels. This manuscript offers lessons and proposes solutions for increasing women's leadership through improving individual level essential skills and fostering environments in which women leaders can emerge and thrive.

Lichen sclerosus et atrophicus-like graft-versus-host disease post stem cell transplant.

A major complication following hematopoietic stem cell transplantation is graft versus host disease. Cutaneous manifestations of chronic graft versus host disease (cGVHD) are varied and this condition impacts patient outcomes and quality of life. We describe two cases of lichen sclerosus et atrophicus-like cGVHD developing in patients after hematopoietic stem cell transplantation. Both patients presented clinically with patches of pigmentary changes and scaling that displayed classic histologic features of lichen sclerosus et atrophicus. The skin is a frequent target organ of cGVHD and often the presenting location of the disease, making dermatologists key in recognition and management. It has been proposed that cutaneous cGVHD is a spectrum of disease and the lesions may evolve through various stages. Lichen sclerosus et atrophicus-like cGVHD may represent a phase in this continuum or a distinct sub-type of disease. Remaining cognizant of the potential manifestations of disease is key for prompt recognition and proper treatment.

The nonvisual illusion of self-touch: Misaligned hands and anatomical implausibility.

The self-touch illusion is elicited when the participant (with eyes closed) administers brushstrokes to a prosthetic hand while the examiner administers synchronous brushstrokes to the participant's other (receptive) hand. In three experiments we investigated the effects of misalignment on the self-touch illusion. In experiment 1 we manipulated alignment (0 degrees, 45 degrees, 90 degrees, 135 degrees, 180 degrees) of the prosthetic hand relative to the participant's receptive hand. The illusion was equally strong at 0 degrees and 45 degrees: the two conditions in which the prosthetic hand was in an anatomically plausible orientation. To investigate whether the illusion was diminished at 90 degrees (and beyond) by anatomical implausibility rather than by misalignment, in experiment 2 hand positioning was changed. The illusion was equally strong at 0 degrees, 45 degrees, and 90 degrees, but diminished at 135 degrees despite the prosthetic hand now being in an anatomically plausible orientation. Thus the illusion is diminished with misalignment of 135 degrees, irrespective of anatomical plausibility. Having demonstrated that the illusion was equally strong with the hands aligned (0 degrees) or misaligned by 45 degrees, in experiment 3 we demonstrated that participants did not detect a 45 degrees misalignment. Large degrees of misalignment prevent a compelling experience of the self-touch illusion, and the self-touch illusion prevents detection of small degrees of misalignment.