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Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.

ABSTRACT: BACKGROUND: There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions. DISCUSSION: To address these issues, we share a series of questions we have asked ourselves-United States' citizens with experience living and working in Central America-in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions. Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health.

SUBMITTER: Ventres WB

PROVIDER: S-EPMC4422227 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.

Ventres William B WB Fort Meredith P MP

BMC international health and human rights 20141028

<h4>Background</h4>There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to ...[more]

PMID: 25346040

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Project description:Introduction: Previous studies have shown significant conditional differences between eyes open, fixated at an image (EO) and eyes closed (EC) in the acquired resting-state functional magnetic resonance imaging (rs-fMRI) data. Aim: We recently showed significant functional network connectivity (FNC) differences between EO and EC across a variety of networks. In this study, we aim at further evaluating differences in dynamic FNC (dFNC) between EO and EC. Materials and Methods: Rs-fMRI were collected from adolescents aged 9-15 years old during both EO and EC conditions, and dFNC was calculated by using the independent component analysis framework. Results: We found that out of five states (clusters), state 1 was observed to be more dominant in the EO condition, whereas state 2 was observed to be more dominant in the EC condition. States 1 and 2 showed significant differences in the mean dwell time based on false discovery rate, and states 1, 2, 3, and 4 differed in the frequency of occurrences. These results are consistent with our previous study of static connectivity in suggesting that EO and EC differences not only are relatively strong but also importantly reveal that these differences vary over time, especially in one particularly transient connectivity pattern. Conclusion: Our results manifest as changes in the proportion of time spent in unique functional connectivity patterns, and they show unique transient functional connectivity patterns in a subset of identified states. Overall, our findings indicate that both static and dynamic rs-fMRI connectivity patterns are strongly impacted by basic conditional differences such as EO and EC. Impact statement Our findings not only suggest that eyes open, fixated at an image (EO) and eyes closed (EC) condition-related resting state functional magnetic resonance imaging differences are relatively strong, but they also reveal an important attribute of these conditions that these differences vary over time, especially in one particularly transient connectivity pattern. Our results manifest as changes in the proportion of time spent in unique functional connectivity patterns, and they show unique transient functional connectivity patterns in a subset of identified states. We believe there is benefit in having the EO/EC as a contrast of interest in future studies, if time allows.

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Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.

Publications

Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.

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