A Medical Student’s View on Interdisciplinary Collaboration

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My name is Temini Ajayi and I am currently a second-year medical student at Duke. I chose Duke Med because it was important to me to be in a supportive community with people that are not only committed to the advancement of science and humanity, but also to their own wellbeing and the wellbeing of their peers. Additionally, the Duke Medical School curriculum is well known for its emphasis on research and outreach. We get a full year to pursue other interests/research projects that help us develop as holistic physicians and people.

I am interested in global health as a future career direction. While discussing this with faculty here at Duke, they were able to guide my interests. I got introduced to the Bass Connections team (Shining Evolutionary Light on Global Health Challenges) and to Charlie Nunn (our team leader), and was excited to learn about the scope, breadth and depth of the project. I found it inspiring to work with individuals from various schools at Duke, learning from them and offering my insight when needed. Interestingly, we had a community of student and graduate researchers that focused on different aspects of the overall project, but we were all involved in the cerebral and formative aspects of all projects. It was a nice way to be exposed to different aspects and still maintain ownership of a part of the project. Charlie was also a phenomenal mentor that pushed us to think outside the box and do more.

The overall project resulted in at least four posters and two theses (one undergraduate and one graduate). My personal project resulted in two posters that were presented at the Duke Global Health Showcase. This project has been an integral part of my decision to pursue global health and was one of the global health projects that earned me the Global Health Emerging Leader Award in the Triangle Area.

I really enjoyed my time on this team. Perhaps the most thrilling part of this project for me was getting to interact with graduate students and faculty from multiple disciplines and learning from them in the process.

The students were very driven and brought about intellectual curiosity that was as challenging as it was refreshing. In my opinion, this was perhaps the strongest part of this experience – the collaboration between students of different disciplines and at different stages of their careers.

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Three New PhD Students Join Doctoral Scholars Program

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Three Duke doctoral students—Faraz Usmani, Christopher Lam and Justin Lana—have been selected to join the Global Health Doctoral Scholars program at the Duke Global Health Institute (DGHI). Lam and Lana are graduates of the Duke Master of Science in Global Health program.

The doctoral scholars program gives Duke PhD candidates from multiple disciplines an opportunity to conduct research on a topic that straddles their primary discipline and global health.

Each scholar is mentored by a DGHI faculty member, who collaborates with the scholar on planning and executing global health research and provides career development and other opportunities to help the scholar prepare for a career in global health.

“Adding to our interdisciplinary synergy in global health, we look forward to further expanding our environmental and economics perspectives and welcome the contributions made by biomedical engineering,” said Kathleen Sikkema, director of doctoral studies at DGHI. “As our first cohorts of doctoral scholars receive their PhDs, we are extremely pleased to continue to build our community of global health scholars.”

Faraz Usmani Studies Uptake of Environmental Health Technologies

Faraz_UsmaniFaraz Usmani began his PhD program in environmental economics with Duke’s University Program in Environmental Policy in 2014. He specializes in the economics of environmental health, energy access and development in low-income countries and is interested in the socioeconomic obstacles that hinder the large-scale adoption and sustained use of new environmental health technologies by poor households.

After graduating from New York University, Usmani worked in the Indian Ministry of Health’s HIV/AIDS control program, where he managed a $25 million grant from the Global Fund. He went on to complete a master’s degree in international and development economics at Yale University, and before heading to Duke to pursue a doctoral program, he spent two years working on environmental management projects at the World Bank.

Usmani is working with Marc Jeuland, assistant professor of public policy and global health, to study the effect of economic incentives and other decision-making factors on the adoption and sustained use of improved cookstoves in Cambodia. He also intends to develop a manual, informed by his interdisciplinary research, that will help environmental health policymakers and practitioners translate innovative research findings into effective programs and initiatives.

Usmani was recently named to the Duke University Energy Initiative’s inaugural class of Energy Doctoral Student Fellows. As a fellow, he’ll work with industry leaders and Duke faculty to conduct interdisciplinary research on energy markets and policy.

“The environmental health challenges that interest me don’t exist in isolation,” Usmani said, “so I’m thrilled to develop my research agenda through engagement with the interdisciplinary DGHI community.”

Christopher Lam Looks to Increase Accessibility of Cervical Cancer Screening

Chris_LamCurrently a fourth-year doctoral student in biomedical engineering, Christopher Lam is a 2012 graduate of the Duke Master of Science in Global Health (MSc-GH) program. His combined interest in global health and biomedical engineering blossomed during his undergraduate involvement with Engineers without Borders; through this group, he and his team designed and developed a water purification system for a community in Tanzania.

For his MSc-GH thesis, Chris worked as a visiting fellow at the George Institute for Chronic Diseases in China, where he evaluated the burden of hypertension and the effectiveness of a dietary salt substitute intervention in reducing hypertension in an elderly pastoralist Tibetan population.

Through his global health work in China, Lam recognized the tremendous need for design and deployment of low-cost, easy-to-use point-of-care diagnostic devices. Under the guidance of his faculty mentor, Nimmi Ramanujam, professor of biomedical engineering and global health, he’s currently evaluating and developing a low-cost transvaginal digital colposcope or POCkeT (Point of Care) colposcope that will allow for increased dissemination of cervical screening in limited-resource settings. Pilot field study sites include Liga Contra El Cancer in Lima, Peru, and the Kilimanjaro Christian Medical Center in Moshi, Tanzania.

Lam’s doctoral scholar funding will enable him to expand the scope of this project; his goal is to improve the sensitivity and specificity of the POCkeT colposcope, which interfaces with a smartphone or tablet. He’s also working with DGHI research scholar Lavanya Vasudevan to incorporate the control software and image processing algorithms in the Android operating system associated with the miniature colposcope.

“Through the support of the Doctoral Scholars program,” Lam said, “I’m now able to get valuable data points from the field to refine and improve upon our lab’s POCkeT colposcope design to ensure clinicians have a robust and intuitive new tool in the fight to increase access to cervical cancer screening.”

Justin Lana Investigates Risk Factors for a Neglected Tropical Disease

Justin_LanaLike Christopher Lam, Justin Lana is a 2012 graduate of the Duke MSc-GH program. He’s pursuing a PhD in Environment at the Nicholas School of the Environment.

While at DGHI for his master’s degree, Lana spent seven months in northern Peru working on his thesis under the mentorship of assistant professor of global environmental health William Pan. Following graduation, Lana worked briefly in Pan’s lab as a senior data technician before taking a 14-month position in South Sudan working as a technical advisor with the South Sudan Guinea Worm Eradication Program.

And now, Pan is once again mentoring Lana. Last summer, Lana joined Pan’s Bass Connections team in Peru, which explored the epidemiology of cutaneous leishmaniasis (CL), a neglected tropical disease transmitted by sandflies. For his dissertation project, he’ll build on this research, evaluating risk factors of CL infection using epidemiological, environmental and clinical approaches.

Specifically, Lana will test the primary hypothesis that artisanal and small-scale gold mining and deforestation are associated with an increased risk for CL infection. The study will leverage long-term partnerships between Pan’s research team, trained field workers, Peruvian medical professionals and the Ministry of Health in the Madre de Dios region.

Lana was recently named a 2016 Emerging Leaders in Science and Society Fellow with the American Association for the Advancement of Science.

“I truly believe global health is a lifestyle as much as it is a serious academic discipline, and as a doctoral scholar I plan to build on both fronts,” said Lana. “The program’s financial support will strengthen my research by allowing me to stay in Peru longer. And as a member of this program, I’m instantly connected with like-minded individuals from whom I can receive feedback and support as I move through this PhD journey.”

Learn more about the Global Health Doctoral Scholars program.

Originally published on the Duke Global Health Institute website

Bass Connections Team Explores Intersections between Evolution and Health in Madagascar

Bass Connections project team in Madagascar

How does understanding evolution help us tackle the world’s most urgent health crises? What can we learn from evolutionary medicine about the spread of new and reemerging pathogens and antibiotic-resistant microbes, and increases in autoimmune diseases, obesity and cancer?

A Bass Connections project team, Shining Evolutionary Light on Global Health Challenges, explored these questions by focusing on the concept of evolutionary mismatch.

An evolutionary mismatch occurs when the traits of organisms that evolved in an ancestral setting are no longer adaptive because of changes in the environment or lifestyle. For example, in some groups of people a lack of Vitamin D and exposure to the sun as well as the stresses of twenty-first-century life have increased the number of cases of autoimmune diseases.

Led by Charles Nunn, Allen Rodrigo and Daniel Schmitt, the team prepared for field research in Madagascar by investigating possible evolutionary mismatches through broad-scale analysis of infectious and noninfectious diseases. In Madagascar, dramatic changes in diet and behavior have been accompanied by an increase in chronic Western diseases and musculoskeletal injuries and pathologies.

Bass Connections project team in Madagascar

Team members included graduate students Teminioluwa Ajayi of the School of Medicine, MD-PhD student Ashley Sobel, and Melissa Manus of Duke Global Health Institute, along with undergraduates Rachael Clark, Taylor Trentadue and James Yu.

They documented their work through videos and shared findings in a series of posters:

The breadth and depth of the team’s research has contributed to the study of evolutionary medicine. The team also built a collaborative community of twenty-five people who are interested in the intersection of medicine and evolution. Their comprehensive research laid the groundwork for the new Triangle Center for Evolutionary Medicine (TriCEM). Formerly known as the National Evolutionary Synthesis Center, TriCEM is researching innovative evolutionary medicine, the intersection between cancer and evolution, social and biological detriments to health, pathogenic and commensal organisms and brain sciences.

New project team in 2016-17

Starting this summer, a new Bass Connections project team led by Nunn, Gerald Bloomfield and Subhrendu PattanayakCookstoves and Air Pollution in Madagascar: Finding Winning Solutions for Human Health and Biodiversity—will investigate the health consequences of traditional cooking practices in Mandena, Madagascar. Team members will quantify the consequences of cooking practices on human respiratory health and air quality; assess the impact of wood extraction for cooking on nearby forests and wildlife, and quantify human effort needed to obtain sufficient firewood.  They will also investigate whether cooking practices contribute to high rates of cardiopulmonary disease observed in their previous Bass Connections project. The priority deadline for student applications has passed, but there may still be room on this and other project teams.

View of cookstove in Madagascar

Learn more about Shining Evolutionary Light on Global Health Challenges and find out how to get involved in Bass Connections.