Faculty and Staff Travel Awards List

2020 Awards

Hepatitis B vaccination among health care workers in Jimma Hospital: access and barriers to vaccination and post-exposure prophylaxix

Project manager: Nimrod Deiss-Yehiely, medical resident, Internal Medicine, School of Medicine and Public Health; PI Dawd Siraj, M.D., MPH & TM

Hepatitis B infection is transmitted through contact with Hepatitis B infected blood or bodily fluids.

Health care workers are at high risk for Hepatitis B infection because they are more likely to be exposed to infectious material. The risk of infection for health care workers decreases significantly with hepatitis B vaccination and post-exposure prophylaxis upon exposure. However, vaccination and post-exposure prophylaxis have not been widely implemented, particularly in resource-limited settings placing health care workers in those settings at higher risk of infection. Improving access requires an understanding of the barriers to Hepatitis B vaccination and post-exposure prophylaxis in resource-limited settings.

We seek to assess the barriers and facilitators to hepatitis B vaccination and post-exposure prophylaxis among health care workers at Jimma University Specialized hospital in Jimma, Ethiopia. We will interview health care workers and ask about hepatitis B vaccination and post-exposure prophylaxis using structured interviews based on the SEIPS model that assesses different factors in the work system that impact implementation. Responses will be coded and analyzed for common themes. Using the themes that emerge, we will propose a recommendation for improving hepatitis B vaccination rates and post-exposure prophylaxis use among health care workers in Jimma, Ethiopia.

Implementation of improved hand hygiene practices in Jimma University Specialized Hospital

Project director: Meredith Kavalier, M.D., Internal Medicine, School of Medicine and Public Health; PI: Daniel Shirley

Using the Systems Engineering Initiative for Patient Safety model, we have collected data to identify barriers and facilitators to hand hygiene (HH) in Jimma, Ethiopia. We have conducted semi-structured interviews with patient-care providers, observed current HH resources and practices, and helped with an education campaign on the importance of HH. Preliminary data suggests that the barriers to hand hygiene are multifold. We found that HH resources are inconsistently supplied. The educational campaign on hand hygiene was completed, but attendance was not required. Heavy workload and high patient burden were also noted to prohibit appropriate HH practices between patient interactions. By identifying barriers, we have also identified areas of intervention. During our trip we will continue to collect hand hygiene observational data to monitor progress following the educational campaign. We will also work with the infection control team, staff members, and hospital administrators to determine the most realistic and impactful interventions based on the barriers we have identified.

This project is part of a larger collaboration between JUMC and UW Health aimed at establishing and improving Infection Control practices. Previous work has included identifying barriers and facilitators to Infection Control program establishment and reducing surgical site infections.

A coupled-systems framework for understanding groundwater quality; health risks; and ecosystem impacts within karst landscapes: building an international research network between Ireland and Wisconsin

Principal Investigator: James LaGro , Ph.D., M.S., MLA, Planning and Landscape Architecture, College of Letters & Science

Groundwater is the primary source of drinking water for about 4 billion people worldwide. The combination of climate change, population growth and land use change (e.g., urbanization, agricultural intensification) has serious implications for environmental quality and human health. Comparative research is needed to improve our understanding of the public health, ecological, and public policy implications of these growing challenges. The GHI Travel Award will help to build an international network of researchers working on the human health and ecosystem impacts of groundwater contamination within karst regions of the world.

Karst terrain is found in many parts of Europe, Africa, South America, Asia, Australia and North American (covering more than 30 percent of Wisconsin’s surface area, for example). The proposed international travel to Ireland will enable face-to-face discussions with Irish researchers whose work focuses on environmental and human health, and on the nexus between land use, groundwater quality and health impacts. Collaborators in Ireland include Paul Hynds, senior research fellow, Environmental Sustainbility and Health Institute, Technological University Dublin, and Eion O’Neill, professor and director, School of Architecture, Planning, and Environmental Policy, University College Dublin. This travel award could be a catalyst for a variety of other future collaborative activities.

Establishing a pediatric neurology teaching curriculum in a global health environment

Principal Investigator: Dalila Lewis, M.D., Neurology, School of Medicine and Public Health

The Pediatric Neurology Division of the Department of Neurology would like to cultivate a partnership with an underserved global health region for the purpose of improving the care of children with acute and chronic neurologic conditions. We aim to do this by contributing to the medical education of trainees and medical personnel in the region via in-person teaching and development of a uniform pediatric neurology teaching curriculum. The University Teaching Hospital in Lusaka, Zambia would be an ideal institution to explore developing such a partnership as it is the primary medical center in this resource limited region.

Lusaka is both the capital and the highest populated city in Zambia, and the University Teaching Hospital is the largest hospital in the region and serves as the primary teaching facility for local medical trainees and personnel. Offering both inpatient and outpatient care, the University Teaching Hospital is the main specialist referral center for the entire country. The University Teaching Hospital in Lusaka, Zambia currently hosts a neurology residency program recently founded by a Johns Hopkins faculty member, and there is a demonstrated need for pediatric neurology teaching and expertise on a consistent basis.

My goal would be to establish a pediatric neurology teaching presence by serving as visiting teaching faculty for the existing neurology residency program and providing clinical supervision and education two to three times per year in two week intervals. Once this has been established then this role could be expanded to include University of Wisconsin-Madison medical trainees with the dual purpose of providing both teaching and learning experience as well as opportunities for clinical research. In order to begin this endeavor, travel funding is needed to support a faculty member to visit the University Teaching Hospital and ensure that the clinical environment is suitable for a sustainable teaching presence.

Hepatitis B e Antigen positivity and demographics of a Hepatitis B cohort from tertiary referral laboratory in Ethiopa … Examining access and barriers to vaccination

Lindsay Matthews, medical resident, Medicine, School of Medicine and Public Health; Co-PIs—Dawd Siraj, M.D., MPH, TM; Hailemichael Mekonen, M.D.

Hepatitis B is a major global health problem, with an estimated two billion people infected at some point in their lives and 250 million chronic carriers worldwide. The incidence has dramatically decreased in much of the world owing to universal vaccination, however in many countries, including Ethiopia, this is not common practice. Transmission is most likely to occur from someone who is positive for HBeAg or who has a high viral load, which are more likely without ready access to antiviral medications. Our study examines the rate of Hepatitis B e antigen (HBeAg) positivity and demographics on tested samples at a referral laboratory in Addis Ababa, Ethiopia. Retrospective data will be analyzed from a Hepatitis B cohort from the International Lab in Addis Ababa, Ethiopia. Cases will be collected from patients who had Hepatitis B surface antigen positive tests at the International Lab.

Training breast radiologists, surgeons and oncologists in Ho Chi Minh City, Vietnam

Principal Investigator: Ryan Woods, M.D., MPH, Radiology, SMPH

Among women in Vietnam, breast cancer is the most common malignancy and impacts approximately 27 women per 100,000 population, with an estimated mortality of 10.5 percent. Breast cancer incidence is rising in Asian countries with increasing development, such as Vietnam, likely related to later age of childbearing and having fewer children, increasing rates of obesity, and improving healthcare (thereby increasing detection). Unfortunately, nearly 65 percent of breast cancer cases in Vietnam present prior to age 50, and at a later stage which makes treatment more difficult. Further complicating the treatment is the low per capita income ($2,600 per year), lack of health insurance and relatively few specialists in breast cancer diagnosis and treatment for the population. Treatment centers are frequently overburdened with a large number of cancer patients.

Mammography screening is the mainstay of early detection of breast cancer and national programs can reduce the health and economic burden of breast cancer by identifying cancers at an earlier, more treatable, stage. In Vietnam, however, there is no established national screening program and is only available at private facilities. In addition, there are few specialists in breast imaging, limiting the ability to establish a widespread screening program.

Hung Vuong Hospital, located in Ho Chi Minh City, is a 1,300 bed tertiary care women’s hospital and is a trusted destination for oncology care in Vietnam. The hospital is associated with the University of

Medicine and Pharmacy at Ho Chi Minh City which has training programs in medicine and surgery, but does not have a formal radiology training program. The Breast Department includes six physicians trained abroad with specialties including medical oncology, surgery, and radiology. Physicians in the department perform imaging-based breast cancer diagnosis with full field (2-D) digital mammography and ultrasound and perform percutaneous as well as surgical biopsies. The department plans to acquire a digital tomosynthesis unit (specialized “3-D” mammographic equipment which increases cancer detection, and which has been widely adopted in Western countries) and the capability for breast MRI in the next year.

This grant will support Ryan Woods travel to Hung Vuong Hospital to achieve the following goals:

1. Further promote the established professional relationship between Nguyen Tran Bao Chi (Deputy Head of the Outpatient Department and Breast Consultant) and Woods (SMPH). Establish a departmental relationship between UWSMPH and Hung Vuong Hospital for sustained collaborative research and the education of consultants and trainees.
2. Directly educate and train breast radiologists, surgeons, oncologists and primary care physicians at Hung Vuong Hospital, leveraging the state-of-the-art breast imaging practice at UW as a screening program is considered and specialized equipment is obtained. This will directly impact the breast health of women in Ho Chi Minh City and beyond as specialists are trained.

2019 Awards

EFFECTIVE REHABILITATION OF A DISTRESSED SPECIES: GREY CROWNED CRANES IN RWANDA

Principal Investigator: Barry Hartup, Department of Surgical Sciences, School of Veterinary Medicine

The endangered Grey Crowned Crane (GCC) is the only species of crane in Rwanda and faces increasing threats from illegal live trade and poaching. A 2018 survey showed less than 500 GCCs remain in the wild, a decline of nearly 80 percent over 50 years. The Rwanda Wildlife Conservation Association (RWCA) has worked with the government on public awareness campaigns, registered nearly 300 GCCs held in captivity and treated, rehabilitated and repatriated 156 healthy cranes to the wild, all to decrease illegal trade of cranes and to promote habitat conservation. Since 2015, the International Crane Foundation/Special Species Health Service, School of Veterinary Medicine partnership has collaborated with RWCA to strengthen professional veterinary training of RWCA staff and support scientific assessments of these activities. Funds will be used to aid the final phase of our collaboration: support biosecurity assessments of 50 disabled, non-releasable GCCs for transfer to a unique sanctuary designed for public outreach on the many benefits of wildlife and native ecosystems, improve the welfare of a subset of cranes requiring surgical procedures and provide intensive training in crane anesthesia and surgery to cooperating, early-career Rwandan veterinarians who will impact biodiversity conservation for years to come.

Key personnel: Olivier Nsengimana, Rwanda Wildlife Conservation Association (RWCA)

AMERICAN COLLEGE OF SURGEONS AND THE COLLEGE OF SURGEONS OF EAST, CENTRAL, AND SOUTHERN AFRICA SURGICAL TRAINING HUB COLLABORATIVE

Principal Investigator: Angela Ingraham, Department of Surgery, School of Medicine

The Global Health Institute Faculty and Staff Travel Award will support travel to Hawassa University in Awassa, Ethiopia in June 2019. There Ingraham will represent the University of Wisconsin as part of the American College of Surgeons (ACS) and the College of Surgeons of East, Central and Southern Africa Surgical Training Hub Collaborative. The goal of the collaborative is to develop a surgical training center of excellence which will serve as a local and regional training hub with a mission that centers around innovation, research and patient care. Ingraham’s work with the collaborative and at Hawassa University is directly in line with the mission, vision and goals of the Global Health Institute. She will provide high-quality care to the people of Ethiopia in collaboration with the local physicians, nurses and staff and will co-lead the journal club for the collaborative, highlighting a variety of topics from research conducted in underserved areas to cultural competencies. Finally, through the Research and Quality Workgroup, she will promote the incorporation of standards of surgical care as outlined by the ACS and engage in formal investigation of the effect of the practices implemented by the collaborative.

CAPE TOWN POST-DROUGHT: HEALTH OUTCOMES, ADAPTIVE BEHAVIORS AND A QUALITY IMPROVEMENT INTERVENTION FOR DIARRHEAL DISEASE

Principal Investigator: Laurel Legenza, Sonderegger Research Center, School of Pharmacy

This travel grant is to extend existing collaborations and interdisciplinary global health research in South Africa. Our research team includes students and mentorship from UW-Madison and the University of the Western Cape. Following our epidemiology and workflow study, a Clostridium difficile infection (CDI) quality improvement intervention, a checklist was developed and tested in low-resource public sector hospitals. The intervention now needs refinement, including feedback from local partners. We expect additional diarrheal illnesses and antibiotic use increased during recent periods of extreme drought in Cape Town, further increasing risk of CDI and poor outcomes. We will evaluate health outcomes and adaptive behaviors during the recent drought in the diverse Cape Town metropole. We will also engage stakeholders in the refinement of the diarrhea alert checklist in preparation for the next cycle of quality improvement. With the expanded research team, we will design methodology for scaled dissemination and implementation of the revised checklist, including within a tertiary hospital in Cape Town, South Africa and with the South African Department of Health. The results of this study will inform future guidance to ensure health for all as climate change threatens populations and ecosystems.

Key personnel: Renier Coetzee, University of Western Cape; Nicholas Spoerk, Department of Medicine, School of Medicine and Public Health (SMPH)

IMPROVING THE IMPLEMENTATION OF CLINICAL GUIDELINES FOR CANCER PAIN MANAGEMENT AND PALLIATIVE CARE IN NEPAL

Principal Investigator: Martha Maurer, Sonderegger Research Center, School of Pharmacy

A foundational principle of palliative care is quality pain management. However, in Nepal this is complicated by a lack of knowledge among healthcare providers about how to manage cancer pain. In 2012, the Nepalese Palliative Care Association published Cancer Pain Management Clinical Guidelines, yet they are not widely used. This project aims to: 1. Assess and describe barriers and facilitators that influence adherence to the pain management guidelines, 2. Design and pilot test a decision support mHealth “app” for oncology providers that will promote implementation of the pain management guidelines and 3. Integrate tailored research enhancement activities to strengthen research capacity within Nepal. As a co-investigator working with the project P.I. at the University of Virginia (UVA), this GHI award would allow Maurer to travel to Kathmandu, Nepal in June 2019 with the UVA team to: 1. Visit each of the four oncology care study sites to engage with the local research teams and 2. Assist in facilitating a one-day workshop for the Nepal study team members to share research skills and resources. The goals of this project advance the mission and vision of the Global Health Institute by advancing equitable access to cancer pain management in Nepal.

INTERNAL MEDICINE RESIDENT GLOBAL HEALTH PATHWAY

Principal Investigator: Daniel Shirley, Division of Infectious Disease, Department of Medicine, School of Medicine and Public Health (SMPH)

Exposure to global health is an important facet of education in the medical field. The Department of Medicine has established a global health pathway for residents that includes an annual one-month international rotation. This will take place from March 11 to April 7 in Jimma, Ethiopia and will include didactic education, clinical learning at the bedside and participation in global health research projects. Trainees will participate in daily didactic learning which will include bedside rounds, afternoon lectures and discussions, and I will assist in these activities. A previous student traveled to Jimma with the goal to understand barriers to the implementation of a more formal Infection Control program. A major research goal of our collaboration is to build on that work to formulate infection control guidelines with the next steps of improving hand hygiene and understanding barriers to surgical site infection prevention. Our team will work closely with infection control staff at Jimma to help move these goals forward. This collaborative work with Jimma has a long term objective of fostering bilateral educational and research activities between Jimma University and University of Wisconsin-Madison.

Key personnel: Andrew Lang, UW Health; Dawd Siraj, Division of Infectious Diseases,Department of Medicine, SMPH; Nasia Safdar, Division of Infectious Diseases, Department of Medicine, SMPH

ADDRESSING MERCURY, LEAD AND ARSENIC MINE-SCARRED LAND IN HUANCAVELICA, PERU

Principal Investigator: Geoffrey Siemering, Department of Soil Science, College of Agricultural and Life Sciences

The Spanish-empire era “Mines of Death” (1570-1790) in Huancavelica, Peru left behind a tremendous toxic legacy of mercury (Hg), arsenic (As) and lead (Pb) soil pollution that impacts local populations to this day. In addition to polluted agricultural soils and waterways, over 50 percent of the homes in this low-income and majority-indigenous area are estimated to be constructed of adobe made from local contaminated soil. Pb, As and Hg exposure is known to deleteriously impact human and environmental health. This project will allow Siemering to provide expertise in soil metal bioaccessability, metal speciation and spatial analysis as well as analytical support to a team of social scientists and public health experts from the U.S., Peru and Bolivia working to address this historic contamination. Comprehensive spatial analysis and determination of soil metal bioaccessability is imperative to the development of culturally appropriate interventions implementable on a large scale to reduce the metal impact on human and environmental health for people living in this area. This work clearly embodies the Wisconsin Idea applied to a global issue and dovetails with his existing research and outreach. Gaining in-field experience will be invaluable in assisting current efforts, planning future activities and seeking additional funding.

Key personnel: Nick Robins, Department of History, North Carolina State University

GLOBAL HEALTH INTERNATIONAL ROTATION TO JIMMA, ETHIOPIA

Principal Investigator: Dawd Siraj, Department of Medicine, SMPH

The Department of Medicine Global Health Pathway has an annual, month-long international rotation. Our international site is in Jimma, Ethiopia and we are traveling in March 2019. This program is engaged in didactic education, international clinical rotation and global health-themed research projects. Trainees are expected to engage in international research and an international one month clinical elective.  As a director of the Global Health Pathway program, Siraj will be traveling with residents to Jimma with three Internal Medicine residents and one Pediatrics Infectious Diseases fellow. During their stay, they will be involved in clinical work, didactic education, participating in conferences and conducting research. Traveling trainees will participate in patient care and didactic learning. This collaborative work with Jimma has a long-term objective of fostering bilateral education and research activities between Jimma University and University of Wisconsin-Madison. Additionally, Siraj will be involved in the implementation of hand hygiene steps and editing the infection control manual of the hospital to build upon to a project his former Shaprio student did on infection control in Jimma, Ethiopia.

MAKING THE INVISIBLE VISIBLE IN COLOMBIA: HOW INSECT HEALTH IS TIED TO HUMAN AND ECOSYSTEM HEALTH

Principal Investigator: Heather Swan, Department of English, College of Letters & Science

Colombia is the second-most biodiverse country in the world. Since war has ended there, many have felt optimistic about the economy. However, both of these positive designations are precarious. With peace comes interest in deforestation and denigration of the environment. Climate change will make agriculture challenging as well. Insects, especially pollinators, are a crucial and often unnoticed part of these systems. Globally we are facing drastic insect decline. A firm resolve to use sustainable, organic agricultural and conservation practices seems necessary in order to keep Colombia’s humans, animals and insects healthy. To help ensure these practices have support, stories of positive change need to be shared. As a writer, Swan’s role is to research and write these stories for a global audience.

GLOBAL SURGERY PROGRAM EVALUATION IN ETHIOPIA

Principal Investigator: Molly Vaux, Department of Surgery, SMPH

The UW Department of Surgery (UW DOS) faculty and staff have traveled to Tikur Anbessa Specialized Hospital (TASH) and Hawassa University Hospital in Ethiopia for over a decade. These trips have ensured a strong international partnership, directly impacting the lives and health of Ethiopians, while also enhancing the education of our UW faculty and residents. Vaux will visit the two partner hospitals in Ethiopia to conduct a program evaluation on the effectiveness of the DOS’s ongoing collaborations with Hawassa Hospital and TASH. The goals of this trip are two fold: 1. Engage with local health professional partners and become familiar with different health care delivery systems between Hawassa, Addis and the U.S. health system and 2. Conduct a program evaluation, inclusive of a survey to be administered to Ethiopian and UW-Madison faculty and residents. This trip will be invaluable to create the biggest impact for the health care delivery system so as to best engage stakeholders and impact the lives of Ethiopians needing surgery; build relationships between UW DOS and Ethiopia partners; and provide an opportunity to monitor and evaluate the sites and programs progress for future framing of extramural grant themes for UW Surgery faculty and residents.

Key personnel: Girma Tefera, Department of Surgery, SMPH; Nebyou Seyoum, surgery director, Tikur Anbessa Specialized Hospital (TASH); Ephrem Hana, Hawassa Clinical Director

2018 Awards

Travel Grant to support a project assessing mycotoxin levels in maize in the highlands of Guatemala

Claudia Calderon, College of Agricultural and Life Sciences, Department of Horticulture

This travel grant requests funding to cover travel costs associated with a project Calderón recently initiated in Guatemala. The project focuses on a critical aspect of food safety in the western highlands of Guatemala: mycotoxin contamination in maize. In Guatemala, maize is a dietary staple that is often consumed to the exclusion of other food commodities. Previous studies have found that people relying on maize often consume high levels of toxic metabolites produced by fungi (mycotoxins) above the threshold proposed by the World Health Organization. This has significant implications for food safety, food security and international trade. The project will focus on 50 small-scale farmers in the western highlands of Guatemala and will support research on the quality of maize, both stored and processed for consumption, and provide recommendations on food safety regarding mycotoxin contaminants in maize, with the overall goal to devise effective and sustainable mechanisms to educate, monitor and reduce exposure to mycotoxin contamination.

Integrating rehabilitative services within an educational setting for children with significant development disabilities in Peru

Karen Patterson, Doctor of Physical Therapy Program, School of Medicine and Public Health

Many school-aged children in low income countries with disabilities are under-served or do not attend school due to lack of resources and qualified personal. In Cusco, Peru according to the disability census statistics, 1582 individuals age 14 and under have disabilities (Peru Ministry of Education 2013 report).

Manos Unidas was founded in 2008 in Cusco as a non-profit organization in an effort to not only to improve access to education for children with disabilities but also to educate local teachers and to transition young adults with disabilities into paying jobs. The physical rehabilitation aspects of these children play a large part in the success of this program. In communication with the directors of Manos Unidas there is a great need for further education revolving around the role of physical rehabilitation for teachers and local providers.

Develop a partnership between with UW DPT program and Manos Unidas that is mutually beneficial. Goals will be to assist Manos Unidas in making informed decisions about improving the quality of the comprehensive school program and individual specific programs to ensure that services are being performed in a manner as to provide a safe, comfortable, and supportive environment that allows the students with disabilities to reach desired outcomes and expectations within the most efficient and effective inclusive educational setting. This program will also serve as an ongoing service learning project for the UW DPT program with potential to expand to an interdisciplinary program with other UW health care professional students.

2017 Awards

Supporting nutrition and Entrepreneurship in rural Kenya

Bret Shaw, Department of Life Sciences Communication.

This award will fund a trip to Majimbo in the north eastern part of Lake Victoria in western Kenya to conduct research and develop a communication plan to promote nutrition, food security and entrepreneurialism through the implementation of sustainable urban gardening practices in secondary schools in the region.  The trip will be facilitated by representatives of a local non-governmental organization called EducationHope.

 2016 Awards

Distribution of Fossil Fuel Subsidy Reform in Indonesia

Corbett Grainger, Department of Agriculture and Applied Economics, College of Agricultural and Life Sciences; Nelson Institute for Environmental Studies.

At a time when cutting carbon emissions is a top concern to mitigate climate change, global fossil fuel subsidies have grown significantly over the past decade. The purpose of this research proposal is to determine the impact of subsidies on exporting industries, which in turn will help understand  the political economy of subsidies and how governments could effectively eliminate them. This proposal lays out a strategy to estimate the impact of fossil fuel subsidies on different measures of exports and growth at the sector level in Indonesia, a country that has recently implemented a series of subsidy reforms.

2015 Awards

2013 Awards