Entry 6

Identify ten specific things you will do to strengthen your next presentation (and responses)

  1. Finalize our slides earlier.
  2. Reach out and receive feedback earlier.
  3. Since we know who the judges are, base our presentation off what they are more interested in.
    1. Talk less about the science behind it and more about the results we’ve collected.
    2. Talk more about the implementation of the device, cost, production plan, excetera.
  4. Switch up who talks about what aspects of the project (background vs. research results)
    1. Become more well versed in the technical part of the project not just the logistics and statistics of why we are conducting this research
  5. Prepare general backup slides.
    1. Our slides were very specific, we prepared for very specific questions however, it would have been nice to have general slides that could be connected to lots of different questions.
  6. Answer the questions with more confidence and trust that my fellow teammates know what they are talking about.
  7. We could try a different flow/order: start with our research and then talk about why it is important compared to talking about the background and then out research
  8. Have a stronger ending
    1. I feel like we ending in the middle of a thought; we should have a closing statement that sums up the entire presentation.
  9. Include pictures/videos of our research and lab work on the slides, show the judges what we have done so far.
  10. Provide numbers/data on the slides (even if it’s just expected cost – all we have so far) to build credibility

Our research and work requires IRB approvals. Our research requires obtaining biospecimens (blood) from patients and interacting with them to administer the test. For our device a blood sample will be taken through a finger prick and then placed on the test strip, the patient will be present for the entire procedure. Our first task will be to write out and develop an informed consent document, to be approved by the IRB, that will be easily understood by the patients in Sierra Leone. The patient’s identity must also say anonymous and their results, medical history, etcetera must stay confidential. This may be difficult to accomplish in Sierra Leone because there is a different medical system in place and consultations are normally not in private. We will have to be very specific with who we want in our patient population. The test strip we are developing will hopefully be used to screen all ages and all people. This means that we will be including minors and pregnant women in our inclusion criteria that will have to be approved by the IRB. While a majority of people speak english in Sierra Leone we should also provide waivers explaining the test and consent forms in their native language.  Conducting research internationally will add another level of approval that needs to be given by the IRB. In order to conduct research in Sierra Leone we also need to receive approval from the Sierra Leone Ethics and Scientific Review Committee. In order to conduct research specifically for a medical device we will also have to receive approval from the Pharmacy Board of Sierra Leone. In order to receive approval from the Lehigh IRB we will first have to secure and submit evidence of international IRB approval. We need to get started on the applications for the IRB in Sierra Leone because it is said to take a while for everything to be finalized.

Our application to the IRB will be sent through IRBNet and should be sent at least six weeks in advance of anticipated start date. Our research will most likely be reviewed by a full committee because our research will involve intervention and we will be working with protected populations. We should start and submit our application as soon as possible because we do not want to get to Sierra Leone and not have the approval to conduct our research because we waited till the last minute.

Logic Model

Inputs: The funding provided by Lehigh, the Global Social Fellowship and outside sources support the project and allow it to get up and running. tThe time and effort from Lehigh faculty, undergraduate students, graduate students and outside resources are also all inputs for the project.

Activities: The work we are doing in the lab and the time we are spending researching projects that have already happened are the activities that make up this project.

Outputs: A fully functioning sickle cell anemia screening rapid diagnostic test is our proposed outcome. We plan on developing the device; from the test strip to the casing/packaging to the training behind administering the test.

Outcomes: After a device has been developed we will need to do a number of trails ensuring correct screening results. After all of the research done in the lab the device should be outputting correct readings and successfully identifying sickle cell anemia.

Impact: To provide Sierra Leone with these test strips, allowing for early diagnosis and early treatment that will result in a greater quality of life.

Entry 5

For me personally, a design process that is both uniquely mine as well as effective would begin with a verbal brainstorming session or “word vomit”. I believe the fastest way to think if a bunch of different ideas is to bounce the idea off of other people. The more people, the better because then we will have more versions of peoples take on the idea (main subject). The next step would be to narrow down the number of ideas and specifically identify them by writing them out in words. The words would then need to be translated into a visual design. I would again ask as many people as I can to implement their take on the visual design so that there is not a shortage of ideas and possibilities. I would then take the time to reflect and decide logically which design or which combination of designs would solve the problem the most efficiently and which design or combination of designs would be the most feasible. The next step would be to execute the design, either testing, prototyping or both would then begin. After a concrete design is chosen and executed, we would need to reach out for opinions and reviews from experts in the field. They could give us tips and suggestions in order to make the design better before implementing the design into its proposed location/environment. For me, the main part of a successful design process is getting a number of different opinions. I believe there can never be too many ideas.

Our idea that a sickle cell anemia test strip can be designed to diagnose sickle cell anemia as well as identify if a person has the sickle cell trait is a valid concept because similar test strips have already been designed. This means that technology/science has already been proven to check out and we are not on a journey that has no hope. Our design is different from current sickle cell test strips because we are proposing a strip that uses a slightly different kind of binding that will ultimately make the test more accurate and reliable. Our test strip project will also be different because the end goal is to implement it into Sierra Leone’s health care system. We are not sure if the other companies have attempted to implement their devices in developing countries health care systems but if they have, they have obviously not been successful. It would be worth looking into if the other companies have attempted to implement their devices and if they have, we can learn from how they failed. As of right now we plan on gathering a lot of different people’s opinions while in Sierra Leone. We plan on asking medical professionals, community health works as well as the local people what they think about our device (if we don’t have a working device by then we plan on bringing a prototype). They will provide insight on if the design is easy to use, if they believe it is appropriate for solving the problem and if they believe it will even be used. By getting the local people’s opinions and taking them into account we are increasing the chance that this device will be successful in Sierra Leone.

Engaging with the community, partners and markets is the most important aspect of making sure our device is successful. If we can get our device to work then the only thing holding us back from implementing the device into the community is our relationship with the community, our partners and the market. Our relationship with the community, our partners and the market has the ability to make or break our device. If we do not have a relationship with them we will not have the connections to get our device out there and implemented into the healthcare system. If we do not have a good relationship with them we will not have people who are willing to do fast and meaningful work and ultimately the local people will not believe in our product. How companies and partners support us will affect how the local people react to our device. If they actively support our device the locals will trust our work and are more likely to seek out our device. The local peoples perception on our device is highly dependent on how the community, our partners and how the market supports us.

Entry 4

Nature can be used as a model for our own designs, for example, Janine Benyus who did a Ted Talk about Biomimicry talked about the skin of a shark repelling bacteria. She talked about how the shape/architecture of the cells keep bacteria from landing on the surface of the sharks skin. Nowadays this type of architecture is being used to design surfaces in hospitals. Learning from nature we are now able to create surfaces that are resistant to bacteria that does not include dowsing the surface in antibacterial chemicals that could ultimately cause a greater issue (bacteria resistance). Learning about this architecture I have learned that there are ways to solve chemical problems without using a chemical solution. Figuring out what these ways are might take a little longer but it will be worth it in the long run. Another example of a product being based off nature that is a little bit more basic, is the design of racing swimsuits. From fish, sharks, dolphins (excetera) and birds we have learned how having a streamline body/coating one can travel much faster and with ease through water. From this information designers have created swimsuits/speedos that are completely skin tight in order to allow for a more streamlined effect in the water, compared to board shorts. Our sickle cell research project is trying to design a test strip that is not the general, one flow strip design, instead we are looking to do more of a tee shape design. Learning how things flow naturally in nature might be worth looking into and we could possibly apply that information to our project. It might streamline/solve issues for our flow device. One final example is how a leaf stores and absorbs energy from the sun. If we could harness a leafs solar system like cell we could learn how to power machines more efficiently and improve devices that already use this technology, solar panels. Solar panels are generally very large and need to be very large in order to power anything. If we get a better grasp on this technology we could possibly use this technology to power smaller devices that could be used in developing countries that don’t necessarily have reliable power sources.

The Life Principle that stood out to me the most was resilience. I believe we start to learn about resilience at a young age. While the situations we face as a child might not be as serious we learn how to handle adversity and adjust from those small moments. How one responds to a tough situation can really show how resilient a person is and being able to bounce back is a very important skill in any field and in life in general. As a student I feel like my resilience is always being tested. It is very easy to give up in a class and believe you will never be able to understand the material but you have to push yourself to work harder to overcome those thoughts/ideas. Having resilience when it comes to research is also very important. I have only been working in the lab a few weeks and it is already very hard to stay motivated when all your tests have been failing. One has to be incredibly resilient but also motivated to do work like this and I am learning a lot about myself being exposed to this type of research. As of right now I don’t really know where I stand with considering research as a career path but I’m really trying to give this research my all and I am being driven by the fact that our research might be able to help someone in the future.

The Cradle to Cradle Design concept takes into account the entire life cycle of the product. For example, take into consideration a plastic child’s toy. The toy will give a child joy for a little bit of that kids life, then maybe the toy gets passed down to their sibling or donated. If the toy keeps getting passed down and down it is still fulfilling its purpose, however, what if this toy starts to release toxic chemicals from the plastic wearing down and causes cancer later on in life for the kids who use the toy after it’s 5th year. On the other hand, what  if the toy takes another direction and instead of being past down gets dumped in a landfill where it will take years to disintegrate. I have completely made up this example but those are all things one has to think about when designing a product; what will this product amount to in 5, 10, 15, 20 years? The device my research group is trying to design is meant to be a one time usage type product. Taking that into consideration we need to figure out ways our device can be disposed of safely and if it is possible to reuse and recycle any part of the project. The one part of the project I can imagine being recycled is the casing the strip will be held in. If we are able to resanitize the casing I believe it could be reused.

When I was growing up I was never exposed to Judaism. I knew the basic beliefs of the religion but nothing else. I didn’t know what Jewish services were like or the true meaning behind a bar mitzvah. About a year and a half ago, I met a friend who is Jewish and grew up in a predominantly Jewish town. I learned about synagogues, their services and the cultural aspects of the religion. I grew up in a place that was prodominatly Muslim and Christain and meeting my friend who was Jewish I learned a lot about how all the religions are very similar and how Judaism wasn’t as different as I thought.

I grew up overseas and attended private schools for most of my life. I had never attended an American public school nor had I ever visited one. Most of my friends here at Lehigh went to public school and a few attend public schools in the inner city. I understand that not all public schools are the same but they told me stories about how people would treat teachers and each other and I was shocked. I learned about how some public schools have metal detectors and how people would fight in the hallway. Hearing these stories I didn’t really know how to respond because those events would never happen at the school I grew up at. I feel like I learned a lot about my friends lives and their stories opened my eyes up to school in the US.

The last thing I’ve learned a lot about through my friends in the past year and a half here at Lehigh is, mental health. I grew up in a relatively small community and while it was a very open, respecting community, mental health was not a topic that was often discussed. I have met people here that are very open about their mental health issues and have no problem answering questions about mental health in general. The organizations here on campus about getting the help you need were also all new concepts to me before coming to Lehigh. It is really nice to know that if I do need the help there are facilities and people who will be there for me.

 

Entry 3

The five major stakeholders that affect the sickle cell anemia project are the suppliers, investors, regulatory bodies, society, and the employees/vendors. The suppliers will be our source to get the test strips developed and delivered after the research has been completed. Obviously the suppliers will be getting paid to produce and deliver these devices. By getting involved in this project they have the potential to be apart of a very successful business. If the test strips take off and are determined to be incredibly useful in Sierra Leone the product will be in high demand and the suppliers business will have increase ultimately making them more money. Similarly the investors, who will be providing money to get the product up in running, will want to see the product succeed because the more successful the device is the more money they will get back. The regulatory bodies in Sierra Leone are equivalent to the FDA in the US. Their job is to insure our device is safe to use, will produce the results the device guarantees and will truly benefit the community. The regulatory bodies have to be involved and are the ones who decide if our device gets out onto the market. If the regulatory bodies approve the sickle cell device they are putting their reputation on the line and trust in the device and that it will not harm anyone specifically or the society as a whole. People trust that regulatory bodies have their best interests in mind, therefore, if we get their approval we will be one step closer to implementing the device as a common medical test in Sierra Leone. Not only does the society trust that the regulatory bodies have their best interest in mind but they trust that we have their best interest in mind. They are trusting us to create and provide a device that works and solves the issue of not being able to test for sickle cell anemia easily. If the people of Sierra Leone accept the device and believe that the test is helping society the device will be very successful. If the people of Sierra Leone dont accept the device it will be incredibly difficult to implement the test into the society. The employees/vendors will be the final stakeholder that will be apart of the sickle cell anemia project. Like the regulatory bodies the employees (CHWs, doctors) who will be administering the test are putting their reputation on the line and their trust in our device (that it will work). If the employees/vendors believe in the device they are more likely to tell their patients that they need to get tested (using our device). Their patients, the people of Sierra Leone, trust and respect the CHWs and doctors and will generally follow their advice. By having the employees/vendors behind the sickle cell test strip, the device has the potential to be very successful. These five stakeholders, suppliers, investors, regulatory bodies, society, and the employees/vendors are crucial parts of the sickle cell anemia project. Without their backing and support the sickle cell test strip will not be successful.

The sickle cell anemia project will be validated and will build its credibility by laying out the benefits of having a diagnosis, receiving support from NGOs on the ground and telling true stories of people who could have benefited from a sickle cell anemia test strip. In order to lay out the benefits of having a diagnosis we must first explain how not having a diagnosis has affected society. By providing the statistics of the amount of people who suffer from sickle cell anemia (world wide and then specifically Sierra Leone) and ultimately die from the disease the numbers will establish a sense of urgency. Statistics around how many people die without knowing they had the disease and how many of those people could have survived if they had known and received the correct treatment should also be provided. These statistics will appeal to a person’s emotions and will ultimately validate the project. The next step in validating the project and enhancing our credibility would be to get established NGOs on board with the project. By receiving support from accredited, trusted companies their reputations will help our project gain respect and will give us credibility by association. Finally, by providing stories of people who could have benefited from a sickle cell test strip we will again establish a sense of urgency and will appeal to a person’s emotions. By appealing to one’s emotions a person gets more involved/attached to the project. By rallying support behind the project our credibility will build. In conclusion, we can validate our project and enhance our credibility by aying out the benefits of having a diagnosis, receiving support from NGOs on the ground and telling true stories of people who could have benefited from a sickle cell anemia test strip.

 

Entry 2

I think the biggest cultural issue that is going to affect the sickle cell anemia project is that people in Sierra Leone believe in spiritual healing. If the people truly believe that the magical services offered by community organizations can heal them they will not feel the need to go get tested. Going off this point, the sickle cell device we are trying to create will also test for sickle cell trait. People carrying the sickle cell trait do not experience the symptoms of the disease and therefore will not go get tested because they believe that they are healthy and maybe that they are healthy because of the magical services.

Another cultural issue that may affect the people of Sierra Leone from using our test strip is the countries main religion and the traditions around that religion, Islam. I am not completely sure that statements I am about to make about tradition based off religion is a cultural issue for Sierra Leone but from my time spent overseas in the Middle East, which are also predominantly Muslium countries, (which I will explain later) I am making this assumption. There is a tradition that is based off religion, that could be described as a cultural ‘norm’, that the man of the house is the person in charge. The man of the house would have to sign off on and give permission for his wife and children to travel, drive, receive medical care, exetra. If this type of tradition is present in Sierra Leone it might be difficult to get mothers and children tested for sickle cell anemia and the sickle cell trait.

A third cultural issue that may affect our ability to provide a successful device is stigma around the disease, sickle cell anemia. The people of Sierra Leone might not want to be tested because their might be an unwritten rule that if you have an incurable disease (no matter the disease or maybe specifically sickle cell anemia) you will be treated like an outcast. People might not want to risk being shunned from the community and in order to guarantee that they just won’t be tested.

Growing up in the Middle East I have been exposed to a culture that is based around religion (Islam) in many ways. One experience that pertains to a cultural issue that we might encounter in Sierra Leone, a predominantly Muslim country, is that the man of the house tends (not always true now a day) to have the power. When I turned 18 I went to the Road and Transportation Office in Dubai, UAE to register for a driver’s license. Before I could even submit any of the paperwork I had to present a permission slip signed by my father that I was allowed to drive. This may seem minor but in Saudi Arabia, the country neighboring the United Arab Emirates, there is a rule that women can not travel without a male family member. If these types of rules are implemented in Sierra Leone we might have some issues with people who want to get tested or want their children to get tested but can’t because of the religious culture.

At home I have known people who believe that their trust in God is the best medicine that will heal them instead of modern medicine. I have also observed Jehovah Witnesses deny medical treatment because of their beliefs. This can be compared to the magical healing services in Sierra Leone. Another cultural issue I have experienced that is similar to what we might experience in Sierra Leone is the stigma behind being sick. Generally when someone is sick even if it is a common cold people tend to keep their distance. This is because they don’t want to get sick themselves. There’s a stigma behind sick people that they are always contagious even if the contagious period has passed or if they don’t even have a contagious sickness.

In Sierra Leone we might encounter community and market problems because of the cultural norms. In order to gain the communities trust and support around the test strip we should bring in doctors, who are generally well respected figures, to explain why they should get tested. In order to insure getting tested does not disrupt their day-to-day lives we need to figure out a way to bring the device to each specific community. If people have to change their social/cultural ways of life people will be less likely to go out of their way to get tested. Finally, having the organizations that run the spiritual services (that also offer other religious services) advertise the sickle cell test strip will encourage people to go get tested because the information is coming from a trusted source.

Implementing our sickle cell test strips in Sierra Leone will be difficult because as we discussed at the retreat processes tend to move slower there. If we want our devices to be delivered somewhere it might take twice as long as it would in the US because people don’t feel the need to get stuff done as quickly. In summary, work is completed at a different pace compared to the US.

Another challenge that we might face is getting our device delivered to rural places after it has been manufactured. The roads might not be suitable for trucks (which would be necessary if we needed to keep our device at a certain temperature) to travel on. Looking at the bigger picture it might be difficult getting our device into the country from the place of manufacturing. Sierra Leone is a developing country and does not have the resources to produce the device therefore we would need to find a place that could manufacture the devices and import them into the country, which would be another challenge.

On the other hand, getting our device out on the market after it works and we have the research behind it should be much easier than in the US. The FDA in the US is extremely strict, if our device was approved by the FDA it would have to go through clinical trials which could take years. There is a different system in Sierra Leone which should speed up the process of getting the device out onto the market.

Finally, in Sierra Leone we will also have the opportunity to talk to the people who would be administering the device and get their advice on how to improve it. In the US it would very difficult to access the people who would be providing and administering the device and could take a very long time to set up those meetings. Apart from the professionals, we will also have the chance to ask the local people about the test strips. By getting the locals opinions we will have the chance to figure out the best way to market our device.

Entry 1

I have always been interested in research, however, the one thing that I didn’t like about it was that most of the time you don’t get to see, first hand, the impact your research has had. This class/ the global social impact fellowship offers both, research and the chance to meet and work with the people your research is trying to help. Being apart of this course and fellowship will expose me to lab work outside of my major required classes. Being apart of the lab will improve my ability to look at results and form conclusions. My ability to take these conclusions and collaborate with others in order to decide what to do next will also improve. The only lab experiences I have had are the biology and chemistry labs offered here at Lehigh that are apart of my major requirements. During each lab a pretty strict procedure was provided and had to be followed. By following these procedures I learned how to complete basic lab tasks like pipetting, titrations and plating. While I mastered these tasks in the regular biology and chemistry labs the strict procedures did not allow us to think for ourselves on how to obtain certain results. I am assuming the past lab members have determined a basic procedure on how to obtain results in the Sickle Cell Anemia Lab. My fellow lab partners and I will now be working on improving this procedure in order to obtain the results we are looking for. As a bioengineering student lab skills are very important and I believe they will improve greatly in this course. Apart from the science, my ability to work with others and explain my ideas in a clear concise way will also improve, this is a skill that can be applied to any situation in my life not just my professional life.  

I think the first step in improving and/or solving the problem of lack of eye care in developing countries is to increase the number of optometrists in these areas. By improving the education system (from kindergarten to university) and making it accessible to everyone, more people will be educated and will have the opportunity to become an optometrist for their community. Schools specifically for optometry should be opened around these developing areas and should be accessible by anyone who has completed their education from kindergarten to university. A good education system would lead to more optometrists in these communities and will in turn improve the eye care in these communities. By implementing this solution these developing countries will eventually be able to solve and eliminate this problem themselves, however, this solution could take years, maybe decades, to set up. In the meantime, a non-profit organization made up of optometrists and volunteers from around the world could set up a program to send a group of doctors every few months to tour around these developing areas. These doctors would help set people up with basic glasses. It would cost a lot of money and would take a lot of time to set every single patient up with their own specific prescription. Instead basic glasses frames could be made using 3D printers could be mass produced for not a lot of money. The glass, prescription part of the glasses, could be pre made with different types of common prescriptions and popped into place after an examination. While the prescription might not be perfect the optometrist would try to get as close to the patient’s prescription as possible with the glasses available. Providing access to eye care and prescription glasses will improve the quality of life for many people and will hopefully prevent (preventable) blindness. These prescription glasses will also increase the productivity of many people at work and will allow them to contribute to the growth of the community.

Hello world!

Hi, my name is Maria Lancia. I am majoring in bio pharmaceutical engineering at Lehigh University, class of 2021. This blog will be focused around the topics presented in the class CINQ 396 for the global social impact fellowship.