An international, case-based, distance-learning collaboration between the UK and Somaliland using a real-time clinical education website
ABSTRACT We established a medical education website to deliver real-time, clinical case-based education to sites in Somaliland from the UK. The website was based on a web 2.0 social networking concept in order to recreate, as nearly as possible, the clinical bedside teaching experience. A survey showed that medical students in Somaliland had sufficient computer access to exploit the website. Teaching began in December 2008 and the teaching programme has developed into a regular weekly teaching session involving up to seven different student groups in Somaliland at different locations. As well as north-south teaching, the website has been employed to support a study module in London. Small groups of UK-based medical students have been partnered with intern tutors in Somaliland. Forty UK students have taken part in this teaching, which is now in its second year. Feedback from those involved has demonstrated that a collaboration in which both north-south and south-north teaching occurs can strengthen partnerships in which both parties contribute and benefit.
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ABSTRACT: Objectives: To examine patterns of amputation (all levels) among veterans who were identified as at-risk and to examine factors that predict greater risks for a major (below-knee, above-knee) amputation. Design: Database approach, secondary data analysis. Setting: Veterans Affairs medical centers (VAMCs). Participants: 451,824 were selected if they had diagnoses of diabetes mellitus or peripheral vascular disease, and were at-risk for lower-extremity amputation. These patients were followed for 4 years (1997–2000) to determine the occurrence of amputation. Interventions: Not applicable. Main Outcome Measures: Differences in frequency and level of amputation were assessed among 132 VAMCs with different Preservation of Amputation Care and Treatment (PACT) rankings. Regression techniques were used to identify factors associated with increased risk. Results: Over the 4-year period, 10,258 patients had at least 1 amputation (2.3%). Highly ranked VAMCs had greater amputation rates and performed more above-knee amputations than less well ranked VAMCs. Factors that increase risk for a major amputation include race, skin ulcers, gangrene, and prior amputation. Conclusion: High-PACT VAMCs are often located in an urban setting, affiliated with academic medical programs, and have higher volume of patients. Higher amputation rate at high-PACT facilities may reflect a movement toward centers of excellence for prevention of and treatment for lower-extremity amputations.
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ABSTRACT: The author of this personal re£ection is a junior doctor from Somaliland, a country that has su¡ered from civil war. He studied medicine there, and became interested in mental health care.This aspect of heath care is among the most neglected in the horn of Africa. However, with the support of British psychiatrists, the author has established educational training in psychiatry. He has also subsequently initiated mental health services in his hometown of Borama.Within a few years, an inpatient psychia-tric unit, an outpatient department and community mental health outreach were also created. Key to his success was intensive cooperation and collaboration with the community, resulting in broad support for mental health programmes. He has also attempted to collaborate with traditional healers, but remains hesitant of their role.Intervention 11/2012; 10(4):274-278. DOI:10.1097/WTF.0b013e32835a29c6
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ABSTRACT: This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damagesMedicine Conflict and Survival 01/2012; 27(4):205-210. DOI:10.1080/13623699.2011.645145