Medical students have an increasing desire to learn about the global context of health. Most UK m... more Medical students have an increasing desire to learn about the global context of health. Most UK medical schools do not include global health (GH) in their core curriculum, but do allow an elective period overseas. Some UK medical schools offer an optional attachment in GH or, in some cases, an intercalated degree. All students at Newcastle University complete three student-selected components (SSCs), each lasting 6 weeks in their fourth year. In 2006, one NU medical student requested to study GH. From this request, an SSC in GH was established. Each year the SC is open to 10 students. The timetable includes lectures from clinicians, nurses and other professionals with experience of developing countries. Weekly topics cover major themes of GH, such as war and conflict, and water supply. Students pick a project to present to their peers at the end of each week. A debate is held on two major current issues in GH. Students from the past SSC present their elective experiences. Clinical components include: infectious diseases clinics, a general practice (GP) surgery with a large number of asylum seekers and refugees, and obstetrics and gynaecology clinics with doctors who have practised abroad. GH teaching prior to going on elective is important to set the scene for students who will never have worked in such settings before. Feeding back experiences to future years helps to consolidate key learning objectives from the SSC. By listening to the needs of medical students we have now secured a core GH session within the curriculum.
Journal of Neurology, Neurosurgery & Psychiatry, 2011
To establish post-stroke case fatality rates within a community based incident stroke population ... more To establish post-stroke case fatality rates within a community based incident stroke population in rural Tanzania. Incident stroke cases were identified by the Tanzanian Stroke Incidence Project and followed-up over the next 3-6 years. In order to provide a more complete picture, verbal autopsy (VA) was also used to identify all stroke deaths occurring within the same community and time period, and a date of stroke was identified by interview with a relative or friend. Over 3 years, the Tanzanian Stroke Incidence Project identified 130 cases of incident stroke, of which 31 (23.8%, 95% CI 16.5 to 31.2) died within 28 days and 78 (60.0%, 95% CI 51.6 to 68.4) within 3 years of incident stroke. Over the same time period, an additional 223 deaths from stroke were identified by VA; 64 (28.7%, 95% CI 20.9 to 36.5) had died within 28 days of stroke and 188 (84.3%, 95% CI 78.1 to 90.6) within 3 years. This is the first published study of post-stroke mortality in sub-Saharan Africa from an incident stroke population. The 28 day case fatality rate is at the lower end of rates reported for other low and middle income countries, even when including those identified by VA, although CIs were wide. Three year case fatality rates are notably higher than seen in most developed world studies. Improving post-stroke care may help to reduce stroke case fatality in sub-Saharan Africa.
Medical students have an increasing desire to learn about the global context of health. Most UK m... more Medical students have an increasing desire to learn about the global context of health. Most UK medical schools do not include global health (GH) in their core curriculum, but do allow an elective period overseas. Some UK medical schools offer an optional attachment in GH or, in some cases, an intercalated degree. All students at Newcastle University complete three student-selected components (SSCs), each lasting 6 weeks in their fourth year. In 2006, one NU medical student requested to study GH. From this request, an SSC in GH was established. Each year the SC is open to 10 students. The timetable includes lectures from clinicians, nurses and other professionals with experience of developing countries. Weekly topics cover major themes of GH, such as war and conflict, and water supply. Students pick a project to present to their peers at the end of each week. A debate is held on two major current issues in GH. Students from the past SSC present their elective experiences. Clinical components include: infectious diseases clinics, a general practice (GP) surgery with a large number of asylum seekers and refugees, and obstetrics and gynaecology clinics with doctors who have practised abroad. GH teaching prior to going on elective is important to set the scene for students who will never have worked in such settings before. Feeding back experiences to future years helps to consolidate key learning objectives from the SSC. By listening to the needs of medical students we have now secured a core GH session within the curriculum.
Journal of Neurology, Neurosurgery & Psychiatry, 2011
To establish post-stroke case fatality rates within a community based incident stroke population ... more To establish post-stroke case fatality rates within a community based incident stroke population in rural Tanzania. Incident stroke cases were identified by the Tanzanian Stroke Incidence Project and followed-up over the next 3-6 years. In order to provide a more complete picture, verbal autopsy (VA) was also used to identify all stroke deaths occurring within the same community and time period, and a date of stroke was identified by interview with a relative or friend. Over 3 years, the Tanzanian Stroke Incidence Project identified 130 cases of incident stroke, of which 31 (23.8%, 95% CI 16.5 to 31.2) died within 28 days and 78 (60.0%, 95% CI 51.6 to 68.4) within 3 years of incident stroke. Over the same time period, an additional 223 deaths from stroke were identified by VA; 64 (28.7%, 95% CI 20.9 to 36.5) had died within 28 days of stroke and 188 (84.3%, 95% CI 78.1 to 90.6) within 3 years. This is the first published study of post-stroke mortality in sub-Saharan Africa from an incident stroke population. The 28 day case fatality rate is at the lower end of rates reported for other low and middle income countries, even when including those identified by VA, although CIs were wide. Three year case fatality rates are notably higher than seen in most developed world studies. Improving post-stroke care may help to reduce stroke case fatality in sub-Saharan Africa.
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