Background: The north-east (NE) region of Sri Lanka observed a critical health workers’ shortage after the long-lasting armed conflict. This study aimed to explore medical students’ attitudes towards working in the ...Background: The north-east (NE) region of Sri Lanka observed a critical health workers’ shortage after the long-lasting armed conflict. This study aimed to explore medical students’ attitudes towards working in the NE and to identify factors determining such attitudes. Methods: A semi-structured, self-administered questionnaire survey was conducted in two medical schools, one in the NE and the other near the capital, in October 2004. Data were qualitatively analysed using the framework approach. Results: Three main themes were identified: 1) Professional motives and career plans;2) Students’ perceptions of the healthcare situation in the NE;and 3) Students’ choice of the NE as a future practice location. It was found that familiarity with the difficulties faced by the NE people was a major motivation for medical students to work in the NE in the future. For NE students, familiarity was linked to their sense of belonging. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Demotivations to work in the NE were poor working and living conditions, fewer opportunities for postgraduate education, language differences, insecurity, and fear of an unpleasant social response from the NE communities. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience also showed a willingness to work there;thus, early exposure programmes in medical education might help to increase the health workforce in the NE. It is also expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups.展开更多
Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the...Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the epidemiology of the fractures limbs bones in a rural area where people live in a context of low economy, low education and insecurity. Methods: We conducted a cross-sectional, retrospective study involving all patients admitted for fracture in the surgical department of FOMULAC-KATANA General Reference Hospital from 1<sup>st</sup> January 2011 to 31<sup>st</sup> December 2014. The patients whose medical records were not completed were excluded. Results: Among 136 patients included in our study, 140 bones limbs were registered. Most of them (60.1%) were aged between 15 - 44 years and the average age is 30, 1 year. Male predominance is noticed (72.8%) with a male/female ratio of 2.7/1, and informal professionals are the most found in our patients (67.6%). The main circumstances of fracture occurrence are, respectively, road traffic accidents (57.4%), falls (22.3%) and firearms (10.3%). The leg bones (33.6%) and forearm bones (20%) are the most concerned bones. Open fractures are recorded in 40.7% of patients. The supporting treatment is mainly orthopedic (64.5%) but also surgical (35.5). The mortality rate is 3.6%. Conclusion: The fractures of the limbs bones in Katana General Reference Hospital mainly affect young male which is informal professional. The road traffic accidents are the first circumstance leading to fractures followed by falls. The leg bones are the most fractured body part and fractures are commonly opened.展开更多
Compared to psychosocial programs implemented in post-conflict settings those executed in areas of ongoing conflicts may have different effects. Their evidence of efficacy has never been systematically reviewed. We se...Compared to psychosocial programs implemented in post-conflict settings those executed in areas of ongoing conflicts may have different effects. Their evidence of efficacy has never been systematically reviewed. We searched PubMed, PsychInfo and the Dutch Tropical Institute Literature Portal from inception to31 January 2013 to identify studies on community-oriented psychosocial and psychiatric/clinical services for adults during ongoing manmade conflict or its direct aftermath. Of 6358 articles screened, 16 met our inclusion criteria. The interventions varied from psycho-educational to psychotropic drugs. The review is presented using outcome indicators such as PTSD, anxiety, depression, physical health, functioning and well being. A substantial improvement of some outcome was found though the small number of studies and their heterogeneity did not justify strong conclusions. PTSD symptoms improved significantly by treatments that included exposure (such as narrative exposure therapy). A number of studies (eight) showed notable improvement of the client’s functioning through counseling interventions. Depression and anxiety both improved considerably using that culturally adapted interventions (two studies), whereas non-culturalized interventions did not. We found a notable lack of studies on the efficacy of medication and on preferred western, evidence-based interventions for PTSD such Eye Movement Desensitization. To measure outcomes only two studies applied locally-developed diagnostic labels and validated instruments. Future research should encourage the use of robust research methods that are culturally valid, including mixed-methods research to combine measurable outputs with qualitative research aimed at improved understanding from the client’s perspective.展开更多
文摘Background: The north-east (NE) region of Sri Lanka observed a critical health workers’ shortage after the long-lasting armed conflict. This study aimed to explore medical students’ attitudes towards working in the NE and to identify factors determining such attitudes. Methods: A semi-structured, self-administered questionnaire survey was conducted in two medical schools, one in the NE and the other near the capital, in October 2004. Data were qualitatively analysed using the framework approach. Results: Three main themes were identified: 1) Professional motives and career plans;2) Students’ perceptions of the healthcare situation in the NE;and 3) Students’ choice of the NE as a future practice location. It was found that familiarity with the difficulties faced by the NE people was a major motivation for medical students to work in the NE in the future. For NE students, familiarity was linked to their sense of belonging. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Demotivations to work in the NE were poor working and living conditions, fewer opportunities for postgraduate education, language differences, insecurity, and fear of an unpleasant social response from the NE communities. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience also showed a willingness to work there;thus, early exposure programmes in medical education might help to increase the health workforce in the NE. It is also expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups.
文摘Background: Trauma is major public health problem in developing countries where they are associated with many factors, mainly such as lack of road safety, poverty and inadequate urban planning. We aim to highlight the epidemiology of the fractures limbs bones in a rural area where people live in a context of low economy, low education and insecurity. Methods: We conducted a cross-sectional, retrospective study involving all patients admitted for fracture in the surgical department of FOMULAC-KATANA General Reference Hospital from 1<sup>st</sup> January 2011 to 31<sup>st</sup> December 2014. The patients whose medical records were not completed were excluded. Results: Among 136 patients included in our study, 140 bones limbs were registered. Most of them (60.1%) were aged between 15 - 44 years and the average age is 30, 1 year. Male predominance is noticed (72.8%) with a male/female ratio of 2.7/1, and informal professionals are the most found in our patients (67.6%). The main circumstances of fracture occurrence are, respectively, road traffic accidents (57.4%), falls (22.3%) and firearms (10.3%). The leg bones (33.6%) and forearm bones (20%) are the most concerned bones. Open fractures are recorded in 40.7% of patients. The supporting treatment is mainly orthopedic (64.5%) but also surgical (35.5). The mortality rate is 3.6%. Conclusion: The fractures of the limbs bones in Katana General Reference Hospital mainly affect young male which is informal professional. The road traffic accidents are the first circumstance leading to fractures followed by falls. The leg bones are the most fractured body part and fractures are commonly opened.
文摘Compared to psychosocial programs implemented in post-conflict settings those executed in areas of ongoing conflicts may have different effects. Their evidence of efficacy has never been systematically reviewed. We searched PubMed, PsychInfo and the Dutch Tropical Institute Literature Portal from inception to31 January 2013 to identify studies on community-oriented psychosocial and psychiatric/clinical services for adults during ongoing manmade conflict or its direct aftermath. Of 6358 articles screened, 16 met our inclusion criteria. The interventions varied from psycho-educational to psychotropic drugs. The review is presented using outcome indicators such as PTSD, anxiety, depression, physical health, functioning and well being. A substantial improvement of some outcome was found though the small number of studies and their heterogeneity did not justify strong conclusions. PTSD symptoms improved significantly by treatments that included exposure (such as narrative exposure therapy). A number of studies (eight) showed notable improvement of the client’s functioning through counseling interventions. Depression and anxiety both improved considerably using that culturally adapted interventions (two studies), whereas non-culturalized interventions did not. We found a notable lack of studies on the efficacy of medication and on preferred western, evidence-based interventions for PTSD such Eye Movement Desensitization. To measure outcomes only two studies applied locally-developed diagnostic labels and validated instruments. Future research should encourage the use of robust research methods that are culturally valid, including mixed-methods research to combine measurable outputs with qualitative research aimed at improved understanding from the client’s perspective.
