Effect of an eLearning Intervention on Undergraduate Health Professional Student's General Histology and Embryology Summative Examination Scores.

Sub-Saharan Africa has the worst global shortage of health professionals. The use of eLearning interventions, that lead to increased interactions according to the Interaction Equivalency theorem, is a potential means of addressing this shortage of health professionals. In this audit we set out to determine the effect of an eLearning general histology and general embryology intervention on student's summative examination scores. The audit compared the written and practical summative examination scores of three sets of student examinations one of which had a five-week eLearning intervention. Two of the examinations were for the same students in one year but different courses while the other two were for students doing the same subject but in different years. In each of the above pair of examinations there was one group from the course that had the eLearning intervention. A Bayesian multilevel regression modelling approach was used to analyse the student scores. The course with the online eLearning intervention had significantly better scores (p-value < 0.01), than the course on a different subject offered at the same time to the same students without the intervention and the same course with students from the previous academic year. On controlling for other factors, the eLearning intervention led to higher examination scores though this was not significant. Student's nationality, sponsorship and program significantly affected the examination scores, controlling for other factors. Overall the students in the course with the online eLearning intervention had significantly better examination scores. The student's nationality, sponsorship and program significantly affect their examination scores. Future, larger and or qualitative studies, are needed to further explore the effect of these factors on student's examination scores.

Listening to the voices: an exploratory study of the experiences of women diagnosed and living with breast cancer in Uganda.

INTRODUCTION: Breast cancer is one of the leading causes of cancer deaths amongst Ugandan women. Most women live through challenging and emotional experiences having been diagnosed with breast cancer. The purpose of this study was to explore the lived experiences of women diagnosed and living with breast cancer. METHODS: This was an exploratory qualitative study using a convenience sample (n = 12) of women confirmed with breast cancer and reporting to the Radiology department for imaging. In-depth individual interviews were conducted and findings were summarized into themes, representative of the participants' lived experiences. RESULTS: All women in this study initially went through emotional trauma of living with breast cancer. However, with time, they seemed to accept and cope with their situation. Four major themes summarizing their experiences included: Thought of Death, Strength to live, Loss of female identity and sexuality and Coping mechanisms. CONCLUSION: This study provided a unique insight of the experiences of women living with breast cancer. By listening to their narratives, one could see emotional pain, anger, anxiety, strength to live and many more. Although women with breast cancer get clinical management, there is need to design holistic palliative healthcare services including counseling to assist then cope with life.

How accurate is ultrasound in evaluating palpable breast masses?

INTRODUCTION: Breast masses have become common in women. Such masses pose a potential threat to women especially in the era of increased cases of breast cancer worldwide. Breast carcinoma ranks first among the malignant tumors affecting females in many parts of the world with the rate of breast cancer being 1 in 8 in USA. There are currently more than 600 000 cancer deaths annually in Africa. By 2020, 70% of the 15 million new annual cancer cases will be in developing countries. Ultrasound is a relatively inexpensive and readily accessible imaging modality that can be utilized in the evaluation of clinically palpable breast masses. The purpose of this study was to find out the accuracy of ultrasound in the diagnosis of palpable breast masses. METHODS: Eighty palpable breast masses were evaluated at ultrasound and information about the characteristic features of the masses was recorded. An impression about the diagnosis was made and results were correlated with histology findings. RESULTS: The overall sensitivity of ultrasound in detecting breast lumps was 92.5%. The sensitivity and specificity of ultrasound for detecting breast carcinoma was 57.1% and 62.8% respectively with a positive predictive value of 68.1%, a negative predictive value of 99.5%, a positive likelihood ratio of 39 and a negative likelihood ratio of 0.07. Ultrasound reliably differentiated cystic from solid breast masses. CONCLUSION: Ultrasound is significant in differentiating cystic from solid breast masses. Ultrasound is also important in detecting suspicious breast masses and should therefore be used in the evaluation of symptomatic breast masses.

Utilisation of obstetric sonography at a peri-urban health centre in Uganda.

BACKGROUND: Maternal mortality is related to obstetric complications in pregnancy some of which could be revealed by obstetric sonography. Obstetric sonography has become part of routine antenatal care in both urban and rural settings. The objective of the study was to assess the utilization of obstetric sonography in a rural hospital of Uganda, including the frequency and appropriateness of its usage as well as determine whether there was any relation between number of obstetric scans, patient management and obstetric outcomes. METHODS: It was a retrospective study in which review of all obstetric charts and obstetric scan requisition forms for all deliveries in Ndejje Health Centre (Uganda) was done. RESULTS: During the study period, there were 105 singleton deliveries, and these mothers underwent a total of 232 obstetric scans. More than half (53.4%) of the scans were classified as inappropriate. There were no significant differences in the number of scans between low- and high-risk pregnancies or between uncomplicated deliveries and those in which induction or instrumental or operative delivery occurred, nor was there any relation between number of scans and obstetric outcome. CONCLUSION: Obstetric sonography has become popular in rural health settings as part of antenatal care. However, it was over-used in the health centre. This overuse was not associated with any identifiable effect on obstetric outcome. Therefore, more appropriate use of obstetric sonography, in accordance with evidence-based guidelines, is recommended.

Current knowledge, attitudes and practices of expectant women toward routine sonography in pregnancy at Naguru health centre, Uganda.

BACKGROUND: Ultrasound has become a routine part of care for pregnant women in Uganda, being one of a range of techniques used in screening. However, it differs from most others because it allows women to view their babies. Routine obstetric sonography is now globally recognized as one of the ways through which maternal mortality can be reduced. This study aimed at finding out the knowledge, attitudes and practices of pregnant women towards prenatal sonography at Naguru Health Centre, Uganda. METHOD: Exploratory -descriptive study using interviewer-administered questionnaires. Thematic analysis was employed for qualitative data and bivariate, multivariate and logistic regression analysis was used for quantitative data. RESULTS: Three themes emerged; Knowledge, Attitude and Practices. Women's knowledge, attitude and practices of obstetric sonography were influenced mainly by their biosocial factors like gravidity, education level and occupation. All women expressed concern that obstetric sonography could lead to cancer. CONCLUSION: Obstetric sonography is highly appreciated as being vital for antenatal care. However, there is need for mothers and health care providers to be well informed about the safety and specific purposes of obstetric sonography and what it can and cannot achieve.