The Medical Evaluation of the Newly Resettled Female Refugee: A Narrative Review

The number of forcibly displaced individuals worldwide is increasing each year, reaching 65 million persons by the end of 2015, half of which were women and children. As the population of displaced persons grows, it is every physician’s responsibility to understand these patients and their health needs. Refugee patients and the providers who care for them face many barriers to effective patient care, including language barriers, cultural differences, and systematic inequalities. Female refugees commonly experience gender-based violence, repetitive trauma, stigmatized mental illness, and cultural barriers to women’s healthcare. This review is intended to be a comprehensive guide for the provider caring for the recently resettled female refugee patient. It addresses general considerations for working with refugee patients, initial medical evaluation guidelines, specific women’s health issues, and mental health care of female refugee patients

Effects of a patient’s name and image on medical knowledge acquisition

Purpose: To assess whether there are differences in medical students’ (MS) knowledge acquisition after being provided a virtual patient (VP) case summary with a patient’s name and facial picture included compared to no patient’s name or image.Method: 76 MS from four clerkship blocks participated. Blocks one and three (Treatment group) were provided case materials containing the patient’s name and facial picture while blocks two and four (Control group) were provided similar materials without the patient’s name or image. Knowledge acquisition was evaluated with a multiple-choice-question examination (CQA_K).Results: Treatment group CQA_K scores were 64.6% (block one, n = 18) and 76.0% (block three, n = 22). Control group scores were 71.7%, (block two, n = 17) and 68.4% (block four, n = 19).  ANOVA F-test among the four block mean scores was not significant; F (3, 72) = 1.68, p = 0.18, η2=0.07. Only 22.2% and 27.3% of the MS from blocks one and three respectively correctly recalled the patient’s name while 16.7% and 40.9% recalled the correct final diagnosis of the patient.Conclusions: These results suggest that including a patient’s name and facial picture on reading materials may not improve MS knowledge acquisition. Corroborating studies should be performed before applying these results to the design of instructional materials

V is for Voluntary: Uptake of HIV Testing and Counseling in Mombasa District, Kenya

Voluntary counseling and testing (VCT) is a crucial HIV intervention strategy, promoting safe behavior, providing personalized support, and serving as an entry point for care and treatment. Experts agree that knowledge of HIV status should ideally be universal; however, as VCT is a voluntary service, certain challenges arise in promoting its uptake. Though Kenya has made remarkable headway in expanding its VCT provision, setting a leading example for the world, 80% of adult citizens still have never been tested. This project investigates the factors controlling the uptake of VCT in Mombasa district and seeks ways to reach more people with testing and counseling services. The first section identifies common barriers that keep individuals from seeking VCT services, including psychological, socio-cultural and physical barriers. The second section explores the wide variety of VCT programs existing in Mombasa district, and how they have contributed to recent increases in uptake. The third section is a case study of the 2007 HIV Testing Week, shedding light on the challenges and possibilities of targeting great numbers of people with VCT. Finally, the last section explores the acceptability and future prospects of alternative strategies to VCT, which are being considered to universalize HIV testing. This study finds that the issues of stigma, poverty, and human rights must continuously be considered in any efforts to expand uptake of HIV counseling and testing services. In order to uphold the efficacy of the VCT intervention, the quality and integrity of services must be prioritized above target numbers of clients

Ventricular Septal Defect from Takotsubo Syndrome

Takotsubo Syndrome is a transient condition characterized by left ventricular systolic dysfunction with apical akinesis/dyskinesis and ballooning. Although the prognosis with medical management is excellent in most cases, rare cases of serious complications can occur. We present here a case of a 71-year-old woman presenting with acute decompensated heart failure with initial findings consistent with a myocardial infarction, who was found instead to have an acute ventricular septal defect as a complication of Takotsubo Syndrome