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Introduction: There has been an increase in global health courses at medical universities in high-income countries. Their effect on students, however, is poorly understood. In 2016 an elective global surgery course was introduced for medical students at Karolinska Institutet in Sweden. The course includes a theoretical module in Sweden and a two-week clinical rotation in Uganda. The present study aimed to assess the format and determine its effect on students' knowledge of global surgery and approach towards patients of non-Swedish origin. Method: A mixed-methods design was used. Semi-structured case-based interviews were conducted individually with 18 students and analysed using qualitative content analysis. Examination scores and the course evaluation were analysed with Kruskal Wallis one-way analysis of variance, Pearson's Chi-square and a Wilcoxon signed-rank test as appropriate. Results: The course was appreciated and students reported gained insights and interest in global surgery. Students' ability to reason about global surgery issues was improved after the course. Students considered complicating aspects in the meeting with patients of non-Swedish origin. Students with abroad clinical experience felt less compelled to act on preconceptions. Discussion: The global surgery course at Karolinska Institutet is appreciated and students gained valuable knowledge. The case-based interviews acted as a catalyst for reflection and showed that students felt insecure as they lacked knowledge about globally common surgical conditions and struggled with generalized preconceptions of patients of non-Swedish origin. To further support students to integrate theoretical knowledge and professional development, we suggest the introduction of problem-based learning. Conclusion: The ability of the course to inspire students' commitment to global surgery is promising as this engagement is the key to reaching the goal of equitable health globally. Offering such courses is a step towards inspiring and recruiting the future clinicians and researchers needed for expanding the field of global surgery. [ABSTRACT FROM AUTHOR]

Five billion people lack timely, affordable access to surgery. A large proportion of these are children. Qualitative research investigating the barriers to surgical care for children and ways of overcoming them is lacking. This study focused on children with hernia, a very common paediatric surgical condition for which surgery is the only effective treatment. The main aim of this qualitative study was to explore barriers to surgical care for children and identify potential solutions. Data were collected from parents of children with hernia and from health care providers at Soroti Regional Referral Hospital in eastern Uganda. Parents' experiences, motives and barriers when accessing care were explored. The health care providers' knowledge, perceptions and practices relating to children with hernia were investigated. The data were analysed using thematic content analysis. Traditional beliefs and gender inequality were considered major issues. Possible solutions included partnering with the local community in efforts to increase knowledge and acceptability in the community in general and by parents in particular. A formation of a surgical team dedicated to the management of children with surgical conditions was suggested as way to improve quality and increase volume of surgery for children. [ABSTRACT FROM AUTHOR]

The literature indicates that although depression is highly prevalent, it is rarely recognized as such. The aim was to test the use of case vignettes in exploring the explanatory models of various subtypes of depression, in six individual interviews, and four focus-group discussions. Depressive symptoms presented in these vignettes seem to be conceptualized as a problem related to cognition (thinking too much) rather than emotion (sadness) and the resulting condition is referred to as `illness of thoughts.' Worrisome thoughts resulting from various socioeconomic problems are seen as important aetiological factors for the illness of thoughts and require no medication as it is believed that there is no medication for thoughts. There are culturally accepted ways of dealing with and healing the condition. Once illness becomes recurrent or chronic, other explanations about causes and a different course of action have to be considered. Further exploration of the relationship between thoughts and emotions among the Baganda may be an important avenue for further research. [ABSTRACT FROM AUTHOR]