No abstract

No abstract

Background: The effectiveness of virtual dermatology curricula in developing countries remains unclear despite an urgent need due to the pandemic and other factors.Objective: To compare a virtual dermatology curriculum deployed in Gondar, Ethiopia with a traditional in-person course.Methods: We developed a free, on-line dermatology course. 104 trainees from the University of Gondar, Ethiopia, completed the course. Pre-and post-course surveys measuring self-reported proficiency were administered. End-of-Course surveys were distributed to elicit feedback on the course. Performance on final examinations was compared to a historical control group, which did not participate in the course but received standard in-person training.Results: Compared to historical controls (n = 236), the pilot cohort (n = 104) averaged over 4 points higher on the final exam (P \ .0001). Most participants were satisfied with all aspects of the on-line course and desire at least a component of virtual learning in the future.Limitations: This pilot study was performed at a single institution, and the participants were not randomized. Further studies in demographically diverse cohorts are needed to validate the results. Conclusion:This dermatology curriculum is a free, innovative platform that can be adapted for dermatology trainees in resource-limited settings.

Background High‐risk alcohol use in the elderly is a common but underrecognized problem. We tested a brief screening instrument to identify high‐risk individuals. Methods This was a prospective, cross‐sectional study conducted at a single emergency department. High‐risk alcohol use was defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines as >7 drinks/week or >3 drinks/occasion. We assessed alcohol use in patients aged ≥ 65 years using the timeline follow back (TLFB) method as a reference standard and a new, 2‐question screener based on NIAAA guidelines. The Alcohol Use Disorders Identification Test (AUDIT) and Cut down, Annoyed, Guilty, Eye‐opener (CAGE) screens were used for comparison. We collected demographic information from a convenience sample of high‐ and low‐risk drinkers. Results We screened 2250 older adults and 180 (8%) met criteria for high‐risk use. Ninety‐eight high‐risk and 124 low‐risk individuals were enrolled. The 2‐question screener had sensitivity of 98% (95% CI, 93%–100%) and specificity of 87% (95% CI, 80%–92%) using TLFB as the reference. It had higher sensitivity than the AUDIT or CAGE tools. The high‐risk group was predominantly male (65% vs 35%, P < 0.001). They drank a median of 14 drinks per week across all ages from 65 to 92. They had higher rates of prior substance use treatment (17% vs 2%, P < 0.001) and current tobacco use (24% vs 9%, P = 0.004). Conclusion A rapid, 2‐question screener can identify high‐risk drinkers with higher sensitivity than AUDIT or CAGE screening. It could be used in concert with more specific questionnaires to guide treatment.

No abstract