Disability inclusion in higher education in Uganda: Status and strategies.

BACKGROUND: Uganda has embraced inclusive education and evidently committed itself to bringing about disability inclusion at every level of education. Both legal and non-legal frameworks have been adopted and arguably are in line with the intent of the Convention on the Rights of Persons with Disabilities (CRPD) on education. The CRPD, in Article 24, requires states to attain a right to education for persons with disabilities without discrimination and on the basis of equal opportunities at all levels of education. OBJECTIVES: Despite Uganda's robust disability legal and policy framework on education, there is evidence of exclusion and discrimination of students with disabilities in the higher education institutions. The main objective of this article is to explore the status of disability inclusion in higher education and strategies for its realisation, using evidence from Emong's study, workshop proceedings where the authors facilitated and additional individual interviews with four students with disabilities by the authors. RESULTS: The results show that there are discrimination and exclusion tendencies in matters related to admissions, access to lectures, assessment and examinations, access to library services, halls of residence and other disability support services. CONCLUSION: The article recommends that institutional policies and guidelines on support services for students with disabilities and special needs in higher education be developed, data on students with disabilities collected to help planning, collaboration between Disabled Peoples Organisations (DPO's) strengthened to ensure disability inclusion and the establishment of disability support centres.

Maggot debridement therapy in the treatment of complex diabetic wounds.

The growth and aging of the population of Hawai'i with a high incidence of diabetes mandates a need for more effective strategies to manage the healing of complicated wounds. Maggot debridement therapy (MDT) is one alternative utilized with successful results. Observations have indicated that maggots have the ability to debride wound beds, provide anti-microbial activity and also stimulate wound healing in diabetic patients. None of the patients refused MDT due to aversion of this treatment modality and the majority of patients had minimal discomfort. In 17 of 23 patients with multiple co-morbidities, the treatment of their complex diabetic wounds by MDT resulted in improvement or cure. Maggot debridement therapy is an effective treatment of diabetic wounds.

Telemedicine: the future of outpatient therapy?

Early hospital discharge of acutely infected patients to received outpatient parenteral antimicrobial therapy has been shown to be safe and effective. However, concerns over safety, potential litigation, and anxieties of the patient and family about not receiving professional care have limited the use of this approach. Telemedicine may overcome these barriers by allowing health care providers to monitor and communicate with acutely infected patients from a remote medical center via a home computer station transmitting audio, video, and vital signs data. Potential benefits of telemedicine include significant cost savings and faster convalescence, because patients at home may feel more comfortable and actively involved in their treatment than patients in the hospital. Clinical studies have shown that telemedicine is safe and cost-effective, compared with hospital treatment, in chronically ill and acutely infected patients. More studies are needed to further establish the widespread and increasing practice of telemedicine, which may represent the future of medicine.

Diagnosis of E. coli tricuspid valve endocarditis: a case report.

Escherichia coli is a rare cause of bacterial endocarditis. We report a case of an elderly man with cirrhosis who developed bacterial endocarditis due to E.coli. We review the literature that summarizes a total of 41 cases, with a predominance of elderly women, diabetics, and patients with urinary tract infections and prosthetic heart valves. E.coli bacteremia may be mistakenly attributed to a more benign source such as urosepsis and overlooked as an indication of endocarditis. A delay in diagnosis may lead to higher mortality as the opportunity for early valve replacement in appropriate cases and more prolonged courses of antibiotics may not be considered.

In the clinic. Cellulitis and soft-tissue infections.

This issue provides a clinical overview of cellulitis and soft-tissue infections, focusing on prevention, diagnosis, treatment, practice improvement, and patient information. Readers can complete the accompanying CME quiz for 1.5 credits. Only ACP members and individual subscribers can access the electronic features of In the Clinic. Non-subscribers who wish to access this issue of In the Clinic can elect "Pay for View." Subscribers can receive 1.5 category 1 CME credits by completing the CME quiz that accompanies this issue of In the Clinic. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including PIER (Physicians' Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing division and with assistance of science writers and physician writers. Editorial consultants from PIER and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult www.acponline.org, http://pier.acponline.org, and other resources referenced within each issue of In the Clinic.

The virtual hospital: treating acute infections in the home by telemedicine.

The growth and aging of the population of Hawaii mandates a need for more effective utilization of hospital beds. One approach is early hospital discharge and outpatient treatment. However, as the acuity of illness increases, satisfactory outcomes of outpatient treatment maybe difficult to achieve. We have utilized telemedicine to closely monitor acutely ill patients with infections, such as community-acquired pneumonia, skin and soft tissue infections, and urinary tract infection, in the home setting. Our treatment paradigm achieved satisfactory outcomes, cost savings, and at the same time resulted in more rapid convalescence than hospitalization.

Treating acute infections by telemedicine in the home.

Patients with community-acquired pneumonia, cellulitis, or urinary tract infection may be treated either in the hospital or as outpatients, depending on the severity of their disease, comorbidities, and Karnofsky performance status. To more efficiently use hospital beds, we discharge many moderately to severely ill patients with acute infections directly from the emergency department or early in the course of hospitalization. To insure satisfactory clinical outcomes, we use telemedicine in the home to monitor patients who would normally be hospitalized. Patients treated with telemedicine have satisfactory clinical outcomes, and their recovery appears to be more rapid than comparable hospitalized patients. Telemedicine in the home results in considerable savings by averting or shortening hospital stays.