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  • Surgery students spend so much time on screens that they have lost the ability to perform simple tasks such as stitching and sewing up patients, a professor has warned. Roger Kneebone, a professor of surgical education at Imperial College, London, says the focus on academic knowledge has come at the expense of craftsmanship. “It is important and an increasingly urgent issue,” Kneebone told the BBC. “It is a concern of mine and my scientific colleagues that whereas in the past you could make the assumption that students would leave school able to do certain practical things – cutting things out, making things – that is no longer the case.” The professor, who teaches surgery to medical students, believes that this is down to an increase in technology which takes away the experience of handling materials and developing skills. ”An obvious example is of a surgeon needing some dexterity and skill in sewing or stitching,” he explained. ”A lot of things are reduced to swiping on a two-dimensional flat screen” Kneebone adds that a growing number of students are becoming “less competent and less confident” in using their hands, resulting in young professionals who “have very high exam grades but lack tactile general knowledge”. The professor will be speaking on Tuesday at the V&A Museum of Childhood in east London, at the launch of a report, published by the Edge Foundation, calling for more creativity in the curriculum. The report warns that entries to creative subjects have fallen by 20 per cent since 2010, including a 57 per cent fall in design and technology GCSE. Tristram Hunt, director of the Victoria and Albert Museum, who will be speaking alongside Professor Kneebone added: “Creativity is not just for artists. “Subjects like design and technology, music, art and drama are vitally important for...
  • WASHINGTON: India has shortage of an estimated 600,000 doctors and 2 million nurses, say scientists who found that lack of staff who are properly trained in administering antibiotics is preventing patients from accessing live-saving drugs. Even when antibiotics are available, patients are often unable to afford them. High out-of-pocket medical costs to the patient are compounded by limited government spending for health services, according to the report by the Center for Disease Dynamics, Economics & Policy (CDDEP) in the US In India, 65 per cent of health expenditure is out-of-pocket, and such expenditures push some 57 million people into poverty each year. The majority of the world’s annual 5.7 million antibiotic-treatable deaths occur in low- and middle-income countries where the mortality burden from treatable bacterial infections far exceeds the estimated annual 700,000 deaths from antibiotic-resistant infections. Researchers at CDDEP in the US conducted stakeholder interviews in Uganda, India, and Germany, and literature reviews to identify key access barriers to antibiotics in low-, middle-, and high-income countries. Health facilities in many low- and middle-income countries are substandard and lack staff who are properly trained in administering antibiotics. n India, there is one government doctor for every 10,189 people (the World Health Organization (WHO) recommends a ratio of 1:1,000), or a deficit of 600,000 doctors, and the nurse:patient ratio is 1:483, implying a shortage of two million nurses. “Lack of access to antibiotics kills more people currently than does antibiotic resistance, but we have not had a good handle on why these barriers are created,” said Ramanan Laxminarayan, director at CDDEP. The findings of the report show that even after the discovery of a new antibiotic, regulatory hurdles and substandard health facilities delay or altogether prevent widespread market entry and drug availability,” Laxminarayan said in a statement. “Our research shows that of...
  • Author: Jeroen Tas Over the past two decades many everyday experiences have turned digital. I remember when my team at Citibank launched Internet banking in the mid-nineties. People thought we were wasting our time, as “nobody would trust the Internet with their financial data”. But almost all of us now bank digitally and even cash is being replaced with the tap of the phone, while payments can be made seamlessly around the globe. Healthcare is moving in the same direction, albeit slowly. As described in my blog two years ago, the future of a hospital is not brick and mortar. Instead, care will be provided in “meshed up” digital and physical networks that provide 24/7 access, improve patient outcomes and provide personalized patient and staff experiences, while simultaneously optimizing operations. Healthcare will find its way into the fabric of communities in different forms and shapes, bringing neighbours, friends and family into care teams. Those providers who are leaders in specialized care, for instance in specific cancer types, cardiovascular or neuro diseases, will increasingly make their expertise available globally. Like internet banking, which took time to really take off, we’re at an inflection point where digital models are getting close to scale. The merger of CVS and Aetna in the US is a sign of the times, providing a one-stop shop for primary care, diagnostics and pharmacy, combined with a virtual consumer experience. People are increasingly seeking care closer to home, without having to travel and wait hours to see a doctor, and in a more comfortable, consumer-friendly environment. They want to get personalized health content and tools on their phones, just like their other consumer experiences. Even complex, minimally invasive procedures, like inserting a stent in an artery, are now increasingly performed in “office-based labs” that are located in communities close to where people...
  • Hospital Acquired Infections (HAIs) or nosocomial infections are complex to treat and are a growing global burden. HAIs affect about one in 25 patients in the US and situation is worse in resource-poor nations. A prevalence survey conducted under WHO in 55 hospitals of 14 countries showed that ~8.7% of in-patients had HAIs. At any time, over 1.4 million people worldwide suffer from infectious complications acquired in hospital. HAIs contributes to increased economic burden, negatively affecting quality of life and deaths. 1,2 As per the existing methodologies direct observation is the gold standard to monitor compliance and to prevent or reduce HAIs. Frequent surveys, interviews and inspections are the other commonest methods implemented as prevention of HAIs. Indirect monitoring involves automated monitoring systems (video monitoring , real time location systems) monitoring hand hygiene product consumption). Hospitals with sophisticated information systems are in a position to streamline surveillance process through computer-based algorithms that identifies patients at highest risk of HAI.3 4 Computerized surveillance helps in better implementation of preventive strategies, but lower infection rates have not been proven conclusively. Conventional training methodologies have not proved to be significantly impactful in knowledge retention and message recall. A newer approach called Gamification is a positive and effective method to change behaviour. It can engage, motivate and influence people. It is a concept that has unknowingly been applied for years though the term was widely used only after 2010. A ‘serious game’ is defined as an ‘interactive computer application, with or without significant hardware component, that has a challenging goal, is fun to play and engaging, incorporates some scoring mechanism, and supplies the user with skills, knowledge or attitudes useful in reality. A hand hygiene improvement campaign in Edinburgh Royal Infirmary (Scotland, UK) using the SureWash gesture recognition system (SureWash, IRL) which concluded that...
  • Surgical practice has evolved over the centuries, more so in past 2 decades. However, continuing surgical education practices remain antique. Strongly dependent on hands-on-training, surgeons limitations of travel and time dedication, affects access to learning. Newer technologies for adaptive and immersive learning, including virtual reality and augmented reality has evolved over the past 5 years. It’s use might help to improve reach and quality of professional surgical education.  But some key questions to be answered are access to technology, adaptability and behaviour change. As an experiment, one year skill development program, Diploma in Minimal Access Surgery, with 80% of learning happening online and 20% offline was introduced for the first time in India to train surgeons on minimal access surgery. Online included the use of smart learning management system with AI, virtual reality, augmented reality, real time app based logbook, live surgery streaming and scheduled mentor interactions. Offline training included over the shoulder learning, hands-on and interactive class room learning over one week. Program enrolled 70 students in the first batch. In total 67/70 accessed the course (Ongoing). Over the period of 8 months, 34 video modules, 8 live interactions, including surgery streaming and one in person session with faculty, were conducted. Course received 100% attendance, with 3 or less reminders. A survey conducted at half time, to evaluate the effectiveness and net promoter,  73% responded (49/67). Average rating for the course stood at 4.35/5. Majority felt ‘Live Surgeries’ and ‘Virtual Contact Sessions’ were the most helpful ones. Ninetysix percent (96%: 47/49) said they either ‘agree/strongly agree’ that faculty provided all the necessary information during live surgeries and video lectures. When asked about ‘How likely are you to recommend the course to your peers?’, 47/49 rated either =or>7/10, and 26 responded 10/10. Providing the course a net promoter score of...
  • Author: Dr.T.V.Rao MD Medical education is in an era of transformation, and medical Colleges are beginning to innovate to prepare new physicians for the emerging new model of care. the regulator ( MCI ) realized what all taught in the past is non-productive and making least skilled doctors to make effective decisions in time of managing simple cases and emergencies, The true crisis are reflected when the fully qualified teachers who are supposed to be mentors to bring in change do not meet to the challenges Today certainly the medical profession under scanner for various reasons just not the fault of students, starting from admission process lacking   inclination to profession and lack of work culture in the professional colleges, and much added by the poor teaching talents of the so called highly qualified teachers just born to spend time in the colleges for sake of MCI records and personal gains which least talents . in the process Almost didactic teaching is dying as same old son sung by many however we are in for change and many curricular changes in medical syllabus wish to make the teachers productive and the students to be better in critical thinking and analytical skills to perform the profession Studying medicine is very much a marathon, not a sprint. It is a 5- or 6-year course, The reason the course is so long is because of the volume of material that needs to be learned; both the basic scientific principles and the clinical skills needed to apply them must be taught. BEGIN YOUR LIFE AS A POSITIVE THINKER – Being a medical student puts you in a very privileged position, among the very top students across the country. It generally seems to be the case that medics follow the mantra “work hard, play hard”. Most importantly,...
  • Author: Dr David Lee, MD Physicians have traditionally been individual thinkers and doers. Healthcare in general has been generally slow to adopt proven successful methods of processes and technologies employed with success in other sectors of society. Medical training from medical school through post-graduate education has been traditionally focused on the individual. Hospitals these days are driven by regulatory issues surrounding patient care. In reading about project management (PM), I have noticed that much of what I did as a practicing physician fit into standard PM teaching. However, it helps to frame a discussion around PM today in the context of healthcare, because of how fragmented care delivery is. 1. Collaborative interaction is a key component to success. It fosters constant and open communication, multidirectional input and conflict resolution as it occurs, not when it is too late. Team management of patients is catching on, but not universally practiced. Multidisciplinary hospital rounds including pharmacy, nursing, discharge planning are important to identify patients at high risk of readmissions, improve the relay of consistent and accurate information to the patient and caregivers, improve documentation and indirectly improve patient satisfaction and efficiency. Collaboration and communication among personnel in the operating room is especially important. According to one study, “communication failures in the OR…occurred in approximately 30 percent of team exchanges and a third of these resulted in effects which jeopardized patient safety by increasing cognitive load, interrupting routine and increasing tension in the OR.” Electronic health records and their interoperability are being implemented to facilitate collaborative interactions among different technologies and providers. There are even intra-office communications problems that have negative outcome implications for patients. There is a long way to go on that front, mostly due to non-technical issues. 2. Planning, execution and management are other important fundamentals of PM. One key to this...
  • “Computers are a mixed blessing, because the ease with which they can make data widely available poses new risks to individual privacy. Compared to paper-based medical records, electronic information is more easily manipulated and linked…. [and] also raises the specter of a huge national database of identifiable, comprehensive health information”…..  Rybowski (1998)  Telemedicine came into existence in the latter half of 90’s, mainly focusing upon patient data storage. Quite obviously it is linked to the growth of information technology across other sectors. However, the boundaries got stretched in the early Y2K period, when the online education trend was picking up. Also online training and certifications for physicians was the new trend. One of the first training programs I remember to be delivered online was on one of most difficult and important procedures, Cardio Pulmonary Resuscitation. That’s around the time legal barriers for telemedicine started kicking in. Legal barriers or rather laws around telemedicine got beefed up only recently also, this is when the actual online physician consultations or tele-radiology began. Tele-medicine or eHealth has for sure increased the access, adherence, and availability of healthcare services, but along with it raised many questions in the minds of healthcare providers, payers, enablers, and recipients. Is storing patient data electronically, ‘on the cloud’, as safe as it is perceived or projected to be? Are the online training or certifications for physicians the same as live or in person training? Are online physician consultations provided by qualified doctors? Is an online consultation equivalent to an in person visit to physician clinic? Does my insurance cover an online consultation? Can a physician practicing in a different country provide a tele-consult to a patient in a different country, without legal implications? Legal considerations remain as a major obstacle in successful implementation of tele-medicine across the globe....

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  • Researchers at the Technion–Israel Institute of Technology have developed a glue gun to put the human body back together when it has been seriously injured. The pins and stitches currently used to treat serious injuries come with drawbacks: They can be painful, they leave scars, they require high skill from the doctor, and they sometimes have to be removed after the tissues heal. Suture on the intestine, lungs or blood vessels often leak and therefore require a sealant. The medical glue that the researchers have developed is a “two in one,” said Prof. Boaz Mizrahi, head of the Biomaterials Laboratory of the Technion. It replaces both stitches and the sealant, and is good for both external and internal injuries, he said. All sorts of medical glues are already being used in dermatology, surgery, and other areas. Israeli startup Nanomedic Technologies Ltd., for example, has developed a medical device that it says can dress burns and other wounds with nano materials that mimic human tissue and peel off once the skin below is regenerated. Still, the glues currently in use to replace sutures and staples are limited by their mechanical properties and toxicity, the researchers said. Because they are very toxic, they can be utilized only on the surface of the skin. In addition, hardening of the glue may make the organ less flexible or the adhesion may not be sufficiently strong. With these limitations in mind, researchers have been on the hunt for a glue that is suitable for different tissues, nontoxic, and flexible after hardening. Such a glue would also need to decompose in the body after the tissue is fused together. Mizrahi worked together with doctoral student Alona Shagan and came up with what they say is a “very strong, nontoxic tissue adhesive that remains flexible even after solidification.” Their study...
  • Pinnacle Ventures has launched a pharmacogenomics programme to enable genetic testing to drive personalised prescribing decisions. The innovation arm of Pinnacle Midlands Health Network, a not-for-profit primary health care management company in New Zealand, is also working on embedding biomarker information into electronic health records and linking it to a clinical-decision support prescribing tool that can help prescribers by providing direct access to international pathways and guidelines. Pharmacogenetics involves prescriptions being tailored to a person’s genetic make-up, as people metabolise drugs in different ways, which can have a significant impact on a drug’s effectiveness. Ventures plans to do about 5,000 pharmacogenetic tests over the next 12 months, says chief executive John Macaskill-Smith. Some will be self-funded because individuals are struggling with their medications and others will be fully funded by Ventures, targeting specific groups within the Midlands population. Macaskill-Smith says it is a simple test that covers 65–70 per cent of medications frequently prescribed in New Zealand. “The New Zealand health system is under strain but using testing like this you could reduce the trial and error of prescribing and prevent adverse reactions to medications,” he said. Ethnicity plays a big part in how a person metabolises drugs, but the clinical trials that prescribing information are based on very rarely involve Māori or Pasifika test subjects. Macaskill-Smith said Ventures is partnering with key kiwi groups, Auckland University and Otago University medical schools and Callaghan Innovation to support research and develop a better understanding of how unique New Zealand populations respond to different medications. People who have a pharmacogenetic test can choose to consent to contributing their non-identifiable demographic information to researchers. Embedding the biomarker information into EHRs ensures a patient’s results are used for both current and future prescribing decisions, he said. Macaskill-Smith says a lot of direct-to-consumer online genetic-testing tools involve people...
  • Surgery students spend so much time on screens that they have lost the ability to perform simple tasks such as stitching and sewing up patients, a professor has warned. Roger Kneebone, a professor of surgical education at Imperial College, London, says the focus on academic knowledge has come at the expense of craftsmanship. “It is important and an increasingly urgent issue,” Kneebone told the BBC. “It is a concern of mine and my scientific colleagues that whereas in the past you could make the assumption that students would leave school able to do certain practical things – cutting things out, making things – that is no longer the case.” The professor, who teaches surgery to medical students, believes that this is down to an increase in technology which takes away the experience of handling materials and developing skills. ”An obvious example is of a surgeon needing some dexterity and skill in sewing or stitching,” he explained. ”A lot of things are reduced to swiping on a two-dimensional flat screen” Kneebone adds that a growing number of students are becoming “less competent and less confident” in using their hands, resulting in young professionals who “have very high exam grades but lack tactile general knowledge”. The professor will be speaking on Tuesday at the V&A Museum of Childhood in east London, at the launch of a report, published by the Edge Foundation, calling for more creativity in the curriculum. The report warns that entries to creative subjects have fallen by 20 per cent since 2010, including a 57 per cent fall in design and technology GCSE. Tristram Hunt, director of the Victoria and Albert Museum, who will be speaking alongside Professor Kneebone added: “Creativity is not just for artists. “Subjects like design and technology, music, art and drama are vitally important for...