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  • More than eight out of 10 teachers say mental health among pupils in England has deteriorated in the past two years – with rising reports of anxiety, self-harm and even cases of suicide – against a backdrop of inadequate support in schools. In a survey of 8,600 school leaders, teachers and support workers, 83% said they had witnessed an increase in the number of children in their care with poor mental health, rising to 90% among students in colleges. Many described a sense of helplessness in the face of the crisis. One said it was “like a slow-motion car crash for our young people that I am powerless to stop and can’t bear to watch or be part of any more” Others complained that real-terms funding cuts in schools were making it harder to support pupils in need, with fewer support staff available. “We are at a crisis point with mental health,” one respondent said. “Much more anxiety, self-harming. Three suicides in three years in my school alone,” said another. The survey of members of the National Education Union before their conference in Liverpool this week also asked about the support available in schools to pupils in distress. Fewer than half said their school had a counsellor, three out of 10 (30%) had been able to access external specialist support such as NHS child and adolescent mental health services (CAMHS), fewer than 30% had a school nurse and only 12% had a “mental health first aider”, as favoured by the government. More than a third of respondents (37%) had training in the past year to help with supporting young people with mental ill health, but there were complaints that it was often inadequate and ineffective. “Mental health first aid is a lip service,” said one. “Seven members of staff trained – nothing...
  • With the rising influence of tech companies such as Amazon and Google in almost every sphere of life, it may be no surprise that these major players are now venturing into the healthcare space. Emerging healthcare technologies 2019 Our world has become increasingly digitised and this has created the opportunity for electronic devices such as smart speakers to streamline patient experiences. Products currently used by tens of millions of US citizens include Amazon’s Alexa and Google Assistant. These devices have the potential to decrease the time spent manually updating patient records, allowing physicians to spend more time with their patients. Such technologies might also reduce the financial burden on healthcare systems by allowing patients to have certain medical questions answered, book appointments and receive reminders. With this market estimated at about $3.5 trillion the financial incentive for tech companies to enter the healthcare industry is significant. US Health Insurance Portability and Accountability Act Recently, Amazon announced it would allow developers to create HIPAA-compliant healthcare abilities for its electronic assistant, Alexa. These developers will have to comply with HIPAA (the US Health Insurance Portability and Accountability Act of 1996), which functions to ensure the protection of patient information. Programmes currently in development for Alexa will allow patients to access their medical records and check the results of certain medical tests. For instance, Livongo has created a programme for patients to access their blood sugar level readings by voice commands. Amazon has also launched its Comprehend Medical, a machine learning tool that gathers information on physician notes and patient health records. Other companies with electronic assistants, such as Google, have the potential to compete with Amazon in the healthcare sector but will need to catch up with Amazon’s HIPAA compliance if they want to stay competitive. According to the HIPAA Journal, Google...
  • 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...
  • 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...
  • 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...
  •   Professors David Armstrong and Charles Liu at first seemed to be an unlikely pair. But the podiatric surgeon and neurosurgeon clicked on a personal level and promptly realized they had a lot to offer each other as Keck School of Medicine of USC collaborators. Both were already studying how much information a person takes in through the nerves of the feet, how to preserve, repair or replace that information system, and how nerve damage can affect a patient’s mobility. Armstrong is interested in metabolic health, mobility and neuropathy — the loss of nerve sensitivity that can occur in patients with diabetes, Liu noted. “As a neurosurgeon, I’m interested in lower-extremity function and metabolic health, too,” he said. “In my work, I think about how to restore mobility to patients who can’t feel their legs. It’s a similar problem to diabetic foot ulcers.” Armstrong added: “We’re meeting in the middle, and it’s fun. It’s so common in medicine for people to silo, but you can’t let your ideas sit there alone. Whatever the other guy is doing will make your thing more interesting.” SMART INSOLE, SMART PHYSICIANS The two started looking for a project on which to collaborate. Oddly enough, they found it with a Canadian security company. The firm was working with the idea of capturing pressure signatures — the way weight is distributed across people’s feet as they walk — which are as distinctive as fingerprints. At the time, the company was working with technology that could signal if, for example, an unknown person walked into a secure room. The doctors soon saw that pressure signatures could be a way to spot changes in a person’s gait early on — a potential warning sign of a more serious problem. With their shared interest in wearable technology, Armstrong and Liu steered the company toward...
  • Antiretroviral therapy may soon be obsolete, as scientists have successfully used immune cells to kick the dormant form of HIV out of its hiding place and destroy it. The findings may soon lead to an HIV vaccine. According to recent estimates, around 1.1 million people in the United States have HIV. With the help of antiretroviral therapy, over half of these people now have a very low level of the virus. This means that they can no longer trasmit it to other people. Antiretroviral therapy can keep HIV in check so well that the virus is near-undetectable in the blood. However, HIV continues to “live” in latent form, so people with it must keep taking the medications to prevent it from flaring up. Antiretroviral therapy can have a host of side effects. These may include gastrointestinal problems, cardiovascular problems, insulin resistance, and bleeding events, as well as effects on bone density, liver health, and neurological and psychiatric health. So, the search for an HIV cure is ongoing. Now, new research may have found a way to “drag” the virus out of its hiding place and neutralize it. The findings may lead to a vaccine that would allow people living with HIV to stop taking antiretroviral medication every day. Senior study author Robbie Mailliard, Ph.D. — an assistant professor of infectious diseases and microbiology at the University of Pittsburgh Graduate School of Public Health in Pennsylvania — and colleagues have published their findings in the journal EBioMedicine. Using an entirely different virus to target HIV Mailliard explains the motivation for their study, saying, “A lot of scientists are trying to develop a cure for HIV, and it’s usually built around the ‘kick and kill’ concept — kick the virus out of hiding and then kill it.” He adds, “There are some promising therapies being developed for the...
  • MUMBAI: A prescription by a doctor without a diagnosis first would amount to culpable negligence, said the Bombay high court while rejecting a pre-arrest bail plea of two doctors accused of culpable homicide not amounting to murder for death of a woman patient five days after child-birth. “The time has come for weeding out careless and negligent persons in the medical profession,” said Justice Sadhana Jadhav, while rejecting the plea made by the gynaecologist couple Deepa and Sanjeev Pawaskar, from Ratnagiri. The HC, however, stayed its order, and consequently their arrest, till August 2 to enable them to appeal. “When a doctor fails in his duty, does it not tantamount to criminal negligence? The courts cannot ignore the ethical nature of the medical law by liberally extending legal protection to the medical professionals. The ethical issues raised by failure to assist a person in need arises from positive duties. According to this court, the breach of these duties could fall within the realm of a criminal law of negligence,” said Justice Jadhav. The couple had said it was a civil case where compensation could be paid to the patient’s family. Can compensation buy a child her mother and beloved wife for a husband, asked the Judge The woman had delivered at Pawaskars’ hospital on February 6. She was discharged three days later, with no check-up and in their absence, as the doctors were out of town for a conference. The woman was re-admitted a day later, unable to keep anything down. Her treatment was done through telephonic instructions by Dr Deepa Pawaskar to her staff and an embolism went undiagnosed and untreated till it was too late, observed the HC. She had to be rushed to another hospital in a pre-dawn emergency and died there within hours. The widower filed an FIR in March...

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  • More than eight out of 10 teachers say mental health among pupils in England has deteriorated in the past two years – with rising reports of anxiety, self-harm and even cases of suicide – against a backdrop of inadequate support in schools. In a survey of 8,600 school leaders, teachers and support workers, 83% said they had witnessed an increase in the number of children in their care with poor mental health, rising to 90% among students in colleges. Many described a sense of helplessness in the face of the crisis. One said it was “like a slow-motion car crash for our young people that I am powerless to stop and can’t bear to watch or be part of any more” Others complained that real-terms funding cuts in schools were making it harder to support pupils in need, with fewer support staff available. “We are at a crisis point with mental health,” one respondent said. “Much more anxiety, self-harming. Three suicides in three years in my school alone,” said another. The survey of members of the National Education Union before their conference in Liverpool this week also asked about the support available in schools to pupils in distress. Fewer than half said their school had a counsellor, three out of 10 (30%) had been able to access external specialist support such as NHS child and adolescent mental health services (CAMHS), fewer than 30% had a school nurse and only 12% had a “mental health first aider”, as favoured by the government. More than a third of respondents (37%) had training in the past year to help with supporting young people with mental ill health, but there were complaints that it was often inadequate and ineffective. “Mental health first aid is a lip service,” said one. “Seven members of staff trained – nothing...
  • With the rising influence of tech companies such as Amazon and Google in almost every sphere of life, it may be no surprise that these major players are now venturing into the healthcare space. Emerging healthcare technologies 2019 Our world has become increasingly digitised and this has created the opportunity for electronic devices such as smart speakers to streamline patient experiences. Products currently used by tens of millions of US citizens include Amazon’s Alexa and Google Assistant. These devices have the potential to decrease the time spent manually updating patient records, allowing physicians to spend more time with their patients. Such technologies might also reduce the financial burden on healthcare systems by allowing patients to have certain medical questions answered, book appointments and receive reminders. With this market estimated at about $3.5 trillion the financial incentive for tech companies to enter the healthcare industry is significant. US Health Insurance Portability and Accountability Act Recently, Amazon announced it would allow developers to create HIPAA-compliant healthcare abilities for its electronic assistant, Alexa. These developers will have to comply with HIPAA (the US Health Insurance Portability and Accountability Act of 1996), which functions to ensure the protection of patient information. Programmes currently in development for Alexa will allow patients to access their medical records and check the results of certain medical tests. For instance, Livongo has created a programme for patients to access their blood sugar level readings by voice commands. Amazon has also launched its Comprehend Medical, a machine learning tool that gathers information on physician notes and patient health records. Other companies with electronic assistants, such as Google, have the potential to compete with Amazon in the healthcare sector but will need to catch up with Amazon’s HIPAA compliance if they want to stay competitive. According to the HIPAA Journal, Google...
  • 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...