mediknit

  • 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...
  • 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,...
  • Have you come across titles / abstracts from search results that sounded very promising, but when you read the article, the content did not match what you first saw? Or have you come across titles that did not mean anything, and there was no abstract? You obviously would not bother to trace and read that article – unless the author was your friend! In the days of information overload, if you want your paper to be read, it is important to frame the title and abstract so well that a) It is easily retrieved when one searches using relevant terms b) A reader would want to read the article, by reading the title and abstract The author of this article has highlighted the importance of writing clear titles and abstracts. And then has proceeded to list and describe the i) Importance ii) Types iii) Drafting iv) Checklists For both titles as well as abstracts A clear set of points makes it easy for any aspiring author to plan these steps right! Article Source: QMed
  • 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...
  • The rise of bacteria that are resistant to multiple drugs highlights the urgency of developing new antibiotics to combat lower extremity infection. Accordingly, this author explores the potential of new pharmacological agents such as tedizolid, oritavancin, dalbavancin and delafloxacin, and discusses other agents in the pipeline. Since the introduction of penicillin as the first true antibiotic in 1928, a plethora of antibiotics has become commercially available and has had a profound impact on life. Antibiotics are manufactured worldwide at an estimated scale of about 100,000 tons annually but the common use of antibiotics for farm animals, aquaculture and human therapy has led to increased strains of pathogens becoming antibiotic resistant.1 Some pathogens have become resistant to multiple antibiotics and pharmaceutical agents, leading to the phenomenon of multidrug resistance. An example of such phenomenon is methicillin-resistant Staphylococcus aureus (MRSA). In addition to being resistant to methicillin, MRSA is usually also resistant to aminoglycosides, macrolides, tetracycline, chloramphenicol, lincosamides and disinfectants.1 Multidrug resistance in bacteria occurs secondary to one of two mechanisms. One is by the accumulation of multiple resistant genes within a single bacterial cell. This accumulation generally occurs on resistance plasmids or transposons of genes with each coding for resistance to a specific drug agent.1,2 Another mechanism is by the increased expression of genes that code for multidrug efflux pumps that essentially have the ability to extrude more than one drug type out of the bacterial cell.1 Researchers reported the first case of MRSA in Great Britain in 1961 and in the U.S. in 1968.2Interestingly, vancomycin, an antibiotic that was first discovered in the 1950s but bypassed in favor of other antibiotics deemed equally or more efficacious and less toxic, was resurrected in the 1980s for the treatment of MRSA and pseudomembranous enterocolitis.3This dramatic resurgence led to a 100-fold increase in the use of...

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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...