The COVID-19 Pandemic and the Effect on the Premedical Student

The COVID-19 pandemic has placed significant restrictions on premedical students trying to meet medical school entrance requirements. Has the pandemic served to inspire or deter pre-medical students from pursuing a career as a physician? To find out, we surveyed members of the Pre-medical Division of the American Medical Women’s Association (AMWA). Those respondents note that COVID-19 restricted clinical shadowing and research opportunities, delayed medical school applications, limited accessibility to academic resources, and in some cases, severely impacted mental health. Our findings show that premedical students are determined to become physicians and take on the challenge of providing care even under the demanding conditions of a pandemic.

Frequency of Atrial Arrhythmias in the Patients With Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) has been linked with various kind of cardiac arrhythmias. The risk of arrhythmias in patients with COPD has been driven by the stage and disease state, with a higher frequency of supraventricular tachycardia during exacerbations. Aim: To evaluate the frequency of atrial arrhythmias (which include atrial fibrillation, atrial flutter, and multifocal atrial tachycardia) in the patients who were suffering from COPD. Methods: It was a cross sectional analysis or prevalence study. This research was piloted in the Medicine Department, Medical Division IV, Services Hospital, Lahore. This research was ended in 365 days after endorsement of synopsis from 1st June, 2017 to 30th May 2018. Results: In our study, 111(46.25%) were in range 40-55 years of age while 129(53.75%) were in range 56-70 years of age, the calculated mean standard deviation was 56.23±8.19 years, 134(55.83%) were male and 106(44.17%) were females, 142(59.17%) between 1-2 years and 98(40.83%) had >2 years of duration. Frequency of atrial arrhythmias in the patients who were suffering from COPD was recorded as 22(9.17%) having Atrial Fibrillation, 53(22.08%) had Atrial flutter and 31(12.92%) had Multifocal atrial tachycardia. Conclusion: Atrial arrhythmias are common findings in patients with COPD. So, it is very important for treating physicians that every patient having COPD, should undergo Electrocardiogram (ECG) for picking up the atrial arrhythmias. Keywords: Chronic obstructive pulmonary disease, atrial arrhythmias, frequency

Developing a Workplace-Based Learning Culture in the NHS: Aspirations and Challenges

Background: The delivery of patient care in the United Kingdom is under increasing financial pressure. The need to continuously improve service delivery while making financial savings is challenging. Alongside this, National Health Service (NHS) Trusts must provide a suitable educational environment that meets the needs of all learners while meeting performance standards and targets set by external regulating authorities. This research addresses the gap in literature concerning educational culture in the NHS. Methods: This case study examines the delivery of postgraduate medical education in the workplace. Semi-structured interviews were conducted with 6 lead educators in the Medical Division of a North West NHS Trust to glean their insights into what works and what needs to change. Results: A thematic analysis of the transcripts revealed a number of factors that facilitated and hindered educational opportunities for doctors in training, including the role of leadership, the demands of external regulatory authorities, and the pressures on frontline staff to deliver safe, personal, and effective care. Conclusion: Opportunities for developing a collaborative approach between educational and clinical leaders and the individuals delivering education in the workplace to enhance the educational environment are discussed. Finally, an evaluatory toolkit based on the themes emerging from the data is proposed, as a resource for other health care organisations to help improve the delivery of workplace-based medical education.

Shared leadership in a medical division of an academic hospital

Purpose The purpose of this paper is to describe a successful model of shared medical leadership within an academic division of an urban children’s hospital. Design/methodology/approach Experience and outcomes were tracked over a three-year period during which two physicians shared the role of interim division chief of pediatric endocrinology and diabetes, resulting in a working model of shared leadership. Findings An evolutionary trajectory occurred over three years in which the strengths of the leaders were combined to optimize decision making in a complex medical division. Improvements in team satisfaction and additional positive outcomes were achieved. Practical implications Benefits of and challenges tackled by the strategic approach to shared leadership are identified to inform other medical institutions, particularly those with many team members or combined programs that include strong clinical and research components. Originality/value Little has been written within medical literature regarding shared leadership. The shared leadership model described in this paper can be implemented by others in a complex academic setting and will hopefully lead to more robust divisions.

Assessing Vitamins, Minerals and Supplements Marketed to Children in Canada

Given the growth of supplements specifically designed for children in Canada, this study examines the nutrient levels of these products, and evaluates them in light of the US Health and Medical Division (HMD)—formerly the Institute of Medicine—and Health Canada’s recommendations. Content analysis was used to document the nutrient levels of child-targeted vitamins, minerals and fish oils/omega-3s (n = 80) in Calgary, Alberta, Canada. Products were assessed according to HMD and Health Canada dosage recommendations for children, and the percentage of Estimate Average Requirements (EAR), Adequate Intakes (AI), and Tolerable Upper Intakes Level (UL) calculated. Median EAR/AI/UL percentages and quartiles were calculated for each nutrient, and estimates for the adequate intake recommendations plotted with box plots. Sixty five percent of the products assessed were multivitamins; the median dose was higher than AI recommendations for vitamins A, B6, B12, and C, as well as thiamin, riboflavin, pantothenic acid, and biotin. Substantial variation in vitamin, mineral, or fish oil dosage was found between similar supplements—with nutrients such as vitamin B12 ranging from 83% to 5557% of AI. Such findings matter because the very existence of these products suggests that children should be taking them, yet more research is needed on their potential (adverse) effects over both the short and long term. The substantial variation in dosages between products also raises questions about the (perhaps unnecessary) fortification of our children, as well as the expectations that parents know—or are even aware of—appropriate nutrient levels for their kids.

Detection of Bone Fracture using Canny Edge Detection Techniques

The Image processing is most valuable aspect in medical services in now days. This technique is used in many other fields like bone fracture, cancer, detection nodules similarly many sun disciplines in medical division. The techniques of picture handling, for example, picture improvement, picture division and highlight extraction are utilized for crack recognition system. This paper utilizes Canny edge discovery strategy for segmentation. Canny strategy produces ideal data from the bone picture. The fundamental point of this exploration is to identify human lower leg bone crack from X-Ray pictures. The proposed framework has three stages, to be specific, preprocessing, division, and break identification. In highlight extraction step, this paper utilizes Hough change system for line identification in the picture. Highlight extraction is the primary errand of the framework. The outcomes from different investigations demonstrate that the proposed framework is extremely precise and proficient.

Ebola virus disease: Case management in the Institute of Infectious Diseases, University Hospital of Sassari, Sardinia, Italy

Since the onset of the worst epidemic of Ebola virus disease in December 2013, 28,637 cases were reported as confirmed, probable, or suspected. Since the week of 3 January 2016, no more cases have been reported. The total number of deaths have amounted to 11,315 (39.5%). In developed countries, seven cases have been diagnosed: four in the United States, one in Spain, one in the United Kingdom, and one in Italy. On 20 July 2015, Italy was declared Ebola-free. On 9 May 2015, an Italian health worker came back to Italy after a long stay in Sierra Leone working for a non-governmental organization. Forty-eight hours after his arrival, he noticed headache, weakness, muscle pains, and slight fever. The following day, he was safely transported to the Infectious Diseases Unit of University Hospital of Sassari. The patient was hospitalized for 19 hours until an Italian Air Force medical division transferred him to Rome, to the Lazzaro Spallanzani Institute. Nineteen people who had contacts with the patient were monitored daily for 21 days by the Public Health Office of Sassari and none presented any symptoms. So far, neither vaccine nor treatment is available to be proposed on an international scale. Ebola is considered a re-emerging infectious disease which, unlike in the past, has been a worldwide emergency. This case study aimed to establish a discussion about the operative and logistic difficulties to be faced and about the discrepancy arising when protocols clash with the reality of facts.

The Royal Naval Medical Services: delivering medical operational capability. The ‘black art’ of Medical Operational Planning

This article looks to dispel the mysteries of the ‘black art’ of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.