Prevalence of Work-Related Thumb Pain in Physiotherapists

Background: Physiotherapy is associated with job tasks that are physically challenging and some of the routine procedures include manual therapy and soft tissue mobilizations which require higher levels of force and may be performed in hazardous or awkward postures. This study was done to find out the prevalence of work-related thumb pain amongst Physiotherapists and also to assess the awareness about the thumb pain and ergonomic strategies to reduce the same. Objectives: 1. To find the prevalence of Work-Related Thumb Pain (WRTP) in Physiotherapists 2. To assess the awareness of ergonomics related to WRTP in Physiotherapists 3. To find the coping strategies used by the Physiotherapists for WRTP Methods: 94 Physiotherapists from various setups in Pune city, with a basic qualification in B.P.Th. having a work experience of minimum 2 years and having minimum 20 hours of clinical duties per week and performing manual therapy techniques on patients were included in the study. Results: The overall prevalence came to 68.1%. 94.7% of the respondents were aware about the ergonomic strategies to prevent/reduce thumb pain and 5.3% were not aware about the same. Multiple coping strategies were used by the Physiotherapists, of which changing or modifying their treatment, modifying either the patient’s position or their position, asking to help handle a heavy patient were the most common ones. Conclusion: This study indicates that thumb problems are common in Physiotherapists. Key words: Physiotherapists, thumb pain, ergonomic strategies, coping strategies.

Hospital load and increased COVID-19 related mortality in Israel

The spread of Coronavirus disease 19 (COVID-19) has led to many healthcare systems being overwhelmed by the rapid emergence of new cases. Here, we study the ramifications of hospital load due to COVID-19 morbidity on in-hospital mortality of patients with COVID-19 by analyzing records of all 22,636 COVID-19 patients hospitalized in Israel from mid-July 2020 to mid-January 2021. We show that even under moderately heavy patient load (>500 countrywide hospitalized severely-ill patients; the Israeli Ministry of Health defined 800 severely-ill patients as the maximum capacity allowing adequate treatment), in-hospital mortality rate of patients with COVID-19 significantly increased compared to periods of lower patient load (250–500 severely-ill patients): 14-day mortality rates were 22.1% (Standard Error 3.1%) higher (mid-September to mid-October) and 27.2% (Standard Error 3.3%) higher (mid-December to mid-January). We further show this higher mortality rate cannot be attributed to changes in the patient population during periods of heavier load.

Hospital load and increased COVID-19 related mortality - a nationwide study in Israel

The spread of Coronavirus disease 19 (COVID-19) has led to many healthcare systems being overwhelmed by the rapid emergence of new cases within a short period of time. We explore the ramifications of hospital load due to COVID-19 morbidity on COVID-19 in-hospital patient mortality. We address this question with a nationwide study based on the records of all 22,636 COVID-19 patients hospitalized in Israel from mid-July 2020 to mid-January 2021. We show that even under moderately heavy patient load (>500 countrywide hospitalized severely-ill patients; the Israeli Ministry of Health defined 800 severely-ill patients as the maximum capacity allowing adequate treatment), in-hospital mortality rate of patients with COVID-19 significantly increased compared to periods of lower patient load (250-500 severely-ill patients): 14-day mortality rates were 22.1% (Standard Error 3.1%) higher (mid-September to mid-October) and 27.2% (Standard Error 3.3%) higher (mid-December to mid-January). We further show this higher mortality rate cannot be attributed to changes in the patient population during periods of heavier load.

Accountability: A magic bullet for emergency care delays and healthcare access blocks

Emergency care delays are one link in a chain of access blocks that permeate our healthcare system. Community patients blocked in hospitals, in-patients blocked in emergency departments, emergent patients blocked in ambulances. The root cause is failure to define, expect, or manage accountability. The easy response to a heavy patient surge is to block access. This protects programs from care demands that would otherwise mandate innovation, and displaces problems to leaders who cannot solve them—a recipe for perpetual dysfunction. Accountability is the evolutionary stressor required to drive system change. The key is a framework defining accountability zones and program expectations. This article focuses on emergency access block, but the proposed solution is relevant across the system.

Medical Research by the Medical Colleges in India

ABSTRACT Background: Research conducted in medical colleges in India is often considered to be of poor quality. The study was done to assess the cause for such occurrence. Materials and Methods: Papers published in indexed journals between 1985 to 2017 were reviewed and the data was synthesized. Results: Poor infrastructure, heavy patient load, restricted number of faculties who had limited exposure to research methodologies, private practice, lack of incentive to do good quality research, poor mentoring, lack of research tradition, research fund, ancillary infrastructures, and copy cat research were found to be some of the reasons. Discussions and Solutions: Teachers education, provision of better infrastructure and funding, short term fellowships at both undergraduate and postgraduate levels, proper assessment for promotion of teachers, training in research methodology, multicentric research, R & D research bases in medical colleges, looking for solutions for day-to-day challenges through operational and translational mode are some of the solutions. Training from undergraduate levels on elements of research needed to be encouraged.

Are Continuity Clinic Patients Less Satisfied When Residents Have a Heavy Inpatient Workload?

The purpose of this study was to assess the influence of resident nonclinic workload on the satisfaction of continuity clinic patients. Over a 2-month period in 2002, residents and patients were surveyed at the University of Kentucky internal medicine continuity clinic. Residents provided a self-report of their nonclinic workload as light or medium versus heavy or extremely heavy. Patient satisfaction was assessed with a 7-item, 10-point scale with items derived from commonly used patient satisfaction instruments. In 168 patient encounters, patients were significantly less satisfied with their clinic visit if they were seen by a resident who had a heavier workload. In addition, these patients gave significantly lower ratings with regard to the amount of time spent with the patient during the visit, and how well the resident listened and paid attention. Although alternative explanations exist, we propose that heavy hospital workload is associated with decreased patient satisfaction in resident continuity clinic.