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Archive for March, 2016

Ottawa 2016 and ANZAHPE Conference

31 Mar, 16 | by Hemali Bedi

By Manasi Jiwrajka

The beautiful city of Perth on the Western Coast of Australia hosted the Ottawa 2016 and ANZAHPE conference this year. Delegates from the US, Canada, the UK, Netherlands, Indonesia, Hong Kong, China, South Africa, Australia and many other countries attended this conference. I downloaded the mobile app for this conference prior to my flight from Brisbane to Perth, and got a minute by minute update on the conferedited_IMG_20160322_144637ence.

There were several important medical education themes addressed during this conference from simulation in the context of medical education, OSCEs, peer tutoring, medical scientist, rural health program, global health, and empathy. My poster was titled ‘Why Should Students Write a Global Health Case Report?’, and I presented it to an eclectic audience that thanked me for my enthusiasm! Several educators approached me after the presentation for more information regarding their students writing case reports for the BMJ, and I reminded them of the elective competition that is due on April 30th.

Some of my favourite parts of the conference included (i) a talk on cultural competency, and including patients culture to provide individualised healthcare, (ii) the concept of ‘phenomics’, suggesting that a patient’s environment can affect their health prognosis, (iii) all the focus on feedback for students, (iv) how empathy levels can be altered following a reflection exercise, and is dependent on coping styles, (v) and acquiring loads of free pens!

I am looking forward to the next ANZAHPE conference in Adelaide next year.

Behaviour change: A bitter pill to swallow

29 Mar, 16 | by Hemali Bedi

By Kristian Dye

The case reported by Dunton et al comes from a very particular cultural context, and yet it demonstrates things that all practitioners see in almost all healthcare settings.

The patient reported is a 60 year old man with type 2 diabetes, who despite taking his medications, is unable to make the diabetes-592006_1920behaviour change that could impact the course of his disease.

The report looks at the complex nature of this phenomenon, that it is not as simplistic as ‘not wanting to change’, but that there are cultural and sociological issues at play.

The real question for clinicians across the globe for many long-term conditions is no longer how to treat them, but how to support patients to manage their own conditions.

What skills are most important for clinicians to facilitate the self-care that long-term conditions rely upon?

World Tuberculosis Day 2016

24 Mar, 16 | by Hemali Bedi

By Hemali Bedi

Tuberculosis (TB) is one of the world’s top global health challenges. [1] It is both ptb-poster-largereventable and curable, yet in 2014, 9.6 million people contracted TB and 1.5 million died from the disease. [1] Currently, over 95% of cases and deaths occur in developing countries. [2]

March 24th marks World TB Day, which aims to increase awareness of the global burden of TB and call for political and social support to tackle the disease. [3] Co-ordinated by the World Health Organization (WHO), this day commemorates Dr Robert Koch’s discovery of the TB bacillus bacteria in 1882. [3] This year, the campaigns focus is “Unite to End TB”. [4]

WHO recognise that tackling this complex disease requires a multifactorial approach – societal, social, economic and medical factors all need to be addressed. [1] This is outlined in WHO’s 2015 Global Tuberculosis Report, which takes an in depth look at the global strategy needed to combat the epidemic.

World TB Day calls for progress in these areas and highlights the need for collaboration across sectors and disciplines to address the medical and social causes of ill health. [4]

If you would like to know more about TB, visit BMJ Case Report’s collection of TB related cases or see our Global Health Collection.

References

[1] 2015 Global Tuberculosis Report. The World Health Organization. http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1 , published 2015

[2] Tuberculosis. The World Health Organization. http://www.who.int/mediacentre/factsheets/fs104/en/, published October 2015

[3] World TB Day. Stop TB Partnership. http://www.stoptb.org/events/world_tb_day/, accessed 21 March 2016

[4] World TB Day 2016: Unite to End TB. The World Health Organization. http://www.who.int/campaigns
/tb-day/2016/en/
, accessed 18 March 2016

An unfortunate injection

7 Mar, 16 | by Hemali Bedi

By Bhavik Shah

Foot drop” due to injured sciatic nerve because of a faulty technique of intramuscular injection is prevalent in developing countries. Some important Global Health issues related to this problem are discussed here.nurse-527622_1280

Indiscriminate use of injections

Oral medications are easier to administer and are equally effective in treating many conditions without causing pain or compromising skin barrier, yet the use of intramuscular injections has increased dramatically in the developing world. Some established facts leading to injection overuse include prescriber misconceptions regarding “strength” of injections, rapid onset of action and desire to meet patient expectations. [1] Such indiscriminate use of injections needs to stop.

Limited training in proper injection technique                 

The most common scenario for sciatic nerve injection injury occurs when the site of needle insertion is located more medial and/or inferior to the recommended site on the upper and outer quadrant of the buttock. [2] As such injuries are easily preventable, proper training to develop an anatomical understanding of the sciatic nerve is essential.

Inequality in access to quality healthcare    

Inadequate access to appropriate healthcare in vulnerable communities is a major constraint for the health of poor and marginalized groups in low and middle-income countries (LMICs). [3] Access to quality healthcare requires improvement in physical infrastructure, appropriate training for rural providers, and assistance to patients accessing care.

References:

  1. Comparison of pharmacokinetics and efficacy of oral and injectable medicine. (2015). [online] Available at: http://www.who.int/occupational_health/activities/5injvsora.pdf [Accessed 3 Sep. 2015].
  2. Kline DG, Kim D, Midha R, Harsh C, Tiel R. Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurg. 1998 Jul; 89(1):13–23.
  3. Haddad S, Narayana D, Mohindra K. Reducing inequalities in health and access to health care in a rural Indian community: An India-Canada collaborative action research project. BMC Int Health Hum Rights. 2011; 11 Suppl 2: S3.

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