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In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors' ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills' training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents. [ABSTRACT FROM AUTHOR]

Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. These applications represent some of the broad range of telemedicine applications possible. An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication. [ABSTRACT FROM AUTHOR]

Resources in medical education are not evenly distributed and access to education can be more problematic in rural areas. Similar to telemedicine's positive influence on health care access, advances in information and communications technologies (ICTs) increase opportunities for medical education. This paper provides a descriptive overview of the use of ICTs in medical education and suggests a conceptual model for reviewing ICT use in medical education, describes specific ICTs and educational interventions, and discusses opportunities and challenges of ICT use, especially in rural areas. The literature review included technology and medical education, 1996-2005. Using an educational model as a framework, the uses of ICTs in medical education are, very generally, to link learners, instructors, specific course materials and/or information resources in various ways. ICTs range from the simple (telephone, audio-conferencing) to the sophisticated (virtual environments, learning repositories) and can increase access to medical education and enhance learning and collaboration for learners at all levels and for institutions. While ICTs are being used and offer further potential for medical education enhancement, challenges exist, especially for rural areas. These are technological (e.g., overcoming barriers like cost, maintenance, access to telecommunications infrastructure), educational (using ICTs to best meet learners' educational priorities, integrating ICTs into educational programs) and social (sensitivity to remote needs, resources, cultures). Finally, there is need for more rigorous research to more clearly identify advantages and disadvantages of specific uses of ICTs in medical education. [ABSTRACT FROM AUTHOR]

Background: Readiness is an integral and preliminary step in the successful implementation of telehealth services into existing health systems within rural communities. Materials and Methods: This paper details and critiques published international peer-reviewed studies that have focused on assessing telehealth readiness for rural and remote health. Background specific to readiness and change theories is provided, followed by a critique of identified telehealth readiness models, including a commentary on their readiness assessment tools. Results: Four current readiness models resulted from the search process. The four models varied across settings, such as rural outpatient practices, hospice programs, rural communities, as well as government agencies, national associations, and organizations. All models provided frameworks for readiness tools. Two specifically provided a mechanism by which communities could be categorized by their level of telehealth readiness. Discussion: Common themes across models included: an appreciation of practice context, strong leadership, and a perceived need to improve practice. Broad dissemination of these telehealth readiness models and tools is necessary to promote awareness and assessment of readiness. This will significantly aid organizations to facilitate the implementation of telehealth. [ABSTRACT FROM AUTHOR]

The article focuses on the progress of the periodical "Journal of Postgraduate Medicine." The year 2004 was an eventful year for the journal. The Journal of Postgraduate Medicine (JPGM) started its golden jubilee celebrations with an international conference, the JPGM GoldCon, on medical writing, editing and publishing. A detailed discussion on the issue of open access was one of the hallmarks of the conference. JPGM has long been committed to the concept of allowing everyone free access to its contents and it can be considered as one of the pioneers in evolving and implementing this notion.

The author offers observation on significance of doing medicolegal work including autopsies in private medical colleges in India. Topics discussed include legal provision in Scotland about autopsy, example that Indian law is not against privatization of medicolegal services, and opportunities for private medical colleges to conduct autopsies and for the overall privatization of medicolegal work/autopsies.

Different definitions used for chronic obstructive pulmonary disease (COPD) preclude getting reliable prevalence estimates. Study objective was to find the prevalence of COPD as per standard Global Initiative for Chronic Obstructive Lung Disease definition, risk factors associated, and treatment seeking in adults >30 years.~Background~Background~Community-based cross-sectional study was conducted in Delhi, among 1200 adults, selected by systematic random sampling. Pretested questionnaire was used to interview all subjects and screen for symptoms of COPD. Postbronchodilator spirometry was done to confirm COPD.~Methodology~Methods~Adjusted odds ratio (aOR) was calculated by multivariable analysis to examine the association of risk factors with COPD. Receiver operating characteristic (ROC) curve was developed to assess predictability.~Statistical Analysis~Methods~The prevalence of COPD was 10.1% (95% confidence interval [CI] 8.5, 11.9%). Tobacco smoking was the strongest risk factor associated (aOR 9.48; 95% CI 4.22, 14.13) followed by environmental tobacco smoke (ETS), occupational exposure, age, and biomass fuel. Each pack-year of smoking increased 15% risk of COPD. Ex-smokers had 63% lesser risk compared to current smokers. Clinical allergy seems to preclude COPD (aOR 0.06; 95% CI 0.02, 0.37). ROC analysis showed 94.38% of the COPD variability can be assessed by this model (sensitivity 57.4%; positive predictive value 93.3%). Only 48% patients were on treatment. Treatment continuation was impeded by its cost.~Results~Results~COPD prevalence in the region of Delhi, India, is high, and our case-finding population study identified a high rate of patients who were not on any treatment. Our study adds to creating awareness on the importance of smoking cessation, early diagnosis of COPD, and the need for regular treatment.~Conclusion~Conclusions [ABSTRACT FROM AUTHOR]

The author discusses the impact of the internet on child mental health, education, and social communication in India. Topics discussed include the estimated number of internet subscribers in the country according to the Telecom Regulatory Authority of India, the definition of electronic media learning, and the establishment of interpersonal connection of adolescents with their peers, parents, siblings, and other adults outside the family unit.

The article discusses a study on ophthalmic abnormalities in children with dyslexia. Topics covered include cornerstone of treatment of dyslexia, two theories that have tried to explain the etiology of dyslexia, and percentage of dyslexic children who complain of eye strain and/or visual distortions while reading.

Background: Obsessive compulsive disorder (OCD) is a psychiatric disorder that often tends to run a chronic course. The lifetime prevalence of OCD is around 1-3%, which is twice as prevalent as schizophrenia and bipolar disorder. Aim: To asses the family burden, quality of life (QoL) and disability in patients suffering from at least moderately ill OCD and then to compare them with schizophrenia patients of comparable severity. Settings and Design: We recruited 70 consecutive subjects (OCD - 35, schizophrenia - 35) who met study criteria between March 2005 and March 2006 from the psychiatric services of the National Institute of Mental Health and Neuro Sciences, Bangalore, India. Materials and Methods: The severity of illness was rated using the Clinical Global Impression-Severity (CGI-S). Instruments used in the current study were the Family Burden Schedule, the World Health Organization (WHO) QoL (Bref) and the WHO - Disability Assessment Schedule (DAS). Statistical Analysis: The Fisher's exact test/chi-square test was used to compare categorical variables and the independent sample t test was used to analyze continuous variables. Analysis of covariance (ANCOVA) was used to compare the groups after controlling for potential confounding variables. Pearson's correlation was used for correlation analysis. Results: Overall family burden, financial burden and disruption of family routines were significantly higher in schizophrenia patients compared to OCD although the groups did not differ with respect to other domains of family burden. On the WHO QoL, OCD patients were comparable to schizophrenia patients with respect to the psychological and social domains. On the WHO - DAS, both the groups were similar in all the domains except getting around. Conclusion: Severe OCD is associated with significant disability, poor QoL and high family burden, often comparable to schizophrenia. Therefore, there is an urgent need to increase the sensitivity among healthcare professionals to recognize and treat OCD. [ABSTRACT FROM AUTHOR]

The current healthcare system is not designed to ensure better patient safety. In addition, healthcare is simultaneously becoming increasingly complex and increasingly fragmented. Medical knowledge and technology are expanding at an incredible rate, making it difficult for the healthcare providers to keep pace with advancing knowledge. Patients' needs are changing too: shifting from the diagnosis and treatment of a single, acute problem to the long-term management of multiple, interrelated chronic conditions. Our systems of care are not keeping up with these changes and, consequently, patients are experiencing unnecessary risk. Improving patient safety requires a transformation in how we currently care for patients. Healthcare organizations must adopt a new paradigm of care that holds patient safety as a core value and practice. To achieve this aim, healthcare organizations should build and maintain a culture of patient safety, provide leadership for patient safety that establishes a blame-free environment, proactively survey and monitor for adverse events, continually engineer patient safety into healthcare processes, and provide information and communication technologies to support patient safety. [ABSTRACT FROM AUTHOR]

The author discusses a research article on the health status of patients in India with hemophilia A, the use of health-care resources by them, and the cost of care. Topics covered include policy decisions in the country in absence of sufficient research evidence, methods of economic analyses in health care, and government expenditure of health at 1.15 percent of gross domestic product.

A response from the author of the article "Involvement of the family members in caring of patients in acute care setting" is presented.

A letter to the editor is presented in response to the article "Involvement of the family members in caring of patients in acute care setting" by Bhalla A, Suri V, Kaur P, and Kaur S.

The article focuses on medical errors. Medication errors that lead to iatrogenic injuries are a well-known worldwide phenomenon and are common, costly, and clinically important. Incidence rates of adverse drug events amongst adults admitted to hospitals have ranged from 2 to 7 per 100 admissions. Approximately, 28% of adverse drug events are related to medication errors and are, therefore, judged to be preventable. Over a period of time, there has been a transition from an era where medical practice and its practitioners were revered to a time when doubt and fear is expressed and legal suits are pursued by aggrieved patients.

The article presents information on the response of Mumbai, India-based King Edward VII Memorial Hospital and Seth GS Medical College to the victims of serial bomb blasts that took place in Mumbai's local trains on July 11, 2006. Considering the need to mobilize adequate manpower, most of the hospital staffs including doctors and medical students rushed to the emergency medical services complex to offer their services.

The article focuses on undergraduate research in the field of medical care. It has been generally observed, that due to the frequency and competitiveness of examinations, there is hardly any focus on undergraduate research and an ignorance about the possible avenues for it among Indian students. The main objective of "Journal of Postgraduate Medicine" is, thus, to make the common undergraduate aware of the basic skills in journal reading and clinical research, thus helping him or her to become a better clinician, well-aware of the rapidly changing trends in the field of medicine.