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Family medicine is the internationally recognized nomenclature for the academic discipline, knowledge domain, and medical specialty of primary care doctors, working in the community setting. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences in the community setting. The distinction of family medicine lies in the tradition of medical generalism, promoting whole person care, in a life cycle mode; providing optimal preventive, promotive, and curative healthcare services in a wide spectrum of setting from home to hospital. In 2016, 92nd report of the department‑related parliamentary standing committee on health and family welfare on the “Functioning of the Medical Council of India” has emphasized the need for postgraduate in family medicine. The committee report has noted that “the medical education system is designed in a way that the concept of family physicians has been ignored. The committee recommends that the Government of India in coordination with State Governments should establish robust PG Programs in Family Medicine and facilitate introduction of Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous healthcare for the individuals and families. The successive National Health Policies of Government of India–NHP 2002 and 2017 have emphasized the need of family medicine training in India. The recently enacted National Medical Commission Act 2019 has mandated NMC to promote training in family medicine at both undergraduate and postgraduate levels. Therefore, in the background of the stated policies of the Government of India the concept of family doctors, which was earlier neglected should be institutionalized within the mainstream medical education system of India. It is now time to accelerate and upgrade family medicine training and thereby strengthen the concept of comprehensive primary care in India. This white paper presents the review of family medicine training in India and proposes a way forward. [ABSTRACT FROM AUTHOR]

Urgent care practice (UCP) is a novel concept for India. Urgent care primarily deals with injuries or illnesses requiring immediate care. Medical emergency and urgency can happen anywhere unannounced. Research has shown that 90% of the morbidities can be resolved within the community by primary care physicians lead teams. Given the changing professional demands, non-specialists tend to refer away far too many cases to specialists, undermining generalist medical care, particularly in Indian settings. The spillover of the patient load from the primary care setting to the tertiary care centers is enormous leading to resource mismatch. Family physicians and other primary care providers are best positioned to develop practices and provide good quality urgent care to society. Family physicians, general practitioners, and medical officers are already functioning as the frontline care providers for any emergency or medical urgency arising within communities. Urgent care is essentially ambulatory care or outpatient care outside of a traditional hospital emergency room. "UCP aims to provide timely support, which is easily accessible with a focus on good clinical outcomes, e.g. survival, recovery, lack of adverse events, and complications. Core interventions of urgent care are centered on the 4Rs - Rescue, Resuscitate, Relate, and Refer. At present, there are no available, established training model for future faculty, residents, and medical students on "UCP" in India. [ABSTRACT FROM AUTHOR]

The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India. [ABSTRACT FROM AUTHOR]

Emergency medicine services and training in Emergency Medicine (EM) has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI) has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers' eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India) has been a powerful advocate for developing Academic EM in India. The ACEE's Education Development Committee (EDC) was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE) to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM. [ABSTRACT FROM AUTHOR]

It is encouraging to see the much needed shift in the understanding and recognition of the concept of "burden of disease" in the context of traumatic injury. Equally important is understanding that the impact of trauma burden rivals that of nontraumatic morbidities. Subsequently, this paradigm shift reinstates the appeal for timely interventions as the standard for management of traumatic emergencies. Emergency trauma care in India has been disorganized due to inadequate sensitivity toward patients affected by trauma as well as the haphazard, nonuniform acceptance of standardization as the norm. Some of the major hospitals across various regions in the country do have trauma care units, but even those lack protocols to ensure that all trauma cases are handled by those units, largely owing to lack of structured referral system. As a first step to reform the state of trauma care in the country, a detailed overview is needed to gain insight into the prevailing reality. The objectives of this paper are to thus weave a foundation based on the statistical and qualitative burden of trauma in the country; the available infrastructure of trauma care centers equipped to deal with trauma; the need and scope of standardized protocols for intervention; and most importantly, the application of these in shaping educational initiatives in advancing emergency trauma care in the country. [ABSTRACT FROM AUTHOR]

Focuses on multiprofessional education in the health profession. Increasing demands of an elderly population; Emergence of infectious and complex diseases such as HIV/AIDS; Advantages of collaborative learning; Barriers to implementing interprofessional and multiprofessional education, practice and research.

Introduction : The volume and quality of biomedical research publications from an institution are considered adequate indicators of the quality of medical care in that institute. King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia (KSA), is one of the oldest and most distinguished medical centers in the country. Methods: In this study, we analyzed the number of publications from the Critical Care Unit of the hospital in the past two decades, from 1996 to 2016. The research publications were evaluated on various parameters. Moreover, the impact of their study on global medicine was determined. Results: Our results indicate a steady progression in the number of publications from the institute in the past two decades. An average of 17.3 papers was published each year during this time. Out of the 283 publications from KAMC included in this study, the majority of the publications were original articles, 61 were review articles, 66 were multicenter trial studies and 28 were randomized control trials. The citation profile of the publications was good indicating global impact of the studies. Conclusion: The global impact of research as evaluated through published manuscripts in KAMC is overall good. This was deduced from both the increase in the number of publications each year and also the quality of papers as evidenced by the citation index of the papers published between 1996 and 2016. [ABSTRACT FROM AUTHOR]

Presents abstracts of selected papers published at the `Academic Medicine', `Medical Education', `Medical Teacher', and `Teaching and Learning in Medicine'. Includes `Evidence and Expertise: The Challenge of the Outcomes Movement to Medical Professionalism,' by Sandra J. Tanenbaum; `Evaluating Assessment: The Missing Link?' by S.L. Fowell, L.J. Southgate and J.G. Bligh.

The paper discusses how volunteerism, especially among nursing students, helps solve health crises. The study emphasizes community preparedness and volunteers' unique role in supporting healthcare professionals during crises. Volunteers seek out opportunities to help, unlike emergency responders. Nursing students, a major employment source, are shown to be capable of first aid and emotional support. The COVID-19 pandemic highlights the unprecedented need for volunteers. Research shows that nursing students worldwide are willing to help in health emergencies. Professional ethics, humanity, and learning motivate. Self-care issues, system support issues, and psychological impacts are obstacles. The study uses a mixed-methods technique and the PRISMA framework to examine nursing students' health crisis volunteering experiences, goals, and perceptions. The data show volunteer nursing students' pleasures and problems. Although volunteering is rewarding, worries about self-care, family well-being, and psychological effects arise. Emotional stress, burnout, compassion fatigue, anxiety, sleep difficulties, guilt, and a lack of support affect nursing students' mental health. Witnessing and experiencing health emergencies can cause emotional stress, highlighting the need for personalized solutions. The report recommends cash incentives, extensive training, and explicit protocols to increase student volunteering. Nursing students can safely volunteer in high-stress situations by recognizing and addressing the mental health risks and providing support and tools. The article recommends a holistic approach to volunteerism that recognizes its benefits and promotes the mental health and well-being of motivated nursing students. Nursing students helping in health emergencies need sufficient training, psychological support, and self-care to protect their mental health, according to the study. Providing support, shifting schedules, and understanding the emotional toll of employment are vital. Nursing schools should include emergency response training to prepare students for pandemic leadership. [ABSTRACT FROM AUTHOR]

The article presents several abstracts related to medical care including a case report regarding anaesthetic management, use of transcutaneous electrical nerve stimulation for labour analgesia, and complications related to post dural puncture headache (PDPH).

The electrocardiogram (ECG) is a fundamental tool in cardiology, providing invaluable insights into cardiac physiology and detecting various abnormalities. This review article presents a comprehensive overview of ECG interpretation, focusing on the procedure, application, and methodology. The placement of electrodes, ECG paper speed, and measurements of intervals and blocks are discussed in detail. The article emphasizes the importance of a systematic approach to ECG interpretation, highlighting six main sections: determination of heart rhythm, calculation of heart rate, assessment of intervals and blocks, analysis of atrial depolarization patterns, assessment of ventricular depolarization complexes, and delving into the intricate characteristics of ST segments and exploration of the electrocardiographic T-wave manifestations. Specific criteria for identifying abnormalities in each section are provided, along with their associated etiologies and clinical implications. Furthermore, the limitations of ECG as a diagnostic tool are acknowledged, emphasizing the need for clinical correlation and consideration of additional tests. The abstract encapsulates the breadth and depth of the review, conveying the relevance and the profound significance of ECG interpretation in the realm of clinical practice and scientific inquiry. [ABSTRACT FROM AUTHOR]

Background: Today, with the rapid growth of scientific production, research misconduct has become a worldwide problem. This article is intended to introduce the successful experience on the management of research paper misconducts in the field of health research. Methods: Our aim was to design and develop the strategy for research misconduct policy. Focusing on the national regulatory system, we developed a hierarchical model for paper misconduct policy in all the medical sciences universities and their affiliated research units. Results: Through our regulatory policy for paper misconduct management, specific protocol was followed in the field of health research publications through which the capabilities of covering the four main elements of prevention, investigation, punishment, and correction have come together. Conclusions: Considering the proposed strategy, regarding the strengths and weaknesses, utilization of evaluation tool can be one of the best strategies to achieving the prospective of health research papers by 2025. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID)-19 pandemic has ever since its outbreak been perplexing healthcare generally at all levels. There is a need to identify, analyze and address the bioethical dilemmas that have emerged during the pandemic. This paper presents a narrative review of the published literature on the ethical issues, frameworks, and guidelines in COVID-19-related healthcare and research. An electronic search was conducted on PubMed, Google Scholar, and Science Direct using the search terms "COVID- 19"[AND] ethical issues, clinical trials, resource allocation, ethical guidelines, vaccine allocation. Articles between 2019 and 2020 focusing on ethics were included and analyzed. Fifteen full-text articles in English, one workshop summary, and 5 guidelines were identified and are discussed under the following themes: global response to the pandemic, allocation of resources, conduct of clinical trials, and fair distribution of vaccines and individual patient care. Despite the global and collaborative response to guide the healthcare sector throughout the pandemic, there have been some worrying repercussions in the form of increased vulnerabilities, precarious imbalances in resources, priority settings, exclusion of individuals or groups, exhaustions of healthcare professionals, impaired individual patient care, slowing down of non-covid research as well as scientific, ethical and logistic challenges in COVID and non-COVID research. These can be ethically justifiable only considering the seriousness and urgency of the pandemic. This paper presents some tenacious challenges that must be addressed if ethical reflection is to be effectively implemented in response to this pandemic. [ABSTRACT FROM AUTHOR]

Medication errors (MEs) present a significant issue in health care area, as they pose a threat to patient safety and could occur at any stage of the medication use process. The objective of this systematic review was to review studies reporting the rates, prevalence, and/or incidence of various MEs in different health care clinical settings in Jordan. We searched PubMed, HINARI, Google, and SCOPUS for relevant published studies. We included observational, cross-sectional or cohort studies on MEs targeting adults in different health-care settings in Jordan. A total of 411 records were identified through searching different databases. Following the removal of duplicates, screening of title, abstract and full-text screening, 24 papers were included for the final review step. Prescribing errors was the most common error reported in the included studies, where it was reported in 15 studies. The prevalence of prescribing errors ranged from 0.1% to 96%. Two studies reported unintentional discrepancies and documentation errors as other types of MEs, where the prevalence of unintentional discrepancies ranged from 47% to 67.9%, and the prevalence of documentation errors ranged from 33.7% to 65%. In conclusion, a wide variation was found between the reviewed studies in the error prevalence rates. This variation may be due to the variation in the clinical settings, targeted populations, methodologies employed. There is an imperative need for addressing the issue of MEs and improving drug therapy practice among health-care professionals by introducing education and training. [ABSTRACT FROM AUTHOR]

Background: Truck drivers in India suffer from many lifestyle-related health problems. Providing primary health care services to truck drivers is essential to improve their overall health and well-being. This paper reports the findings of a community-based mobile medical unit program providing nonemergency and basic primary care services to truck drivers along the major highways of India. Piramal Swasthya Management and Research Institute launched this community-based mobile medical unit program, in partnership with Shriram Transport Finance Corporation Limited (STFCL). Materials and Methods: The paper describes the program model, its coverage, the sociodemographic profile, and common health morbidities of the truck drivers availing the program services. 2-year routine program data (April 2017 to March 2019) were accessed and analyzed. Results: A total of 1,167,210 number of unique truck drivers availed the program services during the reference period, of which 61,331 had complete data. The majority of truck drivers were male (99.1%) and just a few women (0.88%) and transgender (0.003%). The mean age was 45.5 years ± 10.91 and nearly half (49%) were in the productive age group (31-45 years). Noncommunicable and other chronic diseases (34.74%), musculoskeletal problems (24.17%), communicable diseases (14.52%), oral cavity-related problems (1.23%), and other minor ailments (17.77%) were the major consultation categories. Conclusion: Truck drivers in India have significant health morbidities. Providing primary health care services to truck drivers through mobile medical units is a step toward achieving universal health coverage. [ABSTRACT FROM AUTHOR]

Children are our future world and their healthy growth and development are critical for the well-being of any society. Children with special health-care needs (SHCN) have compromised oral health conditions as it may be directly or indirectly associated with their disabilities. There is an increased prevalence oQf gingival diseases and dental caries among children with SHCN due to poor oral hygiene, but the importance of dental care for these children has often been overlooked by health-care professionals. The more compromised their general health conditions, the more dental care needs they have. During earlier days, providing basic dental care was the prime concern, but in recent years, the dental profession has emphasized more on complete oral health care to the SHCN children. Pediatric dentistry is a specialized branch that provides primary, comprehensive, preventive, and therapeutic oral health care to children with SHCN. Children with SHCN may experience challenges in many ways, such as intellectual disability, physical disability, medical disability, and genetic disability. The paper addresses the dental management of intellectually challenged patients, including cerebral palsy, mental retardation, epilepsy, and autism, and also physically disabled children showing speech, vision, and hearing impairment. We should consider the unique qualities of each person and the need to ensure maximum health for all, regardless of their disabilities. [ABSTRACT FROM AUTHOR]

Aims: Dentistry and medicine have been treated as separate entities by healthcare professionals as well as the populace since a long time. Although dentistry as a standalone entity has achieved considerable progress, there is a significant inequity in the accessibility, affordability, and acceptability of dental care among various socioeconomic strata in the community. Moreover, it is becoming increasingly evident that oral diseases and systemic diseases often share multiple risk factors. Management of oral and systemic diseases as distinct units often results in duplication of care and wastage of resources. This paper gives information on the models of medical-dental integration and possible methods for integrating the same into Indian healthcare scenario. Materials and Methods: A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for articles pertaining to medical-dental integration. The data obtained were collated. Results: Literatures show that different modalities for medical-dental integration are in practice. However, there is a paucity in conceptual models that may be applied to bring about such an integration into the Indian healthcare system. Conclusion: Integration of medical and dental care would pave the way for equity in health care for everyone. Conceptual models for integrating oral disease surveillance into systemic disease have been proposed in this paper. [ABSTRACT FROM AUTHOR]

Referral is a dynamic process, in which a health worker at one level of the health system, having insufficient resources (drugs, equipment, skills) to manage a clinical condition, seeks the help of a better or differently resourced facility at the same or higher level to assist in. Health care systems of every country are designed in such a way to encourage patients to first attempt to get care at the primary level and then to approach a higher level of care according to the need. This protocol minimizes the costs for the caretaker/patients. However, in most of the countries, patients often bypass primary care facilities and directly go to the higher center thereby, increasing the burden on higher level facilities, the picture is not very different in India also. Health care system in India is plugged by: overpopulation, lack of expert clinicians, skewed distribution of physicians, lack of motivation among existing health care personnel and an ineffective referral mechanism. Due to failure of conventional paper-based referral systems in our country, we can introduce an e-referral system in the era of internet. It is evident from our experiences, that this artificial intelligence enabled e-referral system has many advantages over the traditional paper-based referral system. It will aid health workers for timely management of cases. Most importantly, it will streamline the existing unorganized referral process. Although, for effective e-Referral system, there should be a collaborative platform where easy search and discovery for health care providers is possible and help in decision making. e- Referral should be incorporated in our health system to strengthen it by bridging the access gap may be through Public Private Partnership model. [ABSTRACT FROM AUTHOR]

High burden of acute malnutrition among children less than 5 years is a major public health problem in India. A "Two-days National Consultation on Addressing Acute Malnutrition" was organized to gather experiences and evidence from 13 states of India on prevention and management of acute malnutrition among children and documenting viewpoints from experts and government counterparts on the same. The consultation centered around five key themes of addressing acute malnutrition: 1) capacity building, 2) strengthening screening, 3) nutritional care of wasting, 4) tracking progress, and 5) scale-up. The paper highlights the experiences and key recommendations around the above key themes. It emerged that there is a need to further accelerate the efforts toward strengthening existing platforms and services to address acute malnutrition among children. Regular trainings of the frontline workers, increased convergence, regular monitoring, and continued service delivery during the pandemic should be undertaken for better outcomes. [ABSTRACT FROM AUTHOR]

A paradigm shift in human evolution, from our predecessors, the 'hunter-gatherers' to the 'era of digital revolution', has made certain human skills more and more machine driven. This digital revolution has made possible a constant connectivity, wearable technologies, customized platforms, enormous data storage and cloud computing at high speeds, smart phones and apps, internet of things, artificial intelligence, telemedicine, etc. These have made real-time monitoring and interventions possible in healthcare. Most advanced countries have made electronic health records (EHR) mandatory. The Government of India has an agenda of Digital India and digital healthcare and might insist on EHRs. EHR is a real-time, patient-centered digital version of a patient's paper record/chart, available instantly and securely to authorized users. EHR contains a patient's medical history, diagnosis, medications, treatment plans, immunization dates, allergies, radiological images, and laboratory results. It can access evidence-based tools that help to make safer decisions about a patient's care with enhanced decision support, clinical alerts, reminders and medical information. The procedure is also more reliable for dispensing medications and introduces the convenience of e-prescriptions. While the advanced technology and digital devices are well received by the healthcare providers, universal acceptance of the EHRs is far from achieving its full potential. The author, in this paper, discusses the current scenario and issues concerned with EHRs in the digital healthcare. [ABSTRACT FROM AUTHOR]

Camps are a popular approach to deliver medical care in India. While it is usually a one-off event for physical ailments, it is a long-term affair in Psychiatry. One of the first camps in psychiatry was rolled out as early as in 1967 at Mandar, Ranchi, followed by Raipur Rani (Haryana) in 1976 and at Gunjur, Karnataka in 1977. This camp approach became extremely popular and got expanded across India as they were thought to be synonymous with community-based outreach for mental illnesses. In the past 5 years, however, newer models of community care have emerged, necessitating a relook at this traditional approach. In this paper, the authors trace the origin, utility and future directions of these camps, taking data from community psychiatry camps conducted by the National Institute of Mental Health and Neurosciences, Bengaluru, a premier neuropsychiatric tertiary care institute in India. Data have been collated from the annual reports of the Institute, database from the District Mental health Program, Government of Karnataka, India, and compared with published literature on the same field. While camps remain as one of the important avenues to reach the unreached, there is a need to change the approach of their functioning by incorporating training (primary care providers) aspects and collaborative care. The latter may make the initiative more meaningful and sustainable. [ABSTRACT FROM AUTHOR]

Introduction: Presently the leprosy program has no defined surveillance protocols for patients who complete the fixed duration multidrug therapy and are released from treatment (RFT). Hence, the information about the post‑RFT events in these patients is sparse and qualitative and quantitative data regarding their health care requirements is missing. During the DermLep survey carried out by the Indian Association of Dermatologists,Venereologists and Leprologists (IADVL), a number of patients presented to dermatologists during the post RFT period for a variety of symptoms. This paper analyses the events in these patients during the post RFT period. Results: Out of a total of 3701 leprosy patients who presented to 201 dermatologists across India during the DermLep survey, 708 (26.2%) were in the post RFT period (488 males; 220 females). Of these, 21% were PB and 79% MB patients as per their treatment records. Majority were in the age group of 31‑59 years (55.5%); however, a significant proportion of them (20.7%) were elderly (>60 years). Majority of the patients (45.5%) presented within the first year of RFT with variable symptoms; 28% were between 1‑5 years, 5.5% between 5‑10 years; and 11.0% presented more than 10 years after RFT. Most common presenting complaint being persistent skin lesions as perceived by patients in 21.2%, followed by neuritis in 14.5%; trophic ulcers in 13.8%; deformities in 67 (11.8%); lepra reactions in 66 (11.6%); and recurrence of original symptoms in 6.7%. Conclusion: The DermLep Survey highlights the importance of ‘post RFT’ patients as an important subset of leprosy patients who visit dermatologists for various health related issues. The most common complaints in this subset were active/persistent skin lesions, lepra reactions and neuritis. In these patients, who are a sub‑group of ‘persons affected with leprosy’ the disease related issues can persist for many years post RFT. Hence, it is important to provide services in the programme to monitor and manage these complications for the prevention of impairments, disability and the related social issues. [ABSTRACT FROM AUTHOR]

Introduction: Research is important in medical and dental sciences to improve healthcare. Faculties play an important role in research productivity and student motivation in research. Aim: The aim of this paper was to assess the attitude and experiences of dental post-graduate teachers toward article writing and reading and to discuss the barriers faced by them. Materials and Methods: A total of 150 dental post-graduate teachers from various Dental Colleges in South India participated as the study group. A questionnaire relating to publishing practices was distributed, and the results were analyzed. Result: Majority of the study group (82%) were involved in the publication with many (48.4%) doing so for career progression. Journal prestige was the main reason for selection of journals. Lack of time was the main reason for those not involved in the publication. Conclusion: This study revealed the positive attitude of teachers toward scientific reading and writing. They only require motivation and time [ABSTRACT FROM AUTHOR]

Although several animal and human studies have investigated the effect of alpha-lipoic acid (ALA) on blood pressure (BP), these findings are inconsistent. This systematic review of randomized clinical trials was conducted to summarize the evidence on the effect of ALA on BP. PubMed, SCOPUS, and Google Scholar databases were searched based on MESH term ("Thioctic acid" in combination with "Hypertension" and "Blood pressure") to identify related papers published up to December 2015. We summarized the results of the relevant studies in this review. In total, nine studies included in this review, seven parallel-designed trials and two crossover-designed trials. The results of parallel-designed studies are inconsistent. Five studies indicate no significant effects for ALA supplementation on BP, but two trials show effects on BP. Unlike parallel-designed trials, two crossover-designed trials have shown similar results and both report no effect for ALA on BP. Several studies investigated the effect of ALA on BP. Most of the papers show no significant effect for supplementation and the studies have shown that associations are limited. However, these findings are limited and there is a need for further and more accurate researches to be clarified. [ABSTRACT FROM AUTHOR]

Background: Regarding the importance of health care providers such as nurses who are always in stressful environments, it is imperative to better understand how they become more engaged in their work. The purpose of this paper is to focus on health care providers (nurses), and examine how the interaction between spiritual intelligence and psychological empowerment affect job engagement. Materials and Methods: This descriptive and quantitative study was conducted among nurses at the Faghihi Hospital in Shiraz, Iran in 2010. A sample of nurses (n = 179) completed standard survey questionnaire including spiritual intelligence, psychological empowerment, and job engagement which included 5 questions for each dimensions. For testing the hypotheses of the study, results were analyzed through structural equation modeling (SEM) using LISREL 8.8. Results: SEM revealed that psychological empowerment could fully mediate the relationship between spiritual intelligence and job engagement. However, the correlation between spiritual intelligence and job engagement was significant but weak using Pearson coefficient method. This can imply that psychological empowerment plays a crucial role in the relationship between spiritual intelligence and job engagement. Conclusions: This paper indicates that spiritual intelligence might affect different organizational parameters, directly or indirectly. Therefore, it is recommended that the researchers evaluate probable relationships between spiritual intelligence and other variables. [ABSTRACT FROM AUTHOR]

The stress that the COVID-19 pandemic has placed on health systems internationally has forced difficult decisions concerning the rationing of medical care and has put the bioethical structures that inform those choices under scrutiny. Often, ethical approaches to pandemic circumstances center around utilitarianism, dehumanizing the treatment process and ignoring the plurality of other philosophical doctrines that inform non-Western bioethics, which could be of use in addressing the pandemic. This paper focuses on philosophical Taoism, as developed in the Tao Te Ching and Zhuangzi, in order to suggest an alternative approach to medical care when medical capacity is limited, grounded in the concept of wu-wei, or inaction. [ABSTRACT FROM AUTHOR]

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out‑of‑pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID‑19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis. [ABSTRACT FROM AUTHOR]

Background: The rapidly changing economic stature and lifestyle choices of young individuals have affected healthcare in India. An increased prevalence of acute coronary syndrome (ACS) in young individuals has been observed. Aims and Objectives: The present cross-sectional, observational study was designed to record the clinical and angiographic profiles of young individuals (<40 years) with ACS. Materials and Methods: This cross-sectional, observational study was also designed to analyze the associations of lifestyle risk factors such as obesity, smoking, and alcohol on the occurrence of ACS and short-term (1 month) prognosis (rehospitalization and mortality). The inclusion criteria were age between 18 and 40 years with angina pectoris or equivalent at presentation and later diagnosed ACS per the consensus paper from the European Society of Cardiology/American College of Cardiology/American Heart Association/World Heart Federation joint task force. Patients with a previous history of ACS/coronary revascularization, atypical chest pain, valvular heart disease, hypertrophic cardiomyopathy, and/or congenital heart disease were excluded. Results: Out of the 403 patients that were screened, 162 young patients (18-40 years, mean ± standard deviation: 31.5 ± 4.64) were enrolled from a single tertiary cardiac care center located at Pune, Maharashtra, from May 2014 to May 2016. Most of the patient population were males (n [%]:151 [93.2]) of which 50% had positive addiction status for alcohol and smoking, family history of coronary artery disease (CAD) and a quarter of the patients had comorbidities of diabetes mellitus, hypertension, and/or abnormal lipid profile. The majority of the young ACS patients had ST-elevated myocardial infarction (STEMI: 87%), wherein anterior wall myocardial infarction was the most common electrocardiogram presentation, and primary angioplasty in myocardial infarction (PAMI) was the preferred modality of treatment in most of the young patients (61.7% vs. 38.3% thrombolysis). Conclusion: The prevalent angiographic profile of this study participants included obstructive CAD, single vessel disease, left ventricular ejection fraction (LVEF) <45, Angina Class IV, New York Heart Association (NYHA) class I, and Killip class I. Low LVEF, NYHA class IV, and Killip class IV showed association with short-term outcomes (mortality). The present study adds to the pool of information related to the western Indian population. However, a larger cohort study with a long-term follow is warranted to analyze the detailed ACS progression status in young individuals. [ABSTRACT FROM AUTHOR]

Background: The occurrence of workplace hazards, occupational diseases, and deaths contribute significantly to the increase in the global burden of diseases. The Municipal Solid Waste (MSW) workers experience occupational stressors throughout the process of waste management that affects their well-being and results in high rates of occupational health problems. It is vital to understand the workplace practices and occupational morbidities of the MSW workers to ensure their safety and well-being. In this context, the study aimed to explore the occupational health and safety practices at the place of work among the MSW workers in Karimnagar and Hyderabad in Telangana, India. Methodology: A cross-sectional study was conducted in two cities of Telangana. A total of 394 MSW workers were surveyed. The number of MSW workers in Karimnagar and Hyderabad were 152 and 194, respectively. A pre-tested questionnaire was administered to the MSW workers to study the occupational morbidities and workplace safety practices. Focused group discussions were conducted among the MSW workers in both cities. In-depth interviews of sanitary supervisors in Karimnagar were conducted. Semi-structured questionnaires and interview guides were used with questions on sociodemographic characteristics, health status, work environment, protection strategy, and healthcare utilization. MS Excel and NVivo-12 were used for data analysis. Results: Musculoskeletal problem was the major reported morbidity among the MSW workers (76.6%). Injuries were reported more among the MSW workers in Hyderabad (39.7%) along with a fear of being hit by vehicles while working on the main roads. About 88.7% of the MSW workers had less than secondary education. There was a wage difference between the contract and permanent MSW workers. There was a lack of provision of personal protective equipment and poor working conditions, overall. Lack of basic amenities such as the provision of drinking water and toilets apart from inadequate social security and healthcare facilities was reported. Conclusion: This paper highlights the unsatisfactory working environment and high-occupational morbidities among the MSW workers in Telangana. There was a lack of basic amenities at the workplace making it difficult for the MSW workers. A comprehensive approach which focuses on the health and safety with social security for the MSW workers is required. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Conditions that are amenable to surgery are found globally. However, surgery is not easily accessible for most people in low- and middle-income countries due to physical and financial barriers, among others. One-way of mitigating against this situation is through surgical outreach programmes.Patients and Methods: A paediatric surgical outreach in a teaching hospital in the Central Region of Ghana was carried out by a paediatric surgeon from Korle Bu Teaching Hospital. Data on the cases done from June 2011 to June 2014 were analysed.Results: A total of 185 patients had surgery during the study. There were 153 males with the mean age of 4.53 ± 3.67 years. Patients aged 1-5 years represented 51.9% of the patients. Twenty-four (13%) had major surgery and 161 (87%) had minor operations. The most common minor operation performed was inguinal herniotomy representing 47.2% of the cases. None of the patients had any complications.Conclusion: The need for paediatric surgical outreach programme has been shown in this paper as well as its cost-effectiveness. With the current rate of graduation of paediatric surgeons in Ghana, paediatric outreach programmes will be needed in Ghana in the foreseeable future. This outreach should be extended to other regions of the country to cover a larger percentage of children in Ghana. [ABSTRACT FROM AUTHOR]

Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals. Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines. Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home. [ABSTRACT FROM AUTHOR]

Introduction: Respectful maternity care (RMC) is not only the marker of quality maternity care but also ensures the protection of basic human rights of every child-bearing woman. This paper discusses the assessment of RMC services during the intrapartum period at public health care facilities in Gujarat state. Material and Methods: A cross-sectional research design was used for the study. The data were collected from three different levels of public health facilities such as primary health center (PHC), community health center (CHC), and district hospital (DH) in one of the districts in Gujarat. A standardized tool developed by the United States Agency for International Development based on the RMC charter was used for data collection. A total of 41 pregnant women across three public health facilities were observed during intrapartum care. Findings: Most women experienced disrespectful intrapartum care provided at the public health care facilities; however, at-least two performance standards of the RMC charter were met during intrapartum care at each public health care facility. Comparatively, the PHC demonstrated higher RMC performance compliance than DH and the CHC. Most often violations of RMC standards included beneficiaries were not greeted, privacy not maintained, they were not encouraged to ask questions, and support not provided during labor. Conclusion: Respectful maternity care is evidently not practiced in public health care facilities. Designing comprehensive behavioral training on RMC, especially for primary, secondary, and tertiary care physicians and nursing staff can improve the adaption of RMC standards in respective public health care facilities. Positive experiences of intrapartum care can potentially improve the uptake of maternal care facilities. Further research is needed to understand local contextual factors, social norms, and patient-provider interactions. [ABSTRACT FROM AUTHOR]

The first Mohalla or Community clinic was set up in July 2015 in Delhi, India. Four hundred and eighty such clinics were set up in Delhi, since then. This review was conducted to synthesize evidence on access, utilization, functioning, and performance of Mohalla clinics. A desk review of secondary data from published research papers and reports was conducted initially from February–May 2020 and updated in August 2020. Eleven studies were included in the final analysis. Studies have documented that more than half to two-third of beneficiaries at these clinics were women, elderly, poor, and with school education up to primary level. One-third to two-third of all beneficiaries had come to the government primary care facility for the first time. A majority who attended clinics lived within 10 min of walking distances. There was high rate of satisfaction (around 90%) with overall services, doctor–patient interaction time and the people were willing to return for future health needs. Most beneficiaries received consultations, medicines, and diagnostics at no cost. A few challenges such as dispensing of medicines for shorter duration, lack of awareness about the exact location of the clinics, and services available among target beneficiaries, and the incomplete records maintenance and reporting system at facilities were identified. Mohalla Clinics of Delhi ensured continuity of primary care and laboratory services during COVID-19 pandemic in 2020. In summary, Mohalla Clinics have made primary care accessible and affordable to under-served population (thus, addressed inequities) and brought attention of policy makers on strengthening and investing on health services. The external evaluations and assessments on the performance of these clinics, with robust methodology are needed. The services through these clinics should be expanded to deliver comprehensive package of primary healthcare with inclusion of preventive, promotive, community outreach, and other public health services. [ABSTRACT FROM AUTHOR]

Telemedicine and related e-health facilities facilitate care from a distance through electronic information systems. COVID-19 pandemic is establishing telemedicine in the health care delivery system of countries. Telehealth is contributing significantly in health care delivery during the COVID-19 crisis. For mild-to-moderate symptoms of COVID-19 or any illness, telehealth services might represent a better, efficient way to receive initial care and perform triaging. Telemedicine also has a significant role in screening for COVID-19 symptoms and delivering routine needs and follow-up care. The large-scale adoption of telemedicine in public health care delivery is still not visible in low- and middle-income countries like India. Adoption by patients and healthcare professionals is limited and their concerns need to be addressed to ensure its utilization in future of the care continuum. In the current paper, we aim to review recent measures of Telemedicine adopted during the course of pandemic and its impact on public health in lower-middle income countries like India. [ABSTRACT FROM AUTHOR]

The current paper is an attempt at highlighting important strategic indicators, as well as important variables, that the audiology community needs to consider in order to play a more central role in pharmaco-vigilance as part of pharmacoaudiology. Pharmaco-vigilance is an important aspect of pharmacological treatment of disease. In developing countries, where burden of disease is high with resource constraints dictating healthcare priorities; it is important to deliberate on risk/benefit of medications prescribed to treat disease. In the form of a literature review, the author presents current arguments with regards to audiology practice. In audiology, pharmaco-vigilance in the form of ototoxicity monitoring is gaining momentum within the South African research and clinical communities. This ototoxicity monitoring is however non-systematic, non-comprehensive, and does not seem to have a strategic plan behind it. This is fundamentally due to lack of involvement of audiologists in the risk/benefit evaluation of medications during the drug development and monitoring process. The current paper agues for an expanded role of the Audiologist which will ensure collaborative engagement with all relevant stakeholders in order to ensure that both quantity and quality of life are considered during the drug development and monitoring process. [ABSTRACT FROM AUTHOR]

Integrated health systems are deemed necessary for the attainment of universal health coverage, and the East, Central, and Southern Africa Health Community (ECSA-HC) recently passed a resolution to endorse the integration of eye health into the wider health system. This review presents the current state of integration of eye health systems in the region. Eight hundred and twelve articles between 1946 and 2020 were identified from four electronic databases that were searched. Article selection and data charting were done by two reviewers independently. Thirty articles met the eligibility criteria and were included in the narrative synthesis. Majority were observational studies (60%) and from Tanzania (43%). No explicit definition of integration was found. Eye health was prioritized at national level in some countries but failed to cascade to the lower levels. Eye health system integration was commonly viewed in terms of service delivery and was targeted at the primary level. Eye care data documentation was inadequate. Workforce integration efforts were focused on training general health-care cadres and communities to create a multidisciplinary team but with some concerns on quality of services. Government funding for eye care was limited. The findings show eye health system integration in the ECSA-HC region has been in progress for about four decades and is focused on the inclusion of eye health services into other health-care programs. Integration of comprehensive eye care into all the health system building blocks, particularly financial integration, needs to be given greater emphasis in the ECSA-HC. [ABSTRACT FROM AUTHOR]

Clinicians have traditionally ordered laboratory tests using paper-based orders and requisitions. However, paper orders are becoming increasingly incompatible with the complexities, challenges, and resource constraints of our modern healthcare systems and are being replaced by electronic order entry systems. Electronic systems that allow direct provider input of diagnostic testing or medication orders into a computer system are known as Computerized Provider Order Entry (CPOE) systems. Adoption of laboratory CPOE systems may offer institutions many benefits, including reduced test turnaround time, improved test utilization, and better adherence to practice guidelines. In this review, we outline the functionality of various CPOE implementations, review the reported benefits, and discuss strategies for using CPOE to improve the test ordering process. Further, we discuss barriers to the implementation of CPOE systems that have prevented their more widespread adoption. [ABSTRACT FROM AUTHOR]

Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures. At present with the better understanding of the safety precautions among the health care workers and general population the Government of India (GoI) has given clearance for functioning of eye care facilities. In order to facilitate smooth functioning of every clinic, in this paper, we prepared preferred practice pattern based on consensus discussions between leading ophthalmologists in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics. The guidelines include triage, use of personal protective equipment, precautions to be taken in the OPD and operating room as well for elective cataract screening and surgery. These guidelines have been prepared based on current situation but are expected to evolve over a period of time based on the ongoing pandemic and guidelines from GoI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has threatened the humanity at a global level to a large extent by the burden of the disease with significant mortality and to a certain extent as a byproduct of the necessary efforts to contain the same. There is a significant impact on the health care system, as we not only have to contain pandemic, but continue to treat our non-COVID-19 patients in a safe and responsible manner. Ophthalmology practice in general and glaucoma in particular needs certain modifications and additional precautions while examining as well as managing these patients keeping their and our safety in mind. As the lockdown relaxations are in vogue we need to learn how to deal with our regular patients as well in addition to emergency care. This paper presents the consensus-based guidelines by an expert panel on how to restart glaucoma practice during this COVID-19 time. These guidelines will be applicable across the country and should help ophthalmologists and glaucoma specialist to restart their practices while safeguarding the patients and their own selves from getting infected. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) disease has shaken the health-care system globally. It has become a global public health emergency for which scientists and physicians are trying to find an answer. This pandemic at present has no answer, as conventional medicine is trying to put their best foot forward by using hydrochloroquinone. Clinical trials are underway to find the efficacy of hydrochloroquinone or to develop any other possible immunization in COVID-19, which leaves us in an uncertain situation. Treating the existing condition remains a challenge in one side whilst containing the spread of this disease remains another challenge. Though nations across the globe have declared lock-downs to prevent community transmission, this is insufficient, looking at the magnitude of the disease. Host friendly interventions from traditional medicine focused on improving immunity and offering mental strength to cope with this pandemic are the need of the hour. Yoga and Naturopathy, a holistic system of medicine under the ministry of AYUSH operates by adapting the principle of salutogenesis can be easily integrated into the existing standard of care in prevention and management. This paper discusses about the possibility and necessity of integrating yoga and naturopathy interventions like fasting, diet therapy, hydrotherapy, sunbath, and yoga therapy based on its evidence in the management of COVID-19. [ABSTRACT FROM AUTHOR]

Background: The unfair distribution and delivery of health-care resources have been recognized as a problem in the worldwide. In the past 18 years, Turkey has undergone rapid social, cultural, and economic changes. The lifestyle and dietary habits of its people have also been changing, and the rates of diabetes, obesity, cancer, and other chronic diseases have increased dramatically over the past two decades. The health transformation program (HTP) has improved the Turkish health-care system since 2003. The main goal of HTP was to progress government, to provide equality between citizens, to give satisfaction to users and providers, and to subsidise the health-care system in Turkey. Aim: The aim of this study is to assess health-care services and health care quality delivery in the Republic of Turkey with special emphasis on governmental hospitals, university hospitals, primary healthcare centers (PHC) and to make comparison with low-, medium- and high-income countries. Methods: This is a retrospective, descriptive study. The ministry of health Annual Reports, websites of the Central Intelligence Agency (CIA), The World Fact Book, organization for economic cooperation and development report, Compendium of Health Statistics, the Google engine, and PubMed were searched for information about Turkey's health-care system and its history. Papers and websites in English were evaluated. There was no restriction on types of articles and sources. Results: Turkey has made outstanding reforms in health status in the last two decades, especially after the implementation of the HTP. The doctor's perception has more influence regarding consultation length and visit than the patient's. The results of consultations in volunteer practices in Istanbul showed that the mean and SD of the consultation length for the whole sample of 360 patients was 7.95 ± 4.38, (with range = 3-25 min). Consultation time has been affected by the patients' diseases, genders that women got longer consultation time, medical practices at the urban or rural areas, and ages which older patients required longer consultation time. The current study revealed that increasing doctor's workload leads to decrease the length of consultations. Moreover, average life expectancy reached 75.3 for men and 80.7 for women in 2015. The infant mortality rate decreased to 10.7/1000 live births in 2015, down from 117.5 in 1980. The leading causes of death are diseases of the circulatory system followed by cancer. Conclusions: The Turkish health system and health-care delivery have been improved over the last decade. Still far from perfect, there is a particular planning to increase medical workforce in PHC including well-trained staffs for a specific area. An urgent need is to acquire more accurate and reliable data from hospital and PHC centers in Turkey. Additional some attempts should be made to assess quality of healthcare in relation to services and process. [ABSTRACT FROM AUTHOR]

Background: A good quality sex life and interest in sex are positively associated with health in middle-aged and later life. For effective diagnosis of sexual health problems, an appropriate discussion about sexual health issues including a sexual history is advised. The sexual health care delivery and management during consultations by primary care physicians is relatively unexplored, especially for older patients. This paper aims to explore primary health care physicians' (PCPs) attitudes to sexual health care and management of middle-aged and older patients in Trinidad and Tobago. Methods: In-depth, semi-structured interviews were conducted with 35 PCPs in Trinidad and Tobago. Topics examined included physician-patient relations, sexual health care management challenges, communication and sexual history taking practices, and training needs of PCPs. The framework analysis method was adopted for analysis. Results: Most doctors stated that they were not comfortable with conducting a sexual history with their older patients, and they rarely discussed or initiated talking about sexual health with them. Barriers included time constraints, inappropriate environmental conditions for privacy, inadequate professional referral services, insufficient medical training in sexual function in middle and old age, reluctant patient behavior, conflicting personal beliefs on sexuality, and socio-cultural factors. Conclusion: PCPs may be reluctant to raise sexual health-related issues with their older patients, and these older patients may not initiate this discussion because of discomfort and embarrassment. Consequently, physicians' inability to effectively communicate with these patients could result in missed opportunities for interventions and patients' concerns may remain unheard and their sexual problems untreated. [ABSTRACT FROM AUTHOR]

Organized medicine is the academic guild of professional medical organizations in India. It was founded at the annual conference of Indian Academy of Pediatrics (PEDICON) on January 7, 2018. Organized medicine is constituted by leading professional medical organizations and mandated to support the sustainability of health agenda of the Government of India. A group of experts on behalf of Organized Medicine Academic Guild (OMAG) of India was constituted to facilitate adequate theories and models on how to make primary care integral to participation of people and intersectoral collaboration in equitable delivery of health care. A subtle, flexible, and comprehensive approach instead of a "compartmentalized existing in silos" approach is likely to be needed. This paper is a formal recommendation on behalf of OMAG with an aspiration to deliver to the people of India, what they need, focusing on discrete objectives with long-term plans. [ABSTRACT FROM AUTHOR]

Background: Current discourses on healthcare environments' design suggest that qualitative healthcare is directly linked with the state and quality of the environment, making reference not only to the physical but also to the ambient and social environments. These conclude that in giving qualitative care to patients, who are the primary targets of these facilities, it is advocated that the healthcare environments are consciously humanised. Background: Current discourses on healthcare environments' design suggest that qualitative healthcare is directly linked with the state and quality of the environment, making reference not only to the physical but also to the ambient and social environments. These conclude that in giving qualitative care to patients, who are the primary targets of these facilities, it is advocated that the healthcare environments are consciously humanised. Results: This review reveals that even though humanisation is crucial, as a driver for change in healthcare environments, its definition varies contextually. The paper further maintains that culture is central to whatever the definitions given to the concept of humanisation and attempts to initiate a discussion on the definition for 'Humanisation' in healthcare environments in Nigeria. It also emphasises the need for and the benefits of evidence-based designs in ensuring the design of well-humanised healthcare environments. In addition, the study finds that there is a dearth of the literature on healthcare environments' design in Nigeria. Conclusion: Currently, there are no commonly identifiable definitions for humanistic designs in healthcare environments in Nigeria. Recommendations are that more healthcare design research should be conducted to support these observations with empirical evidence and uncover how humanisation is defined in the country. [ABSTRACT FROM AUTHOR]

Adult obesity and overweight is affecting every region of the world and is described as one of today's most significant and neglected public health problems. The problem has taken the shape of an epidemic not only because the prevalence of obesity has witnessed a dramatic progress in a short period of time, but also because obesity has paved the way for increased risks for morbidity and mortality associated with it. It has been predicted that about half of the adult men and more than a quarter of adult women would be obese by 2030 in the UK and this figure could rise up to 50% in 2050 for whole of the adult UK population. Although a modest 5-10% weight loss maintained in the long term can significantly decrease health risk, few people engage in weight loss activities. Against this background, this review paper aims to investigate the reasons helping and/or hindering adults in the UK maintain weight loss in the long term; using online and organizational data sources and thematically analyzing the data. Self-body perception, enhanced self-confidence, social support, self-motivation, incentives and rewards, increased physical activity levels and healthy eating habits facilitated people in maintaining weight loss in the long term and overall quality of life. Extreme weather conditions, natural phenomena such as accidents, injuries and ill-health, work commitments, inability for time management and to resist the temptation for food constrained the successful long-term weight loss maintenance. [ABSTRACT FROM AUTHOR]

Health systems are adapting to the unique challenges posed by the COVID-19 pandemic. Social distancing has forced clinicians to provide their services through online platforms in high income countries. Similar trends have been noticed in Low and middle-income countries (LAMIC). Digital health can help LAMIC address traditional barriers to care by overcoming issues related to stigma, discrimination, staffing, and physical and geographical resource constraints. Mobile phone subscriptions exceed 80% of the population in many LAMICs. Mobile platforms represent a viable resource in overcoming the significant mental health gap in LAMIC. This paper discusses the enormous potential that digital health has to transform healthcare delivery in LAMICs, as well as numerous challenges to implementation. We also discuss the need to develop national digital health strategies and suggest solutions to some of the barriers. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced substantial changes in the practice of psychiatry, including that of electroconvulsive therapy (ECT). There is higher risk of transmission of the SARS-CoV-2 virus during ECT unless due care is taken. However, in many cases, ECT cannot be avoided. In this paper, we discuss various measures that may be adapted to reduce the risk of transmission of the virus during ECT. We also suggest certain modifications to the practice of ECT in order to achieve a balance between risks and benefits of the procedure during the pandemic. [ABSTRACT FROM AUTHOR]

The oral health delivery strategies are taking back seat in the universal health coverage scheme in India. This paper highlights the personal experience of a dental professional from India as an educator, motivator, and collaborator to nullify or minimize social policy challenges faced by medical health providers in the administrative cadre to strengthen the oral care delivery model in the health services department in Kerala state. The author has nevertheless persisted with positive educational, motivational, and collaborative approaches with medical health providers in the administrative cadre, general cadre, and specialty cadre in the health services department in Kerala state to change the current climate. [ABSTRACT FROM AUTHOR]