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Step 7 - Ten Steps to Successful Breastfeeding

Every facility providing maternity services and care for newborn infants should: Practice rooming-in - allow mothers and infants to remain together - 24 hours a day. Mothers with normal babies (including those born by caesarean section) should stay with them in the same room day and night, except for periods of up to an hour for hospital procedures, from the time they come to their room after delivery (or from when they were able to respond to their babies in the case of caesareans). It should start no later than one hour after normal vaginal deliveries. Normal postpartum mothers should have their babies with them or in cots by their bedside unless separation is indicated. The seventh step about rooming--in is very important. Unless medically indicated, the baby remains with the mother 24 hours a day. Unless the mother is heavily sedated, she keeps the baby next to her in her bed. More inf http://tensteps.org/step-7-successful-breastfeeding.shtml --.-- Ten Steps to Successful Breastfeeding - Video Series Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk. If the vast majority of babies were exclusively fed breastmilk in their first six months of life -- meaning only breastmilk and no other liquids or solids, not even water -- it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. This video series aims to raise awareness, encourage early adoption, promote training of health care staff, and build capacity for, and to stimulate dialogue about, breastfeeding and its impact on the public, in a range of community and public contexts in low- and middle-income countries. Our goal is to have these ten steps in every facility providing maternal services and care for newborn infants. Videos, presentations, research, evidence, papers, training and counselling materials, tools, and many other related and supporting resources are available. Visit us on-line a http://tensteps.org .  
Nand Wadhwani
about 11 years ago
Www.bmj
1
33

Some progress and some missed targets in the TB epidemic

There is promise of new treatments for tuberculosis (TB), although some goals set by the World Health Organization for 2015 are likely to be missed, said Jennifer Philips of New York University Langone Medical Center in remarks made at a TB day symposium on 24 March at the New York Academy of Sciences.  
bmj.com
over 7 years ago
Www.bmj
1
39

Some progress and some missed targets in the TB epidemic

There is promise of new treatments for tuberculosis (TB), although some goals set by the World Health Organization for 2015 are likely to be missed, said Jennifer Philips of New York University Langone Medical Center in remarks made at a TB day symposium on 24 March at the New York Academy of Sciences.  
bmj.com
over 7 years ago
Preview
1
19

CDIS 2014: Can the UK gain a competitive edge in BioTech? Role, goals, and challenges of NOCRI

Stream CDIS 2014: Can the UK gain a competitive edge in BioTech? Role, goals, and challenges of NOCRI by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 7 years ago
Preview
1
18

CDIS 2014: Can the UK gain a competitive edge in BioTech? Role, goals, and challenges of NOCRI

Stream CDIS 2014: Can the UK gain a competitive edge in BioTech? Role, goals, and challenges of NOCRI by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 7 years ago
Preview
1
31

Marketing Strategy - Marketing Strategies That Drive Go-to-Market Plans - Four Quadrant

The convergence of the appropriate brand, market, product and distribution strategies form the basis of how to support the goals and objectives of the organization.  
Four Quadrant
over 7 years ago
Www.bmj
1
27

Do the solutions for global health lie in healthcare?

Jocalyn Clark argues that the medicalisation of global health, like other aspects of human life and health, produces a narrow view of global health problems and will limit the success of solutions proposed to replace the millennium development goals  
bmj.com
over 7 years ago
Www.bmj
1
42

Obamacare: what the Affordable Care Act means for patients and physicians

The Affordable Care Act’s core achievement is to make all Americans insurable, by requiring insurers to accept all applicants at rates based on population averages regardless of health status. The act also increases coverage by allowing states to expand Medicaid (the social healthcare program for families and people with low income and resources) to cover everyone near the poverty line, and by subsidizing private insurance for people who are not poor but who do not have workplace coverage. The act allows most people to keep the same kind of insurance that they currently have, and it does not change how private insurance pays physicians and hospitals. Although the act falls short of achieving truly universal coverage, nine million uninsured people have received coverage so far. Market reforms have not hurt the insurance industry’s profitability, prices for individual insurance have been lower than expected, and government costs so far have been less than initially projected. The act expands several ongoing pilot programs in Medicare that reform how doctors and hospitals are paid, but it does not directly change how private insurers pay healthcare providers. Nevertheless, it has set into motion market dynamics that are affecting medical practice, such as limiting insurance networks to fewer providers and requiring patients to pay for more treatment costs out of pocket. In response, many hospitals and physicians are forming closer and larger affiliations. Further time and study are needed to learn whether these evolutionary changes will achieve their goals without harming the doctor-patient relationship.  
bmj.com
about 7 years ago
Www.bmj
1
27

Global health agenda on non-communicable diseases: has WHO set a smart goal for physical activity?

Philipe de Souto Barreto argues that, to reduce premature mortality, policies should focus on getting fully inactive people to do a little physical activity rather than strive for the entire population to meet current physical activity recommendations  
bmj.com
almost 7 years ago
Preview
1
43

Initial management of Parkinson’s disease

Parkinson’s disease is one of the most common neurodegenerative disorders seen in the United States and United Kingdom. The disease is characterised by two processes—cellular degeneration and the resulting biochemical deficiency of dopamine. Although these processes are inter-related, they are approached separately in the clinical setting. Currently, no proven neuroprotective or disease modifying treatment is available for Parkinson’s disease. Several agents can be used to treat the motor symptoms associated with dopamine deficiency, and it is important to choose wisely when starting treatment. Drugs can have mild, moderate, or high potency, and the patient’s goals, comorbidities, and the short and long term implications of choosing a specific agent should be taken into account when selecting the appropriate agent. Non-motor symptoms, such as depression, fatigue, and disorders of sleep and wakefulness, also need to be evaluated and treated. Research is under way to deliver dopaminergic therapy more effectively, but studies aimed at slowing or stopping disease progression have not shown promise.  
bmj.com
almost 7 years ago
Www.bmj
1
32

Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity

Polypharmacy, defined as the chronic co-prescription of several drugs, is often the consequence of the application of disease specific guidelines, targeting disease specific goals, to patients with multiple chronic diseases. One common consequence of polypharmacy is the high rate of adverse drug reactions, mainly from drug-drug interactions (the ability of a drug to modify the action or effect of another drug administered successively or simultaneously).1 The risk of a drug-drug interaction in any particular patient increases with the number of co-existing diseases and the number of drugs prescribed.2  
bmj.com
almost 7 years ago
Www.bmj
1
23

Guidelines, polypharmacy, and drug-drug interactions in patients with multimorbidity

Polypharmacy, defined as the chronic co-prescription of several drugs, is often the consequence of the application of disease specific guidelines, targeting disease specific goals, to patients with multiple chronic diseases. One common consequence of polypharmacy is the high rate of adverse drug reactions, mainly from drug-drug interactions (the ability of a drug to modify the action or effect of another drug administered successively or simultaneously).1 The risk of a drug-drug interaction in any particular patient increases with the number of co-existing diseases and the number of drugs prescribed.2  
bmj.com
almost 7 years ago
Www.bmj
1
17

Early diagnosis and treatment: the goal of hepatitis C screening

Koretz and colleagues correctly highlight the need for robust evidence for hepatitis C screening, but a few points warrant a more balanced discussion.1  
bmj.com
almost 7 years ago
Www.bmj
1
25

Early diagnosis and treatment: the goal of hepatitis C screening

Koretz and colleagues correctly highlight the need for robust evidence for hepatitis C screening, but a few points warrant a more balanced discussion.1  
bmj.com
almost 7 years ago
Preview
1
18

The Millennium Development Goals: 15 years in

Stream The Millennium Development Goals: 15 years in by BMJ talk medicine from desktop or your mobile device  
SoundCloud
almost 7 years ago
Foo20151013 2023 thqdyy?1444774274
1
195

Why we need to work to maintain a social life - A Darwinian Medical Training Programme

Book of the week (BotW) = The Darwin Economy by Prof Frank Being a medical student and wanna-be-surgeon, I am naturally very competitive. I know exactly where I want to end up in life. I want to be a surgeon at a major unit doing research, teaching and management, as well as many other things. To reach this goal in a rational way I, and many others like me, need to look at what is required and make sure that we tick the boxes. We must also out-compete every other budding surgeon with a similar interest. Medicine is also a dog-eat-dog world when it comes to getting the job you want. Luckily you can head off into almost any field you find interesting, as long as you have the points on your CV to get access to the training. In recent years, the number of med students has increased, but so has the competition for places. The number of FY1 jobs has increased but so has the competition for good rotations. The number of consultant posts has increased, but so has the competition for the jobs. To even be considered for an interview for a consultant surgeon post these days a candidate (hopefully my future self) will have to demonstrate an excellent knowledge of anatomy, physiology, pathology and demography. They will need to have competent surgical skills and have completed all of the hours and numbers of procedures. To further demonstrate this they will need to have gone on extra-curricular courses and fellowships. They will also need to show that they can teach and have been doing so regularly. They must now also have an understanding of medical leadership and have a portfolio of projects. Finally, they will have had to tick the research box, with posters, publications, oral presentations and research degrees. That’s a long list of tick boxes and guess what? It has been getting longer! I regularly attend a surgical research collaborative meeting in Birmingham. Many of those surgeons didn’t even get taught about research at medical school or publish anything until they were registrars. Now even to get onto a good Core Training post you need to have at the very least some posters in your chosen field and probably a minimum of a publication. That’s a pretty big jump in standards in just 15 years. In two generations the competition has increased exponentially. Why is that? Prof Frank explains economic competition in Darwinian terms. His insights apply equally well to the medical training programme. It’s all about your relative performance compared to your peers and the continual arms race for the best resources (training posts). However, the catch is, if everyone ups their performance by the same amount then you all work harder for no more advantage for anyone, except for the first few people who made the upgrade. The majority do not benefit but are in fact harmed by this continual arms race. I believe that this competition will only get worse as each new year of med students tries to keep up and surpass the previous cohort. This competition will inevitably lead to a greater time commitment from the students with no potential gain. Everything we do is relative to everyone else. If we up our game, we will outperform the competition, until they catch up with us and then relatively we are no better off but are working harder. Why is this relevant? I know everyone will want to select “the best” candidate, but in medicine the “best” candidate doesn’t really exist because we are all almost equally capable of doing the role, once we have had the training. So there is no point us all working ourselves into the ground for a future job, if all our hard work won’t pay off for most of us anyway. But we can’t make these choices as individuals because if one of us says that “I am not going to play the game. I am going to enjoy my free time with my friends and family”, that person won’t get the competitive job because everyone else will out-perform them. We have to tackle this issue as a cohort. How do we ensure that we don’t work ourselves into the ground for nothing? Collectively as medical students and trainees we should ask the BMA and Royal Collages to set out a strict application process that means once candidates have met the minimum requirements, there is no more points for additional effort. For instance, the application form for a surgical consultant post should only have space to include 5 peer-reviewed publications. That way it wouldn’t necessarily matter if you had 5 or 50 publications. This limit may seem counter-intuitive and will possibly work against the highly competitive high achievers, but it will have a positive effect on everyone else’s life. Imagine if you only had to write 5 papers in your career to guarantee a chance at a job, instead of having to write 25. All that extra time you would have had to invest in extra-curricular research can now be used more productively by you to achieve other life goals, like more time with your family or more patient contact or even more time in theatre perfecting your skills. If you were selecting candidates for senior clinicians, would you rather pick an all round doctor who has met all of the requirements and has a balanced work-life balance or a neurotic competitor who hasn’t slept in 8 years and is close to a breakdown? Being a doctor is more than a profession, it is a life-style choice but we should try to prevent it becoming our entire lives.  
jacob matthews
over 7 years ago
Preview
1
26

Textbook of Post-ICU Medicine

Surviving critical illness is not always the happy ending that we imagine for patients. Intensive care unit (ICU) teams have traditionally focused on short term goals such as stabilizing or reversing organ system dysfunction, with little understanding of what became of patients once they left the ICU. However, research conducted in recent years has demonstrated that many ICU survivors can suffer from ill health and mental health issues for months or years to follow. The Textbook of Post-ICU Medicine: The Legacy of Critical Care identifies the long term outcomes of ICU and the steps that can be taken to improve patients' health and wellbeing. Describing the major clinical syndromes affecting ICU survivors, the book delineates established or postulated biological mechanisms of the post-acute recovery process, and discusses strategies for treatment and rehabilitation to promote recovery in the ICU and in the long term. Many ICU survivors suffer from a range of long-lasting physical and psychological issues such as end stage renal disease, congestive heart failure, cognitive impairment, neuromuscular weakness, and depression or anxiety, which affect their overall quality of life and ability to lead productive lives. This book discusses the science of the recovery process and the innovative treatment regimens which are helping ICU survivors regain function as they heal following trauma or disease. This lingering burden or 'legacy' of critical illness is now recognized as a major public health issue, with major efforts underway to understand how it can be prevented, mitigated, or treated. The chapters are written by an interdisciplinary panel of leading clinicians and researchers working in the field. The book serves as a unique reference for general practitioners, internists and nurses caring for long term ICU survivors as well as specialists in intensive care medicine, neurology, psychiatry, and rehabilitation medicine.  
books.google.co.uk
over 6 years ago