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Foo20151013 2023 xc9z4h?1444774045
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3919

Undergraduate Co-Ordinators: Help or hindrance?

Thanks to those who read my last post. I was encouraged to hear from my colleagues at Med school that the post sounded very positive and hopefully. A few of them queried whether I had actually written it because there was a noticeable lack of sarcasm or criticism. So... the following posts may be a bit different. A little warning - some of what I post may be me playing "Devil's advocate" because I believe that everything should be questioned and sparking debate is a good way of making us all evaluate what we truly think on a subject. With no further a do, let's get on to the subject of today's post .... An Introduction to Clinical Medicine The previous year was my first as a clinical med student. Before we started I naively thought that we would be placed in helpful, encouraging environments that would support us in our learning, so that we were able to maximize our clinical experience. My hope was that there would be lots of enthusiastic doctors willing to teach, a well organised teaching schedule and admin staff that would be able to help us with any difficulties. I hoped these would all be in place so that WE medical students could be turned from a bunch of confused, under-grad science students into the best junior doctors we could possibly be. It seems that medical school and the NHS have a very different opinion of what clinical medical teaching should be like. What they seem to want us to do is 1) listen to the same old health and safety lecture at least twice a term, 2) re-learn how to wash our hands every 4 weeks, 3) Practicing signing our name on a register - even when this is completely pointless because there are no staff at the hospital anyway because the roads are shut with 10 inches of snow most of the time, 4) Master the art of filling in forms that no one will ever look at or use in anyway that is productive, 5) STAY OUT OF THE WAY OF THE BUSY STAFF because we are useless nuisances who spread MRSA and C.Dif where ever we go! How we all learn medicine and pass our exams is any ones guess! Undergraduate Co-Ordinators - Why won't you make life easier for us? While at my last placement I was elected as the 3rd year student representative for that hospital. While I was fulfilling that role it got me wondering what it is that Under-grad Co-Ordinators actually do? I thought this may be an interesting topic of debate. 1) Who are they and how qualified are they? 2) what is their job description and what are they supposed to be doing? 3) Are they a universal phenomena? or have they just evolved within the West Midlands? 4) Does anyone know an under-grad Co-Ordinator (UC - not ulcerative colitis) who has actually been more benefit than nuisance? 1) UC's as a species are generally female, middle aged, motherly types who like to colonize obscure offices in far flung corners of NHS training hospitals. They can normally be found in packs or as they are locally known "A Confusion of co-ordinators". How are they qualified? I have absolutely no idea, but I am guessing not degrees in Human Resource Development. 2)I am fairly certain what their job should involve: 1) be a friendly supportive face for the poor medical students; 2) organise a series of lectures; 3) organise the medical students into teaching firms with enthusiastic consultants who are happy to give them regular teaching; 4) ensure the students are taught clinical skills so that they can progress to being competent juniors; 5) be a point of contact for when any students are experiencing difficulties in their hospital and hopefully help them to rectify those problems to aid their learning. What do they actually do? It seems to be a mystery. I quite regularly receive emails that say that I wasn't in hospital on a certain day, when I was in fact at another hospital that they specifically sent me to on that day. I often receive emails saying that my lectures are cancelled just as I have driven for over an hour through rush hour traffic to attend. I sometimes receive emails saying that I, specifically, am the cause of the whole hospitals MRSA infection because I once wore a tie. I never receive emails saying that such and such a doctor is happy to teach me. I never receive emails with lecture slides attached to them so that I can revise said lectures in time for an exam. I NEVER receive any emails with anything useful in them that has been sent by a UC! Questions 3 and 4, I have no idea what the answers are but would be genuinely pleased to hear people's responses. The reason I have written this blog is that, these people have frustrated my colleagues and I all year. I am sure they are integral to our learning in some way and I am sure that they could be very useful to us, but at the moment I just cannot say that they are as useful as they should be. To any NHS manager/ medical educator out their I make this plea I am more than happy to give up 2 weeks of my life to shadow some UC to see what it is they do. In essence I want to audit what it is they do on a day to day basis and work out if they are a cost-effective use of the NHS budget? I want to investigate what it is they spend their time on and how many students they help during a day? I would like someone with a fresh pair of eyes to go into those obscure offices and see if they can find any way of improving the systems so that future generations of medical students do not have to relive the inefficiencies that we have lived through. I want the system to be improved for everyone's sake. OR if you won't let a medical student audit the process, could you manager's at least send your UC's to learn from other hospitals where things are done better! If we (potential future) doctors have to live by the rule of EVIDENCED BASED MEDICINE, why shouldn't the admin staff live by a similar rule of EVIDENCED BASED ADMINISTRATION? Share good ideas, learn from the best, always look for improvements rather than keep the same old inefficient, pointless systems year after year. My final point on the subject - at the end of every term we have to fill in long feedback forms on what we thought of the hospital and the teaching. I know for a fact that most of those forms contain huge amounts of criticism - a lot of which was written exactly the same the year before! So, they are collecting all of this feedback and yet nothing seems to change in some hospitals. It all just seems such a pointless waste. Take away thought for the day. By auditing and improving the efficiency, of the admin side of an undergraduate medical education, I would hope the system as a whole would be improved and hence better, more knowledgeable, less cynical, less bitter, less stressed junior doctors would be produced as a result. Surely, that is something that everyone involved in medical education should be aiming for. Who is watching (and assessing) the watchers!  
jacob matthews
over 8 years ago
Foo20151013 2023 37skir?1444774198
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Biohacking - The Brighter Side of Health

2014 is already more than a month old (if you can believe it) and with each passing day, the world we live in is speeding towards breakthroughs in every sphere of life. We're running full tilt, wanting to be bigger and better than we were the day or the hour before. Every passing day reinvents the 'cutting edge' of technology, including medical progress and advancement. Gone are the medieval days when doctors were considered all knowing deities, while medicine consisted of leeches being used to drain 'bad blood'. Nowadays, health isn't just about waiting around until you pick up an infection, then going to your local GP to get treated; in today's world it's all about sustaining your wellbeing. And for that, the new kid on the block is biohacking. Biohacking is the art and science of maximizing your biological potential. As a hacker aims to gain complete control of the system he's trying to infiltrate, be it social or technological; similarly a biohacker aims to obtain full control of his own biology. Simply put, a biohacker looks for techniques to improve himself and his way of life. Before you let your imagination run away with you and start thinking of genetic experiments gone wrong, let me assure you that a biohack is really just about any activity you can do to increase your capabilities or advance your wellbeing. Exercising daily can be a biohack. So can doing the crossword or solving math sums, if it raises your IQ by a few points or improves your general knowledge. What characterizes biohacking is the end goal and the consequent modification of activities to achieve that goal. So what kind of goals would a biohacker have? World domination? Not quite. Adding more productive hours to the day and more productivity to those hours? Check. Eliminating stress and it's causes from their lives? Check. Improving mood, memory and recall, and general happiness? You bet. So the question arises; aren't we all biohackers of sorts? After all, the above mentioned objectives are what everyone aspires to achieve in their lives at one point or the other. unfortunately for all the lazy people out there (including yours truly), biohacking involves being just a tad bit more pro active than just scribbling down a list of such goals as New Year resolutions! There are two main approaches to selecting a biohack that works for you- the biggest aim and the biggest gain. The biggest aim would be targeting those capabilities, an improvement in which would greatly benefit you. This could be as specific as improving your public speaking skills or as general as working upon your diet so you feel more fit and alert. In today's competitive, cut throat world, even the slightest edge can ensure that you reach the finish line first. The biggest gain would be to choose a technique that is low cost- in other words, one that is beneficial yet doesn't burn a hole through your pocket! It isn't possible to give a detailed description of all the methods pioneering biohackers have initiated, but here are some general areas that you can try to upgrade in your life: Hack your diet- They say you are what you eat. Your energy levels are related to what you eat, when you take your meals, the quantity you consume etc. your mood and mental wellbeing is greatly affected by your diet. I could go on and on, but this point is self expanatory. You need to hack your diet! Eat healthier and live longer. Hack your brain- Our minds are capable of incredible things when they're trained to function productively. Had this not been the case, you and I would still be sitting in our respective caves, shivering and waiting for someone to think long enough to discover fire. You don't have to be a neuroscientist to improve your mental performance-studies show that simply knowing you have the power to improve your intelligence is the first step to doing it. Hack your abilities- Your mindset often determines your capacity to rise to a challenge and your ability to achieve. For instance, if you're told that you can't achieve a certain goal because you're a woman, or because you're black or you're too fat or too short, well obviously you're bound to restrict yourself in a mental prison of your own shortcomings. But it's a brave new world so push yourself further. Try something new, be that tacking on an extra lap to your daily exercise routine or squeezing out the extra time to do some volunteer work. Your talents should keep growing right along with you. Hack your age- You might not be able to do much about those birthday candles that just keep adding up...but you can certainly hack how 'old' you feel. Instead of buying in on the notion that you decline as you grow older, look around you. Even simple things such as breathing and stamina building exercises can change the way you age. We have a responsibility to ourselves and to those around us to live our lives to the fullest. So maximise your potential, push against your boundaries, build the learning curve as you go along. After all, health isn't just the absence of disease but complete physical, mental and social wellbeing and biohacking seems to be Yellow Brick Road leading right to it!  
Huda Qadir
almost 8 years ago
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Facemasks in the prevention of infection

Facemasks are recommended for diseases transmitted through droplets and respirators for respiratory aerosols, yet recommendations and terminology vary between guidelines. This graphic summarises the recommendations from the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) for five diseases.  
bmj.com
almost 7 years ago
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101

Red Flags

Red Flags typically refer to features that may suggest serious life threatening disease such as malignancy (leukaemia), infection (septic arthritis or osteomyelitis) or non-accidental injury. We also include features that may suggest inflammatory joint or muscle disease.  
pmmonline.org
almost 7 years ago
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Antibiotics for acute middle ear infection (acute otitis media) in children | Cochrane

This review compared 1) the clinical effectiveness and safety of antibiotics against placebo in children with an acute middle ear infection (acute otitis media (AOM)) and 2) the clinical effectiveness and safety of antibiotics against expectant observation (observational approaches in which prescriptions may or may not be provided) in children with AOM.  
cochrane.org
over 6 years ago
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36

Microbial Pathogenesis

The fact that infectious diseases claim over 17 million victims worldwide each year, along with the regular emergence of new drug resistance pathogens, signals that infectious diseases will continue to be a daily concern of the Physician well into the future. This reality requires that today's medical students develop a solid foundation in medical microbiology -- a foundation they can achieved by using IMS: Microbial Pathogenesis. This book is developed in response to the changing field of medical microbiology. The number of diseases and the diversity of microbial pathogens that cause these diseases are far too many for simple taxonomic organization. As a result, IMS Microbial Pathogenesis focuses on the common principles of infection rather than the old taxonomic organization, enabling a better long term retention of relevant material, and minimizing the short-term memorization of specific "factoids," many of which may become out-dated in a short time.  
books.google.co.uk
over 6 years ago
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100

Diagnostic Pathology: Infectious Diseases

Diagnostic Pathology: Infectious Diseases takes a comprehensive look at infectious diseases, their anatomic manifestations, and how to ensure a complete and accurate sign out at the microscope. A user-friendly chapter landscape and thousands of high-quality images combine to make this medical reference book a key companion for the general surgical pathologist or resident in training. Comprehensive discussions on how to sign out cases. Formatted into sections by organism type (Virus, Bacteria, Fungi, and Parasite), and further divided by those that can be diagnosed on histological appearance. Species-specific pathologies for finding "zebra" cases.Essential information is listed in a bulleted format with numerous high-quality images to facilitate learning."Key Facts" highlight the quick criteria needed for diagnosis or adequacy evaluation at the time of a procedure.Features clear pictures of diagnostic forms, ancillary diagnostic tools, including microbiology and molecular diagnostics, pathological reaction patterns expected for given organisms, and important common and uncommon pathogens.Explains when and when not to use molecular diagnostics, and discusses histological limitations and how to address them at sign out.  
books.google.co.uk
over 6 years ago
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40

Clinical Cases and Images: ClinicalCases.org: Prerenal Acute Renal Failure due to Volume Depletion

This is a good practical case and very useful for new clinicians. For any clinician:No foley catheter unless oliguric, anuric, obstructed since any catheter is a foreign body and increases infection risk.Rehydrate if U/A has high spec gavity, mucous membranes dry, or if BUN is >30 times the creatinine as in this case. Even CHF pts get dry if not in heart failure. If in doubt, do CXR, BNPT, listen for crackles.Start with 250cc IVF if BNPT not less than 150 or give carefully while checking lung bases posteriorly after each bolus along with pulse ox, etc as above. Half of pts in acute renal failure are septic. Look for and eliminate source such as pneumonia, foreign body, pyelonephritis, joint infections. May be afebrile/ low temp or low WBCs with sepsis. Do cultures, check lactate ASAP to detect sepsis BEFORE the BP drops. Lactic acid "the troponin of sepsis." If septic, give a lot of fluids (up to 10 liters often) since capillary leak syndrome will lead to severe hypotension. If septic expect edema to develop with IV boluses yet be aware pt is intravascularly depleted. No pressors without fluids "pressors are not your friend" as per lecturers on Surviving Sepsis campaign.  
clinicalcases.org
over 6 years ago
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Doctor explains differences between a cold, bronchitis, and pneumonia

SALT LAKE CITY, Utah (ABC 4 Utah) - Winter can be rough for people with colds, bronchitis, and pneumonia - and Utah's air quality can make it even worse.  
good4utah.com
over 6 years ago
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Respiratory tract infections (self-limiting): prescribing antibiotics | Guidance and guidelines | NICE

The advice in the NICE guideline covers adults and children (3 months and older) who see their GP or nurse practitioner because of a respiratory tract infection.  
nice.org.uk
about 6 years ago
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Hepatitis B and C testing: people at risk of infection | Guidance and guidelines | NICE

The guidance is for commissioners and providers of public health services, hepatitis testing and treatment services and laboratory services for hepatitis B and C testing. It is also for local organisations providing services for children and adults at increased risk of hepatitis B and C infection, including those in the NHS, local authorities, prisons, immigration removal centres and drugs services, and for voluntary sector and community organisations working with people at increased risk.  
nice.org.uk
about 6 years ago
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Osteomyelitis in Emergency Medicine Clinical Presentation: History, Physical, Causes

Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms. .  
emedicine.medscape.com
about 6 years ago
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Hot tub folliculitis: MedlinePlus Medical Encyclopedia

Hot tub folliculitis is an infection of the skin around the lower part of the hair shaft (hair follicles). It occurs when you come into contact with certain bacteria that live in warm and wet areas.  
nlm.nih.gov
about 6 years ago
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In a world with no antibiotics, how did doctors treat infections?

While some ancient therapies proved effective enough that they are still used in some form today, on the whole they just aren't as good as modern antimicrobials at treating infections.  
theconversation.com
almost 6 years ago
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Focus On: Emergent Evaluation and Management of Bacterial Meningitis

Bacterial meningitis is defined as infection of the arachnoid mater, subarachnoid space, and the cerebrospinal fluid (CSF).1 It is among the most common infectious causes of death in the world.  
American College Of Emergency Medicine
over 11 years ago
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That peripheral IV can kill you: Suppurative Thrombophlebitis

<p>All the recent emphasis on venous catheter infections has been on central lines. &nbsp; Those peripheral IVs are also dangerous. &nbsp;</p>  
Jeffrey S. Guy, MD, FACS
over 11 years ago
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Ventilator Associated Pneumonia

A discussion on nosocomial infections and VAP.<br/>  
Jeffrey S. Guy, MD, FACS
over 11 years ago