Over the last half century, the practice of primary care for children has evolved tremendously. Although paediatrics is a relatively young field compared to other specialties, like a child, it has grown to become an integral part of the heath system. The previous international award-winning third edition, Paediatrics and Child Health [1]is succeeded by the latest edition Essential Paediatrics and Child Health [2], which includes twenty-six chapters that are covered in a 520-page textbook. This beautifully presented book combines Prof. Mary Rudolf’s four decades of experience as a consultant paediatrician and Professor of Child Health at Leeds University with that of Prof. Anthony Luder and Dr. Kerry Jeavons who both are experts in the field of paediatric medicine.
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Abstract
Introduction
The Australian Government has implemented its National Primary Care Response action plan to combat the growing threat of the COVID-19 pandemic across the country. The plan recognises the integral role of primary care services in protecting the most vulnerable citizens of our nation and recommends a number of interventions aimed at reducing transmission, including expanding telehealth services, physical distancing measures, and the use of personal protective equipment. The efficacy of these suggested measures needs to be evaluated to ensure everything is being done to maximise the safety of Australia’s primary care system while maintaining the highest level of care possible.
Summary
This review article delves into the benefits and limitations of the interventions suggested in the National Primary Care Response action plan and formulates recommendations on each intervention based on the currently available literature. Based on the literature findings, recommendations have been made to implement telehealth, physical distancing, and face masks in primary care settings across Australia to curb the transmission of COVID-19 across the country.
Abstract
Introduction: Healthcare-associated infections (HAI) are particularly prevalent in low- and middle-income countries (LMICs). HAIs cause a serious threat to patient wellbeing and have been associated with increased patient morbidity and mortality, longer hospital admission times, increased risk of antibiotic resistance, and higher healthcare costs.
Case: A case of a 23-year-old polytrauma patient in Zambia reveals the devastating outcomes of lack of resources, HAIs, and delayed treatment in LMICs. Discussion: Research demonstrates the negative influence of LMIC status on health care and patient related outcomes. This report, in conjunction with the literature, emphasises the importance of prompt trauma management and strict infection control. The critical need for more knowledge around infection prevention and control (IPC) and resources to implement IPC processes in LMICs are highlighted
Background
Musculoskeletal disorders (MSDs) are an occupational hazard amongst surgeons, causing detrimental effects in up to 20% of surgeons in their lifetime. However, there is a paucity of data examining solutions for the problem. There is also a lack of research comparing MSDs in surgeons who perform open surgery compared with those who perform newer methods of surgery such as laparoscopic and robotic surgery.
Aims
We aim to explore existing literature about the various risk factors and the consequences of MSDs. We believe that by raising awareness of such risk factors to medical students from early on in their medical careers, they can develop an appreciation of the potential long-term impacts and take an early approach to prevention. We discuss preventative strategies in the categories of individual, occupational, institutional, and intra-operative techniques.
Materials and Methods
Ovid Medline, Cochrane Library, and PubMed databases were used to identify articles. Studies reporting on work-related MSDs in surgeons were included. Articles relevant to medical fields with a high level of surgical involvement, such as gynaecology, were also included. This information was used to construct a narrative review of the literature (see Appendix 1 for full methodology). Within each database search, only a few articles relevant to this review were generated. Therefore, the citations were also screened to find additional articles that fit within the scope of this review.
Results
Multiple factors were found to contribute to the development of MSDs, including individual and occupational factors. MSDs have resulted in a high percentage of surgeons performing fewer surgeries or taking more time off work. Similar risk factors applied to laparoscopic and robotic surgery. Few studies examined strategies to combat MSDs, but techniques such as intraoperative exercise and ergonomic training have shown to be promising.
Conclusion
There is a need for ongoing research into strategies to prevent MSDs in surgeons. Currently there are no evidence-based guidelines for management of work-related MSDs. Medical students should be aware that this occupational hazard has deleterious effects on the body and should be encouraged to employ some of the currently available strategies to prevent MSDs. The authors of this review advocate for ergonomics education to be integrated into surgical training programs via collaboration between ergonomists and surgical program directors.
Main Learning Points
- MSDs in surgeons are under-researched but are still an important occupational hazard that can be potentially debilitating.
- There are no guidelines to manage MSDs – current best strategies involve having a well-balanced lifestyle, seeking help early, and being ergonomically aware of mechanisms of injury.
- Greater awareness of ergonomics among surgeons could possibly reduce the incidence of MSDs among high risk groups.