Setting Up a Department of Neurosurgery in a Government Hospital in an LMIC: Jodhpur, India.

BACKGROUND: The number of government institutes offering affordable super specialty and tertiary healthcare in India has traditionally not been able to keep pace with the growth in population, most of whom are too poor to be able to afford private healthcare services. To meet this mandate, 6 new institutes built on the template of the premier institute of the country-the All India Institute of Medical Sciences, New Delhi-were founded and began operations in 2012. Using the progress of our department as an example, the aim of this report is to outline the principles that were followed to set up the department of neurosurgery. METHODS: The Department of Neurosurgery at All India Institute of Medical Sciences, Jodhpur, began providing services in August 2017. Data related to the inception and development of the department were collected. RESULTS: The department has grown during the past 5 years from 400 outpatients and 79 inpatients in 2017 to 11,144 outpatients and 1624 inpatients in 2022. Only 59 surgeries were performed in 2017 compared with 597 routine and 311 emergency procedures performed in 2022. Currently, the department has 7 faculty members performing all forms of complex skull base, craniovertebral junction, vascular, endovascular, epilepsy, and functional surgeries. A total of 134 studies have been reported in national and international journals, and 8 patents have been granted. CONCLUSIONS: We report the unique experiences of one department that could be useful as a template and as guidelines for the establishment process of a new department.

Best practice: setting up and operating a mid-sized cryo-EM facility.

Ever since the resolution revolution in 2013, cryo-electron microscopy (cryo-EM) has become a powerful methodology in structural biology that is especially suited to study the structure of large flexible molecular complexes. Since then, the need of setting up state-of-the-art cryo-EM facilities around the world has increased tremendously. Access to high-end cryo-EM instrumentation is however expensive and requires expertise. The establishment of large cryo-EM centers worldwide, many of which provide academic users free access for both data collection and user training, has been possible with the support of government agencies across the globe. In addition, many universities, and private institutions like the Van Andel Institute (VAI) have made significant investments to establish their own cryo-EM core facilities, ensuring on-site access to their researchers. This paper aims to serve as a blueprint for establishing a new mid-sized cryo-EM facility, as it provides key information based on our experience at VAI and discusses strategies used to optimize routine operation towards high performance and efficiency for single-particle cryo-EM. Information regarding initial planning, selection of equipment as well as the development of IT solutions that were required to improve data collection and analysis are included. In addition, we present an account of the most common issues affecting operation as well as the needs for maintenance over a 6-year period, which can help interested parties to estimate the long-term costs of running this type of facility. Lastly, a brief discussion on the pros and cons of establishing the facility is also included.

Easy and accessible way to calibrate a fluorescence microscope and to create a microplastic identification key.

We present here a technique for setting up detection limits on any fluorescent microscope in conjunction with the fluorophore Nile Red for microplastic identification. Our method also describes a rigorous morphology-specific identification key for microplastics to reduce subjectivity between researchers. The detection limits were established for nine common polymer types and five natural substrates which could result in false-positive signals when using Nile Red for microplastic identification. This method was then applied to real freshwater samples and identified particles were validated with micro-FTIR or Raman spectroscopy. This approach may reduce subjectivity in microplastic identification and counting and enhances transparency, repeatability and harmonization within microplastic research community.•Instructions for calibration of detection limits for microplastics on fluorescence microscope systems described•Microplastic identification key developed and tested to reduce false positive detection•Lower subjectivity for microplastic identification obtained using the detection limits & identification key.

Starting a C. elegans Research Laboratory: Practical Advice.

This chapter provides practical guidance for scientists starting or reorganizing a C. elegans research group. This includes advice on joining the C. elegans community, on setting up the laboratory for C. elegans work, and on putting into place effective strategies for running a productive and inclusive research group. Also discussed are strategies for managing the group, standard practices in the C. elegans field, lists of resources, and several sample handouts for new research group members.

Setting up and relaxation of public health social and physical distancing measures for COVID-19: a rapid review.

INTRODUCTION: Physical and social distancing refer to purposeful reduction of close contact between people, such as school closures and workplace closures. These measures are useful in containing coronavirus disease 2019 (COVID-19) but have negative effects on social structures and the economy. There is thus a need for optimal timing on when to setup and relax them. We examined the evidence regarding the initiation and lifting of these public health measures. METHODS: We searched for eligible studies in PubMed, Scopus, and Google Scholar in April 2020, and conducted a qualitative synthesis of the study findings. RESULTS: We searched for eligible studies in PubMed, Scopus, and Google Scholar in April 2020, and conducted a qualitative synthesis of the study findings. The electronic searches yielded 2503 records, from which we included 10 observational and mathematical modeling studies. These studies used data from one or multiple countries on COVID-19 (nine studies) or another viral epidemic such as Zika (one study). Most of the studies show the importance of using physical and social distancing at the start of the epidemic and utilising a staggered approach when easing the restrictions, while scaling up testing. The lifting of lockdown measures should be accompanied by continued use of personal protective equipment, the limiting of workdays, and wide-scale testing. CONCLUSION: This review highlights the importance of timeous action when faced with an epidemic, let alone a pandemic. The setting up and relaxation of public measures are time sensitive and data-driven actions. In the absence of a safe and effective vaccine, these findings are relevant for the sustainable containment of COVID-19 in African countries.

Challenges in Having an Infusion Center.

This article presents a comprehensive overview of the model, care, costs, and considerations necessary in having an outpatient infusion suite in a practice. It provides a real-life assessment of the challenges infusion centers face, including financial and clinical impacts. It is also patient centric, showing how a comfortable patient experience can improve care and increase patient compliance in an outpatient setting. Also included is a list of specialty infusions and indications, medication procurement options, an internal process for outside referrals, using nurse practitioners and physician assistants, and the complexities of working with insurance companies and the regulations and requirements necessary.

Barriers to practicing General Practice in rural areas - Results of a qualitative pre-post-survey about medical students during their final clinical year.

Objective: At the end of the Practical Year (PY), medical students decide on a specialization. Individual motivational factors and barriers play a central role in the choice of the subsequent subject area and the place of establishment (city/country). The aim of this study was to document the barriers of PY students within the General Practice (GP) tertiary elective over time. Methodology: Two guided interviews were conducted with each participant (N=19) as part of qualitative process monitoring - a pre-interview at the start and a post-interview after completion of the PY. Evaluation of the interviews was based on Grounded Theory. Results: 13 barriers could be deduced from the 38 interviews. The most frequently cited barriers were "expected workload", "recreational opportunities", "work-life balance" and "compatibility with family". 13 of the participants were firmly committed to continuing GP training, 12 of whom aspired to opening a practice in a rural area. Another three were considering GP training, three had decided against it after the PY. After the PY, some of the previously anticipated individual barriers were now perceived in a more differentiated manner as a result of practical experience. The barriers "work-life-balance", "compatibility with family", "recreational opportunities" and "infrastructure" had been largely eliminated. Conclusion: The PY General Practice Tertiary itself appears to have a positive impact on the individual barriers expressed before the PY. Targeted experience with a PY in General Practice at the end of study seems to be a solution to increase the attractiveness of the subject.

Necessity of setting up the course on clinical healthcare-associated infection according to case-based teaching method in medical higher education / 中国感染控制杂志

Objective To explore the necessity of setting up the course on clinical healthcare-associated infection (HAI) and effectiveness of the case-based teaching method in medical higher education.Methods 198 students who underwent internship in a hospital between July 2015 and July 2016 were selected,according to whether they selected clinical HAI coures,they were divided into course selective group(n =107,adopted case-based teaching method) and unselective group(n =91),questionnaire survey on the knowledge and attitude of HAI was carried out.Results The average score on HAI in selective group was higher than that of unselective group([85.3 ± 1.6] vs [58.3 ± 1.8],t =111.72,P＜0.01).Before and after conducted case-based teaching method,21.49％ and 47.66％ of students actively studied respectively,difference was significant (x2 =16.195,P＜0.01).Conclusion It is necessary to carry out a systematic course on HAI,case-based teaching method can improve the learning enthusiasm of students.

The application of formative assessment in conducting the course of medical English fundamental reading / 中华医学教育探索杂志

The course of medical English fundamental reading carefully chooses reading materials from original English medical textbooks as the course materials, aiming at imparting the skills for reading biomedical English literature, and meeting the reading needs of medical undergraduates. In conducting this course, formative assessment is adopted, the frame of which is the theoretical model developed by Professor Wen Qiufang. There are three key phases in this model: setting up goals, eliciting learning evidence, and providing feedback. Three ways are employed to assess the course (symposium records, reflective journals and quizzes), which confirms that this model of formative assessment has improved the effectiveness of the course.

The necessity of setting up community psychiatry course and teaching experience / 中华医学教育探索杂志

Community psychiatry is an important branch of psychiatry. This article introduced the concept of community psychiatry, the importance and necessity of setting up community psychiatry course in psychiatry , and the modern teaching methods in teaching community psychiatry course . Combined with the research results about knowledge and attitude of college students on mental illness and the teaching activity, the author further explalned the necessity of setting up community psychiatry in the teaching of undergraduate medical students, and put forward the problem-based learning and case teaching method to make it more easy for students to grasp and understand the knowledge points.

The plastic & reconstructive Mohs surgery service.

Mohs Micrographic Surgery (MMS) is the current 'gold-standard' for excision of a number of cutaneous lesions and provides a valuable addition to a skin cancer service. The Mersey Regional Centre for Mohs Surgery is the first MMS service in the UK to be led by an MMS trained Plastic and Reconstructive surgeon, and this article describes an overview of the processes involved in establishing such a service.

Focus on the Establishment of Communist Among Student,Promote the Cultivation of Medical Calibers / 中华医学教育探索杂志

Development of communist party among the students in the universities plays an important role through out the university educational process.Soundly based on the development of advancement of communist party and the party's self-further organization;with laying the stress on the inproving of the technical & moral standard of each party member,Fu Dan University Shanghai Medical College entirely improved the quality of the education on medical calibers through the means of closely connecting the activites of party establishment among the students and the cultivation of medical elite at the same time,which was guaranteed by the system building up through out the process of carrying out of the various activities.

Setting-up and Application of "Drug Use Monitoring Information Platform in Primary Hospitals" in Beijing Dongcheng District / 中国药房

OBJECTIVE: To standardize the management on drug use in primary hospitals in Beijing Dongcheng district so as to enhance the efficiency of drug administration.METHODS: A "Drug Use Monitoring Information Platform in Primary Hospital" comprising management information system on drug use,management system on information of drug wholesalers,drug monitoring management information system was established and its problems in the try-out were analyzed.RESULTS & CONCLUSIONS: The "Drug Use Monitoring Information Platform in Primary Hospital" still faced with the problems of legal basis,psychological concern,and construction of standard basic drug information database etc.However,its operation standardized the drug purchasing channel and management on drug use in hospitals of Beijing Dongcheng district and enhanced the drug administration level and efficiency,which thus deserves to be popularized throughout the country.

Setting Up a Domestic Violence Service.

BACKGROUND: This paper describes some of the issues we confronted and resolved in setting up an independent dedicated domestic violence service. METHOD: In our project we work with violent behaviour that is known or suspected in the contexts of both assessment and therapy. We describe our policy on domestic violence, including confidentiality, our reflecting practices, our relationships with referrers as a means of managing the risk of violence, and the assessment and evaluation procedures we use for the assessment of risk of violence. We include some discussion of the effects of domestic violence on children and the effects of doing this work on ourselves. CONCLUSIONS: We conclude by discussing the moral issues involved for us as therapists in doing this work, the impact of the legal frame within which we work, and some of the social and psychological theories we find helpful in understanding the causes and effects of violent behaviour in the family.

Military medical metrology work / 医疗卫生装备

The leaders of our sanitarium pay much attention to the work of military medical metrology which has formed into a normative,scientific,institutional managing system and the work of military medical metrology develops according to the laws and rules. In continuous five years,the probability of metrology equipments being checked reached into 100%. The development of military medical metrology work is great and healthy.