Notes

q-Rung Orthopair Furred Hard Einstein Location Information-Based EDAS Strategy: Programs throughout Robotic Agrifarming.
Ultrasound has been effective in using low volume of local anesthetics for supraclavicular block. Steroids have been shown to increase the duration of local anesthetics.

In this study, we compare the efficacy of dexamethasone versus midazolam when added to bupivacaine in supraclavicular brachial plexus block for upper-limb surgeries with regard to the time of onset and duration of sensory and motor blockades, duration of analgesia, sedation, and hemodynamic parameters.

This is a prospective, randomized, double-blind study conducted on 60 patients belonging to the American Society of Anesthesiologists physical status classes 1 and 2, undergoing upper-limb surgeries under ultrasound-guided supraclavicular brachial plexus block.

Sixty patients were divided into two groups of 30 each. Group dexamethasone (Group D) received bupivacaine 0.5% 18 mL + dexamethasone 4 mg + 1 mL normal saline. Group midazolam (Group M) received bupivacaine 0.5% 18 mL + 2 mg midazolam. We compared the onset and duration of sensory and motor blocks, hemodynamic variables, pain and sedation scores, and duration of analgesia.

The statistical software, namely SPSS 18.0 and R environment ver. 3.2.2, were used for the analysis of the data.
< 0.05 was considered statistically significant.

The onset of sensory and motor blocks was significantly faster in Group D compared to Group M. The duration of sensory and motor blockades and duration of analgesia showed a significant increase in Group D in comparison with Group M.

Dexamethasone as an adjuvant hastens the onset and prolongs the duration of both sensory and motor blocks and reduces postoperative analgesic requirement when compared to midazolam.
Dexamethasone as an adjuvant hastens the onset and prolongs the duration of both sensory and motor blocks and reduces postoperative analgesic requirement when compared to midazolam.
Disparities encountered by men and women physicians are well documented. However, evidence is lacking concerning the effects of gender on daily practice in the specialty of anesthesiology.

To evaluate gender disparities perceived by female anesthesiologists.

Anonymous, voluntary 30-question, electronic secure REDcap survey.

Survey link was sent via email, Twitter and the Facebook page, Physician Mom's Group. Instructions dictated that only female attending anesthesiologists participate and to partake in the survey one time.

Categorical variables were summarized using frequencies and percentages. Associations between categorical variables were tested using Chi-square test. Likert scale items were treated as continuous variables. T-tests were utilized to examine differences between those who reported burnout and those who did not.

502 survey responses were received and analyzed. Female leadership was valued by 78%, yet only 47% had leadership roles. Being female was identified by 51% as negatively affecting career advancement and 90% perceived that women in medicine need to work harder than men to achieve the same career goals. Sexual harassment was experienced by 55%. Nearly 35% of institutions did not offer paid maternity leave. Burnout was identified in 43% of respondents and was significantly associated with work-life balance not being ideal (
< 0.0001), gender negatively affecting career advancement (
< 0.0001), experiencing sexual harassment at work (
= 0.002), feeling the need to work harder than men (
= 0.0033), being responsible for majority of household duties (
= 0.0074), lack of weekly exercise (
= 0.0135) and lack of lactation needs at work (
= 0.0007).

Understanding perceptions of female anesthesiologists may lead to actionable plans aimed at improving workplace equity or conditions.
Understanding perceptions of female anesthesiologists may lead to actionable plans aimed at improving workplace equity or conditions.
Medical illnesses seen in persons with psychiatric disorders are important but often ignored causes of increased morbidity and mortality. Hence, a community level intervention program addressing the issue is proposed.

Patients with severe mental illnesses will be identified by a door-to-door survey and assessed for comorbid physical illnesses like anemia, hypertension, diabetes, and so on. They will then be randomized into two groups. The treatment as usual (TAU) group will not receive intervention from the trained community level workers, while the Intervention group will receive it.

The two groups will be compared for the prevalence and severity of comorbid physical illnesses. The expected outcome is compared to the TAU group, the intervention group will have a greater reduction in the morbidity due to physical illnesses and improved mental health.

If successful, the module can be incorporated into the community level mental health delivery system of the District Mental Health Program (DMHP).
If successful, the module can be incorporated into the community level mental health delivery system of the District Mental Health Program (DMHP).
India has the second-largest population of elderly in the world. Serious mental illness (SMI) is a subset of the mental disorders that result in significant functional impairment and is usually long term. Persons with SMI face several challenges in their old age that are different from the issues faced by younger people with SMI. Understanding the problems faced by elderly individuals suffering from SMI is fundamental for planning programs to address them. this website The SENIOR (
upport Systems
valuation of
europsychiatric
llness in
ld age) project is a study aimed at evaluating the problems faced in obtaining mental health care by elderly persons having SMI in the Kerala state of India.

To describe the scientific methodology of the SENIOR project.

This study employs mixed-methods cross-sectional design among a minimum sample of 768 SMI patients identified through cluster sampling from three districts, and Focus Group Discussion among mental health program officials.

This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. link2 Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life.
This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life.
Bridging the alarming treatment gap for mental disorders in India requires a monumental effort from all stakeholders. Harnessing digital technology is one of the potential ways to leapfrog many known barriers for capacity building.

The ongoing Virtual Knowledge Network (VKN)-National Institute of Mental Health and Neurosciences (NIMHANS)-Extension of Community Health Outcomes (ECHO) (VKN-NIMHANS-ECHO hub and spokes model) model for skilled capacity building is a collaborative effort between NIMHANS and the University of New Mexico Health Sciences Centre, USA. This article aims to summarize the methodology of two randomized controlled trials funded by the Indian Council of Medical Research (ICMR) designed to evaluate the effectiveness of the VKN-NIMHANS-ECHO model of training as compared to training as usual (TAU).

Both RCTs were conducted in Karnataka, a southern Indian state in which the DMHP operates in all districts. We compared the impact of the following two models of capacity building for the DMHPorkers) medical officers of primary health centers. The location of the HubHub differs in these two studies. Both trials are funded by the ICMR, Government of India.

Both these trials, though conceptually similar, have some operational differences which have been highlighted. If demonstrated to be effective, this model of telementoring can be generalized and widely merged into the Indian health care system, thus aiding in reducing the treatment gap for patients unable to access care.
Both these trials, though conceptually similar, have some operational differences which have been highlighted. If demonstrated to be effective, this model of telementoring can be generalized and widely merged into the Indian health care system, thus aiding in reducing the treatment gap for patients unable to access care.
Task shifting has been recommended as a strategy to reach out to persons with mental illness and bridge the treatment gap. There is a need to explore task-shifting using existing health staff like Accredited Social Health Activists (ASHAs).

ASHAs are involved in ongoing community-based rehabilitation (CBR) program run with a public-private partnership over the last 5 years at Jagaluru Taluk (an administrative block) in Davanagere district (Karnataka, India). This article aims to summarize a randomized controlled trial (RCT) to examine whether CBR delivered by ASHAs is more effective than treatment as usual (TAU) control group in reducing disability associated with severe mental illness (SMI).

A group of proactive ASHAs is already working with us for a follow-up of persons with SMI. For the study, we would allocate areas that are currently not being covered proactively by ASHAs randomly in a 11 ratio via computer-generated randomization list to receive either ASHAs delivered CBR arm or TAU control group.ivering cost-effective and replicable CBR for persons with SMI through ASHAs. If the model turns successful, this could be expanded throughout the state/country. link3 This would go a long way in bridging the huge treatment gap.
Mental health issues are on an exponential rise in Kashmir due to varied reasons including political instability, eco fragility, the growing lag in the provision of education and employment, and several other reasons. Impediments such as the overwhelming stigma and the cultural sensitivity associated with mental health issues both sustain and perpetuate mental ill health and also prevent any treatment and rehabilitation. This article describes the protocol of a research project, funded by the Indian Council of Medical Research, which aims to address this issue.

To screen the population for mental health issues and to provide community-based intervention for the identified cases also to train community health workers for sustainable mental health support.

We will conduct a household survey using the Hopkins Symptom Checklist (HSCL-25) for the identification of the clients. A multi-stage random sampling shall be used to select the villages and the households from the marginalized communities. A sample of vention for more effective results, with an increased level of awareness and sensitization in a conventional society like Kashmir.
The study shall present a roadmap focusing on the indispensability of a comprehensive community-based intervention on mental health utilizing a non-pharmacological method. Assessing and analyzing the dynamics of mental health illness first hand, the study shall move ahead to offer a culturally tailored counseling program at the community level. The study also aims to highlight the role of the indigenous human resource (community health workers) and how its participation leads to a more scientific and sustainable intervention for more effective results, with an increased level of awareness and sensitization in a conventional society like Kashmir.
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