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Daily Dose 2020 Day 3

White-paper-Daily Dose 2020 Day 3

We bring you highlights from Day 2 that was action-packed with lots of exciting activities!

Daily Dose 2020 Day 2

White-paper-Daily Dose 2020 Day 2

The edition is packed with all the highlights from day 1 such as Sheikh Mohammed bin Rashid Al Maktoum's tour of the show as well as an interview with Dr. Maryam Matar, Genetic Scientist, and Founder and Chairperson, UAEGDA, who is presenting at the Patient Experience conference today.

Daily Dose

Discover the latest healthcare advancements at Arab Health 2020

Article-Discover the latest healthcare advancements at Arab Health 2020

Arab Health 2020 is all set to bring the international healthcare industry to the Middle East. More than 55,000 healthcare and trade professionals are set to attend the event, making it the largest healthcare exhibition and congress in the region and the second largest in the world. The theme for the show this year is ‘Connectivity for better healthcare delivery’ and will highlight how interoperability impacts the entire spectrum of healthcare, right from hospital administrators to device manufacturers and IT vendors.

The exhibition will provide an important platform for the MENA healthcare industry to build relationships with international stakeholders. Enabling companies to showcase progress and achievements in the sector, the show facilitates the exploration of new business opportunities in the global healthcare field.

Arab Health hosts more than 4,250 exhibiting companies from 64 plus countries across the globe. Additionally, with over 37 dedicated country pavilions, the exhibition gives a truly international representation of hospital equipment, medical devices and medical technology on display at the exhibition. The event takes up full tenancy of the Dubai World Trade Centre (DWTC) by filling all halls.

Arab Health will host 14 CME conferences where over 400 expert speakers and 5,200 delegates are expected to attend. The show will also feature three educational forums this year.

Product sectorisation

New to 2020, the Arab Health exhibition show floor will be split into sectors according to main product categories. Exhibitor stands will be located on the show floor according to a product category applicable to their business. Visitors will, therefore, navigate the show by product categories, which will promote targeted traffic flow, fast track connections and ultimately increase leads for exhibitors.

The traffic within the halls will, therefore, increase with the relevant audience interested in the product category while the close proximity of related exhibitors in a hall is expected to increase the number of visitor meetings that can take place in a time frame, versus walking through 64,000 plus square meters of exhibition space.

Changing to sectorisation by product categories is in line with how visitors search for exhibitors. Increased satisfaction results in increased time on the show floor, resulting in increased business while bringing the event layout in line with the rest of the industry where it is now standard practice.

The eight sectors include: Medical equipment & devices, Disposable and consumer goods, Imaging & diagnostics, Preventive & post-diagnostics treatments, Healthcare & general services, Healthcare infrastructure & assets, IT Systems & solution and Orthopaedics & physiotherapy/rehabilitation.

Ross Williams, Exhibition Director of Arab Health said: “This year we’re doing things slightly differently. For the first time, the show floor will be split into sectors bringing the show layout in line with the rest of the industry. Ultimately, sectorisation promotes targeted traffic, fast-track connection and generates an increased number of better-quality leads for exhibitors.”

Innovation hub

This is a dedicated area of the show for attendees to immerse themselves in the latest healthcare innovations. The Innovation Hub is located in the Plaza Hall and is comprised of two key sections, the Innov8 Talks and the Start up zone.

Start up zone

With its inception in Arab Health 2019, the Start up zone is back for a second year to once again give start-ups the chance to display and demonstrate their new products and innovations that will contribute to shaping the future of healthcare.

Located within the central Plaza Hall, companies will display and demonstrate their new products and innovations that will contribute to shaping the future of healthcare.

Watch out for – Anatomaze

Anatomaze takes visitors on an unforgettable journey into the human body. View plastinated specimens such as the BVC heart, which gives a realistic view of the arteries of the cardiac muscles showcasing even the smallest coronary arteries and their branches, or the shoulder joint where a view of the anatomical structures of the glenohumeral joint and the various ligaments highlight the complexity of the joint. Various section of the brain will also be featured showcasing the different levels of the meninges, which will be visible for teaching purposes. Anatomaze is organised by Leader Healthcare and takes place on stand M.B50 in Sheikh Maktoum Hall.

Daily Dose

Informa Markets launches Omnia Health Insights

Article-Informa Markets launches Omnia Health Insights

A quick look around any public venue these days reveals that many of us are glued to the phone. These days disruption is the norm, from mobile messaging to social media. We, too, are changing with the times. Our new digital platform Omnia Health Insights will bring the latest content, products and services to you, all on one screen, meaning that you can browse the latest buzzing in the healthcare industry and the key players involved – wherever you happen to be.

Whether it’s an opinion piece from a healthcare thought leader or a news update on one of the many technological advancements impacting the industry, our platform will have information that informs and inspires. And of course, it’s not just text. We will feature video, infographics and other formats to engage your interest.

Perhaps an article will delight you – or perhaps it will irk you. Either way, you will have an opportunity to comment directly, so that your opinion is shared with others.

Which brings us to our next point. While we speak of a platform, we prefer to think of ourselves as a community.

As such, we encourage you to collaborate with us in creating compelling content that meets the needs of healthcare audiences. We have insights and analytics at our disposal so that any storytelling is informed by data.

Omnia Health Insights will complement the digital Omnia Health Global Medical Directory (www.omnia-health.com) that features products from leading healthcare companies from around the world. We are on the path to becoming a powerful business intelligence tool that will support all stakeholders in the healthcare industry grow.

And lastly, while we appreciate you will have a busy schedule this week, we encourage you to visit our platform insights.omnia-health.com and let us know your views!

Daily Dose

Expand your Arab Health experience at Expo 2020 Dubai

Article-Expand your Arab Health experience at Expo 2020 Dubai

In support of Expo 2020’s goal to attract 25 million visits to The World’s Greatest Show of human brilliance and achievement, Informa, one of the world’s leading international events groups, has become an authorised ticket reseller.

Visitors to Arab Health 2021 will be able to purchase group tickets and day passes to Expo 2020, which runs from 20 October 2020 to 10 April 2021, offering a one-stop-shop for visitors and participants of the medical industry event. 

During your visit to Arab Health 2021, you’ll be able to jump on the metro and travel directly to Expo 2020 in time for dinner. Why not take in a few of the 192 participating country pavilions while you’re there? And if you’re staying in town for Medlab Middle East 2021, spend your weekend at Expo 2020 and really immerse yourself in all it has to offer. With 60 plus live shows daily, there’s more than enough on offer to keep you entertained for a full two days.

Expo 2020 will not only be the largest event ever held in the Arab world, but also a time to connect, create and innovate. Visitors, exhibitors and delegates will be able to combine the full suite of Expo 2020 visitor experiences with DEC events, summits, seminars, product launches, networking opportunities and meetings.

Wouter Molman, Executive Vice President of Healthcare at Informa Markets, said: “Being able to work together with the team at Expo 2020 to deliver ease of access to our visitors and exhibitors is fantastic. We’re always striving to offer our participants greater value from their annual visit to Arab Health, and Expo 2020 is an event not to be missed.”

The World’s Greatest Show will welcome artists and academics, pop stars and pioneering thinkers, culinary wizards and corporate gurus, tech ninjas and tomorrow’s leaders. There will be something for everyone, including immersive cultural experiences, unique heritage, exciting innovations and global culinary journeys.

The region is well represented among the 192 Country Pavilions that will spotlight the very best of global culture, creativity and celebrations throughout the six months of Expo 2020 Dubai. Visitors will also gather at Al Wasl Plaza, the iconic centrepiece of Expo 2020.

It will host major ceremonies and celebrations during and after Expo, and the venue’s steel trellis dome will act as an immersive 360-degree projection surface that can be viewed from both inside and outside.

Visitors will be able to explore Expo 2020’s subthemes of Opportunity, Mobility and Sustainability at the three Thematic Pavilions, which will demonstrate tangible ways for each of us to all help shape a brighter tomorrow.

The Opportunity Pavilion will offer journeys that highlight the Sustainable Development Goals, a blueprint set by the United Nations that addresses global challenges, such as poverty, gender inequality and climate change.

The Mobility Pavilion will look at the past, present and future of movement – showcasing human progress through physical and digital realms – while the Sustainability Pavilion will offer an emotional journey through oceans, forests and beyond. Visitors will witness the madness of human consumption and can pledge to help preserve the planet for future generations.

Taking place from 20 October 2020 until 10 April 2021, the next World Expo will be an unmissable celebration welcoming millions from across the planet to the UAE.

More details on how to purchase tickets or arrange VIP packages can be found at www.arabhealthonline.com

Daily Dose

DHA drives forward patient care with pioneering 3D printing lab

Article-DHA drives forward patient care with pioneering 3D printing lab

Medical Experts from Dubai Health Authority’s (DHA) Innovation Centre have collaborated with Sinterex, an additive manufacturing healthcare specialist firm, to bring 3D Printing to the point-of-care at DHA Hospitals-Rashid, Latifa, Dubai, and Hatta Hospital.

The newly opened 3D Printing Lab located at the DHA’s Innovation Centre provides medical professionals at DHA with patient-specific anatomical models allowing them to conduct detailed pre-operative analysis and to improve patient communication.

The workflow starts with patient data acquisition, typically from a CT or MRI scan. This patient data is then brought into medical image segmentation software, which allows the physician to isolate the specific anatomical region of interest. This digital model is then converted into a 3D printable file and produced using the state-of-the-art 3D printers in the lab.

Dr. Farida Al Khaja, CEO of Medical Support Services and Chair of Medical Innovation Council at DHA explained that this initiative in is line with the DHA’s vision of incorporating latest medical technology in the health sector with a primary aim to better patient care. Additionally, technology also helps improve efficiencies and reduce costs.

Al Khaja said this initiative, in particular, will help DHA medical professionals achieve greater surgical success, particularly for complex cases.

She added that the lab is an important milestone in the execution of the DHAs 3D Printing Strategy, which focusses on deploying the latest technologies to improve patient outcomes and support the healthcare ecosystem of Dubai to excel in difficult medical surgeries.

3D Printing to assist in complex surgeries

Sinterex has deployed its biomedical engineers to operate the 3D lab. Julian Callanan, Managing Director, explained that having the biomedical engineers on-site and working side-by-side with the medical professionals, helps boost communication and cooperation and it reduces the time taken to develop the final 3D model.

Mai Al Dossari, Director of the DHA’s Health Innovation Centre, said, “This is the first major project in the Innovation Centre since it was inaugurated. The 3D Lab has been involved in supporting DHA’s surgeons in successfully planning and achieving complex surgeries. The Cardiology team at Rashid Hospital used 3D models to pre-operatively plan and test the fitting of Trans Aortic Valve Implants. The Maxillofacial team have produced models of patients’ jaws and skulls taking these into surgery for visual reference and intra-operative monitoring. Whilst at Hatta Hospital, the Orthopedics department has been printing knees and shoulders to support planning for reconstruction surgeries.”

Not only is the initiative good for patients, but recent research also shows the commercial benefits of bringing 3D printing to the point-of-care.

A recent study published in September by Academic Radiology estimated that hospitals using anatomical models could save more than US$3,700 per surgery by reducing time spent in the Operating Theatre. The authors reached their conclusions by analyzing more than 30 different studies related to 3D models used in orthopaedic and maxillofacial surgery. Based on that review, they estimated that anatomical models could shorten surgery time by about 62 minutes on average. 

Dr. Mohammed Al Redha, Director of Project Management Office and Informatics and Smart Health at DHA says, “This is an important strategic step for the DHA. It is also a further example of how the DHA is integrating 3D Printing into its day-to-day workflows to secure better results for its patients.”

According to Gartner, a leading research and advisory company, in 2018, nearly 3 per cent of large hospitals and medical research institutions had 3D printing capabilities on site.

Al Redha says, “We are truly proud that we have been able to successfully integrate this technology in workflows. Having a 3D printing lab means that we can produce patient-specific 3D printing models especially needed for complicated surgeries. This initiative is in line with the vision of Dubai’s 3D printing strategy to become a global 3D printing technology hub by 2030.”

Daily Dose

Optimising safety, comms, and teamwork in and around the OR

Article-Optimising safety, comms, and teamwork in and around the OR

The role of effective teamwork in accomplishing complex tasks is accepted in many domains. Similarly, there is good evidence that the outcome in trauma care depends on effective surgical team performance. Team training and communication has a proven history in aviation and military organisations. In 1988, after many aircraft accidents, the IATA Technical Committee, the senior international aviation safety agency, recommended that all airlines should establish a safety department managed by a professional safety officer to implement a safety management system with explicit flight safety functions. Prior to 1988, communication between the captain and first officer was more subordination than meaningful collaboration. There was little communication in the cockpit. One pilot would read out the required action and the other pilot would execute and then repeat back confirming the action completed. The aviation industry realised through Crew Resource Management training that meaningful teamwork can only occur when there is truthful, transparent and timely communication between team members. Aviation learned from its mistakes, but it took many incidents, as well as public and regulatory scrutiny, to make flying reliable and safe.

Recently, these experiences and techniques have been applied in healthcare, including in resuscitation and critical care management. Studies of aviation teams revealed failures of coordination, communication, workload management, loss of group situational awareness, and inefficient resource utilisation. Thorough investigation of adverse events in hospital care, patient hand-offs, and resuscitation revealed similar failures that, like aviation, tend to be multifactorial and complex.

Healthcare has turned to learn from the aviation industry and developed processes to create a patient safety culture and communicate effectively to achieve reliable and cost-effective patient outcomes. Briefing the team before a procedure, communicating constantly during a procedure so team members know the intended plan, and then debriefing the team to collectively reflect and learn what went well, and what is needed to be improved are essential components of great teams.

The U.S. spends more per person on healthcare than any other industrialised country, yet our health outcomes, including overall life expectancy, are worse. Teams, we know, make fewer mistakes than individuals, especially when all team members know their individual responsibilities as well as those of the other team members. However, simply bringing individuals together to perform a specified task does not ensure that they will function as a team. Teamwork depends on a willingness of clinicians from diverse backgrounds to cooperate toward a shared goal, to communicate, to work together effectively, and to improve.

Each team member must be able to:

• Anticipate the needs of the others

• Adjust to each other’s actions and to the changing environment

• Monitor each other’s activities and distribute workload dynamically

• Have a shared understanding of accepted processes, and the knowledge of how events and actions should proceed (situational awareness)

Turning healthcare experts into an expert team requires substantial planning and practice. There is a natural resistance to move beyond individual roles and accountability to a team mindset. We can facilitate this organisational commitment by:

• Fostering a shared awareness and mind-set of each member’s tasks and role on the team through cross-training and other team-training modalities

• Training members in specific teamwork skills such as communication, situation awareness, leadership, followership, resource allocation, and adaptability

• Conducting team training in simulated scenarios with a focus on both team learning, behaviours and technical skills

• Training clinical team leaders in the core leadership competencies to build and maintain effective teams

• Establishing and consistently utilising reliable methods of team performance evaluation and rapid feedback

Teams that do not communicate well cannot deliver effective care but are merely groups of individuals working side by side. Effective teamwork and communication are critical to functioning safely in healthcare. They help groups navigate competing priorities, overcome issues associated with human factors, and reduce the risk of error. Surgical training must focus more intently on providing clinicians with the core competencies—the knowledge, skills and attitudes to more effectively communicate with the family and other providers and function as high reliable teams. Continued research on how to improve the safety and quality of perioperative care will be driven by honest and respectful dialogue with providers. This will eventually lead to a deeper understanding of the systemic causes and mechanisms that cause harm and how best to develop resilience to help mitigate this harm and develop more reliable systems of care.

References available on request.

Daily Dose

Unveiling disruptive solutions for next decade

Article-Unveiling disruptive solutions for next decade

What have been the biggest disruptors to the healthcare sector in the last five years, and how has Leader Healthcare Group adapted to these significant changes?

A disruption in the healthcare sector means changing the way disease is treated. The promise of disruption presented by technologies such as Artificial Intelligence (AI), Blockchain, Internet of Things (IoT) enabled devices, etc., has been a work in progress in the healthcare sector so far. While industries such as supply chain logistics, aviation, telecommunication, retail and banking have been transformed through technology-enabled disruption, the same is not the case with the healthcare sector. The scenario is now poised for change, and the healthcare sector is ready to embrace it.

The single biggest disruption in healthcare is slated to be Preventive Targeted Therapeutics or Preventive Precision Medicine. It will allow practitioners to intervene before a disease manifests itself, to identify a disease-prone state of health and develop a precise treatment programme based on the unique genetic-environmental-lifestyle profile of an individual.

Leader Healthcare Group has forged global connections to place these powerful tools at the service of healthcare providers across the GCC countries. The practitioners of the near future will be equipped with the tools of Health Threat Intelligence in a way that has not been possible until recently. Vision 2021 National Agenda emphasises the importance of preventive medicine. It seeks to reduce cancer and lifestyle related diseases such as diabetes and cardiovascular diseases to ensure a longer, healthy life for citizens. The Health Threat Intelligence Programme introduced by Leader Healthcare Group in collaboration with Dr. Giuseppe Mucci at BioSciences Genomics addresses these goals and is being showcased at the Leader Healthcare booth at Arab Health 2020. It incorporates genomics, cell biology, molecular biology and precision medicine to serve the objective of a longer, healthy life for citizens.

Helixmoker is a cancer prevention programme within the Health Threat Intelligence Toolkit. It is designed to reduce the prevalence of smoking. We know that smokers have the highest likelihood of developing lung cancer. But why do some smokers develop lung cancer, while others don’t? The reason is that the body’s ability to repair DNA damage varies from person to person, and lung cancer manifests after years of sustained DNA damage. Once the disease manifests, it is too late for a full reversal. The Helixmoker Programme is an assessment of genes associated with lung cancer combined with precision medicine or targeted therapy. The assessment reveals whether the smoker’s body is able to repair DNA damage caused by smoking. If DNA damage is progressive, the smoker will have the choice to quit smoking before the disease manifests itself. Thus, the smoker makes an informed decision in favour of quitting the habit.

How is the introduction of telemedicine, AI and other technological advancements affecting your work and the future of the business?

Ultra-reliable and super-bandwidth networks are required to facilitate time-bound wireless data transfer required by applications and tools such as Telemedicine, AI, Augmented Reality, Virtual Reality and IoT enabled medical devices.

The availability of 5G networks may provide the impetus for caregiving institutions to integrate these tools into traditional therapy models. Realistically, it is the availability of 6G networks that would empower healthcare providers to truly exploit the power of telemedicine. The purpose of telemedicine is to bridge gaps in access to healthcare. The 6th generation of wireless mobile-communication networks is expected to integrate satellites for global coverage. This translates to near-zero mobile network dead zones. So, an individual living on a mountain, forest or remote village would have access to medical care via telemedicine as easily as city / town residents.

Leader Healthcare Group has been one of the first solution providers to introduce Augmented Reality & Virtual Reality based learning solutions for medical and life sciences education across the GCC countries. Innovative solutions for healthcare education and therapy, are available as plug-n-play or turnkey solutions with the shortest possible turnaround time and learning curve. These solutions bear the stamp of leading companies worldwide – Microsoft, Virtual Rehab, 3D4 Medical, Body Interact, CAE Healthcare to name a few.

Arab Health 2020 will serve as the platform to unleash the power of AI in diagnostic imaging. Leader Group partners with Centre for Advanced Research in Imaging, Neurosciences & Genomics (CARING) to launch CARPL – a diagnostic and analytics platform to support faster, reliable and cost-effective diagnoses through medical imaging. CARPL places the ease and power of AI into the hands of radiologists and physicians, bringing comfort to patients who may have experienced a misdiagnosis, assurance to insurance providers who may have reimbursed in vain, and relief to caregiver institutions who may have encountered litigation arising from inaccurate diagnoses. CARPL can reduce the previously impossible task of parsing through millions of medical scans to the timeframe of a few days – thus overhauling the approach to public health and empowering policy makers towards monitoring of disease-burden in real-time, at a fraction of the cost.

The future of the business at Leader Group hinges upon integrating and aligning these solutions to the curriculum and learning journey of the students. Therefore, a team of project and learning specialists supports learning institutions towards needs assessment, requirements planning, curriculum integration and learning centre operations. The medical and life sciences graduate of the near future will seamlessly integrate the caregiving experience into the busier-by-the-minute schedules of an increasingly globe-trotting patient population.

How do you ensure that your products and services improve patient experience?

Leader Healthcare Group was established with a mission to improve patient outcomes and quality of life. Our global connections and supply chain infrastructure attract the attention of innovators worldwide. Healthcare technologies that add value in unambiguous ways are cherry picked and supported with a platform to grow in the region. The business development teams travel extensively to source affordable, innovative solutions which support a patient’s journey towards health. This ensures that the business remains focused on improving patient experience.

Daily Dose

Lets PARTY back pain away

Article-Lets PARTY back pain away

Back pain is not a disease. It is a symptom. It is not considered a disease, because most cases of low back pain are non-specific, where there is no clear structural or anatomical cause that can be identified. Despite significant advances in medical science, low back pain is on the increase due to an ageing world population. Low back pain alone, globally contributed to 57.6 million total years lived with disability. There is also no medicine, injection, device or operation that can cure back pain. Lifestyle modification and exercises remain the main options for relief of symptoms. Even in spite of the global epidemic of low back pain there are still some inconsistencies among international guidelines regarding the best treatment protocol or measures to prevent recurrence.

What types of exercises are best suited for treating low back pain?

Various forms of exercises exist to treat and prevent low back pain. These fall into three broad categories; general fitness or aerobic exercises, strengthening or resistance exercises and flexibility exercises. Different individual therapies like Pilates and Yoga use a combination of these techniques. Research has not provided clear evidence that one form of exercise is superior to the other in the treatment of lower back pain.

Resistance training

Resistance training or strengthening exercise programmes have been more popular and have shown to be beneficial in injury prevention. The Fédération Internationale de Football Association (FIFA) introduced a 11-point programme to reduce injuries in football. Among these, the two main exercises for the lower back were the forward and side plank. Evidence that has emerged, since the introduction of this warmup programme, suggests that the FIFA protocol has decreased injury on the soccer field by 30 per cent.

Therapeutic patient education

In addition to exercises, therapeutic patient education (TPE) also forms a key element in treating low back pain. Therapeutic patient education reduces the negative effect of fear avoidance and promotes treatment compliance. Metaphors are a powerful and effective modality of TPE. They help the mind to grasp concepts that are new and unknown by linking it to something which is similar but not identical.

If exercise and life-style measures are the key elements in treating and preventing the recurrence of back pain, then the process should be simplified, de-medicalised and made enjoyable and should be real fun to engage in. If treating back pain has to be fun, then the outlook should be “Let’s PARTY back pain away”. PARTY aka Pilates, Aqua Exercises, Running, Tai Chi and Yoga.

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Pilates

Pilates is a method of exercise that was developed by Joseph Pilates, from Germany. His belief was that physical and mental health was closely connected. Lin and co-researches reviewed eight randomised control trials. Their final conclusion was "in patients with chronic low back pain, Pilates showed significant improvement in pain relief and functional enhancement."

Aqua exercises

Aqua exercises are gentle exercises done in water. Usually in a swimming pool. The buoyancy of the water decreases the stress from weight bearing whilst the resistance of the water provides the necessary work out for the muscles. Irandoust and others did a study on a small number of elderly males. However, their conclusion was that a water-based exercise programme improved low back pain and body composition.

Running

Belavy studied 79 individuals between the ages of 25 and 35. There were three groups of patients. The first group did not participate in sports or physical activity, the second group were joggers running 20-40 kms per week and the third were long-distance runners doing more than 50 kms per week. Their research showed that walking and slow running, increased the hydration and the height of the discs. It is possible that the cyclical loading from running may have improved the health of the disc. On the other hand, lack of activity, fast running or high impact jumping activities were not beneficial.

Tai chi

Tai chi is an exercise regime that originated in China. It is a gentle and a smooth flowing exercise. The benefits include increased balance, improved health status with chronic conditions and better awareness of the body.Hall and colleagues studied 160 volunteers. Their conclusion was that, when compared to a 10-week programme of usual care, Tai chi exercise is significantly better at reducing the pain intensity and bothersomeness of back symptoms.

Yoga

Yoga originated in ancient India. Traditionally it encompassed religion, meditation and physical exercises. In the western world, yoga became popular in the 1980s. Its usefulness comes both from the exercises and relaxation. The review by Crow and others analysed six different studies with a total of 570 patients. Their study showed strong evidence that Iyengar yoga was an effective means for treating both back and neck pain in the short term.

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Practical metaphors for therapeutic patient education.

1. Metaphor to demonstrate how strong back muscles prevent injury

Peter and Paul are identical twins. Being identical twins, they have the same genes. Peter works in a removal company. He lifts an average of three tonnes across 50 meters each day. Paul on the other hand works in an office. He is sat on a chair for eight hours every working day. The only physical activity that Paul does is push a pen on paper or keys down a keyboard. Sitting for long periods de-conditions his back. That is, the muscles become weak and cannot support the vertebral column. Over the weekend, both Peter and Paul are gardening in their respective homes. Each of them has to lift a bag of compost weighing about 20 kgs. Peter, the removals man, lifts the bag without a problem. Paul, the office worker, hurts his back when he lifts the same load. It is wrong to blame the act of lifting as the cause of Paul's problem. If lifting was the problem, then it is more likely that Peter who lifts more, would have hurt his back. In reality it was Paul who developed a problem with his back. That is because Paul's back was not fit for purpose.

2. Metaphor to encourage pacing of activity

Patrick needs to drive a distance of 20 kms. He is in a hurry and needs to reach his destination quickly. Driving through red lights may seem fast but is likely to get him into trouble. The Police may stop him for over speeding and failing to obey traffic signals. Driving at a steady pace is more likely to get him to his destination safely and on time. This is similar to recovery from back pain. Patients are very eager to exercise and err on doing too much too soon. This only gets them into more trouble. How then can we handle this? It is common practice to score pain on a scale of 0 to 10. Let us assume that a score of 0 to 4 is “Green”, a score of 5 to 7 is “Amber” and a score of 8 to 10 is “Red”. Let us also assume that before exercise or activity the pain is on green, starting at 0/10. With commencement of activity or exercise, the pain is likely to increase. It is important that the activity and exercise is stopped when one reaches “Amber”. Fighting the pain barrier is only going to get us into trouble with our inner brain which acts as a policemen and modulates our activity.

3. Metaphor to understand why weak muscles in the lower back can damage the discs.

Cars have shock absorbers and tyres. If the tyres are well inflated, then the shock absorbers are unlikely to wear out quickly. However, if the tyres are under inflated then the car wobbles. The increased wobbliness is transferred to the shock absorbers, which will then fail prematurely. Well and adequately inflated tyres will not cause wobbliness of the car. Hence, the shock absorbers are not overstressed. This then allows the shock absorbers to last a lifetime. It is similar in the back. The muscles are the tyres and the discs are the shock absorbers. If the muscles are strong then the discs do not wear out prematurely. However, if the muscles that surround the spine are weak then there is an increased wobbliness between the vertebrae, which will increase the chance of damage to the disc due to repetitive trauma.

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Some difficulties in the classic medical management of back pain

1. Assessment of core strength

Exercise and core strengthening seem to be the mainstay in the treatment and prevention of low back pain. However, the usual clinical assessment of a patient with back pain does not involve testing the strength of the core. Testing this, by observing a patient’s ability to bridge or plank, is a reasonable method to assess the strength of the core.

Evidence suggests a supine plank / bridge of less than 100 seconds and a prone plank / bridge of less than 60 seconds is associated with back pain. On the contrary a supine plank / bridge of 180 seconds and a prone plank / bridge of 90 seconds are not associated with back pain. These are targets which the patient can be motivated to achieve when exercising.

2. Fat infiltration of the multifidus muscle.

Though not essential, MRI scanning is being used more often when assessing low back pain. Unfortunately, the scans and the reports focus on the abnormalities in the disc, the bone and the nerves. Very rarely do MRI reports focus on the muscle. If exercise is a key element in the management of back pain, then the effect, that back pain has on the muscle needs to be evaluated and reported. One of the muscles that form the core and support the spine is the multifidus. This lies very close and adjacent to the spine. In chronic back pain the multifidus muscle becomes smaller and is replaced by fat. MRI scans can identify the infiltration of fat in the multifidus muscle.

Infiltration of fat into the multifidus is not related to obesity or body weight. It is unfortunately a reaction that occurs as a result of back pain. It is important that MRI scans, if and when performed, for mechanical back pain should attempt to describe the state of the multifidus muscle and the extent of fat infiltration. Providing a report which states that there is no degenerate disc or nerve compression provides no measures to the patient to rectify the situation. 

3. Reliance on surgical intervention

Spinal surgery is not a procedure to be taken lightly, it comes with an array of complications and a potential to worsen symptoms from baseline. An important example of this is ‘Failed Back Surgery Syndrome’ (FBSS). FBSS is defined as back pain which persists despite surgery or occurs after surgical intervention for treatment of previous spinal pain in the same region. Essentially, the original pain may still exist or worse still increase despite surgery which was intended for minimising discomfort. Once FBBS has occurred treatment options are often limited and expensive.

The risk of developing failed back surgery syndrome is as high as 1 in 5 spinal surgical interventions. A study compared the annual price of treating FBSS against four other common chronic conditions including rheumatoid arthritis, osteoarthritis and fibromyalgia. Cost calculation concluded that treating FBSS cost €1802, whereas other conditions cost between €183 and €1261 per annum.

Conclusion

Back pain is a global epidemic. However, treatment modalities can be relatively simple. For instance, encouraging patients to regularly perform core exercises may be all that is required.

Furthermore, health professionals should invest time to educate patients regarding core strength and its protective role on the back. The medical focus should be to empower patients to self manage.

References available on request.

Daily Dose

Resume of the future

Article-Resume of the future

TrueProfile.io®, powered by the DataFlow Group, has launched a new digital resume for their blockchain-based document verification platform to reimagine the traditional resume.

Competition for coveted healthcare roles is fiercer than ever. With a huge volume of applications for each role, credible candidates need a new way to display their career accolades. TrueProfile.io have developed a new myTrueProfile page for its Members, which enables hopeful job applicants to build a new, verified digital resume, which can be shared with and viewed by employers.

Do resumes help or hinder during healthcare hiring?

Submitting a resume is common practice for the majority of job applications. However, with around 50 per cent of traditional paper CVs said to contain falsifications, it’s safe to say that this practice is flawed – particularly in high-risk industries like healthcare. When it comes to international recruitment, this issue is only exacerbated on a larger, more complex scale.

Statements made around professional accolades are ultimately designed to impress and, in an increasingly competitive job market, ordinarily scrupulous candidates can give into the temptation of adding embellishments to their CV in the hope of securing a new role.

Thanks to the enforcement of background checks and document verification within the healthcare industry in the GCC, dishonest applicants never get to the finish line when it comes to securing a new position. However, the rise of dishonesty during the application process causes a huge strain on hiring managers and sifting through false information means that less time can be spent on trustworthy candidates.

Qualified healthcare professionals are more than just a resume

The hiring process isn’t just cumbersome for those in charge of recruiting new employees, but also for the potential employees themselves. Writing and updating a resume is just the start, and with so many CVs flooding into a recruiter’s inbox, it’s easy for an authentic candidate to be overlooked.

The first stage is often who can submit the most impressive, yet unverified, paper-based account of their professional accolades. Ultimately, a traditional resume and its unproven written statements are a poor proxy for a ready-to-hire, qualified healthcare professional.

When a job seeker has verified their credentials such as degrees, medical licences, good standing certificates and references they need a legitimate means of displaying their professional validity outside of a few sheets of A4.

The solution? Introducing the new myTrueProfile page

TrueProfile.io has developed just the thing to provide applicants with a level playing field in which to present their career information: the myTrueProfile page.

Helping verified professionals get hired

Once signed up, TrueProfile.io Members are granted with a digital resume that they can populate with their professional documents and traditional CV elements – including their verified credentials, known as ‘TrueProofs®’. Job seekers can choose exactly who they wish to share their information with and can send the link directly to employers or regulators and can even display their new digital CV on LinkedIn. Any verifications they have stored on their myTrueProfile page can be checked and validated by a potential employer via blockchain.

For those who are actively seeking a new position, they can opt to make their profile visible to employers in order to build new career opportunities. As the individual’s career develops, new sections can be added and verified to reflect their professional growth. Once candidates are in their new role, they can switch their profile to private so that it can only be viewed by them until it’s needed for their next big career move.

Getting started

Our ethos is to ensure that trustworthy, verified candidates can fast-track their career potential with the help of TrueProfile.io. The digital resume is completely free of charge for all TrueProfile.io members and by sharing career information in this format it helps to ensure that recruiters and hiring managers do not waste their time and resources on unscrupulous or fraudulent candidates.

To join the TrueProfile.io community, sign up for free at https://www.trueprofile.io/member