Misplaced priorities in the Union Health Budget 2015

The Union Budget presented on 28 February 2015 in the Indian parliament has allocated only INR 33,000 crores for health. It allocates more funds for building newer tertiary care hospitals and increases income tax exemptions for buying health insurance. The article explains that model that is being followed, as indicated by these measures, will create havoc to the lives of Indians and make them sicker and healthcare costlier. The budget is not in line with the actual priorities of India’s health system and nor paves the road map for Universal Health Coverage. The Government of India needs to gets its priorities right.

Read the Commentary by Dr Soumyadeep B published in J Family Med Prim Care here (Open Access)

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Is intermittent short-course anti-TB regimen as efficient and safe as daily anti-TB regimen for treating childhood TB?

Childhood tuberculosis (TB) is a common clinical condition in low- and middle-income nations like India where TB is endemic. Different guidelines vary in the recommendations on treatment regimes for childhood TB. Apart from clinical outcomes the decision to use one regimen over another also has an implication in the form of health system burden. The evidence summary presents the comparison between the intermittent regimens with the daily anti-TB regimen for childhood TB.

Read the Evidence Summary at JFMPC (Click) Open Access

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Misuse and misinterpretation of subgroup analysis

Originally posted on EC EBM:

Misuse and misinterpretation of subgroup analysis Misuse and misinterpretation of subgroup analysis

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Ethics and equity in research priority-setting: stakeholder engagement and the needs of disadvantaged groups

A transparent and evidence-based priority-setting process promotes the optimal use of resources to improve health outcomes. Decision-makers and funders have begun to increasingly engage representatives of patients and healthcare consumers to ensure that research becomes more relevant. However, disadvantaged groups and their needs may not be integrated into the priority-setting process since they do not have a “political voice” or are unable to organise into interest groups. Equitable priority-setting methods need to balance patient needs, values, experiences with population-level issues and issues related to the health system.
Read the full paper published by Dr. Soumyadeep B et al at Indian Journal of Medical Ethics here (Click: Open Access)
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Child and Adolescent Psychiatry in India Part 4: Attachment Theory in the slums of Kolkata

Originally posted on Child Psychiatry OOPE at Calcutta Rescue:

In the not so distant past, academics and clinicians alike debated the relative influence of the environment on the developing mind. At one extreme were those that saw the mind as a ‘tabula rasa’ stating the mind was completely shaped by the environment and experience. At the other were those who believed the child’s innate way of being was the deciding factor. We now know a child’s mind develops through a complex interaction between their environment and genes, with both playing a crucial role. So for example, the presence of a certain gene responsible for reduced levels of an enzyme monoamine oxidase A (MAOA) in the brain places you at greater risk of developing aggressive and antisocial personality traits as an adult. However, that risk is only realised when that child grows up in an abusive or traumatic environment.

One area of child development that is predominately effected by environmental…

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Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia:

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) together contribute to the largest burden of morbidity (14% of disability-adjusted life years) and mortality (over 30% of all deaths) in South Asia.T2DM doubles the risk of developing CVD, and approximately half of patients with T2DM are known to be hypertensive.By 2030, it is projected that there will be 120.9 million people with diabetes in South Asia (90–95% of these will have T2DM), more than double the number affected in North America or Europe.

South Asians experience higher case fatality rates and rates of premature death due to CVD (deaths occurring at least 10–15 years younger) than the rest of the Western world.A report in 2010 suggested that the total annual income loss to households affected by CVDs in India was 144–158 billion INR. The WHO estimates that India will lose US$237 billion due to heart disease, stroke and diabetes, which will slow the growth in India’s GDP (gross domestic product) by 1% over the next 10 years, thereby contributing to poverty. The mortality and morbidity due to CVD/T2DM thus impose a huge economic burden on individuals, families and society, the health system, and the economy as a whole.

CVD and T2DM share various common risk factors (unhealthy diet, physical inactivity, tobacco use, high blood pressure, dyslipidaemia and stress), and hence there is considerable overlap in strategies used to control these diseases.

While the efficacy and safety of various interventions have been tested by several randomised controlled clinical trials and subsequent systematic reviews and meta-analyses, little is known about the cost-effectiveness of these interventions from the perspective of either the patient or the healthcare system.

Full Systematic Review Protocol on the issue was published by Singh K , Sekaran AMC , Bhaumik S et al  recently in BMJ Open and is available here (Click) (Open Access )

So-Called “Special” Issues of Journals: Big Money for Gold OA Publishers

Originally posted on Scholarly Open Access:

journal special issues Vicious cycle

Special issues of journals mean big money for gold (author-pays) OA publishers. It’s a type of affinity marketing. The special issue guest editor typically invites his contacts and colleagues to contribute papers for a special issue on a topic, and they all have to pay author fees to the publisher. 

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