About 54 percent of primary-care medical visits in West Bengal occur in these informal settings. That figure ranges as high as 75 percent in some other Indian states. The paper, “The Impact of Training Informal Healthcare Providers in India: A Randomized Controlled Trial,” is being published Friday in the journal Science. The co-authors are Banerjee; Jishnu Das of the World Bank; Abhijit Chowdhury of the Institute of Post Graduate Medical Education and Research at SSKM Hospitals in Kolkata, India; and Reshmaan Hussam PhD ’15, a postdoc at Yale University. Banerjee is a co-founder of MIT’s Abdul Latif Jameel Poverty Action Lab (J-PAL), which focuses on scientifically rigorous field experiments that produce information potentially relevant to poverty alleviation efforts. Better case management The study was conducted with the cooperation of 304 informal health care providers in West Bengal; the 150 hours of training the participants received was divided into 72 sessions over a nine-month period. The researchers used “standardized patients” to conduct the study — that is, people playing the role of patients who had symptoms consistent with angina, asthma, and diarrhea. The results reveal that providers with training increased, by 4.1 percentage points, how often they developed a checklist of medical data relevant to the patients’ conditions — a standard medical practice that helps with diagnoses and patient assessments over time. Similarly, informal providers increased their “correct case management,” an overall measure of their decision making in a given situation, by 7.9 percentage points.
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The cooked tumor, rather than being tense and bloody as he expected, was soft, and its blood supply had been clotted off. This gave him the idea that he could treat even the larger inoperable tumors safely with LITT if he combined it with a very small craniotomy (a small opening in the head) which would allow him to “suck out” the cooked tumor to prevent swelling. The Neurosurgical Focus paper (and an accompanying video) describe this treatment on 10 patients who had difficult-to-access malignant tumors. The tumors had a median volume of 38 cc. Eight patients had GBMs including “butterfly GBMs,” one had previously treated GBM, and one had a melanoma brain metastasis. GBM is the deadliest of brain tumors and patients with them have a very poor prognosis. Since the study, six patients remain alive and four have died. “I am very excited by the results of this study. This procedure is a new option for patients with these large malignant tumors,” said Dr. Sloan.
For the original version including any supplementary images or video, visit https://www.eurekalert.org/pub_releases/2016-10/uhcm-som100316.php