Latest news with #doctors
Medscape
14 hours ago
- Health
- Medscape
Doctors' End-of-Life Choices Break the Norm
A new survey revealed that most doctors would decline aggressive treatments, such as cardiopulmonary resuscitation (CPR), ventilation, or tube feeding for themselves if faced with advanced cancer or Alzheimer's disease, choosing instead symptom relief and, in many cases, assisted dying. 'Globally, people are living longer than they were 50 years ago. However, higher rates of chronic disease and extended illness trajectories have made end-of-life care the need for improved end-of-life care an issue of growing clinical and societal importance,' the authors, led by Sarah Mroz, PhD, a doctoral researcher with the End‑of‑Life Care Research Group at Vrije Universiteit Brussel and Ghent University, based in Brussels and Ghent, Belgium, wrote. Physicians play a critical role in initiating and conducting conversations about end-of-life care with patients, whose deaths are often preceded by decisions regarding end-of-life practices. These decisions may include choosing to forgo life-prolonging therapies or opting for treatments that could hasten death. Such choices have a significant impact on individuals, families, and the healthcare system. 'Since physicians have a significant influence on patients' end-of-life care, it is important to better understand their personal perspectives on such care and its associated ethical implications. However, existing studies on physicians' preferences for end-of-life practices are outdated and/or focus on a narrow range of end-of-life practices. Additionally, knowledge on whether physicians would consider assisted dying for themselves is limited, and no international comparative studies have been conducted,' the authors wrote. To address this gap, the researchers conducted a cross-sectional survey of 1157 physicians, including general practitioners, palliative care specialists, and other clinicians from Belgium, Italy, Canada, the US, and Australia. Physician Choices Physicians were surveyed regarding their end-of-life care preferences in cases of advanced cancer and end-stage Alzheimer's disease. Over 90% preferred symptom-relief medication, and more than 95% declined CPR, mechanical ventilation, or tube feeding. Only 0.5% would choose CPR for cancer and 0.2% for Alzheimer's disease. Around 50%-54% supported euthanasia in both cases. Support for euthanasia varied by country, from 80.8% in Belgium to 37.9% in Italy for cancer and from 67.4% in Belgium to 37.4% in Georgia, US, for Alzheimer's disease. 'Physicians practicing in jurisdictions where both euthanasia and physician-assisted suicide are legal were more likely to consider euthanasia a (very) good option for both cancer (OR [odds ratio], 3.1) and Alzheimer's disease (OR, 1.9),' the researchers noted. The results show how laws and culture shape end-of-life choices. Practice Gap The article highlights a striking disconnect: While most doctors would refuse aggressive interventions for themselves at the end of life, such treatments are still commonly administered to patients. What explains this gap? 'The gap between doctors' preference for comfort-focused care for themselves and the aggressive treatments they often provide to patients highlights a deeper conflict between personal understanding and professional obligation,' said Andrea Bovero, psychologist at the University Hospital Città della Salute e della Scienza and faculty member in the Department of Neurosciences at the University of Turin, both in Turin, Italy, in an interview with Univadis Italy , a Medscape Network platform. Physicians, he explained, understand the limits of medical interventions and their real impact on quality of life due to their training and experience. 'When they become patients themselves or must make decisions for loved ones, they tend to choose less invasive options — prioritizing quality of life over simply extending it,' he added. However, the situation changes when treating patients. Doctors operate within a system that rewards intervention, action, and a 'fight the disease' mindset — often under pressure from families who want every possible option pursued and from the fear of appearing negligent to the patient. 'There's also the fear of legal consequences,' Bovero said. 'This drives a defensive approach to medicine, where taking action feels safer than choosing not to intervene.' According to Bovero, who was not involved in the study, bridging the gap between what doctors would choose for themselves and what they offer their patients requires a broader rethinking of the healthcare system. 'We need new cultural models, medical education that centers on the individual and the ethics of boundaries, and a healthcare system that prioritizes listening and support,' he said. Rethinking the Role of Death Deeper cultural factors influence the choice of end-of-life care. 'In many Western societies, death is still seen as a failure — even in medicine,' Bovero said. This mindset, he explained, contributes to the avoidance of honest conversations about dying and a preference for treatments that delay or deny death. As a result, physicians are often caught between what they know is clinically appropriate and what social or institutional norms they are expected to follow. 'Regulatory frameworks play a major role in defining what is considered possible or acceptable in end-of-life care,' Bovero said. He emphasized that clear, shared laws on practices, such as deep palliative sedation or euthanasia, could give physicians greater freedom to express and follow care decisions focused on patient comfort and relief. 'In countries where the law explicitly supports patients' rights to palliative care, informed consent, and advance directives, physicians are better positioned to align care with patient values,' Bovero noted. For example, Italy's legislation ensures access to palliative care and upholds the right to refuse treatment or plan future care, which promotes dignity and autonomy at the end of life. Individualized Care Good care doesn't always mean curative treatment; it often means focusing on quality of life,' Bovero said. He noted that this mindset becomes evident when healthcare professionals, as patients, opt for palliative care. However, he cautioned that physicians' personal preferences shouldn't be applied as a universal standard, because 'every patient has unique values, priorities, experiences, and goals that must be acknowledged and respected.' Placing the individual at the center of care is fundamental. Bovero emphasized that good clinical practice involves tailoring medical knowledge, evidence, and even a clinician's personal insights into the specific needs of each patient. Good communication between doctors and patients is key to providing thoughtful care to patients. From the beginning, there should be open, honest discussions between healthcare providers, patients, and families. It is not enough to list treatment options; doctors need to understand what truly matters to the patient, including their fears, desires, and values. This kind of communication requires time, empathy, and real listening qualities that are often overlooked in health systems prioritizing efficiency and technical fixes. 'When doctors and patients connect not only on a medical level but also around personal meaning and existential priorities, care becomes truly personalized,' Bovero said. His research, published in the Journal of Health Psychology , highlights the importance of addressing patients' spiritual needs and encouraging providers to reflect on their own spirituality to improve support for people at the end of life.
The Guardian
18 hours ago
- Health
- The Guardian
The right wants to kill off the NHS. Striking doctors are playing into their hands
There were no pickets when I set out at the weekend to talk to striking doctors. Not even at St Thomas' hospital, a prime site opposite the Houses of Parliament, or at Guy's at London Bridge. 'It's a bit sparse,' said the duty officer from the British Medical Association, the doctors' union. The British Medical Journal (owned by the BMA but with editorial freedom) ran the headline: 'Striking resident doctors face heckling and support on picket line, amid mixed public response.' Public support has fallen, with 52% of people 'somewhat' or 'strongly' opposing the strikes and only 34% backing them. Alastair McLellan, the editor of the Health Service Journal, after ringing around hospitals told me fewer doctors were striking than last time, which isn't surprising given that only 55% voted in the BMA ballot. Managers told him these strikes were less disruptive than the last ones. But even a weaker strike harms patients and pains a government relying on falling waiting lists. 'When you're operating on the margins, it takes very little disruption to send waiting lists up again,' McLellan said. Strikes are costly, since consultants have to be paid to fill shifts, which is typically more expensive. One hospital manager asked me wryly: 'Have you tried paying for an out-of-hours emergency plumber or electrician?' This time Jim Mackey, the head of NHS England, is playing it tough. He told medical directors on Monday to warn doctors that anyone striking on one of their 12 compulsory training days would forfeit their qualification – and not to let strikers take up locum shifts on non-strike days to make up for the money they've lost. No more Mr Nice Guy. Everyone employed by the NHS will get an above-inflation pay rise this year, which is less than the 5.4% (comprising a 4% rise and a consolidated £750 payment) that resident doctors will receive. Nurses and ambulance crews have just voted overwhelmingly against a pay award of 3.6%. That was only a consultative ballot, leaving plenty of time for negotiations that might avoid holding a full strike ballot. Consultants are now balloting too. These looming demands make it vanishingly unlikely that Wes Streeting will give even more money to striking resident doctors, who have already received the top NHS offer. Mackey plays the hard man, but Streeting's emollience is over. He seems indignant and offended by the BMA. His first act as health secretary was to end the resident doctors' 44 days of strikes between March 2023 and July 2024 with a generous 22% pay rise, even while the rightwing press accused him of bowing to 'union paymasters'. Making peace was his welcome political signal that the party of the NHS was setting about repairing Tory damage. There was hope for goodwill and patience from healthcare workers. So the BMA coming back for more within a year was a shock, and a slap in the face for Streeting. The BMA is kicking a government that had been well-disposed towards it. With Tory and Liberal Democrat peers attempting to block the government's radical employment rights bill, Labour's enemies will relish this timely assistance from the strike. A piece on CapX, a comment site owned and produced by the Centre for Policy Studies, called the striking doctors 'Scargills in white coats' with 'blood on their hands', which is of course the literal truth, given what they do at work (Tom Dolphin, the new BMA chair, is a consultant anaesthetist who works in trauma surgery; his job involves 'a fair amount of stabbings, occasional shootings, assaults [and] falls from height'). Keir Starmer has warned that the strikes 'play into the hands' of those who do not want the NHS to 'succeed in its current form'. Vultures are circling: Nigel Farage talks of private insurance; the International Monetary Fund, in its great unwisdom, recently suggested the better-off should pay for NHS services; while the piece on CapX echoed the right's glee at the strike: 'The problem here isn't just that the BMA is populated by socialist thugs, it's that the NHS is a socialist system.' The NHS is ever ready to rescue us all, regardless of status – that is why doctors and nurses top public respect charts, and why they have much to lose as the public turns against them. 'When the BMA asks, 'What's the difference between a Labour government and a Conservative government?', I would say a 28.9% pay rise and a willingness to work together to improve the working conditions and lives of doctors,' Streeting said in vain last week. In a timely contrast, Kemi Badenoch has declared that the Tories would ban doctors' strikes, putting them under the same restrictions that apply to police officers and soldiers. Both sides in this strike are obdurate. 'This could be a marathon. We could be doing this until Christmas or maybe beyond,' the deputy chief executive of NHS England has glumly warned. Streeting says the negotiation door is always open, but the BMA says there's no point without cash on the table. Bad blood between them springs from the negotiations: talks were going well until the BMA resident doctors' committee told its co-chairs that it could not approve the government's deal because it did not address the BMA's demand that resident doctors receive a 29% pay rise over the next few years. Yet Streeting's offer tackled serious grievances: years of bad planning left 20,000 resident doctors without specialist training places, stuck in a bottleneck that he promised to resolve. The BMA damaged people's sympathy for the doctors by absurdly comparing their pay to that of a coffee barista. Resident doctors can expect to be on a steep annual trajectory, averaging £43,400 in year one and £51,600 in year two; as new consultants they will get £105,000, while GP partners earn as much as £160,000. The word in the corridors is that the BMA is losing support across the NHS and among its own members, Nick Hulme, the CEO of the East Suffolk and North Essex NHS foundation trust, told me. He said some of his consultants had this week resigned from the BMA. So has the fertility pioneer Robert Winston. History may reassure the BMA that the public will always trust doctors over politicians. This time, the public backs those trying to cut waiting lists more than the strikers who are adding to them. Polly Toynbee is a Guardian columnist
The Guardian
20 hours ago
- Health
- The Guardian
The right wants to kill off the NHS. Striking doctors are playing into their hands
There were no pickets when I set out at the weekend to talk to striking doctors. Not even at St Thomas' hospital, a prime site opposite the Houses of Parliament, or at Guy's at London Bridge. 'It's a bit sparse,' said the duty officer from the British Medical Association, the doctors' union. The British Medical Journal (owned by the BMA but with editorial freedom) ran the headline: 'Striking resident doctors face heckling and support on picket line, amid mixed public response.' Public support has fallen, with 52% of people 'somewhat' or 'strongly' opposing the strikes and only 34% backing them. Alastair McLellan, the editor of the Health Service Journal, after ringing around hospitals told me fewer doctors were striking than last time, which isn't surprising given that only 55% voted in the BMA ballot. Managers told him strikes were less disruptive than the last ones. But even a weaker strike harms patients and pains a government relying on falling waiting lists. 'When you're operating on the margins, it takes very little disruption to send waiting lists up again,' McLellan said. Strikes are costly, since consultants have to be paid to fill shifts, which is typically more expensive. One hospital manager asked me wryly: 'Have you tried paying for an out-of-hours emergency plumber or electrician?' This time Jim Mackey, the head of NHS England, is playing it tough. He told medical directors on Monday to warn doctors that anyone striking on one of their 12 compulsory training days would forfeit their qualification, and not to let strikers take up locum shifts on non-strike days to make up for the money they've lost. No more Mr Nice Guy. Everyone employed by the NHS will get an above-inflation pay rise this year, which is less than the 5.4% (comprising a 4% rise and a consolidated £750 payment) that resident doctors will receive. Nurses and ambulance crews have just voted overwhelmingly against a pay award of 3.6%. That was just a consultative ballot, leaving plenty of time for negotiations that might avoid holding a full strike ballot. Consultants are now balloting too. These looming demands make it vanishingly unlikely Wes Streeting will give even more money to striking resident doctors, who have already received the top NHS offer. Mackey plays the hard man, but Streeting's emollience is over. He seems indignant and offended by the BMA. His first act as health secretary was to end the resident doctors' 44 days of strikes between March 2023 and July 2024 with a generous 22% pay rise, even while the rightwing press accused him of bowing to 'union paymasters'. Making peace was his welcome political signal that the party of the NHS was setting about repairing Tory damage. There was hope for goodwill and patience from healthcare workers. So the BMA coming back for more within a year was a shock, and a slap in the face for Streeting. The BMA is kicking a government that had been well-disposed towards it. With Tory and Liberal Democrat peers attempting to block the government's radical employment rights bill, Labour's enemies will relish this timely assistance from the strike. A piece on CapX, a comment site owned and produced by the Centre for Policy Studies, called the striking doctors 'Scargills in white coats' with 'blood on their hands', which is of course the literal truth, given what they do at work (Tom Dolphin, the new BMA chair, is a consultant anaesthetist who works in trauma surgery; his job involves 'a fair amount of stabbings, occasional shootings, assaults [and] falls from height'). Keir Starmer has warned that the strikes 'play into the hands' of those who do not want the NHS to 'succeed in its current form'. Vultures are circling: Nigel Farage talks of private insurance; the International Monetary Fund, in its great unwisdom, recently suggested the better-off should pay for NHS services; while the piece on CapX echoed the right's glee at the strike: 'The problem here isn't just that the BMA is populated by socialist thugs, it's that the NHS is a socialist system.' The NHS is ever ready to rescue us all, regardless of status – that is why doctors and nurses top public respect charts, and why they have much to lose as the public turns against them. 'When the BMA asks, 'What's the difference between a Labour government and a Conservative government?', I would say a 28.9% pay rise and a willingness to work together to improve the working conditions and lives of doctors,' Streeting said in vain last week. In a timely contrast, Kemi Badenoch has declared that the Tories would ban doctors' strikes, putting them under the same restrictions that apply to police officers and soldiers. Both sides in this strike are obdurate. 'This could be a marathon. We could be doing this until Christmas or maybe beyond,' the deputy chief executive of NHS England has glumly warned. Streeting says the negotiation door is always open, but the BMA says there's no point without cash on the table. Bad blood between them springs from the negotiations: talks were going well until the BMA resident doctors' committee told its co-chairs that it could not approve the government's deal because it did not address the BMA's demand that resident doctors receive a 29% pay rise over the next few years. Yet Streeting's offer tackled serious grievances: years of bad planning left 20,000 resident doctors without specialist training places, stuck in a bottleneck that he promised to resolve. The BMA damaged people's sympathy for the doctors by absurdly comparing their pay to that of a coffee barista. Resident doctors can expect to be on a steep annual trajectory, averaging £43,400 in year one and £51,600 in year two; as new consultants they will get £105,000, while GP partners earn as much as £160,000. The word in the corridors is that the BMA is losing support across the NHS, as well as among its own members, Nick Hulme, the CEO of the East Suffolk and North Essex NHS foundation trust, told me. He said some of his consultants had this week resigned from the BMA. So has the fertility pioneer Robert Winston. History may reassure the BMA that the public will always trust doctors over politicians. This time, the public backs those trying to cut waiting lists more than the strikers who are adding to them. Polly Toynbee is a Guardian columnist
Yahoo
a day ago
- Health
- Yahoo
Are melatonin supplements safe for kids?
The first time your baby sleeps through the night seems unforgettable — like a hopeful promise of a more rested future — but as many parents (unfortunately) find out, that hope often ends up feeling more like a mirage. Sleep challenges are a common part of parenting, and they can look different from household to household — or even night to night. Whether your child struggles to fall asleep or stay asleep, you're not alone. And if you've ever found yourself searching "natural sleep aids for kids" at 1 a.m., chances are melatonin has popped up. Yet despite this supplement's growing popularity, you may be wondering whether melatonin supplements are actually safe for kids. Melatonin is a hormone that helps regulate the body's internal clock, and while it's often used by adults to help manage sleep disorders and insomnia, over-the-counter melatonin supplements have become increasingly popular for kids too. Whether it's due to travel challenges and disrupted schedules, insomnia or sleep difficulties linked to ADHD or autism, parents are increasingly interested in using melatonin supplements as a way to help their kids (and themselves) get much-needed rest. To help cut through the confusion — and save you another sleepless nighttime scroll — we spoke with three pediatric experts, including two doctors and a registered dietitian, about if and when melatonin might be helpful and what to know about dosing and safety before purchasing a supplement. A note on supplements The products included on this list are dietary supplements. Statements about these products have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Dietary supplements are not appropriate for everyone and may interact with other supplements or medications, so talk to your health care provider before adding a dietary supplement to your routine. Are melatonin supplements safe for children? The short answer is yes, though Dr. Michelle Caraballo, sleep medicine specialist at Children's Health, and Dr. Rupali Drewek, co-medical director of the Sleep Medicine Program at Phoenix Children's, agree that these products aren't appropriate or effective for all kids and should be used only short-term under medical supervision. "Melatonin is usually recommended for short-term use (typically two to six weeks) while behavioral interventions are established. If effective, it can be used intermittently as needed, but long-term daily use should be monitored by a health care provider," says Drewek. She also notes that because melatonin isn't habit-forming, it doesn't require tapering off. "That said, if a child has been using it regularly for months, slowly reducing the dose over one to two weeks can help [you] evaluate whether it's still necessary. Some families find when you gradually taper off from melatonin, it avoids abrupt changes in sleep quality. It's also a good time to reinforce consistent bedtime routines and healthy sleep habits," she says. As for who might benefit, research is ongoing but has mostly looked at the benefits (and safety) of melatonin for kids with certain conditions. "It can be helpful for specific conditions such as delayed sleep-wake phase disorder or sleep issues in children with autism or ADHD. However, it is not FDA-approved for pediatric use, and safety data for long-term use is limited," Drewek says. She also cautions that because dietary supplements aren't tested for label accuracy by the Food and Drug Administration (FDA), quality and dosing can vary greatly between products. What about toddlers? From transitioning out of the crib to starting nighttime potty training, sleep becomes a particularly tricky issue with toddlers. However, Caraballo cautions that these supplements should not be given to children under the age of 3. There simply isn't enough research to determine whether melatonin is safe or appropriate for 1- and 2-year-olds. How much melatonin is safe for kids? How much melatonin to give your child should ultimately be decided by your pediatrician. Here's a general idea of what dosing might look like, according to Drewek: Preschoolers (3–4 years): 1 mg School-age children (5–12 years): 1–3 mg Adolescents (13–18 years): up to 5 mg Keep in mind that your pediatrician may recommend different doses than what's listed above, or encourage starting with a lower dose and gradually increasing. "We ask parents to start with a low dosage, according to age, and carefully evaluate how effective it is. Many children respond to a low dose (1–5 milligrams) when taken 30 minutes before bedtime," says Caraballo. Drewek echoes the importance of starting low and slow, adding, "Higher doses don't always improve sleep and may increase side effects like morning grogginess or vivid dreams." Other factors to consider when choosing a melatonin supplement for kids Once you have the green light from your pediatrician to give your child a bedtime supplement, the next step is choosing a product. As with any supplement, there are a few key factors to keep in mind when making your decision: Age-appropriate dose: To provide a safe and effective dose, only give your child a melatonin supplement that's specifically formulated for their age. Supplement type: Melatonin supplements for kids come in a variety of types, including gummies, liquids, powders, chewables and dissolvable tablets. There are also soft gel options for adolescents. The best option is the one that your child can take safely, though some forms may be more readily absorbed than others. "We generally recommend liquid or oral dissolvable formulation over gummies because the absorption is more reliable with liquid and tablet forms," says Caraballo. Other active ingredients: Some kids' bedtime supplements include other ingredients, like magnesium or L-theanine. While safe for kids, it's best to talk with your pediatrician about whether these ingredients are necessary or appropriate for your child. Sweeteners and food dyes: Some brands add sweeteners and food dyes — natural or artificial — to make supplements more appealing to kids. Ideally, choose options with minimal added sugar and naturally derived flavors and colors, like those from fruit or vegetable juices and extracts. Third-party testing: "Several studies have shown that the amount of melatonin in a bottle can vary significantly from the amount listed on a label," says Caraballo. For this reason, it's important to choose a product made by a reputable brand that's ideally been tested for label accuracy by a trusted independent organization, like NSF or United States Pharmacopeia (USP). Potential side effects and safety concerns We probably sound like a broken record at this point, but research on melatonin in kids is limited, meaning there's still more that researchers and medical experts have to learn when it comes to safety. That said, short-term use of melatonin has not been linked with serious side effects in kids when taken in appropriate amounts. A 2024 review study published in the journal Children found that commonly reported side effects of melatonin supplements in kids include vivid dreams, nightmares and extreme tiredness. Still, this doesn't mean there aren't serious safety concerns. "Supplements should be treated like medications. It is important to discuss with your child's physician before starting a supplement, as some supplements can interact with other medications and may not be appropriate for all children. And just like medications, supplements should be stored in a locked cabinet out of the reach of children," says Caraballo. "Accidental ingestion of melatonin by children has led to a significant increase in ER visits in recent years, so proper storage is critical," adds Drewek. If you're concerned that your child consumed excessive amounts, call your pediatrician or another medical professional right away. Alternatives to melatonin "To help your child sleep well, the most important thing you can do is establish a bedtime routine — and be consistent. Maintain the same bedtime and wake time every day, including weekends and holidays. Kids really respond well to routine, so that their bodies know what to expect," says Caraballo. If your child is struggling to fall or stay asleep, start by checking their sleep environment. "Keep bedrooms cool, dark and quiet. Darkness cues the brain that it's time to sleep. A dim nightlight is fine for children who may not like total darkness," says Caraballo. Bedtime routines should also evolve as kids grow, notes Drewek. For toddlers and preschoolers, predictable steps like brushing teeth, reading and cuddling can create a sense of security. School-age kids benefit from screen-free wind-down time and consistent sleep schedules. And while teens may be harder to guide, encouraging them to leave phones outside the bedroom can help curb late-night scrolling. If the thermostat is set, screens are off, the sound machine is humming and your child's bedtime routine is solid — yet sleep is still a struggle — it might be time to consider other natural sleep aids for kids. Several companies offer melatonin-free supplements featuring ingredients like magnesium or L-theanine. "These ingredients may help promote relaxation and ease bedtime anxiety, especially in children who are sensitive to melatonin or don't tolerate it well. While they don't directly shift the circadian rhythm like melatonin, they can be useful for calming the nervous system," says Drewek. Just note that while these supplements may be more appropriate for long-term use — as long as you have the OK from your pediatrician — Caraballo recommends melatonin more often than other supplements because it "has better data supporting its use in children." Melatonin supplements for kids As a registered dietitian and mom of two, I know firsthand how challenging it can be to navigate the world of kids' supplements. To help, I reviewed 10 of the top melatonin products for kids, evaluating each on dose, ingredients and kid-friendly factors, like taste and texture. Here are three standout options to talk with your pediatrician about. FAQs Can a 3-year-old take melatonin? Yes, according to Caballo, melatonin can be given to a 3-year-old, though it's important to do so only under the recommendation of a pediatrician. How often can you give melatonin to a child? According to Drewek, melatonin supplements are typically recommended for just two to six weeks while other behavioral and bedtime strategies are established. That said, how frequently to give your child melatonin for sleep may vary and should be discussed with a pediatrician. Drewek also notes that while melatonin may be a useful tool for some kids, it doesn't replace the need for a consistent bedtime routine. "Sleep supplements should never replace healthy sleep habits, which are the foundation of good sleep," she says. Is melatonin addictive for kids? No, according to Caraballo, "[Melatonin] is not considered addictive, and discontinuation should not cause withdrawal symptoms." However, due to a lack of research on its safety and effectiveness, melatonin shouldn't be given to your child for more than a few weeks or months. Instead, it's important to work with a health care professional to identify the root cause of your child's sleep disturbances. What's a safe melatonin brand for children? There are several reputable brands offering melatonin supplements for kids, including OLLY, Natrol, Zarbee's, Mommy's Bliss and more. Look for products that are tested to ensure label accuracy, ideally by a third-party lab. Can diet affect kids' sleep? According to Katie Drakeford, board-certified pediatric registered dietitian, yes, your child's diet could be contributing to their sleep troubles. In particular, Drakeford notes that diets low in omega-3 fatty acids and vitamin D may negatively affect your child's sleep, though research on the benefits of supplementation is limited. Overall, no single food is likely to make or break your child's sleep quality. To support better rest, studies (like this 2023 review published in the journal Nutrients) suggest prioritizing a diet rich in fiber — especially fruits and vegetables — while limiting foods high in saturated fat. Meet our experts Michelle Caraballo, MD, pediatric pulmonologist and sleep medicine specialist at Children's Health Rupali Drewek, MD, co-medical director of the Sleep Medicine Program at Phoenix Children's Katie Drakeford, board-certified pediatric registered dietitian Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.
Irish Times
a day ago
- Health
- Irish Times
Almost a quarter of doctors in Ireland work more than European limit
The regulator for the medical profession in Ireland has raised concerns about patient safety and doctor wellbeing after new data found almost a quarter of doctors report working more than European limits. The Medical Council today publishes its 2024 annual workforce intelligence report, which found there were 20,962 clinically active doctors working in the State last year. According to the report, almost a quarter of doctors (23.1 per cent) self-reported working more than 48 hours on average per week, in contravention of the European Working Time Directive (EWTD). The EWTD seeks to safeguard the health and safety of workers by setting minimum standards for working hours and rest periods across the European Union. READ MORE The disciplines most likely to indicate working more than 48 hours a week were surgery (50.9 per cent) and obstetrics and gynaecology (34.9 per cent). Among doctors who reported working more than 48 hours per week, 45.6 per cent also reported working in direct patient care for more than 48 hours per week. The report said this 'raises concerns in relation to doctor wellbeing and patient safety, as excessive work hours are demonstrably associated with attrition, stress, burnout and are predictive of adverse event involvement'. For the first time, doctors were also asked about their views of patient care and safety. Just over one quarter (26.1 per cent) reported experiencing difficulty providing a patient with sufficient care at least once a week or more frequently, while slightly more than one-third (33.6 per cent) reported never experiencing difficulty. 'Pressure on workloads' was the most commonly cited barrier to providing sufficient patient care, with 73 per cent of doctors reporting this. It was followed by 'time spent on bureaucracy/administration', at 55.1 per cent, and 'delays to providing care, treatment and screening', at 46.1 per cent. According to an analysis of the medical register, the mean age of doctors was 43.7, with one in five aged 55 or older. The highest number of clinically active doctors was concentrated in disciplines of general practice (25.9 per cent) and medicine (23.4 per cent), followed by surgery (11.9 per cent). The report also highlighted a continued reliance on international doctors, who now account for 27.8 per cent of the workforce. The most common country of qualification for international graduates was Pakistan, accounting for 39.7 per cent of the international graduate cohort, followed by Sudan at 21.3 per cent. Last year, 1,632 doctors left the Medical Council's medical register. The majority of these were voluntary withdrawals. Of the doctors who voluntarily withdrew from the register, 58.8 per cent (603) said they wanted to practise medicine in another country, while a further 14.5 per cent (149) said they wished to stop practising medicine.
