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Probst, Anna, Iris Natanzon, Joachim Szecsenyi, and Stefanie Joos. "Family Doctors Seen through the Eyes of Specialists: A Qualitative Study." International Journal of Family Medicine 2013 (June 2, 2013): 1–6. http://dx.doi.org/10.1155/2013/729473.
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Germany is facing a shortage of young family doctors. In search of possible reasons the aim of this study was to explore the perception of specialists on family doctors. Within a qualitative study 16 medical specialists from different fields in hospital and outpatient care setting were interviewed. Interviews were analysed using qualitative content analysis according to Mayring. Most of the interviewed specialists have a positive view on family doctors although a certain depreciative assumption is resonated in a number of statements. According to the specialists, family doctors enjoy a high status in public, even if social processes of change may have a negative influence on their rather old-fashioned image. Specialists find that family medicine is underrepresented in university education suffering from an upgrading of specialized disciplines. Altogether the majority of the interviewed specialists certify family doctors in Germany a positive image. Lecturer in medical education and training should be aware of their key role in the career choices of young trainees and avoid degradation or upgrading of certain medical disciplines. Interlinked measures on different levels focusing on the improvement of working conditions and representation at the universities would be needed to regain attractiveness for the family doctor's profession as a career choice for young doctors.
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Shekhar, Rachna, and Sandhya Rani Javalkar. "Health information seeking on the internet (Dr Google) and its effect on doctor-patient relationship: a cross-sectional study from Central Karnataka." International Journal Of Community Medicine And Public Health 7, no. 10 (September 25, 2020): 4076. http://dx.doi.org/10.18203/2394-6040.ijcmph20204379.
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Background: The Internet has proven to be a powerful vehicle for the dissemination of information and the use of Internet by the patients as a source of information on health and disease is increasing rapidly. It has reformed the doctor-patient relationship by empowering patients with information. The objective was to study the trends of patient’s health information seeking behaviour on the internet and its effects on the doctor-patient relationship.Methods: A cross-sectional study was conducted amongst the 73 doctors and 110 patients attending the tertiary health care centre, Davanagere. A pre-tested and pre-validated questionnaire was used to collect data. Percentages and Proportions were used to summarize the study variables.Results: The most common search engine used was Google i.e. 92% and majority of them looked up symptoms/ disease condition 80%. 57% respondents verified doctor’s advice. 73% respondents stated that they used online health information for self-diagnosis but less than 10% of respondents took medications mentioned online. The doctors (60%) stated that the patient’s Internet use proves that the patient or his/her family are involved and take responsibility. However, 49.3% of doctors stated that they get uncomfortable when presented with online health information by the patients.Conclusions: Doctors are starting to recognize the use of the internet by patients as a source of health information. Patients consider the internet as a supplementary resource for better understanding of symptoms and diagnosis. The need of the hour is better communication between doctor and patients; and availability of reliable web-based health resources to patients for better compliance.
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Jang, Sou Hyun, Linda K. Ko, and Hendrika Meischke. "Finding Dr. Kim: Information Sources of Korean Immigrants’ Search for a Doctor in the U.S." Healthcare 8, no. 2 (April 9, 2020): 92. http://dx.doi.org/10.3390/healthcare8020092.
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Korean immigrants in the United States (U.S.) are known for their preference for, and dependence on, co-ethnic doctors due to various barriers to the U.S. healthcare system. Recent immigrants tend to face more barriers than their non-recent counterparts. However, there is little information on how they find their doctors in the U.S. This study includes a self-administrated survey of Korean immigrants aged 18 and above who lived in the New York–New Jersey Metropolitan area in 2013–2014 (n = 440). Descriptive analysis was conducted to understand the most common information sources and the number of sources based on the duration of stay in the U.S. More recent Korean immigrants were female, had no family doctor, uninsured, younger, and more educated than their non-recent counterparts. Regardless of the duration of stay in the U.S., family members and friends were the most frequently sought-after sources for Korean immigrants in their search for doctors. In addition to family members and friends, non-recent Korean immigrants also used other methods (e.g., Korean business directories), whereas recent immigrants used both U.S. and Korean websites. More recent Korean immigrants used multiple sources compared to non-recent Korean immigrants, often combined with a Korean website. Our study suggests policy implications to improve recent immigrants’ accessibility to health information in a timely manner.
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Barry, Eleanor, and Trish Greenhalgh. "General practice in UK newspapers: an empirical analysis of over 400 articles." British Journal of General Practice 69, no. 679 (January 14, 2019): e146-e153. http://dx.doi.org/10.3399/bjgp19x700757.
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BackgroundIn the context of the biggest GP workforce crisis since the NHS began, the alleged negative portrayal of UK general practice in the media is often cited as a reason for falling recruitment.AimTo explore how general practice and GPs are depicted in UK national newspapers.Design and settingA thematic analysis of all newspaper articles mentioning GPs or general practice published in the UK from late October 2016 to early October 2017 was undertaken, along with a sample of articles on hospital medicine.MethodArticles were identified through the LexisNexis® Academic UK search engine; relevant titles were tabulated and data extracted. A preliminary coding scheme was developed through discussion and used to categorise data; additional codes and categories were added iteratively as the analysis progressed.ResultsIn total, 403 articles on general practice or GPs were identified, and 100 on hospital specialists or specialties were sampled. Articles depicted UK general practice as a service in crisis, with low morale and high burnout, and leaving gaps in patient care. The traditional family doctor service was depicted as rapidly eroding through privatisation and fragmentation, with GPs portrayed as responsible for the crisis and the resulting negative impact on quality of care. Hospital specialties were also illustrated as under pressure, but this crisis was depicted as being the fault of the government. GP leaders interviewed in the press were usually defending their specialty; hospital doctors were usually sharing their expertise.ConclusionNewspaper portrayals of general practice are currently very negative. Efforts to influence the media to provide a more balanced perspective of general practice should continue.
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Silva, Ana Catarina Fortunato, Hernâni Pombas Caniço, Susana Rosa Lopes, and Margarida Silvestre. "Principlism in the daily practice of Family Medicine." Revista Portuguesa de Clínica Geral 37, no. 3 (June 1, 2021): 214–21. http://dx.doi.org/10.32385/rpmgf.v37i3.12693.
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Introduction: Principlism, from Tom Beauchamp and James Childress, is the most widely accepted theory in biomedical ethics. It is based on four principles: Beneficence, Non-maleficence, Autonomy and Justice. These are part of a common moral serving general action guides to any clinician, including the Family Doctor. The main purposes of this review are to describe how Principlism can be applied to daily general practice and reflect about how bioethics’ principles can improve the Physician Patient Relationship. Methods: We developed an integrative literature review, including conventions, declarations, treaties, text books and scientific research articles. Three medical databases were selected to search through the medical literature with specific inclusion criteria. From a total of 2352 potential articles, 161 were read and 21 were included in this review. The results were grouped into four categories: Family Medicine and the physician-patient relationship; Respect for autonomy; Non-maleficence and beneficence; and Justice. Results: Family Doctors play their professional role by promoting health, preventing disease and providing cure, care, or palliation. This area may be faced with ethical dilemmas including the moment of obtaining informed consent, medical confidentiality, diseases prevention and also the choice of complementary diagnostic tests and therapeutics. All these moral dilemmas arise in the context of a single interpersonal relationship, which is possibly the most therapeutic aspect of the medical consultation. Conclusions: Despite all the technological innovation, moral conduct and principles governing the profession of Family Doctors remains faithful to the principles of the FM specialty. In a context of a dehumanization threat and global discontent, it is essential to foster a growing humanization of primary health care and recover ethical values, in order to achieve an optimization of physician-patient relationship, to deepen the level of understanding of "patient's needs and values" and finally to meet their expectations.
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Andah, Efioanwan, Blessing Essang, Charlotte Friend, Sarah Greenley, Kathryn Harvey, Maria Spears, and Joanne Reeve. "Understanding the impact of professional motivation on the workforce crisis in medicine: a rapid review." BJGP Open 5, no. 2 (March 2, 2021): BJGPO.2021.0005. http://dx.doi.org/10.3399/bjgpo.2021.0005.
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BackgroundThe NHS is facing a workforce crisis. Responses to date have focused on improving recruitment of staff, but less attention has been paid to retention.AimTo conduct a rapid review using Rosabeth Moss Kanter’s three Ms model of workforce motivation as a sensitising framework to examine the current medical workforce crisis. The work considers how insights from research in other professions offers new thinking for understanding what motivates doctors to continue working.Design & settingRapid literature review with secondary analysis of existing research examining reasons for leaving medicine.MethodA systematic search strategy was developed with the aid of an information specialist. The search terms used were: medical professionals, retention, and NHS. The exclusions were: commentaries, non-medical professionals, non-English language, and it was limited to post-1990. The search was applied to three electronic databases, MEDLINE, Embase, and Healthcare Management Information Consortium (HMIC). This produced a dataset describing study design, and factors related to motivation for leaving the medical profession. Comparative thematic analysis distilled core themes explaining the reasons for leaving and their relation to the three Ms model.ResultsOf 3389 abstracts identified, screening and assessment produced 82 articles included in the final analysis. Thematic analysis identified four key themes: low morale, disconnect, unmanageable change, and lack of personal and professional support. The themes of mastery, membership, and meaning were substantially present within the dataset.ConclusionKanter's three Ms model of motivation can be applied to the medical workforce to understand retention issues. This work supports the development of targeted solutions to tackle the worsening workforce crisis.
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Shapiro, Johanna, and Yves Talbot. "Six behavioral scientists in search of a doctor: Family medicine as tragicomedy." Family Systems Medicine 12, no. 4 (1994): 427–35. http://dx.doi.org/10.1037/h0089126.
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Ghazanfari, Anoosheh, and Jessie Chin. "What Triggers Health Information Search: An Explorative Analysis on the Information Needs, Situations, Technologies, and Habits in Health Information Search Across the Lifespan." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 8, no. 1 (September 2019): 125. http://dx.doi.org/10.1177/2327857919081028.
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Given the access to online health information is no longer a problem, continuous growth in health information seeking has been observed. The goal of the study was to explore the triggers, information needs, contemporary technologies and habits of health information search behavior across the lifespan. The population who seeks online health information has increased stably for two decades (Diaz et al., 2002, Tennant et al., 2015). In addition to its prevalence, online health information plays an important role in patient decision-making. Almost half of people who searched for health information online reported that it influenced the way they think about health factors, and more than one third of them said it influenced their decision to see a doctor, or how they managed chronic conditions (Pew Internet Research, 2013). While earlier studies have explored the triggers of online health information seeking (e.g., Flynn, Smith & Freese, 2006), health information seeking behavior may be evolved with the development of new technologies. To explore the triggers of health information seeking across the lifespan, 69 older (mean age = 63.94, 35 female) and 67 younger (mean age = 35.21, 31 female) adults were recruited to a survey study. We found that there was no age difference in the reliance on health information sources. Physicians and the Internet remained the dominant sources of health information, followed by family, friends and pharmacists. Regarding information seeking habits, there was no age difference in the overall frequencies of online health information search despite the fact that more older adults checked health information online daily. Checking medication information was the dominant reason to trigger both younger and older adults to go online, followed by searching online after doctors’ visits, and making treatment decisions. There was also a trend that older users were more likely to go online when they heard about a new or unknown health information compared to younger users. Further, we explored the information needs of online health information search. While older adults were more likely to search for learning new information than younger adults, more younger adults looked up online health information for confirming or clarifying known health information. Taking advantage of social health information, about one half of younger and older adults shared health information online with their family and friends, and went online for checking review comments of medications, healthcare providers, etc. from their peer patients. Further, while desktop computers remained the most used technology for online health information search, an age difference was found in the usage of tablets and smartphones. Older adults used the tablets to do online health information searches more than younger adults; while younger people used the smart phones to do online health information searches more than older people. Overall, we found increasing importance of online health information for adults across the lifespan, especially for older adults who tended to use online information for acquiring new knowledge about health topics. The triggers of online health information seeking were also not only bounded to doctors’ visits but also related to daily health information needs (such as checking medications). Interestingly, the use of tablets for online health information search among older adults could be associated with the perceived ease of use of tablets among older users (portability, bigger font size and the accessibility of interactions) (Jayroe & Wolfram, 2012). As Pew Internet (2017) suggested that over a third of seniors own tablets, when designing elderly-accessible health websites, tailoring the presentation of health information to different media (including tablets) needs to be considered.
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Rodríguez Cerdeira, Carmen, Sánchez Blanco E, Sánchez Blanco B, and Carnero Gregorio M. "Sexually Transmitted Infections in the PReP Era. Are Family Doctors Ready to Give Advice?" Open Dermatology Journal 11, no. 1 (September 6, 2017): 35–45. http://dx.doi.org/10.2174/1874372201711010035.
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Background:Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) as a method of HIV prevention is not without controversy, and there has been concern that it may lead its users to think that they no longer need other preventive measures such as condoms. Thus, healthcare providers are convinced that PrEP decreases condom use and increases sexually transmitted infections (STIs). This treatment has been studied in men who have sex with men, men and women in heterosexual HIV-discordant couples, and heterosexual men and women.Objective:The objective of this study was to review the current state of evidence on the association of PrEP with condom use, the incidence of STIs, and the change in sexual behaviours in populations with risky practices.Materials and Methods:PubMed (National Center for Biotechnology Information, Bethesda, MD, USA), Science Direct (Elsevier Ltd., Oxford, UK), and Google Scholar (Google Inc., Mountain View, CA, USA) search engines were used during the study. We used the terms HIV, PrEP, sexually transmitted infections (STIs), MSM, condom, heterosexual men / women to search the databases.Results:Here, we present evidence that daily oral treatment is safe and effective in these populations studied, especially when medication adherence is high. STI testing should include extra-genital testing regardless of PrEP use to prevent health deficits and onward transmission.Conclusion:Despite this safety and efficacy, we strongly advise that patients continue to use condoms as a prophylactic measure against other sexually transmitted diseases. This update addresses the benefits and precautions that must be taken when establishing PrEP treatment, focusing mainly on family doctorswho are best positioned to provide follow-up and advice to patients and their relatives.
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Kandiyali, Rebecca, Daniel S. Lasserson, Penny Whiting, Alison Richards, and Jonathan Mant. "Predictive values of referrals for transient ischaemic attack from first-contact health care: a systematic review." British Journal of General Practice 67, no. 665 (November 20, 2017): e871-e880. http://dx.doi.org/10.3399/bjgp17x693677.
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BackgroundOver 150 000 cases of suspected transient ischaemic attack (TIA) are referred to outpatient clinics in England each year. The majority of referrals are made by GPs.AimThis study aimed to identify how many patients referred to a TIA clinic actually have TIA (that is, calculate the positive predictive value [PPV] of first-contact healthcare referral) and to record the alternative diagnoses in patients without TIA, in order to determine the optimal service model for patients with suspected TIA.Design and settingA systematic review of TIA clinic referrals from first-contact health professionals (GPs and emergency department [ED] doctors) was undertaken.MethodFour databases were searched using terms for TIA and diagnostic accuracy. Data on the number of patients referred to a TIA clinic who actually had a TIA (PPVs) were extracted. Frequencies of differential diagnoses were recorded, where reported. Study quality was assessed using the QUADAS-2 tool.ResultsNineteen studies were included and reported sufficient information on referrals from GPs and ED doctors to derive PPVs (n = 15 935 referrals). PPVs for TIA ranged from 12.9% to 72.5%. A formal meta-analysis was not conducted due to heterogeneity across studies. Of those not diagnosed with TIA, approximately half of the final diagnoses were of neurological or cardiovascular conditions.ConclusionThis study highlights the variation in prevalence of true vascular events in patients referred to TIA clinics. For patients without a cerebrovascular diagnosis, the high prevalence of conditions that also require specialist investigations and management are an additional burden on a care pathway that is primarily designed to prevent recurrent stroke. Service commissioners need to assess whether the existing outpatient provision is optimal for people with pathologies other than cerebrovascular disease.
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Orbanida, Firdianita Nuria, Moh Arie Wurjanto, Ari Udijono, and Henry Setyawan. "SYSTEMATIC REVIEW HUBUNGAN ANTARA KEPATUHAN PENGOBATAN ORAL ANTIDIABETES DAN GAGAL GINJAL PENDERITA DIABETES MELLITUS." Jurnal Kesehatan Masyarakat (Undip) 9, no. 6 (November 10, 2021): 755–59. http://dx.doi.org/10.14710/jkm.v9i6.31348.
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Knowledge, Belief, Attitude, Drug Amount, Family Support, Physical Activity, Carbohydrate Intake and Pharmacological Therapy related to DM control with medication adherence and kidney failure in DM patients. This review aims to identify articles regarding adherence to oral antidiabetic drugs and kidney failure in DM patients. Search articles in several databases using keywords in the 2011-2020 period and gray literature. Search libraries using online databases such as MEDLINE, Proquest, Garuda Journal and Google Scholar. Review synthesis using STROBE. Sixteen research articles for review. Taking medication and kidney failure in DM patients are related to the compliance of DM patients. Non-compliance with DM patients through DM control behavior (physical activity, carbohydrate intake, control of blood glucose levels) and awareness for treatment is still low. Motivation, family support and a good relationship between doctors and patients can have an influence on the obedient behavior of DM patients.
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Parker, Daisy, Richard Byng, Chris Dickens, Debbie Kinsey, and Rose McCabe. "Barriers and facilitators to GP–patient communication about emotional concerns in UK primary care: a systematic review." Family Practice 37, no. 4 (January 22, 2020): 434–44. http://dx.doi.org/10.1093/fampra/cmaa002.
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Abstract Background In the UK, general practitioners (GPs) are the most commonly used providers of care for emotional concerns. Objective To update and synthesize literature on barriers and facilitators to GP–patient communication about emotional concerns in UK primary care. Design Systematic review and qualitative synthesis. Method We conducted a systematic search on MEDLINE (OvidSP), PsycInfo and EMBASE, supplemented by citation chasing. Eligible papers focused on how GPs and adult patients in the UK communicated about emotional concerns. Results were synthesized using thematic analysis. Results Across 30 studies involving 342 GPs and 720 patients, four themes relating to barriers were: (i) emotional concerns are difficult to disclose; (ii) tension between understanding emotional concerns as a medical condition or arising from social stressors; (iii) unspoken assumptions about agency resulting in too little or too much involvement in decisions and (iv) providing limited care driven by little time. Three facilitative themes were: (v) a human connection improves identification of emotional concerns and is therapeutic; (vi) exploring, explaining and negotiating a shared understanding or guiding patients towards new understandings and (vii) upfront information provision and involvement manages expectations about recovery and improves engagement in treatment. Conclusion The findings suggest that treatment guidelines should acknowledge: the therapeutic value of a positive GP–patient relationship; that diagnosis is a two-way negotiated process rather than an activity strictly in the doctor’s domain of expertise; and the value of exploring and shaping new understandings about patients’ emotional concerns and their management.
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White, Jonathan. "If GPs who teach medical students were assisted to be good role models might this influence the medical career the students choose?" British Journal of General Practice 70, suppl 1 (June 2020): bjgp20X711281. http://dx.doi.org/10.3399/bjgp20x711281.
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BackgroundMost patients are cared for in the community by GPs, and workforce planning for the UK NHS suggests that 50% of medical school graduates need to train as GPs. While there is pressure on medical schools to provide more student teaching in general practice, general practice must be prepared for this increase in workload and teachers should have appropriate training.AimThis study examined the influence that teachers as role models can have on the development and career choices of medical students and whether GPs who teach medical students might benefit from assistance in developing positive attributes.MethodA literature search was carried out. Relevant papers were those that examined the influence of a doctor as teacher role model for medical students, both in assisting in professional development and clinical skills, and in influencing career choice.ResultsThe review identified eleven papers. There was evidence of association between a student having an influential role model as teacher and choosing specialty training in that area, although evidence of a causative connection is less convincing. A recurring theme is the recommendation that teachers should be aware of the influence they can have as role models, both positive and negative.ConclusionAs medical student teaching moves into general practice GPs who teach will need to be helped to understand and develop positive role model attributes, to promote general practice as an attractive career to the students. Further research needs to identify the extent of assistance required and whether medical schools are prepared for this extra responsibility.
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Williams, Pauline, Peter Murchie, and Christine Bond. "Patient and primary care delays in the diagnostic pathway of gynaecological cancers: a systematic review of influencing factors." British Journal of General Practice 69, no. 679 (January 14, 2019): e106-e111. http://dx.doi.org/10.3399/bjgp19x700781.
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BackgroundGynaecological cancers are the second most common female cancer type, with survival rates in the UK lower than in many comparable countries. A potentially important factor in the UK’s poorer cancer outcomes is diagnostic delay; gynaecological cancers are the cancer type most likely to be affected by less timely diagnosis.AimTo examine current evidence for factors that contribute to patient and primary care delays in the diagnostic pathway of gynaecological cancer.Design and settingA systematic review of the available literature.MethodPRISMA guidelines were followed. MEDLINE and Embase databases and the Cochrane Library were searched using three terms: primary care; gynaecological cancer; and delay. Citation lists of all identified articles were searched. Two authors independently screened the titles, abstracts, and full texts of publications. Data extraction was performed by one author and quality assured by a second reviewer in a 20% sample of selected articles. Synthesis was narrative.ResultsA total of 1253 references was identified, of which 37 met the inclusion criteria. Factors associated with delayed diagnosis were categorised as either patient factors (patient demographics, symptoms or knowledge, and presentation to the GP) or primary care factors (doctor factors: patient demographics, symptoms or knowledge, and referral process); and system factors (such as limited access to investigations).ConclusionDelayed diagnosis in the patient and primary care intervals of the diagnostic journey of gynaecological cancer is complex and multifactorial. This review identifies areas of future research that could lead to interventions to enable prompter diagnosis of gynaecological cancers.
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Kerrigan, Andrew R., Imane Aitnouri, Jessica Mar, and Wayne Altman. "What Barriers Exist in the Minds of Vaccine-Hesitant Parents, and How Can We Address Them?" Family Medicine 52, no. 9 (October 1, 2020): 626–30. http://dx.doi.org/10.22454/fammed.2020.432940.
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Background and Objectives: Despite substantial health benefits and prolific research efforts to demonstrate safety and increase uptake, vaccine hesitancy has increased dramatically. This study aimed to systematically analyze available literature on vaccine hesitancy in the United States and determine the rationale behind vaccine-hesitant parents and potential interventions. Methods: We conducted a literature search and identified 232 articles; we included 90 after screening. We pulled information from each article using standardized questions for “type of study,” “population,” “specific vaccine,” “reasons for hesitancy,” “hesitancy prevalence,” “attempt at change,” “results of intervention,” and “future interventions.” We created recurrent themes from the data and analyzed these themes via descriptive statistics. Results: Vaccine safety was the most commonly identified reason for vaccine hesitancy amongst studies (50%), followed by not enough information (30%), side effects (26%), low risk of disease (26%), social norms (22%), vaccine schedule (21%), not recommended by doctor (21%), efficacy (18%), cost/access (13%), sexual concerns (12%) and distrust of establishment (7%). Only 20% of papers documented an intervention, and <50% of these reported increased vaccination rates or intent. More research was the most commonly identified next step (49%). Conclusions: Despite large amounts of research on vaccination rates, patients are still reporting not enough information and safety as the most common reasons for vaccine hesitancy. Interventions were few and without promising results. More research was the most suggested intervention. Such research must address concerns of the vaccine-hesitant community, comparing risks and benefits of each vaccination in a longitudinal, coherent, and transparently unbiased fashion.
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Afrifa, Alex Darteh, James Kojo Prah, and Kwasi Sobre Nkrumah. "Utilisation of Skilled Delivery in Ghana: A Systematic Review." Extensive Reviews 1, no. 1 (December 7, 2021): 30–38. http://dx.doi.org/10.21467/exr.1.1.4426.
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Background: Access to a doctor, nurse, or a midwife during childbirth is key to the global effort to reduce maternal mortality ratios. Ghana has recorded significant improvements in maternal care over the past three decades. However, despite many policies aimed at improving health care for pregnant women such as the free maternal care policy, many Ghanaian women still deliver without a skilled birth attendant present. This systematic review, therefore, sought to identify the various factors affecting utilisation of skilled birth attendance in Ghana. Methods: PubMed Central, African Journals Online (AJOL), CINAHL Plus with Full Text (EBSCO), and Science Direct were searched for studies from January 2010 to December 2020. A broad range of search terms was used. Studies included had diverse designs, were conducted among Ghanaian pregnant women, and had skilled delivery as an outcome of interest. The quality of studies was assessed. Due to the diversity of types of studies included in this systematic review (including qualitative, descriptive, and evaluative studies that ranged from simple bivariate analyses to complex multivariate modelling), a meta-analysis was neither possible nor appropriate. We, therefore, conducted a narrative synthesis of the search findings. Results: Twenty-four (24) studies met our inclusion criteria for this review. Included studies comprised sixteen (16) cross-sectional studies and eight (8) qualitative studies. The sample size of the included studies cumulatively was 86,998 participants. The emerging themes were: health system factors (10); maternal and family factors (5); and sociodemographic factors (9). Conclusion: In general, health system factors; maternal and family factors; and sociodemographic factors were found to influence skilled delivery services in Ghana. Therefore, in order to ensure that there is a skilled birth attendant present at every birth, efforts should aim at addressing social and cultural factors which have been identified as key determinants to utilisation of skilled delivery in Ghana.
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Bridgwood, Bernadeta M., Andrew TO Nickinson, John SM Houghton, Coral J. Pepper, and Rob D. Sayers. "Knowledge of peripheral artery disease: What do the public, healthcare practitioners, and trainees know?" Vascular Medicine 25, no. 3 (January 30, 2020): 263–73. http://dx.doi.org/10.1177/1358863x19893003.
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This systematic review evaluated the knowledge and awareness of peripheral artery disease (PAD) within the general public (including patients with peripheral vascular disease), nonspecialist healthcare professionals (nsHCP), and trainees (medical students and trainee doctors). Relevant articles were identified from electronic databases using key search terms: ‘peripheral artery disease’; ‘limb ischaemia’; ‘intermittent claudication’; ‘knowledge’; ‘understanding’; ‘public’; ‘medical professional’. The heterogeneous results were described narratively. A lack of knowledge and understanding of PAD (disease awareness) were identified in all groups. Among nsHCPs, factors which affect knowledge include the level of training, early clinical exposure and the presence of family members with cardiovascular/vascular disease. Within the general public, knowledge and awareness was improved if a family member/friend had a diagnosis, or following a patient-centred consultation with any HCP. Public campaigns are proven effective in improving disease knowledge/awareness in conditions such as stroke alongside sustained patient education. These may provide future avenues to improve PAD knowledge and awareness, in order to effectively manage risk factors and minimise delayed or missed diagnosis of PAD. (PROSPERO registration number: CRD42018117304)
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Popova, Olga. "Medical-genetic counseling within the system of social factors: problems and search for solutions." Политика и Общество, no. 2 (February 2021): 29–39. http://dx.doi.org/10.7256/2454-0684.2021.2.36738.
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The subject of this research is ethical, socio-psychological, and legal problems arising in the process of medical-genetic counseling. It is demonstrated that medical-genetic counseling forms in the context of intertwinement of different social factors, and is a complex communicative process that involves scientists, medical doctors, patients, and their relatives in various forms of relationships. It is associated with myths and biases, as well as personal attitudes that distort the information about the diagnosis. It also transforms in the course of technological development. Description is given to the difficulties faced by the geneticist that affect the counseling process. The article demonstrates the peculiarities of family psychodynamics that determine the way of perception of genetic information. It is also indicated that genetic testing is aimed not only at personality of the patient, but may touch upon a wide range of relations: with relatives and friends, employers, and other interested parties. At the same time, the distribution of information on the risks of the disease may instigate discrimination against a person, stigmatization and elimination of a number of social opportunities, namely related to their professional activity. Genetic information pertains not only to physicality of an individual, but also to social body; affect the interests of the family and people living in a certain territory; bearers of common genetic information; as well as employers, insurers, etc. The conclusion is made that the process of genetic counseling based on the basic bioethical principles of autonomy, benevolence, justice, and informed consent requires additional interpretation. Based on consideration of incident A. Jolie and ethical analysis of the possibility of polygenic embryonic screening, the author reveals the peculiarities of perception of genetic information and its personal interpretation, which cause realization of the new types of responsibility in the process of genetic counseling, where the geneticist deals not with the establishment of diagnosis (fact), but with the likelihood of development of a particular pathology (prognosis).
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Elmitt, Nicholas, Elizabeth Sturgiss, Emily Haesler, Chris van Weel, and Kirsty Douglas. "A scoping review of the role of GPs in the management of obesity." British Journal of General Practice 68, suppl 1 (June 2018): bjgp18X697289. http://dx.doi.org/10.3399/bjgp18x697289.
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BackgroundGPs are caring for more adults with obesity. Research in primary health care has provided insight on the components of effective interventions. However, the most appropriate and effective role for GPs in these interventions remains unclear.AimA scoping review was undertaken to examine the literature for descriptions of the role of the GP in managing adults who are overweight or have obesity in: primary research interventions, guidelines, and the role expectations expressed by opinion leaders.MethodBlack and grey literature were searched based on the terms ‘obesity’, ‘doctor’ and ‘primary care’. A customised data extraction tool was used to identify the specific role of GPs and the explicit use of general practice values, including whole person care and person-centred care.Results282 articles were reviewed in full, with a majority of the interventions originating in the US. Poor description of the involvement of healthcare professionals made it difficult to determine if GPs had been involved. When described, GPs were rarely actively involved. Most guidelines explicitly name GPs in obesity management and suggest wide ranging roles for them. Opinions from experts on GP involvement have become more positive in recent years.ConclusionGPs are minimally involved in obesity interventions in primary care research, but are promoted in obesity guidelines as essential to patient care. There is a need for an international standard on how to accurately describe which healthcare professionals were involved in intervention delivery and their specific role.
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Antoun, Jumana, Alan Johnson, Brock Clive, and Maya Romani. "Doctors at times of national instability: What Balint seminars reveal." International Journal of Psychiatry in Medicine 54, no. 1 (August 9, 2018): 3–10. http://dx.doi.org/10.1177/0091217418791449.
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Background It is not known in what ways is the doctor whose practice is secure in a clinic challenged to maintain a therapeutic doctor–patient relationship when confronting a flood of immigrants within a country that is politically volatile, internally fractionalized, and surrounded by sporadic military incursions? Methods During Balint seminars, a family medicine resident presents a troubling case which all group members reflect upon from the perspective of the doctor, the patient, and their relationship. Balint leaders later debrief and review the work of the group. Lebanon has passed through many political, social, and religious conflicts and was affected by the onset of the Syrian Civil War in 2010. The Balint leaders had begun to see in resident case presentations reflections of war’s disruption of the doctor–patient relationship. Two Balint leaders reviewed a log of all the cases between 2013 and 2016. Results In our observations, the discussion of the presented cases mirrored the cultural, social, religious, and political context of the country. First, the political situation was reflected in the dynamics of the group: agitation, conflicts, hopelessness, and a search for norms. Second, the residents subconsciously chose words in their discussion that reflect the country’s situation. Third, the presented case was stirred by a tragic war-related event. Conclusions The social/political/religious context in which the physician is practicing distracts the doctor from fulfilling his/her professional role. Balint seminars are an example of direct, experiential learning that provide an excellent opportunity for the special training of primary care physicians who deal with refugees and citizens to self-reflect on war’s impact on them and their profession.
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Ferreira, Maria Amélia Leite, Alexandra Manuela Nogueira de Andrade Pereira, José Carlos Amado Martins, and Maria do Céu Barbieri-Figueiredo. "Palliative care and nursing in dissertations and theses in Portugal: a bibliometric study." Revista da Escola de Enfermagem da USP 50, no. 2 (April 2016): 317–23. http://dx.doi.org/10.1590/s0080-623420160000200019.
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Abstract Objective To identify the academic scientific production on palliative care in master dissertations and PhD theses carried out by nurses in Portugal. Method A descriptive retrospective study of bibliometric type with search for the abstracts available in repositories of higher education institutions in the period 2000-2014. Results Of the 1814 papers identified, 249 met the inclusion criteria (ten doctoral theses and 239 master dissertations). The most representative methodological approach was quantitative (31.35%) and the most studied area was family/informal caregiver (20.69%). The most studied target population were the students/health professionals (38.51%). Conclusion The academic scientific production in this area has been growing in spite of the need for continued investment in order to fill the identified gaps.
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Trascu, R., and L. Spiru. "FC28-03 - Are there effective strategies for communicating with Alzheimer patients?" European Psychiatry 26, S2 (March 2011): 1973. http://dx.doi.org/10.1016/s0924-9338(11)73676-8.
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IntroductionDiagnosing Alzheimer Disease (AD) is a long-lasting process, mainly due to the variability of initial symptoms (i.e. memory problems, speech difficulties, behavioral changes). Patients are usually either unaware of their difficulties or attempting to conceal them.AimsWe wanted to establish whether, based on existing knowledge, a better understanding of the leading causes of miscommunication can overcome communication barriers for AD patients.ObjectivesWe tried to summarize the existing recommendations and gold-practices and to contract them into key messages in order to improve quality of communication.MethodWe performed a systematic overview of medical literature (PubMed search, disclos* OR communic* NOT communicate AND Alzheimer), selecting of the 516 resulting titles those papers focused on doctor/patient and doctor/caregiver communication issues.ResultsSpecific communication requirements were identified for effective collaboration between(1)physician and patient,(2)physician and patient's caregivers/family and(3)caregivers/family and patient.A minimal set of communication skills and predictable courses of action was further developed, depending on(a)best practices and(b)recommended practices.ConclusionsAlthough communicating with people with Alzheimer is difficult, quite often the communication barriers are mainly due to an inaccurate perception of the disease and of patient limitations and disabilities. Understanding the mechanisms involved and acquiring certain interpersonal habits may significantly improve communication effectiveness, particularly in mild and moderate AD.
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Mat Reffien, Muhammad Alimin, Aniza Ismail, Saperi Sulong, Tengku Putri Zaharah Tengku Bahanuddin, Noridah Mohd Salleh, and Nazrila Hairizan Nasir. "Development, validity and reliability of instrument to evaluate implementation fidelity of the Family Doctor Concept (FDC) programme in public primary care clinics in Malaysia." Malaysian Family Physician 17, no. 1 (December 19, 2021): 20–28. http://dx.doi.org/10.51866/oa1197.
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Introduction: The Family Doctor Concept (FDC) programme was introduced to public primary care clinics in late 2013 as part of the reform agenda in the primary healthcare delivery system. The study aimed to develop a validated and reliable instrument to evaluate the FDC implementation fidelity in primary care clinics. Methods: The instrument, which adapted the concept of patient-centred care (PCC), resulted from a series of expert discussions, a literature search, an FDC guideline, and a review of meeting minutes. A 2-step process was conducted with experts to achieve content and face validity. Consequently, the instrument was piloted in 5 public primary care clinics in Selangor involving 8 trained raters. Inter-rater reliability was estimated using intraclass correlation (ICC), while internal consistency was measured using Kuder–Richardson Formula 20 (KR-20). Results: The final instrument comprises 3 sections (instructions, clinic’s characteristics and assessment items), with Section 3 containing 15 items divided into four components – population registration, formation of a primary care team, integrated treatment, and monitoring and evaluation. The ICC for total score was excellent, 0.981, while the ICCs of the individual component scores were good to excellent (population registration: 0.937, formation of primary care team: 0.742, integrated treatment: 0.996, and monitoring and evaluation: 0.996). The value of KR-20 was 0.615, which was considered adequate. Conclusion: The instrument developed was found to be valid in terms of face and content validity and reliable in measuring the fidelity of FDC implementation with excellent inter-rater reliability.
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Cooper, Esther, Ann Hutchinson, Zain Sheikh, Paul Taylor, Will Townend, and Miriam J. Johnson. "Palliative care in the emergency department: A systematic literature qualitative review and thematic synthesis." Palliative Medicine 32, no. 9 (July 20, 2018): 1443–54. http://dx.doi.org/10.1177/0269216318783920.
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Background: Despite a fast-paced environment, the emergency clinician has a duty to meet the palliative patient’s needs. Despite suggested models and interventions, this remains challenging in practice. Aim: To raise awareness of these challenges by exploring the experience of palliative care patients and their families and informal carers attending the emergency department, and of the clinicians caring for them. Design: Qualitative systematic literature review and thematic synthesis. Search terms related to the population (palliative care patients, family carers, clinicians), exposure (the emergency department) and outcome (experience). The search was international but restricted to English and used a qualitative filter. Title, abstracts and, where retrieved, full texts were reviewed independently by two reviewers against predefined inclusion criteria arbitrated by a third reviewer. Studies were appraised for quality but not excluded on that basis. Data sources: MEDLINE [1946-], Embase[1947-], CINAHL [1981-] and PsycINFO [1987-] with a bibliography search. Results: 19 papers of 16 studies were included from Australia ( n = 5), the United Kingdom ( n = 5), and United States ( n = 9) representing 482 clinical staff involved in the emergency department (doctors, nurses, paramedics, social workers, technicians), 61 patients and 36 carers. Nine descriptive themes formed three analytic themes: ‘Environment and Purpose’, ‘Systems of Care and Interdisciplinary Working’ and ‘Education and Training’. Conclusion: In the included studies, provision of emergency palliative care is a necessary purpose of the emergency department. Failure to recognise this, gain the necessary skills or change to systems better suited to its delivery perpetuates poor implementation of palliative care in this environment.
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Hashim, M. Jawad. "Principles of family medicine and general practice – defining the five core values of the specialty." Journal of Primary Health Care 8, no. 4 (2016): 283. http://dx.doi.org/10.1071/hc16006.
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ABSTRACT The principles of general practice and family medicine are the defining characteristics of the speciality. The five principles are: compassionate care – a caring attitude towards patients and their families shown as kindness and a desire to help; generalist approach – a perspective on the whole person and the context of illness including family, culture and society; continuity of relationship – the interpersonal bond of trust and respect between family physicians, patients, and their families that develops over the life course; reflective mindfulness– doctors’ awareness of their thoughts and emotions manifested as a sense of presence and attentiveness towards self and others; and lifelong learning – a commitment to personal and professional development by participating in learning activities and practice-based research that leads to better patient outcomes. Concepts such as care coordination, preventive care, access to care, professional competence, resource management and community-based care, are part of the principles above. The term ‘comprehensive care’ is should be avoided as it misinterprets the scope of family medicine. The principles of general practice and family medicine characterise the speciality’s core values. These guidelines form the basis of clinical practice as well as the identity of family medicine as a discipline. Aiming to extract the principles from current literature, I searched MEDLINE and Google Scholar for the term ‘principles of family medicine’ with results sorted by relevance, and without limits on language or date of publication. Major textbooks of family medicine and general practice were consulted as well.1–6 As supported by academic literature, the terms ‘general practice’ and ‘family medicine’ are used synonymously.7
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Saraswat, Nikita, Neetu Sachan, and Phool Chandra. "A Review on Ethnobotanical, Phytochemical, Pharmacological and Traditional Aspects of Indigenous Indian Herb Trachyspermum ammi (L)." Current Traditional Medicine 6, no. 3 (March 9, 2020): 172–87. http://dx.doi.org/10.2174/2215083805666191107115544.
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Introduction and Ethnopharmacological relevance: In the Indian Vedic literature, Charakasamhita and Sushritasamhita, the Ajwain is known as Bhootika and in the charaksamhita commentaries, it is termed as Yavanika. The medicinal role of Ajwain fruit is claimed to be very important in the treatment of many ailments in humans. The plant Trachyspermum ammi Linn. is a grassy, aromatic annual plant, which falls in the family Umbelliferae. This plant is grown in India, Iran, Pakistan, Egypt, etc. for its medicinal benefits. Tribals of India use it for the treatment of diarrhea, arthritis, colic and gastrointestinal problems. In the traditional preparations, Indian Vaidya guru’s (Ayurveda Guru’s), the ajwain extract is used as “Admoda Arka”. The Ayurveda doctors, hakims and Vaidya gurus recommend ajwain for treating headaches, cold, flu and even during painful menstrual periods. Aim of the Study: The review paper has compiled the researches conducted on Trachyspermum ammi, which will help in presenting a collective data of the authentic researches conducted on the plant worldwide. It will also present information about the phytoconstituents which can be useful for building up new researches in near future. Materials and Methods: This paper has been prepared by collecting all the information available on the following platforms and the papers were searched from 1975 to 2019. The databases and electronic journals were well searched including Wiley, Springer link, Google Scholar, Science Direct, Pubmed. The key terms used for the search were Ajwain, C. copticum, Trachyspermum ammi and other synonyms of the plant. The search was also done by the names of chemical constituents present in the plant and the pharmacological effect of the plant. Results: The multiple uses of T. ammi are due to the active constituents present in it. As per the phytochemical studies on the fruits of T. ammi, the presence of various phytoconstituents has been found such as saponins, flavonoids, alkaloids, glycosides, fixed oils, thymenes, cumenes, tannins, amino acids, p-cymene, c-terpinene, steroids, etc. Conclusions: This paper is focused on presenting a detailed review on the literature, pharmacological properties, physicochemical studies and the newest researches on the plant. In this paper, we have also compiled the traditional uses of the herb used by Indian peopleon recommendations from their Hakims, Vaidya and use of the herbs by many tribes all across India and Pakistan.
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Larsen, Michael D. "Latent Class Analysis of 1997 NSF Survey Data on Science PHDs." Calcutta Statistical Association Bulletin 56, no. 1-4 (March 2005): 189–208. http://dx.doi.org/10.1177/0008068320050511.
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Summary The field of Information Technology (IT) has provided extraordinary job growth in the United States over the last two decades; however, women and some minority groups are severely underrepresented in IT occupations, especially in management positions. These groups also on average receive lower salaries than their counterparts. The U.S. National Science Foundation's SESTAT database is created from biennial nationally representative surveys of U.S. scientists and engineers. SESTAT provides detailed information, such as employment history, educational background, and demographic characteristics. These data are analyzed here using latent class analysis, which is an exploratory technique that can be used to cluster cases based on categorical variables. The data are from the 1997 Survey of Doctoral Recipients. The subset of respondents received Ph.D.'s between 1990 and 1996 in either than physical or biological sciences or in engineering and work at higher educational institutions. There are a few significant differences between men and women in desired work activities, job search resources, and adequacy of doctoral training. There are many large, significant differences in limitations when searching for a job, work activities, and family and career status. Latent class analysis helped identify important subgroups of females and males based on clustering simultaneously on several categorical variables.
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Lee, Patricia J. "The Information Needs of Clinicians: a Study of the Doctors Nova Scotia Clinical Library." Journal of the Canadian Health Libraries Association / Journal de l'Association des bibliothèques de la santé du Canada 34, no. 3 (December 9, 2013): 159. http://dx.doi.org/10.5596/c13-058.
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Background: The Clinical Library (CL) is a virtual library of books, journals, drug information, and patient information. It has no hard copy books or journals to lend. Objectives: On the 10-year anniversary of the CL, feedback from information skills training indicated a need for a user assessment survey to ensure that the CL continues to meet the medical information needs of the modern clinician. The study was conducted to assess the level of electronic information use, the geographical distribution of users, and the frequency of use by various clinical practitioners. The study also contained a survey of health librarians in the United Kingdom to assess whether our information strategies are in line with international practices and needs. Methods: External consultants were hired to conduct interviews and a survey among the membership and to perform an environmental scan of Canadian and U.S. services. A series of interviews was conducted by the health librarian at health libraries in the U.K. Results: Sixty-two percent of survey respondents said they access information to help inform patient diagnosis or treatment at least every 2–3 days, 40% of respondents regularly use web-based medical information services, and 46% of respondents used the CL as part or all of their electronic search strategy. The use of the CL varied widely depending on the location of respondents and their access to a health library. Respondents in rural areas and those unaffiliated with hospital libraries were more likely to use the virtual CL. Family practitioners showed the most familiarity with the CL offerings and reported the highest use of the CL (66.7% of respondents). A significant minority of respondents found the CL difficult to navigate. The U.K. arm of the study showed that services offered there were similar to those offered by the CL. Conclusions: Based on the findings, the CL remains a vital service for members. The CL should maintain its services for members and make the user interface easier to use. A majority of clinicians are seeking evidence to support decisions about patient care. The use of web-based resources, including journals and textbooks, is growing. The CL is meeting the needs of a significant portion of respondents, mainly family physicians. The U.K. study found that librarians there offer similar services to those offered by the CL and that, based on their use, U.K. librarians expect to be offering these services for some time to come. The CL must look for synergies and duplication with affiliated libraries and find ways to collaborate and promote services.
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A. Kibalnik, Sergey. "OSIP DYMOV AND CHARLES BOVARY (THE INTERTEXTUAL STRUCTURE OF CHEKHOV’S SHORT STORY THE FIDGET)." Проблемы исторической поэтики 9, no. 3 (March 2021): 187–205. http://dx.doi.org/10.15393/j9.art.2021.9922.
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A. P. Chekhov's short story The Fidget (1892) is an abridged hypertext of G. Flaubert's novel Madame Bovary (1856). The article undertakes a detailed comparison of the characters who occupy a similar place in the narrative and figurative system of these two works: Osip Dymov and Charles Bovary. Both of them are doctors, but Chekhov's character seems to realize the untapped potential that was laid down in the character penned by Flaubert. He is no longer a failed doctor, but a talented one, with all the qualities required to become an excellent medical scientist. Thus, Chekhov does not merely stand up for the medical community, which he is no stranger to. Thanks to this, the story of the Russian writer transforms into a polemical interpretation of the classic French novel. In Flaubert's Emma's imaginary search for the meaning of life, which explains her two adulteries in Madame Bovary, Chekhov seems rather inclined to see the selfishness and lack of responsibility that destroy her family and lead to her own death. It is not by chance that Dymov, rather than Olga Ivanovna dies as a result of her own similar behavior in Chekhov’s short story. At the same time, Chekhov's text is also a polemical interpretation of Tolstoy's Anna Karenina (1873–1877), which was created as an explicit hypertext of Flaubert's novel. In the short story, Chekhov's critical reinterpretation of these two works is clearly based on a kind of “folk” morality of the Ant from the canonical Krylov fable The Dragonfly and the Ant (1808), which is clearly referenced in the title and text of the story. The intertextual structure of Chekhov's story is examined in the article primarily as a system of its pretexts, some of which relate to it in unison, and others-dissonantly. At the same time, the former are the object of polemical interpretation, while the latter are the subject of stylization and value orientation.
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Maxwell, David. "Modelling search and stopping in interactive information retrieval." ACM SIGIR Forum 53, no. 1 (June 2019): 40–41. http://dx.doi.org/10.1145/3458537.3458543.
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Searching for information when using a computerised retrieval system is a complex and inherently interactive process. Individuals during a search session may issue multiple queries, and examine a varying number of result summaries and documents per query. Searchers must also decide when to stop assessing content for relevance - or decide when to stop their search session altogether. Despite being such a fundamental activity, only a limited number of studies have explored stopping behaviours in detail, with a majority reporting that searchers stop because they decide that what they have found feels " good enough ". Notwithstanding the limited exploration of stopping during search, the phenomenon is central to the study of Information Retrieval, playing a role in the models and measures that we employ. However, the current de facto assumption considers that searchers will examine k documents - examining up to a fixed depth. In this thesis, we examine searcher stopping behaviours under a number of different search contexts. We conduct and report on two user studies, examining how result summary lengths and a variation of search tasks and goals affect such behaviours. Interaction data from these studies are then used to ground extensive simulations of interaction , exploring a number of different stopping heuristics (operationalised as twelve stopping strategies). We consider how well the proposed strategies perform and match up with real-world stopping behaviours. As part of our contribution, we also propose the Complex Searcher Model , a high-level conceptual searcher model that encodes stopping behaviours at different points throughout the search process (see Figure 1 below). Within the Complex Searcher Model, we also propose a new results page stopping decision point. From this new stopping decision point, searchers can obtain an impression of the page before deciding to enter or abandon it. Results presented and discussed demonstrate that searchers employ a range of different stopping strategies, with no strategy standing out in terms of performance and approximations offered. Stopping behaviours are clearly not fixed, but are rather adaptive in nature. This complex picture reinforces the idea that modelling stopping behaviour is difficult. However, simplistic stopping strategies do offer good performance and approximations, such as the frustration -based stopping strategy. This strategy considers a searcher's tolerance to non-relevance. We also find that combination strategies - such as those combining a searcher's satisfaction with finding relevant material, and their frustration towards observing non-relevant material - also consistently offer good approximations and performance. In addition, we also demonstrate that the inclusion of the additional stopping decision point within the Complex Searcher Model provides significant improvements to performance over our baseline implementation. It also offers improvements to the approximations of real-world searcher stopping behaviours. This work motivates a revision of how we currently model the search process and demonstrates that different stopping heuristics need to be considered within the models and measures that we use in Information Retrieval. Measures should be reformed according to the stopping behaviours of searchers. A number of potential avenues for future exploration can also be considered, such as modelling the stopping behaviours of searchers individually (rather than as a population), and to explore and consider a wider variety of different stopping heuristics under different search contexts. Despite the inherently difficult task that understanding and modelling the stopping behaviours of searchers represents, potential benefits of further exploration in this area will undoubtedly aid the searchers of future retrieval systems - with further work bringing about improved interfaces and experiences. Doctoral Supervisor Dr Leif Azzopardi (University of Strathclyde, Scotland) Examination Committee Professor Iadh Ounis (University of Glasgow, Scotland) and Dr Suzan Verberne (Leiden University, The Netherlands). Thanks to both of you for your insightful and fair questioning during the defence! Availability This thesis is available to download from http://www.dmax.org.uk/thesis/, or the University of Glasgow's Enlighten repository - see http://theses.gla.ac.uk/41132/. A Quick Thank You Five years of hard work has got me to the point at which I can now submit the abstract of my doctoral thesis to the SIGIR Forum. There have been plenty of ups and downs, but I'm super pleased with the result! Even though there is only a single name on the front cover of this thesis, there are many people who have helped me get to where I am today. You all know who you are - from my friends and family, those who granted me so many fantastic opportunities to travel and see the world - and of course, to Leif. Thanks to all of you for confiding your belief and trust in me, even when I may have momentarily lost that belief and trust in myself. This thesis is for you all.
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Yubrina, Irina V., Ludmila N. Degtyareva, and Igor A. Bozhkov. "The viral myocarditis with cardiac аrrhythmia as complication of COVID-19 in the practice of family doctor of the tuberculosis dispensary." Russian Family Doctor 25, no. 3 (November 18, 2021): 41–49. http://dx.doi.org/10.17816/rfd77027.
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BACKGROUND: About 70% of TB dispensary patients have chronic somatic diseases which not only prevent effective treatment of TB but also take progressive course themselves.
AIMS: To timely detect and treat acute and chronic somatic disease combined with TB.
MATERIALS AND METHODS: since 2020 the algorithm of patient complex investigation by specialists of therapeutic profile was developed in the Tuberculosis Dispensary No. 5, among them the general practitioner was the coordinator of the patients medical route. This became especially relevant during the COVID-19 pandemic.
RESULTS: In accordance with the developed algorithms of diagnostic search the patient was comprehensively examined. There were no signs of tuberculosis were in him, however the general practitioner involving to specialists team could diagnose signs of complex cardiac arrhythmia the probable cause which was a new coronavirus infection that he had had six weeks before.
CONCLUSIONS: The organization of a new form of medical service for phthisiatric patients allowed general practitioner to reveal serious cardiac pathology directly at the TB dispensary, to refer the patient for consultation to the cardiologist-arrhythmologist, to follow the patient and perform recommended cardiologic treatment simultaneously with measures or medical supervision over persons contacting with tuberculosis.
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Hampton, Chelsey, Bridie Evans, Khalid Ali, Jenna Bulger, Gary Ford, Chris Moore, Alison Porter, et al. "PP085 A Scoping Review Of Emergency Assessment And Referral Of Suspected Transient Ischemic Attack." International Journal of Technology Assessment in Health Care 33, S1 (2017): 110–11. http://dx.doi.org/10.1017/s0266462317002537.
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INTRODUCTION:Patients who experience Transient Ischaemic Attack (TIA) should be assessed and treated in a specialist clinic to reduce risk of further TIA or stroke. But referrals are often delayed. We aimed to identify published studies describing pathways for emergency assessment and referral of patients with suspected TIA at first medical contact: primary care; ambulance services; and emergency department.METHODS:We conducted a scoping literature review. We searched four databases (PubMed, CINAHL, Web of Science, Scopus). We screened studies for eligibility. We extracted and analysed data to describe setting, assessment and referral processes reported in primary research on referral of suspected TIA patients directly to specialist outpatient services.RESULTS:We identified eight studies in nine papers from five countries: 1/9 randomized trial; 6/9 before-and-after designs; 2/9 descriptive account. Five pathways were used by family doctors and three by Emergency Department (ED) physicians. None were used by paramedics. Clinicians identified TIA patients using a checklist incorporating the ABCD2 tool to describe risk of further stroke, online decision support tool or clinical judgement. They referred to a specialist clinic, either directly or via a telephone helpline. Anti-platelet medication was often given, usually aspirin unless contraindicated. Some patients underwent neurological and blood tests before referral and discharge. Five studies reported reduced incident of stroke at 90 days, from 6–10 percent predicted rate to 1.2-2.1 percent actual rate. Between 44 percent and 83 percent of suspected TIA cases in these studies were directly referred to stroke clinics through the pathways.CONCLUSIONS:Research literature has focused on assessment and referral by family doctors and ED physicians to reduce hospitalization of TIA patients. No pathways for paramedic use were reported. Since many suspected TIA patients present to ambulance services, effective pre-hospital assessment and referral pathways are needed. We will use review results to develop a paramedic referral pathway to test in a feasibility trial.
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Jamoulle, Marc, Enrique Gavilán, Raquel Vaz Cardoso, María Ana Mariño, and Miguel Pizzanelli. "The words of prevention, part I: changing the model." Revista Brasileira de Medicina de Família e Comunidade 10, no. 35 (June 24, 2015): 1–9. http://dx.doi.org/10.5712/rbmfc10(35)1062.
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Objective: this part I article explores the different meanings of relevant keywords for General Practice/Family Medicine (GP/FM) in the prevention domain. The aim is to contribute to information process in GP/FM by keeping in line with the main terms used in health care organization. Methods: important keywords for GP/FM in the prevention domain were selected. Then, a search was carried out on the main sources in GP/FM databases, as well as in Medical Subject Heading and major terminological databases available online. Results and Discussion: there is discrepancy between the conceptual contents of major prevention models amongst the usual bibliographic sources of knowledge in GP/FM in particular and medicine in general. Conclusion: For GP/FM, distribution of preventive activities is now firmly established on a new constructivist model, privileging the doctor-patient relationships and introducing a cybernetic thinking on the health care activities with a special commitment to ethics and the positive duty of beneficence.
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Veselova, E. K., E. Yu Korjova, O. V. Rudykhina, and T. V. Anisimova. "Social Support as a Resource for Ensuring the Subjective Well-being of Students." Social Psychology and Society 12, no. 1 (2021): 44–58. http://dx.doi.org/10.17759/sps.2021120104.
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Objective. Analysis of the role of social support in ensuring the subjective well-being of students. Background. Subjective well-being is an integral experience of physical, psychological, and social health. Social support as an important resource of subjective well-being of young people has not yet received comprehensive coverage. Study design. We studied the differences between students with high and low levels of subjective well-being in terms of attitude to social support and readiness to apply for it. Frequency analysis, descriptive statistics, and comparative analysis were used for data processing. Participants. The study involved 850 respondents. The sample includes students of different courses and faculties of universities in Saint Petersburg and Novosibirsk. Measurements. To collect empirical data, Russian-language versions of the following methods were used: 1) Multidimensional Scale of Perception of Social support — MSPSS by D. Zimet; 2) The Multidi-mensional Scale of Perceived Social Support (MHC-SF) — screening version of the test by C. Keyes to assess subjective well-being; 3) The General Help Seeking Questionnaire (GHSQ). Results. Students are more willing to seek help from people in their immediate environment (romantic partners, friends, parents, relatives) than from specialists (psychologists, doctors, religious figures). There are significant differences between students with high and low levels of subjective well-being in terms of intent to search for different types of social support. Conclusions. There is a large gap in students’ perception of the effectiveness of informal types of support (from family, friends, relatives, significant persons) and formal, professional types of support (psychologists, doctors, helpline). Informal types of support enjoy a degree of trust higher than that of professional types of support. That is why it is necessary to organize and improve the student assistance service at higher educational institutions
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Kuruppu, Jacqueline, Gemma McKibbin, Cathy Humphreys, and Kelsey Hegarty. "Tipping the Scales: Factors Influencing the Decision to Report Child Maltreatment in Primary Care." Trauma, Violence, & Abuse 21, no. 3 (April 7, 2020): 427–38. http://dx.doi.org/10.1177/1524838020915581.
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Child maltreatment (CM) is an important public health issue linked to significant physical and mental health complications across the life span. Given the association between CM and health, general practitioners (GPs) and primary care nurses (PNs) are well-placed to identify and respond to this issue and are mandated to report suspected CM in many jurisdictions. Research has found that primary care doctors and nurses need support when responding to CM. This scoping review sought to answer the following question: What factors influence GPs and PNs decision to report CM when fulfilling their mandatory reporting duty? By exploring these factors, areas where support is needed were pinpointed. A systematic search was run across four databases: Medline (Ovid), PsycINFO, Embase, and CINAHL. Articles that reported on studies conducted in a location that had mandatory reporting legislation specific to CM and had a study population sampled from primary care were included in analysis. Thirty-three articles met the inclusion criteria. This review found that four principal factors influenced the decision to report CM: personal threshold of suspicion of abuse, relationship with the family, faith in the child protection system, and education and discussion. We conclude that improving the support and training to address these four areas may be beneficial for GPs and PNs in responding to CM.
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Rumyeni, Susanne Dida, Purwanti Hadisiwi, and Yanti Setianti. "Information Needs of Indonesian Infertile Patients About Cross-Border Reproductive Care." International Journal of Media and Communication Research 2, no. 1 (January 23, 2021): 37–50. http://dx.doi.org/10.25299/ijmcr.v2i1.5974.
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Infertile patients need to prepare variety of information before decided to perform reproductive care procedures in foreign country. Sufficient information will help the reproductive care run smoothly. The purpose of this study is to determine the source of information, the necessary information, and the barriers to fulfill the necessary information of Indonesian infertile patients undergoing IVF programs in Malaysia. This study used qualitative method by conducting in-depth interviews with 11 infertile patients who had IVF experience in Malaysia. Results showed that infertile patients obtained information about the IVF program in Malaysia through four sources of information, namely: 1) personal sources such as friends and family; 2) online media which includes the google search engine, blogs and youtube; 3) medical professionals, whether doctors, nurses or other medical personnel; and 4) seminars held by hospital management. Patients information needs include specific information about IVF, medical system information, cost information, IVF legal information, and easiness information in the destination country. Language was found as an obstacle in fulfilled information needs. In conclusion, this study provides new knowledge about various sources of information used by infertile patients in fulfil their information needs about cross-border reproductive care procedures, with language as one of the obstacles.
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Semenyuk, B. "The life and work of A.Richinsky as an example of service to Christian ideals." Ukrainian Religious Studies, no. 41 (December 26, 2006): 14–17. http://dx.doi.org/10.32420/2007.41.1843.
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The name of Arsen Rychinsky - a doctor, church and public figure, a prominent religious ethnologist - is being forgotten today. Arsen Rychinsky was born in the village of Tetilitsa, Kremenetsky district of the former Volyn province in a priest's family, studied at the Kremenetsky Pymnasium, and after graduating from Zhytomyr Theological Seminary. While studying at the seminary, Arsen Richinsky produced manuscripts and journals. A well-endowed young man searched hard for himself. Perhaps that is why in 1911 he became not a priest but a teacher of the parish school of the village of Sidnyarka, Lutsk county. He taught Richinsky not for long, but his love for school, he kept his children for life. From September 1911 Rychinsky studied at the University of Warsaw, and from the beginning of World War I transferred to the University of St. Vladimir in Kiev. In March 1917 he successfully passed the exams and was approved "to the degree of a doctor with all the rights and advantages of the laws of this degree assigned."
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Wabl, Chiara A., Raymond Athanas, Vincent Cubaka, Beatrice Mushi, Mamsau Ngoma, Nicaise Nsabimana, Godfrey Sama, et al. "Serious Illness Communication in Cancer Care in Africa: A Scoping Review of Empirical Research." JCO Global Oncology 8, Supplement_1 (May 2022): 47. http://dx.doi.org/10.1200/go.22.53000.
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PURPOSE Serious illness communication (SIC) in cancer care describes conversations between clinicians, patients, and families about prognosis and treatment decisions. Cultural context influences SIC. Researchers have studied SIC across diverse settings in Africa. We aimed to describe and synthesize the heterogeneous body of research on SIC practices, preferences, and needs in Africa to identify research and training priorities. METHODS Our search strategy identified studies that focused on SIC within cancer or palliative care in Africa. Following PRISMA guidelines, a systematic literature search was performed using PubMed, Embase, Web of Science, CINAHL, African Index Medicus, and PsycINFO, yielding 1811 unique titles. After sequential review of abstracts, full text, and cited references, 42 articles met inclusion criteria. Quantitative and qualitative data describing study characteristics, aims, methods, and findings were abstracted and analyzed using descriptive statistics and thematic analysis. Critical appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS The 42 included articles were published from 1997-2021, half since 2017, representing 16 countries and all African Union regions: West (33%), East (29%), South (21%), North (12%), and Central (5%). Most study designs were qualitative (45%) or quantitative surveys (50%). Study participants included patients (35%), family caregivers (18%), doctors (18%), nurses (12%), and/or other (11%). Study aims focused on disclosure of diagnosis (27%) or prognosis (20%), breaking bad news (15%), general patient-clinician communication (12%), truth-telling (8%), shared decision-making (7%), information needs/preferences (5%), and/or advance care planning (5%). Despite diverse contexts, common themes emerged. Study authors frequently recommended communication skills training. Critical appraisal demonstrated high quality of studies overall. CONCLUSION Research on SIC in Africa has increased in recent years. Most studies have focused on information delivery by clinicians; fewer on eliciting information from patients (eg, shared decision-making, advanced care planning). Significant opportunities exist for further study and for communication skills training.
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Коваль, Т. И., Е. М. Изюмская, Е. Г. Марченко, Н. О. Прийменко, Т. М. Котелевская, and В. А. Боднар. "Lymphadenopathy: Algorithm for the Diagnosis and Management." Клиническая инфектология и паразитология, no. 2 (November 4, 2021): 187–99. http://dx.doi.org/10.34883/pi.2021.10.2.025.
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Встатье подробно охарактеризован синдром лимфаденопатии, представлены терминология, причины, патофизиологические механизмы, классификация, варианты поражения лимфатических узлов при инфекционной и неинфекционной патологии. Приведен алгоритм диагностического поиска, который состоит из 3 этапов: оценки клинико-анамнестических данных, проведения рутинных лабораторных и инструментальных исследований и выполнения при необходимости дополнительных исследований согласно клинической ситуации. Предоставлены подходы к тактике ведения пациентов с неуточненной лимфаденопатией. Учитывая мультидисциплинарность синдрома лимфаденопатии, успешное решение проблемы дифференциальной диагностики этого состояния зависит от конструктивного взаимодействия многих специалистов (семейных врачей, инфекционистов, онкологов, гематологов, ревматологов, морфологов), их осведомленности о заболеваниях, проявляющихся увеличением лимфатических узлов, и понимания тактики ведения пациентов. The article is focused on the syndrome of lymphadenopathy, presents the terminology, causes, pathophysiological mechanisms, classification, and variants of damage to lymph nodes in cases of infectious and non-infectious pathologies. The algorithm of diagnostic search is presented, which consists of 3 steps: assessment of clinical and anamnestic data, routine laboratory and instrumental examination results, and, if necessary, additional evaluations according to the clinical situation. Approaches to patient’s management tactics with unspecified lymphadenopathy are provided. Considering the multidisciplinary of lymphadenopathy syndrome, a successful solution to the problem of differential diagnosis of this condition depends on the constructive interaction of many specialists (family doctors, infectious disease specialists, oncologists, hematologists, rheumatologists, morphologists), their awareness of diseases manifested by an increase in lymph nodes, and an understanding of patient`s management tactics.
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Kishi, Tatsuya, Naoya Sakurada, Mayumi Horikawa, Haruaki Ohkubo, Kazumi Ishii, Yasuji Miyakita, Makoto Ohno, Masamichi Takahashi, and Yoshitaka Narita. "COT-15 LITERATURE REVIEW ON THE DECISION MAKING OF THE BRAIN TUMOR PATIENT." Neuro-Oncology Advances 1, Supplement_2 (December 2019): ii43. http://dx.doi.org/10.1093/noajnl/vdz039.195.
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Abstract BACKGROUND Patients with primary brain tumors find it difficult to make decisions during the advanced disease stage and experience decreased consciousness. It is important for patients to receive supported decision-making early. Medical staff should know what to do and when to do it,but there are no clear guidelines. Therefore,we reviewed the literature for supported decision-making for primary brain tumor patients,particularly to provide information for understanding trends reported in previous research. METHOD On January 1,2019,we conducted a search using keywords,such as “brain tumor”and “decision-making,” via PubMed and “Igakuchuo-zashi” in Japan. We extracted literature about treatment decision support and end-of-life care for patients with primary brain tumors. Furthermore,we studied and chose the documents for information provision. RESULT Upon observing 7 studies,we found: 1) about 50% of the patients want more prognostic information; 2) patients with brain tumor tend to be anxious,but they want more information to develop a good understanding of the disease and to lower their anxiety; 3) about half of the brain tumor patients in end-of-life care are unable to make decisions sooner owing to impaired consciousness,and hence are unable to share treatment preferences with their doctors; 4) when medical professionals provide information,such as adding video tools about end-of-life care to oral explanations,it facilitates supported decision-making; and 5) when the caregiver intends to notify patients,the family feels conflicted. DISCUSSION The results suggested that if the timing of the end-of-life conversation is late,it becomes difficult for the patient to make decisions and the burden of decision-making falls on the family. It is necessary to examine effective supported decision-making tools for patients by assessing and comprehending information needs and anxiety levels of primary brain tumor patients.
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Annesley, Luke, Eamonn McKeown, and Katherine Curtis-Tyler. "Parents’ perspectives on their children’s music therapy: A synthesis of qualitative literature." British Journal of Music Therapy 34, no. 1 (March 15, 2020): 39–52. http://dx.doi.org/10.1177/1359457520907636.
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There is no existing qualitative synthesis of the music therapy literature on parents’ perspectives on their children’s music therapy. This study seeks to fill this gap, motivated by the first author’s experiences as a clinician/researcher. A systematic search of health databases, hand searches of key journals and searches of doctoral theses were undertaken to identify relevant studies. Thirteen studies which met inclusion criteria, including a total of 102 participants, were identified. Relevant data were extracted from these studies for comparison and analysis, with quality of studies assessed using the CASP appraisal tool. Findings were analysed following procedures of thematic synthesis. Six descriptive themes were grouped into three analytic themes: Parents perceived positive impacts of music therapy on their children; parents experienced music therapy as a nurturing environment for themselves and their children; and some parents experienced challenges to their engagement with music therapy. Most studies (12/13) explored parents’ perceptions of music therapy where they were included in sessions. The findings identify positive perceptions of family-centred models of music therapy for children and parents. Parents’ perceptions of children were altered positively through experiencing them in new ways in music therapy. Parents also perceived positive outcomes for their children. These findings identify an emphasis in the qualitative literature on parents’ perceptions on research into music therapy which includes parents in sessions. Only one study explored perceptions of a model where parents were not present during their child’s sessions. More research is needed into parents’ perceptions of music therapy where parents are not present during sessions. Further intervention studies into family-centred models of music therapy with children are also recommended.
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Kopeć, Agnieszka, Anna Aftyka, Ewa Humeniuk, Beata Rybojad, and Ilona Rozalska-Walaszek. "Hospitalization of a child in the Neonatal Intensive Care – parents’ experiences." Current Problems of Psychiatry 17, no. 1 (March 1, 2016): 24–30. http://dx.doi.org/10.1515/cpp-2016-0004.
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AbstractIntroduction. Significant progress in the perinatal and intensive care therapy resulted in a meaningful increase of survival of extremely immature, and burdened with severe diseases neonates. Although infants are the patients of the Neonatal Intensive Care Unit, the needs of their parents should also be noticed and realized. The aim of the study was the analysis of the parents’ experiences of children hospitalized in the NICU.Material. The research material comprises 39 written contributions of parents of children hospitalized in the NICU.Method. A qualitative analysis of the text was used. Quotes of parents were classified in three categories: emotions, thoughts and support.Results. Fear, happiness, joy, uncertainty, stress and shock are the most frequently emotions appearing in the parents’ reports. The most frequently mentioned areas of cognitive reactions of parents include: realization of child’s mortality, realizing problems of the premature birth, search for the guilty, and the reformulation of looking at the world. Parents often described support they received, but also pointed to the areas where support lacked.Conclusion: As a result of intense emotions, both positive and negative tint that parents experience at birth of a premature or sick child, multi-disciplinary care is necessary in order to reduce the negative effects of experienced emotions.Support, including information support for parents of critically ill newborns is a key skill in the practice of doctors taking care of children hospitalized in NICU.Psychological support is an essential element of the holistic care of the neonate’s family.
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Genest, Christine, Rosemary Ricciardelli, and R. Nicholas Carleton. "Correctional Work: Reflections Regarding Suicide." International Journal of Environmental Research and Public Health 18, no. 8 (April 17, 2021): 4280. http://dx.doi.org/10.3390/ijerph18084280.
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The Public Health Agency of Canada declared suicide a public health problem in Canada (2016). Employees working in correctional services, researchers find, experience high rates of life-time suicidal ideation in comparison to other public safety professionals and the general population. Suicide behaviours (i.e., ideation, planning, attempts, death) are a multifactorial phenomenon, explained in part by the Interpersonal-Psychological Theory of Suicide that suggests attempted suicide is facilitated by perceived burdensomeness, a lost sense of belonging, a feeling of hopelessness, and a progressively reduced fear of death, as well as capacity and planning to engage a lethal attempt. In the current study, we unpack the factors that can influence suicide behaviours as reported by correctional workers. Our intent is to make explicit the experiences of a small sample (n = 25) of correctional workers in relation to suicidal behaviours, highlighting stories of recovery and acknowledging the importance of facilitating psychologically safe workplaces. Analysis entailed an inductive semi-grounded emergent theme approach. Participants identified certain risk factors as being able to induce suicidal ideation, such as marital or family problems as well as difficulties at work (i.e., bullying or difficult working conditions). Having children and a partner may act as factors preventing suicide for those with ideation. Participants sought help from professionals, such as their family doctor, a psychologist, or the Employee Assistance Program (EAP); however, the lack of perceived organisational supports and recognition of the issue of suicide by the employer are two elements that can hinder the search for help.
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Tsarenko, A. V. "The specialists postgraduate training as an important condition and component of the palliative and hospital care system creation and development." Health of Society 9, no. 5 (April 19, 2021): 200–206. http://dx.doi.org/10.22141/2306-2436.9.5.2020.226948.
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Background. According to international standards and approaches, adequate staffing is a prerequisite and a component of a palliative and hospice care (PHC) system the creation and successful development in any country. One of the main tasks of modern professional training of medical specialists (M/S), who are involved in the provision of PHC to the population, is the formation of their awareness of the patient-family-oriented paradigm, the skills of multidisciplinary (MD)/command, interdepartmental and intersectoral coordination and cooperation. It is also important to ensure careful selection and appropriate motivation of staff. Since the modern PHC system is based on MD, an interdepartmental and intersectoral approach to the provision of PHC, after appropriate professional training, can involve doctors of any specialty, nurses, as well as psychologists, social workers, lawyers and clergymen, volunteers, representatives of local communities and private structures, as well as the palliative patients (PPs) themselves and their family members or caregivers. The purpose was: scientific substantiation of professional postgraduate training of specialists, which are involved in the PHC provision to the population. Materials and methods. Normative and legal documents of Ukraine and authoritative international professional organizations; domestic and foreign literary sources using JAMA, Scholar and PubMed search engines; official statistics data; results of sociological research; research methods: system approach and system analysis, bibliosemantic, sociological (questionnaire survey) and generally accepted medical and statistical methods. Results. The analysis of national and international regulatory documents testifies to the important medical and social significance of the PHC system creation and development. The role of specialists professional training on PHC is shown. The results of the sociological study made it possible to determine: the estimated population need for PHC in Ukraine; the state of the PHC service and the insufficient level of M/S knowledge and the urgent need of M/S for specialized knowledge on PHC issues. Conclusions. Multidisciplinary professional training of specialists is of great importance for the PHC system creating and the PHC availability, quality and efficiency increasing. This will allow the M/S, together with psychologists, social workers, volunteers, clergymen, to provide a comprehensive PHC to PPs and their family members, including medical, psychological, social and spiritual/ religious components.
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Lysunets, O. V., and N. V. Didyk. "Diagnostics of pneumonia in preterm infants of the breast-feeding and the pre-preschool period of the life in the practice of family doctor." Likarska sprava, no. 1-2 (March 26, 2019): 110–16. http://dx.doi.org/10.31640/jvd.1-2.2019(16).
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Diseases of the respiratory system are important causes of children’s morbidity. That is why we suggest that the spreading of the clinical experience is helpful for the pediatric community to improve the practical skills and theoretical knowledge of the physicians. The article describes clinical and anamnestic peculiarities of run of period of the breast-feeding age and pre-preschool age at a preterm newborn with a small body weight at birth with a period of gestation of 32–36 weeks and infants of 38–40 weeks of gestation. Taking into account the anatomical and functional features of premature infants, they need of a multidisciplinary approach in order to care and treat them. The important anamnestic determinants that can point possible the later complication are the interrupted pregnancy and incompetent pregnancy, harmful habits (the active and pasive smoking) of gravids and their infectious diseases (kidney disorders) and no-infectious diseases like diabetes mellitus and arterial hypertension. Actually, a physician has to know many various combinations of symptoms and syndromes, which are characteristic for the preterm infants. The article includes clinical and anamnestic patterns of motion of pneumonia in infants with a period of gestation of 32–36 weeks in the breast-feeding and the pre-preschool period of the life. The important clinical determinants that can be used for diagnostic search of family doctor have been determined. The changes in organs and systems associating with development of pneumonias in the preterm infants have been displayed. The most important the clinical determinants of development of pneumonia are the artificial feeding, the violation of feeding and composition of food, disturbance of respiration, the smoking, hyperplasia of the thymus. The main idea of our article is that the most cases of morbidity premature infants depends on immature of internal organs, immune system and development of the infection complication. The main “take-away lessons” are that premature infants should be observed a long time after disease. Conclusions: premature infants need a multidisciplinary approach in order to care and treat them.
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Bello, Kéfilath, Jan De Lepeleire, Jeff Kabinda M., Samuel Bosongo, Jean-Paul Dossou, Evelyn Waweru, Ludwig Apers, Marcel Zannou, and Bart Criel. "The expanding movement of primary care physicians operating at the first line of healthcare delivery systems in sub-Saharan Africa: A scoping review." PLOS ONE 16, no. 10 (October 22, 2021): e0258955. http://dx.doi.org/10.1371/journal.pone.0258955.
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Introduction In sub-Saharan Africa (SSA), the physicians’ ratio is increasing. There are clear indications that many of them have opted to work at the first-line of healthcare delivery systems, i.e. providing primary care. This constitutes an important change in African healthcare systems where the first line has been under the responsibility of nurse-practitioners for decades. Previous reviews on primary care physicians (PCPs) in SSA focused on the specific case of family physicians in English-speaking countries. This scoping review provides a broader mapping of the PCPs’ practices in SSA, beyond family physicians and including francophone Africa. For this study, we defined PCPs as medical doctors who work at the first-line of healthcare delivery and provide generalist healthcare. Methods We searched five databases and identified additional sources through purposively selected websites, expert recommendations, and citation tracking. Two reviewers independently selected studies and extracted and coded the data. The findings were presented to a range of stakeholders. Findings We included 81 papers, mostly related to the Republic of South Africa. Three categories of PCPs are proposed: family physicians, “médecins généralistes communautaires”, and general practitioners. We analysed the functioning of each along four dimensions that emerged from the data analysis: professional identity, governance, roles and activities, and output/outcome. Our analysis highlighted several challenges about the PCPs’ governance that could threaten their effective contribution to primary care. More research is needed to investigate better the precise nature and performance of the PCPs’ activities. Evidence is particularly needed for PCPs classified in the category of GPs and, more generally, PCPs in African countries other than the Republic of South Africa. Conclusions This review sheds more light on the institutional, organisational and operational realities of PCPs in SSA. It also highlighted persisting gaps that remain in our understanding of the functioning and the potential of African PCPs.
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Anderson, Rebecca J., Steven Bloch, Megan Armstrong, Patrick C. Stone, and Joseph TS Low. "Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence." Palliative Medicine 33, no. 8 (June 11, 2019): 926–41. http://dx.doi.org/10.1177/0269216319852007.
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Background: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. Aim: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. Design: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data sources: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. Results: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient’s deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. Conclusion: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.
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Oliva, Antonio, Gerardo Altamura, Mario Cesare Nurchis, Massimo Zedda, Giorgio Sessa, Francesca Cazzato, Giovanni Aulino, et al. "Assessing the potentiality of algorithms and artificial intelligence adoption to disrupt patient primary care with a safer and faster medication management: a systematic review protocol." BMJ Open 12, no. 5 (May 2022): e057399. http://dx.doi.org/10.1136/bmjopen-2021-057399.
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IntroductionIn primary care, almost 75% of outpatient visits by family doctors and general practitioners involve continuation or initiation of drug therapy. Due to the enormous amount of drugs used by outpatients in unmonitored situations, the potential risk of adverse events due to an error in the use or prescription of drugs is much higher than in a hospital setting. Artificial intelligence (AI) application can help healthcare professionals to take charge of patient safety by improving error detection, patient stratification and drug management. The aim is to investigate the impact of AI algorithms on drug management in primary care settings and to compare AI or algorithms with standard clinical practice to define the medication fields where a technological support could lead to better results.Methods and analysisA systematic review and meta-analysis of literature will be conducted querying PubMed, Cochrane and ISI Web of Science from the inception to December 2021. The primary outcome will be the reduction of medication errors obtained by AI application. The search strategy and the study selection will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the population, intervention, comparator and outcome framework. Quality of included studies will be appraised adopting the quality assessment tool for observational cohort and cross-sectional studies for non-randomised controlled trials as well as the quality assessment of controlled intervention studies of National Institute of Health for randomised controlled trials.Ethics and disseminationFormal ethical approval is not required since no human beings are involved. The results will be disseminated widely through peer-reviewed publications.
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Wyka, Ewa. "Krakowskie pamiątki po Jędrzeju Śniadeckim." Opuscula Musealia 26 (2019): 51–57. http://dx.doi.org/10.4467/20843852.om.18.005.10998.
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Jędrzej Śniadecki memorabilia from Kraków This article presents the results of a search for memorabilia related to Jędrzej Śniadecki (1768–1838), a prominent Polish chemist, doctor and columnist. He was born in Żnin in Greater Poland, educated in Kraków and his professional life was associated with Vilnius. This search for memorabilia related to Jędrzej Śniadecki (except for archival materials) was conducted in Vilnius and Kalczuny in Belarus, which has a school museum devoted to Jędrzej Śniadecki and other scholars. However, no personal belongings related to the scholar were found at these locations. At present, the only items known to have belonged to Jędrzej Śniadecki are included in the collection of the Jagiellonian University in Kraków. These items are: an 18th-century microscope, a line gauge dating to 1834 and a ceremonial spade which formed an element of the academic regalia worn by professors of the Imperial University of Vilnius. The article discusses the above mentioned items and their provenance. In 1964, the microscope was transferred to the Jagiellonian University Museum in Kraków from the Botany Unit of the Jagiellonian University by Professor Władysław Szafer (1886–1970) with the information that it had belonged to Jędrzej Śniadecki. It is a Cuff-type microscope made of wood, cardboard, bone and glass, manufactured in Nuremberg. The microscope attributed to Śniadecki bears the initials JFF. It is not a high quality product, but microscopes from Nuremberg gained popularity as toys rather than test instruments. The second item attributed to Jędrzej Śniadecki is a 24-inch folding line gauge which consists of two parts. It was bought in 1957 by the Jagiellonian University Museum from Professor Andrzej Ciechanowiecki, who had inherited it in 1945 from Maria Kazimierzowa Osiecimska-Czapska (née Śniadecka), a great-granddaughter of Jędrzej Śniadecki. In the family, this item was regarded as a memento of Jędrzej Śniadecki which came from Boltup. Another memento of the scholar is a ceremonial spade. Tradition has it that it belonged to Jędrzej Śniadecki and was an element of the ceremonial regalia worn by the professors of the Imperial University of Vilnius. In 1878, the spade was donated to the Archaeological Cabinet of the Jagiellonian University by Kazimierz Jan Wilczyński (1806–1885), a doctor, art collector, publisher and member of the Vilnius Temporary Archaeological Commission.
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Wyka, Ewa. "Krakowskie pamiątki po Jędrzeju Śniadeckim." Opuscula Musealia 26 (2019): 51–57. http://dx.doi.org/10.4467/20843852.om.18.005.10998.
Full textAbstract:
Jędrzej Śniadecki memorabilia from Kraków This article presents the results of a search for memorabilia related to Jędrzej Śniadecki (1768–1838), a prominent Polish chemist, doctor and columnist. He was born in Żnin in Greater Poland, educated in Kraków and his professional life was associated with Vilnius. This search for memorabilia related to Jędrzej Śniadecki (except for archival materials) was conducted in Vilnius and Kalczuny in Belarus, which has a school museum devoted to Jędrzej Śniadecki and other scholars. However, no personal belongings related to the scholar were found at these locations. At present, the only items known to have belonged to Jędrzej Śniadecki are included in the collection of the Jagiellonian University in Kraków. These items are: an 18th-century microscope, a line gauge dating to 1834 and a ceremonial spade which formed an element of the academic regalia worn by professors of the Imperial University of Vilnius. The article discusses the above mentioned items and their provenance. In 1964, the microscope was transferred to the Jagiellonian University Museum in Kraków from the Botany Unit of the Jagiellonian University by Professor Władysław Szafer (1886–1970) with the information that it had belonged to Jędrzej Śniadecki. It is a Cuff-type microscope made of wood, cardboard, bone and glass, manufactured in Nuremberg. The microscope attributed to Śniadecki bears the initials JFF. It is not a high quality product, but microscopes from Nuremberg gained popularity as toys rather than test instruments. The second item attributed to Jędrzej Śniadecki is a 24-inch folding line gauge which consists of two parts. It was bought in 1957 by the Jagiellonian University Museum from Professor Andrzej Ciechanowiecki, who had inherited it in 1945 from Maria Kazimierzowa Osiecimska-Czapska (née Śniadecka), a great-granddaughter of Jędrzej Śniadecki. In the family, this item was regarded as a memento of Jędrzej Śniadecki which came from Boltup. Another memento of the scholar is a ceremonial spade. Tradition has it that it belonged to Jędrzej Śniadecki and was an element of the ceremonial regalia worn by the professors of the Imperial University of Vilnius. In 1878, the spade was donated to the Archaeological Cabinet of the Jagiellonian University by Kazimierz Jan Wilczyński (1806–1885), a doctor, art collector, publisher and member of the Vilnius Temporary Archaeological Commission.