Family Medicine Doctors Research Articles

Oncofertility in primary health care: the role of the Portuguese family doctor

Abstract Background The increasing number of cancer cases diagnosed at young ages and the impact of the disease and treatments on reproductive function have led to the development of Oncofertility. While oncologists typically lead these discussions, family doctors, as primary care providers, also play a crucial role. This study aims to assess family doctors’ knowledge, attitudes, and practices regarding fertility preservation in cancer patients. Methods This cross-sectional study, conducted between April 2023 and March 2024, surveyed 351 General and Family Medicine doctors from the Portuguese Northern Regional Health Administration. The questionnaire, consisting of 15 questions, assessed sociodemographic profiles, knowledge, attitudes, and practices. Data were analyzed using descriptive statistics and multivariate logistic regression. Results Most participants were female (80.5%) and under 40 years old. The majority (91.5%) had treated fewer than 10 cancer patients under 40 in the past two years. Key barriers included lack of knowledge (63.3%), time constraints (57.0%), and patient age (18.5%). Male physicians were more likely to address specific fertility concerns (OR 2.239) and less likely to view patient age as a barrier (OR 0.459). Physicians aged 31-35 were less likely to discuss fertility preservation (OR 0.553) but more likely to address it in the first consultation (OR 2.969). Urban-based physicians were less likely to discuss fertility preservation (OR 2.099). Only 9.1% always discussed fertility preservation before treatment, 27.6% did so sometimes, and 63.3% never discussed it. Conclusions There are significant gaps in the knowledge and practices of family doctors regarding fertility preservation for cancer patients. Targeted training and resources are urgently needed to support family doctors in effectively discussing fertility preservation, crucial for improving the quality of life of young cancer patients wishing to preserve their fertility. Key messages • Empowering Portuguese family doctors to address fertility concerns in cancer patients contributes to comprehensive oncofertility care, improving patient outcomes and quality of life. • Integrating oncofertility support with Portuguese family doctors strengthens primary care, ensuring discussion of fertility preservation is considered as part of cancer treatment planning.

Development of a computer-based tool to obtain a family health history in Vietnam.

Background: Family health history (FHH) is central to human genomic profiling construction; however, there is no protocol for documenting FHH in a pedigree format in Vietnam.Aim: A "Gia Su Suc Khoe" (GSSK) tool was developed to create a user-friendly interface for collecting FHH and offering diseases' risk assessment.Results: A tool was described (https://giasusuckhoe.vn/) with good feedback from genetic counselors and family-medicine doctors. Among 20 surveys, 100% of respondents noted that the report accurately reflected their FHH and were satisfied with the tool's display. About 74% of familial conditions were covered. Overall, all constructive feedback has been adapted into the updated version.Conclusion: Gia Su Suc Khoe has the potential to significantly improve healthcare delivery and outcomes in Vietnam.

Interventional Radiology Awareness Among Family Physicians and General Practitioners in Jazan Region, Saudi Arabia.

Background Interventional radiology (IR) utilizes minimally invasive procedures guided by imaging to diagnose and treat various conditions, offering less invasive alternatives to traditional surgery. Despite its importance, awareness among family medicine practitioners can vary, affecting patient care. While IR has advanced in Saudi Arabia, there are limited data on family medicine practitioners' understanding of IR. This study assesses awareness of IR procedures among family medicine doctors in Jazan and their perceived need for further education. Methods A cross-sectional interview-administered survey was conducted online among family medicine doctors in Jazan via social media. The survey assessed demographic data, awareness of IR procedures, self-rated knowledge, and attitudes towards IR. Participants' understanding of IR training, hospital privileges, outpatient clinics, and recognition by the Saudi Commission for Health Specialties (SCHS) was evaluated. Data were analyzed using descriptive statistics and chi-square tests. Results Out of 395 respondents, the age distribution was as follows: 20-29 years (44.3%), 30-39 years (32.9%), and 40 years or older (22.8%). Gender distribution was as follows: females (44.6%) and males (55.4%). Specialties included family medicine consultants (10.6%), residents (32.4%), specialists (22.8%), and general practitioners (34.2%). Awareness of IR procedures varied: uterine fibroid embolization (58.7%), coronary angiography (57.5%), vascular angioplasty (63.5%), radiofrequency ablation (61.3%), peripheral vascular bypass (61.8%), brain biopsy (56.2%), nephrostomy tube placement (59.5%), varicose veins treatment (63.0%), and cystoscopic tumor resection (54.7%). Self-rated knowledge was as follows: poor (46.8%), adequate (27.1%), good (15.7%), and excellent (10.4%). Most believed that interventional radiologists' training was in radiology (62.8%), with fewer attributing it to vascular surgery (20.5%) or a combination (16.7%). Regarding privileges and facilities, 248 (62.8%) reported hospital admitting privileges for IRs, 251 (63.5%) reported outpatient clinics, and 45 (11.4%) were unsure about admitting privileges. SCHS recognition was confirmed by 267 (67.6%). Referrals to IRs were made by 283 (71.6%), and 260 (65.8%) would increase referrals with more knowledge. The perceived benefit of additional education was as follows: no benefit (48.4%), some benefit (30.6%), and significant benefit (21.0%). Conclusion The study reveals gaps in awareness and knowledge of IR among family medicine doctors in Jazan. While there is recognition of IR's value and a willingness to refer patients, variations in knowledge highlight the need for targeted educational interventions. Improving education on IR could enhance integration into patient care and optimize outcomes.

Implementation of the clinical practice guidelines among family medicine doctors at primary health care facilities in Khartoum and Gezira states of Sudan

IntroductionThe health system in Sudan faces several challenges, including increasing numbers of patients, shortages of health supplies, and disparities in the distribution of health services. Guidelines implementation improves patients’ outcomes and ensures efficient use of the resources in such a resource limited country. The study aimed to assess the implementation of the clinical practice guidelines among family medicine doctors working in the primary health care centers in Khartoum and Gezira states to provide baseline data about the current practice in Sudan.MethodsDescriptive cross-sectional facility-based survey, conducted from April to December 2021, on 373 of the practicing family-medicine doctors. A total of 101 Primary health care centers were surveyed (77 centers in Khartoum state and 24 in Gezira state). The questionnaire was pilot tested on a small group of physicians to improve clarity and reduce response bias. Descriptive statistics were used to summarize the data and analyzed by frequency tables. Chi square and logistic regression tests were used to determine the association between categorized variables. P value < 0.05 was considered statistically significant.ResultsMost of the practicing family-medicine doctors (98.4%) reported implementation of the guidelines. Moreover, (68.6%) of them received training programs which were organized and funded by the Sudan Ministry of Health. The local Sudanese guidelines were difficult to access and not regularly updated. Services unavailability and inaccessibility (87.1%), health insurance factors (83.9%), and patient factors (81.2%) were the most frequent barriers to guidelines implementation. Service cost (79.9%), lack of regular training programs (79.9%), absence of local guidelines (77.2%), lack of continuity in the comprehensive care process (63.0%), and lack of time (57.1%) were also reported as barriers to guidelines implementation.ConclusionGuidelines implementation is limited by unavailability and inaccessibility of the health services and the health insurance limited coverage. Expansion of the health insurance coverage, organization of continuous training programs, encouragement of regular auditing and issuing regulations to ensure the use of updated guidelines, dissemination of the updated national guidelines along with establishing clinical governance in Sudan can be useful tools for policymakers in the optimum allocation of public health resources.

Clinician care priorities and practices in the fourth trimester: perspective from a California survey

BackgroundProfessional societies such as the American College of Obstetricians and Gynecologists (ACOG) promote the idea that postpartum care is an ongoing process where there is adequate opportunity to provide services and support. Nonetheless, in practice, the guidelines ask clinicians to perform more clinical responsibilities than they might be able to do with limited time and resources.MethodsWe conducted an online survey among practicing obstetric clinicians (obstetrician/gynecologists (OB/GYNs), midwives, and family medicine doctors) in California about their priorities and care practices for the first postpartum visit and explored how they prioritize multiple clinical responsibilities within existing time and resources. Between September 2023 and February 2024, 174 out of 229 eligible participants completed the survey, a 76% response rate. From a list of care components, we used descriptive statistics to identify those that were highly prioritized by most clinicians and those that were considered a priority by very few and examined the alignment between prioritized components and recommended care practices.ResultsClinicians were highly invested in the care components that they rated as most important, indicating that they always check these components or assess them when they perceive patient need. Depression and anxiety, breast health/breast feeding issues, vaginal birth complications and family planning counseling were highly ranked components by all clinicians. In contrast, clinicians more often did not assess those care components that infrequently ranked highly among the priority listing, consisting mainly of social drivers of health such as screening and counseling for intimate partner violence, working conditions and food/housing insecurity. In both instances, we found little discordance between priorities and care practices. However, OB/GYNs and midwives differed in some care components that they prioritized highly.ConclusionsWhile there is growing understanding of how important professional society recommendations are for maternal-infant health, clinicians face barriers completing all recommendations, especially those components related to social drivers of health. However, what the clinicians do prioritize highly, they are likely to perform. Now that Medi-Cal (Medicaid) insurance is available in California for up to 12 months postpartum, there is a need to understand what care clinicians provide and what gaps remain.

Assessment and management of allergic rhinitis: A review and evidence-informed approach for family medicine.

Allergic rhinitis is an inflammatory disorder affecting nasal mucosa in response to al-lergen exposure and is commonly assessed and managed in family medicine. In this article, we review new international guidelines on the diagnosis and management of allergic rhinitis and generate evidence-informed recommendations for family medicine doctors.

The Place and Approaches of Family Medicine Doctors in the Health Management of CBRN Events: The Case of Türkiye

In this study, it was aimed to determine the level of knowledge of Family Medicine residents about Chemical, Biological, Radiological and Nuclear (CBRN) events, their risk assessments and their thoughts on the roles that CBRN events can play in healthcare services. As a multi-center and cross-sectional analytical study, 444 family medicine residents at the national level were included in the study via an online survey application method. The data form included a total of 25 questions prepared to evaluate the sociodemographic information of the participants and their evaluation, awareness, knowledge level, approach to events and general opinions regarding CBRN event risks. 91.7% of physicians evaluated their knowledge level as "very little" or "little" and 95.7% evaluated their preparation level as "very little" or "little". 77.3% of physicians think that family physicians should have a role in CBRN incidents. For a possible CBRN event in the next 5 years, physicians predict biological events as the highest risk and nuclear events as the lowest risk. The rate of physicians who stated that they had previously received CBRN training was 17.8%, and the rate of those who participated in the CBRN drill was only 0.9%. While 89.9% of the participants wanted to receive training on health management in CBRN incidents; 80.2% want the training to be included in the specialty curriculum. While the participants' level of knowledge about the symptoms that may develop after a CBRN event is high, when asked about the awareness of CBRN risks around their institutions, 79.3% of physicians stated that they were not aware. It was determined that the level of knowledge, preparation, training, practice and awareness of family physicians regarding CBRN events was low. On the other hand, their willingness to receive training and their belief that they had a role in CBRN incidents were found to be high. According to the data of our study, we evaluate that there is a need for institutional structuring against CBRN risks, including primary health care services, and we suggest that CBRN training modules should be included in specialty curricula, starting from medical faculties.

Are we braver today in using antidepressants perinatally?- own clinical experiences

Introduction Affective disorders are among the most common mental health problems in women of reproductive age. A life-changing condition, such as pregnancy, may trigger or intensify symptoms of affective disorders, rather than pregnancy being a protective factor for the development of the disorder, as previously thought. Previous research indicates that 18% of women suffer from perinatal depression. One in 7-10 pregnant women and 1 in 5-8 midwives develops a depressive disorder, which is more than half a million women a year. Untreated perinatal depression has significant repercussions for both mother and child. Given that there are no controlled randomized studies during pregnancy, and the results of previous research on the harmfulness of the use of psychotropic drugs are contradictory, we need to nurture an individualized and integrative approach to the use of psychotropic drugs in pregnant women and in the postpartum period. The goal of this lecture is to point out the necessity of treating perinatal depressive disorder with an emphasis on the need to work on dilemmas and selected sources of information by pregnant women themselves, as well as health professionals. In the end, I must emphasize the importance of choosing an adequate psychopharmaceutical in that sensitive period for a woman, nurturing an individual approach as well as the latest knowledge.ObjectivesThe aim of this research is to examine the attitudes of psychiatrists, GP doctors, gynecologists and pregnant women about prescribing and taking pharmacotherapy during pregnancy.MethodsThe research will be conducted at the psychiatry clinic, the gynecology clinic and in health centers through semi-structured questionnaires, which will be filled out by psychiatrists, gynecologists, doctors and pregnant women.ResultsPreliminary results (given that the research is still ongoing) indicate that most psychiatrists avoid prescribing drugs during pregnancy, and if they decide to do so, then diazepam is prescribed. The views of gynecologists, family medicine doctors and pregnant women are still pending.ConclusionsThis lecture aims to point out the factors contributing to the fear of prescribing psychotropic drugs perinatally, based on our own research, which included psychiatrists, gynecologists, family medicine doctors, and pregnant women.Disclosure of InterestNone Declared

HEALTH STATUS AND HEALTH PRACTICES OF MONTENEGRIN FAMILY PHYSCIANS

Introduction: Physicians have lower mortality rates than general population, but similar rates of chronic diseases. Aim: The aim was to investigate health status and heath practices of family medicine doctors in Primary Health Care Center Podgorica, Montenegro and compare it to high school teachers. Method: A total of 104 (69.3%) physicians and 40 teachers (50%) responded to a questionnaire about their health status and health practices. Results: A total of 45% of practitioners and 45% of teachers self-reported at least one disease without significant difference in the incidence and type of disease (p=0.162). There was also no difference in using sick leave (p=0.633). Both groups tended to work when sick, but significantly more physicians worked when tired (p=0.026). Most of respondents were registered with a general practitioner, but only teachers tended to visit their physician when ill (p&lt;0.001). Thirty minutes of daily physical activity was reported by 16.3% of the physicians and 15.0% of the teachers without a significant difference (p=0.915). Conclusion: Compared to the teachers Montenegrin physicians have similar health status and health practices. However, physicians more often tend to work when they are tired and to selfcare when they are ill. Physicians need to pay attention to the lifestayle habits and to follow the recommendations for themselves what they provide to their patients.

Changes in vaccine attitudes and recommendations among US Healthcare Personnel during the COVID-19 pandemic

A recommendation from healthcare personnel (HCP) is a strong predictor of vaccination. This study aimed to measure how HCP vaccine attitudes and recommendations changed during the COVID-19 pandemic. HCP were surveyed in January 2023 using a double opt-in network panel. Survey responses were summarized and stratified by HCP type and COVID-19 booster status. Multivariable logistic regression models were fitted. Comparisons were made to a September 2021 survey, with differences tested for significance (p < 0.05) using Pearson’s χ2 Test. Nearly 82% of the 1207 HCP surveyed had received a COVID-19 booster, most commonly pediatricians (94%), followed by family medicine doctors (87%), pharmacists (74%), and nurses (73%) (p < 0.01). HCP with high trust in the Centers for Disease Control and Prevention (CDC) had nearly 6 times the odds (OR: 5.5; 95%CI: 3.9–7.7) of being boosted compared to HCP with low trust. From September 2021 to January 2023, the proportion of HCP recommending vaccines (COVID-19 and routine) to their patients decreased substantially for nearly all vaccines and patient populations specified. Trust in CDC also decreased (from 79 to 73%, p < 0.01), as did support for HCP COVID-19 vaccine mandates (from 65 to 46%, p < 0.01). HCP interest in additional online resources to improve their vaccine discussions with patients increased from 46 to 66% (p < 0.01). Additional regularly updated online resources from trusted medical sources that clarify progressing science and address dynamic public concerns are needed to improve vaccine confidence among HCP and help them support their patients’ decision-making.

Knowledge of Complications of Diabetes Mellitus Among Patients Visiting the Diabetes Clinics: A Cross-Sectional Study in the Qassim Region.

Background and objectives Diabetes mellitus (DM) is a chronic complex metabolic disease characterized mainly by hyperglycemia. It appears to be a global epidemic and an increasingly major non-communicable disease, posing a threat to both affluent and nonaffluent societies. Diabetes dramatically increases the risk of developing stroke, chronic kidney disease, and coronary artery disease. These complications include chronic kidney disease, retinopathy, coronary artery disease, stroke, and diabetic foot ulcers. Compared to people without diabetes, adults with diabetes have a two to four times greater risk of dying from heart disease and stroke. This study aimed to assess the knowledge and attitude regarding complications among patients with diabetes visiting the Diabetes Clinics at King Fahad Specialist Hospital (KFSH) in the Qassim Region, Saudi Arabia. Methodology A cross-sectional study was conducted in which patients with DM who visited the Diabetic Clinics at KFSH from February 2023 to July 2023 were recruited using a nonprobability sampling technique. A validated questionnaire from previous research was used to collect data on the sociodemographic features of the participants and their knowledge regarding diabetic complications. Data were described using mean with standard deviation for continuous variables and proportion for categorical variables. Results A total of 368 patients were recruited. The majority of the respondents (144, 39.1%) had been living with diabetes for over 10 years, followed by 23.1% (85) of those with less than one year. Exactly 239 (64.9%) reported having a family history of diabetes. About 75% (276) of participants knew about diabetic complications, and 247 (67.1%) reported that their doctor had addressed them about diabetes complications. Among the sources of diabetes complication information, diabetologists were reported by 131 (35.6%) of the respondents, followed by 81 (22.0%) through social media, 65 (17.7%) from relatives, and 39 (10.6%) from family medicine doctors. On the other hand, the findings reveal that the different age groups have different levels of knowledge of hyperglycemia and hypoglycemia as diabetic complications (P = 0.031). However, there were no significant differences in the level of knowledge regarding complications between male and female patients (P > 0.05). Conclusions The study found that while the studied population had a relatively good knowledge of diabetic complications, some still lacked knowledge. The study also supports the need for individuals with a family history of diabetes to be aware of their risk and take steps for prevention, as a large proportion of participants reported having a family history of diabetes. Healthcare providers and diabetologists were the most frequent sources of information on diabetic complications. However, some also turned to social media. Focused education and awareness actions are crucial to ensure that people with diabetes have access to reliable information from various sources.

Adequancy of treatment with canaglifozin alter alerts pharmacovigilance in the health management area

ObjectiveTo analyze the impact of a strategy on the suitability of canaglizozin, and its level of acceptance, after issuing recommendations based on drug surveillance alerts issued by the Spanish Medicines and Medical Devices Agency (AEMPS). DesignA prospective intervention from may 2016 to october 2016. LocationSouth Seville Health Management Area. ParticipantsPatients with active canagliflozin prescription. InterventionsThe study was conducted in three phases, the first one linked to the issuance of the safety information note on the canaglifozin by the AEMPS, the obtaining of the patient lists and the recommendations of the adequacy in the sending of letters. A second phase where the medical professional performed the actions and a final phase in which the degree of acceptance of the recommendations made by the Pharmacy Service is evaluated. Main measurementsSuitability of canaglizozin treatment and the level of acceptance by physicians. ResultsA total of 61 patients at baseline were included in treatment canagliflozin. Of the total number of patients referred to, some type of intervention was performed by the family and community medicine doctor after the pharmaceutical intervention (PI), by means of letters (n = 30), 56.7% were monitored, 33.3% were discontinued and 10.0% were closely monitored ConclusionsInterventions aimed at reviewing patients on canagliptin, based on pharmacovigilance alerts, have been effective, with a high degree of acceptance by the family and community medicine practitioner.

Analysis of pediatric outpatient visits uncovers disparities in molluscum contagiosum treatment across medical specialties in the United States.

Molluscum contagiosum (MC) is a common viral infection that affects the skin of children. In this study, treatment regimens and demographic information for MC patients across US medical specialties were compared. We discovered an average of 471,383 pediatric MC visits annually using the National Ambulatory Medical Care Survey database from 2000 to 2016. Non-Hispanics (82.9%) and Caucasians (91.0%) made up the majority of the visitors. The majority of cases were handled by pediatricians (46.5%), family medicine doctors (10.6%), and dermatologists (36.7%). Compared to pediatricians, dermatologists saw a higher percentage of Caucasian patients (95% vs.84%) and patients with private insurance (83% vs. 73%). Patients were more likely to see family medicine doctors (55.0%) in non-metropolitan areas than pediatricians (26.4%) or dermatologists (16.3%). Dermatologists were less likely than pediatricians (38%) to favor spontaneous resolution (70%). Dermatologists favored terpenoids (20%), imiquimod (12%), and curettage (10%), while pediatricians primarily used terpenoids (12%), steroids (4%), and imiquimod (4%). The majority of MC cases are managed by pediatricians; however, treatment approaches deviate markedly from recommended best practices.

Effects of psychological characteristics of patients with hypertension on their adherence to treatment. Analysis of clinical cases

Objective — to acquaint cardiologists and family medicine doctors with modern treatment approaches that take into account the psychological characteristics of patients. The professional activity of therapeutic doctors is to a large extent (especially in comparison with surgical and anesthesiology specialties) related to the need to develop communication skills, since patients differ not only in clinical features, but also in psychological traits that are revealed in the process of diagnosis and treatment. The authors performed the analysis of four clinical cases with a detailed description of socio‑demographic and behavioral characteristics of patients who ask for a cardiologist’s consultation for the purpose of correcting drug treatment. In addition to the analysis of complaints, anamnesis and data from laboratory and instrumental examinations, typical problems of communication with «difficult» patients have been described and practical recommendations were provided. Four variants of the possible behavior of patients are presented, determined by their psychological characteristics and manifested during communication with doctors of a therapeutic profile. The following psychotypes were chosen as «classical»: «expressive», «directive», «analytical» and «friendly». For the first two, a characteristic feature is the presence of a high level of authority in the process of communicating with interlocutors, and for the last two — a low level. Also, «analytical» and «directive» personalities are marked by a significantly higher degree of self‑control compared to «expressive» and «friendly». Doctors mostly come into contact with patients who combine the features of two psychotypes with the dominance of one of them. Physicians’ understanding of the therapeutic profile of patients’ psychological characteristics will allow understanding their expectations and improving adherence to pharmacotherapy.

O.4.1-4 Integrated geriatric care - a community approach to preventing falls and frailty of elderly Slovenian

Abstract Purpose The need for geriatric treatment is increasing with the aging of the population. Multimorbid patients with social care problems and increased need for rehabilitation and paliative care are more common. Mortality of the elderly, due to falls is 2.5 times higher in Slovenia than in the other EU countries. Until the national regulation of integrated geriatric care in Slovenian health system and in other relevant environments (community, long-term care, social care) and the establishment of appropriate, licensed postgraduate training for health professionals, it is necessary to start educating wider range of health and social care personnel, for most common geriatric syndromes such as frailty, falls and NCDs. Establishing a community approach to health is one effective way to address vulnerability of elderly population. Project description Project Integration of geriatric care for the elderly is implementing the existing commitment from WHO Decade of healthy ageing and the Slovenian Health Care Plan until 2025. With planned activities, it will ensure equal access to quality and safe health services, integrated and comprehensive treatment and will contribute to the deinstitutionalization of the Slovenian eldest population. It will develop a unified set of tools, for the systematic identification of elderly needs, new digital tools for optimization and better communication between different levels of providers and training a wider range of new and already employed health and social care personnel, for optimal health care. Evaluation of new competency models for health care personnel, training methods and proposed clinical pathways will be carried out at the end of the project. Based on final proposals, we will establish a new approach to the system level of integrated geriatric care and bring the treatment closer to the patient's home. Conclusions Project will also contribute to upgrading competences of physiotherapists, kinesiologists, standard health teams in Health Promotion Centers, community nurses, family medicine and internal medicine doctors and social care workers for the integrated geriatric care for the elderly. It will address especially treatment of the physical component in geriatric syndrome, such as decreased muscle strength, balance, impaired walking and frailty, at different levels of health care and communities.

EXPERIENCE OF THE BUKOVINIAN STATE MEDICAL UNIVERSITY IN CONTINUOUS PROFESSIONAL DEVELOPMENT FOR MEDICAL PERSONNEL PERFORMING NEONATAL AND PEDIATRIC CARE IN UKRAINE

Continuous professional development of doctors and nurses using modern learning tools is the key to the quality andeffectiveness of neonatal and pediatric care in Ukraine, especially given the extremely difficult challenges of wartime. The basicprinciples of continuing professional development (CPD) of Ukrainian medical and pharmaceutical practitioners were approvedby the Resolution of the Cabinet of Ministers of Ukraine No. 725 "Regulations on the System of Continuing ProfessionalDevelopment of Medical and Pharmaceutical Workers" dated July 14, 2021.The article presents the experience of the Department of Pediatrics, Neonatology and Perinatal Medicine of Bukovinian State Medical University (BSMU) (Head - Doctor of Medicine, Professor Nechytailo Y. M.) in conducting CPD activities for medical staff providing neonatal and pediatric care in Ukraine. The Department hosts specialization and internship cycles in Neonatology and Pediatric Anesthesiology, as well as all kinds of professional seminars, workshops, simulation trainings and professional schools. The target group of the CPD activities is neonatologists, pediatric anesthesiologists, pediatricians, pediatric neurologists, family medicine doctors, emergency medicine doctors, etc.The educational activity is carried out on the basis of the Training Center for Modern Technologies of Perinatal Medicine(headed by Doctor of Medicine, Professor Yulija Godovanets), the Center for Simulation Medicine and Innovative TechnologiesCOSMIT of BSMU and clinical bases of the department. The training process involves the use of full-time and distance learning.Based on the current educational requirements and the Order of the Ministry of Health of Ukraine No. 2016 dated10.11.2022, the Department of Pediatrics, Neonatology and Perinatal Medicine of BSMU has launched CPD cycles for medicaland pharmaceutical staff with higher, entry-level (short cycle) and first (bachelor's) level of higher medical and pharmaceuticaleducation and Masters in Nursing.

Exploring medical students’ perceptions of family medicine in Kyrgyzstan: a mixed method study

BackgroundDespite knowing that health systems with strong primary care improve overall health outcomes within a population, many countries are facing a global trend of declining interest and shortage of family doctors. This is the case of the Kyrgyz Republic, in which rural areas are struggling to attract and retain family medicine (FM) doctors. This study aims to explore how Kyrgyz medical students perceive FM and the factors that influence their specialty choice.MethodsThis study used a cross-sectional explanatory sequential design, including quantitative survey and focus group discussions that were carried out at the Kyrgyz State Medical Academy (KSMA) in Bishkek in 2017. Overall, 66% (953 out of 1449) of medical undergraduate students registered in year 1, 4 and 6 completed the survey, and 42 participated in the focus groups. The results were organized around 7 factors influencing perceptions and attitudes towards FM identified through a qualitative systematic review.ResultsThe interest of Kyrgyz students for FM was the lowest of all specialties. Access to high medical technologies, career opportunities, salary, patient interaction and possibility to work abroad were the five most important factors influencing specialty choice. FM was perceived as a difficult profession, yet with poor prestige, insufficient remuneration, limited career possibilities and poor working conditions, especially in rural areas. The academic discourse, which disregards FM specialty had a negative influence on student’s perceptions and prevented students’ ability to identify with the practice of family medicine. However, students’ awareness of their social accountability arose as a positive leverage to increase the choice of FM, provided other problems were solved.ConclusionThis study highlighted key factors responsible for the low number of students choosing to become FM in Kyrgyzstan. The first major factor, presumably specific to many low- and lower-middle- income countries was the poor working conditions in remote areas. The second factor, common to many countries, was the distorted image of FM and its specialty transmitted through the medical schools’ institutional culture which does not value FM through positive role models. This study served as a basis to establish a strategy to promote FM within the KSMA and potentially at National level.

THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE

Every year in the world, arterial hypertension is the cause of death in about 9 million cases. Blood pressure control in patients has not yet reached the appropriate level, and the percentage of resistant arterial hypertension remains high. According to the definition of the American Heart Association, those patients whose condition requires taking four or more drugs to control blood pressure should be considered resistant to treatment. It should be understood that uncontrolled hypertension is not synonymous with RAH. The presence of RAH significantly increases the risk of cardiovascular complications, contributes to serious damage to target organs. Preliminary diagnosis of RAH definitely requires the exclusion of secondary hypertension, which is a rather heterogeneous group of diseases that is poorly recognized.&#x0D; The goal of the work. To acquaint general practice - family medicine doctors with the algorithm of treatment of patients with resistant arterial hypertension at the ambulatory stage.&#x0D; Treatment of patients with RAH should be carried out in stages, with increased therapy, using the most simplified scheme of taking drugs. Today, the combination of ACEI (perindopril), BCC (amlodipine) and diuretic (indapamide) is considered as the most optimal triple combination of antihypertensive drugs. Medicines containing three antihypertensive drugs in one tablet are offered precisely for RAH patients.&#x0D; Conclusions. The implementation of the algorithm for the examination of patients with RAH, recommendations for changing their lifestyle and a step-by-step therapy plan allow improving the control of blood pressure. Treatment of patients with RAH should include optimization of dosages and the appointment of rational combinations of antihypertensive drugs in order to enhance synergistic effects. Optimization of pharmacotherapy by prescribing drugs with fixed combinations can improve control of drug administration. The fixed combination of amlodipine-indapamide-perindopril may have the important advantage of increasing treatment adherence due to the principle of "one pill per day".

COVID-19 vaccination among different types of US Healthcare Personnel.

Increasing vaccine coverage remains the best way to control the COVID-19 pandemic. Healthcare personnel (HCP) have long been the most credible and frequently used source of vaccine information for the public, and an HCP recommendation is a strong predictor of vaccination. A survey of HCP was conducted in September 2021 via a double opt-in network panel. Responses to survey items were summarized and stratified by HCP type and adjusted logistic regression models were fitted. >94% of the 1074 HCP surveyed reported receiving at least one dose of COVID-19 vaccine or intending to soon, with vaccinating most common among pediatricians (98%), followed by family medicine doctors (96%), pharmacists (94%), and nurses/nurse practitioners/physician assistants (88%). HCP with high trust in the Centers for Disease Control and Prevention had 26 times the odds of vaccinating of HCP with low trust (95%CI: 9, 74). Nearly half of unvaccinated HCP (47%) were concerned about side effects, and one third of unvaccinated HCP (33%) were concerned the vaccine was developed too quickly. About three quarters of HCP reported strongly recommending the Pfizer-BioNTech (75%) and Moderna (70%) vaccines to their patients, compared to about one quarter (24%) strongly recommending Johnson & Johnson. Although most HCP are vaccinated against COVID-19 and strongly recommend vaccination to their patients, some harbor similar concerns to the public. Additional resources - regularly updated to explain the progressing scientific landscape and address ever evolving public concerns - are needed to further improve vaccine coverage among HCP and aid them in supporting the decision-making of their patients.

Type 2 diabetes mellitus risk assessment among Alrass city employees, Qassim, Saudi Arabia.

Diabetes mellitus (DM) is a serious chronic disease that can affect all parts of human body and associated with short-term and long-term complications such as retinopathy, nephropathy, and neuropathy. Age, obesity, family history, and hypertension are considered to be the most common risk factors for the incidence of DM. This study aimed to assess the risk of type 2 diabetes among governmental employee in Alrass city in Qassim, Saudi Arabia. A cross-sectional survey was done using health professional-administrated questionnaire. Two groups of data collectors were formed and trained to fill out the questionnaire, each group was consist of 1 family medicine doctor and 4 nurses. Data were entered and analyzed using SPSS v. 26. A total of 527 subjects participated in our study with a response rate of 100%. Of them, more than half (55%) were females. Approximately all of our participants were Saudi 92% regarding age, more than three quarters (79.5%) were aged less than 45 years, 15.6% were ranged from 45 to 50 years, and 4.9% were from 55 to 64 years. We reported no significant correlation between gender and nationality regarding the risk of DM. Saudi females who aged less than 45 years and obese participants had a risk for developing DM.