Knowledge Of General Practitioners Research Articles

Dutch GPs' perspectives on addressing obesity: a qualitative study.

Early diagnosis and treatment of obesity in primary care may help to tackle the obesity pandemic. Nonetheless, GPs frequently fail to address obesity and demonstrate limited adherence to guidelines. To explore Dutch GPs' perspectives on addressing obesity regarding the following three target behaviours: discussing weight; diagnosing; and referring patients with obesity. A qualitative focus group study with Dutch GPs. Six focus groups were conducted with a purposive sample of 21 GPs. Thematic analysis was performed using deductive coding, according to the Theoretical Domains Framework (TDF). For discussing weight, the main barriers identified were a presented complaint unrelated to obesity (environmental context and resources), concerns about a negative response from the patient (beliefs about consequences), and worries about obesity being a sensitive subject to discuss (emotions). A long-term trustworthy relationship (social influences) facilitated discussing weight. For diagnosing patients with obesity, the main barriers were related to resources; for example, lack of (appropriate) measuring equipment and time (environmental context and resources). For referring patients with obesity, the main barriers were no referral options nearby (environmental context and resources), and doubts about the positive effects of the referral on weight change (beliefs about consequences). Different barriers for discussing weight, diagnosing, and referring patients with obesity were identified, underscoring the importance for tailored interventions to these specific behaviours. Improving knowledge and skills of GPs seems insufficient as this study showed that particular attention should be paid to establishing long-term relationships, addressing GPs' beliefs about consequences, and creating a supportive environment with sufficient time and resources.

Evaluation of Knowledge, Attitude and Practice of General Practitioners regarding Oral Cancer in Tehran

Background: General practitioners (GPs) are the primary examiners of patients suspected of oral cavity cancer. The present study aims to determine the knowledge, attitude, and practice of general practitioners regarding oral cancer in Tehran.
 Methods: A 17-item questionnaire was applied to evaluate the knowledge, attitude, and practice of general practitioners in this cross-sectional, descriptive-analytical study, in 2019. The questionnaires were completed by 154 GPs participating in different medical congresses. Data were analyzed with a linear regression model using SPSS-25. P-value < 0.05 was considered statistically significant.
 Results: Of 154 GPs, 44.8% were female with a mean age of 44.5 ± 13.3, mean clinical experience of 14.6 ± 11.6 years, and mean time of 16.9 ± 12.1 years elapsed from graduation. Age, sex, and marital status had no significant association with knowledge, attitude, and practice; however, the time elapsed from graduation had a significant indirect association with knowledge (p = 0.04), and mean clinical experience had a significant direct association with attitude towards oral cancer (p = 0.04).
 Conclusion: Educational interventions are required to improve the GPs’ knowledge and practice to improve the early diagnosis and prevention of oral cancer.

Knowledge, attitudes and practices of general practitioners and paediatricians towards Group A beta-haemolytic streptococcal tonsillopharyngitis: A cross-sectional study from Türkiye.

General practitioners (GPs) and paediatricians are very important in the management of sore throat in terms of providing correct diagnosis and treatment. The aim of this study was to evaluate the knowledge, attitudes and practices of GPs and paediatricians towards Group A beta-haemolytic streptococcal (GABHS) tonsillopharyngitis. Three vignettes/case studies, in which the causative agents were GABHS, Epstein-Barr virus (EBV) and non-EBV viral infection, were presented as part of a questionnaire sent to paediatricians and GPs to elicit information regarding their diagnosis and treatment of tonsillopharyngitis. In all, 236 physicians responded to the questionnaire (126 paediatricians, 106 GPs). GPs registered more accurate diagnoses of GABHS tonsillopharyngitis and tended to administer more symptomatic treatment in the case of non-EBV tonsillopharyngitis than paediatricians. Paediatricians requested more tests in the diagnosis of GABHS tonsillopharyngitis than GPs. Most GPs and paediatricians possess adequate knowledge regarding GABHS diagnosis and the differential diagnosis of patients. Differences between the hospital and general practice settings may have affected the approach to symptomatic treatment and requesting tests.

Hereditary angioedema: Patient journey approach in Mexico.

Objective: To understand the patient’s journey with HAE from symptom initiation to diagnosis, treatment allocation, follow-up, and the impact of the disease on their quality of life in Mexico. Methods: A survey was administered to the patients with HAE. Participants completed a questionnaire covering five domains: patient journey; effects on productivity, school performance and daily activities; quality of life; anxiety and depression. Responses were analyzed using descriptive statistics. Results: A total of 17 surveys were analyzed (15 women and 2 men, age range: 23-67 years). Type I HAE was most common (71%), normal C1 inhibitor HAE was 12% and 18% did not know their HAE type. The average disease evolution was 13.7 years and the time from symptom initiation to diagnosis was 20 years. 59% of patients knew of one or two treatments available, 12% knew 3 treatments and 18% were aware of 4 or more, 12% were not aware of any treatments. 53% had a job, 18% referred a severely anxious state, 41% were depressed and all patients referred some social impact due to HAE. Conclusions: There is a need to reinforce the knowledge of general practitioners on HAE to promote an earlier diagnosis and awareness of rare diseases and their impact on quality of life among the general population and promote the removal of barriers to treatment.

Knowledge, Attitudes and Practices of General Practitioners in Lahore with Regard to Excess Weight and Obesity

The number of people suffering from overweight has equaled the number of undernourished people. Objective: To determine knowledge, attitude and practice of resident’s general physician’s related to obesity. Methods: A KAP study was conducted among male and female physician having age between 30-60 years. Participants were asked about their knowledge, attitude and practice and scored according to their responses. The Sample size was 100. It was a questionnaire-based study. The questionnaire was divided into four parts professional and personal characteristics, including training related to obesity; knowledge of current recommendations regarding physical activity; attitudes towards obesity and patients with obesity and reported practices. Data were entered and analyzed using SPSS version 23.0. Results: Showed that Majority of General Practitioners (GP’s) (55%) know the prevalence of obesity and 52% know the body mass index ranges. (73%) think that obese patients are not comfortable discussing their weight. 28% GP’s measured weight and calculated BMI (66%). 54% of GP’s calculate their own body mass index. Conclusions: From this study it is observed that majority of the respondents know about prevalence of obesity and concept of BMI. It also sheds light on the fact that neither patients nor doctors are comfortable in discussing their weight specially when they are obese. General Practitioners involved in study know much about the weight related issues and their treatment as well. This highlights the need for improved communication and sensitivity when addressing excess weight related issues.

Decision making of the endodontic-periodontal interrelation

This present work was aimed at evaluating the clinical knowledge of general practitioners (GPs), attending a specialization course on Endodontics in the cities of Recife - Brazil and João Pessoa - Brazil, as regards the endo-perio lesions, owing to the difficulties, noticed when stablishing their diagnosis and, therefore, when performing the therapeutic decision. On this purpose, a questionnaire with three case-reports, concerned with those lesions, was answered by a sample of 54 GPs. During the interviews, they were inquired on their possible diagnosis and treatment, by means of digitalized radiographies and case decriptions. The results revealed a great range of variation, even higher than what was expected, in reference to the diagnosis and proposed therapies, associated to a low frequency related to the right decision-making. In conclusion, the majority of the interviewed students does not retain the required scientific knowledge towards the studied subject.

Activities of the Japan Council for Implementation of the Maternal Emergency Life Support System reduced direct causes of maternal deaths in Japan.

Here, we aimed to provide an overview of Japan Council for the Implementation of the Maternal Emergency Life-Saving System (J-CIMELS) and its simulation program, which has reduced maternal mortality due to direct causes in Japan. The Japan Association of Obstetricians and Gynecologists (JAOG), Japan Association of Obstetricians and Gynecologists, and Maternal Death Exploratory Committee (JMDEC) launched the Maternal Death Reporting Project in 2010. The project analyzed obstetricians' tendency to delay their initial response to sudden maternal deterioration. Obstetricians can predict small changes before deterioration by monitoring vital signs. In 2015, the J-CIMELS was established to provide practical education. J-CIMELS developed a simulation program (J-MELS; Japan Maternal Emergency Life Support) to ensure that the obstetricians acquire the latest knowledge of emergency physicians, anesthesiologists, and other general practitioners and apply it in clinical situations. In the last 7 years, the J-MELS basic course has been conducted 1000 times with a total attendance of 19 890 people. As a result, the incidence of obstetric hemorrhage progressively decreased from 29% in 2010 to 7% in 2020. We believe that the activities of J-CIMELS are improving obstetric care providers' medical practices in Japan.

General Practitioners' Knowledge, Attitudes, and Practices of Dietary Advice for Weight Control in Their Overweight Patients: A Scoping Review.

This scoping review assessed the knowledge, attitudes, and practices of general practitioners (GPs) regarding dietary advice for weight management. A systematic search of PubMed, EMBASE, CINAHL, and MEDLINE was conducted for any qualitative, quantitative, and mixed-methods studies published in the past five years that informed GPs' dietary advice for weight control. Thirteen studies were included in the analysis after screening 881 papers. These studies tended to focus mostly on GPs' practices rather than their knowledge and attitudes. The most frequently mentioned dietary advice was to reduce calorie intake; however, 32 different types of dietary advice were identified in the literature, including approaches such as intermittent fasting and a ketogenic diet that are not recommended in current guidelines. GPs showed varying levels of knowledge and attitudes regarding the best dietary advice for patients. Further research is needed to better understand GP perspectives, with efforts to assist GPs in providing tailored advice based on the latest evidence to improve patient outcomes required.

Factors affecting communication between transgender and non-binary individuals and general practitioners: Recommendations for inclusive interactions

Research shows that transgender and non-binary (TNB) individuals frequently experience discrimination and mistreatment in health care settings. These negative experiences cause TNB people to underutilize health care and, when they do utilize it, may affect communication of health information. Moving from social cognitive theory (SCT) and theory of planned behavior (TPB), this study investigated what factors influence pre-, during, and post physician visit communication between TNB individuals and general practitioners (GPs) in The Netherlands. Between March and May 2022, fifteen TNB individuals and ten GPs participated in semi-structured interviews and focus groups about their experiences with GP-TNB interactions. The findings suggest that GPs addressing TNB people, GP knowledge and education, GP office procedures and environment, and social environment (in)directly facilitate or hamper communication. These findings support previous ideas about the influence of factors such as knowledge and social environment on one's behavior, as previously described in SCT and TPB. They also add and specify how pre-determined and novel factors affect whether TNB people feel welcome and comfortable at GP offices and if GPs feel equipped to provide TNB people with quality care. More specifically, to facilitate appropriate health communication, GPs are advised to ask patients about their pronouns, adjust intake forms, and put up TNB-specific posters or a Pride flag in their offices. TNB people are advised to make an introductory appointment to discuss their gender identity. Lastly, TNB topics should be included in medical curricula and online GP resources.

Knowledge, attitudes and practice of female genital mutilation and cutting: An observational cross-sectional study in primary care (FGM/C Study).

Female genital mutilation and cutting (FGM/C) describes procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Increasing migration means many communities living in the UK originate from countries where FGM/C is practiced. Consequently, clinicians in the UK are increasingly exposed to women and children who have experienced FGM/C. To explore the knowledge, attitudes and practice of primary care general practitioners and practice nurses about FGM/C. An observational cross-sectional study with general practitioners (GPs) and practice nurses (PNs) working in primary care in the West Midlands, United Kingdom. An online survey was circulated to GPs and PNs between September 2019 and December 2019. 137 survey responses were received. Study participants were predominantly female (81.8%) and general practitioners (59.9%) with a mean age of 47.3 (SD =9.1). 19.7% of responders reported seeing more than one patient with FGM/C in the last 12 months. 91% of responders had received some form of FGM/C training; however the format and frequency of training varied and 34.3% felt they had received inadequate training to manage treatment of FGM/C. Results suggest varying degrees of competence and confidence associated with recognising and managing patients with FGM/C in primary care in the West Midlands. Given that FGM/C patients typically present in primary care it is important that clinicians can provide appropriate support underpinned by up-to-date training.

Topical Steroids: Awareness and Misuse Among General Medical Practitioners

Introduction: Topical steroids (TS) contributed in the management of several inflammatory, tumoral or allergic dermatoses. However, their misuse may lead to serious or even irreversible adverse effects. This study aimed to evaluate the knowledge and attitudes of general medical practitioners in Morocco regarding topical steroids use and misuse. Materials and Methods: Cross-sectional national survey over a 4-month period from 01/09/2022 to 30/12/2022. The data was collected by a Google Forms questionnaire which was shared on different professional groups on the social networks. The target population was Moroccan general practitioners. Data analysis was performed by Excel software. Results: A total of 200 general medical practitioners answered the questionnaire, of which 133(66.5%) practiced in the public sector and 67(33.5%) in the private sector. 11% had rated their frequency of prescription as high, 56% as medium and 33% as minimal or rare; the indications were dominated by eczema, atopic dermatitis and psoriasis. The prescription of topical corticosteroids started from the age of 1 year in 32.5% of general practitioners while the majority prescribed them at any age. Sixty (30%) were aware of the pharmacological effects of topical corticosteroids. The most frequently prescribed galenic form was cream in 95% of cases followed by gels, lotions and finally preparations. One hundred and thirty-three (66%) had answered correctly to the indications of topical corticosteroids and 106(53%) prescribed them in short cures. Few doctors (1%) had been able to identify all side effects. One hundred and fifty (75%) of the general medical practitioners had already seen patients presenting adverse effects dominated by skin atrophy, delayed healing, depigmentation, fungal or bacterial infection; their response consisted of degression in 75% of cases or switching to a lower class, while 11.5% had wrongly suggested an abrupt discontinuation. Conclusion: The high frequency of topical steroids side effects is an increasing problem encountered by dermatologists. Lack of some general practitioners and patient awareness are also important underlying factors. To our knowledge, this is the first Moroccan study that aimed to evaluate the knowledge, attitudes, and behavior regarding topical corticosteroids by general medical practitioners.

Assessment of the Current Knowledge and Practice of General Practitioners Towards Laryngopharyngeal Reflux in Saudi Arabia.

Background General practitioners (GPs) have a significant role in the diagnosis of patients with laryngopharyngeal reflux (LPR). Some published data revealed a lack of knowledge among GPs about the disease, consequently, this lack of knowledge impacted their performance. This survey aims to assess the current knowledge and practice of general practitioners regarding laryngopharyngeal reflux in Saudi Arabia. Methodology This survey study was conducted to assess the current knowledge and practice of general practitioners regarding laryngopharyngeal reflux in Saudi Arabia using an online questionnaire. The questionnaire was distributed and collected from the five regions in Saudi Arabia, which are The Central Region (Riyadh, Qassim), Eastern Region (Dammam, Al-Kharj, Al-Ahasa), Western Region (Makkah, Madinah, Jeddah), Southern Region (Asir, Najran, Jizan), and Northern Region (Tabuk, Jouf, Hail). Results In the current study, we collected data from 387 general practitioners, 61.8% of whom were aged between 21-30 years old, and 57.4% of the participants were males. Moreover, 40.6% of the participants thought that both LPR and gastroesophageal reflux disease (GERD) share pathophysiology, however, they are two different diseases considering their clinical presentation. Moreover, it was found that heartburn was the most known symptom of LPR among the participants (Mean score 2.14 (SD=1.31), where a lower score indicated more relation). Considering the treatment of LPR, 40.6% and 40.3% of the participants reported using proton pump inhibitors once or twice daily respectively. In contrast, antihistamine/H2 blockers, alginate, and magaldrate were used to a lesser extent as reported by 27.1%, 21.7%, and 12.1%. Conclusion The current study showed limited knowledge among general practitioners considering LPR with a higher rate of referring patients to other departments depending on symptoms which may increase the pressure on other departments of mild cases.

Developing a Questionnaire Evaluating Knowledge, Attitudes and Behaviors on Audit & Feedback among General Practitioners: A Mixed Methods Study.

Audit and Feedback (A&F) is one of the most common strategies used to improve quality in healthcare. However, there is still lack of awareness regarding the enabling factors and barriers that could influence its effectiveness. The aim of this study was to develop a questionnaire to measure the knowledge, attitudes and behaviors of general practitioners (GPs) regarding A&F. The study was performed in the context of the EASY-NET program (project code NET-2016-02364191). The survey was developed according to two steps. Firstly, a scoping review was performed in order to map the literature on the existing similar instruments with the aim of identifying the sub-domains and possible items to include in a preliminary version of the questionnaire. In the second phase, the questionnaire was reviewed by a multidisciplinary group of experts and administrated to a convenience sample in a pilot survey. Ten papers were included in the scoping review. The survey target and development methodology were heterogenous among the studies. The knowledge, attitudes and behaviors domains were assessed in six, nine and seven studies, respectively. In the first step, 126 pertinent items were extracted and categorized as follows: 8 investigated knowledge, 93 investigated attitudes, and 25 investigated behaviors. Then, 2 sub-domains were identified for knowledge, 14 for attitudes and 7 for behavior. Based on these results, a first version of the survey was developed via consensus among two authors and then revised by the multidisciplinary group of experts in the field of A&F. The final version of the survey included 36 items: 8 in the knowledge domain, 19 in the attitudes domain and 9 in the behaviors domain. The results of the pilot study among 15 GPs suggested a good acceptability and item relevance and accuracy, with positive answers totaling 100% and 93.3% in the proposed questions. The methodology used has shown to be a good strategy for the development of the survey. The survey will be administrated before and after the implementation of an A&F intervention to assess both baseline characteristics and changes after the intervention.

E091 Improving recognition and referrals for axial spondyloarthritis in primary care

Abstract Background/Aims It is estimated there is an 8.5-year delay from onset of symptoms to diagnosis of axial spondyloarthritis. The condition is poorly recognised in the United Kingdom. An audit of a general practice with 7,500 patients revealed only 7 patients living with the diagnosis, of which only 2 were diagnosed before the age of 45. Estimates suggest this figure should be closer to 35 to 40. In the 12 months prior to the audit, only 2 referrals were sent to rheumatology suspecting axial spondyloarthritis. The short-term aim of this study was to improve the recognition and referrals for axial spondyloarthritis in primary care from 2 per year to 15. The long-term goal is to increase the number of patients living with the diagnosis from 7 to 37. Methods EMIS alerts and pop-ups were created for patients, aged 20-45, presenting with “low back pain” or a similar coding to increase clinicians' clinical suspicion index. The alerts and pops included a hyperlink to the SPADE tool to facilitate reasoning. This was consolidated with an education webinar to refresh General Practitioners and Advanced Nurse Practitioners on the diagnostic criteria for axial spondyloarthritis. Results Following implementation of alerts and hyperlinks to the SPADE tool, general practitioners' confidence and knowledge of knowing when to suspect, assess and refer axial spondyloarthritis increased from 1.9, 1.7 and 2 to 4.8, 4.4 and 4.2 on a 5 point self-rated Likert scale. In the 12 months following the intervention, number of referrals had increased from 2 per year to 11. Conclusion This study has highlighted various findings. It has highlighted an insufficient number of referrals to rheumatology suspecting axial spondyloarthritis in order to maintain the suspected population of a general practice. This is likely linked to poor awareness and screening of the condition. It has also highlighted that clinicians in primary care respond positively to training for knowing when to suspect, assess and refer on for axial spondyloarthritis. However, this only measured a short-term change in knowledge and further testing is required to assess long term change. Furthermore, combined with education and the use of pop up and alerts has increased the awareness and referrals for axial spondyloarthritis from primary to secondary care. Future audits are required in the long term to assess for success in the long term goal. Disclosure D. Hamilton: None.

The problem of toxoplasmosis in outpatient practice. Part I. Toxoplasmosis in immunocompromised patients

Toxoplasmosis remains one of the most common opportunistic infections in immunocompromised patients, primarily in people living with HIV. An increase in the number of requests for medical care by patients with HIV infection as the disease progresses determines the need for knowledge of outpatient therapists and general practitioners of decision-making algorithms for suspected toxoplasmosis in such patients. The main clinical manifestations of toxoplasmosis in patients with immunodeficiency states, the formulation of a preliminary diagnosis, and the routing algorithm are given.

Survey on the management of childhood epilepsy among general practitioners in the area of Marrakech

BackgroundEpilepsy is a common chronic neurological disorder in the pediatric population and its evolution can be fatal. It represents a major public health problem as well as an economic burden for the families of affected children, health systems and the overall economies of countries. This further accentuates the role that general practitioners can play in the management of childhood epilepsy in the face of the persistent lack of neurologists and neuro-pediatricians in our country.MethodsIn order to assess the knowledge and therapeutic habits of general practitioners, we carried out a descriptive and cross-sectional study with general practitioners practicing in the two healthcare sectors: public and private, and in two settings: urban and rural, during the year 2018. The data was collected through a pre-established survey.ResultsIn total, 155 general practitioners responded to the survey. For 85.2% of physicians, the diagnosis of childhood epilepsy was based on interrogation, physical examination, and EEG. While brain imaging would be systematic regardless of the type of epilepsy for 45.2% of doctors. Only 6 doctors (3.9%) had knowledge of the latest classifications of the “ILAE”. For treatment, the majority of physicians (65.5%) adopted first-line monotherapy with valproate in leading position. Almost half of the doctors (48.4%) found that education of parents and children was always necessary. None of the GPs interviewed in our series assessed the academic impact of epilepsy. Only 32% of doctors had received continuing education on epilepsy.ConclusionThe data from our study demonstrates that continuing education on the management of childhood epilepsy and the greater involvement of general practitioners were essential elements in improving care.

Anti-Doping Knowledge, Attitude, and Experience of General Practitioners in Kenya

General practitioners are regarded as athletic support personnel as they are involved in delivering supportive services such as treating athletes participating in or preparing for sports competitions. General practitioners play a vital role in influencing athletes to fulfill their mandate to adhere to clean sports and therefore, their additional knowledge in sports is required to comprehensively address their health needs without affecting the integrity of rules that govern fair play. General practitioners require sufficient doping knowledge to provide athletes with health needs consistent with anti-doping regulations. In Kenya, no studies have investigated or reported the doping knowledge, attitude or experience of General Practitioners, thus leaving a knowledge gap on their ability to treat competitive athletes harmonious with WADA requirements. Therefore, the study sought to unearth General Practitioners' doping knowledge, attitude, and experience in Kenya. The study's findings have implications on doping knowledge, attitude, and experience of Kenya General Practitioners’ essential to inform the current status of the concept. A cross-sectional analytical study design was selected because of its robustness in describing general practitioners' current doping knowledge, attitude, and experiences. Data was collected using a self-reported and validated questionnaire where 250 General practitioners completed the survey. Findings revealed that Kenyan general practitioners are well aware of doping regulatory agencies of WADA and ADAK. The findings demonstrated that General Practitioners had an average doping knowledge (47.77 ± 14.03) punctuated with limited knowledge of prohibited substances, methods, and substances in certain sports. Work experience significantly influenced General Practitioners knowledge, F (4,245) = 10.852, p< .001. General Practitioners had a negative doping attitude of 45.23 ± 13.64. As many as 22% (55) General Practitioners received doping requests for the last 12 months, where 35.7% (89) of requests are about drugs to aid recovery. Anabolic steroids, corticosteroids, and peptide hormones were among the most sought-after PEDs. General Practitioners in Kenya have inadequate doping knowledge, which could limit their efficacy in treating professional athletes in line with WADA guidelines. Additional anti-doping training could benefit them address this limitation. Although General Practitioners demonstrated a negative attitude, expanding their involvement through active participation in doping seminars, and programs can enhance their understanding of the doping concept necessary to develop and maintain a strong negative attitude.

Behavior of general physicians about lung cancer screening in a French region hosting a pilot study

IntroductionLung cancer is the leading cause of cancer-related death in France and has a 5-year survival rate of 20%. Recent prospective randomized controlled trials revealed that lung cancer-specific mortality decreased in patients who underwent screening using low-dose chest computed tomography (low-dose CT). The DEP KP80 pilot study conducted in 2016 showed that an organized lung cancer screening campaign involving general practitioners was feasible. Material and methodWe conducted a descriptive observational study of screening practices by sending a self-reported questionnaire to 1013 general practitioners practicing in the Hauts-de-France region.Our study's primary aim was to investigate the knowledge and practices of general practitioners in the Hauts-de-France region of France regarding lung cancer screening using low-dose CT. The secondary endpoint was to compare practices between general practitioners in the Somme department who had experience of experimental screening and their colleagues in the rest of the region. ResultsThe response rate was 18.8% (190 completed questionnaires). Even though 69.5% of the physicians were unaware of the potential benefits of organized low-dose CT screening for lung cancer, 76% proposed screening tests for individual patients. Despite its proven ineffectiveness, chest radiography was still the most widely recommended screening modality. Half of the physicians stated that they had already prescribed chest CT to screen for lung cancer. Additionally, only 36.3% proposed chest CT screening for patients aged over 50 years with a history of more than 30 pack-years. The physicians working in the Somme department (61% had participated in the DEP KP80 pilot study) were more aware of low-dose CT as a screening modality, and offered it significantly more than their colleagues in the other departments (61.1% vs 13.4% p<0.01). All the physicians were in favor of an organized screening program. ConclusionMore than a third of general practitioners in the Hauts-de-France region offered for lung cancer screening using chest CT, although only 18% specified low-dose CT. Before an organized screening program can be set up, good practice guidelines must be made available about lung cancer screening.

Perceived barriers, benefits, facilitators, and attitudes of health professionals towards type 2 diabetes management in Oujda, Morocco: a qualitative focus group study

BackgroundIn Morocco, the treatment of type 2 diabetes (T2D) is mainly focused on medication and only 2% of patients are coached towards a healthier lifestyle. In Oujda, Eastern Morocco the prevalence of T2D is 10.2%, and the current trend is alarming, especially for women. Therefore, the aim of this study is to explore healthcare professionals (HCP) views on the perceived barriers and benefits of an integrated care approach in primary healthcare centers (PHCCs) to T2D management in Oujda.MethodsA qualitative descriptive study using focus groups in 8 PHCCs. This resulted in a sample of 5 doctors and 25 nurses caring for diabetes patients. The transcripts of all conversations were coded to allow for thematic analysis.ResultsThe participants mentioned different barriers to an integrated approach to DM management:: excessive workload; poor reimbursement policy; lack of staff and equipment; interrupted drug supply; poor working environment; limited referral; gap in the knowledge of general practitioners; health beliefs; poverty; advanced age; gender; the use of psychotropic drugs. An integrated approach could be facilitated by simplified electronic records and referrals; uninterrupted free care; staff recruitment; continuous professional development; internships. Benefits: structured care; promotion of care in PHCCs; empowerment of self-management.ConclusionHCP views reflect the urge to strengthen the management of T2D in PHCCs. There is a need for HCP with expertise in physical activity and nutrition to solve the current gap in the multidisciplinary integrated care approach. The specific local context in this Eastern Moroccan region, with limited resources and remote hard-to-reach rural areas, can contribute to patients’ reluctance to change their lifestyles, and is a challenge to provide care in an efficient and sustainable manner. More research is needed to see how a patient-centered multidisciplinary approach to T2D management can help motivate patients in Morocco to change to a healthier lifestyle.

Knowledge and Perception of Orthodontic Treatment among General and Non-Orthodontic Dental Specialists: A Comparative Study.

The objective of this study is to discover any possible association of gender or practitioner classification with orthodontic knowledge and attitudes towards orthodontic treatment. Descriptive cross-sectional research was conducted on two groups of dentists in the Ha'il region of Saudi Arabia. Group I included general practitioners, while Group II had non-orthodontic specialists. The findings suggest a statistically significant (p < 0.05) difference between the knowledge and attitudes of general practitioners and non-orthodontic specialists. Independent two tailed t-scores for difference in Knowledge (t-score = 3.19919, p = 0.003) and Attitude (t-score = 2.16314, p = 0.048319), highlight significant disparities in the knowledge and attitudes of general practitioners and non-orthodontic specialists. However, no statistically significant difference was observed in terms of knowledge and attitudes based on gender differences. This study captures and highlights subtle information that is very significant in dealing with critically important orthodontics issues. The study suggests that it is possible that a non-orthodontic specialist may suggest an altogether different line of treatment with different consequences when compared to a general practitioner and vice versa. This may result in unwanted, permanent orthodontic effects, highlighting the significance of the early stage of orthodontic treatment awareness. This research reveals disparities between the perceptions of general practitioners and non-orthodontic specialists about the stage and relevance of orthodontic treatment. It is strongly advised to see an orthodontic expert rather than a general practitioner or non-orthodontic specialist for orthodontic issues.