Training Of Health Professionals Research Articles

Don't wait for the perfect moment: The national training program in family medicine in Angola.

Like many Sub-Saharan countries, Angola struggles with a shortage of trained health professionals, especially for primary care. In 2021, the Angolan Ministry of Health in collaboration with the Angolan Medical Council launched the National Program for the Expansion of Family Medicine as a long-term strategy for the provision, fixation and training of family physicians in community health centres. Of the 425 residents 411 (96.7%) who entered the programme in 2021 will get their diplomas in the following months and will be certified as family physicians. Three main aspects make this National Programme unique in the Angolan context: (1) the common effort and engagement of the Ministry of Health with the Angolan Medical Council and local health authorities in designing and implementing this programme; (2) decentralisation of the training sites, with residents in all 18 provinces, including in rural areas and (3) using community health centres as the main site of practice and training. Despite this undeniable success, many educational improvements must be made, such as expanding the use of new educational resources, methodologies and assessment tools, so that aspects related to knowledge, practical skills and professional attitudes can be better assessed. Moreover, the programme must invest in faculty development courses aiming to create the next generation of preceptors, so that all residents can have in every rotation one preceptor or tutor responsible for the supervision of their clinical activities, case discussions and sharing their clinical duties, both at community health centres and municipal hospitals.

Assessing the equivalency of face-to-face and online simulated patient interviews in an educational intervention

BackgroundIn adapting to COVID-19, many health professional training programs moved abruptly from in-person to online simulated patient interviews for teaching and evaluation without the benefit of evidence regarding the efficacy of this mode of delivery. This paper reports on a multi-methods research project comparing in-person and online simulated patient interviews conducted by allied health professionals as part of an educational intervention offered at a large university teaching hospital.MethodsTwenty-three participants conducted two 15-min interviews with simulated patients using previously validated scenarios of patients presenting with suicide risk. In order to assess the equivalency of the two modalities, physiological and psychological stress were measured using heart rate variability parameters and the State-Trait Anxiety Inventory respectively, and then were compared across cohorts using t-tests. Reflective interviews elicited qualitative impressions of the simulations that were subject to thematic qualitative analysis.ResultsThere were no statistical differences in measures of psychological stress or physiological arousal of participant health care professionals who engaged with in-person versus online simulated interviews, suggesting they were equally effective in eliciting reactions commonly found in challenging clinical situations. In reflective interviews, participants commented on the realism of both modalities of simulated patient encounters and that simulated interviews provoked emotional and physiological responses consistent with actual patient encounters.ConclusionsThese findings provide developing evidence that carefully designed online clinical simulations can be a useful tool for the education and assessment of healthcare professionals.

Reproduction in cisgender same-sex couples: a scoping review.

The aim of this article is to present the state of the art, in the field of public health, on cis homoparental reproduction, from 28 studies addressing barriers to reproduction by homoparental couples for legal, ethical, technical or economic reasons, in addition to prejudice and discrimination. Six studies addressed facilitators, such as receptiveness in services, availability of conception and contraceptive methods and training of health professionals. The results show that the discussion has focused more on the barriers than on the facilitating factors. This may indicate a continuing need to problematise the hegemonic model of a heterosexual, nuclear family.

Onco'sport à l’épreuve des patients : expérience vecue des patients atteints d’un cancer pratiquant de l’activité physique adaptée dans le cadre du programme Onco'sport, une étude qualitative

Physical activity is a major determinant in the prevention of chronic diseases, equally on the side effects of treatments and the consequences of the disease. It improves quality of life, but also reduces morbidity and mortality, and therefore health expenses. A sedentary lifestyle is the fourth cause of premature death in the world, in the context of chronic non-communicable diseases. In France, the prescription for adapted physical activity (APA) has been included in the law since 2016. With the development of "Maisons Sport santé", the Onco'sport program was developed to enable people affected by cancer to participate in adapted physical activity. The objective of our work is to explore the lived experience of cancer patients practicing adapted physical activity as part of the Onco'sport program. This is a qualitative study of 10semi-directed individual interviews with patients participating in the Onco'sport program, recruited from the "Maison Sport Santé" from Nîmes and the association "Les Roses du Gard". A phenomenological analysis was carried out with a semiopragmatic approach. For all participants, the APA through a program provides professional supervision of Physical Activity, influences adherence and builds confidence. This program is at the origin of changes in lifestyle habits and improves the relationship with illness and their cancer thanks to the physical and psychological benefits felt. Thus, APA appears as a full-fledged supportive care which requires informing patients and promoting it so that access is facilitated and becomes a standard. Health professionals including general practitioners do not currently have an important place in the promotion of APA, and patients most often obtain documentation on their own or through associations of patient. An APA program like Onco'sport is often the cause of a return to physical activity in patients, brings overall well-being and changes lifestyle habits. It seems important to promote physical activity to patients but also to the general population, given the benefits. This promotion involves easier access to this type of supervised program, financial support and better training of health professionals.

Leading the transition to ethical human body sourcing in Africa: The South African experience

BackgroundThe use of human bodies for anatomy education and research forms an integral part of the training of health professionals around the world. However, the ethical acquisition of human remains for this purpose has been a challenge in many countries, particularly for those on the African continent. South African institutions have however, been able to progressively transition to a more ethical approach to human body acquisition. The aim of the current study was to investigate the provenance of human bodies and the number used in South African health sciences institutions during the period 2017-2021. Methodsan online self-administered anonymised questionnaire was circulated to all health sciences institutions in South Africa. Questions were focused on establishing the provenance and the associated number of bodies and body donor programmes. Resultsresponses were received from thirteen of the fourteen South African institutions. All thirteen institutions use human bodies for teaching and research, with the majority of the institutions being reliant on bequests (77%) and family donations (62%), and less on unclaimed remains (46%). Most institutions have established body donor programmes. Four institutions were negatively affected by the effects of the pandemic. Memorial services, which continued during the pandemic, were conducted by eight of the thirteen institutions. ConclusionSouth Africa is leading the transition to the ethical acquisition of human remains on the African continent. It is hoped that South African institutions will soon transform to the exclusive sourcing of bodies through willed donation and provide guidance and support for the other countries on the continent.

Prevalence and Factors Responsible for Asymptomatic Malaria Reservoir of Plasmodium Falciparum Among Adults in Nasarawa State, Nigeria

Asymptomatic malaria is prevalent in highly endemic areas of Africa, with only a small percentage of individuals exhibiting clinical symptoms. The clinical consequence of asymptomatic malaria is not fully understood. Some researchers are of the view that asymptomatic parasitaemia is involved in the development of partial immunity and may protect against clinical disease from new infections. The purpose of this study was to assess the prevalence of malaria reservoir of plasmodium falciparum among adult people of Nasarawa state of Nigeria and to identify the factors associated with malaria in this category of people. A community-based cross-sectional study was conducted among selected local government areas of the state. The outcome variable was the presence or absence of malaria in which its asscoiation with demographic information, knowledge and awareness, measures and control, environmental factors are tested. The local government areas were observed to have reported the highest positivity rate of malaria between 2017 to 2022. The study was conducted from August 2022 to April 2023. A semi-structured questionnaire was employed to collect socio-demographic data and other associated risk factors by trained health professionals. Body temperature and other clinical manifestations were examined to identify the asymptomatic individuals. This examination was carried out after selection of individuals from households before mRDT is conducted. Data entry and analysis was carried out using SPSS (Statistical Package for the Social Sciences) version 20 software. The results obtained are very desirable.

Generative Artificial Intelligence as a Tool for Teaching Communication in Nutrition and Dietetics Education-A Novel Education Innovation.

Although effective communication is fundamental to nutrition and dietetics practice, providing novice practitioners with efficacious training remains a challenge. Traditionally, human simulated patients have been utilised in health professions training, however their use and development can be cost and time prohibitive. Presented here is a platform the authors have created that allows students to interact with virtual simulated patients to practise and develop their communication skills. Leveraging the structured incorporation of large language models, it is designed by pedagogical content experts and comprises individual cases based on curricula and student needs. It is targeted towards the practice of rapport building, asking of difficult questions, paraphrasing and mistake making, all of which are essential to learning. Students appreciate the individualised and immediate feedback based on validated communication tools that encourage self-reflection and improvement. Early trials have shown students are enthusiastic about this platform, however further investigations are required to determine its impact as an experiential communication skills tool. This platform harnesses the power of artificial intelligence to bridge the gap between theory and practice in communication skills training, requiring significantly reduced costs and resources than traditional simulated patient encounters.

Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings

BackgroundFeasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings.MethodsPublished literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches.ResultsMany articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl’s Model of Learning, an assessment framework based on the Bayer–Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid.ConclusionAn analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education.Trial registrationThis study did not involve any clinical intervention. Therefore, trial registration was not required.

APPLICATION OF STEM-TECHNOLOGIES IN THE PROFESSIONAL TRAINING OF SPECIALISTS IN THE FIELD OF HUMAN HEALTH

The article examines the current aspects of the use of STEM technologies in the professional training of specialists in the field of human health. Focusing on scientific and technical disciplines such as materials science, engineering, computer science and mathematics, the article highlights the benefits and challenges of applying STEM approaches in the educational process. The impact of the specified technologies on the development of key competencies and increasing the efficiency of professional training of future specialists in the field of health care was studied. The article also considers the possibilities of integrating STEM education into training programs, thereby contributing to the creation of better conditions for the successful implementation of these technologies in the field of training specialists in education and human health.
 The purpose of the article is to analyze scientific approaches to defining and studying the features of STEM education; the study of existing educational practices related to the development and implementation of STEM subjects and the determination of ways of their respective implementation in the educational process for the purpose of health protection.
 Methodology. The methodological basis of the research is a systematic and person-oriented approach to the analysis of psychological-pedagogical literature and pedagogical experience on issues of social-pedagogical activity. The work uses a multi- level systematic analysis of scientific sources, which is based on philosophical, general scientific and partly scientific and specific scientific levels of knowledge.
 Scientific novelty. The scientific novelty of this article lies in the in-depth study and analysis of the impact of STEM technologies on the professional training of specialists in the field of human health. The work highlights the latest approaches to the use of scientific and technical knowledge and skills for health maintenance, revealing in detail their role in the development and improvement of the quality of education in this field. In addition, the article offers innovative strategies and methods of introducing STEM approaches into educational programs to optimize the process of professional training, which contributes to the continuous improvement of educational practices in the field of human health.
 Conclusions. Studies of the use of STEM technologies in the professional training of health professionals indicate the significant potential of these innovations in the field of improving the quality of education and improving the practical skills of future medical workers. The use of STEM approaches allows not only to effectively combine scientific knowledge and technical skills, but also stimulates critical thinking, creative approach and the ability to solve complex problems in the medical field. The results of the analysis indicate the need to integrate STEM education into pedagogical programs to provide students with a wider range of competencies, taking into account the development of technologies in the modern world. At the same time, it is important to take into account the specifics of human health education and provide adapted STEM strategies to ensure their optimal effectiveness in the context of human health. In general, the use of STEM technologies in the training of specialists in the field of human health is a promising direction that can contribute to raising the quality of health education and training qualified personnel for the challenges of the modern public health system.

The Impact of Health Communication Research on Medical and Health Professional Education and Training

ABSTRACT In this essay, we review how health communication scholarship has been translated into various communication skills trainings (CSTs), we present four case studies of how health communication research informed the development and implementation of specific CSTs, and we reflect on how we can productively define “impact” in looking back as well as looking forward within this line of research.

Exploring therapeutic communication in managing chronic non-communicable diseases: a mixed-method study in Ghana

BackgroundGlobally, the burden of chronic non-communicable diseases is increasing rapidly and approximately one in three of all adults suffer from multiple chronic conditions. Therapeutic communication plays a crucial role in achieving curative, preventive, and promotive goals regarding chronic disease management. We examined therapeutic communication between health professionals and patients with chronic non-communicable diseases at the Ho Teaching Hospital.MethodsWe adopted a concurrent mixed-methods approach. The quantitative aspect of the study was descriptive while the qualitative was explanatory. The quantitative study was conducted among 250 patients. The qualitative data was collected among eight health professionals. A stratified sampling and simple random sampling methods were used to recruit patients for the quantitative survey while purposive and convenient sampling was used for the qualitative aspect of the study. The quantitative data was collected using a semi-structured questionnaire while the qualitative data was collected using an in-depth interview guide. The quantitative data were analyzed using STATA v17 and the qualitative data were analyzed thematically using Atlas ti. The major themes that emerged were, therapeutic communication practices, barriers to therapeutic communication and possible solutions to good therapeutic communication.ResultsWe found that 37% patients were 60 years and above with 53.2% being females. It was noted that 36.4% of patients have had tertiary-level education. We found that 59.2% of patients reported having good therapeutic communication with health professionals. We, however, noted that male participants were 92% less likely to practice good therapeutic communication compared with females (aOR = 0.92,95% Cl = 0.46–1.84). Health professionals’ activities to ensure good therapeutic practices included their capacity to listen, build rapport with their patients, and clarify information. We found that the major facilitators of good therapeutic communication included trust in the health professionals (90.4%), conducive environment (93.2%), using simple and plain language by health professionals (92.0%) We found that there are myriad of barriers that impede communication process. This included language, health professionals’ inability to break terminologies, and the unconscious state of patients.ConclusionsThe study revealed that there was good therapeutic communication between health professionals and patients with CNCDs. Nevertheless, it was also identified that ineffective therapeutic communication between health professionals and their patients due to barriers like language could lead to dissatisfaction with care, misdiagnosis, and noncompliance to treatment regimen. For Ghana as a country to achieve SDG target 3.4 by reducing mortality due to NCDs and improve wellbeing of patients by 2030, it will be imperative on Ghana Health Service to design communication strategy training for health professionals that could help improve therapeutic communication between patients and health professionals.

Primary care professionals' perspectives on tailoring buprenorphine training for rural practice.

Buprenorphine is a highly effective medication for opioid use disorder (OUD) that remains substantially underutilized by primary care professionals (PCPs). This is particularly true in rural communities, which have fewer prescribers and significant access disparities. The Drug Enforcement Administration removed the X-waiver requirement in December 2022, yet many rural clinicians still report barriers to prescribing buprenorphine. In this study, we examined rural PCPs' experiences with buprenorphine to identify tailored training strategies for rural practice. Physicians, nurse practitioners, and physician associates practicing in rural Ohio counties were recruited through contacts at statewide health associations and health professions training programs. Twenty-three PCPs were interviewed about their perspectives on prescribing buprenorphine, including their training history. PCPs self-reported being motivated to respond to OUD. However, they also reported that current training efforts failed to equip them with the knowledge and resources needed to prescribe effectively, and that urban-focused training often alienated rural clinicians. Participants suggested tailoring training content to rural settings, using rural trainers, and bolstering confidence in navigating rural-specific barriers, such as resource deficits and acute opioid fatigue. Our study found that current training on buprenorphine prescribing is inadequate for meeting the needs of rural PCPs. Tailored buprenorphine training is needed to improve accessibility and acceptability, and to better support the clinical workforce in communities disproportionately impacted by the opioid epidemic.

Comparative study on informed consent regulation in health care among Italy, France, United Kingdom, Nordic Countries, Germany, and Spain

The information and subsequent expression of will, so-called informed consent, have become the essential element of health right, understood as the right to autonomous choice in health, based on the fiduciary relationship between physician and patient. This gradually leads European Countries to adopt special legislations and to issue frequent judgments on the subject. However, new challenges in daily clinical practice call for further study of legal solutions. The authors analyse and compare the regulations on informed consent in health care of Italy, France, the United Kingdom, the Nordic Countries, Germany, and Spain. The health and legal contexts, existence of special regulations on informed consent and their characteristics are discussed. Informed consent resulted a mandatory requirement. Clear communication about treatment, therapeutic alternatives, and major risks, discussed in conversation, but preferably documented in writing, are agreed upon. The possibility of dissent and withdrawal of consent are also included. There is a growing interest in involving and regulating the entire health team in information and consent. Lowering the age of consent for minors or analysing the maturity of minors are attempts to increase their participation in health decisions. On another side, the protection of adult incapables persons requires greater involvement of family and fiduciaries to better adapt to changing health needs. Health policy must take responsibility for training health professionals and citizens about the value of health information and communication as a shared choice in care planning, to strengthen the bond of trust with the healthcare system and users.

Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study.

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.

The SBAR tool for communication and patient safety in gynaecology and obstetrics: a Tunisian pilot study

BackgroundIn healthcare, inadequate communication among providers and insufficient information transmission represent primary contributors to adverse events, particularly in medical specialties such as obstetrics and gynecology. The implementation of SBAR (Situation-Background-Assessment-Recommendation) has been proposed as a standardized communication tool to enhance patient safety. This study aims to evaluate the knowledge, attitudes, and practices related to SBAR communication through a pilot study conducted in a middle-income country.MethodsThis prospective longitudinal study took place in the gynecology-obstetrics department of a Tunisian university hospital from May to June 2019. All medical and paramedical staff underwent comprehensive theoretical and practical training through a 4-hour SBAR simulation. To gauge participants’ knowledge, anonymous multiple-choice questionnaires were administered before the training initiation, with a second assessment conducted at the end of the training to measure satisfaction levels. Two months later, the evaluation utilized questionnaires validated by the French National Authority for Health (HAS).ResultsAmong the 62 care staff participants in this study, a majority (89%) demonstrated a low level of knowledge regarding the SBAR tool. The majority (75.8%) expressed enjoyment with the training and indicated their intention to implement changes in their practice by incorporating the SBAR tool in the future (80.7%). Notably, over half of the participants (79%) expressed satisfaction with the training objectives, and 74% reported acquiring new information. Evaluation of the practice revealed positive feedback, particularly in terms of clarity, the relevance of communication, and the time spent on the call.ConclusionOur pilot study showed that the majority of professionals on the ward had little knowledge of the SBAR tool, a good attitude and a willingness to put it into practice. It is essential that healthcare managers and professionals from all disciplines work together to ensure that good communication practice is developed and maintained. Organisations, including universities and hospitals, need to invest in the education and training of students and health professionals to ensure good quality standardised communication.

(223) Specific Training Needs of Student Midwives in Sexual Health and Clinical Sexology

Abstract Introduction According to the WHO, sexuality is an integral part of human life, encompassing all dimensions of human beings: physical, emotional, mental, and social well-being associated with sexuality, involving a positive and respectful approach. It is essential to educate and train health professionals such as midwives to address sexual problems and provide the necessary information to their clients, in order to ensure comprehensive and quality care. There is still a lack of specific sexual health training programs in the midwifery curriculum in several countries worldwide. Objective This study aims to assess the student midwives’ training needs in sexual health and clinical sexology. Methods It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting March 1st, 2023. All enrolled student midwives in public and private midwifery schools in the country were contacted through the schools’ social media groups. The online questionnaire was a 29-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid of questions. Results The study included 206 student midwives (answer rate: 87%). The participants were representative of the population of student midwives (31% 1st, 33% 2nd, and 36% 3rd year and 31% from the North, 38% from the center, and 31% from the South of the country). The participants’ mean age was 22,1± 1,04 years and 96% were single. When asked about their experience with sexual interviews, 60.7% felt uncomfortable. The reasons for that feeling were the absence of previous learning simulations and experiences (84%), the lack of confidence in their knowledge (70%), the fear of a potential lack of interest of the clients about sexual health (59%), sexuality is taboo (28%). Regarding their training and education in sexual health and clinical sexology, 94% declared that it was only theoretical, 47% considered it as unorganized and 68,5% thought that there was a lack of correlation between the time allowed and the content of the sessions. The instructors were judged as qualified by 36% of the participants. The resources were considered useful by 19%. And 23.3% of the students enrolled in other non-academic training in sexology during the previous year. The expressed need for specific sexology training was expressed in 94%. The needs were regarding knowledge in 55%, Attitudes in 80%, and practices in 55%. Conclusions A specific academic curriculum in sexual health and clinical sexology is a necessity within the student midwives' training. This educational program needs to reinforce some knowledge and practices and mainly address the attitudes of healthcare professionals toward clients asking for information and/or help regarding their sexual health. Prevention has also to be integrated into this program. Role-playing and simulations in small groups seem the most adapted pedagogical techniques to re-enforce attitudes within students. Disclosure No.

Pathways to professional mental care in the Swiss young adult community: a case-control study.

Treatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the 'Bern Epidemiological At-Risk' (BEAR) study on 16-40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the 'WHO pathway-to-care questionnaire', from which the outcome 'most intensive MH professional contact' was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The 'most intensive MH professional contact' was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, 'substance misuse' and 'central-vegetative problems' increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome.

Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol

IntroductionPremature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of...

An analysis of Nepal's federal health system in the context of the COVID-19 pandemic and the Sustainable Development Goals

Nepal's public health slogan was 'Health for All' with integrated community health services in 1991. The female community health volunteer network was created. District Public health offices (DPHO) managed these programs in their districts. After 2008 federalism, 2017 brought federal, provincial, and local governments. The federal health system substituted the administrative District Public / Health Offices in districts. The local governments or health institutions now oversee the Sustainable Development Goals (SDGs). The federal and provincial authorities should have employed qualified professionals to oversee public health at local health facilities. Healthcare efficacy and goal attainment are concerns today. This study did a microscopic investigation using health system studies. The researcher conducted field observations and stakeholder interviews and participated in public discussions. Data from Nepal's federal health system's community status was compared using SWOT analysis. The study delved into specific research gaps thoroughly. According to previous research, health infrastructure could be more effective with financial expenditures. A hypothesis was formed after comparing further information to domestic and international situations. The researcher emphasizes the need for good governance and suggests allocating 6% of national GDP to health spending, in line with WHO recommendations. To fulfil the needs of the healthcare sector, deliver quality medical services, and attain SDGs, it is imperative to ensure the presence of adequately trained health professionals at the local government level. The head of the local health institution must conduct administrative work connected to public health. Hence, public health-trained health staff are needed there.

Educating primary care physicians about eating disorders: Pilot data from a microlearning programme.

Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. Fifty-one Australian general practitioners aged between 25-to-60years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6-10week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness-to-treat, skill change; and their overall experience of microlearning. All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness-to-treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n=39) found microlearning to be an effective method to learn about EDs; with 87.5% (n=35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre-existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale.