Training Of Primary Physicians Research Articles

Perception of Nutrition Education and Subjective Competency in Nutrition Topics among Korean Family Medicine Residents.

Appropriate nutrition is necessary for maintaining good health in the general population. During primary physician training, it is important to educate residents on the basic concepts of nutrition and methods to manage nutritional aspects according to various disease. However, little is known about the perception of nutritional education among Korean family medicine residents. This study analyzed the recognition of the importance of nutritional education, the amount received, and satisfaction with it as well as self-perceived competency in various nutrition topics among residents. Web-based questionnaires were sent via mobile messages to all the residents registered with the Korean Academy of Family Medicine (KAFM). Out of 566 residents, 68 voluntarily participated in the study. The questionnaire consisted of 41 items related to perceptions of nutrition education, self-perceived competency in nutrition topics, and demographic characteristics. The response rate was 12.01%. Residents rated their satisfaction with nutrition education at 4.78 out of 10, and 83.3% considered it important. However, only 13.24% of the participants felt that it was adequate. The most common training method for nutrition education was lectures at KAFM conferences. Among the 29 nutritional topics, the residents reported highest confidence in subjects related to chronic diseases such as obesity (77.94%), diabetes (75%), cardiovascular disease (67.65%), gastrointestinal disorders (67.65%), and weight loss management (67.65%). Conversely, topics related to women (36.76%), children and adolescents (38.23%), drug-nutrient interactions (39.7%), eating disorders (42.64%), and food labels (42.64%) showed low self-perceived confidence rates. Korean family medicine residents value nutrition education but believe that more education is necessary and they demonstrate differences in self-perceived competency in various nutrition topics.

The role of primary physician training in improving regional standardized management of diabetes: a pre-post intervention study

BackgroundHierarchical diagnosis and treatment has been gradually implemented throughout the China. Primary physicians are the main force in primary-level medical and health services, which means that standardized training of primary-level doctors is indispensable.ObjectivesEvaluation of the effect of primary physician training on standardized management of diabetes, and comparison of the effects of different training models.MethodThe study selected 24 community health service centers from 4 cities in Liaoning Province, and consisted of two groups: primary physicians (n = 2083) who received training; and patients with diabetes (n = 585) in community health service centers. Short-term training effects on primary physicians were assessed through diabetes knowledge tests at baseline and at the end of training; the long-term effects of training on patients with diabetes were assessed by questionnaires at baseline and 1 year after training. The differences in training effects between different training models were compared. Complication screening results were also assessed.ResultsAfter training, the primary physicians’ knowledge of diabetes diagnosis and treatment improved (p < 0.05). The complication screening rate of local diabetes patients increased from 22.2% before training to 27.7% 1 year after training (p = 0.033). There were significant differences in the training effect between different training models (p = 0.038). The short-term intensive training group demonstrated the greatest training effect, primary physicians under this training model are more likely to conduct standardized screenings for patients (OR = 1.806, 95%CI 1.008–3.233), and the complication screening rate was the highest (37.6%).ConclusionThis study shows that training of primary physicians is an effective way to improve the standardized management of diabetes, by improving the ability of primary physicians to manage diabetes in a standardized manner, so that patients in primary hospitals receive more comprehensive diagnosis and treatment services. Compared with scattered training throughout the year, short-term intensive training was found to be more effective.

Juvenile Myoclonic Epilepsy in Rural Western India: Not Yet a Benign Syndrome.

Purpose. To study prevalence of uncontrolled seizures in patients with juvenile myoclonic epilepsy [JME] and assess factors responsible for it. Methods. An ambispective study of all patients with JME attending our epilepsy clinic was done. We recruited all patients with JME evaluated between 1 January 2009 and 31 December 2013 and followed them up to 31 December 2015. Results. Amongst 876 patients with epilepsy, JME was present in 73 patients. Amongst them, 53 [72.6%] had uncontrolled seizures prior to neurology consultation. Factors responsible for uncontrolled seizures included pitfalls in diagnosis like absence of prior neurology consultation missed history of myoclonus in prior consults and pitfalls in interpretation of EEG. Pitfalls in management were incorrect antiepileptic drug use, underdosing of AED, noncompliance with lifestyle, noncompliance with medicines, associated psychogenic nonepileptiform events, patients deliberately missing medicines for secondary gain, and concomitant alternative medicine use. 45 (84.9%) patients had “pseudorefractoriness.” True refractoriness [seizures despite 2 correctly dosed rational drugs] was seen in 8 (15.1%) patients only. Conclusion. Three-fourth of our patients had uncontrolled seizures initially, predominantly due to pitfalls in its diagnosis and management. Improving patient awareness and primary physician training for JME management is the need of the hour.

Addressing the Mental Health Needs of Children and Adolescents

Worldwide 10-20% of children and adolescents experience mental disorders. Mental disorders, if remain untreated, can impose enormous and lifelong burden to the individual, family and society. Yet, a large proportion of affected children do not receive treatment owing to poor accessibility to appropriate services-the so-called treatment gap. Access barriers to mental health services include social stigma, systemic factors like fragmented services, shortage of pediatric psychiatrists, insufficient training of primary physicians, lack of integration of mental health services with primary care facilities, and underequipped community resources. In addition, children’s mental health is susceptible to external environmental risk factors and poor socioeconomic family status. Protective interventions and mental health promotion programs starting at an early age (like early childhood education and development) are propagated in several studies. The paper addresses both, the barriers to unmet needs as well as reviews the progress on evidence-based interventions.

The Training of Primary Physicians.

This work traces the evolution of the primary care movement in American medicine and the impact of national policies on one particular academic medical center.

The Training of Primary Physicians.

The Training of Primary Physicians.

Training primary physicians as psychotherapists

Thrown back on his own resources, the doctor, often shamefacedly, prescribes some placebo, and gives advice or a “reassuring” pep talk…. Then there are the advocates of “common-sense” psychology who advise the patient to take a holiday, to change his job, to pull himself together, not to take things too seriously, to leave home, to get married, to have a child, or not to have any more children but to use some contraceptive, etc. None of these recommendations is necessarily wrong, but the fallacy behind them is the belief that an experienced doctor has acquired enough well-proved “common-sense” psychology to enable him to deal with his patient's psychological or personality problems…. But minor surgery, for instance, does not mean that a doctor can pick up a well-proved carving-knife or a common-sense carpentry tool and perform minor operations. On the contrary, he has to observe carefully the rules of antisepsis and asepsis, he must know in considerable detail the techniques of local and general anaesthesia, and must have acquired skill in using scalpel, forceps, and needle, the tools of the professional surgeon. Exactly the same is true of psychotherapy in general practice. The uses of empirical methods acquired from everyday life are as limited in professional psychotherapy as are carving-kinfe and screwdriver in surgery. 1