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1 |
Knowledge, attitudes and practices regarding prediabetes among general practitioners in Reunion Island
دانش، نگرش و عملکرد در مورد پیش دیابت در میان پزشکان عمومی در جزیره Reunion-2021 Background: General practitioners (GPs) are among the first health care providers to be
involved in prediabetes care, and their actions can prevent patients’ transition from
prediabetes to diabetes. However, data on knowledge and management of prediabetes in
primary care remain scarce.
Aim: To describe the knowledge, attitudes and practices of GPs towards prediabetes.
Design and setting: This descriptive cross-sectional study included all private GPs working
in Reunion Island.
Method: GPs were sent an electronic questionnaire that specifically sought to establish whether GPs knew the definition of prediabetes and whether their practices were in line with French guidelines for prediabetes screening and management. Results: A total of 121 GPs completed the questionnaire. Of these, 95.0% knew the definition of impaired fasting glucose, but only 66.1% knew that of impaired glucose tolerance. Many GPs reported practices that are not recommended in guidelines. Thus, 59% of respondents declared that they monitored prediabetes with HbA1c and 10% said that they prescribed oral anti-diabetic drugs as prediabetes treatment. The risks factors associated with prediabetes were generally well known. Although 59.5% of respondents reported not having enough time to provide therapeutic education and medical follow up, only 19% referred their patients to a nutritionist or dietician. Lastly, 93.4% of respondents favoured the implementation of a local therapeutic education program targeting prediabetic individuals. Conclusion: Prediabetes management in primary care can be made more effective by improving GPs’ knowledge of prediabetes and official guidelines, facilitating referral of prediabetic patients to lifestyle specialists and implementing local therapeutic education programs. keywords: Prediabetes | Primary Health Care | Secondary Prevention | Health Knowledge | Attitudes | Practice | Diabetes Mellitus. |
مقاله انگلیسی |
2 |
Knowledge, beliefs and management of childhood fever among nurses and other health professionals: A cross-sectional survey
دانش، باورها و مدیریت تب دوران کودکی در پرستاران و سایر متخصصان بهداشت و درمان: یک مرور مقطعی-2021 Background: Fever phobia, the unfounded fear regarding the potential harms of fever in children, has been
internationally documented among parents. This fear causes anxiety in parents and health professionals are
regularly consulted for advice.
Objectives: This study aimed to investigate the knowledge, beliefs and recommended treatments among
Australian nurses, pharmacists, general practitioners and paediatricians in the management of febrile children.
Design, setting and participants: This was an online cross-sectional survey of Australian nurses, pharmacists,
general practitioners and paediatricians designed to evaluate the knowledge and preferred recommendations in
the management of febrile children.
Methods: The health professionals were recruited via Facebook. Demographic information, knowledge, beliefs
and preferred treatments were collected through the online survey, and responses were compared across
professions.
Results: Of the 839 health professionals who completed the survey, 52.0% correctly identified a fever as 38 ◦C or
above. Overall, 23.6% underestimated the temperature that constitutes a fever. Respondents reported concerns
leaving fever untreated in children, with dehydration (65.1%), seizures (65.2%), serious illness (34.4%) and
brain damage (29.9%) the most common concerns. Pharmacists were more likely to hold these concerns. The
beliefs that reducing a child’s fever with medication will reduce the risk of harm (34.7%) and prevent febrile
convulsions (51.1%) were prevalent among respondents. These beliefs were more common among pharmacists.
Pharmacists were also more likely to recommend parents monitor a child’s temperature (48.5%) and give
medication to reduce fever (64.6%).
Conclusions: Australian nurses, pharmacists, general practitioners and paediatricians reported many mis-
conceptions surrounding the definition of fever, the potential harms of fever and its management, which may
perpetuate parental fears. These misconceptions were most common among pharmacists. Continuing profes-
sional development is essential to ease unfounded concerns and ensure the safe and judicious care of febrile
children. keywords: تب | کودک | پرستاران | داروسازان | پزشکان عمومی | مرورها و پرسشنامه ها | Fever | Child | Nurses | Pharmacists | General practitioners | Paediatricans | Surveys and questionnaires |
مقاله انگلیسی |
3 |
Opportunities for improving hypertensive disorders of pregnancy (HDP) management in primary care settings: A review of international published guidelines in the context of pregnancy care in Indonesia
فرصت ها برای بهبود اختلالات فشار خون بالا در مدیریت بارداری (HDP) در مراقبت های اولیه: بررسی دستورالعمل های منتشر شده بین المللی در زمینه مراقبت از بارداری در اندونزی-2020 Almost all of global maternal mortality caused by HDP occurs in low to middle-income countries (LMIC).
However, limited guidance is available to local primary care practitioners who are usually the main health care
providers. This review examined existing international practice guidelines to identify potential practices to
improve HDP management in Indonesian primary care settings. We performed structured literature search
strategies and snowballing searches in six databases (MEDLINE, Web of Science, EMBASE, CINAHL, Cochrane
reviews and Google Scholar) for guidelines that were published between 2007 and 2018 using relevant keywords
and phrases of ‘guidelines’, ‘hypertensive disorders of pregnancy’ or ‘preeclampsia’ and ‘primary care’. The
AGREE II instrument was used to assess quality and reporting of the eligible guidelines. Thematic analysis was
performed on all of the guidelines and the results were discussed among the project investigators. Sixteen international
practice guidelines or similar management recommendations were reviewed. Almost all of them
were partially applicable, with some managements potentially able to be adopted to Indonesian primary care
settings. Three main themes for improving HDP management were identified, namely clinical management, care
planning, and professional communication. These potential improvements in managing women with HDP in
Indonesia may also be relevant in other LMIC. Further contextualisation is required to facilitate their adoption in
practice settings. Keywords: High blood pressure | Pregnancy | Preeclampsia | General practitioners | Midwives | Primary care |
مقاله انگلیسی |
4 |
The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review
تاثیر سیستم رفاهی در برنامه های پرداخت عملکرد برای پزشکان عمومی : یک بررسی بحرانی-2017 While pay-for-performance (P4P) programs are increasingly common tools used to foster quality and
efficiency in primary care, the evidence concerning their effectiveness is at best mixed. In this article, we
explore the influence of welfare systems on four P4P-related dimensions: the level of healthcare funders
commitment to P4Ps (by funding and length of program operation), program design (specifically target
based vs. participation-based program), physicians acceptance of the program and program effects.
Using Esping-Andersens typology, we examine P4P for general practitioners (GPs) in thirteen European
and North American countries and find that welfare systems contribute to explain variations in P4P
experiences. Overall, liberal systems exhibited the most enthusiastic adoption of P4P, with significant
physician acceptance, generous incentives and positive but modest program effects. Social democratic
countries showed minimal interest in P4P for GPs, with the exception of Sweden. Although corporatist
systems adopted performance pay, these countries experienced mixed results, with strong physician
opposition. In response to this opposition, health care funders tended to favour participation-based over
target-based P4P. We demonstrate how the interaction of decommodification and social stratification in
each welfare regime influences these countries experiences with P4P for GPs, directly for funders
commitment, program design and physicians acceptance, and indirectly for program effects, hence
providing a framework for analyzing P4P in other contexts or care settings.
Keywords: Pay-for-performance | Welfare systems | General practitioners | Decommodification | Social stratification | North America | Europe |
مقاله انگلیسی |
5 |
Mini-encyclopaedia of the wound healing - Opportunities for integrating multi-omic approaches into medical practice
دایره المعارف زخم - امکان ادغام رویکردهای چندگانه در عمل پزشکی-2017 Wound healing is a highly complex life-important repair process triggered by plenty of local and/or systemic organ
and tissue damaging events, such as an acute surgical invasion, accidental organ and tissue damages, acute and
chronic diseases, aggressive local and systemic therapeutic approaches (e.g. irradiation and systemic chemothera
py). Individual health condition determines over the quality of wound healing. Impaired wound healing, in turn,
may lead, for example, to post-surgical complications frequently observed in elderly, chronic ulcers in diabetic pa
tients, hindered and ineffective pain management, etc. However, these well-acknowledged examples are just the tip
of the iceberg. The entire spectrum of potential consequences is much broader. Therefore, all the aspects of wound
healing need to receive a dedicated attention of many specialised medical fields and healthcare as a whole. In con
trast, there is still strongly limited knowledge collected regarding the molecular and cellular mechanisms underly
ing the physiological versus impaired wound healing. The contents of this article might be of great importance for
multi-professional considerations as well as for the experts working in specific fields such as clinical proteomics,
general practice, laboratory medicine, surgery including plastic surgery and aesthetic medicine, gerontology,
psychology, diabetology, endocrinology, oncology, cardiovascular disease, radiology, and healthcare economy.
Significance: The contents of this article are strongly motivated by the particular value of wound healing quality for
medical care and might be of great importance for multi-professional considerations and experts working in
specialised fields: predictive and preventive medicine, general practitioners, laboratory medicine, surgery including
plastic surgery and aesthetic medicine, gerontology, psychology, diabetology, endocrinology, oncology, cardiovascu
lar disease, radiology, and healthcare economy. The article is aiming at both educational and scientific purposes: on
one side it summarises comprehensive information available regarding wound healing mechanisms and molecular
pathways involved. On the other side the article provides highly innovative hypotheses for multi-professional con
siderations relevant for several research fields which may potentially advance medical services in the close future
such as clinical proteomics and multi-omics.
Keywords: Wound healing | Predictive preventive personalised medicine | General practitioners | Laboratory medicine | Surgery | Aesthetic medicine | Psychology | Gerontology | Diabetology | Endocrinology | Oncology | Cardiovascular disease | Radiology | Healthcare economy |
مقاله انگلیسی |
6 |
The effect of registry-based performance feedback via short text messages and traditional postal letters on prescribing parenteral steroids by general practitioners—A randomized controlled trial
اثر بازخورد عملکرد مبتنی بر رجیستری از طریق پیام های متنی کوتاه و نامه های سنتی پستی در استروئید تزریقی تجویز شده توسط پزشکان عمومی - مطالعه کنترل شده تصادفی-2016 Background: It is conjectured that providing feedback on physicians’ prescribing behavior improves quality of drug prescriptions. However, the effectiveness of feedback provision and mode of feedback delivery
is not well understood. The objective of this study was to assess and compare the effect of traditional
paper letters (TPL) and short text message (STM) feedback on general practitioners’ prescribing behavior
of parenteral steroids (PSs).
Methods: In a single-blind randomized controlled trial, 906 general practitioners (GPs) having at least 10 monthly prescriptions were randomly recruited into two interventions and one control study arms with 1:1 allocation, stratified by percentage of prescriptions. The intervention was the provision of 3 feedback messages containing prescribing indices in TPL and STM (in the first two arms) versus the control arm (CG) with an interval of 3 months between these messages. We calculated the PS Defined Daily Dose (DDD) for every GP, every month, and compared between the 3 arms, before and after the interventions. The expected primary outcome was to reduce prescription of parenteral steroids by participants. The study was performed in the Kerman Social Security Organization in Iran. Results: A total of 906 GPs were selected for the trial, but only 721 of them (TPL = 191, STM = 228, CG = 302) were recruited for the 1st feedback. The mean age of GPs was 44 and 59% of them were male. The prescribed parenteral steroid DDDs at baseline were similar (TPL = 121.62, STM = 127.49, CG = 115.68, P > 0.5). At the end of the study, DDDs in the TPL and STM arms were similar (TPL = 104.38, STM = 101.90, P > 0.9) but DDDs in each intervention arm was statistically significantly lower than in CG (CG = 156.17, P < 0.0001). Being in TPL and STM arms resulted in 36.1 and 41.7 units of decrease in DDD respectively, compared to the control arm (P < 0.02 and P < 0.005) after the one-year duration of the study. Conclusion: Feedback by TPLs and STMs on prescribing performance effectively reduced prescribing PSs by GPs. STM, being a cheap and fast tool, is potentially powerful and efficient for drug prescription rationalization. Keywords: Performance feedback | Short Text Message | Prescription quality | Drug rationalization | Steroids |
مقاله انگلیسی |
7 |
سیستم خبره دندانپزشکی
سال انتشار: 2015 - تعداد صفحات فایل pdf انگلیسی: 15 - تعداد صفحات فایل doc فارسی: 32 در اوایل قرم بیستم، بیماری های دندانی و پیشگیری از آنها بهتر درک شد. با این حال، پیشرفت در فناوری کامپیوتر، محققان را تشویق کرد تا نرم افزاری را برای کمک به پزشکان در تصمیم گیری بدون مشاوره ی مستقیم با یک متخصص بسازند. توسعه ی نرم افزار از هوش انسان سو استفاده می کند مانند استدلال، تصمیم گیری، یادگیری از طریق تجربه و بسیاری از موارد دیگر. نرم افزار به معنی جایگزینی متخصص یا دکتر نیست، اما در عین حال توسعه یافته است تا به پزشکان عمومی و متخصصان در تشخیص و پیش بینی شرایط بیمار برای تجربیات خاص کمک کند. هدف از این مقاله، نشان دادن کاربرد عملی اطلاعات و فناوری ارتباطات (ICT) برای تشخیص بیماریهای دندان بر اساس مجموعه علائم است. سیستم خبره یک سیستم کامپیوتری است که قابلیت تصمیم گیری یک انسان خبره را شبیه سازی می کند. سیستم خبره در کاربردهای پزشکی باعث کاهش هزینه، زمان و تخصص بشر و خطاهای پزشکی می شود. این مقاله در مورد سیستم خبره ی دندانپزشکی یک سیستم راهنمای کلی است که توسط بیشتر سازمانهای پزشکی برای درمان استفاده می شود. این مقاله به استفاده از سیستم های خبره برای تشخیص مشکلات خفیف دندانی کمک می کند.
در این مقاله، سیستم خبره ED که به عنوان دندانپزشک الکترونیک نامیده می شود مبتنی بر مدل سیستم خبره ی عصبی-فازی است و با استفاده از زبان برنامه نویسی C# پیاده سازی می شود. این سیستم خبره یک کاربرد کاربردوستانه و ساده دارد که می تواند توسط هر کسی برای تکمیل فرآیند دستی تشخیص به کار گرفته شود.
عبارات عمومی: علائم | هوش مصنوعی | شبکه های عصبی کلمات کلیدی: سیستم خبره | دندانپزشک | بیمار | بیماری های دندان | منطق فازی |
مقاله ترجمه شده |
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آموزش حرفه ای در مراقبت های اولیه سالمندان: یک مطالعه مقدماتی
سال انتشار: 2013 - تعداد صفحات فایل pdf انگلیسی: 7 - تعداد صفحات فایل doc فارسی: 16 پیش زمینه: سیستم مراقبت سلامتی هلند با چالش های بزرگی در رابطه با تقاضا در مراقبت از سالمندان و مهارت های مورد نیاز پرستاران و پزشکان برای مواجه با این تقاضا روبرو میباشد . در حال حاضر، تمرکز اصلی مراقبت های بهداشتی در هلند بر بیماری و درمان است . با این حال، سالمندان ( افراد ناتوان و ضعیف ) نیاز به مواقبت وحمایتی دارند تا وظایف روزانه و رفاهشان را در نظر گیرد . بنابراین، متخصصین مراقبت های بهداشتی ، به ویژه کسانی که در مراقبت های اولیه نظیر: پزشکان و پرستاران عمومی تخصص دارند ، با یک تغییر الگو در اهمیت درمان بیماری به ترویج سلامت ( پیری سالم ) به چالش کشیده میشوند . برای تشخیص این تغییر در رفتار حرفه ای نیاز به تحصیلات تخصصی می باشد. شواهد نشان می دهد که تحصیلات حرفه ای ( IPE ) می تواند نقش مهمی را در ارتقای صلاحیت های حرفه ای به منظور ارائه مراقبت های سالمندان ایفا کند که به طور موثری ، یکپارچه و هماهنگ میباشد . با این حال ، IPE به ندرت در مراقبت های اولیه هلند مورد استفاده قرار میگرد . بنابراین، هدف این مطالعه مقدماتی ، توسعه یک برنامه IPE برای پزشکان عمومی و پرستاران قراردادی و ارزیابی احتمال یک برنامه IPE برای حرفه ای ها با زمینه های مختلف آموزشی و تاثیر آن بر تقسیم وظایف و مسئولیت های حرفه ای است .
روش ها : ده پزشک عمومی و ده پرستار قراردادی از هشت شیوه مراقبتی در دو استان در شمال هلند، گرونینگن و درنته ( کل جمعیت 1.1 میلیون نفر( در برنامه مقدماتی IPE شرکت کردند . یک طرح از روش های مختلط که شامل روش های کمی و کیفی است برای ارزیابی برنامه IPE مورد استفاده قرار گرفت .
نتایج : در طول برنامه ، وظایف و مسئولیت ها ، خصوصا، آن هایی که مرتبط با طرح مراقبتی هستند ، از پزشکان عمومی به پرستاران قراردادی تغییر یافت. نگرش شرکت کنندگان نسبت به افراد مسن ( مراقبت از آنها ) تغییر یافت و ابزار قراردادیی برای تنظیمات ضروری افراد مسن و بحث در مورد کاربرد داروهایشان ، به عنوان ارزش افزوده به توسعه طرح مراقبت در نظر گرفته شد .
نتیجه گیری : نتایج این مطالعه مقدماتی نشان می دهد که یک برنامه آموزش حرفه ای برای حرفه ای ها با پیش زمینه های مختلف آموزشی ( پزشکان عمومی و پرستاران قراردادی ) امکان پذیر است و دارای ارزش افزوده در تعریف جدید وظایف و مسئولیت ها در میان پزشکان عمومی و پرستاران قراردادی است .
کلمات کلیدی: حرفه ای | آموزش | مراقبت های اولیه | پزشک | پرستاری |
مقاله ترجمه شده |