scholarly journals Dermoscopic Lotus of Learning: Implementation and Dissemination of a Multimodal Dermoscopy Curriculum for Primary Care

2021 ◽  
Vol 8 ◽  
pp. 238212052198998
Author(s):  
Elizabeth Seiverling ◽  
Hadjh Ahrns ◽  
Kathryn Stevens ◽  
Lindsay Ayers ◽  
Tyler Nussinow ◽  
...  
Keyword(s):  
Primary Care ◽  
Learning Strategies ◽  
Cost Effective ◽  
Primary Care Providers ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Primary Care Residency ◽  
Workshop Intervention

Dermoscopy is a cost-effective tool for detection of skin cancers yet there is limited training available for primary care. The goal of this project was to develop, implement, and disseminate a multimodal curriculum for primary care across a health system based on a previously validated algorithm (Triage Amalgamated Dermoscopic Algorithm; TADA). This cross-sectional study analyzes the dermoscopy workshop intervention of a dermoscopy multimodal curriculum. Volunteers attended one 120-minute dermoscopy workshop on benign and malignant growths using a validated algorithm. Participants took a 30-image pre- and posttest. Survey questions on dermoscopy use, preferences for learning, and skin biopsy performance were included to enhance curriculum development. About 96 participants completed both pre- and postintervention tests. The mean preintervention score (out of 30) was 18.6 and increased to 24.4 on the postintervention evaluation. There was a statistically significant improvement in scores for both benign and malignant skin growths after the intervention ( P < .05). Short dermoscopy workshops have a positive intervention effect when training primary care providers to identify images of benign and malignant dermoscopic skin lesions. A multimodal dermoscopy curriculum allows learners to build on initial training using spaced review and blended learning strategies. The “Dermoscopic Lotus of Learning” has the potential to be a model for other primary care residency programs. A healthy partnership between dermatologists and primary care is essential.

scholarly journals Knowledge and Awareness Regarding T1DM in Primary Health care Providers

2019 ◽  
Vol 1 (2) ◽  
pp. 21-25
Author(s):  
Saira Yousaf ◽  
Rozina Arshad ◽  
Muhammad Waqeel ◽  
Maria Javaid ◽  
Hafiza Rabia Naeem ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Mechanism Of Action ◽  
Correct Answer ◽  
General Medicine ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Care Providers ◽  
Cross Sectional

Background: Diabetes is one of the commonest non-communicable diseases in the world. Type 1 Diabetes Mellitus (T1DM) is relatively less common but it is associated with greater morbidity and mortality. It is important to have the knowledge and awareness of T1DM especially in primary care providers (PCPs) to save the lives of children and young adults with T1DM. Methods: A cross sectional study was performed by distributing questionnaires amongst the doctors belonging to the field of General Medicine working at the primary care level with practices comprising approximately 10% of diabetic patients. Responses were recorded on a questionnaire and the data was analyzed by SPSS versions 20. Results: Only 62% doctors were aware about the correct pathogenesis of T1DM. Regarding the most important and fatal complications of T1DM i.e. diabetic ketoacidosis (DKA), 88.9% came up with correct answer. However when asked about the mortality related to T1DM only 22% PCPs gave the right answer. Only 40% of the PCPs could give correct answer regarding the mechanism of action of insulin. 55.6% PCPs were aware of the variation in blood glucose levels and had knowledge how to adjust them. Only 55.6% doctors were aware of cause of hypoglycemia. Conclusion: Most of the PCPs had suboptimal knowledge regarding T1DM, its pathogenesis, complications and mechanism of action of insulin. This study had identified the need for further improvement in PCPs practices for treating and educating diabetes and recommended that awareness and educational programs are necessary to update the PCPs on screening, effective treatment of T1DM, and prevention of its complications.

scholarly journals Drivers and strategies for avoiding overuse. A cross-sectional study to explore the experience of Spanish primary care providers handling uncertainty and patients’ requests

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e021339 ◽  
Author(s):  
José Joaquín Mira ◽  
Irene Carrillo ◽  
Carmen Silvestre ◽  
Pastora Pérez-Pérez ◽  
Cristina Nebot ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Association between Suicidal Ideation and Causes of Primary Care Visits: A Cross-Sectional Study to Identify Patients with Suspected Suicidal Ideation

2020 ◽  
Vol 17 (7) ◽  
pp. 667-673 ◽  
Author(s):  
Gyeongsil Lee ◽  
Jung-Ha Kim
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk ◽  
Primary Care Patients

Objective Suicide victims are likely to visit a primary care provider within 1 month of the suicide attempt. However, it is impossible for primary care providers to screen all patients for suicidal ideation or attempts. We, therefore, aimed to investigate potential differences in the chief diagnoses received by primary care patients with and without suicidal ideation, as this information may provide clues and predict patients at risk of suicide.Methods This cross-sectional study included 1,211 Korean adults aged ≥20 years who had participated in the Korea National Health and Nutrition Examination Survey during 2014 and provided information about their histories of suicidal ideation and visits to primary care providers. Multiple logistic regression analyses were used to examine whether suicidal ideation was associated with specific diseases after controlling for age, sex, household income, education, occupation, marital status, smoking, alcohol consumption, and physical activity.Results Among primary care patients, the sample-weighted percentage of suicidal ideation was approximately 12%. The diagnoses of neoplasm and mental disorder were associated with a higher likelihood of suicidal ideation {odds ratio (OR) [95% confidence interval (CI)] 8.32 (1.01–68.56) and 6.19 (1.72–22.33), respectively}. Notably, diseases of the musculoskeletal system and connective tissue were also associated with suicidal ideation [OR (95% CI): 1.93 (1.09–3.43)].Conclusion The observed visit patterns and correlations of certain diagnoses with suicidal ideation suggest that primary care physicians should pay attention to patients with relevant disorders, consider screening suicidal ideation, and properly consult to a psychiatrist.

scholarly journals Pandemic response in pluralistic health systems: a cross-sectional study of COVID-19 knowledge and practices among informal and formal primary care providers in Bihar, India

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047334
Author(s):  
Krishna D Rao ◽  
Japneet Kaur ◽  
Michael A Peters ◽  
Navneet Kumar ◽  
Priya Nanda
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Management Practices ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Contact Tracing ◽  
Care Seeking ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesResponding to pandemics is challenging in pluralistic health systems. This study assesses COVID-19 knowledge and case management of informal providers (IPs), trained practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) and Bachelor of Medicine, Bachelor of Surgery (MBBS) medical doctors providing primary care services in rural Bihar, India.DesignThis was a cross-sectional study of primary care providers conducted via telephone between 1 and 15 July 2020.SettingPrimary care providers from 224 villages in 34 districts across Bihar, India.Participants452 IPs, 57 AYUSH practitioners and 38 doctors (including 23 government doctors) were interviewed from a census of 1138 primary care providers used by community members that could be reached by telephone.Primary outcome measure(s)Providers were interviewed using a structured questionnaire with choice-based answers to gather information on (1) change in patient care seeking, (2) source of COVID-19 information, (3) knowledge on COVID-19 spread, symptoms and methods for prevention and (4) clinical management of COVID-19.ResultsDuring the early days of the COVID-19 pandemic, 72% of providers reported a decrease in patient visits. Most IPs and other private primary care providers reported receiving no COVID-19 related engagement with government or civil society agencies. For them, the principal source of COVID-19 information was television and newspapers. IPs had reasonably good knowledge of typical COVID-19 symptoms and prevention, and at levels similar to doctors. However, there was low stated compliance among IPs (16%) and qualified primary care providers (15% of MBBS doctors and 12% of AYUSH practitioners) with all WHO recommended management practices for suspect COVID-19 cases. Nearly half of IPs and other providers intended to treat COVID-19 suspects without referral.ConclusionsPoor management practices of COVID-19 suspects by rural primary care providers weakens government pandemic control efforts. Government action of providing information to IPs, as well as engaging them in contact tracing or public health messaging can strengthen pandemic control efforts.

scholarly journals Distance Learning and Spaced Review to Complement Dermoscopy Training for Primary Care

2021 ◽  
pp. e2021030
Author(s):  
Elizabeth Seiverling ◽  
Danielle Li ◽  
Kathryn Stevens ◽  
Peggy Cyr ◽  
Gregory Dorr ◽  
...  
Keyword(s):  
Primary Care ◽  
Distance Learning ◽  
Learning Strategies ◽  
Primary Care Providers ◽  
Knowledge Retention ◽  
Skin Lesions ◽  
Care Providers ◽  
Melanoma Detection ◽  
Learning Platform ◽  
The Impact

Background: Dermoscopy aids in skin cancer identification. For family physicians who use dermoscopy, there is higher sensitivity for melanoma detection than naked-eye examination. There is a shortage of dermoscopy training for primary care providers. The Triage Amalgamated Dermoscopic Algorithm (TADA) is designed for novice dermoscopists. While TADA can be taught in a short dermoscopy workshop, spaced review and blended learning strategies improve knowledge retention. Objectives: This study determined the impact that the addition of a distance learning platform has on clinical dermoscopy use. Moreover, it evaluated dermoscopic image identification (knowledge retention) following the addition of distance learning via Extension for Community Health Outcomes (ECHO) to a traditional TADA dermoscopy workshop. Methods: Primary care providers voluntarily attended a 120-minute TADA dermoscopy workshop. Participants completed pre-intervention, post-TADA, and post-ECHO tests of 30 dermoscopic images of benign and malignant skin lesions. A survey was also administered to analyze clinical dermoscopy use and prior dermoscopy training. Results: Twenty-seven residents, faculty, and advanced practice providers participated in this longitudinal observational cohort study. Mean test scores (out of 30) for images of benign and malignant lesions improved from 20.29 pre-intervention to 24.62 post-TADA and 27.63 post-ECHO (P < .001). On average, participants attended 4 ECHO sessions (out of 7 total) and there was a positive correlation (r = 0.77) between the number of ECHOs attended and post-ECHO scores. Dermoscope use increased from 37.0% to 96.3% (P < .001). Conclusion: Distance learning and spaced review complement dermoscopy workshop training for primary care.

scholarly journals Association between suicidal ideation and causes of primary care visits: A cross-sectional study to identify patients with suspected suicidal ideation

2019 ◽  
Author(s):  
Gyeongsil Lee ◽  
Jung-Ha Kim
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Care Physician ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patients At Risk ◽  
Primary Care Patients

Abstract Background: Evidence increasingly suggests that suicide victims are highly likely to visit a primary care provider within one month of the suicide event. However, it would be impossible for primary care providers to act as gatekeepers and thus screen all patients for suicidal ideation or attempts. Therefore, we aimed to investigate potential differences in the chief diagnoses received by primary care patients with and without suicidal ideation, as this information may provide clues and predict patients at risk of committing suicide. Methods: This cross-sectional study included 1,211 Korean adults aged ≥20 years who had participated in the Korea National Health and Nutrition Examination Survey during 2014 and provided information about their histories of suicidal ideation and visits to primary care providers. Multiple logistic regression analyses were used to examine whether suicidal ideation was associated with specific diseases after controlling for age, household income, education, occupation, marital status, smoking, alcohol consumption and physical activity. Results: Among primary care patients, the sample-weighted percentage of suicidal ideation was 11.8%. The diagnoses of neoplasm and mental disorder were associated with a higher likelihood of suicidal ideation (odds ratio; OR [95% confidence interval, CI]: 8.32 [1.01–68.56] and 6.19 [1.72–22.33], respectively). Notably, diseases of the musculoskeletal system and connective tissue were also associated with suicidal ideation (OR [95% CI]: 1.93 [1.09–3.43]). Conclusions: The observed visit patterns and correlations of certain diagnoses with suicidal ideation suggest that primary care physician should pay careful attention to their patients with mood or musculoskeletal disorders and consider screening to determine the risk of suicide.

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