scholarly journals Evaluating 10 years of state-funded GP training in GP offices in Switzerland

2020 ◽  
Author(s):  
Kim Baumann ◽  
Fanny Lindemann ◽  
Beatrice Diallo ◽  
Zsofia Rozsnyai ◽  
Sven Streit

Abstract Background Switzerland lacks future general practitioners (GPs). Residents who wished to specialize as general practitioners were formerly trained solely in hospital settings. To better prepare and also attract more young doctors to become GPs, the canton of Bern has implemented a partly state-funded vocational training program in GP practices. Our study examines the efficacy of this 10-year program, identifies factors that positively influence residents in their decision to become a GP and the distribution of new GPs in the canton of Bern, who had taken part in the traineeship. Methods This cross-sectional survey among all residents, who participated in a traineeship in general practice from 2008 to 2017 in the canton of Bern asked if residents had taken a subsequent career choice as a GP and if so in which region. Residents scored the importance of their traineeship and their mentor’s influence on becoming a GP. By using zip codes of work area of respondents already working as GPs and matching it with population census data, we could obtain the distribution of GPs on a per capita basis. Results Out of 165 residents who participated in a traineeship, 151 (92%) completed our survey. 81% had chosen a career as a GP or were on track to become a GP. Almost half of the participants became GPs in the offices of their mentors. Our respondents emphasized the importance of their mentors influence as well as the training program in their decision-making to become a GP. Most mentioned benefits of being a GP were broad field of medical care (37%) and a fulfilling doctor-patient relationship (34%). We could show an increase in GP practices in the canton of Bern, not only in urban but also accordingly in rural areas. Conclusions Most residents continued subsequent careers as general practitioners after having completed a GP traineeship, with almost half of them in the region of their training. A vocational training program helped motivating young doctors to become GPs and underserved regions of the canton of Bern to gain new GPs.

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043365
Author(s):  
Subhasish Das ◽  
Md. Golam Rasul ◽  
Md Shabab Hossain ◽  
Ar-Rafi Khan ◽  
Md Ashraful Alam ◽  
...  

IntroductionWe conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.SettingSelected urban and rural areas of Bangladesh.Participants106 urban and 106 rural households.Outcome variables and methodHousehold food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.ResultsWe found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).ConclusionBoth urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.


Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.


2001 ◽  
Vol 12 (2) ◽  
pp. 98-100 ◽  
Author(s):  
B Craig Lee

PURPOSE:To evaluate training in infectious diseases, determining which components of the training program best prepare residents for their career choices and where improvements are needed.METHOD:A cross-sectional survey was mailed to all 14 physicians who had graduated from both the Adult and Paediatric Infectious Diseases Training Program at the University of Calgary from 1985 to 1998. Responses about the adequacy of training were measured using a Likert-type scale and a qualitative questionnaire.RESULTS:Of 14 mailed questionnaires, nine responses were received (64%). Two-thirds of respondents were in an academic setting, and seven (78%) graduates obtained postfellowship training. The specialists in academic settings were all engaged in multiple nonclinical activities. The clinical and diagnostic microbiological components of training received the highest scores in terms of adequacy of training.CONCLUSION:Graduates of the University of Calgary training program indicated an overall satisfaction with their training. However, improvements are needed in career counselling, health administration, antibiotic utilization, infection prevention and specialized outpatient clinics. Potential strategies for addressing these issues include didactic lectures, enhanced exposure to clinical outpatient settings and provision of designated faculty mentors.


Author(s):  
Rafat Hussain ◽  
Stuart Wark ◽  
Peta Ryan

Australia has one of the world’s highest life expectancy rates, and there is a rapidly growing need for informal caregivers to support individuals who are ageing, have chronic illness or a lifelong disability. These informal carers themselves face numerous physical and psychological stressors in attempting to balance the provision of care with their personal life, their work commitments and family responsibilities. However, little is known about the specific challenges facing rural carers and the barriers that limit their capacity to provide ongoing support. A cross-sectional survey composed of open-ended responses and demographic/socioeconomic measures used routinely by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health & Welfare (AIHW) was used with a cohort of 225 rurally-based carers within New South Wales, Australia. Demographic questions specified the respondents’ age, gender, employment, caregiving status, condition of and relationship to the care recipient, postcode, residency status, and distance and frequency travelled to provide care. Open-ended comments sections were provided to allow participants to describe any issues and problems associated with caregiving including employment, travel, residency, carer support groups and any other general information. The results show that most rural carers were middle-aged women supporting a spouse or a child. Unpredictability associated with providing care exacerbated demands on carers’ time, with many reporting significant employment consequences associated with inflexibility and limited job options in rural locations. Specific issues associated with travel requirements to assist with care were reported, as were the impacts of care provision on the respondents’ own personal health. The majority of carers were aware of the social supports available in their local rural community, but did not access them, leaving the carers vulnerable to marginalisation. Problems associated with employment were noted as resulting in financial pressures and associated personal stress and anxiety for the caregivers. While this issue is not necessarily limited to rural areas, it would appear that the lack of opportunity and flexibility evident in rural areas would exacerbate this problem for non-metropolitan residents. The participants also identified specific barriers to the provision of care in rural areas, including the significant impact of travel. Access to support services, such as carer groups, were rarely accessed due to a mix of factors including inaccessibility, poor timing and a lack of anonymity. Financially, there was considerable evidence of hardship, and there is an urgent need for a comprehensive review of government and community-based support to better meet the needs of rural carers.


2005 ◽  
Vol 37 (6) ◽  
pp. 761-771 ◽  
Author(s):  
JOSEPH KEATING ◽  
KATE MACINTYRE ◽  
CHARLES M. MBOGO ◽  
JOHN I. GITHURE ◽  
JOHN C. BEIER

A geographically stratified cross-sectional survey was conducted in 2002 to investigate household-level factors associated with use of mosquito control measures and self-reported malaria in Malindi, Kenya. A total of 629 households were surveyed. Logistic regressions were used to analyse the data. Half of all households (51%) reported all occupants using an insecticide-treated bed net and at least one additional mosquito control measure such as insecticides or removal of standing water. Forty-nine per cent reported a history of malaria in the household. Of the thirteen household factors analysed, low (OR=0·23, CI 0·11, 0·48) and medium (OR=0·50, CI 0·29, 0·86) education, mud–wood–coral (OR=0·0·39, CI 0·24, 0·66) and mud block–plaster (OR=0·47, CI 0·25, 0·87) wall types, farming (OR=1·38, CI 1·01, 1·90) and travel to rural areas (OR=0·48, CI 0·26, 0·91) were significantly associated with the use of mosquito control, while controlling for other covariates in the model. History of reported malaria was not associated with the use of mosquito control (OR=1·22, CI 0·79, 1·88). Of the thirteen covariates analysed in the second model, only two household factors were associated with history of malaria: being located in the well-drained stratum (OR=0·49, CI 0·26, 0·96) and being bitten while in the house (OR=1·22, CI 0·19, 0·49). These results suggest that high socioeconomic status is associated with increased household-level mosquito control use, although household-level control may not be enough, as many people are exposed to biting mosquitoes while away from the house and in areas that are more likely to harbour mosquitoes.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Iqbal Fahs ◽  
Zainab Khalife ◽  
Diana Malaeb ◽  
Mohammad Iskandarani ◽  
Pascale Salameh

Introduction. CVDs are largely driven by modifiable risk factors. This study sought to determine the awareness and prevalence of the modifiable CVDs risk factors among the Lebanese population.Methods. In a cross-sectional survey, 1000 participants aged ≥ 45 years were randomly selected from pharmacies and interviewed. The data was analyzed with SPSS version 21.0 software.Results. Differences between urban and rural areas include alcohol consumption (2.8% versus 1.7%;p=0.0001), cardioprotective vegetable servings (6.1% versus 2.3%;p=0.016), sedentary hours per day (18.6% versus 15.1%;p=0.002), and hypertension (38.5% versus 25.4%;p=0.001). The prevalence of overweight and obesity (77.3% versus 75.2%;p=0.468), smoking (39.3% versus 43.3%;p=0.232), diabetes (25.4% versus 21.4%;p=0.173), and dyslipidemia (25 versus 21.2%) was reported. Measurements revealed 19.3% of undiagnosed hypertension (12.4% versus 22.4%,p=0.001), 61.7% of hypertension (59.8% versus 62.6%;p=0.203), and 7.9% of undiagnosed diabetes (6.6% versus 8.6%;p=0.323). The declared awareness of CVDs risk factors was highest for smoking (91.5% versus 89.7%;p=0.339) and lowest for diabetes (54.4 versus 55.7%;p=0.692).Conclusion. This study has shown a high prevalence of modifiable CVDs risk factors in the Lebanese population ≥ 45 years, among which hypertension is the most prominent.


2015 ◽  
Vol 12 (2) ◽  
pp. 121-125
Author(s):  
KR Thapa ◽  
BK Shrestha ◽  
MD Bhattarai

Background Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation.Objective A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country.Method The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments’ postings.Result Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around.Conclusion The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.Kathmandu University Medical Journal Vol.12(2) 2014: 121-125


2022 ◽  
Vol 12 (1) ◽  
pp. 175-187
Author(s):  
Sumani Abdul-Manan ◽  
Alhassan Iddrisu Abdullai ◽  
Buhari Gunu Yussif

Background: A proven strategy for saving lives from vaccine-preventable diseases is the timely vaccination of the people. In Ghana, there is considerable hesitation about the Covid-19 vaccines due to anxieties and uncertainties about their safety. With varying perceptions and believes being developed about Covid-19 vaccines, there is a likely negative effect on vaccine acceptance or otherwise. This study aims to ascertain the levels of acceptance of potential Covid-19 vaccine among Ghanaian adults, to identify predictors of vaccine acceptance or hesitance. Methodology: A web based cross-sectional survey conducted among Ghanaians above 18 years, conducted between the month of February and March, 2021. Data were collected by administering online google forms (Questionnaire). The questionnaire was shared through social media platforms. A snowball sampling technique was used where researchers shared google forms to close friends and family. Analyses were conducted at p-value <0.05 using descriptive statistics, cross-tabula­tions and logistic regression. Results: A total of 350 responses were achieved by end of data collection. Out of these, only 348 were considered for analysis based on the inclusion and exclusion criteria. Majority of the respondents (65.2%) were male, a third (30%) of them live in rural areas and about 57.5% were married. Factors such as age, educational level, prior vaccine acceptance history, personal vulnerability and self-feeling of health were significantly associated with covid-19 vaccine acceptance. Conclusion: The results depict low acceptance rate for potential covid-19 vaccine among Ghanaians. Government and MoH should engage the media on its role in combating misinformation with regards the Covid-19 vaccine. Key words: coronavirus disease 2019 (Covid-19), vaccine, hesitance, acceptance.


Author(s):  
Sadia Jahan ◽  
Md. Saddam Hossain ◽  
Md. Anisur Rahman Bhuiyan ◽  
Susmita Roy Lisa ◽  
Somaia Haque Chadni

Aim: To evaluate the household iodine content and knowledge, attitude, and behavior regarding salt iodization among the residents of Cumilla, Bangladesh. Subjects and Methods: We conducted a cross-sectional survey of 700 inhabitants in Cumilla's urban and rural areas to determine the iodine concentration of salt they consume. The participants were asked about what they know about iodine deficiency and salt iodization as well as how their salt was packaged and stored. Among them, 338 people provided a sample of salt to be tested of its iodine content by the titrimetric method. Results: 46.57% of people knew that iodization was the best way to prevent iodine deficiency while 35.14% considered salt iodization during purchasing. Most people stored salt in plastic boxes (89.7%) and closed containers (84.14%).Among all participants, only 37.14% of people were aware of the iodine requirement during pregnancy. In urban regions, the median iodine content was 36.76 ppm (OR=0.658, 95% CI, 0.469-0.925), while in rural areas, the median iodine content was 40.92 ppm (OR=1.188, 95% CI, 1.022-1.380). Iodine levels were less than 15 ppm (minimum limit) in 6.8% of samples and greater than 40 ppm (maximum limit) in 56.5%. Only 36.7% of the salt samples contained adequate iodine. Conclusion: An effective and consistent approach for controlling iodine concentration in distributed salt is required at Cumilla, Bangladesh.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255986
Author(s):  
Arno Stöcker ◽  
Ibrahim Demirer ◽  
Sophie Gunkel ◽  
Jan Hoffmann ◽  
Laura Mause ◽  
...  

Background The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. Objectives The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. Methods Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March–April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. Results In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. Conclusion The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.


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