French general practitioners’ willingness to prescribe mHealth devices and apps: a quantitative study (Preprint)

2021 ◽  
Author(s):  
Claire Della Vecchia ◽  
Tanguy Leroy ◽  
Charlotte Bauquier ◽  
Myriam Pannard ◽  
Aline Sarradon-Eck ◽  
...  
Keyword(s):  
General Practitioners ◽  
Medical Practice ◽  
Randomized Clinical Trials ◽  
Training Programs ◽  
Care Pathway ◽  
General Medicine ◽  
Population Data ◽  
Professional Associations ◽  
Online Questionnaire ◽  
Healthy Behaviors

BACKGROUND The field of mHealth is in constant expansion. Integrating connected objects and applications for patient healthcare (COA) in clinical practice is a major and complex challenge. General practitioners (GP) are the essential link in a patient’s care pathway. As they are patients’ preferred healthcare intermediaries, GP have an important support role to play in patients’ transition to mHealth since they must be able to both guide and advise them. OBJECTIVE To identify the factors associated with the willingness of French GP to prescribe COA to their patients. METHODS The present study was part of the ApiApps project whose overall objective is to help remove barriers GP face when prescribing COA by developing a custom-built platform to aid them. It is funded by the National Research Agency (ANR-17-CE19-0027). The study included GP recruited from several academic department of general practice of several medical faculties in France (Lyon, Nice, Rouen) and also from mailing lists of academic GP, healthcare professional associations, and social and professional networks. Participants were asked to complete an online questionnaire which collected data on various sociodemographic variables, on indicators of their involvement in continued training programs and the amount of time they dedicated to promoting healthy behaviors during patient consultations, as well as indicators characterizing their patient population. Data on their representations and beliefs regarding COA were also collected. Finally, the questionnaire included items to measure specific indicators of GP acceptability of prescribing COA for the management of various pathologies. RESULTS Three quarters (74% (129/174)) of GP declared they were ready to prescribe OCA to their patients. In the multivariate analysis of 174 GP, involvement in continued education programs (OR = 6.17 [1.52-28.72]), ease of communication with their patients (OR = 1.45 [1.13-1.88]), GP-perceived benefits of COA for both patients and for their medical practice and GP-perceived drivers for COA implementation in their medical practice (same indicator) (OR = 1.04 [1.01-1.07]), as well as validation of COA through randomized clinical trials (OR = 1.02 [1.00-1.04]) were all associated with GP willingness to prescribe COA. In contrast, older GP (OR = 0.95 [0.91-0.98]), female GP (OR = 0.26 [0.09-0.69]) and those who perceived risks for the patient and/or for their medical practice (OR = 0.96 [0.94-0.99]) were less inclined to prescribe COA. CONCLUSIONS COA were generally seen by GP as useful in general medicine to complement other existing tools and respondents were for the most part favorable to prescribing them. However, the full integration of COA in general medicine will be conditioned by the need for conclusive certification, for transparency (reliable and precise data concerning COA methods of construction and clinical validation), for software aids to assist GP prescribe them, and for COA training programs.

scholarly journals Healthcare Professionals’ Perspectives on the Cross-Sectoral Treatment Pathway for Women with Gestational Diabetes during and after Pregnancy—A Qualitative Study

2021 ◽  
Vol 10 (4) ◽  
pp. 843
Author(s):  
Anne Timm ◽  
Karoline Kragelund Nielsen ◽  
Ulla Christensen ◽  
Helle Terkildsen Maindal
Keyword(s):  
Type 2 Diabetes ◽  
Qualitative Study ◽  
Gestational Diabetes ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Adverse Outcomes ◽  
Treatment Pathway ◽  
Healthy Behaviors ◽  
The Cross

Gestational diabetes mellitus (GDM) increases the risk of adverse outcomes during and after pregnancy, including a long-term risk of type 2 diabetes. Women with GDM are treated by numerous healthcare professionals during pregnancy and describe a lack of preventive care after pregnancy. We aim to investigate healthcare professionals’ perspectives on the cross-sectoral treatment pathway for women with GDM—during and after pregnancy. A qualitative study was conducted using systematic text condensation. Nine healthcare professionals (two general practitioners, four midwives, two obstetricians and one diabetes nurse) were interviewed and eight health visitors participated in two focus group discussions., Three major themes emerged: (1) “professional identities”, which were identified across healthcare professionals and shaped care practices; (2) ”unclear guidelines on type 2 diabetes prevention after GDM”, which contributed to uncertainty about tasks and responsibilities during and after pregnancy; and (3) “cross-sectoral collaboration”, which relied heavily on knowledge transfers between hospitals, general practice and the local municipality. The findings implicate that clear, transparent guidelines for all sectors should be prioritized to strengthen cross-sectoral care to women with GDM during and after pregnancy. As a result, strong cross-sectoral care throughout the GDM care pathway may improve maternal health by supporting healthy behaviors, facilitate weight loss and reduce the risk of subsequent GDM and early onset diabetes.

Physician moral injury in the context of moral, ethical and legal codes

2021 ◽  
pp. medethics-2021-107225
Author(s):  
Philip Day ◽  
Jennifer Lawson ◽  
Sneha Mantri ◽  
Abhi Jain ◽  
David Rabago ◽  
...  
Keyword(s):  
Medical Practice ◽  
Moral Distress ◽  
Codes Of Ethics ◽  
Professional Associations ◽  
Moral Injury ◽  
Systematic Change ◽  
Ethical Codes ◽  
Validity Tests

After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything.The current research seeks to develop the construct of moral injury outside military contexts, generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics.

Balint Groups: Training or Treatment?

1972 ◽  
Vol 3 (4) ◽  
pp. 373-377 ◽  
Author(s):  
Howard A. Bacal
Keyword(s):  
General Practitioners ◽  
Training Programs ◽  
Training Process ◽  
Balint Groups ◽  
Personality Changes ◽  
Training Approach ◽  
Critical Attention ◽  
Formal Procedures

Michael Balint's views about the personality changes required of a doctor during the acquisition of psychotherapeutic skill are discussed as having important implications for training programs both in patient-oriented medicine and in the more formal procedures where psychotherapeutic work is involved. The evolution of Balint's training approach for general practitioners can be traced from the Hungarian psychoanalytic supervisory method; its further adaptation could greatly enhance the training process. While critical attention is drawn to the practice of rigidly conceptualizing “training” as an entity distinct from “treatment,” it must be stressed that the internal changes which the acquisition of skills requires must take place in the area of what can be termed the “professional ego.”

Do academic and professional institutions promote the awareness and knowledge of Islamic banking and finance in Nigeria?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Umar Habibu Umar ◽  
Mustapha AbuBakar ◽  
Abubakar Jamilu Baita ◽  
Tasiu Tijjani Kademi ◽  
Md Harashid Haron
Keyword(s):  
Training Programs ◽  
Continuing Professional Development ◽  
Professional Associations ◽  
Islamic Banking ◽  
Content Type ◽  
Fully Integrated ◽  
Banking And Finance ◽  
Finance Industry ◽  
National University ◽  
And Training

Purpose The purpose of this study is to examine the contribution of academic and professional institutions in promoting the awareness and knowledge of Islamic banking and finance in Nigeria. Design/methodology/approach The data were generated through a documentary research method by examining the Benchmark Minimum Academic Standards (BMAS) for Nigerian universities and Nigerian university curricula for the relevant undergraduate programs, as well as examination syllabi and training brochures for the relevant professional associations. Findings The study found that universities do not promote significantly the awareness and knowledge of Islamic banking and finance. Similarly, the relevant professional associations through their examinations and training programs contribute little or nothing to the promotion of awareness and knowledge. Research limitations/implications This study solely relied upon documentary evidence upon which the findings were based. In addition, for academic institutions, only undergraduate BMAS and curricula were examined. Practical implications There should be collaborations between the National University Commission of Nigeria, relevant Islamic and non-Islamic professional bodies and Nigerian Universities to ensure that courses (subjects) that could promote the awareness and knowledge of Islamic banking and finance are fully integrated into academic and professional curricula and training programs. Social implications The integration of an adequate number of relevant courses/topics into academic curricula and professional institution examination syllabi and their Mandatory Continuing Professional Development programs would greatly contribute to the production of competent and skillful employees to work for the growth and development of the Islamic banking and finance industry. Originality/value This study provides better ways of ensuring that knowledgeable and qualified employees are produced to work for the sustainability of the global Islamic banking and finance industry.

ANXIETY AND DEPRESSIVE DISORDERS IN GENERAL MEDICAL PRACTICE: TOPICAL ISSUES AND UNSOLVED PROBLEMS

2021 ◽  
pp. 14-22
Author(s):  
A. A. Kirpichenka ◽  
Keyword(s):  
General Practitioners ◽  
Medical Practice ◽  
Depressive Disorders ◽  
Psychiatric Care ◽  
Modern Medicine ◽  
General Medical Practice ◽  
Foreign Countries ◽  
The Republic ◽  
Somatic Diseases ◽  
Quality Diagnosis

Diagnosis of anxiety and depressive disorders in general medical practice is a very important problem of modern medicine. This review article provides basic information about the epidemiology and economic burden of anxiety-depressive disorders, their comorbidity with other mental and somatic diseases, and the connection with suicidal behavior. According to the Decree of the Ministry of Health of the Republic of Belarus dated 02.03.2020 № 13 «On approval of the clinical protocol» «Diagnosis and treatment of patients with mental and behavioral disorders by general practitioners», this article focuses on depression, generalized anxiety, panic, mixed anxiety and depressive disorder in general medical practice. Relevant issues of low quality diagnosis of anxiety and depressive disorders are identified, which are associated both with the complexity of the clinical picture of the diseases in question and with organizational problems. Particular attention is also paid to the need for further integration of psychiatric care into general medical practice while increasing its accessibility and quality. For this, it is necessary to continue studying the best practices of foreign countries in which family and general practitioners have been providing psychiatric care to patients for many years.

Knowledge, Skills, and Competency

2010 ◽  
pp. 93-106
Author(s):  
Gilbert Paquette
Keyword(s):  
Knowledge Management ◽  
Teacher Training ◽  
Vocational Training ◽  
Training Programs ◽  
Professional Associations ◽  
The Internet ◽  
Governmental Agencies ◽  
School Programs ◽  
Management Perspective ◽  
Competency Based

A search on the Internet shows the renewed importance given to competency-based approaches in Education and Administration. Ministries of education, school boards, and teacher training institutes use competency profiles to define school programs or required qualities from the teachers, especially in the use of technologies in education. Consulting companies present their expertise by enumerating competencies, marketing their services in this way. Other companies offer services or computerized tools to help their prospective customers define or manage the competence of their staff, looked upon as the main asset of an organization in a knowledge management perspective. Governmental agencies or professional associations use competency-based approaches to define conditions to the exercise of a profession and to orient their vocational training programs.

The spectrum of disorders associated with adult rheumatic and musculoskeletal diseases

2018 ◽  
pp. 205-240
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
General Practitioners ◽  
Musculoskeletal Diseases ◽  
Real Life ◽  
General Medicine ◽  
Differential Diagnoses ◽  
Medical Comorbidities ◽  
Adult Disease ◽  
Adults And Children ◽  
Rheumatological Disease ◽  
Rheumatic Conditions

The Oxford Handbook of Rheumatology, 4th edition, takes the reader through a pragmatic and realistic way of assessing musculoskeletal and rheumatological disease presentation in its first four chapters. The text reflects real life, with differential diagnoses suggested as information becomes available through the details from history, then examination, then investigations. The chapters focus on patterns of, and focal regional, symptoms in adults and children. In this chapter, the book considers musculoskeletal and rheumatic conditions which occur in, or are closely associated with, other conditions of the skin, eye, heart, lung, kidney, and in hormonal, neurological, and gastrointestinal systems. Such an approach should help general practitioners and rheumatology trainees caring for their patients across their medical comorbidities and in general medicine. There is also a section on musculoskeletal–rheumatological features in patients with neoplasia. The chapter focuses primarily on adult disease.

scholarly journals Parenting While in Training: A Comprehensive Needs Assessment of Residents and Fellows

2020 ◽  
Vol 12 (2) ◽  
pp. 162-167 ◽  
Author(s):  
Kirti Magudia ◽  
Thomas S. C. Ng ◽  
Alexander G. Bick ◽  
Megan A. Koster ◽  
Camden Bay ◽  
...  
Keyword(s):  
Clinical Training ◽  
Training Programs ◽  
Parental Leave ◽  
Fellowship Training ◽  
Parental Status ◽  
Specific Information ◽  
Online Questionnaire ◽  
Access And Affordability ◽  
Selection Of ◽  
Individual Training

ABSTRACT Background Parenting issues can affect physicians' choice of specialty or subspecialty, as well as their selection of individual training programs, because of the distinctive challenges facing residents and fellows with children. Specific information about how residents perceive these challenges is limited. Objective We sought to better understand the challenges associated with parenting during residency and fellowship training in order to inform policy and research. Methods In 2017, a voluntary online questionnaire was distributed to all 2214 Partners HealthCare graduate medical education trainees across 285 training programs. The survey queried attitudes of and about trainees with children and assessed needs and experiences related to parental leave, lactation, and childcare. Responses were compared between subgroups, including gender, surgical versus nonsurgical specialty, parental status, and whether the respondent was planning to become a parent. Results A total of 578 trainees (26%) responded to the questionnaire. Of these, 195 (34%) became parents during training. An additional 298 (52%) planned to become parents during training. Respondents overwhelmingly agreed that their institution should support trainees with children (95%) and that doing so is important for trainee wellness (98%). However, 25% felt that trainees with children burden trainees without children. Childcare access, affordability, and availability for sufficient hours were identified as key challenges, along with issues related to parental leave, lactation facilities, and effect on peers. Conclusions This survey highlights trainees' perspectives about parenting during their clinical training, signaling parental leave, lactation facilities, and childcare access and affordability as particular challenges and potential targets for future interventions.

scholarly journals The Rockefeller University Clinical Scholars (KL2) program 2006–2016

2017 ◽  
Vol 1 (5) ◽  
pp. 285-291 ◽  
Author(s):  
Sarah J. Schlesinger ◽  
Michelle Romanick ◽  
Jonathan N. Tobin ◽  
Donna Brassil ◽  
Rhonda G. Kost ◽  
...  
Keyword(s):  
Medical Practice ◽  
Training Programs ◽  
Human Subjects ◽  
Leadership Skills ◽  
Team Science ◽  
Translational Science ◽  
Government Service ◽  
Content Expert ◽  
Foreign Government ◽  
Science Training

Introduction and MethodsThe Rockefeller Clinical Scholars (KL2) program began in 1976 and transitioned into a 3-year Master’s degree program in 2006 when Rockefeller joined the National Institute of Health Clinical and Translational Science Award program. The program consists of ∼15 trainees supported by the Clinical and Translational Science Award KL2 award and University funds. It is designed to provide an optimal environment for junior translational investigators to develop team science and leadership skills by designing and performing a human subjects protocol under the supervision of a distinguished senior investigator mentor and a team of content expert educators. This is complemented by a tutorial focused on important translational skills.ResultsSince 2006, 40 Clinical Scholars have graduated from the programs and gone on to careers in academia (72%), government service (5%), industry (15%), and private medical practice (3%); 2 (5%) remain in training programs; 39/40 remain in translational research careers with 23 National Institute of Health awards totaling $23 million, foundation and philanthropic support of $20.3 million, and foreign government and foundation support of $6 million. They have made wide ranging scientific discoveries and have endeavored to translate those discoveries into improved human health.ConclusionThe Rockefeller Clinical Scholars (KL2) program provides one model for translational science training.

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