scholarly journals Role of Primary Care Physician in COVID-19 Response: A Review

2021 ◽  
pp. 207-214
Author(s):  
Faisal Suliman Algaows ◽  
Amro Youssef A. Elias ◽  
Abdulwahab Abdulmannan M. Alshaikh ◽  
Rawan Saleh Nabzah ◽  
Anas Ebrahim Almejewil ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Family Medicine ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Physician ◽  
Clinical Consequences ◽  
Tertiary Care Centers ◽  
The Impact

All healthcare providers have had to adapt and be flexible in order to respond to COVID-19. Nonetheless, the emphasis, particularly at the start of the outbreak, was on the impact and response of secondary and tertiary care. The primary care sector's responsibilities in the response focused on how it could help secondary and tertiary care centers respond. A small percentage of current research and evidence focuses on health services implications or applied public health approaches, with even fewer on the role of primary care and family medicine providers. So, while our scientific understanding of the virus and its subsequent clinical consequences has grown exponentially, information about primary care responses to COVID-19 in a variety of settings, as well as the interaction with patient perspectives and priorities, and broader public health responsibilities, remains significantly hazier.

scholarly journals The Role of the Primary-Care Physician in Treating Relapses in Multiple Sclerosis Patients

2009 ◽  
Vol 11 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Sarah A. Morrow ◽  
Marcelo Kremenchutzky
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Care Physician ◽  
Diagnosis And Treatment ◽  
High Prevalence ◽  
Tertiary Care Centers ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MS) is a common disabling neurologic disease with an overall prevalence in Canada of 240 in 100,000. Multiple sclerosis clinics are located at tertiary-care centers that may be difficult for a patient to access during an acute relapse. Many relapses are evaluated by primary-care physicians in private clinics or emergency departments, but these physicians' familiarity with MS is not known. Therefore, a survey was undertaken to determine the knowledge and experience of primary-care physicians regarding the diagnosis and treatment of MS relapses. A total of 1282 licensed primary-care physicians in the catchment area of the London (Ontario, Canada) Multiple Sclerosis Clinic were identified and mailed a two-page anonymous survey. A total of 237 (18.5%) responses were obtained, but only 216 (16.8%) of these respondents were still in active practice. Of these 216 physicians, only 9% reported having no MS patients in their practice, while 70% had one to five patients, 16.7% had six to ten, and 1.9% had more than ten (3.7% did not respond to this question). Corticosteroids were recognized as an MS treatment by 49.5% of the respondents, but only 43.1% identified them as a treatment for acute relapses. In addition, 31% did not know how to diagnose a relapse, and only 37% identified new signs or symptoms of neurologic dysfunction as indicating a potential relapse. Despite the high prevalence of MS in Canada, primary-care physicians require more education and support from specialists in MS care regarding the diagnosis and treatment of MS relapses.

The impact of cognitive challenges in major depression: the role of the primary care physician

2016 ◽  
Vol 128 (7) ◽  
pp. 665-671 ◽  
Author(s):  
Gregory Mattingly ◽  
Richard H. Anderson ◽  
Stephen G. Mattingly ◽  
Elizabeth Q. Anderson
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Primary Care Physician ◽  
Care Physician ◽  
The Impact ◽  
Cognitive Challenges

scholarly journals 26.A. Workshop: Assessing the role of policies and actions to address childhood obesity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Childhood Obesity ◽  
Stakeholder Engagement ◽  
Special Focus ◽  
Policy Options ◽  
Sustainable Solutions ◽  
Relevant Evidence ◽  
Multi Stakeholder ◽  
The Impact

Abstract   Childhood obesity has grown to become one of the most dramatic features of the global obesity epidemic, with long-term consequences. The spread of obesity has been fueled by changes in social norms and living environments that have shaped individual behaviours making them conducive to excessive and imbalanced nutrition, sedentary lifestyles, and ultimately obesity and associated diseases. The STOP project will aim to generate scientifically sound, novel and policy-relevant evidence on the factors that have contributed to the spread of childhood obesity in European countries and on the effects of alternative technological and organisational solutions and policy options available to address the problem. STOP will translate the evidence gathered and generated into indicators and measurements, policy briefs and toolkits and multi-stakeholder frameworks. A special focus of STOP is understanding the stakeholders' networks and drivers of stakeholders' action. STOP will establish new ways for policy-relevant evidence to be generated, made available and used in the design and implementation of effective and sustainable solutions for childhood obesity at the EU, national and local levels. Each of the policy work packages will: Produce evidence syntheses and impact simulations for different policy approaches;Assess selected policy approaches and actions in children cohorts and other relevant settings;Devise policy toolkits and policy guidance to support the adoption and implementation of specific actions by relevant actors;Establish a country-based European accountability and monitoring framework in each policy area. The workshop aims to: Showcase the impact of different policy options evaluated throughout the STOP project;Increase participants' understanding and awareness of the opportunities and challenges associated with the implementation of selected policies;Increase awareness of public health professionals of the importance of overcoming siloes in identifying and implementing public health policies;Increase the understanding of multi-stakeholder engagement. The discussion will explore the role of stakeholders across different policy areas. We will explore the different definitions of “stakeholders” and “multi-stakeholders” engagement. This will also be an opportunity to explore some of the benefits, risks and challenges around stakeholder engagement, and explore what are the different types of stakeholders involved in these policies as well as their roles. The workshop will offer an opportunity to: Inform participants about existing physical activity, regulatory and fiscal policies to address childhood obesity;Inform participants about new, innovative EU-level projects that aim to address childhood obesity;Outline preliminary findings of the STOP project with regards to the effectiveness of the evaluated policies;Identify some of the gaps and limitations of existing policies and discuss some of the steps to ensure successful policy implementation. Key messages Present new evidence on what policy approaches work in addressing key determinants of childhood obesity. Showcase findings on the attitudes of different stakeholders towards obesity policies, and debate the benefits, risks and challenges of multi-stakeholder engagement.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

Establishment of Primary Care Continuity Experiences in Community Pediatricians' Offices: Nuts and Bolts

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1185-1189
Author(s):  
Janice R. Sargent ◽  
Lucy M. Osborn ◽  
Kenneth B. Roberts ◽  
Thomas G. DeWitt
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Professional Education ◽  
Primary Care Physicians ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Tertiary Care ◽  
Ambulatory Training ◽  
Lengths Of Stay ◽  
Tertiary Care Centers

During the past 30 years, there has been an increasing awareness of the importance of ambulatory care training in medical education. The discrepancy between education and practice was pointed out in the General Professional Education Panel report that indicated training was based largely in hospital settings even though the vast majority of doctor-patient encounters do not result in hospitalization.1 Perkoff,2 noting changes in hospital care such as shorter lengths of stay, increased outpatient care, and the need for well-trained primary care physicians, stated that programs need to make a major effort to emphasize clinical teaching in outpatient settings. Recognizing the need for these changes, the Accreditation Council on Graduate Medical Education (ACGME) has increased dramatically the requirement in primary care specialties for clinical ambulatory training.3 For pediatrics, these requirements have progressed from the suggestion that clinical training should be obtained in outpatient clinics (1961) to requiring clinical training in primary care clinics weekly for 3 years (1985). The problems in providing good training in ambulatory settings have been well described.2-4 In comparison inpatient teaching, training students and residents in an outpatient clinic is inefficient and costly. One of the methods suggested to address these problems has been to move ambulatory training out of tertiary care centers to community sites.5-9 Many pediatric programs are now using community sites for at least a portion of resident education.10 Alpert et al10 and Greenberg et al,11 although encouraging the use of these sites to reduce the gap between pediatric education and the service delivery system, pointed out that there are no standards for use of community sites.

scholarly journals Antimicrobial Resistance and Social Inequalities in Health: Considerations of Justice

2020 ◽  
pp. 257-278
Author(s):  
Lynette Reid
Keyword(s):  
Global Health ◽  
Health Inequalities ◽  
Social Inequalities ◽  
Tertiary Care ◽  
Practical Importance ◽  
Social Inequalities In Health ◽  
Inequalities In Health ◽  
Catching Up ◽  
The Impact

Abstract Within-country social inequalities in health have widened while global health inequalities have (with some exceptions) narrowed since the Second World War. On commonly accepted prioritarian and sufficientist views of justice and health, these two trends together would be acceptable: the wealthiest of the wealthy are pulling ahead, but the worst off are catching up and more are achieving sufficiency. Such commitments to priority or sufficiency are compatible with a common “development” narrative about economic and social changes that accompany changes (“transitions”) in population health. I set out a very simple version of health egalitarianism (without commitment to any particular current theory of justice) and focus on two common objections to egalitarianism. Priority and sufficiency both address the levelling down and formalism objections, but these objections are distinct: giving content to equality (I argue here) places in question the claimed normative superiority of priority and sufficiency. Using examples of the role of antimicrobials in both these trends – and the future role of AMR – I clarify (first) the multiple forms and dimensions of justice at play in health, and (second) the different mechanisms at work in generating the two current patterns (seen in life course narratives and narratives of political economy). The “accelerated transition” that narrowed global health inequalities is fed by anti-microbials (among other technology transfers). It did not accelerate but replaced the causal processes by which current HICs achieved the transition (growing and shared economic prosperity and widening political franchise). The impact of AMR on widening social inequalities in health in HICs will be complex: inequality has been fed in part by tertiary care enabled by antimicrobials; AMR might erode the solidarity underlying universal health systems as the well-off seek to maintain current expectations of curative and rehabilitative surgery and chemotherapy while AMR mounts. In light of both speculations about the impact of AMR on social and global health inequalities, I close with practical and with theoretical reflection. I briefly indicate the practical importance of understanding AMR from the perspective of health justice for policy response. Then, from a broader perspective, I argue that the content by which I meet the formalism objection demonstrates that the two trends (broadening within-country inequality and narrowing global inequality) are selective and biased samples of a centuries-long pattern of widening social inequalities in health. We are not in the midst of a process of “catching up”. In light of the long-term pattern described here, is the pursuit of sufficiency or priority morally superior to the pursuit of equality as a response to concrete suffering – or do they rationalize a process more objectively described as the best-off continuing to take the largest share of one of the most important benefits of economic development?

scholarly journals Television and Fertility

2010 ◽  
pp. 67-82 ◽  
Author(s):  
Stuart Basten
Keyword(s):  
Public Health ◽  
Mass Media ◽  
Low Fertility ◽  
Future Research ◽  
Media Presentation ◽  
Sliding Scale ◽  
The Media ◽  
Television Plays ◽  
The Impact

Much research has been conducted in the field of utilising the media - television and radio in particular - to promote particular public health messages. However, a burgeoning canon has examined how mass media can play a role in affecting change in fertility preferences and outcomes. In this paper we review these researches which have primarily focussed upon higher fertility settings. The impact of mass media presentation of families and children in low fertility settings has not yet been subject to rigorous sociological investigation so its impact can not be accurately inferred. However, given the pervasive nature of mass media and celebrity culture, we suggest that this is an important avenue for future research. We conclude that television plays a multi-faceted role in shaping individuals decision-making procedures concerning both demographic events and public health interactions. To illustrate this, we present a model which demonstrates a sliding scale of intent - but not impact - of various genres in order to understand the actual role of the media in shaping attitudes towards family size - either explicitly in terms of edutainment or implicitly as a forms of normalization.

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