Coping Strategies as Predictors of COVID-19 related Anxiety among General Physicians of Faisalabad

Emergence of COVID-19 pandemic created numerous physical and psychosocial upheavals for all. Specifically, health care professionals are at great risk of being contaminated by this life-threatening virus; consequently, they may prone to fear and anxiety related to COVID-19 situation. Thus, the present study aimed to examine the coping strategies as predictors of COVID-19 in general physicians of Faisalabad. The present correlational study was done on general physicians working in the outpatient departments of public and private sector hospitals of Faisalabad, Pakistan. Demographic Information Form, Brief Cope Scale and COVID-19 related Anxiety Scale were used to meet the present objectives. Multiple regression analysis revealed active coping (? = -.247, t(118) = -2.446, p < .05), venting (? = .332, t(118) = 3.959, p < .001), religion (? = -.274, t(118) = -3.058, p < .01), emotional support (? =.207, t(118) = 2.085, p < .05), behavioral disengagement (? = .336, t(118) = 3.873, p < .001), humor (? = -.199, t(118) = -2.659, p < .01) and substance use (? = .363, t(118) = 4.158, p < .001) as significant predictors of COVID-19 related anxiety in general physicians. Three types of coping strategies seemed effective in overcoming COVID-19 related anxiety among general physicians. However, venting, behavioral disengagement, emotional support and substance abuse may decrease the COVID-19 related anxiety, if are used less by general physicians at work. The present findings have implications for general physicians who need to use coping strategies which may effectively reduce their anxiety associated with COVID-19 situation.

A Survey of Physicians’ Opinion and Treatment Preferences Regarding Febrile Seizures in Children

Background: Fever of either low or high-grade is a big concern when present in the pediatric age group; it is much more worrisome if children are younger than 5 years of age. Fever can subside on its own or with the help of simple remedies and or medications. However, some children will develop seizures when they have a fever. Febrile seizures are one of the most common presenting complaints seen in pediatric patients in emergency room visits and physician consult. Two different types of seizures are seen in children, simple and complex seizures. Simple febrile seizures are non harming and self-limiting, while, complex seizures are prone to have long-term side effects on children. Febrile seizures can occur with or without a source of an underlying cause. In this study, we aimed to identify physicians’ opinions, knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age. Objectives: To determine physicians’ opinion knowledge, and suggestions to improve guidelines on current treatment trends for fever and fever’s association with febrile seizures in children less than 5 years of age. Methods: A cross-sectional study plan was designed and conducted in June - July 2021 involving general physicians and pediatricians (n = 600). The questionnaire form including 15 closed-end questions was distributed to physicians. Descriptive statistics were used to analyse the data. Results: 100% of physicians prescribed antipyretics to control fever and or to prevent complications, especially febrile seizures. All participants were aware that axillary temperature of > 37.2 ° C is defined as fever. All most all, general physicians and most pediatricians used antipyretics to treat other associated symptoms and signs, even when the fever was absent. 76.3% believed that high fever might be an indicator of underlying serious occult bacterial infection. Almost all physicians (91.3%) advised parents to switch to the use of alternate medication when the fevers did not subside after initial treatment with paracetamol; everyone recommended that non-medical supportive treatments like tepid sponging along with antipyretics and ibuprofen to reduce the fever soonest possible. 68% of pediatricians and 90% of general practitioners believe that febrile seizures will cause brain damage. 74% of general practitioners preferred to refer children immediately to specialty centers, for further management of seizures. However, Pediatricians at tertiary care centers, as well as those in private practice used diazepam or lorazepam. Conclusion: Differences are negligible between general physicians and pediatricians while managing fever and fever complications including febrile seizures. Irrespective of the knowledge, awareness and the availability of fever guidelines by many national and international organizations, physicians are leaning towards child and parents comfort in treatment fever. The gap is wider in general physicians’ preparedness than pediatricians. A considerable gap exists to improve physicians' approach, diagnosis, and management of fever in the pediatric population.

H63D-Syndrome: Quick Reference Guide

Herewith the most condensed and at the same time most comprehensible guide to Gene H63D Syndrome is available. It is specifically made for general physicians in primary and family medicine.

Influence of Vaccination Characteristics on COVID-19 Vaccine Acceptance Among Working-Age People in Hong Kong, China: A Discrete Choice Experiment

Background: Along with individual-level factors, vaccination-related characteristics are important in understanding COVID-19 vaccine hesitancy. This study aimed to determine the influence of these characteristics on vaccine acceptance to formulate promotion strategies after considering differences among respondents with different characteristics.Methods: An online discrete choice experiment was conducted among people aged 18–64 years in Hong Kong, China, from 26 to 28 February 2021. Respondents were asked to make choices regarding hypothetical vaccination programmes described by vaccination-related characteristics—the attributes derived from a prior individual interview. Subgroup analysis was performed to identify the differences in vaccination-related characteristics among respondents with different personal characteristics.Results: A total of 1,773 respondents provided valid responses. The vaccine efficacy and brand were the most important factors affecting acceptance, followed by the exemption of quarantine for vaccinated travelers, safety, venue for vaccination, vaccine uptake of people in their lives, and recommendations by general physicians or government. Frequent exposure to vaccination information on social media has been associated with increasing vaccine refusal. Substantial preference heterogeneity for the attributes was found among people of different ages, incomes, chronic conditions, and previous acceptance of influenza vaccines.Conclusion: The findings provided evidence to formulate interventions to promote vaccine uptake, including the provision of vaccination at housing estate or workplaces, involvement of general physicians and interpersonal communication in vaccine promotion and information dissemination, and exemption of quarantine for vaccinated people. Moreover, social media is a significant information channel that cannot be neglected in the dissemination of official information.

Professional moral character of physicians and clinical working environment

INTRODUCTION. A survey of the experience of Icelandic medical candidates, general physicians, and specialty physicians of clinical work, aimed to show how the working environment affects doctors’ moral character and experience of support, well-being and expectations. For comparison, results of a British survey with the same questions for specialty physicians were used. MATERIAL AND METHODS. A total of 89 physicians answered 15 questions. Statistical comparison was made between results from topical clusters of questions. RESULTS. The results show a significant problem in work conditions of Icelandic doctors. Their experience is rated low in the second quarter (2,1 – 3,0) on a numerical scale of how the environment thwarts professional character and of lack of support. In comparison with British specialists, their experience is similar but slighly better regarding supportiveness. Icelandic candidates and general physicians experience significantly more stress, less support and autonomy in their work than specialists. Compared to the British, the experience of Icelandic specialists was more positive about professional autonomy and emotional attachment to the work. Our survey shows for the first time the effect of the working environment on professional virtues of Icelandic doctors. DISCUSSION. These findings resonate with the literature that the moral character of doctors contributes to satisfaction, flourishing and experience of meaningfulness. They substantiate views raised by Icelandic physicians about tremendous work stress and scarcity of staff. The survey demonstrates the doctors‘ experience of work-related challenges and provides reasons for society to improve their working conditions to enable them to live up to their ideals.

Abordagem do Delirium na Comunidade

INTRODUÇÃO: O delirium é uma das complicações neuropsiquiátricas mais frequentes em Cuidados Paliativos. Constitui uma disfunção neurológica grave, não existindo diretrizes bem estabelecidas para a sua gestão na comunidade. O objetivo deste trabalho consiste na revisão da evidência existente sobre a abordagem do delirium na comunidade, em particular em Portugal.MÉTODOS: Revisão da literatura utilizando os termos MeSH delirium, palliative care, domiciliary care, general practitioners, general physicians, primary care, Portugal e end of life.RESULTADOS E CONCLUSÃO: O delirium é, habitualmente, multifatorial, tendo um impacto importante nos serviços de saúde, profissionais, cuidadores e, sobretudo, nos doentes. A evidência científica para o seu tratamento é escassa e aplica-se, sobretudo, aos cuidados hospitalares. A estruturação de cuidados de qualidade no âmbito da prevenção, identificação atempada e gestão precoce do delirium, no contexto dos Cuidados Paliativos na comunidade, deve incluir o doente, a sua família e o ambiente onde se insere.

Job satisfaction among Syrian healthcare workers in refugee health centres

Background Achieving universal health coverage is subject to the availability, accessibility, acceptability, and quality of health workers. Countries that host refugees and migrants, such as Turkey, must strengthen the capacity of their health systems to increase access to services, especially for refugees and migrants. The Turkish Ministry of Health adapted Syrian refugee healthcare workers in the healthcare services to boost Syrian refugees’ access to healthcare. This study aimed to assess job satisfaction and the factors influencing job satisfaction among refugee physicians and nurses working in Refugee Healthcentres (RHCs) in Turkey. Methods A self-administered, cross-sectional survey targeted all Syrian physicians and nurses working in RHCs across Turkey. The short-form Minnesota Satisfaction Questionnaire(MSQ) was used to assess job satisfaction. In total, 555 nurse/midwives and 336 physicians responded, yielding a total response rate of 56.5%. Descriptive analyses and linear regression tests were conducted to determine the level of job satisfaction and to analyze determinant factors. Results Nurses/midwives reported the highest level of general job satisfaction, followed by specialist physicians and general physicians. Physicians who had worked as specialists in Syria but were now working as general physicians in Turkey had the lowest job satisfaction levels. Multiple regression analysis showed that professional status in Turkey, income, teamwork and team management were significantly associated with job satisfaction. Conclusions To maintain a high level of job satisfaction in refugee healthcare workers, human resources management should consider matching job placements with training specialization and support good leadership and good teamwork. Remuneration that accounts for the cost of living and non-financial incentives could also play a significant role in job satisfaction.

Artificial intelligence-supported lung cancer detection by multi-institutional readers with multi-vendor chest radiographs: a retrospective clinical validation study

Background We investigated the performance improvement of physicians with varying levels of chest radiology experience when using a commercially available artificial intelligence (AI)-based computer-assisted detection (CAD) software to detect lung cancer nodules on chest radiographs from multiple vendors. Methods Chest radiographs and their corresponding chest CT were retrospectively collected from one institution between July 2017 and June 2018. Two author radiologists annotated pathologically proven lung cancer nodules on the chest radiographs while referencing CT. Eighteen readers (nine general physicians and nine radiologists) from nine institutions interpreted the chest radiographs. The readers interpreted the radiographs alone and then reinterpreted them referencing the CAD output. Suspected nodules were enclosed with a bounding box. These bounding boxes were judged correct if there was significant overlap with the ground truth, specifically, if the intersection over union was 0.3 or higher. The sensitivity, specificity, accuracy, PPV, and NPV of the readers’ assessments were calculated. Results In total, 312 chest radiographs were collected as a test dataset, including 59 malignant images (59 nodules of lung cancer) and 253 normal images. The model provided a modest boost to the reader’s sensitivity, particularly helping general physicians. The performance of general physicians was improved from 0.47 to 0.60 for sensitivity, from 0.96 to 0.97 for specificity, from 0.87 to 0.90 for accuracy, from 0.75 to 0.82 for PPV, and from 0.89 to 0.91 for NPV while the performance of radiologists was improved from 0.51 to 0.60 for sensitivity, from 0.96 to 0.96 for specificity, from 0.87 to 0.90 for accuracy, from 0.76 to 0.80 for PPV, and from 0.89 to 0.91 for NPV. The overall increase in the ratios of sensitivity, specificity, accuracy, PPV, and NPV were 1.22 (1.14–1.30), 1.00 (1.00–1.01), 1.03 (1.02–1.04), 1.07 (1.03–1.11), and 1.02 (1.01–1.03) by using the CAD, respectively. Conclusion The AI-based CAD was able to improve the ability of physicians to detect nodules of lung cancer in chest radiographs. The use of a CAD model can indicate regions physicians may have overlooked during their initial assessment.

Job Satisfaction Among Syrian Healthcare Workers in Refugee Health Centers in Turkey

Background: Achieving universal health coverage is subject to the availability, accessibility, acceptability and quality of health workers. Countries that host refugees and migrants, like Turkey, must strengthen the capacity of their health systems to increase access to services, especially for refugees and migrants. The Turkish Ministry of Health adapted Syrian refugee healthcare workers in the healthcare services to boost Syrian refugees' access to healthcare. This study aimed to assess job satisfaction and the factors influencing job satisfaction among refugee physicians and nurses working in Refugee Health Centers (RHCs) in Turkey.Methods: A self-administered, cross-sectional survey targeted all Syrian physicians and nurses working in RHCs across Turkey. The short-form Minnesota Satisfaction Questionnaire(MSQ) was used to assess job satisfaction. In total, 555 nurse/midwives and 336 physicians responded, yielding a total response rate of 56.5%. Descriptive analyses and linear regression tests were conducted to determine the level of job satisfaction and to analyze determinant factors. Results: Nurses/midwives reported the highest level of general job satisfaction, followed by specialist physicians and general physicians. Physicians who had worked as specialists in Syria but were now working as general physicians in Turkey had the lowest job satisfaction levels. Multiple regression analysis showed that professional status in Turkey, income, teamwork and team management were significantly associated with job satisfaction.Conclusions: To maintain a high level of job satisfaction in refugee healthcare workers, human resources management should consider matching job placements with training specialization and support good leadership and good teamwork. Remuneration that accounts for the cost of living and non-financial incentives could also play a significant role in job satisfaction.