Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis

Background: Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. Methods: PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. Results: Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. Conclusion: Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.

A Financial Social Work Certificate Program for Community and Family Practitioners

A Financial Social Work Certificate program launched, responding to a need for greater financial knowledge and skill development among social workers. Community leaders who were alumni of a social work school partnered with educators and researchers to plan and organize an intensive 7-day training over the course of 7 months, through the School’s Office of Continuing Professional Education. Content focused on understanding personal finance, learning about interventions to address clients’ financial needs, exploring critical and emerging macro issues, and focusing on how these dovetail with clinical practice. Preliminary results on financial social work self-efficacy indicate greater self-efficacy over three evaluation time points. Next steps will include a more robust evaluation and fostering a network of engaged graduates.

Dermatologie Pediatrică

This must-have clinical reference, by Prof. Anca Chiriac from University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine- PhD Student, Iasi, Romania, provides practical, authoritative guidance for identification and management of all types of skin disorders seen in children and adolescents. Dermatologie Pediatrică, 1st Edition, is ideal for pediatricians, dermatologists, family practitioners and anyone who sees children with skin disorders – no matter what level of experience you may have.

Aspects of classification and diagnostic search for transient and persistent facial erythema

Розацеа – одно из наиболее частых заболеваний кожи лица. Клиническая картина розацеа характеризуется покраснением центральных частей лица, приливами, телеангиэктазиями, реже папулами и пустулами, фиматозными проявлениями. С покраснением кожи лица сталкиваются дерматологи, аллергологи, терапевты, семейные врачи. В типичных случаях диагностика розацеа не вызывает затруднений, однако покраснением кожи лица и приливами может сопровождаться множество заболеваний, как доброкачественных, так и злокачественных. Большинство случаев вызваны очень распространенными доброкачественными заболеваниями, такими как розацеа, которые легко диагностируются после тщательного сбора анамнеза и осмотра. Однако в некоторых случаях точный диагноз требует дальнейших лабораторных, радиологических или гистопатологических исследований. Например, карциноидный синдром, феохромоцитому, системный мастоцитоз, дерматомиозит, системную красную волчанку, анафилаксию необходимо исключить лабораторными исследованиями. В статье приведены основные заболевания, которые необходимо учитывать при диагностике транзиторной или постоянной эритемы при розацеа. Rosacea is one of the most common conditions on the face. Rosacea affecting the central parts of the face and is characterized by erythema, flushing, telangiectasia; papules and pustules. Cutaneous flushing – a common presenting complaint to dermatologists, allergists, internists, and family practitioners. Diagnosis typical cases of rosacea is not difficult, but many diseases, both benign and malignant, can be associated with facial flushing and erythema. Most cases are caused by very common, benign diseases, such as rosacea, that are readily apparent after a thorough taking of history and physical examination. However, in some cases, accurate diagnosis requires further laboratory, radiologic, or histopathologic studies. In particular, the serious diagnoses of carcinoid syndrome, pheochromocytoma, mastocytosis, systemic lupus erythematosus, dermatomyositisand anaphylaxis need to be excluded by laboratory studies. In the article, we present main diseases that dermatologysts should consider when diagnosing rosacea.

What Do Those Cohabiting Believe about Relationship Social Support and Premarital Counseling? A Comparative Analysis

Relationship researchers have long studied factors that boost or detract from relationship success. Social support and premarital counseling are factors that have been shown to boost relationship satisfaction and relationship success. However, little is known about how relationship status may influence attitudes toward social support and premarital counseling. Using a human ecology lens, this study explores the relationship between relationship status and attitudes toward social support and premarital counseling from a sample of 385 individuals. Implications for family practitioners and future researchers are provided based on study results.

COVID-19: Can early home treatment with Azithromycin alone or with Zinc help prevent hospitalisation, death, and long-COVID-19? A review

IntroductionThe effects of the SARS-CoV-2 pandemic continues to disrupt health systems worldwide, leading to population lockdowns in many countries. Preventing hospitalisation, death and long-COVID-19 with repurposed drugs remains a priority. Hydroxychloroquine (HCQ) and azithromycin (AZM) are the most commonly used in ambulatory care, with divergent results. With the aim of decentralizing early treatment to family practitioners, we addressed the question: Can early home treatment with AZM alone or with zinc help prevent hospitalisation, death, and long-COVID-19?MethodologyWe conducted a scoping review of articles published from 31st December 2019 to 5th November 2020 in Pubmed, Google Scholar, MedRxiv, and BioRxiv databases, and a review of undergoing clinical trials published in the Clinicaltrial.gov database.ResultsMany studies report on outpatient treatment with a combination of AZM + HCQ versus AZM alone, and few studies propose the addition of Zinc (Zn) to AZM. In addition, we identified 5 clinical trials currently recruiting individuals for early outpatient treatment with AZM. However, we failed in identifying any study or clinical trial conducted with family practitioners responding to our question.DiscussionThe antiviral, anti-inflammatory, immunomodulatory benefits of AZM + Zn make this drugs combination a good candidate therapy to treat flu-like-COVID-19 and atypical pneumoniae. The antibacterial action of AZM can also help disrupting the bacteria/virus cooperation that is poorly documented. Considering pros and cons of macrolide use (including antimicrobial resistance), we call for early use of this therapy by family practitioners for home treatment of individuals presenting mild or moderate symptoms under rigorous scientific guidance to prevent hospitalisation, death and long-COVID.

RECOMMENDATIONS ON COPD AND FAMILY PRACTITIONERS: WHAT IS THE LEVEL OF ADHERENCE?

Y. M. Mostovoy, T. V. Konstantinovych, O. R. Lindiuk, O. V. Bugaichuk Abstract Majority of COPD patients should receive medical care provided by family practitioners. Only the cases of severe, uncontrolled diseases must be managed by pulmonologists. That is why family practitioners must be well informed on actual requirements on diagnosis and treatment of COPD in order to give effective care to this population of patients. Following the aim to study quality of medical care, provided to COPD patients by family practitioners, we analyzed 220 out-patient records (95 men (43,2 %), 125 women (56,8 %); mean age 69 years). Analyzing medical records the attention was mainly focused at two issues — accuracy of diagnosis formulation and correctness of treatment prescription. It was revealed that the clinical group of disease was not mentioned in 107 (48,6 %) patients. This made impossible to prescribe maintenance treatment correctly. Long-acting anticholinergic drugs and it combinations were prescribed unreasonably rarely (11 (5 %) vs needed 97 (44,1 %) cases). On the contrary, short-acting bronchodilators (salbutamol, berodual monotherapy) and inhaled corticosteroid/long-acting beta 2 agonist combination were used in 51 (23,2 %) and 50 (22,7 %) cases, respectively. Among them 48 (48,9 %) patients required hospitalization, use of antibiotics and systemic corticosteroids. This is mainly explained by incorrect use of maintenance therapy for COPD. The authors conclude about low adherence of family practitioners to state and international COPD guidelines. Further work is needed to increase the knowledge of physician regarding COPD diagnosis and treatment along with active consultancy of out-patient facilities by the pulmonologists.

Qualitative Needs Assessment for the Development of Chronic Pain Group Medical Visits

Group medical visits (GMVs) for patients with chronic pain are becoming more accessible and have been shown to be successful in furthering patient education on multidisciplinary, nonopioid interventions. Unfortunately, evidence suggests that many group visit models lack sustainability due to recruitment issues and retention rates. Additionally, most of the studies surrounding GMVs are located in primarily urban health centers, potentially limiting their generalizability. This study aims to identify patient interest in and barriers to GMVs for chronic pain and to explore how chronic pain impacts daily lives for GMV content optimization in a nonurban population. Nineteen participants age 18 to 65 years participated in semistructured phone interviews to generate a thematic analysis. Participants received their care from family practitioners at a suburban multiclinic academic medical group and were being prescribed at least 50 morphine milligram equivalents (MME) at the time of recruitment. Analysis generated two themes: (1) Participants expressed specific interest in GMVs with few barriers identified, and (2) Pain has a negative impact on mental health and most aspects daily life, creating a foundation for discussion in GMVs. Findings support significant patient interest in group medical visits for chronic pain, but careful planning is necessary to address patient needs, expectations, and barriers in order to ensure GMV sustainability.