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JMIR Medical Education Jul 2023Supporting patients to live well by optimizing behavior is a core tenet of primary health care. General practitioners and practice nurses experience barriers in...
BACKGROUND
Supporting patients to live well by optimizing behavior is a core tenet of primary health care. General practitioners and practice nurses experience barriers in providing behavior change interventions to patients for lifestyle behaviors, including low self-efficacy in their ability to enact change. Web-based learning technologies are readily available for general practitioners and practice nurses; however, opportunities to upskill in behavior change are still limited. Understanding what influences general practitioners' and practice nurses' adoption of web-based learning is crucial to enhancing the quality and impact of behavior change interventions in primary health care.
OBJECTIVE
This study aimed to explore general practitioners' and practice nurses' perceptions regarding web-based learning to support patients with behavior change.
METHODS
A qualitative, cross-sectional design was used involving web-based, semistructured interviews with general practitioners and practice nurses in Queensland, Australia. The interviews were recorded and transcribed using the built-in Microsoft Teams transcription software. Inductive coding was used to generate codes from the interview data for thematic analysis.
RESULTS
In total, there were 11 participants in this study, including general practitioners (n=4) and practice nurses (n=7). Three themes emerged from the data analysis: (1) reflecting on the provider of the Healthy Lifestyles suite; (2) valuing the web-based learning content and presentation; and (3) experiencing barriers and facilitators to using the Healthy Lifestyles suite.
CONCLUSIONS
Provider reputation, awareness of availability, resources, content quality, usability, cost, and time influence adoption of web-based learning. Perceived quality is associated with culturally tailored information, resources, a balance of information and interactivity, plain language, user-friendly navigation, appealing visual presentation, communication examples, and simple models. Free web-based learning that features progress saving and module lengths of less than 2 hours alleviate perceived time and cost barriers. Learning providers may benefit by including these features in their future behavior change web-based learning for general practitioners and practice nurses.
PubMed: 37498657
DOI: 10.2196/45587 -
Psychiatria Danubina Oct 2023Mental health problems have become a major topic of public health these last years, particularly since the pandemic of COVID-19. Primary care givers are confronted with... (Review)
Review
BACKGROUND
Mental health problems have become a major topic of public health these last years, particularly since the pandemic of COVID-19. Primary care givers are confronted with high rates of common mental health problems (CMHPs) in population. This questions healthcare organization and specifically collaboration between general practitioners (GPs) and clinical psychologists (CPs). In this paper we aim to review recent literature to identify factors that facilitate or hinder collaboration between GPs and CPs when caring for their patients' CMHPs.
METHODS
A non-systematic qualitative literature review was performed, using the PRISMA method. We restricted the review to papers published between 2010 and 2023.
RESULTS
We identified 52 papers and after filtering, only 6 were included in the synthesis. Six main themes were identified: barriers to interprofessional collaboration, lack of mutual trust, mutual dissatisfaction with information exchanged, the paradox of professional secrecy, the necessity of a paradigm shift, and conceptual frameworks of collaboration. These themes were discussed to improve collaboration between GPs and CPs.
CONCLUSION
This work provides some recommendations to support the development of interprofessional collaboration between GPs and CPs in primary care.
Topics: Humans; General Practitioners; Mental Health; Qualitative Research; Cooperative Behavior; Interprofessional Relations; COVID-19; Primary Health Care; Attitude of Health Personnel
PubMed: 37800246
DOI: No ID Found -
Journal of Plastic, Reconstructive &... Nov 2023The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners...
INTRODUCTION
The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners has been published.
AIM
We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom.
METHODS
We performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies, with extraction of registration number, date of registration and presence or absence from the Specialist Register or General Practitioner Register.
RESULTS
3000 websites were visited and evaluated. 1224 independent clinics with 4405 practitioners were identified. 738 were identified as those in business support functions and the remaining 3667 practitioners were undertaking injectable practice. The profile of professions were doctors 32%, nurses 13%, dentists 24% and dental nurses 8%. Of the 1163 doctors identified 481 were on the specialist register (41%) and 219 were on the GP register (19%). 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%.
CONCLUSION
This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.
Topics: Humans; United Kingdom; England; Physicians; Plastic Surgery Procedures; Cohort Studies
PubMed: 37717299
DOI: 10.1016/j.bjps.2023.06.057 -
BMJ Open Ophthalmology Jan 2024Many children with progressive myopia are still prescribed single-vision correction. An investigation into UK eyecare practitioners' (ECPs) perceptions of myopia...
OBJECTIVE
Many children with progressive myopia are still prescribed single-vision correction. An investigation into UK eyecare practitioners' (ECPs) perceptions of myopia management was carried out to ascertain factors which may be limiting its implementation and uptake within clinical practice.
METHODS AND ANALYSIS
Online focus groups were held with UK ECPs. Participants were encouraged to discuss their knowledge of the available myopia management options, their perception of how myopia management is being delivered in the UK and any barriers limiting ECPs' prescribing of these management options in practice. The discussions were transcribed and analysed thematically.
RESULTS
Focus groups were held with 41 ECPs from primary and secondary eyecare. ECPs felt that provision of myopia management in the UK is variable. Most ECPs believe they have sufficient knowledge, but felt a lack of confidence in decision-making and practical experience. Less experienced ECPs sought more definitive guidance to support their decision-making. ECPs desired clarity on their duty of care obligations and were concerned over possible future litigation if they had not offered, or referred for, myopia management when indicated. The greatest barrier appears to be financial-treatment is expensive and ECPs are uncomfortable communicating this to parents. Many barriers were indicative of systemic problems within UK eyecare, such as commercial pressures, inadequate National Health Service funding and poor public awareness of paediatric eyecare.
CONCLUSION
Myopia management is not implemented consistently across the UK. To improve accessibility, changes are required at multiple levels, from individual ECPs through to wider stakeholders in UK eyecare provision.
Topics: Humans; Child; State Medicine; Attitude; Focus Groups; Myopia, Degenerative; United Kingdom
PubMed: 38216174
DOI: 10.1136/bmjophth-2023-001527 -
Medical Care Research and Review : MCRR Dec 2023Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practitioners... (Review)
Review
Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practitioners (NPs) plays an active role in providing primary care to this patient population. This study identifies the effect of NP primary care models, compared with models without NP involvement, on cost, quality, and service utilization by patients with MCCs. We conducted a literature search of six databases and performed critical appraisal. Fifteen studies met inclusion criteria (years: 2003-2021). Overall, most studies showed reduced or similar costs, equivalent or better quality, and similar or lower rates of emergency department use and hospitalization associated with NP primary care models for patients with MCCs, compared with models without NP involvement. No studies found them associated with worse outcomes. Thus, NP primary care models, compared with models without NP involvement, have similar or positive impacts on MCC patient outcomes.
Topics: Humans; United States; Multiple Chronic Conditions; Hospitalization; Nurse Practitioners; Emergency Service, Hospital; Primary Health Care
PubMed: 37438917
DOI: 10.1177/10775587231186720 -
BMC Nephrology Mar 2024Patients with kidney transplants have a significant co-morbidity index, due to a high number of pre-existing conditions and use of immunosuppression medications. These... (Review)
Review
Patients with kidney transplants have a significant co-morbidity index, due to a high number of pre-existing conditions and use of immunosuppression medications. These patients are at higher risk of developing conditions such as hypertension, dyslipidemia, post-transplant diabetes, cardiovascular events, and anemia. Moreover, they are particularly susceptible to infections such as urinary tract infections or pyelonephritis, cancers, and gastrointestinal complications such as diarrhea, which in turn may be attributed to medication adverse effects or infectious causes. Along with these concerns, meticulous management of electrolytes and allograft function is essential. Prior to prescribing any new medications, it is imperative to exercise caution in identifying potential interactions with immunosuppression drugs. This review aims to equip primary care practitioners to address these complex issues and appropriate methods of delivering care to this rapidly growing highly susceptible group.
Topics: Humans; Kidney Transplantation; Diabetes Mellitus; Transplantation, Homologous; Hypertension; Primary Health Care; Transplant Recipients
PubMed: 38500081
DOI: 10.1186/s12882-024-03504-2 -
Nutrients Aug 2023Long COVID is a recognized post-viral syndrome characterized by neurological, somatic and neuropsychiatric symptoms that might last for long time after SARS-CoV-2...
What Is the Role of Palmitoylethanolamide Co-Ultramicronized with Luteolin on the Symptomatology Reported by Patients Suffering from Long COVID? A Retrospective Analysis Performed by a Group of General Practitioners in a Real-Life Setting.
Long COVID is a recognized post-viral syndrome characterized by neurological, somatic and neuropsychiatric symptoms that might last for long time after SARS-CoV-2 infection. An ever-growing number of patients come to the observation of General Practitioners complaining of mild or moderate symptoms after the resolution of the acute infection. Nine General Practitioners from the Rome area (Italy) performed a retrospective analysis in order to evaluate the role of the supplementation with Palmitoylethanolamide co-ultramicronized with Luteolin (PEALUT) on neurologic and clinical symptoms reported by their patients after COVID-19 resolution. Supplementation with PEALUT helped to improve all patient-reported symptoms, especially pain, anxiety and depression, fatigue, brain fog, anosmia and dysgeusia, leading to an overall improvement in patients' health status. To our knowledge these are the first data presented on Long COVID patients collected in a territorial setting. Despite their preliminary nature, these results highlight the pathogenetic role of "non-resolving" neuroinflammation in Long COVID development and consequently the importance of its control in the resolution of the pathology and put the focus on the General Practitioner as the primary figure for early detection and management of Long COVID syndrome in a real-life setting. Future randomized, controlled, perspective clinical trials are needed to confirm this preliminary observation.
Topics: Humans; Post-Acute COVID-19 Syndrome; Luteolin; COVID-19; General Practitioners; Retrospective Studies; SARS-CoV-2
PubMed: 37686733
DOI: 10.3390/nu15173701 -
Pathways to Developing Clinical Pharmacist Practitioners: Is There a Better Way Forward? (Path-CPP).The Canadian Journal of Hospital... 2023Clinical Pharmacist Practitioners (CPPs) are independent care providers who practise to their full scope and have a positive impact on the quality of patient care....
BACKGROUND
Clinical Pharmacist Practitioners (CPPs) are independent care providers who practise to their full scope and have a positive impact on the quality of patient care. Ideally, all pharmacists in Canada would perform at this level. However, there is significant diversity in pharmacy practice across the country and among practice settings. It would be valuable to better understand how pharmacists attain CPP-level practice and what strategies might enable more pharmacists to practise at this level.
OBJECTIVES
To understand the perceptions of current CPPs and stakeholders in the health care system regarding the status of the CPP role in Canada and to propose pathways that would facilitate the attainment and recognition of CPP-level practice.
METHODS
A qualitative study was conducted using semistructured interviews of peer-nominated CPPs and health care system stakeholders. Interviews were recorded, transcribed, and then analyzed using thematic analysis.
RESULTS
Interviews involving 13 CPPs and 6 health care system stakeholders, conducted between March and July 2020, yielded 3 theme categories related to CPP roles, each containing subthemes, and 3 distinct themes relating to pathways forward. The 3 pathway themes were the following: that a legislative solution for expanded pharmacist scope is needed, that a new degree program is not required for pharmacy in Canada, and that a unified national credential signifying high-level practice might allow for better recognition of CPPs.
CONCLUSIONS
The full potential of pharmacists practising with advanced scope of practice in Canada has yet to be realized. Although significant external challenges exist, pharmacists must reframe the narrative by clearly articulating and defining their role within the Canadian health care system to increase CPP-level practice.
PubMed: 37767392
DOI: 10.4212/cjhp.3384 -
Journal of Global Health Jan 2024Gender mainstreaming has been central to the development agenda for advancing gender equality globally for nearly three decades. We examined key learning across gender... (Review)
Review
BACKGROUND
Gender mainstreaming has been central to the development agenda for advancing gender equality globally for nearly three decades. We examined key learning across gender mainstreaming models and experiences and assess key successes and challenges in actualising gender mainstreaming's transformative potential, in order to inform future research agendas.
METHODS
We reviewed 27 years of peer-reviewed literature on gender mainstreaming (1995-2022) and described scholarly publishing trends on the topic based on a set of 528 articles and bibliographic data retrieved from the Scopus database and supplemental coding. The review provides a thematic synthesis of the extant literature, assessing the evidence base to identify gaps and opportunities for future research and collaboration with practitioners. We also contextualise recent research by tracing common threads of scholarly and practitioner discussions over the last two decades.
RESULTS
Publications on gender mainstreaming have increased, primarily from authors with European and USA academic affiliations and funding. Gender mainstreaming in the health and law and policy sectors has been researched most frequently. Trends in co-authorship suggest increasing collaboration among academics, yet limited collaboration among researchers and practitioners. Widespread low citation counts raise concerns about engagement with the literature. Key challenges in gender mainstreaming identified include conceptual clarity, academic-practitioner disjunctures, politics, leadership and organisational culture, men's roles, intersectionality, monitoring and evaluation, and public health sectoral concerns.
CONCLUSIONS
The gender mainstreaming literature has expanded considerably over the last 25 years, yet there remain critical knowledge gaps, theoretical inconsistencies, weak research methods and evaluation processes, and implementation challenges. Funders, researchers, and practitioners have failed to prioritise bridging north-south and academic-practitioner divides in gender mainstreaming policy, programmes, and research. Integration of intersectionality also remains nascent. A more inclusive, collaborative, and structured research agenda on gender mainstreaming is needed to effect greater change in the face of persistent and new challenges. Engaging and empowering regional women's organisations, collaborative learning and research programmes, and joint research and advocacy groups; implementing gender-attuned editorial policies; and incorporating gender mainstreaming in educational curricula are recommended.
Topics: Male; Humans; Female; Sex Factors; Health Policy; Curriculum; Public Health; Bibliometrics
PubMed: 38275086
DOI: 10.7189/jogh.14.04011 -
Journal of Athletic Training Aug 2023Hamstring strain injuries (HSIs) are the most frequently sustained injury in Major League Baseball (MLB). However, the beliefs and practices of MLB practitioners...
CONTEXT
Hamstring strain injuries (HSIs) are the most frequently sustained injury in Major League Baseball (MLB). However, the beliefs and practices of MLB practitioners regarding HSI risk factors and prevention strategies in baseball athletes, have not been documented.
OBJECTIVE
To document the current beliefs and practices of MLB practitioners in relation to HSI prevention.
DESIGN
cross-sectional study.
SETTING
Major League Baseball via an online survey.
PARTICIPANTS
Athletic trainers, physical therapists and strength and conditioning coaches employed in MLB during the 2021 season.
DATA COLLECTION AND ANALYSIS
An online survey was conducted with participants completing the survey once. Questions pertained to risk factor identification, the use and perceived effectiveness of preventative strategies, and barriers to implementation. Descriptive statistics were calculated for each question.
RESULTS
91 responses were received featuring respondents from 28 of 30 MLB organizations. The perceived most important intrinsic risk factor for first-time HSI was tolerance to high-speed running and previous HSI for recurrent injury. The perceived most important extrinsic risk factor for both first-time and recurrent HSI was internal communication between staff.The perceived most effective prevention strategies were managing overall workload, exposure to high-speed running, and periodization. The most used prevention strategies were core/lumbopelvic strengthening, resistance training and workload management.Approximately half (53%) of respondents reported barriers to effective implementation of HSI prevention strategies, including player and coach buy-in, compliance, training time constraints, and in-season scheduling/reduced recovery time.
CONCLUSIONS
This was the first survey to investigate MLB practitioner beliefs and practices regarding HSI prevention. Responses from practitioners regarding their beliefs about risk factors and appropriate prevention strategies were varied, and discrepancies existed between the perceived most effective strategies and those most frequently employed.
PubMed: 37647238
DOI: 10.4085/1062-6050-0640.22