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Background In a therapeutic partnership, physicians rely on patients to describe their health conditions, join in shared decision-making, and engage with supported self-management activities. In shared care, the patient, primary care, and specialist services partner together using agreed processes and outputs for the patient to be placed at the centre of their care. However, few empirical studies have explored physicians' trust in patients and its implications for shared care models. Aim To explore trust in patients amongst general practitioners (GPs), and the impacts of trust on GPs' willingness to engage in new models of care, such as colorectal cancer shared care. Methods GP participants were recruited through professional networks for semi-structured interviews. Transcripts were integrity checked, coded inductively, and themes developed iteratively. Results Twenty-five interviews were analysed. Some GPs view trust as a responsibility of the physician and have a high propensity for trusting patients. For other GPs, trust in patients is developed over successive consultations based on patient characteristics such as honesty, reliability, and proactivity in self-care. GPs were more willing to engage in colorectal cancer shared care with patients with whom they have a developed, trusting relationship. Conclusions Trust plays a significant role in the patient's access to shared care. The implementation of shared care should consider the relational dynamics between the patient and health care providers. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: Continuing medical education is a process of continuous learning to maintain physicians' competence and professional performance. Efforts to make continuing medical education (CME) programs mandatory in the South-East Asia Region by linking credits to the renewal of registration have met with mixed success. However, there are no recent reviews on the CME status in regions with a large number of developing countries. This review aims to map the practices and regulation of the CME activities in the South-East Asia and Eastern Mediterranean regions. Methods: A scoping review was undertaken using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A search was conducted within PubMed, Embase, Web of Science, Scopus databases, and national medical and health council websites. Results: Evidence on the provision of CME is available for all but seven of the 33 countries in both regions. Fourteen countries of varying income levels have implemented mandatory CME linked to the renewal of registration. They have statutory bodies governing CME and allocating credits, with most requiring a large number of hourly based activities for the renewal of registration and evidence of a wide range of local providers. Discussion: Financial resources, a thorough organizational structure and standards, and a wide range of local CME providers seem to promote the implementation of mandatory CME in most of these countries. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students' satisfaction in the Medicine program. Methods: Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach's α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students' overall satisfaction with the program. Results: A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation= 0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the "online resources" factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students' overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students' experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: "being cared for," "satisfaction with teaching," and "satisfaction with assessment" (β=0.327, 0.148, 0.148, respectively; all with P<0.001). Conclusion: MedSEQ has good construct validity and high reliability, reflecting students' satisfaction with the Medicine program. Key factors impacting students' satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery, and fair assessment tasks which enhance learning. [ABSTRACT FROM AUTHOR]

Objective: To assess the knowledge and practice of medical students regarding standard precautions in an Australian undergraduate medical programme. Study Design: Cross sectional study. Place and Duration of Study: University of New South Wales, Australia, duration of study was six-years. Methodology: Fifty medical students who were involved in clinical practice, were invited to complete a comprehensive questionnaire on standard precautions. Results: The majority of participants agreed that hand hygiene was the most important factor in infection control. Only 32 (16%) knew to use a full personal protective equipment for Ebola. Regarding sharps disposal, 46 (92%) students always disposed used needles in the recommended bin, 27 (54%) indicated they sometimes recapped used needle while 25 (20%) sometimes bent used needles. Conclusion: This study showed that there is a gap between knowledge and practice of medical students regarding hand hygiene and other infection control measures. There is a need for standardized and regular student training in the use of standard precautions in infection prevention and control. [ABSTRACT FROM AUTHOR]

Background: Multiple studies have shown that physical activity improves cancer survivorship, by decreasing risk of second primary cancers and chronic conditions. However, cancer survivor physical activity levels remain low. General practice presents more opportunities for lifestyle interventions, such as increasing physical activity. We conducted a realist review of physical activity interventions relevant to general practice., Methods: A total of 9728 studies were obtained from a systematic search of the CINAHL, Embase, PsycINFO, PubMed, and SPORTDiscus databases from the inception of the electronic database to 21 June 2024. We focussed on intervention studies that improved physical activity among cancer survivors and were relevant to general practice. Data extraction focussed on: what makes physical activity interventions effective for cancer survivors (what works) and what factors promote physical activity for cancer survivors (for whom it works)., Results: Thirty-seven studies were used to generate themes on the components of physical activity interventions that are likely to work and for whom; these studies facilitated goal setting, action planning, self-monitoring, social support, and shaping of knowledge; through delivering tailored motivational support, evoking a teachable moment, and promoting the use of self-monitoring tools. Interventions that were cost-effective and easily implementable improved sustainability, deployability, and uptake by cancer survivors. Cancer survivor psychological and physical factors, such as baseline motivational levels and post-treatment symptoms, influenced the uptake of physical activity interventions., Conclusion: Our realist review has highlighted opportunities for general practices to promote physical activity among cancer survivors through collaborative goal setting, action planning, self-monitoring, social support, and shaping of knowledge., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Noncommunicable diseases (NCDs), specifically diabetes and hypertension, are rising in high HIV-burdened countries such as South Africa. How integrated HIV care into primary health care (PHC) influences NCD care is unknown. We aimed to understand whether differences existed in NCD care (pre- versus post-integration) and how changes may relate to HIV patient numbers., Setting: Public sector PHC clinics in Free State, South Africa., Methods: Using a quasiexperimental design, we analyzed monthly administrative data on 4 indicators for diabetes and hypertension (clinic and population levels) during 4 years as HIV integration was implemented in PHC. Data represented 131 PHC clinics with a catchment population of 1.5 million. We used interrupted time series analysis at ±18 and ±30 months from HIV integration in each clinic to identify changes in trends postintegration compared with those in preintegration. We used linear mixed-effect models to study relationships between HIV and NCD indicators., Results: Patients receiving antiretroviral therapy in the 131 PHC clinics studied increased from 1614 (April 2009) to 57, 958 (April 2013). Trends in new diabetes patients on treatment remained unchanged. However, population-level new hypertensives on treatment decreased at ±30 months from integration by 6/100, 000 (SE = 3, P < 0.02) and was associated with the number of new patients with HIV on treatment at the clinics., Conclusions: Our findings suggest that during the implementation of integrated HIV care into PHC clinics, care for hypertensive patients could be compromised. Further research is needed to understand determinants of NCD care in South Africa and other high HIV-burdened settings to ensure patient-centered PHC.

Background: Occupational exposure to ionising radiation poses potential health risks to radiation workers unless adequate protection is in place. The catheterisation laboratory is a highly contextualised workplace with a distinctive organisational and workplace culture., Objective: This study was conducted to understand the culture of radiation protection (CRP)., Methods: This study was a qualitative study and data were collected through 30 in-depth and 6 group interviews with 54 purposively selected South African interventionalists (interventional radiologists and cardiologists). The participants included a diversity of interventionalists who varied in sex, geographic location and years of experience with fluoroscopy. The transcribed data were analysed thematically using a deductive and inductive approach., Results: 'Culture of radiation protection' emerged as a complex theme that intersected with other themes: 'knowledge and awareness of radiation', 'radiation safety practice', 'personal protective equipment (PPE) utilisation' and 'education and training'., Conclusion: Establishing and sustaining a CRP provides an opportunity to mitigate the potentially detrimental health effects of occupational radiation exposure. Education and training are pivotal to establishing a CRP. The time to establish a culture of radiation in the catheterisation laboratory is now., Competing Interests: The authors declare that they have no financial or personal relationship(s) which may have inappropriately influenced them in writing this article., (© 2018. The Authors.)