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Abstract Background The professional dental cleaning (PDC) is an effective supplement that can make up for the lack of self-oral health care. Everyone should develop the habit of regular PDC. This study aimed to investigate the knowledge, behaviors and medical compliance of dentists, medical doctors and non-medical staffs about the PDC, identify the gaps, and provide information to help individuals develop healthy oral hygiene habit. Materials and methods A web-based survey with 21 questions designed based on the characteristics, the PDC knowledge, behaviors, and medical compliance of respondents. A cross-sectional study was conducted in the main districts of Chongqing, China, in the period of September–November 2020. A total of 456 respondents including 153 dentists, 137 medical doctors and 166 non-medical staffs in 3 communities and 4 hospitals were sampled online with multistage sampling and surveyed. The data was analyzed by chi-square test using IBM SPSS Statistics v. 21.0. Results The cognitive level and behavior of dentists on the PDC was significantly better than that of medical doctors and non-medical staffs (p = 0.000–0.044). The rates of not knowing “dental plaque” were 32.85% and 61.45%, of the medical doctors and non-medical staffs. Meanwhile, most of them had misunderstanding about effects of the PDC. They thought it would whiten teeth (72.99%, 80.72%), damage gums (16.79%, 19.88%) and teeth (15.33%, 21.69%), and create bigger gaps between teeth (24.82%, 33.13%). In terms of gum health and the PDC behavior, significant differences were observed, 23.53% of dentists experienced irritated gum bleeding in the last 12 months, 42.28% did not have their teeth cleaned professionally in the last 12 months, even 7.84% never had it before. Compared with it, in the same situation, the ratios of medical doctors and non-medical staffs were about 60% experiencing irritated gum bleeding, 69.34% and 77.71% not experiencing the PDC in the last 12 months, up to 33.58% and 45.18% never experienced it before. 41 respondents (8.99%) disagreed with the reasonable and necessary medical behaviors before the PDC. Conclusion People's understanding about the PDC was insufficient, and many people, included some dentists, had not developed the habit of regular dental cleaning. Our study provided a new understanding of the PDC among dentists, medical doctors, and non-medical staffs, which may help to improve their awareness and behavior of oral hygiene health, and establish the multidisciplinary collaborations between dentists and medical doctors.

Career fulfilment among medical doctors is crucial for job satisfaction, retention, and healthcare quality, especially in developing nations with challenging healthcare systems. Traditional career guidance methods struggle to address the complexities of career fulfilment. While recent advancements in machine learning, particularly Artificial Neural Network (ANN) models, offer promising solutions for personalized career predictions, their applicability, interpretability, and impact remain challenging. This study explores the applicability, explainability, and implications of ANN models in predicting career fulfillment among medical doctors in developing nations, considering socio-economic, psychological, and professional factors. Box plots visualized data distribution, while Heatmaps assessed data intensity and relationships. Matthew's correlation coefficient and Taylor's chart were used to evaluate model performance. Input feature contributions to ANN predictions were analyzed using permutation importance, SHAP, LIME, and Williams plots. The model was tested on a dataset tailored to medical professionals in Nigeria and China, with evaluation metrics including Mean Absolute Error, Mean Squared Error, Root Mean Squared Error, and R2 Score. The ANN model demonstrates strong predictive accuracy, capturing relationships between input factors and outcomes. For Chinese doctors, it achieved an MSE of 0.0004 and R2 of 0.9994, while for Nigerian doctors, it recorded an MSE of 0.0003 and R2 of 0.9998. Key factors for Chinese doctors' satisfaction were IF1 and IF2, while EF1 and EF3 were crucial in preventing dissatisfaction. For Nigerian doctors, IF2 and IF3 drove satisfaction, while EF1 and EF4 were significant in avoiding dissatisfaction. The results highlights the ANN model's effectiveness in predicting career fulfillment among medical doctors in developing nations, offering a valuable tool for career guidance, policymaking, and improving job satisfaction, retention, and healthcare quality. • High-precision ANN: a breakthrough in modelling complex career satisfaction dynamics. • Transparent ANN predictions achieved through multiple XAI techniques. • ANN model shows exceptional predictive performance with high accuracy: MSE <0.0005, R2 > 0.9994 for both groups. • Cross-national study reveals unique predictors of job satisfaction and dissatisfaction among doctors. • Findings support targeted career guidance and healthcare policy improvements. [ABSTRACT FROM AUTHOR]

Work-related skin conditions, including work-related irritant and allergic contact dermatitis, rank as the second most prevalent among work-related diseases. The most commonly reported manifestation of these conditions is hand eczema, which develops due to exposure to various substances in the workplace. Understanding the origins and triggers of eczema and contact dermatitis enables healthcare professionals to educate themselves and their patients about effective preventive measures, such as avoiding specific irritants and allergens, using protective equipment, and maintaining proper skincare hygiene. Additionally, this knowledge facilitates the development of new recommendations to enhance skin protection in work-related settings, regulate the use of substances known to cause work-related skin diseases, and provide healthcare practitioners with the necessary training to recognize and manage these conditions. Given that approximately one in every five healthcare workers is considered to have hand eczema, the objective of this study was to review the existing literature regarding the characteristics of eczema in healthcare workers. Furthermore, this study aimed to comprehensively investigate environmental and constitutional factors (including years of work experience involving exposure to skin hazards, frequent glove use, regular handwashing and water contact, frequent use of disinfectants and detergents, and a history of previous allergies and atopic dermatitis) that influence the occurrence and progression of eczema.

Introduction: high blood pressure is a health problem in the Mexican population, there are social determinants that condition its development, so it is important that the doctor controls high blood pressure based on an adequate assessment, examination and clinical history; as well as proper use and management of clinical practice guidelines. Objective: to know in greater detail the characteristics of health professionals who could influence the control of hypertension. Material and methods: a descriptive study was carried out, the study population was the doctors of a health center in Mexico City, a 26-item questionnaire with closed and open questions was applied, through an in-depth interview directly. divided into 4 sections: i) identification and demographic factors; ii) academic training; iii) information sources and iv) prescription criteria. Results: with regard to hypertension, the age of the doctors appears to be a determining factor in its control: the degree of control can vary up to almost three times more depending on the age of these doctors, the influence of the number of patients seen would be less. However, deficiencies associated with age, such as lack of updating, could be compensated with specific training interventions by health administrations; alternatively, or complementary, clinical sessions and case discussion among colleagues could play a crucial role in this regard. Conclusions: the age of the doctors appears as a determinant in the control of arterial hypertension. [ABSTRACT FROM AUTHOR]

Medical specialists' lifelong learning is essential for improving patients' health. This study identifies affordances for learning general practitioners (GPs) engage in, and explores what influences engagement in those affordances. Eleven GPs were interviewed and the interview transcripts were analysed thematically. Stephen Billett's theoretical framework of workplace participatory practices was used as an analytical lens to explore the topic. Challenging patient cases were identified as the main trigger for engagement in learning. Local, national and international colleagues from the same and other specialties, were found to be an important affordance for learning, as was written material such as websites, journals and recommendations. Other inputs for learning were conferences and courses. Workplace aspects that were essential for GPs to engage in learning related to: place and time to talk, relevance to work, opportunity for different roles, organisation of work and workload, and working climate. Importantly, the study identifies a need for a holistic approach to lifelong learning, including spontaneous and structured opportunities for interaction over time with colleagues, establishment of incentives and arenas for exchange linked to peer learning, and acknowledgement of the workplace as an important place for learning and sufficient time with patients. This study contributes with a deepened understanding of how GPs navigate existing affordances for learning both within and outside their workplaces. [ABSTRACT FROM AUTHOR]

The evolution of medicine and technologies applied to medical knowledge has made it possible to extend patients' life expectancy by changing the prognosis of certain pathologies and often transforming their outcome. This has made it possible not only to keep a patient alive after acute events (e.g. cerebrovascular accidents, critical conditions linked to major traumas or road accidents) but also to 'chronicise' certain pathologies. These reflections are within the grasp of health professionals, legal scholars, politicians and ordinary citizens. This study aims to explore health professionals knowledge on terms pertaining to "end of life", that are often used improperly and interchangeably. It also offers an overview of the degree of knowledge and attitudes of health professionals and students of Medicine and Surgery and of the classes of the health professions, through a cognitive survey carried out by means of a digitalized survey on a Google platform administered by e-mail through the Order of Surgeons and Dentists of Salerno, Naples and Caserta, the Professional Order of Nurses of Naples and the student associations. The results point to the need for end-of-life organic legislation and for the implementation of training and continuing education programmes. It is desirable for the widest possible sample to take part in the survey in order to obtain more meaningful statistical information., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The migration of health workers remains one of the most pressing challenges facing many countries in the global South. This short communication seeks to reignite debate on the effectiveness of the World Health Organisation (WHO) Code as a tool for managing the migration of health workers from the South. While the WHO Code was somewhat effective in reducing the migration of health workers from countries such as Zimbabwe during the first five years of its implementation, demand for health workers in the UK after Brexit and the COVID-19 pandemic has accelerated the rate of migration of health workers from countries facing critical shortages. Clearly, new solutions are needed that strike a balance between the right of health workers in the South to migrate and the right of citizens in the region to a stable supply of health workers., (© 2024 The Author(s). The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Purpose – This paper aims to assess the tie-in between psychological contract breach (PCB) and job satisfaction (JST) amongst medical doctors (MDs) working in two stress-prone regions of Ghana, and further analyses the moderating effect of openness to experience (OPE) on this tie-in. Design/methodology/approach – Responses from 214 MDs were analysed. Questionnaires were self-administered. Research philosophy was positivism, research approach was quantitative, research design was explanatory and study design was cross-sectional. Test of normality, Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett’s test of sphericity were applied. Both reflective measurement and structural models were assessed. Path coefficients were analysed using partial least squares (PLS) algorithm tool and moderation effect was conducted using the product indicator approach. Control variables were sex (GEN1), age (GEN2), employment type (GEN3) and tenure (GEN1). A significant level was set at 5%. Smart PLS 2.0 M.3 software was used. Findings – The analysts found support for a significant moderating effect of OPE on the tie between PCB and JST, such that the consequences of PCB on JST was minimised for MDs who scored high on OPE trait. Practical implications – PCB, if not addressed, may lead MDs to be less satisfied with their jobs. In stress-prone health zones where PCB exists, MDs who are inspired, creative, self-sufficient, experimenting and visionary are more likely to be satisfied with their job. Originality/value – This study offers health-care literature on the moderating role of OPE personality dimension on the bond between PCB and JST, using PLS-structural equations modelling, which is a superior and robust analytical tool.

Extant studies in service-dominant (SD) logic put emphasis on the need to develop mid-range theories to bridge the gap between theoretical abstraction and empirical findings. While institutions are integral to midrange-theoretical advancement, little is known about how organisations deal with it. Additionally, present research in medical tourism has been focusing on private hospitals leaving the role of medical doctors with less attention. In view of the gap, this article briefly states the institutional types that constrain value co-creation in Malaysian medical tourism. Subsequently, the institutional work for medical doctors as derived from the expectations of other stakeholders is given a thorough discussions. Thus, two direct observations were held and a total of 13 semi-structured interviews were conducted with private hospitals, medical doctors, government section, and medical tourism facilitators. Interpretive analysis was done with the assistance of ATLAS.ti. Hence, the study derived seven institutions and the specific institutional work describing how medical doctors can improve their communication and collaboration with service providers and health travellers. This paper contributes to bridging the gaps in the mid-range theory of institutions by focusing on communication and collaboration. Additionally, medical doctors could improve their service exchange with other stakeholders through the suggested institutional work provided. Considering their integral role in treating patients, this article is important for service providers in crafting their strategies to optimise their service offerings.

Abstract Background Infections due to resistant bacteria are associated with severe illness, increased risk for complications, hospital admissions, and higher mortality. Inappropriate use of antibiotics, which contributes to increased antibiotic resistance (ABR), is common in healthcare settings across the globe. In Cameroon, antibiotics have been reported as high as 45–70% of prescriptions. We sought to investigate the knowledge, attitudes, and perceptions regarding appropriate antibiotic use and ABR of medical doctors practicing in tertiary hospitals in Yaoundé, Cameroon. Methods We conducted a cross-sectional survey using a 54-item self-administered questionnaire sent via email to medical doctors working in the four major tertiary hospitals of Yaoundé. The questionnaire recorded socio-demographics, perceptions on antibiotic use and ABR, sources and usefulness of education on ABR, and clinical scenarios to appraise knowledge. Results A total of 98/206 (48%) doctors responded. Years of experience ranged between 1 and 17 years. Most participants agreed that ABR is a problem nationwide (93%) and antibiotics are overused (96%), but only one third (32%) thought that ABR was a problem in their wards. Most respondents (65%) were confident that they use antibiotics appropriately. We found a mean knowledge score of 56% (± 14), with prescribers not influenced by patient-exerted pressure for antibiotic prescribing scoring better compared to those influenced by patients (67% vs 53%, p = 0.01). Overall, most participants (99%) expressed interest for further education on both appropriate antibiotic use and ABR. Conclusion Confidence of prescribers in their ability to appropriately use antibiotics conflicts with the low level of knowledge on antibiotic use in this group of doctors. Moreover, the opinion of the majority, that ABR is not a problem in their own backyard is in keeping with similar studies in other countries and is of significant concern. Introduction of formal antibiotic stewardship programmes in Cameroon may be a useful intervention.

The aim of the research was to explore experiences of a Positive Psychology 2.0 (PP2.0) intervention for burnout among Generation Y medical doctors working in a South African public hospital. The emphasis was on the potential benefits and recommended intervention amendments in a specific cultural context of South Africa. A phenomenological approach was followed in the collective case study. The Maslach Burnout Inventory was administered in phases I and III to quantify the level of burnout. This study offers findings that could be incorporated into a bigger burnout intervention strategy in the South African public hospital, involving all stakeholders to ensure that burnout is combatted on a long-term basis. Furthermore, the findings emphasized certain culture-specific structural issues and the impact that the neglection of burnout has on newly qualified medical doctors working in a South African public hospital and patients in their care. Certain recommendations were made for the South African public hospital for future research in PP2.0 interventions and for facilitators working with burnout among newly qualified medical doctors.

Background: Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors' clinical practices concerning the promotion of patients' physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors' physical activity level and sedentary behaviours. Methods: A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors' attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables. Results: A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients' physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p < 0.001): working in primary healthcare settings (p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients' physical activity promotion in healthcare settings (p < 0.001), being approached by patients to address physical activity (p < 0.001), and having higher levels of physical activity (p = 0.001). Conclusions: The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors' own physical activity levels. [ABSTRACT FROM AUTHOR]

Introduction: Considering the geopolitical changes in the six Western Balkan countries—Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia—over the last three decades, particularly as it concerns the progress and changes in the healthcare systems, we argue that there is a need for a detailed analysis of people's trust in those healthcare systems and healthcare providers. Methods: In this cross‐sectional, intercountry study, we examine the trust trends of Western Balkans citizens in medical doctors and public and private healthcare institutions from 25 July 2021 to 30 October 2021, with 3789 participants using a self‐reported questionnaire, and Google Forms. Snowball sampling is used to collect data from six Western Balkans countries: Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia. Findings: The primary findings of our study show that citizens in the Western Balkans have a low level of trust in their healthcare system (X̄ = 4.3/10). Medical doctors working in private healthcare institutions, on the other hand, are afforded a higher level of trust (X̄ = 6.6/10) than those working in public healthcare institutions (X̄ = 5.7/10). In the event that they or their family members need to visit a health institution, half of the study participants would choose private healthcare institutions over public ones. We found a statistically significant difference between countries on the mean points from the questions concerning one's trust in the healthcare system, private healthcare institutions and medical doctors working in public and private sectors (p <.05). Conclusion: Despite its limitations, this study is the first cross‐sectional research on the 'trust interface' among western Balkan citizens, revealing that they have low trust in their healthcare systems. Public Contribution: The information in this manuscript was gathered on the level of 3789 citizens from six Western Balkan countries. Before we began collecting data, we conducted a piloting procedure with 40 citizens who were clients of health institutions to validate the data collection questionnaire. [ABSTRACT FROM AUTHOR]

Background: Healthcare students that refuse to get vaccinated may expose themselves and their patients to several vaccine-preventable diseases, especially during outbreaks or at peak epidemic activity, becoming a threat to themselves and their patients. This study aimed to assess their attitudes towards and perception of vaccines and vaccination. Methods: An anonymous questionnaire was shared with medical students, pharmacy students and medical residents in Hygiene and Preventive Medicine at the University of Florence (Italy), in February 2021. The questionnaire contained 39 questions with open, multi-choice, yes–no, Likert scale answers. A Vaccine Hesitancy Index (VHI) was then calculated. A descriptive statistical analysis was performed. Results: A total of 473 students participated in this study. All students were in favour of vaccination (99.2%) but a relatively low number of participants judged their level of knowledge about vaccinations as "good" (21.8%) or "excellent" (0.6%). About half of students declared that they are not adequately trained during their academic courses. The VHI showed low levels of vaccine hesitancy (mean ± SD 0.38 ± 0.16); moreover, the students were willing to get vaccinated against SARS-CoV-2 when recommended (88.2%) and thought that these vaccines are generally safe. Few students considered the development of SARS-CoV-2 vaccines (13.1%) and the procedures for evaluating clinical trials for marketing authorisation of these vaccines (12.9%) too fast to guarantee their efficacy and safety. Conclusions: Since vaccination and vaccine hesitancy and acceptance topics are being paid increasing attention by the population, new strategies to increase future healthcare professionals' willingness to promote vaccination and get vaccinated, as well as knowledge on vaccines and vaccination, will be of the utmost importance to fight vaccine preventable diseases. [ABSTRACT FROM AUTHOR]

Background: Dyspnea is common in patients with advanced cancer. Diagnostic procedures in patients with dyspnea are mandatory but often time-consuming and hamper rapid treatment of the underlying refractory symptoms. Opioids are the first-line drugs for the treatment of refractory dyspnea in palliative care patients with advanced lung cancer.Methods: To evaluate the knowledge levels of medical doctors with different educational levels on the diagnosis of and treatment options for dyspnea in patients with advanced lung cancer in a palliative care setting, a case report and survey were distributed to physicians at the University Hospital Krems, describing acute dyspnea in a 64-year-old stage IV lung cancer patient. A total of 18 diagnostic and 22 therapeutic options were included in the survey. The physicians were asked to suggest and rank in order of preference their diagnosis and treatment options. Statistical analyses of the data were performed, including comparison of the responses of the senior doctors and the physicians in training.Results: A total of 106 surveys were completed. The respondents were 82 senior physicians and 24 physicians in training (response rates of 86% and 80%, respectively). Regarding diagnostic investigations, inspection and reading the patient's chart were the most important diagnostic tools chosen by the respondents. The choices of performing blood gas analysis (p = 0.01) and measurement of oxygen saturation (p = 0.048) revealed a significant difference between the groups, both investigations performed more frequently by the physicians in training. As for non-pharmacological treatment options, providing psychological support was one of the most relevant options selected. A significant difference was seen in choosing the option of improving a patient's position in relation to level of training (65.9% senior physicians vs. 30.4% physicians in training, p = 0.04). Regarding pharmacological treatment options, oxygen application was the most chosen approach. The second most frequent drug chosen was a ß-2 agonist. Only 9.8% of the senior physicians and 8.7% of the physicians in training suggested oral opioids as a treatment option, whereas intravenous opioids were suggested by 43.9% of the senior physicians and 21.7% of the physicians in training (p = 0.089). For subcutaneous application of opioids, the percentage of usage was significantly higher for the physicians in training than for the senior physicians (78.3% vs. 48.8%, p = 0.017, respectively).Conclusion: The gold standard treatment for treating refractory dyspnea in patients with advanced lung cancer is opioids. Nevertheless, this pharmacological treatment option was not ranked as the most important. Discussing hypothetical cases of patients with advanced lung cancer and refractory dyspnea with experienced doctors as well as doctors at the beginning of their training may help improve symptom control for these patients. [ABSTRACT FROM AUTHOR]

Aim: To explore and describe critical challenges in current dementia care practice as perceived by healthcare professionals (HCPs) in old age homes (OAHs) in Kathmandu, Nepal. Background: In Nepal, the number of older people with dementia is rapidly rising, and there is a need for knowledge of how to provide quality dementia care in OAHs. Methods: An exploratory hermeneutic design, employing qualitative interviews with eleven HCPs caring for residents with dementia in a total of five OAHs. Findings: The analysis showed that HCPs found limited educational training in dementia‐specific care to be a critical challenge leading to reduced quality in caregiving practice. Insufficient HCP competence in dementia‐specific care undermined adequate coping with residents' cognitive disturbances and the behavioural and psychological symptoms in dementia (BPSD). Poor HCP/medical doctor (MD)‐to‐patient ratio was perceived as a critical challenge preventing proper diagnostic examination, treatment and dementia‐specific care practice. Conclusions: Limited educational training, sparse competence in mastering residents' cognitive disturbances and BPSD, and insufficient resources to ensure sufficient numbers of HCPs and MDs for proper diagnostic examination, treatment and dementia‐specific care were identified as critical challenges restricting quality dementia care in these Nepalese OAHs. Implications for practice: The study findings indicate a need for a clear Nepalese policy and a national plan for dementia care in OAHs that includes strategies for HCP educational training and how to provide resources to ensure a sufficient workforce of HCPs and MDs for proper diagnostic examination, treatment and dementia‐specific care. [ABSTRACT FROM AUTHOR]

Introduction: Physical therapists works in a number of environments including hospitals, private practitioners, outpatient clinics, health care agencies, colleges, sports and recreation centres, workplaces and nursing homes. In Pakistan, the referral of patients to the physical therapy is mainly by physicians or doctors. It is it is important for the doctors to have awareness about the role of physical therapists. Material & Methods: This was a cross sectional survey conducted from Jan 2020 to August 2020. The research was based on a self-structured questionnaire which was provided to medical doctors at a hospital in Swabi, Khyber Pakhtunkhwa. The total number of participants in this survey was 145 doctors. The sampling techniques used for this survey was convenient sampling. Inclusion criteria of the study was medical doctors holding MBBS or equivalent degree. Data collected was analysed through SPSS version 22. Results: Out of 145 participants, 112 (77.2%) were males and 33 (22.8%) were females. Questionnaire was filled by 11.7% orthopaedic specialists, 11.0% neurologists, 13.1% paediatricians, 20.7% gynaecologists and 43.4% by doctor of other specialties. From the total participants, only 98 (67.4%) were aware about the eligibility criteria of entering in the field of physiotherapy, 77.9 % were aware about the specialization in physiotherapy and 90.3% were aware about the treatment of physiotherapy. Those who agreed that physiotherapy helps in reducing pain were 132 with percentage 91.0%.120(82.8%) doctors agreed that physical therapy is crucial in community-based recovery. According to 125 doctors, early intervention through physical therapy leads to an effective rehabilitation. A total of 61(42.1%) doctors agreed that physiotherapy was an excellent field. Conclusion: It was found out that nearly 60% of the medical doctors in District Swabi were familiar with physiotherapy care and with the field of physiotherapy. A big number of these doctors (80 percent of doctors) were aware that physiotherapy helps in reducing pain, provide appropriate care and plays an important role in the community.

Alcohol, psychoactive substance abuse, and burnout are areas of significant problems within health care professionals and medical doctors. In 2011 we did a survey (n = 1601) in Belgium among the medical specialists. Beginning of 2021, exactly 10 years after the first survey, we repeated the survey this time among both medical specialists, general practitioners, and pharmacists. The results of this survey (N = 4361) will be presented and tendencies compared with international findings. We discuss the findings from both the longitudinal perspective using our 2011 data and also from the perspective of the impact of the Covid19 pandemic on health professionals.

Abstract Purpose Most of the resilience scales were developed for the non-medical population, therefore the purpose of this study was developing and validating a resilience scale for medical professionals – namely Medical Professionals Resilience Scale (MeRS). Methods A questionnaire development and validation study was conducted. The resilience domains and items were identified and generated through a literature review. The content validation was carried out by content experts and the content validity index (CVI) was calculated. The face validation was performed by medical officers and the face validity index (FVI) was calculated. The final MeRS was administered to 167 medical officers, exploratory factor analysis (EFA) and reliability analysis were performed to assess MeRS’s factorial structure and internal consistency. Results Four domains with 89 items of medical professionals’ resilience were developed. Following that, the content and face validation was conducted, and a total of 41-items remained for construct validation. EFA extracted four factors, namely growth, control, involvement, and resourceful, with a total of 37 items. The items’ CVI and FVI values were more than 0.80. The final MeRS’s items had factor loading values ranged from 0.41 to 0.76, and the Cronbach’s alpha values of the resilience domains ranged from 0.72 to 0.89. Conclusions MeRS is a promising scale for measuring medical professionals’ resilience as it showed good psychometric properties. This study provided validity evidence in terms of content, response process, and internal structure that supported the validity of MeRS in the measurement of resilience domains among medical professionals.

Abstract Background Increasing feminization of medical professions is well-acknowledged. However, this does not always equate to equitable representation of women within medicine, regarding their socio-demographic indicators, regions, sectors and fields of practice. Thus, this paper quantifies the gap in supply of female medical doctors in relation to demand, towards reaching different gender equity scenarios. Methods A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered medical doctors (medical practitioners and medical specialists) from 2002 until 2019 was utilized as an indicator of supply. Descriptive statistics were used to summarize data, and inferential statistics (considering a significance level of 0.05) were utilized to determine the association between the number of male and female doctors, disaggregated by demographic variables. We forecasted future gaps of South African male and female doctors up to 2030, based on maintaining the current male-to-female ratio and attaining an equitable ratio of 1:1. Results While the ratio of female doctors per 10 000 population has increased between 2000 and 2019, from 1.2 to 3.2, it remains substantially lower than the comparative rate for male doctors per 10 000 population which increased from 3.5 in 2000 to 4.7 in 2019. Men continue to dominate the medical profession in 2019, representing 59.4% (27,579) of medical doctors registered with the HPCSA with females representing 40.6% (18,841), resulting in a male-to-female ratio of 1:0.7. Female doctors from the Black population group have constantly grown in the medical workforce from 4.4% (2000), to 12.5% (2019). There would be a deficit of 2242 female doctors by 2030 to achieve a 1:1 ratio between male and female medical doctors. An independent-samples t-test revealed that there was a significant difference in the number of male and female doctors. The Kruskal–Wallis test indicated that there was a sustained significant difference in terms of the number of male and female doctors by population groups and geographical distribution. Conclusions Based on the investigation, we propose that HRH planning incorporate forecasting methodologies towards reaching gender equity targets to inform planning for production of healthcare workers.

This study explores how shared decision-making (SDM) is integrated in undergraduate nursing and medical education. A dual-method design was applied. The integration of SDM in medicine and nursing education programs (i.e. SDM on paper) was explored through document analyses; the integration of SDM in curricula (i.e. SDM in class) through interviews with teachers and curriculum coordinators (N = 19). A majority of the education programs featured SDM, mostly non-explicit. In curricula SDM was generally implicitly featured in compulsory courses across all study years. SDM was often integrated into preexisting theories and models and taught through various methods and materials. Generally, teachers and supervisors were not trained in SDM themselves. They assessed students' competence in SDM in a summative manner. Overall, SDM was featured in undergraduate nursing and medical education, however, very implicitly. • Shared decision-making is featured in undergraduate nursing and medical education • Nonetheless, shared decision-making is variedly and mostly implicitly integrated • Teachers and supervisors often are not trained in shared decision-making • The competency of taking the patient's perspective into account should receive more attention [ABSTRACT FROM AUTHOR]

Background: The professional dental cleaning (PDC) is an effective supplement that can make up for the lack of self-oral health care. Everyone should develop the habit of regular PDC. This study aimed to investigate the knowledge, behaviors and medical compliance of dentists, medical doctors and non-medical staffs about the PDC, identify the gaps, and provide information to help individuals develop healthy oral hygiene habit. Materials and methods: A web-based survey with 21 questions designed based on the characteristics, the PDC knowledge, behaviors, and medical compliance of respondents. A cross-sectional study was conducted in the main districts of Chongqing, China, in the period of September–November 2020. A total of 456 respondents including 153 dentists, 137 medical doctors and 166 non-medical staffs in 3 communities and 4 hospitals were sampled online with multistage sampling and surveyed. The data was analyzed by chi-square test using IBM SPSS Statistics v. 21.0. Results: The cognitive level and behavior of dentists on the PDC was significantly better than that of medical doctors and non-medical staffs (p = 0.000–0.044). The rates of not knowing "dental plaque" were 32.85% and 61.45%, of the medical doctors and non-medical staffs. Meanwhile, most of them had misunderstanding about effects of the PDC. They thought it would whiten teeth (72.99%, 80.72%), damage gums (16.79%, 19.88%) and teeth (15.33%, 21.69%), and create bigger gaps between teeth (24.82%, 33.13%). In terms of gum health and the PDC behavior, significant differences were observed, 23.53% of dentists experienced irritated gum bleeding in the last 12 months, 42.28% did not have their teeth cleaned professionally in the last 12 months, even 7.84% never had it before. Compared with it, in the same situation, the ratios of medical doctors and non-medical staffs were about 60% experiencing irritated gum bleeding, 69.34% and 77.71% not experiencing the PDC in the last 12 months, up to 33.58% and 45.18% never experienced it before. 41 respondents (8.99%) disagreed with the reasonable and necessary medical behaviors before the PDC. Conclusion: People's understanding about the PDC was insufficient, and many people, included some dentists, had not developed the habit of regular dental cleaning. Our study provided a new understanding of the PDC among dentists, medical doctors, and non-medical staffs, which may help to improve their awareness and behavior of oral hygiene health, and establish the multidisciplinary collaborations between dentists and medical doctors. [ABSTRACT FROM AUTHOR]

Introduction: There is a gap in healthcare literature related to the spiritual competence of physicians and nurses practicing in South Asian Muslim communities. To fill that gap, the Spiritual Care Competence Questionnaire (SCCQ) was applied which was developed to address multi-professional spiritual care competences. Materials and Methods: A cross-sectional study among 294 health professionals (61% physicians, 17% nurses, and 22% other professions) in 10 hospitals in Punjab, Pakistan. Results: The highest scoring competences were "Dealing with patients/Communication competences", while "Team Spirit" scored lowest. There were no gender related differences, but there were effects related to professions. "Team Spirit", "Dealing with patients/Communication competences", and "Empowerment competences" scored significantly higher in nurses as compared to physicians and other health care professionals, while there were no significant differences for their "Perception/Documentation competences". These competences were not relevantly related to the intensity of their prayer/meditation activity. Conclusions: Health care professional from Punjab were preferred to tolerate the pain and the suffering of patients and their relatives rather than to talk about spiritual care issues. Their spiritual care competences were less developed. Thus, there is a clear need for further specific education and training of health professionals. [ABSTRACT FROM AUTHOR]

Background: Similar to understanding how blood pressure is measured by a sphygmomanometer, physicians will soon have to understand how an artificial intelligence–based application has come to the conclusion that a patient has hypertension, diabetes, or cancer. Although there are an increasing number of use cases where artificial intelligence is or can be applied to improve medical outcomes, the extent to which medical doctors and students are ready to work and leverage this paradigm is unclear. Objective: This research aims to capture medical students’ and doctors’ level of familiarity toward artificial intelligence in medicine as well as their challenges, barriers, and potential risks linked to the democratization of this new paradigm. Methods: A web-based questionnaire comprising five dimensions—demographics, concepts and definitions, training and education, implementation, and risks—was systematically designed from a literature search. It was completed by 207 participants in total, of which 105 (50.7%) medical doctors and 102 (49.3%) medical students trained in all continents, with most of them in Europe, the Middle East, Asia, and North America. Results: The results revealed no significant difference in the familiarity of artificial intelligence between medical doctors and students (P=.91), except that medical students perceived artificial intelligence in medicine to lead to higher risks for patients and the field of medicine in general (P<.001). We also identified a rather low level of familiarity with artificial intelligence (medical students=2.11/5; medical doctors=2.06/5) as well as a low attendance to education or training. Only 2.9% (3/105) of medical doctors attended a course on artificial intelligence within the previous year, compared with 9.8% (10/102) of medical students. The complexity of the field of medicine was considered one of the biggest challenges (medical doctors=3.5/5; medical students=3.8/5), whereas the reduction of physicians’skills was the most important risk (medical doctors=3.3; medical students=3.6; P=.03). Conclusions: The question is not whether artificial intelligence will be used in medicine, but when it will become a standard practice for optimizing health care. The low level of familiarity with artificial intelligence identified in this study calls for the implementation of specific education and training in medical schools and hospitals to ensure that medical professionals can leverage this new paradigm and improve health outcomes. [ABSTRACT FROM AUTHOR]

This study integrates two competing views to examine whether medical doctors are satisfied with their jobs when they perceive their hospitals as being oriented toward profit (i.e., rational choice theory) or purpose (i.e., public service motivation). Using a sample of 127 doctors from 70 hospitals, this study tests these competing views. The results show that doctors who perceive their hospitals as purpose-driven are likely to experience job satisfaction, and this pattern still holds even if they also perceive their hospitals to be emphasizing profits. However, only the purpose-driven orientation results in job satisfaction via a sense of meaningfulness. Thus, this study offers comprehensive evidence that while medical doctors are likely to be satisfied with their jobs when they work at either purpose-driven or profit-driven hospitals, only purpose-driven hospitals give doctors a sense of meaningfulness. This finding suggests that both rational choice theory and public service motivation perspective are valid; however, public service motivation plays a greater role in terms of a sense of meaningfulness. Theoretical contributions and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the range of experiences and attitudes of Croatian medical doctors (MDs) related to vaccination and vaccine hesitancy. In January 2021 three asynchronous online focus groups were held using MRQual, a web-based platform, which included 46 MDs from all three levels of the healthcare system in Croatia. NVivo, a qualitative data analysis software package, was used for the thematic analysis of collected data. The participants expressed a high level of support for the Croatian immunization program and vaccines in general. However, some skepticism was expressed regarding new vaccines and the regulatory processes of their approval. A significant number of participants raised concerns over the approval of COVID-19 vaccines, especially given their rapid development. The results also revealed that the process of communication with patients is often based on the very elaborate categorizations of patients based on previous experience, which leads to prioritizing and a communication breakup when dealing with "problematic patients". MDs find themselves in a delicate situation where a fine balance between time-consuming communication with patients and the demands for maintaining satisfying vaccination uptake is needed. The situation arises from a social roles conflict that is embedded in wider social values and expectations, since communication problems do not arise in the doctor's office, and therefore cannot be solved without addressing the social forces that cause trust deficiencies. To achieve better immunization results public health leaders need to better understand the social contexts and constraints of MDs vaccine-related behaviors. [ABSTRACT FROM AUTHOR]

Background: Empathy is the competence of a physician to understand the patient's situation, perspective and feelings and to act on that understanding in a helpful therapeutic way. Empathy is the backbone of patient-physician communication in clinical care, it can be innate, learnt or acquired in the course of the medical career. This study, evaluated empathy and its correlates among medical doctors working in the University College Hospital, Ibadan, Nigeria. Methods: This was a cross-sectional study of 188 interns, resident and specialist doctors working at the University Hospital College, Ibadan in March-May 2018. Consecutive consenting doctors were given a self-administered questionnaire that collected information on sociodemography, work and empathy using the 20-items Jefferson Scale of Physician Empathy. Data were analyzed using the SPSS version 23 and statistical significance was set at P < 0.05. Results: The majority of the respondents were male (60.1%), between 30 and 39 years (60.6%) old, married (60.6%) and Christians (91.5%). Many worked in the Internal Medicine Department (38.3%), were Senior-Resident doctors (41.0%) and of Yoruba (82.4%) ethnicity. Senior-Residents doctors ([120.2 ± 15.4]; P = 0.009) and Consultants ([117.8 ± 21.4]; P = 0.009) had highest empathy scores. Doctors who are raised in lower social status families, lacked ability in taking patient's perspective ([56.2 ± 12.2]; P = 0.046). Doctors in surgical-related specialities had lower empathy scores, those in medical-related specialities, especially Psychiatrists (127.1 ± 10.1) and Family Physicians (125.8 ± 7.9) had the highest scores (P = 0.034). Doctors who had never learnt about empathy had the lowest score in perspective-taking ([50.5 ± 30.4]; P = 0.041). Duration of practice and work-hours respectively correlated positively ([rs = 0.174]; P = 0.018) and negatively ([rs = −0.206]; P = 0.005) with empathy scores. Conclusions: Medical doctors possessed varying levels of empathy relative to their sociodemographic characteristics, the speciality of choice and level of expertise. Exposure to teachings on empathy and work-related challenges underscores empathic skills.

Objective: To determine job satisfaction level of doctors working at Ayub Teaching Hospital and correlate it to factors that affect job contentment with the help of a standardized tool. Study Design: Cross-sectional Analysis study. Setting: Ayub Teaching Hospital, Abbottabad. Period: First Two Weeks of December, 2019. Material & Methods: A selfadministered online questionnaire was designed on Google Forms and was used to collect data from the doctors working at the aforementioned facility for more than three months. Data regarding various sociodemographic and professional characteristics as well as respondents' views about their job as per Warr-Cook-Wall scale were noted. Pearson's Correlational analysis, student's t-test and one way ANOVA were applied for data analyze. Results: Among a total of 176 doctors, mean Job Satisfaction Score (JSS) was 37.56±13.35, which is below the neutral level, showing overall discontent and only 72 (40.9%) respondents were actually satisfied with their jobs. Highest content was noted for "Colleagues & fellow workers" and "Amount of Responsibility", among the scale's parameters. Whereas doctors were least satisfied with their "income". Salary had a weak but statistically significant correlation with satisfaction score. Those working at basic medical sciences departments were more satisfied (p=0.006) and so were permanent employees (p=0.024). Professors were significantly more content (p=0.005). 71% of the doctors would like to be a doctor again if given an opportunity, whereas 63.1% would leave the country to serve abroad in case they get such an opportunity. Conclusion: Most of the doctors were not satisfied with their jobs. Among many factors, dissatisfaction with pay structure seems to be the most significant one. This discontent with their jobs is probably the reason most of them are willing to leave the country and serve abroad. Thus further research on the topic should be conducted to explore and implement strategies to alleviate this dissatisfaction. [ABSTRACT FROM AUTHOR]

Copyright of German Journal of Sports Medicine / Deutsche Zeitschrift fur Sportmedizin is the property of Verein zur Forderung der Sportmedizin Hannover e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background The paediatric Moral Distress Scale-Revised (MDS-R) was previously translated and adapted to Swedish paediatric oncology. Cognitive interviews revealed five not captured situations among the 21 items, resulting in five added items: 22) Lack of time for conversations with patients/families, 23) Parents’ unrealistic expectations, 24) Not to talk about death with a dying child, 25) To perform painful procedures, 26) To decide on treatment/care when uncertain. The aim was to explore experiences of moral distress in the five added situations in the Swedish paediatric MDS-R, among healthcare professionals (HCPs) in paediatric oncology. Methods In this national cross-sectional survey, the Swedish paediatric MDS-R, including five added items, were used. Descriptive statistics, non-parametric analysis of differences between professions and a MDS-R score for each item were calculated. Internal consistency was tested using Cronbach’s alpha and inter-item correlation test. HCPs (n = 278) at all six Swedish paediatric oncology centres participated (> 89%). The Regional Ethical Review Board had no objections. Consent was assumed when the survey was returned. Results Nursing assistants (NAs) reported higher intensity and lower frequency on all added items; registered nurses (RNs) reported a higher frequency on item 22–25; medical doctors (MDs) reported higher MDS-R score on item 26. On item 22, intensity was moderate for RNs and MDs and high for NAs, and frequency was high among all. Item 22, had the second highest MDS-R score of all 26 for all professional groups. On item 23, the level of disturbance was low but it occurred often. The 26-item version showed good internal consistency for the overall sample and for all professional groups. However, item 22 and 24 could be viewed as redundant to two of the original 21. Conclusion In accordance with other studies, the intensity was higher than the frequency, however, the frequency of the added items was higher than of the original items. In line with previous research, item 22 and 23 are important elements of moral distress. RNs experience the situations more often while NAs find them more disturbing. The results indicate that the added items are important in capturing moral distress in paediatric oncology.

Abstract Background The past two decades have been marked by impressive growth in the migration of medical doctors. The medical profession is among the most mobile of highly skilled professions, particularly in Europe, and is also the sector that experiences the most serious labour shortages. However, surprisingly little is known about how medical doctors choose their destinations. In addition, the literature is scarce on the factors determining the sharp rise in the migration of doctors from Africa, Asia and Eastern and Southeastern Europe, and how the last economic crisis has shaped the migration flows of health professionals. Methods We use the new module on health worker migration provided by the Organisation for Economic Co-operation and Development (OECD) for 2000–2016 in order to examine the channels through which OECD countries attract foreign physicians from abroad. We estimate a gravity model using the Pseudo-Poisson Maximum Likelihood estimator. Results Our results reveal that a lower unemployment rate, good remuneration of physicians, an aging population, and a high level of medical technology at the destination are among the main drivers of physicians’ brain drain. Furthermore, an analysis of the mobility of medical doctors from a number of regions worldwide shows that individuals react differently on a country-wise basis to various determinants present in the destination countries. Physicians from African countries are particularly attracted to destination countries offering higher wages, and to those where the density of medical doctors is relatively low. Concurrently, a higher demand for healthcare services and better medical technology in the receiving country drives the inflow of medical doctors from Central and Eastern Europe, while Asian doctors seem to preferentially migrate to countries with better school systems. Conclusions This study contributes to a deeper understanding of the channels through which OECD countries attract foreign medical doctors from abroad. We find that, apart from dyadic factors, a lower unemployment rate, good remuneration of physicians, an aging population, and good medical infrastructure in the host country are among the main drivers of physicians’ brain drain. Furthermore, we find that utility from migration to specific countries may be explained by the heterogeneity of origin countries.

Background: Vaccine hesitancy defined as “delay in acceptance or refusal of vaccination despite availability of vaccination services is a global phenomenon. There have been anecdotal evidence or rather poor documentation of hesitancy or noncompliance among medical practitioners in Northern Nigeria. Objective: We explored the perceptions and perspectives of doctors in Kebbi State, Nigeria, on immunization programs. Materials and Methods: We conducted this cross-sectional study involving 63 medical doctors, whose self-administered questionnaires were analyzed using descriptive statistics. Results: Only 43.55% of the doctors reported having under-five children with complete vaccination, whereas 84% of the doctors surveyed had a child or a relative with a child who had missed routine immunization (RI) previously. Approximately 66.67% and 67.74% of the doctors believed in the quality of the vaccine and capacity of the health workers to effectively deliver polio supplementary immunization activities (PSIAs), respectively. Adequate training of workers (26.23%) and public enlightenment campaigns (23.68%) were suggested as PSIAs enhancers. Collaboration with community and religious leaders (29.2%), education and public sensitization (28.09%), and improved government funding (13.48%) to improve RI were suggested. Others include incentives and fines (8.99%), adequate training of staff (10.11%), house-to-house vaccination (4.49%), and media publicity (5.62%). Conclusion: Vaccine hesitancy among medical doctors could be a threat to sustained polio interruption and efforts toward improving RI in Kebbi State. The state government and development partners should modify the current approaches to attaining polio-free certification standards and strengthen RI in the state. In addition, there is a need to improve sensitization of doctors in the state on vaccines and their safety profiles with a view to reducing vaccine hesitancy among them.

BackgroundBullying is public health problem globally in workplaces with untold deleterious effects on the health and well-being of individuals at the receiving end. Bullying has been found to disrupt social interaction at workplace thereby creating an unhealthy and seemingly unproductive work environment. Studies have reported varying rates of workplace bullying as high as 83% in Europe, 65% in the Americas and 55% in Asia with very little documented in the contemporary African setting and Nigeria in particular. It therefore became imperative to assess the level of bullying and its associated factors among medical doctors in residency training in a tertiary health institution in Plateau state Nigeria.MethodologyThis was a cross sectional study conducted among resident doctors in Jos University Teaching Hospital between November 2019 and February 2020 using quantitative method of data collection and SPSS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a p-value of ≤0.05 considered statistically significant.ResultsThe mean age of the respondents was 32.3 ± 3.9 years with 78 (62.9%) being 31 years and above. Bullying was currently being experienced by 74 (59.7%) of the respondents with verbal aggression and threats as well as insult and use of derogatory remarks being the forms of bullying experienced by 85.1 and 74.3% of the respondents, respectively. Furthermore, witnessing a colleague being bullied was the sole factor found to be significantly associated with workplace bullying (AOR = 0.18; 95% CI = 0.068–0.449; p < 0.001).ConclusionWorkplace bullying has been found to be in existence and relatively high among medical doctors in residency training in this setting with witnessing someone being bullied as its sole associated factor.

Aim: To describe the challenges for optimum resuscitation processes in Emergency Departments in Limpopo Province, South Africa. Design: A qualitative explorative research approach was adopted to explore the resuscitation team’s experiences in Emergency Departments. Method: Five medical doctors and twelve professional nurses were purposively sampled to participate in the study. The depth of the information obtained from the participants determined the sample size. Data collected from semi-structured individual interviews were analyzed using thematic analysis. Data quality was ensured by applying four elements: credibility, transferability, dependability, and confirmability. Results: The study findings indicated diverse challenges for optimum resuscitation processes that include: A general shortage of emergency personnel, the lack of material resources and the unavailability of funds for payment of national and international trauma symposiums, the poor maintenance of emergency equipment, the lack of a continuous training program and the resuscitation team receiving different instructions from various team leaders about the standardized procedures and policies of the resuscitation process. The team leaders and managers often blamed, depreciated and disregarded the resuscitation team for failed resuscitation efforts. Public contribution: The study findings are a point of reference for the emergency resuscitation team and the department of health policymakers. Trained and well-equipped emergency resuscitation teams can improve the quality of life for patients with cardiac arrest.

Background:  Medicine is a self-regulating profession. Doctors must learn how to self-regulate to keep up-to-date with evolving health care needs. This is challenging for those working at District Hospitals (DHs) in rural settings, where limited resources and understaffing may compound a poor approach and understanding of how to become a self-directed learner., Aim:  To explore perspectives of doctors working in rural DHs, regarding their understanding of learning and learning needs., Setting:  This study was conducted in Bethesda and Mseleni DHs, in rural KwaZulu-Natal., Methods:  This was a qualitative study. Data was collected through 16 semi-structured interviews and non-participatory observations., Results:  Four major themes emerged: "Why I learn," "What I need to learn," "How I learn," and our learning environment." This paper focussed on the first three themes. Doctors' learning is influenced by various factors, including their engagement with clinical practice, personal motivation, and their learning process. Deliberate practice and engagement in reflective practice as key principles for workplace learning became evident., Conclusion:  In rural DHs, doctors need to take a proactive self-regulated approach to their learning due to difficulties they encounter. They must build competence, autonomy, a sense of connection in their learning process, thus recognizing the need for continuous learning, motivating themselves, and understanding where they lack knowledge, all essential for achieving success.Contribution: This article contributes towards strengthening medical education in African rural context, by empowering medical educators and facility managers to meet the learning needs of doctors, thus contributing to the provision of quality health care.

Introduction: Access to care for children and adolescents affected by ADHD in France remains below the levels attained in most industrialised countries. To contribute to improving ADHD care in France, we assessed existing ADHD knowledge among medical doctors (MDs) and described associated care pathways in two large French regions in 2021. We produced tools to evaluate the regional impact of implementing a stepped-care pathway for ADHD., Methods: A SurveyMonkey® study was sent to professionals from two regions in France accounting for 14 million inhabitants, allowing them to describe their role in child/adolescent ADHD, as well as their representations and knowledge about the disorder., Results: Around 9.4% of all MDs potentially involved with children took part in the study; 34.9% considered themselves untrained, 40.5% were involved in ADHD care at a first-tier level, and 19.6% at a second-tier level. Access to a second or third-tier service for ADHD was associated with mean waiting times of 5.7 and 8.5 months, respectively. Initiation of stimulant therapy remained mainly restricted to second or third-tier MDs, and adaptation of dosage or change in the galenic formulation was rarely performed by first-tier MDs (27.2% and 18%, respectively). Training in neurodevelopmental disorders and tier-level were the strongest determinants of knowledge, attitudes and self-assessed expertise about ADHD., Conclusions: This study provides insight into training needs for MDs regarding healthcare pathways in ADHD and should support the implementation of health policies, such as a stepped healthcare access for ADHD. The study design and dissemination have been validated and will be available in France and other countries facing similar obstacles in care pathways for ADHD. Official recommendations on ADHD in children and adults are being updated in France, and our data and the survey design will be a starting point for their implementation., (Copyright © 2023 L'Encéphale, Paris. All rights reserved.)

Study Objectives: Social jetlag, the difference between imposed and endogenous sleep schedules, may be detrimental to resident physicians' health. The current profiles of sleep habits, particularly the differences between workdays and free days, are unknown in that population. This cross-sectional study of Quebec resident physicians aimed at assessing sleep habits on workdays and free days, and predictors of social jetlag., Methods: Residents were recruited via their residency programs and social media to complete an online questionnaire. Measures included means of sleep duration and timing, chronotype, sleep debt, sleep disturbances, and social jetlag. A range of socio-demographic variables, lifestyle characteristics, and mental health indicators were examined as predictors of severe social jet lag using logistic regressions., Results: A total of 492 residents were included in the study (mean [SD] age, 27.6 [3.6] years; 330 women [67.1%]). The mean sleep duration was 7.15h (95%CI, 7.02-7.28h) on workdays and 8.36h (95%CI, 8.18-8.54h) on free days. The mean sleep debt was 1.59h (95% CI, 1.37-1.81h), and mean social jetlag was 1.37h (95% CI, 1.28-1.47h), with 31.9% (95% CI, 25.0%-39.6%) of residents experiencing ≥2 hours of sleep debt, and 21.8% (95% CI, 16.5%-28.3%) experiencing severe social jetlag. The prevalence of sleep disturbances was 51.7% (95% CI, 44.4%-58.8%). Severe social jetlag was associated with earlier stage of training, later chronotype, decreased physical activity, increased sleep debt, and depressive symptoms., Conclusions: Many residents experience severe social jetlag, chronic sleep deprivation and sleep disturbances. Importantly, severe social jetlag was associated with depressive symptoms, suggesting a potential intervention target for promoting resident mental health., (© 2024 American Academy of Sleep Medicine.)

The Polish healthcare system faces many problems, among which the shortage of healthcare professionals is one of the most urgent. In less than ten years, more than twenty Higher Education Institutions (HEIs) have been allowed to add medical programmes to their offer, aiming to increase the number of doctors in Poland. Recently, the healthcare system was faced with a proposal to abolish the mandatory postgraduate internship which has been a mandatory component of medical training for years. Two main reforms were considered. The first one focused on the programme of the internship and aimed to update it. The second one recommended an abolition of the internship. The authors of this article analysed the opinions and positions of key players within the system regarding the postgraduate internship. Opinions in this regard are diverse, leading to the conclusion that additional actions would be required prior to the internship abolition. Undergraduate training has changed and currently students are taught in modern facilities, using new teaching methods. On the other hand, internship allows trainees to improve or even acquire skills they may not have obtained during their studies. The postgraduate internship is an essential part of doctors' training. However, in Poland, there is still a lack of a well-thought, long-term policy or strategy for physicians' workforce development. Our study presents a Polish perspective on common challenges in medical training and workforce policy, highlighting the clash over the growing demand for physicians and the limitations of the existing system., Competing Interests: Declaration of competing interest Authors declare no conflict of interests., (Copyright © 2024. Published by Elsevier B.V.)

Copyright of Romanian Journal of Family Medicine / Revista Română de Medicina Familiei is the property of Media DOM Express and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This essay explores the short period of time that Arthur Conan Doyle spent between March and June 1891 when he moved his family into rooms in Bloomsbury and took a consulting room near Harley Street in an attempt to set up as an eye specialist. This last attempt to move up the professional hierarchy from general practitioner to specialist tends to be seen as a final impulsive move before Conan Doyle decided to become a full-time writer in June 1891. The essay aims to elaborate a little on the medical contexts for Conan Doyle's brief spell in London, and particularly to track the medical topography in which he placed himself, situated between the radical, reformist Bloomsbury medical institutions and the fame and riches of the society doctors of Harley Street. These ambivalences are tracked in the medical fiction he published in Round the Red Lamp, his peculiar collection of medical tales and doctoring in 1894. [ABSTRACT FROM AUTHOR]

Background: Infections due to resistant bacteria are associated with severe illness, increased risk for complications, hospital admissions, and higher mortality. Inappropriate use of antibiotics, which contributes to increased antibiotic resistance (ABR), is common in healthcare settings across the globe. In Cameroon, antibiotics have been reported as high as 45-70% of prescriptions. We sought to investigate the knowledge, attitudes, and perceptions regarding appropriate antibiotic use and ABR of medical doctors practicing in tertiary hospitals in Yaoundé, Cameroon.Methods: We conducted a cross-sectional survey using a 54-item self-administered questionnaire sent via email to medical doctors working in the four major tertiary hospitals of Yaoundé. The questionnaire recorded socio-demographics, perceptions on antibiotic use and ABR, sources and usefulness of education on ABR, and clinical scenarios to appraise knowledge.Results: A total of 98/206 (48%) doctors responded. Years of experience ranged between 1 and 17 years. Most participants agreed that ABR is a problem nationwide (93%) and antibiotics are overused (96%), but only one third (32%) thought that ABR was a problem in their wards. Most respondents (65%) were confident that they use antibiotics appropriately. We found a mean knowledge score of 56% (± 14), with prescribers not influenced by patient-exerted pressure for antibiotic prescribing scoring better compared to those influenced by patients (67% vs 53%, p = 0.01). Overall, most participants (99%) expressed interest for further education on both appropriate antibiotic use and ABR.Conclusion: Confidence of prescribers in their ability to appropriately use antibiotics conflicts with the low level of knowledge on antibiotic use in this group of doctors. Moreover, the opinion of the majority, that ABR is not a problem in their own backyard is in keeping with similar studies in other countries and is of significant concern. Introduction of formal antibiotic stewardship programmes in Cameroon may be a useful intervention. [ABSTRACT FROM AUTHOR]

This study was carried out to find out the Information Needs and Resource Utilization by Medical Doctors of Federal Medical Centre Katsina State. To achieve this objective, quantitative research method was adopted, whereas survey design was employed for the study. Data were collected from the respondent's using questionnaire. A total of seventy-six (76) copies of questionnaire were administered to the respondents and seventy-two (72) were returned and found useful. All data collected were categorized and presented in tabular forms. Analyses of categorized data were done through simple percentages. Ultimately, it was found that the main types of information sought by the respondents are information to satisfy curiosity and personal interest, information for formal course of study, information for research and business opportunities. Based on the findings of the research, it was recommended that management of the hospital should provide functional library within the hospital premises with adequate and relevant information resources. Secondly, more and reliable internet service should be provided in the hospital so that medical doctors can benefit from this information sources right from their various offices. [ABSTRACT FROM AUTHOR]

Background: Empathy is the competence of a physician to understand the patient's situation, perspective and feelings and to act on that understanding in a helpful therapeutic way. Empathy is the backbone of patient-physician communication in clinical care, it can be innate, learnt or acquired in the course of the medical career. This study, evaluated empathy and its correlates among medical doctors working in the University College Hospital, Ibadan, Nigeria. Methods: This was a cross-sectional study of 188 interns, resident and specialist doctors working at the University Hospital College, Ibadan in March-May 2018. Consecutive consenting doctors were given a self-administered questionnaire that collected information on sociodemography, work and empathy using the 20-items Jefferson Scale of Physician Empathy. Data were analyzed using the SPSS version 23 and statistical significance was set at P < 0.05. Results: The majority of the respondents were male (60.1%), between 30 and 39 years (60.6%) old, married (60.6%) and Christians (91.5%). Many worked in the Internal Medicine Department (38.3%), were Senior-Resident doctors (41.0%) and of Yoruba (82.4%) ethnicity. Senior-Residents doctors ([120.2 ± 15.4]; P = 0.009) and Consultants ([117.8 ± 21.4]; P = 0.009) had highest empathy scores. Doctors who are raised in lower social status families, lacked ability in taking patient's perspective ([56.2 ± 12.2]; P = 0.046). Doctors in surgical-related specialities had lower empathy scores, those in medical-related specialities, especially Psychiatrists (127.1 ± 10.1) and Family Physicians (125.8 ± 7.9) had the highest scores (P = 0.034). Doctors who had never learnt about empathy had the lowest score in perspective-taking ([50.5 ± 30.4]; P = 0.041). Duration of practice and work-hours respectively correlated positively ([rs = 0.174]; P = 0.018) and negatively ([rs = −0.206]; P = 0.005) with empathy scores. Conclusions: Medical doctors possessed varying levels of empathy relative to their sociodemographic characteristics, the speciality of choice and level of expertise. Exposure to teachings on empathy and work-related challenges underscores empathic skills. [ABSTRACT FROM AUTHOR]