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Introduction: Proton pump inhibitors (PPIs) are commonly used to treat acid-related disorders. Their appropriate use depends on the correct indications from the clinician. Owing to the high incidence of use and misuse, PPIs have been identified as an essential pharmacological class for developing deprescribing recommendations. Therefore, assessing physicians' knowledge and practice regarding PPI usage is critical for paving the way toward targeted recommendations and efforts. Objective: This study aimed to assess Syrian physicians' perceptions of proton pump inhibitors adverse effects, their benefit in upper gastrointestinal bleeding (UGIB) prophylaxis, and how these perceptions are related to PPI prescription practice. Methods: A cross-sectional study was performed using a web-based questionnaire distributed among Syrian physicians in internal medicine between 28 November and 23 December 2022. The questionnaire assessed perceptions and experiences of PPIs, concerns about specific adverse effects, and their effectiveness for UGIB prophylaxis, in addition to the different scenarios used to determine the best practice for appropriate treatment to manage minimal, mild, moderate, and high-risk UGIB patients. Results: A total of 473 participants completed the questionnaire, with median age ±SD was (28.46 ± 4.58), and most participants (83.3%) were residents. Approximately half of the participants (45.5%) agreed that discussion assistance was provided to continue or terminate PPIs properly. Only 8.9% were very familiar with published evidence of PPI adverse effects. Bone weakening and vitamin B12 deficiency were the most frequently reported side effects (81.8% and 79.7%, respectively). However, dementia (0.4%) and mortality (1.9%) were the least reported adverse effects. More than half of the participants (64%) perceived using PPIs to prevent upper GI bleeding. Non-trainee physicians were less knowledgeable about appropriate GERD management than resident physicians (p < 0.001). Conclusion: The study showed a gap between Syrian physicians' perceptions and practices regarding PPI use, which necessitates spreading awareness of updated guidelines for PPI usage and their side effects. [ABSTRACT FROM AUTHOR]

This systematic review aims to explore the association between abusive behaviour and physician–patient relations in healthcare settings. Systematic review. We searched for related studies on databases such as PubMed, Embase, and the Cochrane library, without restrictions on language, from inception until July 15, 2022. The risk of bias and the methodological quality was evaluated using the Newcastle–Ottawa Scale and Risk of Bias in Non-randomised Studies of Interventions tool. Ten studies were included in this systematic review, the participants of which were physicians and patients. The research from all the studies highlighted the detrimental effects of abusive behaviour on the relationship between physicians and patients, regardless of who the abusers were. Abusive behaviour in a clinical setting has a negative influence on the physician–patient relationship, whoever the perpetrator might be. The research sheds light on the importance of teaching communication skills to physicians and training them to manage conflicts and aggressive behaviours in healthcare settings. [ABSTRACT FROM AUTHOR]

Background: Burnout among health care professionals contributes to high job turnover. Within the United States, burnout among specialty palliative care (PC) providers will accentuate provider shortage problems. Objectives: This systematic review was conducted to answer the question "what is known about burnout among specialty PC providers practicing in the United States?" More specifically, it was designed to identify the rate of burnout and factors that influence or mitigate it among PC nurse practitioners (NPs), physician assistants (PA), and physicians and to inform future research. Data sources: An electronic literature search of studies conducted in the United States between 2012 and September 2022 was completed in Embase, PubMed, CINAHL, and PsycINFO. Conclusions: Analysis of 14 studies showed that there are five primary themes related to burnout among PC providers: (1) the rate of burnout, (2) the physical, psychological, and clinical manifestations of burnout, (3) predictors of burnout, (4) factors of resiliency, and (5) interventions piloted to decrease burnout. The majority of studies have delineated the physician role but have failed to determine the rate and factors of burnout among PC NPs and PAs. Implications for practice: As NPs and PAs are integral to the PC provider workforce, future research should be designed to understand more clearly how burnout affects these two PC roles to inform efforts to sustain the PC workforce. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the availability of provider health programs (PHPs) for physician associates/assistants (PAs), as well as the accessibility of information about these resources through state licensing boards and PA constituent organizations. Methods: Data were collected through audits of the websites of the PA licensing board and state/district constituent group for each state and the District of Columbia from October to November 2022. Results: Every state except Massachusetts has a PHP that serves PAs. Review of the 51 respective state licensing board websites revealed that 23 states (45.1%) list PHP information; only 9 states (17.6%) have PHP information listed on state PA constituent organization websites. Conclusions: The results of this study indicate that PHPs for PAs are widely available. Unfortunately, the broad availability of PHPs may be limited by the lack of accessible information about these programs in many states. [ABSTRACT FROM AUTHOR]

Not available

BackgroundHeart transplant selection committee meetings have transitioned from in-person to remote video meetings during the COVID-19 pandemic, but how this impacts committee members and patient outcomes is unknown.ObjectiveThe aim of this study is to determine the perceived impact of remote video transplant selection meetings on usability and patient care and to measure patient selection outcomes during the transition period from in-person to virtual meetings.MethodsA 35-item anonymous survey was developed and distributed electronically to the heart transplant selection committee. We reviewed medical records to compare the outcomes of patients presented at in-person meetings (January-March 2020) to those presented during video meetings (March-June 2020).ResultsAmong 83 committee members queried, 50 were regular attendees. Of the 50 regular attendees, 24 (48%) were physicians and 26 (52%) were nonphysicians, including nurses, social workers, and coordinators; 46 responses were received, 23 (50%) from physicians and 23 (50%) from nonphysicians, with 41 responses fully completed. Overall, respondents were satisfied with the videoconference format and felt that video meetings did not impact patient care and were an acceptable alternative to in-person meetings. However, 54% (22/41) preferred in-person meetings, with 71% (15/21) of nonphysicians preferring in-person meetings compared to only 35% (7/20) of physicians (P=.02). Of the 46 new patient evaluations presented, there was a statistically nonsignificant trend toward fewer patients initially declined at video meetings compared with in-person meetings (6/24, 25% compared to 10/22, 45%; P=.32).ConclusionsThe transition from in-person to video heart transplant selection committee meetings was well-received and did not appear to affect committee members' perceived ability to deliver patient care. Patient selection outcomes were similar between meeting modalities.

Background: This study aimed to investigate perceptions of Clostridioides difficile infection (CDI) diagnostic tests among physicians who prescribe CDI diagnostic tests as part of providing direct patient care. Methods: In August 2018, we provided a 12-question survey of gastroenterologists (the most common referral source for CDI testing) to 35 medical institutions in Korea, asking them about their perceptions of CDI diagnosis and testing. Results: A comparison of the perceptions of physicians and clinical pathologists (CPs) found that physicians had a lower perceived sensitivity of the toxin AB enzyme immunoassay test. For nucleic acid amplification tests, physicians exhibited a perception of higher assay sensitivity and specificity than CPs. The specificity of culture tests was generally perceived as high by physicians, whereas CPs regarding expressed mixed opinions. All but one physician and one CPs found the algorithmic test useful. Concerning the CDI isolation criteria, physicians commenced patient isolation by concurrently assessing both test results and clinical symptoms, rather than exclusively relying upon test results. Among CPs, 84.6% said they could rely on symptoms to determine when to release a patient from isolation, while 46.2% of physicians said they would rely on test results. Conclusion: This study provides useful information on the status of laboratory diagnosis of CDI in Korea and what needs to be improved, which will help to standardize and improve laboratory diagnosis of CDI in Korea.

Abstract Rationale Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes. Objectives Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement. Method A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability. Results The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records. Discussion Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce. Conclusions Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement’s actual impact on health care organizations’ performance.

Abstract Backgrounds Medical education has shifted from passive forms of teaching to more active learning strategies, particularly in response to the COVID-19 pandemic. Research has discussed the challenges and disadvantages associated with online education, but there is limited documentation on physicians’ perceptions of this sudden and unexpected transformation in medical education. This study aimed to determine the effect of online interactive visual learning on physicians’ perceptions of the effectiveness and their satisfaction with this online learning experience. Methods We routinely recruited 64 unclassified physicians in the hospital’s postgraduate year (PGY) program between September 2021 and April 2022. PGY physicians received an online interactive visual learning course. Online (Google Form) testing and questionnaires before and after this course evaluated learning performance, learning attitude and satisfaction of these physicians. Results The interactive online learning tools facilitated the physicians’ active learning processes by reducing their learning burden (burden vs. no burden: 4.69% vs. 68.75%) and increasing their learning interest (interest vs. no interest: 84.38% vs. 3.12%) in the online format. Post-test scores were significantly improved compared with pretest scores (post-test vs. pre-test: 5 vs. 4; p

Abstract Background One of the most important and ethically challenging decisions made for children with life-limiting conditions is withholding/withdrawing life-sustaining treatments (LST). As important (co-)decision-makers in this process, physicians are expected to have deeply and broadly developed views. However, their attitudes and experiences in this area remain difficult to understand because of the diversity of the studies. Hence, the aim of this paper is to describe physicians’ attitudes and experiences about withholding/withdrawing LST in pediatrics and to identify the influencing factors. Methods We systematically searched Pubmed, Cinahl®, Embase®, Scopus®, and Web of Science™ in early 2021 and updated the search results in late 2021. Eligible articles were published in English, reported on investigations of physicians’ attitudes and experiences about withholding/withdrawing LST for children, and were quantitative. Results In 23 included articles, overall, physicians stated that withholding/withdrawing LST can be ethically legitimate for children with life-limiting conditions. Physicians tended to follow parents’ and parents-patient’s wishes about withholding/withdrawing or continuing LST when they specified treatment preferences. Although most physicians agreed to share decision-making with parents and/or children, they nonetheless reported experiencing both negative and positive feelings during the decision-making process. Moderating factors were identified, including barriers to and facilitators of withholding/withdrawing LST. In general, there was only a limited number of quantitative studies to support the hypothesis that some factors can influence physicians’ attitudes and experiences toward LST. Conclusion Overall, physicians agreed to withhold/withdraw LST in dying patients, followed parent-patients’ wishes, and involved them in decision-making. Barriers and facilitators relevant to the decision-making regarding withholding/withdrawing LST were identified. Future studies should explore children’s involvement in decision-making and consider barriers that hinder implementation of decisions about withholding/withdrawing LST.

Background: New tobacco products, particularly heated tobacco products (HTPs), have been introduced across several international markets as alternatives to combustible products, such as cigarettes. However, there are limited studies on physicians’ perceptions of HTPs. This study analyzes the awareness of HTPs among physicians and assesses their concerns and attitudes toward patients using HTPs. Methods: A self-administered questionnaire was sent to a sample of 7,500 member physicians (6,000 male and 1,500 female) from the Japan Medical Association (JMA). The smoking status of physicians was categorized as never smokers, ever HTP smokers, current HTP smokers, and ever and current smokers of other products. Physicians’ awareness and attitudes toward patients using HTPs were analyzed using descriptive statistics. The correlation between the outcomes was examined using logistic regression models, whereas physicians’ concerns about HTPs were analyzed using descriptive statistics. Results: Data were obtained from 5,492 physicians (21.9% women; aged 60.4; standard deviation, 12.1 years) with a response rate of 74.6%. Overall, 76.7% of the physicians had awareness of HTP, and about half of whom asked patients about using HTPs. Physicians who took longer to discuss cessation were more likely to discourage patient use. Smoking status was associated with discouraging HTP use in patients. Physicians who had experience with HTP use were primarily concerned about the products’ long-term safety and less about product regulation. Conclusion: Japanese physicians do not have sufficient information and knowledge about HTPs. Therefore, evidence-based guidelines are required to support physicians in advising patients against HTP use.

Abstract Background Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians’ intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. Methods In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin’s integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data was collected only six months after courses and responses to open-ended questions were analyzed using the Theoretical Domains Framework. Results A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of whom 78/192(40.6%) were female; 59/192(30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialist physicians. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74(SD = 1.52) and 6.35(SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from − 0.31(p = 0.17) to 2.25(p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p

Background. Drugged driving is a growing traffic safety issue in many countries. Adequate knowledge of physicians concerning the effects of different medicines on driving can help them prescribe safer medications. This study aimed to assess the knowledge and attitudes of family physicians regarding the effect of medicines on driving. Methods. This cross-sectional study was conducted on 91 family physicians in East Azerbaijan Province. A researcher-made questionnaire was used for data collection. This study considered knowledge and attitude as dependent variables and demographic characteristics as independent variables. To investigate the relationship between independent and dependent variables, independent t-test, one-way analysis of variance (ANOVA), chi-square, and multiple linear regression were used. Data were analyzed using Stata version 17. Results. According to the results, almost 65 (71.43%) of the participants were women and 26 (28.57%) were men with an average age of 31.54 years. The average score of physicians’ attitude about the effect of medicines on driving was 71.70 ± 14.94, and the average score of their knowledge was 37.52 ± 10.23. Therefore, 44 (48.35%) of the physicians had a good level of attitude, whereas 46 (52.87%) of them had a low level of knowledge regarding medications and driving. Receiving education regarding medications and driving was significantly correlated with the level of knowledge and the attitude of physicians (P

Objective:Workplace violence is an important source of problem for employees worldwide. The present study aimed to identify the prevalence of exposure to violence among healthcare professionals, the type of violence they experienced and influencing occupational features, and to determine the healthcare professionals’ opinion about the causes of violence and the potential measures to be taken against violence in health.Methods:A 37-question survey was performed in 598 medical doctors and 357 healthcare assistants including nurses as well in Adana, Turkey. SPSS (Statistical Package for Social Sciences) for Windows 25.0 program was used for the statistical analysis of study data.Results:Of the 955 healthcare professionals participated in the study, 48.5% were male and 51.5% were female, and 85.9% have been subjected to violence at least once in their professional lifetime. The most common type of violence was psychological or verbal attack, which stated to be most frequently committed by the patient relatives and by male gender. Male healthcare workers were exposed to statistically significantly more physical violence. There was statistically significant correlation between the number of patients healthcare professionals dealt with in a day and the rate of exposure to violence. It was found that those who had been exposed to physical violence filed a complaint more than those who had been subjected to other forms of violence.Conclusion:High rates of violent behavior against healthcare workers are at worrying levels indicating that violence in health is a critical problem. Solution of this problem requires all parties’, primarily the health policy makers’ undertaking important tasks.

Haotao Li, Yuankai Huang,&ast; Xiaoyu Xi&ast; The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, 211198, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuankai Huang; Xiaoyu Xi, The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, 211198, People’s Republic of China, Tel +86 134-0414-2338 ; +86 138-5229-7573, Email hyk@cpu.edu.cn; xixy@cpu.edu.cnPurpose: This study aims to investigate the current health status of Chinese physicians in primary healthcare institutions (PHI) and the effects of personal characteristics, lifestyle, work-related environment and life-related environment on the subhealth status (SHS) of them.Methods: A conceptual framework of various influencing factors was constructed with reference to the concept of health-related quality of life before the convenience sampling. Self-administered questionnaires are distributed to acquire the cross-sectional information of nationwide PHI physicians. A logit regression model was constructed to investigate the influence of various factors on the SHS of PHI physicians.Results: Among 682 valid cases included in the logit regression, 457 physicians were in SHS, with an SHS rate of 67%. The regression results (R2=0.3934, chi-square=337.07, p< 0.0001) showed that long working hours (p< 0.05), personal income (p< 0.05) and life stress (p< 0.05) were protective factors for subhealth. The frequency of alcohol consumption (p< 0.01), smoking (p< 0.05), fear of making mistakes at work (p< 0.001), tension with colleagues (p < 0.0001), and job satisfaction (p < 0.05) were all risk factors. Other factors such as education (p < 0.1) also had an effect on the SHS of primary care physicians.Conclusion: A large proportion of PHI physicians in China are in SHS and many of them are not aware that they are in a poor health state. The logit regression model showed that factors including worries about the occurrence of accidents, strained relationships with colleagues, job satisfaction, and frequency of smoking and drinking negatively influence the SHS of PHI physicians, which should be paid more attention. Meanwhile, annual personal income, long working hours and life stress are protective factors, which means that these factors need to be encouraged.Keywords: physician, primary healthcare institution, sub-optimal health, influencing factors, China

ABSTRACT Aim: It is aimed to determine the opinions of physicians and nurses on the evaluation of pain in the postoperative period of pediatric patients undergoing general anesthesia. Materials and Methods: Qualitative research method was used in the study. The study was carried out with a total of 13 physicians and nurses working voluntarily in the anesthesia and pediatric surgery clinic of Selçuk University Medical Faculty Hospital. Data were collected through individual in-depth interviews through a semi-structured questionnaire in October 2022. Individual interviews were held in a suitable meeting room within the hospital with the participation of two researchers. Note-taking technique was used in the interviews and a voice recorder was used. The qualitative data obtained were analyzed by the researchers with the content analysis method. Results: Qualitative findings were determined as four main themes: thoughts about pain, beliefs about pain management, the role of health professionals in pain management, and the role of family/parent in pain management. Conclusion: As a result of the study, it was determined that pain was followed, pharmacological methods were used, non-pharmacological methods were not in the clinical routine, teamwork was important in pain management, and the family/parent were with the child.

Abstract Background In Türkiye, as in other countries, the maldistribution of the health workforce is a serious concern. Although policymakers have developed various incentive packages, this problem has not been thoroughly addressed yet. Discrete choice experiment (DCE) is a valuable method to provide evidence-based information for these incentive packages to attract healthcare staff for rural jobs. The main aim of this study is to investigate the stated preferences of physicians and nurses when choosing a job region. Methods A labelled DCE was conducted to assess job preferences of physicians and nurses from two hospitals one of which is urban, and the other is in a rural region in Türkiye Job attributes included wage, creche, infrastructure, workload, education opportunity, housing, and career opportunity. Mixed logit model was used to analyse the data. Results The strongest attribute associated with job preferences was region (coefficient − 3.06, [SE 0.18]) for physicians (n = 126) and wages (coefficient 1.02, [SE 0.08]) for nurses (n = 218). According to the Willingness to Pay (WTP) calculations, while the physicians claimed 8627 TRY (1,813 $), the nurses claimed 1407 TRY (296 $) in addition to their monthly salaries to accept a rural job. Conclusion Both financial and non-financial factors did affect the preferences of physicians and nurses. These DCE results provide information for policymakers about what characteristics might increase the motivation of physicians and nurses to work in rural areas in Türkiye.

The last part of Ben Sira’s reflections on the activities of his contemporary physicians and the medicine of the time contained in Sir 38:1–15 is devoted to the attitude of the medical practitioner when healing the sick person (38:12–15). The pericope has a concentric structure with the attitude of the physicians towards God at its centre (38:13–14). The frame verses are devoted to the attitude of the sick person (38:12) and the sinner (38:15) towards the physician. According to the sage, it is not enough for a suffering person to turn to God alone asking to restore their health (Sir 38:9–11), but they should call on a doctor to help them recover (38:12a). The sick person needs a doctor’s help (38:12b). The Greek text emphasises that one should not be afraid of a doctor because God created them (the Hebrew version omits this argument; see 38:12a). Therefore, physicians are desired by the Lord and, like all creatures, God has also assigned them a specific task. However, physicians cannot rely solely on their knowledge and skills while healing a sick person. They should ask (pray to) God to allow them first to make the correct diagnosis (as explicitly stated in the Hebrew version), and then to heal their patient. The last verse of the pericope (38:15) poses many difficulties, which are reflected in numerous interpretations of its content. According to the analysis made in the article, it does not contain a negative image of a medical practitioner because its main message is the link between the cause of illness and sin (traditional perception of illness expressed in the Old Testament based on the principle of retribution). In Sir 38:12–15, as well as in the entire reflection on the contemporary medicine (38:1–15), Ben Sira made an excellent synthesis between this field of sci­ence and Israel’s faith in the divine Physician.

ABSTRACTThe importance of doctors’ knowledge and awareness of infectious diseases was felt worldwide during the COVID-19 pandemic. With this study, we aimed to evaluate the effect of the long and dynamic pandemic process on resident physicians’ knowledge and protective behaviors for infection control in a tertiary hospital setting and protective behaviors for infection control in a tertiary hospital setting. The population of this cross-sectional study consisted of assistant physicians working at Suleyman Demirel University Faculty of Medicine Training and Research Hospital. A questionnaire evaluating information and protective practices for COVID-19 was applied to the participants through face-to-face interviews using the convenience sampling method, with an interval of one year. In the second year of the pandemic, resident physicians’ awareness of the correct use of personal protective equipment decreased (p = 0.001). Despite the continuous training, it was determined that the residents preferred masks with high protection at a lower rate when they encountered patients who received oxygen support of 5 lt/min and above (p

Introduction: Proton pump inhibitors (PPIs) are commonly used to treat acid-related disorders. Their appropriate use depends on the correct indications from the clinician. Owing to the high incidence of use and misuse, PPIs have been identified as an essential pharmacological class for developing deprescribing recommendations. Therefore, assessing physicians’ knowledge and practice regarding PPI usage is critical for paving the way toward targeted recommendations and efforts.Objective: This study aimed to assess Syrian physicians’ perceptions of proton pump inhibitors adverse effects, their benefit in upper gastrointestinal bleeding (UGIB) prophylaxis, and how these perceptions are related to PPI prescription practice.Methods: A cross-sectional study was performed using a web-based questionnaire distributed among Syrian physicians in internal medicine between 28 November and 23 December 2022. The questionnaire assessed perceptions and experiences of PPIs, concerns about specific adverse effects, and their effectiveness for UGIB prophylaxis, in addition to the different scenarios used to determine the best practice for appropriate treatment to manage minimal, mild, moderate, and high-risk UGIB patients.Results: A total of 473 participants completed the questionnaire, with median age ±SD was (28.46 ± 4.58), and most participants (83.3%) were residents. Approximately half of the participants (45.5%) agreed that discussion assistance was provided to continue or terminate PPIs properly. Only 8.9% were very familiar with published evidence of PPI adverse effects. Bone weakening and vitamin B12 deficiency were the most frequently reported side effects (81.8% and 79.7%, respectively). However, dementia (0.4%) and mortality (1.9%) were the least reported adverse effects. More than half of the participants (64%) perceived using PPIs to prevent upper GI bleeding. Non-trainee physicians were less knowledgeable about appropriate GERD management than resident physicians (p < 0.001).Conclusion: The study showed a gap between Syrian physicians’ perceptions and practices regarding PPI use, which necessitates spreading awareness of updated guidelines for PPI usage and their side effects.

Background: Communication and leadership communication are key for an efficient performance of physicians. They hold a team together, help hospitals to develop and retain capable employees, and are directly related to physicians' job satisfaction. We aim to test the impact of leadership models and various items of leadership communication on job satisfaction and well-being of physicians working in Swiss hospitals. Method: We conducted a nationwide survey of physicians in Swiss hospitals in 2019 to assess the correlation between communication and leadership style with job satisfaction and well-being of physicians. The evaluation of the survey uses multivariate, statistical analysis (descriptive evaluations, regression model, factor analyses). Results: The data reveal that leadership communication, e.g., the tone of communication, information quality and information behaviour and feedback have the most positive impact on job satisfaction and well-being. These items have a stronger influence on well-being when physicians belong to a younger generation, such as Generation Y (born after 1980). Leadership communication has the greatest impact on job satisfaction on residents and a lesser impact on physicians in higher hierarchical levels. Conclusions: To increase job satisfaction and well-being amongst physicians, hospitals superiors and supervisors are advised to invest in education and training on leadership communication and feedback with special focus on the younger generation as well as on female physicians as this will have the greatest impact. [ABSTRACT FROM AUTHOR]

Gregory of Nazianzus is known for his role in the Pneumatomachian debates of the fourth century and the resultant Nicene-Constantinopolitan Creed. He is less well known for his Oration 2, which was simultaneously a personal defense of his initial flight from the pastorate and also a pastoral theology which highlighted the dangers, difficulties, and duties of those called to the ministry. The oration is long, containing 170 sections, and so the focus will be on a smaller portion, highlighting the theme of the pastor as the physician of souls. After dealing with a few preliminary matters-- such as the setting for the oration and other introductory issues--the article moves to an analysis of sections 16-34 of Gregory's Oration 2. [ABSTRACT FROM AUTHOR]

To assess changes in biological measures of acute stress in surgeons during surgery in real-world settings A prospective cohort study. A tertiary teaching hospital. 8 consultant and 9 training gynecologists. A total of, 161 elective gynecologic surgeries of 3 procedures: laparoscopic hysterectomy, laparoscopic excision of endometriosis, or hysteroscopic myomectomy. Changes in surgeons' biological measures of acute stress while undertaking elective surgery. Salivary cortisol, mean and maximum heart rate (HR), and indices of the HR variability were recorded before and during surgery. From baseline to during surgery over the cohort, salivary cortisol decreased from 4.1 nmol/L to 3.6 nmol/L (p =.03), maximum HR increased from 101.8 beats per min (bpm) to 106.5 bpm (p <.01), root mean square of standard deviation decreased from 51.1 ms to 39.0 ms (p <.01), and standard deviation of beat-to-beat variability decreased from 73.7 to 59.8 ms (p <.01). Analysis of individual changes in stress by participant-surgery event by paired data graphs reveal inconsistent direction of change in all measures of biological stress despite stratification by surgical experience, role in surgery, level of training, or type of surgery performed. This study measured biometric stress changes at both a group and individual level in real-world, live surgical settings. Individual changes have not previously been reported and the variable direction of stress change by participant-surgery episode identified in this study demonstrates a problematic interpretation of mean cohort findings previously reported. Results from this study suggest that either live surgery with tight environment control or surgical simulation studies may identify what, if any, biological measures of stress can predict acute stress reactions during surgery. [ABSTRACT FROM AUTHOR]

The workplace represents a relevant source of stress for workers, being a risk factor for many mental disorders and psychological difficulties, including burn-out syndrome. Healthcare workers and other help-professions are particularly susceptible to work-related stress. The present systematic review aims to (1) identify available interventions for managing workplace-related stress symptoms; (2) assess their efficacy; and (3) discuss the current limitations of available interventions. A systematic review has been conducted, searching on PubMed, APA PsycInfo, and Scopus databases. Eighteen papers have been identified, which included different interventions for the management of work-related stress in healthcare professionals. These approaches can be grouped as follows: (1) interventions focusing on the individual level using cognitive-behavioral therapy (CBT) approaches; (2) interventions focusing on the individual level using relaxation techniques; and (3) interventions focusing on the organizational level. As regards interventions targeting the individual level using CBT approaches, mindfulness-based interventions were effective in reducing levels of burn-out, stress, and anxiety and in improving quality of life. As regards intervention using relaxation techniques, including art therapy, Emotional Freedom Techniques (ECT) and brief resilience retreats had a positive effect on the levels of anxiety, stress, and burnout. As regards interventions at the organizational level, we found no evidence for supporting its effectiveness in reducing the levels of burnout. Furthermore, available studies are heterogeneous in terms of assessment tools, target populations, and type of interventions, which limits the generalizability of findings. [ABSTRACT FROM AUTHOR]

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Background: One of the most important and ethically challenging decisions made for children with life-limiting conditions is withholding/withdrawing life-sustaining treatments (LST). As important (co-)decision-makers in this process, physicians are expected to have deeply and broadly developed views. However, their attitudes and experiences in this area remain difficult to understand because of the diversity of the studies. Hence, the aim of this paper is to describe physicians' attitudes and experiences about withholding/withdrawing LST in pediatrics and to identify the influencing factors. Methods: We systematically searched Pubmed, Cinahl®, Embase®, Scopus®, and Web of Science™ in early 2021 and updated the search results in late 2021. Eligible articles were published in English, reported on investigations of physicians' attitudes and experiences about withholding/withdrawing LST for children, and were quantitative. Results: In 23 included articles, overall, physicians stated that withholding/withdrawing LST can be ethically legitimate for children with life-limiting conditions. Physicians tended to follow parents' and parents-patient's wishes about withholding/withdrawing or continuing LST when they specified treatment preferences. Although most physicians agreed to share decision-making with parents and/or children, they nonetheless reported experiencing both negative and positive feelings during the decision-making process. Moderating factors were identified, including barriers to and facilitators of withholding/withdrawing LST. In general, there was only a limited number of quantitative studies to support the hypothesis that some factors can influence physicians' attitudes and experiences toward LST. Conclusion: Overall, physicians agreed to withhold/withdraw LST in dying patients, followed parent-patients' wishes, and involved them in decision-making. Barriers and facilitators relevant to the decision-making regarding withholding/withdrawing LST were identified. Future studies should explore children's involvement in decision-making and consider barriers that hinder implementation of decisions about withholding/withdrawing LST. [ABSTRACT FROM AUTHOR]

Backgrounds: Medical education has shifted from passive forms of teaching to more active learning strategies, particularly in response to the COVID-19 pandemic. Research has discussed the challenges and disadvantages associated with online education, but there is limited documentation on physicians' perceptions of this sudden and unexpected transformation in medical education. This study aimed to determine the effect of online interactive visual learning on physicians' perceptions of the effectiveness and their satisfaction with this online learning experience. Methods: We routinely recruited 64 unclassified physicians in the hospital's postgraduate year (PGY) program between September 2021 and April 2022. PGY physicians received an online interactive visual learning course. Online (Google Form) testing and questionnaires before and after this course evaluated learning performance, learning attitude and satisfaction of these physicians. Results: The interactive online learning tools facilitated the physicians' active learning processes by reducing their learning burden (burden vs. no burden: 4.69% vs. 68.75%) and increasing their learning interest (interest vs. no interest: 84.38% vs. 3.12%) in the online format. Post-test scores were significantly improved compared with pretest scores (post-test vs. pre-test: 5 vs. 4; p < 0.05) and their imaging recognition was markedly improved from baseline (post-test vs. pre-test: 85.19% vs. 61.11%). Levels of satisfaction correlated positively with the physicians' learning burden (rs = 0.541), learning interest (rs = 0.562), and perceived benefits of imaging recognition (post-course: rs = 0.508; future: rs = 0.563) (all p < 0.05). Conclusions: Our online course with interactive visual learning facilitated PGY physicians' learning performance, levels of satisfaction, interest, and perceived benefits of online learning. Hospitals and policymakers need to be aware that this learning approach can markedly enhance physicians' academic outcomes and levels of clinical practice. [ABSTRACT FROM AUTHOR]

Physicians are the successors of Bakshis among Kazakhs and Kyrgyz and they have made themselves accepted by the society under the influence of the Islamic belief to continue their existence. They have also carried the remnants of shamanism to the present day with its more traditional aspect. Bakshis, who call themselves physicians today, ask for help from God with their assistant jinns when they start their rituals. While this creates an Islamic effect on the remains of shamanism, it is an indication that it leads to a change in the content of shamanic rituals. The study aims to reveal that Kazakhs and Kyrgyz people still have the remnants of shamanism in their lives, despite accepting the religion of Islam and to clarify the reason for this. In addition, it is to analyze the practice of medicine, which became popular in Kazakhstan and Kyrgyzstan after independence and continues today, and the practices of doctors. This study aims to reveal the shamanic beliefs that still exist among Kazakhs and Kyrgyz. The conditions of the Kazakh and Kyrgyz people to become a physician, their ancestral origin, their relationship with the assistant jinns, the methods and means of examining the patient, the attitude of the society towards the physicians, the reasons for the patients' departure, and the satisfaction of the applicants are the focal points of this study. The study was produced on the example of Kazakh and Kyrgyz physicians and the people who apply to them. This study, in which the interview method was used, was conducted face-to-face with the aforementioned glances and speech, and to a lesser extent, by telephone. The most important duties of these doctors, who serve people who cannot solve their problems by medical means or who prefer tradition to medical sciences, are to cure the evil demons that haunt the patients, to guide people in solving their problems about the future. The treatment tools that medical practice use during the ritual vary according to the disease; they generally use whips, pine trees, medicinal plants grown in the steppe, forty stones, and knucklebones. The number of treatment sessions depends on the extent of the disease. Physicians who believe that medicine is inherited from their ancestors, as in the case of gaze, sincerely believe in their demons and their ability to communicate with them. After the capture, both doctors often see their assistant genies in their dreams and after they are taken down, they execute them on instructions and signs. During the treatment, they do not neglect to read Islamic prayers, they see themselves as devout Muslims. In addition, Kazakh and Kyrgyz people do not have the habit of consulting a psychologist yet, so these physicians also meet society's need for a psychological counselling. As a result, Kazakhs and Kyrgyz, who consider the concepts of good and evil as destiny, believe that they can change their destiny with the help of physicians, as they used to do with the bakshis. This is evidenced by the fact that Kazakh and Kyrgyz society applied to all parts of the society, regardless of whether they were educated or uneducated, young or old, male or female. For this reason, traditional practices such as medicine, which is a heirloom of care, continue and keep alive today without losing their functions in the modern era and places where technology has developed. There is no pressure from the states of Kyrgyzstan and Kazakhstan towards today's doctors, but they do not receive support either. Ethics committee report was received for publication of the study. [ABSTRACT FROM AUTHOR]

Background: Obesity is a serious chronic disease that adversely affects health and quality of life. However, a significant percentage of people do not participate in or adhere to weight loss programs. Therefore, a multidisciplinary approach is needed to identify critical barriers to effective obesity management and to examine health practitioners' attitudes and behaviors towards effective obesity treatment. Methods: This systematic review was conducted in accordance with PRISMA 2020. Eligible studies were identified through a systematic review of the literature using Medline, Scopus, Cochrane, Google Scholar, Web of Science, and Embase databases from January 1, 2011 to March 2, 2021. Results: A total of 57 articles were included. Data on 12 663 physicians were extracted from a total of 35 quantitative articles. Some of the most commonly perceived attitude issues included "obesity has a huge impact on overall health", "obesity is a disease" and "HCPs are to blame". Health professionals were more inclined to believe in "using BMI to assess obesity," "advice to increase physical activity," and "diet/calorie reduction advice." The major obstacles to optimal treatment of obesity were "lack of motivation", "lack of time" and "lack of success". Conclusion: Although the majority of health professionals consider obesity to be a serious condition with significant impact on overall health, nearly half of the visits include counseling, pharmacological or surgical interventions regarding lifestyle changes. Increasing the length of physician visits as well as tailoring appropriate training programs could improve health care for obesity. [ABSTRACT FROM AUTHOR]

Online purchase is becoming an increasingly viable alternative to in-store transactions due to constraints on in-person interaction. However, medical nutrition customers, mostly healthcare patients in Sri Lanka, are still apprehensive about purchasing products online. Doctors' recommendations can positively influence patients' decisions to buy medical nutrition online, but few researchers have studied this. This study incorporated the Unified Theory of Acceptance and User of Technology (UTAUT) to assess what influences doctors to recommend online medical nutrition purchases to their patients. This study utilized a quantitative survey involving 64 medical doctors in Sri Lanka and used partial least squares structural equation modeling for data analysis. The results showed that Performance Expectancy (PE), Social Influence (SI), and Effort Expectancy (EE) affect doctors' Behavior Intention (BI) in recommending online purchasing for medical nutrition. This study will benefit the pharmaceutical industry in accelerating medical nutrition online purchases in Sri Lanka by leveraging doctors as social influencers to recommend online purchases and extend the application of UTAUT in the field. [ABSTRACT FROM AUTHOR]

Background: Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians' intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. Methods: In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin's integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data was collected only six months after courses and responses to open-ended questions were analyzed using the Theoretical Domains Framework. Results: A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of whom 78/192(40.6%) were female; 59/192(30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialist physicians. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74(SD = 1.52) and 6.35(SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from − 0.31(p = 0.17) to 2.25(p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p < 0.0001), and beliefs about consequences (β = 0.11, p = 0.04) influenced post-course intention. Post-course intention was correlated with behavior six months later (DM = 0.63; p = 0.02). Qualitative analysis showed that facilitators to behavior adoption after six months were most often related to the TDF domains of beliefs about capabilities. Most frequent barriers to adoption related to lack of resources. Conclusions: Overall, scores for intention to adopt targeted behaviors increased after the courses. CPD providers could increase participants' intention by including interventions that emphasize beliefs about capabilities, moral norm and beliefs about consequences. [ABSTRACT FROM AUTHOR]

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Copyright of Social Sciences Studies is the property of Social Sciences Studies 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.)