Knowledge towards Physical Medicine and Rehabilitation among Training Doctors and Medical Students at the Mohammed VI University Hospital of Marrakech

The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Evaluation of the famous classic formula Sanhua decoction based on network pharmacology and multi-component quantitative analysis

Background:Sanhua decoction has significant effects in the treatment of stroke.The study of the Sanhua decoction material benchmark was carried out to analyze the value transfer relationship between the Chinese herbal pieces and the substance benchmark.Methods:Network pharmacology was employed to investigate the potential active components and molecular mechanisms of Sanhua decoction in the treatment of stroke.15 batches of Sanhua decoction lyophilized powder were prepared using traditional formulas and subjected to high-performance liquid chromatography analysis to generate fingerprints of the Sanhua decoction substance benchmarks.Then,a multi-component quantitative analysis method was established,allowing for the simultaneous determination of ten components,to study the transfer of quantity values between pieces and substance benchmarks.Results:60 active ingredients were screened from Sanhua decoction by network pharmacology,of which gallic acid,magnolol honokiol,physcion,and aloe-emodin may have a greater effect than other active components.63 key targets and 134 pathways were predicted as the potential mechanism of Sanhua decoction in treating stroke.The fingerprint similarity of the Sanhua decoction substance benchmarks was found to be good among the 15 batches,confirming the 19 common peaks.The content of the 10 components was basically consistent.The components’transfer rates were within 30%of their respective means.Conclusions:This study provided a comprehensive and reliable strategy for the quality evaluation of Sanhua decoction substance benchmarks and held significant importance in improving its application value.

How Marie Sklodowska-Curie Doctoral Networks Can Support European Refractory Ecosystem in Context of The European Green Deal

The movement of the Iron&Steelmaking(I&S)industry towards Net-Zero emissions and digitalized processes through disruptive,breakthrough technologies will be achieved through the use of Hydrogen.The biggest challenge for the refractory industry is to continue to meet the performance expectations while,at the same time,moving to a more sustainable production direction.The complexity and urgency of these technological changes,highlighted by the European Green Deal,requires ambitious,international,interdisciplinary and intersectoral projects,bringing together institutes from across the global value chain,to carry out cutting edge research.The European Union,through its flagship doctoral training program,MSCA,has,and continues to support research and development as well as the promotion of the refractory industry in Europe.An introduction to two MSCA projects and some of the results achieved are highlighted within this article.

Herbal medicine prescribing patterns from contemporary famous old TCM doctors for treating coronary heart disease: an analysis based on data mining

To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.

Evaluation of Need and Distribution of National Essential Medicines List in Village Clinics:A Cross-sectional Study Based on the Perspective of Village Doctors in China

This study aimed to evaluate the satisfaction of village doctors to essential medicines list (EML) and accessibility of essential medicines (EMs) distribution to improve the implementation of EML in village clinics.A total of 422 village doctors from five counties in three provinces of China were surveyed by questionnaires.Logistic regression analysis was conducted to identify the main factors associated with village doctors' evaluation of EML.The results showed that village doctors had a negative evaluation in satisfaction level of EML to village-based care and accessibility of EM distribution.The government should adjust EML regularly based on the actual health status of local villagers in China and focus on adding appropriate drugs that meet the needs of villagers with chronic disease.The local government should also attach importance to the distribution of EMs and maintain their supply in village clinics.

Standardized training for resident doctors in China

Medical graduates are not fully trained physicians when they leave medical school.Currently,standardized training for resident doctors in most hospitals in China is carried out according to the Ministry of Health guidelines.However,these guidelines provide only outline guidance,and specific resident training is managed independently by and varies with individual institutions.Therefore,it is important to study training demand to learn about the content and emphasis of training.

Underlying Beliefs Influencing Vietnamese Nurses and Doctors in Screening for Victims of Domestic Violence: An Exploratory Study

Many health professionals in Vietnam have limited knowledge and experience in coordinating care for victims of Domestic Violence (DV). This qualitative study aimed to elicit the beliefs of nurses and doctors that are influencing the care of victims of DV. Data were collected by semi-structured interviews with nineteen nurses and doctors. Data were analyzed by content analysis and organized by three main themes;behavioral beliefs, normative beliefs and control beliefs. The outcomes of this study will inform the development of intervention strategies that will enable health professionals to better respond to and manage care for women who experience domestic violence in Vietnam.

Health Problem and Occupational Stress among Chinese Doctors

This paper provides an overview of research into mental health problem and occupational stress among Chinese doctors in recent 10 years. It indicates that doctors in general hospitals have worse mental status. Occupational stress comes from over workload, high demanding from patients, occupational risk, effort-reward imbalance and fierce competition for job promotion. For medical staffs battling against severe acute respiratory syndrome (SARS), or working in catastrophic Wenchuan earthquake-affected areas, they have elevated stress and worrying levels of psychological distress. Post-traumatic stress disorder (PTSD) is a common mental health problem among them. The most common diseases the Chinese doctors usually suffered were cervical spondylosis, hyperlipidemia, hypertension, fatty liver and hyperglycemia. It could be important for health administrators to note that mental health appears to be an?increasing problem in Chinese doctors and corresponding helping measure should be made.

Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

How do family doctors choose their own family doctor?

Background and objectives: The medical care that doctors receive is different than that of individuals who are not in the medical profession. The objective was to assess how family doctors in the Negev region chose their own doctors. Methods: 103 family doctors in the southern region of Israel completed a self-administered, anonymous questionnaire that included sociodemographic data and how doctors choose their own doctors. Results: The study population included 103 family doctors with a mean age of 44.7±9.8, of them 65 women (63.1%). Most of the participants (69.9%) were born in the former Soviet Union and completed their medical studies there (71.8%). Thirty two (31.4%) were specialists in family medicine and 42 (41.2%) were residents in family medicine. For most of the participants the gender and age of their treating physician were not important (74.8% and 63.1%, respectively). The treating physician’s level of expertise was very important to 87.4%. Only half consulted a colleague before choosing a physician. Their personal connection to the treating physician was very important to 46 (44.7%). Female doctors were more likely to choose a female physician com-pared to males (P=0.025). Residents were more likely to consult a colleague than specialists before choosing a treating physician (P=0.023). Female doctors are more likely than male to care for themselves both for chronic and acute conditions. Conclusions: Choosing a treating physician is a subjective process with each doctor having individual requirements and ex-pectations. The factors that most influenced the choice of treating physician were professional skills and specialization.

Use of Malaria Rapid Diagnostic Tests among Medical Doctors in a Tertiary Hospital, South East Nigeria

Malaria is a major health problem in Nigeria that has as high as 25% of all global cases, and 30% of deaths attributable to malaria. In 2010, World Health Organization (WHO) recommended universal confirmation of diagnosis of malaria through blood parasitological test, prior to initiation of treatment. In addition to Microscopy, Malaria Rapid diagnostic Tests (mRDTs) are blood tests for malaria. Early diagnosis of malaria ensures that the correct treatment is commenced in good time, and this subsequently improves the prognosis. The objective of this study is to assess the use of mRDTs among medical doctors working in a tertiary hospital, Southeast Nigeria. This study was conducted in Enugu State Teaching hospital, Southeast Nigeria. The study was of cross-sectional design, and conducted in October 2016 among medical doctors working in the General Outpatient, Internal Medicine, and Paediatrics departments of the Teaching hospital. Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. A total of 86 medical doctors, out of the eligible 91 in the three departments participated in the study, and were distributed as follows;24 (27.9%) in the General Outpatient, 30 (34.9%) in the Internal Medicine, and 32 (37.2%) in the Paediatrics departments. More medical doctors in the Paediatrics department (31.3%) used mRDTs in making diagnosis of malaria, followed by Internal medicine (13.3%), then General Outpatient Department (8.3%). Malaria rapid diagnostic tests are cost-effective, and useful tools in malaria control and elimination programmes. If tangible progress on the implementation of the WHO guidelines on confirming diagnosis of malaria before treatment;and the T3: Test, Treat, Track initiative is to be made;then the government and the Management of hospitals ought to take more determined efforts aimed at educating and informing health workers, especially medical doctors on the benefits of mRDTs.

Knowledge and Perception of Malaria Rapid Diagnostic Test among Medical Doctors in a South Eastern Nigeria Tertiary Hospital

Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more accessible. The objective of this study was to assess knowledge, and perception of malaria rapid diagnostic test (mRDT), among doctors in a tertiary health facility. A descriptive, cross sectional study, conducted in October 2016, in a state University Teaching hospital, Enugu state, Nigeria. 86 doctors in the General Outpatient, Internal Medicine, and Paediatrics departments participated. 90.7% of respondents knew parasitological examination of blood is the certain method of making malaria diagnosis, 89.5% knew microscopy and RDT are methods for parasitological diagnosis, 91.9% knew mRDT is quick blood test for malaria, 54.7% knew mRDT is usually specific for one or more species of malaria, 46.5% knew mRDT detects circulating malaria parasite antigen, 29.1% knew mRDT is read 15 to 20 minutes after the test, 70.9% knew mRDT is not superior to microscopy, 79.1% knew mRDT is not 100% specific, 80.2% knew mRDT ought not be done always by Laboratory Scientists, and 66.3% knew more than one type of mRDT kit is available. On perception, 64.0% thought it was important to confirm diagnosis before commencing treatment, 90.7% perceived mRDT as being very useful, 96.5% did not perceive mRDT as endangering patients, 70.9% opinioned that presumptive diagnosis of malaria is not a better way of making diagnosis, 76.7% did not believe malaria diagnosis is always clear on listening to the patient, 90.7% did not perceive mRDT as being hazardous, 83.7% believe using mRDT can reduce the quantity of anti-malaria drugs consumed, and 94.2% opinioned that mRDT should be encouraged and promoted. Training and re-training of health workers shall greatly enhance mRDT use in implementing the WHO T3 Initiative, and ultimately eliminating malaria.

Utilization of Consultant Doctors’ Competence and Impact on Perceived Psychosocial Work Environment: A Pilot Study

Background: Work agencies that assign temporary jobs to doctors and nurses are becoming an increasing phenomenon. Aim: The purpose of this pilot study was to explore how consultant doctors (CDs) experience their competence as utilized in practice and what impact this has on their perceived psychosocial work environment. Methods: The findings are based on 11 interviews with CDs working on consultancy assignments in Norway. The CDs were all specialists in fields such as general practice, psychiatry, anesthesia, gynecology, orthopedics, and otolaryngology. Results: The competence that the CDs contributed to their hosting work organization was interpreted differently based on whether the consultant played an active role in the psychosocial work environment and also depended on the doctor’s specialty. Not being integrated into the hosting work organization enhanced the feeling of exclusion and the idea that little or no room was available to contribute one’s competence. Most of the CDs experienced their competence as being utilized to a certain extent, which strengthened their work satisfaction and feeling of playing an active role in the psychosocial work environment.

Dissemination of <i>Staphylococcus warneri</i>in the Hair of ICU Doctors

This study reports a case of Staphylococcus warneri dissemination in the hair of ICU/ER doctors. Eleven of 23 doctors in the first survey and 11 of 24 doctors in the second survey, which were conducted after 6 months, carried S. warneri, while hair contamination of other coagulase-negative staphylococci was only sporadic. Chromosomal DNA analysis with PFGE revealed that 7 S. warneri strains isolated in the first survey and 7 strains isolated in the second survey showed similar PFGE patterns, suggesting that a cross-infection with a S. warneri strain continued over 6 months among the ICU doctors.

Humanity factors and more: A little heads up for medical students and future doctors

Exactly how can we become a successful doctor in the future? It has been widely accepted that chasing perfection in our field of expertise alone is not enough. Here in China, doctors have the liability to do more. Chinese doctors are relatively more prone to confronting difficult situations in a more complex manner. Therefore, the humanity factor in medical practice is discussed, and some essential communication skills are suggested for medical practitioners, with heartfelt anticipation for a better medical environment as well as a more pleasant Doctor-Patient relationship.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

AIM To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders(FGIDs) in doctors that work 24 hour-on-call shifts.METHODS In this cross-sectional observation study, using the Rome Ⅲ Questionnaire and Pittsburgh Sleep Quality Index(PSQI), we analyzed 170 doctors with 24 houron-call shifts. RESULTS Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48(28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome(IBS) and functional dyspepsia(FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores(PSQI)(8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm(83.3%vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work(81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD(OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality(PSQI ≥ 6) was a predictor of IBS(OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). CONCLUSION Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Work-family conflict and job burn-out among Chinese doctors:the mediating role of coping styles

Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services.This study aims to explore the relationship between workfamily conflict(WFC) and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory(CMBI), WFC Scale and the Simplified Coping Style Questionnaire(SCSQ). A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family conflict, reported more emotional exhaustion(r=0.514, P<0.001) and had a sense of accomplishment(r=-0.149, P<0.001). Simultaneously,family interfering with work(FIW) was positively associated with all dimensions of burn-out(r=0.213,0.504,0.088,respectively, P<0.001). Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn?out.

Prevalence and Factors Associated with Burnout Syndrome among Resident Doctors at Tertiary Teaching Hospitals in Dar es Salaam, Tanzania

Introduction: Burnout syndrome is prevalent to a great extent among medical residents, and this can interfere with their training and patient management. However, the extent of the problem is still unknown in our setting. This study therefore aimed at determining prevalence and factors associated with burnout syndrome among resident doctors at tertiary teaching hospitals in Dar es Salaam, Tanzania. Method: A cross-sectional study of resident doctors was carried out in four teaching hospitals of Muhimbili University of Health and Allied Sciences between January 2021 and March 2021. Participants were interviewed using a structured questionnaire and Maslach Burnout Inventory. Results: The study had 398 participants with a mean age of 35 ± 3.5 years. Overall burnout prevalence was 33.7%, as for the burnout dimensions, 205 (51.5%) respondents reported burnout in the dimension of emotional exhaustion (EE), 177 (44.5%) in the dimension of depersonalization (D), and 144 (36.2%) in the dimension of reduced personal accomplishment (RPA). Independent factors associated with burnout syndrome were: inadequate support from residency program supervisors (Odds Ratio (OR) 1.97, 95% CI: 1.23 - 3.14, p = 0.005), work-related family conflicts (Odds Ratio (OR) 3.2, 95% CI: 1.35 - 7.71, p = 0.008), stressful call perception (Odds Ratio (OR) 3.31, 95% CI: 1.90 - 5.76, p = 0.001) and each added year of study (Odds Ratio (OR) 3.46, 95% CI: 1.08 - 6.73, p = 0.009). Conclusion: Burnout is a problem among resident doctors in Tanzania. This could be addressed by directing preventive and intervention measures in the residency training program. Periodic assessment is also needed to mitigate factors associated with burnout among resident doctors.

Under the narrative medicine theory to establish the evidence-based medical record written by doctors and patients through integrated therapy of traditional Chinese and western on digestive system diseases

目的:遵循叙事循证医学理念,抽提医患共建式循证病历的理论,建立医患共建式循证病历的范本.方法:检索Pubmed等重要医学数据库,参照叙事医学的理念,咨询中西医消化内科及循证医学专家,初步达成共识.结果:本研究是一次叙事循证医学指导下医患共建式循证病历建立的有益尝试.思考与展望:医患共建式病历有可能成为叙事医学指导下的中西医合作治疗脾胃病相关疗效评价方法学体系的内容.