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.

How to Treat Others' Advice

In our life, we can't avoid making mistakes. So some advice on how to correct them is very important and helpful to us.The people who care about you will give you some wise advice. When you are in trouble,good advice can always teach you how to solve it and do better.

The Doctor's Advice

The doctor looked at his patient’stongue,felt of his pulse(脉搏),knocked onhis chest,and began:“Same old story,myfriend.Too much confinement(闭门不出).Don’t deny it.What you need is plenty ofoutdoor exercise.Walk,walk,walk.”“But,doctor—”“Don’t argue with me.I am the doctor.Take my advice.Walk ten times as much

Study on AIDS Epidemic from Unsafe Blood Handling among Rural Doctors

Objectives: This paper examines the basic knowledge ofAIDS and HIV transmission through unsafe blood collec-tion and supply among rural Chinese doctors. It also ex-plores the accessibility of AIDS intervention methods inrural area. Methods: We did Case studies, held focus group discus-sions and provided questionnaires to all rural doctors inone township where the epidemic of HIV was known to bespread through blood collection and supply. Data were col-lected and analyzed with software EPI 6.0.Results: The effective response rate to the questionnairewas 100%. The results showed that more than 95% of in-formants gave correct answers to the questions about thesexual and blood-bourne transmission of HIV as well as itscontagiousness. Half of the participants were ignorant aboutmother to child transmission of HIV and did not know thatHIV couldn’t be transmitted by saliva, sweat, mosquito bites,sharing of bathtubs or toilets. More than 80% of infor-mants were opposed to blood selling and reportedly under-stood the objective of the blood organizers in their villages,knew the peak time of blood selling by the villagers, and ,were aware of the risks of diseases being spread throughblood. . 27.3% used disposable syringes ‘once in a while’,and 15.2% discarded or sold used disposable syringes.Conclusions: The authors assert that there are severe lurk-ing perils of iatrogenic cross infection in rural areas. Ruraldoctors urgently need formal training on prevention andtreatment of HIV infection. We believe that rural doctorsshould become the key force in AIDS prevention and con-trol in rural area.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

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.

Nutrigenetics, Nutrigenomics, and the Future of Dietary Advice

Our individual metabolic phenotype is the result of the interaction between nutrients and DNA to modify gene expression. This is a combination of epigenetic interactions whereby nutrients modify the structure of DNA to affect gene expression as well as individual genetic variation that alters our response to diet. Our metabolic phenotype is influenced by developmental plasticity, imprinting in early life and interactions with environmental factors over time. Unlike the human genome which is relatively fixed and stable throughout the body, the human metabolic phenotype is far more complex and dynamic, varying over time and among cells and varying greatly from person to person. Dietary recommendations are often generalized and intended to avert chronic illnesses such as diabetes and cardiovascular disease. In a climate where we are striving for personalisation of healthcare maybe we need a simpler approach;one that embraces genetic variation yet focuses on the optimum nutritional benefit of dietary components.

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.

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 work-family confict （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 Simplifed 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 confict, 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.

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

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.METHODSIn this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.RESULTSAmong 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).CONCLUSIONPhysicians 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.

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.

Explaining Customer Experience of Digital Financial Advice

The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have been considered. It is found that experiential subjective system aspects are the most important. Surveys have been conducted in The United Kingdom and The Netherlands. In exploratory factor analysis, five dominant factors were obtained in the UK and six factors in The Netherlands to explain customer experience. Based on the factor scores, multiple regression analysis has been performed to develop the digital customer experience model （DCX model）. This is the first cross-cultural model to evaluate customer experience of financial advice. In an era in which financial institutions and FinTech companies battle for the engagement of customers, the DCX model is the first to fundamentally drive value creation, differentiation, regulation, and future research.

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.

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

Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.

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.

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.

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.

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.