Sleep quality among family medicine physicians before and during COVID-19 in Jeddah, Saudi Arabia

Background: This study aimed to assess the sleep quality of family medicine physicians before and during the COVID-19 pandemic in Jeddah, Saudi Arabia, and to explore the associations between sleep quality and various demographic and health-related factors. Methods: A total of 109 family medicine physicians participated in this cross-sectional study. The Pittsburgh sleep quality index (PSQI) was utilized to evaluate sleep quality, encompassing seven components: subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. Data were collected asking questions regarding both before and during the pandemic period. Descriptive statistics, paired-sample t-tests, and Chi-square tests were used for data analysis. Results: The study revealed significant changes in sleep quality components before and during the pandemic. While sleep latency and sleep duration improved, sleep disturbance, use of sleep medication, and daytime dysfunction worsened during the pandemic. The overall global PSQI score indicated a decline in sleep quality during the pandemic. Females reported poorer sleep quality than males. Participants with general anxiety disorder, diabetes mellitus, and hypertension experienced worse sleep quality. Other demographic and health-related factors exhibited mixed associations with sleep quality. Conclusions: The study highlights the nuanced impact of the COVID-19 pandemic on the sleep quality of family medicine physicians. The observed changes in sleep quality components and their associations with various factors underscore the need for tailored interventions to address sleep disturbances among healthcare professionals. These findings contribute to a comprehensive understanding of sleep quality dynamics in the context of a global crisis and emphasize the significance of promoting well-being among healthcare providers for enhanced patient care.

Preventive care for osteoporosis in family medicine: risk assessment, bone health, and fracture prevention

Osteoporosis is a health condition that involves bones and an elevated likelihood of fractures. In the realm of family medicine, the prevention of osteoporosis entails evaluating risks promoting bone health and minimizing the occurrence of fractures. This review explores aspects of care for osteoporosis in family medicine, focusing on early detection and intervention. Family physicians need to be observant of signs like fragility fractures, postural changes, and height loss that indicate osteoporosis. Many different elements, such as one’s age, gender, family medical background and the choices they make in their lifestyle can contribute to the likelihood of developing osteoporosis. These factors also help in devising measures to address the condition effectively. Managing osteoporosis requires an approach led by family physicians that includes lifestyle adjustments, medication interventions tailored to risks, and patient education. Emphasizing weight-bearing exercises, nutrition personalized medications are elements of preventive care. Patient education plays a role in ensuring adherence to prescribed treatments as well as adopting strategies to prevent falls. Tools like FRAX help family physicians assess risks and tailor interventions accordingly. Collaborating with therapists and dietitians further enhances the effectiveness of managing osteoporosis through care. Family doctors go beyond their duties. Take a role in community initiatives that aim to increase awareness offer education and carry out screenings to prevent osteoporosis. Family doctors, as healthcare providers, play a role in minimizing the effects of osteoporosis on bone health and overall well-being. This review provides a summary of measures for osteoporosis, in family medicine emphasizing the significance of early identification, personalized treatment and community involvement.

Primary healthcare training in the Democratic Republic of the Congo

Family medicine is a relatively new discipline in the Democratic of the Congo. It was developed under South­South and Churches Collaboration with the aim of responding in a cost-efficient manner to the crisis of health practitioners in mostly Christian and protestant hospitals based in rural areas in the Democratic Republic of the Congo.

Strengthening healthcare through family medicine training in the Gambia: The journey so far

According to the World Health Organizations (WHO) family medicine forms the bedrock upon for accessible, affordable and equitable healthcare for any country. The need for family doctors is more acute for low income countries like The Gambia. More so that The Gambian health infrastructure is suboptimal and appropriate health personnel is low. This is worsened by brain drain leading to poor health indices. Despite these challenges and more, the department of Family Medicine was accredited for training in the Gambia with improved infrastructure (at the training centre), with 7 residents. Though there are still challenges there are also opportunities and strengths. There is therefore hope that the right personnel will be produced for an improved Gambian health system.

Caracterización de los adultos mayores con cáncer colorrectal en la comunidad / Characterization of Community Older Adults with Colorectal Cancer

Introducción: El cáncer colorrectal es la neoplasia más frecuente del sistema digestivo en los adultos mayores. En Cuba es un problema de salud de primer orden por su elevada incidencia y mortalidad, que constituye la tercera causa de muerte. Objetivo: Caracterizar a los adultos mayores con cáncer colorrectal en el Policlínico Sur de Sancti Spíritus. Métodos: Investigación de tipo descriptiva en el Policlínico Sur del municipio y la provincia de Sancti Spíritus de enero a marzo del 2019. Muestra intencional de 127 adultos mayores, pertenecientes a consultorios urbanos. Las variables: edad, sexo, escolaridad, estadio del cáncer colorrectal al diagnóstico, estado de salud, comorbilidades, capacidad y percepción del autocuidado y supervivencia. Para determinar el estadio al diagnóstico se utilizó la clasificación anatomoclínica. La comorbilidad se midió mediante el índice de Chalson mientras que para medir la capacidad y percepción del autocuidado se empleó el Test de CYPAC-AM. Resultados: En la caracterización de la muestra predominaron las mujeres, el grupo de edad entre 70 y 79 años y la escolaridad de secundaria básica. El estadio II, con un mal estado de salud y la inadecuada percepción de autocuidado, fue mayoritario. La comorbilidad fue moderada con una supervivencia entre 40 a 60 meses. Conclusiones: La adecuada caracterización de los adultos mayores con cáncer colorrectal en la comunidad posibilita trazar estrategias dirigidas a la mejora del autocuidado y el estado de salud de los gerontes desde el primer nivel de atención(AU)

Introduction: Colorectal cancer is the most frequent neoplasm of the digestive system in older adults. In Cuba, it is a highly significant health problem due to its high incidence and mortality, also being the third cause of death. Objective: To characterize older adults with colorectal cancer at Policlínico Sur of Sancti Spíritus. Methods: A descriptive research was carried out in Policlínico Sur of Sancti Spíritus Municipality and Province from January to March 2019. The intentional sample was made up of 127 older adults, belonging to urban family medical offices. The variables were age, sex, school level, stage of colorectal cancer at diagnosis, health status, comorbidities, selfcare capacity and perception, and survival. The anatomoclinical classification was used to determine the stage at diagnosis. Comorbidity was measured using the Chalson index, while the CYPAC-AM (older adult selfcare capacity and perception) test was used to measure selfcare capacity and perception. Results: In the characterization of the sample, there was a predominance of women, the age group between 70 and 79 years, and the junior high school level. Stage II prevailed, together with poor health status and inadequate selfcare perception. Comorbidity was moderate, with survival between 40 to 60 months. Conclusions: The adequate characterization of older adults with colorectal cancer in the community makes it possible to outline strategies aimed at improving selfcare and their health status from the first level of care(AU)

¿Medicina General Integral o Medicina Familiar?, una reflexión a tres lustros de esta publicación / Comprehensive General Medicine or Family Medicine? A Reflection Three Decades After This Publication

Introducción: Más de 15 años han transcurrido desde que se publicó, como experiencia médica, el artículo ¿Medicina General Integral o Medicina Familiar? y hace aproximadamente diez años, el tema de reflexión: La Medicina General Integral una especialidad clínica con un verdadero enfoque biopsicosocial de la salud de la población. En el primero de los artículos se tomaba partido con relación al nombre que debía mantener la especialidad de referencia, que debía ser el de Medicina General Integral. En el segundo se resaltaba el carácter general e integral de esta. La Medicina General Integral, según plantean algunos, la Medicina Familiar cubana, definitivamente está a punto de asumir esa última denominación de manera oficial. No creo que la nueva denominación resulte adecuada. Objetivo: Fundamentar por qué no debe modificarse el nombre de la especialidad teniendo en cuenta específicamente su carácter general e integral. Métodos: Se realizó una revisión exhaustiva de los artículos publicados, todos vinculados al trabajo dentro del modelo de Medicina Familiar. Conclusiones: La especialidad en la que se forman y desarrollan los médicos que se desempeñan, fundamentalmente, en consultorios de la comunidad del primer nivel de atención en Cuba debería seguir denominándose Medicina General Integral(AU)

Introduction: It has been more than 15 years since the article Comprehensive General Medicine or Family Medicine? was published as a medical experience. It has been about ten years since this thought was disseminated: Comprehensive General Medicine, a clinical specialty with a true biopsychosocial approach to the population health. The first article supported the position of naming this specialty as Comprehensive General Medicine. The second article remarked the general and comprehensive character of this specialty. Comprehensive General Medicine, according to some authors, is definitely about to be accepted as the official name of this specialty. I do not think that Cuban Family Medicine would be appropriate as a name. Objective: To justify why the name of this specialty should not be modified, specifically taking into account its general and comprehensive nature. Methods: A thorough review of published articles was carried out, all linked to work within the Family Medicine model. Conclusions: The specialty in which doctors are trained and developed, mainly in community offices at the first level of care in Cuba, should maintain the name of Comprehensive General Medicine(AU)

Fellowship training of family medicine in the United States and its implications for China / 中华全科医师杂志

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Past Activities and Prospects of Japanese Association of Family Physician Trainees / 日本プライマリ・ケア連合学会誌

A certain period of time has passed since the transition to the General Medicine residency system under the Japanese Medical Specialty Board and Family Medicine specialist training system by the Japan Primary Care Association. We have summarized the needs of residents identified in the survey, and detailed the activities to date and prospects of the Japanese Association of Family Physician Trainees, a self-help support organization, which is an official subcommittee of the Japan Primary Care Association, from the viewpoint of the residents. We believe that this paper will serve as a resource for the training of residents, help guide them under the new system, and help to improve the training system, considering evidence suggesting that information may not be reaching residents who need support.

A Qualitative Study Exploring the Impact of Covid-19 Pandemic on Teaching and Learning of Family Medicine Course among Undergraduates in a Local University in Malaysia

@#Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future.

Improving outcomes in co-morbid diabetes and COVID-19: A quasi-experimental study

Background: High-risk people living with diabetes (PLWD) have increased risk for morbidity and mortality. During the first coronavirus disease 2019 (COVID-19) wave in 2020 in Cape Town, South Africa, high-risk PLWD with COVID-19 were fast-tracked into a field hospital and managed aggressively. This study evaluated the effects of this intervention by assessing the impact of this intervention on clinical outcomes in this cohort. Methods: A retrospective quasi-experimental study design compared patients admitted pre- and post-intervention. Results: A total of 183 participants were enrolled, with the two groups having similar demographic and clinical pre-Covid-19 baselines. Glucose control on admission was better in the experimental group (8.1% vs 9.3% [p = 0.013]). The experimental group needed less oxygen (p < 0.001), fewer antibiotics (p < 0.001) and fewer steroids (p = 0.003), while the control group had a higher incidence of acute kidney injury during admission (p = 0.046). The median glucose control was better in the experimental group (8.3 vs 10.0; p = 0.006). The two groups had similar clinical outcomes for discharge home (94% vs 89%), escalation in care (2% vs 3%) and inpatient death (4% vs 8%). Conclusion: This study demonstrated that a risk-based approach to high-risk PLWD with COVID-19 may yield good clinical outcomes while making financial savings and preventing emotional distress. Contribution: We propose a risk-based approach to guide clinical management of high risk patients, which departs significantly from the current disease-based model. More research using randomised control trial methodology should explore this hypothesis.

Medical preceptorship: perceptions and perspectives of new family doctors in Brazil / Preceptoria médica: percepções e perspectivas de novos médicos de família no Brasil

Abstract: Introduction: Learning in practical environments consists in an essential component of medical education. In recent decades, medical schools have sought to immerse their students in professional settings since the early years of studying. In these scenarios, the preceptors, more experienced physicians, are responsible for supporting their students in the development of professional knowledge, skills, and attitudes. Objective: This study aimed to analyze the perceptions and perspectives of participants of the Preceptorship Training Course (PTC) in Family Medicine - UNA-SUS about preceptorship and medical education. Methods: The quantitative descriptive study was conducted in two phases: 'Population Outlining' phase, including participants' academic data, and 'Survey Questionnaire' phase, performed by applying a questionnaire through a digital platform. Results: The 'Population Outlining' identified 2,530 participants in the PTC, with the predominance of females and southeastern residents. The 'Survey Questionnaire' phase constituted of 232 respondents, of whom 73.4% reported acknowledging their preceptors' contributions, and more than 90% expressed interest in teaching activities, valuing their curriculum enhancement and academic acknowledge. Conclusion: Our findings evidenced positive perceptions about preceptorship and a propensity to engage in teaching activities among the participants, reinforcing the importance of debates about qualification, recruiting and retention of preceptors.

Resumo: Introdução: O aprendizado em ambientes práticos consiste em um componente essencial da educação médica. Nas últimas décadas, as escolas médicas têm procurado imergir os estudantes em ambientes profissionais desde os primeiros anos do curso. Nesses cenários, médicos mais experientes, preceptores, são responsáveis por apoiar seus aprendizes no desenvolvimento de conhecimentos, habilidades e atitudes profissionais. Objetivo: Este estudo teve como objetivo analisar as percepções e perspectivas de participantes do curso de Especialização em Preceptoria em Medicina de Família - UNA-SUS sobre preceptoria e educação médica. Método: O estudo quantitativo descritivo foi realizado em duas fases: "delineamento da população", que incluiu dados acadêmicos dos participantes, e "questionário de pesquisa", em que se aplicou um questionário por meio de uma plataforma digital. Resultado: O "delineamento da população" identificou 2.530 participantes do curso de Especialização, com predominância do sexo feminino e moradores da Região Sudeste. A fase "questionário da pesquisa" foi composta por 232 respondentes, dos quais 73,4% relataram reconhecer as contribuições de seus preceptores, e mais de 90% manifestaram interesse em atividades de ensino, valorizando sua valorização curricular e seu reconhecimento acadêmico. Conclusão: Nossos achados evidenciaram percepções positivas sobre a preceptoria e a propensão ao engajamento em atividades docentes dos participantes, reforçando a importância de debates sobre qualificação, recrutamento e retenção de preceptores.

Qual família e qual comunidade? Reconfigurações da Medicina de Família e Comunidade na saúde suplementar / ¿Qué familia y qué comunidad? Reconfiguraciones de la Medicina Familiar y Comunitaria en salud complementaria / Which family and which community? Reconfigurations of Family and Community Medicine in supplementary health

RESUMO: Trata-se de um estudo cartográfico que buscou analisar a atuação de médicos(as) de família e comunidade na Atenção Primária da saúde suplementar, realizado por meio de diários e entrevistas cartográficas entre março de 2021 e janeiro de 2022, processados semanalmente em reuniões de pesquisa. Tal estudo se deu com base nos analisadores: 'território', 'família' e 'comunidade'. Notou-se que a territorialização e a abordagem familiar ganham outros contornos na Medicina de Família e Comunidade praticada na saúde suplementar. Além disso, verificou-se que algumas das ferramentas típicas da Atenção Básica - como visita domiciliar, educação em saúde, genograma, ecomapa e vigilância em saúde - não eram utilizadas na atenção suplementar ou tiveram outras aplicabilidades dissonantes do modelo preconizado. Concluiu-se que a Medicina de Família e Comunidade na saúde suplementar se aproxima de uma atuação mais clínica, com perda da potência das linhas de força que constituem tal especialidade, tendendo a uma medicina menos familiar e comunitária.

RESUMEN: Se trata de un estudio cartográfico que buscó analizar el desempeño de los médicos de familia y comunidad en atención primaria de salud complementaria, realizado a través de diarios y entrevistas cartográficas entre marzo de 2021 y enero de 2022, que fueron procesados semanalmente en reuniones de investigación. Este estudio se basó en los analizadores: 'territorio', 'familia' y 'comunidad'. Se observó que la territorialización y el enfoque familiar adquieren otros contornos en la Medicina Familiar y Comunitaria practicada en salud complementaria. Además, se encontró que algunas de las herramientas típicas de la atención básica, como las visitas domiciliarias, la educación sanitaria, el genograma, el ecomap y la vigilancia sanitaria, no se utilizaron en la atención complementaria o tenían otra aplicabilidad disonante del modelo recomendado. Se concluyó que la Medicina Familiar y Comunitaria en salud complementaria se aproxima a una práctica más clínica, con pérdida de potencia de las líneas eléctricas que constituyen dicha especialidad, tendiendo a una medicina menos familiar y comunitaria.

ABSTRACT: This is a cartographic study that sought to analyze the performance of family and community physicians in primary care of supplementary health, carried out through diaries and cartographic interviews between March 2021 and January 2022, which were weekly processed in research meetings. This study was based on the analyzers: 'territory', 'family' and 'community'. It was noticed that territorialization and family approach gain other contours in Family and Community Medicine practiced in supplementary health. In addition, it was found that some of the typical tools of basic care - such as home visits, health education, genogram, ecomap and health surveillance - were not used in supplementary care or had other dissonant applicabilities of the recommended model. It was concluded that Family and Community Medicine in supplementary health approaches a more clinical practice, with loss of power from the power lines that constitute such specialty, tending to a less familiar and community medicine.

Pain Management and Treatment: Primary Healthcare's Role

Pain is invariably present in most of the primary care medical requests. The general practitioner plays a key role in its adequate diagnosis and managing. Chronic pain is especially common between the elderly, who require a careful pharmacological prescription. Non-pharmacological therapies have few adverse effects and can be used alone or in combination with pharmacological therapies. Since effective pain control is a duty of health professionals and a human right for patients, it is of the utmost importance that we make this institutional investment in order to make this a reality.

La evaluación del desempeño profesional pedagógico del tutor del residente de Medicina General Integral / Compliance with the recommendations for physical activity set by the WHO by public bicycle users in a Spanish municipality

Introducción: La evaluación del desempeño pedagógico del tutor es vital para elevar la calidad del proceso educativo. Objetivo: Definir la evaluación del desempeño pedagógico del tutor en la especialidad de Medicina General Integral. Material y Métodos: Se realizó una revisión documental de enero a diciembre de 2020. Se utilizaron la base de datos Pubmed y la biblioteca científica electrónica SciELO, así como el buscador de información científica Google Académico. Se evaluaron artículos de revisión, de investigación y páginas Web que tenían menos de 10 años de publicados, en idioma español, portugués e inglés, y que hicieran referencia al tema de estudio a través del título. Desarrollo: Se identificaron regularidades entre los autores de la comunidad científica de la Educación Avanzada: proceso vinculado con los objetos de la pedagogía desde la actuación y el comportamiento de los especialistas con funciones docentes como tutores; se realiza a partir del cumplimiento de los objetivos y métodos propios de su contenido de trabajo; se refiere a ejercer las actividades con cuidado, precisión, exactitud, profundidad, originalidad y rapidez, y está asociado con el proceso de profesionalización. Conclusiones: Se definió la evaluación del desempeño pedagógico del tutor de la especialidad de Medicina General Integral como un proceso sistemático, continuo y flexible que permite comprobar, medir y valorar el cumplimiento de las funciones, acciones y tareas que se expresan en el modo de actuación profesional del tutor desde lo relacionado con el saber, saber hacer y saber ser, en correspondencia con las exigencias actuales en el contexto de la educación en el trabajo(AU)

Introduction: The evaluation of the pedagogical performance of the tutor is vital to raise the quality of the educational process. Objective: To define the evaluation of the pedagogical performance of the tutor in the formation of the specialist in Comprehensive General Medicine. Material and Methods: A literature review was carried out from January to December 2020. Database Pubmed, the scientific electronic library SciELO, and Google Scholar were used. Review articles, research articles, and Web sites published less than 10 years ago in both Spanish and English that made reference to the topic through the title were evaluated. Development: Regularities among authors from the scientific community in Advanced Education were identified: process related to the objects of pedagogy from the action and behavior of specialists with the teaching roles of tutors, which starts from the fulfillment of the objectives and own methods of the work content, and refers to undertake the activities carefully to ensure precision, accuracy, depth, originality, and speed all of which is associated with the professionalization process. Conclusions: The evaluation of the pedagogical professional performance of the tutor in the formation of the specialist in Comprehensive General Medicine is defined as a systematic, continuous, and flexible process that allows to check, measure, and evaluate the fulfillment of the functions, actions, and tasks expressed in the professional performance of the tutor from knowing, knowing how to do, and knowing how to be in accordance with the current requirements within the context of in-service training(AU)

Diagnostic costs: a research in a family medicine outpatient clinic

The aim of this study is to evaluate the direct diagnostic costs for disease groups and other variables (such as gender, age, seasons) that are related to the direct diagnostic costs based on a 3-year data. The population of the study consisted of 31,401 patients who applied to family medicine outpatient clinic in Turkey between January 1st, 2016 and December 31st, 2018. With this study, we determined in which disease groups of the family medicine outpatient clinic weremost frequently admitted. Then, total and average diagnostic costs for these disease groups were calculated. Three-year data gave us the opportunity to examine the trend in diagnostic costs. Based on this, we demonstratedwhich diseases' total and average diagnostic costs increased or decreased during 3 years. Moreover, we examined how diagnostic costs showed a trend in both Turkish liras and USA dollars' rate for 3 years. Finally, we analysedwhether the diagnostic costs differed according to variables such as age, gender and season. There has been relatively little analysis on the diagnostic costs in the previous literature. Therefore, we expect to contribute to both theoristsand healthcare managers for diagnostic costs with this study.

Changes in Outpatient Visits to the Family Medicine Centre at a Medium-Sized Urban Hospital during the COVID-19 Pandemic: A Retrospective Cohort Study of the Patient Characteristics and Reason for Encounter / 日本プライマリ・ケア連合学会誌

Introduction: This study assessed the changes in outpatient visits during the COVID-19 pandemic.Methods: Subjects were patients who visited the outpatient clinic of the Family Medicine Centre at Kanai Hospital between April and May in 2019 and 2020. We compared the number of outpatients, their age, and their reasons for encounter (RFEs) classified according to the International Classification of Primary Care, 2nd Edition between 2019 and 2020.Results: A total of 1159 patients in 2019 and 859 patients in 2020 were evaluated. There were 553 male patients in 2019 and 452 in 2020 (P =0.029). The mean age of the patients was 48.4 years in 2019 and 52.4 years in 2020 (P =0.010). The mean number of patients per day was 25.2 in 2019 and 17.9 in 2020 (P < 0.001), with a significant reduction in patients aged 0-4 years in 2020 relative to 2019 (3.64 in 2019 vs.1.02 in 2020; P < 0.001). On evaluation of RFEs classified by organic system, the proportion of respiratory RFEs decreased from 45.3% in 2019 to 31.6% in 2020 (P =0.026), and gastrointestinal RFEs decreased from 17.9% to 5.3% (P =0.003) among children. Among adults, the proportion of respiratory RFEs decreased from 22.6% in 2019 to 15.6% in 2020 (P < 0.001) and skin RFEs decreased from 20.1% in 2019 to 15.3% in 2020 (P =0.011).Conclusion: The number of outpatients decreased during the COVID-19 pandemic. There were differences in the proportion of RFEs between the two periods.

Mastering your fellowship: Part 3, 2022

The series, 'Mastering your Fellowship', provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP SA) examination. The series is aimed at helping family medicine registrars (and their supervisors) prepare for this examination.Keywords: family physicians; FCFP (SA) examination; family medicine registrars; postgraduate training; national exit examination; infectious diseases.

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe

Background: The Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs. Aim: This study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians. Methods: An anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs. Results: Twenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration. Lessons learnt: This study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.

Mastering Your Fellowship: Part 4, 2022

The 'Mastering Your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa examination. The series is aimed at helping family medicine registrars prepare for this examination.

Conducta sexual en el Altiplano, un estudio con estudiantes universitarios / Sexual behavior in the Altiplano, a study with university students / Comportamento sexual no Altiplano, estudo com universitários

En la actualidad diversos problemas de salud pública afectan las naciones, como los embarazos adolescentes, el inicio de la vida sexual a tempranas edades, la masificación del uso de redes sociales y su influencia en adolescentes y jóvenes, convirtiéndose este último en un peligro para la educación sexual y reproductiva. Objetivo. determinar las características y los factores que influyen en la conducta sexual reproductiva en estudiantes universitarios del Altiplano Peruano (AP). Materiales y Métodos. Corresponde al tipo no experimental, con diseño descriptivo correlacional, la muestra de estudio estuvo conformado por 202 estudiantes entre varones y mujeres seleccionados bajo un criterio no probabilístico. El instrumento utilizado fue un cuestionario de 20 ítems que permitió caracterizar la conducta sexual de la muestra. Resultados. Revelan que en el AP el inicio de la VSA se da mayormente a los 18 años siendo el principal factor de abstención el no sentirse preparado. Además, los factores que influyen en el inicio de la VSA son el sexo, la estructura familiar, y las fuentes de información. Así mismo, se encontró que los varones tienden a la promiscuidad más que las mujeres, y que existe un mayor consumo de bebidas alcohólicas durante las relaciones sexuales en varones. Conclusiones. Los universitarios del AP, tienen un inicio de VSA tardía sobre todo las mujeres, siendo los factores influyentes la información formal sobre sexualidad que reciben, y la funcionalidad familiar como predictor del inicio tardío de la VSA.

Currently, several public health problems affect nations, such as teenage pregnancies, the beginning of sexual life at an early age, the massive use of social networks and their influence on adolescents and young people, the latter becoming a danger for sexual and reproductive education. Objective. to determine the characteristics and factors that influence sexual and reproductive behavior in university students of the Peruvian Altiplano (AP). Materials and Methods. The study sample consisted of 202 male and female students selected under a non-probabilistic criterion. The instrument used was a 20-item questionnaire that allowed characterizing the sexual behavior of the sample. Results. They reveal that in the AP the onset of SAV occurs mostly at 18 years of age, the main factor of abstention being not feeling ready. In addition, the factors that influence the onset of SAV are sex, family structure, and sources of information. It was also found that males tend to be more promiscuous than females, and that there is a greater consumption of alcoholic beverages during sexual intercourse in males. Conclusions. The AP university students, especially women, have a late onset of SAV, being influential factors the formal information on sexuality that they receive, and family functionality as a predictor of late onset of SAV.

Atualmente, vários problemas de saúde pública afetam as nações, como a gravidez na adolescência, o início da vida sexual em tenra idade, o uso generalizado de redes sociais e sua influência sobre adolescentes e jovens, estes últimos se tornando um perigo para a educação sexual e reprodutiva. Objetivo. Determinar as características e fatores que influenciam o comportamento sexual e reprodutivo de estudantes universitários no Altiplano peruano (AP). Materiais e métodos. Corresponde ao tipo não experimental, com um desenho descritivo correlacional, a amostra de estudo consistiu de 202 estudantes masculinos e femininos selecionados sob um critério não probabilístico. O instrumento utilizado foi um questionário de 20 itens que tornou possível caracterizar o comportamento sexual da amostra. Resultados. Eles revelam que na AP, o início do SAV ocorre principalmente aos 18 anos de idade, sendo que o principal fator de abstenção não se sente pronto. Além disso, os fatores que influenciam o início do SAV são sexo, estrutura familiar e fontes de informação. Também foi constatado que os homens tendem a ser mais promíscuos que as mulheres, e que há um maior consumo de bebidas alcoólicas durante o ato sexual nos homens. Conclusões. Os estudantes universitários da AP têm um início tardio do SAV, especialmente as mulheres, com informações formais sobre sexualidade e funcionamento da família como preditores do início tardio do SAV sendo fatores influentes.