'Microcosm of the Pacific': Colonial encounters at the Central Medical School in Fiji.

While larger British colonies in Africa and Asia generally had their own medical services, the British took a different approach in the South Pacific by working with other colonial administrations. Together, colonial administrations of the South Pacific operated a centralised medical service based on the existing system of Native Medical Practitioners in Fiji. The cornerstone of this system was the Central Medical School, established in 1928. Various actors converged on the school despite its apparent isolation from global centres of power. It was run by the colonial government of Fiji, staffed by British-trained tutors, attended by students from twelve colonies, funded and supervised by the Rockefeller Foundation, and jointly managed by the colonial administrations of Britain, Australia, New Zealand, France and the United States. At the time of its establishment, it was seen as an experiment in international cooperation, to the point that the High Commissioner for the Western Pacific called it a 'microcosm of the Pacific'. Why did the British establish an intercolonial medical school in Oceania, so far from the imperial metropole? How did the medical curriculum at the Central Medical School standardise to meet the imperial norm? And in what ways did colonial encounters occur at the Central Medical School? This article provides answers to these questions by comparing archival documents acquired from five countries. In doing so, this article will pay special attention to the ways in which this medical training institution enabled enduring intercolonial encounters in the Pacific Islands.

Data Visualization Support for Tumor Boards and Clinical Oncology: Protocol for a Scoping Review.

BACKGROUND: Complex and expanding data sets in clinical oncology applications require flexible and interactive visualization of patient data to provide the maximum amount of information to physicians and other medical practitioners. Interdisciplinary tumor conferences in particular profit from customized tools to integrate, link, and visualize relevant data from all professions involved. OBJECTIVE: The scoping review proposed in this protocol aims to identify and present currently available data visualization tools for tumor boards and related areas. The objective of the review will be to provide not only an overview of digital tools currently used in tumor board settings, but also the data included, the respective visualization solutions, and their integration into hospital processes. METHODS: The planned scoping review process is based on the Arksey and O'Malley scoping study framework. The following electronic databases will be searched for articles published in English: PubMed, Web of Knowledge, and SCOPUS. Eligible articles will first undergo a deduplication step, followed by the screening of titles and abstracts. Second, a full-text screening will be used to reach the final decision about article selection. At least 2 reviewers will independently screen titles, abstracts, and full-text reports. Conflicting inclusion decisions will be resolved by a third reviewer. The remaining literature will be analyzed using a data extraction template proposed in this protocol. The template includes a variety of meta information as well as specific questions aiming to answer the research question: "What are the key features of data visualization solutions used in molecular and organ tumor boards, and how are these elements integrated and used within the clinical setting?" The findings will be compiled, charted, and presented as specified in the scoping study framework. Data for included tools may be supplemented with additional manual literature searches. The entire review process will be documented in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) flowchart. RESULTS: The results of this scoping review will be reported per the expanded PRISMA-ScR guidelines. A preliminary search using PubMed, Web of Knowledge, and Scopus resulted in 1320 articles after deduplication that will be included in the further review process. We expect the results to be published during the second quarter of 2024. CONCLUSIONS: Visualization is a key process in leveraging a data set's potentially available information and enabling its use in an interdisciplinary setting. The scoping review described in this protocol aims to present the status quo of visualization solutions for tumor board and clinical oncology applications and their integration into hospital processes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53627.

Cross-sectional comparison of health care delivery and reimbursement between segregated and nonsegregated communities in Hungary.

Introduction: Spatially segregated, socio-economically deprived communities in Europe are at risk of being neglected in terms of health care. In Hungary, poor monitoring systems and poor knowledge on the health status of people in these segregated areas prevent the development of well-informed effective interventions for these vulnerable communities. Aims: We used data available from National Health Insurance Fund Management to better describe health care performance in segregated communities and to develop more robust monitoring systems. Methods: A cross-sectional study using 2020 health care data was conducted on each general medical practice (GMP) in Hungary providing care to both segregated and nonsegregated (complementary) adult patients. Segregated areas were mapped and ascertained by a governmental decree that defines them as within settlement clusters of adults with low level of education and income. Age, sex, and eligibility for exemption certificate standardized indicators for health care delivery, reimbursement, and premature mortality were computed for segregated and nonsegregated groups of adults and aggregated at the country level. The ratio of segregation and nonsegregation specific indicators (relative risk, RR) was computed with the corresponding 95% confidence intervals (95% CI). Results: Broad variations between GMPs were detected for each indicator. Segregated groups had a significantly higher rate of health care service use than complementary groups (RR = 1.22, 95% CI: 1.219;1.223) while suffering from significantly reduced health care reimbursement (RR = 0.940, 95% CI: 0.929;0.951). The risk of premature mortality was significantly higher among segregated patients (RR = 1.184, 95% CI: 1.087;1.289). Altogether, living in a segregated area led to an increase in visits to health care services by 18.1% with 6.6% less health spending. Conclusion: Adults living in segregated areas use health care services more frequently than those living in nonsegregated areas; however, the amount of health care reimbursement they receive is significantly lower, suggesting lower quality of care. The health status of segregated adults is remarkably lower, as evidenced by their higher premature mortality rate. These findings demonstrate the need for intervention in this vulnerable group. Because our study reveals serious variation across GMPs, segregation-specific monitoring is necessary to support programs sensitive to local issues and establish necessary benchmarks.

Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study.

BACKGROUND: Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support. OBJECTIVE: This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach. METHODS: A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app. RESULTS: Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly. CONCLUSIONS: To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.

Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study.

BACKGROUND: The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. OBJECTIVE: This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. METHODS: A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. RESULTS: On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (ß=-.55; P<.001) and work overload (ß=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. CONCLUSIONS: This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

Continuing professional development proposed guidelines of national medical commission, India - A critique.

The National Medical Commission 'Ethics and Medical Registration Board' (EMRB) proposed 'The registered Medical Practioner (Professional Conduct) Regulations' 2022 on 23.05.2022 for public opinion. One of the major regulations included Continuing Professional Development (CPD) Guidelines in Chapter 2, Section 5. The main objective of the CPD Guidelines is to upgrade knowledge and skills regularly and ensure compliance with existing guidelines by the Registered Medical Practitioner (RMP) under NMC. The drafted CPD guidelines provide a framework for uniform, clear, and structured CPD modules for both in-person conferences and online webinars as well as accreditation. The proposed CPD guideline will ensure adequate up-gradation of knowledge, along with the improved quality of the content of CPD. This article aims to map the trajectory of CPD on its roads from origin to becoming a reality in the Indian scenario as well as identify the challenges and opportunities in implementing CPD in India.

Cancer Patient Motives and Expectations on Non-medical Practitioners.

BACKGROUND/AIM: Non-medical practitioners (NMPs) are an ill-defined group of professionals offering patient diagnostic and therapeutic methods mostly in the field of complementary and alternative medicine (CAM). Despite a lack of quality-assessed structured professional formation, many patients with cancer visit NMPs for advice. This study aimed to learn more on patients' motives and expectations for consulting an NMP. PATIENTS AND METHODS: A standardized questionnaire was distributed to adult cancer patients addressing attitudes towards NMPs, motives and expectations for consulting an NMP. RESULTS: A total of 279 patients took part in the survey. Of the included patients 44.8% had already visited an NMP and 16.5% planned to do so. Reasons to visit an NMP were seeking for a supplementary treatment (72.0%) or control of side-effects (68.0%). While the oncologist ranked higher than the NMP in all aspects of physician-patient interaction and patients more often trusted in the oncologist, those patients rating their oncologist rather low in any of these questions significantly more often consulted an NMP. The methods applied or recommended by the NMPs were highly heterogenous ranging from biologically-based methods to mind-body-techniques. Most often used methods were homeopathy (72.0%) vitamin D (62.7%), selenium (42.7%), acupuncture (38.7%). CONCLUSION: There is a high proportion of cancer patients visiting NMPs mostly for additional treatment. Biologically-based treatments may induce side-effects and interactions, especially as NMPs are not trained on medically accepted cancer treatment and medications. Offering information on CAM and improving the physician-patient relationship are important means to answer unmet needs from the side of the patient.

[The attitude of medical workers to professional self-education and system of post-graduate medical education in Russia].

The article presents analysis of changes in attitudes of medical practitioners toward professional self-education and barriers to increasing level of education in system of continuing medical education from beginning of its implementation in 2013 to 2020. The most important factor for medical workers motivation is internal factor: more than 90% of respondents indicated acquiring new knowledge and personal development as motivation both in 2020 and in 2014. However, in 2020, 63% of respondents are not ready to pay for their own education. So, medical workers are less interested to invest in their own professional development while interest in obtaining new knowledge and personal growth was soundly expressed. The alarming trend is in the fact that proportion of medical practitioners who consider professionally oriented reading necessary for self-education decreased in 2020. The medical workers also noted mistrust and several subjectively perceived barriers for professional development in the system of continuing medical education.

An evaluation of a collaborative pharmacist prescribing model compared to the usual medical prescribing model in the emergency department.

BACKGROUND: Workforce reform has placed a significant focus on the role of non-medical prescribers in the healthcare system. Pharmacists are trained in pharmacology and therapeutics, and therefore well placed to act as non-medical prescribers. OBJECTIVES: To assess the safety and accuracy of inpatient medication charts within a pharmacist collaborative prescribing model (intervention), compared to the usual medical model (control) in the emergency department (ED). Another objective compared venous thromboembolism (VTE) risk assessment and prescribing, between intervention and control groups. METHODS: Adult patients in ED referred for hospital admission were randomised into control or intervention by a block randomisation method, until the required sample size was reached. Medication charts were audited retrospectively by an independent auditor, using validated audit forms. RESULTS: Intervention group medication charts contained significantly fewer prescribing errors, omissions and discrepancies compared to the control group, and improved documentation of adverse drug reactions. VTE risk assessment and prescribing had higher guideline concordance in the intervention group compared to the control group. CONCLUSIONS: This collaborative prescribing trial showed excellent results in safety and accuracy of pharmacist prescribing when compared to the usual medical model of prescribing. The admitting medical practitioner and extended scope pharmacist prescriber worked as a collaborative team in emergency, which improved Australian national prescribing safety indicators.

[The phenomenon of patient aggression according opinion of medical practitioner].

The article considers the problem of patient aggression during medical care provision. The purpose of the study was to estimate factual prevalence of patient aggressive behavior versus medical practitioners (with emphasis on primary health care) and specification of such manifestations. The anonymous survey of 508 physicians practicing in Moscow and the Moscow Region was carried out. The original questionnaire included 9 items regarding particular forms of patient aggression, its frequency and personal harm received. The feeling of personal safety at workplaces was evaluated according to 10-point scale. The study revealed that 412 respondents (81.1%) reported about episodes of patient aggressive behavior during performance of professional duties. In the year prior to the survey 66 respondents (16.0%) regularly experienced aggression from patients, 85 respondents (20.6%) recalled more than 5 such cases, 176 respondents (42.8%) - from 2 to 5 cases and 85 respondents (20.6%) - 1 case. The forms of aggression and damage suffered due to the aggressive behavior of patients were described. The physicians do not feel themselves safe at their workplaces regardless of their gender, professional experience, medical specialty and practice setting. The respondents assess their average feeling of safety in 5.4±2.5 points. The study established that 251 respondents (40.6%) considered patient aggressive behavior as manifestation of specific features developed in response to impact of present somatic disease. The study results demonstrated that physicians are exposed to aggressive actions from their patients more often than this is commonly considered and prefer to conceal such kind of incidents. The most common form of patient aggression was verbal abuse though physical aggression also took place. The application of preventive measures and management of conflict are key practical skills for any physician.

Stiffen the sinews, summon up the blood, and strain upon the start: enfranchising the medical profession for clinically proximate advocacy of improved healthcare.

OBJECTIVE: To discuss and reflect upon the role of medical practitioners, including psychiatrists, as health advocates on behalf of patients, carers and staff. CONCLUSIONS: Health advocacy is a key professional competency of medical practitioners, and is part of the RANZCP framework for training and continuing professional development. Since advocacy is often a team activity, there is much that is gained experientially from volunteering and working with other more experienced health advocates within structurally and financially independent (of health systems and governments) representative groups (RANZCP, AMA, unions). Doctors may begin with clinically proximate advocacy for improved healthcare in health systems, across the public and private sectors. Health advocacy requires skill and courage, but can ultimately influence systemic outcomes, sway policy decisions, and improve resource allocation.

Health care seeking behaviour among rural women in Telangana: A cross sectional study.

BACKGROUND: The health of women is of particular concern because, in many societies, they are disadvantaged by discrimination rooted in sociocultural factors. Women need to breach many social barriers to empower and to get access for quality health care services. Health seeking behavior is one of the important determinants of women health. OBJECTIVES: To assess healthcare seeking behavior among rural women in Telangana. METHODS: Cross-sectional study with sample size of 200 was conducted in three villages attached to a medical college. Women of aged 20 years and above were included in the study. Data was collected by predesigned pretested semi-structured questionnaire. Data was presented in proportions with confidence interval and Chi-square test was applied to find the association between variables by using SPSS ver. 23. RESULTS: Only 34.5% [95% CI: 27.9, 41.5] of the subjects seek medical care as soon as symptoms appear and 69% [95% CI: 62.1, 75.3] of the participants were aware of nearby functioning health centres. Majority (60.5%) of the subjects Visits qualified medical practitioner during illness. CONCLUSIONS: The present study found that there is still a need to create awareness about the importance of healthcare and available health centers as significant proportion of women population approached unqualified medical practitioners and seeking home remedies as first consultancy source for their health remedies.

Exploring health professionals' understanding of evidence-based treatment for idiopathic toe walking.

BACKGROUND: Idiopathic toe walking (ITW) is an exclusionary diagnosis resulting in a child walking on the balls of their feet. Preferred treatment options may be due to the severity of the toe or the health professional preference There are limited guidelines supporting consistent treatment recommendations for this condition. This research aimed to understand agreement between health professionals' knowledge of evidence for common treatment strategies for ITW and if health professionals supported these strategies being used in clinical practice. METHODS: An international online survey was opened to registered health professionals who treat children with ITW between July 2017 and March 2018. The survey had two components: (a) demographic variables and variables relating to knowledge of evidence about ITW treatments and (b) support for common treatment strategies. Additional data on strategy use, referrals, and preference were collected. Kappa statistics described intra-rater agreement between evidence knowledge and support. Multivariable regression analyses identified factors associated with the 10 most commonly preferred treatments. RESULTS: There were 908 international responses. Kappa agreement for paired correct responses determined a fair agreement for evidence support knowledge for four strategies including watch and wait (Kappa = 0.24), stretching (Kappa = 0.30), sensory integration strategies (Kappa = 0.40), and motor control strategies (Kappa = 0.24) and moderate responses for 13 others. No strategies had greater than moderate agreement between correct knowledge of evidence and strategy support. Profession, location, number of children seen in practice, and not correctly identifying the evidence factored into many of the most commonly used strategies for ITW (p < .05). CONCLUSIONS: The results from this study, which confirm a variety of interventions, are utilized in the management of ITW around the world. Furthermore, there remains a disconnection between paediatric health professionals' understanding of the evidence of common treatment strategies of ITW and a consensus for the treatment of this condition.

Unlicensed medical practitioners in tribal dominated rural areas of central India: bottleneck in malaria elimination.

BACKGROUND: In India, Accredited Social Health Activists (ASHAs) deliver services for diagnosis and treatment of malaria, although unlicensed medical practitioners (UMPs) (informal health providers) are most preferred in communities. A cross sectional survey was conducted to: (i) assess knowledge and treatment-seeking practices in the community, and (ii) explore the diagnosis and treatment practices related to malaria of UMPs working in rural and tribal-dominated high malaria endemic areas of central India, and whether they adhere to the national guidelines. METHODS: A multi-stage sampling method and survey technique was adopted. Heads of the households and UMPs were interviewed using a structured interview schedule to assess knowledge and malaria treatment practices. RESULTS: Knowledge regarding malaria symptoms was generally accurate, but misconceptions emerged related to malaria transmission and mosquito breeding places. Modern preventive measures were poorly accessed by the households. UMPs were the most preferred health providers (49%) and the first choice in households for seeking treatment. UMPs typically lacked knowledge of the names of malaria parasite species and species-specific diagnosis and treatment. Further, irrational use of anti-malarial drugs was common. CONCLUSIONS: UMPs were the most preferred type of health care providers in rural communities where health infrastructure is poor. The study suggests enhancing training of UMPs on national guidelines for malaria diagnosis and treatment to strengthen their ability to contribute to achievement of India's malaria elimination goals.

What makes an effective One Health clinical practitioner? Opinions of Australian One Health experts.

Despite agreement that One Health practices facilitate effective management of zoonoses, the pathways to a coordinated and collaborative approach by general medical practitioners (GPs) and veterinarians are hampered by limited understanding of how this can be practically incorporated in routine clinical settings. Data collected during a Delphi survey of Australian One Health 'experts' was used to explore opinions and insights into desired knowledge, attitudes and practices of effective One Health clinical practitioners. Five categories were identified as essential for GPs and veterinarians, namely: accurate baseline knowledge of specific zoonoses; a 'big picture' understanding of zoonoses; understanding of professional roles within the One Health paradigm; understanding one's own professional limitations; and collaboration and referral improve outcomes. An outline of the roles and responsibilities of GPs and veterinarians as effective One Health clinicians was determined based on the opinions of the expert panel. Educational interventions that foster interprofessional communication and collaboration will be necessary to successfully bring about the cultural change required to achieve effective One Health practice in Australia, and thus expedite improved human, animal and environmental health outcomes.

Responsible Use of Machine Learning Classifiers in Clinical Practice.

Machine learning models are increasingly being used in clinical settings for diagnostic and treatment recommendations, across a variety of diseases and diagnostic methods. To conceptualise how physicians can use them responsibly, and what the standard of care should be, there needs to be discussion beyond model accuracy levels and the types of explanation provided by such classifiers. There needs to be consideration of how the explanations are provided and how historical accuracy rates can together constitute the overall epistemic status of the model, and how models with different epistemic statuses should subsequently be deferred to by medical practitioners. Answering this will require a multi-disciplinary consideration of the literature on automation bias in human factors and ergonomics to higher-order evidence in social epistemology. Adjudicating physician responsibility will also require assessing when a physician's ignorance of the appropriate ways to engage with such classifiers, as outlined above, will be culpable and when not.

Non-medical practitioner roles in the UK: who, where, and what factors influence their development?

BACKGROUND: traditional health workforce roles are changing, with existing roles being extended and advanced, while new roles are being created, often undertaking duties previously completed by doctors, sometimes referred to as non-medical practitioners (NMPs). AIM: to investigate which NMP roles exist within the UK, mapping distribution, and explore factors influencing their development and recruitment. METHODS: two descriptive, exploratory, online self-completed semi-structured questionnaires were used. One was sent to all NHS acute healthcare providers (n=156) and private/independent healthcare providers in England (n=90). A separate questionnaire collected data, using convenience and snowballing approaches, from NMPs across the UK. Quantitative data were analysed using descriptive and frequency statistics. Qualitative data derived from open questions and comments were analysed using content and thematic analysis. RESULTS: healthcare organisations in England returned 23/246 useable questionnaires; 115 NMPs returned responses, 19 did not meet the criteria, leaving 96 useable responses. CONCLUSION: seven NMP roles were identified, throughout the UK, with regional variation. Several factors influence the development and recruitment of NMP roles in England such as service delivery and national policies. Inconsistencies were noted in Agenda for Change pay banding. Many practitioners undertook NMP roles to progress their career clinically.

Establishing research priorities to improve the One Health efficacy of Australian general practitioners and veterinarians with regard to zoonoses: A modified Delphi survey.

While general medical practitioners (GPs) and veterinarians are often the first line responders in the face of a disease outbreak, pathways to improving the One Health efficacy of these clinicians remain unclear. A two-phase modified Delphi survey of professionals with known expertise in One Health ('expert panel') was used to 1) identify key knowledge, attitudes and practices (KAPs) of GPs and veterinarians that would be consistent with a One Health approach to zoonoses; and 2) determine priorities for future surveys with Australian GPs and veterinarians to identify important gaps that impede effective diagnosis and management of zoonoses. A list of 13 topics/sub-topics, as well as a list of 25 specific zoonotic diseases/agents emerged from the first phase of the survey. In the second phase the expert panel identified general knowledge of the clinical aspects and epidemiological aspects of zoonoses, as well as risk management practices, as the most important KAPs and research priorities for both GPs and veterinarians. In terms of diseases, the expert panel regarded knowledge of Hendra virus, Q fever, Australian bat lyssavirus (ABLV), anthrax and Brucella suis most important for veterinarians, whilst for GPs, Q fever, gastrointestinal/foodborne diseases, influenza, ABLV and local vector-borne diseases were found to be most important by the expert panel. Some differences were noted in terms of prioritization of topics/sub-topics and diseases/agents according to expert background (veterinary and non-veterinary). The Delphi survey technique enabled efficient collection of data from a diverse range of One Health 'experts'/specialists and provided clear priorities for proposed future research, and potentially for educational interventions to improve One Health efficacy of clinicians.

Gender specific association between the use of complementary and alternative medicine (CAM) and alcohol consumption and injuries caused by drinking in the sixth Tromsø study.

BACKGROUND: Alcohol is consumed almost worldwide and is the most widely used recreational drug in the world. Harmful use of alcohol is known to cause a large disease-, social- and economic burden on society. Only a few studies have examined the relationship between CAM use and alcohol consumption. To our knowledge there has been no such research in Norway. The aim of this study is to describe and compare alcohol consumption and injuries related to alcohol across gender and different CAM approaches. METHODS: The data used in this study is based on questionnaire data gathered from the sixth Tromsø Study conducted between 2007 and 2008. Information on CAM use and alcohol consumption was available for 6819 women and 5994 men, 64.8% of the invited individuals. Pearson chi-square tests and independent sample t-tests were used to describe the basic characteristics of the participants and to calculate the differences between men and women regarding these variables. Binary logistic regression analyses were used to investigate the associations between the different CAM approaches and alcohol consumptions and injuries caused by drinking. RESULTS: Women who drank alcohol more than once a month were more likely to have applied herbal or "natural" medicine and self-treatment techniques (meditation, yoga, qi gong or tai-chi), compared to those who never drank, and those who only drank monthly or less. For women, an association was also found between having experienced injuries caused by drinking and use of self-treatment techniques and visit to a CAM practitioner. No association was found between amount of alcohol consumed and use of CAM approaches. For men, an association was found between injuries caused by drinking and use of herbal or "natural" medicine. CONCLUSION: The findings from this cross-sectional study suggests that women who drink frequently are more likely to use "natural" medicine and self-treatment techniques. Both men and women who had experienced injuries because of their drinking were more likely to have used CAM approaches.

Assessment of Knowledge and Attitude of Medical Practitioners Towards Pediatric Dental Care in Raichur District, Karnataka, India-A Survey.

AIM: To determine the knowledge and attitude of medical practitioners towards dental care of children in Raichur district. MATERIALS AND METHODS: The present study is a cross-sectional survey conducted among the medical practitioners of Raichur district. The study was conducted on 300 practitioners, randomly selected. The data pertaining to their knowledge and attitude about oral health was gathered using a self-administered questionnaire. Data were analyzed using descriptive studies. RESULTS: Among the study subjects, 32.7% of the respondents could recognize the precancerous and cancerous lesions in the oral cavity. A total of 65.3% considered that dental caries is not infectious. About 52.7% of the physicians thought that scaling causes tooth sensitivity and only 22.7% knew that tooth brushing should be initiated after the eruption of the first milk tooth. CONCLUSION: Medical practitioners had a moderate knowledge and attitude towards pediatric dental care.How to cite this article: Rao DG, Sheereen S, Havale R, Prakasha SS, Zulfikar MM. Assessment of Knowledge and Attitude of Medical Practitioners Towards Pediatric Dental Care in Raichur District, Karnataka, India-A Survey. Int J Clin Pediatr Dent, 2018;11(5):375-381.