The COVID-19 pandemic has led to a surge in scientific publications, some of which have bypassed the usual peer-review processes, leading to an increase in unsupported claims being referenced. ...Therefore, the need for references in scientific articles is increasingly being questioned. The practice of relying solely on quantitative measures, such as impact factor, is also considered inadequate by many experts. This can lead to researchers choosing research ideas that are likely to generate favourable metrics instead of interesting and important topics. Evaluating the quality and scientific value of articles requires a rethinking of current approaches, with a move away from purely quantitative methods.
Artificial intelligence (AI)-based tools are making scientific writing easier and less time-consuming, which is likely to further increase the number of scientific publications, potentially leading to higher quality articles.
AI tools for searching, analysing, synthesizing, evaluating and writing scientific literature are increasingly being developed. These tools deeply analyse the content of articles, consider their scientific impact, and prioritize the retrieved literature based on this information, presenting it in simple visual graphs. They also help authors to quickly and easily analyse and synthesize knowledge from the literature, prepare summaries of key information, aid in organizing references, and improve manuscript language. The language model ChatGPT has already greatly changed the way people communicate with computers, bringing it closer to human communication. However, while AI tools are helpful, they must be used carefully and ethically.
In summary, AI has already changed the way we write articles, and its use in scientific publishing will continue to enhance and streamline the process.
Simulation is a technique used to create an experience without going through the real event. Competency-based medical education focuses on outcomes and ensures professionals have the necessary ...knowledge, skills, and attitudes. The purpose of this study was to develop a set of competencies for the instructors providing basic and advanced levels of simulation-based training in healthcare.
We conducted a qualitative study in three steps, with each next step building on and influenced by the previous one. First, we conducted a literature review, then a consensus development panel, and finally a three-step Delphi process. The participants were experts in the fields of healthcare, education, and simulations.
The six main competencies identified for the instructor providing simulation-based training at the basic level in healthcare include knowledge of simulation training, education/training development, education/training performance, human factors, ethics in simulation, and assessment. An instructor providing simulation-based training at an advanced level in healthcare should also possess the following five competencies: policies and procedures, organisation and coordination, research, quality improvement, and crisis management.
The identified competencies can serve as a valuable resource for simulation educators and organisations involved in simulation education, to plan curriculum and implement a continuous train-the-trainers programme.
Abstract
Introduction
A smoking-cessation program was implemented as a randomized non-inferiority trial in primary care practices in Croatia and Slovenia to investigate whether a standard 4-week ...treatment with cytisine was at least as effective and feasible as a standard 12-week treatment with varenicline in helping smokers quit.
Aims and Methods
Out of 982 surveyed smokers, 377 were recruited to the non-inferiority trial: 186 were randomly assigned to cytisine and 191 to varenicline treatment. The primary cessation outcome was 7-day abstinence after 24 weeks, while the primary feasibility outcome was defined by adherence to the treatment plan. We also compared the rates of adverse events between the two treatment groups.
Results
The cessation rate after 24 weeks was 32.46% (62/191) in the varenicline group and 23.12% (43/186) in the cytisine group (odds ratio OR: 0.63, 95% credible interval CI: 0.39 to 0.98). Of 191 participants assigned to varenicline treatment 59.16% (113) were adherent, while 70.43% (131 of 186) were adherent in the cytisine group (OR: 1.65, 95% CI: 1.07 to 2.56). Participants assigned to cytisine experienced fewer total (incidence rate ratio IRR: 0.59, 95% CI: 0.43 to 0.81) and fewer severe or more extreme adverse events (IRR: 0.72, 95% CI: 0.35 to 1.47).
Conclusions
This randomized non-inferiority trial (n = 377) found the standard 4-week cytisine treatment to be less effective than the standard 12-week varenicline treatment for smoking cessation. However, adherence to the treatment plan, ie, feasibility, was higher, and the rate of adverse events was lower among participants assigned to cytisine treatment.
Implications
The present study found the standard 12 weeks of varenicline treatment to be more effective than the standard 4 weeks of cytisine treatment for smoking cessation in a primary care setting in Croatia and Slovenia. Participants assigned to cytisine, however, had a higher adherence to the treatment plan and a lower rate of adverse events. Estimates from the present study may be especially suitable for generalizations to high-smoking prevalence populations in Europe. Given the much lower cost of cytisine treatment, its lower rate of adverse events, and higher feasibility (but its likely lower effectiveness with the standard dosage regimen), future analyses should assess the cost-effectiveness of the two treatments for health policy considerations.
Independence in daily activities is defined as the ability to perform functions related to daily living, i.e. the capacity of living independently in the community with little or no help from others.
...We focused on non-attenders as a subgroup of patients whose health status is not well known to family practice teams. Our goal was to estimate the prevalence of dependence and its severity level in the daily activities of patients, and to determine the factors that are associated with the occurrence of dependence.
Cross-sectional observational study.
Data was obtained in family medicine settings. Participants in the study were adults living in the community (aged 18 or over) who had not visited their chosen family physician in the last 5 years (non-attenders) and who were able to participate in the study. Through the electronic system, we identified 2,025 non-attenders. Community nurses collected data in the participants' homes. The outcome measure was dependence in daily activities, assessed through eight items: personal hygiene; eating and drinking; mobility; dressing and undressing; urination and defecation; continence; avoiding hazards in the environment; and communication.
The final sample consisted of 1,999 patients (98.7% response rate). The mean age was 59.9 (range 20 to 99). Dependence in daily activities was determined in 466 or 23.3% (95% CI: 21.5, 25.2) of the patients. Older patients (over 60 years), with at least one chronic disease, increased risk of falling, moderate feelings of loneliness and a lower self-assessment of health were statistically significantly more likely to be dependent in their daily activities, according to our multivariate model.
A considerable proportion of family practice non-attenders were found to be dependent in daily activities, though at a low level. We identified several factors associated with this dependence. This could help to identify people at risk of being dependent in daily activities in the general adult population, and enable specific interventions that would improve their health status.
While other models focus more on disease and pathophysiology, the biopsychosocial approach emphasises the importance of human health and disease in their fullest contexts. If we are to gain an ...insight into physical and psychological health needs, and address them quickly and adequately, it is important that we recognise them already at the family practice stage. An approach that assesses needs at patient level could also be seen as patient-centred care, which is one of the key elements of high-quality care. To the best of our knowledge, no scale for measuring the biopsychosocial approach of family physicians has yet been developed.
The aim of this study was to develop and validate a scale that measures the biopsychosocial approach of family physicians to their patients through the Delphi and validation process.
The scale was developed through the Delphi study and validated by means of significant statistical methods. Pearson's correlation coefficient, Cronbach's alpha, the intracorrelation coefficient, the Spearman-Brown coefficient and exploratory factor analysis were applied.
Five family physicians took part in a brainstorming process and 24 family medicine experts took part in the Delphi study. For the first part of the validation process, there were 31 family medicine trainees in the first group and 32 in the second group. For the last part of the validation process, 164 family physicians completed the scale.
Through the Delphi study, 39 final items covering three areas within the biopsychosocial approach were identified. Construct validity was high, with positive linear correlation and good face validity. The intraclass correlation coefficient for test-retest reliability was 0.862. The Spearman-Brown coefficient was the highest (0.931) on an even and odd division. Factor rotation showed that three factors on 35 items explained 39.5% of variances. The final internal consistency on 35 items was 0.911.
The developed scale measures the biopsychosocial dimension of family physicians' work with high Cronbach's alpha measures and good validity.
For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO ...experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.
Objective
To assess the prevalence of unmet needs in post-treatment breast cancer survivors and identify sociodemographic, clinical, and psychosocial variables associated with reported unmet needs ...during the COVID-19 pandemic.
Materials and methods
In this cross-sectional study, 430 post-treatment breast cancer survivors, ranging between 1 and 5 years after the procedure, completed the Cancer Survivors’ Unmet Needs (CaSUN) questionnaire from September 2021 and January 2022. The multivariate logistic analysis identified factors associated with at least one reported unmet need in the total CaSUN scale and specific domains.
Results
A total of 67% of survivors reported at least one unmet need. The most frequently reported unmet needs were the lack of accessible hospital parking (43%) and recurrence concerns (39.5%). The majority of reported unmet needs relate to comprehensive care (44%), followed by the psychological and emotional support domain (35.3%). Younger age (OR = 0.95, 95% CI = 0.92–0.99;
p
< 0.001), three or more comorbidities (OR = 0.27, 95% CI = 0.11–0.71,
p
< 0.01), a lower quality of life (OR = 0.06, 95% CI = 0.01–0.47,
p
< 0.01) and low resilience (OR = 0.95, 95% CI = 0.93–0.99) were associated with a high level of unmet needs in the multivariate regression model. Results are presented for factors associated with a high level of unmet needs for comprehensive cancer care and psychological and emotional support domain.
Conclusion
A high prevalence found in our study could be attributed to the COVID-19 pandemic, where patients may have missed adequate follow-up care, although comparing to studies done in non-pandemic time is difficult. Family physicians should be more attentive toward younger cancer survivors and those with more comorbidities as both characteristics can be easily recognized in the family practice.
Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians' competencies as listed in the Educational Agenda produced by the ...European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies.
A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach.
The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies.
All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education.
Healthcare professionals are highly likely to experience various causes of work-related stress, which often leads to burnout. This became even more obvious during the Covid-19 pandemic. This ...systematic review aimed to analyze articles where psychological interventions with elements of mindfulness (PIM) were used to support healthcare professionals to foster well-being and reduce burnout levels. Compared to other recently published reviews, it is unique, due to its focus on a wide group of healthcare professionals, a broader selection of psychological interventions, and the evaluation of any sustained effects.
Systematic searches were carried out in February 2021 with different combinations of Boolean operators within six electronic databases: PubMed, EBSCOhost, MEDLINE, PsycArticles, Cochrane Library, JSTOR and Cobiss. We included articles that had been published in the last ten years (2011 to 2021) and which reported on original research focused on evaluating the influence of PIM on healthcare professionals. MERSQI was used to assess the quality of the included studies.
Of 1315 identified studies, 15 were included in this systematic review. Regardless of the specific type, duration and setting (individual vs group) of PIM applied, the results demonstrated a positive impact on well-being and burnout in participating healthcare professionals. The most studied interventions involved MBSR (mindfulness-based stress reduction) and other mindfulness training programmes, in online as well as in-person versions.
Given the new reality with the presence of the SARS-Cov-2 virus, it is of the utmost importance to offer feasible, effective interventions for burnout reduction to vulnerable groups of healthcare professionals. By focusing on their needs, several key aspects of burnout and mindfulness could be efficiently improved; this review demonstrates that short, online interventions could be as effective as longer, in-person ones.
The easy access to data from electronic patient records has made using this type of data in pay-for-performance systems increasingly common. General practitioners (GPs) throughout Europe oppose this ...for several reasons. Not all data can be used to derive good quality indicators and quality indicators can’t reflect the broad scope of primary care. Qualities like person-centred care and continuity are particularly difficult to measure. The indicators urge doctors and nurses to spend too much time on the registration and administration of required data. However, quality indicators can be very useful as starting points for discussions about quality in primary care, with the purpose being to initiate, stimulate and support local improvement work. This led to The European Society for Quality and Patient Safety in General Practice (EQuiP) feeling the urge to clarify the different aspects of quality indicators by updating their statement on measuring quality in Primary Care. The statement has been endorsed by the Wonca Europe Council in 2018.
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