Journal of General Practice

ISSN: 2329-9126

Open Access

Articles in press and Articles in process

    Opinion Pages: 1 - 2

    Impact Of Family Medicine Education On The Standard Of Care For Diabetes Patients

    Reham Abo Emara*

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    Mini Review Pages: 1 - 2

    General Practitioners And Drug & Alcohol Specialists Experiences With The Barriers

    Judit Simon*

    Introduction: Substance use disorders (SUDs) have an impact on physicians' health and quality of life, as well as possibly on the care they
    provide. Despite the existence of efficient particular Physician Health Programs (PHPs), physicians with SUD frequently encounter obstacles when
    attempting to get professional assistance. Therefore, using a multi-perspective approach, we looked at the facilitators and barriers to physicians
    getting care for SUD. Methods: For two sub studies, a qualitative design was chosen. First, responses to two open-ended questionnaire items
    (regarding predicted barriers and facilitators) were examined. 1,685 general practitioners responded to this survey (47% response rate). These
    open-ended questions responses were inductively coded. Second, 21 semi-structured interviews with physician SUD patients, their partners, and
    PHP staff members were conducted (regarding experienced barriers and facilitators).

    Perspective Pages: 1 - 2

    Cross-Efficiency Data Envelopment Analysis Of Basic Healthcare In The City Of Lagos

    Yanni Yang*

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    Mini Review Pages: 1 - 2

    Disaster Preparedness In Primary Health Care: A Review Of The Literature And A New Framework Proposal

    Yanni Yang*

    Primary healthcare management of chronic diseases affecting Aboriginal and Torres Strait Islander peoples calls for systems that promote improved team-based care and meet healthcare quality and equity requirements. Although elements that facilitate or impede integration within these contexts need to be better explored, non-dispensing pharmacists (NDPs) integrated within primary healthcare settings can improve the quality of patient care. A new comprehensive approach to disaster management (DM) has been established in recent years, stressing prevention and preparedness measures as well as effective resource and information coordination. The World Health Organization (WHO) released the Health Emergency and Disaster Risk Management (H-EDRM) Framework in 2019 to highlight the crucial role that health plays in disaster preparedness (DM) and to provide detailed instructions for creating resilient health infrastructures and lowering the risks and effects of emergencies and disasters on human health. The Sendai Framework for Disaster Risk Reduction 2015–2030, the International Health Regulations, the Paris Agreement on Climate Change, and other prior international instruments with the goal of improving health disaster preparedness are all incorporated into the H-EDRM framework.

    Review Pages: 1 - 2

    The Identification Of Obstacles To Breast Cancer Screening Programmes Using A Health Systems Approach

    Zohreh Ghomian*

    Although the advantages of population-based breast cancer screening are now widely acknowledged, programmes frequently fall short of their full potential in practise. In order to comprehend the elements that affect screening programmes' results, we present a conceptual model in this study that places screening programmes within the context of the larger health system. In our opinion, the overall screening system consists of several sub-systems that work together to identify at-risk populations, produce knowledge about how well they work, increase uptake, run the programme, and optimise follow-up and treatment assurance. We created the Barriers to Effective Screening Tool (BEST) based on this paradigm to analyse population-based screening programmes run by the government from the viewpoint of health systems. We tested the tool, which was designed as a self-assessment tool.

      Mini Review Pages: 1 - 3

      Factors Associated towards Mothers Practicing Acceptable Diet of 6-23 Months Old Children in Gimbichu Woreda, Oromia Regional State, Ethiopia

      Techane Sisay Tuji and Addisu Dabi Wake

      The infant young child feeding model of World Health Organization (WHO) suggests introducing complementary food for new born babies starting at the sixth month. Breast milk has to be round out by any other foods to fill the nutrient demand of the child. These complementary foods are required to fill the calorie, protein, and micronutrient gap between the total nutritional need of the child and the amount contributed by the breast milk. Sufficient complementary food has to be diversified and prepared from different food groups in a solid or semisolid form and needs to be commenced timely from the sixth month of the child’s age by implementing the quality of foods consumed as the child get older.

      Research Article Pages: 1 - 9

      Factors Associated Towards Mothers Practicing Acceptable Diet of 6?23 Months Old Children in Gimbichu Woreda, Oromia Regional State, Ethiopia: A Community Based Cross-Sectional Study

      Tuji Techane Sisay* and Addisu Dabi Wake

      Background: Accurate complementary feeding plays a great role in preventing childhood under nutrition, infectious disease, and mortalities. The available data suggests that the rates for Minimum Acceptable Diet (MAD) are low across all regions worldwide. For instance, rates are four in every ten (41.1%), in East Asia and Pacific and lowest in West and Central Africa at 8.6%, East and South Africa at 9.8%, and South Asia at 13.0%. However, Factors Associated towards Mothers Practicing Acceptable Diet of 6–23 Months Old Children living in study area is unknown. Therefore, this study was aimed to assess factors associated towards mothers practicing acceptable diet of 6-23 months old children in Gimbichu Woreda, Oromia Regional State, Ethiopia.

      Materials and methods: A community-based cross-sectional study was conducted among 782 mothers/caregivers paired with infants and children aged 6 to 23 months with a response rate of 97.1%, from March 12 to April 08, 2019. One-stage cluster sampling technique was employed. A structured pretested tool was used to collect the data. The binary logistic regression analysis was applied for MAD. All variables were transformed to multivariable logistic regression model irrespective of any transforming criteria to control the effects of confounder/s and to identify statistically significant variables. Finally, the variables which had independent correlations with MAD were identified on the basis of Adjusted Odds Ratio (AOR) and a p-value less than 0.05with 95%CI were claimed as statistically significant.

      Results: The proportion of acceptable diet was 30.1% (26.7, 33.1%). Mothers’ secondary and above educational level (AOR= 2.78, 95%CI (1.12, 6.89), mothers attending PNC (AOR=6.45, 95%CI (1.71, 13.33), mothers’ who had good knowledge in infant feeding AOR=8.46, 95%CI; (3.81,11.80), mothers’ involvement on feeding AOR=5.10, 95%CI; (2.47,10.52), mothers whose attending ANC (AOR=3.86, 95% CI (1.99,14.94), wealth index ranked at richest category (AOR=3.24 ,95%CI (1.24,8.45) and husbands’ involvement (AOR=5.75, 95% CI (1.18,12.79) were positively associated with MAD.

      Conclusion: The proportion of MAD practice by infants and children of the study area was low. Mothers’ secondary and above educational level, mothers’ attending PNC, mothers’ who had good knowledge on infant feeding, mothers’ involvement on feeding, mothers whose attending ANC, wealth index and husband’s involvement were factors positively associated with MAD. Assuring mother’s involvement on decision making and promoting husband involvement on infant and child feeding are strongly recommended to mitigate the problem.

        Review Article Pages: 1 - 8

        Stillbirth and its Association with Early Rupture of Membranes in Sub-Saharan Africa: Systematic Review and Meta-Analysis

        Telksew Yelma Yezengaw*, Tariku Dingeta Amante, Tesfaye Assebe Yadeta and Biruk Shalmeno Tusa

        Background: Stillbirth rate is an important indicator of access to quality antenatal and delivery care services. Many previous pocket studies were conducted to assess the magnitude of stillbirth and its association with premature rupture of membrane. However, the level of stillbirth, as well as its relationship with Premature Rupture of Membrane (PROM) varies from study to study. Objectives: This systematic review and meta-analysis was conducted to estimate the pooled prevalence of stillbirth and its association with the early rupture of membranes in sub-Saharan Africa. Search strategy: Electronic databases such as PubMed Central PMC, Cochrane library, Medline via Virtual Health Library (VHL), HINARI (Health Inter Network Access to Research Initiative) portal, and Google scholar were used for searching for original articles. Selection criteria: All Published and unpublished observational studies (prospective and retrospective cohort studies, case-control studies, and cross-sectional studies) that deal with stillbirth and their association with early rupture of membranes in sub-Saharan African women were included. Data collection and analysis: The extracted data analyses were done using STATA (version.16.0) software. Texts, figures, and tables were used to describe the included original articles. The heterogeneity of the studies was checked by I-squared statistics. A Random-effects method was applied to estimate the pooled prevalence of stillbirth and the effect size of the early rupture of membranes in sub-Saharan Africa. Subgroup analysis was performed based on region (East, West, Central, and Southern Africa) and year of study (before 2015 and after 2015). A funnel plot and Egger’s regression test was used to see publication bias. Main result: Pooled prevalence of stillbirth in sub-Saharan Africa was 6.4% (95% CI: 5.5-7.3). In sub-group analysis, Southern African regions had a higher stillbirth prevalence and the western African regions had a lower than East and Southern Africa. The prevalence of stillbirth in the region is increased from 4.1% (95% CI: 2.2–6.0) before 2015 to 7.1%(95% CI: 5.8-8.3) after 2015. The pooled odds ratio results from seven studies showed the non-significant effect of early rupture of membrane on stillbirth (pooled OR=1.54, 95% CI: 0.26-2.82). According to the regression test (Egger test), there was no small study effects or publication bias (P=0.108). Conclusions: The pooled prevalence of stillbirth in sub-Saharan Africa was relativity high. The analysis establishes the minimal effects of early rupture of membrane on stillbirth. Therefore, we recommend that strengthening the testing intervention is crucial to reduce the still relatively high stillbirths. Funding: No fund was received for this work.

          Editorial Pages: 1 - 1

          Diagnostic Strategies are the Specific Tools

          H. Innesu

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          Prognosis is the identity of the character and reason of a sure
          phenomenon. Analysis is used in lots of exclusive disciplines, with
          versions in the use of good judgment, analytics, and revel in, to
          determine "motive and impact". In systems engineering and computer
          science, it's far usually used to determine the reasons of symptoms,
          mitigations, and answers. Analysis is frequently tough, because many
          signs and symptoms and symptoms are nonspecific, and can best be
          undertaken with the aid of registered and licensed health experts. As
          an instance, redness of the skin (erythema), through itself, is an
          indication of many disorders and for this reason does not tell the
          healthcare expert what is incorrect. Accordingly differential analysis,
          wherein several feasible reasons are compared and contrasted, need
          to be achieved. This entails the correlation of numerous pieces of
          records observed by using the popularity and differentiation of
          patterns. Occasionally the procedure is made clean by a sign or
          symptom (or a set of several) this is pathognomonic. The method of
          differential analysis is based totally on locating as many candidate
          illnesses or situations as viable which can in all likelihood purpose
          the symptoms or symptoms, observed via a process of removal or as
          a minimum of rendering the entries greater or much less likely by
          means of similarly medical assessments and other processing,
          aiming to attain the point wherein handiest one candidate disorder or
          condition stays as likely. The final end result may additionally remain
          a list of feasible conditions, ranked so as of possibility or severity.
          One of these lists is frequently generated by means of computeraided
          analysis systems. In a pattern reputation approach the
          company makes use of experience to apprehend a sample of
          scientific characteristics. Its miles specifically primarily based on sure
          symptoms or signs being related to certain diseases or situations,
          now not necessarily related to the extra cognitive processing
          concerned in a differential analysis. This will be the number one
          method utilized in cases where illnesses are "apparent", or the
          issuer's revel in may additionally allow her or him to understand the
          circumstance quick. Theoretically, a certain pattern of symptoms or
          signs and symptoms can be at once associated with a sure therapy,
          even without an exact decision concerning what's the actual disease,
          but this type of compromise contains a full-size hazard of missing a
          analysis which simply has a distinctive therapy so it can be
          restrained to instances wherein no diagnosis may be made. Over
          diagnosis is the diagnosis of "ailment" so one can by no means
          purpose signs and symptoms or loss of life at some stage in a
          affected person's lifetime. It’s far a problem as it turns people into
          patients unnecessarily and due to the fact it could cause monetary
          waste (overutilization) and remedies which could reason harm. Over
          diagnosis takes place whilst a disorder is diagnosed effectively, but
          the analysis is inappropriate. A correct prognosis can be beside the
          point because treatment for the sickness is not to be had, now not
          needed, or now not desired. Clinical diagnosis or the actual
          procedure of creating a analysis is a cognitive manner. A clinician
          uses several assets of information and puts the portions of the puzzle
          together to make a diagnostic impression. The preliminary diagnostic
          affect can be a broad time period describing a category of sicknesses
          in place of a selected ailment or circumstance. After the initial
          diagnostic influence, the clinician obtains comply with up
          assessments and processes to get extra facts to assist or reject the
          authentic prognosis and could try to narrow it all the way down to an
          extra unique stage. Diagnostic strategies are the specific tools that
          the clinicians use to slender the diagnostic opportunities.

          Editorial Pages: 1 - 1

          Anesthesiologists are Predicted to Have Knowledge of Human Physiology

          Bingxi Zhao

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          Anesthesiology is the medical uniqueness involved with the overall
          perioperative care of patients earlier than, throughout and after
          surgery. It encompasses anesthesia, intensive care medicine,
          important emergency medicinal drug, and pain medicinal drug. A
          medical doctor specialized in anesthesiology is known as an
          anesthesiologist. There are special approaches of referring to the
          sector of anesthesiology and physicians who specialize in it relying
          on the area of the world. As a strong point, the core element of
          anesthesiology is the exercise of anesthesia. This comprises using
          diverse injected and inhaled medications to provide a loss of
          sensation in patients, making it feasible to carry out approaches that
          might in any other case motive intolerable ache or be technically
          unfeasible. Safe anesthesia calls for in-depth understanding of
          diverse invasive and non-invasive organ aid techniques which might
          be used to control sufferers' critical capabilities while under the
          results of anesthetic pills; those include superior airway management,
          invasive and non-invasive hemodynamic video display units, and
          diagnostic strategies like ultrasonography and echocardiography.
          Anesthesiologists are predicted to have professional knowledge of
          human physiology, medical physics, and pharmacology, as well as a
          large general understanding of all regions of medication and surgical
          procedure in every age of patients, with a particular cognizance on
          the ones components which might also effect on a surgery. In latest
          decades, the function of anesthesiologists has broadened to attention
          now not just on administering anesthetics all through the surgical
          operation itself, however additionally ahead so as to pick out highrisk
          patients and optimize their fitness, in the course of the process to
          keep situational awareness of the surgical procedure itself to be able
          to improve protection, in addition to afterwards so as to sell and
          enhance healing. This has been termed "perioperative medicine". In
          the 19th century, the beginnings of preferred anesthesia began with
          the advent of ether in Boston and chloroform inside the UK to bring
          about a state of unawareness and unresponsiveness to the ache of
          surgical insult. With the isolation of cocaine in the mid-nineteenth
          century there started out to be tablets available for neighborhood
          anesthesia. Through the stop of the nineteenth century, the quantity
          of pharmacological alternatives multiplied and that they commenced
          to be implemented both peripherally and neuraxially. Then within the
          20th century neuromuscular blockade allowed the anesthesiologist to
          completely paralyze the affected person pharmacologically and
          breathe for him or her through mechanical air flow. With those new
          tools, the anesthetist may want to intensively manage the affected
          person's body structure bringing about vital care remedy, which, in
          many nations, is in detail related to anesthesiology. Anesthesiologists
          have key roles in primary trauma, resuscitation, airway management,
          and worrying for other patients outside the operating theatre who
          have critical emergencies that pose an instantaneous danger to
          existence, again reflecting transferable competencies from the
          operating room, and allowing continuity of care whilst patients are
          brought for surgical operation or in depth care. This branch of
          anesthesiology is together termed critical emergency remedy, and
          includes provision of pre-medical institution emergency medication
          as a part of air ambulance or emergency scientific offerings, as well
          as safe switch of significantly ill sufferers from one part of a clinic to
          another, or among healthcare facilities. Anesthesiologists typically
          shape part of cardiac arrest groups and speedy reaction teams
          composed of senior clinicians that are without delay summoned while
          a affected person's coronary heart stops beating, or after they
          deteriorate acutely whilst in sanatorium. Exclusive models for
          emergency medicine exist internationally: inside the Anglo-American
          version, the patient is hastily transported by means of non-health
          practitioner vendors to definitive care along with an emergency
          department in a health center. Conversely, the Franco-German
          technique has a health practitioner, often an anesthesiologist, come
          to the patient and offer stabilizing care inside the area. The patient is
          then triaged at once to the appropriate branch of a health facility.

          Commentary Pages: 1 - 1

          Neuroscience is the Medical Study of Apprehensive Machine

          Lei Wang

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          Neuroscience is the medical study of the apprehensive machine.
          It’s far a multidisciplinary technological know-how that combines
          physiology, anatomy, molecular biology, developmental biology,
          cytology, pc technology and mathematical modeling to apprehend the
          fundamental and emergent residences of neurons, glia and neural
          circuits. The expertise of the biological basis of gaining knowledge of,
          reminiscence, conduct, belief, and attention has been defined by
          using Eric Kandel because the "remaining assignment" of the
          biological sciences. The view that the heart became the supply of
          awareness becomes no longer challenged till the time of the Greek
          physician Hippocrates. He believed that the mind turned into now not
          simplest concerned with sensation—due to the fact that most
          specialized organs (e.g., eyes, ears, tongue) are located in the head
          close to the mind—however becomes also the seat of intelligence.
          Plato additionally speculated that the mind become the seat of the
          rational a part of the soul. Aristotle, but, believed the coronary heart
          become the middle of intelligence and that the mind regulated the
          quantity of warmth from the coronary heart. This view became
          normally normal until the Roman health practitioner Galen, a follower
          of Hippocrates and doctor to Roman gladiators, determined that his
          sufferers misplaced their mental faculties after they had sustained
          harm to their brains. In parallel with these studies, paintings with
          brain-damaged sufferers by Paul Broca cautioned that positive
          regions of the mind had been answerable for certain functions. On
          the time, Broca's findings had been visible as a affirmation of Franz
          Joseph Gall's idea that language turned into localized and that sure
          mental functions have been localized in unique areas of the cerebral
          cortex. The localization of function hypothesis became supported via
          observations of epileptic patients performed by way of John Hugh
          lings Jackson, who effectively inferred the organization of the motor
          cortex by looking the progression of seizures via the frame. Carl
          Wernicke further advanced the concept of the specialization of
          particular brain systems in language comprehension and production.
          present day studies through neuroimaging techniques, still makes
          use of the Bradman cerebral cytoarchitectonic map (relating to study
          of cell structure) anatomical definitions from this period in continuing
          to show that distinct areas of the cortex are activated inside the
          execution of unique obligations. The medical take a look at of the
          anxious machine extended considerably for the duration of the
          second one half of the 20 th century, basically due to advances in
          molecular biology, electrophysiology, and computational
          neuroscience. This has allowed neuroscientists to have a look at the
          anxious gadget in all its factors: how it's far structured, the way it
          works, how it develops, the way it malfunctions, and how it could be
          modified. Neuroscience is also allied with the social and behavioral
          sciences, as well as with nascent interdisciplinary fields. Examples of
          such alliances encompass neuroeconomics, choice theory, social
          neuroscience, and neuromarketing to address complex questions
          about interactions of the brain with its environment. A observe into
          purchaser responses for instance uses EEG to research neural
          correlates related to narrative transportation into testimonies
          approximately strength performance. As an example, it has emerged
          as viable to apprehend, in a good deal detail, the complicated
          strategies occurring within a single neuron. Neurons are cells
          specialized for conversation. They’re capable of talk with neurons and
          other mobile kinds through specialized junctions called synapses, at
          which electrical or electrochemical indicators can be transmitted from
          one mobile to some other. Many neurons extrude an extended skinny
          filament of axoplasm known as an axon, which may expand to distant
          parts of the body and are able to swiftly wearing electric alerts,
          influencing the activity of other neurons, muscle tissues, or glands at
          their termination points. An anxious device emerges from the
          assemblage of neurons which might be connected to each other.

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