UNASSIGNED: Despite the increasing global demand, few medical students aspire to become generalists. To address this shortage, we investigated medical students\' impressions of generalists in Japan.
UNASSIGNED: This cross-sectional study used a web-based questionnaire from a previous study. The participants chose the impression of a generalist from four categories based on the previous report: family physician, hospital family physician, hospitalist, and general internal medicine.
UNASSIGNED: Medical students\' impressions were as follows: family physicians (32%), hospitalists (28%), general internal medicine staff (20%), and hospital family physicians (18%). Students considered reasonable working hours, research opportunities, a clinical clerkship in generalist medicine, and information from university faculty as essential for making career choices.
UNASSIGNED: The study demonstrated that the number of Japanese medical students who considered generalists to be family physicians/hospital family physicians and the number of those who considered generalists to be hospitalists/general internal medicine were almost equal. To increase the number of medical students who consider and choose to become generalists, understanding their impressions of generalist practice and their needs regarding work settings in that role is crucial.

BACKGROUND: While brief duration primary care appointments may improve access, they also limit the time clinicians spend evaluating painful conditions. This study aimed to evaluate whether 15-minute primary care appointments resulted in higher rates of opioid prescribing when compared to ≥ 30-minute appointments.
METHODS: We performed a retrospective cohort study using electronic health record (EHR), pharmacy, and administrative scheduling data from five primary care practices in Minnesota. Adult patients seen for acute Evaluation & Management visits between 10/1/2015 and 9/30/2017 scheduled for 15-minute appointments were propensity score matched to those scheduled for ≥ 30-minutes. Sub-groups were analyzed to include patients with acute and chronic pain conditions and prior opioid exposure. Multivariate logistic regression was performed to examine the effects of appointment length on the likelihood of an opioid being prescribed, adjusting for covariates including ethnicity, race, sex, marital status, and prior ED visits and hospitalizations for all conditions.
RESULTS: We identified 45,471 eligible acute primary care visits during the study period with 2.7% (N = 1233) of the visits scheduled for 15 min and 98.2% (N = 44,238) scheduled for 30 min or longer. Rates of opioid prescribing were significantly lower for opioid naive patients with acute pain scheduled in 15-minute appointments when compared to appointments of 30 min of longer (OR 0.55, 95% CI 0.35-0.84). There were no significant differences in opioid prescribing among other sub-groups.
CONCLUSIONS: For selected indications and for selected patients, shorter duration appointments may not result in greater rates of opioid prescribing for common painful conditions.

UNASSIGNED: Diabetes Mellitus (DM) is a chronic Non-Communicable Disease (NCD) with rising prevalence worldwide. DM increases the risk for depression as the prevalence of depression has been reported to be three times more in diabetics than in non-diabetics. Though depressive symptoms are more common in diabetes, they are not usually recognized and treated. Little is known about the predictors of depression in this group of people, especially among the Nigerian population. This study explored the sociodemographic factors associated with depression in patients with type 2 DM without prior psychiatric history.
UNASSIGNED: This was a cross-sectional study conducted among two hundred and sixty-four patients using structured questionnaires. Data were analyzed using the Statistical Package for Social Sciences version 20. Chi-square tests were performed to compare associations between categorical variables. A probability (p) value less than 0.05 was taken as statistically significant.
UNASSIGNED: Females [176 (66%)] were three times more than males [88 (33.3%)] respectively. The prevalence of depression was 49.2%. Level of education (p= 0.008), occupation (p= 0.014), and social class (p= 0.040) were significantly associated with depression among the respondents. Depression was higher among the older age group, females, and the widowed.
UNASSIGNED: Females and older adults were more affected by depression. The predictors of depression were level of education, occupation, and social class. Thus, there is a need to screen those who have been diagnosed with T2DM for depression, especially females and older adult patients.

Workplace-based assessment has become increasingly crucial in the postgraduate training of specialists in South Africa, particularly for family physicians. The development of a Portfolio of Learning (PoL) has been a central focus within the discipline of family medicine for over a decade. Initially, a paper-based portfolio was adopted to collect evidence of learning for 50 out of 85 agreed exit-level outcomes. Stellenbosch University led the conversion of this portfolio into an electronic format, known as e-PoL, utilising Scorion software. The e-PoL was successfully implemented in the Western and Eastern Cape regions and was subsequently adopted nationally under the coordination of the South African Academy of Family Physicians. In 2023, the e-PoL underwent a redesign to gather evidence of learning for 22 entrustable professional activities (EPAs). Key insights from this development process underscore the importance of the PoL in supporting assessment-for-learning rather than merely assessment-of-learning. This necessitates features for feedback and interaction, ensuring that the PoL functions beyond a mere repository of forms. Additionally, the e-PoL should facilitate triangulation, aggregation, and saturation of data points to effectively measure EPAs. Furthermore, the PoL has not only documented learning but has also played a pivotal role in guiding the development of clinical training by explicitly outlining expectations for both registrars and supervisors. While the initial design and development costs are significant, operational costs become affordable when shared across all training programmes.

UNASSIGNED: Following the World Health Organization statement \'Health for all\', family medicine is a specialty that provides continuing, comprehensive healthcare to individuals and their families. Despite that, it is still not yet utilized to its full potential by the developing Middle-Eastern community. The aim of our study is to assess the perception and utilization of family medicine services among Abu Dhabi Island\'s community.
UNASSIGNED: A cross-sectional study was conducted targeting Abu Dhabi Island\'s community. A representative sample with 95% confidence level and 5% margin of error was calculated taking into consideration the latest report by the Abu Dhabi Statistics Center. A total of 395 adult participants were included in the study, who were asked to fill in an electronic-based validated questionnaire. SPSS software was then used for data analysis.
UNASSIGNED: Majority of participants were UAE nationals (81%) and married (71.1%), with almost equal male (50.4%) to female ratio (49.6%). Participants had positive experiences in primary healthcare (PHC) overall, regardless of their gender, nationality and marital status. Positive experience percentages dropped with higher age and educational level (P-value <0.05). A better understanding was noticed among ≥50 years of age with the rightful destination for emergency symptoms (P-value <0.05). Participants overall agreed on PHC being the preferred allocation for treatment of fever, body aches and sore throat.
UNASSIGNED: Primary healthcare centres were chosen as preferred destinations for emergency and non-emergency cases, as the vast majority had positive experiences when attending them.

UNASSIGNED: The Saudi Commission for Health Specialties (SCHS) recently proposed the Saudi Meds Family Medicine (FM) 2020 program, which is based on CanMEDS-FM 2017 and includes a number of competencies. The purpose of this study is to evaluate the professionalism of FM residents who follow the modified curriculum of the SCHS.
UNASSIGNED: A cross-sectional study was conducted between June and August 2023 at King Abdulaziz University Hospital in Jeddah among FM residents from year 1 to year 3 and postgraduates from the FM residency program of both genders. For data collection, a structured self-administered web-based questionnaire adapted from CanMEDS was used.
UNASSIGNED: A total of 45 FM residents responded, with the majority (73.3%) between the ages of 20 and 30 (77.8%), and 62.2% females. In terms of patient professionalism, 93.3% frequently/always demonstrated appropriate professional behavior and relationships in all aspects of practice; 62.2% frequently/always demonstrated a commitment to excellence in all aspects of practice. In terms of professionalism and societal commitment, 80% frequently/always demonstrated accountability to patients, society, and the profession by responding to societal expectations of physicians, and 86.6% frequently/always demonstrated a commitment to patient safety and quality improvement. In terms of professional commitment, 88.9% frequently/always fulfil and adhere to professional and ethical codes, standards of practice, and laws governing practice. In terms of self-commitment, it was discovered that 86.6% frequently/always demonstrated self-awareness and managed influences on personal well-being and professional performance. The majority (80%) managed personal and professional demands for a sustainable practice throughout the physician lifecycle, and 86.7% frequently/always promoted a culture that recognizes, supports, and effectively responds to colleagues in need.
UNASSIGNED: FM residents in Jeddah, Saudi Arabia, demonstrated acceptable levels of dedication to patients, society, profession, and self, indicating a high level of professionalism.

UNASSIGNED: The role of caregivers in grooming the neuro-developmental outcome of high-risk newborns and developmental challenges in children needs to be explored.
UNASSIGNED: To find the knowledge and perception among parents regarding the neuro-developmental outcome of high-risk newborns, methods adopted to address these problems, and to identify areas on which awareness generation needs to focus.
UNASSIGNED: A questionnaire-based awareness survey was conducted to understand the knowledge, attitude, and practices of families of children with developmental challenges.
UNASSIGNED: The study revealed that more than 70 percent of families lack information about child development, developmental challenges, and means to deal with them. They are unaware of the available health care services and other resources. One in three families has misconceptions on developmental disabilities; consider them as curse or jinx and consequently neglected. Female children with developmental problems are further ostracized due to gender inequity in families. About 10 percent of families have shown great openness toward acquiring new skills and knowledge for handling their children with developmental delays.
UNASSIGNED: This study is based on the précis research findings of our grass-root level fieldwork conducted in remote rural Bengal areas. The observation will be of interest and learning materials for general primary care practitioners, family physicians, and stakeholders to initiate appropriate intervention strategies for properly rehabilitating children with developmental delay at grass-root levels of primary health care.

The Alma-Ata Declaration of 1978 was a historic hallmark in the history of public health of the 20th century. It stressed on comprehensive primary health care and led to the slogan of \"Health for All by 2000 A.D.\" The Conference documents made it clear that primary health care was essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country could afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It was proclaimed to form an integral part of a country\'s health system. In addition, as a consequence, the overall social and economic development of the community depended on its survival. It was regarded as the first level of contact of individuals, the family, and community with the national health system bringing health care as close as possible to where people live and work. Instead of disease-centred vertical programs, it emphasised to adopt the horizontal community-based programs. Though the worldwide stir caused by the historic Alma-Ata Conference (1978), giant MNCs of the world remained hibernated for some time but never gave up to turn \"health\" into \"health care\" as commodity. Intriguingly enough, health was \"forgotten\" when the Covenant of the League of Nations was drafted after the First World War. Only at the last moment, world health was included, leading to the Health Section of the League of Nations. Recently, Intergovernmental Negotiating Body has drafted a new Pandemic Treaty which might become disastrous for general well-being and rightful living for citizens in future. All these observations are very much relevant if family medicine and primary care are given due importance at the present moment.

A 50-year-old man presented with fever and a generalized rash, with chronic fatigue and lymphadenopathy for a year and a half. Initial tests ruled out lymphoproliferative disorders, showing reactive hyperplasia and cytomegalovirus. Symptoms worsened after ampicillin treatment, leading to suspected drug-induced hypersensitivity syndrome (DIHS). Upon admission, amoxicillin was discontinued, and prednisolone and antiviral treatment were initiated. The patient\'s condition improved with this therapy. A drug-induced lymphocyte stimulation test confirmed hypersensitivity to both ampicillin and allopurinol. This case illustrates the diagnostic challenge of chronic and acute DIHS because of the rare presentation. It underscores the need for high suspicion of DIHS in patients with chronic lymphadenopathy and fatigue, particularly with recent drug exposure. Effective management involves recognizing symptoms, withdrawing the offending drug, and using corticosteroids. Viral infections like cytomegalovirus can complicate DIHS diagnosis and treatment, necessitating a comprehensive approach. This case highlights the importance of considering DIHS in differential diagnoses and the complexities of managing it alongside co-infections in rural healthcare settings.

This case report discusses the management of anti-neutrophil cytoplasmic antibodies (ANCA)-negative rapid progressive glomerulonephritis (RPGN) in a 68-year-old man with a complex medical history, presenting with fatigue, edema, and acute renal failure. Despite the absence of positive biomarkers for specific RPGN types, the clinical progression suggested microscopic polyangiitis, leading to intensive immunosuppressive therapy with cyclophosphamide and rituximab. The patient\'s condition was further complicated by the coexistence of nephritic and nephrotic syndromes, requiring nuanced management strategies, including prolonged hemodialysis. After initial treatment failure, remission was eventually achieved, allowing cessation of dialysis and significant recovery of renal function. This case highlights the challenges of diagnosing and managing ANCA-negative RPGN, particularly the importance of a tailored, dynamic approach to treatment in resource-limited settings. The recovery observed underscores the potential for renal function improvement even after prolonged periods of intensive therapy, reinforcing the need for persistence and adaptability in managing complex RPGN cases.