Primary care clinicians’ knowledge and confidence about newborn screening for sickle cell disease: randomized assessment of educational strategies.
J Natl Med Assoc. 2010 Aug;102(8):676-82
Authors: Oyeku SO, Feldman HA, Ryan K, Muret-Wagstaff S, Neufeld EJ
OBJECTIVE: In Massachusetts, primary care clinicians receive and act upon hemoglobinopathy newborn screening results. We assessed clinicians’ knowledge, confidence, and practices regarding hemoglobinopathy newborn screening, and the effect of mailed educational materials vs interactive seminar on knowledge and confidence. METHODS: A randomized educational intervention trial was performed at 15 community health sites. Practices were randomized to determine the order in which the educational interventions were administered: mailed educational materials first or interactive seminars on the management of hemoglobinopathy newborn screening results first. Clinicians’ demographics, knowledge, confidence, and practices were assessed by a survey. Posttests were administered soon after the intervention. RESULTS: Responses came from 85 of 170 eligible providers (50%). Twenty-nine percent of respondents provided both pretests and posttests. In respondents with paired data, knowledge on a 5-point scale improved by 1.4 +/- 0.4 (mean +/- standard error of the mean, p = .003), while self-efficacy on a 16-point scale increased by 1.3 +/- 0.3, p = .002. There were no significant differences between seminar and mailed-materials groups. CONCLUSIONS: Both educational strategies led to modest improvements in knowledge about newborn screening for hemoglobin disorders. Enhancing knowledge and confidence about newborn screening-related tasks may improve clinicians’ capacity to act upon newborn screening results for hemoglobinopathies.
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– Primary care clinicians’ knowledge and confidence about newborn screening for sickle cell disease: randomized assessment of…
Adherence of primary care physicians in Aseer region, Saudi Arabia to the National Protocol for the Management of Asthma.
East Mediterr Health J. 2010 Feb;16(2):171-5
Authors: Abudahish A, Bella H
To determine adherence of primary health care (PHC) physicians to the National Protocol for the Management of Asthma and barriers affecting adherence, we conducted a cross-sectional study in Aseer region, Saudi Arabia. Sixty-one PHC physicians completed self-administered questionnaires on the protocol recommendations. We also checked 212 medical records for adherence. Despite high awareness among the physicians, adherence to the protocol was low: perceived barriers included lack of essential medications, insufficient time and lack of training on the protocol. We recommend establishing a new strategy for effective training of PHC physicians on the protocol.
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– Adherence of primary care physicians in Aseer region, Saudi Arabia to the National Protocol for the Management of Asthma.
Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence.
Br Med Bull. 2010 Aug 14;
Authors: Seah R, Mani-Babu S
To summarize the best available evidence in the last decade for managing ankle sprains in the community, data were collected using MEDLINE database from January 2000 to December 2009. Terms utilized: ‘ankle injury primary care’ (102 articles were found), ‘ankle sprain primary care’ (34 articles), ‘ankle guidelines primary care’ (25 articles), ‘ankle pathways primary care’ (2 articles), ‘ankle sprain community’ (18 articles), ‘ankle sprain general practice’ (22 articles), ‘Cochrane review ankle’ (58 articles). Of these, only 33 satisfied the inclusion criteria. The search terms identified many of the same studies. Two independent reviewers reviewed the articles. The study results and generated conclusions were extracted, discussed and finally agreed on. Ankle sprains occur commonly but their management is not always readily agreed. The Ottawa Ankle Rules are ubiquitous in the clinical pathway and can be reliably applied by emergency care physicians, primary care physicians and triage nurses. For mild-to-moderate ankle sprains, functional treatment options (which can consist of elastic bandaging, soft casting, taping or orthoses with associated coordination training) were found to be statistically better than immobilization for multiple outcome measures. For severe ankle sprains, a short period of immobilization in a below-knee cast or pneumatic brace results in a quicker recovery than tubular compression bandage alone. Lace-up supports are a more effective functional treatment than elastic bandaging and result in less persistent swelling in the short term when compared with semi-rigid ankle supports, elastic bandaging and tape. Semi-rigid orthoses and pneumatic braces provide beneficial ankle support and may prevent subsequent sprains during high-risk sporting activity. Supervised rehabilitation training in combination with conventional treatment for acute lateral ankle sprains can be beneficial, although some of the studies reviewed gave conflicting outcomes. Therapeutic hyaluronic acid injections in the ankle are a relatively novel non-surgical treatment but may have a role in expediting return to sport after ankle sprain. There is a role for surgical intervention in severe acute and chronic ankle injuries, but the evidence is limited.
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– Managing ankle sprains in primary care: what is best practice? A systematic review of the last 10 years of evidence.
