Health promotion, disease prevention and periodic health checks: perceptions and practice among family physicians in eastern Mediterranean region

Introduction: The aim of this study was to identify the current practices and perceptions of family physicians regarding health promotion, disease prevention including periodic screening and health checks in Eastern Mediterranean Region. Methods: A multi-country cross-sectional study was conducted in six countries of EMR, from September 2014 to March 2015. Family Physicians who were currently practicing in different countries of EMR were invited to participate in the study through email. A pre-tested structured questionnaire was used for data collection. Data was entered and analyzed on SPSS 19 and logistic regression analysis was performed. Results: A total of 100 physicians data was included in the final analysis. The majority were female physicians (76%): 63% were 25 to 35 years of age. Approximately 53% of Family physicians always recommend periodic screening and health checks to their patients. The common screening question asked to patients in medical history was related to their blood pressure (86%). Almost all (99%) of the Family physicians believe they should conduct periodic health checks. Those who had postgraduate training in Family Medicine (OR: 0.5; 95% CI: 0.39-1.67) and attended CME sessions regularly (OR: 0.11; 95% CI: 0.01-0.93), are more likely to recommend periodic screening and health checks to their patients. Conclusion: Periodic screening and health check is an important strategy to prevent disease and maintain health. It is an underutilized practice and a great need exists for its implementation in family practice

New leadership model for family physicians in the Eastern Mediterranean region: a pilot study across selected countries

Background: Family Medicine is growing rapidly across the Eastern Mediterranean Region. However, it needs support in terms of overall health system development. This will require strong leadership in family medicine to implement the change required to improve current conditions. Objective: To collect data that will support the development of a leadership program for the future family physicians in the region. Methods: A cross-sectional study was conducted from July 2016 to September 2016 in eight countries of the Eastern Mediterranean Region, (Bahrain, Egypt, Iraq, Jordan, Kuwait, Qatar, Pakistan, and Saudi Arabia). These countries were selected to obtain perceptions of Family Physicians (FPs) regarding the current leadership model and to explore the need for a new future innovative model in Family Medicine (FM) across the region. Results: The information of 68 family physicians was included in the final analysis. The majority of the FPs was females as compared to males (71% vs. 29%). Forty-four percent of the FPs had 10 to 19 years of experience. Almost all of the FPs (96%) had completed some training in family medicine after graduation. About three fifths of the FPs had completed postgraduate qualifications and out of those, 64% had passed Board or Membership Examinations. Twenty-one percent of them are currently in a leadership role and 45% who were not in any leadership role responded that the current situation of FM in their country is poor. All of the leaders believed that it is important to develop strong leadership in FM to take the specialty forward. Almost similar proportions (67% and 64%) of leaders and non-leaders thought that establishing regional associations would enhance the FM practice model. Approximately two thirds of leaders (67%) responded that the current role of decision makers in the Ministry of Health (MOH) regarding capacity building in FM is not effective. The majority of the FPs (54% and 38%) considers that the existing postgraduate curriculum does not address leadership skill development in FM. Eighty-eight percent of the FPs both from leadership and non-leadership groups agreed that academic institutions and practicing FPs can play an effective leadership role in taking FM forward. Conclusion: The Family Medicine specialty will have to develop leadership capabilities in line with today’s fast-moving changes in healthcare for it to obtain the due recognition in the healthcare delivery system

On-chip analysis of C. elegans muscular forces and locomotion patterns in microstructured environments

The understanding of force interplays between an organism and its environment is imperative in biological processes. Noticeably scarce from the study of C. elegans locomotion is the measurement of the nematode locomotion forces together with other important locomotive metrics. To bridge the current gap, we present the investigation of C. elegans muscular forces and locomotion metrics (speed, amplitude and wavelength) in one single assay. This assay uses polydimethylsiloxane (PDMS) micropillars as force sensing elements and, by variation of the pillar arrangement, introduces microstructure. To show the usefulness of the assay, twelve wild-type C. elegans sample worms were tested to obtain a total of 4665 data points. The experimental results lead to several key findings. These include: (1) maximum force is exerted when the pillar is in contact with the middle part of the worm body, (2) C. elegans locomotion forces are highly dependent on the structure of the surrounding environment, (3) the worms' undulation frequency and locomotion speed increases steadily from the narrow spacing of 'honeycomb' design to the wider spacing of 'lattice' pillar arrangement, and (4) C. elegans maintained their natural sinusoidal movement in the microstructured device, despite the existence of PDMS micropillars. The assay presented here focuses on wild type C. elegans, but the method can be easily applied to its mutants and other organisms. In addition, we also show that, by inverting the measurement device, worm locomotion behaviour can be studied in various substrate environments normally unconducive to flexible pillar fabrication. The quantitative measurements demonstrated in this work further improve the understanding of C. elegans mechanosensation and locomotion. © 2013 The Royal Society of Chemistry

Formation of Nanoscale Bioimprints of Muscle Cells Using UV-Cured Spin-Coated Polymers

We report a nanoscale replication method suitable for biological specimens that has potential in single cell studies and in formation of 3D biocompatible scaffolds. Earlier studies using a heat-curable polydimethylsiloxane (PDMS) or a UV-curable elastomer introduced Bioimprint replication to facilitate cell imaging. However, the replicating conditions for thermal polymerization are known to cause cell dehydration during curing. In this study, a UV-cured methacrylate copolymer was developed for use in creating replicas of living cells and was tested on rat muscle cells. Bioimprints of muscle cells were formed by spin coating under UV irradiation. The polymer replicas were then separated from the muscle cells and were analyzed under an Atomic Force Microscope (AFM), in tapping mode, because it has low tip-sample forces and thus will not destroy the fine structures of the imprint. The new polymer is biocompatible with higher replication resolution and has a faster curing process than other types of silicon-based organic polymers such as PDMS. High resolution images of the muscle cell imprints showed the micro-and nanostructures of the muscle cells, including cellular fibers and structures within the cell membranes. The AFM is able to image features at nanoscale resolution with the potential for recognizing abnormalities on cell membranes at early stages of disease progression

Fabrication of bismuth nanowire devices using focused ion beam milling

In this work, a focused ion beam (FIB) milling process has been developed to fabricate 50nm Bi nanowire and transistor structures using FEI-200 dual beam FIB system. For the fabrication, 50nm bismuth film was thermally evaporated through EBL patterned PMMA windows onto SiO2 substrates with pre-defined contact pads. Bi nanowire widths ranging from 30nm to 100nm have been successfully fabricated by milling out unwanted areas using 30KeV Ga+ ion beam. A single-pixel-line ion beam blanking technique has been utilised to fabricate Bi nanowire as small as 30nm in diameter and few micrometers long. In order to form good ohmic contacts for sub 50nm bismuth nanowires, a drill-and-fill process has been developed using FIB to sputter away the surface oxide of bismuth after the in-situ platinum nanowire contacts deposition. To our knowledge, this is the first time a focused ion beam process has been used to fabricate bismuth nanowire. The fabricated Bi nanowires were electrically characterised using a semiconductor analyser that showed good ohmic contact to the electrodes. In this paper, the fabrication experiments and the characterisation results for Bi nanowires as small as 50nm in diameter are presented. Several FIB issues involved in Bi device making and ohmic contacts to Bi nanowires will also be discussed