In May 2023, the Chinese Stomatological Association promulgated the group standard of "Standard on Clinical Dental Treatment for Children under General Anesthesia Orsedation". These specifications were formulated through broad-based expert consultation, iterative revisions, and a comprehensive review of relevant literature, incorporating the collective expertise of nationally recognized authorities in the field. The standard establishes a unified evaluation system and clinical guidelines tailored to China's medical context, aiming to regulate related medical practices. This paper aims to provide an in-depth interpretation of the standard, integrating the clinical research and experiences from the Pediatric Dentistry Department of West China Hospital of Stomatology, Sichuan University, in performing dental treatments under general anesthesia in last 12 years. It particularly focuses on interpreting key aspects, including safety considerations, treatment protocol selection, prevention and management of postoperative complication, postoperative follow-up, and oral health maintenance, to provide a reference for medical staffs to understand and apply them in clinical practice.
Humans ; Anesthesia, General ; Child ; Dental Care for Children/standards* ; China ; Postoperative Complications/prevention & control* ; Anesthesia, Dental/standards* ; Practice Guidelines as Topic

Human ; Family Practice ; Medicine ; Case Reports

Background: Diabetes mellitus is one of the most commonly encountered diseases in primary care. The complications of diabetes, especially uncontrolled diabetes, are extensive. Given the broad and devastating complications of diabetes, achieving optimal glycemic control is paramount. The onslaught of the COVID-19 pandemic has caused a recent and rapid increase in the utilization of telemedicine, especially in primary care. Due to the significant complications of uncontrolled diabetes, it is crucial to determine if this change in the manner of delivering healthcare is effective for our patients with chronic diseases such as diabetes. Objective: This study aimed to systematically review and analyze existing data using meta- analysis on the effectiveness of using telemedicine as a platform for managing patients with diabetes in family practice. Methods: The researchers performed a systematic review and meta-analysis of randomized controlled trials that compared telemedicine versus standard care for the management of Type 2 Diabetes Mellitus with HbA1c as the primary outcome. Results: All 11 studies that were included in this study reported a mean difference in favor of telemedicine over standard care, with HbA1c significantly lower in the telemedicine group as compared to standard care in 91% of the studies. The overall effect of the 11 studies is a decrease in HbA1c by a pooled mean of -0.63% with a 95% CI between -0.78% to -0.48% (p<0.00001). Conclusion The results of this meta-analysis demonstrate that various forms of telemedicine and telemedicine-assisted programs are effective in the management of adult patients with Type 2 Diabetes Mellitus as compared to standard face-to-face outpatient visits.
Telemedicine ; Diabetes Mellitus ; Family Practice

Objective To put forward suggestions for improving the scheme of general practice for functional communities from the perspective of supply and demand,guide the efficient use of the resources of general practice by the communities,and incorporate the general practice of communities into hierarchical diagnosis and treatment management. Methods In July 2021,stratified random sampling was employed to conduct the questionnaire surveys of the young and middle-aged (demand side) and the general practitioners (supply side),respectively.SPSS 20.0 was used for data analysis. Results The two sides had the same cognition about the main reasons for not signing a contract with a family doctor,which were the lack of knowledge about general practitioners and the lack of face-to-face communication opportunities.They had the same response about the form of services,with high acceptance of medical services via WeChat,outpatient consultation,and the internet.There were differences in service content between the two sides.The top three demands of the young and middle-aged were appointment registration and referral in superior hospitals,medication guidance,and massage,acupuncture,and moxibustion.The top service self-rated by general practitioners was personalized guidance and report interpretation of physical examination,and the bottom was massage,acupuncture,and moxibustion. Conclusions The general practice varies between the demand and supply sides.General practitioners should be encouraged to enter and learn functional communities and provide personalized services,thus improving the general medical service in functional communities.
General Practice ; Surveys and Questionnaires

In evidence-based family practice, we place great emphasis on shared decision-making with the goal of helping patients make informed decisions about their care and subsequently to improve patient health outcomes. Appropriate decision-making in family practice is affected by information delivery and patient education and interpersonal clinician-patient communication. Effective communication is essential for improved health outcomes, adherence to treatment and patient satisfaction. Informed patients are more likely to participate actively in their care, make wiser decisions, come to a common understanding with their physicians, and adhere more fully to treatment. Communicating evidence can transform a physician-dominated relationship into one that is patient-centered relationship. Techniques to improve patient communication have been associated with greater satisfaction especially when patients are involved in the decision-making process. Research about medical evidence in a particular clinical encounter has shown equally important elements: a) expertise of the provider; b) medical evidence; and c) the patient’s preferences, goals and concerns. These elements though separate, but when combined, results to a well-informed medical decision emphasizing the role of medical evidence in future communication and patient-engagement activities. Models of patient-centered communication are recommended.
Family Practice ; Patient Satisfaction

Humans ; Family Practice

The Key Feature Problem (KFP), is part of the Conjoint MAFP/FRACGP exit examination for Family Medicine specialisation in Malaysia. KFP tests candidates’ skills in clinical reasoning and decision making. Over the years, KFP has been the cause of most of the failures in the Part 1 theory examination. This paper aims to highlight common errors committed by candidates and provide recommendations and practical examination technique tips on how to mitigate these errors. A summary of the 26 KFP cases used in the 2020 Conjoint KFP examination demonstrates the breadth and types of cases. From the feedback reports collated from eight assessors involved in this exam, we determined that although inadequate knowledge is probably the main contributor to failure, other easily correctible mistakes made by candidates further aggravate the situation. Common errors include offering more answers than requested, giving duplicate or incomplete answers, and writing answers out of context to the case scenario. The paper concludes with recommendations and sources for effective learning, and provides 12 examination technique tips. The tips include time management, reading carefully through the case, and checking that the answers are congruent with the questions asked.
Family Practice ; General Practice

Evidence-based medicine is the foundation of current medical practice. Suitable evidence is needed to support the holistic approach in clinical practice. Quantitative research produces some evidence needed for disease treatment based on probabilities or averages. However, the practice of evidence-based medicine should be personalised to individual patients without relying solely on an average perspective. Beliefs, values and expectations are unique for each individual and may differ significantly from the average. Therefore, understanding individual differences requires evidence from qualitative research. This is particularly important in family medicine practice, which focuses on holistic care for the person, family and community. Findings from properly conducted qualitative research can offer in-depth and comprehensive accounts on healthcare issues from patient and practice perspectives. Qualitative research also provides explanatory power and analytical transferability, which can be applied into daily family medicine practice. In conclusion, evidence from qualitative research should be rightfully equally acknowledged in family medicine and healthcare.
Family Practice ; Evidence-Based Medicine ; Qualitative research

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, causing a pandemic. The Philippines ranks 3rd in Southeast Asia with more than 15,000 confirmed cases, and a case fatality rate of 6.01%, close to the global average of 6.33%. Objective: This clinical pathway was developed to guide family and community physicians on the diagnosis and initial management of COVID-19 in terms of 1) clinical history and physical examination; 2) laboratory and ancillary procedures to be requested; 3) pharmacologic interventions; 4) non-pharmacologic interventions, and 5) patient outcomes to expect. Method: The PAFP Clinical Pathways Group reviewed the published medical literature to identify, summarize, and operationalize the evidence in clinical publication on the management of patients with COVID-19 in family and community practice. Recommendations: The recommendations are time-bound tasks on patient care processes, in terms of history and physical examination, laboratory tests, pharmacologic and non-pharmacologic interventions. The recommendations are presented as a table and algorithm. Implementation At the clinic level, self-audit using the recommendations of this clinical pathway as the standard may be done. At the organizational level, the PAFP should establish a new model of quality improvement initiative where self-practice audits are included as part of the program.
COVID-19 ; Family Practice

Background: Diabetes mellitus type 2 (T2DM) is a chronic metabolic disease leading to target organ complications over time. The delays in treatment and glycemic control have significant implications in short and long-term health outcomes resulting in increased healthcare resource utilization thus timely insulin initiation and intensification is recommended Objective: This clinical pathway was developed to guide family and community physicians on how to intensify the treatment of Type 2 Diabetes Mellitus (T2DM) using insulin intended for patients who require insulin initiation or titration Methods: The PAFP Clinical Pathways Group reviewed published literature in order to identify, summarize and operationalize the evidence in the management of T2DM patients on insulin use in family and community practice. The recommendations are time bound tasks on patient care processes, in terms of history and physical examination, laboratory tests, pharmacologic and non-pharmacologic interventions and patient outcomes Summary of Recommendations The recommendations on clinical history and physical examination, laboratory, pharmacologic interventions, non-pharmacologic interventions subdivided into patient-centered, family-focused and community-oriented and patient outcomes are grouped into first visit and second visit, continuing visits
Diabetes Mellitus, Type 2 ; Insulin ; Family Practice