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ABSTRACT BACKGROUND Increasing the attractiveness of primary care careers is a key step in addressing the growing shortage of primary care physicians. The purpose of this review was to (1) identify interventions aimed at increasing the proportion of undergraduate medical students choosing a primary care specialty, (2) describe the characteristics of these interventions, (3) assess the quality of the studies, and (4) compare the findings to those of a previous literature review within a global context. METHODS We searched MEDLINE, EMBASE, ERIC, CINAHL, PsycINFO, The Cochrane Library, and Dissertations & Theses A&I for articles published between 1993 and February 20, 2015. We included quantitative and qualitative studies reporting on primary care specialty choice outcomes of interventions in the undergraduate medical curriculum, without geographic restrictions. Data extracted included study characteristics, intervention details, and relevant outcomes. Studies were assessed for quality and strength of findings using a five-point scale. RESULTS The review included 72 articles reporting on 66 different interventions. Longitudinal programs were the only intervention consistently associated with an increased proportion of students choosing primary care. Successful interventions were characterized by diverse teaching formats, student selection, and good-quality teaching. Study quality had not improved since recommendations were published in 1995. Many studies used cross-sectional designs and non-validated surveys, did not include control groups, and were not based on a theory or conceptual framework. DISCUSSION Our review supports the value of longitudinal, multifaceted, primary care programs to increase the proportion of students choosing primary care specialties. Isolated modules or clerkships did not appear to be effective. Our results are in line with the conclusions from previous reviews and add an international perspective, but the evidence is limited by the overall low methodological quality of the included studies. Future research should use more rigorous evaluation methods and include long-term outcomes.

The early identification of patients suffering from SARS-CoV-2 infection in primary care is of outmost importance in the current pandemic. The objective of this study was to describe the clinical characteristics of primary care patients who tested positive for SARS-CoV-2. We conducted a cross-sectional study between March 24 and May 7, 2020, involving consecutive patients undergoing RT-PCR testing in two community-based laboratories in Lyon (France) for a suspicion of COVID-19. We examined the association between symptoms and a positive test using univariable and multivariable logistic regression, adjusted for clustering within laboratories, and calculated the diagnostic performance of these symptoms. Of the 1561 patients tested, 1543 patients (99%) agreed to participate. Among them, 253 were positive for SARS-CoV-2 (16%). The three most frequently reported ‘ear-nose-throat’ and non-‘ear-nose-throat’ symptoms in patients who tested positive were dry throat (42%), loss of smell (36%) and loss of taste (31%), respectively fever (58%), cough (52%) and headache (45%). In multivariable analyses, loss of taste (OR 3.8 [95% CI 3.3–4.4], p-value < 0.001), loss of smell (OR 3.0 [95% CI 1.9–4.8], p < 0.001), muscle pain (OR 1.6 [95% CI 1.2–2.0], p = 0.001) and dry nose (OR 1.3 [95% CI 1.1–1.6], p = 0.01) were significantly associated with a positive result. In contrast, sore throat (OR 0.6 [95% CI 0.4–0.8], p = 0.003), stuffy nose (OR 0.6 [95% CI 0.6–0.7], p < 0.001), diarrhea (OR 0.6 [95% CI 0.5–0.6], p < 0.001) and dyspnea (OR 0.5 [95% CI 0.3–0.7], p < 0.001) were inversely associated with a positive test. The combination of loss of taste or smell had the highest diagnostic performance (OR 6.7 [95% CI 5.9–7.5], sensitivity 44.7% [95% CI 38.4–51.0], specificity 90.8% [95% CI 89.1–92.3]). No other combination of symptoms had a higher performance. Our data could contribute to the triage and early identification of new clusters of cases.

Meat consumption has significant implications for both individual health and the environment. Understanding individuals’ attachment to meat is crucial for designing effective interventions to reduce consumption. The MAQ is a tool developed to assess individuals’ attachment to meat. This study aims to translate and validate the MAQ into French for use in a general practice population in France. The study was conducted in three phases: translation, pretesting through cognitive interviews, and testing through a cross-sectional study of general practice patients. Descriptive, factorial, and internal consistency analyses were performed to validate the French version of the MAQ. The French version of the MAQ consists of 17 items in four dimensions: Hedonism, Affinity, Entitlement, and Dependence. Face validity was confirmed by cognitive interviews. The RMSEA and CFI were 0.06 and 0.92 respectively, showing acceptable goodness-of-fit. Internal consistency was demonstrated with Cronbach’s alpha and Loevinger’s H coefficients exceeding 0.7 and 0.3, respectively. The French version of the MAQ is a valid and reliable tool for assessing individuals’ attachment to meat in a general practice population. Its application shows promise for the design of targeted interventions to reduce meat consumption, benefiting both individual health and environmental sustainability.

Clinical placements significantly impact medical students' career choices. Primary care physicians supervising these placements can influence students' career decisions through role modelling and by creating supportive learning environments. This qualitative study aimed to identify factors contributing to role modelling and students' sense of integration during placements and their influence on career decisions, with a focus on primary care. Semi-structured interviews were conducted with postgraduate trainees selected based on interest in primary care, exploring their experiences during undergraduate clinical placements and factors influencing career choices. Data were thematically analysed to identify key themes related to student integration, well-being, and supervisor role modelling. Analysis revealed four key domains where primary care physicians can positively influence students' career interest: onboarding students effectively, fostering positive and inclusive team dynamics, involving students in patient care, and providing high-quality supervision and feedback. Students reported that feeling valued and socially included contributed to their well-being and professional self-efficacy, which in turn impacted their career choices. Supportive and inclusive learning environments during placements are critical to fostering students' professional growth. While relevant across clinical settings, this study's findings hold particular significance for primary care due to the challenge of balancing clinical and practice management duties and teaching. Implementing structured onboarding, team integration, and effective supervision can enhance students' experiences and promote interest in primary care. Future research should extend these findings beyond primary care. The proposed roadmap could both spark interest in primary care and promote future collaboration between primary and secondary care.

The 16-item Meat Attachment Questionnaire (MAQ-16) assesses emotional and cognitive attachment to meat across four dimensions: hedonism, affinity, entitlement, and dependence. Recently validated in French, we aimed to develop and validate a shorter, four-item version (MAQ -4) to reduce participant burden. In this 2023 observational study in the Rhône-Alpes region, 919 primary care patients were invited to complete the French MAQ-16 (MAQ -16). Classical test theory guided the development of the MAQ -4, and Spearman's correlation coefficients assessed its correlation with the MAQ -16 (dimension and overall scores). We also evaluated the diagnostic performance of the MAQ -4 for identifying patients with high meat attachment (MAQ -16 score > 60). A total of 822 patients participated (65.3% women; median age = 52; participation rate = 89.5%). The MAQ -4 showed strong correlations with the MAQ -16 (rho = 0.83 for hedonism, 0.77 for affinity, 0.70 for entitlement, 0.79 for dependence, and 0.86 for the overall score, all -values <0.001). A score < 15 on the MAQ -4 (sensitivity = 91%, NPV = 96%) effectively excluded patients with low meat attachment, while a score ≥ 17 (specificity = 96%, PPV = 84%) accurately identified those with high attachment. The MAQ -4 demonstrated strong correlation with the MAQ -16 and accurately identified high attachment to meat. It may serve as a useful tool in research and clinical settings, though further validation is required before broad implementation in French primary care.

Background Home remedies are anchored in patients’ everyday life, but their use in Western cultures remains scarcely explored. Our objectives were to investigate primary care patients’ perspectives and use of non-pharmacological home remedies in Geneva (Switzerland). Methods In spring 2020, we conducted a cross-sectional survey among adult primary care patients in randomly selected general practices ( N  = 15). Patients were recruited in the waiting rooms and asked to complete a questionnaire about their sociodemographic characteristics, their home remedy use, and their expectations and reasons for using (or not using) home remedies. We employed descriptive statistics to summarise the data and logistic regression adjusted for clustering within practices to explore associations between home remedy use and participants’ sociodemographic characteristics. Results Three hundred fourteen of three hundred ninety patients agreed to participate in the study (participation rate 80.5%). Home remedies were used by 64.4% of patients. The main reasons given were for preventive purposes (55.3%), self-care (41.0%), as an alternative to conventional medicine (40.5%) and to avoid or delay a medical consultation (38.5%). One-third of patients considered that it was the GP’s role to spontaneously inform them about home remedies (36.4%), another third considered that it was the GP’s role to inform them, but only upon specific request (32.3%), and the last third of patients declared that it was not the GP’s role to provide information about home remedies (30.3%). Patients living in an urban zone (adjusted OR 2.1; 95%CI 1.0–4.4; p 0.05) and those with a tertiary education background (adjusted OR 1.9; 95%CI 1.0–3.6; p 0.05) believed that it was their GP’s role to inform them about home remedies. Conclusions Home remedies are used by a majority of primary care patients in Geneva. For a comprehensive and safe healthcare management in the context of patient-oriented medicine, more evidence-based research on efficacy and safety of home remedies as well as their place in primary care consultation is required.

Nocturnal Legs Cramps are a frequent disorder, which have a negative impact on quality of life, particularly among patients over 60 years old. Lifestyle factors such as alcohol consumption have been shown to be associated with Nocturnal Leg Cramps. This study aimed to explore the association between nocturnal leg cramps and a sedentary lifestyle among elderly patients. A case-control study was conducted with a Bayesian approach for sensitivity analysis. Patients over 60 years old consulting their family doctor were recruited in the Alsace region, France. Cases were matched with controls free from cramps for age, sex, medical history and medications known to trigger cramps. The level of physical activity was assessed using the Dijon Physical Activity Score (DPAS). We performed univariate and multivariate analyses adjusting for alcohol consumption. 272 participants were matched into 136 pairs. 11% of all were sedentary persons. Adjusting for alcohol consumption, we observed an association between Nocturnal Leg Cramps and a sedentary lifestyle OR = 9.84 (95% credibility interval [1.74; 101.9]; posterior probability 99.68%). Our findings represent an additional argument to promote physical activity to patients over 60 years old. They also highlight the need to develop and evaluate physical activity interventions in the treatment of Nocturnal Legs Cramps.

Investigates guideline use amongst general practitioners (GP) from 26 European countries and from Brazil, Israel and New Zealand, regarding best management of hypertension in frail oldest-old (>80 years of age). Examines if guideline use relates to different decisions when managing hypertension in frail oldest-old. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.