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Background. General Practice/Family Medicine includes approaches to the biological, technological, behavioural, sociological and anthropological domains. Objectives. To document the domains addressed in the final assignments of the Integrated Master's Degree in Medicine at the Faculty of Medicine, University of Coimbra, in the area of GP/FM. Material and methods. Observational study of the titles of final assignments, between 2008 and 2017, granted by the Faculty of Medicine of the University of Coimbra. A domain analysis using as codes the International Classification in Primary Care-2 and the Q-Codes, a context classification in Primary Care, year of elaboration and gender of author was carried out for each title of final assignment. A descriptive and inferential analysis was performed through parametric and nonparametric tests. Results. 169 papers were analysed, 23.1% written by male students, with a positive overall growth dynamics (Δ = +7) between 2008 and 2017. Q-Codes were registered 276 times, while the ICPC-2 codes were used 133 times. Under the Q-Codes, "doctor's issues" is the most frequently addressed (n = 112; 67.2%), and under the International Classification in Primary Care-2 classifications, the chapter "Psychological" was predominant (n = 35; 21%). Under the Q-Codes, subcategories "primary care setting" (n = 26; 15.6%), "health issue management" (n = 23; 13.8%) and "unable to code, unclear" (22; 13.2%) were dominant. Within the International Classification in Primary Care-2, the subcategories "diabetes noninsulin dependent" (n = 22; 13.2%), "depressive disorder" (8, 4.8%) and "hypertension uncomplicated" (8; 4.8%) were predominantly focused on. Conclusions. The 3CGP may become a professional tool, allowing for more precise identification of final works, for a better communication method in medical activity and for avoiding the loss of previously developed works. [ABSTRACT FROM AUTHOR]

Screening significantly decreases the severity and incidence of conditions, as well as mortality, and therefore can improve the health of the population. Screening in Poland falls below the acceptable level of 45% of organised screening uptake and the recommended level of 65%. Multidimensional factors have been implicated as barriers and facilitators of screening uptake in the primary care setting. This paper summarises the existing evidence on factors influencing screening uptake in a Pap smear for cervical cancer (CC), mammography screening for breast cancer and faecal occult blood test (FOBT) for colorectal cancer (CRC). We performed a literature search in the MEDLINE (PubMed) and EMBASE databases and included articles of any study design published between 2010 and 2020. We also demonstrate the original concept of ‘Ugly Value’, which describes factors that may reduce screening uptake. Primary care practitioners play a vital role in increasing screening rates in the populations and can improve these rates through a variety of systematically implemented strategies and interventions. We determine four areas to improve cancer screening uptake in primary healthcare institutions: data gathering and data use (IT systems, meaningful use of Electronic Health Records to generate reminders, prompting healthcare professionals to refer patients for screening), cost effectiveness (avoiding overuse of screening in low-risk populations), innovative efficient management (use of effective interventions and thoughtful allocation of resources, e.g. engaging nurses into patient navigation instead of assigning them to answer patient concerns about screening by telephone), organisational system (team based, integrated care and patient navigation are ways to improve screening rates).

This article presents the steps of family medicine implementation in Ukraine, the results and problems of reorganization of the health system, educational and economic problems and the role of the Institute of Family Medicine at the Shupyk National Medical Academy of Postgraduate Education in all processes. The new structure of primary care includes centers with administrative facilities, several ambulatory primary care clinics and emergency care departments. The main problem is to provide a substantial quantity of general practitioners (GPs) to cover affordable primary care for the Ukrainian population (42 million). The target is approximately 28,000 working GPs for the short period of 2011–2020, where in 2016, there were approximately 14,000 GPs. Other problems include the insufficient financing and equipment of primary care centers, low number of computers, paper medical records and low salary. The situation has been worsened since 2014 when the antiterroristic operation was started and funding of primary care was cut. Further steps of reformation according to the plan of the Ministry of Health of Ukraine are: reformation of the financing system, organization of hospital areas, autonomization of health establishments, creation of centers of public health, wide implementation of licensing and health insurance, state reimbursement of medications for patients, implementation of syndrome classification ICPC-2, improvement of national clinical guidelines and implementation of digital medical records. The reformation of the health system of Ukraine upon the principles of family medicine for 30 years, more active in the last 5 years, showed some positive results, but at the same time determined the existence of quality problems in medical education and financing of primary care.

Over the past 30 years, the incidence of cancer in Poland has more than doubled. Advances in technology, early diagnosis and improved treatment make more and more malignancies curable. An increase in the survival of cancer patients has also been observed. An increased rate of survival leads to the development of subsequent malignancies. Their cause is yet unclear however, chemotherapy as well as genetic and environmental factors may be involved in the process. The key prognostic factors for patients who were once diagnosed with cancer are: type of cancer, its stage and available treatment options. The aim of this work is to introduce the issue of multiple primary malignancies, with particular emphasis on their epidemiology. From the perspective of the whole population, the occurrence of multiple malignancies is quite rare. Triple or quadruple malignancies are even less common. Multiple malignancies may develop at any age, although, as it is shown in this paper, the type of cancer, its stage and location vary depending on the age at which the first and later subsequent cancers have presented. The most frequently found subsequent cancers are: colon cancer, lung cancer, cancers of the genital system and breast cancer. Based on statistical analysis and current literature, we discuss the risk of developing a second malignancy depending on the type of cancer that was diagnosed first.

Background . Home care (HC ) is placed between the health and social welfare systems, and the clients of HC mostly need health services. Along with other providers, family doctors (FDs) are usually involved in the provision of care. Objectives. This paper aims to describe and compare the involvement of HC providers to elderly and disabled persons in Poland and Estonia. Material and methods . This study is part of the international project EURHOMA P (Mapping Professional Home Care in Europe). Data was collected in 2008–2010. Experts from different areas of health and social care were queried by using a questionnaire containing structured case narratives, which were hypothetical descriptions of the situations of elderly or disabled persons living at home and in need of care. Results. There are a number of HC services, e.g. nursing, medical and social, available in both countries. The application for HC is mostly made by the patient or a close family member; the point of entry to HC can differ and depends on the client’s primary problem. FDs, together with social workers, play an important role in the provision of HC services in both countries. However, due to a shortage of round-the-clock professional services at a client’s home, families are also expected to play a large role in providing HC . Conclusions . Health care professionals, mainly those working in primary health care, play a remarkable role in access to and provision of HC services. Nevertheless, responsibility for 24-hour care lies, to a large extent, with the client’s immediate family. This situation seems to be typical in Eastern European countries.