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New hypertension and diabetes diagnoses following the Affordable Care Act Medicaid expansion

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Family Medicine and Community Health 2020年第4期8卷 84-89页

作者： Heather Angier Nathalie Huguet David ezekiel-Herrera Miguel Marino Teresa Schmidt Beverly B Green jennifer e devoe Family Medicine Oregon Health&Science UniversityPortlandOregonUSA Biostatistics Group Oregon Health&Science University-Portland State University School of Public HealthPortlandOregonUSA Research OCHINPortlandOregonUSA Kaiser Permanente Washington Health Research Institute SeattleWashingtonUSA

Objective To assess the Affordable Care Act(ACA)Medicaid expansion’s impact on new hypertension and diabetes diagnoses in community health centres(CHCs).Design Rates of new hypertension and diabetes diagnoses were computed using generalised estimating equation Poisson models and we tested the difference-in difference(DID)pre-ACA versus post-ACA in states that expanded Medicaid compared with those that did *** We used electronic health record data(pre-ACA:1 January 2012-31 December 2013-post-ACA:1 January 2014-31 December 2016)from the Accelerating Data Value Across a National Community Health Center Network clinical data *** included clinics with≥50 patients contributing to person-time at risk in each study *** Patients aged 19-64 with≥1 ambulatory visit in the study period were *** then excluded patients who were pregnant during the study period(N=127530).For the hypertension outcome,we excluded individuals with a diagnosis of hypertension prior to the start of the study period,those who had a hypertension diagnosis on their first visit to a clinic or their first visit after 3 years without a visit,and those who had a diagnosis more than 3 years after their last visit(pre-ACA non-expansion N=130973;expansion N=193198;post-ACA non-expansion N=186341;expansion N=251015).For the diabetes analysis,we excluded patients with a diabetes diagnosis prior to study start,on their first visit or first visit after inactive patient status,and diagnosis while not an active patient(pre-ACA non-expansion N=145435;expansion N=198558;post-ACA non-expansion N=215039;expansion N=264644).Results In non-expansion states,adjusted hypertension diagnosis rates saw a relative decrease of 6%,while in expansion states,the adjusted rates saw a relative increase of 7%(DID 1.14,95%CI 1.11 to 1.18).For diabetes diagnosis,adjusted rates in non-expansion states experienced a significant relative increase of 28%and in expansion states the relative increase was 25%

关键词： diagnosis hypertension expansion

健康的社会决定因素在初级卫生保健中的融入路径

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中国全科医学 2016年第22期19卷 2617-2618页

作者： jennifer e.devoe Andrew W.Bazemore erika K.Cottrell Sonja Likumahuwa-Ackman Jené Grandmont Natalie Spach Rachel Gold 杨文俄勒冈医科大学家庭医学学院美国俄勒冈州波特兰市 OCHIN有限公司 Robert Graham中心华盛顿特区 HealthLandscape 俄亥俄州辛辛那提市 Kaiser Permanente健康研究中心俄勒冈州波特兰市中国全科医学杂志社

健康的社会决定因素（SDH）指非临床上的可以影响患者健康的因素,如社会地位、经济状况及邻里资源等。WHO将其定义为人们出生、成长、工作、生活、衰老的环境,以及广义上的塑造这些日常生活条件的力量和系统。SDH与疾病发病率、死亡率... 详细信息

健康的社会决定因素（SDH）指非临床上的可以影响患者健康的因素,如社会地位、经济状况及邻里资源等。WHO将其定义为人们出生、成长、工作、生活、衰老的环境,以及广义上的塑造这些日常生活条件的力量和系统。SDH与疾病发病率、死亡率及其他健康指标相关,且其对人群健康的影响大于医疗服务。

关键词：健康的社会决定因素初级卫生保健人口特征医学信息学数据收集

家庭医学：加速患者与人群健康提升的突破性革新

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中国全科医学 2016年第28期19卷 3392-3393页

作者： Glen Stream jennifer e.devoe Lauren S.Hughes Robert L.Phillips 本刊编辑部(译) Family Medicine for America's Health Leawood KS the Department of Family Medicine Oregon Health & Science University Portland OR OCHIN Inc. Port - land the Pennsylvania Department of Health Harrisburg PA the American Board of Family Medicine Lexington KY 不详

本文由参加第4届*** Stephens研讨会的作者于会后撰写,这些作者同时也是家庭医学与美国健康(FMAHealth)委员会的成员。文章将现阶段FMAHealth所做的战略与沟通工作的志向与会议得出的理念进行了关联。FMAHealth项目由8个国家家庭医学机... 详细信息

本文由参加第4届*** Stephens研讨会的作者于会后撰写,这些作者同时也是家庭医学与美国健康(FMAHealth)委员会的成员。文章将现阶段FMAHealth所做的战略与沟通工作的志向与会议得出的理念进行了关联。FMAHealth项目由8个国家家庭医学机构赞助,力图在最初的家庭医学未来项目的基础上进行开展。此项目的目标之一是使实力充足的家庭医生队伍在持续改善的医疗之家模式中工作,并且由足够维持医疗之家和私人医生与患者保持联系的综合付费模式支持。

关键词：医治家庭医学家庭医生医疗卫生提供私人医生人口健康基层医疗职业化社会公正

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回到未来：家庭医学未来项目历史的反思

中国全科医学 2015年第7期18卷 733-735页

作者： Noemi C.Doohan Jill endres Nerissa Koehn John Miller Joseph e.Scherger James Martin jennifer e.devoe 王田竹格加利福尼亚大学河滨分校医学院爱荷华大学罗伊J和露西尔A卡佛医学院家庭医学系蒙大拿大学卫生与生物医学学院西蒙大拿家庭医学住院医生系艾森豪威尔医疗中心基督圣罗萨医疗系统俄勒冈健康与科学大学中国全科医学杂志社

历史能力对家庭医学的未来发展至关重要，反思家庭医学历史是探讨其未来的首要环节。本期为您带来《Journal of the American Board of Family Medicine》杂志的最新家庭医学动态——回到未来：家庭医学未来项目（FFM）历史的反思；从... 详细信息

历史能力对家庭医学的未来发展至关重要，反思家庭医学历史是探讨其未来的首要环节。本期为您带来《Journal of the American Board of Family Medicine》杂志的最新家庭医学动态——回到未来：家庭医学未来项目（FFM）历史的反思；从多代人的角度对FFM历史和家庭医学过去十年演变进行反思，旨在引发代际对话。此类代际对话能够使年长者与年轻人共享智慧，同时以后代之眼呈现学科历史，期望对我国的全科医学未来发展规划有所启发。

关键词：医疗政策医学教育初级医疗保健

Storylines of family medicine Ⅴ:ways of thinking—honing the therapeutic self

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Family Medicine and Community Health 2024年第S03期12卷 43-51页

作者： William B Ventres Leslie A Stone Johanna F Shapiro Cynthia Haq Jéssica R B Leao Donald e Nease Jr Liz Grant Stewart W Mercer John C M Gillies Pablo González Blasco Maria Auxiliadora C De Benedetto Graziela Moreto Marcelo R Levites jennifer e devoe William R Phillips Jane M Uygur Thomas R egnew Colette S Stanley Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine University of California Irvine School of MedicineIrvineCaliforniaUSA Faculty of Medicine University of Sao PauloSao PauloBrazil Family Medicine University of Colorado Anschutz Medical Campus School of MedicineAuroraColoradoUSA Usher Institute Edinburgh Medical SchoolUniversity of EdinburghEdinburghUK SOBRAMFA-Medical education and Humanism Sao PauloBrazil Family Medicine Oregon Health&Science University School of MedicinePortlandOregonUSA Family Medicine University of Washington School of MedicineSeattleWashingtonUSA General Practice Royal College of Surgeons in IrelandDublinIreland General Internal Medicine Geriatrics&Palliative MedicineTulane University School of MedicineNew OrleansLouisianaUSA

Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅴ:ways of thinking—honing the therapeutic self’,authors present the following sections:‘Reflective practice in action’,‘The doctor as drug—Balint groups’,‘Cultivating compassion’,‘Towards a humanistic approach to doctoring’,‘Intimacy in family medicine’,‘The many faces of suffering’,‘Transcending suffering’and‘The power of listening to stories.’May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.

关键词： illustration dimensions suffering

变化中的家庭医学：来自夏延山Keystone Ⅲ大会的新观点

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中国全科医学 2014年第13期17卷 1451-1452页

作者： elizabeth Steiner erika Bliss Kara Cadwallader Terrence e. Steyer Deborah S. Clements jennifer e. devoe Kenneth Fink Marina Khubesrian Paul Lyons David Weismiller 王静俄勒冈健康与科学大学美国俄勒冈州波特兰市97239 中国全科医学杂志社

美国家庭医学小组于2000年10月在夏延山召开了KeystoneⅢ大会。与会者包括第一代(1970年之前进入,代表专业的创始人),第二代(1970—1990年进入,代表积极建立和推进这一领域的人员)及第三代家庭医学成员(1990年以后进入,代表当时最新的... 详细信息

美国家庭医学小组于2000年10月在夏延山召开了KeystoneⅢ大会。与会者包括第一代(1970年之前进入,代表专业的创始人),第二代(1970—1990年进入,代表积极建立和推进这一领域的人员)及第三代家庭医学成员(1990年以后进入,代表当时最新的家庭医生)。会议期间,三代成员一起讨论思考过去、现在及家庭医学的未来,我们在其中的角色,以及如何理解现有的及发展中的家庭医生和家庭医学。历经10多年的发展后,由10名第三代成员撰写了本文,反映了他们目前的观点。本刊编辑部特翻译此篇文章,希望对中国的全科医生也有一定的启发和帮助。

关键词：医学发展史家庭医疗家庭医学卫生保健工作

The sexually dimorphic expression of glutamate transporters and their implication in pain after spinal cord injury

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Neural Regeneration Research 2025年第11期20卷 3317-3329页

作者： jennifer M.Colón-Mercado Aranza I.Torrado-Tapias Iris K.Salgado Jose M.Santiago Samuel e.Ocasio Rivera Dina P.Bracho-Rincon Luis H.Pagan Rivera Jorge D.Miranda Department of Physiology University of Puerto RicoMedical Sciences CampusSan JuanPRUSA National Institutes of Health National Human Genome Research InstituteBethesdaMDUSA Universidad Central del Caribe School of MedicineBayamónPRUSA University of Puerto Rico Carolina CampusCarolinaPRUSA Institute of Neurobiology San JuanPRUSA

In addition to the loss of motor function,~60% of patients develop pain after spinal cord *** cellular-molecular mechanisms are not well understood,but the data suggests that plasticity within the rostral,epicenter,and caudal penumbra of the injury site initiates a cellularmolecular interplay that acts as a rewiring mechanism leading to central neuropathic *** can lead to the formation of new connections triggering abnormal sensory *** excitatory glutamate transporters are responsible for the reuptake of extracellular glutamate which makes them a critical target to prevent neuronal hyperexcitability and *** previous studies showed a sexually dimorphic therapeutic window for spinal cord injury after treatment with the selective estrogen receptor modulator *** this study,we investigated the anti-allodynic effects of tamoxifen in male and female rats with spinal cord *** hypothesized that tamoxifen exerts anti-allodynic effects by increasing the expression of glutamate transporters,leading to reduced hyperexcitability of the secondary neuron or by decreasing aberrant *** and female rats received a moderate contusion to the thoracic spinal cord followed by subcutaneous slow-release treatment of tamoxifen or matrix pellets as a control(placebo).We used von Frey monofilaments and the“up-down method”to evaluate mechanical *** treatment decreased allodynia only in female rats with spinal cord injury revealing a sexdependent *** expression profile of glutamatergic transporters(excitatory amino acid transporter 1/glutamate aspartate transporter and excitatory amino acid transporter 2/glutamate transporter-1)revealed a sexual dimorphism in the rostral,epicenter,and caudal areas of the spinal cord with a pattern of expression primarily on *** rodents showed a significantly higher level of excitatory amino acid transporter-1 expression while male rodents showed increased

关键词： allodynia central neuropathic pain eAAT-1/GLAST eAAT-2/GLT-1 glutamate transporters selective estrogen receptor modulator sexual dimorphism spinal cord injury trauma

Advancements and challenges in treating advanced gastric cancer in the West

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 652-664页

作者： jennifer L Leiting Travis e Grotz Division of Hepatobiliary and Pancreas Surgery Mayo Clinic

Gastric cancer is a leading cause of cancer incidence and death *** with advanced gastric cancer benefit from a multi-modality treatment *** oncologic resection with negative margins and complete lymphadenectomy plays a crucial role in long-term survival for patients with resectable *** utilization of minimally invasive techniques for gastric cancer has been slowly increasing and is proving to be both technically and oncologically *** chemotherapy is the current standard of care for advanced gastric cancer.A variety of chemotherapy regimens have been used with the combination of docetaxel,oxaliplatin,5-fluorouracil,and leucovorin being the current recommendation given its superior ability to induce a complete pathologic response and prolong *** use of radiation has been more controversial with its optimal place in the treatment sequence being *** are current ongoing studies assessing the impact of radiation as an adjunct or in place of *** treatments(e.g.,trastuzumab for human epidermal growth factor receptor 2 positive tumors and pembrolizumab for programmed death-ligand 1 positive tumors)are showing promise and are part of a continued emphasis on individualized *** chemotherapy may also play a role in preventing peritoneal recurrences for patients with high risk *** treatment of patients with advanced gastric cancer in the West continues to advance and improve with a better understanding of optimal treatment sequences and the utilization of personalized treatment regimens.

关键词： Gastric cancer D2 lymphadenectomy Minimally invasive surgery Neoadjuvant chemotherapy Chemoradiation Targeted treatments

A new role for primary care teams in the United States after“Obamacare:”Track and improve health insurance coverage rates

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Family Medicine and Community Health 2016年第4期4卷 63-67页

作者： jennifer devoe Heather Angier Megan Hoopes Rachel Gold Oregon Health and Science University PortlandORUSA OCHIN IncPortlandORUSA Kaiser Permanente Center for Health Research NorthwestRegion PortlandORUSA

Maintaining continuous health insurance coverage is *** recent expansions in access to coverage in the United States after“Obamacare,”primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to *** describe efforts to longitudinally track health insurance rates using data from the electronic health record(eHR)of a primary care network and to use these data to support practice-based insurance outreach and *** we highlight a few examples from one network,we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of *** partnering with researchers through practice-based research networks and other similar collaboratives,primary care practices can greatly expand the use of eHR data and eHR-based tools targeting improvements in health insurance and quality health care.

关键词： Insurance,health Affordable Care Act electronic health records