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Storylines of family medicine Ⅲ:core principles—primary care,systems and family

family medicine and Community health 2024年第S3期12卷 23-32页

作者： William B Ventres Leslie A Stone Timothy A Joslin John W Saultz Sommer Aldulaimi Paul R Gordon John C Lane Eric R Lee Jacob Prunuske Limor Gildenblatt Michael H Friedman Colleen T Fogarty Susan H McDaniel Tessa Rohrberg Amy Odom family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family medicine Oregon Health&Science UniversityPortlandOregonUSA family and Community medicine University of Arizona Medical Center–South CampusTucsonArizonaUSA family and Community medicine University of Arizona Medical Center–University CampusTucsonArizonaUSA UAMS West Regional Campus family medicine Residency Program Fort SmithArkansasUSA Medical College of Wisconsin–Central Wisconsin Campus WausauWisconsinUSA family and Community medicine Medical College of Wisconsin–Central Wisconsin CampusWausauWisconsinUSA family medicine Advocate Illinois Masonic Medical CenterChicagoIllinoisUSA family medicine Presence Saints Mary and Elizabeth Medical CenterChicagoIllinoisUSA family medicine University of Rochester Medical CenterRochesterNew YorkUSA Psychiatry and family medicine University of Rochester Medical CenterRochesterNew YorkUSA family and Community medicine University of Kansas School of Medicine-WichitaWichitaKansasUSA Sparrow/Michigan State University family medicine Residency Program LansingMichiganUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅲ:core principles—primary care,systems,and family’,authors address the following themes:‘Continuity of care—building therapeutic relationships over time’,‘Comprehensiveness—combining breadth and depth of scope’,‘Coordination of care—managing multiple realities’,‘Access to care—intersectional,systemic,and personal’,‘Systems theory—a core value in patient-centered care’,‘family-oriented practice—supporting patients’health and well-being’,‘family physician as family member’and‘family in the exam room’.May readers develop new understandings from these essays.

关键词： individual Storyline principles

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Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

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Journal of Biosciences and medicines 2024年第3期12卷 316-327页

作者： Sahar Moawia Balla Elnour Tayseer Abdelmotalib Ahmed Taha Haiam Abdalla Wadatalla Ziryab Zainelabdin Mohamed Elmahdi Marwah Isam Abdulmajeed Mohammedahmed Rowa Abdelmonem Sidig Hamadto Nahla Yousif Osman Mohammed Saeed Omnia Mubarak Saad Abdallah Sulafa Abdelbagi Mustafa Ahmed Hanady Abdelhameed Ahmed Mohamed Sarah Khalil Fathi Khalil family medicine Health Gates Primary Care Riyadh SAU family medicine Dhaman Health Assurance Hospitals Company Kuwait KWT family medicine First Health Cluster Riyadh SAU Emergency Department Sheikh Khalifa Medical City Abudahbi ARE family medicine University of Medical Sciences and Technology Khartoum SDN family medicine Sudan Medical Specialization Board-Sudan Khartoum SDN family medicine Ultra Care Home Care Company Riyadh SAU medicine Department Health Gates Primary Care Riyadh SAU family medicine Mouwasat Hospital Madinah SAU

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management

关键词： Sudan Adherence Intervention Education Self-Management Diabetes

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Temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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family medicine and Community health 2024年第4期12卷 1-8页

作者： Elizabeth T Thomas Diana R Withrow Cynthia Wright Drakesmith Peter J Gill Rafael Perera-Salazar Carl Heneghan Centre for Evidence-Based medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK Nuffield Department of primary care health Sciences University of OxfordOxfordUK Department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective The primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis This was a descriptive study of population-based data from Clinical Practice Research Datalink Aurum primary care consultation records from 1 January 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).Tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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Storylines of family medicine Ⅷ:clinical approaches

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family medicine and Community health 2024年第S3期12卷 70-78页

作者： William B Ventres Leslie A Stone Lauren E Gibson-Oliver Elizabeth Kyle Meehan Mari A Ricker David Loxterkamp Stacy A Ogbeide Frank V deGruy Megan R Mahoney Steven Lin Clare MacRae Stewart W Mercer family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family and Community medicine The University of Arizona College of Medicine-TucsonTucsonArizonaUSA Bucksport Regional health Center BucksportMaineUSA family and Community medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA Eugene S.Farley Jr.Health Policy CenterUniversity of Colorado Anschutz Medical Campus School of MedicineAuroraColoradoUSA family and Community medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Division of primary care and Population health Stanford MedicinePalo AltoCaliforniaUSA Usher Institute Edinburgh Medical SchoolUniversity of EdinburghEdinburghUK

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅷ:clinical approaches’,authors address the following themes:‘Evaluation,diagnosis and managementⅠ—toward a working diagnosis’,‘Evaluation,diagnosis and managementⅡ—process steps’,‘Interweaving integrative medicine and family medicine’,‘Halfway—the art of clinical judgment’,‘Seamless integration in family medicine—team-based care’,‘Technology—uncovering stories from noise’and‘Caring for patients with multiple long-term conditions’.May readers recognise in these essays the uniqueness of a family medicine approach to care.

关键词： uniqueness dimensions illustration

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Storylines of family medicine Ⅱ:foundational building blocks—context,community and health

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family medicine and Community health 2024年第S3期12卷 12-22页

作者： William B Ventres Leslie A Stone Rupal Shah Tamala Carter Geoffrey M Gusoff Winston Liaw Bich-May Nguyen Joanna V Rachelson Mary Alice Scott Teresa L Schiff-Elfalan Seiji Yamada Robert C Like Kathleen Zoppi A Peter Catinella Richard M Frankel Shailendra Prasad family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Bridge Lane Group Practice LondonUK Penn Center for Community health Workers University of PennsylvaniaPhiladelphiaPennsylvaniaUSA National Clinician Scholars Program UCLA David Geffen School of MedicineLos AngelesCaliforniaUSA health Systems and Population health Sciences University of Houston Tilman J Fertitta Family College of MedicineHoustonTexasUSA Southern New Mexico family medicine Residency Program Las CrucesNew MexicoUSA New Mexico primary care Training Program Silver CityNew MexicoUSA Anthropology New Mexico State UniversityLas CrucesNew MexicoUSA family medicine and Community health University of Hawai'i at Manoa John A Burns School of MedicineHonoluluHawaiiUSA family medicine and Community health Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA family medicine Indiana University School of MedicineIndianapolisIndianaUSA family medicine–Transmountain Texas Tech University Health Sciences CenterEl PasoTexasUSA medicine Indiana University School of MedicineIndianapolisIndianaUSA family medicine and Community health University of Minnesota Medical School-Twin Cities CampusMinneapolisMinnesotaUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅱ:foundational building blocks—context,community and health’,authors address the following themes:‘Context—grounding family medicine in time,place and being’,‘Recentring community’,‘Community-oriented primary care’,‘Embeddedness in practice’,‘The meaning of health’,‘Disease,illness and sickness—core concepts’,‘The biopsychosocial model’,‘The biopsychosocial approach’and‘family medicine as social medicine.’May readers grasp new implications for medical education and practice in these essays.

关键词： thematic illustration dimensions

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Storylines of family medicine Ⅶ: family medicine across the lifespan

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family medicine and Community health 2024年第S3期12卷 61-69页

作者： William B Ventres Leslie A Stone Katharine C Barnard Sara G Shields Mark J Nelson Maria Verónica Svetaz Clara M Keegan Joel J Heidelbaugh Paige B Beck Lucille Marchand family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family medicine and Community health UMass Chan Medical SchoolWorcesterMassachusettsUSA John Peter Smith Hospital family medicine Residency Fort WorthTexasUSA family and Community medicine Hennepin HealthcareMinneapolisMinnesotaUSA family medicine University of Vermont Larner College of MedicineBurlingtonVermontUSA family medicine University of Michigan Medical SchoolAnn ArborMichiganUSA family medicine and Community health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅶ:family medicine across the lifespan’,authors address the following themes:‘family medicine maternity care’,‘Seeing children as patients brings joy to work’,‘family medicine and the care of adolescents’,‘Reproductive healthcare across the lifespan’,‘Men’s health’,‘care of older adults’,and‘Being with dying’.May readers appreciate the range of family medicine in these essays.

关键词： life illustration family

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Mental health Consequences among Sudanese Due to the Armed Conflicts and Civil Unrest of 2023: One Year Later

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Journal of Biosciences and medicines 2024年第4期12卷 21-37页

作者： Sahar Moawia Balla Elnour Nahla Yousif Osman Mohammed Saeed Awadia Babiker Mohammed Osman Abeer Alawad Hassan Eman Mohamed Nour Hamad Alneel Mustafa Rowa Abdelmonem Sidig Hamato Malaz Mohamed Khair Alsafi Mohamed Amna Alnaim Mohamed Ahmed Osman Awab Abdelbagi Mustafa Ahmed Jalal Abdelrasool Hassan Eltaib Department of family medicine Health Gates Riyadh Saudi Arabia family medicine Department Ultracare Home Health Care Riyadh Saudi Arabia Psychiatic Department Erada Hospital and Mental Health Alkharj Saudi Arabia family medicine Department Ahmed Gasim Diabetic Center Portsudan Sudan QCHP Qatar Qatar primary care Najran Health Cluster Najran Saudi Arabia Emergency Department Best Care Hospital Khartoum Sudan family medicine Department Mouwasat Hospital Khobar Saudi Arabia

Aim: To investigate depression, anxiety, PTSD, and insomnia levels among Sudanese citizens after a year has passed since the start of Armed Forces conflict in Sudan. Methods: An online survey was distributed. It is composed of five parts, covering the following areas: 1) sociodemographic data;2) depression assessment;3) generalized anxiety disorder assessment;4) post-traumatic stress disorder assessment;and 5) insomnia assessment. Statistical Package for Social Sciences version 27 was used for data analysis;frequency and percentage were used to describe the qualitative variables. Spearman’s correlation analysis and Chi-square test were used for correlation and association analysis;a P-value equal to or less than 0.05 was considered statistically significant. Results: The study included 283 participants, primarily female (76.0%), with a mean age of 35.26 ± 6.96 years. The majority of participants were married (50.5%) and had a university level of education (50.2%). At the start of the war, 70.3% of participants were inside the war zones, and at the time of data collection, 73.5% were outside Sudan. The length of stay in the war zone ranged from 1 to 300 days, with a mean of 48.59 ± 70.284 days. Additionally, 63.3% of participants stated that they did not receive any form of mental health intervention, and the remaining did not provide an answer. There was a high prevalence of moderate-severe depression (50.5%), moderate anxiety (35.3%), PTSD (56.5%), and sub-threshold insomnia (53.4%) among the participants. Correlation analyses revealed associations between demographic factors such as sex, age, marital status, and education and mental health issues. Notably, female participants showed a higher prevalence of PTSD (53.0%) compared to male participants (67.6%). Conclusions: There is a substantial impact of war-related trauma on mental health, revealing a high prevalence of moderate-severe depression, moderate anxiety, PTSD, and sub-threshold insomnia among the particip

关键词： Sudan War Conflict Mental health

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Storylines of family medicine Ⅺ:professional identity formation—nurturing one’s own story

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family medicine and Community health 2024年第S3期12卷 99-108页

作者： William B Ventres Leslie A Stone Hamish J Wilson Sumi M Sexton David J Doukas Jessica P Cerdena David M Kelley Michael D Fetters Jeffrey J Haney John J Frey III family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA General Practice and Rural health University of Otago Dunedin School of MedicineDunedinNew Zealand family medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA family and Community medicine Tulane University School of MedicineNew OrleansLouisianaUSA family medicine Residency Program Middlesex HealthMiddletownConnecticutUSA family medicine University of Michigan Medical SchoolAnn ArborMichiganUSA Medical Education and Clinical Sciences Washington State UniversitySpokaneWashingtonUSA family medicine and Community health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅺ:professional identity formation—nurturing one’s own story’,authors address the following themes:‘The social construction of professional identity’,‘On becoming a family physician’,‘What’s on the test?—professionalism for family physicians’,‘The ugly doc-ling’,‘Teachers—the essence of who we are’,‘family medicine research—it starts in the clinic’,‘Socially accountability in medical education’,‘Personal philosophy and how to find it’and‘Teaching and learning with Storylines of family medicine’.May these essays encourage readers to find their own creative spark in medicine.

关键词： own becoming professional

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Storylines of family medicine Ⅵ:ways of being—in the office with patients

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family medicine and Community health 2024年第S3期12卷 52-60页

作者： William B Ventres Leslie A Stone Lisa A LaVallee David Loxterkamp Jonisha R Brown Dael M Waxman Peter S Dorward Jeanne Cawse-Lucas Larry B Mauksch Autumn M Kieber-Emmons Benjamin F Crabtree William L Miller Veronica M Brohm Timothy P Daaleman Kelly Bossenbroek Fedoriw family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA MAHEC family medicine Residency Mountain Area Health Education CenterAshevilleNorth CarolinaUSA Bucksport Regional health Center BucksportMaineUSA family medicine Atrium HealthCharlotteNorth CarolinaUSA Southfield Medical Practice EdinburghUK family medicine University of Washington School of MedicineSeattleWashingtonUSA family medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA Morsani College of medicine University of South FloridaTampaFloridaUSA family medicine and Community health Rutgers Robert Wood Johnson Medical SchoolPiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA family medicine UNC School of MedicineChapel HillNorth CarolinaUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅵ:ways of being—in the office with patients’,authors address the following themes:‘Patient-centred care—cultivating deep listening skills’,‘Doctor as witness’,‘Words matter’,‘Understanding others—metaphor and its use in medicine’,‘Communicating with patients—making good use of time’,‘The patient-centred medical home—aspirations for the future’,‘Routine,ceremony or drama?’and‘The life course’.May readers better appreciate the nuances of patient care through these essays.

关键词： centre illustration dimensions

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Storylines of family medicine Ⅹ:standing up for diversity,equity and inclusion

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family medicine and Community health 2024年第S3期12卷 89-98页

作者： William B Ventres Leslie A Stone Wayne W Bryant Jr Mario F Pacheco Edgar Figueroa Francis N Chu Shailendra Prasad David N Blane Na'amah Razon Ranit Mishori Robert L Ferrer Garrett S Kneese family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family and Community medicine University of New Mexico School of MedicineAlbuquerqueNew MexicoUSA medicine Weill Cornell Medical CollegeNew YorkNew YorkUSA San Jose family medicine Residency Kaiser PermanenteSan JoseCaliforniaUSA family medicine and Community health University of Minnesota Medical School—Twin Cities CampusMinneapolisMinnesotaUSA School of health and Wellbeing University of GlasgowGlasgowUK family and Community medicine University of CaliforniaDavisSacramentoCaliforniaUSA family medicine Georgetown University School of MedicineWashingtonDistrict of ColumbiaUSA family and Community medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA UC San Diego family medicine Residency Program San DiegoCaliforniaUSA

Storylines of family medicine is a 12-part series of thematically linked mini-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 ***‘Ⅹ:standing up for diversity,equity and inclusion’,authors address the following themes:‘The power of diversity—why inclusivity is essential to equity in healthcare’,‘Medical education for whom?’,‘Growing a diverse and inclusive workforce’,‘Therapeutic judo—an inclusive approach to patient care’,‘Global family medicine—seeing the world“upside down”’,‘The inverse care law‘,‘Social determinants of health as a lens for care’,‘Why family physicians should care about human rights’and‘Toward health equity—the opportunome’.May the essays that follow inspire readers to promote change.

关键词： illustration education family

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