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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

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

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

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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

Storylines of family medicine Ⅻ:family medicine and the healthcare system

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family medicine and community Health 2024年第S3期12卷 109-118页

作者： William B Ventres Leslie A Stone Jeannette E South-Paul Kendall M Campbell Aerial R Petty Hima Ekanadham Kurt C Stange Rebecca S Etz William L Miller Robert L Ferrer Marianna Kong Thomas Bodenheimer Roger Strasser Sharon C M Reece Joshua Freeman John M Westfall family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Meharry Medical College NashvilleTennesseeUSA family medicine University of Texas Medical Branch at Galveston School of MedicineGalvestonTexasUSA family medicine Residency Program New York-Presbyterian Columbia University Medical CenterNew YorkNew YorkUSA Center for family and community medicine Columbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA Center for community Health Integration Case Western Reserve University School of MedicineClevelandOhioUSA family medicine and Population Health Virginia Commonwealth University School of MedicineRichmondVirginiaUSA family medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA University of South Florida Morsani College of medicine TampaFloridaUSA family and community medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA family and community medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Northern Ontario School of medicine University SudburyOntarioCanada family medicine Baylor Scott and White HealthTempleTexasUSA family medicine University of Kansas School of MedicineKansas CityKansasUSA DARTNet Insitute AuroraColoradoUSA

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 ***‘Ⅻ:family medicine and the future of the healthcare system’,authors address the following themes:‘Leadership in family medicine’,‘Becoming an academic family physician’,‘Advocare—our call to act’,‘The paradox of primary care and three simple rules’,‘The quadruple aim—melding the patient and the health system’,‘Fit-for-purpose medical workforce’,‘Universal healthcare—coverage for all’,‘The futures of family medicine’and‘The 100th essay.’May readers of these essays feel empowered to be part of family medicine’s exciting future.

关键词： system illustration family

Validity of fatty liver prediction scores for diagnosis of fatty liver by Fibroscan

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 353-360页

作者： Seogsong Jeong Sun Jae Park Seong Kyun Na Sang Min Park Byung-Cheol Song Yun Hwan Oh department of Biomedical Sciences Seoul National University Graduate SchoolSeoul 03080Korea department of Biomedical Informatics CHA University School of MedicineCHA UniversitySeongnam 13488Korea department of Internal medicine Inje University College of MedicineSeoul 50834Korea department of family medicine Seoul National University HospitalSeoul National University College of MedicineSeoul 03080Korea department of Internal medicine Jeju National University HospitalJeju National University College of MedicineJeju 63241Korea department of family medicine Jeju National University HospitalJeju National University College of MedicineJeju 63241Korea department of family medicine Chung-Ang University Gwangmyeong HospitalChung-Ang University College of MedicineGwangmyeong 14353Korea

Background:The Korea National Health and Nutrition Examination Survey nonalcoholic fatty liver disease(K-NAFLD)score was recently developed with the intent to operationally define nonalcoholic fatty liver disease(NAFLD).However,there remained an external validation that confirmed its diagnostic performance,especially in patients with alcohol consumption or hepatitis virus ***:Diagnostic accuracy of the K-NAFLD score was evaluated in a hospital-based cohort consisting of 1388 participants who received Fibroscan®.Multivariate-adjusted logistic regression models and the contrast estimation of receiver operating characteristic curves were used for validation of the K-NAFLD score,fatty liver index(FLI),and hepatic steatosis index(HSI).Results:K-NAFLD-moderate[adjusted odds ratio(aOR)=2.53,95%confidence interval(CI):1.13-5.65]and K-NAFLD-high(aOR=4.14,95%CI:1.69-10.13)groups showed higher risks of fatty liver compared to the K-NAFLD-low group after adjustments for demographic and clinical characteristics,and FLI-moderate and FLI-high groups revealed aORs of 2.05(95%CI:1.22-3.43)and 1.51(95%CI:0.78-2.90),*** addition,the HSI was less predictive for Fibroscan®-defined fatty *** K-NAFLD and FLI also demonstrated high accuracy in the prediction of fatty liver in patients with alcohol consumption and chronic hepatitis virus infection,and the adjusted area under curve values were comparable between K-NAFLD and ***:Externally validation of the K-NAFLD and FLI showed that these scores may be a useful,noninvasive,and non-imaging modality for the identification of fatty *** addition,these scores also predicted fatty liver in patients with alcohol consumption and chronic hepatitis virus infection.

关键词： Nonalcoholic fatty liver disease Fatty liver index Hepatic steatosis index

Autologous hematopoietic stem cell transplantation conditioning regimens and chimeric antigen receptor T cell therapy in various diseases

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World Journal of Transplantation 2024年第1期14卷 32-41页

作者： Shahzaib Maqbool Maryam Farhan Baloch Muhammad Abdul Khaliq Khan Azeem Khalid Kiran Naimat department of medicine Holy Family HospitalRawalpindi 46000Pakistan department of community medicine Allama Iqbal Medical CollegeLahore 45000Pakistan department of community Dentistry Baqai Medical UniversityKarachi 43000Pakistan department of medicine Allama lqbal Medical CollegeLahore 45000Pakistan department of medicineLiaquat University of Medical and Health Sciences Karachi 43000Pakistan

Conditioning regimens employed in autologous stem cell transplantation have been proven useful in various hematological disorders and underlying malignancies;however,despite being efficacious in various instances,negative consequences have also been *** conditioning regimens were extracted from various literature searches from databases like PubMed,Google scholar,EMBASE,and *** regimens for each disease were compared by using various end points such as overall survival(OS),progression free survival(PFS),and leukemia free survival(LFS).Variables were presented on graphs and analyzed to conclude a more efficacious conditioning *** multiple myeloma,the most effective regimen was high dose melphalan(MEL)given at a dose of 200/mg/*** comparative results of acute myeloid leukemia were presented and the regimens that proved to be at an admirable position were busulfan(BU)+MEL regarding OS and BU+VP16 regarding *** case of acute lymphoblastic leukemia(ALL),BU,fludarabine,and etoposide(BuFluVP)conferred good disease control not only with a paramount improvement in survival rate but also low risk of ***,for ALL,chimeric antigen receptor(CAR)T cell therapy was preferred in the context of better OS and *** respect to Hodgkin’s lymphoma,mitoxantrone(MITO)/MEL overtook carmustine,VP16,cytarabine,and MEL in view of PFS and vice versa regarding ***-Hodgkin’s lymphoma patients were administered MITO(60 mg/m2)and MEL(180 mg/m2)which showed promising ***,amyloidosis was considered,and the regimen that proved to be competent was MEL 200(200 mg/m2).This review article demonstrates a comparison between various conditioning regimens employed in different diseases.

关键词： Conditioning regimens Multiple myeloma Lymphoma Hodgkin Non-Hodgkin Acute leukemia

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

Patients’experiences with‘sludge’(administrative burden)in the cancer screening process and its relationship with screening completion,experience and health system distrust

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family medicine and community Health 2024年第S2期12卷 8-17页

作者： Michelle S Rockwell Brianna Chang Vivian Zagarese Jamie K Turner Ally Southworth YingXing Wu Paul Yeaton Li Li Jeffrey S Stein Sarah H Parker John W Epling department of family and community medicine Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA department of family and community medicine Carilion ClinicRoanokeVirginiaUSA Virginia Tech Carilion School of medicine RoanokeVirginiaUSA department of Health Systems and Implementation Science Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Graduate Program in Translational Biology Medicineand HealthVirginia TechRoanokeVirginiaUSA Health Analytics Research Team Carilion ClinicRoanokeVirginiaUSA Division of Gastroenterology Department of Internal MedicineCarilion ClinicRoanokeVirginiaUSA department of family medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA Center for Health Behaviors Research Fralin Biomedical Research Institute at VTCRoanokeVirginiaUSA

Objective‘Sludge’refers to administrative burdens or frictions that preclude people from getting what they want or need(eg,duplicative forms,complicated instructions,long waiting times).This mixed methods study evaluated patients’perceptions of sludge in the colorectal cancer(CRC)screening process and some impacts of this *** We employed an exploratory sequential mixed methods study design that comprised patient interviews and a patient *** interviews informed final survey revisions and captured contextual data about patients’experiences with *** transcripts were inductively and deductively analysed to identify overarching *** survey quantified sludge,delayed or forgone screenings,screening experience(Net Promoter Score)and health system distrust(Health System Distrust Scale).We usedχ2 or t-tests for univariable comparisons and logistic or linear regressions to evaluate the association between cumulative sludge score and delayed or forgone screenings,screening experience and health system *** were integrated for *** Southeastern United *** Patients who were 45–75 years of age,at average risk for CRC and had either completed or been referred for CRC screening(colonoscopy or stool-based test)within the previous 12 *** 22 interview participants and 255 survey participants completed the study.38(15%)survey participants rated their screening experience as poor(Net Promoter Score=0–7 out of 10).The mean(SD)Health System Distrust Scale score was 22.4(6.3)out of 45 possible points(higher score=greater distrust).Perceptions of sludge in the CRC screening process varied,with long waiting times and burdensome communication being the most common sources(58%and 35%of participants,respectively).Sludge was positively associated with delayed or forgone screenings(OR=1.42,95%CI 1.28,1.57,p<0.001),poor screening experience(OR=1.15,95%CI 1.04,1.28,p=0.009)and health system distrust(β=0.47,p

关键词： sludge screening burden

Storylines of family medicine Ⅸ:people and places—diverse populations and locations of care

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family medicine and community Health 2024年第S3期12卷 79-88页

作者： William B Ventres Leslie A Stone Emad R Abou-Arab Julio Meza David S Buck Jerome W Crowder Jennifer Y C Edgoose Alexander Brown Ellen J Plumb Amber K Norris Jay J Allen Lauren E Giammar John E Wood Scott M Dickson G Austin Brown family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA family medicine University of Michigan Medical SchoolAnn ArborMichiganUSA family medicine University of California Los AngelesDavid Geffen School of MedicineLos AngelesCaliforniaUSA community medicine University of HoustonTilman J Fertitta Family College of MedicineHoustonTexasUSA Social and Behavioral Sciences University of HoustonTilman J Fertitta Family College of MedicineHoustonTexasUSA family medicine and community Health University of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA NH Dartmouth family medicine Residency ConcordNew HampshireUSA San Francisco VA Medical Center San FranciscoCaliforniaUSA Duluth family medicine Residency Program University of Minnesota Medical School Duluth CampusDuluthMinnesotaUSA UAMS Northeast Regional Campus family medicine Residency Program JonesboroArkansasUSA Cascades East family medicine Residency Program Oregon Health&Science University School of MedicineKlamath FallsOregonUSA

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 ***‘Ⅸ:people and places—diverse populations and locations of care’,authors address the following themes:‘LGBTQIA+health in family medicine’,‘A family medicine approach to substance use disorders’,‘Shameless medicine for people experiencing homelessness’,“Difficult”encounters—finding the person behind the patient’,‘Attending to patients with medically unexplained symptoms’,‘Making house calls and home visits’,‘family physicians in the procedure room’,‘Robust rural family medicine’and‘Full-spectrum family medicine’.May readers appreciate the breadth of family medicine in these essays.

关键词： illustration family dimensions