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fRAP 2.0:a community engagement method applied to cervical cancer disparities among Hispanic women

family Medicine and Community Health 2024年第S2期12卷 44-57页

作者： Autumn M Kieber-Emmons Susan E Hansen Michael Topmiller Jaskaran Grewal Carlos Roberto Jaen Benjamin F Crabtree William L Miller Department of family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA College of Medicine USFTampaFloridaUSA Lehigh Valley Health Network AllentownPennsylvaniaUSA American Academy of family Physicians-Health Landscape CincinattiOHUSA Lafayette College EastonPennsylvaniaUSA UT Health San Antonio San AntonioTexasUSA Rutgers Robert Wood Johnson Medical School PiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA

focused Rapid Assessment Process(fRAP)2.0 is a community engagement approach combining geospatial mapping with rapid qualitative assessment in cyclical fashion within communities to capture multifactorial and multilevel features impacting primary care *** 2.0 offers primary care researchers a methodology framework for exploring complex community features that impact primary healthcare delivery and *** fRAP 2.0 study design expands the fRAP from a sequential design to a cyclical process of geospatial mapping and rapid qualitative assessment in search of modifiable contextual *** participants are stakeholders from various socioecological levels whose perspectives inform study outcomes that they may use to then become the agents of change for the very problems they helped ***,we present a proof-of-concept study for fRAP 2.0 examining disparities in cervical cancer mortality rates among Hispanic women in *** primary outcomes of interest are features at the community level,medical health system level and regional government policy levels that offer opportunities for collaborative interventions to improve cervical cancer *** this study,geospatial mapping of county and ZIP code-level variables impacting postdiagnosis cervical cancer care at community,medical and policy levels were created using publicly available data and then overlaid with maps created with Texas Cancer Registry data for cervical cancer cases in three of the largest population *** disparate areas were then qualitatively explored using participant observation and ethnographic field work,alongside 39 key informant *** discussion groups and stakeholder engagement existed at every phase of the *** the fRAP 2.0 method,we created an action-oriented roadmap of next steps to improve cervical cancer care disparities in the three Texas counties with emphasis on the high disparity *** identified local change

关键词： cervical qualitative policy

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The Value of MRI and CT in the Diagnosis of Retroperitoneal Tumours

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Proceedings of Anticancer Research 2024年第4期8卷 7-12页

作者： Xinlian Jin Ying Zhou Beijing United family Hospital Beijing 100015China Beijing Anzhen Hospital Capital Medical UniversityBeijing 100029China

Objective:This study aimed to investigate the effectiveness and value of MRI and CT in the diagnosis of retroperitoneal ***:60 patients with retroperitoneal tumours admitted to our hospital between July 2022 and March 2023 were selected as the study *** of them received MRI and CT *** detection of the two examination methods was compared and analyzed using the pathological findings as the ***:The detection rate of MRI(58/60,96.67%)was significantly higher than that of CT(50/60,83.33%),and the difference was significant(P=0.015<0.05).Conclusion:Both MRI and CT have important application values in the diagnosis of retroperitoneal *** has advantages in observing soft tissue structures,nerve tissues,etc.,and can provide more detailed anatomical structure information,which can help differentiate the retroperitoneal tumours and locate them ***,on the other hand,has unique advantages in observing the skeletal structure and the density of certain tumours,*** can quickly obtain comprehensive imaging information,which helps to determine the extent and invasion of the tumour.

关键词： MRI CT Retroperitoneal tumour

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Physically active primary care physicians consult more on physical activity and exercise for patients: A public teaching-hospital study

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Sports Medicine and Health Science 2024年第1期6卷 82-88页

作者： Ann Kee Lee Rosediani Bt Muhamad Vina Phei Sean Tan Exercise&Sports Science School of Health SciencesHealth CampusUniversiti Sains Malaysia16150Kubang KerianMalaysia Department of family Medicine School of Medical SciencesHealth CampusUniversiti Sains Malaysia16150Kubang KerianMalaysia

Physical activity and exercise(PAE)improve quality of life and reduce the effects of chronic *** care physicians(PCPs)play an important role to encourage PAE in *** aim to assess PCPs'current PAE consultation practices and their enablers/barriers in daily clinical *** had 64 PCPs(age[35.3±4.7]y,47 women)that completed self-administered questionnaires on PAE consultation practices,training,and confidence ***(n=42)also completed the International Physical Activity Questionnaire-Short Form to assess their physical activity(PA)*** conducted correlation,one-way analysis of variance and a linear regression to assess the associations between enablers,barriers and PA levels to PAE consultation *** average,PCPs consulted on PAE in 49.7%of their daily clinical *** of PCPs(70%)strongly agreed that more PAE knowledge were needed to increase consultation *** three barriers related(p<0.001)to practices were lack of PAE education(r=0.47),patients’preference of pharmaceutical interventions(r=0.45)and lack of continuing education in PAE for PCPs(r=0.37).Physically active PCPs(health-enhancing PA levels,n=6)gave significantly more daily consultations in PAE,73.2%±21.9%,compared to inactive PCPs(n=13),37.4%22.8%(p=0.013).In our regression output,PCPs who had higher PA levels consulted more on PAE daily(R^(2)=0.38,p<0.001)while controlling for ***,PCPs require more knowledge on PAE and need be physically active themselves to increase PAE consultation for patients in their daily *** education should consider including more PA and exercise topics that may benefit both physicians and their patients.

关键词： Physical activity and exercise Primary care physicians Consultations Exercise prescription Medicine

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Epidemiology of Hand Injuries That Presented to the Emergency Department of a Tertiary Care Facility in Suburban Mumbai, India: A Study Including 489 Patients

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Open Journal of Emergency Medicine 2024年第2期12卷 47-58页

作者： Farzin Vajifdar Renaldo Pavrey Department of Emergency Medicine Holy Family Hospital Mumbai India Centre for Accident & Emergency Medicine Nanavati Max Hospital Mumbai India

Background: Hand injuries are very common and responsible for a significant number of emergency department (ED) visits, most of which are not to hand specialists [1]. The functionality and outcome of hand injuries can vary significantly depending on the mechanism and pattern of injuries, which is why it is imperative for emergency physicians to recognize the complexities, and the potential repercussion of missed injuries in such cases. Objective: The aim of this study is to provide epidemiological information on hand injuries and their patterns. The objective is 1) to assess whether most hand injuries are superficial (simple), or involve underlying deeper structures (complex) and 2) to assess whether most hand injuries presented to the emergency department were managed by the emergency physician or plastic/orthopaedic surgeon. Methods: This retrospective single-centre observational study conducted at an emergency department in a tertiary care hospital in Mumbai, India collected data from hand trauma patients using a standardized documentation form. Demographic data, trauma-related data, and disposition plans were analysed. Results: A total of 489 cases sustained hand injuries over a period of one year. The patients were predominantly males in the 20 - 30 year age group and injuries were mainly sustained over the right hand. Most of the injuries were sustained at home (42%). The most common mechanism (34%) was sharp object injury (including needle-stick and other sharps in hospital), followed by blunt injury (30%). Among grievous hand injuries, door jamb was a mechanism noted in 11% of patients, accounting for 50% of all crush injuries. Lacerations were the most common pattern (24.7%) noticed, followed closely by fractures (23.3%). Digits II - IV were injured most commonly (54%), followed by carpals (14%) and the thumb (10%). Nearly 80% of the hand injuries were managed by emergency physicians alone, with 61% of cases involving superficial structures. Though 14% of t

关键词： Emergency Department Hand Trauma Trauma Registry Emergency Medicine

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Analysis of the History and Current Situation of the Development of General Practice Teaching Clinics in China

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Open Journal of Preventive Medicine 2024年第2期14卷 29-38页

作者： Xiaotong Huo Yajun Lian Graduate School Changzhi Medical College Changzhi China Department of family Medicine Peace Hospital Changzhi Medical College Changzhi China

A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.

关键词： General Practice Teaching Clinic Teaching Models Teaching Deficiencies in the Clinic Significance of the Teaching Clinic

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The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria

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International Journal of Clinical Medicine 2024年第2期15卷 101-122页

作者： Iwunze Anuli Egwim Jideuma Onuoha Frank Olekanma Chinonye Ndukwu Chiagozie Igbonagwam Hope Dike Victor Department of family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Public Health Central Michigan University Mount Pleasant Michigan USA

Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor f

关键词： Hypertension Undiagnosed Hypertension Risk Factors Rural Community

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Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system

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family Medicine and Community Health 2024年第1期12卷 16-27页

作者： John Kevin Ong Dayao Caroline E L Duffy Amalia M Cristiano Gene'Rusty'Kallenberg Sarah E Linke University of California San Diego School of Medicine La JollaCaliforniaUSA Milken Institute of Public Health The George Washington UniversityWashingtonDistrict of ColumbiaUSA The University of Texas Medical Branch at Galveston School of Medicine GalvestonTexasUSA Scripps family Medicine Residency Scripps Mercy Hospital Chula VistaChula VistaCaliforniaUSA Herbert Wertheim School of Public Health&Human Longevity Science University of California San DiegoLa JollaCaliforniaUSA Department of family Medicine University of California San DiegoLa JollaCaliforniaUSA Omada Health San FranciscoCaliforniaUSA

Objective Exercise is Medicine(EIM)is a global initiative encouraging healthcare providers to routinely assess and promote physical activity(PA)among *** objective of this study was to evaluate the feasibility,adoption,implementation and effectiveness of EIM from patient,clinician and healthcare staff perspectives using a combination of electronic health record(EHR),survey and interview *** This study used a combination of the Practical Robust Implementation and Sustainability Model(PRISM)and the Learning Evaluation model to implement *** captured from the EHR,including Physical Activity Vital Sign(PAVS)scores,and data collected from qualitative surveys and interviews were used to evaluate the programme’s Reach,Effectiveness,Adoption,Implementation,Maintenance(RE-AIM,which is embedded within PRISM)from provider,staff and patient *** Five primary care clinics within a large academic health *** A total of 24443 patients from all participating clinics had at least one PAVS score during the study period.A total of 17 clinicians completed surveys,and 4 clinicians,8 medical assistants and 9 patients completed *** Implementation fidelity metrics varied widely between components and across clinics but were generally consistent over time,indicating a high degree of programme *** was highest during the first 6 months of the COVID-19 pandemic when most visits were *** PAVS scores increased from 57.7(95%CI:56 to 59.4)to 95.2(95%CI:91.6 to 98.8)min per week at 6 months for patients not meeting PA guidelines at baseline and decreased from 253.84(95%CI:252 to 255.7)to 208.3(95%CI:204.2 to 212.4)min per week at 6 months for patients meeting PA guidelines at *** EIM implementation,clinician-estimated time spent discussing PA with patients increased for 35%of providers and stayed the same for 53%.Conclusion Overall,this study established EIM’s feasibility,adoption,implementation

关键词： routine qualitative completed

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Community Caregivers’ Experiences and Programmatic Strategies to Improve Active Case Finding in Community Tuberculosis Care in Botswana 2016-2021

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Journal of Tuberculosis Research 2024年第2期12卷 105-118页

作者： Unami Modongo-Mathebula Mary Moleki Tefera Agizew Faculty of Health Sciences University of South Africa Pretoria South Africa Department of family Medicine and Public Health Faculty of Medicine University of Botswana Gaborone Botswana

Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.

关键词： Community Experiences Caregivers Active Case Finding Tuberculosis Community Tuberculosis Care

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The Impact of Lifestyle Factors on Migraine Frequency and Severity in Neurology

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Journal of Biosciences and Medicines 2024年第7期12卷 301-313页

作者： Oluwatosin B. Iyun Okelue Edwards Okobi Nneka P. Sams Eleni Asfaw Kebede Oboatarhe Blessing Ezie Department of Public Health and family Medicine University of Cape Town Cape Town South Africa Larkin Community Hospital PSC Miami FL USA College of Health Sciences & Public Policy Walden University Minneapolis MN USA College of Health Sciences Addis Ababa University Addis Ababa Ethiopia Department of family Medicine University of Benin Benin City Nigeria

Objective: This systematic review examines the impact of lifestyle factors on migraine frequency and severity through a comprehensive analysis of lifestyle factors such as diet, physical activity, sleep patterns, stress, mental health, and environmental influences. Methods: We thoroughly searched Google Scholar, PUBMED, Scopus, and Web of Science databases using keywords related to migraines and lifestyle factors. Keywords incorporated the Boolean operator “and” to narrow search results. Following the PRISMA guidelines, we identified, screened, and evaluated studies for inclusion, resulting in nine studies meeting the eligibility criteria. Results: A total of 4917 records were initially identified from Scopus (2786), PubMed (854), and Web of Science (1277). Following deduplication, 3657 records underwent title screening, with 382 additionally screened by abstract. Ultimately, 88 full-text articles were assessed, resulting in 9 studies meeting eligibility for qualitative synthesis: 7 prospective and 2 retrospective studies. Our findings highlight the multifaceted role of lifestyle factors in migraine pathophysiology and management. Dietary habits, such as high-calorie, high-fat, and gluten-containing diets were linked to migraine triggers. Moderate physical activity showed beneficial effects on migraine management, while intense exercise could exacerbate symptoms. Poor sleep hygiene and insomnia were strongly associated with increased migraine frequency and severity. Chronic stress and poor mental health significantly contributed to migraine exacerbation, with stress management techniques proving beneficial. Environmental factors, including light, sound, weather changes, and allergens, were also identified as significant migraine triggers. Conclusions: Personalized lifestyle modifications, tailored to individual patient profiles, are crucial in managing migraines. Evidence-based recommendations include balanced diets, moderate physical activity, improved sleep hygien

关键词： Migraine Lifestyle Factors Diet Physical Activity Sleep Patterns Stress Mental Health Environmental Factors Neurology

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Fabrication and evaluation of carboxymethyl guar gum-chitosan interpenetrating polymer network (IPN) nanoparticles for controlled drug delivery

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Medicine in Novel Technology and Devices 2024年第2期22卷 73-79页

作者： Chandrani Roy Arijit Gandhi Sreejan Manna Sougata Jana Department of Pharmaceutics Gupta College of Technological SciencesAshram MoreG.T.RoadAsansol713301West BengalIndia Department of Pharmaceutical Technology Brainware UniversityBarasatKolkataWest Bengal700125India Department of Health and family Welfare Directorate of Health ServicesKolkataIndia

Guar gum(GG)has drawn more interest from researchers in the last several decades for the controlled delivery of *** aim of the research is to fabricate and evaluate an interpenetrating polymer network(IPN)based nanocarriers system employing chemically modified GG to achieve controlled release of *** present study,we have reported the synthesis of carboxymethyl GG-chitosan IPN nanoparticles for controlled release of metformin *** guar gum(CMGG)was synthesized and employed for developing IPN nanoparticles in combination with chitosan in varying polymeric ratios.A cross-linking agent,sodium tripolyphosphate(Na-TPP)was used for the synthesis of IPN colloidal suspension of nanoparticles which was lyophilized to obtain *** carboxymethylation of GG was confirmed through Fourier transform infra-red spec*** mean particle size was 440.6 nm indicating a polydispersity index of *** drug entrapment efficiency was found to vary between 67.461.64%to 88.232.02%.The differential scanning calorimetry study revealed the presence of amorphous metformin hydrochloride as a homogenous dispersion in nanoparticles(NPs)*** vitro drug release study indicated controlled release ability of developed IPN matrix.A2 formulation(chitosan:CMGG-1:1)exhibited 78.110.27%release after 8 *** evaluation performed in alloxan-treated diabetic rat model exhibited a prolonged hypoglycemic efficacy over 6 h,for A2 formulation treated group,compared to the group receiving only metformin HCl,which demonstrated a reduction in blood glucose levels for up to 4 *** study findings demonstrated the efficacy of the CMGG-chitosan based IPN nanoparticulate system for sustained delivery of therapeutic agents.

关键词： Carboxymethyl guar gum Chitosan Interpenetrating polymer network Nanoparticles Controlled release Metformin hydrochloride

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