Family Medicine and Community Health Journal最新文献

{"title":"Prevalence of risk factors for noncommunicable diseases among rural women in Yemen","authors":"Gawad M. A. Alwabr","doi":"10.15212/FMCH.2018.0105","DOIUrl":"https://doi.org/10.15212/FMCH.2018.0105","url":null,"abstract":"Objective The objective of this study was to expand the evidence base on the prevalence of risk factors for the main noncommunicable diseases (such as diabetes mellitus, blood pressure, and obesity) among rural women in Yemen. Methods A descriptive cross-sectional study was conducted among 450 rural women in the age range from 18 to 60 years who presented in the targeted health centers of Sana’a and Al-Mahweet governorates during the time of the study. Data were collected by a structured questionnaire developed as per World Health Organization STEPS guidelines. Body mass index, blood pressure, and biochemical measurements of fasting blood glucose were recorded. Results Ninety-four percent of the respondents were physically inactive. Only 3.5% of respondents were smokers, while 66.3% were qat chewers. Forty-seven percent watched TV. Thirty-nine percent of respondents ate vegetables daily, while 19.5% consumed fruits daily. Among the respondents, 31.3% were obese, 15.0% were hypertensive, and 7.8% had diabetes mellitus. Age group, marital status, and education level were significantly associated with obesity, blood pressure, and diabetes mellitus. There were significant associations between obesity and blood pressure, as well as between blood pressure and diabetes mellitus. Conclusion Frequent campaigns and educational programs are to be encouraged for the adoption of healthy lifestyle practices and health promotion. Significance statement Noncommunicable diseases (NCDs) morbidity and death are increasing rapidly, particularly among developing countries, including Yemen. Information on risk factors predicts the future burden of diseases. The results of this study will complement the limited knowledge of the existing interactions between sociodemographic characteristics, behavior, and noncommunicable diseases among rural women in Yemen. It will also be a fundamental starting point for health planning and execution of health promotion interventions.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"46 38","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132390313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts from the implementation of a Novel Clinical Pharmacist Training Program in Changsha, Hunan Province, China","authors":"P. Xu, Da-Xiong Xiang, A. Cave, H. L. Banh","doi":"10.15212/FMCH.2017.0142","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0142","url":null,"abstract":"The Ministry of Health and Family Planning of the People’s Republic of China issued a mandate to all hospitals to implement clinical pharmacy services by 2020. Implementation of clinical pharmacy services to provide pharmaceutical care is a priority. The Second Xiangya Hospital of Central South University in collaboration with the University of Alberta implemented a structured train-the-trainer program to train pharmacists to provide direct patient care in collaboration with physicians, to teach/mentor other pharmacists and students from Hunan province, and to conduct clinical pharmacy research. Following implementation of the program, the pharmacy department increased the number of clinical pharmacists, expanded the clinical pharmacy services, made changes to hospital policies, and received a financial award of five million renminbi (one million Canadian dollars) to support the department. Significant statement This is the first clinical pharmacy train-the-trainer program in China in collaboration with a university in Canada teaching clinical pharmacists how to provide direct patient care and to conduct clinical research. The program was well accepted by the hospital staff and administration. As a result of the changes implemented, the hospital was ranked as having the third best clinical pharmacy department in China.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131583433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic disease in a digital health environment","authors":"C. Pearce","doi":"10.15212/FMCH.2017.0144","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0144","url":null,"abstract":"Although we know that there are benefits to individual patients from electronic data, the next potential, and potentially the biggest, benefit will come from the technologies known as big data, machine learning, and artificial intelligence. Harnessing the potential of computers to sift through large amounts of data will result in the possibility of generating insights into individual patients, and into whole populations, predicting the risk of hospital admission for an individual, or tracking influenza epidemics to prepare adequate responses. Once the data are reliable, recorded in a computer-interpretable way, new horizons will open. Significance statement The health care of individual patients and communities is being affected by two distinct changes: the increase in chronic disease (with emphasis on continuing management and preventive care) and the development of digital health using electronic tools to manage and improve care. Caring for patients with chronic disease requires regular monitoring of progress, the involvement of multiple health professionals who are often not in the same institution, and the involvement of the patient and the patient’s family. Thus care becomes as much about managing information. Digital health is crucial to this process, with the ability to share information across institutions and with the patient. But to do so the information must be structured in such a way as to be machine interpretable, as well and human interpretable.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126433477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practice training in China: A multimodal experiential program provided by Australian educators","authors":"G. Blashki, Hui Yang, L. Piterman","doi":"10.15212/FMCH.2018.0102","DOIUrl":"https://doi.org/10.15212/FMCH.2018.0102","url":null,"abstract":"Our small group of expert GP academic trainers from Monash University and the University of Melbourne have been collaborating over the last decade to develop a GP model training program based in Luohu, Shenzhen, that deeply engages Chinese GPs and seeks to provide personal and professional development of the GPs. The program is closely linked to continuing offshore GP education in Australia, with many trainees of the program having attended intensive training hosted by Monash University in Australia. Significance statement Countries around the world are dealing with rising rates of chronic diseases and increasing health care costs, and China is no exception. Primary care, and especially general practice, provides a strong backbone for an effective health care system, is affordable and accessible, and is suited to managing complex illnesses over the long term. We describe an approach to GP training that has been developed in the Luohu district of Shenzhen and that focuses on clinical as well as leadership skills for the growing GP workforce.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114528534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Offshore teaching in chronic disease management: The Monash-Shenzhen experience","authors":"L. Piterman, Hui Yang, G. Blashki","doi":"10.15212/FMCH.2018.0101","DOIUrl":"https://doi.org/10.15212/FMCH.2018.0101","url":null,"abstract":"The important role of GPs and the high prevalence and burden of chronic disease in China have been discussed in other articles in this series, so there is no need to reiterate this background here. This article deals with the pedagogy of chronic disease management as presented to cohorts of Chinese GPs from Shenzhen attending an offshore program at Monash University in Australia. The program, which commenced in 2010, was 7 weeks in duration and has now expanded to 13 weeks, enabling greater coverage of important topics, more site visits, and instruction in teaching and research methods, along with development of research proposals often based on management of a chronic disease. Significance statement Since 2010, groups of GPs from Shenzhen have been trained at Monash University in Melbourne, Australia, as part of an agreement with the Government of Shenzhen to train GP leaders. This article describes the history and scope of the program. More than 200 physicians have now participated in the program, which currently consists of 13 weeks of offshore experiential learning in Melbourne. As we confront the epidemic of chronic noncommunicable disease, in addition to clinical training with a strong emphasis on systems of care for patients with chronic disease, the Shenzhen physicians receive research training and are expected to implement projects in their clinics in Shenzhen designed to improve the care of patients with chronic physical or mental illness.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116873948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative exploration of GPs’ perspectives on managing chronic nonspecific musculoskeletal pain in Australian general practice – a focus group study","authors":"M. Gaikwad, S. Vanlint, P. Aylward, N. Stocks","doi":"10.15212/FMCH.2017.0125","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0125","url":null,"abstract":"Objective Chronic nonspecific musculoskeletal pain (CNMP) is a complex idiopathic condition that causes significant disruption to patients’ lives, their relationships, and functionality. The cause of CNMP is not fully understood, which makes diagnosis and management challenging. As general practitioners (GPs) are central to the management of chronic pain, their perspectives on managing CNMP are important. Purpose To explore the clinical reasoning GPs use when diagnosing and managing CNMP. Methods A qualitative study design using focus group discussion was conducted with Australian GPs. Five focus group discussion were conducted across Adelaide. All focus group discussions were audio-recorded, and transcripts were coded and analyzed thematically with the program NVivo. Results The main themes remained consistent across the five focus group discussion’s: the ambiguous cause of CNMP; sex differences; developing the “right strategy”; patient-centered care; and verifying vitamin D levels. Conclusion The findings show that GPs use a patient-centered approach tailored to individual patients’ medical history, physical examination findings, and psychosocial health. There was general concern about low levels of vitamin D in patients with CNMP, and vitamin D supplements were recommended if indicated by a patient’s history.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121470960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic non-communicable disease","authors":"L. Piterman, Hui Yang","doi":"10.15212/FMCH.2017.0145","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0145","url":null,"abstract":"","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133248982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic heart failure: Role of the GP in management","authors":"L. Piterman, Hui Yang, Z. Yin","doi":"10.15212/FMCH.2018.0100","DOIUrl":"https://doi.org/10.15212/FMCH.2018.0100","url":null,"abstract":"The commonest cause of chronic heat failure in China is ischemic heart disease, followed by hypertension and valvular heart disease. Echocardiography is essential in establishing a diagnosis as well as helping to identify a cause and to monitor progress. Management includes nonpharmacological as well as pharmacological treatment, and self-care with careful monitoring of salt and fluid intake as well as regular weight measurement. Care planning and team-based care are essential in managing patients with chronic heart failure, who often have concurrent multimorbidity and are receiving polypharmacy. Significance statement In keeping with the global rise in the prevalence of chronic and noncommunicable disease, the prevalence of chronic heart failure (CHF) is increasing globally, with estimates of 10% of the population older than 75 years affected in developed countries, despite improvements in the management of cardiovascular disease more generally. This article discusses current management of CHF, illustrating the important role played by the GP in coordinating care. Management includes nonpharmacological as well as pharmacological treatment, and self-care with careful monitoring of salt and fluid intake as well as regular weight measurement. Care planning and team-based care are essential in managing patients with CHF, who often have concurrent multimorbidity and are receiving polypharmacy.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124343879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 diabetes: Challenges facing GPs","authors":"L. Huo, J. Shaw","doi":"10.15212/FMCH.2018.0107","DOIUrl":"https://doi.org/10.15212/FMCH.2018.0107","url":null,"abstract":"China faces a huge task in managing the large numbers of people with diabetes. Primary care is at the forefront of this challenge, and needs to begin to adopt some of the management and organizational approaches that have been shown to be successful in tackling diabetes and similar chronic diseases. Significance statement China faces a huge task in managing the large numbers of people with diabetes. General practitioners (GPs) are in a privileged position to provide first contact and continuing care for most diabetic patients. However, the GP system in China is still in its infancy and faces a range of challenges, such as a shortage of health care providers, GPs’ poor adherence to guideline recommendations, patients’ poor adherence to treatment, and lack of access to health care. In this article we describe the challenges that GPs in China are struggling with and some of the management and organizational approaches that have been shown to be successful in tackling diabetes and similar chronic diseases.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126290955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the implementation of the family care team in the district health system of health region 2, Thailand","authors":"Nithra Kitreerawutiwong, Sunsanee Mekrungrengwong, Artitaya Wongwonsin, Chakkraphan Phetphum","doi":"10.15212/FMCH.2017.0139","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0139","url":null,"abstract":"Background The family care team (FCT) was established to improve the quality of care. This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT. Methods Forty in-depth interviews were conducted. The interviewees consisted of five primary care managers in the provincial medical health office, five directors of community hospitals, five administrators in district health offices, ten subdistrict health-promoting hospital directors, representatives from ten local organizations, and five heads of village health volunteers. Data were collected in accordance with semistructured interview guidelines and analyzed by thematic analysis. Results Participants’ expressed their opinions through five themes: (1) the role and scope of practice, (2) the communication in collaboration of the FCT, (3) the management of the FCT, (4) the impact of the FCT on the team members’ feelings and primary care performance, and (5) the main challenges, including the insufficiency of a teamwork culture and a biomedical approach. Conclusion The information suggests the importance of issues such as the clarification of the team members’ roles and managers’ roles, communication within and across FCTs, and the preparation for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system. Significance statement This study was conducted to gain in-depth understanding of the implementation of the family care team (FCT) in Thailand and its challenges. Since there had been no previous qualitative study that combined views from primary care managers, community hospital directors, administrators in district health offices, subdistrict health-promoting hospital directors, local organizations, and heads of village health volunteers, this study filled the gap by integrating all the views of the stakeholders in implementing the FCT. It was found that the FCT requires a range of interprofessional collaboration that involves the role and scope of practice, the communication, the management, and the impact of the FCT. The main limitation of the FCT was the insufficiency of a teamwork culture, and a biomedical approach was needed to overcome the challenges.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"06 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129023676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}