Family Medicine and Community Health Journal最新文献_第5页

Burden of road traffic accidents in Nepal by calculating disability-adjusted life years 通过计算残疾调整生命年计算尼泊尔道路交通事故负担

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0111

Ling Huang, A. Poudyal, Nanping Wang, R. Maharjan, K. Adhikary, S. Onta

{"title":"Burden of road traffic accidents in Nepal by calculating disability-adjusted life years","authors":"Ling Huang, A. Poudyal, Nanping Wang, R. Maharjan, K. Adhikary, S. Onta","doi":"10.15212/FMCH.2017.0111","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0111","url":null,"abstract":"Objective To calculate the burden of road traffic accidents in Kathmandu Valley and then extrapolate this to the national level. Methods A prospective study was performed to compute the burden of road traffic accidents by quantification of disability-adjusted life years (DALYs) using the Global Burden of Disease Study method on the basis of 1-year data from nine hospitals in Nepal and the Department of Forensic Medicine and cross-checked with the Nepal Traffic Directorate. Multiple methods were applied to the extrapolated population metrics of the burden of road traffic accidents in Nepal. Results The total number of years of life lived in disability, years of life lost, and DALYs in Nepal were 38,848±194, 119,935±1464, and 158,783±1658 (95% confidence interval) respectively. The number of years lost because of morbidity and death was similar in Kathmandu Valley. Most (75%) of the DALYs resulted from years of life lost in Nepal. Males accounted for 73% of DALYs. Almost half (44%) of the DALYs were contributed by the group aged 15–29 years. Conclusion This study is the first to calculate the burden of road traffic accidents in Nepal using Nepal’s own data. Nepal needs to develop and enhance its own system to identify significant public health issues so as to set national priorities for prevention of road traffic accidents.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126961720","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}

引用次数: 5

Social prescribing for healthy aging: sustaining social capital in India 健康老龄化的社会处方:维持印度的社会资本

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0117

Geetha Mani

引用次数: 2

Mental health problems due to community violence exposure in a small urban setting 在小城市环境中由于社区暴力而造成的精神健康问题

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0128

Faraz Ahmad, J. Medder, Jenenne Geske, Jann Taylor, Ruth Margalit

{"title":"Mental health problems due to community violence exposure in a small urban setting","authors":"Faraz Ahmad, J. Medder, Jenenne Geske, Jann Taylor, Ruth Margalit","doi":"10.15212/FMCH.2017.0128","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0128","url":null,"abstract":"Objective Studies conducted in large metropolitan inner-city communities with high violent crime rates have demonstrated an association between exposure to violence and mental health problems; therefore the purpose of this study was to determine if similar trends exist in smaller inner-city communities with substantially lower violent crime rates. Methods One hundred twenty-six children and young adults living in inner-city Omaha, Nebraska, were screened for posttraumatic stress disorder (PTSD), depression, and anxiety symptoms and assessed for community violence exposure (CVE). Pearson’s correlation and analysis of variance were used to determine the relationship between PTSD, depression, and anxiety symptoms and CVE. Results A statistically significant relationship was found between CVE and PTSD and anxiety symptoms among participants despite their having lower rates of exposure to violent events in comparison with other studies. No association was found between violence and depression symptoms. Additionally, the presence of anxiety and depression, as well as increased age of participants, was associated with higher rates of PTSD symptoms. Conclusion We recommend that health care providers in smaller cities, where the effects of violent crime may be underestimated or overlooked, be informed of the existence of this public health problem within their community and that they screen at-risk patients for mental health problems.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128068621","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}

引用次数: 1

Adult-onset celiac disease for the primary care physician 初级保健医生的成人发病乳糜泻

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0120

K. Naidoo, L. McCrossan

引用次数: 1

Assessing the accuracy of patient report of the 5As (ask, assess, advise, assist, and arrange) for smoking cessation counseling 评估患者报告的5a(询问、评估、建议、协助和安排)戒烟咨询的准确性

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0116

S. Flocke, Elizabeth Antognoli

{"title":"Assessing the accuracy of patient report of the 5As (ask, assess, advise, assist, and arrange) for smoking cessation counseling","authors":"S. Flocke, Elizabeth Antognoli","doi":"10.15212/FMCH.2017.0116","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0116","url":null,"abstract":"Objective The 5As framework (ask, advise, assess, assist, arrange) is a recommended strategy for smoking cessation counseling in primary care. This study compares patient report with direct observation to assess the degree of recall bias for each of the 5As. Methods Primary care visits by 107 adult smokers and 16 physicians were audio-recorded. Within 48 hours after the visit, patients completed a survey assessing whether or not smoking was discussed and items specific to each of the 5As. The audio recordings were evaluated to assess the presence of each A. The sensitivity, specificity, positive predictive value, and negative predictive value of patient report versus direct observation were computed. Results The frequency of the 5As based on evaluation of the audio recording ranged from 13% (arrange) to 98% (ask). The sensitivity and specificity of patient report were 92% and not applicable for ask, 90% and 50% for assess, 94% and 33% for advise, 90% and 50% for assist, and 85% and 67% for arrange follow-up. Positive predictive values ranged from 28% to 98%; negative predictive values ranged from 0% to 97%. Conclusion Compared with the gold standard of direct observation, patient report of each of the 5As is reasonably sensitive but not specific. Patients overreport the occurrence of each of the 5As.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127129347","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}

引用次数: 2

Overnight pulse oximetry for screening of obstructive sleep apnea in at-risk adult patients in the primary care setting: prospective case series 夜间脉搏血氧测定在初级保健环境中筛查阻塞性睡眠呼吸暂停的高危成人患者:前瞻性病例系列

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0123

Lap-kin Chiang, Cheuk-Wai Kam, Lorna V. Ng

{"title":"Overnight pulse oximetry for screening of obstructive sleep apnea in at-risk adult patients in the primary care setting: prospective case series","authors":"Lap-kin Chiang, Cheuk-Wai Kam, Lorna V. Ng","doi":"10.15212/FMCH.2017.0123","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0123","url":null,"abstract":"Objective To estimate prevalence of OSA among at risk adult patients in primary care setting. To test the correlation and agreement between overnight pulse oximetry and polysomnography (PSG). To test the OSA screening performance of overnight pulse oximetry. Design and Setting Prospective case series involving adult Chinese patients with risk factors for OSA at a primary care clinic of Hong Kong. Methods The prevalence and severity of OSA were established based on overnight pulse oximetry derived oxygen desaturation index (ODI). Screening performance of overnight pulse oximetry was compared directly with gold standard diagnostic test PSG. Results Three hundred and five male and 229 female patients were recruited. Snoring (48.3%) was the top presenting symptom. Three hundred and twenty five patients (60.9%) were screened positive to have OSA. One hundred and nine patients had performed PSG, the ODI_4 and apnoea-hypopnea index (AHI) had Pearson correlation coefficient 0.71 (P<0.001). Bland and Altman plot showed good agreement. Using designation criteria of ODI_4≥5 events/hr, the sensitivity and specificity for OSA diagnosis are 94.4% and 78.9% respectively. Conclusion The prevalence of OSA is 60.9% among adult primary care population who are at risk for OSA. Overnight pulse oximetry shows good performance as a screening tool for the screening of OSA.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132817021","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}

引用次数: 4

Effect of an educational intervention and parental vaccine refusal forms on childhood vaccination rates in a clinic with a large Somali population 在一个有大量索马里人口的诊所，教育干预和父母拒绝接种疫苗表格对儿童疫苗接种率的影响

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0119

D. Madlon-Kay, Emily R. Smith

{"title":"Effect of an educational intervention and parental vaccine refusal forms on childhood vaccination rates in a clinic with a large Somali population","authors":"D. Madlon-Kay, Emily R. Smith","doi":"10.15212/FMCH.2017.0119","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0119","url":null,"abstract":"Objective The purpose of this study is to improve vaccination rates at a clinic with a large Somali population, and many vaccine hesitant parents. The study evaluated the effectiveness of some new materials for vaccine hesitant parents. Methods Educational sessions were given to providers and staff to give “talking points” and to introduce a vaccine refusal form. Chart reviews were done for notes from 50 random well child visits per month of children less than six years old for 7 months before and after the intervention. Results Before the intervention, 44% of Somali children who needed shots did not get them at their well child visit. Afterwards, 34% of the Somali children did not get their needed shots. Of non-Somali children, 16.8% did not get needed shots before the intervention, and 12.7% did not get needed shots after the intervention (P=0.07). The MMR was the most frequent vaccine omitted. After the intervention, 29 parents signed the vaccine refusal form. Conclusion The “talking points” and vaccine refusal form were associated with improvements in immunization rates in this challenging patient population that were not statistically significant. Refusal form use was not well documented, so its true value requires further study.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"23 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130599003","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}

引用次数: 1

Understanding cultures beyond medicine 了解医学以外的文化

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0135

Sheng-lin Liu

引用次数: 0

Tobacco cessation pharmacotherapy use among racial/ethnic minorities in the United States: Considerations for primary care 戒烟药物治疗在美国少数种族/民族中的应用:初级保健的考虑

Family Medicine and Community Health Journal Pub Date : 2017-10-01 DOI: 10.15212/FMCH.2017.0138

M. Hooper, Michael Payne, Kimberly A. Parkinson

{"title":"Tobacco cessation pharmacotherapy use among racial/ethnic minorities in the United States: Considerations for primary care","authors":"M. Hooper, Michael Payne, Kimberly A. Parkinson","doi":"10.15212/FMCH.2017.0138","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0138","url":null,"abstract":"Pharmacotherapies for tobacco cessation are efficacious and recommended during quit attempts. Racial/ethnic minorities in the United States are less likely to use medication-based aids for tobacco cessation, despite greater difficulty achieving long-term abstinence. The reasons for this include, among others, provider- and patient-level considerations. Primary care clinicians play an important role in encouraging racial/ethnic minority tobacco users to use cessation pharmacotherapy. To better understand pharmacotherapy use, we conducted a narrative review of patient-level factors that may determine uptake and adherence. This review indicates that social and cultural factors impact pharmacotherapy use, including health care experiences, beliefs, perceptions, and norms. The proportion of individuals using pharmacotherapy during quit attempts and adhering to the full course of treatment may be enhanced with greater attention to the ethnocultural concerns of these groups. Culturally appropriate assessment and brief advice delivered by primary care providers could yield significant benefits in population health. Recommendations for treating racial/ethnic tobacco users with pharmacotherapy for cessation are offered.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133704580","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}

引用次数: 58

Use of prostate-specific antigen testing in Medicare beneficiaries 在医疗保险受益人中使用前列腺特异性抗原检测

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0131

G. Cooper, T. Kou, M. Schluchter, A. Dor, S. Koroukian, Simon P. Kim

{"title":"Use of prostate-specific antigen testing in Medicare beneficiaries","authors":"G. Cooper, T. Kou, M. Schluchter, A. Dor, S. Koroukian, Simon P. Kim","doi":"10.15212/FMCH.2017.0131","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0131","url":null,"abstract":"Objective Determine uptake of prostate-specific antigen (PSA) testing in Medicare beneficiaries according to previous receipt of PSA testing. Methods A 5% random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009–2012 Medicare claims. We measured the annualized frequency of PSA screening among men due for PSA testing, stratified by PSA testing use in the previous 2 years, and clustered by ordering provider. Results Throughout the study period, PSA testing use was consistently higher for men with previous screening than for men without previous screening. For men without previous screening, there was a decline in testing that was most pronounced in 2012. Compared with 2009, the corresponding odds ratios were 0.98 [95% confidence interval (CI) (0.96–1.00)] in 2010, 0.94 [95% CI (0.92–0.95)] in 2011, and 0.66 [95% CI (0.65–0.68)] in 2012. In contrast, for men with previous screening, PSA testing frequency was stable from 2009 to 2011, and declined to a lesser extent in 2012 [odds ratio 0.80, 95% CI (0.79–0.81)]. Conclusion Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past. In previously unscreened men, the largest decrease occurred in 2012, which may reflect in part the publication of US Preventive Services Task Force guidelines, but there was much less impact among men already being screened.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117351050","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}

引用次数: 1