Family Medicine and Community Health Journal最新文献_第6页

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0132

Li Li

引用次数: 2

The association of inherited variation in the CLOCK gene with breast cancer tumor grade CLOCK基因遗传变异与乳腺癌肿瘤分级的关系

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0126

N. Gupta, Li Li, C. Thompson

{"title":"The association of inherited variation in the CLOCK gene with breast cancer tumor grade","authors":"N. Gupta, Li Li, C. Thompson","doi":"10.15212/FMCH.2017.0126","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0126","url":null,"abstract":"Background Sufficient sleep and maintenance of circadian rhythm are important to health. We have shown that short duration of sleep before diagnosis is associated with higher-grade tumors among breast cancer patients. Earlier studies suggest that genetic variation in the CLOCK gene is associated with risk of cancers, including breast cancer. Studies of the association of genetic variation, including in CLOCK, and tumor grade, a standard marker of tumor aggressiveness, are lacking. Methods We investigated the relationship between single nucleotide polymorphisms (SNPs) in the CLOCK gene and tumor grade and estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status in 293 breast cancer patients. Nine SNPs were determined by standard TaqMan assays. Tumor grade, receptor status, and other clinical variables were abstracted from medical records. Results Two SNPs were excluded because of poor genotyping performance. None of the remaining seven variants had a statistically significant association with breast cancer tumor grade or with receptor status. Conclusion As with all novel studies, further work is needed to examine the association of CLOCK and other genes in the circadian rhythm pathway with breast cancer tumor grade in other populations.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"151 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":"116526039","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: 0

Distribution and equity trends for general practitioners in China from 2012 to 2015 2012 - 2015年中国全科医生分布与公平性趋势

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0115

Yuanyuan Wang, Weiwei Liu, Xiaoli Wang

{"title":"Distribution and equity trends for general practitioners in China from 2012 to 2015","authors":"Yuanyuan Wang, Weiwei Liu, Xiaoli Wang","doi":"10.15212/FMCH.2017.0115","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0115","url":null,"abstract":"Objective This study aimed to identify the distribution and equity trends for general practitioners (GPs) in China from 2012 to 2015 and to provide evidence to guide the discipline’s development of general practice and for policy-making. Methods On the basis of data from the National Health Statistics yearbooks, the distribution and equity trends for GPs from 2012 to 2015 were analyzed with the Lorenz curve and Gini coefficient as indictors of health equity. Results From 2012 to 2015 the number of GPs increased at rates ranging from 9.3% to 32.5%, while the number of registered GPs increased at rates ranging from 32.6% to 37.2%. In 2015 the average number of GPs was 1.38 per 10,000 people (among the 31 provinces the highest rate was 3.90 per 10,000 people in Zhejiang and the lowest rate was 0.50 per 10,000 people in Xizang) and 1.98 per 100 km2 (among 31 provinces the highest rate was 89.23 per 100 km2 in Shanghai and the lowest rate was 0.01 per 100 km2 in Xizang). From 2012 to 2015 the Gini coefficients weighted by population were 0.31, 0.29, 0.26, and 0.25 respectively, while the Gini coefficients weighted by geographical area were 0.74, 0.72, 0.72, and 0.72 respectively. Conclusion The number of GPs increased rapidly in China; however, the proportion of registered GPs was unsatisfactory, and there were inequities among the different provinces. The government should launch integrated strategies to encourage GP trainees to become registered GPs and optimize the distribution and equity of GPs.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"123 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":"134495008","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

Short sleep duration as a contributor to racial disparities in breast cancer tumor grade 睡眠时间短与乳腺癌肿瘤分级的种族差异有关

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0140

A. Kevin, N. Berger, Li Li, C. Thompson

{"title":"Short sleep duration as a contributor to racial disparities in breast cancer tumor grade","authors":"A. Kevin, N. Berger, Li Li, C. Thompson","doi":"10.15212/FMCH.2017.0140","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0140","url":null,"abstract":"Although African Americans (AAs) are less likely to get breast cancer than European Americans (EAs), they get more aggressive forms. We previously showed that short sleep is associated with higher tumor grade. It is well documented that AAs get less sleep, on average, than EAs. We studied the contribution of short sleep to racial disparities in breast cancer aggressiveness among 809 invasive breast cancer patients who responded to a survey on their lifestyle. Multivariable regressions and mediation analyses were performed to assess the effect of sleep duration on the association of race with tumor grade. AAs reported shorter average sleep (mean [standard deviation] 6.57 [1.47] h) than EAs (mean [standard deviation] 7.11 [1.16] h; P<0.0001) and were almost twice as likely to report less than 6 h of sleep per night (48.0% vs. 25.3%, P<0.0001). AA patients were more likely to have high-grade tumors (52.6% vs. 28.7% in EAs, P=0.0002). In multivariate analysis, race was associated with tumor grade (P<0.0001). On adjustment for sleep duration, the effect of race was reduced by 7.1%, but remained statistically significant (P=0.0006). However, the Sobel test did not indicate statistical significance (z=1.69, P=0.091). In other models accounting for these and additional confounders, we found similar results. Because of the conservative nature of the mediation analysis and smaller sample size, replication of our results in larger studies with more AA patients is warranted.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"26 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":"117012946","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

The relationship between anxiety about prostate cancer among patients with biochemical cancer recurrence and the use of complementary and alternative medicines, diet, and exercise 生化癌复发患者前列腺癌焦虑与补充和替代药物使用、饮食和运动的关系

Family Medicine and Community Health Journal Pub Date : 2017-07-01 DOI: 10.15212/FMCH.2017.0129

Richard T. Lee, J. Hemmerich, N. Kwon, K. Bylow, W. Stadler, S. Mohile, W. Dale

{"title":"The relationship between anxiety about prostate cancer among patients with biochemical cancer recurrence and the use of complementary and alternative medicines, diet, and exercise","authors":"Richard T. Lee, J. Hemmerich, N. Kwon, K. Bylow, W. Stadler, S. Mohile, W. Dale","doi":"10.15212/FMCH.2017.0129","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0129","url":null,"abstract":"Objective We aimed to explore associations between anxiety and specific health behaviors such as complementary and alternative medicine (CAM), diet, and exercise among prostate cancer patients. Methods PCa patients enrolled in a prospective cohort study of men with biochemical cancer recurrence were surveyed about use of CAM, diet, and exercise. Anxiety was measured with the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and the anxiety subscale of the Hospital Anxiety and Depression Scale. Results Nearly 70% (44 of 67) of the original cohort of patients completed the supplementary CAM survey. The mean age was 68 years. Eighty percent of respondents reported engaging in a relevant health behavior, and 64% reported doing so in direct response to their PCa diagnosis. Overall, the most prevalent specific behaviors were exercising (56%), making dietary changes (50%), taking calcium supplements (41%), and taking vitamin D supplements (39%). Elevated baseline PCa-specific anxiety (MAX-PC score >16) after biochemical cancer recurrence was associated with use of any CAM (P=0.01), use of herbs/supplements (P=0.01), and dietary changes (P=0.04). Conclusion PCa patients commonly use CAM, dietary changes, and exercise in response to their diagnosis, and these changes are associated with elevated general and PCa-specific anxiety.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"1 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":"123659606","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

Modified Advanced Life Support in Obstetrics course: Feasibility, trainee satisfaction, and sustainability potential 改良的高级生命支持在产科课程:可行性，学员满意度和可持续性潜力

Family Medicine and Community Health Journal Pub Date : 2017-05-01 DOI: 10.15212/FMCH.2017.0107

A. Aggarwal, J. Salemi, Bernice Yap, Jennifer L Matas, Sameer Naik, R. Zoorob, H. Salihu

{"title":"Modified Advanced Life Support in Obstetrics course: Feasibility, trainee satisfaction, and sustainability potential","authors":"A. Aggarwal, J. Salemi, Bernice Yap, Jennifer L Matas, Sameer Naik, R. Zoorob, H. Salihu","doi":"10.15212/FMCH.2017.0107","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0107","url":null,"abstract":"Objective The main objective of this initiative was to present evaluation results from an innovative adaptation of the Advanced Life Support in Obstetrics (ALSO) training course. We modified the traditional ALSO curriculum in our institution by adding hands-on training in laceration repairs and simulation scenarios on acute maternity care. Methods The modified ALSO provider course was designed to enhance cognitive and procedural skills of health care professionals in managing obstetric emergencies. Forty-nine participants attended this course and completed a posttraining survey. Descriptive statistics were used to describe the participant-reported assessment scores for the ALSO course on three domains (subject knowledge, organization and clarity, and teaching effectiveness) for each of 12 course topics. Results Evaluation of the results showed a high rate of trainee satisfaction as evidenced by the mean assessment scores across all topics ranging from 4.80 to 4.98 (out of 5.00). All trainees said they would refer others to the course. Our modified ALSO course effectively addressed the important needs of primary care physicians involved in maternity care, especially in underserved communities where specialized obstetric care is not readily available. Both simulation scenarios and workshops using simulated human tissue provide a better foundation before formal training. Conclusion Given the changing legal and regulatory climate, we expect that learning to treat complex obstetric situations on the job will become increasingly risky. With this in mind, both simulation scenarios and workshops using simulated human tissue will provide a better foundation before formal training.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131612722","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

Ten year risk assessment of ischemic cardiovascular disease and intervention analysis among middle-aged residents with moderate risk and above in a Shanghai-based community 上海某社区中等及以上中年居民缺血性心血管病10年风险评估及干预分析

Family Medicine and Community Health Journal Pub Date : 2017-05-01 DOI: 10.15212/FMCH.2017.0100

Qi Xu, Jieyan Shen, Rong Shi, Hui Zhao

{"title":"Ten year risk assessment of ischemic cardiovascular disease and intervention analysis among middle-aged residents with moderate risk and above in a Shanghai-based community","authors":"Qi Xu, Jieyan Shen, Rong Shi, Hui Zhao","doi":"10.15212/FMCH.2017.0100","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0100","url":null,"abstract":"Objective The exposure conditions with regard to 10-year ischemic cardiovascular disease (ICVD) risk among residents aged 45–59 years treated in Hudong Community Health Service Center were surveyed to provide an objective basis for further studies on the relation between risk factors and ICVD events. Methods The survey was conducted from October 2013 to March 2014 with use of the principle of cluster sampling. Our investigation involved questionnaire and laboratory tests. All residents were evaluated according to the table of National 10-Year Risk Assessment for ICVD to forecast the 10-year risk. The community intervention methods were medication and lifestyle intervention based on the relevant guidelines. Results The body mass index and smoking rate were significantly higher in men than in women. The 10-year ICVD risk was 6.1% for moderate risk or above. We performed intervention in such residents for 1 year, with the result that the blood pressure and total cholesterol levels were significantly decreased (P<0.05). Conclusion It is imperative that early prediction and intervention be conducted for the residents with risk factors. After the intervention, we found that the risk declined in 79.41% of the residents with moderate risk and or above and that the 10-year ICVD risk score decreased.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127276881","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

Self-reported preferences for patient and provider roles in cancer treatment decision-making in the United States 美国癌症治疗决策中患者和提供者角色的自我报告偏好

Family Medicine and Community Health Journal Pub Date : 2017-05-01 DOI: 10.15212/FMCH.2017.0102

Kiara K. Spooner, Charles C. Chima, J. Salemi, R. Zoorob

{"title":"Self-reported preferences for patient and provider roles in cancer treatment decision-making in the United States","authors":"Kiara K. Spooner, Charles C. Chima, J. Salemi, R. Zoorob","doi":"10.15212/FMCH.2017.0102","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0102","url":null,"abstract":"Objective To describe differences in preferred roles in cancer treatment decision-making and identify associated sociodemographic and health-related factors among adults in the United States. Methods We conducted a cross-sectional analysis of nationally representative data from the 2014 Health Information National Trends Survey. Descriptive statistics were calculated and multivariable logistic regression was conducted to examine associations. Results Half (48.3%) of respondents preferred a collaborative role in decision-making under the supposition of a moderate chance of survival; while 53.4% preferred a more active role when the chance of survival was low. Approximately 7%–8% indicated a preference for a passive role in decision-making, for both low and moderate chances of survival. Several predictors of role preference for cancer treatment decision-making emerged, including age, sex, education, race/ethnicity, and having a regular health care provider. At both low and moderate chances of survival, the college educated were less likely to prefer a passive role, whereas Hispanics were two to three times more likely than whites to indicate a preference for a passive role. Conclusion Adults’ role preference for cancer treatment decision-making may be influenced by sociodemographic and health-related factors. Increased awareness of these factors, paired with enhanced patient–provider communication, may assist health care professionals in providing individualized and high-quality, patient-centered cancer care.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121368390","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: 6

Unplanned hospitalizations for metastatic cancers: The changing patterns of inpatient palliative care, discharge to hospice care, and in-hospital mortality in the United States 转移性癌症的计划外住院:美国住院姑息治疗、临终关怀出院和住院死亡率的变化模式

Family Medicine and Community Health Journal Pub Date : 2017-05-01 DOI: 10.15212/FMCH.2017.0106

J. Salemi, Charles C. Chima, Kiara K. Spooner, R. Zoorob

{"title":"Unplanned hospitalizations for metastatic cancers: The changing patterns of inpatient palliative care, discharge to hospice care, and in-hospital mortality in the United States","authors":"J. Salemi, Charles C. Chima, Kiara K. Spooner, R. Zoorob","doi":"10.15212/FMCH.2017.0106","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0106","url":null,"abstract":"Objective To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States. Methods We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to 2011. Multivariable logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care, palliative care, and in-hospital mortality. Temporal trends in outcomes were characterized with use of joinpoint regression. Results There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic cancer. During their inpatient stay, 5.8% of patients received palliative care, and among those discharged alive, 12.2% were referred to hospice care. The rate of inpatient palliative care increased from 2.3% to 13.6%, the rate of discharge to hospice care increased from 4.1% to 15.6%, and the in-hospital mortality rate decreased from more than 14.0% to 9.8%. These patterns were consistent across cancer subtypes, and were most pronounced among patients with extreme risk of mortality. Conclusion Despite increases in the provision of comfort-oriented care to patients with metastatic cancer, few receive such services. We recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127064759","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

Primary and secondary prevention of colorectal cancer: An evidencebased review 结直肠癌的一级和二级预防:基于证据的综述

Family Medicine and Community Health Journal Pub Date : 2017-05-01 DOI: 10.15212/FMCH.2017.0104

S. Gonzalez, Maria C Mejia de Grubb, R. Levine

引用次数: 4