Family Medicine and Community Health Journal最新文献

{"title":"Socioeconomic, environmental, and geographic factors and US lung cancer mortality, 1999–2009","authors":"Maria C. Mejia de Grubb, B. Kilbourne, K. Kilbourne, M. Langston, L. Gittner, R. Zoorob, R. Levine","doi":"10.15212/FMCH.2017.0108","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0108","url":null,"abstract":"Background The American Cancer Society estimates that about 25% of all US cancer deaths will be due to lung cancer – more than from cancers of the colon, breast, and prostate combined. Methods We ascertained county-level age-adjusted and age-specific death rates and 95% confidence intervals from the Centers for Disease Control and Prevention Compressed Mortality File. Multiple regression analyses were used to estimate the strength and direction of relationships between county poverty, smoking, fine particulate matter (PM2.5) air pollution, and US Census divisions and race- and sex-specific lung cancer deaths. Results Poverty, smoking, and particulate matter air pollution were positively and significantly related to lung cancer deaths among white men, but of these, only poverty and smoking were significantly associated with lung cancer deaths among white women. Residence in the South Atlantic, East South Central, and West South Central US Census divisions at the time of death was significantly associated with lung cancer deaths for both white men and white women. As with white men, poverty and smoking were associated with lung cancer deaths among black men, but of these, only adult smoking had a statistically significant association among black women. Conclusions The results support the need for further research, particularly in high-risk areas, to better differentiate factors specific to race and sex and to understand the impact of local risk factors.","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":"133622212","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":"Temporal trends in colorectal cancer incidence among Asian American populations in the United States, 1994–2013","authors":"Haijun Wang, Maria C Mejia de Grubb, S. Gonzalez, Mohamad A Sidani, Jianping Ma, R. Zoorob","doi":"10.15212/FMCH.2017.0103","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0103","url":null,"abstract":"Objective To investigate the incidence and trends in colorectal cancer (CRC) among Asian American populations in the United States. Methods CRC incidence data from 1994 through 2013 were obtained from 13 Surveillance, Epidemiology, and End Results registries. SEER*Stat and IBM SPSS Statistics were used. Results The age-adjusted incidence of CRC among Asian Americans decreased from 45.6 per 100,000 in 1994 to 33.0 per 100,000 in 2013, with the annual percent change being −1.8% (P<0.05). The incidences were higher for men, the elderly (aged 60 years or older), and several geographic areas. For those younger than 70 years, the rectal site was more affected compared with those aged 70 years or older, in whom the proximal site were more affected. Most patients presented with localized and regional stages. Men, 80 years or older, in situ stage, and some geographic areas such as Connecticut and California experienced significant incidence decreases in the 20-year observation period. Conclusion Although CRC incidence has declined among Asian American populations in the United States in the past 2 decades, there are persistent differences by age and geographic areas. Further research is needed to guide the design and implementation of tailored strategies to reduce CRC outcome differences across Asian American populations.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"79 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":"131637092","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":"The global burden of preventable cancer mortality","authors":"R. Zoorob","doi":"10.15212/FMCH.2017.0101","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0101","url":null,"abstract":"","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"22 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":"127301490","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":"Student self-assessment versus preceptor assessment at the midpoint of a family medicine clerkshipa","authors":"William W. Huang, L. Grigoryan","doi":"10.15212/FMCH.2017.0105","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0105","url":null,"abstract":"Objective To study how student self-assessment compared with the faculty's assessment on our family medicine clerkship and to explore the effect of demographic factors on the ratings. Methods Students and their faculty preceptors assessed the students' achievement of clerkship objectives at mid clerkship. We performed Mann-Whitney U tests to compare student ratings and faculty ratings for each clerkship objective. We performed linear regression analyses to investigate the effect of medical school year and student sex on student ratings and the effect of sex concordance or sex difference of the faculty-student pair on faculty ratings. Results Two hundred one students completed the family medicine clerkship between July 2015 and June 2016. Faculty ratings were higher than student ratings for all 12 clerkship objectives (P<0.05 for all comparisons). Third-year students rated themselves higher than second-year students for nine of the clerkship objectives. There was no difference in student ratings between female students and male students and no difference in faculty ratings whether there was a sex-concordant or a sex-different preceptor-student pair. Discussion Our findings add to the knowledge of the mid-clerkship feedback process offered by different clerkships. Further study is needed to investigate how students use this feedback to improve for the remainder of the clerkship.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"67 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":"125888288","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":"Characteristics of patients with erectile dysfunction in a family physician-led erectile dysfunction clinic: Retrospective case series","authors":"Lap-kin Chiang, Cheuk-Wai Kam, K. Yau, Lorna V. Ng","doi":"10.15212/FMCH.2017.0114","DOIUrl":"https://doi.org/10.15212/FMCH.2017.0114","url":null,"abstract":"Objective To examine the characteristics of patients with erectile dysfunction in a family physician led erectile dysfunction clinic; To review association of chronic disease spectrum and erectile dysfunction; To review initial treatment pattern and outcome. Design Retrospective case series review. Subjects All consecutive patients seen in a regional hospital family physician led erectile dysfunction clinic from April 2014 to March 2015. Main outcome measures The severity of erectile dysfunction, based on International Index of Erectile Function (IIEF-5). The associated chronic comorbidities of patients. Treatment patterns and patient outcomes. Results One hundred and eighty three patients presented with erectile dysfunction (ED) with mean age 58.7 (range 23 to 82) years old were seen during the study period. One hundred and twenty seven patients (69.4%) had comorbidity of chronic diseases, including 50.8% had hypertension, 38.8% had diabetes mellitus and 33.9% had hyperlipidaemia. Their mean body mass index was 25.2 kg/m2, the mean blood pressure was 137.3/79.5 mm Hg (1 mm Hg = 0.133 kPa). According to IIEF-5 score, 50.3%, 30.6% and 18.6% had severe, moderate and mild erectile dysfunction respectively. The average duration of ED before seeking medical help was 3.9 years. Phosphodiesterase 5 (PDE5) inhibitors were prescribed to 119 patients (65%), and 57.1% of them achieved good response. Twenty nine patients (15.8%) were referred to other specialty for further management, including 27.6% had contraindication for PDE5 inhibitor. Conclusion High proportion of erectile dysfunction patients had comorbitiy of chronic diseases. 57.1% of those patients receiving PDE5 inhibitors showed good response.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"12 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":"123881729","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":"Healthy China 2030: “Without national health, there will be no comprehensive well-being”","authors":"Wei Wang, D. Zakus","doi":"10.15212/FMCH.2016.0126","DOIUrl":"https://doi.org/10.15212/FMCH.2016.0126","url":null,"abstract":"","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121588142","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":"Patient-centered care in a multicultural world","authors":"N. Mathers, A. Bansal","doi":"10.15212/FMCH.2016.0123","DOIUrl":"https://doi.org/10.15212/FMCH.2016.0123","url":null,"abstract":"Received 22 August 2016; Accepted 14 September 2016 Introduction To be a good clinician in 2016 is challenging – not only do we have to ensure that our biomedical knowledge is up to date, but increasingly we need to practice medicine within the much broader context of patient-centered care (PCC) in diverse populations. The knowledge, skills, and attitudes required to deliver good PCC in these settings are the same in whatever part of the world we practice. However, PCC presents considerable challenges to us that are highlighted and magnified when we are delivering care to individuals outside our own culture. A particular issue is not only that PCC has yet to be accepted as the ‘cultural norm’ by patients and clinicians alike, but also increasingly, sophisticated knowledge and skills are required by clinicians to address the complexities inherent in consulting within diverse populations. How can we build on our current knowledge of best practice in PCC to embrace those challenges and complexities resulting from an increasingly diverse multicultural world?","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126818937","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":"‘Feeling of despair’ as the leading cluster theme of conceptual descriptive analyses in participatory assessment: Russia Oxfam GB case study","authors":"V. Zakirova, D. Zakus","doi":"10.15212/FMCH.2016.0131","DOIUrl":"https://doi.org/10.15212/FMCH.2016.0131","url":null,"abstract":"This article provides a case study on participatory assessment based on experience gained from an EU–Oxfam GB project entitled “Empowering Municipalities to Effectively Address Poverty” conducted in five small towns in Russia. Participatory assessment through focus group discussions (FGDs) was the main approach used in the implementation of the project. A participatory assessment was performed through 25 FGDs in five remote areas in central Russia. More than 200 participants representing people living in poverty, such as single mothers, people with disabilities, families with many children, families with disabled children, and pensioners, voluntarily participated in the meetings. Most of the participants were women (75%) aged between 25 and 70 years. We consider that the participants’ representation is relevant in accordance with the official poverty studies. Through identification of patterns of recurrent ideas and opinions, a qualitative method helps us understand social phenomena from the views of and on the basis of the opinions of the participants. The FGDs’ narratives underwent pattern analysis, resulting in the framing of the cluster themes and narrative conceptualization. Cluster analysis of the FGDs’ narratives led to the framing of 10 cluster themes of importance, followed by conceptual descriptions and related narratives. The conceptual description of the leading theme, feeling of despair (theme 1), was described by respondents’ expressions/narratives, such as “Nobody needs us and there is no future for us and our children in this town,” the narrative idea that crosscuts the subsequent themes. The following nine themes are of equal importance, are interlinked, and for the major part constitute the leading theme, feeling of despair (theme 1): state social and family support (theme 2); health care (theme 3); who are those living in poverty? (theme 4); housing (theme 5); living costs (theme 6); employment (theme 7); children’s well-being and future (theme 8); environment and recreation (theme 9); and legal rights (theme 10). Equal importance of these themes is justified by the analysis of patterns and recurrence of the FGDs’ narrative ideas. The assigned numbers from 2 to 10 are given to simplify the references to the corresponding cluster throughout the analysis and do not reflect the ranks of the clusters. The leading theme (theme 1) touches on the psychological status of the FGDs’ participants, while the remaining nine themes (themes 2–10) relate to the state system of social services, including health care. For example, per the conceptual descriptions, the state social and family support (theme 2) is described by the following narrative: “Those who have a family network get their support, for those without family help, state support is crucial but is very little and not everybody can get it. Nobody wants to help or provide decent services – people in local government get fed up with you, you get sent from one place to another.” The fr","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121424106","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":"Mothers’ health-related quality of life: Its relationship with children’s health-related quality of life and behavior in low-income families","authors":"R. Wong, V. Guo, P. Ip, C. Wong, E. Y. Yu, C. Fung, C. Lam","doi":"10.15212/FMCH.2016.0124","DOIUrl":"https://doi.org/10.15212/FMCH.2016.0124","url":null,"abstract":"Objective To examine the association between mothers’ health-related quality of life (HRQOL) and their children’s HRQOL and behavior in low-income families. Methods Mothers of 278 children aged 6–12 years from low-income families were invited to complete the Child Health Questionnaire Parent Form 50 (CHQ-PF50) and the Strength and Difficulties Questionnaire (SDQ) for their children as well as the 12-item Short-Form Health Survey version 2 (SF-12v2) and the Patient Health Questionnaire-2 (PHQ-2). Multiple linear regressions with mother–child pairs as the unit of analysis were performed to examine the associations between maternal and child variables with adjustment of mother- and child-level confounders. Results Compared with the general population, low-income mothers had a lower mean SF-12v2 mental component summary score and their children also had lower mean CHQ-PF50 physical and psychosocial summary scores and SDQ total difficulties score. Children of mothers with SF-12v2 scores below the population mean of 50 had significantly worse CHQ-PF50 scores and higher SDQ total difficulties scores. The mother’s PHQ-2 depression status had no association with the child’s CHQ-PF50 scores. Conclusion Our findings suggest that more attention should be paid to reducing the negative impact of health problems on mothers’ daily roles in childcare in low-income families.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115853085","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":"Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs","authors":"Lap-kin Chiang, Michael K. Yau, Cheuk-Wai Kam, Lorna V. Ng, B. Zee","doi":"10.15212/FMCH.2016.0114","DOIUrl":"https://doi.org/10.15212/FMCH.2016.0114","url":null,"abstract":"Objective The objective is to estimate the prevalence and grading of hypertensive retinopathy in the primary care setting; examine the patient characteristics associated with hypertensive retinopathy; and examine the association of hypertensive retinopathy and other hypertension complications. Methods This is a retrospective cross-sectional study. Subjects included adult hypertensive patients with available and gradable retinal photographs. Results Two hundred fifty-six male hypertensive patients (34.3%) and 491 female hypertensive patients (65.7%) were included. The average duration of hypertension was 7.2 years, and 49.8% and 41.2% of patients were taking one or two antihypertensive medications respectively. Among 1491 qualified retinal photographs (744 right eye and 747 left eye), 24.9%, 62.6%, and 12.5% were classified as showing normal, mild, and moderate hypertensive retinopathy respectively. The three commonest retinal signs were generalized or focal arteriolar narrowing (650 cases, 43.6%), hard exudates (168 cases, 11.3%), and opacity (copper or silver wiring) of the arteriolar wall (166 cases, 11.1%). Patients older than 61 years, having hypertension for more than 15 years, or taking three or more antihypertensive medications were significantly associated with hypertensive retinopathy (P<0.05). Conclusion In a primary care clinic in Hong Kong, 77.1% of hypertensive patients had hypertensive retinopathy. Advanced hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.","PeriodicalId":152216,"journal":{"name":"Family Medicine and Community Health Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125148023","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}