Family Medicine and Community Health最新文献

{"title":"Determinants of polydoctoring among patients with multimorbidity: a Nationwide Longitudinal Fixed-Effects Study in Japan.","authors":"Takayuki Ando, Bhautesh D Jani, Junji Haruta, Rei Goto","doi":"10.1136/fmch-2025-003809","DOIUrl":"10.1136/fmch-2025-003809","url":null,"abstract":"<p><strong>Objective: </strong>To identify which chronic conditions and patient characteristics contribute to increases in the number of regularly visited facilities (RVF), a measure of polydoctoring, among adults with multimorbidity in Japan.</p><p><strong>Design: </strong>Retrospective cohort study using individual fixed-effects Poisson regression models to estimate within-person associations between the onset of each chronic condition and changes in RVF. This approach controlled for all time-invariant personal characteristics. Effect modification by age, geographic region and baseline multimorbidity was also assessed.</p><p><strong>Setting: </strong>A nationwide health claims database covering multiple insurance systems in Japan, including municipal National Health Insurance, Employees' Health Insurance and the Long-Life Medical Care System.</p><p><strong>Participants: </strong>4 696 790 adults with two or more chronic conditions and two or more consecutive years of follow-up.</p><p><strong>Results: </strong>The onset of examined chronic conditions was associated with changes in RVF, with substantial variation in effect size across conditions. The strongest association was observed for malignancy (RR=1.102; 95% CI 1.101 to 1.103), followed by osteoporosis (RR=1.065; 95% CI 1.064 to 1.065), arthritis (RR=1.061; 95% CI 1.060 to 1.061), obesity (RR=1.049; 95% CI 1.044 to 1.055), stroke (RR=1.044; 95% CI 1.041 to 1.048) and cardiovascular disease (RR=1.043; 95% CI 1.042 to 1.044). Associations between disease onset and RVF were consistently attenuated among individuals aged ≥75 years and those with higher baseline multimorbidity while differences between urban and rural residents were minimal.</p><p><strong>Conclusion: </strong>Substantial heterogeneity was observed in the magnitude of RVF increases across chronic conditions, with particularly strong associations for malignancy, osteoporosis and arthritis. Attenuated effects among older adults and individuals with higher multimorbidity suggest that patient capacity and treatment burden may influence patterns of healthcare utilisation. These findings underscore condition-specific drivers of care fragmentation and may inform more tailored care-coordination strategies for people living with multimorbidity.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards proactive, integrated care across boundaries: panel management next level.","authors":"Anna Wilhelmina de Boer, Mattijs Everard Numans, Hedwig Miirjam Maria Vos, Josefien De Bruin, Janet Margriet Kist, Rimke Cathelijne Vos","doi":"10.1136/fmch-2025-003618","DOIUrl":"10.1136/fmch-2025-003618","url":null,"abstract":"<p><p>A promising integrated care approach is Panel Management, first described by Kaiser Permanente as a set of tools and processes for population-oriented care that are applied systematically at the level of a primary care panel. We aimed to develop an advanced panel management approach towards an iterative process across settings and boundaries. We define Panel Management Next Level as a structured set of tools and processes-based on medical and social needs-that are applied systematically at the level of a patient panel sharing a similar risk on adverse health events, with healthcare professionals directing proactive care for their empanelled patients. There are four iterative steps: (1) empanelment of (patient) groups that share a similar risk; (2) allocation of the appropriate intervention to each panel based on medical and social needs; (3) surveillance of care gaps and (4) effect and process evaluation. In conclusion, Panel Management Next Level is a proactive, integrated care approach which can be embedded in and across different settings. Challenges are multimorbidity, integrated information technology (IT) systems and alternative payment models. Panel Management Next Level has the potential to reach the quadruple aim of improved patient experience, improved population health and improved healthcare professional experience while reducing the costs of care.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How direct access to physiotherapy reshapes GP gatekeeping for musculoskeletal care in primary care: an exploratory organisational typology across health systems.","authors":"Matthieu Fischer, Nicolas Pinsault, Mathilde François, Stéphanie Mignot","doi":"10.1136/fmch-2026-004078","DOIUrl":"10.1136/fmch-2026-004078","url":null,"abstract":"<p><strong>Objective: </strong>To characterise the organisational role configurations of physiotherapists in direct access (DA) models and describe how general practitioner (GP) gatekeeping for musculoskeletal (MSK) conditions is redistributed across health systems.</p><p><strong>Design: </strong>Secondary qualitative content analysis of organisational descriptions reported in published DA/first-contact physiotherapy (FCP) studies, using a structured extraction matrix and Enhancing Transparency in Reporting the synthesis of Qualitative research (ENTREQ) reporting standards. Configuration dimensions were informed ex ante by gatekeeping and task-shifting frameworks; configurations themselves were identified inductively. A dimension of operationalised treatment authority was derived during revision from existing extraction-matrix fields.</p><p><strong>Setting: </strong>Primary care settings across high-income health systems, including Beveridge-type (UK, Sweden), Bismarck-type (Netherlands, France) and pluralistic systems (USA), identified through a companion systematic review prospectively registered on the Open Science Framework (osf.io/897ub).</p><p><strong>Participants: </strong>19 empirical DA/FCP primary studies were eligible for the source review; 14 contained sufficient organisational detail for configuration mapping.</p><p><strong>Results: </strong>Four configurations were empirically observed and a fifth was theoretically anticipated but not found. Autonomous first-contact MSK clinician models predominated (12 of 14 studies, predominantly Beveridge-type systems) and differentiated into two subconfigurations on the basis of operationalised treatment authority: front-end assessment and signposting (type 3a, 4 studies, including the National Health Service FCP programme) and full-episode autonomous management (type 3b, 8 studies). Protocol-governed triage with mandatory post hoc medical validation (type 2) and advanced practice with extended scope (type 4) were each observed as illustrative variants supported by a single study. DA redistributed rather than abolished gatekeeping.</p><p><strong>Conclusions: </strong>In well-documented implementations, DA physiotherapy is most commonly configured as a first-contact model that redistributes GP gatekeeping for MSK conditions. This exploratory typology provides a framework for hypothesis generation and future primary research, particularly in under-represented Bismarck-type health systems.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative screening accuracy of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-Chat-R/F) for early autism spectrum disorder: a systematic review.","authors":"Aaron Siong Fatt Tsen, Mohammad Azri Bantalani, Muhammad Nazrin Ab Rahim, Siti Zuraina Ain Amat, Khalid Mokti","doi":"10.1136/fmch-2026-004072","DOIUrl":"10.1136/fmch-2026-004072","url":null,"abstract":"<p><strong>Objective: </strong>Early screening for autism spectrum disorder (ASD) is critical for timely intervention, making the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) a widely adopted tool globally. However, a recent systematic synthesis of its comparative accuracy is lacking. This review aimed to evaluate the screening accuracy of the M-CHAT-R/F against other ASD screening instruments.</p><p><strong>Design: </strong>A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A narrative synthesis was employed to integrate findings across diverse study designs and methodological quality was assessed using the Joanna Briggs Institute checklist.</p><p><strong>Eligibility criteria: </strong>Peer-reviewed, English-language observational studies published between January 2020 and October 2025 that compared the accuracy metrics of the M-CHAT-R/F with alternative screening tools.</p><p><strong>Information sources: </strong>Scopus, PubMed, ScienceDirect and ProQuest.</p><p><strong>Results: </strong>From 172 identified articles, six high-quality studies encompassing 12 633 participants aged 12-48 months were analysed. The synthesis revealed a complex performance profile for the M-CHAT-R/F. While its sensitivity for detecting potential cases was highly inconsistent, its negative predictive value remained consistently high, reliably identifying children who screened negative. Conversely, the tool demonstrated variable specificity and a persistently low positive predictive value, indicating a substantial false-positive burden and reduced confidence in positive results. Furthermore, the M-CHAT-R/F's accuracy was highly age-dependent, with performance degrading outside the optimal 16-30-month window compared with other specialised tools.</p><p><strong>Conclusions: </strong>The M-CHAT-R/F may not be an optimal instrument in every clinical setting. Its clinical utility may be limited by variable sensitivity and a lower positive predictive value, potentially creating a higher false-positive burden. Clinicians and health systems should consider adopting age-specific, tiered screening protocols to improve diagnostic efficiency and better allocate intervention resources.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of family medicine on health systems in the Americas: scoping review.","authors":"Erwin Hernando Hernandez Rincon, July Andrea Hernandez Rincon, Laura Daniela Saza Salas, Mauricio Fernando Ulloa Roddriguez, Claudia Liliana Jaimes Peñuela, Diana Marcela Diaz Quijano","doi":"10.1136/fmch-2025-003527","DOIUrl":"10.1136/fmch-2025-003527","url":null,"abstract":"<p><strong>Objective: </strong>To synthesise the available evidence on the reported role of family physicians in health systems in the Americas.</p><p><strong>Design: </strong>A scoping review was conducted following the methodology of the Joanna Briggs Institute. The results were grouped into thematic categories and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.</p><p><strong>Eligibility criteria: </strong>Peer-reviewed articles and relevant grey literature published between 2010 and 2025 examining the role or impact of family physicians within health systems in the Americas. Studies that did not explicitly address family physicians or lacked accessible full text were excluded.</p><p><strong>Information sources: </strong>A comprehensive search was performed in PubMed, Scopus, Embase, LILACS and the Virtual Health Library (BIREME). Grey literature was identified through institutional repositories, policy reports and targeted searches of official websites.</p><p><strong>Results: </strong>Of 1397 records identified, 34 studies met the inclusion criteria. Most publications were produced between 2013 and 2024 and represented diverse health system contexts across the region. The attributes most frequently associated with family physicians were comprehensiveness, accessibility, continuity of care, coordination and family and community orientation. Across multiple national settings, the included studies consistently reported that stronger integration of family physicians within primary healthcare systems was associated with improved access to services, greater continuity of care, more efficient coordination across levels of care and a more rational use of diagnostic and therapeutic resources.</p><p><strong>Conclusions: </strong>Family physicians appear to represent an important component of effective primary healthcare systems in the Americas. Their integration within health services is associated with improved service accessibility, greater care continuity and more efficient resource use. Strengthening family medicine workforce capacity and its institutional role may contribute to more equitable, resilient and sustainable health systems across the region.</p><p><strong>Trial registration number: </strong>Protocol registered and available on this OSF project https://osf.io/pnf2b/.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why family medicine requires a paradigm shift from linear guidelines to complexity science.","authors":"Muhammed İnan, Cenk Aypak","doi":"10.1136/fmch-2025-003864","DOIUrl":"10.1136/fmch-2025-003864","url":null,"abstract":"<p><p>Evidence-based medicine (EBM) has standardised care by reducing variance, yet its reliance on linear, reductionist models often fails the patient in primary care, especially the multimorbid patient. Current clinical guidelines assume that biological inputs lead to predictable outputs, effectively treating the human body as a machine. However, the patient, especially the multimorbid patient, functions as a complex adaptive system, characterised by emergent behaviours where small perturbations can lead to disproportionate outcomes. This paper argues that the 'straight-line thinking' of current EBM is mathematically insufficient for general practice. Through clinical vignettes, we demonstrate how single-disease guidelines create unsustainable treatment burdens. Furthermore, we present a rationale for how non-linear analyses of physiological signals can predict frailty years before clinical diagnosis. We propose that family medicine must integrate soft computing methodologies-such as fuzzy logic, fractal analysis and causal inference-not as technological novelties but as the theoretical necessity required to map the non-linear topology of human health. This perspective reframes family medicine not as an exception to evidence-based practice but as the clinical setting where complexity-aware evidence is most critically needed.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of AI tool assisting primary healthcare physicians to diagnostic and treatment tasks.","authors":"Tianran Wang, Jinyu He, Yiran Wang, Ning Zhang, Kaiyuan Chen, Wannian Liang","doi":"10.1136/fmch-2025-003860","DOIUrl":"10.1136/fmch-2025-003860","url":null,"abstract":"<p><p>Primary healthcare (PHC) plays an important role in the healthcare system, yet the shortage of qualified primary healthcare physician (PHP) restricts the quality of diagnostic and treatment services provided by PHC institutions. The rapid development and prevalence of artificial intelligence (AI) offer a solution to this challenge. Existing research primarily focused on two themes: evaluating the performance of AI tools and investigating PHPs' attitudes and use intention to such AI. There are three main modes used to evaluate the performance of AI tools: evaluation of single AI tool, comparison across different AI tools and comparison between AI tool and physicians. Confusion metrics and examination are two types of indicators primarily used to assess these products. PHPs generally hold positive attitudes and use intentions towards AI tools. According to the technology acceptance model, influential factors of PHPs' attitudes and use intention can be categorised into usefulness and ease of use. Limitations and future research directions are also discussed in this article, which provides insights for future research and practice to improve AI tools assisting PHPs in diagnostic and treatment tasks and promote AI adoption in PHC.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 Suppl 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming primary healthcare through person-centred practice: a mixed-method study from the perspectives of healthcare providers.","authors":"Jailani Anis-Syakira, Nur Zahirah Balqis-Ali, Pui San Saw, Weng Hong Fun, Sondi Sararaks, Shaun Wen Huey Lee","doi":"10.1136/fmch-2024-002967","DOIUrl":"10.1136/fmch-2024-002967","url":null,"abstract":"<p><strong>Objective: </strong>Effectively administering person-centred care (PCC) in primary healthcare hinges on healthcare providers and their work environment embodying, endorsing and actively engaging in PCC principles. Therefore, it is crucial to investigate the extent to which person-centred practice is implemented among healthcare providers, the working environment and organisational support.</p><p><strong>Design: </strong>This mixed-method cross-sectional study was conducted through a translated and validated questionnaire comprising 59 items covering three distinct domains: attributes of healthcare providers (prerequisites), the context in which care is delivered (care environment) and the extent of providing care (care processes). Associations between regions, job categories, clinic type and service year duration with the PCC practice level were analysed and stratified according to the 17 constructs. All comments from the free-text responses were thematically analysed.</p><p><strong>Setting: </strong>Public primary healthcare clinics within the Malaysian central zone regions of Selangor and Kuala Lumpur-Putrajaya.</p><p><strong>Participants: </strong>A total of 3800 primary healthcare providers, including family medicine specialists, medical officers, medical assistants, pharmacists, pharmacist assistants, nurses, occupational therapists, physiotherapists and dietitians.</p><p><strong>Results: </strong>'Developed interpersonal skills' (mean: 5.77, SD: 0.819), 'being committed to the job' (mean: 5.48, SD: 0.892) and 'knowing self' (mean: 5.44, SD: 0.990) were among the constructs with the highest scores. Meanwhile, 'supportive organisational system' (mean: 4.62, SD: 1.188) and 'clarity of beliefs and values' (mean: 4.84, SD: 0.953) had lower mean scores, suggesting areas for improvement in teamwork and organisational support. The findings also underscored significant disparities in scoring, potentially stemming from differences in work cultures and hierarchical dynamics, particularly regarding shared decision-making and inclusivity among seniority levels.</p><p><strong>Conclusion: </strong>Recognising the impact of seniority, workload and diverse work cultures among different job categories, leveraging each other's strengths can catalyse successful PCC implementations. The pursuit of instilling and implementing PCC practices calls for a comprehensive organisational transformation, emphasising the need for sustained efforts to enhance support structures and facilitate shared decision-making within healthcare organisations.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of healthy lifestyles score and cardiovascular disease: a cohort study.","authors":"Shijie Shen, Lanqing Ma, Xiaoxue Li, Haotong Fang, Kaiwen Liu, Jianglong Chen, Xueying Han, Pengxiang Zuo, Heng Guo","doi":"10.1136/fmch-2025-003508","DOIUrl":"10.1136/fmch-2025-003508","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality worldwide, and healthy lifestyles play a crucial role in maintaining individual cardiovascular health. Given that both CVD progression and lifestyles are dynamic in nature, assessing the association between healthy lifestyles score (HLS) and CVD risk at a single time point may have certain limitations. This study aims to identify HLS trajectories via group-based trajectory model and analyse the relationship between these trajectories and CVD risk.</p><p><strong>Design: </strong>This cohort study completed the baseline survey in 2016 and conducted at least one follow-up annually from 2019 to 2024, with the first occurrence of CVD as the outcome. The epidemiological investigation included questionnaire surveys, anthropometric and physiological measurements and serum biochemistry tests. The group-based trajectory model was constructed via SAS V.9.4 PROC TRAJ and the results were visualised via R (V.4.2.2).</p><p><strong>Setting: </strong>This study involved a rural cohort in southern Xinjiang, China.</p><p><strong>Participant: </strong>A total of 2313 participants from four communities were included in this study, with a median (IQR) follow-up time of 6.86 (5.75-8.44) years.</p><p><strong>Results: </strong>The differences in HLS across years were significant (p<i><</i>0.001), whereas the differences between the CVD group and the healthy control group were significant only in 2016 (p<i><</i>0.001), 2019 (p<i><</i>0.001) and 2024 (p<i><</i>0.001). This study identifies five distinct HLS trajectory groups (long-term low, mid-level stable increase, mid-level unstable increase, high-level decrease and ideal trajectory). Compared with the ideal trajectory group, the long-term low-level group presented the highest risk of CVD incidence (HR 6.23, 95% CI 3.38 to 11.49), followed by the mid-level unstable increase group (HR 4.14, 95% CI 2.30 to 7.45) and the mid-level stable increase group (HR 3.14, 95% CI 1.73 to 5.70). The results of stratified analysis by gender, age, hyperlipidaemia, diabetes mellitus and hypertension are consistent with the main findings.</p><p><strong>Conclusions: </strong>Distinct trajectories of HLS corresponded to differing CVD risks. Moreover, both sustained low and unstable healthy lifestyles significantly contribute to CVD risk. Therefore, the early adoption and maintenance of healthier lifestyles provide long-term benefits in reducing CVD risk.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From class consciousness to class suicide: considering community integration as a primary care ethic.","authors":"Bilal Irfan, Aayesha Soni, Wei Meng Vincent Chia, Suha Quasmi Khan, Roberto Daniel Sirvent","doi":"10.1136/fmch-2025-003584","DOIUrl":"10.1136/fmch-2025-003584","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}