Journal of General and Family Medicine最新文献

{"title":"Motivating Factors for Continuous Participation in a Municipality-Initiated Incentive-Based Health Promotion Program: A Qualitative Study.","authors":"Hana Wakasa, Isaku Kurotori, Michiko Aoyanagi, Takashi Kimura, Akiko Tamakoshi","doi":"10.1002/jgf2.70117","DOIUrl":"https://doi.org/10.1002/jgf2.70117","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases (NCDs) are the leading global cause of death, with physical inactivity being a major modifiable risk factor. In Japan, high NCD mortality and low physical activity rates prompted municipalities to launch incentive programs promoting healthier behaviors. However, long-term experiences and motivations beyond immediate rewards remain unclear.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted in Nakasatsunai Village, Hokkaido, Japan. In 2022, 17 individual and one focus group interviews were held with 21 participants continuously engaged in the Health Point Project. Participants earned points through step tracking, health checkups, and events, which could be exchanged for vouchers. Data were analyzed using inductive content analysis with co-author review and member checking.</p><p><strong>Results: </strong>Participants' mean age was 60.3 years. Eight categories described continued participation: looking forward to the benefits without active effort; being encouraged to engage in physical activity within well-designed environments; hoping to maintain good health; recognizing the benefits and impacts of exercise; engaging in activities in their own way or style; adopting exercise and health care as habits; being inspired by peers; and feeling a sense of community. Incentives motivated initial participation, while habit formation, health improvements, social interaction, and community involvement sustained long-term engagement.</p><p><strong>Conclusions: </strong>Participants' sustained involvement was driven not only by financial incentives but also by experiences of personal connection and community belonging. Thus, municipal incentive programs may enhance both individual health behaviors and social well-being, underscoring the importance of integrating opportunities for social interaction alongside financial incentives in sustainable health promotion initiatives.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70117"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Spinal Artery Infarction With Unilateral Lumbar Spinal Cord Lesion: A Challenge in Early Diagnosis.","authors":"Munenori Iwamoto, Aoi Fukunaga, Toshiyuki Uehara","doi":"10.1002/jgf2.70122","DOIUrl":"https://doi.org/10.1002/jgf2.70122","url":null,"abstract":"<p><p>A 71-year-old woman presented with acute muscle weakness and paresthesia in her left lower limb with the preceding back pain and impaired deep sensation. Although initial brain and spinal MRI were normal, follow-up spinal MRI confirmed the left-sided posterior lesion at T10 to T12 vertebral level, leading to the diagnosis of posterior spinal artery (PSA) infarction. PSA infarction with unilateral lumbar spinal cord lesion is rare and can mimic cerebral stroke. Clinicians should check for back pain and deep sensation in cases with symptoms of acute unilateral lower limb on suspicion of PSA infarction, even when initial MRI is normal.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70122"},"PeriodicalIF":2.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13131063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Isolated Celiac Artery Dissection With Subtle Non-Contrast CT Findings.","authors":"So Sakamoto","doi":"10.1002/jgf2.70123","DOIUrl":"https://doi.org/10.1002/jgf2.70123","url":null,"abstract":"","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70123"},"PeriodicalIF":2.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Actual Turnover Among Part-Time Homecare Nurses in Japan: A Longitudinal Study.","authors":"Maiko Noguchi-Watanabe, Noriko Yamamoto-Mitani, Hanako Numata, Asa Inagaki-Asano","doi":"10.1002/jgf2.70121","DOIUrl":"https://doi.org/10.1002/jgf2.70121","url":null,"abstract":"<p><strong>Background: </strong>High turnover among homecare nurses leads to nursing shortages and a decline in care quality. In Japan, part-time nurses are crucial to the workforce. However, their turnover predictors have not been extensively studied, despite the fact that they have higher turnover rates than full-time nurses. This study aims to identify factors contributing to actual turnover among part-time homecare nurses in Japan, providing insights for prevention.</p><p><strong>Methods: </strong>This longitudinal study analyzed data from 161 part-time nurses who participated in a baseline survey in 2018 and a 2-year follow-up survey in 2020. The participants were selected from a baseline survey of 265 nurses. Data collected at baseline by homecare nurses included individual, work-related, and workplace characteristics. The outcome was nurses' turnover (left or remained) 2 years later, as reported by nurse managers. The lengths of conversations with managers and colleagues were dichotomized into \"short\" and \"long\" using the lower 25th percentile as the cut-off. Multivariate logistic regression analysis was conducted to identify predictors of turnover.</p><p><strong>Results: </strong>This study analyzed 161 part-time nurses (mean age, 46.9 years). The turnover of nurses after 2 years was 32 (19.9%). Multivariate logistic regression analysis revealed that participants with short manager/long colleague conversations were less likely to experience turnover (odds ratio: 0.11; 95% confidence interval: 0.01-0.85) than those with short conversations with managers and colleagues.</p><p><strong>Conclusions: </strong>The results suggest that the combination of brief communication with managers and extended interactions with colleagues was associated with lower turnover among part-time homecare nurses.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70121"},"PeriodicalIF":2.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired Angioedema Associated With Systemic Lupus Erythematosus Presenting as Acute Abdomen: A Case Report.","authors":"Seiji Shiota, Shogo Kodama, Kouichirou Tahara","doi":"10.1002/jgf2.70116","DOIUrl":"https://doi.org/10.1002/jgf2.70116","url":null,"abstract":"<p><p>Acquired angioedema (AAE) due to C1 inhibitor deficiency can present as acute abdomen. A 24-year-old woman developed severe abdominal pain and bowel wall edema initially suggestive of hereditary angioedema, but genetic testing excluded it. She later manifested fever, arthritis, rash, and serological abnormalities consistent with systemic lupus erythematosus (SLE). SLE-associated AAE was diagnosed, and immunosuppressive therapy led to clinical and biochemical improvement. This case highlights the importance of considering AAE in patients with unexplained abdominal pain and hypocomplementemia to avoid misdiagnosis and unnecessary surgical intervention.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70116"},"PeriodicalIF":2.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Lies Beyond the Thyroid? A Case of Neck Pain, Fever, and Hypertension.","authors":"Atsuhiko Sunaga, Takuya Inoue, Atsushi Omoto","doi":"10.1002/jgf2.70119","DOIUrl":"https://doi.org/10.1002/jgf2.70119","url":null,"abstract":"","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70119"},"PeriodicalIF":2.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership and Research Productivity in Japan's Academic Departments of Regional Healthcare: A Nationwide Cross-Sectional Study.","authors":"Hiroki Yasuhara, Satoshi Inaba, Shinya Aoki, Takeshi Kawaguchi, Tomoki Ikai, Takashi Watari","doi":"10.1002/jgf2.70120","DOIUrl":"https://doi.org/10.1002/jgf2.70120","url":null,"abstract":"<p><strong>Background: </strong>Academic departments related to regional health care in Japan play a crucial role in addressing healthcare disparities and workforce shortages. However, a comprehensive understanding of their structures, leadership, and activities is lacking. This study aimed to provide the first nationwide profile of academic departments related to regional healthcare (chiiki iryou) in Japanese medical schools.</p><p><strong>Methods: </strong>A cross-sectional study of 82 Japanese medical schools was conducted in 2024. Data on departments whose names included <i>chiiki</i> and their chairpersons were collected from official university websites and the National Physician Registration Database. To assess research output, a PubMed search was conducted for English-language original articles published over a 2-year period, where the chairperson was listed as the first, second, or last author.</p><p><strong>Results: </strong>A total of 145 chairpersons from 168 eligible departments were included in the analysis. Most of the departments were at national universities (66.1%), were headed by endowed chairpersons (78.0%), who were predominantly male (94.5%). Analysis of chairperson characteristics revealed: (1) a predominance of Internal Medicine specialists (44.1%) and a limited proportion of certified General Medicine specialists (10.3%); (2) limited research output, with 36.6% having no PubMed-indexed articles published during the study period; (3) a research focus primarily on clinical (59.9% of articles) and basic science (15.6% of articles), with few articles focusing on regional healthcare issues.</p><p><strong>Conclusions: </strong>This nationwide study reveals a lack of diversity in chairperson characteristics, with a predominance of Internal Medicine specialists, limited international research output, and a possible mismatch between academic focus and regional healthcare needs.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":"e70120"},"PeriodicalIF":2.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Club Activity, Study Groups, and Academic Achievement: A Nationwide Study of Japanese Medical Students' Extracurricular Life","authors":"Hirohisa Fujikawa,&nbsp;Hidetaka Tamune,&nbsp;Yuji Nishizaki,&nbsp;Hirotake Mori,&nbsp;Sho Fukui,&nbsp;Kiyoshi Shikino,&nbsp;Taro Shimizu,&nbsp;Yu Yamamoto,&nbsp;Hiroyuki Kobayashi,&nbsp;Toshio Naito,&nbsp;Yasuharu Tokuda","doi":"10.1002/jgf2.70118","DOIUrl":"https://doi.org/10.1002/jgf2.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Student involvement in extracurricular activities (ECAs) possesses multiple benefits and has attracted substantial interest in medical education. Most studies on ECAs have been conducted in Western contexts, and findings on the association between ECAs and academic achievement are mixed. We examined the current status of ECA, particularly club activities and study groups, the most representative ECAs in Japan, among medical trainees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a nationwide cross-sectional study from April to May 2025 in Japan, using an online anonymous self-administered questionnaire. Potential participants were takers of the General Medicine In-Training Examination postgraduate “Year-0” (GM-ITE PGY-0). We asked the participants about their participation in club activities and study groups during their medical school life and evaluated their medical knowledge using their GM-ITE PGY-0 test score. The data were analyzed by descriptive statistics and multivariable linear regression analysis with adjustment for possible confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 437 of 748 medical trainees. 398 (91.1%) were involved in club activities, predominantly those involving music, while 156 (35.7%) participated in study groups, with clinical reasoning emerging as the most popular. On multivariable linear regression analysis, weekly or more frequent participation in club activities was associated with lower medical knowledge compared with no participation. In contrast, study group participation was positively and dose-dependently associated with medical knowledge test score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Medical schools should consider strategies to encourage academic ECAs such as study groups while promoting balanced engagement with nonacademic ECAs to optimize both their potential benefits and learning outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147683709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Patients Diagnosed With Cancer After Emergency Medical Center Transport in Japan","authors":"Yoshitaka Ooya,&nbsp;Mayumi Ishida,&nbsp;Nozomu Uchida,&nbsp;Izumi Sato,&nbsp;Akira Yoshioka,&nbsp;Hideki Onishi","doi":"10.1002/jgf2.70114","DOIUrl":"10.1002/jgf2.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although early cancer detection relies on routine primary care and screening, some patients first receive a cancer diagnosis after emergency transport. We described patients diagnosed with (or strongly suspected of having) cancer after emergency transport to a tertiary Emergency and Acute Medicine Center in Japan, focusing on access to primary care and family support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cross-sectional study of patients transported between April 2007 and December 2023 who were diagnosed with or strongly suspected of cancer at the initial visit. We extracted age, sex, cancer site, presenting symptoms, presence of an established primary care medical institution, and cohabiting family members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 76,989 patients who visited the Center during the study period, 202 (0.6%) were diagnosed with (or strongly suspected of having) cancer. Mean age was 73.1 years (range 22–101), and 141 (69.8%) were male. The most common cancer sites were colorectal/rectal (<i>n</i> = 49), gastric (<i>n</i> = 46), lung (<i>n</i> = 29), and liver (<i>n</i> = 21). Presentations commonly involved bleeding, pain, dyspnea, or general deterioration. Overall, 142 patients (70.3%) had an established primary care medical institution, and 152 (75.2%) lived with family members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many patients with emergency-based cancer diagnoses had documented access to primary care and cohabiting family members. These descriptive findings underscore the need for future comparative studies to clarify diagnostic pathways and factors associated with emergency-based cancer diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes Zoster Vaccine Awareness and Uptake Among Older Adults in Saudi Arabia: Insights for Public Health, Preventive Medicine, and Primary Care Practice","authors":"Adam F. Aldhawyan,&nbsp;Mohammed A. BuSaad,&nbsp;Hasan M. Alswiket,&nbsp;Abdullah M. Alradhi,&nbsp;Ryad F. Alamry,&nbsp;Fadel A. Almulla,&nbsp;Amjad Z. Boarish,&nbsp;Reema J. Alghamdi,&nbsp;Abdullatif K. Althunyan,&nbsp;Amani M. AlQarni","doi":"10.1002/jgf2.70115","DOIUrl":"10.1002/jgf2.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>Complications from Herpes Zoster (HZ) are common among older adults and immunosuppressed populations. The HZ vaccine is a clinically and financially superior alternative to antiviral medications. However, a knowledge gap exists within the population regarding HZ and the vaccine. This quantitative cross-sectional study assessed the knowledge, practices, and attitudes of people aged &gt; 50 years towards HZ vaccination in the Eastern Province of Saudi Arabia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected via an online self-administered Arabic questionnaire. It captured sociodemographic and health-related parameters, knowledge of HZ and its vaccine, and attitudes towards vaccination. A total of 431 responses were collected and a multivariate linear regression was applied to test the association between study variables and participants' awareness about the HZ virus and vaccine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants comprised 53.4% men and 46.6% women with a median age of 54 years (interquartile range 7); 86.5% and 61% of participants were aware of HZ and the vaccine, respectively. The multivariate linear regression model demonstrated that female sex, older age, health insurance, and pox-history, were significantly associated with greater knowledge of HZ (<i>p</i> &lt; 0.05); 85.4% of participants were not vaccinated, citing vaccine side effects (30.2%), low perceived risk (20.9%), and lack of awareness (20.0%). 65.2% and 84.9% of participants expressed interest in learning more about HZ and its prevention, respectively. 69.4% were willing to receive the vaccine if recommended by a healthcare provider.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite relatively high awareness, vaccine uptake remained low. These findings highlight the need to explore additional barriers influencing vaccination uptake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13042362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}