Journal of General and Family Medicine最新文献

{"title":"Time to Discontinuation and Risk Factors for Outpatient Medical Nutrition Therapy in Primary Care: A Retrospective Cohort Study Using Survival Analysis","authors":"Machiko Ukai,&nbsp;Kazuhiro Abe,&nbsp;Kazuki Ohashi,&nbsp;Katsuhiko Ogasawara","doi":"10.1002/jgf2.70191","DOIUrl":"https://doi.org/10.1002/jgf2.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical nutrition therapy (MNT) provided by registered dietitians is effective for managing non-communicable diseases, but patient discontinuation remains common in clinical practice. Studies examining the timing and predictors of MNT discontinuation are limited. This study aimed to identify the timing and patient factors associated with MNT discontinuation in primary care settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort study included patients who initiated outpatient MNT at a primary care clinic between April 2018 and March 2023. Patients aged &lt; 18 years and those with cancer- or malnutrition-related conditions were excluded. Discontinuation was defined as no MNT visit or scheduled appointment within 3 months after the last visit. Patients were followed for up to 24 months through March 2025. Kaplan–Meier analysis estimated continuation rates, and multivariable cause-specific Cox proportional hazards models identified factors associated with discontinuation. Multiple sensitivity analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 470 patients (median age, 63 years; 59.4% women), 241 (51.3%) discontinued MNT during follow-up. Median time to discontinuation was 15 months (95% confidence interval [CI], 12–21). Continuation rates were 88.3% at 3 months, 70.4% at 6 months, and 43.5% at 24 months. Obesity, dyslipidemia, and medication use were associated with lower discontinuation risk, whereas complications, living with family, and preparation stage of behavior change were associated with higher risk. Sensitivity analyses confirmed the robustness of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MNT continuation declined rapidly within 6 months. Multiple patient factors were associated with discontinuation risk, suggesting the need for early risk identification and individualized support strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149259448","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":"Appearance Over Health: A Phenomenological Study of Obese Adolescents With a Family History of Type 2 Diabetes Mellitus in a Collectivistic Indonesian Context","authors":"Anika Candrasari,&nbsp;Vina Yanti Susanti,&nbsp;Oryzati Hilman,&nbsp;Mora Claramita","doi":"10.1002/jgf2.70190","DOIUrl":"https://doi.org/10.1002/jgf2.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity is a major modifiable risk factor for Type 2 Diabetes Mellitus (T2DM), and Indonesia ranks fifth in the prevalence of diabetes worldwide, coupled with the increasing rate of youth obesity. This phenomenological study explored adolescent obesity as a high-risk group within Indonesia's collectivistic cultural context to generate qualitative insights that may inform culturally grounded, family- and peer-supported interventions for T2DM prevention. The study does not evaluate the effectiveness of any specific intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Conducted in Surakarta, Central Java, Indonesia (March 2021–April 2022), the study recruited 11 adolescents, 11 parents, and 9 peers from four primary care clinics using purposive sampling until data saturation. Data were gathered through in-depth interviews and analyzed using Colaizzi's method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of adolescents reported being more concerned about their appearance than about their health. The findings also indicated that all groups had limited awareness of T2DM risks. Adolescents perceived intimate relationships as important in shaping healthy lifestyle choices. Peers offered emotional support and encouragement for healthier behaviors, while parents were described as supervising diet and promoting physical exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that health education could potentially address adolescents' appearance-related concerns as an initial entry point to enhance engagement. For Indonesian adolescents to effectively avoid obesity and lower their risk of T2DM, strategies involving peers and parents may be an important consideration; however, these are presented as implications derived from the qualitative findings, rather than as interventions whose effectiveness has been demonstrated. Future research is needed to empirically test such culturally tailored approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149258524","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":"Factors Associated With Care Workers' Perceived Difficulty in Collaborating With Nurses on Bowel Care in Dementia Group Homes: A Nationwide Survey in Japan","authors":"Yumi Fukuyama,&nbsp;Chie Furushima,&nbsp;Syoko Ito,&nbsp;Akiko Akiyama","doi":"10.1002/jgf2.70189","DOIUrl":"https://doi.org/10.1002/jgf2.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This exploratory study aimed to identify factors associated with care workers' perceived difficulty in collaborating with nurses regarding bowel care in dementia group homes (GHs) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a nationwide cross-sectional survey from July to October 2025. Using stratified random sampling, questionnaires were mailed to 2000 of 14,202 GHs listed in national open data. Of 437 responses (21.9%), 423 from care workers were included. Perceived difficulty was rated on a 0–10 numeric rating scale and dichotomized as difficulty (scores 6–10) or no difficulty (scores 0–5). Group comparisons and multivariable binary logistic regression were performed. Missing covariates were multiply imputed. A sensitivity analysis treated perceived difficulty as a continuous outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 417 respondents with valid outcome data, 182 (43.6%) reported difficulty. Four factors were significantly associated with perceived difficulty. Older age (adjusted odds ratio [aOR] = 1.044, 95% confidence interval [CI]: 1.020–1.069), a stronger belief in the importance of abdominal warming (aOR = 1.222, 95% CI: 1.077–1.386), and greater uncertainty about when to report bowel-related concerns to nurses (aOR = 1.282, 95% CI: 1.175–1.398) were associated with higher odds of perceived difficulty. Longer caregiving experience (aOR = 0.939, 95% CI: 0.906–0.973) was associated with lower odds. Sensitivity analysis produced similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher perceived difficulty was associated with older age, shorter caregiving experience, and uncertainty regarding the appropriate timing of consultation with nurses. Clarifying when care workers should seek nursing input may support more effective collaboration in bowel care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205879","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":"Color-Bar Bedsheet: Affordable Assistive Tool for Dix-Hallpike Test in Primary Care","authors":"Suwicha Kaewsiri Isaradisaikul,&nbsp;Pitchayanan Namung,&nbsp;Sanathorn Chowsilpa","doi":"10.1002/jgf2.70184","DOIUrl":"https://doi.org/10.1002/jgf2.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo encountered in general practice. The definitive diagnosis relies on the Dix-Hallpike test (DHT), which remains underperformed in primary care due to limited training and unfamiliarity among general practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop the color-bar bedsheet as a simple visual positioning guide for DHT and demonstrate its usefulness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Setting</h3>\u0000 \u0000 <p>After the color-bar bedsheet was developed, a prospective within-subject comparative design in healthy participants was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Healthy adult subjects with 141–190 cm height were recruited. Each examiner performed the DHT with and without bedsheet. The proportion of the appropriate position and the satisfaction of subjects and examiners were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty subjects and 12 examiners were enrolled. Subjects' average age was 37.8 ± 15.0 years and average BMI was 22.5 ± 3.6 kg/m². The DHT with the bedsheet showed significantly better appropriate positions when compared to the group without using the bedsheet (65% vs. 18.33%, <i>p</i> &lt; 0.001), with the odds ratios (OR) of 8.27. Also, there was significantly higher satisfaction of subjects and examiners in DHT with the bedsheet, compared to DHT without the bedsheet (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The DHT with the color-bar bedsheet provided an 8 times higher chance of appropriate position (particularly in individuals under 170 cm in height) with better satisfaction of both examiners and subjects. The bedsheet could be used as an assistive tool for the DHT, especially for novice examiners, in order to increase the diagnostic yield of BPPV in primary care settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146415","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":"Association Between Trust in Healthcare Providers and Readiness to Deprescribe in Older Adults: A Cross-Sectional Comparative Study in the United States and Japan","authors":"Kenya Ie,&nbsp;Amy M. Linsky,&nbsp;Xinran Liu,&nbsp;Melina B. Martin,&nbsp;Rie Oyama,&nbsp;Steven M. Albert","doi":"10.1002/jgf2.70186","DOIUrl":"https://doi.org/10.1002/jgf2.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding how patient trust in healthcare providers is related to readiness to deprescribe is essential for optimizing deprescribing. This study examined this association among older adults with polypharmacy in the U.S. and Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted cross-sectional surveys involving Japanese older adults receiving care from a community hospital and primary care clinic (Kawasaki City, <i>n</i> = 185) and American older adults recruited to a research registry within a university hospital system (Pittsburgh, <i>n</i> = 107). Cohorts were recruited using similar inclusion criteria (5+ prescriptions, community-resident, stable regimens, recent physician care, no dementia). Participants completed the 11-item Patient Perceptions of Deprescribing short form to assess readiness to deprescribe (range 6–30) and trust in healthcare providers (range 5–25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater trust in providers was associated with lower readiness to deprescribe across both samples, with no significant interaction by location. A higher number of medications was associated with greater readiness. Although U.S. participants had higher readiness (16.7 vs. 15.4, <i>p</i> &lt; 0.05) and trust (21.9 vs. 19.8, <i>p</i> &lt; 0.001), the greater readiness observed among U.S. participants remained after adjustment for demographics and clinical characteristics (+2.45 points, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Greater trust in healthcare providers was consistently associated with lower readiness to deprescribe across both samples. Although U.S. older adults demonstrated greater readiness to deprescribe compared to Japanese counterparts, the association between trust and motivation was similar across settings. This finding suggests that how trust functions in patient–provider relationships may be important for designing shared decision-making interventions for deprescribing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099993","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":"Dual Identities of Family Physicians Caring for Their Dying Family Members: An Interpretative Phenomenological Analysis","authors":"Junki Mizumoto,&nbsp;Hirohisa Fujikawa","doi":"10.1002/jgf2.70187","DOIUrl":"https://doi.org/10.1002/jgf2.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although professional guidance generally discourages physicians from treating their own family members, family physicians often become involved in caring for dying relatives. However, little is known about how they experience caring for dying relatives. This study aims to explore how family physicians made sense of caring for a dying family member while simultaneously inhabiting the roles of physician and family member.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an interpretative phenomenological analysis (IPA) of family physicians in Japan who had cared for a dying family member as the primary physician. Participants were recruited through purposive sampling. Semi-structured interviews were conducted and analyzed iteratively according to the methodology of IPA, focusing on how participants made sense of their experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven family physicians participated. Participants described a dynamic interplay between two identities, physician and family member, throughout the process of providing end-of-life care. Four interrelated themes were identified: negotiating for practical family needs, leading decision-making within the family contexts, redefining the best care, and using the physician role as both protection and connection. Participants fluidly navigated and integrated these identities. Care was guided less by biomedical correctness than by relational considerations, with participants balancing responsibility and emotional burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Caring for a dying family member involves not only role conflict but also the integration of professional and familial identities. This duality can enable context-sensitive and meaningful care while introducing ethical and emotional complexity. Rather than focusing solely on prohibiting such involvement, support should help physicians navigate these roles in practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099654","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":"Transient Cholangitis due to Post-Cholecystectomy Clip Migration","authors":"Hirotaka Yamamoto,&nbsp;Masafumi Kawamura,&nbsp;Yoshinori Taniguchi","doi":"10.1002/jgf2.70178","DOIUrl":"https://doi.org/10.1002/jgf2.70178","url":null,"abstract":"<p>An 82-year-old woman who had undergone cholecystectomy 10 years earlier presented with a 2-day history of acute abdominal pain. Physical examination revealed epigastric tenderness with rebound. Laboratory findings showed elevated levels of C-reactive protein (8.24 mg/dL), alanine aminotransferase (756 U/L), aspartate aminotransferase (740 U/L), and lactate dehydrogenase (754 U/L). Total bilirubin (2.11 mg/dL) and gamma-glutamyl transferase (842 U/L) levels were also elevated. Antinuclear antibodies, antineutrophil cytoplasmic antibodies, serological tests for Epstein–Barr virus, hepatitis B virus, and hepatitis C virus were negative. Blood cultures showed no growth and all tumor markers were within the normal range. Computed tomography revealed a metallic density lesion inside the common bile duct (Figure 1A,B, arrowheads). Thus, the patient was diagnosed with cholangitis due to post-cholecystectomy clip migration (PCCM). Endoscopic retrograde cholangiopancreatography was performed; however, the clip was no longer visible and could not be retrieved. The patient was managed conservatively. Her symptoms and laboratory abnormalities gradually resolved, and serial abdominal radiographs showed progressive passage of the clip over 2 days (Figure 1C,D, arrowheads). PCCM is a rare cause of cholangitis [<span>1</span>]. Although the mechanism remains uncertain, one proposed explanation is inversion of the cystic duct stump into the common bile duct due to pressure from the liver, resulting in ischemic necrosis and clip migration [<span>2</span>]. Another hypothesis is that improper clip placement leads to bile leakage and local inflammation, causing erosion of the bile duct wall and subsequent migration [<span>3</span>]. In patients with a history of cholecystectomy, PCCM should be considered in the differential diagnosis of cholangitis.</p><p><b>Hirotaka Yamamoto:</b> conceptualization, investigation, data curation, visualization, writing – original draft, writing – review and editing. <b>Masafumi Kawamura:</b> investigation. <b>Yoshinori Taniguchi:</b> investigation, supervision.</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>Written informed consent was obtained from the patient for publication of this clinical image and the accompanying text.</p><p>The authors declare no conflicts of interest.</p><p>Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.70178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099287","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":"Effect of Clinicians' Empathetic Communication on Anxiety: A Randomized Video Vignette Study.","authors":"Tadayuki Hashimoto, Yoshie Inoue, Kaori Ito, Takeshi Uemura, Shunichi Nakagawa, Misuzu Yuasa, Eriko Onishi, Ayano Kiyota, Kenji Morimoto, Masaya Higuchi, Shoko Ariyoshi, Hiroki Yasuhara, Takaaki Isoya, Satoshi Fujita, Yusuke Yasumoto, Rie Maurer, Liesbeth M van Vliet, Kei Ouchi","doi":"10.1002/jgf2.70173","DOIUrl":"10.1002/jgf2.70173","url":null,"abstract":"<p><strong>Context: </strong>Empathetic communication is a core component of serious illness conversations. The NURSE statement (Name, Understand, Respect, Support, Explore) is widely used to respond to emotion, but its independent effect on anxiety and the role of cultural adaptation remain unclear.</p><p><strong>Objectives: </strong>To evaluate whether empathetic communication using the NURSE framework mitigates the anxiety-provoking effect of difficult news and improves satisfaction among patients with serious illness and their family members, and to compare culturally adapted and non-adapted versions.</p><p><strong>Methods: </strong>We conducted a randomized video vignette study in which Japanese patients with serious illness and their families viewed one of three scenarios: no empathetic response, the U.S. NURSE version, or a culturally adapted Japanese NURSE version. The State-Trait Anxiety Inventory (adjusted for baseline) was the primary outcome; satisfaction with communication was secondary.</p><p><strong>Results: </strong>Among 120 participants, both NURSE groups had significantly lower anxiety and higher satisfaction than the no-empathy group (all <i>p</i> < 0.01), with no significant difference between the U.S. and Japanese versions. Results were consistent across patients and family members.</p><p><strong>Conclusion: </strong>Structured empathetic communication using the NURSE framework mitigated the anxiety-provoking effect of difficult news and improved satisfaction, with comparable effects between a directly translated and a culturally adapted version, both delivered within a Japanese-language clinical context.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 5","pages":"e70173"},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026617","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":"Raw Whitebait as a Probable Source of Human <i>Diplogonoporus balaenopterae</i> Infection in Non-Coastal Area: A Case Report.","authors":"Yukako Hirayama, Hiroko Sato, Keita Kamiyama, Suguru Hiramoto, Akihito Kimura, Ayumi Ito, Kuniko Yoshida, Norio Horiguchi, Keiko Kawai-Kowase","doi":"10.1002/jgf2.70153","DOIUrl":"10.1002/jgf2.70153","url":null,"abstract":"<p><p>We describe a case of a man in his late 20s who presented with symptoms of diarrhea, abdominal pain, and passage of string-like materials following the consumption of raw whitebait. Stool analysis was negative for eggs and parasites. However, a worm segment corroborated by subsequent genetic sequencing confirmed infection with <i>Diplogonoporus balaenopterae</i>. Treatment with praziquantel led to complete resolution of symptoms without recurrence. This case demonstrates that marine tapeworm infections can occur even in non-coastal regions. This is likely due to the widespread availability of fresh seafood. This emphasizes the importance of obtaining a dietary history when diagnosing parasitic infections.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 5","pages":"e70153"},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026635","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":"Autonomic Storm in a Patient With Amyotrophic Lateral Sclerosis in a Home-Care Setting.","authors":"Yuki Toda, Shoichi Masumoto, Yousuke Kimura, Maie Aramaki, Jun Hamano","doi":"10.1002/jgf2.70182","DOIUrl":"10.1002/jgf2.70182","url":null,"abstract":"<p><p>Amyotrophic lateral sclerosis (ALS) can cause autonomic storms characterized by blood pressure fluctuations, particularly in the advanced stages of the disease and among ventilator-dependent patients. Although benzodiazepines are used to manage these symptoms, the optimal agent is unclear. We present the case of a 78-year-old home-care patient with ventilator-dependent ALS who developed autonomic storms. Clotiazepam did not adequately control the episodes; however, diazepam was associated with resolution of the episodes, followed by improved sleep and nutritional intake. This report highlights the importance of recognizing an autonomic storm in advanced ALS patients and the potential benefit of diazepam in home-care settings.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"27 5","pages":"e70182"},"PeriodicalIF":1.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018694","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}