Journal of General and Family Medicine最新文献

{"title":"A trial of structured debate as a self-learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan","authors":"Tatsuki Ikejiri MD, Jeonse Lee MD, Natsuki Yokoyama BS, Arisa Hakariya MD, Yuki Otsuka MD, PhD, Hayase Hakariya PhD","doi":"10.1002/jgf2.706","DOIUrl":"https://doi.org/10.1002/jgf2.706","url":null,"abstract":"<p>Structured debate is broadly played by university students and graduates as a competition. The educational benefits of debates, such as fostering critical thinking, are acknowledged across various disciplines.<span><sup>1</sup></span> Hence, we proposed using debates as a self-learning method for medical students and young healthcare providers. Herein, we report a trial where debate serves as a tool for self-learning in Japan.</p><p>Our debate adhered to the systematic procedures outlined by the Japan Debate Association.<span><sup>2</sup></span> Time allocation was slightly modified (Table S1). We held debates using Zoom, with approximately 5–10 voluntary participants: medical students and young healthcare providers. A “plan (agenda)” was collaboratively based on participants' daily observations and interests (Table 1). The participants were divided into two sides: the “pro” (Affirmative side) and the “con” (Negative side), enabling the debate. After the debate, a panel of three judges decided the persuasiveness of each side. The roles of “pro” and “con” were blindly assigned by a third party, irrespective of individuals' opinions on the topic. We performed four debates, as shown below (Table 1). Participants' motivation for these topics is also described.</p><p>After each debate, time for reflection was provided. Summarizing the participants' feedback, we found three distinctive characteristics of learning through structured debate as follows. First, students and early-career healthcare providers demonstrated their capability of thinking and researching actively (more easily with a single axis) when given the role of agreeing or disagreeing with a topic in which their interest was vague rather than with no axis. Second, developing discussions within a certain structure will foster the ability to think logically. Lastly, the students will be able to have a multifaceted viewpoint through arguments from both sides, rather than from one point of view.</p><p>Of note, our structured debate was conducted online. Given the increased attention toward online educational systems in light of the COVID-19 pandemic, this trial could potentially serve as a promising alternative tool in the future.</p><p>As a limitation, our debates were performed without the involvement of leadership experts, as we intended to provide a voluntarily investigating platform to explore topics of participants' interest. Consequently, the quality of the debates depended markedly on the participants' motivation. Moreover, given that participants of this trial were sufficiently motivated at least enough to invest their precious time voluntarily, well-organized and appealing instructions should be required to install our method in the usual classroom education. For instance, supervision by senior group mentors, who have already acquired the credit, during participants' preparation stage may be beneficial. Prior discussion and consultation with such mentors could also serve as studen","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"293-294"},"PeriodicalIF":1.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152139","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":"Exploring social determinants of health in primary care: Approaches to increase research inclusivity","authors":"Takuya Maejima MD, Junki Mizumoto MD, Gemmei Iizuka MD, PhD, Maho Haseda MD, PhD","doi":"10.1002/jgf2.705","DOIUrl":"10.1002/jgf2.705","url":null,"abstract":"<p>Research on the social determinants of health (SDH) aims to foster a healthier, more equitable society by reducing health disparities. Nonetheless, primary care researchers often face challenges in engaging marginalized populations in their studies. It is essential to explore diverse methodologies to promote inclusive research.</p><p>During the fifth annual Primary Care Research (PCR) Connect conference, dedicated to primary care research in Japan, we held a symposium to discuss strategies for enhancing inclusivity in SDH research.</p><p>Using large-scale datasets from multiple centers or municipalities offers the advantage of evaluating the subtle effects of meso- and macro-level factors on individual health and their heterogeneities. However, the exclusion of individuals because of healthcare access barriers, language barriers, absence from official databases, or unstable housing situations can introduce sampling and selection biases. Such biases may compromise the studies' validity and generalizability of those findings.<span><sup>1</sup></span> Therefore, the following studies focusing on marginalized populations highlight their potential benefits in specific contexts.</p><p>By tailoring surveys to fit the target population, researchers can gather responses from individuals typically overlooked in large-scale surveys, allowing insights into their characteristics and concerns, including their lived experiences. For instance, investigations focus on individuals residing in marginalized communities, such as street dwellers living around train stations<span><sup>2</sup></span> or residents in impoverished neighborhoods.<span><sup>3</sup></span> Collaboration with local authorities ensures access to this data, essential for these studies. Furthermore, researchers should endeavor to mitigate health disparities by implementing interventions.</p><p>Qualitative research offers researchers a window into the lived experiences, thoughts, and emotions of socially marginalized individuals. For instance, qualitative inquiry holds the potential to unveil the barriers perceived by women with a history of substance use, transgender individuals, or youth contemplating suicide,<span><sup>4</sup></span> during their interactions within primary care settings.</p><p>Case reports can elucidate the detailed experiences of patients facing complex social adversities.<span><sup>5</sup></span> Reports concentrating on SDH equip primary care professionals with critical insights for managing SDH-related challenges in daily practice. Maintaining patient confidentiality is a critical responsibility for all reporters.</p><p>Although we did not refer to a systematic review or scoping review in the conference, these reviews will synthesize the available evidence and identify evidence gaps.</p><p>In conclusion, research on SDH can employ diverse methodologies to illuminate the experiences of marginalized populations. Primary care professionals, often the initial point of cont","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"291-292"},"PeriodicalIF":1.8,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115875","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":"Improving outcomes of type 2 diabetes mellitus patients in primary care with Chronic Care Model: A narrative review","authors":"Arwa Ahmed Al-Qahtani MD","doi":"10.1002/jgf2.659","DOIUrl":"10.1002/jgf2.659","url":null,"abstract":"<p>Designed and implemented over two decades ago, the Chronic Care Model is a well-established chronic disease management framework that has steered several healthcare systems in successfully improving the clinical outcomes of patients with type 2 diabetes mellitus. Research evidence cements the role of the Chronic Care Model (with its six key elements of organization of healthcare delivery system, self-management support, decision support, delivery system design, clinical information systems, and community resources and policies) as an integrated framework to revamp the type 2 diabetes mellitus-related clinical practice and care that betters the patient care and clinical outcomes. The current review is an evidence-lit summary of importance of use of Chronic Care Model in primary care and their impact on clinical outcomes for patients afflicted with one of the most debilitating metabolic diseases, type 2 diabetes mellitus.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"171-178"},"PeriodicalIF":1.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119589","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":"Reasons for encounters, diagnoses, and admission rate among emergency referrals at an urban primary care clinic in Japan: A retrospective cohort study","authors":"Yoshinao Satoi MD,&nbsp;Masato Matsushima MD, MPH, PhD,&nbsp;Hiroyoshi Iwata MD, PhD","doi":"10.1002/jgf2.704","DOIUrl":"10.1002/jgf2.704","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Comprehensive understanding of emergency referrals (EmR), encompassing reasons for encounters (RFEs) and diagnoses, is crucial for primary care physicians (PCPs). Comparing EmR rates and subsequent admission rates can potentially enhance the quality of primary care for EmR practice. However, no study has evaluated RFEs among patients with EmRs. This study aimed to identify RFE/diagnosis in relation to subsequent admission among patients receiving EmR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study at an urban family physician teaching clinic in Kawasaki City, Japan. Our cohort recruited consecutive EmR episodes with their medical records and admissions confirmed through response letters from receiving hospitals. Using the 2nd edition of the International Classification of Primary Care, we explored the frequency of RFEs and diagnoses, calculating EmR rates and admission rates as primary outcomes. Bivariate analyses were employed to compare admission and non-admission cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The present study encompassed 162 EmR episodes out of 47,901 visits, yielding an EmR rate of 3.38/1000 visits. Among 153 completely followed episodes, 99 patients were emergently admitted, resulting in a 64.7% admission rate. The admission group exhibited significantly higher age and a greater prevalence of dementia. Descriptive analysis revealed fever and pneumonia as the most frequent RFE and diagnosis, respectively, with significant differences between admission and non-admission groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study reports EmR and admission rates following EmR, highlighting differences in patient characteristics, RFEs, and diagnoses. The findings offer insights to enhance PCPs' EmR practices and serve as a benchmark for the scope of EmR practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"256-266"},"PeriodicalIF":1.8,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966802","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":"A large increase in Group A streptococcus bacteremia in the 2 month short period in 2024; report from a tertiary care hospital in Chiba, Japan","authors":"Kanta Kurasawa MD,&nbsp;Misato Yoshida MD,&nbsp;Masahiko Nakao MD,&nbsp;Emiri Muranaka MD,&nbsp;Yushi Hachisu DVM,&nbsp;Mitsuru Kishizawa,&nbsp;Takashi Kikuchi DVM,&nbsp;Ryota Hase MD","doi":"10.1002/jgf2.702","DOIUrl":"10.1002/jgf2.702","url":null,"abstract":"&lt;p&gt;Following the COVID-19 pandemic, several European countries and the United States reported a marked increase in scarlet fever and invasive Group A streptococcus (GAS) infection.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Although this trend is likely because of reduced exposure and the immunity gap associated with a strict mask policy or social distancing during the pandemic, it is also thought to be related to the emergence and spread of the more toxigenic M1 UK variant.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In Japan, an increasing number of cases of streptococcal toxic shock syndrome (STSS) caused by GAS have been reported since July 2023.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In the first 2 months of 2024, a large increase in GAS bacteremia was detected at the Japanese Red Cross Narita Hospital, a tertiary teaching hospital with 710 beds. A total of six cases of bacteremia (2.37906 cases/1000 hospital admissions) were detected during the 2 months (Table 1). The median age was 45 years (range: 34–75 years). No patient was severely immunocompromised. The most common focus of infection was pneumonia with empyema (n = 3). The median Pitt bacteremia score and SOFA score were 2 and 3.5, respectively. Among six isolates from these cases, five were serotype T1 and positive for allele-specific PCR for the M1UK lineage.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Two patients died within the first day of hospitalization, and most of the surviving patients required surgical intervention. Given this increase, we analyzed the distribution of cases of GAS bacteremia during 2016–2023. The average number of cases of GAS bacteremia per year was 3.25 cases during 2016–2019 (0.21125 cases/1000 hospital admissions) and 1.75 cases during 2020–2023 (0.11654/1000 hospital admissions), respectively.&lt;/p&gt;&lt;p&gt;Circulation of the M1&lt;sub&gt;UK&lt;/sub&gt; variant strain may have contributed to the large increase in STSS cases in Japan. Previous reports have suggested that the M1&lt;sub&gt;UK&lt;/sub&gt; lineage may drive the observed increase in GAS infections in Europe.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; In Japan, the M1&lt;sub&gt;UK&lt;/sub&gt; strains account for only 6.4% of all 780 strains collected at eight reference centers during 2018–2023, but nine out of 19 strains were found to be the M1&lt;sub&gt;UK&lt;/sub&gt; strains in reported STSS cases since August 2023 in the Kanto region.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The incidence of GAS bacteremia in our hospital during the 2 month short period in 2024 was much higher than that before and during the COVID-19 pandemic, and most cases were caused by the M1&lt;sub&gt;UK&lt;/sub&gt; variant strain, which is consistent with the trend in the surveillance data shown above.&lt;/p&gt;&lt;p&gt;In conclusion, this report suggests that the M1&lt;sub&gt;UK&lt;/sub&gt; variant has been spread in certain areas in Japan and is likely to contribute to the large increase in invasive GAS infections.&lt;/p&gt;&lt;p&gt;Physicians should be cautious about this significant increase.&lt;/p&gt;&lt;p&gt;None.&lt;/p&gt;&lt;p&gt;The authors report that there are no competing interests to disclose.&lt;/p&gt;&lt;p&gt;This study was approve","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"289-290"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140990817","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":"Chronic cerebrospinal fluid leak can cause amyotrophic lateral sclerosis mimic","authors":"Satoshi Saito MD,&nbsp;Ryotaro Ikeguchi MD, PhD,&nbsp;Kazuo Kitagawa MD, PhD","doi":"10.1002/jgf2.691","DOIUrl":"10.1002/jgf2.691","url":null,"abstract":"<p>Chronic cerebrospinal fluid leak with spinal cord compression can mimic the symptoms of ALS, with a snake-eyes appearance on MRI.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"237-238"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.691","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991989","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":"The relation between resident mentorship and in-training examination scores: A nation-wide, cross-sectional study in Japan","authors":"Kohta Katayama MD, PhD,&nbsp;Yuji Nishizaki MD, MPH, PhD,&nbsp;Toshihiko Takada MD, MPH, MSc, PhD,&nbsp;Koshi Kataoka MMSc,&nbsp;Nathan Houchens MD,&nbsp;Taro Shimizu MD, PhD, MSc, MPH, MBA,&nbsp;Yu Yamamoto MD,&nbsp;Takashi Watari MD, MHQS, MCTM, PhD,&nbsp;Yasuharu Tokuda MD, MPH,&nbsp;Yoshiyuki Ohira MD, PhD","doi":"10.1002/jgf2.703","DOIUrl":"10.1002/jgf2.703","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mentorship is a dynamic reciprocal relationship, wherein a novice (mentee) grows with the encouragement of an advanced careerist (mentor). It is widely implemented in medical training programs. However, there are few reports on mentorship's educational effects in the Japanese context. This study investigated the association between mentorship and in-training examination scores during a clinical residency program in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in Japan, involving first and second year postgraduate (PGY-1 and PGY-2) residents set to take the General Medicine In-Training Examination (GM-ITE) at the end of the academic year of 2021. The GM-ITE, developed by a non-profit organization in 2012, assesses the overall clinical knowledge of PGY-1 and PGY-2 residents. Data on mentorship were obtained through an electronic survey, conducted immediately after the GM-ITE. The association between a resident's self-reported identification of at least one mentor and GM-ITE score was analyzed at multiple levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total 4929 residents, 3266 (66.3%) reported having mentors. However, there was no association between mentorship and GM-ITE scores (adjusted score difference [aSD] = −0.22; 95% confidence interval [95% CI]: −0.64 to 0.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among Japanese residents, in-training examination scores were not associated with mentorship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 5","pages":"249-255"},"PeriodicalIF":1.8,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140992812","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":"Personal, health system, and geosocial disparities in appointment nonadherence at family medicine clinics in southcentral Pennsylvania, United States","authors":"Wen-Jan Tuan DHA, MS, MPH,&nbsp;Ashley Weems,&nbsp;Shou Ling Leong MD","doi":"10.1002/jgf2.698","DOIUrl":"10.1002/jgf2.698","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess the relationship between patients' demographic, health system-related, and geosocial characteristics and the risk of missed appointments among patients in family medicine practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was based on a retrospective cross-sectional design using electronic health records and neighborhood-level social determents of health metrics linked by geocoded patients' home address. The study population consisted of patients who had a primary care provider and at least one appointment at 14 family medicine clinics in rural and suburban areas in January–December 2022. Negative binomial regression was utilized to examine the impact of personal, health system, and geosocial effects on the risk of no-shows and same-day cancellations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 258,614 appointments were made from 75,182 patients during the study period, including 7.8% no-show appointments from 20,256 patients. The analysis revealed that individuals in the ethnic minority groups were 1.24–1.65 times more likely to miss their appointments than their White counterpart. Females and English speakers had 14% lower risk for no-show. A significant increase (32%–64%) in the odds of no-shows was found among individuals on Medicaid and uninsured. Persons with prior history of no-shows or same day cancellations were 6%–27% more likely to miss their appointments. The no-show risk was also higher among people living in areas experiencing socioeconomic disadvantage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The risk of missed appointments is affected by personal, health system, and geosocial contexts. Future efforts aiming to reduce no-shows could develop personalized interventions targeting the at-risk populations identified in the analysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"214-223"},"PeriodicalIF":1.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141009165","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":"Scalp vein sign caused by intracranial dural arteriovenous fistula","authors":"Munenori Iwamoto MD,&nbsp;Yoshihisa Otsuka MD, PhD,&nbsp;Tsuneaki Kenzaka MD, PhD,&nbsp;Masaaki Kohta MD, PhD,&nbsp;Yusuke Okamura MD, PhD","doi":"10.1002/jgf2.701","DOIUrl":"10.1002/jgf2.701","url":null,"abstract":"<p>A 68-year-old man presented with a headache that had started 1 month earlier. The scalp vein dilatation was observed at presentation. The findings of computed tomography and magnetic resonance imaging raised suspicion of a dural arteriovenous fistula, leading to the definitive diagnosis by digital subtraction angiography. Scalp vein signs can be a useful clue to suspect intracranial abnormalities, including dural arteriovenous fistula.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"239-240"},"PeriodicalIF":1.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015883","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":"Japanese primary care physicians' postpartum mental health care: A cross-sectional study","authors":"Keiichiro Narumoto MD, MPH, PhD,&nbsp;Miho Endo MD,&nbsp;Makoto Kaneko MD, MClSc, PhD,&nbsp;Tomoko Iwata MD,&nbsp;Machiko Inoue MD, MPH, PhD","doi":"10.1002/jgf2.700","DOIUrl":"10.1002/jgf2.700","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postpartum mental health care is a public health priority requiring interprofessional and interorganizational collaboration. Primary care physicians (PCPs) have the potential to play an essential role in facilitating access to health care and providing comprehensive and coordinated care for postpartum mental health problems. In Japan, however, there are no previous studies on the extent to which PCPs are involved in postpartum mental health care. Therefore, this study aimed to investigate the practices and experiences of Japanese PCPs in providing such care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study presents a subset of the findings from a cross-sectional study using an online questionnaire on postpartum care among Japanese PCPs. We employed descriptive analysis to examine their practices and experiences in providing general and postpartum mental health care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We received 339 valid responses from 5811 PCPs. The median proportion of the outpatients with mental health problems that PCPs regularly saw was 15%. Approximately two out of three PCPs (68.7%) reported routinely performing screening for depression and anxiety. Seventy-six percent of PCPs had the opportunity to provide care for postpartum women. Approximately one in two PCPs (47.8%) had managed cases of postpartum mental health problems and collaborated with various professionals and resources to provide care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The majority of Japanese PCP participants in the study provide mental health care and have managed cases of postpartum mental health problems, collaborating with various health professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 4","pages":"224-231"},"PeriodicalIF":1.8,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018740","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}