Annals of family medicine
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Context: Cancer is associated with many risk factors, including obesity. Specifically, abdominal obesity is linked to metabolic syndrome and is quantified by waist circumference (WC). Compared to WC, body mass index (BMI) is more accessible in the office to assess a patient's overall body fat composition. ⋯ We found that BMI and WC were significantly correlated in this cohort. Further follow-up is needed with a larger sample size and over a longer period. As body composition in this cohort has not been previously studied, further analyses may provide more biomarkers to aid in disease management.
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Annals of family medicine · Jan 2023
Association of Adverse Childhood Experiences and Gun Violence Exposure in North Carolina Adolescents/Young Adults.
Context: Adverse Childhood Experiences (ACEs) are a set of early life events associated with toxic stress and long-term health consequences. The more ACEs a person has experienced, the greater their risk of physical and mental illness later in life. It has been proposed that gun violence, an increasingly common experience for children in the United States, should be considered an ACE due to its lifelong physical and psychosocial impacts. ⋯ Over half (55%) reported being exposed to gun violence in their lifetime. ACE Score was associated with both lifetime gun violence exposure and SaFETy Score (p=0.001 for both). Conclusions: In this study, ACEs were correlated with both lifetime gun violence exposure and SaFETy score, suggesting that gun violence exposure is more common in rural and suburban North Carolina youth who have also experienced other childhood traumas.
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Annals of family medicine · Jan 2023
Evaluation of Childhood Beverage Consumption and Perceptions of Water Safety.
Context: Children ages 1-3 should consume about 35oz of plain water per day. The CDC and AAP recommend that children under 12 months do not receive any juice and children over 12 months should receive no more than 4oz of 100% juice with no sugar-sweetened beverages (SSBs). SSB consumption is associated with overweight and obesity, as well as an increase of tooth decay. 22% of preschool children do not regularly drink plain water and 46% regularly drink SSBs. ⋯ Conclusions: Children drank more juice and SSBs and less water than recommended. Previous assessment suggests that families may be more open to beverage consumption changes that other lifestyle changes that prevent childhood obesity. Improved perceptions of tap water safety may be a possible mechanism to decrease juice and SSB and increase water consumption.
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Annals of family medicine · Jan 2023
The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions in a Real-World Health System.
Context: Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there is limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. Objective: The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010-2020. Study Design and Analysis: Retrospective cohort study. ⋯ Univariate analyses indicated that the presence of at least one identified gene-x-drug interaction increased risk of 90-day readmission by more than 40% (OR=1.42, 95% confidence interval (CI) 1.09-1.84)(p=0.01). A multivariable model adjusting for age, race, sex, employment status, body mass index, and medical conditions, slightly attenuated the effect (OR=1.32, 95% CI 1.02-1.73)(p=0.04). Conclusions: Our results suggest that the presence of one or more CPIC gene-x-drug interactions increases the risk of 90-day hospital readmission, even after adjustment for demographic and clinical risk factors.
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Annals of family medicine · Jan 2023
Observational StudyPersonal Continuity and Prescribing Correctly: A Perfect Couple in Primary Care.
Context Personal continuity is a widely accepted core value of primary care. Previous studies suggest that personal continuity is associated with fewer Potentially Inappropriate Prescriptions (PIPs). However, this has not been studied in the primary care population. ⋯ Three of four continuity measures (BBI, HI and UPC) were positively and significantly associated with fewer potentially inappropriate prescriptions. Conclusions High personal continuity is associated with appropriate prescribing. Increasing personal continuity may improve quality of prescriptions and reduce harmful consequences.