Annals of family medicine
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Annals of family medicine · Nov 2024
Assessment and comparison of the ILI case definition in clinical and school-based community settings: ORCHARDS/IISP.
Context: Influenza-like illness (ILI) is commonly used in clinical and public health settings to identify influenza cases. CDC defines ILI as fever and either cough or sore throat, with symptom onset within 7 days. Objective: Assess performance of ILI criteria in two settings (clinical and community), comparing symptom profiles and laboratory detection of influenza in children. ⋯ Conclusions: ILI performed well in both clinical and community contexts. Factors most highly associated with increased odds of RT-PCR(+) results were cough, fever, and ILI. Inclusion of seasonality and influenza vaccination status improved the predictive value of ILI in both datasets.
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Annals of family medicine · Nov 2024
Randomized Controlled TrialEffectiveness of Collaborative, Trauma-Informed Care on Depression Outcomes in Primary Care: A Cluster Randomized Control Trial in Chile.
The purpose of this study was to evaluate the effectiveness of collaborative trauma-informed care (CTIC) for treating depression in primary care in Chile. ⋯ The CTIC approach demonstrated superior outcomes in treating depression and improving adherence compared with UT. Moreover, the observed trends in anxiety improvement warrant further exploration in future research with a larger sample size. It is necessary to assess the effectiveness of this approach in treating more complex, difficult-to-treat forms of depression.
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Annals of family medicine · Nov 2024
Comparative StudyHealth Care Utilization After a Visit to a Within-Group Family Physician vs a Walk-In Clinic Physician.
Primary care access is a key health system metric, but little research has compared models to provide primary care access when one's regular physician is not available. We compared health system use after a visit with a patient's own family physician group (ie, within-group physician who was not the patient's primary physician) vs a visit with a walk-in clinic physician who was not part of the patient's family physician group. ⋯ Compared to visiting a walk-in clinic physician, seeing a within-group physician after hours might decrease downstream emergency department visits. This finding could be explained by better continuity of care and can inform primary care service models and the policies that support them.
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Annals of family medicine · Nov 2024
Relation Between Chest Radiography Results and Antibiotic Initiation in Community-Acquired Pneumonia Management by General Practitioners.
For most guidelines, diagnosis of community-acquired pneumonia (CAP) is based on a combination of clinical signs and focal consolidation visible on chest radiographs (CRs). Our objective was to analyze antibiotic initiation by general practitioners for patients with suspected CAP according to CR. ⋯ For patients with suspected CAP, general practitioners systematically took into account results of positive CRs to initiate antibiotics and took much less account of negative CRs. These results justify clarification of what should be done in cases of clinical suspicion of CAP without radiologic confirmation.
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Annals of family medicine · Nov 2024
Exploring HIV Self-Testing: Barriers and Facilitators Among Undergraduate Students in Nairobi, Kenya.
Infection with HIV remains a global health challenge, with >36.9 million individuals living with HIV in 2017. Despite efforts to increase HIV testing and treatment, traditional services have not effectively reached marginalized communities. The use of HIV self-testing (HIVST) offers a discreet and accessible alternative, potentially improving testing rates among at-risk populations including university students in Kenya. ⋯ This study highlights the importance of school-based interventions and the critical role of academic institution support in HIV prevention. Participants' substantial knowledge of HIV contrasts with findings from other regions, underscoring the need for targeted education and safe-sex promotion. Addressing fear and stigma via comprehensive interventions is essential for improving HIVST uptake. Integrating HIVST into existing prevention programs can enhance HIV care frameworks in East Africa. Strategies to destigmatize HIV, ensure privacy in testing, and address misconceptions are vital for improving health outcomes among young individuals. Continuous efforts to strengthen self-testing programs are crucial to achieving global HIV targets.