Annals of family medicine
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Annals of family medicine · Jan 2023
Primary Care Physicians' Perspectives on Identifying Familial Hypercholesterolaemia in Primary Care: A Qualitative Study.
Context Familial hypercholesterolaemia (FH) is a common autosomal dominant disorder, causing elevated cholesterol from birth, premature heart disease, and early death. Objective This study explored primary care physicians' experiences and perspectives on identifying FH in Malaysian primary care. Study Design and Analysis A qualitative study involving semi-structured interviews and focus group discussions with 22 primary care physicians (PCPs) in two primary care clinic settings. ⋯ The PCPs recommended a user-friendly case-finding tool for FH, and establishing FH registry and clinical practice guideline in Malaysia, alongside a national FH screening strategy and awareness campaigns for both clinicians and general public. Conclusions PCPs are positive about improving the identification of FH in primary care. However greater support in their practice and wider system developments and change are needed.
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Annals of family medicine · Jan 2023
Suicide Prevention - Unified Research; Developing capacity for community engaged suicide prevention research in Colorado.
Context: Suicide is currently the second leading cause of death among adolescents and young adults. Colorado has the seventh highest suicide rate in the US, and rates continue to climb. Suicide prevention research ranked highest amongst all stakeholder groups in PBRN-related topic generating activities. ⋯ This work also resulted in a community driven research agenda identifying: the relationship of social determinants of health and substance use in suicidality; sleep and suicidality; and lived experience/survivorship as priority topics. An example of a specific question that arose from this engagement work is "How can we address sleep issues AND suicidality in primary care (i.e. why aren't sleep concerns assessed and addressed as a way of reducing distress that leads to mental illness and suicide?)". Conclusions: Thoughtful community engagement takes time and support, but in this case, resulted in a clear research agenda that is responsive to stakeholder interests and involves stakeholders as equal research partners.
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Annals of family medicine · Jan 2023
Risk of Postneonatal Infant Mortality Associated With Prior Founded Allegations of Child Abuse.
Context: There are ∼7500 postneonatal deaths (28 days to under 1 year) in the US annually, of which a majority are preventable. Previous studies have reported a child's prior encounter with child protective services (CPS) as a risk factor for preventable death but few studies have evaluated this in relation to subsequent postneonatal deaths. Objective: To measure the association between prior reports of child abuse and subsequent postneonatal death. ⋯ Lower maternal education, age, inadequate prenatal care and infant-parent bedsharing were also associated with higher odds of postneonatal death. Conclusions: Child protective services involvement is an opportunity for education to help reduce the incidence of potentially preventable infant deaths. Families should have access to appropriate acute and preventive care and receive ongoing education about child abuse prevention, infant safety, reducing the risk of preventable deaths such as SIDS, and when to seek medical attention.
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Annals of family medicine · Jan 2023
A Survey Snapshot Measuring Insulin Underuse in a Primary Care Clinic.
The rising cost of insulin has created problems for physicians in the management of diabetes. The objective of our study was to determine the prevalence of cost-related insulin underuse in a primary care environment. ⋯ Ninety respondents completed the survey with results indicating 44% experienced cost-related suboptimal therapy. Prevalence of insulin underuse remains high in primary care and prescribers should regularly assess medication cost barriers with all patients.
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Annals of family medicine · Jan 2023
Understanding Indigenous Health Literacy Through Community-Led Engagement.
Context: This is the last in a four-part series that describes the outcome of a mixed-methods participatory social justice (MMPSJ) research project. A community engagement model was designed by participants as a synthesis of working with urban Indigenous peoples living on Treaty Six Territory and traditional homeland of the Metis in Saskatchewan, Canada. It responds to the Truth and Reconciliation Commissions calls to Action 10, 18-20. ⋯ Participants: Twelve Indigenous people representing four intergenerational families were invited to two Talking Circles to respond to questions derived from the Aboriginal Regional Health Surveys; as well as answer the following questions: What are the current connections between literacy and health within urban Indigenous families? What literacy issues continue to marginalize the community? How would you like this knowledge disseminated? This research was reviewed and approved by the University of Saskatchewan's Behavioural REB. Results/Findings: Knowledge of Treaty Six teachings was increased; participants described the social justice/transformative nature of this work an opportunity to be seen well and whole; and the Community Engagement Model evolved within the MMPSJ design. Conclusions: Community-based research can be transformed to being community-led through careful consideration of power and authentically engaging with the community at each step in the process.