Primary care
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Both mental illness and overall mental health are determined by a complicated interplay of life experiences and genetic predisposition. While genetic predisposition is difficult to modify, many of the life experiences that worsen mental health and exacerbate serious mental illness are associated with social policies and cultural norms that are changeable. Now that we have identified these associations, it is time to rigorously test scalable interventions to address these risks. These interventions will need to focus on high-impact stages in life (like childhood) and will need to address risk beyond the individual by focusing on the family and community.
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This article, focused on outlining the digital domain as a "super" social determinant of health, considers the core issues of digital equity (ie, digital access, digital devices, and digital skills) to structure the implications that the digital domain has on human health and well-being. In addition to considering an ever-evolving landscape of digital health, telehealth, and other digital health technologies, we pay particular attention to the influence the digital domain has on patient-provider relationships, as well as the challenges, opportunities, and key considerations that advancements in digital health and technologies have for extending and enhancing direct patient care.
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Consideration of the definition of the social determinants of health (SDOHs) requires health care to include work, play, and worship environments because they are important to the health of patients and communities. This article attempts to discuss the issues with limited focus on these areas and the importance of using multidisciplinary health-care teams during primary care visits. The expectation from this information is to advance the ability for primary care providers to support patients and the communities they work in to effect change toward decreasing health disparities and enhancing overall health outcomes.
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The gut microbiome represents a complex microbial ecosystem that exerts direct and indirect effects on other organ systems and contributes to both health and disease. It is sensitive to various stimuli such as childhood immunity, medications, diet, stressors, and sleep. Modulating the gut microbiome can prevent and even treat certain disease states. Although no definitive guidelines exist to support a healthy microbiome, there are several evidence-based interventions proved to improve gut health and reduce the risk for numerous chronic diseases.
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Symptoms potentially attributable to gastroesophageal reflux disease are among those most commonly reported to primary care providers in the outpatient setting. In this review, we discuss clinical approaches to the evaluation and management of these symptoms, including proton pump inhibitor trials as well as specific indications or clinical settings that warrant referral to Gastroenterology specialists.