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BIRTH CONTROL (22 journals)

Showing 1 - 19 of 19 Journals sorted by number of followers
Journal of Maternal-Fetal & Neonatal Medicine     Hybrid Journal   (Followers: 40)
Birth     Hybrid Journal   (Followers: 37)
Contraception     Hybrid Journal   (Followers: 19)
Africa Journal of Nursing and Midwifery     Full-text available via subscription   (Followers: 16)
Journal of Family Planning and Reproductive Health Care     Hybrid Journal   (Followers: 14)
Adoption Quarterly     Hybrid Journal   (Followers: 10)
Journal of the American Board of Family Medicine     Open Access   (Followers: 10)
Obstetric Medicine     Hybrid Journal   (Followers: 7)
Perspectives On Sexual and Reproductive Health     Hybrid Journal   (Followers: 7)
Studies In Family Planning     Hybrid Journal   (Followers: 6)
Human Fertility     Hybrid Journal   (Followers: 6)
European Journal of Contraception & Reproductive Health Care     Hybrid Journal   (Followers: 5)
Fetal and Pediatric Pathology     Hybrid Journal   (Followers: 5)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 3)
Biodemography and Social Biology     Hybrid Journal   (Followers: 1)
Revista Chilena de Obstetricia y Ginecologia     Open Access   (Followers: 1)
Contraception : X     Open Access  
Raigal     Open Access  
Teratology     Hybrid Journal  
Similar Journals
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Journal of the American Board of Family Medicine
Journal Prestige (SJR): 1.174
Citation Impact (citeScore): 2
Number of Followers: 10  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1557-2625 - ISSN (Online) 1558-7118
Published by American Board of Family Medicine Homepage  [1 journal]
  • Clinically Useful Family Medicine Research

    • Authors: Seehusen, D. A; Bowman, M. A, Ledford, C. J. W.
      Pages: 1039 - 1041
      Abstract: What is next for family medicine' After the long, rough road since the beginning of the COVID-19 pandemic, other topics are again receiving renewed attention. Family medicine researchers continue to consider issues important to our patients and practices. There is a collection of clinical research on children’s health care. One article outlines practical actions to move medical academia past racism. The need for physician trust in patients is also often overlooked. Other articles address how to improve the practice of family medicine and a framework for thinking about legal and ethical issues in sports medicine. Three in-depth clinical reviews cover lumps and bumps of wrists and hands, spondylosis/spondylolistheses, and vitamin D association with specific disease entities.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220334R0
      Issue No: Vol. 35, No. 6 (2022)
  • Welcome, Family Medicine Residents!

    • Authors: Bowman, M. A; Seehusen, D. A.
      Pages: 1042 - 1042
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220367R0
      Issue No: Vol. 35, No. 6 (2022)
  • Examining the Effects of Formal Education Level on the Montreal Cognitive

    • Authors: White, R. S; Barber, J. M, Harp, J. P, Jicha, G. A.
      Pages: 1043 - 1057
      Abstract: Background:Brief, global assessments such as the Montreal Cognitive Assessment (MoCA) are widely used in primary care for assessing cognition in older adults. Like other neuropsychological instruments, lower formal education can influence MoCA interpretation.Methods:Data from 2 large studies of cognitive aging were used—Alzheimer’s Disease Neuroimaging Initiative (ADNI) and National Alzheimer’s Coordinating Center (NACC). Both use comprehensive examinations to determine cognitive status and have brain amyloid status for many participants. Mixed models were used to account for random variation due to data source.Results:Cognitively intact participants with lower education (≤12 years) were more likely than those with higher education (>12 years) to be classified as potentially impaired using the MoCA cutoff of .67).Conclusions:The alternative MoCA score neutralized the effects of formal education. Although further research is needed, this alternative score offers a simple procedure for interpreting MoCAs administered to older adults with ≤12 years education. These educational effects also highlight that the MoCA is part of the assessment process—not a singular diagnostic test—and a comprehensive workup is necessary to accurately diagnose cognitive impairments.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220093R1
      Issue No: Vol. 35, No. 6 (2022)
  • Development and Validation of Simple Risk Scores to Predict
           Hospitalization in Outpatients with COVID-19 Including the Omicron Variant

    • Authors: Ebell, M. H; Hamadani, R, Kieber-Emmons, A.
      Pages: 1058 - 1064
      Abstract: Introduction:Outpatient physicians need guidance to support decisions regarding hospitalization of COVID-19 patients and how closely to follow outpatients. Thus, we sought to develop and validate simple risk scores to predict hospitalization for outpatients with COVID-19 that do not require laboratory testing or imaging.Methods:We identified outpatients 12 years and older who had a positive polymerase chain reaction test for SARS-CoV-2. Logistic regression was used to derive a risk score in patients presenting before March, 2021, and it was validated in a cohort presenting from March to September 2021 and an Omicron cohort from December, 2021 to January, 2022.Results:Overall, 4.0% of 5843 outpatients in the early derivation cohort (before 3/1/21), 4.2% of 3806 outpatients in the late validation cohort, and 1.2% in an Omicron cohort were hospitalized. The base risk score included age, dyspnea, and any comorbidity. Other scores added fever, respiratory rate and/or oxygen saturation. All had very good overall accuracy (AUC 0.85–0.87) and classified about half of patients into a low-risk group with < 1% hospitalization risk. Hospitalization rates in the Omicron cohort were 0.22%, 1.3% and 8.7% for the base score. Two externally derived risk scores identified more low risk patients, but with a higher overall risk of hospitalization than our novel risk scores.Conclusions:A simple risk score suitable for outpatient and telehealth settings can classify over half of COVID-19 outpatients into a very low risk group with a 0.22% hospitalization risk in the Omicron cohort. The Lehigh Outpatient COVID Hospitalization (LOCH) risk score is available online as a free app:
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220056R1
      Issue No: Vol. 35, No. 6 (2022)
  • A Quantitative Study of the Decision Threshold for the Diagnosis of
           Infectious Mononucleosis

    • Authors: Cai, X; Ebell, M. H, Russo, G.
      Pages: 1065 - 1071
      Abstract: Background:Ordering a serologic test for infectious mononucleosis (IM) in all young patients with sore throat is costly and impractical. The test threshold to determine when to order a diagnostic test for IM based on the patient’s symptoms has not been previously studied.Objective:To determine the test threshold for IM in the management of patients with sore throat.Design and Setting:Online surveys were sent to a convenience sample of US primary care clinicians regarding their decision making about whether or not to order a test for IM in a patient with sore throat.Method:7 clinical vignettes were created, each with a different combinations of symptoms and signs. The probability of IM for each vignette was estimated by the investigator based on the number of symptoms present to generate a plausible range of disease probabilities. Clinicians were then asked to decide whether to test or not test for IM, and mixed-effect logistic regression was used to determine the test threshold for IM where half of physicians chose to test and half chose not to test.Results:A total of 117 clinicians provided responses for a total of 819 clinical vignettes. The overall test threshold for IM as estimated using the logistic regression was 9.5% (95% CI: 8.2% to 10.9%). The test threshold for clinicians practicing greater than 10 years was significantly higher than for those practicing less or equal to 10 years (10.5% vs 7.3%, P = .02). No significant differences between specialties and practice sites were found with respect to the test threshold.Conclusion:This study identified a test threshold for IM of approximately 10% based on realistic clinical vignettes. This threshold was stable regarding the clinician’s specialty and practice sites and could be used in the development of a clinical prediction rule to determine the cutoff for low- versus high-risk groups.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.210185R1
      Issue No: Vol. 35, No. 6 (2022)
  • Food Intake Compared to Exercise Association with Obesity in Children Ages

    • Authors: Bedell, D; Sevcik, T, Daly, J. M, Levy, B. T.
      Pages: 1072 - 1080
      Abstract: Background:Childhood obesity affects 19.3% of children ages 2 to 19 years in the US, and 25.6% of Hispanic children. Study objectives were to (1) assess the feasibility of monitoring physical activity and daily caloric intake in children ages 3 to 6 years, (2) assess whether known obesity risk factors apply to this age-group, and (3) explore the factors that may contribute to the higher prevalence of obesity in Hispanic preschooler.Methods:Children ages 3 to 6 years were recruited at well child visits (n = 37, 65% male, 30% Hispanic). Parents completed a questionnaire (child’s physical activity and screen time) along with a detailed dietary assessment. Children were provided with a fitness tracker worn for 5 days. Fisher’s exact test, t test/Wilcoxon rank sum tests were conducted.Results:Thirty-four (92%) participants produced usable activity data. Baseline dietary recall was completed by 35 (97%) of the parents and 25 (68%) completed the second unassisted dietary recall. Mean body mass index of the study sample was 60th percentile, 12 (32%) classified as overweight/obese. Children with overweight/obesity showed no significant difference in mean daily calories compared with those without (1403.9 vs 1406.1 Kcal/day, P = .980) or daily hours of screen time (1.5 ± 1.1 vs 1.7 ± 0.8, P = .442). Children with overweight/obesity had fewer mean daily steps compared with those without overweight/obesity (8038 ± 2685 vs 10038 ± 2599 P = .051).Discussion:Findings indicate that pedometer activity tracking can be used in children 3 to 6 years old and that decreased physical activity correlates more closely to preschool overweight/obesity than caloric intake.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220159R1
      Issue No: Vol. 35, No. 6 (2022)
  • Outcomes of Delay of Care After the Onset of COVID-19 for Patients
           Managing Multiple Chronic Conditions

    • Authors: Rose, G. L; Bonnell, L. N, Clifton, J, Natkin, L. W, Hitt, J. R, ORourke-Lavoie, J.
      Pages: 1081 - 1091
      Abstract: Purpose:Many patients delayed health care during COVID-19. We assessed the extent to which patients managing multiple chronic conditions (MCC) delayed care in the first months of the pandemic, reasons for delay, and impact of delay on patient-reported physical and behavioral health (BH) outcomes.Methods:As part of a large clinical trial conducted April 2016–June, 2021, primary care patients managing MCC were surveyed about physical and behavioral symptoms and functioning. Surveys administered between September 3, 2020, and March 16, 2021, included questions about the extent of and reasons for any delayed medical and BH care since COVID-19. Multivariable linear regression was used to assess health outcomes as a function of delay of care status.Results:Among patients who delayed medical care, 58% delayed more than once. Among those who delayed behavioral health care, 63% delayed more than once. Participants who delayed multiple times tended to be younger, female, unmarried, and reported food, financial, and housing insecurities and worse health. The primary reasons for delaying care were lack of availability of in-person visits and perceived lack of urgency. Participants who delayed care multiple times had significantly worse outcomes on nearly every measure of physical and mental health, compared with participants who delayed care once or did not delay.Conclusions:Delay of care was substantial. Patients who delayed care multiple times were in poorer health and thus in need of more care. Effective strategies for reengaging patients in deferred care should be identified and implemented on multiple levels.Trial NCT02868983. Registered on August 16, 2016.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220112R1
      Issue No: Vol. 35, No. 6 (2022)
  • Associations Between Healthcare Experiences, Mental Health Outcomes, and
           Substance Use Among Transgender Adults

    • Authors: Levine, S; Heiden-Rootes, K, Salas, J.
      Pages: 1092 - 1102
      Abstract: Introduction:Transgender and nonbinary (TGNB) adults face significant barriers to healthcare, including healthcare denials, limited access to clinicians, and mistreatment by healthcare clinicians. While prior studies have explored the consequences of overt discrimination in healthcare, they often overlook the possible impacts of more subtle forms of discrimination.Aim:Is there a relationship between specific healthcare experiences, including both overt and subtle forms of discrimination, and mental health/substance use among TGNB adults'Methods:This study was a secondary analysis of the 2015 U.S. Transgender Survey (USTS), a cross-sectional survey conducted by the National Center for Transgender Equality (NCTE) that included 27,715 TGNB adults from across the US and several US territories. This study analyzed variables including healthcare experiences, mental health, and substance use outcomes.Results:Doctors refusing to give non-TGNB-related care was associated with 71% increased odds of severe psychological distress and 95% increased odds of suicidal ideation. Further, having to teach doctors about TGNB care and doctors asking invasive questions were associated with all our studied negative mental health outcomes. Doctors asking invasive questions was additionally related to increased odds of heavy alcohol use, marijuana use, and illicit drug use.Conclusions:The results of this study indicate that negative health care experiences are significantly associated with mental health and substance use for TGNB adults. Specifically, these results emphasize the role of more subtle forms of discrimination, including a lack of clinician knowledge about the care of TGNB patients, asking invasive questions, and treating TGNB patients with respect.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220186R1
      Issue No: Vol. 35, No. 6 (2022)
  • The Psychosocial Needs of Patients Participating in Diabetes Shared
           Medical Appointments

    • Authors: Nederveld, A. L; Gurfinkel, D, Hosokawa, P, Gritz, R. M, Dickinson, L. M, Phimphasone-Brady, P, Waxmonsky, J. A, Kwan, B. M.
      Pages: 1103 - 1114
      Abstract: Background:Patient reported outcomes (PROs) for diabetes are self-reported and often give insight into outcomes important to people with diabetes. Federally Qualified Health Centers (FQHCs) see patients who may have higher levels of diabetes distress and lower levels of self-care behaviors.Methods:The Invested in Diabetes study is a comparative effectiveness trial of diabetes Shared Medical Appointments (SMAs) in FQHCs and non-FQHC settings. PROs measure outcomes including validated measures on diabetes distress.Setting and Participants:616 people from 22 practices completed PROs prior to SMAs. At FQHCs, participants were younger (average 57.7 years vs 66.9 years, p < 0.0001), more likely to be female (36.8% vs 46.1%, p = 0.02), and fewer spoke English (72.7% vs 99.6%, p < 0.0001).Results:At FQHCs, diabetes distress was higher (2.1 vs 1.8, P = .02), more people were current smokers (14.3% vs 4.7%, P = .0002), on insulin (48.9% vs 22.3%, P < .0001) and reported food insecurity (52.7% vs 26.2%, P < .0001). After controlling for sociodemographic factors, these differences were nonsignificant.Conclusions:Higher numbers of patients at FQHCs report diabetes distress and food insecurity compared with patients in non-FQHC settings, indicating that patient social circumstances need to be considered as part of program implementation.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220062R1
      Issue No: Vol. 35, No. 6 (2022)
  • How Does Prior Experience Pay Off in Large-Scale Quality Improvement

    • Authors: Cohen, D. J; Balasubramanian, B. A, Lindner, S, Miller, W. L, Sweeney, S. M, Hall, J. D, Ward, R, Marino, M, Springer, R, McConnell, K. J, Hemler, J. R, Ono, S. S, Ezekiel-Herrera, D, Baron, A, Crabtree, B. F, Solberg, L. I.
      Pages: 1115 - 1127
      Abstract: Introduction:To examine the association of prior investment on the effectiveness of organizations delivering large-scale external support to improve primary care.Methods:Mixed-methods study of 7 EvidenceNOW grantees (henceforth, Cooperatives) and their recruited practices (n = 1720). Independent Variable: Cooperatives’s experience level prior to EvidenceNOW, defined as a sustained track record in delivering large-scale quality improvement (QI) to primary care practices (high, medium, or low). Dependent Variables: Implementation of external support, measured as facilitation dose; effectiveness at improving (1) clinical quality, measured as practices’ performance on Aspirin, Blood Pressure, Cholesterol, and Smoking (ABCS); and (2) practice capacity, measured using the Adaptive Reserve (AR) score and Change Process Capacity Questionnaire (CPCQ). Data were analyzed using multivariable linear regressions and a qualitative inductive approach.Results:Cooperatives with High (vs low) levels of prior experience with and investment in large-scale QI before EvidenceNOW recruited more geographically dispersed and diverse practices, with lower baseline ABCS performance (differences ranging from 2.8% for blood pressure to 41.5% for smoking), delivered more facilitation (mean=+20.3 hours, P = .04), and made greater improvements in practices’ QI capacity (CPCQ: +2.04, P < .001) and smoking performance (+6.43%, P = .003). These Cooperatives had established networks of facilitators at the start of EvidenceNOW and leadership experienced in supporting this workforce, which explained their better recruitment, delivery of facilitation, and improvement in outcomes.Discussion:Long-term investment that establishes regionwide organizations with infrastructure and experience to support primary care practices in QI is associated with more consistent delivery of facilitation support, and greater improvement in practice capacity and some clinical outcomes.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220088R1
      Issue No: Vol. 35, No. 6 (2022)
  • Organizational Factors Associated with Guideline Concordance of Chronic
           Disease Care and Management Practices

    • Authors: Cohen, D. J; Wyte-Lake, T, Bonsu, P, Albert, S. L, Kwok, L, Paul, M. M, Nguyen, A. M, Berry, C. A, Shelley, D. R.
      Pages: 1128 - 1142
      Abstract: Background:Guidelines for managing and preventing chronic disease tend to be well-known. Yet, translation of this evidence into practice is inconsistent. We identify a combination of factors that are connected to guideline concordant delivery of evidence-informed chronic disease care in primary care.Methods:Cross-sectional observational study; purposively selected 22 practices to vary on size, ownership and geographic location, using National Quality Forum metrics to ensure practices had a ≥ 70% quality level for at least 2 of the following: aspirin use in high-risk individuals, blood pressure control, cholesterol and diabetes management. Interviewed 2 professionals (eg, medical director, practice manager) per practice (n = 44) to understand staffing and clinical operations. Analyzed data using an iterative and inductive approach.Results:Community Health Centers (CHCs) employed interdisciplinary clinical teams that included a variety of professionals as compared with hospital-health systems (HHS) and clinician-owned practices. Despite this difference, practice members consistently reported a number of functions that may be connected to clinical chronic care quality, including: having engaged leadership; a culture of teamwork; engaging in team-based care; using data to inform quality improvement; empaneling patients; and managing the care of patient panels, with a focus on continuity and comprehensiveness, as well as having a commitment to the community.Conclusions:There are mutable organizational attributes connected-guideline concordant chronic disease care in primary care. Research and policy reform are needed to promote and study how to achieve widespread adoption of these functions and organizational attributes that may be central to achieving equity and improving chronic disease prevention.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.210502R2
      Issue No: Vol. 35, No. 6 (2022)
  • Tailoring Implementation Strategies for Cardiovascular Disease Risk
           Calculator Adoption in Primary Care Clinics

    • Authors: Baldwin, L.-M; Tuzzio, L, Cole, A. M, Holden, E, Powell, J. A, Parchman, M. L.
      Pages: 1143 - 1155
      Abstract: Introduction:When implementing interventions in primary care, tailoring implementation strategies to practice barriers can be effective, but additional work is needed to understand how to best select these strategies. This study sought to identify clinicians’ contributions to the process of tailoring implementation strategies to barriers in clinical settings.Methods:We conducted a modified nominal group exercise involving 8 implementation scientists and 26 primary care clinicians in the WWAMI region Practice and Research Network. Each group identified implementation strategies it felt would best address barriers to using a cardiovascular disease (CVD) risk calculator previously identified across 44 primary care clinics from the Healthy Hearts Northwest pragmatic trial (2015 to 2018). These barriers had been mapped beforehand to the Consolidated Framework for Implementation Research (CFIR) domains. We examined similarities and differences in the strategies that 30% or more of each group identified (agreed-on strategies) for each barrier and for barriers in each CFIR domain. We used the results to demonstrate how strategies might be tailored to individual clinics.Results:Clinicians selected 23 implementation strategies to address 1 or more of the 13 barriers; implementation scientists selected 35. The 2 groups agreed on at least 1 strategy for barriers in each CFIR domain: Inner Setting, Outer Setting, Intervention Characteristics, Characteristics of Individuals, and Process. Conducting local needs assessment and assessing for readiness/identifying barriers and facilitators were the 2 most common implementation strategies chosen only by clinicians.Conclusions:Clinician stakeholders identified implementation strategies that augmented those chosen by implementation scientists, suggesting that codesign of implementation processes between implementation scientists and clinicians may strengthen the process of tailoring strategies to overcome implementation barriers.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.210449R1
      Issue No: Vol. 35, No. 6 (2022)
  • Parental Reading to Infants Improves Language Score: A Rural Family
           Medicine Intervention

    • Authors: Franks, A. M; Seaman, C, Franks, E. K, Rollyson, W, Davies, T.
      Pages: 1156 - 1162
      Abstract: Introduction:Both expressive and receptive language development begins early in life. While the benefits of reading to toddlers (over 12 months old) is well-established, benefits of reading to infants (birth to 12 months old) is less established. This study’s objective is to determine if consistent reading to infants improves expressive and receptive language development during the first year of life.Methods:We prospectively randomized infants at a family medicine clinic during their 2-week-old visits and gave them a collection of books. Group A (n = 16) received no instructions, while patients in Group B (n = 18) committed to read 1 book a day. Parents in Group C (n = 18) enrolled after 34 weeks gestation, committed to read 1 book a day, and watch an infant brain development video. We obtained average book counts and both expressive and receptive language testing at standard preventative visits through 12 months.Results:Language scores did not differ between randomized groups. Always reading 7 books per week led to higher expressive, receptive and combined language scores at 9 months than sometimes reading fewer than 7 books per week (P = .025, 0.009 and 0.011 respectively). These differences increased by 12 months (P = .004, 0.002, and 0.003, respectively). Instructing parents to read daily encouraged parents to read more books per week at 4 months (P = .031) and 6 months (P = .049).Discussion:Early, consistent reading demonstrates improved language scores as early as 9 months of age. Setting expectations of minimal daily reading impacted daily reading compliance early in life.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220064R2
      Issue No: Vol. 35, No. 6 (2022)
  • Risk of Thromboembolic Events Following COVID-19 Diagnosis Without

    • Authors: Schreck, K; Carlin, C, Ricco, J.
      Pages: 1163 - 1167
      Abstract: Introduction:Current research shows no increased risk of thromboembolic events with mild COVID-19 but does not account for comorbidities. The aim of this study was to examine the incidence of thromboembolic events, including pulmonary embolism, cerebral infarction, and deep vein thrombosis, in nonhospitalized patients diagnosed with COVID-19 while accounting for comorbidities such as diabetes, asthma, COPD and cancer.Methods:We completed a large retrospective observational analysis of adult patients within a large urban health system.Results:Using a logit framework (with and without propensity score weighting), there was no increased risk of thromboembolic events among patients positive for SARS-CoV-2 who did not require hospitalization for COVID-19.Conclusion:This data suggest prophylactic anticoagulation is likely not warranted in the outpatient setting.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220180R2
      Issue No: Vol. 35, No. 6 (2022)
  • The Association Between Social Isolation and Memory Loss Among Older

    • Authors: Mosen, D. M; Banegas, M. P, Keast, E. M, Ertz-Berger, B. L.
      Pages: 1168 - 1173
      Abstract: Introduction:Social isolation among older individuals is associated with poor health outcomes. However, less is known about the association between social isolation and memory loss, specifically among Medicare enrollees in large, integrated health care systems.Methods:We conducted a cross-sectional, observational study. From a cohort of 46,240 Medicare members aged 65 years and older at Kaiser Permanente Northwest (KPNW) who completed a health questionnaire, we compared self-reported memory loss of those who reported feeling lonely or socially isolated and those who did not, adjusting for demographic factors, health conditions, and use of health services in the 12 months before the survey.Results:Patients who reported sometimes experiencing social isolation were more likely than those who rarely or never experienced social isolation to report memory loss in both unadjusted (odds ratio [ORsometimes]: 2.56, 95% CI= 2.42-2.70, P = 0.0076) and adjusted (ORsometimes: 2.45, 95% CI= 2.32-2.60, P = 0.0298) logistic regression models. Similarly, those who reported social isolation often or always were more likely to report memory loss than those who reported rarely or never experiencing isolation in both unadjusted (ORoften/always: 5.50, 95% CI = 5.06-5.99, P < 0.0001) and adjusted logistic regression models (ORoften/always: 5.20, 95% CI = 4.75-5.68, P < 0.0001).Conclusions:The strong association between social isolation and memory loss suggests the need to develop interventions to reduce isolation and to evaluate their effects on potential future memory loss.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.210497R2
      Issue No: Vol. 35, No. 6 (2022)
  • Factors Associated with Intention to Vaccinate Children 0-11 Years of Age
           Against COVID-19

    • Authors: Stockwell, M. S; Porucznik, C. A, Dixon, A, Duque, J, Stanford, J. B, Veguilla, V, Dawood, F. S.
      Pages: 1174 - 1178
      Abstract: Background:Millions of children have tested positive for SARS-CoV-2, and over 1000 children have died in the US. However, vaccination rates for children 5 to 11 years old are low.Methods:Starting in August 2020, we conducted a prospective SARS-CoV-2 household surveillance study in Spanish and English-speaking households in New York City and Utah. From October 21 to 25, 2021, we asked caregivers about their likelihood of getting COVID-19 vaccine for their child, and reasons that they might or might not vaccinate that child. We compared intent to vaccinate by site, demographic characteristics, SARS-CoV-2 infection detected by study surveillance, and parents’ COVID-19 vaccination status using Chi-square tests and a multivariable logistic regression model, accounting for within-household clustering.Results:Among parents or caregivers of 309 children (0 to 11 years) in 172 households, 87% were very or somewhat likely to intend to vaccinate their child. The most prevalent reasons for intending to vaccinate were to protect family and friends and the community; individual prevention was mentioned less often. The most prevalent reasons for not intending to vaccinate were side effect concerns and wanting to wait and see.In multivariable analysis, parents had much lower odds of intending to vaccinate if someone in the household had tested SARS-CoV-2-positive during the study (adjusted odds ratio = 0.09; 95% confidence interval, 0.03-0.3).Conclusion:This study highlighted several themes for clinicians and public health officials to consider including the importance and safety of vaccination for this age-group even if infected previously, and the benefits of vaccination to protect family, friends, and community.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220150R1
      Issue No: Vol. 35, No. 6 (2022)
  • Trust Takes Two...

    • Authors: Williamson, L. D; Thompson, K. M, Ledford, C. J. W.
      Pages: 1179 - 1182
      Abstract: Research throughout the COVID-19 pandemic, including investigations of resulting pandemic response strategies, evolving public health recommendations, and vaccine development, has highlighted the role of trust between physicians and patients. The focus, however, has largely been on patient trust in physicians. Although the importance of patient trust in physicians has long been recognized, physician trust in patients remains underappreciated. Physician trust in patients is an important factor in the physician-patient relationship. When physicians trust patients, patients can communicate freely, their experiences are validated, and trust may be engendered through reciprocal trust. Thus, a bidirectional approach to trust is necessary that acknowledges the role of physician trust in patients. We posit that shared trust is the dyadic factor that influences positive patient outcomes and is the foundation of shared decision making. Recognizing shared trust as an important outcome of the physician-patient relationship is a necessary step in evaluating how our practice, research, and education can influence or sow distrust of patients. In this commentary, we discuss the importance of attending to shared trust and physician trust in patients, particularly in family medicine.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220126R1
      Issue No: Vol. 35, No. 6 (2022)
  • The Impending Collapse of Primary Care: When is Someone Going to

    • Authors: Miller; W. L.
      Pages: 1183 - 1186
      Abstract: For 2 years, the Larry A. Green Center conducted weekly to monthly surveys among a national sample of primary medical care practices on how they were faring during the on-going COVID-19 pandemic in the United States. As both a family physician and as one of the analysts of these surveys and the thousands of detailed comments accompanying them, I witnessed a courageous, professional, and deeply distressing saga. The most recent surveys hint at an impending collapse of primary medical care as we have known it. This Commentary reflects what I heard, from remarkable efforts to rapidly implement virtual care platforms and reach out to vulnerable patients in the face of workforce losses and inadequate assistance including lack of personal protective equipment to a sense of betrayal when vaccines finally arrived but primary medical care was, too often, left out of the distribution efforts. The last surveys highlighted a loss of primary care workforce and the potential collapse of relationship-centered primary medical care. One of the respondents asks, "When is someone going to notice'"Three areas for change are recommended. Build a larger, more diverse primary medical care workforce. Emphasize capitation as a foundation for payment reform in primary medical care. Establish primary health care extension services that focus on supporting practices and in helping them integrate with public health and their communities. Listening to each other, let us rise together with our patients and be noticed.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220145R2
      Issue No: Vol. 35, No. 6 (2022)
  • Ready (or Not)--Here They Come

    • Authors: Hanrahan; K. D.
      Pages: 1187 - 1190
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220365R0
      Issue No: Vol. 35, No. 6 (2022)
  • Pandemic Disruption in Residency Did Not Alter Trends in Intended Scope of

    • Authors: Sonoda, K; Morgan, Z. J, Peterson, L. E.
      Pages: 1191 - 1193
      Abstract: We found the intended scope of practice remained unchanged in graduating family medicine residents between pre-pandemic and pandemic period. Tracking these trends with later cohorts will fully assess the pandemics’ impact on training so that residencies can adjust their education accordingly.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220081R1
      Issue No: Vol. 35, No. 6 (2022)
  • Practical Management of Lumps and Bumps of the Fingers, Hand, and Wrist

    • Authors: Gong, J. H; Mehrzad, R, Bhatt, R. A.
      Pages: 1194 - 1203
      Abstract: Background:Primary care physicians encounter many patients who present with lumps and bumps on their fingers, hands, and wrists. Some benign lesions including ganglion cysts, epidermal inclusion cysts, and giant cell tumors of the tendon sheath that are benign and can be managed by primary care clinicians most of the time in an outpatient setting.Methods:We conducted a narrative of review of literature on the clinical presentation, diagnosis, prognosis, and management of common types of lumps and bumps found on the fingers, hand, and wrist.Conclusions:Based on the literature review and our clinical practice, we provide indications for referral to plastic surgeons or other specialists for these lesions.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220028R2
      Issue No: Vol. 35, No. 6 (2022)
  • Spondylolysis and Isthmic Spondylolisthesis: A Guide to Diagnosis and

    • Authors: Mohile, N. V; Kuczmarski, A. S, Lee, D, Warburton, C, Rakoczy, K, Butler, A. J.
      Pages: 1204 - 1216
      Abstract: Introduction:Spondylolysis and isthmic spondylolisthesis are commonly implicated as organic causes of low back pain in this population. Many patients involved in sports that require repetitive hyperextension of the lumbar spine like diving, weightlifting, gymnastics and wrestling develop spondylolysis and isthmic spondylolisthesis. While patients are typically asymptomatic in mild forms, the hallmark of symptoms in more advanced disease include low back pain, radiculopathy, postural changes and rarely, neurologic deficits.Methods:We conducted a narrative review of the literature on the clinical presentation, diagnosis, prognosis and management of spondylolysis and isthmic spondylolisthesis.Results:A comprehensive physical exam and subsequent imaging including radiographs, CT and MRI play a role in the diagnosis of this disease process. While the majority of patients improve with conservative management, others require operative management due to persistent symptoms.Conclusion:Due to the risk of disease progression, referral to a spine surgeon is recommended for any patient suspected of having these conditions. This review provides information and guidelines for practitioners to promote an actionable awareness of spondylolysis and isthmic spondylolisthesis.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220130R1
      Issue No: Vol. 35, No. 6 (2022)
  • An Evidence-Based Review of Vitamin D for Common and High-Mortality

    • Authors: Michael, W; Couture, A. D, Swedlund, M, Hampton, A, Eglash, A, Schrager, S.
      Pages: 1217 - 1229
      Abstract: Background:Vitamin D is a fat-soluble vitamin available from food and sun exposure. Vitamin D receptors are present in cells throughout the body and cause it to act like a hormone. Observational studies document the association of low vitamin D levels with multiple health conditions. This article reviews the evidence for vitamin D in prevention and treatment in primary care.Methods:We performed a literature review of randomized controlled trials, meta-analyses, systematic reviews, and large prospective trials looking at the role of vitamin D deficiency in the most common conditions seen in primary care and the top 10 causes of mortality since 2010.Results:Vitamin D supplementation in patients with known cardiovascular disease does not reduce risk of stroke or heart attack. Vitamin D supplementation does not seem to have an effect in the treatment of hypertension or in cancer prevention. There is emerging evidence that supplementation reduces COVID-19 severity and risk of mechanical ventilation. Vitamin D at more moderate levels may reduce the risk of falls, but higher doses may cause increased fall risk. There does not seem to be a link between vitamin D supplementation and improved cognition. Vitamin D supplementation may be helpful in patients with major depression. High dose vitamin D may improve pain in people with fibromyalgia. Supplementing patients with prediabetes reduced the risk of progression to type 2 diabetes mellitus. Vitamin D supplementation in addition to standard emollient treatment helped to reduce symptoms in people with atopic dermatitis.Conclusion:Prospective studies of vitamin D supplementation demonstrate variable impact on disease specific and patient-oriented outcomes, suggesting a correlation but not a causal relationship between low vitamin D levels and disease pathogenicity. Future research should determine dosing standards and timing of vitamin D in treatment and prevention.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220115R1
      Issue No: Vol. 35, No. 6 (2022)
  • A General Framework for Exploring Ethical and Legal Issues in Sports

    • Authors: Lennon, R. P; Day, P. G, Marfin, E. C, Onks, C. A, Silvis, M. L.
      Pages: 1230 - 1238
      Abstract: Background:Medicolegal dilemmas faced by Sports Medicine providers differ from those of other primary care physicians in type and frequency. Exotic, high-profile challenges are widely covered in the literature and offer guidance on how to navigate challenging situations. However, there is a gap in the literature on how to approach more mundane, but nevertheless common, medicolegal dilemmas.Purpose:The purpose of this article is to provide Sports Medicine providers simple tools for determining whether a course of action is legal or ethical and offer Sports Medicine educators a model for teaching these skills.Methods:We searched U.S. federal and state law using the LexisNexis® database for laws regulating Sports Medicine practice, and PubMed for articles related to physician approaches to Sports Medicine legal and ethical challenges. Searches started with the term sports medicine, and included winnowing terms of ethics, ethical practice, ethical guidelines, law, and legal guidelines. We used current ethical practice guidelines followed by the American Medical Association and described in detail by Beauchamp and Childress.Results:We offer a framework for how to approach legal challenges in Sports Medicine and apply it to four common scenarios that Sports Medicine physicians often face. We further suggest that the profession formally address this literature gap with a standardized curriculum in Sports Medicine law.Conclusion:A curriculum using this framework and clinical vignettes provides learners and practitioners with familiarity and confidence when legal and ethical challenges arise in Sports Medicine.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220208R1
      Issue No: Vol. 35, No. 6 (2022)
  • Addressing and Dismantling the Legacy of Race and Racism in Academic
           Medicine: A Socioecological Framework

    • Authors: Edgoose, J. Y. C; Carvajal, D. N, Reavis, K. M. P, Yogendran, L, Echiverri, A. T, Rodriguez, J. E.
      Pages: 1239 - 1245
      Abstract: Over the past several years, in both clinical and academic medicine, there seems to be a growing consensus that racial/ethnic health inequities result from social, economic and political determinants of health rather than from nonexistent biological markers of race. Simply put, racism is the root cause of inequity, not race. Yet, methods of teaching and practicing medicine have not kept pace with this truth, and many learners and practitioners continue to extrapolate a biological underpinning for race. To achieve systemic change that moves us toward racially/ethnically equitable health outcomes, it is imperative that medical academia implement policies that explicitly hold us accountable to maintain a clear understanding of race as a socio-political construct so that we can conduct research, disseminate scholarly work, teach, and practice clinically with more clarity about race and racism. This short commentary proposes the use of a socioecological framework to help individuals, leadership teams, and institutions consider the implementation of various strategies for interpersonal, community-level, and broad institutional policy changes. This proposed model includes examples of how to address race and racism in academic medicine across different spheres, but also draws attention to the complex interplay across these levels. The model is not intended to be prescriptive, but rather encourages adaptation according to existing institutional differences. This model can be used as a tool to refresh how academic medicine addresses race and, more importantly, normalizes conversations about racism and equity across all framework levels.
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220050R2
      Issue No: Vol. 35, No. 6 (2022)
  • Re: Impact of Geodemographic Factors on Antibiotic Prescribing for Acute,
           Uncomplicated Bronchitis or Upper Respiratory Tract Infection

    • Authors: Mainous; A. G.
      Pages: 1246 - 1246
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220260R0
      Issue No: Vol. 35, No. 6 (2022)
  • A Leadership Challenge: Providing Hope for Our Patients, Practices and

    • Authors: Newton, W. P; Michelfelder, A, Stutzman, K, Critchlow, R, Wergin, R.
      Pages: 1247 - 1248
      PubDate: 2022-12-23T10:41:35-08:00
      DOI: 10.3122/jabfm.2022.220364R0
      Issue No: Vol. 35, No. 6 (2022)
  • Author Index to Volume 35, 2022

    • Pages: 1249 - 1256
      PubDate: 2022-12-29T07:24:23-08:00
      Issue No: Vol. 35, No. 6 (2022)
  • Subject Index to Volume 35, 2022

    • Pages: 1257 - 1270
      PubDate: 2022-12-29T07:24:23-08:00
      Issue No: Vol. 35, No. 6 (2022)
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