Annals of family medicine
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Annals of family medicine · Apr 2022
The role of Canadian family physicians in the response to the COVID-19 pandemic.
Context: In Canada, most medical care is delivered through front line, first contact primary care. As nations traverse the most significant health event in a century, it is important to understand how primary care has been engaged in the challenge. Objective: Assess the patterns of direct clinical patient care involvement of Canadian family physicians (FPs) in the response to the COVID-19 pandemic by province, age, remuneration model, and practice setting. ⋯ Conclusions: While most family physicians have been involved in the COVID-19 response, discrepancies exist across jurisdiction, ages, remuneration types, and practice models. These results suggest that there were obstacles to the full involvement of Canada's primary care system in the response to the pandemic. Evidence generated by this study points to factors that could enable a more responsive future primary health care system.
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Annals of family medicine · Apr 2022
Understanding culturally tailored approaches in males of punjabi ancestry with alcohol use disorder at Roshni Clinic.
1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. ⋯ Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC's Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers.
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Annals of family medicine · Apr 2022
Increased use of birth interventions during the COVID-19 pandemic?: An exploratory qualitative study.
Context: Since the onset of the COVID-19 pandemic policies have been implemented to limit disease transmission and manage patient flow in clinical settings, including perinatal healthcare settings. Emergent literature indicates increased medicalization of childbirth during the pandemic, however experiences of pregnancy and birth remain unexplored. Understanding the impact of pandemic policies on healthcare practices is important for planning better care in future. ⋯ Conclusions: For some people in Canada, giving birth during the COVID-19 pandemic entails medicalization and implementation of non-medically necessary interventions. If healthcare systems are increasing intervention use at the same time that the "safety net" intended to catch the complications from those interventions is reduced, then birthing people are being exposed to extra risk precisely when it is most important to minimize it. Continuity of care throughout pregnancy and postpartum, labour support persons, and non-medical forms of care are all essential components of safe maternal healthcare, however pandemic perinatal care demonstrates that they are not viewed as such.
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Annals of family medicine · Apr 2022
ReviewCommunity-based physical activity and/or nutrition interventions to promote mobility in older adults: An umbrella review.
Background: Physical activity and a healthy diet are important in helping to maintain mobility and quality of life with aging. Delivery of physical activity and nutrition interventions in a group setting adds the benefits of social participation. Several published systematic reviews have explored a broad range of PA and/or nutrition interventions for older adults, making it challenging to bring together the best scientific evidence to inform program design and to inform multicomponent intervention development. ⋯ There was no evidence of benefit for nutritional supplementation with physical activity. Conclusions: Multicomponent group-based physical activity interventions can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.
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Annals of family medicine · Apr 2022
Multimorbidity and frailty in middle-aged adults with type 2 diabetes mellitus.
Context: Frailty and multimorbidity are common in type 2 diabetes, including in middle-aged people (<65 years). Clinical guidelines recommend adjustment of treatment targets in people with frailty or multimorbidity. However, guidelines do not specify how frailty/multimorbidity should be identified. ⋯ For the frailty phenotype, the relationship between HbA1c and mortality was steeper and more linear in frail compared with pre-frail or robust participants. Conclusion: Assessment of frailty/multimorbidity should be embedded within routine management of middle-aged and older people with type 2 diabetes. Method of identification as well as features such as age impact baseline risk and should influence clinical decisions (eg. glycaemic control).