Family medicine research: seizing the moment to advance the field.

Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.

Trial sequential analysis involving same-year studies requires careful temporal ordering.

Trial sequential analysis (TSA) is an increasingly used tool in systematic reviews to monitor synthesized evidence. However, the current practice of TSAs often overlooks the order of same-year studies, which are typically ordered alphabetically based on the last names of the studies' authors by default in the widely used TSA software application. This practice is inappropriate and contrary to the TSA's definition.

Global impact of ten-valent and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal disease in all ages (the PSERENADE project): a global surveillance analysis.

Background: Pneumococcal conjugate vaccines (PCVs) that are ten-valent (PCV10) and 13-valent (PCV13) became available in 2010. We evaluated their global impact on invasive pneumococcal disease (IPD) incidence in all ages.

Methods: Serotype-specific IPD cases and population denominators were obtained directly from surveillance sites using PCV10 or PCV13 in their national immunisation programmes and with a primary series uptake of at least 50%.

Associations of early life per- and polyfluoroalkyl substances (PFAS) exposure with body mass index and risk of overweight or obesity at age 2-18 years: Mixture analysis in the prospective Boston Birth Cohort.

Background: Per- and polyfluoroalkyl substances (PFAS) are a class of widespread persistent chemicals, which may have obesogenic effects during the fetal period. This study investigated the long-term association of maternal plasma PFAS concentrations at delivery and their mixture with child body mass index (BMI) and the risk of Overweight or Obesity (OWO) at the age of 2-18 years.

Methods: The study included 1189 mother-child dyads from the prospective Boston Birth Cohort.

Transmission models of respiratory infections in carceral settings: A systematic review.

Background: The prevention and control of infectious disease outbreaks in carceral settings face unique challenges. Transmission modeling is a powerful tool for understanding and addressing these challenges, but reviews of modeling work in this context pre-date the proliferation of outbreaks in jails and prisons during the SARS-CoV-2 pandemic. We conducted a systematic review of studies using transmission models of respiratory infections in carceral settings before and during the pandemic.

Understanding human papillomavirus vaccine response and efficacy in people living with HIV: A systematic mixed studies review and meta-analysis.

Coinfection with human papillomavirus (HPV) and HIV compounds the risks of developing cervical, anal, and HPV-associated oral neoplasia. Safe prophylactic vaccines are available to prevent HPV infections in people with HIV(PWH). Yet, vaccine efficacy and duration of protection remain questionable.

Glucose Abnormalities Detected by Continuous Glucose Monitoring in Very Old Adults With and Without Diabetes.

Objective: To characterize the prevalence of continuous glucose monitoring (CGM)-defined glucose abnormalities in a large, community-based population of very old adults (>75 years).

Research Design And Methods: A cross-sectional analysis of 1,150 older adults with and without diabetes who attended the Atherosclerosis Risk in Communities Study (2021-2022). Diabetes was based on a self-reported diagnosis of diabetes by a health care provider, use of diabetes medication, or a hemoglobin A1c (HbA1c) ≥6.

A randomized, double-blind, placebo-controlled study of a GHSR blocker in people with alcohol use disorder.

BACKGROUNDStudies have demonstrated the role of ghrelin in alcohol-related behaviors and consumption. Blockade of the growth hormone secretagogue receptor (GHSR), which is the ghrelin receptor, has been shown to decrease alcohol drinking and reward-related behaviors across several animal models. We previously conducted a human study testing a GHSR inverse agonist/competitive antagonist, PF-5190457, in individuals who are heavy drinkers and showed its safety when coadministered with alcohol.

Impact of COVID-19 on the utilisation of maternal and child health services in Peru at national and subnational levels: An interrupted time series analysis.

Background: The resilience of Peru´s health system was weakened by a political crisis that started in 2016 and was further challenged by the coronavirus 2019 (COVID-19) pandemic. We assessed the indirect impact of the pandemic on the utilisation of essential maternal and child health (MCH) services in Peru at national and subnational levels.

Methods: We assessed the trends in MCH services utilisation and the percentage change from 2018 to 2021, using routine health facility data.

A meta-synthesis of the cycle of financial strain, coping behaviors and health outcomes across the life course.

Background: The lived experience and impact of financial strain on broad physical and mental health outcomes is important and yet underexplored. Improving our depth of understanding of the relationship between financial strain and health may offer important insights to address this complex phenomenon.

Objective: The primary objective of this study was to conduct a meta-synthesis of existing qualitative literature that investigated or described the relationship between financial strain and health outcomes.

Multimorbidity patterns, sociodemographic characteristics, and mortality: Data science insights from low-resource settings.

Multimorbidity data is typically analysed by tallying disease counts, which overlooks nuanced relationships among conditions. We identified clusters of multimorbidity and subpopulations with varying risks and examined their association with all-cause mortality using a data-driven approach. We analysed 8-year follow-up data of people ≥35 years who were part of the CRONICAS Cohort Study, a multisite cohort from Peru.

COVID-19 Epidemiology in Fragile Contexts: A Descriptive Analysis of COVID-19 in Host Communities in Cox's Bazar, Bangladesh During the First Year of the Pandemic.

Objectives: In 2020, COVID-19 modeling studies predicted rapid epidemic growth and quickly overwhelmed health systems in humanitarian and fragile settings due to preexisting vulnerabilities and limited resources. Despite the growing evidence from Bangladesh, no study has examined the epidemiology of COVID-19 in out-of-camp settings in Cox's Bazar during the first year of the pandemic (March 2020-March 2021). This paper aims to fill this gap.

Longitudinal anemia status and risk for adverse outcomes in former smokers with COPD.

Background: Anemia is a prevalent comorbidity in COPD associated with increased morbidity. However, the significance of longitudinal anemia status and variation in anemia status trends over time in COPD are not known. Furthermore, individuals with COPD and smoking history often have multiple comorbidities, in particular cardiovascular disease.

Multiple material need insecurities and severity of psychological distress during the COVID-19 pandemic among women who use drugs.

Background: The COVID-19 pandemic highlighted the salience of material needs and financial precarity on mental health and distress. Women who use drugs (WWUD) experienced significant mental distress and multiple material need insecurities before the pandemic. However, research is limited on the nature of these insecurities during the pandemic despite both material scarcity and mental distress placing WWUD at greater risk of drug-related harms such as overdose.

Revisiting cost-effectiveness of folic acid supplementation in primary stroke prevention in China: considering vitamin B12 deficiency masking issue.

Objectives: To identify the cost-effectiveness of four policy options related to folic acid supplements after considering the side effects of masking vitamin B12 (B12) deficiency in primary stroke prevention for hypertensive patients in China.

Study Design: A cost-effectiveness analysis.

Methods: Four policies were considered: Policy A, Do nothing to address folate status in hypertensive patients at risk for stroke; Policy B, Folate supplementation without pre-screening for vitamin B12 deficiency; Policy C, Folate supplementation with pre-screening all patients for B12 deficiency and add B12 supplements if B12 is deficient; and Policy D, Folate supplementation only for those whose folate is deficient, pre-screen all patients for both B12 and folate deficiencies and add B12 supplements if B12 is deficient.

Viral Acute Lower Respiratory Tract Infections (ALRI) in Rural Bangladeshi Children Prior to the COVID-19 Pandemic.

Background: Acute lower respiratory tract infections (ALRIs) remain the leading infectious cause of death among children < 5 years, with viruses contributing to a large proportion of cases. Little is known about the epidemiology and etiology of viral ALRI in rural Bangladesh.

Methods: We enrolled 3- to 23-month-old children with ALRIs attending a subdistrict hospital outpatient clinic in Sylhet district in Bangladesh.

Demographic and clinical risk factors of developing clinically-recognized varicose veins in older adults.

Introduction: Varicose veins are common in older adults and are associated with adverse clinical outcomes such as deep venous thrombosis. Established risk factors for varicose veins include female sex, height, and obesity, but other risk factors are relatively uncharacterized.

Methods: This was a prospective cohort analysis of 6241 participants aged 66-70 years from the Atherosclerosis Risk in Communities (ARIC) Study.

Impact of late rainy season indoor residual spraying on holoendemic malaria transmission: a cohort study in northern Zambia.

Background: Indoor residual spraying (IRS) is a malaria control strategy implemented before the rainy season. Nchelenge District, Zambia is a holoendemic setting where IRS has been conducted since 2008 with little impact on malaria incidence or parasite prevalence. Pre-rainy season IRS may not reduce the post-rainy season peak abundance of the major vector, Anopheles funestus.

Location Preferences for Accessing Long-Acting Injectable Pre-Exposure Prophylaxis (LA-PrEP) Among Men Who Have Sex With Men (MSM) Currently on Daily Oral PrEP.

We investigated men who have sex with men's (MSM) location preferences for long-acting injectable pre-exposure prophylaxis (LA-PrEP). MSM ( = 1076) who completed the 2021 American Men's Internet Survey, were currently prescribed oral PrEP, and expressed LA-PrEP interest reported location preferences for receiving LA-PrEP: healthcare provider (HCP) setting, pharmacy, or at-home. HCP settings were preferred by 60% of participants; 26% preferred home and 14% preferred pharmacy.

Placental Pathology and Blood Pressure at Age 7: A Longitudinal Discordant Twin Analysis.

Background: Evidence suggests that the intrauterine environment shapes offspring cardiovascular disease risk. Although placental dysfunction may be an important pathophysiologic pathway, numerous parental and pregnancy characteristics that influence offspring blood pressure are strong confounders of the mechanistic role of the placenta in observational analyses of singletons. Therefore, we leverage twin- and sibling-based comparison designs to determine whether placental pathology is associated with offspring blood pressure at age 7 while mitigating major sources of confounding.