ABSTRACT Background The scope of primary care cancer research on the island of Ireland has not been clearly mapped, despite primary care's pivotal role across the cancer care continuum. Methods We conducted a systematic search of studies from the Republic of Ireland (RoI) and Northern Ireland (NI) up until October 2022 and summarized the literature using bibliometric analysis and narrative synthesis. From 3911 screened abstracts, 100 eligible outputs were identified: 60 journal articles, 38 conference abstracts, and 2 doctoral theses. Most papers (92%) were published after 2000. Results Research output from NI and the RoI was proportional to population size; only one cross‐border study was identified. Study designs were predominantly comparative observational (51%), with fewer non‐comparative observational (23%), qualitative (23%), and experimental studies (3%). The most frequently studied cancers were cervical, breast, prostate, lung, and colorectal. Conclusion This review provides a foundation for strategically directing future primary care cancer research in Ireland.
ABSTRACT Background Medical nutrition therapy (MNT) provided by registered dietitians is effective for managing non‐communicable diseases, but patient discontinuation remains common in clinical practice. Studies examining the timing and predictors of MNT discontinuation are limited. This study aimed to identify the timing and patient factors associated with MNT discontinuation in primary care settings. Methods This single‐center retrospective cohort study included patients who initiated outpatient MNT at a primary care clinic between April 2018 and March 2023. Patients aged < 18 years and those with cancer‐ or malnutrition‐related conditions were excluded. Discontinuation was defined as no MNT visit or scheduled appointment within 3 months after the last visit. Patients were followed for up to 24 months through March 2025. Kaplan–Meier analysis estimated continuation rates, and multivariable cause‐specific Cox proportional hazards models identified factors associated with discontinuation. Multiple sensitivity analyses were performed. Results Among 470 patients (median age, 63 years; 59.4% women), 241 (51.3%) discontinued MNT during follow‐up. Median time to discontinuation was 15 months (95% confidence interval [CI], 12–21). Continuation rates were 88.3% at 3 months, 70.4% at 6 months, and 43.5% at 24 months. Obesity, dyslipidemia, and medication use were associated with lower discontinuation risk, whereas complications, living with family, and preparation stage of behavior change were associated with higher risk. Sensitivity analyses confirmed the robustness of the results. Conclusions MNT continuation declined rapidly within 6 months. Multiple patient factors were associated with discontinuation risk, suggesting the need for early risk identification and individualized support strategies.
ABSTRACT Background Obesity is a major modifiable risk factor for Type 2 Diabetes Mellitus (T2DM), and Indonesia ranks fifth in the prevalence of diabetes worldwide, coupled with the increasing rate of youth obesity. This phenomenological study explored adolescent obesity as a high‐risk group within Indonesia's collectivistic cultural context to generate qualitative insights that may inform culturally grounded, family‐ and peer‐supported interventions for T2DM prevention. The study does not evaluate the effectiveness of any specific intervention. Methods Conducted in Surakarta, Central Java, Indonesia (March 2021–April 2022), the study recruited 11 adolescents, 11 parents, and 9 peers from four primary care clinics using purposive sampling until data saturation. Data were gathered through in‐depth interviews and analyzed using Colaizzi's method. Results The majority of adolescents reported being more concerned about their appearance than about their health. The findings also indicated that all groups had limited awareness of T2DM risks. Adolescents perceived intimate relationships as important in shaping healthy lifestyle choices. Peers offered emotional support and encouragement for healthier behaviors, while parents were described as supervising diet and promoting physical exercise. Conclusions The findings suggest that health education could potentially address adolescents' appearance‐related concerns as an initial entry point to enhance engagement. For Indonesian adolescents to effectively avoid obesity and lower their risk of T2DM, strategies involving peers and parents may be an important consideration; however, these are presented as implications derived from the qualitative findings, rather than as interventions whose effectiveness has been demonstrated. Future research is needed to empirically test such culturally tailored approaches.
ABSTRACT Background This exploratory study aimed to identify factors associated with care workers' perceived difficulty in collaborating with nurses regarding bowel care in dementia group homes (GHs) in Japan. Methods We conducted a nationwide cross‐sectional survey from July to October 2025. Using stratified random sampling, questionnaires were mailed to 2000 of 14,202 GHs listed in national open data. Of 437 responses (21.9%), 423 from care workers were included. Perceived difficulty was rated on a 0–10 numeric rating scale and dichotomized as difficulty (scores 6–10) or no difficulty (scores 0–5). Group comparisons and multivariable binary logistic regression were performed. Missing covariates were multiply imputed. A sensitivity analysis treated perceived difficulty as a continuous outcome. Results Of the 417 respondents with valid outcome data, 182 (43.6%) reported difficulty. Four factors were significantly associated with perceived difficulty. Older age (adjusted odds ratio [aOR] = 1.044, 95% confidence interval [CI]: 1.020–1.069), a stronger belief in the importance of abdominal warming (aOR = 1.222, 95% CI: 1.077–1.386), and greater uncertainty about when to report bowel‐related concerns to nurses (aOR = 1.282, 95% CI: 1.175–1.398) were associated with higher odds of perceived difficulty. Longer caregiving experience (aOR = 0.939, 95% CI: 0.906–0.973) was associated with lower odds. Sensitivity analysis produced similar results. Conclusions Higher perceived difficulty was associated with older age, shorter caregiving experience, and uncertainty regarding the appropriate timing of consultation with nurses. Clarifying when care workers should seek nursing input may support more effective collaboration in bowel care.
ABSTRACT Background Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo encountered in general practice. The definitive diagnosis relies on the Dix‐Hallpike test (DHT), which remains underperformed in primary care due to limited training and unfamiliarity among general practitioners. Aim To develop the color‐bar bedsheet as a simple visual positioning guide for DHT and demonstrate its usefulness. Design and Setting After the color‐bar bedsheet was developed, a prospective within‐subject comparative design in healthy participants was conducted. Methods Healthy adult subjects with 141–190 cm height were recruited. Each examiner performed the DHT with and without bedsheet. The proportion of the appropriate position and the satisfaction of subjects and examiners were compared. Results Sixty subjects and 12 examiners were enrolled. Subjects' average age was 37.8 ± 15.0 years and average BMI was 22.5 ± 3.6 kg/m 2 . The DHT with the bedsheet showed significantly better appropriate positions when compared to the group without using the bedsheet (65% vs. 18.33%, p < 0.001), with the odds ratios (OR) of 8.27. Also, there was significantly higher satisfaction of subjects and examiners in DHT with the bedsheet, compared to DHT without the bedsheet ( p < 0.001). Conclusions The DHT with the color‐bar bedsheet provided an 8 times higher chance of appropriate position (particularly in individuals under 170 cm in height) with better satisfaction of both examiners and subjects. The bedsheet could be used as an assistive tool for the DHT, especially for novice examiners, in order to increase the diagnostic yield of BPPV in primary care settings.
