Aggerholmmortensen2302

This article has an associated First Person interview with the first author of the paper.

To explore the perceptions and experiences of FPs with emerging adult (EA) mental health to inform opportunities for improvement in EA mental health care.

Constructivist grounded theory methodology, including theoretical sampling and constant comparative analysis of data to synthesize results.

Southwestern Ontario.

Twenty practising FPs.

In-depth, semistructured, in-person interviews, which were audiorecorded and transcribed verbatim.

Family physicians recognized the unique situation of EAs being between adolescence and adulthood, having heavy psychosocial needs, and lacking a connection to the health care system. Experience and confidence are needed to treat the EA population, but provision of mental health care to EAs is influenced by resources, knowledge, and communication. Family physicians noted that they are the default physician while EAs wait for specialized care, and are often the physicians that the patient is referred back to after specialized care. Often, the FP knows and treats the EA's entire family, which participants described as enabling them to understand the EA's unique context.

Family physicians and EAs are "lost together" in a fragmented health care system. Family physicians have the unique potential to assist EAs with their mental health needs, but that is not being actualized. Family physicians can support mental health outcomes for EAs through an improvement in knowledge and skills, and through forming family practice teams.

Family physicians and EAs are "lost together" in a fragmented health care system. Family physicians have the unique potential to assist EAs with their mental health needs, but that is not being actualized. Family physicians can support mental health outcomes for EAs through an improvement in knowledge and skills, and through forming family practice teams.Question If a child presents to my office with several days of fever and a few features of Kawasaki disease (KD) but does not meet the diagnostic criteria, could they still have KD and is treatment needed?Answer Presentations of KD have a range of clinical signs and symptoms. With the lack of a criterion standard test, the diagnosis of KD relies on syndrome recognition and a high index of suspicion in cases where KD does not present classically. It is still possible to have KD even if not all of the criteria are met, and these children are referred to as having incomplete forms of KD. The diagnosis of incomplete KD is usually made in a child or infant who presents with a history of prolonged fever, a few clinical criteria for KD, and other supportive features such as positive laboratory or echocardiographic findings. It is important to recognize children with incomplete forms of KD to avoid poor outcomes such as coronary artery aneurysms.

To guide family physicians working in a range of primary care clinical settings on how to provide care and support for patients who are vulnerably housed or experiencing homelessness.

The approach integrates recommendations from evidence-based clinical guidelines, the views of persons with lived experience of homelessness, the theoretical tenets of the Patient's Medical Home framework, and practical lessons learned from family physicians working in a variety of clinical practice settings.

Family physicians can use simple and effective approaches to identify patients who are homeless or vulnerably housed; take initial steps to initiate access to housing, income assistance, case management, and treatment for substance use; and work collaboratively using trauma-informed and anti-oppressive approaches to better assist individuals with health and social needs. Family physicians also have a powerful advocacy voice and can partner with local community organizations and people with lived experience of homelessness to advocate for policy changes to address social inequities.

Family physicians can directly address the physical health, mental health, and social needs of patients who are homeless or vulnerably housed. Moreover, they can champion outreach and onboarding programs that assist individuals who have experienced homelessness in accessing patient medical homes and can advocate for broader action on the underlying structural causes of homelessness.

Family physicians can directly address the physical health, mental health, and social needs of patients who are homeless or vulnerably housed. Selleck RMC-4630 Moreover, they can champion outreach and onboarding programs that assist individuals who have experienced homelessness in accessing patient medical homes and can advocate for broader action on the underlying structural causes of homelessness.Glioma stem-like cells (GSC) in glioblastoma (GBM) structure tumor cells into a hierarchical organization and are postulated to be recalcitrant to conventional treatments, resulting in fatal relapse of the disease. A better understanding of these cells would be essential for meaningful and lasting treatments. In this issue of Cancer Research, Virolle and colleagues report a fascinating phenotype whereby the extracellular signal-regulated kinase (ERK) pathway regulates a mechanism of dedifferentiation of GBM cells into a stem-like state expressing markers of pluripotency through an EGFR-ERK-EGR1-dependent axis. This aptly termed "toggle switch" may contribute to maintenance of GSCs, promote intratumor heterogeneity, and potentially provide innovative treatment options.See related article by Almairac et al., p. 3236.Senescent cells release a mélange of factors that drive multiple forms of pathology, including cancer aggressiveness. In this issue of Cancer Research, Han and colleagues show that small extracellular vesicles (sEV), membrane-enclosed bubbles that carry signaling molecules, from senescent stromal cells can promote tumorigenesis and multidrug resistance in prostate or breast cancer cells. They find that loss of SIRT1 activity drives senescence-associated sEV release, and treatment with a SIRT1 agonist prevented this effect. This adds another mechanism by which senescent cells can promote tumorigenesis and offers another activity of senescent cells that might be targeted to limit the spread of cancer.See related article by Han et al., p. 3383.