Health Equity: The Only Path Forward for Primary Care.

The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report on Implementing High-Quality Primary Care identifies 5 high-level objectives regarding payment, access, workforce development, information technology, and implementation. Nine junior primary care leaders (3 internal medicine, 3 family medicine, 3 pediatrics) invited from broad geographies, practice settings, and academic backgrounds used appreciative inquiry to identify priorities for the future of primary care. Highlighting the voices of these early career clinicians, we propose a response to the report from the perspective of early career primary care physicians. Health equity must be the foundation of the future of primary care. Because Barbara Starfield's original 4 Cs (first contact, coordination, comprehensiveness, and continuity) may not be inclusive of the needs of under-resourced communities, we promote an extension to include 5 additional Cs: convenience, cultural humility, structural competency, community engagement, and collaboration. We support the NASEM report's priorities and its focus on achieving health equity. We recommend investing in local communities and preparatory programs to stimulate diverse individuals to serve in health care. Finally, we support a blended value-based care model with risk adjustment for the social complexity of our patients.Appeared as Annals "Online First" article.

Obesity and elevated blood pressure in suburban student athletes.

OBJECTIVE: To assess the prevalence of obesity and elevated blood pressure in a suburban population of middle school and high school student athletes and examine the differences from the previously published populations. STUDY DESIGN: The Student Athlete Cardiac Evaluation Registry Study is a single-centre, community hospital-based registry study, that provided free annual preparticipation physical examinations (PPE) from 2009 to 2017. The PPE on the 906 athletes included a history, a physical examination and body metrics including height, weight and blood pressure. The blood pressure was measured with an automated blood pressure cuff and, if elevated, was remeasured using a manual blood pressure cuff with aneroid manometer. The data from the PPE were collected and analysed for prevalence of obesity, overweight and elevated blood pressure measurements. RESULTS: The prevalence of obesity was 11%, and 19% of participants were overweight. Many of the athletes had an elevated blood pressure (15%). There was a significant association (P<0.001) between weight and elevated blood pressure. Among athletes with elevated blood pressure, 50% were either obese or overweight. CONCLUSIONS: There was a similar prevalence of overweight athletes in our study compared with previously published populations, but there were a lower proportion of obese athletes, which may be explained by differences in demographics. Despite the differences in study populations and the lower rate of obesity, the proportion of athletes with elevated blood pressure in our study was similar to prior populations. Weight issues and elevated blood pressure affect athletes across a range of different populations.

Positive and Negative Themes Found in Superhero Films.

Superhero films have become incredibly popular. The objective of this study was to determine the positive and negative themes found in a select number of superhero films. A total of 30 superhero films were analyzed. The average numbers of positive and negative themes were 19.4 and 29.5 mean events per hour for all included films, respectively. The most common positive themes were "assisting others/protecting the public," "positive relationships with family/friends," and "teamwork/collaboration." The most common negative themes were "acts of violence/fighting," "use of guns/knives/lethal weapons," and "bullying/intimidation/torture." Based on the superhero films included in our study, the number of negative themes, especially acts of violence, outweighs positive themes. Although an exposure to positive themes found in superhero films may be beneficial to the development of children, pediatric health care providers should counsel children and their families in an attempt to limit their exposure to violence.