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Full-Text Articles in Medicine and Health Sciences

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips, Alberto Coustasse, Sara Johnson, Briana Washington Nov 2018

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips, Alberto Coustasse, Sara Johnson, Briana Washington

Alberto Coustasse, DrPH, MD, MBA, MPH

Needle Exchange Programs (NEPs) have been controversial aspects of public health care due to conflicting beliefs and opinions for public policies. NEPs have allowed Injection Drug Users the ability to exchange their used equipment for clean, unused supplies. Research into the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. Injection Drug Users have accounted for 10% of HIV transmission cases in West Virginia, and this state has been ranked as the highest in the whole United States for incidents of Hepatitis C. NEPs …


Putting The Patient Back In Patient Care: Health Decision-Making From The Patient’S Perspective, Bill R. Garris, Amy J. Weber Oct 2018

Putting The Patient Back In Patient Care: Health Decision-Making From The Patient’S Perspective, Bill R. Garris, Amy J. Weber

Bill R. Garris

This research explored health decision-making processes among people recently diagnosed with type 2 diabetes. Our analysis suggested that diagnosis with type 2 was followed by a period of intense emotional and cognitive disequilibrium. Subsequently, the informants were observed to proceed to health decision-making which was affected by three separate and interrelated factors: knowledge, self-efficacy, and purpose. Knowledge included cognitive or factual components and emotional elements. Knowledge influenced the degree of upset or disequilibrium the patient experienced, and affected a second category, agency: the informants’ confidence in their ability to enact lifestyle changes. The third factor, purpose, summarized the personal and …


The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips Aug 2018

The Effectiveness Of Needle Exchange Programs In The United States And West Virginia, Margie J. Phillips

Margie J. Phillips

Needle Exchange Programs (NEPs) have been controversial aspects of public health care due to conflicting beliefs and opinions for public policies. NEPs have allowed Injection Drug Users the ability to exchange their used equipment for clean, unused supplies. Research into the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. Injection Drug Users have accounted for 10% of HIV transmission cases in West Virginia, and this state has been ranked as the highest in the whole United States for incidents of Hepatitis C. NEPs …


Medico-Legal Collaboration Regarding The Sex Offender: Othering And Resistance, Mary Lay Schuster, Brian Larson, Amy D. Propen Apr 2018

Medico-Legal Collaboration Regarding The Sex Offender: Othering And Resistance, Mary Lay Schuster, Brian Larson, Amy D. Propen

Brian Larson

We examined medico-legal collaboration regarding dangerous sex offenders where state legislators have adopted statutes that determine the criteria for commitment to and discharge from civil commitment programs. The application of these statutes relies on medical diagnoses of pathologies such as paraphilia, anti-social personality disorder, and pedophilia along with prognoses for cure or recidivism. In our study, we examined court opinions from commitment hearings and observed a trial in federal court on the constitutionality of these commitments. We found that one result of this medico-legal collaboration is the marginalization or othering of sex offenders by essentializing, dividing, shaming, and impeaching them. …


Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson Feb 2018

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Deborah Simpson, PhD

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …


Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson Feb 2018

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Will Lehmann, MD

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …


Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh Feb 2018

Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh

Adrienne M. Mays-Kingston

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program.

We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included.

This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.


Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh Feb 2018

Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh

Dilip Nair

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program.

We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included.

This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.


Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell Feb 2018

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Jacob Bidwell, MD

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.


Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo Feb 2018

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Fabiana Kotovicz, MD

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …


Every Word, Every Gesture, Dennis J. Baumgardner Jan 2018

Every Word, Every Gesture, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Two nonverbal patients teach a novice clinician the power and often hidden impact of the physician-patient relationship.


The Value In Verifying Medical Folklore, Dennis J. Baumgardner Jan 2018

The Value In Verifying Medical Folklore, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Citing a related article published within this issue of the Journal of Patient-Centered Research and Reviews, the author opines on why traditional ideas regarding human health can persist over decades, and even centuries, despite a lack of scientifically accumulated evidence. It is important to keep in mind that some commonly accepted truths are supported by little to no factual data, and that occasionally patients may benefit from clarification on what is (or, often, is not) actually known about longstanding “rules of thumb” (eg, certain home remedies, disease-prevention measures or behavioral concerns). On the flip side, traditions that are shown to …