Medicine and Health Sciences Commons^™

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Aurora Family Medicine Residents

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Identifying Disparities In Colorectal Cancer Screening Rates In Milwaukee-Based Academic And Nonacademic Clinics, Jasmine Wiley, Jonathan J. Blaza, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns, Shelby L. Pischke, Tracy L. Greiten

Journal of Patient-Centered Research and Reviews

Background: The Institute for Healthcare Improvement’s Triple Aim focuses on improving the patient’s experience of care, improving population health and reducing the per capita cost of health care. Health care systems and providers continuously seek to improve quality of care through understanding what percentage of their patients are achieving quality-of-care standards for various indicators, including immunizations, tobacco cessation, asthma and cancer screening. As health care moves toward reimbursing for value-based care, deepening our understanding of patient population characteristics within each of these conditions is vital to continuous quality improvement.

Purpose: To determine if there are race/ethnicity/age/preferred language (REAL) disparities in …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Carolyn A. Curtis, MD

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …

Symptoms, Contributing Factors, And Screening For Perinatal Mood And Anxiety Disorders In U.S. Latinas: A Literature Review, Jennifer N. S. Massie

Master's Projects and Capstones

This literature review was conducted to gather the published information on the topic of perinatal mood and anxiety disorders in the Latina population in the United States. Academic databases were searched for articles published between 2005 and 2016. 60 articles were considered, and a final sample of 36 articles and websites was included in this review.

Evidence suggests that Latina women in the perinatal period (pregnant and up to one year postpartum) in the United States of America tend to have a higher risk and incidence of perinatal mood and anxiety disorders than White women, and a higher risk and …

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones, 2016 to 2019

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations …

Predictive Value Of The Functional Movement Screen As It Relates To Anterior Cruciate Ligament Injury, Daniel A. Herring, Kyle D. Cherry, Hannah L. Stedge

The Research and Scholarship Symposium (2013-2019)

Introduction: Anterior cruciate ligament injuries occur over 200,000 times annually in the United States alone (Brophy, et al. 2009). This injury strains the healthcare system and affects the players, teams, parents, and the organization they are a part of. There have been, however, clinically researched risk factors that predispose athletes to ACL injury (Gignac, et al. 2015; Laible, et al. 2014). As a result, there is a clinical need for an effective screening tool to identify those athletes at risk for ACL injury. The Functional Movement Screen has been shown to be an effective screening tool for detecting athletes who …

Elderly Mistreatment: Risk Factors And Therapy, Ummi Ulfah Madina, Noto Dwimartutie

Jurnal Penyakit Dalam Indonesia

Elderly mistreatment is a preventable serious health problem that lowering older adults quality of life. Elderly mistreatment can be done by the caregiver or even the patient himself, regardless the intention. Meanwhile, defining an elderly mistreatment is still a challenge due to varied risk factors and cultural differences in each country. Those conditions result in challenges in identifying and managing elderly mistreatment. This review will also discuss screening modalities to identify elderly who is at risk or currently abused to prevent and manage elderly mistreatment properly.

Prostate Cancer: Screening, Current Guidelines And Patient Education, Timothy F. Flanagan

Family Medicine Clerkship Student Projects

Recent changes in prostate cancer screening guidelines may create an opportunity for patient education. By creating a succinct hand-out on prostate cancer screening, providers enable their patients to understand screening, and provide sites with opportunities for further learning.

Vitamin D Screening And Supplementation, Christina Cahill

Family Medicine Clerkship Student Projects

Vitamin D helps protect against osteoporosis (by promoting calcium absorption), moderates cell growth, aids in neuromuscular and immune function and reduces inflammation. However, there is insufficient data to access the benefits and harms for screening for Vitamin D deficiency. This study looks at current recommendations for Vitamin D screening and aims to provide information to providers and patients about Vitamin D.

Documentation Of Smoking History And Adherence To The Uspstf Recommendation For Lung Cancer Screening: A Retrospective Chart Review, Laura A. Golden

DNP Projects

Purpose: The purpose of this project was to evaluate provider compliance with documentation of smoking history and, if criteria met, referral for lung cancer screening as recommended by the United States Preventive Services Task Force in 2013.

Methods: A retrospective chart review was conducted using an electronic medical record (EMR) at a large, rural community family practice clinic. Patients meeting inclusion criteria of having a smoking history (current or past) of 30 pack years, aged 55 to 80 years, and no history of lung cancer diagnosis were included for randomization. One hundred patients were selected from 300 randomized charts; five …

Evaluating Adherence To Colorectal Cancer Screening, Jaime Bradley-Miller

DNP Projects

Purpose: The purpose of this project and literature review was to determine provider documentation practices of colorectal cancer (CRC) screening, identify the percent of clinic patients who need to be screened, and develop a set of recommendations and targeted interventions which will increase CRC screening rates.

Methods: A retrospective chart review including males and females of all ethnicities between the ages of 45 and 80 was performed in one primary care practice. A randomized sample of 360 office visits between February and November of 2015 were selected, of which 281 met the inclusion and exclusion criteria. Patient demographics and characteristics …

1h-Nmr Urinary Metabolomic Profiling For Diagnosis Of Gastric Cancer, Angela W. Chan, Pascal Mercier, Daniel Schiller, Robert Bailey, Sarah Robbins, Dean T. Eurich, Michael B. Sawyer, David Broadhurst

Research outputs 2014 to 2021

Background:

Metabolomics has shown promise in gastric cancer (GC) detection. This research sought to identify whether GC has a unique urinary metabolomic profile compared with benign gastric disease (BN) and healthy (HE) patients.

Methods:

Urine from 43 GC, 40 BN, and 40 matched HE patients was analysed using ¹H nuclear magnetic resonance (¹H-NMR) spectroscopy, generating 77 reproducible metabolites (QC-RSD < 25%). Univariate and multivariate (MVA) statistics were employed. A parsimonious biomarker profile of GC vs HE was investigated using LASSO regularised logistic regression (LASSO-LR). Model performance was assessed using Receiver Operating Characteristic (ROC) curves.

Results:

GC displayed a clear discriminatory biomarker profile; the BN profile overlapped with GC and HE. LASSO-LR identified …

Integrating Care: The Primary Care Provider’S Role In Age-Related Macular Degeneration In Eastern Maine, Homer Chiang, Steven Coffin

Family Medicine Clerkship Student Projects

Objectives: To assess general patient knowledge of age-related macular degeneration (AMD), including risk factors, early signs, treatment options, and low-vision resources. We also aimed to assess primary care provider practice patterns including early detection, timely referral to ophthalmology, and management after diagnosis of AMD.

Methods: A 20-point patient questionnaire was distributed to all adult patients at check-in by front office staff at the Center for Family Medicine office in Bangor, ME. Additionally, a looping waiting room slideshow and informational exam room flyer were created for patient education. A 10-point online questionnaire was distributed to residents and faculty at the Center …

Evaluating Patient Literacy To Improve Health Outcomes In Milton, Vt, Lindsay R. Miller

Family Medicine Clerkship Student Projects

Health literacy is one aspect of overall literacy that has an enormous impact on patient health outcomes, including knowledge of disease, health markers, general health status, and number of hospitalizations, among others. More than 1/3 of the US population has basic or below basic health literacy status. In Chittenden County, diabetes and heart disease deaths are higher than the state average; these diseases require complex personal care and management. Health care providers working at Milton Family Practice in Milton, VT, often noted that patients were often unwilling to disclose literacy issues and there were often problems communicating instructions to patients …

Linking Food Insecure Patients With Community Supported Agriculture (Csa), Daniel Orlins Trigg

Family Medicine Clerkship Student Projects

Food insecurity screening is needed to link food insecure patients to interventions that will help improve their nutrition and overall health such as annual community supported agriculture (CSA) shares. In Vermont, food insecurity is widespread, as 76% of Vermonters experience some level of food insecurity. This has serious health consequences. Food insecure patients are more likely to suffer from hypertension and diabetes than non-food insecure patients. Clinicians need to screen for and detect food insecurity. Several methods are available, yet clinician awareness varies. Providers can rely upon predictive metrics that utilize patient characteristics or simple question-based screening tools. This study …

Screening For Domestic Violence Against Women: A Public Health Crisis In Maine, Clare Park

Family Medicine Clerkship Student Projects

The role of healthcare providers in stopping domestic violence against women, a public health crisis, through promoting a culture of universal screening and community education.

Development Of Guidelines For Refugee Screening At Cmmc Family Medicine Residency, Lewiston, Maine, Catherine Hayes

Family Medicine Clerkship Student Projects

Lewiston Maine has the second highest number of refugees in the state of Maine, with 191 total intakes in 2015. Refugee populations face unique health concerns, and providing care for refugees requires education and development of a specialized skill set. This project provided a reference for clinic providers to assist with medical intake screening visits for refugees.