Preventive Medicine Commons^™

Examining Factors Associated With Bcg And Poliomyelitis Vaccination Coverage In Tanzanian And Kenyan Children Aged 12 To 23 Months Using Dhs Surveys, Ognyan Simeonov

Independent Study Project (ISP) Collection

The rapid spread of infectious diseases in eastern Africa has made vaccination a major health factor in the region. This study aims to evaluate the factors affecting vaccination coverage with the BCG and Poliomyelitis vaccines in Tanzanian and Kenyan children aged 12 to 23 months. In May 2021, we collected data from the Demographic and Health Surveys (DHS) from 2014-2016 for Kenya and Tanzania and evaluated how different variables such as the sex of the child, maternal age, maternal educational level, availability of health facilities, access to electricity in the household, and birth order affect the vaccination coverage. We used …

Association Of Cardiovascular Health And Epigenetic Age Acceleration, Tess D. Pottinger, Sadiya S. Khan, Yinan Zheng, Wei Zhang, Hilary A. Tindle, Matthew Allison, Gretchen Wells, Aladdin H. Shadyab, Rami Nassir, Lisa Warsinger Martin, Joann E. Manson, Donald M. Lloyd-Jones, Philip Greenland, Andrea A. Baccarelli, Eric A. Whitsel, Lifang Hou

Nursing Faculty Publications

BACKGROUND: Cardiovascular health (CVH) has been defined by the American Heart Association (AHA) as the presence of the "Life's Simple 7" ideal lifestyle and clinical factors. CVH is known to predict longevity and freedom from cardiovascular disease, the leading cause of death for women in the United States. DNA methylation markers of aging have been aggregated into a composite epigenetic age score, which is associated with cardiovascular morbidity and mortality. However, it is unknown whether poor CVH is associated with acceleration of aging as measured by DNA methylation markers in epigenetic age.

METHODS AND RESULTS: We performed a cross-sectional analysis …

Colorectal Cancer: Screening And Prevention Education, Johnna Boggs

Rural Health Professions Projects

Colorectal cancer is the 2^nd leading cause of cancer related deaths in the United States (USPSTF, 2016). In 2017 there were over 141, 000 cases diagnosed with over 51,000 deaths reported (Center for Disease Control, 2020). This raises great concern for primary care clinicians. One guideline recommended by USPSTF, is that patients undergo screening who are at low to moderate risk for colorectal cancer. This can be done by various studies. Cologuard, which is a fecal occult screening that detects certain DNA markers or blood is currently recognized by the USPSTF for colorectal cancer. The purpose of this quality …

Evaluation Of A Rural Clinic's Compliance With Bone Density Screening In Women Aged 65 And Greater, Chelsea B. Brincks

Rural Health Professions Projects

Osteoporosis affects over 12 million Americans, leading to fractures, chronic pain, reduced independence, and decreased quality of life (United States Preventative Services Task Force [USPSTF], 2018). Up to 30% of individuals who suffer an osteoporotic hip fracture will not survive 12 months post-fracture, and 71% of all osteoporotic fractures occur in women (USPSTF, 2018). Due to increased risk with age, the USPSFT recommends all women have initial bone densitometry at age 65 or greater (2018). Medicare reimburses DEXA screening, the gold standard bone densitometry, every 24 months in individuals at risk (Centers for Medicare & Medicaid Services [CMMS], 2018). The …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

Do Adults Utilizing Intermittent Fasting Improve Lipids More Than Those Following A Restricted-Calorie Diet? A Clin-Iq, Mitchell A. Sanford, Tracy S. Sanford, K. F. Campbell, Dustin Davis, Tammy Tandberg, L. N. Eagle Road

Journal of Patient-Centered Research and Reviews

With approximately 95 million Americans diagnosed with high cholesterol, and many searching for a nonmedicinal treatment, intermittent fasting as a method to improve health has become increasingly popular in the lay public. We conducted a clinical inquiry to determine whether intermittent fasting is superior to a low-calorie diet in improving lipids, searching the Cochrane, EBSCOhost, Embase, MEDLINE, and Scopus databases using the terms intermittent fasting, lipids, and calorie-restricted diet. Studies that included surgical weight loss or medicine-assisted weight loss were excluded. We identified 6 published studies, 5 of which were randomized controlled trials. In reviewing the selected studies, …

A Case For Delirium Risk Prediction Models To Aid In Triaging Resources To Those Most At Risk An Integrative Literature Review, Tammy Perttula

Nursing Masters Papers

Abstract

Delirium is a complex syndrome resulting from compounding effects of acute illness, comorbidities, and the environment. It results in adverse outcomes: elevated mortality rates, length of stay, readmissions, institutionalization, long-term cognitive changes, and diminished quality of life. The rate of iatrogenic delirium is astounding, ranging from 10%-89%. There are no curative treatments; thus, primary prevention is the key. The purpose of this literature review is to identify and critique the research for the accuracy of risk stratification and feasibility in practice. Support for interventions that prevent delirium is mounting; however, interventions are resource-intensive and often not implemented. Researchers have …

10 Patient-Centered Questions For Clinical Encounters With Transgender Patients, Blossom Kim

Physician Assistant Studies | Student Authored Articles

Transgender (TG) individuals face extensive barriers to care that result in detrimental health disparities and increased prevalence of certain medical conditions such as mood disorders, HIV, and substance abuse. Existing research details multiple approaches to aid healthcare providers in reducing these disparities, but they tend to either generalize the transgender community or provide a surplus of information that may potentially overwhelm healthcare providers. This best practices review aims to provide clinicians with an approach that includes 10 patient-centered questions in hopes of improving patient-clinician rapport and addressing the main disparities and health concerns a TG patient may have.

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Compassion And Suppression In Caregivers: Twin Masks Of Tragedy And Joy Of Caring, Emanuele Maria Merlo, Sean M. Mcnabney, Fabio Frisone, Federica Sicari, Mihai Paunica, Catalina Motofei, Salvatore Settineri

Journal of Mind and Medical Sciences

Background: Compassionate caregiving is a critical skill for workers among the helping professions, but the degree of empathy required by caregivers can place high demands on their mental and emotional resources. While many professionals employ successful coping strategies to mitigate these stressors, others experience compassion fatigue or burnout from emotional exhaustion. The objective of this research was to evaluate the relationships between caregivers’ demographic/career variables, compassion satisfaction, compassion fatigue, and psychodynamic defense mechanisms such as suppression, repressive function, regression in the service of the Ego, and rationalization. Methods: Participants were 250 caregivers with 178 (71,2%) women and 72 men (28,8%) …

Turning Passion Into Purpose: A Journey To Medicine Through Global Health, Laurenie Louissaint Md

Family Medicine

No abstract provided.

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Healthcare Provider Attitudes Toward Personalized Care Plan Development, Kafi Rudolph, Adarsh Gupta

Rowan-Virtua Research Day

Background: Prevention care plans are created by healthcare workers to direct patient care and are guidelines to optimize patient health. The care plans include actions patients can take to prevent worsening of chronic conditions and potentially decrease hospitalizations. The current research project was conducted to assess satisfaction of using automated personalized care plans among healthcare providers, which can increase office visit efficiency.

Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie

Doctor of Nursing Practice

The use and misuse of opioid pain medication has reached epidemic proportions in the United States. More than 16,000 people die each year due to the misuse or abuse of prescription opioid medications, which is more than from heroin, cocaine, and benzodiazepines combined. The purpose of this evidence-based practice project is to establish processes enabling a primary care clinic to implement and adhere to the 2016 Centers for Disease Control’s guidelines for opioid prescription practices in the primary care setting. A retrospective chart review conducted prior to implementation of the guidelines demonstrated that four of six of the CDC’s recommendations …

Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson

Doctor of Nursing Practice

A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health …

Abstracts From The 23rd Annual Health Care Systems Research Network Conference, March 21–23, 2017, San Diego, California

Journal of Patient-Centered Research and Reviews

This proceedings supplement includes selected abstracts presented at the 23rd annual conference of the Health Care Systems Research Network (HCSRN), held March 21–23, 2017, in San Diego, California. Formerly called the HMO Research Network, HCSRN aims to improve individual and population health through research that connects the resources and capabilities of its member health care systems.

Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, Sally R. Greenwald, Sarah Watson, Mindy Goldman, Tami S. Rowen

Journal of Patient-Centered Research and Reviews

Purpose

Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer.

Methods

A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to …

Want To Lose Weight? Commercial Weight Loss Programs Vs. Primary Care, Jessica Jacobson, Katherine Chui

Physician Assistant Capstones, 2016 to 2019

Context Overweight and obesity rates are on a continuous incline in the United States leading to increased rates of diabetes, cardiovascular disease and death. Much of the healthcare costs are going into treating this disease; therefore, it is vital to find effective weight loss treatments in both the primary care and community settings to reduce the prevalence of overweight and obesity and subsequent healthcare costs.

Objective To assess whether primary care-based therapy or commercial weight loss programs help overweight and obese patients lose 5% of their weight from baseline.

Design, Setting and Participants A systematic review of four randomized control …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

End-Of-Life Care For Hospitalized Patients With Lung Cancer: Utilization Of A Palliative Care Service., Barbara Reville, M.S., Achpn, Marshal N Miller, B.S., Richard W Toner, M.S., Joanne Reifsnyder, Ph.D., Achpn

Department of Family & Community Medicine Faculty Papers

PURPOSE: High symptom burden and hospital mortality among patients with lung cancer argues for early palliative care intervention. Patient characteristics and discharge dispositions in hospitalized patients with lung cancer receiving usual care were compared to those referred to a new palliative care service.

METHODS: A retrospective database review of all lung cancer discharges receiving usual care (UC) and palliative care service (PCS) consultation was conducted. Demographics, length of stay, discharge disposition, and mortality were described and compared. Palliative Performance Scale scores were described according to discharge disposition in the PCS group. Disposition of all patients receiving either chemotherapy or surgery …

Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np

School of Nursing and Health Science: Faculty Scholarship

Purpose

To describe and compare patient perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who receive flu vaccines and those who do not.

Data Sources

Data collection during 2003 included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight (108) patients participated in the study.

Conclusions

Top barriers included fear of side effects from vaccine (35%) and fear of contracting the flu (30%). Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Barriers, motivators and patient decisional conflict differed depending upon patient …