Primary Care Commons^™

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

A Chronic Pain Self-Management Quality Improvement Bundle For Veterans, Srijana D. Baniya

Doctor of Nursing Practice (DNP) Scholarly Projects

Introduction: Veterans often face challenges accessing care services due to limited awareness of available resources for support, Self-care, and mental health (Harding et al., 2019; Patel et al., 2024). Given the high prevalence of Chronic pain and opioid use in this population, Self-management (SM) education and non-pharmacologic interventions are required to address the biological, psychological, and social effects of pain (Bair et al., 2015; Mumba et al., 2024; Nahin, 2017; Higgins et al., 2020). This Quality improvement project aims to determine whether implementing an evidence-based SM bundle for chronic pain improved Pain severity scores and increased understanding of SM strategies. …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

The Impact Of An Iron-Rich Diet On Fatigue In Menstruating Women With Non-Anemic Iron Deficiency, Meagan Seraydar, Lauren Latimer, Sam Miragliatto

Department of Nutrition Student Projects

Fatigue without diagnosed anemia is prevalent in menstruating women, with iron deficiency being a potential contributor. While iron supplementation is a standard intervention, dietary sources of iron may offer a sustainable alternative. This study aims to assess the impact of an iron-rich diet on fatigue levels in menstruating women. A 12-week randomized controlled trial (RCT) will be conducted, assigning participants to either an iron-rich diet group or a control group following their usual diet without specific iron recommendations. Fatigue will be measured using the Fatigue Severity Scale (FSS) at baseline, six weeks, and twelve weeks, alongside iron status biomarkers, including …

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Improving Food Security To Decrease Hypertension At An Urban Community Clinic, Christine S. Villalta

Master's Projects and Capstones

Diet and lifestyle changes have been proven to reduce blood pressure in patients with hypertension, and a key dietary approach aligned with this recommendation is the DASH diet, which includes consuming fruits and vegetables. Food insecurity, defined as lacking enough safe, nutritious food to maintain an active and healthy life, is a growing crisis in the United States, affecting 13.5% of U.S. households in 2023. This is especially significant for those whose chronic disease management depends on the accessibility of healthy food. An urban community clinic implemented a Food Security Program to decrease food insecurity and reduce hypertension among their …

Gender Segregation In Caring Labor: The Impact Of Social Norms On Career Choices, Evelyn Xinhui Cheng

CBER Conference

Women engage in work stereotypically seen as "women's work," or work based on the perceived "natural" female tendency towards caring and relational thinking (Tung 2000). In pre-reform China, Shu (2005) found that women were more concentrated in the lowerpaying collective sector compared to men in the state-owned sector, contributing to the gender wage gap. China's horizontal occupational segregation by gender has significant implications for gender pay gaps, workforce attachment, and the perceived value of caring labor in society. Feminist scholars argue that gendered norms around caring originate that conflate womanhood with nurturing (England 2005; Litt & Zimmerman 2003). The main …

The Effects Of The Covid-19 Pandemic On Resident Education And Burnout, Timbre Backen, Oliwier Dziadkowiec, Jeffery S. Durbin, Gregory Guldner, Glenda Quan

HCA Healthcare Journal of Medicine

Background

The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic.

Methods

We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using …

Bilateral Eagle Syndrome: A Surprising Cause Of Neck Pain, Kailyn M. Mutsch, Alla Zamulko

Aesculapius Journal (Health Sciences & Medicine)

We report the case of a 45-year-old female who presented with chronic neck pain primarily left sided, globus sensation, and dysphagia for several years. Bilateral elongated styloid processes were identified on CT scan completed prior to the visit. Clinical and radiographic features were consistent with bilateral Eagle syndrome. Eagle syndrome can manifest as a constellation of symptoms characterized by throat and neck pain aggravated by rotation of the head, globus sensation of the throat, dysphagia, headache, tinnitus, syncope, or transient ischemic attacks in some cases. The objective of this case report was to discuss the features of Eagle syndrome and …

A Systematic Review: Mirror Neurons & Schizophrenia, Yashesvi Sharma, Surajit Dey

Annual Research Symposium

This research project establishes a link between Mirror Neuron System (MNS) activity and this information's implications in treating and understanding schizophrenia, specifically, schizophrenic patients with negative symptoms.

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

Revolutionizing Denture Excellence: An Invigorating In-Vitro Exploration Of Organic Products In Prosthetic Rehabilitation, Nighila Ravindran, Sneha Joseph, Aswani Surya K

Annual Research Symposium

The denture base comes into contact with diverse substances in the oral cavity, acting as a reservoir for microorganisms like corynebacterium, streptococcus, lactobacillus, and candida. This colonization elevates the risk of complications such as denture stomatitis and candidiasis. Commercial denture cleaners have explored the use of natural ingredients, less commonly employed but offering various advantages. These ingredients aim to mitigate the potential issues associated with microbial colonization on denture surfaces, contributing to improved oral hygiene for denture wearers. The exploration of natural elements reflects a nuanced approach to denture care, considering both efficacy and less conventional alternatives.

Investigating Racial And Ethnic Healthcare Disparities In Screenable Ob/Gyn-Related Cancers, Lara Laughrey

Annual Research Symposium

This is a scoping review of peer-reviewed literature addressing healthcare inequity based on race and ethnicity with a specific focus on Ob/Gyn-related management and treatment of screenable cancers.

Assessment Of Emotional Intelligence Among Students In Dental College, Gowri Nandana S Final Year Student, Sudeep C. B Professor And Head Of The Department Of Public Health Dentistry

Annual Research Symposium

Over an extended period, the examination of intelligence predominantly centered on the adaptive deployment of cognitive abilities. In more recent times, scholars such as Gardner (1983) and Sternberg (1988) have proposed comprehensive frameworks for comprehending intelligence. Pioneering the concept of "emotional intelligence," Salovey and Mayer (1990) posited that emotional intelligence encompasses three distinct categories of adaptive capabilities: the evaluation and expression of emotions, the regulation of emotions, and the utilization of emotions in problem-solving. The objective is to evaluate emotional intelligence among dental students across various educational institutions.

Quality Of Life In Orthodontics, Claudia Eisenhuth, Gabriel Eisenhuth, Connor Schwartz, Amir Mohajeri, Man Hung, Tiffany Nelson, Ryann Glenn

Annual Research Symposium

Orthodontic treatment goes beyond mere cosmetic enhancement; it significantly impacts various aspects of an individual's quality of life. Beyond the physical benefits of improved oral function and prevention of dental issues, orthodontics also yields profound psychological benefits. Aligned teeth enhance self-confidence, reduce social anxiety, and contribute to better relationships and professional opportunities. Moreover, addressing dental concerns through orthodontic treatment reduces psychological distress and promotes overall happiness and satisfaction. Real-life case studies vividly illustrate the transformative effects of orthodontic interventions, emphasizing the importance of considering quality of life outcomes in dental care.

Investigating The Interplay Between Glucose Regulation, Neural Activity, And Motivation: A Novel Approach Utilizing Vibration Stimulation, Blake D. Harris, Patrick Tanner Brain, Alessandra Maisie Rivera, Tiffany Nguyen, James Barber, Amar Paul, John Dougherty Jr., Matthew Jennings, Bridger Gunter, David W. Sant, Christina A. Small, Scott Steffenson, Kyle B. Bills

Annual Research Symposium

This research explores the intricate relationship between glucose regulation, neural activity, and motivation in key brain regions, including the hypothalamus, basal ganglia, ventral tegmental area (VTA), and nucleus accumbens (NA). We aim to unravel the potential relationship of these factors on dopamine (DA) release and the broader implications for mental health, glucose regulation, well-being, and overall health. Our innovative approach involves using a chair that causes heterodyned whole-body vibration designed to stimulate DA release from the VTA and NA, areas associated with motivation and rewards.

Exploring The Interconnected Role Of The Oral Microbiome And Periodontal Disease In The Development And Progression Of Oral Squamous Cell Carcinoma, Malak Al-Regib, Claudia M. Tellez Freitas

Annual Research Symposium

This comprehensive review explores the complex linkage among the oral microbiome, periodontal disease, and the onset and progression of oral squamous cell carcinoma (OSCC).

Neuropsychological Findings In Idiopathic Adult-Onset Epilepsy Case Study: Noorda Com Student Investigation, Jacob Warner, Michael Milius, Jordyn Huecker, Tiffany Nguyen, Luke Sanders, Joseph Harbold, Kennedy Madrid, Nicholas Curtis, Chase Taylor, James Barber, Jayne Stuter, Ethan Zaugg, Aaron Andrews, John A. Kriak, David W. Sant, Kyle B. Bills

Annual Research Symposium

We report the case of a 25-year-old male patient with idiopathic adult-onset epilepsy. The patient presented with a chief complaint of recurrent seizures and no identifiable cause. These seizures were associated with a lack of extremity control, muscle spasms, and loss of cognitive function. His condition began while living in Thailand, where he experienced multiple environmental stressors including hostile living conditions and tense situations, approximately five years before being seen in the clinic. Over the past several years, the seizures have not ceased, and the patient now notes a loss or decrease of several special senses.

Development Of A Protocol For Obtaining Biological Samples For Genetic Testing From Remote Individuals, Noah R. Schultz, Brandon J. Burger, Jacob Warner, Alfred Amendolara, Jameson Williams, Molly Henley, Layla Risdon, Alessandra Maisie Rivera, Amanda Page, Millicent Jiang, Denisse Castaneda, Garret Phillips, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

Pharmacogenomic sequencing allows individuals to learn more about how they will respond to certain medications but requires shipping of a biological sample. One complication of sending biological samples to remote laboratories is stability. Blood generally yields sufficient quantities of high-quality DNA but requires a clinic visit. Saliva and buccal swabs are routinely used for DNA extractions, but the DNA quality is notoriously low due to the presence of bacteria in the mouth. Additionally, elderly individuals have difficulty producing enough saliva for testing, and the tubes contain several milliliters of liquid and shipping requires special considerations. Dried blood spot cards, which …

Dna Extraction Method Development For Solid Tissues, Ryan Powers, Noah R. Schultz, Brandon J. Burger, John Dougherty Jr., Ezenna Obilor, Alexander Ruiz, Corwin Frey, Nathaniel Hill, Lara Laughrey, Patrick Tanner Brain, Sara Mcmahon, Parker Feltner, Steven Tung, Daoud Sajady, Elden Jenkins, Julian Jarquin, Serin Baker, Aaron Andrews, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

Although germline variation testing is traditionally performed using DNA obtained from blood or other liquid samples, determining somatic variation in cancer samples requires DNA extraction directly from tissues. Additionally, epigenetic markers, such as 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) are tissue-specific and change in selected disease states. However, several substances present in tissues are known to inhibit downstream reactions, including polymerase chain reaction PCR). For this project, we are assessing the quantity and quality of DNA obtained from extractions of various vital organs using 30 different commercially available DNA extraction kits to determine optimal kits for each tissue.

Investigating The Genetics Of Chronic Intractable Migraine With Reactive Hypoglycemia, C Yvonne Russell, Jacob Warner, Brandon J. Burger, Jordan Cutshall, Naeel Uddin, Patrick Tanner Brain, Alessandra Maisie Rivera, Braden Cunningham, Kailee Edwards, Katie Beechay, Luke Sanders, Zachary Ta, John A. Kriak, David W. Sant, Kyle B. Bills

Annual Research Symposium

Migraines affect roughly 1-in-6 males and 1-in-5 females in the United States. Of these, approximately 5-30% experience intractable migraines, or migraines resistant to abortive treatments. Despite this large population, relatively little is known about intractable migraines compared to other types of migraines. Our recent work indicates that reactive hypoglycemia is common among these individuals. Additionally, empirical evidence suggests that individuals in families with chronic intractable migraines are more likely to have the same condition than people of the general population, suggesting a possible genetic link between both migraines and metabolic abnormalities. Previous Genome Wide Association Studies (GWAS) have found several …

Investigating The Role Of Chaos In Minimizing Tumor Growth, Maxwell Geiger

Annual Research Symposium

Chaos is a type of motion found in mathematical systems that is highly sensitive to initial conditions. While many biological systems described in literature have been analyzed for the presence of chaotic dynamics, there are still many that are yet to be discovered. The goal of this project is to reassess Itik and Banks’ discovery of chaotic behavior in their population dynamics model of cancer growth. Once chaotic behavior is confirmed, we want to investigate how chaos could possibly be controlled to minimize tumor growth and discover novel treatments for cancer patients.

Development Of A Curriculum For Osteoporosis Education In Rural Populations, Serin Baker, Hannah Berhow, Rebekah Hans, Emily Schwartz, Hunter Stutz, Mehruba Alam, Alizon Pachas, Darell Schmick, David Sant Phd, Erika Noonan Md

Annual Research Symposium

Osteoporosis contributes to annual costs exceeding $10 billion in the U.S. due to hip fractures and is the primary cause of hospitalization among older women. Historically, geriatric populations have received inadequate education in navigating the U.S. medical system, emphasizing the importance of targeted education among the elderly. The study’s objective is to improve health literacy among the geriatric population in rural Utah by expanding their understanding of osteoporosis.

Ligaplant: Recreating Natural From Artificial, Disha Kamavisdar

Annual Research Symposium

Missing teeth can be substituted by the use of the dental implants. The most widely used implants in the current scenario are the osseointegrated implants with various shortcomings and the most prominent one is the lack of the periodontal ligament. To overcome this, implants with periodontal ligaments can be procured and this can be possible by the application of the tissue engineering concept along with suitable implant material.

Application Of In-Silico Computational Biology Strategies To Demonstrate Mechanism Of Oral Cancer Cell Death By Natural Peptide, Dr Dominic Augustine

Annual Research Symposium

This research work is designed to identify biomolecules from Earthworm Coelomic Fluid (ECF) of Eudrilus Eugeniae (EE) that can inhibit oral cancer cells from proliferating. The study aims to construct a homology model of the 18 kDa protein from ECF of EE (18-ECFP) with molecular dynamics simulation (MDS) to enable its molecular docking with pro-apoptotic caspase receptors with determination of binding energy scores. The study also evaluates the anti-cancer potential of 18-ECFP on SCC-9 cells in vitro by wet lab techniques.

Pathogenic Implications Of Candidal Species In Both Oral Cancer And Oral Potentially Malignant Disorders - A Review, Dr Dominic Augustine, Sowmya Sv, Kuntala Mondal

Annual Research Symposium

Oral squamous cell carcinoma (OSCC) is the 6th most common cancer in worldwide. Cigarette smoking, alcohol consumption, and betel quid chewing are its major risk factors other factors that can lead to OSCC include excessive sun exposure, viral or fungal infection, poor nutrition, and poor oral hygiene. The carcinogenesis of OSCC occurs gradually and oral epithelial dysplasia is considered a potential histologic precursor of OSCC. Most OSCC cases are preceded by clinically evident oral potentially malignant disorders (OPMDs). The aim of this review is to correlate the association between Candida species and oral potentially malignant disorders and its possible mechanisms …

Immunohistochemical Expression Of Cyclin D1 In Dentigerous Cyst, Odontogenic Keratocyst And Unicystic Ameloblastoma- An In-Vitro Study, Kuntala Mondal, Sv Sowmya, Dominic Augustine

Annual Research Symposium

Cyclin D1, a G1 cyclin member, regulates the transition of the cell cycle from the G1 phase to the S phase. The uncontrolled and elevated expression of cyclin D1 has been associated with rapid growth, heightened proliferative activity and increased histologic aggressiveness. Unicystic ameloblastoma pertains to cystic lesions that present clinical, radiographic, or gross features akin to jaw cysts. Nevertheless, upon histological scrutiny, these lesions display a distinctive ameloblastomatous epithelium lining the cystic cavity, with or without luminal or mural proliferation. This cystic variant of tumor bears substantial resemblances to dentigerous cysts, and occasionally, both entities can become indistinguishable upon …

An Immunohistochemical Panel For The Accurate Differentiation Between Mucoepidermoid Carcinoma And Pleomorphic Adenoma, Kuntala Mondal, Sv Sowmya, Dominic Augustine

Annual Research Symposium

Salivary Gland Tumors (SGTs) are a diverse group of neoplasms, with a wide range of histological subtypes, some of which can exhibit overlapping features. Amongst this group of tumors, Pleomorphic Adenoma (PA) and Mucoepidermoid Carcinoma (MEC) stand out as prevalent entities originating from the salivary glands. The accurate differentiation between these two entities is crucial for treatment planning, as it influences decisions regarding the extent of surgical resection. Because of the overlapping histopathological features, it is difficult to differentiate these two lesions with the help of conventional Hematoxylin & Eosin (H& E). The evaluation of Immunohistochemical (IHC) markers holds pivotal …