Primary Care Commons^™

Previous Health Care Experiences’ Influence On Health Care Perceptions Among Residents In Six Homeless Shelters In Seattle, Washington, July–October 2021, Ashley A. Meehan, Sarah N. Cox, Nicholas B. Thuo, Julia H. Rogers, Amy C. Link, Miguel A. Martinez, Natalie K. Lo, Brian J. Manns, Melissa A. Rolfes, Eric J. Chow, Helen Y. Chu, Emily Mosites, Morhaf Al Achkar

Journal of Patient-Centered Research and Reviews

Purpose: The study purpose was to learn and describe 1) where homeless shelter residents receive health care, 2) what contributes to positive or negative health care experiences among shelter residents, and 3) shelter resident perceptions toward health care.

Methods: Semi-structured interviews (SSIs) utilizing purposive sampling and focus group discussions (FGDs) utilizing convenience sampling were conducted at 6 homeless shelters in Seattle-King County, Washington, during July–October 2021. All residents (age ≥ 18) were eligible to participate. SSIs were conducted with 25 residents, and 8 FGDs were held. Thematic analysis was conducted using Dedoose.

Results: Participants received health care …

Pediatric Adhd And Screening For Comorbidities, Colleen Kelly

SIU Journal of Medical Science Scholarly Works

Psychiatric disorders are very common in the general pediatric population. Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis in childhood but can mimic and be found comorbidity with other psychiatric disorders. It is necessary for primary care providers to perform a thorough initial workup for ADHD and possible comorbidity psychiatric disorders to ensure proper diagnosis and treatment of pediatric patients.

Professional Perspectives On Bilingualism In Persons With Autism Spectrum Disorder: A Pilot Study, Rosa N. Benavidez Saldivar, Jessica R. Stewart, Ruth Crutchfield, Roy K. Chen, Lily Puente

Internet Journal of Allied Health Sciences and Practice

Purpose: The present study examined the perspectives of professionals regarding bilingualism and ASD. Methods: A total of 27 professionals participated in this study. Data was collected via an online survey. The survey was designed based on a literature review and consultation with a team of experts in the field of ASD. Information relating to demographic information, professional practice information, and perspectives of bilingualism and ASD was collected. Results: Professionals participating in the present study were most likely to agree with the statement, “A child with ASD from a bilingual household is able to understand both languages” and least likely to …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

Healthcare Altruism And Dysconscious Healthism In The Delivery Of Integrated Healthcare Services To Individuals Who Are Deaf, Hard Of Hearing, And Deafblind, Jaime A.B. Wilson, Michael John Gournaris

JADARA

Healthcare altruism and dysconscious healthism are terms proposed to recognize the barriers to healthcare access faced by not only individuals with hearing loss but also all minority populations. The implications of an integrated healthcare model to provide services to individuals who are d/Deaf, hard of hearing, or DeafBlind (D/HH/DB) are explored. Unique insights are then offered regarding existing barriers to healthcare access and the next steps.

Assessment Of Stakeholder Engagement In A Down Syndrome Research Study, Jeanhee Chung, Ashwini Sarathy, Yichuan Grace Hsieh, Greg Estey, Amy Torres, Vasiliki Patsiogiannis, Karen Donelan, Brian G. Skotko

Journal of Patient-Centered Research and Reviews

There is growing recognition of the importance of engaging patients early in the design of research studies. For studies involving patients with intellectual and cognitive disabilities, researchers may consider engaging with family caregivers, health professionals, community advocates, and/or subject matter experts to provide a more multifaceted, surrogate perspective. Evaluating the engagement of these stakeholder groups in research is nascent, and tools are limited. Research studies involving these individuals provide the opportunity to test new methods of measurement of stakeholder engagement in research. We conducted a 3-year research study implementing and evaluating Down Syndrome Clinic to You, an online platform for …

Anxiety-Related Issues In Cancer Survivorship, Maresi A. Berry-Stoelzle, Anna C. Mark, Peter Kim, Jeanette M. Daly

Journal of Patient-Centered Research and Reviews

Purpose: The purpose of this qualitative study was to examine patient opinions about anxiety in cancer survivorship, particularly the role of the primary care provider in management of anxiety related to the trajectory of long-term cancer survivorship.

Methods: Respondents to a mass email (N = 22,000) were invited to participate in 1 of 3 institutional review board-approved focus group meetings. Inclusion criteria were being an adult patient older than 25 years of age, having any type of cancer diagnosis, and being at least 18 months from treatment. The following specific issues were discussed: role of the primary care provider …

Post-Traumatic Stress Disorder: Review Of Dsm Criteria And Functional Neuroanatomy, Cornelius W. Thomas

Marshall Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) consist of over twenty possible symptoms that can be divided into six broad categories. These categories correlate with specific brain networks that regulate emotions, behaviors, and autonomic function. Normal functioning of these networks depends on two key regions; the prefrontal cortex and the amygdala. The prefrontal cortex provides top-down executive control over amygdala, whereas the amygdala is critical for threat detection and activation of the ‘fight or flight’ response. Events that trigger extreme and/or prolonged fear can cause persisting dysregulation within the prefrontal-amygdala circuit; resulting …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Every Word, Every Gesture, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

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

Primary Care Behavioral Health Consultation Reduces Depression Levels Among Mood-Disordered Patients, Bill Mcfeature, Thomas W. Pierce

Journal of Health Disparities Research and Practice

The purpose of this study was to examine the effects of behavioral health consultative services on levels of depressive symptoms in patients diagnosed with a mood disorder. Two-hundred fifty-one patients with a form of mood disorder completed the PHQ-9 screening tool for depression both before and after a treatment period lasting an average of three months, during which patients received behavioral health consultation services. Results showed that 49.8% of patients participating in this integrated behavioral health care program experienced improvements of at least 50% in PHQ-9 scores from pre- to post-test. Improvements in PHQ-9 scores of at least a five …