Primary Care Commons^™

Student Perception On The Implementation Of An End-Of-The-Day Quiz And Its Impact On Student Learning And Class Attendance In A Three-Year Accelerated Doctorate Program Of Pharmacy., Desiree Chong, Jousef Alandy0dy, Arup Chakraborty

Annual Research Symposium

No abstract provided.

Participation In Curriculum And Cultural Ambassador Group To Enhance Student Belongingness, Jake Tuft, Jacob Schvaneveldt

Annual Research Symposium

COVID-19 negatively impacted students' abilities to participate in live, in-person events; students were unable to interact with peers or build relationships critical to success and well-being. Quarantine, social distancing and video conferencing did not create this problem however, it simply amplified the fact that dental students seemingly lack camaraderie and a sense of belongingness. The Curriculum and Cultural Ambassador group was created to allow students to bond over shared goals in the hopes of improving their experiences within dental school. This group gives students the ability to “Be the Change” on campus and enact real-time change to foster a sense …

A Standardized Approach To Blood Pressure Training In First-Year Medical Students, Andrew Romney

Annual Research Symposium

No abstract provided.

Identifying Bias In Healthcare And Creating Intervention Strategies At Colleges Of Medicine And Other Healthcare Professions, Cameron Chalmers, Emmanuel Oyalabu

Annual Research Symposium

No abstract provided.

Current Trends In The Sars-Cov-2 Pandemic During The Emergence Of The Omicron Variant, Benjamin Mennell

Annual Research Symposium

No abstract provided.

Number Of Active Social Media Users As Predictors Of Hipaa Infringements, Alexander Sheppert, Taylor Purcell, Nathaniel Hill, David Sant

Annual Research Symposium

HIPAA Infringements Correlate Linearly with Number of Social Media Users.

Social media use has made information sharing much easier – including protected health information. Interestingly, as social media has become more popular over the years, HIPAA violations have also become more common.

The calculated R and P values suggest a strong correlation exists between social media use and HIPAA complaints.

Potential Cost Savings With Implementation Of Systemwide Rasburicase Protocol, Parker Gundersen, Adalyn Lee

Annual Research Symposium

Purpose: Tumor Lysis Syndrome is a condition that takes place when apoptosis in cancer cells occurs within a short time period. This condition can lead to organ dysfunction and even death. Rasburicase is used to treat high uric acid levels in patients that are experiencing tumor lysis syndrome and is expensive. Dosing and frequency of rasburicase varies across health care institutions. This project evaluated if adherence to a systemwide rasburicase protocol could help reduce drug waste and reduce costs across a healthcare system.

Methods: We conducted a retrospective data analysis reviewing rasburicase doses administered across Intermountain Healthcare over the course …

Developing A Sexual Health Consent Strategy For Refugees: A Qualitative Approach, Amita Tuteja, Elisha Riggs, Lena Sanci, Lester Mascarenhas, Anna Power, Di Vanvliet, Katrina Sangster, Kimberley Mcguinness, Meredith Temple-Smith

The Qualitative Report

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, …

Evaluating Patient Experience At A Novel Health Service For Aboriginal And Torres Strait Islander Prisoners: A Pilot Study, Lachlan Arthur, Ana Herceg, Heidi Shukralla, Jason Payne, Julie Tongs Oam

Journal of the Australian Indigenous HealthInfoNet

Background
The Winnunga Alexander Maconochie Centre Health and Wellbeing Service (AMCHWS) is the first prison health service operated by an Aboriginal Community Controlled Health Organisation in Australia. This pilot study developed and implemented a patient experience survey to evaluate the novel model of healthcare delivered by the Winnunga AMCHWS to Aboriginal and Torres Strait Islander prisoners.

Methods
Patients accessing the Winnunga AMCHWS between February and May 2020 were invited to participate in the study. Descriptive data were analysed and compiled for demographics, patient satisfaction, patient perception of care quality, cultural safety, and patient thoughts on the Winnunga AMCHWS.

Findings
Sixteen …

Clinical Outcomes Of Immunomodulatory Therapies In The Management Of Covid-19: A Tertiary-Care Experience From Pakistan, Noreen Nasir, Salma Tajuddin, Sarah Khaskheli, Naveera Khan, Hammad Niamatullah, Nosheen Nasir

Section of Internal Medicine

The pharmacological management of COVID-19 has evolved significantly and various immunomodulatory agents have been repurposed. However, the clinical efficacy has been variable and a search for cure for COVID-19 continues. A retrospective cohort study was conducted on 916 patients hospitalized with polymerase chain reaction (PCR)-confirmed COVID-19 between February 2020 and October 2020 at a tertiary care academic medical center in Karachi, Pakistan. The median age was 57 years (interquartile range (IQR) 46–66 years). The most common medications administered were Methylprednisolone (65.83%), Azithromycin (50.66%), and Dexamethasone (46.6%). Majority of the patients (70%) had at least two or more medications used in …

The Emergence Of Covid-19 Associated Mucormycosis: A Review Of Cases From 18 Countries, Martin Hoenigl, Danila Seidel, Agostinho Carvalho, Shivaprakash M. Rudramurthy, Amir Arastehfar, Jean-Pierre Gangneux, Nosheen Nasir, Alexandro Bonifaz, Javier Araiza, Nikolai Klimko

Department of Medicine

Reports of COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19-associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or …

Perceived Risk And Distress Related To Covid-19 In Healthcare Versus Non-Healthcare Workers Of Pakistan: A Cross-Sectional Study, Adeel Abid, Hania Shahzad, Hyder Ali Khan, Suneel Piryani, Areeba Raza Khan, Fauziah Rabbani

Medical College Documents

Background:
Healthcare workers (HCWs) have found themselves and their families more susceptible to contracting COVID-19. This puts them at a higher risk of psychological distress, which may compromise patient care. In this study, we aim to explore the risk perceptions and psychological distress between HCWs and non-healthcare workers (NHCWs) in Pakistan.
Methods:
A cross-sectional study was conducted using an online self-administered questionnaire. Psychological distress was assessed through The Hospital Anxiety and Depression Scale (HADS). Comparisons were made between HCWs (front/backend, students/graduates) and NHCWs related to risk perceptions and stress levels related to COVID19. Following tests for normality (Shapiro–Wilk test), variables …

A Fond Farewell, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this From the Editor introduction to Volume 9, Issue 1, the retiring editor-in-chief of Journal of Patient-Centered Research and Reviews recalls the history and initial aims of JPCRR, discusses the contents of articles in the current issue, and says good-bye.

Bridging The Patient Engagement Gap In Research And Quality Improvement Utilizing The Henry Ford Flexible Engagement Model, Heather A. Olden, Sara Santarossa, Dana Murphy, Christine C. Johnson, Karen E. Kippen

Journal of Patient-Centered Research and Reviews

Purpose: This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings.

Methods: Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants …

Prevalence Of Infectious Diseases Among 6078 Individuals With Down Syndrome In The United States, Veronica Fitzpatrick, Anne Rivelli, Sagar Chaudhari, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky, Brian Chicoine

Journal of Patient-Centered Research and Reviews

A recent disease prevalence study of the largest documented Down syndrome (DS) cohort in the United States strongly suggested significant disparity in general infectious disease conditions among individuals with DS versus those without DS. In this follow-up retrospective analysis, we explored these differences in greater detail by calculating prevalence of 52 infectious diseases, across 28 years of data among 6078 individuals with DS and 30,326 age- and sex-matched controls, abstracted from electronic medical records within a large Midwestern health system. We found that the DS cohort had higher prevalence of pneumonias (including aspiration, viral, bacterial, pneumococcal, and unspecified/atypical); otitis externa; …

The Role Of Emergency Departments For Antimicrobial Stewardship In Covid-19 Pandemic; The Time Is Now, Madiha Ismail, Nazeer Najeeb Kapadia, Sara Usman

Department of Emergency Medicine

No abstract provided.

Trauma-Informed Care Training For Medical Students, Tanisha Clark, Jill Mcleigh, Hilda Loria, Laura Lamminen

Integrated, Trauma-Informed Care

Due to the high prevalence of trauma and secondary trauma and the associated potential adverse health outcomes for both patients and providers, it is imperative that medical and allied professionals receive training in trauma as a constitutive element of their professional development. Despite the growing recognition of the importance of TIC, Ditcher and colleagues (2018) found in a survey of 263 family medicine residency programs that only 27.0% had TIC in the curriculum. Following a review of the literature and discussions with healthcare providers offering TIC in an integrated pediatric primary care setting, a brief, 45-minute online TIC training adapted …

Perceptions Of Physical Activity Guidelines Among Wheelchair Users With Multiple Sclerosis, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum.

OBJECTIVE: This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS.

METHODS: One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the …

A Survey On Self-Medication For The Prevention Or Treatment Of Covid-19 And Distrust In Healthcare Of Veterans In A Primary Care Setting In The United States, Eva Amenta, Larissa Grigoryan, Laura Dillon, Casey Hines-Munson, John Van, Barbara Trautner

Faculty, Staff and Students Publications

BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic brought the public overwhelming and conflicting information. Rates of trust in healthcare professionals have been declining among laypersons over the past five decades. In this setting, we sought to evaluate the use of medications, both with or without a prescription, to prevent and treat SARS-CoV-2 as well as trust in healthcare among patients in a primary care clinic.

DESIGN: We surveyed 150 veterans in primary care clinic waiting rooms at a large southwestern tertiary care Veterans Affairs hospital. This survey was performed in March-November 2021.

METHODS: The survey asked about respondents' demographics, use of medications, …

Analysis Of Recurrent Urinary Tract Infection Management In Women Seen In Outpatient Settings Reveals Opportunities For Antibiotic Stewardship Interventions, Marissa A Valentine-King, Barbara W Trautner, Roger J Zoorob, George Germanos, Michael Hansen, Jason L Salemi, Kalpana Gupta, Larissa Grigoryan

Faculty, Staff and Students Publications

OBJECTIVES: We characterized antibiotic prescribing patterns and management practices among recurrent urinary tract infection (rUTI) patients, and we identified factors associated with lack of guideline adherence to antibiotic choice, duration of treatment, and urine cultures obtained. We hypothesized that prior resistance to nitrofurantoin or trimethoprim-sulfamethoxazole (TMP-SMX), shorter intervals between rUTIs, and more frequent rUTIs would be associated with fluoroquinolone or β-lactam prescribing, or longer duration of therapy.

METHODS: This study was a retrospective database study of adult women with

RESULTS: Among 214 patients with 566 visits, 61.5% of prescriptions comprised first-line agents of nitrofurantoin (39.7%) and TMP-SMX (21.5%), followed by …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Primary Care Practices In Western North Carolina: Adaptation To The Covid-19 Pandemic And Ongoing Challenges, Hannah R. Friedman, Joseph Konstanzer, Erica Richman, Brian Cass, Bryan Hodge, Sheri Denslow, Jacqueline Halladay

HCA Healthcare Journal of Medicine

Introduction

The COVID-19 pandemic has created unique challenges for primary care practices while also highlighting their importance in the pandemic response. To understand primary care practice needs, a survey was conducted of practices in Western North Carolina.

Methods

Phase 2 of a primary care needs assessment was administered to 63 practices in Western North Carolina over the course of six weeks, from July 23 to August 31, 2021.

Results

Most practices were operating with normal hours, though some still operated with reduced hours. Many practices reported insufficient personal protective equipment (PPE) supplies. While most practices provided at least some care …

Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke

Department of Paediatrics and Child Health

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low …

Categorization And Frequency Of Indications For Packed Cell Transfusion In The Preterm Newborn During The Initial Hospital Stay At A Tertiary Care Hospital: A Cross-Sectional Study, Shirin Surani, Heeramani Lohana, Sheraz Ahmed, Rabia Hassan, Sapna Kewalani, Khalil Ahmed

Department of Paediatrics and Child Health

Introduction: Packed cell transfusion is a lifesaving procedure in premature babies as they have more complications as compared to babies who are born at term. Complications related to prematurity increase as gestational age decreases and anemia is one of the complications of prematurity which needs packed cell transfusions. To date, when to transfuse preterm babies and what would be the threshold for hemoglobin and hematocrit is still a point of argument as well as liberal versus restrictive transfusion protocols have been developed but what should be followed still needs more data. In our study, we have observed frequencies of different …

Refining A Postpandemic Approach To Cancer Screening, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

In introducing Volume 8, Issue 4 of Journal of Patient-Centered Research and Reviews — a specially themed issue comprised of several works focused on improving cancer screening processes in clinical practice — JPCRR editor and hematologist/oncologist Michael Thompson reflects on the current state of various screening modalities and how the pandemic has already begun to shape ongoing research in this area. A delicate balance must be struck between avoiding overtesting or overdiagnosis and identifying the presence of malignant tumors early enough to allow for successful treatment.

Communication Skills Training: A Means To Promote Time-Efficient Patient-Centered Communication In Clinical Practice, Else Dalsgaard Iversen, Maiken Wolderslund, Poul-Erik Kofoed, Pål Gulbrandsen, Helle Poulsen, Søren Cold, Jette Ammentorp

Journal of Patient-Centered Research and Reviews

Purpose: We hypothesized that health care providers would behave in a more patient-centered manner after the implementation of communication skills training, without causing the consultation to last longer.

Methods: This study was part of the large-scale implementation of a communication skills training program called "Clear-Cut Communication With Patients" at Lillebaelt Hospital in Denmark. Audio recordings from real-life consultations were collected in a pre-post design, with health care providers' participation in communication skills training as the intervention. The training was based on the Calgary-Cambridge Guide, and audio recordings were rated using the Observation Scheme-12.

Results: Health care providers improved their communication …

Improving Cancer Screening Rates In Primary Care Via Practice Facilitation And Academic Detailing: A Multi-Pbrn Quality Improvement Project, Christopher P. Morley, Laura A. Schad, Laurene M. Tumiel-Berhalter, Laura A. Brady, Alexandrea Bentham, Karen Vitale, Amanda Norton, Gary Noronha, Carlos Swanger

Journal of Patient-Centered Research and Reviews

Purpose: In the United States, cancer screening rates are often below national targets. This project implemented practice facilitation and academic detailing aimed at increasing breast, cervical, and colorectal cancer screening rates in safety-net primary care practices.

Methods: Three practice-based research networks across western and central New York State partnered to provide quality improvement strategies on breast, cervical, and colorectal cancer screening. Pre/postintervention screening rates for all participating practices were collected annually, as were means across all practices over 7 years. Simple ordinary least squares linear regression was used to calculate the trend for each cancer type and test for statistical …

Patient Perceptions Of Using Clinical Decision Support For Cancer Screening And Prevention: “I Wouldn’T Have Thought About Getting Screened Without It.”, Daniel M. Saman, Melissa L. Harry, Laura A. Freitag, Clayton I. Allen, Patrick J. O'Connor, Joann M. Sperl-Hillen, Joseph A. Bianco, Anjali R. Truitt, Heidi L. Ekstrom, Thomas E. Elliott

Journal of Patient-Centered Research and Reviews

Purpose: We sought to gain an understanding of cancer prevention and screening perspectives among patients exposed to a clinical decision support (CDS) tool because they were due or overdue for certain cancer screenings or prevention.

Methods: Semi-structured qualitative interviews were conducted with 37 adult patients due or overdue for cancer prevention services in 10 primary care clinics within the same health system. Data were thematically segmented and coded using qualitative content analysis.

Results: We identified three themes: 1) The CDS tool had more strengths than weaknesses, with areas for improvement; 2) Many facilitators and barriers to cancer prevention and screening …

Patient-Centered Home Cancer Screening Attitudes During Covid-19 Pandemic, Christelle El Khoury, Elizabeth Haro, Martha Alves, Marie Claire O'Dwyer, Kate Meixner, Laura Crespo Albiac, J Nicoll Capizzano, Manasi Ramakrishnan, Cullen Salada, Sherri Sheinfeld Gorin, Masahito Jimbo, Ananda Sen, Diane M. Harper

Journal of Patient-Centered Research and Reviews

The COVID-19 pandemic disrupted health care delivery of cancer screenings. The primary aim of our work was to evaluate the degree to which populations were accepting of home-based screenings for colorectal cancer (CRC) and cervical cancer (ie, primary human papillomavirus [HPV] testing). Three groups of adults having distinct health burdens that may affect acceptance of home-based cancer screening were identified through outpatient electronic medical records: those having survived a COVID-19 hospitalization; those having been positive for a non-COVID-19 respiratory illness; or those having type 2 diabetes. A total of 132 respondents (58% female) completed an online survey with hypothetical cases …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.