Primary Care Commons^™

From In-Person To Technology-Based Interpreting: Evolution And The Need For Flexible, Community-Based Standards, Muhiyadin (Mo) Aden

Theses and Graduate Projects

This study examines the significance of language access in healthcare and the transformative impact of technology-based interpreting modalities. Language barriers in healthcare can lead to misunderstandings and negative health outcomes for Limited English Proficiency (LEP) patients. The case study presents a Safety Net hospital, Hennepin Healthcare System (HHS), which successfully transitioned from in-person to a hybrid model utilizing Video Remote Interpreting (VRI) and Over-the-Phone Interpreting (OPI). Data analysis revealed improved productivity, reduced wait times, and surplus budget. The study challenges misconceptions around technology-based interpreting and recommends standardized protocols, interpreter documentation, and interhospital collaboration. By embracing technology and cultural understanding, healthcare …

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

Investigating The Relationship Between Mental Health And Co- Morbidity Management During The Covid-19 Pandemic: A Literature Review, Alejandra Soto

Theses and Graduate Projects

Background: The COVID-19 pandemic caused many disruptions to millions of lives, especially with the enforcement of government shutdowns, isolations, and social distancing. These measures lead to increased anxiety and depression in the general population. With many high- risk patient populations having chronic comorbidities, accessing routine medical care and supplies became difficult during the pandemic.

Purpose: How has mental health affected the management of pre-existing comorbidities during the COVID-19 pandemic?

Methods: A comprehensive literature review was conducted using the research engine PubMed using the search terms: “pandemic”, “COVID-19”, “comorbidities”, “mental health”, “morbidity”, and “mortality”. Inclusion criteria were studies …

What Are The Most Effective Risk Factor Management Strategies For The Prevention And Control Of Hypertension?, Sherlyne Barasa

Theses and Graduate Projects

Hypertension (HTN) affects millions of people globally. With the rising burden of HTN in primary care and its associated morbidity and mortality, it is necessary to explore effective risk factor management to control and prevent it in people most at risk. This research addressed both modifiable risk factors such as obesity, smoking, alcohol, and diet as well as non- modifiable risk factors such as age, race/ethnicity, and family history. The aim of this paper was to examine the most effective risk factor management strategies to control and prevent hypertension. The studies reviewed indicate that there are various risk factor management …

Continuous Glucose Monitoring: Optimizing Type 1 Diabetes Management In Older Adults, Alyssa Clements

Theses and Graduate Projects

Introduction: Type 1 diabetes (T1D) impacts many individuals around the world. Treatment goals of T1D include lowering hemoglobin A1c (HbA1c) values while minimizing the time spent in hypoglycemia. Frequent glucose monitoring is required to achieve optimal glycemic control.

Background: HbA1c has been used for many years to track glycemic control. When discussing care of older adults, hypoglycemia is a more important marker to track. The risks associated with hypoglycemia are higher among older adults with T1D than the general population. Multimorbidity, polypharmacy, and age-related mental decline increase the likelihood and danger of severe hypoglycemic episodes. Self-monitoring blood glucose (SMBG) provides …

What Is The Effect Of Physical Activity On The Reduction Of Macrovascular Complications In Patients Diagnosed With Type 2 Diabetes Mellitus?, Rachael M. Gordon

Theses and Graduate Projects

The increasing prevalence and healthcare burden of type 2 diabetes is a worldwide concern. It is the seventh leading cause of mortality and a significant cause of morbidity. While both the macrovascular and microvascular complications of diabetes can have a profound impact on overall health and quality of life, cardiovascular events are the leading cause of mortality in patients with type 2 diabetes. Adults with diabetes have a two to four-fold increased risk of cerebrovascular events and myocardial infarctions. Oral medications combat insulin resistance and aid in the control of hemoglobin A1c, blood pressure, and cholesterol, therefore, contributing to a …

Medical Treatment Of Diabetes Compared To Bariatric Surgery, Daniel Thornley

Theses and Graduate Projects

In this retrospective review, metabolic factors present in diabetic patients who underwent bariatric surgery were compared against those who were treated with medical therapy alone. These factors include: diabetes remission, glycosylated hemoglobin levels, medication use, changes in beta cells function, insulin sensitivity, incretin levels, weight loss, lipid profiles and blood pressures. Following bariatric surgery, patients observed superior changes in diabetes remission rates, glycosylated hemoglobin levels, medication use, beta cell function, insulin sensitivity, incretin levels, and weight loss when compared to those who were treated with medical therapy alone. Blood pressure changes were not significantly different among the two treatment groups. …

Factors That Impact Glycemic Control In Adolescents With Type 1 Diabetes, Kelsey Mcfarling

Theses and Graduate Projects

The incidence of Type 1 Diabetes (T1D) is increasing worldwide and is diagnosed disproportionately in adolescent populations. Additionally, studies show that adolescents with T1D experience worse glycemic control during this developmental period. Maintaining glycemic control in patients with T1D decreases the risk of developing future diabetic-related complications. Factors such as race, ethnicity, gender identity, sexual orientation, socioeconomic status, and medical comorbidities influence disparities in maintaining glycemic control in adolescents. The recognition of these factors on the management of T1D through an integrative team approach leads to increased glycemic control and decreased diabetic- related complications. This paper explores the effects of …

Misuse Of Prescription Stimulants And Their Effect On Cognition, Zachary Friederichs

Theses and Graduate Projects

Prescription stimulants like Adderall and Ritalin are increasingly being diverted and misused by college students who fail to recognize the potential health risks in an effort to improve academic performance. The main aim of this literature review is to address the prevalence of their misuse, the effects they have on cognition, and adverse side effects that are typically associated with their use. Despite being frequently referred to as "cognitive enhancers" or "smart pills," results from studies on these m􏰗edications remain mixed/unclear as to whether cognitive domains such as memory, executive function, and processing speed are actually enhanced. However, not surprisingly, …

Comparison Of Non-Nsaid Pain Management In The Treatment Of Patients With Symptomatic Knee Osteoarthritis, Nicholas Schmitz

Theses and Graduate Projects

Objective To compare the efficacy of other modalities and interventions versus standard first-line therapy of nonsteroidal anti-inflammatory drugs for pain management in patients with symptomatic knee osteoarthritis

Methods Perform literature reviews outlining patients suffering from Grade II or higher KOA using the Kellgren-Lawrence classification system and currently experiencing symptoms of pain, stiffness, and impaired physical functioning. Use data and results from various studies to compare improvement of symptoms from these modalities versus improvement of NSAIDs alone.

Results Weight loss and physical activity should remain the mainstay of early osteoarthritis treatment to help slow disease progression and symptoms of KOA. Duloxetine …

An Evaluation Of The Refugee Experience Of Liminality And The Impact Of Best Practice Models Of Care, Hanna Erickson

Theses and Graduate Projects

Globalization presents massive challenges for healthcare providers and the blend of language, expectation and cost creates increased risk for all patients. Refugees are among the most vulnerable of populations when overall health outcomes are measured and access to healthcare is analyzed.1 This is due to rapid modernization of health care systems and the fact that refugees are typically leaving a volatile place of origin and migrating to a wealthier, more stable country where different modalities are used to access care. Women of childbearing age comprise a huge portion of refugees and will be the population of focus examined here.

A …

An Evaluation Of Home-Based Primary Care (Hbpc): Impact On Cost And Outcomes And Patient Satisfaction In The United States And Abroad, Isaac Pierre

Theses and Graduate Projects

Over the past century, the role of medical home visits in patient care has undergone significant changes. Historically, physicians routinely delivered medical care to sick patients in their own homes. In 1930, for example, such calls represented 40% of physician-patient encounters. As healthcare providers developed an increasing reliance on technology and as payment models began to prioritize volumes and efficiency, the provision of health care shifted to hospitals and office-based settings. An analysis of house calls in 1972 found that the number of in-home visits amounted to a mere 5% of physician-patient encounters and these rates continued to decrease to …

Interventions In Reducing Weight Bias In Healthcare Providers And Preservice Students, Nora Powers

Theses and Graduate Projects

Weight bias is harmful to patients and pervasive in healthcare providers and healthcare students. Effective interventions to reduce weight bias in healthcare providers and students are urgently needed and would improve patient care and patient outcomes. A literature review of current research on interventions to reduce weight bias in healthcare professionals and students was conducted to evaluate strategies for efficacy. Twenty articles investigating weight bias reducing interventions in healthcare providers and students were analyzed. Five primary strategies are currently used: self- reflection and awareness of one’s own bias; empathy building experiences; the influence and experiences of others; narratives of and …