Primary Care Commons^™

Lavender Aromatherapy: Ready For Prime-Time Office Use?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the perioperative use of lavender aromatherapy and its potential to relieve pain and anxiety during minor primary care office procedures.

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Fresh Fruits And Vegetables Really Do Keep The Doctor Away: Symptomatic Vitamin Deficiency In A Middle Aged Man, Matthew J. Turnquist Md, Christina Holt Md, Msc

Journal of Maine Medical Center

Introduction

We present a clinical case of symptomatic vitamin deficiency typically seen only in resource limited environments or alcoholics, presenting in an adult male with frequent oral intake, but limited diet of prepared foods, as well as co-occurring pernicious anemia.

Clinical Findings

The patient presented with complaints of ascending paresthesia leading to near syncope, lower extremity edema and hyperpigmentation on his anterior legs bilaterally which had been present for years.

Diagnosis and interventions

He was found to have mixed B12, thiamine, and folate deficiency. These were attributed to a combination of nutritional deficiency due to a diet of exclusively cooked …

Registered Nurse Perception Of Physician Assistants, Erin Renee Alpers, Linda Charles, Kaitlyn Mellesmoen

All Electronic Theses and Dissertations

The physician assistant (PA) profession is a relatively new and ever-growing field within healthcare. PAs serve patients in many different specialties alongside a wide variety of other members of healthcare teams. With the exponential growth of the PA profession the understanding of the role they provide is essential to other healthcare workers. Since the emergence of the PA there has been one study on the relationship between Registered Nurses (RNs) and PAs, and this occurred over thirty years ago. An understanding between team members continues to be key to promoting effective care of patients in healthcare teams. Therefore, the study …

A Community Service Project: Creating Awareness Of Chronic Malnutrition In Guatemalan Children, Mallory A. Beswick, Bree A. Blanchette, Brooke L. Elvehjem

All Electronic Theses and Dissertations

Guatemala City is home to one of Central America’s largest garbage dumps. Many individuals living in Guatemala City scavenge the dump for recyclables and other goods, that they can then sell for income. Family earnings vary greatly on a daily basis and can range anywhere from approximately $2.00 to $6.00. Since family income is very low and often unpredictable, many families living in the area struggle to supply not only a sufficient amount of food for their children, but also nutritious food needed for proper growth and development. As a result, many children in Guatemala face chronic malnutrition. Transforming Futures, …

Postpartum Depression Education Of Doulas For Incarcerated Women, Tatia Marie Hibbs, Mikaela Reed, Claire Sautner

All Electronic Theses and Dissertations

As of 2017, there were 111,360 females in a state or federal correctional facility (Bronson & Carson, 2019). Many women in prison are mothers with 5-10% being pregnant while imprisoned (Baldwin, Sobolewska, & Capper, 2018). Some programs have started in female prisons with the goal to provide opportunities to nourish relationships with their children and educate on prenatal health, mental and physical health, and parenting skills. One of these organizations is the Minnesota Prison Doula Project (MnPDP) which utilizes the skills of doulas to provide supportive care to the incarcerated women of the Minnesota Correctional Facility-Shakopee (MCF-Shakopee). MCF-Shakopee is the …

Change In Empathy Levels Among Practicing Physician Assistants, Matthew P. Horn, Jacqueline Roff, Lisa Xiong

All Electronic Theses and Dissertations

This research sought to determine whether empathy declined with either increased years of physician assistant (PA) clinical experience or increased years of pre-PA healthcare experience (HCE). Although there has been an abundance of research examining empathy level trends among healthcare providers, most of these studies have looked at student empathy and not empathy level changes among practicing healthcare providers. However, among clinical healthcare providers, burnout trends with increasing years of experience (Smith, 2018) and a decline in empathy (Wilkinson, Wittington, Perry, & Eames, 2017); therefore, this project examined the link between years of practice and empathy decline. This cross-sectional study …

Hunger Solutions Market Bucks Program Improvement In The Rural Setting: A Research Project, Kollin D. Michels, Nicholas S. Reich, Jeffrey D. Sandquist

All Electronic Theses and Dissertations

Food insecurity – a lack of food required for a healthy and productive life – affects approximately 150 million households in the United States alone (Coleman-Jensen, Rabbit, Gregory, & Singh, 2018). The implications of this are numerous – as individuals who are “food insecure” have a statistically increased risk of numerous health conditions and disorders. In an effort to combat the burden of food insecurity, organizations such as the Supplemental Assistance and Nutrition Program (SNAP) have been created to provide increased access to food items. Furthermore, numerous state organizations have developed additional programs, which incentivize SNAP users to purchase nutrient …

The Need For A Physical Therapy Clinic In Pucallpa, Peru, Isabella M. Sutton, Abby M. Waldek, Brylie M. Wiedmaier

All Electronic Theses and Dissertations

In developing countries, complications from traumatic injuries account for a significantly higher number of deaths annually compared to developed countries. Not only are traumatic injuries more likely to occur in developing countries, but limited access to quality healthcare and adequate funds to pay for services make it much more likely for individuals to be left with lifelong disabilities. With that, this community service project worked with Scalpel at the Cross (SATC), an orthopedic medical ministry based in Pucallpa, Peru to expand their ability to provide free orthopedic surgeries and physical therapy following traumatic injuries. The community service project will help …

Opioid Knowledge, Confidence, And Concern Of Bethel University Physician Assistant Students, Lealand A. Torgerson, Travis A. Williams

All Electronic Theses and Dissertations

With more than 130 people dying daily, 47,000 overdose-related deaths per year, and $55 billion in societal costs, the opioid epidemic is producing widespread, catastrophic consequences on the population and healthcare system. Healthcare providers report high concern and lack of confidence that their training prepared them adequately to manage chronic pain with opioid therapy. There is insufficient evidence determining whether educating healthcare providers on opioid prescribing guidelines leads to improved knowledge, confidence, and a decrease in concern. The aim of this study is to assess the knowledge, confidence, and concern of 2020 Bethel University physician assistant (PA) students of opioid …

Vaping Education In The Adolescent Population, Megan M. Meinders, Morgan Sauvage, Shania Scheidt, Alexa Trakalo

All Electronic Theses and Dissertations

The prevalence of e-cigarette use in the United States is drastically rising, deeming vaping an epidemic. With the surge in the use of e-cigarettes, cases of e-cigarette or vaping product use-associated lung injury (EVALI) are simultaneously increasing. The most common tobacco product used among adolescents are e-cigarettes, posing serious concerns regarding health consequences. Adolescents are unaware of the potential harmful effects of e-cigarette use, due to the lack of vaping education provided in high school curriculums.The purpose of this research project is to educate high school students about the harmful effects of e-cigarette use. The need for vaping education was …

Caring For Children In Child Welfare Systems: A Trauma-Informed Model Of Integrated Primary Care, Jill Mcleigh, Laura Lamminen, Heidi Roman

Integrated, Trauma-Informed Care

Children involved with the child welfare system have high rates of behavioral health concerns, chronic health conditions, and developmental disabilities. Further, as a result of the complicated relationships among the court system, child protective services, and caregivers (i.e., biological, kinship, and/or foster caregivers) and the high volume of health-, behavior-, and development-related services children in care need, the services they receive tend to be fragmented and problem driven. On top of these challenges, children involved with the child welfare system have been exposed to trauma, and often more than one form of trauma. Taken together, these factors point to the …

The Va Mission Act Of 2018: A Potential Game Changer For Rural Gme Expansion And Veteran Health Care, Anne Victoria Neale, Phil Lupo, Marjorie A. Bowman, Dean A. Seehusen

Population and Public Health Sciences Faculty Publications

The Veterans Healthcare Administration (VHA) is the largest health care delivery system in the United States. It includes 172 medical centers (VAMCs), with over 1,100 Community Based Outpatient Centers (CBOCs) and various other sites of care. In addition to training physicians to care for veterans and active duty service members, the VHA is also directed to assist in supplying health care personnel to the nation.Through its Office of Academic Affiliations (OAA), VHA develops partnerships with Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) accredited residency program sponsoring institutions. These collaborations include 144 out of 152 allopathic medical schools …

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim …

The Efficacy Of Adding Eicosapentaenoic Acid To Statin Monotherapy In The Prevention Of Acute Coronary Syndrome In Patients With Coronary Artery Disease, Carlo Escudero

Capstone Showcase

Introduction: Coronary artery disease (CAD) is a chronic medical condition caused by the buildup of plaque within the coronary artery endothelium. If left untreated it can progress to an acute coronary syndrome (ACS) which can lead to myocardial ischemia and death. Statins are lipid lowering agents used in clinical practice for the medical management of CAD. However, incidence of major adverse cardiovascular (CV) events still occurs despite optimal statin therapy. Currently eicosapentaenoic acid (EPA) has been promoted to be effective when added to statin therapy in lowering the incidence of CV events in patients with hypercholesterolemia. This paper will address …

A High Docosahexaenoic Acid Diet Alters The Lung Inflammatory Response To Acute Dust Exposure, Edward C. Dominguez, Art J. Heires, Jacqueline A. Pavlik, Tricia D. Larsen, Stephanie Guardado, Joseph H. Sisson, Michelle L. Baack, Debra J. Romberger, Tara M. Nordgren

Journal Articles: Internal Medicine

Agricultural workers are at risk for the development of acute and chronic lung diseases due to their exposure to organic agricultural dusts. A diet intervention using the omega-3 fatty acid docosahexaenoic acid (DHA) has been shown to be an effective therapeutic approach for alleviating a dust-induced inflammatory response. We thus hypothesized a high-DHA diet would alter the dust-induced inflammatory response through the increased production of specialized pro-resolving mediators (SPMs). Mice were pre-treated with a DHA-rich diet 4 weeks before being intranasally challenged with a single dose of an extract made from dust collected from a concentrated swine feeding operation (HDE). …

Age-Related Visual Dynamics In Hiv-Infected Adults With Cognitive Impairment., Boman R. Groff, Alex I. Wiesman, Michael T. Rezich, Jennifer O'Neill, Kevin R. Robertson, Howard S. Fox, Susan Swindells, Tony W. Wilson

Journal Articles: Internal Medicine

OBJECTIVE: To investigate whether aging differentially affects neural activity serving visuospatial processing in a large functional neuroimaging study of HIV-infected participants and to determine whether such aging effects are attributable to differences in the duration of HIV infection.

METHODS: A total of 170 participants, including 93 uninfected controls and 77 HIV-infected participants, underwent neuropsychological assessment followed by neuroimaging with magnetoencephalography (MEG). Time-frequency analysis of the MEG data followed by advanced image reconstruction of neural oscillatory activity and whole-brain statistical analyses were used to examine interactions between age, HIV infection, and cognitive status. Post hoc testing for a mediation effect of …

Myd88 Regulates A Prolonged Adaptation Response To Environmental Dust Exposure-Induced Lung Disease, Amber N. Johnson, Jack R. Harkema, Amy J. Nelson, John D. Dickinson, Julianna Kalil, Michael J. Duryee, Geoffrey M. Thiele, Balawant Kumar, Amar B. Singh, Rohit Gaurav, Sarah C. Glover, Ying Tang, Debra J. Romberger, Tammy Kielian, Jill A. Poole

Journal Articles: Internal Medicine

BACKGROUND: Environmental organic dust exposures enriched in Toll-like receptor (TLR) agonists can reduce allergic asthma development but are associated with occupational asthma and chronic bronchitis. The TLR adaptor protein myeloid differentiation factor88 (MyD88) is fundamental in regulating acute inflammatory responses to organic dust extract (ODE), yet its role in repetitive exposures is unknown and could inform future strategies.

METHODS: Wild-type (WT) and MyD88 knockout (KO) mice were exposed intranasally to ODE or saline daily for 3 weeks (repetitive exposure). Repetitively exposed animals were also subsequently rested with no treatments for 4 weeks followed by single rechallenge with saline/ODE.

RESULTS: Repetitive …

The Effect Of A Sun Damage Simulation Photography App On The Skin-Protective Behavior Intentions Of Women With Children Age 18 Or Younger, James Bowlds

DNP Projects

Abstract

Background: Skin cancer is the most common form of cancer diagnosed in the U.S. annually, despite being a largely preventable disease through the limitation of ultraviolet radiation exposure. Attempts to decrease its incidence have focused on appearance-based interventions. These have been effective at improving sun-protective behaviors among various subpopulations including people of color. Anecdotal observations suggest mothers more frequently utilize sun protection for their children than on themselves.

Purpose: The purpose of this project was to gain an understanding of the sun protection practices and beliefs of Caucasian and African American mothers, to assess the response to an appearance-based …

Pilot Study Of Behavioral Activation As Adjunct Treatment For Depression In Primary Care, Lindsay Ellen Toler

Graduate Theses, Dissertations, and Problem Reports (ETD)

Many individuals receiving care at a predominantly free primary health care clinic in the northern part of West Virginia are experiencing depression, and medication therapy is the most common form of management with limited resources for psychosocial treatment. Brief psychosocial therapy interventions provided by the primary care provider should be explored as an adjunct treatment for this population in the primary care setting.

A pilot study was conducted to explore the integration of behavioral activation, a brief psychosocial intervention focused on decreasing depressed behavior by increasing nondepressed behavior to reinforce corresponding improvements in mood. Eligible patients were invited to attend …