Primary Care Commons^™

P5: Covid-19 Vaccine: Technology Platform, Efficacy And Immune Protection, Manas Mandal

Annual Research Symposium

Roseman Research Day Symposium.

P2: Characteristics Of Individuals With Oral Hpv Positive Results, Val Cheever, Eric Hon, Andrew J. Gross, Man Hung

Annual Research Symposium

No abstract provided.

O2: In-Silico Approach To Analyze Anticancer Activity Of Withania Somnifera In Oral Cancer, Gauri Kumbhar

Annual Research Symposium

No abstract provided.

Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula

Evidence-Based Practice Project Reports

Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …

Save The Rich, Connor Harris

English Department: Research for Change - Wicked Problems in Our World

The problem of medication pricing and lobbying in the healthcare industry has caused millions of people within the United States to not be able to afford medications essential to their lives. Pharmaceutical companies are taking advantage of the need people have for certain drugs by setting the sale price far higher than it costs to produce. My suggested solution is to make lobbying illegal in the United States so that pharmaceutical companies would not have control over government officials who pass laws to help or hurt the issue of medication pricing. Illegalizing government lobbying will take away the incentive politicians …

Suicide Assessment, Angelo Rannazzisi, Psyd

Department of Family & Community Medicine Presentations and Grand Rounds

Agenda

● Risk & Protective Factors of Suicide

• Demographic, Diagnostic, Psychological Variables

● Suicide Risk Assessment

• C-SSRS (Columbia-Suicide Severity Rating Scale)
• BDI-II (Beck Depression Inventory 2nd Edition)
• Reasons for Living Inventory (RFL)

● Creating a Safety Plan

Natural Recovery By The Liver And Other Organs After Chronic Alcohol Use, Paul G. Thomes, Karuna Rasineni, Viswanathan Saraswathi, Kusum K. Kharbanda, Dahn L. Clemens, Sarah A. Sweeney, Jacy L. Kubik, Terrence M. Donohue, Carol A. Casey

Journal Articles: Internal Medicine

Chronic, heavy alcohol consumption disrupts normal organ function and causes structural damage in virtually every tissue of the body. Current diagnostic terminology states that a person who drinks alcohol excessively has alcohol use disorder. The liver is especially susceptible to alcohol-induced damage. This review summarizes and describes the effects of chronic alcohol use not only on the liver, but also on other selected organs and systems affected by continual heavy drinking-including the gastrointestinal tract, pancreas, heart, and bone. Most significantly, the recovery process after cessation of alcohol consumption (abstinence) is explored. Depending on the organ and whether there is relapse, …

Patellofemoral Disfunction, Chris Mulholland, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

The Future Of American Primary Care, Julianne M. Johnsonwall

Classical Conversations

Historically, primary care has been delivered by physicians in private practices. However, pre-medical and medical students considering primary care should consider that market trends and physician preferences are changing the delivery methods of primary care. This thesis aims to predict the future delivery methods of primary care in America. By analyzing current studies, articles, and physician polls, it asserts that private practices are not a financially viable practice model and that medical systems will dominate primary care. Firstly, it identifies low insurance reimbursement rates, increasing quality documentation requirements, and an unhealthy work-life balance as the primary obstacles to private practice …

Research Participation Of Minor Adolescents In Foster Care, Jenny Francis, Jane Andresen, Heidi Kloster, Jill Mcleigh, Alexis Guzman, Susan Rosenthal

Health Status, Outcomes, and Literacy and Healthcare Utilization

In this study we evaluated published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

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.

Improving Care Coordination For The Homeless Population Using Systematic Quality Improvement, Rutendo Nyasvisvo

Doctoral Projects

Background and Objectives: Care coordination for the homeless population is challenging due to the complexity of healthcare and the uncertain life circumstances of the homeless individual. Objectives were developed to guide care coordination for the homeless by utilization of the free clinic to create PCP referrals, appointments and tracking follow-up care to increase appointment attendance and improve health outcomes for the homeless individual.

Design: A quality improvement project.

Setting: A faith-based non-profit homeless shelter organization in the Midwestern United States.

Participants: Participants include 25 homeless guests, 5 staff members including a clinic coordinator, 3 registered nurses and 1 licensed practical …

A Program Evaluation To Assess Readiness For The National Committee For Quality Assurance’S Patient Centered Medical Home Model Application, Alida M. Semrinec

Doctoral Projects

The Patient Centered Medical Home Model is associated with enhanced patient experience and quality improvement outcomes. The Model has the capacity to guide primary care practices to enhance quality, provide more comprehensive, patient centered care, and increase practice revenue. An urban, nurse managed community health center that has recently implemented the nurse care manager role (a Model requirement) desires to apply for recognition. A program evaluation was conducted to assess current practice, policies, and procedures in place at a Community Health Center through the lens of the National Committee for Quality Assurance’s forty Patient Centered Medical Home Model core competencies. …

Social Isolation: Impact On Physical And Mental Health, Alexa Waters, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the impact of social isolation and loneliness on important aspects of health and well-being, with a focus on older adults
• Review risk and protective factors for social isolation and loneliness
• Discuss how the health care system and primary care physicians can better identify and address social isolation
• Briefly highlight interventions to enhance social connectedness and reduce loneliness

Outline

• Background
• Impacts of social isolation and loneliness on health and well-being
• Risk and protective factors for social isolation and loneliness
• Role of the health system and primary care in addressing social isolation and loneliness
• Cases throughout

Preparticipation Evaluation Of The Special Olympics Athlete, Mary M. Stephens, Md, Mph

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• By the end of this module the student will be able to describe the components of a pre-participation sports evaluation.
• By the end of this module the student will be able to articulate an assessment for atlantoaxial instability.
• By the end of this module the student will be able to apply the learned knowledge from the module to a case study.
• By the end of this module the student will be able to recommend appropriate anticipatory guidance to the athlete.

The Limping Child, Bob Wiley, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the definition of limp
• Describe the approach to initial evaluation of a limping child, including key items in the history and physical exam
• Appreciate the broad differential that one must keep when evaluating a limping child
• Understand the different types of limp and how they can be used to formulate a differential
• Recognize red flag signs and symptoms which require more urgent evaluation
• Use cases to demonstrate some of the common presentations that are seen by the GP

Understanding The Prevalence Of Compassion Fatigue, Compassion Satisfaction, And Resilience In Primary Care, Christina M. O'Connell

Doctor of Nursing Practice Scholarly Projects

Compassion fatigue (CF), its components of burnout (BO) and secondary traumatic stress (STS), and compassion satisfaction (CS) affect healthcare providers and staff and can dramatically influence patient care and access to primary care services. Resilience is a tool which serves as a protective factor that can mitigate CF and enhance CS. There is a gap in research regarding the relationship between compassion fatigue, compassion satisfaction, and resilience among primary care providers and frontline staff. Additionally, the current COVID-19 pandemic has revealed healthcare’s deficits related to staff and provider burnout, a myriad of workforce safety issues, disparities in care, and a …

Hospice Care For The Primary Physician, Katie Mechler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Palliative vs Hospice Care
• History of Hospice Care
• Description of the Hospice Benefit
• Review of Hospice Eligibility
• Discussing Hospice with your Patients

A Study In Sodium: Or... "If I Look Confused, It's Because I'M Thinking...", Gregory A. Jaffe, Md, Msed

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Describe the three questions we ask when approaching a patient with hyponatremia.
• Identify how your history and physical can aid in the diagnosis of hyponatremia.
• Recall how we treat different types of hyponatremia

Integrating Behavioral Health And Primary Care (Ibh-Pc) To Improve Patient-Centered Outcomes In Adults With Multiple Chronic Medical And Behavioral Health Conditions: Study Protocol For A Pragmatic Cluster-Randomized Control Trial, Terry Stancin, Kurt C. Stange, Kathryn Teng

Faculty Scholarship

Background: Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has difficulty responding. Some primary care practices are providing integrated behavioral health care (IBH), where primary care and behavioral health providers work together, in one location, using a team-based approach. Research suggests there may be an association between IBH and improved patient outcomes. However, it is often difficult for practices …

Smoking Cessation, Julita Mitchell, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

● Appreciate the significance of addressing smoking cessation

● Learn a brief interventional model for cessation counseling

● How to structure a quit plan

● Understand the role/risks/benefits of

• Pharmacologic therapy
• Behavioral therapy
• Electronic cigarettes

● Learn practical tips and hear sample language

● Watch a sample intervention

Assessment Of Knowledge, Attitude, And Practice Of Child Abuse Amongst Health Care Professionals Working In Tertiary Care Hospitals Of Karachi, Pakistan, Khuld Nihan, Aamir Makda, Huzaifah Salat, Munawar Khursheed, Jabeen Fayyaz, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: UNICEF report (2004) states that a significant percentage of total child population under the age of 5 years suffered malnutrition. Child sexual abuse remains undiscussed across Pakistan. Health care professionals (HCPs) are usually the first notifiers of child abuse and are ethically obliged to manage and report it.
Objective: This study was conducted to assess HCPs' response in dealing with patients of child abuse. With a better understanding, we can have a better outcome for the victims.
Methods: A total of 101 participants filled out a structured questionnaire by HCPs working in three tertiary hospitals of Karachi i.e., Aga …

Drug Susceptibility Patterns Of Mycobacterium Tuberculosis From Adults With Multidrug-Resistant Tuberculosis And Implications For A Household Contact Preventive Therapy Trial, Anne-Marie Demers, Soyeon Kim, Sara Mccallum, Kathleen Eisenach, Michael Hughes, Linda Naini, Alberto Mendoza-Ticona, Neeta Pradhan, Kim Narunsky, Selvamuthu Poongulali, Sharlaa Badal-Faesen, Caryn Upton, Elizabeth Smith, N Sarita Shah, Gavin Churchyard, Amita Gupta, Anneke Hesseling, Susan Swindells, Actg A5300/Impaact I2003 Phoenix Feasibility Study Team

Journal Articles: Internal Medicine

BACKGROUND: Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household contacts (HHCs).

METHODS: As part of a feasibility study done in preparation for an MDR-TB preventive therapy trial in HHCs, smear, Xpert MTB/RIF, Hain MTBDRplus, culture and DST results of index MDR-TB patients were obtained from routine TB programs. A sputum sample was collected at study entry and evaluated by the same tests. Not all tests were performed on all specimens due to variations …

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …

Lipid Droplet Membrane Proteome Remodeling Parallels Ethanol-Induced Hepatic Steatosis And Its Resolution, Carol A. Casey, Terrence Donohue, Jacy L. Kubik, Vikas Kumar, Michael J. Naldrett, Nicholas T. Woods, Cole P. Frisbie, Mark A. Mcniven, Paul G. Thomes

Journal Articles: Internal Medicine

Lipid droplets (LDs) are composed of neutral lipids enclosed in a phospholipid monolayer, which harbors membrane-associated proteins that regulate LD functions. Despite the crucial role of LDs in lipid metabolism, remodeling of LD protein composition in disease contexts, such as steatosis, remains poorly understood. We hypothesized that chronic ethanol consumption, subsequent abstinence from ethanol, or fasting differentially affects the LD membrane proteome content and that these changes influence how LDs interact with other intracellular organelles. Here, male Wistar rats were pair-fed liquid control or ethanol diets for 6 weeks, and then, randomly chosen animals from both groups were either refed …

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Perinatal Maternal Mood Disorders, Sarah Elizabeth Hirsh Cokenakes, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To identify the spectrum of peripartum mood disorders, their features, diagnostic criteria, and treatments.
2. To review FDA pregnancy safety categories and lactation categories for commonly prescribed mood medications.
3. To identify the role of family physicians in identifying and treating peripartum mood disorders.

Gender Identity And Pronoun Usage In Standardized Patient Encounters, Martha M. Popescu, Emily J. Noonan, Laura A. Weingartner

Grawemeyer Colloquium Papers

One of the most common documentation frameworks clinicians use for patient evaluations are Subjective, Objective, Assessment, and Plan, (SOAP) notes. The clinician will usually record medical, family, social, etc. history as “subjective” information. Temperature, blood pressure, lab work, etc. would be considered “objective” information. An evaluation of the patient’s health and possible medical issues would be considered the “assessment,” and their intentions for current and future treatment would be the “plan” within these notes. Trainees often write SOAP notes after completing a standardized patient (SP) encounter—an educational practice used in medical schools to simulate real-world physician-patient interactions in order to …

Effect Of Consumption Of Animal Milk Compared To Infant Formula For Non-Breastfed/Mixed-Fed Infants 6-11 Months Of Age: A Systematic Review (Protocol), Aamer Imdad, Julie Melissa Ehrlich, Joseph Catania, Emily Tanner-Smith, Abigail Smith, Olivia Tsistinas, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Prevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children's health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal's milk. The objective of this review is …

Preventive Care: Controversies, Challenges And Upcoming Changes In Guidelines, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Organizations who make guidelines
• Current guidelines for average-risk adults, with a focus on guidelines with differing recommendations and challenges to implementation/operational issues
• Preview of upcoming changes in guidelines
• Cases to illustrate some of the common questions that come up in delivering office-based preventive care
• Some disclaimers