Primary Care Commons^™

Smoking Cessation Interventions In South Asian Countries: Protocol For Scoping Review, Sajid Iqbal, Rubina Barolia, Laila Ladak, Pammla Petrucka

School of Nursing & Midwifery

Introduction: Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the …

Docosanoid Signaling Modulates Corneal Nerve Regeneration: Effect On Tear Secretion, Wound Healing, And Neuropathic Pain, Thang L. Pham, Haydee E P Bazan

School of Medicine Faculty Publications

The cornea is densely innervated, mainly by sensory nerves of the ophthalmic branch of the trigeminal ganglia (TG). These nerves are important to maintain corneal homeostasis, and nerve damage can lead to a decrease in wound healing, an increase in corneal ulceration and dry eye disease (DED), and neuropathic pain. Pathologies, such as diabetes, aging, viral and bacterial infection, as well as prolonged use of contact lenses and surgeries to correct vision can produce nerve damage. There are no effective therapies to alleviate DED (a multifunctional disease) and several clinical trials using ω-3 supplementation show unclear and sometimes negative results. …

Female Sexual Dysfunction In Older Adults, Madeline Taskier, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. Review female sexual response and anatomy/physiology of the older female adult
2. Define different types of sexual dysfunction and risk factors
3. Review approaches to screening for sexual dysfunction in the primary care setting
4. Discuss practical approaches to treatment or referral in the primary care setting

Cardiac Stress Testing, Michael Bozzi, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Learning Objectives

-- Questions to be answered:
• What is a stress test?
• Who should I send for a stress test?
• Which kind of stress test should I order?
• How do I interpret these results?

-- 4 Cases

Primary Care In A Pandemic: A Qualitative Study On The Impact Of Covid-19 On Workplace Wellness, Oriana Pando, Amy Cunningham, Erin Kelley, Randa Sifri, Kelsey Smith

Phase 1

Introduction:

On March 16, 2020, the city of Philadelphia announced a state of emergency due to the COVID-19 global pandemic. The Primary Care Department of Thomas Jefferson Hospital had to alter operations to protect patients, providers and staff. These changes included an increase in telehealth, personal protective equipment (PPE), spacing in-person visits, and working from home. This study was designed to qualitatively assess how these changes have impacted providers and staff in Jefferson’s primary care settings.

Methods:

We conducted 31 qualitative semi-structured interviews with employees of Jefferson Primary Care practices. Though, our population was heavily skewed toward clinical staff (N=9), …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

A Watched Pot Never Boils: Attentive Care Needs No Timer, 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 comments on the premise that length of patient consultation time is less important than what patients perceive happened during that time. Regardless of the time allotted to a clinical visit, health care providers should make efforts to address the emotional and psychosocial needs of their patients. As always, taking a little time to express empathy can make a big difference in patient satisfaction.

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

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 …

The Silence Of Food Insecurity: Disconnections Between Primary Care And Community Organizations, Nicole K. Runkle, David A. Nelson

Journal of Patient-Centered Research and Reviews

Purpose: Food insecurity is a prominent issue in the United States, and it is well established that food insecurity is linked to health and chronic illnesses. Studies show that screening for food insecurity is not yet part of standardized practice among all primary care physicians, nor are care providers comfortable with how to proceed with a patient who presents with this issue. Food insecurity is often handled by community-based organizations (CBOs) such as food pantries. Family medicine and pediatric clinics (FMPC) and CBOs hold unique relationships with their clients and can benefit from partnerships with each other to improve health …

Approach To Ruq Pain, Jose Medina, Md, Msw

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Highlight the prevalence of RUQ pain
• Review the anatomy relevant to RUQ pain
• Discuss the broad differential associated
• Walk through important history, physical exam, and lab work components of the work up for RUQ pain
• Review the appropriateness/clinical utility of different imaging modalities
• Highlight common US findings associated with RUQ pain
• Case review and management of common RUQ diagnoses

The Implementation Of Telemedicine In The Covid-19 Era, Rebecca K. Bell, Katherine Badger, Kerri L. Barton Mph, Michael Kohut Phd, Michael Clark Md

Journal of Maine Medical Center

Introduction: During the COVID-19 global pandemic in 2020, social distancing policies called for health care providers to turn to telemedicine platforms for most of their patient encounters. We aimed to better understand the experiences and perspectives of patients and providers who used telemedicine in the primary care setting.

Methods: This study included semi-structured interviews with patients and providers who participated in telemedicine visits during the beginning of the COVID-19 pandemic. Patients (n = 14) were from a rural Maine practice and providers (n = 10) were from practices within 100 miles of a tertiary care center. The interviews were analyzed …

Implementing A Health And Wellness Program For Low Income Children And Their Families: A Community Outreach Program, Kailey Ann Geib, Hannah N. Moland, Emily Nicole Nelson

All Electronic Theses and Dissertations

Low income status has been proven to have negative effects on overall health, such as increased prevalence of chronic diseases and poor childhood development (Gupta, de Wit, & McKeown, 2007). Children living in communities of this status often do not have access to healthy foods or exercise facilities in comparison to middle and upper class children (Gupta, de Wit, & McKeown, 2007). Enhancement of education on these topics has the ability to combat the risk for poor health outcomes. A health and wellness program called SMILE was created and implemented at a child care center, called Carol Mathey’s Center for …

Pa School And Relationship Satisfaction, Hannah M. Kerkhof, Rebecca Kornowski

All Electronic Theses and Dissertations

Physician assistant programs are rigorous, fast-paced, and time intensive, putting significant stress on PA students themselves and their romantic relationships. Research has been done on the effects of medical school on student mental health and romantic relationships, but there is a lack of research on PA students who undergo a similar didactic education. Determining the relationship between PA school stressors and relationship satisfaction may aid in the development of coping mechanisms for couples, reduce student and partner stress, and improve student well-being. The study revealed students who were married, male, between the ages of 30-39,cohabiting, or in long term relationships …

Assessment Of Medical Experiences Of Hearing Guardians With Deaf Or Hard Of Hearing Children In The Twin Cities, Hannah R. Jaster, Erin R. Rudolph, Melinda Sorensen

All Electronic Theses and Dissertations

This paper assesses the medical experiences guardians of deaf or hard of hearing children have after their children are first diagnosed with a hearing loss within the Twin Cities region of Minnesota. Data collection used a mixed methods approach through a survey containing Likert scale questions and opportunities to elaborate on personal experiences. The non-profit organization MN Hands & Voices provided a population qualified to participate in this study who were hearing guardians with a child under ten years old diagnosed within the Twin Cities region of Minnesota. Hearing loss can cause delays in language development if not diagnosed early, …

Diagnosing Dermatological Conditions In The Non-Caucasian Population, Mackenzie M. Mellum, Candace Joyce Nysted, Kassidy E. Westrom

All Electronic Theses and Dissertations

There is currently a lack of resources available on dermatological conditions in the non-Caucasian population; therefore, additional educational materials are needed to supplement the education of healthcare professionals (Ebede & Papier, 2006). The researchers created an educational module with common dermatological conditions, the presentation of various dermatological conditions, and descriptive pictures of how each condition presents in the non-Caucasian population to use as a supplement to the current dermatology modules that are used throughout various health and social science programs at Bethel University in Arden Hills, MN. The topics of the module include basal cell carcinoma, squamous cell carcinoma, melanoma, …

The Effects Of Socialization On The Progression Of Dementia, Caitlyn Hagstrom, Ashley G. Heppner, Katelyn N. Kunde

All Electronic Theses and Dissertations

Dementia is an umbrella term for a group of disorders marked by a decline from baseline in memory, executive function, and other cognitive functions such as reasoning, handling complex tasks, and spatial orientation, all of which interferes with activities of daily living and independence (Larson, 2019). Current pharmaceutical management of dementia and related symptoms is limited (Press & Alexander, 2019b). As dementia progresses, the cognitive skills required to maintain social interactions and familial relationships decline, therefore affecting the perceived loneliness and isolation of the person living with dementia. This research was conducted to understand the role of socialization in the …

Mitigating Mitochondrial Dysfunction In The Insulin Resistant Phenotype: A Ketogenic Diet And Intermittent Hypoxia, William Christian Grillo, Joshua Pinson, Bethany K. Tangen

All Electronic Theses and Dissertations

Chronic disease currently affects 45%, nearly half, of all persons in the United States (Raghupathi & Raghupathi, 2018). A systemic, cellular etiology of chronic disease has been proposed: literature supports the mechanism of a universal cell danger response (CDR) (Naviaux, 2019). The hallmark of the CDR, the shift in metabolism to anaerobic glycolysis, is initiated by altered functionality of the mitochondria (Naviaux, 2019). Current research on mitochondrial dysfunction has demonstrated that a hypoxic intervention has successfully increased longevity in mice with mitochondrial dysfunction, but such an intervention has not, to our knowledge, been attempted in humans (Jain et al., 2016). …

High-Throughput Analysis Of Lung Immune Cells In A Combined Murine Model Of Agriculture Dust-Triggered Airway Inflammation With Rheumatoid Arthritis, Rohit Gaurav, Ted R. Mikuls, Geoffrey M. Thiele, Amy J. Nelson, Meng Niu, Chittibabu Guda, James D. Eudy, Austin E. Barry, Todd A. Wyatt, Debra J. Romberger, Michael J. Duryee, Bryant R. England, Jill A. Poole

Journal Articles: Internal Medicine

Rheumatoid arthritis (RA)-associated lung disease is a leading cause of mortality in RA, yet the mechanisms linking lung disease and RA remain unknown. Using an established murine model of RA-associated lung disease combining collagen-induced arthritis (CIA) with organic dust extract (ODE)-induced airway inflammation, differences among lung immune cell populations were analyzed by single cell RNA-sequencing. Additionally, four lung myeloid-derived immune cell populations including macrophages, monocytes/macrophages, monocytes, and neutrophils were isolated by fluorescence cell sorting and gene expression was determined by NanoString analysis. Unsupervised clustering revealed 14 discrete clusters among Sham, CIA, ODE, and CIA+ODE treatment groups: 3 neutrophils (inflammatory, resident/transitional, …

Early Palliative Care Implementation In Metastatic Lung Cancer Patients: A Quality Improvement Project, Megan Joan Biegler, Erin Hamar, Stephanie Spinolo

All Electronic Theses and Dissertations

This was a quality improvement project that will allow improvements to be made in healthcare services offered and the overall health status of Stage IV metastatic lung cancer patients receiving palliative care referrals. Data was collected retrospectively from electronic medical records of Stage IV metastatic lung cancer patients with palliative care referrals between January 2019 and March 2020. The palliative care referrals between January 2019 and August 2019 were given per oncologist discretion in timing compared to August 2019-March 2020 when new patients received nurse navigator driven palliative care referrals immediately upon diagnosis. Data analysis looked at correlations for each …

Preventive Healthcare Services Receipt And Primary Care Provider Utilization Among People Who Inject Drugs, E K. Nenninger, Kinna Thakarar

Costas T. Lambrew Research Retreat 2021

Introduction:

People who inject drugs (PWID) face barriers to accessing primary care providers (PCPs) and preventive services, but are at increased risk for preventable infections

Preventive services can be accessed through PCPs, or while hospitalized or at community organizations like syringe service programs (SSPs)

Transitioning From Foster Care To Adulthood: Supporting Adolescents And Young Adults, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children involved in foster care have significant trauma histories and have often experienced substantial neglect and/or abuse. Such adverse childhood experiences can lead to cumulative toxic stress, which if not buffered by support and a consistent adult caregiver, can negatively impact physical, mental and socio-emotional development. Such experiences can also result in a lack of trust in adults and systems of care, which can further reduce sources of support for children in foster care.

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

childrens.com/fostercare

The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could …

Alcohol-Induced Lysosomal Damage And Suppression Of Lysosome Biogenesis Contribute To Hepatotoxicity In Hiv-Exposed Liver Cells, Moses New-Aaron, Paul G. Thomes, Murali Ganesan, Raghubendra Singh Dagur, Terrence Donohue, Kusum K. Kharbanda, Larisa Y. Poluektova, Natalia A. Osna

Journal Articles: Internal Medicine

Although the causes of hepatotoxicity among alcohol-abusing HIV patients are multifactorial, alcohol remains the least explored “second hit” for HIV-related hepatotoxicity. Here, we investigated whether metabolically derived acetaldehyde impairs lysosomes to enhance HIV-induced hepatotoxicity. We exposed Cytochrome P450 2E1 (CYP2E1)-expressing Huh 7.5 (also known as RLW) cells to an acetaldehyde-generating system (AGS) for 24 h. We then infected (or not) the cells with HIV-1_ADA then exposed them again to AGS for another 48 h. Lysosome damage was assessed by galectin 3/LAMP1 co-localization and cathepsin leakage. Expression of lysosome biogenesis–transcription factor, TFEB, was measured by its protein levels and by …

Development Of An Integrated Medical And Behavioral Health Care Model For Children In Foster Care: The Rees-Jones Center For Foster Care Excellence, Kimberly Stone, Sara Moore, Sara Pollard

Integrated, Trauma-Informed Care

Children in foster care are classified as a population with special health care needs. They face multiple adverse childhood experiences and disrupted relationships, yet face barriers accessing consistent, high-quality health care. The American Academy of Pediatrics recommends integrated physical and behavioral health care for children in foster care, but little is known about the implementation of integrated care for this population. As a pediatrician, doctor of nursing practice, and psychologist in an academic medical setting, we describe the development and implementation of the Rees-Jones Center for Foster Care Excellence, emphasizing the role of medical and behavioral health providers in promoting …

Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack

All Graduate Theses, Dissertations, and Other Capstone Projects

Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20^th, 2020 to November 10^th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, …

Cost Outcomes Of Physical Therapist Providers Compared To Primary Care Providers In The Treatment Of Musculoskeletal Patients In A Military Treatment Facility: A Retrospective Chart Review”, Troy E. Mcgill, Debra F. Stern, Morey J. Kolber, John Mcgee

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a …

Acupuncture Therapy In The Treatment Of Osteoarthritis Of The Knee, Reece Bartell

Capstone Showcase

Abstract

Introduction: Osteoarthritis (OA) is a chronic condition that affects the joints of the body, most commonly the knees; it has the potential to cause debilitating pain, and stiffness and decrease quality of life. The current management involves lifestyle modifications of a healthy diet and exercise as well as analgesics like NSAIDs or acetaminophen to manage symptoms. Long-term use of these medications has been associated with many side effects affecting the GI and CV system. This review analyzes the use of acupuncture therapy (I) for symptom management (O) in patients aged 60-80 years old suffering from mild to moderate …

Evaluating The Use Of Telehealth To Manage Hypertension In Primary Care, Alexandra M. Wiesner

DNP Projects

Background: Hypertension remains one of the most common chronic conditions in the United States leading to several health complications and immense financial burdens, yet it remains grossly undertreated despite the availability of evidence-based treatment options. The 2017 guidelines from the American College of Cardiology and American Heart Association recommended the use of home blood pressure monitoring with a telehealth component as an adjunct to regular hypertension treatment; however, implementing this into practice can be difficult depending on the setting, available resources, and the knowledge and skills of the providers. Aims: The purpose of this investigation is to evaluate patient adherence …

The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid

All Graduate Theses, Dissertations, and Other Capstone Projects

Human trafficking (HT) is a growing concern within the United States (U.S.) and internationally. With the alarming number of HT victims presenting for medical care, primary care providers (PCPs) are in a unique and privileged position to encounter HT victims within the healthcare system. Adolescents, in particular, are vulnerable to HT because of minimal life experiences, inadequate social support, and limited coping mechanisms (Ertl et al., 2020). Failure to recognize and intervene in cases involving HT victims who are minors is detrimental to the individual’s health, wellbeing, and safety. With the assistance of education and training, community resources, guideline adoption, …