Primary Care Commons^™

Vitamin D Supplementation: Preventing Fractures, Courtney L. Carn, Michael S. Doherty

Physician Assistant Capstones, 2016 to 2019

Objective: To assess the ability of vitamin D supplementation in preventing musculoskeletal fractures. Methods: Systematic literature review using Google Scholar search terms “vitamin D supplementation” and “preventing hip fractures” from 2006-2015. Only RCTs, meta-analysis, and clinical guidelines were included. Results: Our search resulted in one meta-analysis and two randomized controlled trials. Conclusion: The summation of our investigation into vitamin D deficiency and the presence of musculoskeletal fractures has proven to be relatively inconclusive. The resulting data from our three studies did not provide any definitive proof that improved vitamin D levels correlates with better bone health.

Want To Lose Weight? Commercial Weight Loss Programs Vs. Primary Care, Jessica Jacobson, Katherine Chui

Physician Assistant Capstones, 2016 to 2019

Context Overweight and obesity rates are on a continuous incline in the United States leading to increased rates of diabetes, cardiovascular disease and death. Much of the healthcare costs are going into treating this disease; therefore, it is vital to find effective weight loss treatments in both the primary care and community settings to reduce the prevalence of overweight and obesity and subsequent healthcare costs.

Objective To assess whether primary care-based therapy or commercial weight loss programs help overweight and obese patients lose 5% of their weight from baseline.

Design, Setting and Participants A systematic review of four randomized control …

Clinical Approach To Nonresponsive Pneumonia In Adults Diagnosed By A Primary Care Clinician: A Retrospective Study, Kiley B. Vander Wyst, Jessica J. F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose

Community-acquired pneumonia (CAP) is commonly diagnosed in the primary care setting. Management of nonresponsive pneumonia (NRP), i.e. failure to respond to CAP treatment, is not clearly understood. The purpose of this study was to describe the initial work-up and treatment of CAP in the ambulatory primary care setting and to determine relative proportion of, diagnostic approach to and treatment of NRP.

Methods

We retrospectively studied adult patients diagnosed with CAP within our large, integrated health care system from October 2006 through July 2013. Cases were defined as patients with CAP who worsened after 4 days, or did not improve …

A Quality Improvement Collaborative To Improve Pediatric Primary Care Genetic Services., Michael L. Rinke, Amy Driscoll, Natalie Mikat-Stevens, Jill Healy, Elizabeth Colantuoni, Abdallah F. Elias, Beth A. Pletcher, Ruth S. Gubernick, Ingrid Larson, Wendy K. Chung, Beth A. Tarini

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To investigate if a national pediatric primary care quality improvement collaborative (QIC) could improve and sustain adherence with process measures related to diagnosis and management of children with genetic disorders.

METHODS: Thirteen practices in 11 states from the American Academy of Pediatrics' Quality Improvement Innovation Networks participated in a 6-month QIC that included regular educational opportunities, access to genetic professionals, and performance feedback. The QIC identified 11 aims related to improving diagnosis and management of children with genetic disorders. The practices evaluated adherence by reviewing patient records at baseline, monthly for 6 months (active improvement period), and then once …

Generational Differences In Practice Site Selection Criteria Amongst Primary Care Physicians., Christopher Duffrin Phd, Mches, Molly Cashion Mph, Doyle M. Cummings Pharmd, Lauren Whetstone Phd, Jonathon Firnhaber Md, Gary Levine Md, Ricky Watson Md, Msph, Aaron Lambert Md

Marshall Journal of Medicine

ABSTRACT

Background and Objectives: Generational differences are often viewed as shaping the overall attitudes and actions of different age cohorts. It is essential to understand the motivations and generational differences in primary care physicians for efforts to recruit, retain, and educate the future physician workforce. Determining what factors most influence different generations of primary care physicians when choosing a practice site is essential to build our future primary care system. This study examined generational differences in the factors that attracted primary care physicians to their current practice.

Methods: A survey instrument was mailed to all active members of the North …

Trends In Vaccination Rates Amongst Young Children And The Factors Affecting Parent Decisions, Kaitlyn C. Baldridge, Janna Bjoin, Katherine Pool

All Electronic Theses and Dissertations

Problem: Throughout the United States, there has been an increasing trend in the number of parents refusing to vaccinate their children. Studies have shown that since the upward trend of refusal to vaccinate has started, there has been an increase in outbreaks of preventable diseases. In Minnesota, there have been no studies to evaluate how many parents are refusing vaccinations for their children or the reasons why. Purpose: This study will evaluate how many parents with children ages five and under are choosing to vaccinate their children or refusing vaccination, and the reasons behind their choice to vaccinate or not. …

The Knowledge And Attitude Of Bethel's Undergraduate Population On Sun Protective Behaviors, Sarah R. Beddow, Chelsea V. Domeier, Karien Wilson

All Electronic Theses and Dissertations

OBJECTIVES: To compare the attitude and knowledge of health science majors versus non-health science majors of the Bethel University undergraduate population. BACKGROUND: Despite public education about the use of sunscreen and skin cancer protection, researchers are still finding a gap in public knowledge. Sun exposure education is crucial and must happen during childhood and adolescence because these are the times people receive the most UV exposure. Repeat sunburns during childhood can double an individual's risk of developing melanoma in adulthood. METHODS: This was a pre-experimental design single evaluation via a survey. The following research questions were investigated in our research …

Antihypertensive Medication Adherence In The Twin Cities, Jacob J. Clairmont, Taylor J. Cunningham, Krista M. Nauman

All Electronic Theses and Dissertations

A retrospective study of antihypertensive medication adherence was conducted on patients’ demographics data at Eastside Health Clinic in St. Paul, MN. The study sought to determine whether or not interventional means were needed to improve adherence to antihypertensive medication based on serial blood pressure measurements collected over the course of 6 clinic visits. The study found that patients were consistently more non-adherent than adherent in every category assessed, yet there was an overall decrease in mean systolic and diastolic blood pressure. Based upon these findings, it can be concluded that while individual adherence rates were imperfect for each demographic category …

Knowledge Of Behaviors That Contribute To A Healthy Pregnancy In Women Aged 18-25, Sarah K. Coffey, Rebecca Jennings

All Electronic Theses and Dissertations

Knowledge of behaviors that contribute to a healthy pregnancy may enhance the overall pregnancy experience. However, there are currently no studies that evaluate where discrepancies exist between current recommendations of behaviors contributing to healthy pregnancies and knowledge of those behaviors in women ages 18-25. The objective of this study was to determine where those discrepancies exist. Survey data of women’s knowledge was compared to current recommendations set forth by the American College of Obstetricians and Gynecologists (ACOG). The behaviors assessed included alcohol consumption, cigarette smoking, sleeping, caloric intake, exercise, caffeine intake, weight gain, and folic acid intake. This knowledge was …

An Analysis Of Immunization Understanding In Undergraduate Students At Bethel University, Jeff Dahlquist, Steven D. Lindblom

All Electronic Theses and Dissertations

This investigation studied the level of understanding of the nature of immunizations and vaccine preventable diseases in undergraduate students at Bethel University. Immunization literature demonstrates a significant lack of understanding in the general population in relation to the nature of vaccine preventable diseases and the immunizations used to counter them. Furthermore, the literature concludes that such a grossly inadequate understanding of the nature of vaccine preventable diseases may precipitate dire epidemiological consequences. This investigation was a pre-experimental design and utilized a short questionnaire administered one time to a sample population of 171 subjects over 18 years of age who were …

Anterior Cruciate Ligament Reconstruction: Which Graft Is Best To Prevent Re-Tear?, Katherine Ann Eslinger, Brittany Kapala, Noelle Kreofsky

All Electronic Theses and Dissertations

The three most widely used graft choices currently employed in anterior cruciate ligament (ACL) repair are: patellar tendon autograft, hamstring tendon autograft, and cadaver tendon allograft. The purpose of this study is to examine the efficacy of each of these 3 graft choices (patellar tendon autograft, hamstring tendon autograft and cadaver tendon allograft) and determine which graft is less prone to re-tear. The study was implemented using a quantitative design process. The patient data was obtained and analyzed via Facebook survey. All identifying patient information was removed. Patients were included based on whether or not their ACL reconstruction was performed …

Cardiovascular Strain In Overweight 5k Runners, Sara Geier, Polly Hendel

All Electronic Theses and Dissertations

Previous research is vast and varied regarding how exercise affects the physiology of the cardiac system. Many studies have found adverse effects to the heart in ultra-endurance athletes, but fewer studies have focused on overweight populations. Hamer and Boutcher (2006) observed abnormal post exercise cardiovascular changes in obese individuals when compared to individuals of normal body mass index (BMI) but, were unable to draw any definitive conclusions from the results. With Americans facing an obesity epidemic and healthcare providers increasingly prescribing regular exercise routines to combat it, definitive conclusions regarding the topic of healthy long-term exercise in overweight and obese …

Diabetes Education For The Hispanic Population, Nohemi I. Haben, Misty M. Schmitz

All Electronic Theses and Dissertations

The purpose of this study is to investigate the effects, if any, of utilizing Spanish language on the efficacy of an education program for type 2 diabetes among the Hispanic population in the twin-cities Minneapolis/St. Paul metro area. In the United States adult Hispanics over the age of twenty have a 5.2% higher incidence of type 2 diabetes than Non-Hispanic Whites, a number that keeps rising despite preventability. In this study, a diabetes education program was delivered in Spanish based on material developed by the Centers for Disease Control and Prevention and the National Diabetes Education Program. The program focused …

Minnesota Healthcare Barriers To The Medically Underserved, Ashley C. Hoffmann, Amanda Walters

All Electronic Theses and Dissertations

Quality medical services and patient oriented satisfaction are important factors in a healthcare setting. Barriers preventing such factors are more prevalent in medically underserved areas (MUAs) ( Brems, Johnson, Warner, & Roberts, 2006 ). The purpose of this study was to identify barriers in the care of patients within Minnesota MUAs. The study was conducted by an online survey emailed to Minnesota Academy of Physician Assistant (MAPA) members, and only members who were currently employed in a Minnesota MUA county had valid data collection. Twelve barriers to healthcare were listed on the survey and required the MAPA members to grade …

Dietary Supplements: A Consumer Profile Of Knowledge And Use, Sarah J. Kucera, Yen Nguyen

All Electronic Theses and Dissertations

Alternative medicine, in the form of dietary supplements, is appealing to Americans. Supplements have been marketed as being natural promoters of general well-being, healing, and disease prevention. Even with minimal regulation and research, the majority of supplement use is self-prescribed, fueling an industry last estimated at $32.5 billion in 2012. The study explored the degree of consumer knowledge with regards to regulation, appropriate indications and dosages, and potential adverse effects of various dietary supplements. The study also sought to evaluate the relationship between supplement knowledge and demographic information as well as the extent of discussion about supplement use with a …

Individual Physician Assistant's Spirituality And Job Satisfaction, Kyle J. Smisek, Kelsa L. Hovelson, Mali D. Langlie

All Electronic Theses and Dissertations

The factors that contribute to job satisfaction have been studied extensively. Additionally, in the healthcare setting, the influence of spirituality has been a topic of substantial research. However, few studies have researched a physician assistant’s individual spirituality and its influence on job satisfaction. The goal of this study was to first identify the effect, if any, between the spirituality of a PA and his or her perceived job satisfaction, and second, to determine where spirituality ranks among the various factors that influence job satisfaction. In addition, the study addressed whether there appears to be a connection between one’s spirituality and …

Bone Health Promotion For Youth: A Primary Care Intervention, Kay G. Wilson

Doctor of Nursing Practice Projects

Obese youth have high rates of vitamin D and calcium deficiencies and are at risk for developing osteoporosis. Clinical guidelines are needed in primary pediatric care services to promote bone-healthy behaviors. The aim of this project was to: a) implement the infrastructure and processes for physiological monitoring, consistent parameter-based vitamin D & calcium supplementation, family education, and coaching, and b) evaluate the impact of bone promotion changes on patients and parents and the primary care delivery system. The project outcomes included modest gains in bone health awareness among staff, patients, and families. In addition, modifications to clinical pathways and related …

The Impact Of An Implemented Scribe Program In Emergency Room Settings On Patient And Provider Satisfaction, Overall Patient Volume, And Emergency Room Cost Effectiveness, Kendra L. Kruger, Tara L. Tait

All Electronic Theses and Dissertations

The purpose of the study is to evaluate medical scribe programs in emergency room settings as to their role, impact on patient satisfaction, patient volume, and cost-effectiveness, as well as their perceived value by emergency room medical providers through survey methods. This prospective, quantitative research study obtained information via surveys of Emergency Physicians Professional Association (EPPA) providers concerning the value emergency room providers placed on the function and role of scribes in emergency room settings. The data obtained from the surveys was analyzed using correlation and comparison of means. The results of the study indicated that emergency room providers thought …

Awareness Of Antibiotic Resistance In The General Population As Related To Education Level, Rachel M. Cantlon, Emma Wilson

All Electronic Theses and Dissertations

An antibiotic is a drug, also known as an antimicrobial, which is used to treat infectious diseases caused by bacteria (National Institute of Allergy and Infectious Diseases (NIAID), 2012). The effect of antibiotic overuse and mistreatment with these drugs has led to infectious bacteria developing antibiotic resistance (Centers for Disease Control and Prevention (CDC), 2014). Antibiotic resistance results in at least 23,000 deaths each year in the United States alone (CDC, 2014). The purpose of this study was to evaluate the general population’s awareness of antibiotic resistance in regard to education level, and proper use of antibiotics as measured by …

Caring For Children With Intrauterine Drug Exposure, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Overview of national statistics regarding in utero substance exposure and the impacts on health care for children involved with the child welfare system.

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

childrens.com/fostercare

Addressing The Health And Safety Of Children In Foster Care, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

The Texas foster care system is an integral part of the safety net for the state’s most vulnerable children, and is charged with the daunting task of providing safe homes to thousands of children who are in crisis. Children and youth in foster care still face persistent barriers when they interact with the health system, which blunt the effectiveness of reform initiatives and potentially create lifelong harms for children in the program. Addressing disparities in the areas of physical health, mental health, educational attainment and special health care needs is integral to improving safety, stability and permanency for every child …

Medical Interns', Residents' And Attending Physicians' Attitudes Towards Integrative Medicine And Recommended Treatments For Patients With Psoriasis, Jennifer L. Pacyon

PCOM Psychology Dissertations

Background: Psoriasis is a multifactorial disease that effect approximately 7.5 million Americans. There are a variety of traditional treatments for psoriasis (e.g. topical medications, biologics) that for many, are effective in combating the disease. However, traditional treatments often have aversive side effects and may not be appropriate for every patient (e.g. pregnant women). Additionally, the efficacy of these medications are variable leaving some looking for adjunctive treatment options. There is increasing evidence to support the use of adjunctive treatments for psoriatic patients (e.g. psychotherapy, mindfulness). However, research is variable in regards to medical professionals’ attitudes towards integrative medicine (IM) as …

Alzheimer's Disease: Knowledge Of Early Detection, Risk Factors, And Treatment, Anna H. Smith, Katlyn S. Spadino

All Electronic Theses and Dissertations

Alzheimer's disease causes a progressive and irreversible decline in cognitive functioning. There are many people living with this disease, and the prevalence is expected to triple between 2010 and 2050. Many members of society are affected through either a personal diagnosis or the diagnosis of a family member. There have been numerous studies outlining risk factors, signs and symptoms, and treatments for this disease, but it is unknown if this has translated to greater public awareness. This study aims to assess the general adult population's knowledge of Alzheimer's disease. The participants are 35 to 70 years old and live in …

Patient-Reported Variables Associated With The Success Of Behavioral Intervention For Patients With Chronic Cough, Bridget Loomis

Graduate Student Theses, Dissertations, & Professional Papers

Purpose: To determine if patient-related variables exist that can potentially discriminate patients with refractory chronic cough (RCC) that are reasonable candidates for behavioral cough therapy (BCT). This study is a small sub-set of a larger, ongoing study, which aims to create and validate a screening tool that primary care physicians can use in order to refer patients early and appropriately for medical or behavioral intervention.

Methods: In this prospective, exploratory study, 20 adult participants, aged 29-68 years of age, answered a bank of questions developed by an expert panel, and the Leicester Cough Questionnaire (LCQ), before and after BCT. Questions …

Improving Access To Primary Care For Aboriginal Babies In Western Australia: Study Protocol For A Randomized Controlled Trial, Dan Mcaullay, Kimberley Mcauley, Rhonda Marriott, Glenn Pearson, Peter Jacoby, Chantal Ferguson, Elizabeth Geelhoed, Juli Coffin, Charmaine Green, Selina Sibosado, Barbara Henry, Dorota Doherty, Karen Edmond

Research outputs 2014 to 2021

Background:

Despite a decade of substantial investments in programs to improve access to primary care for Aboriginal mothers and infants, more than 50 % of Western Australian Aboriginal babies are still not receiving primary and preventative care in the early months of life. Western Australian hospitals now input birth data into the Western Australian electronic clinical management system within 48 hours of birth. However, difficulties have arisen in ensuring that the appropriate primary care providers receive birth notification and clinical information by the time babies are discharged from the hospital. No consistent process exists to ensure that choices about primary …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

Translating Knowledge For Action Against Stroke--Using 5-Minute Videos For Stroke Survivors And Caregivers To Improve Post-Stroke Outcomes: Study Protocol For A Randomized Controlled Trial (Movies4stroke)., Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Nargis Asad, Asma Ahmed, Iqbal Azam, Sarah Saleem, Saleem Sayani

Department of Medicine

Background: Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world’s sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing >70 % mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers.

Methods: Movies4Stroke will be a randomized control, outcome assessor …

Furthering The Quality Agenda In Aboriginal Community Controlled Health Services: Understanding The Relationship Between Accreditation, Continuous Quality Improvement And National Key Performance Indicator Reporting, Beverly Sibthorpe, Karen Gardner, Daniel Mcaullay

Research outputs 2014 to 2021

A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment …

Dashing Away Hypertension: Evaluating The Efficacy Of The Dietary Approaches To Stop Hypertension Diet In Controlling High Blood Pressure, Preeya Shah Phd, Kyle D. Maxwell, Joseph I. Shapiro Md

Biochemistry and Microbiology

The dietary approaches to stop hypertension (DASH) diet has been developed and popularized as a non-pharmaceutical intervention for high blood pressure reduction since 1995. However, to date, a comprehensive description of the biochemical rationale behind the diet’s principal guidelines has yet to be compiled. With rising interest for healthy and reliable life-style modifications to combat cardiovascular disease, this review aims to compile the most recent and relevant studies on this topic and make an informed assessment as to the efficacy of and underlying mechanisms operant in the DASH diet. Specifically, the merits of lowering dietary intake of sodium and saturated …