Primary Care Commons^™

Chemically Self-Assembled Antibody Nanorings: A Novel Approach To Bispecific Design For Cancer Therapeutics, Kari A. Gabrielse

All Electronic Theses and Dissertations

Targeted antibody therapeutics are currently being developed for treatment of a wide variety of cancers. By extending the scope of targeted antibody therapeutics into a bispecific design, it has been shown that simultaneous targeting of the CD3 T cell receptor and cancer cell receptors is possible. While great success has been achieved with the use of bispecific agents, many of these agents are genetically fused antibody fragments that can only target one type of cancerous receptor. Here we describe a simple and straightforward method of spontaneously assembling bispecific antibody therapeutics. Using fusion proteins consisting of two dihydrofolate reductase proteins and …

Health Disparities On American Indian Reservations: Can Mid-Level Practitioners Make A Difference?, David Evard Johnston

All Electronic Theses and Dissertations

Introduction: American Indians/Alaskan Natives (AI/AN) suffer from a number of health issues and at higher rates than other United States populations. Efforts have been made through the Indian Health Service (IHS) to improve the AI/AN state of health, but healthcare disparities remain. Purpose: The purpose of this study was to assist in identifying options in reducing healthcare disparities on American Indian reservations in South Dakota. The need for recruitment of additional physicians and mid-level practitioners (also known as mid-level providers or advanced practice providers) was assessed, as well as the potential for mid-level practitioners to meet that need. Methods: A …

Prevalence Of Non-Conventional And Folk Medicine Usage Among Hmong In St. Paul, Minnesota, Matthew T. Vang

All Electronic Theses and Dissertations

Hmong Americans have been identified to utilize various modes of medicine including: folk/herbal remedies, spiritual/shamanistic rituals, and adapted treatments from countries like Thailand or Laos. However, there is a lack of studies that measured the prevalence of these medications among the Hmong community in Saint Paul, Minnesota. A questionnaire was distributed at a Saint Paul, Minnesota Hmong market to explore the prevalence of Hmong medicine usage. Demographical information was also collected to help determine any relationships that might exist between certain socio-cultural factors and Hmong medicine usage. The study had a total of 54 participants. Of the 54 participants, twenty-eight …

Assessing Deaf Culture Awareness Of Physician Assistant Students In The Midwest, Sheryl E. Delude, Morgan, Kay Foizie

All Electronic Theses and Dissertations

Currently, there has been insufficient research to support the need for implementation of deaf awareness training into physician assistant (PA) program curriculums. To address this gap in research, PA students in the Midwest United States were surveyed in order to assess student knowledge of Deaf culture and knowledge regarding appropriate management of patients who are deaf. Survey knowledge scores were compared to previously documented knowledge scores of medical students enrolled in the Medical Students, Cancer Control, and the Deaf Community Training (DCT) program at the University of California, San Diego (UCSD). PA student scores were also compared to scores of …

Analysis Of Lean/Six Sigma Production Model In A Tertiary Care Asthma And Allergy Clinlic, Erika Lynn Bullert, Laura Johnson, Ariel M. Schibilla

All Electronic Theses and Dissertations

In response to demands on healthcare, systems have looked to refine current processes to use time, materials, and finances more efficiently. Lean/Six Sigma (L/SS) is a model that has been used to improve procedural efficiency in various settings. The purpose of this study was to implement L/SS into an outpatient private practice setting and to evaluate the effect on efficiency as measured in the length of individual patient visits who presented to that clinic for routine re-evaluation. In this study, the amount of time between a patient’s entrance and exit from the clinic was documented for 878 patients before implementation …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

The Experiences Of Occupational Therapists Working On Interprofessional Primary Health Care Teams: A Case Study., Emma Blake Mcclellan

Online Theses and Dissertations

The aim of this research was to provide evidence on the integration of occupational therapy (OT) intervention in primary care from the perspective of OTs. Typical services provided, experience with team members, and the identified value of OT in primary health care was explored. OT possesses the expertise and skill set to address the most common chronic conditions that primary care providers treat by entry level educational preparation. OT services are based upon a holistic view of individuals creating an affective skill set to participate in and coordinate health care delivery for the client. Currently limited evidence is available to …

Measuring Adherence To Evidence-Based Practice Guidelines For The Management Of Hypertension In Women, Cristina M. Jorgensen

DNP Projects

Approximately 1 in 3 adults In the United States (U. S.) with approximately half being women have hypertension, a significant risk factor for cardiovascular disease (CVD) and stroke (Nwankwo, Yoon, Burt, & Gu, 2013). Nearly 70% of people who had a first heart attack, 80% of those who had a first stroke, and 75% of those who had congestive heart failure (CHF) have hypertension (Mozaffarian et al., 2013). Hypertension was the underlying or contributing cause of more than 375,000 deaths in 2011. Despite multiple publications of national hypertension guidelines, only 50% of adults with hypertension have their blood pressure under …

Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel

DNP Projects

The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Exploring Attitudes Toward Physician-Nurse Collaboration Within A Team-Based Primary Care Environment, Tom Karagiannis Pharmd, C. Coschignano, Sarah E. Hegarty Mphil, L. Polenzani, E. Messina, R. Zoli, Mohammadreza Hojat Phd, Vittorio Maio Pharmd,Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Patient Experience Of Care In A Student-Faculty Collaborative Practice, Rebecca A. Berman, Scott Elman, Pratyaksh Kumar Srivastava, Janine Knudsen, Laura Huppert, Kyle Dempsey, Michael Barnett, Camille Powe, Karen Donelan

Patient Experience Journal

Student Run Clinics (SRCs) are a popular means of caring for the underserved while providing valuable medical education opportunities. Reports of patient experience surveys are rare in this setting. This is troublesome because it is possible that underserved patients, who are more likely to receive care at SRCs, are not receiving the same level of care as at more traditional medical practices. The purpose of this research was to measure patient experience in a student-led medical clinic. The method included the use of patient experience surveys, which were self-administered pre-visit and self- and interviewer administered post-visit. The key results, 100% …

Recurrent Aphthous Stomatitis: Diagnosis And Management In Primary Care, Jillian Hudson

Journal of Patient-Centered Research and Reviews

Recurrent aphthous stomatitis (canker sores) is a very common oral condition that remains incompletely understood. Presentation has been well-classified into minor, major or herpetiform subcategories based on clinical features, but exact etiology is unknown. Because etiology is unclear, treatments are primarily empiric and aimed at symptom reduction rather than prevention or cure. However, there are several methods, both topical and systemic, that can be easily and affordably utilized in the primary care setting.

Neglected Or Non-Compliant? Assessing The Difficulties Of Tuberculosis Patients In Salvador-Ba, Brazil, Erin Slatery

Independent Study Project (ISP) Collection

Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, …

The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove

9th Annual Rural HIV Research & Training Conference (2014-2019) (Archived)

“The CAPUS Project-Innovative Solutions for HIV/AIDS Linkage to Care”

Objectives: 1) Expand knowledge of the current linkage to care landscape within Georgia; 2) Identify essential components of the Resource Hub to enhance linkage to care efforts throughout Georgia; and 3)Promote effective use of the Resource Hub to facilitate HIV/AIDS linkage to care within highly impacted communities

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Characterization Of Primary Care Clinicians’ Use Of Genomic And Pharmacogenomic Testing, Brian Stello Md, Heather Bittner-Fagan Md, Mph, Christopher V. Chambers Md, Melanie B. Johnson Mpa, Geoffrey Mills Md, Phd, Michael P. Rosenthal Md, Kyle Shaak Bs

Department of Family Medicine

No abstract provided.

Disparities In Patient-Reported Barriers To Attend Diabetes Group Visits, Beth Careyva Md, Melanie B. Johnson Mpa, Kyle Shaak Bs, Brian Stello Md

Department of Family Medicine

No abstract provided.

Primary Care Clinicians Use Of Genomics And Pharmacogenomic Testing, Heather Bittner-Fagan Md, Mph, Brian Stello Md, Christopher V. Chambers Md, Geoffrey Mills Md, Phd, Beth Careyva Md, Melanie B. Johnson Mpa, Dierdre B. Axell-House Ba, Michael P. Rosenthal Md

Department of Family Medicine

No abstract provided.

Patient Reported Barriers And Limitations To Attending Diabetes Group Visits (Poster), Beth Careyva Md, Melanie B. Johnson Mpa, Kyle Shaak Bs, Brian Stello Md

Department of Family Medicine

No abstract provided.

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

Update On Hyperlipidemia Guidelines, Drew Keister Md

Department of Family Medicine

No abstract provided.

Information Mastery Open Workshop, Drew Keister Md

Department of Family Medicine

No abstract provided.

Diabetes Prevention Of The Hispanic Population: Health Lifestyle Management Education At Our Lady Of Guadelupe Clinic In Worthington, Minnesota., Laura J. Bade, Amber E. Dionne, Erin A. Manoles, Lisa R. Milbrant

All Electronic Theses and Dissertations

The purpose of this research study was to utilize educational tools on healthy lifestyles in order to promote Diabetes Mellitus Type II (DMII) prevention in the Hispanic population in Worthington, Minnesota. Hispanic adults are 1.7 times more likely to be diagnosed with Diabetes Mellitus (DM) by a physician than non-Hispanics. Since DMII is a preventable disease, education focused on nutrition and activity will help prevent diabetes and its associated comorbidities. An educational seminar was conducted at Our Lady of Guadalupe in Worthington, Minnesota. A pretest/posttest was administered to assess the knowledge gained with the utilization of the educational tool. Despite …

Pediatric Obesity: Taking Advantage Of Well-Child Visits For Early Identification, James E. Gelement

DNP Projects

Background: Pediatric obesity has reached epidemic levels in the United States and the burden of early identification and prevention lies with Primary Care Providers. With this burden comes the responsibility of increased documentation in order for patients to obtain the appropriate counseling, treatment, and referrals.

Objective: The objective of this study is to identify missed opportunities to identify pediatric patients that meet the criteria for overweight or obesity during well-child visits within a primary care practice.

Method: A retrospective chart review of 100 randomly selected patients born between 9/1/2001 and 9/1/2010 that have received a well-child visit between 1/1/2010 and …

Assessing Blood Pressure Control In Primary Care, Ashley W. Guiliani

DNP Projects

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and …

The Association Of Primary Care Physician Supply To The Prevalence Of Diabetes, Obesity, Smoking, And Hypertension In Georgia, Dennis L. White

MUSC Theses and Dissertations

The primary focus of this study was to compare primary care physician supply throughout Georgia to the prevalence of diabetes, obesity, smoking, and hypertension county by county, identifying potential issues related to primary care physician supply. This research identified the distribution of the primary care physician workforce across Georgia; county by county, and in urban and rural areas, and across public health districts. Then, the research identifies whether the current supply of Georgia primary care physicians is sufficient to meet the growing need for population healthcare. Studying the area of primary care physician supply in correlation to the prevalence of …

Factors In Optimal Collaboration Between Psychologists And Primary Healthcare Physicians, Margaret A. Drewlo

Antioch University Dissertations & Theses

This survey study explored factors in optimal collaboration between registered psychologists and primary healthcare physicians (PHCP). With rising costs of healthcare, healthcare funding cuts, and changes in the way healthcare delivery is perceived, interprofessional collaboration is timely to explore. In particular, the attitudes of registered psychologists about salient factors noted in the collaboration literature, such as education and training, accessibility, and communication factors are important to the practice of psychology. As part of the exploratory nature of the study, questions about gender and hierarchy were also presented. While most data were quantitative, qualitative data were gathered on 6 of the …