Primary Care Commons^™

Vitamin D Level Testing In An Urban Midwest Clinic: To Test Or Not To Test?, Daniel Mundt, Marianne Klumph, Kayla Heslin, Wajih Askar

Journal of Patient-Centered Research and Reviews

Vitamin D deficiency (VDD) is significantly higher among urban populations in the U.S. Midwest, with African Americans being disproportionately affected. There is ongoing debate surrounding who and how often individuals should be screened for VDD. This study aimed to understand the prevalence of VDD, associated risk factors, and discrepancies in testing at an urban-based internal medicine residency clinic. Data were retrospectively collected on all adult patients seen by the clinic during 2018 and descriptive statistical analysis performed. Among 3976 total patients (mean age: 53 years), 18% (n = 698) had vitamin D levels analyzed, with deficiency found in 71% of …

Clinical Characteristics, Risk Factors, And Outcomes Among A Large Midwestern U.S. Cohort Of Patients Hospitalized With Covid-19 Prior To Vaccine Availability, Viviana Zlochiver, Ana Cristina Perez Moreno, Michael Peterson, Khalil Odeh, Ashley Mainville, Katherine Busniewski, Jon Wrobel, Mohamed Hommeida, Blair Tilkens, Payal Sharma, Hlu Vang, Sara Walczak, Fekadesilassie Moges, Kritika Garg, A. Jamil Tajik, Suhail Q. Allaqaband, Tanvir Bajwa, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic posed unprecedented demands on health care. This study aimed to characterize COVID-19 inpatients and examine trends and risk factors associated with hospitalization duration, intensive care unit (ICU) admission, and in-hospital mortality.

Methods: This retrospective study analyzed patients with SARS-CoV-2 infection hospitalized at an integrated health system between February 2, 2020, and December 12, 2020. Patient characteristics and clinical outcomes were obtained from medical records. Backward stepwise logistic regression analyses were used to identify independent risk factors of ICU admission and in-hospital mortality. Cox proportional hazards models were used to evaluate relationships between ICU admission and in-hospital …

Process Improvement To Return Stabilized Behavioral Health Patients To Primary Care, Tessa Woodroof

Epsilon Sigma at-Large Research Conference

Purpose: The purpose of this project is to increase the number of open patient appointments by implementing a validated process in which stabilized behavioral health patients are repatriated to primary care. Currently, there is an increased demand for behavioral health services and decreased supply of behavioral health clinicians at the Nashville Veterans Affairs Medical Center (VAMC).

Aims: This project aims to teach behavioral health providers how to identify appropriate patients and complete successful discharges while helping primary care providers integrate the repatriation process into their workflow. Without the proposed intervention, veterans initiating behavioral health services in the catchment area will …

Advocating For Occupational Therapy In The Pediatric Primary Care Setting, Margaret Bauer

Spring 2022 Virtual OTD Capstone Symposium

This project explored the experiences of caregivers interacting within the pediatric primary care setting in order to determine a need for occupational therapy to help support acquisition of child developmental milestones, screening for developmental delays, and implementation of health behaviors into family routines. An IRB research study was conducted to survey primary caregivers of children across the country to ascertain their experiences and knowledge of OT, ease of health behavior implementation, and comfortably discussing child development with their pediatrician's. A needs assessment survey was distributed at a San Diego pediatric primary care clinic, and a program was developed to support …

Envisioning Future Urinary Tract Infection Diagnostics, Robin Patel, Christopher R Polage, Jennifer Dien Bard, Larissa May, Francesca M Lee, Valeria Fabre, Mary K Hayden, Sarah D B Doernberg, David A Haake, Barbara W Trautner, Larissa Grigoryan, Ephraim L Tsalik, Kimberly E Hanson

Faculty, Staff and Students Publications

Urinary tract infections (UTIs) are among the most common bacterial infections in the United States and are a major driver of antibiotic use, both appropriate and inappropriate, across healthcare settings. Novel UTI diagnostics are a strategy that might enable better UTI treatment. Members of the Antibacterial Resistance Leadership Group Laboratory Center and the Infectious Diseases Society of America Diagnostics Committee convened to envision ideal future UTI diagnostics, with a view towards improving delivery of healthcare, patient outcomes and experiences, and antibiotic use, addressing which types of UTI diagnostics are needed and how companies might approach development of novel UTI diagnostics.

Mcph1: A Novel Case Report And A Review Of The Literature, Stefano Giuseppe Caraffi, Marzia Pollazzon, Muhammad Farooq, Ambrin Fatima, Lars Allan Larsen, Roberta Zuntini, Manuela Napoli, Livia Garavelli

Department of Biological & Biomedical Sciences

Microcephaly primary hereditary (MCPH) is a congenital disease characterized by nonsyndromic reduction in brain size due to impaired neurogenesis, often associated with a variable degree of intellectual disability (ID). The genetic etiology of MCPH is heterogeneous and comprises more than 20 loci, nearly all following a recessive inheritance pattern. The first causative gene identified, MCPH1 or Microcephalin, encodes a centrosomal protein that modulates chromosome condensation and cell cycle progression. It is also involved in DNA damage response and telomere maintenance in the nucleus. Despite numerous studies on MCPH1 function, MCPH1-affected individuals are rare and the available clinical reports are …

Non-Opioid Pharmacologic Agents In The Treatment Of Non-Cancer Chronic Pain In The Outpatient Setting, Diane Eannotti

DNP Projects

Opioid prescription related overdose deaths have increased substantially with evidence demonstrating only modest short-term benefits in chronic pain and thus represents the need to identify alternative treatments to opioids. A needs assessment performed for a federally qualified community health center revealed patients presently taking non-opioid pharmacologic agents in the treatment of chronic non-cancer pain (CNCP) needed additional education in managing multiple non-opioid medications. A targeted approach at improving patient experience and population health supporting the quadruple aim was undertaken with this project.

Purpose: The purpose of this quality improvement project consisted of performing medication management visits for 28 referred patients …

Medical Norm Of Psychiatric Misdiagnoses In Rare Disease Patients, Rachel Han

Publications and Research

Spring 2022 ENG 120 Student Final Research Paper on the medical norm of psychiatric misdiagnosis throughout the diagnostic journeys of rare disease patients. The idea of a norm was taken from Chimamanda Ngozi Adichie's Tedx Talk "The Danger of a Single Story". Paper discusses prevalence, harmful effects, and origin of this medical norm. Includes discussion of statistical data quoted relating to prevalence of rare diseases as well as anecdotal evidence of the severe ramifications of this norm. Discussion of how medically unexplained symptoms such as mysterious chronic pain often lead to the phenomenon of the psychogenic inference. Origins of this …

Health Care Services: Utilization And Perception Among Elderly In An Urban Resettlement Colony Of Delhi, Shivani Singh, Somdatta Patra, Amir M Khan

Faculty, Staff and Student Publications

CONTEXT: Health care utilization informs us about the utility of services which are available. We have a paucity of studies related to health care utilization among elderly in India.

AIMS: The aim of this study is to find out utilization of health care services by elderly (≥60 years), pattern, factors associated with, and perception of the elderly population regarding facilitators and barriers for the same.

SETTINGS AND DESIGN: A community based cross-sectional, observational study was conducted in a resettlement colony of East Delhi.

MATERIALS AND METHODS: A pretested, semi-structured, and interviewer-administered questionnaire was used. Duration of data collection was November …

Acute Generalized Exanthematous Pustulosis: A Painful And Pruritic Presentation Of Pustulosis Following Pharmacotherapy For Pharyngeal Phlegmon., Chase Silvers, John Casey

Ambulatory and Primary Care Articles

Acute generalized exanthematous pustulosis (AGEP) is primarily a drug-induced skin eruption, which typically presents within two days of starting an offending medication; it is often self-limiting with spontaneous resolution within two weeks upon medication cessation. We report the case of a patient who presented with generalized desquamation, characteristic pustules, and several morbilliform rashes on the body surface in association with recent amoxicillin-clavulanic acid exposure. This was associated with significant pruritus, which was the associated chief complaint. A multimodal approach to symptomatic management with topical corticosteroids, barrier ointments, oral antihistamines, and analgesics was required, in addition to the cessation of the …

Reliever-Triggered Inhaled Glucocorticoid In Black And Latinx Adults With Asthma, Alex Colon

Annual Research Symposium

No abstract provided.

Application And Efficacy Of Color-Coded Learning Models, Parker Grossman

Annual Research Symposium

No abstract provided.

Covid-19 Ramifications And Effects, Landon Ledingham

Annual Research Symposium

No abstract provided.

Rnpc: Educating Nursing Students For The Future Of Healthcare Utilizing Interprofessional Collaboration, J. Hurlbut, Imelda Revuelto

Annual Research Symposium

No abstract provided.

Covid-19 Variant, Vaccine And Booster, Manas Mandal

Annual Research Symposium

No abstract provided.

Rna Sequencing Reveals That Cyp3a5 Sirna Treatment Induces Cell Cycle Blockade And Senescence In Mdapca2b Human Prostate Cancer Cells, Jeetesh Sharma

Annual Research Symposium

No abstract provided.

Evaluation Of Appropriate Initiation And De-Escalation Of Piperacillin-Tazobactam In Hospitalized Patients At An Acute Care Hospital, Ivy Yang

Annual Research Symposium

No abstract provided.

Student Perception On The Implementation Of An End-Of-The-Day Quiz And Its Impact On Student Learning And Class Attendance In A Three-Year Accelerated Doctorate Program Of Pharmacy., Desiree Chong, Jousef Alandy0dy, Arup Chakraborty

Annual Research Symposium

No abstract provided.

Participation In Curriculum And Cultural Ambassador Group To Enhance Student Belongingness, Jake Tuft, Jacob Schvaneveldt

Annual Research Symposium

COVID-19 negatively impacted students' abilities to participate in live, in-person events; students were unable to interact with peers or build relationships critical to success and well-being. Quarantine, social distancing and video conferencing did not create this problem however, it simply amplified the fact that dental students seemingly lack camaraderie and a sense of belongingness. The Curriculum and Cultural Ambassador group was created to allow students to bond over shared goals in the hopes of improving their experiences within dental school. This group gives students the ability to “Be the Change” on campus and enact real-time change to foster a sense …

A Standardized Approach To Blood Pressure Training In First-Year Medical Students, Andrew Romney

Annual Research Symposium

No abstract provided.

Identifying Bias In Healthcare And Creating Intervention Strategies At Colleges Of Medicine And Other Healthcare Professions, Cameron Chalmers, Emmanuel Oyalabu

Annual Research Symposium

No abstract provided.

Current Trends In The Sars-Cov-2 Pandemic During The Emergence Of The Omicron Variant, Benjamin Mennell

Annual Research Symposium

No abstract provided.

Number Of Active Social Media Users As Predictors Of Hipaa Infringements, Alexander Sheppert, Taylor Purcell, Nathaniel Hill, David Sant

Annual Research Symposium

HIPAA Infringements Correlate Linearly with Number of Social Media Users.

Social media use has made information sharing much easier – including protected health information. Interestingly, as social media has become more popular over the years, HIPAA violations have also become more common.

The calculated R and P values suggest a strong correlation exists between social media use and HIPAA complaints.

The Implementation Of Telehealth Scenarios And Covid-19 Training To Prepare Nurses For The Future Of Healthcare, Kiley Anders, Shamar Lejardi, Georgene Kreger

Annual Research Symposium

No abstract provided.

Potential Cost Savings With Implementation Of Systemwide Rasburicase Protocol, Parker Gundersen, Adalyn Lee

Annual Research Symposium

Purpose: Tumor Lysis Syndrome is a condition that takes place when apoptosis in cancer cells occurs within a short time period. This condition can lead to organ dysfunction and even death. Rasburicase is used to treat high uric acid levels in patients that are experiencing tumor lysis syndrome and is expensive. Dosing and frequency of rasburicase varies across health care institutions. This project evaluated if adherence to a systemwide rasburicase protocol could help reduce drug waste and reduce costs across a healthcare system.

Methods: We conducted a retrospective data analysis reviewing rasburicase doses administered across Intermountain Healthcare over the course …

High Cd44 Immunoexpression Correlates With Poor Overall Survival: Assessing The Role Of Cancer Stem Cell Markers In Oral Squamous Cell Carcinoma Patients From The High-Risk Population Of Pakistan, Yumna Mirza, Syed Adnan Ali, Hasnain Ahmed Farooqui, Hammad A. Kayani, Romana Idress, Mohammad Sohail Awan

Department of Surgery Docs

Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. Materials and Methods. Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment …

Developing A Sexual Health Consent Strategy For Refugees: A Qualitative Approach, Amita Tuteja, Elisha Riggs, Lena Sanci, Lester Mascarenhas, Anna Power, Di Vanvliet, Katrina Sangster, Kimberley Mcguinness, Meredith Temple-Smith

The Qualitative Report

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, …

Knowledge, Attitude And Practices Of Pregnant Women Related To Covid-19 Infection: A Cross-Sectional Survey In Seven Countries From The Global Network For Women's And Children's Health, Farnaz Naqvi, Seemab Naqvi, Sk Masum Billah, Sarah Saleem, Elizabeth Fogleman, Nalini Peres Da-Silva, Lester Figueroa, Manolo Mazariegos, Ana L. Garces, Sana Yousaf

Community Health Sciences

Objective: We sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC).
Design: Population-based prospective, observational study.
Settings: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan and Guatemala.
Population and sample: Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR).
Methods: A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.
Main outcome measures: KAP regarding COVID-19 during pregnancy.
Results: In all, 25 260 women completed the survey. Overall, 56.8% of women named ≥3 …

Understanding The Context Of Healthcare Utilisation For Children Under-Five With Diarrhoea In The Drc: Based On Andersen Behavioural Model, Siyu Zou, Xinran Qi, Keiko Marshall, Maria Asif Bhura, Rie Takesue, Kun Tang

Department of Paediatrics and Child Health

Background: Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC.
Methods: Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey …

Compounding Inequalities: Adolescent Psychosocial Wellbeing And Resilience Among Refugee And Host Communities In Jordan During The Covid-19 Pandemic, Nicola Jones, Sarah Baird, Bassam Abu Hamad, Zulfiqar Ahmed Bhutta, Erin Oakley, Manisha Shah, Jude Sajdi, Kathryn M. Yount

Department of Paediatrics and Child Health

Purpose: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience.
Methods: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable …