Family Medicine Commons^™

Maternal Cortisol Concentration Is Associated With Reduced Brain Activation To Infant Cry And More Intrusive Parenting Behavior, Andrew Erhart, Sarah Enos Watamura, Aviva K. Olsavsky, Alexander J. Dufford, Rebekah C. Tribble, Tom Yeh, Pilyoung Kim

Psychology: Faculty Scholarship

Previous research indicates that maternal cortisol function and maternal brain response to infant are each in turn related to variations in parenting behavior. However, little is known about how maternal cortisol and maternal brain function are associated, thus studying these two mechanisms together may improve our understanding of how maternal cortisol assessed during interactions with own infant is associated with brain response to infant cry. First-time mothers (N = 59) of infants aged 3-4 months old were recruited to participate. Mothers' cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for two parenting …

Inappropriate Survey Design Misstates Findings On Use Of Preference Signaling., Bailey Slone White

Medical Education Articles

No abstract provided.

The Hunger Vital Sign Alone Misses Patients Who Are Not Food Secure, Avry Logeman, Susan Evans, Jenenne Geske

Posters and Presentations: Family Medicine

No abstract provided.

Beyond The Mirage: Confronting Historic Inequities In Maternal Care Deserts., Chynna Smith

Women’s Health Articles

No abstract provided.

Early Intervention System Contextual Factors Contributing To Treatment Attendance And Clinical Outcomes, Anthony Eldridge

Theses and Dissertations

Early Intervention Programs (EI) are an established method of addressing and treating earlier childhood developmental problems that involves a system of complex processes which families must navigate to secure and maintain care. Extensive wait times and multiple service providers burdensome caregivers which may impact treatment engagement. Telehealth offers some clinical utility for improving EI service provision. However, little is known how system contextual factors predict a child’s Part B Eligibility and level of engagement with treatment. The primary aim of this study is to describe the effect that wait time, number of service providers, number of treatment services, and treatment …

Impact Of Covid-19 Lockdown On Patient-Provider Electronic Communications, Michael A Hansen, Rebecca Chen, Jacqueline Hirth, James Langabeer, Roger Zoorob

Faculty, Staff and Students Publications

BACKGROUND: SARS CoV-2 virus (COVID-19) impacted the practice of healthcare in the United States, with technology being used to facilitate access to care and reduce iatrogenic spread. Since then, patient message volume to primary care providers has increased. However, the volume and trend of electronic communications after lockdown remain poorly described in the literature.

METHODS: All incoming inbox items (telephone calls, refill requests, and electronic messages) sent to providers from patients amongst four primary care clinics were collected. Inbox item rates were calculated as a ratio of items per patient encountered each week. Trends in inbox rates were assessed during …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

The Abfm Core Outcomes: The Next Step To Outcome-Based, Time-Variable Training In Family Medicine., Bryce A Ringwald

Medical Education Articles

No abstract provided.

Assessing Preparedness, Attitudes, And Knowledge Of Knapp-Utrgv Family Medicine Residents On Geriatric Nursing Home Care: Phase 1 - Creation Of Interactive Modules, Maria M. Ferreira Caceres, Miguel A. Alvarez Silva, Juan C. Lopez-Alvarenga

Research Colloquium

Background: Training in geriatrics and nursing home care are a critical element of medical education. This gap in knowledge becomes increasingly significant given the changing demographics and the need to provide adequate care for an aging population. Improving geriatrics curriculum and implementing nursing home rotations are essential to ensure optimal care for the elderly, thereby fulfilling both educational and healthcare imperatives.

Objective: We aim to analyze and assess the influence of geriatrics training through a survey to collect attitudes, skills, and knowledge of UTRGV Knapp Family Medicine residents. Additionally, the goal is to create interactive modules to boost their skills …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, F. O. De Meijer, N. Nyamu, A. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to …

Can Written Prompts Help Medical Residents To Accurately Monitor Their Own Communication Skills And Those Of Others?, Fleur Demeijer, Nelson Nyamu, A. B. H. De Bruin

Family Medicine, East Africa

In healthcare, effective communication in complex situations such as end of life conversa- tions is critical for delivering high quality care. Whether residents learn from communica- tion training with actors depends on whether they are able to select appropriate informa- tion or ‘predictive cues’ from that learning situation that accurately reflect their or their peers’ performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predic- tive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties …

Imprecise Clinical Assessments And Inaccurate Grades: Family Medicine Clerkship Director Perspectives, Arindam Sarkar, Joel J Heidelbaugh, Gage Hallbauer, Nital Appelbaum

Faculty, Staff and Students Publications

BACKGROUND AND OBJECTIVES: As application to residency programs becomes increasingly competitive, educational leaders face growing student concern about imprecise clinical assessments and clerkship grades.

METHODS: As part of a large annual survey of family medicine clerkship directors (FMCDs), 10 questions were disseminated in May 2023 about perceived levels of imprecise assessments by faculty. We aimed to determine to what extent respondents felt their institution's evaluation system propagated inaccurate grading.

RESULTS: A total of 52% of 169 FMCDs responded to the survey. Of these, 7% of respondents were completely confident that their preceptors would give two students of identical competence the …

Exploring Overactive Bladder Symptoms In Premenopausal And Postmenopausal Women: A Comparative Cross-Sectional Study, Egemen Tural, Ayşe Deniz Ertürk Coşkun, Gizem Pınar, Fisun Vural

Makara Journal of Health Research

Background: Overactive bladder syndrome affects millions globally. It can intermittently cause urinary incontinence, which can significantly diminish the quality of life. This study investigated overactive bladder symptoms in premenopausal and postmenopausal individuals by analyzing the influence of demographic, gynecological, and obstetric factors.

Methods: This single-center prospective cross-sectional study was conducted between September 1 and November 1, 2023, among premenopausal and postmenopausal women. In total, 244 patients meeting the inclusion criteria were selected using a simple random method. Participants were asked to complete an information collection form, and the Turkish version of the Overactive Bladder-V8 questionnaire was administered. A …

Physicians’ Attitude, Knowledge, And Perceived Control Towards The Use Of Exercise As A Form Of Preventive Medicine, Matthew Robert Warner

All-Inclusive List of Electronic Theses and Dissertations

Exercise is a component of physical activity that can aid in the reduction of deaths, lowering obesity rates, and chronic illness. However, many Americans are not meeting the recommended physical activity levels (Carlson, et al., 2018). Quality and accurate health information regarding physical activity is one way to help combat health disparities. Health professionals such as primary care physicians can aid in promoting this lifestyle modification. However, there are shortfalls in physicians’ knowledge of using exercise as a form of preventive medicine for chronic illness. Many medical programs have little to no training in exercise principles (Cardinal et al., 2015). …

"It Shouldn't Be Just Hush-Hush": A Qualitative Community-Based Study Of Menstrual Health Communication Among Women In Philadelphia, Allison R. Casola, Lynette Medley, Brianna C. Kunes, Nya Mcglone, Alexis Silverio

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community.

METHODOLOGY: In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N …

A Mixed Methods Acceptability And Feasibility Study Of A Patient-Initiated Approach To Increasing Weight Communication In Primary Care, Jocelyn E. Remmert, Leon Mccrea, Nicole T. Crane, Adam Gilden, Meghan L. Butryn

The Journal of Integrated Primary Care

Background: Weight discussions between patients and physicians can have a positive impact on patients’ health, yet they occur infrequently in primary care. No study to date has promoted patient-initiated weight discussions. This study aimed to test the feasibility, acceptability, and explore trends of the effect of a waiting room-based pamphlet intervention to promote patient-initiated weight discussions.

Methods: Adults (n=60) with overweight or obesity attending a primary care appointment were recruited from the waiting room and randomized to receive the intervention pamphlet or to a non-intervention control condition. All participants attended their appointment and completed post-appointment assessments.

Results: Three …

Modeling Interprofessional Excellence Transforming Medical Education For Collaborative Care, Kerry Miller, Paige Hardy, Neil Kalsi, Nathan Gollehon, Brianna Brei, Jason Burrows, Liliana Bronner

Posters and Presentations: Family Medicine

In our medical school, we designed an innovative interprofessional education (IPE) experience to prepare medical students for collaborative healthcare. Through a family-centered NICU high-risk follow-up clinic, students observed and engaged with a diverse team, including a developmental specialist, neonatal nurse practitioner, physician, and nurse. We developed a rubric based on the four IPEC competencies, evaluating students’ understanding before and after the rotation. Results from 118 participants showed significant improvement (p < .001) across competencies, with large effect sizes (Cohen's d: 1.02 to 2.14). This experience highlights the effectiveness of clinical modeling in enhancing interprofessional practice skills among medical students.

Administrative Time Expectations For Residency Core Faculty: A Cera Study., Bryce A Ringwald, Stephen Auciello, Joseph Ginty, Melissa Jefferis, Stephen Stacey

Medical Education Articles

BACKGROUND: Academic family medicine (FM) physicians aim to balance competing needs of providing clinical care with nonclinical duties of program administration, formal education, and scholarly activity. FM residency is unique in its scope of practice, clinical settings, and training priorities, which may differ between university-based and community-based programs. In both types of programs, these competing needs are a source of faculty dissatisfaction and burnout. We performed this study to explore the allocation of nonclinical administrative full-time equivalents (FTE) for FM residency core faculty members.

RESULTS: Reported nonclinical administrative FTE time allocation is equivalent between university/medical school-based and community-based programs. The …

The Heart Of Residency, Julia Fashner, Samantha Gionocchio

HCA Healthcare Journal of Medicine

As part of wellness activities in 2023, our family medicine residents produced individual paintings. Samantha coalesced these 4 x 4 canvases to create this heart. The following quote is also poignant for those of us in family medicine:

Wherever the art of Medicine is loved there is also a love of Humanity. -Hippocrates