Primary Care Commons^™

Adult Development And Associated Health Risks, Elizabeth C. Halloran

Journal of Patient-Centered Research and Reviews

Much has been learned about adult development in recent decades. Adults go through stages of development (emerging adulthood, young adulthood, middle adulthood, post-retirement, and very old age) with certain challenges at each stage. Viewing patients through a developmental lens is part of providing patient-centered care. Knowing the prominent issues, stressors, and risks at each stage of development is important in understanding patients. This knowledge can help customize medical advice to patients regarding obesity, disability, sleep, substance use, relationships, and age-related declines. This paper summarizes an updated view of adult development and discusses its relevance to health risks and patient-centered care …

A Systematic Review: Mirror Neurons & Schizophrenia, Yashesvi Sharma, Surajit Dey

Annual Research Symposium

This research project establishes a link between Mirror Neuron System (MNS) activity and this information's implications in treating and understanding schizophrenia, specifically, schizophrenic patients with negative symptoms.

Independent Study Project: The Impact Of Digitization And Payment On Community Health Promoter (Chp) Motivation And Effectiveness In A Peri-Urban Community In Kisumu, Kenya., Fiona Yohannes

Independent Study Project (ISP) Collection

Community Health Promoters (CHPs) in Kenya are the liaison between the community and higher levels of healthcare. As CHPs’ responsibility in the country has grown, stipends started being distributed, and digitization efforts have begun to support them. This ISP paper aims to investigate how recent digitization and payment of CHPs impact their motivation and effectiveness in a peri-urban community in Kisumu, Kenya. The project includes data analysis on CHP performance data from 2016 to 2021 and analyses of interviews with CHPs and CHAs in April of 2024. It was found that time was positively related to CHP performance. It was …

Supervision Needs Of Novice Behavioral Health Providers In Integrated Primary Care Settings: A Delphi Study, Nicholas D. Schmoyer

Counseling & Human Services Theses & Dissertations

The integration of behavioral health providers (BHPs, i.e., clinical mental health counselors, clinical psychologists, clinical social workers, marriage and family therapists) into primary care settings has developed as a healthcare practice associated with enhanced patient clinical outcomes, enhanced patient satisfaction, reduced healthcare expenditures, and enhanced provider wellness and satisfaction, known together as the Quadruple Aim. For BHPs practicing in integrated primary care (IPC) settings, researchers have highlighted a variety of challenges they experience when integrating in these settings, with a consistent challenge being a lack of satisfactory training and supervision. Clinical supervision has been hailed as the “signature pedagogy” for …

Deprescribing Proton Pump Inhibitors In A Rural Health Clinic, Jason Thomas Barney

Doctoral Dissertations & Projects

Background: Proton pump inhibitors (PPIs) have been extensively prescribed for gastrointestinal pathologies, contributing to $14 billion in annual expenditure in the United States alone. Inappropriate PPI prescriptions, affecting 48% of adults, raise concerns about prolonged usage and associated health risks. Addressing these issues is vital, considering the significant impact of PPIs on patient health and healthcare costs.

Local Problem: A Midwestern clinic grapples with inappropriate and unnecessary PPI use among patients. In response, a comprehensive deprescribing intervention combining a provider algorithm with patient education was implemented to reduce PPI usage that was medically unnecessary.

Methods: A literature …

The Dementia Care Study (D-Care): Recruitment Strategies And Demographic Characteristics Of Participants In A Pragmatic Randomized Trial Of Dementia Care, Mia Yang, Rafael Samper-Ternent, Elena Volpi, Aval-Na'ree Green, Maya Lichtenstein, Katy Araujo, Pamela Borek, Peter Charpentier, James Dziura, Thomas M Gill, Rebecca Galloway, Erich J Greene, Kristin Lenoir, Peter Peduzzi, Can Meng, Jordan Reese, Amy Shelton, Eleni A Skokos, Jenny Summapund, Erin Unger, David B Reuben, Jeff D Williamson, Alan B Stevens

Faculty, Staff and Student Publications

INTRODUCTION: Pragmatic research studies that include diverse dyads of persons living with dementia (PLWD) and their family caregivers are rare.

METHODS: Community-dwelling dyads were recruited for a pragmatic clinical trial evaluating three approaches to dementia care. Four clinical trial sites used shared and site-specific recruitment strategies to enroll health system patients.

RESULTS: Electronic health record (EHR) queries of patients with a diagnosis of dementia and engagement of their clinicians were the main recruitment strategies. A total of 2176 dyads were enrolled, with 80% recruited after the onset of the pandemic. PLWD had a mean age of 80.6 years (SD 8.5), …

Effectiveness Of A Training Program For The Management Of Risky Alcohol Use In Primary Care Professionals Based On Motivational Interviewing, Celia Pérula-Jiménez, Esperanza Romero-Rodríguez, Juan Manuel Parras-Rejano, Ana González De La Rubia, Juan Baleato Gómez, Luis Angel Pérula De Torres

Faculty, Staff and Student Publications

OBJECTIVE: To assess the effectiveness of a training program for Primary Care (PC) professionals developed to increase knowledge, attitudes, and skills for managing patients with risky alcohol use and in the motivational interview.

DESIGN: Multicenter, two-arm parallel, randomized, open-label controlled clinical trial.

SETTING: PC of the Andalusian Health Service.

PARTICIPANTS: The study was completed by 80 healthcare professionals from 31 PC centers.

INTERVENTIONS: In both experimental and control groups, a workshop on managing patients with risky alcohol consumption and the resolution of two videotaped clinical cases with standardized patients were conducted. The experimental group attended a workshop on motivational interviewing. …

Establishing The First Student-Run Clinic To Provide Free Health Care To A South Texas Colonia, John Nicholas Cauba, Andrew B. Callan, Beatriz Tapia

Research Symposium

Purpose: The purpose of the University of Texas Rio Grande Valley School of Medicine Student Run Clinic is to bridge the healthcare gap in the local colonias by providing excellent, compassionate primary care to all who enter our doors, free of charge. We also work to connect our patients to low-cost, high-quality services in the area like women’s health visits, appointments with social workers, and dental services. Additionally, we offer medical students’ opportunities from their first year to serve an underserved population and get hands-on experience with patients.

Many patients in colonias face challenges like limited transportation options and a …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Baclofen Induced Excessive Perspiration; A Case Report, Othman Farahneh, Lois C. Akpati, Miguel Alvarez Silva

Research Symposium

This case report highlights an unexpected side effect of Baclofen, a well-known medication, excessive sweating, a rare occurrence not typically associated with the drug. The patient, a 63-year-old woman, experienced persistent sweating despite initial attributions to postmenopausal symptoms and subsequent medication adjustments. Extensive testing revealed an association between Baclofen use and the symptoms, which resolved upon discontinuation of the drug.

The significance of this case lies in drawing attention to the underreported side effects of excessive sweating linked to Baclofen, emphasizing the importance of considering medication-related effects even with established drugs. The report urges increased awareness among healthcare professionals, addressing …

A True Bloody Emergency: An Unusual Case Of Thrombotic Thrombocytopenic Purpura, Joshua M. Ninan

Research Symposium

Background: Thrombotic thrombocytopenic purpura (TTP) is a primary thrombotic microangiopathy that is classically characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). Although rare with an annual incidence of 3.7 cases per one million adults, it is considered a true hematological emergency due to its fatality rate of almost 100% if appropriate treatment is not initiated immediately. This makes it vitally important to identify and treat patients with TTP, a task that becomes unusually challenging in the absence of the disorder’s other characteristically diagnostic clinical features such as mucosal bleeding, fever, or presence of schistocytes.

Case Presentation: A 30-year-old gentleman with …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Efficacy Of A Primary Care Ehealth Obesity Treatment Pilot Intervention Developed For Vulnerable Pediatric Patients, Joshua S Yudkin, Marlyn A Allicock, Folefac D Atem, Carol A Galeener, Sarah E Messiah, Sarah E Barlow

Faculty, Staff and Student Publications

Background:

Challenges to treat excess weight in primary care settings include time constraints during encounters and barriers to multiple visits for patient families, especially those from vulnerable backgrounds. Dynamo Kids! (DK), a bilingual (English/Spanish) e-health intervention, was created to address these system-level challenges. This pilot study assessed the effect of DK use on parent-reported healthy habits and child BMI.

Methods:

In this 3-month, quasi-experimental cohort design, DK was offered to parents with children aged 6–12 years with BMI ≥85th percentile in three public primary care sites in Dallas, Texas. DK included three educational modules, one tracking tool, recipes, and links …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Acne Vulgaris - Comedonal Acne, Christopher M. Wong, Christina Guo, Christian J. Scheufele, Daniel A. Nguyen, Jean Elizze M. Charles, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Acne vulgaris is a common inflammatory skin condition of the pilosebaceous unit in adolescents and young adults and is primarily characterized by the presence of open and closed comedones. In patients of various skin pigmentations, skin-colored comedones may be difficult to appreciate and lead to incorrect or delayed diagnosis of acne. To aid in the identification of acne vulgaris in patients of various skin pigmentations, we present comedonal acne in different skin types and commonly encountered differential diagnoses. With its significant volume and burden of disease, acne vulgaris should be correctly identified in various skin pigmentations by primary care clinicians …

Identifying Virtual Care Modality In Electronic Health Record Data, Kurt C. Stange

Faculty Scholarship

Background: Virtual care increased dramatically during the COVID-19 pandemic. The specific modality of virtual care (video, audio, eVisits, eConsults, and remote patient monitoring) has important implications for the accessibility and quality of care, but rates of use are relatively unknown. Methods for identifying virtual care modalities, especially in electronic health records (EHR) are inconsistent. This study (a) developed a method to identify virtual care modalities using EHR data and (b) described the distribution of these modalities over a 3-year study period. Methods: EHR data from 316 primary care safety net clinics throughout the study period (4/1/2020-3/31/2023) were included. Visit type …

Revolutionizing Denture Excellence: An Invigorating In-Vitro Exploration Of Organic Products In Prosthetic Rehabilitation, Nighila Ravindran, Sneha Joseph, Aswani Surya K

Annual Research Symposium

The denture base comes into contact with diverse substances in the oral cavity, acting as a reservoir for microorganisms like corynebacterium, streptococcus, lactobacillus, and candida. This colonization elevates the risk of complications such as denture stomatitis and candidiasis. Commercial denture cleaners have explored the use of natural ingredients, less commonly employed but offering various advantages. These ingredients aim to mitigate the potential issues associated with microbial colonization on denture surfaces, contributing to improved oral hygiene for denture wearers. The exploration of natural elements reflects a nuanced approach to denture care, considering both efficacy and less conventional alternatives.

Investigating Racial And Ethnic Healthcare Disparities In Screenable Ob/Gyn-Related Cancers, Lara Laughrey

Annual Research Symposium

This is a scoping review of peer-reviewed literature addressing healthcare inequity based on race and ethnicity with a specific focus on Ob/Gyn-related management and treatment of screenable cancers.

Assessment Of Emotional Intelligence Among Students In Dental College, Gowri Nandana S Final Year Student, Sudeep C. B Professor And Head Of The Department Of Public Health Dentistry

Annual Research Symposium

Over an extended period, the examination of intelligence predominantly centered on the adaptive deployment of cognitive abilities. In more recent times, scholars such as Gardner (1983) and Sternberg (1988) have proposed comprehensive frameworks for comprehending intelligence. Pioneering the concept of "emotional intelligence," Salovey and Mayer (1990) posited that emotional intelligence encompasses three distinct categories of adaptive capabilities: the evaluation and expression of emotions, the regulation of emotions, and the utilization of emotions in problem-solving. The objective is to evaluate emotional intelligence among dental students across various educational institutions.

Quality Of Life In Orthodontics, Claudia Eisenhuth, Gabriel Eisenhuth, Connor Schwartz, Amir Mohajeri, Man Hung, Tiffany Nelson, Ryann Glenn

Annual Research Symposium

Orthodontic treatment goes beyond mere cosmetic enhancement; it significantly impacts various aspects of an individual's quality of life. Beyond the physical benefits of improved oral function and prevention of dental issues, orthodontics also yields profound psychological benefits. Aligned teeth enhance self-confidence, reduce social anxiety, and contribute to better relationships and professional opportunities. Moreover, addressing dental concerns through orthodontic treatment reduces psychological distress and promotes overall happiness and satisfaction. Real-life case studies vividly illustrate the transformative effects of orthodontic interventions, emphasizing the importance of considering quality of life outcomes in dental care.