Primary Care Commons^™

Risk Factors For Acute Respiratory Infections In Children Between 0 And 23 Months Of Age In A Peri-Urban District In Pakistan: A Matched Case–Control Study, Fatima Mir, Shabina Ariff, Maria Asif Bhura, Suhail Chanar, Aspara Ali, Muhammad Jawwad, A Hussain, Arjumand Rizvi, Muhammad Umer, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Acute respiratory infection (ARI) accounts for nearly 15% of all childhood mortality in South Asia, with children from rural areas at higher risk due to inaccessibility to healthcare facilities. We therefore aimed to identify risk factors associated with ARI in children under 2 years of age in rural Pakistan.
Methods: A retrospective 1:2 matched case-control study was conducted between October and December 2018 in Taluka Kotri, Jamshoro District of Pakistan. Cases were identified as children between 0 and 23 months of age with a history of fever, cough, sore throat, fast breathing, difficulty breathing, or chest indrawing in the …

The Promise Of Telemedicine In Pakistan: A Systematic Review, Syed Sarosh Mahdi, Raheel Allana, Gopi Battineni, Tamsal Khalid, Daniyal Agha, Mariam Khawaja, Francesco Amenta

Department of Paediatrics and Child Health

Background:
Telemedicine offers the possibility of provision of medical assistance to remote patients, and it has great potential in developing countries like Pakistan. Telemedicine solves logistical barriers, gives support to weak health systems, and helps to establish worldwide networks of healthcare professionals. Because of the high implementation costs, it is not possible yet to adopt telehealth systems for low- and middle-income nations.
Objective:
To present a revision of region-based telemedical services in Pakistan.
Methods:
Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE), and Google Scholar were used for document search. Newcastle-Ottawa Scale …

Nutritional Support And Prophylaxis Of Azithromycin For Pregnant Women To Improve Birth Outcomes In Peri-Urban Slums Of Karachi, Pakistan-A Protocol Of Multi-Arm Assessor-Blinded Randomized Controlled Trial (Mumta Pw Trial), Ameer Muhammad, Zoha Zahid Fazal, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan, Yasir Shafiq

Medical College Documents

Background: Maternal undernutrition is critical in the etiology of poor perinatal outcomes and accounts for 20% of small-for-gestational-age (SGA) births. High levels of food insecurity, antenatal undernourishment, and childhood undernutrition necessitate the supplementation of fortified balanced energy protein (BEP) during pregnancy in low-income settings especially with scarce literature available in this subject. Hence, this paper extensively covers the protocol of such a trial conducted in an urban slum of Karachi, Pakistan.
Methods: The trial is community-based, open-labelled, four-arm, and randomized controlled that will include parallel group assignments with a 1:1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. …

Improving Nutrition Literacy In Primary Care, Kami D. Dykes

DNP Research Projects

Abstract

By the year 2030, nearly one in every two adults will have obesity (Body Mass Index [BMI] ≥30 kg/m².), and one in four adults will have severe obesity (BMI ≥35 kg/m²) (Ward et al., 2019). Equally troubling is that obesity poses a threat to the health of individuals, decreases the quality of life, shortens life expectancy, causes and worsens comorbidities, and increases all- cause mortality (Abdelaal et al., 2017). Studies have shown a link between BMI, nutritional knowledge, and dietary practices. Nutrition literacy is a newer term that refers to the complex relationship between nutrition …

Nature Effects On Stress, Jaclyn Griffith

Graduate Research Projects

No abstract provided.

Obstructive Sleep Apnea And Cardiovascular Disease, Evan Gagnon

Graduate Research Projects

No abstract provided.

Dermatologic Manifestations Of Rheumatic Disease: Cutaneous Manifestations Of Sarcoidosis, Sarah Shapiro, Sindhuja Koppu, Mavra Masood, Beth Rubinstein, Huzaefah Syed

Open and Affordable Course Content at VCU

No abstract provided.

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

Investigating The Relationship Between Mental Health And Co- Morbidity Management During The Covid-19 Pandemic: A Literature Review, Alejandra Soto

Theses and Graduate Projects

Background: The COVID-19 pandemic caused many disruptions to millions of lives, especially with the enforcement of government shutdowns, isolations, and social distancing. These measures lead to increased anxiety and depression in the general population. With many high- risk patient populations having chronic comorbidities, accessing routine medical care and supplies became difficult during the pandemic.

Purpose: How has mental health affected the management of pre-existing comorbidities during the COVID-19 pandemic?

Methods: A comprehensive literature review was conducted using the research engine PubMed using the search terms: “pandemic”, “COVID-19”, “comorbidities”, “mental health”, “morbidity”, and “mortality”. Inclusion criteria were studies …

The Role Of Emergency Departments For Antimicrobial Stewardship In Covid-19 Pandemic; The Time Is Now, Madiha Ismail, Nazeer Najeeb Kapadia, Sara Usman

Department of Emergency Medicine

No abstract provided.

Acute Ethanol-Induced Liver Injury Is Prevented By Betaine Administration, Madan Kumar Arumugam, Srinivas Chava, Sathish Kumar Perumal, Matthew C. Paal, Karuna Rasineni, Murali Ganesan, Terrence Donohue, Natalia A. Osna, Kusum K. Kharbanda

Journal Articles: Internal Medicine

Binge drinking is the most common form of excessive alcohol use. Repeated episodes of binge drinking cause multiple organ injuries, including liver damage. We previously demonstrated that chronic ethanol administration causes a decline in the intrahepatic ratio of S-adenosylmethionine (SAM) to S-adenosylhomocysteine (SAH). This decline causes impairments in essential methylation reactions that result in alcohol-induced fatty liver (steatosis) and other features of alcohol-associated liver disease (ALD). Co-treatment with betaine during chronic ethanol feeding, normalizes hepatocellular SAM:SAH ratio and alleviates many features of liver damage including steatosis. Here, we sought to examine whether betaine treatment similarly protects against liver injury in …

Trauma-Informed Care Training For Medical Students, Tanisha Clark, Jill Mcleigh, Hilda Loria, Laura Lamminen

Integrated, Trauma-Informed Care

Due to the high prevalence of trauma and secondary trauma and the associated potential adverse health outcomes for both patients and providers, it is imperative that medical and allied professionals receive training in trauma as a constitutive element of their professional development. Despite the growing recognition of the importance of TIC, Ditcher and colleagues (2018) found in a survey of 263 family medicine residency programs that only 27.0% had TIC in the curriculum. Following a review of the literature and discussions with healthcare providers offering TIC in an integrated pediatric primary care setting, a brief, 45-minute online TIC training adapted …

A Pathway For Inclusive Innovation In Pediatric Mental Health: Prevention And Intervention Using Technology, Kate Corinne Bennett

DSW Capstone Projects

It is no secret that access to quality healthcare is difficult for citizens to achieve in the United States. Racism, discrimination, and oppression further exist at the root of compounding social problems, including limits in minority access to mental health services. The COVID-19 pandemic has also exacerbated mental health problems for young children, especially those who are already underserved and at risk. For these reasons, it is imperative that the social work profession emphasizes innovative approaches to equitable treatment access, including a focus on early intervention and the use of technology. Product one of this capstone engages a systematic review …

Increasing Awareness Of Personal Harm Reduction Interventions In The Clinical Setting: A Quality Improvement Project, Shawn Theberge

DNP Scholarly Projects

Abstract

The ever-rising concern for safety in the healthcare setting has become increasingly prevalent and levels of hostility and violence more publicly visible. Over the last decade both patients and clinicians have been targeted in healthcare facilities at record levels. These incidents have created an environment of not only risk but increased anxiety and feelings of uncertainty for most clinical personnel. The study will initially measure clinician’s viewpoint of the clinical setting that they work in; and over the span of the project, track and evaluate the effects of the interventions on clinicians’ overall feelings and perceptions. The expected outcome …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Initial Antihyperglycemic Options For Populations With Type 2 Diabetes Who Cannot Take Metformin, Rena Ogino

Capstone Showcase

Type 2 diabetes is a common disease in the United States that can result in life-threatening cardiac, vascular, and/or renal complications. The treatment of type 2 diabetes includes but is not limited to exercise, diet, multi-disciplinary approaches, and pharmaceuticals. Metformin is the first line pharmaceutical for newly diagnosed type 2 diabetes, however patients may be unable to tolerate metformin. With more than seven different antihyperglycemic drug classes and over twenty antihyperglycemic drugs, clinicians may have difficulty choosing the best agent for patients when metformin is not tolerated. This article compares common anti-hyperglycemic pharmaceutical agents and their drug classes, focusing on …

Conditions That Mimic Attention Deficit Hyperactivity Disorder In A Pediatric Population: A Diagnostic Guide For Primary Care Providers, Elena Schatell

Capstone Showcase

This article outlines common neurobiological, developmental, psychological, and other medical diagnoses and conditions that symptomatically mimic attention deficit hyperactivity disorder (ADHD) in the pediatric population. Many of these disorders are comorbid with ADHD, but they may also be misdiagnosed as ADHD. Due to the similarity in presentation, these conditions must be included when formulating a differential diagnosis. Accurately diagnosing a child with ADHD requires a thorough evaluation and work up to rule out diagnoses on the differential.

An Evidence-Based, Structured, Expert Approach To Selecting Essential Indicators Of Primary Care Quality, Sylvia J Hysong, Kelley Arredondo, Ashley M Hughes, Houston F Lester, Frederick L Oswald, Laura A Petersen, Lechauncy Woodard, Edward Post, Shelly Deperalta, Daniel R Murphy, Jason Mcknight, Karin Nelson, Paul Haidet

Faculty, Staff and Students Publications

BACKGROUND: The purpose of this article is to illustrate the application of an evidence-based, structured performance measurement methodology to identify, prioritize, and (when appropriate) generate new measures of health care quality, using primary care as a case example. Primary health care is central to the health care system and health of the American public; thus, ensuring high quality is essential. Due to its complexity, ensuring high-quality primary care requires measurement frameworks that can assess the quality of the infrastructure, workforce configurations, and processes available. This paper describes the use of the Productivity Measurement and Enhancement System (ProMES) to compile a …

Analysis Of Recurrent Urinary Tract Infection Management In Women Seen In Outpatient Settings Reveals Opportunities For Antibiotic Stewardship Interventions, Marissa A Valentine-King, Barbara W Trautner, Roger J Zoorob, George Germanos, Michael Hansen, Jason L Salemi, Kalpana Gupta, Larissa Grigoryan

Faculty, Staff and Students Publications

OBJECTIVES: We characterized antibiotic prescribing patterns and management practices among recurrent urinary tract infection (rUTI) patients, and we identified factors associated with lack of guideline adherence to antibiotic choice, duration of treatment, and urine cultures obtained. We hypothesized that prior resistance to nitrofurantoin or trimethoprim-sulfamethoxazole (TMP-SMX), shorter intervals between rUTIs, and more frequent rUTIs would be associated with fluoroquinolone or β-lactam prescribing, or longer duration of therapy.

METHODS: This study was a retrospective database study of adult women with

RESULTS: Among 214 patients with 566 visits, 61.5% of prescriptions comprised first-line agents of nitrofurantoin (39.7%) and TMP-SMX (21.5%), followed by …

A Survey On Self-Medication For The Prevention Or Treatment Of Covid-19 And Distrust In Healthcare Of Veterans In A Primary Care Setting In The United States, Eva Amenta, Larissa Grigoryan, Laura Dillon, Casey Hines-Munson, John Van, Barbara Trautner

Faculty, Staff and Students Publications

BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic brought the public overwhelming and conflicting information. Rates of trust in healthcare professionals have been declining among laypersons over the past five decades. In this setting, we sought to evaluate the use of medications, both with or without a prescription, to prevent and treat SARS-CoV-2 as well as trust in healthcare among patients in a primary care clinic.

DESIGN: We surveyed 150 veterans in primary care clinic waiting rooms at a large southwestern tertiary care Veterans Affairs hospital. This survey was performed in March-November 2021.

METHODS: The survey asked about respondents' demographics, use of medications, …