Primary Care Commons^™

The Effect Of The Screening, Brief Intervention, Referral To Treatment (Sbirt) Model On Adult Depression In An Outpatient Setting, Genevieve E. Sweeney

Doctoral Projects

Depression is one of the most common chronic conditions in the world. Despite this, depression continues to be under-screened, inaccurately assessed and diagnosed, and poorly treated in outpatient settings. Many providers solely rely on clinical judgement instead of a screening tool or evidence-based toolkit when a patient presents with depression symptoms, resulting in underdiagnosis and inappropriate treatment. Utilization of resources can help a provider appropriately screen, diagnose and treat an individual with depression. Screening, Brief Intervention, Referral to Treatment (SBIRT) is an evidence-based model intended to improve these measures. Studies from the literature support the efficacy of the SBIRT model …

Improving Blood Pressure Control Among Patients Diagnosed With Hypertension In A Primary Care Setting, Eriko Apriliando

Doctoral Projects

Hypertension affects over 38% of adults or approximately 103 million Americans, costing around $131 billion annually in treatment and loss of productivity. It is also an independent risk factor for coronary events, heart failure, stroke, and end-stage renal disease contributing to 410,624 United States (U.S.) deaths in 2014. The American Heart Association (2016) has released the Measure Accurately, Act Rapidly, and Partner with Patient (MAP) protocol in order to address this issue. This project focused on implementing parts of the MAP protocol. The purpose was to improve blood pressure (BP) control of patients diagnosed with hypertension in a primary care …

Primary & Secondary Prevention Of Cardiovascular Disease In Primary Care, Marshall Miller, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Review historical perspective and complexity of primary CVD prevention

Discuss primary & secondary prevention of CAD and the 2019 ACC/AHA guidelines

-- Review of the evidence & primary literature

• Focus on CV risk assessment, DM, ASA/DAPT
• Practical guidance and management considerations

-- CASES- let’s practice and discuss

Male Luts – Introduction And Overview, Thenappan Chandrasekar, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline & Goals

• Background – What are “LUTS”?

• Anatomy

• Pathophysiology

• Storage – bladder filling symptoms
• Voiding – urine flow symptoms
• Post-micturition

• Major etiologies and management

• BPH / BOO
• OAB
• Nocturia

• Related to Prostate Cancer?

Proteinuria, Goni Katz-Greenberg, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Objectives

• Definition
• Screening/Measurement
• Etiology
• Treatment

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

The Effect Of Physician Held Stigmas And Bias On The Health Outcomes Of Patients With Obesity: A Review Of The Literature, Rachel Cohen, Catherine Jones

Journal of Health Disparities Research and Practice

Obesity is a growing epidemic that continues to garner attention throughout healthcare. The goal of this study was to review the literature on physician bias and stigmas surrounding obesity to assess the current state of research on connections between obesity-related stigma and the health outcomes and care of patients with obesity. A specific search string was used to obtain articles via PubMed and psychINFO, yielding 14 studies found that investigate these connections. The studies were categorized into three distinct pathways leading from physician stigma and biases to differing health outcomes of patients with obesity. These three pathways- perceptions, patient interaction, …

Listening To The Patient: A Typology Of Contextual Red Flags In Disease Management Encounters, Amy E. Binns-Calvey, Gunjan Sharma, Naomi Ashley, Brendan Kelly, Frances M. Weaver, Saul J. Weiner

Journal of Patient-Centered Research and Reviews

Purpose: Patients send clues, often unwittingly, when they are grappling with a life challenge that complicates their care. For instance, a patient may lose control of a previously well-managed chronic condition or start missing appointments. When explored, these clues help clinicians uncover the life circumstance impacting the individual’s ability to manage their health and health care. Such clues are termed “contextual red flags.” Effective care requires recognizing them, asking about them, and customizing the care plan where feasible. We sought to develop a typology of contextual red flags by analyzing audio recordings along with the medical records of encounters between …

Lavender Aromatherapy: Ready For Prime-Time Office Use?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the perioperative use of lavender aromatherapy and its potential to relieve pain and anxiety during minor primary care office procedures.

Anxiety-Related Issues In Cancer Survivorship, Maresi A. Berry-Stoelzle, Anna C. Mark, Peter Kim, Jeanette M. Daly

Journal of Patient-Centered Research and Reviews

Purpose: The purpose of this qualitative study was to examine patient opinions about anxiety in cancer survivorship, particularly the role of the primary care provider in management of anxiety related to the trajectory of long-term cancer survivorship.

Methods: Respondents to a mass email (N = 22,000) were invited to participate in 1 of 3 institutional review board-approved focus group meetings. Inclusion criteria were being an adult patient older than 25 years of age, having any type of cancer diagnosis, and being at least 18 months from treatment. The following specific issues were discussed: role of the primary care provider …

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Fresh Fruits And Vegetables Really Do Keep The Doctor Away: Symptomatic Vitamin Deficiency In A Middle Aged Man, Matthew J. Turnquist Md, Christina Holt Md, Msc

Journal of Maine Medical Center

Introduction

We present a clinical case of symptomatic vitamin deficiency typically seen only in resource limited environments or alcoholics, presenting in an adult male with frequent oral intake, but limited diet of prepared foods, as well as co-occurring pernicious anemia.

Clinical Findings

The patient presented with complaints of ascending paresthesia leading to near syncope, lower extremity edema and hyperpigmentation on his anterior legs bilaterally which had been present for years.

Diagnosis and interventions

He was found to have mixed B12, thiamine, and folate deficiency. These were attributed to a combination of nutritional deficiency due to a diet of exclusively cooked …

Registered Nurse Perception Of Physician Assistants, Erin Renee Alpers, Linda Charles, Kaitlyn Mellesmoen

All Electronic Theses and Dissertations

The physician assistant (PA) profession is a relatively new and ever-growing field within healthcare. PAs serve patients in many different specialties alongside a wide variety of other members of healthcare teams. With the exponential growth of the PA profession the understanding of the role they provide is essential to other healthcare workers. Since the emergence of the PA there has been one study on the relationship between Registered Nurses (RNs) and PAs, and this occurred over thirty years ago. An understanding between team members continues to be key to promoting effective care of patients in healthcare teams. Therefore, the study …

A Community Service Project: Creating Awareness Of Chronic Malnutrition In Guatemalan Children, Mallory A. Beswick, Bree A. Blanchette, Brooke L. Elvehjem

All Electronic Theses and Dissertations

Guatemala City is home to one of Central America’s largest garbage dumps. Many individuals living in Guatemala City scavenge the dump for recyclables and other goods, that they can then sell for income. Family earnings vary greatly on a daily basis and can range anywhere from approximately $2.00 to $6.00. Since family income is very low and often unpredictable, many families living in the area struggle to supply not only a sufficient amount of food for their children, but also nutritious food needed for proper growth and development. As a result, many children in Guatemala face chronic malnutrition. Transforming Futures, …

Postpartum Depression Education Of Doulas For Incarcerated Women, Tatia Marie Hibbs, Mikaela Reed, Claire Sautner

All Electronic Theses and Dissertations

As of 2017, there were 111,360 females in a state or federal correctional facility (Bronson & Carson, 2019). Many women in prison are mothers with 5-10% being pregnant while imprisoned (Baldwin, Sobolewska, & Capper, 2018). Some programs have started in female prisons with the goal to provide opportunities to nourish relationships with their children and educate on prenatal health, mental and physical health, and parenting skills. One of these organizations is the Minnesota Prison Doula Project (MnPDP) which utilizes the skills of doulas to provide supportive care to the incarcerated women of the Minnesota Correctional Facility-Shakopee (MCF-Shakopee). MCF-Shakopee is the …

Change In Empathy Levels Among Practicing Physician Assistants, Matthew P. Horn, Jacqueline Roff, Lisa Xiong

All Electronic Theses and Dissertations

This research sought to determine whether empathy declined with either increased years of physician assistant (PA) clinical experience or increased years of pre-PA healthcare experience (HCE). Although there has been an abundance of research examining empathy level trends among healthcare providers, most of these studies have looked at student empathy and not empathy level changes among practicing healthcare providers. However, among clinical healthcare providers, burnout trends with increasing years of experience (Smith, 2018) and a decline in empathy (Wilkinson, Wittington, Perry, & Eames, 2017); therefore, this project examined the link between years of practice and empathy decline. This cross-sectional study …

Hunger Solutions Market Bucks Program Improvement In The Rural Setting: A Research Project, Kollin D. Michels, Nicholas S. Reich, Jeffrey D. Sandquist

All Electronic Theses and Dissertations

Food insecurity – a lack of food required for a healthy and productive life – affects approximately 150 million households in the United States alone (Coleman-Jensen, Rabbit, Gregory, & Singh, 2018). The implications of this are numerous – as individuals who are “food insecure” have a statistically increased risk of numerous health conditions and disorders. In an effort to combat the burden of food insecurity, organizations such as the Supplemental Assistance and Nutrition Program (SNAP) have been created to provide increased access to food items. Furthermore, numerous state organizations have developed additional programs, which incentivize SNAP users to purchase nutrient …

The Need For A Physical Therapy Clinic In Pucallpa, Peru, Isabella M. Sutton, Abby M. Waldek, Brylie M. Wiedmaier

All Electronic Theses and Dissertations

In developing countries, complications from traumatic injuries account for a significantly higher number of deaths annually compared to developed countries. Not only are traumatic injuries more likely to occur in developing countries, but limited access to quality healthcare and adequate funds to pay for services make it much more likely for individuals to be left with lifelong disabilities. With that, this community service project worked with Scalpel at the Cross (SATC), an orthopedic medical ministry based in Pucallpa, Peru to expand their ability to provide free orthopedic surgeries and physical therapy following traumatic injuries. The community service project will help …

Opioid Knowledge, Confidence, And Concern Of Bethel University Physician Assistant Students, Lealand A. Torgerson, Travis A. Williams

All Electronic Theses and Dissertations

With more than 130 people dying daily, 47,000 overdose-related deaths per year, and $55 billion in societal costs, the opioid epidemic is producing widespread, catastrophic consequences on the population and healthcare system. Healthcare providers report high concern and lack of confidence that their training prepared them adequately to manage chronic pain with opioid therapy. There is insufficient evidence determining whether educating healthcare providers on opioid prescribing guidelines leads to improved knowledge, confidence, and a decrease in concern. The aim of this study is to assess the knowledge, confidence, and concern of 2020 Bethel University physician assistant (PA) students of opioid …