Primary Care Commons^™

Attitudes Towards Vaccinations In The Minnesota Slavic Community, Maksim Kozak, Hannah Margaret Roy, Rachel Van Heest

All Electronic Theses and Dissertations

The incidence of vaccine preventable illnesses is increasing in the United States. Negative attitudes towards vaccinations, or vaccine hesitancy is fueling the decreasing vaccination rates. Ascertaining the level of vaccine hesitancy in susceptible populations is essential in combatting the rise of vaccine preventable illnesses in the United States. Very little research has previously been compiled on vaccine attitudes in Slavic immigrants. Slavic immigrants identify racially as “white” on surveys, masking differences in the Slavic population from the much larger Caucasian population in the United States. In order to better understand the level of vaccine hesitancy in the Minnesota Slavic immigrant …

Factors Contributing To Physician Assistant Burnout, Sarah F. Leonard, Tiffany J. Mellang, Connor Sacks

All Electronic Theses and Dissertations

Workplace burnout is known to be extremely prevalent among employees in the medical professions. For other health care professions such as physicians or nurses there is a plethora of existing literature on workplace burnout, but there is a lack of research on workplace burnout as it relates to Physician Assistants (PAs). This research study sought to discover what potential factors are specifically contributing to workplace burnout among PAs, symptoms of burnout experienced, and the personal strategies that PAs have found useful in coping with burnout. Interviews with ten currently practicing PAs in the Minnesota and Wisconsin region were conducted to …

The Impact Of Religious Beliefs Of Medical Practitioners On The Prescribing Of Contraceptives, Ashley M. Overby, Kayla Westling

All Electronic Theses and Dissertations

For centuries, the use of artificial birth control has been a highly debated topic across different religions and this debate continues to remain strong today. Living in a country made up of diverse cultural backgrounds and beliefs, religious differences may influence the way practitioners and patients interact with each other when it comes to a variety of medical issues, especially contraception. There is little research, however, that has been done to evaluate for a significant correlation between religious views of practitioners and their tendencies to prescribe contraceptives to patients. A questionnaire was distributed to the Association of Physician Assistants in …

An Overview Of Perinatal Health And Childhood Development In Honduras, Rose Margaret Carlson, Abigail D. Conrad, Alexandra Nicole Lothe, Caitlin M. O'Donnell, Cameron Svihla

All Electronic Theses and Dissertations

Honduras is a country with great healthcare needs. Within health care, the largest percentage of mortality is due to conditions occurring in the perinatal period, including prenatal and maternal health, delivery and postnatal care (PAHO, 2017a). Additionally, malnutrition continues to affect infants as they growth throughout their childhood (Gray, Cossman, & Powers, 2006). Education is shown to produce positive outcomes in low-income populations (Perkins, et al, 2011). The purpose of this project was to identify Honduran healthcare needs and provide effective and sustainable intervention. A needs assessment with a Honduran-Canadian health organization reiterated evidence found in the literature, illustrating the …

Attitudes Regarding Physician-Assisted Suicide Among Minnesota Family Medicine Physicians, Lauren M. Cooke, Lindsay Emmerich, Sam Feyder

All Electronic Theses and Dissertations

An affinity for bioethics lead researchers to investigate the attitudes of physicians toward physician-assisted suicide amidst growing conversation regarding patient liberties. Physician-assisted suicide (PAS) refers to the prescription of a lethal dose of a drug to prematurely end a patient’s life (Gather & Vollmann, 2013). The purpose of this study was to understand the attitudes of physicians toward PAS and thus, predict how their approach to end-of-life issues will change under its legalization. A case-based survey was created to determine the relationship between physician age and support for access to PAS, patient diagnosis and support for access to PAS, physician …

Integrative Medicine In Primary Care, Ashley M. Bjornerud

Physician Assistant Scholarly Project Posters

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, IM is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.

Trauma Treatment For Children In The Child Welfare System, The Rees-Jones Center For Foster Care Excellence

White Papers and Policy Briefs

Children involved in the child welfare system almost universally have experienced trauma, and many have experienced complex trauma. Research has shown that early intervention, treatment, and positive caregiving can reduce damage to the brain caused by trauma. Children coming into care should be screened to determine their trauma histories and related symptoms. Based on the outcomes of screenings and assessments, trauma-specific, evidence-based treatments or interventions should be provided.

For questions about this publication or others, please email [email protected]

childrens.com/fostercare

Root-Cause Analysis Of Persistently High Maternal Mortality In A Rural District Of Indonesia: Role Of Clinical Care Quality And Health Services Organizational Factors, Mohammad Afzal Mahmood, Ismi Mufidah, Steven Scroggs, Amna Rehana Siddiqui, Hafsa Raheel, Koentijo Wibdarminto, Bernardus Dirgantoro, Jorien Vercruyssen, Hayfaa A. Wahabi

Community Health Sciences

Background: Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants.
Method: Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays.
Findings: The root causes were found in poor quality of care, which caused …

Midwest Pharmacists' Familiarity, Experience, And Willingness To Provide Pre-Exposure Prophylaxis (Prep) For Hiv, Jordan M. Broekhuis, Kimberly K. Scarsi, Harlan R. Sayles, Donald G. Klepser, Joshua P. Havens, Susan Swindells, Sara H. Bares

Journal Articles: Internal Medicine

INTRODUCTION: Pharmacist provision of pre-exposure prophylaxis (PrEP) through collaborative practice agreements with physicians could expand access to people at risk for HIV. We characterized pharmacists' familiarity with and willingness to provide PrEP services in Nebraska and Iowa.

METHODS: An invitation to complete an 18-question survey was emailed to 1,140 pharmacists in Nebraska and Iowa in June and July of 2016. Descriptive analyses and Pearson chi-square tests were used to determine to what extent demographics, familiarity and experience were associated with respondent willingness to provide PrEP. Wilcoxon rank-sum tests compared ages and years of experience between groups of respondents.

RESULTS: One …

Impact Of Advanced Practice Providers (App) Care Models And Outcomes In Primary Care, Kathleen Exline

DNP Projects

Background: The Affordable Care Act, an aging population, and the increased burden of caring for the chronically ill are factors that have resulted in a significantly increased demand on primary care. This has prompted the strategy to utilize advanced practice providers (APPs) to supplement primary care physicians. Due to the inconsistency of a defined national model and measurement system, the impact of APP utilization in healthcare is not clear.

Purpose: The purpose of this project was to examine the use of APPs in primary care. The study involved a review of the current utilization of APPs, an evaluation of the …

Home-Based Primary Care: Impact On Cost And Patient Satisfaction, Sarah R. Tupper

All Graduate Theses, Dissertations, and Other Capstone Projects

The aging American population means more people will need healthcare than ever before. Many of these people are or will be Medicare beneficiaries who are predicted to be completely or mostly homebound at some point in time. This literature review was conducted to investigate Home-based Primary Care (HBPC) and whether or not this care delivery model has impacts on cost and patient satisfaction when compared to traditional outpatient encounters. A comprehensive and robust search of the literature was conducted using four different healthcare literature databases. Relevant articles were included if the site of care was ambulatory or office-based and if …

Short Term Dynamics Of The Sputum Microbiome Among Copd Patients., Rohita Sinha, Lisa A. Weissenburger-Moser, Jennifer L. Clarke, Lynette M. Smith, Art J. Heires, Debra J. Romberger, Tricia D. Levan

Journal Articles: Internal Medicine

Chronic obstructive pulmonary disease (COPD) is an inflammatory disorder characterized by incompletely reversible airflow obstruction. The complexity of the lung microbial community in COPD patients has been highlighted in recent years. Evidence suggests that transplantation, medications, age, and disease severity influence microbial community membership. However, the dynamics of the lung microbiome in stable COPD patients remain poorly understood. In this study, we completed a longitudinal 16S ribosomal RNA survey of the lung microbiome on replicate sputum samples collected from 4 former smokers with COPD (Stage 2) within a 2-day time period. Samples from each individual over the two-day period were …

Relationship Of Systemic Il-10 Levels With Proinflammatory Cytokine Responsiveness And Lung Function In Agriculture Workers, Tricia D. Levan, Debra J. Romberger, Mohammad Siahpush, Brandon L. Grimm, Athena K. Ramos, Patrik L. Johansson, Tzeyu L. Michaud, Art J. Heires, Todd A. Wyatt, Jill A. Poole

Journal Articles: Internal Medicine

BACKGROUND: Agriculture workers are exposed to microbial component- and particulate matter-enriched organic dust aerosols. Whereas it is clear that exposure to these aerosols can lead to lung inflammation, it is not known how inflammatory responses are resolved in some individuals while others develop chronic lung disease. Interleukin (IL)-10 is an immunomodulatory cytokine that is recognized as a potent anti-inflammatory and pro-resolving factor. The objective of this study was to determine whether there is a relationship of systemic IL-10 and proinflammatory responses and/or respiratory health effects in humans with prior agriculture exposure.

METHODS: This is a cross sectional study of 625 …

The Effect Of A School-Based Health Center On Access To Care In A Rural Community, Macey Cornwell

DNP Projects

BACKGROUND: Lack of access to healthcare is a nationwide issue that affects underserved, minority, and rural populations. School-Based Health Centers (SBHCs) is one way to help increase access to care for students, staff, and family members.

PURPOSE: The purpose of this project was to provide preliminary data on the impact of a SBHC in a rural Kentucky community on access to care and school attendance.

METHODS: A univariate descriptive analysis was conducted to evaluate the perceived impact of the SBHC on access to care and demographic factors. Data was analyzed using Pearson’s Product Moment Correlation, two-sample t-tests, and The Wilcoxon …

Sedentary Time And The Cumulative Risk Of Preserved And Reduced Ejection Fraction Heart Failure: From The Multi-Ethnic Study Of Atherosclerosis, Brandi Scot Rariden

UNF Graduate Theses and Dissertations

ABSTRACT

Purpose: The purpose of this study was to examine the relationship between self-reported sedentary time (ST) and the cumulative risk of preserved ejection fraction heart failure (HFpEF) and reduced ejection fraction heart failure (HFrEF) using a diverse cohort of U.S. adults 45-84 years of age.

Methods: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects (52.9% female). All were free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with baseline ST and risk of overall heart failure (HF), HFpEF, and HFrEF. Weekly self-reported ST was dichotomized …

Integrative Medicine In Primary Care, Ashley M. Bjornerud

Physician Assistant Scholarly Project Papers

Integrative medicine (IM) is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health (Rakel, 2017). Commonly, integrative medicine is associated with complementary and alternative medicine therapies (CAM). These are two separate entities. CAM is one of the modalities used in integrative medicine.

The review of the literature on IM analyzed studies in primary care settings in all parts of the world. Definitions of IM and CAM are evaluated. Defining what IM is and how to incorporate this approach in …

Inequities In Antenatal Care, And Individual And Environmental Determinants Of Utilization At National And Sub-National Level In Pakistan: A Multilevel Analysis, Ambreen Sahito, Zafar Fatmi

Community Health Sciences

Background: Nationally representative surveys are vital for gauging progress in health and planning health services. However, often marred with inadequate analysis to provide any guidance to health policy and planning. Most recent Pakistan Demographic and Health Survey (PDHS) 2012-2013 is an inclusive nationally representative investigation. Nonetheless, its published report offers limited evidence regarding antenatal care (ANC). Furthermore, after 18th constitutional amendment, policies are principally made at provincial level in Pakistan; therefore, it is imperative to have contextual evidence at sub-national level to feed programs and policies.
Methods: We analysed 7142 women with a recent birth, to assess the …

Implementing Evidence-Based Opioid Prescription Practices In A Primary Care Setting, Cyril Gaiennie

Doctor of Nursing Practice

The use and misuse of opioid pain medication has reached epidemic proportions in the United States. More than 16,000 people die each year due to the misuse or abuse of prescription opioid medications, which is more than from heroin, cocaine, and benzodiazepines combined. The purpose of this evidence-based practice project is to establish processes enabling a primary care clinic to implement and adhere to the 2016 Centers for Disease Control’s guidelines for opioid prescription practices in the primary care setting. A retrospective chart review conducted prior to implementation of the guidelines demonstrated that four of six of the CDC’s recommendations …

Initiating Hpv Co-Testing For Women Aged 30-65 In An Ob/Gyn Practice Setting, Stephen Cavazos

Doctor of Nursing Practice

The purpose of this project was to improve the rate of successful human papilloma virus (HPV) screening in a small Texas based Women's Health clinic through a co-testing method. The intended goal was to increase the rate of HPV screening, from a 73% baseline, to 95% over a 10-week period for women between the ages of 30-65 years old. Approximately 79 million American women are currently infected with HPV, and 14 million people contract it every year. Seventy percent of cervical cancers today are caused by HPV, leading to approximately 12,820 new diagnoses of invasive cervical cancer predicted for 2017, …

Assessing The Long-Term Effects Of Brief Behavioral Health Treatment In Primary Care Patients, Debbie Gomez

Graduate Theses and Dissertations

Although increasingly studies show brief behavioral health services are effective for primary care patients (Bridges et al., 2013; Bryan, Morrow, & Appolonio, 2009; Corso et al., 2012; Gomez et al., 2014), there is a paucity of research exploring the long-term effects of these interventions (e.g., Ray-Sannerud, 2012). The primary aim of the current study was to explore long-term effectiveness. Specifically, the current study 1) examined whether reductions in patient global distress following brief behavioral health care services were maintained long-term, 2) evaluated whether improvements were reliable and not due to regression to the mean effects, and 3) explored medical cost …