Primary Care Commons^™

A Missed Opportunity For Shared Responsibility In Adolescent Contraception, Vasiliki Rahimzadeh

Journal of Adolescent and Family Health

The American Academy of Pediatrics Committee on Adolescence recently endorsed IUDs as the clinical contraceptive method of choice among sexually active adolescents. This commentary highlights the ways in which these recommendations reinforce a gender normative notion that contraceptive responsibilities continue to lie squarely with young women, and now adolescent girls. It critiques the absence of guidance from the Committee regarding how to approach both sexual partners equally in discussions of contraception. The reflection also identifies paucity in how to address sexual health among trans/intersexed adolescents and those with complex sexual orientations. Such exclusion has adverse implications, inviting marginalization of young …

An Analysis Of The Effects Of The Carbohydrate Intake And Hydration On Feeling Of Exertion Throughout A Marathon, Kristine M. Baumann, Kaitlyn Proulx

All Electronic Theses and Dissertations

The popularity of marathon running has grown exponentially since the 1970s (Noakes, 2003). This major gain in popularity has led to an increased interest in hydration and nutrition for marathon runners (Tucker et al 2009). The effects of dietary factors such as carbohydrates (CHO) and water on endurance has been extensively studied related to performance, but few studies have examined nutrition’s effect on feelings of exertion. The current study aimed to determine how the in-race nutrition and hydration habits of marathon runners affect their feelings of exertion throughout a 26.2-mile race. Individuals running Grandma’s Marathon in Duluth, MN on June …

The Effect Of Education On Folic Acid In Women On Childbearing Age And Low Socioeconomic Status, Macey I. Bentley, Anna R. Goetsch, Courtney L. Perpich

All Electronic Theses and Dissertations

The purpose of this study was to investigate the effect of education to women of lower socioeconomic status about the importance of folic acid use before and during pregnancy. Previous research has shown the significance of folic acid in preventing neural tube defects; however, research has shown that women of lower socioeconomic status are not equipped with proper education regarding folic acid usage periconceptionally. An educational session was provided to three women’s shelters regarding folic acid, and questionnaires were used to gauge knowledge on folic acid before and after the sessions. The statistical analysis was consistent with our hypothesis in …

Concussion Education In High School Athletes, Nathan A. Birno, Larson Davick, Kyle Oostra

All Electronic Theses and Dissertations

This paper examines concussion education in high school athletes. Specifically, it examines how educationally beneficial a concussion presentation is for high school athletes. The study examined eighteen-year-old participants from two Minnesota high schools participating in Minnesota State High School League (MSHSL) sanctioned spring sports. A presentation on concussion definitions, signs/symptoms, and adverse effects was presented to the participants. A pre and posttest questionnaire was used to evaluate participants’ baseline knowledge on concussion related topics and their knowledge gained after hearing the presentation. Data was analyzed via a comparison of the mean score differences using a paired t-test of within group …

Oncology Providers’ Opinions On Preventative Recommendations For Patients With Brca1 Or Brca2 Breast Cancer Mutations, Rebecca L. Crissman, Kathleen Dunsmore

All Electronic Theses and Dissertations

BRCA1 and BRCA2 gene mutations have been identified as increasing an individual’s risk for developing breast cancer. Genetic testing for these genes has become increasingly more common. However, once genetic testing has established that an individual has either a BRCA1 or BRCA2 mutation, there is no set guideline for preventative measures. The purpose of this study is to gain the opinions of oncology healthcare providers on their recommendation for preventative treatment in women who have been diagnosed with the mutation at varying ages. A web-based survey was emailed to oncology healthcare providers from Minnesota Oncology in Minnesota and Allegheny Health …

Current Usage Of Animal Assisted Therapy In Nursing Homes In Ramsey County, Minnesota, Lauren K. Duerst, Natalie E. Nikonovich, Ashley M. Young

All Electronic Theses and Dissertations

The main purpose of this study was to determine the use of animal assisted therapy (AAT) for residents living in nursing home facilities in Ramsey County, Minnesota. Furthermore we compiled the thoughts and opinions of each facility director regarding the usage and perceived barriers that accompany the implementation of AAT programs.

Attitudes And Utilization Of Tissue Plasminogen Activator Involving Telemedicine, Karin K. Filip, Brittany R. Kelly, Stacy M. Underhill

All Electronic Theses and Dissertations

Tissue plasminogen activator (tPA) is used to treat acute ischemic stroke and is widely accepted as standard practice in the medical community. Literature shows that providers are hesitant to use this therapy due to the associated risks. Supporting literature shows that tPA is highly effective if administered within a three hour window, when adhering to strict protocols and guidelines for patient qualification. Telestroke programs have been shown to improve the time from stroke onset to administration of tPA by allowing a neurologist to be present during the decision making process. The aim of the study was to examine attitudes of …

Comparison Of Oral And Printed Health Literacy Tools In Hypertension Education For Low-Income Patients, Andrew D. Forsgren, Annie Heggestad, Charles Ruegemer

All Electronic Theses and Dissertations

Hypertension is a prevalent health concern in today’s society, especially among individuals of low-income economic status. An increased risk for heart disease has long been correlated to hypertension, and this risk increases further as the population ages. Patient education is crucial for prevention and management of diseases such as hypertension; therefore it is necessary to develop effective education tools. This is particularly true among high-risk groups such as low-income populations. This study compared the efficacy of printed educational materials versus orally presented educational materials in terms of improving patient knowledge regarding hypertension. Subjects were randomly assigned to either the printed …

Chemically Self-Assembled Antibody Nanorings: A Novel Approach To Bispecific Design For Cancer Therapeutics, Kari A. Gabrielse

All Electronic Theses and Dissertations

Targeted antibody therapeutics are currently being developed for treatment of a wide variety of cancers. By extending the scope of targeted antibody therapeutics into a bispecific design, it has been shown that simultaneous targeting of the CD3 T cell receptor and cancer cell receptors is possible. While great success has been achieved with the use of bispecific agents, many of these agents are genetically fused antibody fragments that can only target one type of cancerous receptor. Here we describe a simple and straightforward method of spontaneously assembling bispecific antibody therapeutics. Using fusion proteins consisting of two dihydrofolate reductase proteins and …

Health Disparities On American Indian Reservations: Can Mid-Level Practitioners Make A Difference?, David Evard Johnston

All Electronic Theses and Dissertations

Introduction: American Indians/Alaskan Natives (AI/AN) suffer from a number of health issues and at higher rates than other United States populations. Efforts have been made through the Indian Health Service (IHS) to improve the AI/AN state of health, but healthcare disparities remain. Purpose: The purpose of this study was to assist in identifying options in reducing healthcare disparities on American Indian reservations in South Dakota. The need for recruitment of additional physicians and mid-level practitioners (also known as mid-level providers or advanced practice providers) was assessed, as well as the potential for mid-level practitioners to meet that need. Methods: A …

Prevalence Of Non-Conventional And Folk Medicine Usage Among Hmong In St. Paul, Minnesota, Matthew T. Vang

All Electronic Theses and Dissertations

Hmong Americans have been identified to utilize various modes of medicine including: folk/herbal remedies, spiritual/shamanistic rituals, and adapted treatments from countries like Thailand or Laos. However, there is a lack of studies that measured the prevalence of these medications among the Hmong community in Saint Paul, Minnesota. A questionnaire was distributed at a Saint Paul, Minnesota Hmong market to explore the prevalence of Hmong medicine usage. Demographical information was also collected to help determine any relationships that might exist between certain socio-cultural factors and Hmong medicine usage. The study had a total of 54 participants. Of the 54 participants, twenty-eight …

Assessing Deaf Culture Awareness Of Physician Assistant Students In The Midwest, Sheryl E. Delude, Morgan, Kay Foizie

All Electronic Theses and Dissertations

Currently, there has been insufficient research to support the need for implementation of deaf awareness training into physician assistant (PA) program curriculums. To address this gap in research, PA students in the Midwest United States were surveyed in order to assess student knowledge of Deaf culture and knowledge regarding appropriate management of patients who are deaf. Survey knowledge scores were compared to previously documented knowledge scores of medical students enrolled in the Medical Students, Cancer Control, and the Deaf Community Training (DCT) program at the University of California, San Diego (UCSD). PA student scores were also compared to scores of …

Analysis Of Lean/Six Sigma Production Model In A Tertiary Care Asthma And Allergy Clinlic, Erika Lynn Bullert, Laura Johnson, Ariel M. Schibilla

All Electronic Theses and Dissertations

In response to demands on healthcare, systems have looked to refine current processes to use time, materials, and finances more efficiently. Lean/Six Sigma (L/SS) is a model that has been used to improve procedural efficiency in various settings. The purpose of this study was to implement L/SS into an outpatient private practice setting and to evaluate the effect on efficiency as measured in the length of individual patient visits who presented to that clinic for routine re-evaluation. In this study, the amount of time between a patient’s entrance and exit from the clinic was documented for 878 patients before implementation …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

The Experiences Of Occupational Therapists Working On Interprofessional Primary Health Care Teams: A Case Study., Emma Blake Mcclellan

Online Theses and Dissertations

The aim of this research was to provide evidence on the integration of occupational therapy (OT) intervention in primary care from the perspective of OTs. Typical services provided, experience with team members, and the identified value of OT in primary health care was explored. OT possesses the expertise and skill set to address the most common chronic conditions that primary care providers treat by entry level educational preparation. OT services are based upon a holistic view of individuals creating an affective skill set to participate in and coordinate health care delivery for the client. Currently limited evidence is available to …

Measuring Adherence To Evidence-Based Practice Guidelines For The Management Of Hypertension In Women, Cristina M. Jorgensen

DNP Projects

Approximately 1 in 3 adults In the United States (U. S.) with approximately half being women have hypertension, a significant risk factor for cardiovascular disease (CVD) and stroke (Nwankwo, Yoon, Burt, & Gu, 2013). Nearly 70% of people who had a first heart attack, 80% of those who had a first stroke, and 75% of those who had congestive heart failure (CHF) have hypertension (Mozaffarian et al., 2013). Hypertension was the underlying or contributing cause of more than 375,000 deaths in 2011. Despite multiple publications of national hypertension guidelines, only 50% of adults with hypertension have their blood pressure under …

Primary Care Providers’ Knowledge And Experience With Pediatric Acute Watery Diarrhea And Hemolytic Uremic Syndrome, Krista Marie Cassel

DNP Projects

The purpose of this capstone is to investigate the potential for hemolytic uremic syndrome (HUS) risk reduction in children through the evaluation of current evidence as well as pediatric primary care providers' knowledge and experience with children at risk for HUS. The goals of this capstone are to 1) evaluate the current literature to determine best practice for prevention of HUS, 2) assess primary care provider knowledge of HUS and experience with children with acute watery, and 3) develop a guideline for the initial management and referral of these children at risk for HUS.

Foster Parents' Perceptions And Beliefs About Social Emotional Development In Infants And Toddlers, Susan R. Noel

DNP Projects

Infants and toddlers placed in foster care are at increased risk for social-emotional (SE) development dysregulation. Foster parents, as surrogate parents, play a critical role in a young child having the potential for healthy SE development. The transactional model supports the complex and intricate interplays and transactions of the child, the foster parent, and the environment that influences a healthy SE development. This qualitative descriptive study explored foster parent knowledge, behavioral cue recognitions, and role perception regarding a young child's SE development. Although the sample size was small, the study provides relevant information, from the on-going experiences of foster parents, …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …