Publications by authors named "Kristen Klemenhagen"

Objective: The objective of this pilot study was to explore the impact of interpreter format (virtual vs in person) on clinical outcomes in patients with non-English language preference (NELP) and type 2 diabetes mellitus (T2DM) in a primary care setting. We hypothesized that NELP patients utilizing in person interpreters would have improved HbA1c values, better follow-up rate, and more complex care plans compared to patients utilizing virtual interpreters.

Methods: We completed a retrospective chart review of 137 NELP patients with T2DM who required a medical interpreter (February to June 2021).

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  • Studies show that family/shared meal frequency is linked to better health and well-being in children, but less is known about its effects on adults or across different countries.
  • A 2022 study surveyed adults from the U.S., Italy, and Germany to analyze family meals and emotional well-being, revealing most participants engage in six or more shared meals weekly, particularly on weekends.
  • Results indicated that more frequent family meals correlate with reduced depressive symptoms, increased connectedness, and greater happiness, suggesting positive impacts for all household members involved in family meals.
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Background And Objectives: Proficiency in procedural care achieved during residency is a major driver of family physician scope of practice. To date, no inventory exists of the advanced procedures and clinical skills performed by teaching family physicians. This study comprises the first such survey and assesses the attitude of respondents toward the importance of family physicians performing procedures.

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  • Continuity of care (COC) in primary care leads to better patient satisfaction, health outcomes, and reduced healthcare costs, but patients often see their primary care provider (PCP) less than half the time, especially in outpatient settings.* -
  • There are over 32 different ways to measure COC, influenced by factors like data source, measurement purpose (research vs. clinical), and patient visit patterns, making it essential for primary care to find the best metrics for quality improvement.* -
  • No single formula perfectly represents COC; however, understanding the variations in measurement can help analyze how consistently patients visit the same provider, which is crucial for improving primary care practices.*
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  • Continuity of care between patients and primary care providers is linked to better outcomes, lower costs, and improved provider satisfaction; the study evaluated the effects of a set-day clinic (SDC) model on continuity in a family medicine residency.
  • In July 2019, Bethesda Clinic transitioned from a rotation-driven scheduling model to the SDC model, collecting visit data from two different six-month periods to compare continuity rates before and after the implementation.
  • Results showed heightened continuity for PGY3 residents and general satisfaction among faculty and residents regarding the SDC model, indicating that predictable scheduling can enhance continuity and well-being in residency programs.*
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In recent years, there has been an increasing interest in the pathophysiology of repetitive concussive traumatic brain injury (rcTBI) in large part due to the association with dramatic cases of progressive neurological deterioration in professional athletes, military personnel, and others. However, our understanding of the pathophysiology of rcTBI is less advanced than for more severe brain injuries. Most prominently, the mechanisms underlying traumatic axonal injury, microglial activation, amyloid-beta accumulation, and progressive tau pathology are not yet known.

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The debilitating effects of repetitive concussive traumatic brain injury (rcTBI) have been increasingly recognized in both military and civilian populations. rcTBI may result in significant neurological, cognitive, and affective sequelae, and is often followed by physical and/or psychological post-injury stressors that may exacerbate the effects of the injury and prolong the recovery period for injured patients. However, the consequences of post-injury stressors and their subsequent effects on social and emotional behavior in the context of rcTBI have been relatively little studied in animal models.

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Although an influence of adult neurogenesis in mediating some of the effects of antidepressants has received considerable attention in recent years, much less is known about how alterations in this form of plasticity may contribute to psychiatric disorders such as anxiety and depression. One way to begin to address this question is to link the functions of adult-born hippocampal neurons with specific endophenotypes of these disorders. Recent studies have implicated adult-born hippocampal neurons in pattern separation, a process by which similar experiences or events are transformed into discrete, non-overlapping representations.

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Leptin inhibition of bone mass accrual requires the integrity of specific hypothalamic neurons but not expression of its receptor on these neurons. The same is true for its regulation of appetite and energy expenditure. This suggests that leptin acts elsewhere in the brain to achieve these three functions.

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The dentate gyrus (DG) is modified throughout life by integration of new adult-born neurons. Similarities in neuronal maturation during DG development and adult hippocampal neurogenesis suggest that genetically encoded intrinsic regulatory mechanisms underlying these temporally distinct processes are conserved and reused. Here, we identify a novel transcriptional regulator of dentate granule neuron maturation, Krüppel-like factor 9 (Klf-9).

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Serotonin 1A receptor knockout (5-HT1AR KO) mice exhibit increased behavioral inhibition in conflict tests. To gain further insight into their anxiety-related phenotype, we subjected these mice to additional behavioral tests. First, we considered whether behavioral inhibition in these knockout mice is a consequence of reduced exploratory motivation.

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Responses to threat-related stimuli are influenced by conscious and unconscious processes, but the neural systems underlying these processes and their relationship to anxiety have not been clearly delineated. Using fMRI, we investigated the neural responses associated with the conscious and unconscious (backwardly masked) perception of fearful faces in healthy volunteers who varied in threat sensitivity (Spielberger trait anxiety scale). Unconscious processing modulated activity only in the basolateral subregion of the amygdala, while conscious processing modulated activity only in the dorsal amygdala (containing the central nucleus).

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