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Effective Communication with Refugees and Immigrants
Immigrant and refugee patients may have limited English proficiency. Effective use of professional interpreter services reduces clinically significant errors and increases the quality of care. A multitude of professional interpreter services are available, and clinicians should carefully select the preferred modality of interpretation based on the type of encounter. Ad hoc interpreters, such as family members, are least preferred because of concerns of privacy and evidence of poorer outcomes. Children less than 18 years of age should only be used as interpreters in emergency situations. Professional telephonic, video, or i...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Carina M. Brown, Scott Bland, Nadia Saif Source Type: research

Cultural Considerations in Caring for Refugees and Immigrants
This article describes the different ways culture affects health care, in terms of patient-related factors, health care provider –related factors, and health care system–related factors. This article also reviews interventions and best practices that draw on the incorporation of culture into health care and that thus may be effective for building cross-cultural understanding between providers and their immigrant and refug ee patients. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Joseph S. Tan, Claudia W. Allen Source Type: research

Women ’s Health and Gender-Specific Considerations
Women ’s health is largely influenced by cultural beliefs, local traditions, and access to care across the world. Immigrant and refugee women experience health in varied ways; prior experiences with health care and beliefs about health should be explored with women on their arrival to the United States. Topics that should be discussed include menstrual practices, contraception and beliefs about family planning, prior screening for preventable diseases, pregnancies and experiences with childbirth, sexual assault and trauma, and history of traditional practices, including female genital mutilation ( dependent on area of or...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Alison N. Huffstetler, Sarah I. Ramirez, Sarah N. Dalrymple, Megan H. Mendez Miller Source Type: research

Special Issues in Immigrant Medicine
Immigrants enrich the United States through economic contributions and unique perspectives. Immigrants find themselves navigating a new culture, a complicated health care system, unfamiliar social programs, and an ever-changing policy environment. They may be discouraged by unmet expectations of life in the United States, changing family dynamics, and discrimination. Screening for the social determinants of health is crucial, as not all patients will proactively seek the advice of their health care provider for these issues. Health care providers can assist and empower immigrants to navigate these challenges, as well as se...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Kristina Johnson, Elizabeth Carpenter, Taylor Walters Source Type: research

Caring for the Forcibly Displaced
Immigration, and health issues surrounding the immigration status of patients, remains much in the media forefront and will likely remain so in the future due to ongoing political challenges. Although precise definitions of immigrants, refugees, and asylum seekers remain vitally important when framing discussions around immigration, all newcomers face health challenges. By educating themselves about these issues, health care professionals can better care for their patients, no matter their specialty. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Jeffrey Walden Source Type: research

Autosomal Dominant Polycystic Kidney Disease
is an inherited multisystemic disorder of the renal tubules with subsequent formation of multiple cysts and enlargement of the kidney, affecting various organs. Diagnosis is initially suspected in those with family history and/or individuals who develop hypertension early on (secondary hypertension) or certain symptoms. Renal function is initially preserved for years secondary to compensatory mechanisms. Associated conditions include: liver cysts, berry aneurysms, kidney stones, etc. The disease course is variable, but patients often progress to end-stage renal failure by age 60. There is no known cure, however, risk fact...
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Authors: Parvathi Perumareddi, Darin P. Trelka Source Type: research

Nephrology
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Authors: Parvathi Perumareddi Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Forthcoming Issues
Immigrant Health (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Impact of COVID-19 on Resettled Refugees
Refugees are among the world ’s most vulnerable people, and COVID-19 presents novel threats to their well-being. Suspension of resettlement prolongs persecution for those accepted but not yet relocated to a host country and delays family reunification. For new arrivals, pandemic-related modifications to resettlement services impair smooth transitions. Refugees are additionally more vulnerable to economic hardship, COVID-19 infection, and mental illness exacerbations. Communication barriers make telehealth access uniquely difficult, and children lose the school environment that is essential for their adaptation in a new c...
Source: Primary Care: Clinics in Office Practice - October 5, 2020 Category: Primary Care Authors: Micah Brickhill-Atkinson, Fern R. Hauck Source Type: research

Acute Kidney Injury
Acute kidney injury (AKI) is defined as an increase in serum creatinine or a decrease in urine output over hours to days. A thorough history and physical examination can help categorize the underlying cause as prerenal, intrinsic renal, or postrenal. Initial evaluation and management of AKI in the community setting includes laboratory work-up, medication adjustment, identification and reversal of underlying cause, and referral to appropriate specialty care. Even one episode of AKI increases the risk of cardiovascular disease, chronic kidney disease, and death. Therefore, early determination of etiology, management, and lon...
Source: Primary Care: Clinics in Office Practice - September 30, 2020 Category: Primary Care Authors: Jackcy Jacob, Joanne Dannenhoffer, Annie Rutter Source Type: research

Renovascular Hypertension
This article discusses various definitions of hypertension, approach to diagnosis of RVH, and management. Data from clinical trials are discussed with evidence-based medicine practice recommendations. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 30, 2020 Category: Primary Care Authors: Sai Sudha Mannemuddhu, Jason C. Ojeda, Anju Yadav Source Type: research

Nephrotic Syndrome
Nephrotic syndrome is one cause of end-stage kidney disease. Because edema is a common presenting feature and hypertension and dyslipidemia are often present in nephrotic syndrome, it is important for the primary care physician to suspect this entity. Common causes in adults include diabetic nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy. In adults, many primary causes are due to an underlying disease. A cause of the nephrotic syndrome should be established with serologic workup and renal consultation. Renal biopsy is necessary in those with an unknown cause to or classify disease. Treatment fo...
Source: Primary Care: Clinics in Office Practice - September 24, 2020 Category: Primary Care Authors: Seth Anthony Politano, Gates B. Colbert, Nida Hamiduzzaman Source Type: research