Digital Commons Network^™

Motivational Interviewing For Cpap Adherence, Grayton Downing, Caitlin Green, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Untreated obstructive sleep apnea (OSA) leads to negative health outcomes. Yet, compliance rates for continuous positive airway pressure (CPAP), the gold standard of treatment, range from 30-60%. This study examines how motivational interviewing (MI), a goal-oriented form of psychotherapy, increases CPAP adherence. We hypothesize that MI increases CPAP compliance when incorporated into CPAP follow-up care.

Methods: We developed and trained our staff with a novel MI training protocol consisting of MI background readings and videos, CPAP technician shadowing, and MI role-play for certification. For the clinical trial, newly diagnosed OSA patients from Jefferson’s sleep center will be randomized …

The Effect Of Reflection Rounds On Medical Students’ Empathy, Erica Westlake, Jennifer Desantis, Med, Fred Markham, Md

Phase 1

Background: A decline in empathy has been noted in medical students in medical education and training. This decline raises concerns because empathic physician-patient interactions positively impact health outcomes and patient satisfaction. We tested the hypothesis that Reflection Rounds would increase empathy scores of third-year medical students.

Methods: Third-year students entering their Family and Community Medicine (FCM) clerkship completed the Jefferson Physician Scale of Empathy – Student Version (JPSE-S) at the onset of their clerkship; students at the Jefferson Campus site were assigned to the experimental group and students at Affiliate Sites were assigned to the control group. The experimental group …

Mechanical Thrombectomy In Acute Ischemic Stroke Patients Greater Than 90 Years Of Age Experience In 26 Patients In A Large Tertiary Care Center: Outcome Comparison With Younger Patients, Nicholas Elmer, Ahmad Sweid, Md, Joshua H. Weinberg, Vivian Xu, Kavya Shivashankar, Tyler D. Alexander, Ms, Jane Khalife, Md, Michael R. Gooch, Md, Nabeel Herial, Md, Nohra Chalouhi, Md, Pascal Jabbour, Md, Robert H. Rosenwasswer Md, Stavropoula Tjoumakaris, Md

Phase 1

Introduction: Several independent randomized control trials have shown the superior efficacy of mechanical thrombectomy for acute ischemic stroke (AIS). However, the elderly has been underrepresented or excluded in these trials. In this study, we investigated the feasibility and safety of mechanical thrombectomy in patients with AIS aged 90 years or greater.

Methods: A retrospective review of patients age 90 years or older presenting with AIS who underwent mechanical thrombectomy between 2010 and 2018.

Results: Of total 453 patients with AIS, 5.74 % (26) were aged 90 or older, and 69.32 % (314) ranged from 60-89 years of age. Of …

A Report From The Grndad Multi-Site Registry For Sickle Cell Disease: Iron Overload Is Under-Recognized And Under-Managed, Matthew Sears, Phd, Sophie Lanzkron, Md, Mhs, Carolyn Hoope, Md, Joshua J. Field, Md, E. Leila Jerome Clay, Md, Mcts, Faap, Susan Padrino, Md, Payal C. Desai, Md, Lynne D. Neumayr, Deepa Manwani, Md, Jane Little, Md

Phase 1

Introduction: GRNDaD is a prospective registry for people with SCD that opened to enrollment in 2016. Nine comprehensive SCD centers from across the United States are currently enrolling patients. The registry includes iron status and management data, important in SCD because chronic transfusion therapy is a mainstay of prophylactic management. Each unit of transfused blood introduces approximately 250 mg of iron into the blood, which can lead to systemic iron deposition, and untreated may lead to organ dysfunction or death.

Methods: GRNDaD currently contains prospective baseline and annual update information on approximately 1000 people with SCD. We analyzed ferritin levels …

Evaluating Cardiac Anatomy As A Predictor For Success After Pulmonary Vein Isolation For The Treatment Of Atrial Fibrillation, Paul Richter, Evan Rochlis, Ethan Halpern

Phase 1

Introduction: Atrial Fibrillation is a condition characterized by the production of ectopic beats by the heart. One common treatment for Atrial Fibrillation is catheter guided pulmonary vein isolation (PVI), however this treatment is only effective in around 60-70% of the population. Our research hopes to elucidate a link between cardiac anatomy and successful treatment of A-fib by pulmonary vein isolation.

Methods: The medical records for 78 consecutive patients who underwent PVI for atrial fibrillation at Jefferson from July 2013 to March 2016 were gathered. Included in these charts were ECG-gated cardiac CT angiogram and two-year follow up history. Different variables …

Vaccination Exemptions For School-Aged Children In Delaware, Anna Melnick, Mph, Meghan Gannon, Phd

Phase 1

Background: Current awareness around childhood vaccinations and associated requirements for school entry has been heightened both nationally and internationally as governments work to find a balance between protecting their residents’ health and personal freedoms. Scant research exists examining the characteristics of these vaccine exemptors, but as the percentage of students seeking these exemptions increases yearly, this yields an opportunity to identify trends and inform future policy.

Question: What are the associations between reason for exemption from mandated vaccinations and the demographics of race and gender for school-aged children in the state of Delaware?

Results: Drawing from school nurse vaccine exemption …

Functional Outcomes After Lumbar Fusion In Opioid-Tolerant Patients, Max Detweiler, Noah Levy, Dhruv K.C. Goyal, Ariana Reyes, Alex R. Vaccaro, Md, Phd, Mba

Phase 1

Introduction: Prolonged opioid use after lumbar fusion surgery is implicated with increased hospital readmissions, higher postoperative pain scores, and longer return to work time. There are several non-modifiable risk factors for postoperative opioid use including socioeconomic status and gender. The purpose of this study was to determine the effects of opioid-tolerance on PROMs and to determine risk factors for prolonged opioid use after lumbar spine surgery.

Method: Using retrospective cohort analysis, patients who underwent lumbar spinal fusion at TJUH were identified and determined to be either opioid-naïve or opioid-tolerant using the Pennsylvania PDMP. Outcomes included number of opioid tablets consumed, …