Digital Commons Network^™

A Mixed Methods Acceptability And Feasibility Study Of A Patient-Initiated Approach To Increasing Weight Communication In Primary Care, Jocelyn E. Remmert, Leon Mccrea, Nicole T. Crane, Adam Gilden, Meghan L. Butryn

The Journal of Integrated Primary Care

Background: Weight discussions between patients and physicians can have a positive impact on patients’ health, yet they occur infrequently in primary care. No study to date has promoted patient-initiated weight discussions. This study aimed to test the feasibility, acceptability, and explore trends of the effect of a waiting room-based pamphlet intervention to promote patient-initiated weight discussions.

Methods: Adults (n=60) with overweight or obesity attending a primary care appointment were recruited from the waiting room and randomized to receive the intervention pamphlet or to a non-intervention control condition. All participants attended their appointment and completed post-appointment assessments.

Results: Three …

Emergency Department Staff Compassion Is Associated With Lower Fear Of Enacted Stigma Among Patients With Opioid Use Disorder., Savannah Steinhauser, Rachel Haroz, Iris Jones, William Skelton, Brian M Fuller, Michael B. Roberts, Christopher W Jones, Stephen Trzeciak, Brian W Roberts

PCOM Scholarly Works

OBJECTIVES: Fear of enacted stigma (fear of discrimination or being treated unfairly) is associated with decreased health care-seeking behaviors among patients with opioid use disorder (OUD). We sought to describe the prevalence of fear of enacted stigma among patients presenting to the emergency department (ED) with OUD and to test whether experiencing greater compassion from ED staff is associated with lower fear of enacted stigma.

METHODS: We conducted a cross-sectional study in the ED of an academic medical center between February and August 2023. We included adult patients with OUD presenting to the ED and assessed patient experience of compassion …

Eating Disorders In Hispanic Females Living In The Us: A Review Of Literature, Yesenia P. Stephens, Natalia Miles

Research Day

INTRODUCTION: According to the United States Census, Hispanics make up 19.1% of the total population, making it the nation’s largest racial or ethnic minority. Of interest, nearly 22% of Hispanic adults report having a mental illness, yet only 36% receive mental health services compared to non-Hispanic Whites (52%).2

OBJECTIVES: There is limited research on diagnosing eating disorders in Hispanic females living in the US. To understand this disparity, the aims of this study are to 1) gain understanding of what psychological constructs are unique to the experience of Hispanic females living in the US and 2) determine the risk factors …

Rural And Urban Differences In Eye Care Among Persons With Diabetes Enrolled In Original Medicare - Georgia, 2019, Pathya Kunthy, Grace M. Perry, Lauren Ball

Research Day

No abstract provided.

Exploring Medication Adherence In Children: A Survey-Based Approach To Addressing Disparities And Improving Treatment Outcomes., Rajat Sharma, Phuongloan Hoang, Drew Mccanless, Seana-Pierre Williams, Mariam-Sere Diaby, Lauren Callaway, Jihui Diaz, Xinyu Wang, Yujin Kim

Research Day

INTRODUCTION

Medication Therapy Management (MTM) aims to boost medication adherence, primarily focusing on seniors covered by Medicare and Medicaid. However, vulnerable populations like children with medical complexity or disabilities on medication (MCDM) lack access to this service. Previous research using the NHIS database identified disparities in medication adherence rates across socioeconomic levels, education, and ethnicity among caregivers. To investigate if these disparities persist in our community, we're developing a survey to assess medication adherence rates in children with MCDM. We conducted a literature review to create a questionnaire analyzing the impact of MTM services on children with MCDM.

METHODS

From …

Chest Binding Alters Thoracic Anatomy In Transmasculine Youth, Julienne Ryland, Jeannel Miclat, Diana Peterson

Research Day

Introduction:

With the recent legislation restricting gender-affirming care for minors, more mechanical means of gender-confirming methods are being used as a substitute. For adolescent transmasculine people, this includes chest binding, designed to flatten breast tissue and give a more streamlined masculine appearance. Chest binding is a relatively inexpensive and widely available technique to affirm gender identity without the need for healthcare professional involvement. Although chest binders are recommended to be worn for less than 8 hours daily, transmasculine youth have been documented wearing their chest binders for upwards of 18-21 hours a day. This consistent pressure on their chest essentially …

The Effect Of State And Trait Anxiety On Pain-Pressure Threshold, Scott Lowe, Christian T. Hughey, Kathryn E. Downing, Breana L. Fair

Research Day

Background:

The global burden of persistent pain is substantial, affecting up to 30% of the world's population. Despite growing awareness, challenges persist with accurate pain measurement, limiting research and clinical efforts. One method to assess pain perception is the Pain-Pressure Threshold (PPT), indicating the pressure at which pain is reported. Anxiety, comprising state and trait anxiety, has been suggested as a potential influencer of PPT, yet its precise impact remains uncertain. State anxiety is defined as a "transient state of arousal subjectively experienced as anxiety" Trait anxiety is “an individual's tendency to appraise situations as threatening, avoid anxiety-provoking situations, and …

Impact Of Covid-19 On Food Insecurity And Subsequent Consequences In Post-Secondary Students In The United States: A Systematic Review With Meta Analysis, Meshora Suthanthira, Valerie Cadet

Research Day

Introduction

Food insecurity is a prevalent problem in the United States that affects the livelihoods of many individuals and families. Food security is defined as “a situation that exists when all people, at all times, have physical and social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy lifestyle.” (Committee on World Food Security (CFS), 2012). The purpose of this systematic review is to compare food insecurity and its effects on mental health, physical health, and academics, prior to the start of the pandemic and after stay-at-home …

Analyses Of The Correlation Of Hpv Vaccination And Oropharyngeal Cancer/Lesion In Men: From Allofus Research Database, Anna M. Terzian, Ahmad B. Cader, Qian Chen

Research Day

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. It is most well-known as the leading cause of cervical cancer. However, there is a rising prevalence of HPV-related oropharyngeal cancers, particularly in men from high-income countries. Therefore, it is urgent to advocate prevention. This study aims to understand the correlation between the HPV vaccination and reduced HPV-related oropharyngeal cancer development. Additionally, many factors, such as race, income, risky sexual behavior, smoking, and recreational drugs are worth analyzing to appreciate their role in cancer development. This study was conducted using the AllofUs research database. The keywords included …

Academic Degree Bias Among Speaking And Leadership Roles At The American Academy Of Orthopaedic Surgeons Annual Meeting 2016-2021, Lucas Bartlett, Alton Daley, Adam Kazimierczak, Brandon Klein, Casey Humbyrd, Adam Bitterman, Randy Cohn

Research Day

Objective: This study examined the proportion of osteopathic physicians (DO) across various speaking and leadership roles at recent American Academy of Orthopaedic Surgeons (AAOS) annual meetings.

Design: Meeting programs from the AAOS were publicly accessed and compiled between 2016 and 2021. Two categories of AAOS meeting participants were created. Invited speaker and faculty roles included moderators of symposia and program committee members while authors of presented papers were classified into academic roles. The proportion of DOs in each role type (invited speaker, academic) were recorded for each meeting program. The representation of DO's in these roles were then examined longitudinally …

The Prevalence Of Demodex Folliculorum And Brevis Colonization In Patients Presenting With Blepharitis To An Outpatient Resident Clinic, David Broytman, Eric Rosenberg, Alanna Nattis, Ryan Kent, Vinh Ngo

Research Day

Purpose: To examine the prevalence of Demodex in two large, tertiary care, outpatient resident clinic settings; meanwhile, exploring demographic variables, use of ocular medications, and OTC cosmetic products with respect to prevalence. Lastly, analyze potential inadequacies in the rate of treatment amongst patients in the resident clinic setting.

Methods: A cross-sectional non-randomized, prospective study investigating the prevalence of Demodex folliculorum (DF) and brevis (DB) in patients presenting with blepharitis, and in control patients without clinical evidence of dry eye blepharitis syndrome (DEBS). Epilation of one eyelash from each lid was performed and studied under high power light microscopy. Each patient …

Informed Consent In Shoulder And Elbow Surgery, Puru Sadh, Antonio J. Almeda-Lopez, Benjamin Hershfeld, Dan Monessa, Brandon Klein, Randy M. Cohn, Adam D. Bitterman

Research Day

Introduction:

Informed consent, a dynamic process, involves explaining procedure details to patients. Crucial for preserving autonomy, it requires comprehensive discussions, emphasizing necessity for documentation. Laws ensure awareness, but legal standards lack protection against paternalistic bias, posing legal risks. In orthopaedics, inadequacies in informed consent training contribute to litigation.

Methods:

A comprehensive literature review was conducted using the PubMed database to explore the landscape of informed consent practices in the context of shoulder and elbow surgery. The search strategy utilized a combination of Medical Subject Headings (MeSH) terms and free-text keywords, including "informed consent," "shoulder surgery," "elbow surgery," and "patient communication." …

The Liebelt Attitudes, Knowledge, And Engagement Scale: The Development And Validation Of A Psychometric Test Between Rural And Urban Adults, Anna F. Liebelt, Robert A. Ditomasso

Research Day

INTRODUCTION: While the prevalence of mental illness is comparable between rural and urban populations, adults in rural locations receive mental health treatment on a less frequent basis, and when received, the care offered is of lower quality relative to urban adults. Underutilization of mental health services in rural areas is a serious, well-documented problem and has been attributed to several possible factors, including geographic inaccessibility, reduced access to appropriate or culturally competent providers, lack of anonymity when seeking treatment, and reluctance to seek help due to discrimination and stigma. However, rural individuals may also remain reluctant to initiate treatment, possibly …

A Survey Assessment Of Neurosurgeons' Interest In Osteopathic Medicine And Its Integration Into Their Practice., Devin W Kolmetzky, Dillon B Gooder, Evan S Polly, Sarah N Glisan, Zein Al-Atrache, Clint A Badger, Steven S Yocom, Alan R Turtz, Donald Allison

PCOM Scholarly Works

INTRODUCTION: Osteopathic manipulative medicine (OMM) encompasses techniques guided by the tenets of osteopathy aimed at facilitating the body's natural self-healing capabilities as a treatment option for injury or illness. This approach recognizes the interrelationship of structure and function in promoting overall health. The clinical applications of OMM have been highly researched throughout different subspecialties of medicine; however, there is a notable lack of osteopathic-based research targeted toward neurosurgical patient populations.

METHODS: This cross-sectional descriptive study was conducted via a survey generated using SurveyMonkey (SurveyMonkey, San Mateo, CA, USA; accessed at www.surveymonkey.com). Subjects for this survey were gathered using a convenience …

Ameliorative Effects Of Fmrfamide On 3,4-Methylenedioxyl-Methamphetamine/Tramadol-Induced Neurodegeneration In The Hippocampus, O. E. Ogunbiyi, K. O. Adeniji, L. Arietarhire, P. Okwute, D. Abaneme, J. I. Enya, O. Soremekun, M. Adekunle, O. Soyinka, S. T. Adelodun, S. Y. Olatunji, T. Afolabi, T. P. Ajibade, A. G. Obaoye, M. Dada, Joshua Owolabi, John A. Olanrewaju

PCOM Scholarly Works

Objective: Tramadol and 3,4-methylenedioxy-methamphetamine (MDMA) use over an extended period is linked to deficits in memory encoding and retrieval. We aimed to determine the neurotoxic effects of co-administration of MDMA and tramadol (TRAM) on hippocampal function and investigate the potential of FMRFamide in attenuating resulting alterations in the Wistar rat model. Methods: Thirty adult male Wistar rats were grouped into six (n=5): Control, FMRFamide, TRAM, MDMA, TRAM+MDMA, and TRAM + MDMA + FMRFamide groups. The opiates were administered orally at 20mg/kg each, while 2mg/kg of FMRFamide was administered intraperitoneally for 12 days using normal saline as a vehicle. The Barnes …

Recovery Capital, Mental Health And Substance Use Among Individuals Initiating Office-Based Buprenorphine Treatment For Opioid Use Disorder, Hannah R. Callahan, Karen Dugosh, Emily Hurstak, Patty Mccarthy, Emily Garber, Daniel Dejoseph, Julia Dejoseph, Michelle R. Lent

The Journal of Integrated Primary Care

Recovery capital refers to the internal and external resources available to support an individual in their recovery from substance use disorders. Using data from an ongoing trial, the current study examined recovery capital among 225 individuals initiating office-based buprenorphine treatment for opioid use disorder (OUD) at Federally Qualified Health Centers in the mid-Atlantic region. At baseline, participants completed the Brief Assessment of Recovery Capital-10 (BARC-10), a validated measure assessing the 4 major domains of recovery capital and completed a urine toxicology screening. Participants reported BARC-10 scores of 49.22 on average (SD = 8.14). Average scores were highest for the …

Anxiety Severity And Prescription Medication Utilization In First-Time Medical Marijuana Users, Karen L. Dugosh, Megan M. Short, Paulina Syracuse, Thomas R. Mccalmont, Michelle R. Lent

PCOM Scholarly Works

Background

Anxiety and post-traumatic stress disorder (PTSD) are qualifying psychiatric conditions for medical marijuana (MM) treatment in Pennsylvania. This study examined baseline prevalence and changes in prescription anxiety medication use three months following MM treatment initiation among individuals with these qualifying conditions.

Methods

The study sample was comprised of 108 adults with anxiety or PTSD as a referring condition; they were enrolled in a longitudinal study evaluating biopsychosocial outcomes in new MM patients. Consenting participants completed an assessment battery at baseline and Month 3 (n = 94, 87 % follow-up rate) that included a measure of anxiety severity and …

Awareness With Paralysis And Symptoms Of Post-Traumatic Stress Disorder Among Mechanically Ventilated Emergency Department Survivors (Ed-Awareness-2 Trial): Study Protocol For A Pragmatic, Multicenter, Stepped Wedge Cluster Randomized Trial., Brian M Fuller, Brian E Driver, Michael B. Roberts, Christa A Schorr, Kathryn Thompson, Brett Faine, Julianne Yeary, Nicholas M Mohr, Ryan D Pappal, Robert J Stephens, Yan Yan, Nicholas J Johnson, Brian W Roberts

PCOM Scholarly Works

BACKGROUND: Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1-0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3-7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence. As NMB are given to more than 90% of ED patients during tracheal intubation, this trial provides a …

Salivary Extracellular Micrornas For Early Detection And Prognostication Of Esophageal Cancer: A Clinical Study., Kai Li, Yusheng Lin, Yu Zhou, Xiao Xiong, Lu Wang, Junkuo Li, Fuyou Zhou, Yi Guo, Shaobin Chen, Yuping Chen, Hui Tang, Xiaofu Qiu, Songwang Cai, Dianzheng Zhang, Edwin Bremer, Sai-Ching Jim Yeung, Hao Zhang

PCOM Scholarly Works

BACKGROUND & AIMS: Early detection of esophageal squamous cell carcinoma (ESCC) will facilitate curative treatment. We aimed to establish a microRNA (miRNA) signature derived from salivary extracellular vesicles and particles (EVPs) for early ESCC detection and prognostication.

METHODS: Salivary EVP miRNA expression was profiled in a pilot cohort (n = 54) using microarray. Area under the receiver operator characteristic curve (AUROC) and least absolute shrinkage and selector operation regression analyses were used to prioritize miRNAs that discriminated patients with ESCC from controls. Using quantitative reverse transcription polymerase chain reaction, the candidates were measured in a discovery cohort (n = 72) …

Implications Of Caspase 1/ Interleukin-1 Beta (Il-1Β) Signaling And Hypoxia-Inducible Factor 1-Alpha (Hif-1Α) On Diabetic Retinopathy Pathology., Drew Garber, Shu Zhu

PCOM Scholarly Works

Diabetic retinopathy (DR) is the leading cause of adult blindness and partial vision loss in modern society for hyperglycemic patients. Accordingly, new treatment options are imperative to the overall reduction of DR prevalence and the ongoing progression of already affected candidates. There are many diseases that are the direct result of specific inflammatory processes. In this literature, DR is looked at as a potential disease that can be alleviated by targeting caspase 1/ interleukin-1 beta (IL-1β), and hypoxia-inducible factor 1-alpha (HIF-1α) signaling pathways and reducing cytokine mobilization within retinal tissues. Caspase-1 is thought to be upregulated during retinal capillary degeneration …

Prevalence And Predictors Of Suicidality Among Adults Initiating Office-Based Buprenorphine., Michelle R. Lent, Karen L Dugosh, Emily Hurstak, Hannah R. Callahan, Kimberly Mazur, Greater Philadelphia Opioid Use Disorder Research Group

PCOM Scholarly Works

BACKGROUND: Individuals who have substance use disorders may have an elevated risk of suicidality. This study sought to examine the prevalence of, and identify factors associated with, suicidality in adults with opioid use disorder (OUD) initiating office-based buprenorphine treatment.

METHODS: Individuals were eligible to participate if they had OUD and had initiated treatment in the past month. Participants (n = 244) completed a semi-structured interview using the Addiction Severity Index-Lite.

RESULTS: At baseline, 37.70% of participants reported significant thoughts of suicide over their lifetime and 27.46% reported suicidal attempts over their lifetime. Logistic regression analyses were used to identify predictors …

Commencement, Philadelphia (2023), Philadelphia College Of Osteopathic Medicine

Commencements

Philadelphia Campus Commencement Program, 2023. Degrees include Doctor of Osteopathic Medicine, Doctor of Philosophy in Educational Psychology, Doctor of Psychology in Clinical Psychology, Doctor of Psychology in School Psychology, Educational Specialist in School Psychology, Master of Science in Applied Behavioral Analysis, Master of Science in Applied Positive Psychology, Master of Science in Biomedical Sciences, Master of Science in Forensic Medicine, Master of Science in Mental Health Counseling, Master of Science in Organizational Development and Leadership, Master of Science in Health Sciences - Physician Assistant Studies, Master of Science in Public Health Management and Administration, and Master of Science in School …

Case Series Of Common Skin Lesions Encountered In Elderly Cadavers: A Dermatopathology Analysis, Tamryn L. Van Der Horn, Brigitte L. Cochran, Savita Arya

Research Day

INTRODUCTION: Gaining hands-on experience in both dermatology and pathology is a common barrier that prevents first and second year medical students from refining skills that are not later taught until residency. This prompted a study to develop gross differential diagnostic skills and how to analyze histopathology slides to diagnose common skin lesions to refine skills in both clinical and histology presentation for medical students.

METHODS: A case series was designed to examine multiple shave biopsies on all abnormal skin lesions observed from nine cadavers used for the first-year medical students gross anatomy lab during the year 2022-2023. Biopsies were stained …

Atypical Presentation Of Obstructive Coronary Artery Disease In A Diabetic Female, Alexis Rodriguez, Zhi Kuat, Humaira Bibi, Lawrence Ukpong

Research Day

According to the World Health Organization (WHO), cardiovascular diseases (CVDs) account for 17.9 million deaths yearly and are the leading cause of mortality in the United States. CVDs are heart and blood vessel disorders, including coronary artery disease (CAD), coronary heart disease (CHD), cerebrovascular disease, cardiomyopathy, and more. In 2018, diabetic adults accounted for 1.87 million hospitalizations for major cardiovascular diseases. Diabetes Mellitus (DM) is a global epidemic affecting about 422 million people worldwide. The Centers for Disease Control and Prevention (CDC) has reported more than 37 million people in the United States are diagnosed with DM, and 1 in …

A Cadaveric Case Study On Lung Cancer Pathology, Anna Beth Boyette, Sarah Kate Boyette, Haley Garrett, Janai Groves, Perry Chandler Mullis, Sofia Sirocchi, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Lung cancer is the most commonly diagnosed cancer amongst both genders, currently accounting for about 18% of all cancer deaths.

OBJECTIVES: The overall purpose of this study was to evaluate the pathology associated with the patient’s cause of death, cardiorespiratory failure and lung cancer. The secondary aims of this study were to confirm the presence of malignant neoplasms within a human cadaver, determine the type of cancer present, and take specimens for histological examination to evaluate the patient’s cause of death.

METHODS: This is a case report from one of the cadavers in the Gross Anatomy laboratory at the …

A Radiologic Analysis: Relationships Of The Thoracic Spine To Aid Palpation Of The Thoracic Transverse Processes, Christopher Baker, Darshan Patel, Michael B. Roberts, Kristie Petree, Randall L. Mcgill

Research Day

Introduction: In the field of osteopathic manipulative medicine, palpation is an important skill used by physicians to localize structures to diagnose and treat patients with somatic dysfunction throughout the musculoskeletal system. Specifically, in the thoracic spine, physicians can use the more superficial spinous process of each vertebra to assist in locating the deeper, more challenging to palpate, transverse process of the vertebra. Historically, the “rule of threes”, proposed by Mitchell et al in 1979, describing the relationships between spinous processes and transverse processes of the thoracic spine has been taught in osteopathic medical schools. However, another model was more recently …

Assessment Of Attitudes And Knowledge Of Osteopathic Manipulative Medicine Amongst Neurosurgeons, Devin Kolmetzky, Dillon B. Gooder, Evan Polly, Sarah Glisan, Zein Al-Atrache, Clint Badger, Steven Yocom, Alan Turtz, Donald Allison

Research Day

Introduction: Osteopathic Manipulative Medicine (OMM) is highly researched and integrated into many medical and surgical subspecialties. Though OMM has been shown to have benefits in treating non-specific cervical and lower back pain and managing post-operative pain, it has rarely been integrated or studied in the neurosurgical community.

Method: Using SurveyMonkey, a survey was dispersed to physicians of the American Association of Neurological Surgeons (AANS). Information collected included the provider’s type of practice, degree type (MD vs. DO), familiarity with the tenets of OMM, frequency of referral/use of OMM, comfort level with OMM as a non-surgical pre-op option, a post-op pain …

Sex And Gender Differences In Attention-Deficit / Hyperactive Disorder (Adhd): A Literature Review, Kaitlyn N. Blair, Min Young Kim

Research Day

Background:

The American Medical Women's Association (AMWA) Sex and Gender Health Collaborative identified the need for a concise factsheet for clinicians outlining sex and gender differences in Attention Deficit Hyperactive Disorder (ADHD) as ADHD is underdiagnosed, undertreated, and frequently misdiagnosed in women due to lack of recognition of gender-specific presentation. AMWA's goal is to improve access and exposure to sex and gender differences in healthcare as few medical schools educate students on these differences. The poster summarizes the reviewed literature on the prevalence, diagnosis, referral for, prevention, clinical presentation, and treatment of ADHD with a goal to reduce sex and …

Reasons For Not Refilling Medications: A Research Proposal, Tori E. Abdalla, Frederick J. Goldstein

Research Day

INTRODUCTION:

It is estimated that medication non-adherence costs the United States approximately 528 billion dollars annually. Of that amount, it is estimated that only 50% of medications are adhered to for treatment of chronic diseases. Targeting improvement of a single aspect of medication non-adherence, e.g., refill compliance, could increase successful treatment of any medical condition where this a problem. Several broad solutions have been proposed, such as provider education, increased communication, and technology-based interventions; however, without knowing why patients do not refill their medications, providers might not know which solution(s) to initiate.

OBJECTIVES:

The aim of the proposed study is …

Building Inclusive And Welcoming Student Health Centers For Transgender Students, Corey N. Brisseau, Peter J. Ehrig, Erika L. Thomas, Sherry Mendez

Research Day

INTRODUCTION:

While health, wellness, and healthcare are essential to every human being, not much is known about the health and healthcare experiences of transgender students on college campuses. Understanding these healthcare experiences are important because when we recognize them, we can establish a healthy relationship of trust. There is a growing number of transgender students on West Chester University campus, who felt they were not getting the appropriate support and care. As a result, a project was started at student health services to help transgender students effectively access sensitive and welcoming care and support.

METHODS:

To address the needs of …