Medicine and Health Sciences Commons^™

Pt/Ot Students Experience Working At Overnight Camp For Children With Disabilities, Audrey L. Zapletal, Ms, Otr/L, David A. Lehman, Phd, Pt

Department of Occupational Therapy Posters and Presentations

Objectives:

• Describe the innovative interprofessional field experience
• Discuss how the camp program enhances the OT/PT students’ skills towards interprofessional practice and discipline specific clinical reasoning
• Examine how this opportunity has influenced OT/PT students’ educational and professional development

Perceptions Of Neonatal Nurse Practitioner Role Among Nicu Nurses, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

Purpose: The purpose of this project was to examine Neonatal Intensive Care Unit (NICU) nurses’ perceptions of the NNP role and barriers to entering the role.

Background: A shortage of neonatal nurse practitioners (NNPs) exists. Hiring NNPs from outside the current NICU staff has resulted in turnover and additional cost. If current nursing staff prepared as NNPs, the organization would benefit; yet few nurses have done so. Reasons that dissuade nurses from pursuing the NNP role have not been adequately examined. Knowing how nurses perceive the NNP role may help to decrease barriers and inform plans to address the problem.

A Descriptive Study Of Non Traditional School Health Delivery; Funding Sources, Outcomes And Staff Configurations, Sherri Becker, Msn, Mba, Rn, Erin D. Maughan, Phd, Ms, Rn, Aphn-Bc, June Horowitz, Phd, Rn, Faan

College of Nursing Faculty Papers & Presentations

Background:

1) The traditional funding for school nursing has been educational dollars.

2) As school district budgets tighten, the number of students with health needs continues to rise and the Affordable Care Act (ACA) puts increased emphasis on community care, new school health delivery models are emerging.

3) There is limited study in this area. Anecdotal stories of wide variability exist.

Synergistic Trigeminal Pain Molecules In A Model Of Traumatic Brain Injury: Implications For Post-Traumatic Headache, Brittany V. Daiutolo, Ashley L. Tyburski, Shannon W. Clark, Md, Melanie B. Elliott, Phd.

Department of Neurosurgery Faculty Papers

Introduction

Headache following traumatic brain injury (TBI) is highly prevalent, and also the most common and persistent symptom of post-concussion syndrome [1,2]. It could also arise de novo or as a pre-existing headache disorder, in which migraine was the most frequent headache phenotype in both civilian and military patients with mild TBI [1,2]. Most post-traumatic headaches will resolve within a couple of weeks following injury; however, headache in a substantial subset of patients it may last more than three months and contribute to a prolonged recovery from injury, disability, and a poor quality of living [2]. Headaches can persist well …

Surgical Outcomes Of Sequential Versus Concomitant Glaucoma Drainage Implant And Boston Keratoprosthesis Type 1, Varum Patel, Marlene R. Moster, Louis J. Kishfy, Julian Barkan, Tingting Zhan, Irving M. Raber, Brandon D. Ayers, Michael J. Pro, Michael Waisbourd

Wills Eye Hospital Papers

BACKGROUND

The Boston Keratoprosthesis Type 1 (KPro) is a surgical device used in patients who have failed traditional corneal transplant treatment or are poor candidates for it.¹ Candidates for KPro often have advanced anterior segment disease that predisposes them to developing glaucoma.² As a result, these patients may require both a KPro, to treat their corneal pathology, and a glaucoma drainage implant (GDI), to treat their glaucoma. To date, there have been no long-term studies comparing the order of GDI placement with KPro surgery and how it affects surgical outcomes.

Burden Of Periprosthetic Joint Infection And Its Treatment On Kidney Function

Rothman Institute Conference Posters

Introduction:

Patients with periprosthetic joint infection (PJI) are subjected to several potentially nephrotoxic conditions such as acute and chronic systemic inflammatory reactions, multiple surgical procedures and noxious antibiotics. This study aims to investigate 1) the incidence and severity of kidney injury in patients undergoing surgical treatment for PJI, 2) whether the number of surgeries affects renal function in PJI patients and 3) the potential risk factors for kidney injury.

Red Cell Distribution Width: An Unacknowledged Predictor Of Mortality And Length Of Stay Following Revision Arthroplasty, Pouya Alijanipour, Md, Snir Heller, Md, Fatih Kucukdurmaz, Md, Benjamin Zmistowski, Md, Maryam Rezapoor, Ms, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

Introduction

Red blood cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is routinely reported in complete blood cell analysis, and together with mean cell volume (MCV) has conventionally been used to distinguish the cause of anemia. It is calculated by (Standard deviation of MCV÷ mean MCV) x 100, with normal range being 11.5%-14.5%. Several recent publications have described RDW as an independent predictor of adverse outcome and mortality in patients with different underlying medical conditions such as acute and chronic heart failure, peripheral artery disease, chronic pulmonary disease and acute kidney injury1. The purposes of …

Low Dose Aspirin: An Effective Chemoprophylaxis For Preventing Venous Thromboembolic Events, Javad Parvizi, Md, Frcs, Antonia F. Chen, Md, Mba, Camilo Restrepo, Md, Ronald Huang, Md, Jenny Cal, Bs, William J. Hozack, Md, Jess H. Lonner, Md

Rothman Institute Conference Posters

The available guidelines, endorsed by Surgical Care Improvement Project (SCIP), have advocated that aspirin (ASA) is a safe and eff­ective strategy for venous thromboembolic events (VTE) prophylaxis following total joint arthroplasty (TJA). The optimal dose of aspirin for this purpose is not known. The first guidelines for prevention of VTE that were issued by the American Academy of Orthopedic Surgeons recommended 325 mg Bis in die (twice a day) (bid) for this purpose with the recommendation having a 1C grade (little evidence to support the recommendation). It is known that platelet aggregation inhibition occurs at lower doses. Traditionally, ASA 81mg …

Radiation Exposure To The Eye With Mini C-Arm Use During Hand Surgery, Mark L. Wang, Md, Phd, C. Edward Hoffler, Md, Phd, Frederick E. Liss, Md, Asif Ilyas, Md, Charles Leinberry, Md, Pedro Beredjiklian, Md

Rothman Institute Conference Posters

Introduction:

Fluoroscopic radiation exposure is a potential occupational health risk to the Hand Surgeon, given operator proximity and the relative lack of eye shielding. The association of eye radiation exposure and the early development of cataracts have been previously reported. Mini C-arm fluoroscopy is commonly utilized during routine Hand Surgery. At present, the amount of radiation exposure to the eye, associated with the routine use of mini C-arm fluoroscopy, is unknown, thus warranting further investigation. The purpose of this study is to test the hypothesis that eye radiation exposure, sustained during routine mini C-arm use, does not exceed that of …

The Patellar Tendon Can Cause External Tibial Component Malrotation In Lateral Unicondylar Knee Arthroplasty, Glenn J. Kerr, Md, Patrick O'Toole, Md, Eddie Wu, Do, Jess H. Lonner, Md

Rothman Institute Conference Posters

Introduction:

The optimal rotational axis of the tibial component in lateral unicompartmental knee arthroplasty (UKA) should be aligned parallel to the lateral tibial spine. However, the relatively lateral positions of the tibial tubercle and patellar tendon make the sagittal tibial cut in lateral UKA difficult and commonly predisposes to inadvertent external rotation of the tibial component. The purpose of this study was to quantify the potential rotational impact that occurs when aligning the anterior edge of the sagittal tibial cut with the lateral edge of the patellar tendon in lateral UKA.

Rotational Alignment In Medial Unicompartmental Knee Arthroplasty: Comparison Of Anatomic Landmarks, Glenn J. Kerr, Md, Patrick O'Toole, Md, Eddie Wu, Do, Jess H. Lonner, Md

Rothman Institute Conference Posters

Introduction:

The landmarks used for tibial component rotation in total knee arthroplasty (TKA) and medial unicompartmental knee arthroplasty (UKA) may differ, utilizing the medial edge of the tibial tubercle and the medial edge of the tibial spine, respectively. However, some surgeons reference from the medial edge of the tibial tubercle in UKA. Use of the tibial tubercle to determine orientation of the sagittal cut in medial UKA can result in external rotation of the tibial component, leading to rotational mismatch between the femoral and tibial components, potential disruption of the ACL and tibial component undersizing. The purpose of this study …

Trigger Finger Release Performed Wide Awake: Prospective Comparison Of Local Anesthetics, Constantinos Ketonis, Md, Phd, Nayoung Kim, Bs, Frederic Liss, Md, Benjamin Zmistowski, Md, Jonas L. Matzon, Md, Charles Leinberry, Md, Mark L. Wang, Md, Phd, Christopher Jones, Md, William Kirkpatrick, Md, Asif M Ilyas, Md

Rothman Institute Conference Posters

Introduction:

Trigger fi­nger (TF) is one of the most common conditions treated by hand surgeons with a lifetime risk up to 10% in patients with diabetes. If conservative management fails, surgical treatment is undertaken, with or without sedation and a tourniquet, via a small incision to release the A1 pulley. A number of local anesthetics are readily available including Lidocaine, Ropivacaine and Marcaine as well as encapsulated formulations thereof such as Exparel. Since it’s approval in 2011, there have been numerous reports of successfully achieving prolonged pain relief with locally injected Exparel after various procedures, but to the best of …

When Is It Safe For Patients To Drive After Right Total Hip Arthroplasty?, Victor H. Hernandez, Md, Alvin C. Ong, Md, Fabio Orozco, Md, Anne Marie Madden, Zachary D. Post, Md

Rothman Institute Conference Posters

Introduction:

• Driving restrictions after total hip arthroplasty (THA) can be inconvenient and burdensome for patients.
• When patients may safely be allowed to drive remains controversial.
• Most studies recommend 6 weeks but recent advances in surgical approach, pain management and rapid recovery may have changed this time frame.
• The purpose of this study was to prospectively evaluate driving safety after THA through brake reaction time.

Aspirin May Be Adequate For Venous Thromboembolic Event Prophylaxis After Revision Hip And Knee Arthroplasty, Greg K. Deirmengian, Md, Snir Heller, Md, Eric B. Smith, Md, Mitchell Maltenfort, Phd, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

Introduction:

The optimal prophylaxis for prevention of venous thromboembolic events (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) remains unknown.(1) Current studies focus on primary arthroplasty and there are little to no data on the ideal prophylaxis for VTE following revision arthroplasty.(2) Revision surgery, due to its complexity, longer operative time, higher risk of bleeding and infection diff­ers from primary arthroplasty.(3) The objective of this study was to evaluate whether aspirin, known to be e­ffective for prevention of VTE after primary arthroplasty, is also e­ffective against such events following revision THA and TKA.

Moyamoya Disease And Acute Inpatient Rehabilitation In A 17-Month Old Previously Healthy Male, Cassandra Coleman, Nicole Marcantuono

CwiC-PH

Case Diagnosis

17-month old male with newly diagnosed MoyaMoya after presenting with new onset seizures and right-sided weakness.

Case Description

MoyaMoya is a rare cerebrovascular condition predisposing patients to stroke in association with progressive stenosis of the intracranial internal carotid arteries and their proximal branches.

The patient presented initially after a fall with subsequent inability to bear weight on his right leg along with minimized use of his right arm. Patient was treated for a suspected tibial Salter-Harris II and nursemaid’s elbow. He presented four days later to the ED with new onset seizures. CT of the brain showed loss …

Adolescent Pregnancy In Ecuador, Paige Bates

CwiC-PH

Description of the Problem

• Teen pregnancy, commonly defined as pregnancy in a girl less than 18 or 19 years of age, is often a target of public health efforts because of the far-reaching economic, social and health effects.¹
  • A girl who becomes pregnant attends 2.5 less years of school, and each additional child translates into 1 less year of education.²
  • Girls who get pregnant before age 18 are more likely to experience violence within marriage or a partnership than girls who postpone child-bearing.¹
  • Babies born to adolescent mothers have a higher incidence of perinatal complications (like asphyxia …

An Interdisciplinary Approach To Combat Obesity In The Galapagos, Christopher Busack, Bethany Fox

CwiC-PH

Galapagos Background

• Total Population (2010) = 25,124¹
• Largest city = Puerto Ayora (Santa Cruz)
• Average monthly income in Galapagos = $772.03/month²
• Average monthly income in mainland Ecuador = $251.70/month²
• Booming tourism industry contributes to rapid population growth³

4 of 18 main islands (>1km²) open for human residence (Santa Cruz, Isabela, San Cristobal, Floreana)

Care With Dignity: Understanding How To Care For Hiv Positive And Formerly Incarcerated Populations, Caroline Komanecky, Terry Trudeau, Med, James D. Plumb, Md, Mph, Helen Koenig, Md

CwiC-PH

Philadelphia FIGHT is a comprehensive HIV/AIDS service organization providing primary care, consumer education, advocacy, and research on potential treatments and vaccines. FIGHT was formed as a partnership of individuals living with HIV/AIDS and clinicians, who joined together to improve the lives of people living with the disease. Today, FIGHT serves an even broader patient population and recently received designation as a Federally Qualified Health Center. FIGHT strives to address not only HIV-infected patients, but all at-risk populations through education, outreach, and preventative medicine. The annual Bridging the Gaps interns are responsible for several projects, including a client satisfaction survey, a …

Establishing Roots In West Philadelphia, Nina Millman, James Larosa, Skip Weiner, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Urban Tree Connection

Urban Tree Connection is an organization that utilizes plots of land which have been abandoned. The organization uses the land to create gardens that grow produce which is then sold at markets and to the community. Their goal is to provide access to fresh fruits and vegetables in the food desert areas of West Philadelphia. Members of the community are able to get involved by allowing some of their land to be used as gardens and helping to maintain the sites. The organization also tries to spread information about sustainability including a compost program in the neighborhood.

Healthy Habits, Happy Baby!, Amanda Ocran, Suvidha Polu, Joan I. Gluch, Phd, Rdh, James D. Plumb, Md, Mph, Rickie Brawer, Mph, Phd

CwiC-PH

Cribs for Kids, a component program of the Maternity Care Coalition, provides needy families in Philadelphia with cribs and education on safe sleeping environments.

• Cribs for Kids also provides education on how to reduce the risk of sudden infant death syndrome (SIDS).
• The organization hosts workshops throughout the city and home visits for those who cannot attend the workshops.
• Cribs for Kids also increases awareness about safe sleeping habits and their program by attending community health fairs.
• In the last year Cribs for Kids has provided families the city of Philadelphia with over 2,000 safe sleeping environments.

The Effect Of Peer Educators On Medication Adherence In Hiv Patients In Cochabamba, Bolivia, George Ru

CwiC-PH

BACKGROUND INFORMATION

• Bolivia is the least developed country in South America, with high levels of poverty, poor access to safe water, and low economic activity. Bolivia’s GDP, in US dollars, in 2013 was $30.60 billion and the gross national income, per capita in US dollars was $2,550, which both rank either at or near the bottom of the list for all South American countries (7).
• The Ministry of Health and Sports (MSD) is the national governing body responsible for formulating the strategy, policies, plans and programs in health. The Department of Health Services (SEDES) is the highest level of technical …

The Heart Of Healthcare: The Role Of Authentic Relationships In Caring For Patients With Frequent Hospitalizations, Charlotte Weisberg, Ba, Margaret Hawthorne, Mph, Marianna Lanoue, Phd, Jeffrey Brenner, Md, Dawn B Mautner, Md, Ms

CwiC-PH

INTRODUCTION

Frequent hospital utilization is a major contributor to the costs of healthcare. Despite a vast body of literature, there remains great uncertainty about the characteristics and care needs of individuals with frequent hospitalizations.^1,2 In the movement to reduce the need for hospitalizations, care management programs have garnered wide attention and support. Of the many studies that exist on the efficacy of care management interventions, only a handful espouse the benefits of “continuous healing relationships.”^3,4,5 Fewer studies, if any, explain the role of affect between care providers and patients in the healing process and how to achieve a …

Experiences With Prenatal Care Among Women In A Philadelphia Homeless Shelter, Stephanie Rand, Ms4, Montida Fleming, Ms3, Maria Somohod, Ms3, Caitlin Callaghan, Ms2, Alexandra Strauss, Ms2, Natalie Ziegler, Ms2, Anita Modi, Ms4, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Prenatal care for the underserved is a national concern, with pregnancy rates as high as 22% in homeless women and 75% of these women reporting barriers to care during pregnancy. Inadequate prenatal care confers increased risk for gestational complications and unfavorable postnatal outcomes, including prematurity and low birth weight. Yet while many studies delineate the prevalence and health consequences of inconsistent prenatal care in the homeless population, few address healthcare barriers. To both fill this gap in the literature and design effective interventions increasing consistency of care, we explored prenatal care experiences of pregnant homeless women at Philadelphia’s primary intake …

Health Needs Assessment For Head Start Children, Gerald Gibbons

CwiC-PH

Background: Head Start Program

• Preschool program for low-income families, providing comprehensive learning and care for children ages birth through 5 years old.¹
• Receives federal funds through the Department of Health & Human Services. However, each Head Start program is a locally designed and implemented model based on local community needs and resources.¹
• One of many government requirements involves yearly health check-ups and up-to-date immunization records for all children enrolled.¹
• NSCA elicited services from Jefferson Center for Urban Health to investigate why some families have a difficult time completing the medical record requirements.

Cervical Cancer In Guatemala: Using Visual Inspection With Acetic Acid Screening To Reduce Incidence Of And Mortality From Cervical Cancer, Zachary Klock

CwiC-PH

Guatemala is a developing nation of nearly 16 million in Central America. Among the many health problems the nation suffers, cervical cancer remains a leading cause of cancer-related death. Cervical cancer, an easily detectable cancer, predominantly affects women in developing nations. Traditional cytology techniques have been used to screen women in the country for over 25 years, but less than 10% of the Guatemalan population is screened. The Visual Inspection with Acetic Acid (VIA) is a simple produce that uses acetic acid to visualize precancerous cervical lesions and has been proven to be more effective in resource-poor settings. The screening …

Alternative Income Generation For Kenyan Women: Preventing Prostitution And The Spread Of Hiv, Megan Elizabeth Lundy

CwiC-PH

HIV/AIDS in Mlolongo, Kenya

Mombasa Highway and Weigh Station

• Truckers spend 3+ days waiting to be processed, providing a costumer base for prostitution
• In Kenya, 27.6% of female sex workers are HIV positive and only 26.8% use condoms with all of their partners (Morris, Morris, and Ferguson, 2009).
• The rampant spread of HIV and lack of contraception has led to rapid growth in the population in an area that has little ability to support any residents
• Development of Slums that now line the highway

Rural And Urban Medicine In Ecuador, Moira Black

CwiC-PH

Free, Universal Health Care

• Health care is free to all workers and their children with support from the government, employers, and a portion of the workers’ paychecks.¹
• Military personnel do not contribute part of their paychecks to paying for healthcare.¹

Universal Healthcare: Costa Rica As A Model, Annie J. Ferris

CwiC-PH

What it Looks Like in Costa Rica

• Run by the Costa Rican Social Security Administration
• Financed by employers, employees, and the Ministry of Health. Employer and employee contributions together make up over 90% of contributions.
• Costa Rica is divided into 105 health areas, which are further divided up into primary care units called Basic Provision Units of Integrated Healthcare, or EBAIS. There are 947 of these primary care centers throughout Costa Rica, and everyone is assigned to one.
• The EBAIS clinics provide a wide range of services to cover the general and specific health needs of the community, including primary …

Regional Disparities In Neurocritical Care Outcomes, Kali Graham

CwiC-PH

BACKGROUND

• Determinants of Neurocritical Care Outcomes: Social as opposed to biological disparities can frequently dictate health outcomes for neurocritically ill patients. Survival rates are determined both by a patient’s access to a NCU (Neurocritical Care Unit) as well as the level of inpatient care he or she receive once admitted to a NCU.
• Regional Inequality in Access to Care¹:
• Only 12.8% of Americans have access to a NCU within 45 min by ground transportation and 36.8% have access to a NCU within 45 minutes by air transportation.
• Racial Disparities in NCU Admissions and Outcomes²:
• Non …

Addiction: A Treatable Disease, Nathaniel Graham

CwiC-PH

Addiction: Definitions and Statistics

Nearly 1 in 7 Americans (~40 million people) are addicted to a chemical substance.

An additional 2 in 7 Americans (~80 million people) qualify as risky substance users; those who use chemical substances in ways that threaten their health and safety.