Medicine and Health Sciences Commons^™

Jcph Presentations At The American Public Health Association Annual Conference 2019

JCPH at APHA 2019

No abstract provided.

Jefferson Digital Commons Quarterly Report: July-September 2019, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• Articles
• Conferences
• From the Archives
• Grand Rounds and Lectures
• Journals and Newsletters
• Master of Population Health Capstone Presentations
• Master of Public Health Capstone Presentations
• Posters
• What People are Saying About the Jefferson Digital Commons

Do Employees From Less-Healthy Communities Use More Care And Cost More? Seeking To Establish A Business Case For Investment In Community Health., Russell K. Mcintire, Martha C. Romney, Greg Alonzo, Jill Hutt, Lauren Bartolome, Greg Wood, Gary Klein, Neil I. Goldfarb

College of Population Health Faculty Papers

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel …

Photo Elicitation Study 2018-2019, Lisa Armstrong, Kaela Edwards, Violetta Feshchenko, Kimberly Kullmann, Alexandre Martinez, Rebecca Mercier, Nicole Murray, Pamela Myers, Priyanka Prasad, Victoria Ramos, Nicholas Salter, Madalene Zale, Amy Henderson Riley, Drph, Rosemary Frasso, Phd, Adrea Cope, Nataki Duncan, Rachel Ewalt, Catherine Freeland, Nichole Holmes, Laura Slifer, April Smith, Sabina Spigner, Simal Thind, Eliza Whiteman Kinsey, Phd

JCPH at APHA 2019

Photographer and researcher John Collier first named photo elicitation in a paper published in 1957. Photo elicitation involves a qualitative interview stimulated and guided by participant photographs. This method can help break down barriers between researchers and participants and can promote rich and collaborative discussions (Harper, 1994).

Student Perspectives on Work-Life Balance: A Photo Elicitation Study

Each student in Qualitative Research Methods (PBH 512, Summer 2018) recruited a study participant (n=12) from across the colleges of Thomas Jefferson University. Students trained participants in the appropriate and ethical use of this method. Study participants were asked to define and explore the …

A Multicomponent Quality Improvement Project To Improve Sleep In Hospitalized Patients: A Single Center Pilot Experience, Michelle Konkoly, Alan Kubey, Md

Phase 1

No abstract provided.

Effect Of Tort Reform On Diagnostic Imaging Rates, Israel Ojalva, Ba, Arthur Hong, Md, Mph

Phase 1

Introduction: Defensive medicine, is defined as “order[ing] tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not solely) because of concern about malpractice liability.” Nearly all physician who fear malpractice litigation have admitted to practicing some degree of defensive medicine. In response, many states have enacted policy reforms to lighten the threat of malpractice on physicians.

Objective: The most common defensive medicine behavior is ordering diagnostic imaging tests when it is potentially unwarranted. Many states have enacted non-economic damage caps from 2000-2010. We explored if these laws had an impact on the rates of diagnostic imaging …

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Katie Holland, Emily Wei, Allison Zibelli

Phase 1

While there are large efforts to decrease readmission rates in the United States, cancer patients represent a population that has been overlooked. Cancer patients are a vulnerable population who make up a large portion of hospital readmissions. Most of the current research on the causes of readmissions in cancer patients focuses on medical chart reviews and insurance claims. Many of these studies fail to incorporate patient input which could further the understanding of the complete burden associated with cancer readmissions. The goal of this study is to understand the personal reasons behind the decision of cancer patients to return to …

Mindfulness-Based Stress Reduction Intervention For The Treatment Of Chronic Pain In The Elderly, Austin Roadarmel, Diane Reibel, Phd, Aleeze Moss, Phd, Andrew Newberg, Md

Phase 1

One of the most common complaints of adults in their 80s and above, a growing portion of our population, is chronic pain and it is often inadequately treated. A secular mindfulness-based stress reduction (MBSR) program was developed by Jon Kabat-Zinn in 1979 and has since shown measurable benefits to individuals in decreasing depression, pain, and anxiety. Considering the significant risk of side effects and age-associated changes of pharmacodynamics and pharmacokinetics in the traditional pharmacologic approach to chronic pain in the elderly, non-pharmacologic intervention such as MBSR may be particularly effective for the elderly population.

Methods: We conducted a 6 week, …

An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd

Phase 1

Introduction: The utilization of ultrasound-guided peripheral nerve blocks in orthopedic surgery has increased in popularity as the anesthesia of choice for the management of perioperative pain. Peripheral nerve blockade has been shown to increase overall surgical efficiency, improve patient satisfaction, reduce postoperative narcotic use, and decrease the duration of facility admissions, while increasing overall cost-effectiveness. To date, scant literature exists regarding the safety and efficacy of ultrasound-guided supraclavicular blocks used in common hand surgery procedures, and the rate of neurologic and vascular complications remains unknown.

Objective: The purpose of this study was to examine the effectiveness and complication rate of …

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Emily Wei, Katie Holland, Allison Zibelli, Md

Phase 1

Introduction: Readmission rates of cancer patients remain high, while the rates of many other conditions are decreasing in the United States. Cancer patients are a plurality of patients readmitted to hospitals within 30 days of discharge, and have a high rate of avoidable readmission. Therefore, it is important to understand why these readmissions happen in order to prevent their occurrence.

Objective: This study hopes to identify specific, and potentially personal, reasons that bring cancer patients back to the hospital. Patient perspective may reveal trends that are not apparent in medical record chart reviews. This information can present an opportunity to …

Adaptive Statistical Iterative Reconstruction-V For Lung Nodule Analysis, Cherry Au, Zhenteng Li, Md, Eric Gingold, Md, Ethan Halpern, Md, Baskaran Sundaram, Md

Phase 1

Introduction: Low-dose CT in lung cancer screening has demonstrated benefits in select patients. As the traditional filtered back projection (FBP) technique is limited by poor image quality, adaptive statistical iterative reconstruction-V (ASIR-V) algorithm has been developed to achieve higher image quality with processing efficiency.

Objective: To investigate the impact of various CT scan parameters on the semi-automated measurement of lung nodules using a Computer Aided Detection (CAD) program.

Methods: This IRB-exempt phantom experiment was conducted with a CT scanner capable of ASIR-V algorithm. Eight lung nodules sized 5-12 mm, of solid or ground glass type, were placed inside a multipurpose …

Diagnostic Accuracy Of Home Sleep Apnea Testing (Hsat) Based On Recording Duration, Angela Alnemri, Theodora Fynn, Prakash Vasudevan, Ritu Grewa, Karl Doghramji

Phase 1

Introduction: Obstructive Sleep Apnea (OSA) is a chronic sleeping disorder with serious health consequences. Currently, standard diagnosis is through in-lab polysomnography; however, there has been a shift to greater use of Home Sleep Apnea Testing (HSAT) for patients with a high pre-test probability of having OSA.

Objective: To investigate the minimum recording time needed during HSAT to accurately diagnose the presence and severity of OSA.

Methods: A retrospective review was conducted of HSATs done from January-October 2017. Each study was divided into 1-, 2-,3-,4-,5-, 6-, and 7 hour intervals beginning at the recording start time. The respiratory event index (REI) …

A Qualitative Evaluation Of The Interprofessional Student Hotspotting Learning Collaborative: Perceptions Of Student And Faculty Advisor Participants, Ashley Traczuk, Bsn, Rn, Angela Gerolamo, Phd, Rn, Elena Umland, Pharmd

Phase 1

Introduction: Student participation in interprofessional education has proven beneficial in regards to students’ understanding of professional roles, team situational awareness¹,and appreciating the need for collaboration². The interprofessional student hotspotting learning collaborative enables students to work in teams to help serve patients categorized as health-system “super-users”, defined as those who overuse inpatient and/or emergency hospital services, over a period of six months’ time. This model will allow students to have real patient encounters and to begin utilizing their own roles within interdisciplinary teams.

Objective: This study aims to evaluate the impact of the interprofessional student hotspotting learning …

The Impact Of Student Hotspotting On Patients & The Jefferson Health System, Mishael Khan, Bs, Lauren Collins, Md, Shoshana Sicks, Edm, Richard Hass, Phd, Tracey Vause Earland, Phd, Otr/L, Courtney Newsome, Ba, Sara Cohen, Ots

Phase 1

Introduction

“Super-utilizers”, patients with five or more hospital admissions in the past year, account for half of all healthcare expenditures and present a significant financial burden to our healthcare system. In Pennsylvania “super-utilizers” result in $1.25 billion of healthcare spending and Philadelphia has the highest number of “super-utilizers” in the state. To address this crisis, Jefferson University serves as one of four new national hubs for student hotspotting. Teams of interprofessional health professions students along with faculty and staff advisors enroll “super-utilizers” and provide targeted interventions to address social determinants of health, reduce hospitalizations and improve patient outcomes.

Methods

To …

Enhancing Services For Homeless Populations: Impact Of A Virtual-Reality Training Tool On Health Professional Students’ Self-Efficacy In Working With Homeless Populations, Madeline Russell, Susan Toth-Cohen, Phd, Otr/L

Phase 1

INTRODUCTION

Despite the rising prevalence and unmet healthcare needs of homeless populations, most healthcare providers do not receive specific training on working with this population. The growth of simulation-based technology in the medical classroom offers new opportunities for such training. Virtual-reality tools have been shown to facilitate learning and minimize restraints such as time and travel. The Enhancing Service to Homeless Populations (ESHP) program was designed to provide health professions students at Thomas Jefferson University with training on how to interact with homeless populations using an interprofessional virtual-reality setting, with the ultimate goal of improving students’ self-efficacy.

METHODS

Participants (n=15) …

Outcomes Reporting In Regional Anesthesia Patients: A Comparison Of Manual Phone Calls Versus Automated Phone App Messaging, Gavyn Ooi, Mba, Eric Schwenk, Md, Fasa, Jeffrey Mojica, Do, Alexander Grant, Md, Max Shilling, Md, David Barnabei, Md, Jennifer Lessin, Ba, Rn, Ccrc, Marc Torjman, Phd, Kent Berg, Md, Mba

Phase 1

Automation of patient follow-up via mobile phone apps have the potential to save time for physicians, standardize responses from patients, and increase the patient response rate. Studies that assess the effectiveness of mobile phone-based surveys have been favorable, with completion rates of about 60% in the surgical population. The impact of mobile phone-based patient management in anesthesia deserves further study. This study examines the follow-up success rates of (1) manual phone calls (the current standard of care) vs. (2) automated patient outreach (APO) in patients who receive a regional anesthesia block procedure.

As part of normal follow up, anesthesia team …

Total Body Skin Exam And Number Needed To Screen, Audra Hugo, Michael Bui, Alexander Sherban, Shayan Waseh, Elizabeth Jones, Md

Phase 1

Introduction/Background: Skin cancer screening could impact mortality and morbidity in US adults; however, the effectiveness of widespread screening remains unclear. Further research is necessary to determine what age groups, with what risk factors, might benefit from routine total body skin exams (TBSE) in the US.

Objective: This study sought to determine, on average, the number of patients, per decade, needed to screen via TBSE to identify one person with skin cancer.

Methods: A retrospective review of Jefferson Dermatology outpatient data in Epic was conducted. All patient charts from 1/1/2017 - 1/1/2018 were reviewed if they received a TBSE. The type …

Signs Of Humanity – A Researcher-Artist Collaboration, Katherine Brierly, Steven Buffer, Kaela Edwards, Zach Fusfeld, Jenna Garret, Nisha George, Katie Holland, Nichole Holmes, Josephine Hwang, Alyssa Tate, Emily Wei, Rosemary Frasso, Willie Baronet

JCPH at APHA 2019

A team of Jefferson students, alumni and faculty in collaboration with artist Willie Baronet, employed qualitative methods to explore poverty in Philadelphia.

Background

The Signs of Humanity (SOH) Project is a researcher-artist collaboration. This joint venture was designed to explore the interactions between people using signs to ask for help and those who pass by with the goal of reducing the dehumanization of this community. The research arm was designed to qualitatively explore the experiences of people who seek financial support or in-kind help from passersby. This is referred to as "panhandling" in the literature and that term will be …