Medicine and Health Sciences Commons^™

Utilizing Livers From Donors Older Than 65: A Single Center Experience, Krishnaraj Mahendraraj, Jorge H. Castro, Sean Devitt, Chad Gorn, Cataldo Doria, Adam Frank, Warren Maley, Carlo G. Ramirez

Adam M. Franks, MD

Conclusions:

Use of liver grafts from older donors presents similar survival outcomes as grafts from younger donor age. Therefore, it offers a viable option to expand the donor pool and increase number of OLTs.

However, there is higher incidence of retransplantation due to primary graft non-function, and longer hospital length of stay observed in the older donor age group.

Further studies using larger patient populations are needed to validate our results.

Improving The Quality Of Patient-Provider Interactions And Promoting Equitable, Accessible And Patient-Centered Cancer Care, C. Vaughan-Briggs, Lcsw, A. Petok, Lcsw, Mph, T. Dejesse, Amy Leader, Drph, Mph

Department of Medical Oncology Posters

• Philadelphia is among the top 10 cities in the US with populations over 500,000 with a high Community Need Index score (CNI- severity of Health disparity)
• Data from 2015 County Health Ranking, had Philadelphia last of all 67 counties in the state for social economic factors. (unemployment, income inequality, injury deaths, etc. )
• Cancer is a leading cause of mortality in the US
• The SKCC participated in a year-long, externally supported self study to improve the quality of patientprovider interactions and promote more equitable, accessible and patient- centered cancer care. This program aligned with internal initiatives.
• SKCC at Jefferson is …

Racial Disparities In Head And Neck Cancers In An Urban Hospital, Jessica Kraus-Lavy, Charnita Zeigler-Johnson, Scott W Keith, Frances Guiles, David Cognetti, Voichita Bar-Ad, Rita S. Axelrod, Md

Phase 1

Introduction: Head and neck cancer incidence rates are higher for white residents in Philadelphia, while related mortality rates are highest for black residents. It is unclear how risk factors like HPV and smoking contribute to these disparities. The goal of this study is to determine which factors are associated with head and neck cancers in a diverse patient population from a Philadelphia hospital.

Methods: Cancer registry data from Thomas Jefferson University was used to obtain records from 922 head and neck cancer patients. One patient of other race was excluded. Twenty in-situ cancer cases were excluded. Chi-square tests were used …

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 …

Alexander Koppel: Pioneer - Physician - Provider, Max Koppel

Jefferson Biographies

Alexander Koppel was born to immigrant parents on the Lower East Side of New York City in 1905. Early in his life, his mother was forced to return to Austria to her tenant farmer parents with Alexander and his two sisters because of a severe downturn in the American economy. A few years later, his mother brilliantly sensed the upcoming disastrous World War in 1913, and returned with the three children to Wilmington, Delaware where by that time, her husband, Samuel Koppel, had established the Wilmington Window Cleaning Company.

Alexander Koppel seized the opportunity for higher education made available to …

Signs Of Humanity: A Qualitative Exploration Of Panhandling In Philadelphia, Alyssa Tate, Rosemary Frasso, Phd, Msc, Cph, Willie Baronet, Mfa, Katherine Brierly, Steven Buffer, Kaela Edwards, Zach Fusfeld, Jenna Garret, Nisha George, Nichole Holmes, Emily Wei

Phase 1

People who participate in panhandling are those who ask for financial or other assistance on the street. In Philadelphia, it is known that a large portion of people who panhandle also experience housing insecurity or other hardship. Panhandlers are a very visible fraction of a city’s homeless population and their experiences are of particular interest because their cardboard signs can give insight into common hardships such as housing and food insecurity and substance abuse disorders. While panhandlers in Philadelphia have been surveyed in the past, there is not recent literature on their lived experiences and perspectives and information was not …

Demographics, Support Opportunities, And Self-Reported Well-Being Of Patients Presenting For Hepatitis C Treatment At A Federally Qualified Health Center In Philadelphia, Dina Zaret, C. Coleman, M. Dorshimer, J. Kostman, L. Magaldi, T. Preston, R. Rivera, S. Trooskin

Phase 1

Introduction: As the opioid epidemic develops and evolves, the number of people who inject drugs is rising. A growing number of new Hepatitis C Virus (HCV) infections have been identified in people who inject drugs.

Objective: This study aims to better understand the demographics, well-being, and satisfaction with medical care of patients presenting for HCV treatment at a Federally Qualified Health Center (FQHC) in an urban setting. The study also looks to assess the impact of continued connection to holistic medical care.

Methods: Surveys were administered to 51 unique patients at their first visit for HCV treatment. Along with demographic …

Health Needs Of Philadelphia’S Latinos Through Photovoice, Martin Hehir, Rickie Brawer, Phd, Mph, Mches, Caleb Dafilou

Phase 1

Introduction: The Patient Protection and Affordable Care Act requires non-profit hospitals to complete a Community Health Needs Assessment (CHNA) every three years that provides insight into the health and social needs of the community served and develop a plan to address priority needs. Community engagement and collaborative participation are essential to the process. For the 2019 CHNA, Thomas Jefferson University Hospitals is conducting a more in-depth assessment of the Philadelphia Latino community in North Philadelphia in order to better understand the specific issues faced by this population.

Objective: To conduct a CHNA in North Philadelphia’s Latino community that identifies priority …

A Longitudinal Assessment Of Change In Blood Pressure Among Participants In The Heart Smarts Program, Kathryn Haskins, Susana Suzrez, Rickie Brawer, Phd, Mph, Sandra Sherman, Edd, Michelle Abel, Msph, James Plumb, Md, Mph

Phase 1

Many low-income areas of the United States are considered food deserts because people living in those communities have limited access to fresh fruits and vegetables (FFV); lack of FFV is tied to numerous health issues, including cardiovascular disease and obesity. The Heart Smarts Program (HSP) provides increased access to FFV in food deserts, as well as providing participants with nutrition education courses and health screenings, including blood pressure. The purpose of this study is to examine HSP participants who have been with the program for differing lengths of time in order to determine if length of participation has an impact …

Normalized Healthcare Utilization Among Refugees Resettled In Philadelphia, 2007-2016, Kaushal Desai, Mph, Colleen Payton, Phd, Mph, Ches, Kevin Scott, Md, Brandon George, Phd, Ms, Marc Altshuler, Md

Phase 1

Background/Purpose: About 70,000 new refugees are resettled in the United States each year, of which approximately 600 are resettled in Philadelphia. This project seeks to better understand the patterns of healthcare utilization, including primary care, emergency, and hospitalization, among refugees resettled in Philadelphia, PA, between 2007 and 2016.

Methods: Demographic and healthcare utilization data for 1,144 refugees seen at Jefferson Family Medical Associates were compiled from the Jefferson Longitudinal Refugee Health Registry. Descriptive statistics were used to describe the demographic characteristics of the refugee population. Negative binomial count regressions were used to test for significant correlations between major demographic variables …

Mental Health And Resilience In Adolescent Refugees Resettled In Philadelphia, Saya Bery, Pia Ghosh, Mph, Ellen Plumb, Md

Phase 1

Introduction: Mental health in adolescents has a large impact on physical health, academic achievement, and overall well-being; moreover, refugee youth are at an increased risk for mental health disorders. While growing evidence shows that positive youth development interventions can prevent health risk behaviors, there is need for further evaluation that shows how to tailor interventions to meet population-specific needs.

Objective: The aim is to assess how targeted interventions can enhance protective factors and reduce negative adult outcomes in vulnerable refugee adolescents. The goals are to understand the current status of mental health and access to resources among resettled adolescents in …

Knowledge And Awareness Of Std Risk Perception Of Msm In Philadelphia, Timothy Chou, Nancy Brisbon, Md

Phase 1

There has been a rise in incidence of sexually transmitted diseases (STDs), in particularly in men who have sex with men (MSM). MSM were 106x as likely to have primary or secondary syphilis as compared to men who exclusively had sex with women (MSW). MSM account for large portion of antimicrobial resistant gonorrhea diagnoses and saw a 151% increase in incidence while compared to a 31.7% increase in MSW. This study examines what MSM in Philadelphia know about transmission methods and outcomes of syphilis and gonorrhea to better understand MSM risk perception of these diseases. A multiple-choice test was distributed …

Perspectives Of Asian/Pacific Islanders On Lung Cancer Screening In Philadelphia: A Qualitative Study, Melissa Chai, Kristine Pham, Mph, Rickie Brawer, Phd, Mph, Mches

Phase 1

Introduction: Even though rates of smoking, the leading cause of cancer, are lower in Asian/Pacific Islanders (API), the rates of lung cancer deaths are still one of the highest compared to those of other minority groups in the US. However, little is known about the beliefs and attitudes that influence lung cancer screening behaviors of APIs.

Objective: The objective of this study is to better understand the current beliefs, attitudes, and knowledge of APIs in Philadelphia towards lung cancer and lung cancer screening.

Methods: Six in-depth interviews were conducted with key informants, who all had extensive experience working with the …

A Mixed-Methods Refugee Community Health Needs And Assets Assessment, Eleni Florakis, Rickie Brawer, Phd, Mph, Mches, Abby Cabrera, Kaushal Desai, Saya Bery

Phase 1

Introduction:

Many factors may negatively affect the experience of refugees navigating the healthcare system in Philadelphia. These factors include, but are not limited to, lack of familiarity with the healthcare system, language and cultural barriers, limited health literacy, physical and transportation barriers, and fear and/or distrust of the healthcare system. In addition, there are a large proportion of United States refugees in Pennsylvania. According to usnews.com, Pennsylvania was ranked the top 6th state for taking in the most refugees in the year 2017.

Objective:

The primary objective is to assess the experiences of refugees within the healthcare system since resettlement …

Medication Assisted Treatment For Opioid Use Disorder In The Primary Care Setting In Philadelphia: A Retrospective Review, Denis Ostick, Lara Weinstein, Md, Mph

Phase 1

Introduction:

The opioid crisis continues to be a growing public health concern across the United States. Americans struggling with Opioid Use Disorder (OUD) can seek different resources to help curtail their addiction. These include abstinence -based programs such as Narcotics Anonymous and Specialty treatment facilities including methadone and suboxone clinics. It has been shown that increased availability of drugs to treat opioid use addiction, such as methadone and buprenorphine, is linked to a lower likelihood of relapse and fatal overdoses. Therefore, medication assisted treatment (MAT) is a valuable asset because it combines behavioral therapy and medications to treat opioid use …

Medication Assisted Treatment In The Primary Care Setting: A Prospective Review, Bridget M. Smith, Lara Weinstein, Md

Phase 1

Introduction: Project HOME Health Services (PHHS) initiated a Medication Assisted Treatment program for Opioid Use Disorder in a primary care setting that is the first of its kind in the city of Philadelphia. This study assesses the MAT program by evaluating the Quality of Life (QoL) of the participants as well as their perception of the program.

Objective: The purpose of this study is to assess the QoL of the participants in the MAT program at PHHS and to evaluate the participants’ satisfaction with the program.

Methods: The population includes patients enrolled in the MAT program at PHHS who consented …

Medical Respite Care Services For Homeless Patients Discharged From Thomas Jefferson University Hospital: A Needs Based Assessment, Taylor Treacy, Lara Weinstein, Md

Phase 1

Introduction: Medical respite programs have been proposed as a temporary solution to address the increased hospital readmission rates and lack of appropriate discharge options that exist for homeless patients.

Objective: This study examines the 90-day readmission rate and discharge locations of patients experiencing homelessness.

Methods: We conducted a retrospective chart review of homeless patients discharged from Thomas Jefferson University Hospital (TJUH) between April 30^th 2017 to April 30^th 2018. Homelessness was identified as any patient with 1 of the following locations listed for residency: 833 Chestnut Street, Broad Street Ministry, St. John’s Hospice, shelter as address, no address …

Lnp Mediators For Posterity, Yinelia De La Cruz, Stephen Adasonla, Kieara Martin, Yi Soo Hahm, Jaymi Phillips, Holly Spring

Nexus Maximus

We have decided to tackle substance abuse in Lower North Philadelphia by eliminating the stigma around mental health in low income communities. By preventing drug usage in teen and young adult mental awareness, we can combat issues like suicide and the opioid epidemic. Using mediators by partnering with university students we can offer positive role models into the school system, while also offering internships and residency opportunities.

Nexus Maximus V

The 2018 Challenge: "Improving Lives Through Healthy Communities" Teams will evaluate and seek innovation that supports the health and well-being of specific local community populations. The team’s project work will …

Drug Abuse Manifesting As Persistent Hypoglycemia: A Case Report Of Hidden Sulfonylurea Poisoning, Frederick B. Peng, Sharon Li, Md

Department of Medicine Posters

Background

• Prescription drug abuse is on the rise. According to the Philadelphia Department of Health data in 2017, up to 26% of adults may be using benzodiazepines and/or opioids (Table 1).
• 12% or 1/8 Philadelphians are estimated to be current benzodiazepine users and have taken one in the last 7 days. Benzodiazepine use is most common among people with household incomes below $25,000 and among the 45-54 years old age group (17.7%) [1].
• Most current users (84%) obtain benzodiazepines from health care providers [1]. However, with new policies to closely monitor controlled substances, those with dependence on benzodiazepines may turn …

Mobilized Peripheral Blood Stem Cells Versus Unstimulated Bone Marrow As A Graft Source For T-Cell-Replete Haploidentical Donor Transplantation Using Post-Transplant Cyclophosphamide., Asad Bashey, Mei-Jie Zhang, Shannon R Mccurdy, Andrew St Martin, Trevor Argall, Claudio Anasetti, Stefan O Ciurea, Omotayo Fasan, Sameh Gaballa, Md, Mehdi Hamadani, Pashna Munshi, Monzr M Al Malki, Ryotaro Nakamura, Paul V O'Donnell, Miguel-Angel Perales, Kavita Raj, Rizwan Romee, Scott Rowley, Vanderson Rocha, Rachel B Salit, Melhem Solh, Robert J Soiffer, Ephraim Joseph Fuchs, Mary Eapen

Department of Medicine Faculty Papers

Purpose T-cell-replete HLA-haploidentical donor hematopoietic transplantation using post-transplant cyclophosphamide was originally described using bone marrow (BM). With increasing use of mobilized peripheral blood (PB), we compared transplant outcomes after PB and BM transplants. Patients and Methods A total of 681 patients with hematologic malignancy who underwent transplantation in the United States between 2009 and 2014 received BM (n = 481) or PB (n = 190) grafts. Cox regression models were built to examine differences in transplant outcomes by graft type, adjusting for patient, disease, and transplant characteristics. Results Hematopoietic recovery was similar after transplantation of BM and PB (28-day neutrophil …

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 8, Number 1, 2017

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE), Volume 8, Number 1, 2017

A Comparative Analysis Of The Paris System And Institutional Reporting System For Urine Cytology In Upper Tract Urothelial Specimens, Kim Hookim, Md, James P. Casey, Md, Rossitza Draganova-Tacheva, Md, Marluce Bibbo, Md, Charalambos C. Solomides, Md

Department of Pathology, Anatomy, and Cell Biology Posters

The authors of this abstract have no conflicts of interest

Introduction

Cytology is integral in the assessment of urothelial cell carcinoma (UCC). However, upper urinary tract (UUT) specimens are cytologically challenging due to limited tissue and reactive atypia. At our institution UUT biopsies are processed as cell blocks (CB). We compared our institution’s reporting system (IRS) with the recently proposed Paris System for Reporting Urine Cytology (PRS) (Table 1) in UUT specimens and correlated the findings with CB and follow-up resections.

Public Reporting Of Cardiac Surgery Outcomes In Pennsylvania: A 20 Year Personal Perspective, Raymond Singer, Md, Mmm, Cpe

Raymond L Singer MD

This forum presentation will describe the national trends of public reporting, pay for performance, and related health care reform measures as well as describe both the intended and unintended consequences of public reporting of cardiac surgery outcomes. PowerPoint slides attached below: 65 slides Presentation: 51 minutes

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Benefits Of Wireless Telephone Technologies For Bilaterally Implanted Adults, Louisa Liang, Au.D., Paula Marcinkevich, Au.D.

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

Cochlear implant (CI) recipients often have difficulty conversing on the telephone, particularly in noise. Successful use of landline and cellular telephones also can be limited because of less-than-optimal phone placement with respect to the sound processor microphone. One solution for recipients of Advanced Bionics cochlear implants may be the use of new streaming technologies from Phonak to improve the ability to talk on the phone. In addition to reducing interference caused by noise, use of these technologies is not strictly placement-dependent and also allows bilateral/bimodal recipients to take advantage of hearing with two ears.

The primary objective of this …

Gaining Competencies During Early Medical Training: Medical Students As Teaching Assistants In Dissection-Based Anatomy Course, Martin T. Brown, Bruce Fenderson, Guiyan Zhang

Department of Pathology, Anatomy, and Cell Biology Posters

Introduction and Objectives

• In 2002, ACGME identified six ACGME Core Competencies: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice.
• AAMC recommended lists of similar competencies for the curricula of medical schools. Competency based curricula have been widely implemented in medical schools.
• Effective shifting in the graduate medical educational programs has been reported in various clinical specialties.
• There is a lack of reported efforts and development on competency training in early preclinical years of medical education.

Objectives:

• To explore methods for strengthening medical students’ competency training during preclinical undergraduate medical education.
• To measure …

Thyroid Cancer Metabolism: A Review, Kurren Gill, Ba, Patrick Tassone, Md,, James Hamilton, Md, Nikolaus Hjelm, Md, Adam J. Luginbuhl, Md, David Cognetti, Md, Madalina Tuluc, Md, Ubaldo E. Martinez-Outshoorn, Md, Jennifer Johnson, Md, Joseph Curry, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

Metabolic dysregulation within the tumor microenvironment (TME) is critical to the process of tumorigenesis in various cancer types. Thyrocyte metabolism in papillary and anaplastic thyroid cancer, however, remains poorly characterized, and studies analyzing the role of multicompartment metabolism in thyrocyte oncogenesis are sparse. We present a review of the current knowledge on cellular metabolism in non-cancerous and cancerous thyroid tissues, focusing on the monocarboxylate transporters MCT1 and MCT4, and on a transporter of the outer mitochondrial membrane TOMM20. Understanding the metabolic phenotype of tumor cells and associated stromal cells in thyroid cancer can have profound implications on the use …

Application Of Dual Task Performance In Pediatrics And Adults With Traumatic Brain Injury: A Systematic Review, Lauren Bilski, Kathleen Clancy, Victoria Dean, Danielle Melfi, Kristin Reardon, Louis N. Hunter, Pt, Dpt

Department of Physical Therapy Capstone Posters

Purpose:

The aim of this systematic review of the literature is to investigate the application of cognitive and motor dual task paradigms in the physical therapy management of moderate to severe TBI population across the lifespan in physical therapy practice.

Health Care Reform: Current Updates And Future Initiatives For Ambulatory Care Nursing, Beth Ann Swan, Phd, Crnp, Faan, Sheila Haas, Phd, Np, Faan

Sheila A. Haas, PhD, NP, FAAN

Executive Summary: While the signing of the Patient Protection and Affordable Care Act was a historical event marking the beginning of health care reform in the United States, it signaled the start of a golden age for ambulatory care nursing. Ambulatory care RNs are well-positioned to fully participate in health care reform initiatives. RNs are well-positioned to lead, facilitate, and/or participate in all patient care medical homes' and accountable care organizations'quality and safety initiatives through enhanced use of major ambulatory care RN role dimensions such as advocacy, telehealth, patient education, care coordination and transitional care, and community outreach. RNs are …

Saving Life And Brain With Extracorporeal Cardiopulmonary Resuscitation: A Single-Center Analysis Of In-Hospital Cardiac Arrests., Graham Peigh, Nicholas C. Cavarocchi, Hitoshi Hirose

Department of Surgery Faculty Papers

OBJECTIVE: Despite advances in medical care, survival to discharge and full neurologic recovery after cardiac arrest remains less than 20% after cardiopulmonary resuscitation. An alternate approach to traditional cardiopulmonary resuscitation is extracorporeal cardiopulmonary resuscitation, which places patients on extracorporeal membrane oxygenation during cardiopulmonary resuscitation and provides immediate cardiopulmonary support when traditional resuscitation has been unsuccessful. We report the results from extracorporeal cardiopulmonary resuscitation at the Thomas Jefferson University.

METHODS: Between 2010 and June 2014, 107 adult extracorporeal membrane oxygenation procedures were performed at the Thomas Jefferson University. Patient demographics, survival to discharge, and neurologic recovery of patients who underwent extracorporeal …