Mental and Social Health Commons^™

Neighborhood Disadvantage And Neural Correlates Of Threat And Reward Processing In Survivors Of Recent Trauma, E. Kate Webb, Timothy D. Ely, Grace E. Rowland, Lauren A.M. Lebois, Sanne J.H. Van Rooij, Steven E. Bruce, Tanja Jovanovic, Stacey L. House, Francesca L. Beaudoin, Xinming An, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Robert A. Swor, Jose L. Pascual, Mark J. Seamon, Elizabeth M. Datner, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Paulina Sergot, Leon D. Sanchez, Ronald C. Kessler, Karestan C. Koenen, Samuel A. Mclean, Jennifer S. Stevens, Kerry J. Ressler, Nathaniel G. Harnett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.

OBJECTIVE: To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data …

The Role Of Repetitive Transcranial Magnetic Stimulation (Rtms) V. Electroconvulsive Therapy (Ect) In Geriatric Depression Treatment: Efficacy & Tolerability, Madeleine Sarro

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

• Geriatric depression, or depression in a population over the age of 60, is a highly debilitating mental health condition with a prevalence of 25% versus 10% in the general population.^{1, 2} Increasing prevalence is expected in the next 30 years with a rise in the population size for adults over 60 from 12% to 22%.³
• Limiting variables in the treatment of geriatric depression include polypharmacy, intolerable adverse effects, medical comorbidities, drug resistance and atypical symptom presentation.^2-7
• Due to uniformity in underlying pathophysiology, current treatment guidelines for geriatric depression are the same as for the general population. …

The End Of Roe V. Wade: Implications For Women's Mental Health And Care, Amalia Londoño Tobón, Eileen Mcnicholas, Camille A Clare, Luu D Ireland, Jennifer L Payne, Tiffany A Moore Simas, Rachel K Scott, Madeleine Becker, Nancy Byatt

Marcus Institute of Integrative Health Faculty Papers

The Supreme Court decision in Dobbs v. Jackson in June 2022 reversed precedent which had previously protected abortion prior to fetal viability as a universal right within the United States. This decision almost immediately led to abortion restrictions across 25 states. The resulting lack of access to abortion care for millions of pregnant people will have profound physical and mental health consequences, the full effects of which will not be realized for years to come. Approximately 1 in 5 women access abortions in the U.S. each year. These women are diverse and represent all American groups. The Supreme court decision, …

The Association Between Food Insecurity And Physical Activity In Adults With Serious Mental Illness Living In Supportive Housing, Amy Taylor Cunningham, Lara Carson Weinstein, Ana Stefancic, Alexis Silverio, Leopoldo J. Cabassa

Department of Family & Community Medicine Faculty Papers

Rates of food insecurity are high among adults with serious mental illness (SMI); this population also engages in less physical activity than the general population. However, the relationship between food insecurity and physical activity in this group has not been explored. We examined food insecurity prevalence and its association with physical activity in 314 adults with SMI living in supportive housing in New York City and Philadelphia and enrolled in an institutional review board-approved randomized controlled trial of a Peer Group Lifestyle Balance (PGLB) program. We analyzed 2014 baseline survey data, including demographic data and self-reported food security, and four …

Predicting At-Risk Opioid Use Three Months After Ed Visit For Trauma: Results From The Aurora Study, Brittany E. Punches, Uwe Stolz, Caroline E. Freiermuth, Rachel M. Ancona, Samuel A. Mclean, Stacey L. House, Francesca L. Beaudoin, Xinming An, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Tanja Jovanovic, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey Jr., Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Michael C. Kurz, Nina T. Gentile, Meghan E. Mcgrath, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Erica Harris, Anna M. Chang, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Leon D. Sanchez, Steven E. Bruce, Robert H. Pietrzak, Jutta Joormann, Deanna M. Barch, Diego A. Pizzagalli, Jordan W. Smoller, Beatriz Luna, Steven E. Harte, James M. Elliott, Ronald C. Kessler, Kerry J. Ressler, Karestan C. Koenen, Michael S. Lyons

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Whether short-term, low-potency opioid prescriptions for acute pain lead to future at-risk opioid use remains controversial and inadequately characterized. Our objective was to measure the association between emergency department (ED) opioid analgesic exposure after a physical, trauma-related event and subsequent opioid use. We hypothesized ED opioid analgesic exposure is associated with subsequent at-risk opioid use.

METHODS: Participants were enrolled in AURORA, a prospective cohort study of adult patients in 29 U.S., urban EDs receiving care for a traumatic event. Exclusion criteria were hospital admission, persons reporting any non-medical opioid use (e.g., opioids without prescription or taking more than prescribed …

Suicide Assessment, Angelo Rannazzisi, Psyd

Department of Family & Community Medicine Presentations and Grand Rounds

Agenda

● Risk & Protective Factors of Suicide

• Demographic, Diagnostic, Psychological Variables

● Suicide Risk Assessment

• C-SSRS (Columbia-Suicide Severity Rating Scale)
• BDI-II (Beck Depression Inventory 2nd Edition)
• Reasons for Living Inventory (RFL)

● Creating a Safety Plan

Social Isolation: Impact On Physical And Mental Health, Alexa Waters, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Review the impact of social isolation and loneliness on important aspects of health and well-being, with a focus on older adults
• Review risk and protective factors for social isolation and loneliness
• Discuss how the health care system and primary care physicians can better identify and address social isolation
• Briefly highlight interventions to enhance social connectedness and reduce loneliness

Outline

• Background
• Impacts of social isolation and loneliness on health and well-being
• Risk and protective factors for social isolation and loneliness
• Role of the health system and primary care in addressing social isolation and loneliness
• Cases throughout

Implementing Nudges For Suicide Prevention In Real-World Environments: Project Inspire Study Protocol, Molly Davis, Courtney Benjamin Wolk, Shari Jager-Hyman, Rinad S Beidas, Jami F Young, Jennifer A Mautone, Alison M Buttenheim, David S Mandell, Kevin G Volpp, Katherine Wislocki, Anne Futterer, Darby Marx, E L Dieckmeyer, Emily M Becker-Haimes

College of Life Sciences Faculty Papers

Background: Suicide is a global health issue. There are a number of evidence-based practices for suicide screening, assessment, and intervention that are not routinely deployed in usual care settings. The goal of this study is to develop and test implementation strategies to facilitate evidence-based suicide screening, assessment, and intervention in two settings where individuals at risk for suicide are especially likely to present: primary care and specialty mental health care. We will leverage methods from behavioral economics, which involves understanding the many factors that influence human decision making, to inform strategy development.

Methods: We will identify key mechanisms that limit …

Training The Next Generation Of Family Medicine Providers Through Group Buprenorphine-Naloxone Visits, Krystina Callahan, Lara Weinstein, Md, Erica Li, Md, Sunny Lai, Md, Alexis Silverio

Phase 1

Introduction: The rise in opioid use disorders (OUD) and fatal overdoses highlight the need to expand access to and capacity for treating OUD. Medication Assisted Treatment (MAT), a medication/group visit model, done in the office setting, is an effective remedy for treating OUD. Understanding residents’ perspectives on their clinical training in MAT can inform the design of a more effective and responsive curriculum.

Methods: A qualitative study using group semi-structured interviews with residents in an urban family medicine residency rotating through a federally qualified health center. Interviews centered on strengths and weaknesses of the MAT program, resident likeliness to …

Effects Of Neonatal Abstinence Syndrome On Long-Term Growth Parameters, Ayoung Kim, Anastasiya Latushko, Md, Zubair H. Aghai, Md

Phase 1

Introduction: Past studies have shown that babies with Neonatal Abstinence Syndrome (NAS) have lower weight, head circumference, and height at birth. This study aims to compare their growth at 9 and 18 months of age, and to compare growth parameter of NAS infants below 10th percentile to those above 10th percentile at birth.

Methods: In this retrospective review, 260 infants admitted to Jefferson Neonatal Intensive Care Unit between 2006 and 2018 were included. The weight, height, and head circumference at birth, 9 months, and 18 months were collected and correlated by Pearson correlation. The growth parameters of infants below …

The Effect Of Perceived Physician Opinion On Breastfeeding In Women With Opioid Use Disorder Who Are Receiving Medication-Assisted Treatment, Lacey Murray, Meghan Gannon, Phd, Vanessa Short, Phd, Mph

Phase 1

Women who receive medication-assisted treatment (MAT) for opioid use disorder (OUD) are less likely to breastfeed than the general population despite the many possible benefits to the newborn. The ongoing study examines the effect of perceived physician opinion on the outcome of breastfeeding in women receiving MAT for OUD. Women who were receiving MAT for OUD at Thomas Jefferson University’s Family Center were given a survey during their third trimester (n=45), and at 1 month postpartum (n=33) to gather information on the perceived opinion of their physicians on how they should feed their baby and the importance of those opinions. …

Does Maternal Methadone Dose Correlate With Severity Of Intrauterine Growth Restriction In Infants With Neonatal Abstinence Syndrome?, D. Friedman, J. Smith, M. Lafferty, Z. H. Aghai

Phase 1

Introduction : Previous studies demonstrate a relationship between maternal opioid use during pregnancy and smaller head circumference of infants with neonatal abstinence syndrome (NAS). The goal of this study is to correlate maternal methadone dose and severity of growth restriction in infants with NAS admitted to the neonatal intensive care unit (NICU).

Methods: This is a retrospective analysis of infants (≥35 weeks gestation) exposed to in utero methadone, born between August 2006 and May 2018, and admitted to a Philadelphia NICU for medical therapy for NAS. Growth parameters (birth weight, birth length, and birth head circumference) were compared between infants …

Anxiety And Depressive Symptoms Pre-Trauma As A Predictor Of Dissociative Symptoms Post-Trauma – An Aurora Study, Vishal Swaminathan

Phase 1

Introduction: Increased states of anxiety or depression may lead to increased occurrences of dissociative behavior, justifying the need to validate pre-traumatic cognitive states as a predictor of dissociation post-trauma. Early prediction can lead to medical intervention for high-risk patients and prevent potential adverse sequalae. The AURORA Study evaluates biomarkers and neuropsychological sequelae in patients immediately following traumatic events. We predict patients who suffered from depressive symptoms and anxiety prior to the traumatic event will experience increased dissociative symptoms post-trauma.

Methods: This study includes survey data collected at ED’s from survivors (n = 666) of traumatic motorized vehicle collisions (MVC) at …

Renewing Hearts: Catholic Perspectives In Valve Replacement Surgery For Those Who Use Intravenous Drugs, Kimberly Feeney, Robert Perkel, Md

Phase 1

Introduction: The incidence of infectious endocarditis has been increasing, particularly among those with a history of intravenous drug use (IVDU). Although current bioethics literature supports valve surgery as treatment for this patient population, clinical guidelines and literature continues to provide unclear recommendations for physicians. Catholic bioethics may provide a different perspective to re-contextualize the recommendations of secular ethics.

Methods: A PubMed search was used to gain background information regarding the incidence of infectious endocarditis and current treatment guidelines, as well as historical and current ethical considerations. Search terms included: “infectious endocarditis,” “IE,” “intravenous drug use,” “IVDU,” “ethics.” Related citations were …

Wellness Initiative Program And Effect On Pathology Resident Burnout Rate, Kaitlin Collura, Md, Phd, Michelle Nagurney, Md, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Posters

Increasing rates of physician burnout are reported across many medical specialties, including Pathology. In 2014, 52.5% of pathologists experienced symptoms of burnout compared to 37.6% in 2011. Suicide and depression rates in physicians are also higher than the average population. As a result, the ACGME began a campaign, in 2015, to foster resident wellness. The campaign calls for strategies to develop resiliency, identify problems, and promote well-being. While wellness initiatives may not change underlying mental illness, they may mitigate environmental factors that can exacerbate mental illness or suicidal behavior. Here we report results from a recently implemented resident wellness initiative …

Mindfulness Based Stress Reduction Increases Pathology Resident Self Wellness, Kaitlin Collura, Md, Phd, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Posters

Stress during medical residency is a common, complex issue influenced by time demands, level of social support, and environmental factors. Increased stress levels can lead to resident burnout, and may contribute to the high rates of depression and suicide seen among physicians. In 2015, the ACGME began a campaign to promote resident wellness by calling on programs to implement strategies to develop resiliency, identify problems, and promote wellbeing. Mindfulness based stress reduction (MBSR) strategies have been shown to decrease burnout, improve mood, and increase compassion in healthcare providers. We implemented a wellness retreat to educate residents on the principles of …

Out Of The Straitjacket., Michael Weinstein

Department of Surgery Faculty Papers

No abstract provided.

Mater: Innovative Programs For Maternal Addiction Education Treatment And Research, Meghan Gannon Phd Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Adverse Childhood Experiences, Disability And Health-Risk Behaviors, Sophia Miryam Schussler-Fiorenza Rose Md, Phd

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Evaluating The Effectiveness Of The Blood Pressure Plus Program At Thomas Jefferson University, Adam C. Winters

Department of Family & Community Medicine Faculty Papers

Thomas Jefferson University Hospital’s Blood Pressure Plus program enhances the role of the community in chronic disease prevention and management. There is much evidence that controlling disease and cost is greatly improved through the involvement of community leaders and resources. By offering free blood pressure screenings, the BP+ program was able to document the current status of many underserved individuals in the city of Philadelphia, provide the necessary education and referrals. Perhaps more importantly, the program allowed us to foster relationships with individuals who could further the efforts of chronic care management within their communities. More and more we’re seeing …

Community-Based Partnerships For Improving Chronic Disease Management, James Plumb, Laura Carson Weinsten, Rickie Brawer, Kevin Scott

Department of Family & Community Medicine Faculty Papers

With the growing burden of chronic disease, the medical and public health communities are re-examining their roles and opportunities for more effective prevention and clinical interventions. The potential to significantly improve chronic disease prevention and have an impact on morbidity and mortality from chronic conditions is enhanced by adopting strategies that incorporate a social ecology perspective, realigning the patient-physician relationship, integrating population health perspectives into the Chronic Care Model, and effectively engaging communities using established principles of community engagement.

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