Translational Medical Research Commons^™

Understanding Coordinated Specialty Care Best Practice Through Fidelity Practices: A Qualitative Exploration, Halley Read

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Coordinated Specialty Care (CSC) is a multidisciplinary care model for providing care to youth and young adults having their first episode of psychosis. While outcomes of CSC effectiveness are overwhelmingly positive, and widespread implementation has occurred in all US states and territories, what is CSC best practice regarding components and fidelity to the model is not clear. CSC implementation is well documented from a fidelity to the model standpoint, but the highly variable fidelity practices and versions of the model are not well understood. Nor are the experiences of those who deliver or receive care. Adding to the complexity …

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 …

Understanding The Relationship Between Drug Overdose Death Rates And Socioeconomic Factors, William Duan, Dennis J. Hand

Phase 1

Drug-overdose deaths increased rapidly recently. What are the causes? We believe socioeconomical factors play critical roles. Secondary data analyses are done on the US population, using mortality-data files from the National Vital Statistics System. Deaths are grouped by race, age, sex, education and marital status. We believe that the percentage-of-total-death (PoTD) value, which equals to the number-of-overdose-deaths divided by the total-number-of-deaths in the corresponding group, more accurately reflect the severity of overdose-deaths. Analysis of 2017 data reveals that among all age groups, PoTD is highest in the age 25-34 group, with dramatic differences between white (PoTD 24%) and black (PoTD …

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 …

Gut Microbiome Analysis In Morphine Exposure And Naltrexone-Induced Withdrawal, Nick Rapp, Sean O'Sullivan, James Schwaber

Phase 1

Introduction and Objectives: Relatively little is understood about the underlying physiological changes that occur in the withdrawal state of opiate users. Research on the effects of alcohol withdrawal on the Gut-brain axis (GBA) has revealed shifts in relative numbers of specific bacterial species that correlate with increased central nervous system (CNS) inflammation via neurological crosstalk. The purpose of this research was to determine if similar shifts in the relative abundance of bacterial populations occur in the opiate withdrawal state.

Methods: Fourteen rats were randomized into four groups. Control and experimental rats were administered 75 mg morphine pellets or placebo (sugar) …

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 …

Similarity Based Classification Of Adhd Using Singular Value Decomposition, Taban Eslami, Fahad Saeed

Parallel Computing and Data Science Lab Technical Reports

Attention deficit hyperactivity disorder (ADHD) is one of the most common brain disorders among children. This disorder is considered as a big threat for public health and causes attention, focus and organizing difficulties for children and even adults. Since the cause of ADHD is not known yet, data mining algorithms are being used to help discover patterns which discriminate healthy from ADHD subjects. Numerous efforts are underway with the goal of developing classification tools for ADHD diagnosis based on functional and structural magnetic resonance imaging data of the brain. In this paper, we used Eros, which is a technique for …

Hockey Fans In Training: A Pilot Pragmatic 1 Randomized Controlled Trial, Robert Petrella, Dawn P. Gill, Guangyong Zou, Ashleigh De Cruz, Brendan Riggin, Cassandra Bartol, Karen Danylchuk, Kate Hunt, Sally Wyke, Cindy M. Gray, Christopher Bunn, Merrick Zwarenstein

Lifestyle Research Team

Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months.

Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of …

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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