Digital Commons Network^™

Association Between Microbiome And The Development Of Adverse Posttraumatic Neuropsychiatric Sequelae After Traumatic Stress Exposure, Abigail L. Zeamer, Marie-Claire Salive, Xinming An, Francesca L. Beaudoin, Stacey L. House, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Scott L. Rauch, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Robert A. Swor, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Erica Harris, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Paulina Sergot, Leon D. Sanchez, Steven E. Bruce, Ronald C. Kessler, Karestan C. Koenen, Samuel A. Mclean, Vanni Bucci, John P. Haran

Einstein Health Papers

Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biological mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as possibilities for intervention. Microbiome composition after trauma exposure has been poorly examined regarding neuropsychiatric outcomes. We aimed to determine whether the gut microbiomes of trauma-exposed emergency department patients who develop APNS have dysfunctional gut microbiome profiles and discover potential associated mechanisms. We performed metagenomic analysis on stool samples (n = 51) from a subset of adults enrolled in the Advancing Understanding of RecOvery afteR traumA …

Reminiscence Therapy For Prevention Of Post-Stroke Anxiety And Depression In Adults, Carly Porter

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

Introduction

Anxiety and depression are prevalent after a stroke.^1,2 Peer support is a non-pharmacologic intervention utilized to manage post-stroke anxiety and depression with inconsistent results.³ Reminiscence therapy is an intervention that has been studied in the dementia population but is a relatively new intervention for the stroke population and has the potential to impact the psychological care provided to stroke patients.⁴

The Experiences Of Autistic Doctors: A Cross-Sectional Study, Sebastian C.K. Shaw, Alexander Fossi, Laura A. Carravallah, Kai Rabenstein, Wendy Ross, Mary Doherty

Jefferson Autism Center of Excellence Faculty Papers

Introduction: Medicine may select for autistic characteristics. As awareness and diagnosis of autism are growing, more medical students and doctors may be discovering they are autistic. No studies have explored the experiences of autistic doctors. This study aimed to fill that gap.

Methods: This is a cross-sectional study. A participatory approach was used to identify the need for the project and to modify a pre-existing survey for use exploring the experiences of autistic doctors.

Results: We received 225 responses. 64% had a formal diagnosis of autism. The mean age of receiving a formal diagnosis was 36 (range 3–61). Most were …

Trauma-Informed And Family-Centered Paediatric Resuscitation: Defining Domains And Practices, Nancy Kassam-Adams, Lucas Butler, Julia Price, Marcie Gawel, Leila Graham, Sage Myers, Marc Auerbach

Department of Pediatrics Faculty Papers

Aim

For paediatric patients and families, resuscitation can be an extremely stressful experience with significant medical and psychological consequences. Psychological sequelae may be reduced when healthcare teams apply patient- and family-centered care and trauma-informed care, yet there are few specific instructions for effective family-centered or trauma-informed behaviours that are observable and teachable. We aimed to develop a framework and tools to address this gap.

Methods

We reviewed relevant policy statements, guidelines, and research to define core domains of family-centered and trauma-informed care, and identified observable evidence-based practices in each domain. We refined this list of practices via review of provider/team …

Implementation And Outcomes Of The Trauma Ambassadors Program: A Case Study Of Trauma-Informed Youth Leadership Development, Jeanne Felter, Phd, Lpc, He Len Chung, Amanda Guth, Stephen Didonato, Phd, Lpc, Ncc

Counseling and Behavioral Health Faculty Papers

Community-based programs serve a critical need for vulnerable youth and families. In recent years, researchers and practitioners have urged programs to adopt a trauma-informed care (TIC) approach to address adversity in young people's lives. The purpose of this article is to describe the implementation and outcomes of the Trauma Ambassador (TA) Program, a pilot youth leadership program guided by a community-university partnership that utilized a TIC approach in an underserved East North Philadelphia neighborhood. Fourteen youth engaged in interactive trainings to build their understanding of trauma and develop practical tools to support encounters with individuals with trauma histories. Focus groups …

Emergency Medicine Clinician Experiences Addressing Uncertainty In First-Trimester Bleeding., Garrison Nord, Amanda Doty, Andrew J Monick, Danielle M Mccarthy, Robin J Casten, Amer Z Aldeen, Philip S Nawrocki, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

The purpose of this work is to understand Emergency Department (ED) clinicians' experiences in communicating uncertainty about first-trimester bleeding (FTB) and their need for training on this topic. This cross-sectional study surveyed a national sample of attending physicians and advanced practice providers (APPs). The survey included quantitative and qualitative questions about communicating with patients presenting with FTB. These questions assessed clinicians' frequency encountering challenges, comfort, training, prior experience, and interest in training on the topic. Of 402 respondents, 54% reported that they encountered challenges at least sometimes when discussing FTB with patients where the pregnancy outcome is uncertain. While the …

Transcriptional Profiles In Olfactory Pathway-Associated Brain Regions Of African Green Monkeys: Associations With Age And Alzheimer’S Disease Neuropathology, Jacob D Negrey, Dorothy L Dobbins, Timothy D Howard, Karin E Borgmann-Winter, C G Hahn, Sergey Kalinin, Douglas L Feinstein, Suzanne Craft, Carol A Shively, Thomas C Register

Department of Neuroscience Faculty Papers

Introduction: Olfactory impairment in older individuals is associated with an increased risk of Alzheimer's disease (AD). Characterization of age versus neuropathology-associated changes in the brain olfactory pathway may elucidate processes underlying early AD pathogenesis. Here, we report age versus AD neuropathology-associated differential transcription in four brain regions in the olfactory pathway of 10 female African green monkeys (vervet, Chlorocebus aethiops sabaeus), a well-described model of early AD-like neuropathology.

Methods: Transcriptional profiles were determined by microarray in the olfactory bulb (OB), piriform cortex (PC), temporal lobe white matter (WM), and inferior temporal cortex (ITC). Amyloid beta (Aβ) plaque load in …

Technology-Enabled Behavioral Health Integration Decreases Emergency Department Utilization, Adam Pardes, Rachelle Rene, Phansy Chun Chun, Mollie Cherson

Jefferson Hospital Staff Papers and Presentations

Background:

Behavioral health integration allows for patient-centered care, leads to higher levels of provider-patient engagement, and is key to improving patient outcomes. However, behavioral health integration is administratively burdensome and therefore is often not adopted. Technology presents opportunities to increase care team efficiency and improve patient outcomes. The goal of this study was to retrospectively compare clinical outcomes and emergency department utilization in patients using a technology platform compared to patients receiving treatment as usual.

Methods:

The technology platform, NeuroFlow, was deployed to deliver technology-enabled behavioral health integration in 30 clinics, and 598 electronic health records were analyzed.

Results:

In …

A Forward-Thinking Approach To Addressing The New Synthetic Opioid 2-Benzylbenzimidazole Nitazene Analogs By Liquid Chromatography-Tandem Quadrupole Mass Spectrometry (Lc-Qqq-Ms), Sara E Walton, Alex J Krotulski, Barry K Logan

College of Life Sciences Faculty Papers

Novel psychoactive substances (NPS) continue to represent a threat to public health and safety. The number of new drugs in the latest emergent synthetic opioid class-the 2-benzylbenzimidazole analogs-also called the nitazenes-has begun to dominate the current new synthetic opioid (NSO) subclass of NPS. We describe a liquid chromatography-tandem quadrupole mass spectrometry method for the quantification of nine analogs and/or metabolites of drugs in this series: isotonitazene, metonitazene, protonitazene, etonitazene, clonitazene, flunitazene, N-desethyl isotonitazene, 5-amino isotonitazene and 4'-hydroxy nitazene in human whole blood, urine, and tissue. Samples were prepared for analysis using a basic liquid-liquid extraction. Chromatographic separation was achieved using …

Multiple Sclerosis: Relationship Between Locus Of Control And Quality Of Life In Persons With Low Versus High Disability, Judith Bijoux Leist, Thomas P. Leist

Department of Neurology Faculty Papers

Background: Health Locus of Control (HLOC) is the degree to which individuals believe that their health outcomes are controlled by 'external' factors - environmental forces, chance, fate, other people, or some higher power - or by 'internal' factors - their own behavior or action. Most of the literature on HLOC associates an Internal Health Locus of Control (IHLOC) to pro-health behaviors and better health outcomes. However, a few studies also suggest that in chronic illnesses, an External Health Locus of Control (EHLOC) could be beneficial with respect to pro-health behaviors and perceptions of Quality of Life (QoL), challenging assumptions about …

Lessons Of The Opioid Epidemic - December 3, 2021, Mitchell J. Cohen, Md, Joey Flaxer, Md, Phd, Marianna Lanoue, Phd

Department of Psychiatry and Human Behavior Grand Rounds

No abstract provided.

Psychological Problems Among Patients With Chronic Medical Disorders During The Covid-19 Pandemic, Ali Akbar Asadi-Pooya, Seyed Ali Nabavizadeh, Saeid Sadeghian, Mina Shahisavandi, Zohreh Barzegar, Abdullah Nezafat, Nahid Ashjazadeh, Hamed Bazrafshan Drissi, Ali Sahraian

Department of Neurology Faculty Papers

The aim of the current study was to investigate the rates of stress, anxiety, and depression among people in south Iran (a group from the general population without a history of any chronic medical problems, and cohorts of patients were recruited from epilepsy, diabetes, and cardiac disease clinics). We surveyed a sample of people during September 2020: a group of the general population without a history of any chronic medical problems, people with epilepsy, people with diabetes mellitus (DM), and people with cardiac problems. The survey included four general questions and two COVID-19 specific questions [contracting COVID-19, relatives with COVID-19]. …

Cannabis Use And Car Crashes: A Review., Ulrich W Preuss, Marilyn A. Huestis, Miriam Schneider, Derik Hermann, Beat Lutz, Alkomiet Hasan, Joseph Kambeitz, Jessica W M Wong, Eva Hoch

College of Health Professions Faculty Papers

In this review, state-of-the-art evidence on the relationship between cannabis use, traffic crash risks, and driving safety were analyzed. Systematic reviews, meta-analyses, and other relevant papers published within the last decade were systematically searched and synthesized. Findings show that meta-analyses and culpability studies consistently indicate a slightly but significantly increased risk of crashes after acute cannabis use. These risks vary across included study type, crash severity, and method of substance application and measurement. Some studies show a significant correlation between high THC blood concentrations and car crash risk. Most studies do not support this relationship at lower THC concentrations. However, …

Assessing Civility At An Academic Health Science Center: Implications For Employee Satisfaction And Well-Being., Lisa A Campbell, Jenna R Lafreniere, Mhd Hasan Almekdash, David D Perlmutter, Huaxin Song, Patricia J Kelly, Rohali Keesari, Kay Leigh Shannon

College of Nursing Faculty Papers & Presentations

Incivilities are pervasive among workers in healthcare institutions. Previously identified effects include deterioration of employee physical and mental health, absenteeism, burnout, and turnover, as well as reduced patient safety and quality of care. This study documented factors related to organizational civility at an academic health sciences center (AHSC) as the basis for future intervention work. We used a cross-sectional research design to conduct an online survey at four of five campuses of an AHSC. Using the Organizational Civility Scale (OCS), we assessed differences across gender, race (White and non-White) and job type (faculty or staff) in the eleven subscales (frequency …

How Do Counselors Support Clients During The Coronavirus Pandemic?, Yoon Suh Moh, Katharine Sperandio

Counseling and Behavioral Health Faculty Papers

It is impossible to deny the extraordinary societal impact of the outbreak of the novel coronavirus, severe acute respiratory syndrome 2 (SARS-Cov-2). All of us are bombarded daily with messages and information related to the pandemic. As this virus garners heightened attention from the media, individuals may have difficulty delineating between misinformation and accurate information about the illness.

We are not writing this article to perpetuate increased fear among the counseling community regarding the spread of the novel coronavirus, but rather to:

• Provide resources helpful for staying informed about the impact of COVID-19, which is a disease caused by SARS-Cov-2 …

Therapeutic Art For Individuals With Multiple Sclerosis, Alexandra Kocsik, Silva Markovic-Plese, Md, Phd

Phase 1

Introduction: Depression is more prevalent in individuals with MS than in the average population, which presents complications of quality of life beyond simply the primary disease process. This project aims to explore the immediate emotional benefits of therapeutic art sessions for individuals with MS, in addition to exploring the feasibility of reducing concomitant depression in this population with therapeutic art alongside standard medical therapy.

Methods: Therapeutic art sessions were held with 3 support groups of 5 to 12 individuals with MS. Participants were initially prompted with a writing exercise regarding how they perceive themselves, and then prompted to paint a …

Maternal Addiction Treatment Education Research Program, Meghan Gannon, Lhd, Msph

Department of Obstetrics and Gynecology Posters

MATER is a program in the Department of Obstetrics & Gynecology at Thomas Jefferson University Hospitals, and includes the Sidney Kimmel Medical College departments of OB/GYN, Pediatrics and Psychiatry. The MATER Program includes Family Center Outpatient and Intensive Outpatient Services and My Sister’s Place Residential Program

Family Center Outpatient and Intensive Outpatient Programs

• 18 years or older
• Pregnant or parenting
• Needing treatment for any substance problems

My Sister's Place Residential Program

• 18 years or older
• Pregnant or parenting
• Needing treatment for any substance problems
• Children under 6 years old are welcome to live in the residence with their mother

Prevalence And Characterization Of Adverse Childhood Experiences Of Women In Substance Use Treatment, Meghan Gannon, Phd, Msph, Vanessa Short, Phd, Mph, Marianna Lanoue, Phd, Diane J. Abatemarco, Phd, Msw

Department of Obstetrics and Gynecology Posters

• Rates of illicit drug use among women reproductive age significant national public health problem
• Adverse childhood experiences (ACE’s) associated with higher rates of prenatal depression and maternal childhood maltreatment
• Ace’s prevalent in those with Opioid Use Disorder (OUD)

Aims of Study:

1. Determine prevalence of ACE’s in a population of pregnant and parenting women in treatment for substance use disorder
2. Characterize ACE’s
3. Compare our sample to Behavioral Risk Factor Surveillance System (BRFSS) Pennsylvania data

Relationships Among Patient Diabetes Self-Care Behaviors, Depression And Self-Reported Medication Adherence In African Americans With Diabetes, Shu Xiao, Phd, Pharmd Candidate, Monica Woloshin, Bs, Pharmd Candidate, Robin Casten, Phd, Barry Rovner, Md, Ginah Nightingale, Pharmd, Bcop

College of Pharmacy Posters

Objectives

To determine the extent to which self-care behaviors and self-reported medication adherence are related to depression in older African Americans with diabetes who presented to the ED.

Using The System Of Care Approach To Distinguish School Refusal From School Truancy, Connie Chang, Md, Aneela Khan, Md

Department of Psychiatry and Human Behavior Posters

Learning Objectives

To recognize the importance of taking a system of care approach to determine whether the symptoms of school avoidance are due to mental illness

Feasibility Pilot Outcomes Of A Mammography Decision Support And Navigation Intervention For Women With Serious Mental Illness Living In Supportive Housing Settings., Lara Weinstein, Marianna Lanoue, Katelyn Hurley, Colleen Payton, Randa Sifri, Ronald Myers

Department of Family & Community Medicine Faculty Papers

Objective: People with serious mental illness (SMI) experience significant disparities in morbidity and mortality from preventable and treatable medical conditions. Women with SMI have low mammography screening rates. SMI, poverty, and poor access to care can have a significant effect on a woman’s opportunity to learn about and discuss breast cancer screening with health care providers. This study examines the feasibility pilot outcomes of mammography decision support and patient navigation intervention (DSNI) for women with SMI living in supportive housing settings. The primary research question was: Does the DSNI increase knowledge, promote favorable attitudes, and decrease decisional conflict relating to …

Meet An Ipe Faculty Champion From Thomas Jefferson University: Richard Hass, Phd, Assistant Professor Of Psychology, Richard Hass, Phd

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

Meet an IPE Faculty Champion from Thomas Jefferson University: Richard Hass, PhD, Assistant Professor of Psychology

De-Stigmatizing Mental Illness Through Graphic Medicine, Megumi Tsuda

Phase 1

Graphic medicine - or the communication of health-related narratives through images and texts, such as comics - has been increasingly recognized as a powerful educational tool. My project investigates the value of integrating graphic medicine to medical education, specifically to improve mental health literacy and de-stigmatize mental illness. As a medical student, I have encountered several instances where fellow medical students and even doctors casually throw around diagnostic terminology, especially those used to describe mental health disorders, in a colloquial and insensitive manner that seem to indicate that they do not take mental illness seriously, or even ignorant of what …

Use Or Consequences: Probing The Cognitive Difference Between Two Measures Of Divergent Thinking, Richard W. Hass, Roger E. Beaty

College of Humanities and Sciences Faculty Papers

Recent studies have highlighted both similarities and differences between the cognitive processing that underpins memory retrieval and that which underpins creative thinking. To date, studies have focused more heavily on the Alternative Uses task, but fewer studies have investigated the processing underpinning other idea generation tasks. This study examines both Alternative Uses and Consequences idea generation with a methods pulled from cognitive psychology, and a novel method for evaluating the creativity of such responses. Participants were recruited from Amazon Mechanical Turk using a custom interface allowing for requisite experimental control. Results showed that both Alternative Uses and Consequences generation are …

Optimizing Psychosocial Care Of Older Adults With Cancer: An Early Assessment And Intervention Model, Lora Rhodes, Lcsw, Andrew Chapman, Do, Facp

Department of Medical Oncology Posters

Background

Jefferson Multidisciplinary Senior Adult Oncology Center

History

• Established September 2010
• First multidisciplinary geriatric oncology evaluation center in the tristate area

Demographics

• 890 patients evaluated to date
• All tumor types
• Age 70 and above & Pre-transplant (Bone Marrow) evaluation age 65 and above

Format

• Consultative service
• Two sessions weekly
• Average evaluation time: two hours

Multidisciplinary Team

• Navigator, Medical Oncologist, Geriatrician, Pharmacist, Nutritionist, Social Worker
• As needed: Psychiatry, Rehab Medicine, Radiation Oncology, Surgery

Order From Order Sets: Analysis Of Ordering Patterns And Patient Outcomes Before And After Order Set Changes On The Inpatient Psychiatry Units At Tjuh, David Halpern, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Aims

Short Term

To decrease the total number of times one-time orders were added for patients for Vistaril, Remeron, Melatonin, Colace, Senna, and MiraLAX. Increase number of times urine PCP and urine oxycodone added to the urine drug screen.

Long Term

To decrease overall length of stay and improve treatment outcomes

Additive Drug-Specific And Sex-Specific Risks Associated With Co-Use Of Marijuana And Tobacco During Pregnancy: Evidence From 3 Recent Developmental Cohorts (2003-2015)., Suena H Massey, Daniel K Mroczek, David Reiss, Emily S Miller, Jessica A Jakubowski, Eileen K Graham, Shannon M Shisler, Meaghan Mccallum, Marilyn A. Huestis, Jody M Ganiban, Daniel S Shaw, Leslie D Leve, Rina D Eiden, Laura R Stroud, Jenae M Neiderhiser

Institute of Emerging Health Professions Faculty Papers

BACKGROUND: Methodologic challenges related to the concomitant use (co-use) of substances and changes in policy and potency of marijuana contribute to ongoing uncertainty about risks to fetal neurodevelopment associated with prenatal marijuana use. In this study, we examined two biomarkers of fetal neurodevelopmental risk-birth weight and length of gestation-associated with prenatal marijuana use, independent of tobacco (TOB), alcohol (ALC), other drug use (OTH), and socioeconomic risk (SES), in a pooled sample (N = 1191) derived from 3 recent developmental cohorts (2003-2015) with state-of-the-art substance use measures. We examined differential associations by infant sex, and multiplicative effects associated with co-use of …

"My Bitterness Is Deeper Than The Ocean": Understanding Internalized Stigma From The Perspectives Of Persons With Schizophrenia And Their Family Caregivers., Yin-Ling Irene Wong, Dexia Kong, Lufei Tu, Rosemary Frasso Phd, Msc, Cph

College of Population Health Faculty Papers

Background: It is estimated that 8 million of the Chinese adult population had a diagnosis of schizophrenia. Stigma associated with mental illness, which is pervasive in the Chinese cultural context, impacts both persons with schizophrenia and their family caregivers. However, a review of the literature found a dearth of research that explored internalized stigma from the perspectives of both patients and their caregivers.

Methods: We integrated data from standardized scales and narratives from semi-structured interviews obtained from eight family-dyads. Interview narratives about stigma were analyzed using directed content analysis and compared with responses from Chinese versions of the Internalized Stigma …

Professional Practices, Training, And Funding Mechanisms: A Survey Of Pediatric Primary Care Psychologists, Kathryn W. Hoffses, Andrew R. Riley, Kathryn M. Menousek, Kriston B. Schellinger, Allison O. Grennan, Chrissy Cammarata, Jason L. Steadman

Department of Pediatrics Faculty Papers

The integration of mental health services in primary care settings has expanded rapidly in recent years with psychologists being at the forefront of efforts to promote healthy behaviors, reduce disease, and care for behavioral, emotional, and developmental needs to promote overall health and well-being for children and families (Asarnow, Kolko, Miranda,&Kazak, 2017; Stancin& Perrin, 2014). While there are many psychologists working in pediatric primary care (PPC), little is known about the specific activities that these psychologists engage in, the training they receive, or funding mechanisms that support their work. This study sought to address this gap in the literature through …

Spotlight On The Integrated Primary Care Special Interest Group, Kathryn W. Hoffses, Andrew R. Riley, Kathryn M. Menousek, Kriston B. Schellinger, Allison O. Grennan, Chrissy Cammarata, Jason L. Steadman

Department of Pediatrics Faculty Papers

No abstract provided.