Digital Commons Network^™

Jefferson Digital Commons Quarterly Report: October-December 2012, Daniel G. Kipnis, Msi

Jefferson Digital Commons Reports

Jefferson Digital Commons quarterly report includes statistics, top 10 most downloaded items and new assets added to the collection.

Patient Safety Symposium: Issues, Analyses, Prevention, Alan Forstater, Marcia Levinson, Jennifer Bellot, Mary Hess, John Spandorfer

Department of Medicine Presentations and Grand Rounds

Abstract Introduction: While learning the basics of patient safety, students can also learn about the contribution members of the various health professions can make to patient safety, which is why we stress the importance of interprofessional interactions in this Introduction to Patient Safety Symposium.

Methods: This 4-hour symposium is designed as an introduction to patient safety presented in a classroom setting, with students seated in groups made up of representatives of each health profession. The course revolves around a case scenario presentation of a hypothetical patient who has had his knee replaced and is the victim of a series of …

Adiponectin Inhibits Oxidative/Nitrative Stress During Myocardial Ischemia And Reperfusion Via Pka Signaling., Yanqing Zhang, Xiao-Liang Wang, Jianli Zhao, Ya-Jing Wang, Wayne Bond Lau, Yue-Xing Yuan, Er-He Gao, Walter J. Koch, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

The cardioprotective effects of adiponectin (APN) against myocardial ischemia/reperfusion (MI/R) injury are well known. However, comprehension of the mechanisms mediating intracellular APN signaling remains incomplete. We recently demonstrate the antioxidant/antinitrative effects of APN are not dependent on AMPK. Protein kinase A (PKA) has been previously shown to be activated by APN, with uncertain relevance to APN cardiac protection. The current study determined whether the antioxidative/antinitrative effect of APN is mediated by PKA. Administration of APN (2 μg/g) 10 min before reperfusion significantly enhanced cardiac PKA activity, reduced oxidative stress, and decreased infarct size. Knockdown of cardiac PKA expression (PKA-KD) by …

Full Issue, Vol. 67, Issue 4

Sci-Tech News

No abstract provided.

Engineering Division, Penny Sympson, Jenny Wong Welch, Laura Palumbo, Nancy Flury Carlson

Sci-Tech News

No abstract provided.

Toward A Unifying Taxonomy And Definition For Meditation., Jonathan D Nash, Andrew Newberg, Bhuvanesh Awasthi

Marcus Institute of Integrative Health Faculty Papers

One of the well-documented concerns confronting scholarly discourse about meditation is the plethora of semantic constructs and the lack of a unified definition and taxonomy. In recent years there have been several notable attempts to formulate new lexicons in order to define and categorize meditation methods. While these constructs have been useful and have encountered varying degrees of acceptance, they have also been subject to misinterpretation and debate, leaving the field devoid of a consensual paradigm. This paper attempts to influence this ongoing discussion by proposing two new models which hold the potential for enhanced scientific reliability and acceptance. Regarding …

Comparing The Cumulative Pain Patients Experience Waiting For Knee Arthroplasty To Their Postoperative Pain, Eric S. Schwenk, Richard H. Epstein, Md, Cphims, Franklin Dexter

Department of Anesthesiology Faculty Papers

Introduction: Reduction of pain is a major goal of anesthesiologists treating patients undergoing knee arthroplasty. This has been achieved traditionally through the use of regional analgesia. Although these techniques decrease postoperative pain, they inherently do not affect the longstanding pain patients experience as they wait for surgery. Our objectives were to quantify: 1) the decrease in pain achieved by surgical joint replacement; and 2) the decrease in postoperative pain achievable through femoral nerve blocks versus opioids. From a systems-based perspective, we wanted to determine how much reduction in waiting time before surgery would be necessary to achieve an equal cumulative …

Two Phase 3, Multicenter, Randomized, Placebo-Controlled Clinical Trials Of Fampridine-Sr For Treatment Of Spasticity In Chronic Spinal Cord Injury., D. D. Cardenas, J. F. Ditunno, V. Graziani, A. B. Mclain, D. P. Lammertse, P. J. Potter, M. S. Alexander, R. Cohen, A. R. Blight

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Two randomized, double-blind, placebo-controlled trials.

OBJECTIVE: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI).

SETTING: United States and Canada.

METHODS: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors …

Evidence Based Practice (Ebp) Literature Searching Skills-Part 1 And 2, Patricia Wynne, Bsn, Ms

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Two PowerPoint presentations presented at 8th Annual Nursing Research Conference, Christiana Hospital, Newark Delaware.

Part 1: slides 1-30

Part 2: slides 31-47

The State Of Healthcare For Bhutanese Refugees In South Philadelphia: Challenges & Progress, Sarah Wells

CwiC-PH

Who the Bhutanese Refugees Are ^[1]

• Mid-19^th Century: Nepalese farmers recruited to work farmlands of Southern Bhutan (called Lhotshampa, or “southerners”)
• Lhotshampa retained Nepali and Hindu customs, but lived in peace with the Drukpa (Buddhist elite) majority for many years
• 1989: “One Nation, One People” policy of ethnic cleansing: Drukpa culture imposed on all Bhutanese
• Torture, sexual assault and murder forced over 130,000 Lhotshampa to flee Bhutan
• These refugees spent decades of their lives in camps in Nepal (many still remain there)
• Over 68,000 have resettled to the USA, many coming to South Philadelphia ^[2]

Generating Hypotheses About Care Needs Of High Utilizers: Lessons From Patient Interviews., Dawn B Mautner, Hauchie Pang, Jeffrey C Brenner, Judy A Shea, Kennen S Gross, Rosemary Frasso, Carolyn C Cannuscio

Department of Family & Community Medicine Faculty Papers

Informed by a largely secondary and quantitative literature, efforts to improve care and outcomes for complex patients with high levels of emergency and hospital-based health care utilization have offered mixed results. This qualitative study identifies psychosocial factors and life experiences described by these patients that may be important to their care needs. Semi-structured interviews were conducted with 19 patients of the Camden Coalition of Healthcare Providers' Care Management Team. Investigators coded transcripts using a priori and inductively-derived codes, then identified 3 key themes: (1) Early-life instability and traumas, including parental loss, unstable or violent relationships, and transiency, informed many participants' …

Perspectives Of Older Adults On Co-Management Of Low Back Pain By Doctors Of Chiropractic And Family Medicine Physicians: A Focus Group Study., Kevin J Lyons, Stacie A Salsbury, Maria A Hondras, Mark E Jones, Andrew A Andresen, Christine M Goertz

Department of Medical Genetics Faculty Papers

BACKGROUND: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs and to identify their concerns for receiving care under such a treatment model.

METHODS: We conducted 10 focus groups with 48 older adults who received LBP care in the past year. Interviews explored participants' care seeking experiences, co-management preferences, and perceived challenges to successful implementation of a MD-DC co-management model. We analyzed …

Occupational Exposure To Hepatitis C Virus: Early T-Cell Responses In The Absence Of Seroconversion In A Longitudinal Cohort Study., Theo Heller, Jens Martin Werner, Fareed Rahman, Eishiro Mizukoshi, Yuji Sobao, Ann Marie Gordon, Arlene Sheets, Averell H. Sherker, Ellen Kessler, Kathleen S. Bean, Steven K. Herrine, M'Lou Stevens, James Schmitt, Barbara Rehermann

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: T-cell responses have been described in seronegative patients who test negative for hepatitis C virus (HCV) RNA despite frequent HCV exposure. However, the cross-sectional design of those studies did not clarify whether T cells were indeed induced by low-level HCV exposure without seroconversion or whether they resulted from regular acute infection with subsequent antibody loss.

METHODS: Over a 10-year period, our longitudinal study recruited 72 healthcare workers with documented HCV exposure. We studied viremia and antibody and T-cell responses longitudinally for 6 months.

RESULTS: All healthcare workers remained negative for HCV RNA and antibodies. However, 48% developed proliferative T-cell …

Identifying Barriers To Patient Acceptance Of Active Surveillance: Content Analysis Of Online Patient Communications., Mark V Mishra, Michele Bennett, Armon Vincent, Olivia T Lee, Costas D Lallas, Edouard J Trabulsi, Leonard G Gomella, Adam P Dicker, Timothy N Showalter

Department of Urology Faculty Papers

OBJECTIVES: Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS.

METHODS: English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of …

The Use Of Interpreters To Improve The Quality And Safety Of Healthcare Through Better Communication In Obstetrical Patients: Effect On Primary Cesarean Delivery Rate, Stephen A. Pearlman, Md

Master of Science in Healthcare Quality and Safety Capstone Presentations

Patients with limited English proficiency have poorer healthcare outcomes. An assessment of the cultural and linguistic competency of Christiana Care Health Systems revealed that our language services were not sufficiently robust and this was affecting care. Therefore, the purpose of this quality improvement study was to improve healthcare outcomes, specifically the rate of primary cesarean delivery, through improved language assistance, to patients with limited English proficiency presenting to labor and delivery. The methods employed included use of the TeamSTEPPS program to educate the staff on how to improve safety for patients with limited English proficiency, adding a live Spanish interpreter …

Doing It Well: Education To Promote Satisfaction With Sexual Intimacy For People With Spinal Cord Injury, Allison Duggan, Erin Maniscalco, Dannielle Miccinello, Lauren Pasciuto, Catherine Scaccia

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Physical and psychosocial effects of a spinal cord injury may lead to concerns and difficulty with sexual satisfaction, exploration, and arousal as well as diminished confidence with participation in intimate relationships (Craig Hospital, 2012). Current research indicates a decreased level of satisfaction with participation in sexual intimacy for adults with spinal cord injury (Fisher et al., 2002). Occupational therapists have a key role in the rehabilitation of individuals with spinal cord injury, and sexuality is an area of occupation which falls within our scope of practice (AOTA, 2008). Therefore it is necessary that occupational therapists are assertive in addressing the …

Technology In Practice: Promoting Participation In Patients With High Level Of Spinal Cord Injury, Morgan Gill, Kate Nuschke, Kaitlin O'Sullivan, Casey Puvogel, Alex Sagnor

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Motor impairment often occurs following a spinal cord injury, limiting participation in functional tasks. Although the primary rehabilitative focus is to cure paralysis, not all patients experience full recovery. For those who may not regain complete motor function, rehabilitative interventions are needed to bridge the gap between disability and optimal participation. During rehabilitation, patients prioritize increasing independence and participation in meaningful activities (Rigby, Ryan, & Campbell, 2010). More specifically, regaining arm and hand function was reported as a top priority during treatment for individuals with complete spinal cord injury (Peckham, et al., 2001). Technology has been utilized to improve participation …

Can't Hold Me Back! Constraint-Induced Movement Therapy For Children With Cp: Evidence Based Review, Rebecca Coale, Danni Eisner, Alissa Herman, Sarah Merhaut

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children with cerebral palsy (CP) have various functional impairments impacting participation in meaningful occupations. While Constraint-Induced Movement Therapy (CIMT) is a widely used intervention for adult populations, a modified version of this technique is a relatively new practice in pediatrics (Charles et al., 2006). Occupational therapy intervention, such as CIMT, can support functional goal attainment to enhance participation and quality of life (Boyd et al., 2010). The purpose of this presentation is to synthesize results of a comprehensive evidence-based review and identify treatment characteristics that impact efficacious use of mCIMT on children with hemiplegic CP. Practitioners will learn about best …

Clinical Effectiveness Of Motor Imagery Post-Stroke: An Evidence Based Review, Azadeh Narimanian, Amanda Reese, Karina Ryabo, Rachel Shepp, Annalisa Synnestvedt

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Following a stroke, many individuals experience participation limitations secondary to upper extremity hemiparesis (Shenn & Leishear, 2011). Motor imagery, the mental representation of movement without any body movement, is an evidenced-based intervention to optimize upper extremity function for patients following stroke (Dickstein & Deutsch, 2007). Motor imagery is a readily applicable, safe, and cost-effective intervention that can help clients achieve a variety of occupational goals within diverse environments (Guttman, Burstin, Brown, Bril, & Dickstein, 2012). The purpose of this presentation is to present the results of an evidence-based review examining the use of motor imagery to increase functional outcomes for …

Paws With A Purpose: Evidence Supporting The Use Of Animal Assisted Therapy To Improve Quality Of Life In Adults With Psychiatric Diagnoses, Julia Andraka, Lacey Brinser, Kelly D'Ambrosio, Jordan Justice, Elizabeth Rugen

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Approximately 62.7 million Americans have a psychiatric diagnosis, including Alzheimer’s disease and mental disorders^1,6. Adults who are diagnosed with these conditions experience a variety of limitations, including decreased quality of life⁴. Occupational Therapy (OT) has been shown to be an effective treatment to increase quality of life in adults with psychiatric diagnoses³. Occupational therapists working within the mental health field often need to use creative and innovative approaches to motivate their clients, including Animal-assisted therapy (AAT). AAT is a unique intervention approach that has the potential to improve a person’s emotional, physical, cognitive and …

Transitions For Tomorrow: An Evidence-Based Review Of Post-Secondary Transition Planning For Individuals With Autism, Julie Bardenwerper, James Gillette, Elizabeth Luk, Hilary Moser, Alanna Raffel

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disability in the US other than ADHD (IACC, 2012). Currently, the prevalence of individuals with ASD is estimated to be 1 in 88 in the US (CDC, 2012). Therefore, increasing numbers of children with ASD will age out of high school and transition to postsecondary settings. Individuals with ASD have demonstrated less successful postsecondary outcomes than individuals with other disabilities (Shattuck et al., 2011). Currently, there is limited research supporting the methods of successful transition planning for students with ASD (IACC, 2012). The purpose of this presentation is to introduce the …

Oncogenes And Inflammation Rewire Host Energy Metabolism In The Tumor Microenvironment: Ras And Nfκb Target Stromal Mct4., Ubaldo E. Martinez-Outshoorn, Md, Joseph Curry, Md, Ying-Hui Ko, Md, Zhao Lin, Md, Madalina Tuluc, Md, David Cognetti, Md, Ruth Birbe, Md, Edmund A. Pribitkin, Md, Alessandro Bombonati, Richard Pestell, Md, Anthony Howell, Federica Sotgia, Michael P. Lisanti, Md

Kimmel Cancer Center Faculty Papers

Here, we developed a model system to evaluate the metabolic effects of oncogene(s) on the host microenvironment. A matched set of "normal" and oncogenically transformed epithelial cell lines were co-cultured with human fibroblasts, to determine the "bystander" effects of oncogenes on stromal cells. ROS production and glucose uptake were measured by FACS analysis. In addition, expression of a panel of metabolic protein biomarkers (Caveolin-1, MCT1, and MCT4) was analyzed in parallel. Interestingly, oncogene activation in cancer cells was sufficient to induce the metabolic reprogramming of cancer-associated fibroblasts toward glycolysis, via oxidative stress. Evidence for "metabolic symbiosis" between oxidative cancer cells …

Scott Memorial Library Information Flyer Fall 2013-2014, Education Services

The AC's Research Support Newsletter (Formerly AISR Connections)

Scott Memorial Library information flyer for Fall 2013.

Too Tall For Guatemala, Evan M. Lapinsky, Md

The Medicine Forum

I was clearly out of place. I came to the highlands of Guatemala during my fourth year of medical school to study Spanish, work in a rural clinic, and experience a different way of life. For a month, I lived with a Guatemalan family, ate plantains with every meal, and generally tried to immerse myself in the rich Mayan culture surrounding me. Almost a year later, my Spanish is fading fast. The handful of days I spent in volunteer clinic is a distant memory at this point. Why did I go there again?

I was the epitome of an outsider. …

Leadership Considerations For Executive Vice Chairs, New Chairs, And Chairs In The 21st Century., Elisabeth J.S. Kunkel, Jon A. Lehrmann, Michael J. Vergare, Laura Weiss Roberts

Department of Psychiatry and Human Behavior Faculty Papers

The need to fulfill academic goals in the context of significant economic challenges, new regulatory requirements, and ever-changing expectations for leadership requires continuous adaptation. This paper serves as an educational resource for emerging leaders from the literature, national leaders, and other “best practices” in the following domains: 1. Mentorship; 2. Faculty Development; 3. Promotion; 4. Demonstrating value in each of the academic missions; 5. Marketing and communications; and 6. Barriers

Global Health In The World's Youngest Nation, Masashi Rotte Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Population Health Matters, Spring 2013, Vol. 26, No. 2. Download Full Pdf

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

2013 Commencement For Jefferson School Of Health Professions, Jefferson School Of Pharmacy, And Jefferson School Of Nursing

Jefferson College of Health Professions and Jefferson College of Pharmacy

No abstract provided.

2013 Commencement For Jefferson School Of Health Professions, Jefferson School Of Pharmacy, And Jefferson School Of Nursing

Jefferson College of Nursing Commencements

No abstract provided.

The Karabus Affair Speaks To Larger Issues For American Academic And Medical Centers., Leonard A Zwelling, Md, Mba, Razelle Kurzrock, Md, Philip R Cohen, Md, Bernard Levin, Md, Ch, Lawrence Parish, Md

Department of Dermatology and Cutaneous Biology Faculty Papers

Finally, on March 12, 2013, a major American newspaper, The Wall Street Journal, reported on the plight of Dr. Cyril Karabus (1,2). Dr. Karabus is the 78 year old pediatric oncologist from Claremont, Capetown, South Africa who is well known as the retired head of the Oncology and Hematology Unit of the Red Cross Children’s Hospital, University of Cape Town, as well as for his devoted service to poor children in the apartheid era. In 2002, he cared for a three-year old Yemeni girl with acute myelogenous leukemia during a locum tenens in the United Arab Emirates (UAE).