Digital Commons Network^™

A Neuronal Network Of Mitochondrial Dynamics Regulates Metastasis., M. Cecilia Caino, Jae Ho Seo, Angeline Aguinaldo, Eric Wait, Kelly G. Bryant, Andrew V. Kossenkov, James E. Hayden, Valentina Vaira, Annamaria Morotti, Stefano Ferrero, Silvano Bosari, Dmitry I. Gabrilovich, Lucia R. Languino, Andrew R. Cohen, Dario C. Altieri

Department of Cancer Biology Faculty Papers

The role of mitochondria in cancer is controversial. Using a genome-wide shRNA screen, we now show that tumours reprogram a network of mitochondrial dynamics operative in neurons, including syntaphilin (SNPH), kinesin KIF5B and GTPase Miro1/2 to localize mitochondria to the cortical cytoskeleton and power the membrane machinery of cell movements. When expressed in tumours, SNPH inhibits the speed and distance travelled by individual mitochondria, suppresses organelle dynamics, and blocks chemotaxis and metastasis, in vivo. Tumour progression in humans is associated with downregulation or loss of SNPH, which correlates with shortened patient survival, increased mitochondrial trafficking to the cortical cytoskeleton, greater …

Applying Multiple Data Collection Tools To Quantify Human Papillomavirus Vaccine Communication On Twitter., Philip M. Massey, Amy Leader, Elad Yom-Tov, Alexandra Budenz, Kara Fisher, Ann C. Klassen

Department of Medical Oncology Faculty Papers

BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are several vaccines that protect against strains of HPV most associated with cervical and other cancers. Thus, HPV vaccination has become an important component of adolescent preventive health care. As media evolves, more information about HPV vaccination is shifting to social media platforms such as Twitter. Health information consumed on social media may be especially influential for segments of society such as younger populations, as well as ethnic and racial minorities.

OBJECTIVE: The objectives of our study were to quantify HPV vaccine communication on …

Coexisting Cardiac And Hematologic Disorders., Jordan E. Goldhammer, Benjamin A. Kohl

Department of Anesthesiology Faculty Papers

Patients with concomitant cardiac and hematologic disorders presenting for noncardiac surgery are challenging. Anemic patients with cardiac disease should be approached in a methodical fashion. Transfusion triggers and target should be based on underlying symptomatology. The approach to anticoagulation management in patients with artificial heart valves, cardiac devices, or severe heart failure in the operative setting must encompass a complete understanding of the rationale of a patient's therapy as well as calculate the risk of changing this regimen. This article focuses common disorders and discusses strategies to optimize care in patients with coexisting cardiac and hematologic disease.

Stephen Klein Wellness Center Patient Satisfaction Survey: Development And Preliminary Results, Emily Knudsen-Strong, Msc, Joseph Flaxer, Rickie Brawer, Mph, Phd, Mudit Gilotra, Md, James Plumb, Md, Mph

CwiC Posters

Study design:

•Selected the CAHPS® with Patient Centered Medical Home question set to administer to patients receiving medical care at SKWC (52 questions)

•Included 2 supplemental questions to assess patients’ likelihood to refer others to SKWC

•Developed an additional survey for patients receiving behavioral health services (16 questions)

Participant recruitment and data collection:

•Calculated a target number of 130 participants based on CAHPS® guidelines of 50 surveys per Full Time Employee

•Observed patient flow and developed recruitment strategy for a convenience sample

•Eligibility criteria: patient ≥18 y/o and had a medical appointment in the last 12 months

•Participants were invited …

Barriers To Care Amongst Rural Indigenous Mayans In Guatemala’S Western Highlands, Nirali Butala

CwiC Posters

Information presented here is based on 5-week volunteering experience at Primeros Pasos clinic in the rural Palajunoj Valley outside the city of Quetzaltenango, Guatemala. Almost all of the patient population is rural, indigenous Quiche Maya. Guatemala has a relatively high GDP and patient-doctor ratio (1000:1) compared to its neighboring Latin American countries, but these resources are extremely localized to its capital, Guatemala City, where 70% of the country’s physicians work.

Only the wealthy are able to utilize private clinics and hospitals that are known to provide the highest quality care. At these clinics, patients pay out-of-pocket. Indigenous, rural communities typically …

Jeffhope News-Fall 2016

JeffHOPE News

This issue includes:

• Updates: HCV Testing
• From the Project Director
• New Position: Triage Director
• Clinic at a Glance
• Advocacy Spotlight
• Research at JEFFHope
• Eye screening in an urban homeless shelter
• Contraception
• Self-Reported Indicators for Hepatitis C Virus Screening in JEFFHope Patients
• EKG Study
• Assessing the Need for Dermatological Care and Prevalence of Dermatologic conditions in an urban homeless shelter
• Spotlight on the John Bell Center
• If you had to describe JEFFHope in one word...
• Reflections by Committee Members and Directors
• 2016-2017 JEFFHope Volunteers

Implementing Ipe In Community College Health Professions Programs, Challenges And Rewards, Mary Kay Demarco, Phd, Rn, Cne, Judith Blum, Ms, Otr/L

JCIPE Conference

The health care literature is rich with Interprofessional Education (IPE) and collaborative learning research based in major universities, but similar evidence is limited at the associate degree level. National data indicate that graduates of associate degree allied health and nursing programs account for 49% of the total healthcare workforce (Brookings Institute, 2014)[1]. To improve education for students in its School of Health Professions, The Community College of Baltimore County (CCBC) embarked on a grant-funded mission to infuse interprofessional collaboration into nursing and allied health programs. Faculty attended immersion training programs to learn, evaluate, and adapt different IPE approaches …

Trial To Improve Inter-Professional Practice Behaviors At A Student-Run, Free Clinic, Alexandra Evans, Brian Grice, Steven Horbal, Lauren Wright, Josselyn Howell, Andrea Pfeifle, Edd, Pt, Fnap, Javier Sevilla-Martir, Md, Aurelian Bidulescu, Md, Phd, Mph, Faha

JCIPE Conference

The Indiana University Student Outreach Clinic (IUSOC) is a student-run, free clinic on the east side of Indianapolis. Students from eleven different disciplines (pharmacy, social work, occupational therapy, physical therapy, law, dentistry, global health, optometry, public health, nursing and medicine), covering three institutions (Indiana University, Butler University, and the University of Indianapolis), volunteer at the IUSOC. This study is a randomized-controlled intervention designed to improve inter-professional practice knowledge and behaviors within the IUSOC. On intervention clinic days, all clinic volunteers will gather in a huddle before seeing patients for a structured didactic information session. The session will highlight the importance …

Impact Of Student Experiences In Team-Based Practice In A Student-Run Outreach Clinic, Jennifer Taylor, Dhed, Mph, Andrea Pfeifle, Edd, Pt, Fnap, Paul Porter, Phd, Javier Sevilla-Martir, Md

JCIPE Conference

If trainees from differing health professions work together in a team-based setting to provide quality care to underserved individuals, they may be more inclined to work in an interprofessional collaborative health care team. The purpose of the study was to learn about student experiences at the Indiana University Student Outreach Clinic (IUSOC) as it relates to caring for underserved individuals. The IUSOC is a free clinic run out of the Neighborhood Fellowship Church in Indianapolis, Indiana. The IUSOC clinic provides primary care-based medical services free of charge for the uninsured and underserved within the community. The patient population includes individuals …

Clinical Impact Of A Novel Interprofessional Dental And Pharmacy Student Tobacco Cessation Education Program On Dental Patients, Matthew Boyd, Pharmd Candidate, Jillian Lykon, Pharmd Candidate, Jacqueline M. Theodorou, Pharmd, Bcps, Melissa E. Rotz, Pharmd, Bcps, Shannon Myers Virtue, Psyd, Elizabeth Waldron, Ba

JCIPE Conference

Objectives:

• To compare the difference between IPE care and standard care (SC) groups regarding dental patients' perceptions of knowledge gained about tobacco cessation, intentions to quit tobacco use, and quit attempts at follow-up.

• To evaluate perceptions of IPE care.

Background:

Based on the link between tobacco use and oral health and the frequent contact between dental providers and patients, the dental clinic is an ideal setting to address tobacco use.1

• Many dentists feel unprepared providing tobacco cessation education, particularly pharmacologic treatment options.1-3

• Pharmacists promote safe and effective pharmacologic treatment options for tobacco dependence and patients’ perceptions …

Improving Patient Outcomes And Student Learning Through Interprofessional Collaboration, Lucy Chappee, Rn, Mpa, Sheri Banovic, Rn, Msn, Fnp-Bc

JCIPE Conference

The purpose of this interprofessional collaborative project is to integrate primary healthcare, oral health, exercise science, occupational therapy and mental health services at one site, thus making it a single healthcare destination for patients. This project also provides interprofessional education opportunities to students in these healthcare disciplines. The model is targeted toward underserved populations and focuses on treatment, prevention and health education. This approach not only improves care and long term patient outcomes, but also expands the scope of practice for each professional group involved, including students.

Lewis and Clark’s interprofessional model involves a care team that is integrated into …

Evaluating The Impact Of An Interprofessional Practice Experience Involving Pharmacy And Dental Students On Medication Histories Within An Urban Academic Dental Admissions Clinic, Alexander Radovanovich, Pharmd Candidate, Rachel Von Vital, Pharmd Candidate, Melissa E. Rotz, Pharmd, Bcps, Jacqueline M. Theordorou Pharmd, Bcps, Shannon Myers Virtue Psyd, Chizobam Idahosa, Bds, Dds, Ms, Laurie A. Macphail, Dmd, Phd, Huaqing Zhao, Phd

JCIPE Conference

Primary Objective:

To compare interprofessional (IP) care versus standard care on medication history clarifications in dental patients.

Secondary Objectives:

To assess the clinical significance of these clarifications with regards to the potential impact on dental treatment plans.

To describe the interventions provided by IP care to clarify discrepancies and/or resolve medication-related problems.

Designing And Evaluating An Interprofessional Practice Experience Involving Dental And Pharmacy Students, Melissa Rotz, Pharmd, Bcps, Jacqueline Theodorou, Pharmd, Bcps, Maria Fornatora, Dmd, Chizobam Idahosa, Bds, Dds, Ms, Laurie Macphail, Dmd, Phd, Elizabeth Tweddale, Dmd, Shannon Myers Virtue, Psyd

JCIPE Conference

Purpose: To describe the design and evaluation of an innovative interprofessional practice experience involving pharmacy and dental students.

Background: Accreditation standards for pharmacy and dentistry schools mandate that interprofessional education (IPE) is introduced and practiced throughout the curriculum. There is a paucity of data involving interprofessional practice experiences with dental and pharmacy students.

Description of Program: Pharmacy and dental student-teams conduct health and medication histories for patients seen at Temple University’s dental admissions clinic. Additionally, these teams collaborate to conduct tobacco cessation counseling for current tobacco users. This interprofessional practice experience was designed to prepare students to build more effective …

Development Of A Data Management System To Support Quality Improvement In Ipe, Jennifer Taylor, Dhed, Mph, Andrea Pfeifle, Edd, Pt, Fnap

JCIPE Conference

It is vital to understand best practices in interprofessional education (IPE) that teaches competencies needed to practice collaboratively to improve patient care.¹ Universities are increasingly looking for evidence of their own best practices and a better understanding of the return on investment in IPE. Continuous quality improvement, which seeks to discern what works for addressing a particular problem, for whom, and under what set of specific conditions can support our work in this area but real time and relevant data is needed to support this process.^2,3

The Indiana University Center for Interprofessional Health Education and Practice (CIPHEP) brings …

Medicare At Fifty Years: Impact On Health Care Disparities, Edith P. Mitchell, Md, Facp

JCIPE Conference

Objectives:

• To review history of legislation to development of Medicare program in the United States
• To delineate key Medicare milestones
• To review recent changes in Medicare
• To define impact on disparities

An examination of the history of Medicare and its impact on our ability to deliver patient-centered, interprofessional care.

A description of global interprofessional education and practice, highlighting real world examples from the work of Partners In Health in West Africa and Haiti.

Are Researchers Registering Systematic Reviews In Clinicaltrials.Gov?, Gary E. Kaplan, Ms, Ahip

Academic Commons and Scott Memorial Library Staff Papers and Presentations

BACKGROUND:

ClinicalTrials.gov (CT) is an increasingly important resource for systematic reviewers attempting to identify published and unpublished clinical studies. In addition to clinical studies, however, some searches of the CT database also return systematic reviews (SRs). When I inquired about the SRs appearing in the results, the NLM Help Desk responded that “We do not recommend that systematic reviews be entered in ClinicalTrials.gov, since we only want the results of a clinical trial entered once. However, we will not refuse them if they are entered.” I wanted to find out how many SRs are included, describe their characteristics, and suggest …

Stimulation Of Transforming Growth Factor-Β1-Induced Endothelial-To-Mesenchymal Transition And Tissue Fibrosis By Endothelin-1 (Et-1): A Novel Profibrotic Effect Of Et-1., Peter J. Wermuth, Zhaodong Li, Fabian A. Mendoza, Sergio A. Jimenez

Department of Medicine Faculty Papers

TGF-β-induced endothelial-to-mesenchymal transition (EndoMT) is a newly recognized source of profibrotic activated myofibroblasts and has been suggested to play a role in the pathogenesis of various fibrotic processes. Endothelin-1 (ET-1) has been implicated in the development of tissue fibrosis but its participation in TGF-β-induced EndoMT has not been studied. Here we evaluated the role of ET-1 on TGF-β1-induced EndoMT in immunopurified CD31+/CD102+ murine lung microvascular endothelial cells. The expression levels of α-smooth muscle actin (α-SMA), of relevant profibrotic genes, and of various transcription factors involved in the EndoMT process were assessed employing quantitative RT-PCR, immunofluorescence histology and Western blot analysis. …

Chemical Modification Of Extracellular Matrix By Cold Atmospheric Plasma-Generated Reactive Species Affects Chondrogenesis And Bone Formation., Peter Eisenhauer, Natalie Chernets, You Song, Danil Dobrynin, Nancy Pleshko, Marla J Steinbeck, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

The goal of this study was to investigate whether cold plasma generated by dielectric barrier discharge (DBD) modifies extracellular matrices (ECM) to influence chondrogenesis and endochondral ossification. Replacement of cartilage by bone during endochondral ossification is essential in fetal skeletal development, bone growth and fracture healing. Regulation of this process by the ECM occurs through matrix remodelling, involving a variety of cell attachment molecules and growth factors, which influence cell morphology and protein expression. The commercially available ECM, Matrigel, was treated with microsecond or nanosecond pulsed (μsp or nsp, respectively) DBD frequencies conditions at the equivalent frequencies (1 kHz) or …

Grand Rounds Panel Discussion: Blood Thinners Peri-Operatively: What To Do?, Jad Al Danaf, Md, Anusha Govind, Md, Loheetha Ragupathi, Md, Shuwei Wang, Md

The Medicine Forum

PANELISTS

Mathew DeCaro, MD: Associate Professor of Cardiology, Director of the Coronary Cardiac Unit, Cardiology fellowship program director

John Doherty, MD: Professor of Cardiology

Gregary Markefka, MD: Associate Professor of Cardiology, Associate Director of the Coronary Cardiac Unit, Cardiology fellowship assistant program director

Geno Merli, MD: Professor of Vascular Medicine, Co-director of Jefferson Vascular Center

Srikanth Nagalla, MD, MS: Associate Professor of Medicine, Director, Clinical Hematology

Eric Schwenk, MD: Assistant Professor of Anesthesiology, Director of orthopedic anesthesia

Barry Ziring, MD: Clinical Associate Professor of Internal Medicine / Primary Care, Director of the division …

Jefferson Digital Commons Quarterly Report: April-June 2016, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi, James Copeland, Libt

Jefferson Digital Commons Reports

This quarterly report includes:

• TJU Archives & Special Collections Adds Content to the DPLA
• JDC Feature write-up in The Bulletin and JCIPE Newsletter
• New Dashboard with amazing metrics
• 8th Annual Faculty Day presentations
• Surgery Residents Research Day presentations
• Commencements videos
• CREATE Day Occupational therapy presentations
• Quality and Safety posters and much more
• What People are saying about the JDC

Comprehensive Refugee Health Surveillance In Philadelphia: A Combined Resettlement And Clinical Patient Registry, Colleen Payton, Mph, Ches, Brittany Divito, Mph, Bsn, Rn, Gretchen Shanfeld, Mph, Zoe Agoos, Md, 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.

Goal:

To improve the success of refugee resettlement and health outcomes in Philadelphia by establishing a multi-agency registry with social services and clinical measures.

Expression Of Μ-Protocadherin Is Negatively Regulated By The Activation Of The Β-Catenin Signaling Pathway In Normal And Cancer Colorectal Enterocytes., Lucia Montorsi, Sandra Parenti, Lorena Losi, Fabrizio Ferrarini, Claudia Gemelli, A Rossi, Gianrocco Manco, Stefano Ferrari, Bruno Calabretta, Enrico Tagliafico, Tommaso Zanocco-Marani, Alexis Grande

Department of Cancer Biology Faculty Papers

Mu-protocadherin (MUCDHL) is an adhesion molecule predominantly expressed by colorectal epithelial cells which is markedly downregulated upon malignant transformation. Notably, treatment of colorectal cancer (CRC) cells with mesalazine lead to increased expression of MUCDHL, and is associated with sequestration of β-catenin on the plasma membrane and inhibition of its transcriptional activity. To better characterize the causal relationship between β-catenin and MUCDHL expression, we performed various experiments in which CRC cell lines and normal colonic organoids were subjected to culture conditions inhibiting (FH535 treatment, transcription factor 7-like 2 siRNA inactivation, Wnt withdrawal) or stimulating (LiCl treatment) β-catenin activity. We show here …

A Community College Interprofessional Nurse Managed Center Practice Model, Donna Meyer, Msn, Rn, Anef

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

Lewis and Clark Community College (L&C) has initiated an innovative interprofessional collaborative practice (IPCP) model at its Family Health Clinic (FHC), a nurse managed center, located at the main campus in Godfrey, Illinois. The FHC previously operated successfully for seven years, and has exceeded the projected impact with the numbers of individuals served in the community. The project is innovative and distinctive in providing an IPCP model in that it is inter-institutional, with several of the participating practitioners from institutions other than L&C. The core leadership of the model remains with the nursing professionals at the FHC. It is important …

A Review Of Current Quality Metrics For Evaluating Patient-Centered Medical Homes, Stefan Varga, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

This review sought to explore the quality metrics that are currently utilized to assess PCMHs

Poster presented at 2016 ISPOR conference in Washington DC.

Intraoperative Neurophysiological Monitoring For Endoscopic Endonasal Approaches To The Skull Base: A Technical Guide., Harminder Singh, Richard W. Vogel, Robert M. Lober, Adam T. Doan, Craig I. Matsumoto, Tyler J. Kenning, James J. Evans

Department of Neurosurgery Faculty Papers

Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory …

Integrating Correctional And Community Health Care: An Innovative Approach For Clinical Learning In A Baccalaureate Nursing Program., Mary T. Bouchaud, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

PROBLEM: With an evolving focus on primary, community-based, and patient-centered care rather than acute, hospital-centric, disease-focused care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses need to be prepared from a different and broader knowledge base and skills set. A culture change among nurse educators and administrators and in nursing education is needed to prepare competent registered nurses capable of practicing from a health promotion, disease prevention, community- and population-focused construct in caring for a population of patients who are presenting health problems and conditions that persist across decades …

Treatment Of Dental Complications In Sickle Cell Disease., Priti Mulimani, Samir K. Ballas, Adinegara B L Abas, Laxminarayan Karanth

Cardeza Foundation for Hematologic Research

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in …

Lois Whaley Highsmith, Lois Whaley Highsmith, Kelsey Duinkerken

Jefferson Nursing Oral Histories

After originally studying chemical engineering at Penn State, Lois Highsmith decided to instead pursue nursing. At Jefferson she found a passion for community health nursing, specifically related to obstetrics, gynecology, and maternal child health. Ms. Highsmith graduated in 1986 and over the years worked mostly in maternal care but also in psychology. Among other positions, she worked for ten years at Pennsylvania Hospital where she founded STEPS, Strategies to Encourage Parental Self-Sufficiency, a teen pregnancy clinic, and worked as a home visitor for Mercy Home Health educating new moms about postpartum care. Since 2002 she has worked for Nurse Family …