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Opioid Use In Pelvic Fractures: The Impact Of Opioid Prescribing Laws In Pennsylvania, Nicole Ann Villa, Kristina Shum, Allison Atkinson, Adrian Ong, Alison Muller, Eduardo Espiridion

Tower Health Research Day

No abstract provided.

Effectiveness Of Behavioral Graded Activity In Decreasing Functional Limitations In Older Adults With Lower Extremity Osteoarthritis, Fatou Dieye, Sarah Durham, Devon Fogel, Anastasia Hester, Steph Kim, Ethan Tucker, Borko Rodic

Physical Therapy Student Scholarship

Introduction & Purpose

Osteoarthritis (OA) is the most common joint disease and the leading cause of disability in older adults.1 Physical therapy (PT) offers many benefits for patients with OA. Unfortunately, the long-term outcomes for these patients even after receiving PT treatment may be inadequate.2-7

As a profession, we need to continue to explore treatment strategies to improved quality of life. Behavioral Graded Activity (BGA) could be a treatment strategy to utilize.

Long-Term Effects Of Hvla And Exercise Vs. Exercise Alone For Adults With Chronic Lbp, Alicia Hagan, Ashley Martincek, Kylee O'Hara, Noah Esbenshade, Stefanie Kent, Borko Rodic

Physical Therapy Student Scholarship

Introduction & Purpose

Chronic low back pain is among the leading causes of disability globally and continues to have a high reoccurrence rate within the first year of treatment.

The treatment cost of low back pain has become an increased burden on the healthcare system and patients at an estimated $100 billion per year.

With incidence and economic burden of LBP on the rise, physical therapy has been shown to be an efficient and costeffective treatment.

Previous research shows improvements to pain and function following HVLA mobilization and exercise in short-term outcomes (< 3 months), but there is limited evidence showing the long-term effects (> 6 months.)

PICO: In adults with chronic …

Examining The Effectiveness Of Body-Weight Supported Treadmill Training On Children Under 21 With Cerebral Palsy, Marcus Betzer, Rubin Chavarria, Joel Huck, John Miller, Rony Roman, Summer Schell, Michael Lehr

Physical Therapy Student Scholarship

Introduction & Purpose

Cerebral Palsy is a disorder characterized by abnormal muscle tone, postural dysfunction, gait dysfunction, and abnormal movement patterns.

This disease affects children worldwide, specifically about 2-3 children out of every 1,000 in the USA as well as about 500,000 children under 18 total.

Early intervention for development of gross motor function is highly important when considering improvement in functional capabilities.

The research shows that utilization of body-weight supported treadmill training (BWSTT) in children aged 0-21 with cerebral palsy (CP) is one of the most effective ways in developing gross motor function.

In Patients Post-Stroke, Is Implantable Peroneal Nerve E-Stim More Effective Than Transcutaneous E-Stim In Improving Foot Clearance?, Alvyn Abraham, Aurora Bailey, Elizabeth Kue, Garrett March, Vanessa Quintero, Cynthia Tan, Amy Humphrey

Physical Therapy Student Scholarship

A cerebrovascular accident (CVA) more commonly known as a stroke, is a life changing event resulting in impairments that decrease the quality of life.1 Over 795,000 people each year suffer from a stroke and are affected by resulting impairments and disabilities, of these impairments 20% of those affected by a stroke will acquire foot drop.2 Foot drop is due to paralysis or weakness of the ankle dorsiflexor muscles3,4 and therefore describes the inability to actively raise the toes up required to clear the ground during swing phase, resulting in the toes to drag. Foot drop not only causes abnormal gait …

Virtual Reality Therapy For Fall Prevention In Older Adults A Comparative Study To Conventional Exercise, Isaac Bachert, Graham Brugger, Lauren Demaioribus, Nathan Fritz, Johanna Redick, Carder Smith, Amy Humphrey

Physical Therapy Student Scholarship

Purpose

The purpose of this critically appraised topic is to investigate if VR-HMD interventions have a superseding impact on older adults in preventing falls in comparison to conventional physical therapy balance exercises.

Introduction

• Increases in technology, one of the newest being virtual reality, has positively impacted the world of rehabilitation.
• There are many different types of virtual reality systems that are used, but the most common is the Virtual Reality Head Mounted Display (VR-HMD).
• In the United States, 28% of adults aged 65 and older report falling each year. This is significant because falls are the leading cause of injury-related …

Effectiveness Of Mechanical Versus Manual Traction In Reducing Cervical Radiculopathy Pain And Disability, Kelsey Ader, Nathaniel Apgar, Joel Clabaugh, Cody Frye, Caitlyn Harper, Brian Shenk, Michael Lehr

Physical Therapy Student Scholarship

Purpose

To compare cervical traction methods and determine the most effective method for treating cervical radiculopathy to reduce pain and disability in patients aged 20-70 years old.

Introduction

• Cervical radiculopathy is a common musculoskeletal disorder resulting in pain and disability among patients seeking physical therapy services.
• Radicular pain arising from irritation of cervical spine nerve roots affects approximately one in every thousand individuals and the cost associated with diagnosis and treatment for this condition places a substantial burden on the healthcare system.
• The estimated non-operative cost to an average patient is $1,143 and is often accompanied by up to 10 …

The Prescription Drug Monitoring Program In A Multifactorial Approach To The Opioid Crisis: Pdmp Data, Pennsylvania, 2016–2020, Jenna R. Adalbert, Amit Syal, Karan Varshney, Brandon George, Jeffrey Hom, Asif M. Ilyas

College of Population Health Faculty Papers

Background: Prescription opioids remain an important contributor to the United States opioid crisis and to the development of opioid use disorder for opioid-naïve individuals. Recent legislative actions, such as the implementation of state prescription drug monitoring programs (PDMPs), aim to reduce opioid morbidity and mortality through enhanced tracking and reporting of prescription data. The primary objective of our study was to describe the opioid prescribing trends in the state of Pennsylvania (PA) as recorded by the PA PDMP following legislative changes in reporting guidelines, and discuss the PDMP's role in a multifactorial approach to opioid harm reduction.

Methods: State-level opioid …

Spatiotemporal Correlation Analysis Of Hydraulic Fracturing And Stroke In The United States, Chuanbo Hu, Bin Liu, Shuo Wang, Zhenduo Zhu, Amelia Adcock, James Simpkins, Xin Li

2020-Current year OA Pubs

Hydraulic fracturing or fracking has led to a rapid growth of oil and gas production in the United States, but the impact of fracking on public health is an important but underresearched topic. We designed a methodology to study spatiotemporal correlations between the risk of fracking and stroke mortality. An annualized loss expectancy (ALE) model is applied to quantify the risk of fracking. The geographically and temporally weighted regression (GTWR) model is used to analyze spatiotemporal correlations of stroke mortality, fracking ALE, and nine other socioeconomic- and health-related factors. The analysis shows that fracking ALE is moderately correlated with stroke …

Spatial Analysis Of Health Care Utilization Among Medicare Beneficiaries With Coal Workers’ Pneumoconiosis And Other Related Pneumoconiosis, Ahmed A. Arif, Claudio Owusu, Rajib Paul, Christopher M. Blanchette, Ripsi P. Patel, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The states with the highest number of Medicare beneficiaries with coal workers’ pneumoconiosis (CWP) were Kentucky, West Virginia, Virginia, and Pennsylvania.
• Significant clustering of health care utilization rates for Medicare beneficiaries with CWP was observed in the central Appalachian states of Kentucky, West Virginia, and Virginia.
• Significant clustering of health care utilization rates for Medicare beneficiaries with Other Related Pneumoconiosis was observed in Appalachia and the southeast parts of Texas and Louisiana. This clustering merits additional research to understand underlying disease etiology.

Comparative Analysis Of Salmonella Infantis Cases To Non-Infantis Salmonella Cases In Pennsylvania, Brittany Peterson, Margaret Ulfers, Kelly Kline, Shannon Mcginnis

GW Research Showcase 2021-2024

No abstract provided.

Solving Community Sars-Cov-2 Testing With Telehealth: Development And Implementation For Screening, Evaluation And Testing., Aditi Joshi, Resa E. Lewiss, Maria Aini, Bracken Babula, Patricia C. Henwood

Department of Emergency Medicine Faculty Papers

BACKGROUND: Telehealth has emerged as a crucial component of the SARS-CoV-2 pandemic emergency response. Simply stated, telehealth is a tool to provide health care from a distance. Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19-related concerns.

OBJECTIVE: This study aims to describe the expansion and results of using a telehealth program to increase access to care while minimizing additional potential exposures during the early period of the COVID-19 pandemic.

METHODS: Screening algorithms for patients with SARS-CoV-2-related complaints were created, and 150 new clinicians were trained within 72 hours to address …

We Know Health Is Not Elective: Impacts Of Covid-19., David B. Nash, Mark Angelo, Esther J Nash, Jonathan L Gleason, Bruce A Meyer

College of Population Health Faculty Papers

Several months into the impact of the global COVID-19 pandemic, the authors use the framework of "radical uncertainty" and specific regional health care data to understand current and future health and economic impacts. Four key areas of discussion included are: (1) How did structural health care inequality manifest itself during the closure of all elective surgeries and visits?; (2) How can we really calculate the so-called untold burden that resulted from the closure, with a special emphasis on primary care?; (3) The Pennsylvania experience - using observations from the population of one major delivery ecosystem (Jefferson Health), a major accountable …

Pennsylvania’S Covid-19 Response Vs. Homeland Security Frameworks And Research: Masking The Whole Community, Alexander Siedschlag

Publications

This essay offers an intermediate discussion of select policy, strategic, operational, and tactical issues that demonstrate where and how the Commonwealth of Pennsylvania’s novel coronavirus response on the one hand, and homeland security frameworks and research on the other, converge or—more often so—diverge, and how to narrow this gap. Although typically framed as a pandemic owned by the public health sector, the COVID-19 response falls directly within the homeland security mission space, whose core missions include “Ensuring Resilience to Disasters.” In some respects, Pennsylvania’s response exemplifies best practices suggested by research. In other dimensions, it is neither in line with …

Do Employees From Less-Healthy Communities Use More Care And Cost More? Seeking To Establish A Business Case For Investment In Community Health., Russell K. Mcintire, Martha C. Romney, Greg Alonzo, Jill Hutt, Lauren Bartolome, Greg Wood, Gary Klein, Neil I. Goldfarb

College of Population Health Faculty Papers

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel …

Assessing The Effect Of Patient To Provider Language Discordance On Depression Screening Utilizing The Patient Health Questionnaire: An Epidemiology Study., Luis A. Murillo, Georgi Alex Grekoff, John C. Sheffield

Reading Hospital Family Medicine Residency

Background: As depression screening becomes a standard in primary care, the question remains of how effective and equitable screening can be implemented to avoid cultural and language-related disparities.

Methods: In this retrospective cohort study, rates of depression screening were compared for 3626 adult patients at a family medicine residency-based health centre in Pennsylvania, USA. The PHQ-2/PHQ-9 modality was verbally administered by nursing staff at the time of patient intake as part of a universal screening initiative. Chi-square analysis was used to determine the univariate associations of performed depression screening with variables of language, ethnicity, gender and number of office visits. …

Assessing The Effect Of Patient To Provider Language Discordance On Depression Screening Utilizing The Patient Health Questionnaire: An Epidemiology Study., Luis A. Murillo, Georgi Alex Grekoff, John C. Sheffield

Reading Hospital Family Medicine Residency

Background: As depression screening becomes a standard in primary care, the question remains of how effective and equitable screening can be implemented to avoid cultural and language-related disparities.

Methods: In this retrospective cohort study, rates of depression screening were compared for 3626 adult patients at a family medicine residency-based health centre in Pennsylvania, USA. The PHQ-2/PHQ-9 modality was verbally administered by nursing staff at the time of patient intake as part of a universal screening initiative. Chi-square analysis was used to determine the univariate associations of performed depression screening with variables of language, ethnicity, gender and number of office visits. …

Advocating For Support For Families Of Pregnant And Parenting Women Impacted By The Opioid Crisis In Pennsylvania, Caitlin Weiss, Rosemarie Halt, Rph, Mph

Phase 1

Introduction:

The perinatal period is a key opportunity for intervention for families impacted by opioid use disorder (OUD). However, in 2016 only 7.6% of treatment facilities in PA offered childcare for parents receiving treatment and only 2.8% of residential facilities offered beds for clients’ children.

Objective:

The purpose of this project was to understand the magnitude of the opioid crisis as it affects pregnant women and their children in PA as well as what avenues exist to advocate for policy changes to better support their recovery.

Methods:

1. A policy brief was prepared for the Maternity Care Coalition (MCC) using …

Mining For Voices: Reframing Hydraulic Fracturing As A Public Health Issue, Benjamin Chipkin, Ms, Pouné Saberi, Md, Mph

Phase 1

Introduction: Hydraulic fracturing extracts fossil fuels from rock formations by injecting chemicals underground. While 80% of studies demonstrate risks or actual harms to health from fracking, Pennsylvania does not require chemical disclosures. Fracking accelerates climate change, a phenomenon linked to increases in health emergencies. With 1.6 million Pennsylvanians living within 1 mile of active oil or gas development sites, there is considerable risk. In 2012, Pennsylvania banned physicians from discussing health impacts of fracking, an order struck down in 2016. Following the gag order, deficits in physician knowledge and urgency may remain around fracking. Outlining a precautionary approach to fracking …

Myocardial Dysfunction After Out-Of-Hospital Cardiac Arrest: Predictors And Prognostic Implications., Yuan Yao, Nicholas James Johnson, Sarah Muirhead Perman, Vimal Ramjee, Anne Victoria Grossestreuer, David Foster Gaieski

Department of Emergency Medicine Faculty Papers

We aim to determine the incidence of early myocardial dysfunction after out-of-hospital cardiac arrest, risk factors associated with its development, and association with outcome. A retrospective chart review was performed among consecutive out-of-hospital cardiac arrest (OHCA) patients who underwent echocardiography within 24 h of return of spontaneous circulation at three urban teaching hospitals. Our primary outcome is early myocardial dysfunction, defined as a left ventricular ejection fraction < 40% on initial echocardiogram. We also determine risk factors associated with myocardial dysfunction using multivariate analysis, and examine its association with survival and neurologic outcome. A total of 190 patients achieved ROSC and underwent echocardiography within 24 h. Of these, 83 (44%) patients had myocardial dysfunction. A total of 37 (45%) patients with myocardial dysfunction survived to discharge, 39% with intact neurologic status. History of congestive heart failure (OR 6.21; 95% CI 2.54-15.19), male gender (OR 2.27; 95% CI 1.08-4.78), witnessed arrest (OR 4.20; 95% CI 1.78-9.93), more than three doses of epinephrine (OR 6.10; 95% CI 1.12-33.14), more than four defibrillations (OR 4.7; 95% CI 1.35-16.43), longer duration of resuscitation (OR 1.06; 95% CI 1.01-1.10), and therapeutic hypothermia (OR 3.93; 95% CI 1.32-11.75) were associated with myocardial dysfunction. Cardiopulmonary resuscitation immediately initiated by healthcare personnel was associated with lower odds of myocardial dysfunction (OR 0.40; 95% CI 0.17-0.97). There was no association between early myocardial dysfunction and mortality or neurological outcome. Nearly half of OHCA patients have myocardial dysfunction. A number of clinical factors are associated with myocardial dysfunction, and may aid providers in anticipating which patients need early diagnostic evaluation and specific treatments. Early myocardial dysfunction is not associated with neurologically intact survival.

Castillo, Jesse (Fa 983), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 983. Project titled: “Folklore Collection.” Includes survey sheets with brief descriptions of folk remedies, sayings, and ghost stories from Warren County, Kentucky, Pennsylvania and Texas.

Public Reporting Of Cardiac Surgery Outcomes In Pennsylvania: A 20 Year Personal Perspective, Raymond Singer, Md, Mmm, Cpe

Raymond L Singer MD

This forum presentation will describe the national trends of public reporting, pay for performance, and related health care reform measures as well as describe both the intended and unintended consequences of public reporting of cardiac surgery outcomes. PowerPoint slides attached below: 65 slides Presentation: 51 minutes

Right Ventricular Dysfunction After Resuscitation Predicts Poor Outcomes In Cardiac Arrest Patients Independent Of Left Ventricular Function., Vimal Ramjee, Anne V. Grossestreuer, Yuan Yao, Sarah M. Perman, Marion Leary, James N. Kirkpatrick, Paul R. Forfia, Daniel M. Kolansky, Benjamin S. Abella, David F. Gaieski

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Determination of clinical outcomes following resuscitation from cardiac arrest remains elusive in the immediate post-arrest period. Echocardiographic assessment shortly after resuscitation has largely focused on left ventricular (LV) function. We aimed to determine whether post-arrest right ventricular (RV) dysfunction predicts worse survival and poor neurologic outcome in cardiac arrest patients, independent of LV dysfunction.

METHODS: A single-center, retrospective cohort study at a tertiary care university hospital participating in the Penn Alliance for Therapeutic Hypothermia (PATH) Registry between 2000 and 2012.

PATIENTS: 291 in- and out-of-hospital adult cardiac arrest patients at the University of Pennsylvania who had return of spontaneous …

Decriminalizing Mental Illness: The Need For Treatment Over Incarceration Before Prisons Become The New Asylums For The Mentally Ill, Rebecca L. Brown

Psychology Summer Fellows

Currently, US prisons are home to 10 times more mentally ill individuals than state psychiatric hospitals. Instead of treating those with mental illness, an extremely vulnerable population is being thrown behind bars. Mental illness is often exacerbated during incarceration, leaving inmates much sicker than when they entered. Moreover, upon discharge mentally ill inmates have virtually no support, making recidivism almost inevitable. This lack of treatment has devastating consequences for the mentally ill as well as the community at large. Removing the mentally ill from jails and prisons would reduce recidivism, increase public safety and save money.

The current research explores …

African American Men With Low-Grade Prostate Cancer Have Increased Disease Recurrence After Prostatectomy Compared With Caucasian Men., Kosj Yamoah, Curtiland Deville, Neha Vapiwala, Elaine Spangler, Charnita M. Zeigler-Johnson, Bruce Malkowicz, David I Lee, Michael Kattan, Adam P. Dicker, Timothy R. Rebbeck

Department of Radiation Oncology Faculty Papers

PURPOSE: To explore whether disparities in outcomes exist between African American (AA) and Caucasian (CS) men with low-grade prostate cancer and similar cancer of the prostate risk assessment-postsurgery (CAPRA-S) features following prostatectomy (RP).

METHODS: The overall cohort consisted of 1,265 men (234 AA and 1,031 CS) who met the National comprehensive cancer network criteria for low- to intermediate-risk prostate cancer and underwent RP between 1990 and 2012. We first evaluated whether clinical factors were associated with adverse pathologic outcomes and freedom from biochemical failure (FFbF) using the entire cohort. Next, we studied a subset of 705 men (112 AA and …

Promoting Your Institutional Repository On And Off Campus, Daniel G. Kipnis, Msi

Daniel G. Kipnis

Webinar presentation for Association for Library Collections and Technical Services.

The Effect Of Required Ipads On Library Use, Gary Kaplan, Mslis, Dorothy Berenbrok, Mslis, Daniel G. Kipnis, Msi, Helena Washington, Mls

Daniel G. Kipnis

OBJECTIVES Measure the impact on Library use of a new requirement by anaccelerated, one-year nursing program that all students haveiPads loaded with the required texts and determine whether theLibrary should continue offering these books in print. Poster presented at Medical Library Association Annual Conference, Seattle, WA 2012.

Striving For Cultural Competence In An Hiv Program: The Transformative Impact Of A Microsystem In A Larger Health Network, Judith N Sabino, Timothy Friel, Lynn Deitrick, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Slides: Public Health Research On Near O&G Development: Challenges And Needs, John L. Adgate

Water and Air Quality Issues in Oil and Gas Development: The Evolving Framework of Regulation and Management (Martz Summer Conference, June 5-6)

Presenter: John L. Adgate, PhD, MSPH, Professor and Chair, Department of Environmental and Occupational Health, University of Colorado

19 slides

Family Presence During Trauma Resuscitation: Ready For Primetime?, Mae Pasquale, Michael Pasquale, Leslie Baga, Sherrine Eid, Jane Leske

Michael D Pasquale MD, FACS, FCCM

BACKGROUND: The concept of family presence during trauma resuscitation (FPTR) remains controversial. Healthcare providers have expressed concern that resuscitation of severely injured trauma patients is inappropriate for family members as they may have psychologic distress, disrupt resuscitative efforts, or misinterpret provider actions, which can ultimately impact satisfaction with care. The minimal evidence that exists is descriptive or anecdotal.

METHODS: Using a previously developed FPTR protocol, a prospective, comparative study assessing 50 adult family members, who were present (n = 25) or not present (n = 25) with their severely injured adult family member during resuscitation, was conducted. Family member anxiety …