Medicine and Health Sciences Commons^™

Genomics In Primary Care: The Promise Of Personalized Medicine, Heather B. Fagan Md, Mph, Brian Stello Md, Christopher V. Chambers Md, Melanie B. Johnson Mpa, Geoffrey Mills Md, Phd, Michael P. Rosenthal Md

Department of Family Medicine

No abstract provided.

Diabetes Care Management During Cancer Treatment, Gregory R. Harper Md, Phd, Janelle M. Sharma Dnp, Crnp, Cara Habeck Rn, Cde, Cathy A. Coyne Phd, Mph, Hope Kincaid Mph, Cph, Roya Hamadani Mph, Ada M. Rivera Mba, Cph, Gretchen Perilli Md, Nicole R. Sully Do

Department of Family Medicine

No abstract provided.

Modified Cage As A Screening Tool For Mechanical Fall Risk Assessment: A Pilot Survey, Marna R. Greenberg Do, Mph, Facep, Michael Nguyen Md, Bernadette Gl-Porter Bs, Robert D. Barraco Md, Brian Stello Md, Arnold R. Goldberg Md, Clare M. Lenhart Phd, Mph, Anita Kurt Phd, Rn, Bryan G. Kane Md

Department of Emergency Medicine

Modified CAGE as a Screening Tool for Mechanical Fall Risk Assessment: A Pilot Survey

Marna Rayl Greenberg DO, MPH, Michael C Nguyen MD, Bernadette G Porter BA,Robert DBarraco, MD MPH, Brian Stello MD, Arnold Goldberg MD, Clare M Lenhart, PhD MPH,Anita Kurt PhD, RN, Bryan G Kane, MD

Background: Falls in the elderly cause serious injury. The literature does not hold answers to patient perceptions about their personal fall risk, their comfort level in discussing their fall history, or a home safety plan with their healthcare provider. Existing risk-assessing tools may be prohibitive in the Emergency Department due to their …

Further Discussion On The Treatment Of Hypertension, Jessica Kim Md

Family Medicine Scholarly Works

Hypertension is a common primary care problem with guidelines to help with management, however recent studies have shown there may be important considerations in blood pressure management. Blood pressure varies during different times of day, and one summarized study showed significant benefits to taking blood pressure medications at bedtime on major cardiovascular events. In addition, individual variation in blood pressure may also pose a difference in stroke risk and certain medications address this variation better than others. A systematic review and meta-analysis are summarized that address these issues.

Impact Of Postpartum Anxiety And Depression On Child’S Mental Development From Two Peri-Urban Communities Of Karachi, Pakistan: A Quasi-Experimental Study, Niloufer Sultan Ali, Sadia Mahmud, Asia Khan, Badar Sabir Ali

Department of Family Medicine

Background

Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children’s mental development on all sub-scales in a Pakistani population.

Methods

A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children’s growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family …

Improvement In Access And Equity For Maternal And Neonatal Health Services: Comparative Advantages Of Contracted-Out Versus Non-Contracted-Out Facilities, Shehla Zaidi, Fauziah Rabbani, Iqbal Azam Syed, Atif Riaz, Peter Hatcher, Gul Nawaz Khan Nawaz Khan, Nousheen Pradhan, Hassan Fazli, Shiraz Shaikh, Yasmeen Khan, Syeda Nida Naim, Unaib Rabbani

Community Health Sciences

No abstract provided.

Asthma, Alicia Jacobs Md

Family Medicine Scholarly Works

Improving asthma management includes improving provider education on asthma management, operational use of spirometry, provider competency in spirometry interpretation and use of a chronic disease platform in our electronic medical record to ensure adherence to current national guidelines. Key concepts in improving clinical asthma management are reviewed.

Adolescent Prescription Drug Abuse: An Overview Of Current Data, Tavis Cowan Md

Family Medicine Scholarly Works

Prescription drug abuse among adolescents is a growing and increasingly lethal problem. Recent survey studies show a concerning increase in abuse and poor awareness among users, parents, and medical providers. Access to prescription drugs of abuse is often through relatives’ supply of medications. Categories of abused drugs include opiates, stimulants, and benzodiazepines. Methamphetamine is a special case as prescription-only pseudoephedrine can drastically change patterns of abuse. Awareness programs are emerging for youths, parents, community members, and medical providers; but data on effectiveness of these interventions is not yet available.

Adolescent Health, Nellie Wirsing Md, Clara Keegan Md

Family Medicine Scholarly Works

Overview on adolescent health including a basic approach to dealing with this patient population, risk assessment / risk-directed care, and evidence-based adolescent care.

Beta-Blocker Use And Clinical Outcomes In Stable Outpatients With And Without Coronary Artery Disease, Elena Simon Md

Family Medicine Scholarly Works

Clinical Question: Which patients should be placed/kept on beta-blocker therapy?

Bottom Line Answer:

• Randomized control trials show beta-blockers benefit patients with systolic congestive heart failure and for the first three years after a patient has a MI.
• Beta-blocker use may not be associated with lower event rates of CV death, non-fatal MI, stroke of hospitalization in patients even with prior history of MI after 3 years.

Healthcare Delivery System Improvements: A Way Forward To Improve Health In Developing Countries And Pakistan, Waris Qidwai

Department of Family Medicine

No abstract provided.

Patients With Disabilities As Teachers (P-Dat) Training In Medical Education, Rebecca Royce-Hickey Do, Sweety Jain Md, Susan E. Hansen Ma, Nyann Biery Ms

Department of Family Medicine

No abstract provided.

Increasing Health Care Costs And Its Adverse Impact On Healthcare, Waris Qidwai

Department of Emergency Medicine

No abstract provided.

Public Private Partnerships For Improving Maternal And Neonatal Health Service Delivery A Review Of The Evidence, Shehla Zaidi, Rehana Salam, Zulfiqar Ahmed Bhutta, Shahid Ansari, Syeda Subika Rizvi, Beenish Fatima Zehra, Amin Pethani

Community Health Sciences

No abstract provided.

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

Compliance For Latent Tuberculosis Infection Treatment Among Incoming Refugees At Jefferson Center For Refugee Health, Elizabeth Bates, Marc Altshuler, Md, Kevin Scott, Md

CwiC-PH

80% of active TB cases in the US originate from reactivation of Latent Tuberculosis Infection (LTBI), identifying treatment of LTBI as a public health imperative. All incoming refugees at the Jefferson Center for Refugee Health (JCRH) are screened for LTBI upon arrival. Incidence of LTBI and compliance rates were assessed using a retrospective chart review and analysis of prescription refill records. The study showed 23.1% of incoming refugees were diagnosed with LTBI. Once treatment was initiated, only 33.1% were completed, while 56.2% were lost to follow up. Nepali women showed the highest rates of adherence, while Iraqi women and Burmese …

The Contribution Of Schizophrenia To Homelessness: Analysis Of The Housing First Model And Possible Prevention Of Serious Mental Illness, Elijah Grillo

CwiC-PH

The Problem

• 2.6 million schizophrenics in the US accounting for more inpatient treatment days than any other medical illness (national cost: $62 billion/year).

• 6% (~160,000) are homeless or live in shelters

• Make up 36% of the 700,000 homeless individuals in the US.

Asthma Questionnaire For An Immigrant Chinese Population, Ho-Hin Choy, Whitney Shiau, Md, Audrey Lung Md, Faap

CwiC-PH

Asthma is a key public health problem for the pediatric population of the United States. 7 million children in the United States have been diagnosed with asthma at some point in their lives (1). Asthma remains a disease that occurs in higher rates among minority populations. Those living in inner-city environments are most at risk. A study performed in an inner-city area of Boston, MA showed that 16% of an Asian American school age population had previously diagnosed asthma with an additional 3% having possible undiagnosed asthma (2). Northeast Medical Services (NEMS), a federally qualified community health center (FQHC), serves …

Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox

CwiC-PH

• Assessed needs and looked for solutions that are
• Executed and maintained locally Income-generating
• Provided skills trainings to CHWs on these topics
• Help initiate projects using these skills
• These projects show some modest continuing success

Helping Refugees Navigate The Health Care Maze, Jenna Fox, Andy Kay

CwiC-PH

Jenna’s main focus during her Bridging the Gaps assignment at NSC was an outcomes assessment for use in grant applications. Her side projects included client service and education development

Increasing Human Papillomavirus (Hpv) Vaccination Rate Among Adolescent And Young Adult Males In A Primary Care Setting, Michele Fascelli, Anna Marie Quinn, Amy Leader, Christopher Chambers

CwiC-PH

Study Purpose:

To increase HPV vaccination rates among adolescent males through the use of an informational aid designed to increase knowledge and favorable attitudes about HPV vaccination.

Evaluate the educational aid for feasibility of use in a primary care setting, interest among patients for participating, and increases in intentions to vaccinate among patient and providers.

The Current State Of Health Care In China, Jonathan Yadlosky

CwiC-PH

After decentralizing health management in the early 1980s, China’s health care system developed many of the problems that we in the United States are currently working to solve. Though China is literally on the other side of the world, I think we might learn a few very important lessons from a close look at their successes, failures, trends, and goals in health care administration and delivery.

Wellbody Alliance, Sierra Leone, Kevin Rurak

CwiC-PH

Pharmacy Project:

Inventory database development

• Streamlined tracking of daily and monthly drug dispensing
• New database to plan requisitions based on trends

Jeffhealth Soil-Transmitted Helminths, David Maniscalco

CwiC-PH

Soil-transmitted helminth (STH) infections are known to be a significant problem in Rwanda. The Ministry of Health and individual villages are aware of its impact on people’s health and well-being as well as its impact on the country’s economy. The goal of the JeffHEALTH project is to educate poor, rural villages in Rwanda so that village members can take the knowledge they gain, put it into practice and share this knowledge with generations to come.

Integrated Medical Pluralism To Sustain Health Care In The Indian Trans-Himalayas, Jane Babiarz

CwiC-PH

Inadequate health care delivery in the Indian trans-Himalayas arises from the harsh landscape and climate, poverty, the inaccessibility of health care centers, and a burden of chronic diseases and preventable acute illnesses that exceeds the number of traditional healers in the region. Systematizing a pluralistic healer network that integrates NGOs, international health organizations, mobile camps, district clinics, and traditional healers could address the issue of sustaining health care in this region. The backbone of this strategy would be a pre-existing resource relied upon by public and private health organizations: community health workers.

Continued Clinic Staff Education, Joseph S. Hong

CwiC-PH

Improving patient care by providing teaching sessions to hospital and clinic staff. The staff include medical assistants, technicians, and front office staff. The desired result would be to create an environment of scientific curiosity and improved understanding, for what the patients are dealing with. Thereby improving empathetic care when interacting with the patient.

Analysis Of Importance Of Implementing Spiritual Assessment And Care Of Patients In Clinical Settings, You Na Park

CwiC-PH

Health professionals need to take care of patients’ spirituality, evaluate various spiritual approaches from both professional and public voices, and address concerns and potential conflicts in meeting the patients’ spiritual needs. There is a number of strategies and solutions to addressing the concerns of spiritual assessments and management of the patients in clinical setting.

Where Are They Now? Understanding How Src Directorship Influences Medical Student Career Trajectories And Outcomes Post-Graduation, Anita Modi,, Ann Vale, James D. Plumb, Md, Mph

CwiC-PH

JeffHOPE, a student-run clinic (SRC) designed to empower and care for Philadelphia's underserved population, was established in 1991 by the students of Jefferson Medical College. Since its inception, the program has been led by over 100 student directors, who oversee each of the five JeffHOPE clinics staffed by fellow medical students every week. But where are the directors now, and how did their leadership experiences caring for the underserved influence their career trajectories? Through the administration of a 20-question survey, we aimed to explore the experiences and accomplishments of medical student directors throughout the 20-year history of JeffHOPE, as well …

Adolescent Sexual And Reproductive Health: Interviewing Skills, Clara Keegan Md, Nellie Wirsing Md

Family Medicine Scholarly Works

Objectives

Increase comfort with discussion of sexual health topics relevant to adolescents: sexual history, contraception, sexually transmitted infections, options counseling, coming out.

Begin to apply motivational interviewing techniques to the adolescent population.

Missing The Boat: Odds For The Patients Who Leave Ed Without Being Seen, Jabeen Fayyaz, Munawar Khursheed, Mohammed Umer Mir, Amber Mehmood

Department of Emergency Medicine

BACKGROUND:

A patient left without being seen is a well-recognized indicator of Emergency Department overcrowding. The aim of this study was to define the characteristics of LWBS patients, their rates and associated factors from a tertiary care hospital of Pakistan.

METHODS:

A retrospective patient record review was undertaken. All patients presenting to the Aga Khan University Hospital, Karachi, between April and December of the year 2010, were included in the study. Information was collected on age, sex, presenting complaints, ED capacity, month, time, shift, day of the week, and waiting times in the ED. A basic descriptive analysis was made …