Medicine and Health Sciences Commons^™

Patient-Reported Outcome Measures-Challenges And Opportunities For China., Donald E Casey

College of Population Health Faculty Papers

No abstract provided.

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial., Melissa S Bauserman, Carla M Bann, K Michael Hambidge, Ana L Garces, Lester Figueroa, Jamie L Westcott, Jackie K Patterson, Elizabeth M Mcclure, Vanessa R Thorsten, Sumera Ali Aziz, Sarah Saleem, Robert L Goldenberg, Richard Derman, Veena Herekar, Manjunath Somannavar, Marion W Koso-Thomas, Adrien L Lokangaka, Antoinette K Tshefu, Nancy F Krebs, Carl L Bose, Shivaprasad Goudar, Sangappa Dhaded, Bhalchandra Kodkany, Omrana Pasha, Abhik Das, Menachem Miodovnik, N K Raju Tonse

Global Health Articles

BACKGROUND: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.

OBJECTIVE: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.

METHODS: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Common Concerns, Barriers To Care, And The Lived Experience Of Individuals With Hepatitis B: A Qualitative Study., Catherine Freeland, Sean Farrell, Priyanka Kumar, Maureen Kamischke, Michaela Jackson, Sierra Bodor, Timothy M Block, Rosemary Frasso Phd, Msc, Cph, Chari Cohen

College of Population Health Faculty Papers

BACKGROUND: An estimated between 257 and 292 million people live with chronic HBV globally. While much is known about the causes, and epidemiology of HBV, little is understood about the quality of life and impact of HBV on those living with the infection.

METHODS: A random sample of HBV-related email queries sent to the Hepatitis B Foundation, a U.S.-based non-profit organization, over a 12-month period in 2018-2019 were retrieved, tabulated, and analyzed qualitatively to highlight information needs and explore the experiences of people living with HBV and their families and loved ones. Codebook development was informed by the literature and …

The Human In The Middle: Artificial Intelligence In Health Care Summary Proceedings Symposium Presentation And Reactor Panel Of Experts Thomas Jefferson University December 10, 2019., Janice L. Clarke, Alexandria Skoufalos, Steven Klasko, Md, Mba

College of Population Health Faculty Papers

No abstract provided.

Reduction In Unplanned Hospitalizations Associated With A Physician Focused Intervention To Reduce Potentially Inappropriate Medication Use Among Older Adults: A Population-Based Cohort Study., M Alcusky, R B Thomas, N Jafari, Scott W Keith, A Kee, S Del Canale, M Lombardi, Vittorio Maio

College of Population Health Faculty Papers

BACKGROUND: A multimodal general practitioner-focused intervention in the Local Health Authority (LHA) of Parma, Italy, substantially reduced the prevalence of potentially inappropriate medication (PIM) use among older adults. Our objective was to estimate changes in hospitalization rates associated with the Parma LHA quality improvement initiative that reduced PIM use.

METHODS: This population-based longitudinal cohort study was conducted among older residents (> 65 years) using the Parma LHA administrative healthcare database. Crude and adjusted unplanned hospitalization rates were estimated in 3 periods (pre-intervention: 2005-2008, intervention: 2009-2010, post-intervention: 2011-2014). Multivariable negative binomial models estimated trends in quarterly hospitalization rates among individuals at …

Health Design Thinking: An Innovative Approach In Public Health To Defining Problems And Finding Solutions, Sylvie Abookire, Colin Plover, Phd, Rosemary Frasso Phd, Msc, Cph, Bon Ku

College of Population Health Faculty Papers

No abstract provided.

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Peer Assessments May Predict Objective Long-Term Academic Performance, Noah Christian, Yousif Hanna, John Spandorfer, Md

Phase 1

Introduction: A common challenge in medical education is to create a curriculum that both teaches the required material but still delivers a personable physician. In this data study, 673 Sidney Kimmel Medical College (SKMC) students were given a required survey to judge their group members on personal attributes ranging from preparedness to affability. These scores were used to aid students and hopefully prevent unfortunate habits from settling. We hypothesize that peer assessments will predict academic performance.

Methods: A five-question, Likert scale, peer assessment was given to each first-year medical student at SKMC. The electronic survey was given twice during the …

Knowledge, Attitudes, And Beliefs About Sexual Health And Behavior In Huye, Rwanda, Sara Charles, Lianna Drobatz, Ryan Dorey

Phase 1

Introduction: Pregnancy and its associated complication is the leading cause of death for women aged 15-19 worldwide. Teenage pregnancy is correlated with increased health complications, death, poverty, and societal stigma. Pregnancy in Rwanda has been documented at rates of 7% among teen women.

Objective: The objectives of this research study include assessing the attitudes, knowledge, and beliefs of adolescents in the Huye District of Rwanda regarding sexual health and behavior. We hypothesize that gaps in sexual health knowledge may exist and that differing beliefs among male and female adolescents affect adolescent sexual decision making, and, therefore, teenage pregnancy prevalence.

Methods: …

Successes And Limitations Of Hepatitis C Screening In The Inpatient Setting: Initial Impact Of Pa Act Of 87 (Apha Roundtable Discussion), Madalene Zale, Mph Candidate, Ashley Park, Mph, Francis Nelson, Ms, Priya Mammen, Md, Mph

College of Population Health Lectures, Presentations, Workshops

The Problem:

• Estimated 3.2 million in US with chronic HCV; Baby Boomers 5 times more likely to be infected compared to other cohorts
• Complex nature of HCV requires confirmation of HCV Ab screens to determine management and treatment needs.

Round table held at 2017 Annual APHA meeting in Atlanta, Georgia

Reaching High-Risk Patient Populations Through Emergency Department Opt-Out Hiv Testing: A Retrospective Chart Review, Tyler G. Boyce, Ba, Priya Mammen, Md, Mph

CwiC Posters

Specific Aims and Hypotheses:

This study aimed to identify socioeconomic (SE), sexual, and other risk factors (RFs), among patients diagnosed with HIV infection through an emergency department-based opt-out HIV screening program, and to examine trends in intravenous drug use (IVDU) as a RF.

• H1: Unsafe sexual practices are the most commonly reported RF.
• H2: Role of IVDU as a RF has increased over the time period studied.

Poster presented at 2017 APHA conference in Atlanta Georgia.

Borders And Blood Pressure: Understanding The Role Of Acculturation In A Hypertension Diagnosis Among Hispanic Americans: 2014 California Health Interview Survey, Lia Scalzo, Mph, Hee-Soon Juon, Phd, Msn, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background:

In the U.S. Hispanic population overall, heart disease is the leading cause of death. The prevalence of hypertension among Mexican American immigrants is lower than the general population, yet it is on the rise. Health risks among Hispanics vary depending on their length of stay in the US (as proxy measure of acculturation). The purpose of this study was to examine the association between acculturation and the individual's likelihood of being diagnosed with hypertension among Hispanic Americans.

Methods:

We used data from the 2014 California Health Interview Survey (CHIS) and performed univariate analysis to examine racial differences in prevalence …

Climate Change And Resulting Floods: Using Social Capital To Strengthen Community Resilience In Eastwick, Philadelphia A Known Floodplain, Natasha Bagwe, Md, Mph, Richard Pepino, Phd, Mss, Erin Johnson, Mph, Msn, Rn, Julie Becker, Phd, Mph

College of Population Health Posters

• Climate change will produce intense weather events like increased precipitation and flooding

• Based on climate projections, Philadelphia will be hotter and wetter, and will experience more frequent and intense weather events (OOS, 2016)

•Floods are the second most common hazards in our city (OEM, 2017)

• Vulnerable population such as children, people of color, elderly population and people with disability are severely impacted by climate change

Poster presented at AHPA conference in Atlanta Georgia, United States.

Leading Causes Of Death In Vietnam, Lindsey Roth

CwiC Posters

Vietnam is currently facing a public health crisis. Rates of chronic and preventable diseases are climbing, in addition to mortality rates from these diseases. If nothing is done to halt these rising rates, the health of the Vietnamese people will only continue to decline. Although there may be many factors contributing to these high death rates due to chronic diseases, risky health behaviors, such as smoking, and the state of the healthcare system can be considered two main contributors to the leading causes of death in Vietnam. The high smoking rates and high costs of healthcare are hindering the health …

Initiating C.H.E.W. At Maternity Care Coalition, Haley Wicklum, Rickie Brawer, Mph, Phd

CwiC Posters

The purpose of this project is to provide access to healthy and affordable foods to the families involved in Maternity Care Coalition’s Early Head Start program as means to reduce obesity in the 0-3 year old children. Implementing the C.H.E.W. (Cultivating Healthy Eating and Wellness) program, which includes a new food buying club where families can access healthy food at whole sale prices as well as nutrition education workshops throughout the year, will provide access to the healthy and affordable foods needed. The program is focused on pregnant women and young families with children 0-3 years of age to attempt …

Delaware Health Sciences Alliance Global Health Symposium: Refugee And Immigrant Access To Care Locally And Globally

Global Health Events

Welcome to the 6th annual Global Health Symposium! As always, we are pleased to highlight the latest in our growing Global Health interests across the DHSA. The Delaware Health Sciences Alliance is a partnership of:

• Christiana Care Health System
• Jefferson Philadelphia University & Thomas Jefferson University
• Nemours / Alfred I. duPont Institute for Children
• University of Delaware

Aboriginal Urban Design For Health, Kate Clark, Mpa, Kirby Broadnax, Antionette Carroll, Jonathan Cha, Naomi Doerner, Allie Kast, Matthew Kennedy, Michael Mendez, Pascale C. Annoual, Carrie Martin, Wendall Nicholas

College of Population Health Lectures, Presentations, Workshops

Montreal’s Aboriginal population is growing rapidly, yet the community lacks a culturally safe and holistic health service center that is accessible to all Aboriginal people. On Friday, June 2, 2017 The Montreal Urban Aboriginal Health Centre (MUAHC) joined forces with Next City & Concordia University to co-create a 7-minute pitch for a $7,000 prize through the Vangaurd Conference Big Idea Challenge. An interdisciplinary team of 8 conference attendees worked with MUAHC leadership to design a short-term solution that would be a step in the right direction towards MUAHC’s goal to build a fully functioning and independent health center dedicated …

Evaluating Value-Based Frameworks Used For Relapsed Or Refractory Multiple Myeloma Regimens: Icer Report, Asco Value Framework, And Nccn Evidence Blocks, Laurence M. Djatche, Pharmd, Joseph Goble, Pharmd, Grace Chun, Pharmd, Stefan Varga, Pharmd

College of Population Health Posters

BACKGROUND: With the continuous rise in costs for oncology drugs, the Institute for Clinical and Economic Review (ICER), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) have developed value-based frameworks (VBFs) to assist stakeholders in formulary and treatment decisionmaking. While emerging VBFs have the potential to significantly impact therapeutic options for patients, it is important to understand the differences associated with those VBFs within a therapeutic area. OBJECTIVE: To compare ICER, ASCO, and NCCN VBFs across three therapeutic options for relapsed or refractory multiple myeloma (RRMM).

METHODS: The values of carfilzomib (CFZ), elotuzumab (ELO), …

Jeffhealth: Helping East Africa Link To Health, Elizabeth Kuhn, Emily Zhang, Naveed A. Rahman, Rebecca Margolis, Savannah Coe

CwiC Posters

JeffHEALTH-Helping East Africa Link to Health is a student-run organization at Thomas Jefferson University dedicated to improving basic medical education and quality of life in Rwanda, which was devastated in 1994 by civil war and genocide. Working in partnership with the Rwanda Village Concept Project, a student organization at the National University of Rwanda, JeffHEALTH seeks to implement sustainable health initiatives in our partner villages. Graduate students from Thomas Jefferson University travel to Rwanda where we taught Community Health Workers from the Villages of Akarambi and Ruli the following topics: Nutrition and Vitamin Deficiencies, Family Planning, Prenatal care, HIV, Sexually …

Addressing Childhood Obesity In Early Head Start Population In Philadelphia Through Early Intervention And Food Buying Clubs, Nishant Pandya, Rickie Brawer, Mph, Phd, Sarah Roescher

CwiC Posters

Aims:

To implement a food buying club model to increase access to fresh and healthy foods for families whose children (ages 2-5) participate in Early Head Start and the Maternity Care Coalition.

Compare four potential food distributors: Philadelphia SHARE, Asociacion Puertorriquenos in Marcha (APM), The Common Market, and JETRO to find the organization that can best implement a feasible food buying club run through Early Head Start to fit the families needs.

Sexual And Reproductive Health In Rwanda, Emily Zhang

CwiC Posters

KEY MESSAGES

• Empowerment (women, youth, communities)
• Inclusion (age + gender)
• Prevention/Early Detection

PROGRAM RECOMMENDATIONS

• Partner with Rwandan medical students to improve program delivery
• Communicate monthly with local leaders
• Partner with Community Health Center

FUTURE INTERVENTIONS

• Partner with Rwandan medical students to improve program delivery
• Communicate monthly with local leaders
• Partner with Community Health Center

Decentralization And Health: Case Studies Of Kenya, Pakistan, And The Philippines, Christina E. Lewis, David Clarke, Jd, Maryam Bigdeli, Phd

CwiC Posters

Decentralization, defined by the World Bank (2001) as, “the transfer of authority and responsibility for public functions from the central government to intermediate and local governments or quasi-­‐independent government organizations and/or the private sector,” is a movement that has gained much traction in recent history. For many countries undergoing decentralization, a major driver has been a desire to increase the role and participation of local governments in the decision-­‐making space. In doing this, it is hoped to create governance structures that are more accountable and responsive to the people. For health, decentralization has been touted as a potential way to …

Public Health Considerations And The Culture Of Alcohol In Vietnam, Daniel Baquet

CwiC Posters

The problem of alcohol in Vietnam is interesting when considering the culture surrounding alcohol throughout the country, particularly amongst men. In 2010, Vietnamese men drank 12.1 liters of pure alcohol per capita, while women drank only 0.2 liters (WHO, 2014). The WHO Global Status Report on Alcohol and Health stated, “Vietnam’s national drinking patterns … are among the most fatal with the highest possible score for alcohol-attributable years of life lost,” a metric which includes liver cirrhosis, road traffic crashes, and the prevalence of alcohol use disorders and alcohol dependence (WHO, 2014). In addition, domestic alcohol production in Vietnam has …

Water Crisis In Vietnam, Jordan M. Zaid

CwiC Posters

• Immediately after the Vietnam War ended in 1975, Vietnam experienced economic turmoil and famine as the roots of industrialization began to grip the nation.

• In 1986, the government declared a rapid transition from a planned to a market economy would take hold. The ensuing change caused further increased industrial development and a subsequent growth of the emerging market economy. 1

• To this day, Vietnam’s GDP is rising yearly at a rapid rate.

• For this reason, much of Vietnam has been developed in a relatively short amount of time (since the end of the war) but much …

Does Age Influence Knowledge And Attitudes About Intrauterine Devices?, Sara Edwards, Lisa Perriera, Md, Mph, Rebecca J. Mercier Md Mph

CwiC Posters

Primary objectives:

• Are there differences in attitudes and beliefs about IUDs based on age?
• We hypothesized that older women may be more familiar with the negative outcomes of earlier models of the IUD and therefore may hold more negative attitudes toward IUDs.

An Interactive Curricula Experience (Ice) For Latino Immigrant Health, Kevin Molyneux, Ellen Plumb, Md, Martha Langley Ankeny, Med

CwiC Posters

The Interactive Curricula Experience (iCE) is an educational platform intended for interactive education utilizing multiple forms of media. It is being utilized at Thomas Jefferson University (TJU) in various classes, among them Global Health.

One of the pertinent global-health-at-home topics at TJU relates to Latino immigrant health. Latino immigrants number more than 20,000 in Philadelphia. They are located throughout the city, although the highest concentrations are in North and South Philadelphia. With respect to health care, Latino immigrants are less likely to have a regular health care provider than non-immigrant Latinos.

Education to provide culturally sensitive care to Latino immigrants …

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 …

Hepatitis C Screening In The Homeless Population Of Philadelphia, Adam Zimilover

CwiC Posters

Hepatitis C is a viral infectious disease that is a major cause of liver disease around the world. By the 1970s, it was recognized that many hepatitis cases were not due to the known hepatitis A or hepatitis B viruses. It was not until 1989 when the virus, then known as non--‐A, non--‐B hepatitis, was identified as a new distinct virus, hepatitis C. The virus has seven major genotypes, with genotype 1 causing about 75% of cases in the United States. By 1990, a screening test for the virus was developed, and within a year, the first treatment for the …

The Public Health Crisis In Greece And Its Ties To A Failing Economy, Anna M. Carleen

CwiC Posters

In 2009 the Greek government admitted that the numbers it had been reporting to the European Union about its national budget deficit were artificially small. The deficit was actually huge, way larger than what the EU requires of member countries if they want to reap the benefits of being in this financial network. A benefit of being in the EU is that it makes it much easier for governments to take out large loans, because lenders trust that a member country will make good on its debts due to the security it has from being part of the union. This …

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 …