Medicine and Health Sciences Commons^™

Orally Delivered, Plant-Produced Tat Protein Primes Mice For A Challenge Dna Vaccine Expressing Tat, A V. Karasev, S Foulke, C Wellens, I Zwierzynski, R Baldwin, H Koprowski, M S. Reitz Jr

Department of Microbiology and Immunology Faculty Papers

Oral Presentation.

Asthma Management Programs In Managed Care Organizations, Christine W. Hartmann Mss, Phd, Vittorio Maio Pharmd, Ms, Neil I. Goldfarb, Nicole M. Cobb Maom, David B. Nash

College of Population Health Faculty Papers

The aim of this work was to investigate how managed care organizations (MCOs) currently approach asthma treatment and management and to determine factors affecting asthma outcomes. A Web-based survey was administered to a national sample of 351 medical directors of MCOs to investigate the asthma management program components in their organizations as well as gaps and barriers in the management of patients with asthma. All 134 (38.2%) responding medical directors reported that their organizations monitor asthma patients. Plans use a variety of asthma management activities, including general member education (90%), member education by mail (87%), self-management education (85%), and provider …

Remote Physiological Monitoring: Clinical, Financial, And Behavioral Outcomes In A Heart Failure Population, Laurel R. Hudson Msn, Rn, G. Brent Hamar Dds, Mph, Patty Orr Rn, Edd, Jeffrey H. Johnson Bs, Amy Neftzger Ma, Richard S. Chung Md, Myra L. Williams Mph, William M. Gandy Edd, Albert Crawford Phd, Mba, Msis, Janice L. Clarke Rn, Bba, Neil I. Goldfarb

College of Population Health Faculty Papers

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived …

Mammalian Micrornas: A Small World For Fine-Tuning Gene Expression, Cinzia Sevignani, George A. Calin, Linda D. Siracusa, Carlo M. Croce

Department of Microbiology and Immunology Faculty Papers

The basis of eukaryotic complexity is an intricate genetic architecture where parallel systems are involved in tuning gene expression, via RNA-DNA, RNA-RNA and RNA-protein and DNA-protein interactions. In higher organisms, about 97% of the transcriptional output is represented by non-coding RNA (ncRNA) encompassing not only rRNA, tRNA, introns, 5’ and 3’-untranslated regions, transposable elements and intergenic regions, but also a large rapidly emerging family, named microRNAs. MicroRNAs are short 20-22 nucleotide RNA molecules that have been shown to regulate the expression of other genes in a variety of eukaryotic systems. MicroRNAs are formed from larger transcripts that fold to produce …

Continuous Asl Perfusion Fmri Investigation Of Higher Cognition: Quantification Of Tonic Cbf Changes During Sustained Attention And Working Memory Tasks, Junghoon Kim, John Whyte, Jiongjiong Wang, Hengyi Rao, Kathy Z. Tang, John A. Detre

Department of Rehabilitation Medicine Faculty Papers

Arterial spin labeling (ASL) perfusion fMRI is an emerging method in clinical neuroimaging. Its non-invasiveness, absence of low frequency noise, and ability to quantify the absolute level of cerebral blood flow (CBF) make the method ideal for longitudinal designs or low frequency paradigms. Despite the usefulness in the study of cognitive dysfunctions in clinical populations, perfusion activation studies to date have been conducted for simple sensorimotor paradigms or with single-slice acquisition, mainly due to technical challenges. Using our recently developed amplitude-modulated continuous ASL (CASL) perfusion fMRI protocol, we assessed the feasibility of a higher level cognitive activation study in twelve …

Posterior Longitudinal Ligament Status In Cervical Spine Bilateral Facet Dislocations, John A. Carrino, Geoffrey L. Manton, William B. Morrison, Alex R. Vaccaro, Mark E. Schweitzer, Adam E. Flanders

Department of Orthopaedic Surgery Faculty Papers

Objective: It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status.

Design: Retrospective case series.

Patients: A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between …

Barnacles, Old Age Marks, Or Just Plain Seborrheic Keratoses., Lawrence Charles Parish, Joseph A. Witkowski

Department of Dermatology and Cutaneous Biology Faculty Papers

Growing older may mean more wrinkles and creaking joints, but why does it also entail an accumulation of barnacles. These brown, somewhat friable, often warty lesions are more common on senior citizens but are not necessarily limited to the chronologically challenged. Seborrheic keratoses (SKs) can be easily recognized (fig 1), but the itching and the occasional scratch-induced dermatitis make them more than a cosmetic nuisance. (fig 2)

SKs can go by a variety of names, ranging from basal cell papillomas, senile warts, and senile keratoses to seborrheic verrucae and verrucous senilis. The various terms provide no more information on their …

The Role Of Spiritual Well-Being In Moderating Frail Elders' Affective Response To Functional Difficulty, Marie P. Dennis, Laura N. Gitlin, Laraine Winter, Yeon K. Chee

Center for Applied Research on Aging and Health Research Papers

Anxiety and depression have been well documented as affective consequences of functional impairment. Little research, however, has examined factors that moderate these associations. The present cross-sectional study examined the role of spiritual well-being in buffering the impact of functional difficulty on the anxiety and depressive symptoms of 319 functionally vulnerable community-dwelling elders, aged 70 or older, participating in a 6-month randomized controlled trial designed to enhance function. As demonstrated in recent research on spirituality and health, we expected that spiritual well-being would moderate the association between functional difficulty and anxiety as well as the relationship between functional difficulty and depression. …

The Tension Of Loss In Old Age, Christa Caruso, Helen K. Black

Center for Applied Research on Aging and Health Research Papers

Our poster is based on a larger qualitative study that explores the personal meaning of suffering to 122 community-dwelling elders. Because loss in old age emerges as a significant aspect of suffering in elders' narratives, we focus on suffering as loss. We are recruiting community dwelling elders aged 80 and above, stratified by ethnicity, gender and self-reported health for extended qualitative interviews. Respondents tell their life story and story of suffering along with personal definitions of suffering. Through narrative analysis we examine responses to the many losses experienced during a long life and the suffering that results from loss. By …

Religious Locus Of Control, Laraine Winter

Center for Applied Research on Aging and Health Research Papers

No abstract provided.

What Is Valuation Of Life For Frail Community-Dwelling Older Adults: Factor Structure And Criterion Validity Of The Vol, Marie P. Dennis, Laraine Winter, Helen K. Black, Laura N. Gitlin

Center for Applied Research on Aging and Health Research Papers

Lawton et al. (1999) defined valuation of life (VOL) as a cognitive-affective schema consisting of complex judgments, emotions and projections influenced by demographic and QOL factors. However, little is known about what constitutes VOL for frail elders. The present study evaluated the psychometric properties of a 13-item version of Lawton et al's. (2001) VOL Scale and examined correlational evidence in support of its construct validity with 319 elders enrolled in the Project ABLE study. Responses of half the sample (N=159) were submitted to principal axis factoring, yielding two factors (spiritual well-being, a = .88 and goal-related self-efficacy, a = .84), …

Jefferson Review - Fall 2005

Jefferson Review

Contents

• 2 - Dean’s Column
• 3 - Spotlight on Faculty
• 4 - At the New Heart of Campus

• DEPARTMENTAL NEWS
• 7 - Bioscience Technologies
• 8 - General Studies
• 9 - Nursing
• 13 - Occupational Therapy
• 14 - Physical Therapy
• 14 - Radiologic Sciences

• 16 - OT, PT, RS: Exploring Cultural Contexts
• 17 - The Jefferson Foundation
• 18 - Events
• 19 - Admissions Office Moves to the Edison Lobby
• 20 - Class Notes
• 23 - JCHP Trains Jefferson Hospital Docs and Residents
• 24 - Bookshelf

Experts Recommend Strategies For Strengthening The Use Of Advanced Practice Nurses In Nursing Homes., Mathy Mezey, Sarah Greene Burger, Harrison G Bloom, Alice Bonner, Mary Bourbonniere, Barbara Bowers, Jeffrey B Burl, Elizabeth Capezuti, Diane Carter, Jacob Dimant, Sarah A Jerro, Susan C Reinhard, Marilyn Ter Maat

College of Nursing Faculty Papers & Presentations

In 2003, The John A. Hartford Foundation Institute for Geriatric Nursing, New York University Division of Nursing, convened an expert panel to explore the potential for developing recommendations for the caseloads of advanced practice nurses (APNs) in nursing homes and to provide substantive and detailed strategies to strengthen the use of APNs in nursing homes. The panel, consisting of nationally recognized experts in geriatric practice, education, research, public policy, and long-term care, developed six recommendations related to caseloads for APNs in nursing homes. The recommendations address educational preparation of APNs; average reimbursable APN visits per day; factors affecting APNs caseload …

Bullous Eruption On The Posterior Thigh, James Studdiford, Amber Stonehouse

Department of Family & Community Medicine Faculty Papers

No abstract provided.

Comparative Effectiveness Of Total Population Versus Disease-Specific Neural Network Models In Predicting Medical Costs, Albert G. Crawford, Joseph P. Fuhr Jr., Janice Clarke, Brandon Hubbs

College of Population Health Faculty Papers

The objective of this research was to compare the accuracy of two types of neural networks in identifying individuals at risk for high medical costs for three chronic conditions. Two neural network models—a population model and three disease-specific models—were compared regarding effectiveness predicting high costs. Subjects included 33,908 health plan members with diabetes, 19,264 with asthma, and 2,605 with cardiac conditions. For model development/testing, only members with 24 months of continuous enrollment were included. Models were developed to predict probability of high costs in 2000 (top 15% of distribution) based on 1999 claims factors. After validation, models were applied to …

Nurses Alumni Association Bulletin, Fall 2005, Paula Levine, Elizabeth K. Prisnock, Sally H. Wagner, John J. Wagner

Nursing Alumni Bulletins

2005 - 2006 Meeting Date Calendar

2006 Annual Luncheon & Meeting Notice

Officers, Committee Chairs, Satellite and Volunteers

Bulletin Publication Committee

The President's Message

Treasurer's Report

Resume of Minutes

Office News

Committee Reports

• Relief Trust Fund
• Satellite - Harrisburg Satellite Area
• Bulletin
• Scholarship
• Nominating
• Social
• Development

Annual Giving

Janet C. Hindson Award Recipients and Nominees

Janet C. Hindson Award Qualifications

Quotes from Janet C. Hindson's Recipients Letters

Quotes from Letters on Nursing at Jefferson

Biography of Lenora Schwartz, '66

News About Graduates

Memories

Odds & Ends

How I got my Education

U.S. Cadet Nurse Corps

Normandy Nightingales Weathered War's Worst …

The Implications Of “Pay-For-Performance” Reimbursement For Otolaryngology – Head And Neck Surgery, David M. Cognetti, David Reiter

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objective: To introduce otolaryngologists to outcomes-linked reimbursement ("pay-for-performance"), identify clinical practice implications and recommend changes for successful transition from the traditional "pay-for-effort" reimbursement model. Study design: Policy review Results: Payers are actively linking reimbursement to quality. Since the Institute of Medicine issued its report on medical errors in 1999, there has been much public and private concern over patient safety. In an effort to base health care payment on quality, "pay-for-performance" programs reward or penalize hospitals and physicians for their ability to maintain standards of care established by payers and regulatory groups. More than 100 such programs are operational in …

Selective Role For Superoxide In Insp3 Receptor-Mediated Mitochondrial Dysfunction And Endothelial Apoptosis., Muniswamy Madesh, Brian J Hawkins, Tatyana Milovanova, Cunnigaiper D Bhanumathy, Suresh K Joseph, Satish P Ramachandrarao, Kumar Sharma, Tomohiro Kurosaki, Aron B Fisher

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Reactive oxygen species (ROS) play a divergent role in both cell survival and cell death during ischemia/reperfusion (I/R) injury and associated inflammation. In this study, ROS generation by activated macrophages evoked an intracellular Ca2+ ([Ca2+]i) transient in endothelial cells that was ablated by a combination of superoxide dismutase and an anion channel blocker. [Ca2+]i store depletion, but not extracellular Ca2+ chelation, prevented [Ca2+]i elevation in response to O2*- that was inositol 1,4,5-trisphosphate (InsP3) dependent, and cells lacking the three InsP3 receptor (InsP3R) isoforms failed to display the [Ca2+]i transient. Importantly, the O2*--triggered Ca2+ mobilization preceded a loss in mitochondrial membrane …

Methemoglobinemia Induced By Topical Anesthesia During Fiberoptic Endotracheal Intubation, Matthew C. Miller, Michael T. Gaslin, Kathleen Herb, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Poster presentation at 2005 American Academy Of Otolaryngology Head and Neck Surgery Annual Meeting, Los Angeles, CA September 25-28, 2005.

Introduction: Although local anesthetics are usually well tolerated, otolaryngologists need to be aware of the sometimes serious adverse events they can cause. The benzocaine containing sprays Hurricaine and Cetacaine are occasionally associated with the onset of life-threatening methemoglobinemia. The specific treatment for this condition is methylene blue.

Methods and Measures: We describe a case report of a 48 year old female who developed a methemoglobin level of 41% after receiving topical benzocaine to her oropharynx. We discuss the case in …

Measuring Nurse Workload In Ambulatory Care, Beth Ann Swan Phd, Crnp, Karen F. Griffin Msn, Rn, Cnaa

College of Nursing Faculty Papers & Presentations

Nurses and adequate nurse staffing are critical to the delivery of safe, cost-effective, and quality patient care in every health care setting.

This has been proven time and again through various research studies and recognized by various accrediting bodies such as JCAHO.

However, the information available on required or optimal ambulatory care nurse staffing is limited and varies across ambulatory care settings.

An overview of instruments for measuring nursing workload in ambulatory care, a critical prerequisite when identifying best nurse staffing models for diverse ambulatory care settings, is provided.

Jefferson Alumni Bulletin – Volume 54, Number 4, September 2005

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

Jefferson Alumni Bulletin – Volume 54, Number 4, September 2005

Learning as a Team, Healing as a Team; Page 2

Dean’s Column: How Many Hours Should Residents Work? Page 7

Input or Outcome: Which Determines Academic Excellence? Page 10

Alumni Weekend, Page 12

Commencements 2005: Surgeon General Carmona Receives Honorary Degree; Page 14

Listening In: The President’s Lecture; Page 15

In Memoriam; Page 16

Class Notes; Page 18

Gift of Health; Page 22

Nominations for the Simon Gratz Research Prize; Page 23

The Global Campaign (Gc) To Reduce The Burden Of Headache Worldwide. The International Team For Specialist Education (Itse)., Paolo Martelletti, Redda T Haimanot, Miguel J A Láinez, Alan M Rapoport, K Ravishankar, Fumihiko Sakai, Stephen Silberstein, Maurice Vincent, Timothy J Steiner

Department of Jefferson Headache Center papers and presentations

The social perception of headache, everywhere at low levels in industrialised countries, becomes totally absent in developing ones. Headache disorders came into the World Health Organization's strategic priorities after publication of the 2001 World Health Report. Among the leading causes of disability, migraine was ranked 19th for adults of both sexes together and 12th for females. The Global Campaign (GC) to Reduce the Burden of Headache Worldwide was planned by the major international headache organizations together with WHO in order to identify and remove those cultural, social and educational barriers recognised as responsible factors for the inadequate treatment of headache …

Review Of "Multiple Pregnancy: Epidemiology, Gestation & Perinatal Outcome. Second Edition", Edward J. Hayes

Department of Obstetrics and Gynecology Faculty Papers

Book Review

Annual Report, 2004-2005, Jouni Uitto

Annual Reports and Administrative Documents

No abstract provided.

Brain Neprilysin Activity And Susceptibility To Transgene-Induced Alzheimer Amyloids, Troy L. Carter, Steve Pedrini, Jorge Ghiso, Michelle E. Ehrlich, Sam Gandy

Department of Neurology Faculty Papers

Neprilysin (NEP) is a zinc metalloproteinase that degrades enkephalins, endothelins, and the Alzheimer’s disease amyloid ß (Aß) peptides. NEP-deficient mice possess increased levels of brain Aß^1-40 and Aß^1-42. The objective of this study was to determine whether tissue NEP specific activity differs according to age and/or across mouse strains, especially those strains predisposed toward formation of Aß-amyloid plaques following overexpression of the human Alzheimer amyloid precursor protein (APP). The C57Bl/6J mouse strain appears to be relatively susceptible to cerebral amyloidosis, whereas the Swiss Webster (SW) strain appears more resistant. We investigated whether NEP specific activity in brain …

Use Of Chromium Picolinate And Biotin In The Management Of Type 2 Diabetes: An Economic Analysis, Joseph P. Fuhr Jr., Hope He, Neil Goldfarb, David B. Nash

College of Population Health Faculty Papers

This paper addresses the potential economic benefits of chromium picolinate plus biotin (Diachrome ®) use in people with Type 2 diabetes (T2DM). The economic model was developed to estimate the impact on health care systems’ costs by improved HbA1C levels with chromium picolinate plus biotin (Diachrome). Lifetimes cost savings were estimated by adjusting a benchmark from the literature, using a price index to adjust for inflation. The cost of diabetes is highly dependent on the HbA1C level with higher initial levels and higher annual increments increasing the cost. Improvement in glycemic control has proven to be cost-effective in delaying the …

Jefferson Medical College Annual Report, 2005, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Functionally Active T1-T1 Interfaces Revealed By The Accessibility Of Intracellular Thiolate Groups In Kv4 Channels., Guangyu Wang, Mohammad Shahidullah, Carmen A Rocha, Candace Strang, Paul J Pfaffinger, Manuel Covarrubias

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Gating of voltage-dependent K(+) channels involves movements of membrane-spanning regions that control the opening of the pore. Much less is known, however, about the contributions of large intracellular channel domains to the conformational changes that underlie gating. Here, we investigated the functional role of intracellular regions in Kv4 channels by probing relevant cysteines with thiol-specific reagents. We find that reagent application to the intracellular side of inside-out patches results in time-dependent irreversible inhibition of Kv4.1 and Kv4.3 currents. In the absence or presence of Kv4-specific auxiliary subunits, mutational and electrophysiological analyses showed that none of the 14 intracellular cysteines is …

Annual Report 2004-2005, David B. Nash

College of Population Health Annual Reports

No abstract provided.

Total Knee Arthroplasty Using Computer-Assisted Navigation In Patients With Deformities Of The Femur And Tibia: A Report Of 5 Cases, Gregg R. Klein Md, Matthew S. Austin Md, Eric B. Smith Md, William J. Hozack Md

Department of Orthopaedic Surgery Faculty Papers

Anatomic aberrations of the femur and tibia secondary to trauma, congenital defects, and prior surgery present challenges for the reconstructive knee surgeon because of an altered mechanical axis and distorted anatomic landmarks. Five patients with arthritis of the knee and extra-articular femoral and/or tibial deformity, retained hardware, or intramedullary (IM) implants underwent total knee arthroplasty using a computer navigation system. The navigation system obviated the need for an IM guide, and the normal mechanical axis of the patients was restored. Extensive dissection for hardware removal or osteotomy was not necessary in these patients. In these 5 cases, a navigation system …