Medicine and Health Sciences Commons^™

Saving Life And Brain With Extracorporeal Cardiopulmonary Resuscitation: A Single-Center Analysis Of In-Hospital Cardiac Arrests., Graham Peigh, Nicholas C. Cavarocchi, Hitoshi Hirose

Department of Surgery Faculty Papers

OBJECTIVE: Despite advances in medical care, survival to discharge and full neurologic recovery after cardiac arrest remains less than 20% after cardiopulmonary resuscitation. An alternate approach to traditional cardiopulmonary resuscitation is extracorporeal cardiopulmonary resuscitation, which places patients on extracorporeal membrane oxygenation during cardiopulmonary resuscitation and provides immediate cardiopulmonary support when traditional resuscitation has been unsuccessful. We report the results from extracorporeal cardiopulmonary resuscitation at the Thomas Jefferson University.

METHODS: Between 2010 and June 2014, 107 adult extracorporeal membrane oxygenation procedures were performed at the Thomas Jefferson University. Patient demographics, survival to discharge, and neurologic recovery of patients who underwent extracorporeal …

Simple New Risk Score Model For Adult Cardiac Extracorporeal Membrane Oxygenation: Simple Cardiac Ecmo Score., Graham Peigh, Nicholas Cavarocchi, Scott W. Keith, Hitoshi Hirose

Department of Surgery Faculty Papers

BACKGROUND: Although the use of cardiac extracorporeal membrane oxygenation (ECMO) is increasing in adult patients, the field lacks understanding of associated risk factors. While standard intensive care unit risk scores such as SAPS II (simplified acute physiology score II), SOFA (sequential organ failure assessment), and APACHE II (acute physiology and chronic health evaluation II), or disease-specific scores such as MELD (model for end-stage liver disease) and RIFLE (kidney risk, injury, failure, loss of function, ESRD) exist, they may not apply to adult cardiac ECMO patients as their risk factors differ from variables used in these scores.

METHODS: Between 2010 and …

Evaluation Of A Pharmacist-Led Medication Assessment Used To Identify Prevalence Of And Associations With Polypharmacy And Potentially Inappropriate Medication Use Among Ambulatory Senior Adults With Cancer., Ginah Nightingale, Emily Hajjar, Kristine Swartz, Jocelyn Andrel-Sendecki, Andrew Chapman

College of Pharmacy Faculty Papers

PURPOSE: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment.

PATIENTS AND METHODS: We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were …

Inside Out, Spring 2015

Inside Out

Contents:

Checkmate, Joshua Cannon, 1

Contort, Michael Natter, 2

For Vastness’ Sake, Marc McShane, 3

Old Country Road, Jonathan Elias, 4

Dippers, Ethan Sellers, 5

A Liberated Caravan, Tanziyah Muqeem, 6

To be, or Not to be, Danylo I. Holubnyk, 7

San Francisco, 2009, Sina Vahedi, 8

Tranquil Days, David Chou, 9

Living, Marc McShane, 10

Never Too Early for a Nap, Tuc To, 11

Reclining Nude, Chen Zhou,12

Peace Crane, Lauren Burgoon, 13

Untitled Hand, Amanda Joseph, 14

Japan Memorial, Lauren Burgoon, 15

The Clearing Storm, Eric W. Kostuk, 16

Wild Flowers, Amanda Joseph, 17

Female Nudes, Elise Campbell, …

Inside Out, Spring 2013

Inside Out

Contents:

Imp of the Perverse, Evan J. Slagle

Mom, Ethan Sellers

Curves of the Albatross, Christina Nguyen

Colors, Sarah Drejet

Rajasthan, India, Nishi Dedania

Heights that I Remember, Daniel Gealy

Girl in Transit, Michela Mickler

Chemo, Emily Fay

Energy, Dierdre Axell-House

African Dreaming, Michela Mickler

Flight, Michela Mickler Rittenhouse

Reflections, Kami L. McManus

Lovers in Washington Square, Wendy Diao

No Agenda, Laura Steel

I’ve Come to Know Sepia, Ethan Sellers

Re-imagine-d, Jonathan Elias

Glee, Rebecca Julian

A Creature Void of Form, Daniel Gealy

The Column, Emily Fay

Bold, Bald, Black & White, Dierdre Axell-House

Salar de Uyuni, Bolivia Nicholas Bishop …

Inside Out, Spring 2012

Inside Out

Contents

Limbless, Desmond Wilson, Cover

The Daily Grind, Dave Miller, Inside Cover

The Sea Conqueror, Jonathan Elias, 5

Fear, Yuliya Baratt, 5

Dreamer Mosaic, Huong Le, 6

The Colored White Desert of Egypt, MIranda Law, 6

The Hands of My First Autopsy, Nathan Fried, 7

Esperar, Neil Flannery Haidorfer, 8

Retrograde Frequency, Evan Slagle, 9

Childhood, Yuliya Baratt, 9

Flying South for the Winter, Nishi Dedania, 10

Barn in Winter, Michael Minckler, 10

Mountain Goat, Alissa Herman, 11

Tree Burr, Nate Jordan, 11

Wake, Andrea Frankenburger, 12

Mt. Rainier Viewed from Seattle, WA, Michael Minckler, 12

Sisterhood, Sharon Li, 13 …

Inside Out, Spring 2011

Inside Out

Contents:

Winter Boardwalk, Heather Tattersall, 1

Boundaries, Kanani Titchen, 2

Nightline, To Dung Nguyen, 4

Blue Jeans, Bonnie Bennet, 5

After the Genocide, Rwanda, Christine Chen, 6

Trails, Matt Richards, 7

Various Facades, Subhasree Basu, 8

On Our Mistakes, and Physics, Khalid Mohamood, 9

Valle Sagrado, Lara Murphy, 11

Pink Study, Han Koon Ooi, 12

Passage, Rites, Jennifer Lewis, 13

Layers, Mara Modest, 15

Heather Tattersall, Aivi Nguyen, 16

Pulse, Christina Furia, 17

Penmanship, Christina Nguyen, 18

Small Jeffersonians, Francina Girard, 19

Growing Up In Guatemala, Christine Chen, Front Cover

Lady Watering, Aimee J. Lee, Inside Front Cover

Singed, Matt …

The Ot's Role In An Interprofessional Research Team, Sara Benham, Otd, Otr/L, Atp, Susan Toth-Cohen, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Why Interprofessional Research?

The research field receives contributions from multiple disciplines and is inclusive by nature. •Feels natural in our day to day work practices to collaborate with other professions. •A plan to build research capacity includes establishing a research culture, environment, and infrastructure as well as partnership with other disciplines (Frontera et al., 2006).

Human Books: Social Media, Unplugged, Patricia Wynne, Mslis, Dorothy E. Berenbrok, Mslis, Gary E. Kaplan, Mslis, Ahip, Helena Washington, Mslis

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Objectives

Purpose: Enable health sciences students and staff to engage in dialogue to challenge common prejudices in a positive manner and to promote empathy for the patients and families they encounter.

Methods

Setting/Participants: Academic Health Sciences library serving students and staff in an urban hospital and university. The ‘reader’ participants included students, staff, and faculty from the academic medical center. The ‘book’ participants included volunteers from both inside and outside the institution.

Results

Brief Description: Adapting an international program, The Human Library, the library recruited ‘books’ who had experienced discrimination based on aspects of their lives such as race, sexual …

Jefferson Digital Commons Quarterly Report: January-March 2015, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi

Jefferson Digital Commons Reports

Outline of report:

• 10 year birthday for the JDC
• Parenting and Emotional Growth content from Henri Parens, MD
• Jefferson Faculty Books
• Women at Jefferson: New Oral Histories
• Assorted asset highlights
• What people are saying about the JDC

Moyamoya Disease And Acute Inpatient Rehabilitation In A 17-Month Old Previously Healthy Male, Cassandra Coleman, Nicole Marcantuono

CwiC-PH

Case Diagnosis

17-month old male with newly diagnosed MoyaMoya after presenting with new onset seizures and right-sided weakness.

Case Description

MoyaMoya is a rare cerebrovascular condition predisposing patients to stroke in association with progressive stenosis of the intracranial internal carotid arteries and their proximal branches.

The patient presented initially after a fall with subsequent inability to bear weight on his right leg along with minimized use of his right arm. Patient was treated for a suspected tibial Salter-Harris II and nursemaid’s elbow. He presented four days later to the ED with new onset seizures. CT of the brain showed loss …

Adolescent Pregnancy In Ecuador, Paige Bates

CwiC-PH

Description of the Problem

• Teen pregnancy, commonly defined as pregnancy in a girl less than 18 or 19 years of age, is often a target of public health efforts because of the far-reaching economic, social and health effects.¹
  • A girl who becomes pregnant attends 2.5 less years of school, and each additional child translates into 1 less year of education.²
  • Girls who get pregnant before age 18 are more likely to experience violence within marriage or a partnership than girls who postpone child-bearing.¹
  • Babies born to adolescent mothers have a higher incidence of perinatal complications (like asphyxia …

An Interdisciplinary Approach To Combat Obesity In The Galapagos, Christopher Busack, Bethany Fox

CwiC-PH

Galapagos Background

• Total Population (2010) = 25,124¹
• Largest city = Puerto Ayora (Santa Cruz)
• Average monthly income in Galapagos = $772.03/month²
• Average monthly income in mainland Ecuador = $251.70/month²
• Booming tourism industry contributes to rapid population growth³

4 of 18 main islands (>1km²) open for human residence (Santa Cruz, Isabela, San Cristobal, Floreana)

Addiction: A Treatable Disease, Nathaniel Graham

CwiC-PH

Addiction: Definitions and Statistics

Nearly 1 in 7 Americans (~40 million people) are addicted to a chemical substance.

An additional 2 in 7 Americans (~80 million people) qualify as risky substance users; those who use chemical substances in ways that threaten their health and safety.

Regional Disparities In Neurocritical Care Outcomes, Kali Graham

CwiC-PH

BACKGROUND

• Determinants of Neurocritical Care Outcomes: Social as opposed to biological disparities can frequently dictate health outcomes for neurocritically ill patients. Survival rates are determined both by a patient’s access to a NCU (Neurocritical Care Unit) as well as the level of inpatient care he or she receive once admitted to a NCU.
• Regional Inequality in Access to Care¹:
• Only 12.8% of Americans have access to a NCU within 45 min by ground transportation and 36.8% have access to a NCU within 45 minutes by air transportation.
• Racial Disparities in NCU Admissions and Outcomes²:
• Non …

Underrepresented Minorities And Jefferson Medical System Healthcare: What Can We Do To Diversify The Physician Workforce?, David Halpen

CwiC-PH

Why Diversity?

• An increasingly diverse workforce leads to better levels of care.¹
• Underserved areas need better care and this is currently not being provided by Physicians from non URM backgrounds. ²
• Research shows that physicians from diverse backgrounds are more likely to return to service the communities of underrepresented minorities (URMs). ³
• There will be a decrease in overall healthcare disparities between different groups. ⁴

Care With Dignity: Understanding How To Care For Hiv Positive And Formerly Incarcerated Populations, Caroline Komanecky, Terry Trudeau, Med, James D. Plumb, Md, Mph, Helen Koenig, Md

CwiC-PH

Philadelphia FIGHT is a comprehensive HIV/AIDS service organization providing primary care, consumer education, advocacy, and research on potential treatments and vaccines. FIGHT was formed as a partnership of individuals living with HIV/AIDS and clinicians, who joined together to improve the lives of people living with the disease. Today, FIGHT serves an even broader patient population and recently received designation as a Federally Qualified Health Center. FIGHT strives to address not only HIV-infected patients, but all at-risk populations through education, outreach, and preventative medicine. The annual Bridging the Gaps interns are responsible for several projects, including a client satisfaction survey, a …

Lgbt Healthcare And Our Role In Smoking Cessation, Leor Krichilsky, John Covotta, Valerie Canavin, Rickie Brawer, Mph, Phd, Robert Winn, Md, Ms, Aahivs

CwiC-PH

Mazzoni’s goal is comprehensive LGBT care

The interns learned the value of comprehensive care through observing roles of the nurses, transgender intake counselor, case managers, and physicians. Mazzoni’s multi-disciplinary model allows patients’ various needs to be met directly.

The interns also learned the importance of LGBT care through discussions about use of unisex bathrooms, preferred pronouns, and inclusive language. This is demonstrated by Mazzoni’s new patient forms.

Universal Healthcare: Costa Rica As A Model, Annie J. Ferris

CwiC-PH

What it Looks Like in Costa Rica

• Run by the Costa Rican Social Security Administration
• Financed by employers, employees, and the Ministry of Health. Employer and employee contributions together make up over 90% of contributions.
• Costa Rica is divided into 105 health areas, which are further divided up into primary care units called Basic Provision Units of Integrated Healthcare, or EBAIS. There are 947 of these primary care centers throughout Costa Rica, and everyone is assigned to one.
• The EBAIS clinics provide a wide range of services to cover the general and specific health needs of the community, including primary …

Health Care In Bolivia: A First Hand Experience, Sanchi Malhotra

CwiC-PH

This research project is based on a one month work experience in Cochabamba, Boliva through the NGO Sustainable Bolivia at Hosptial Viedma, a major public hospital and Centre de Salud Pacata, a rural outpatient health clinic. The information presented below is derived from both research and personal experience. This trip was partially funded by Jefferson Office of International Affairs with the goal of gaining experience and knowledge about the Bolivian health care system.

Establishing Roots In West Philadelphia, Nina Millman, James Larosa, Skip Weiner, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Urban Tree Connection

Urban Tree Connection is an organization that utilizes plots of land which have been abandoned. The organization uses the land to create gardens that grow produce which is then sold at markets and to the community. Their goal is to provide access to fresh fruits and vegetables in the food desert areas of West Philadelphia. Members of the community are able to get involved by allowing some of their land to be used as gardens and helping to maintain the sites. The organization also tries to spread information about sustainability including a compost program in the neighborhood.

Globally Minded, Locally Serving: Refugee Health In Philadelphia, Sarah Jamieson, Angelica Montes, Gretchen Shanfeld, Mph, Rickie Brawer, Mph, Phd, Caryn Johnson, Ms, Otr/L, Faota, James D. Plumb, Md, Mph

CwiC-PH

Introduction

A refugee is someone who is forced to leave their country of origin due to war, violence, or persecution. The United States is the world’s top resettlement country. Out of the 50 states, Pennsylvania is 5^th in terms of the number of annually resettled refugees. Each year, Philadelphia resettles approximately 800 refugees. Bhutan, Burma, Iraq, Eritrea, Sudan, and Democratic Republic of Congo are the most frequent countries of origin in Philadelphia.

Healthy Habits, Happy Baby!, Amanda Ocran, Suvidha Polu, Joan I. Gluch, Phd, Rdh, James D. Plumb, Md, Mph, Rickie Brawer, Mph, Phd

CwiC-PH

Cribs for Kids, a component program of the Maternity Care Coalition, provides needy families in Philadelphia with cribs and education on safe sleeping environments.

• Cribs for Kids also provides education on how to reduce the risk of sudden infant death syndrome (SIDS).
• The organization hosts workshops throughout the city and home visits for those who cannot attend the workshops.
• Cribs for Kids also increases awareness about safe sleeping habits and their program by attending community health fairs.
• In the last year Cribs for Kids has provided families the city of Philadelphia with over 2,000 safe sleeping environments.

The Effect Of Peer Educators On Medication Adherence In Hiv Patients In Cochabamba, Bolivia, George Ru

CwiC-PH

BACKGROUND INFORMATION

• Bolivia is the least developed country in South America, with high levels of poverty, poor access to safe water, and low economic activity. Bolivia’s GDP, in US dollars, in 2013 was $30.60 billion and the gross national income, per capita in US dollars was $2,550, which both rank either at or near the bottom of the list for all South American countries (7).
• The Ministry of Health and Sports (MSD) is the national governing body responsible for formulating the strategy, policies, plans and programs in health. The Department of Health Services (SEDES) is the highest level of technical …

Bridging The Gaps Chip: Prevention Point, Patrick Prior, Clayton Ruley, Mss, Mlsp, Shp, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Prevention Point Philadelphia aims to reduce the harm associated with injection drug use and sex industry work through an array of harm reduction programs, including syringe exchange, condom distribution, naloxone rescue, social workers, and opioid replacement therapy.

The Heart Of Healthcare: The Role Of Authentic Relationships In Caring For Patients With Frequent Hospitalizations, Charlotte Weisberg, Ba, Margaret Hawthorne, Mph, Marianna Lanoue, Phd, Jeffrey Brenner, Md, Dawn B Mautner, Md, Ms

CwiC-PH

INTRODUCTION

Frequent hospital utilization is a major contributor to the costs of healthcare. Despite a vast body of literature, there remains great uncertainty about the characteristics and care needs of individuals with frequent hospitalizations.^1,2 In the movement to reduce the need for hospitalizations, care management programs have garnered wide attention and support. Of the many studies that exist on the efficacy of care management interventions, only a handful espouse the benefits of “continuous healing relationships.”^3,4,5 Fewer studies, if any, explain the role of affect between care providers and patients in the healing process and how to achieve a …

Rural And Urban Medicine In Ecuador, Moira Black

CwiC-PH

Free, Universal Health Care

• Health care is free to all workers and their children with support from the government, employers, and a portion of the workers’ paychecks.¹
• Military personnel do not contribute part of their paychecks to paying for healthcare.¹

Experiences With Prenatal Care Among Women In A Philadelphia Homeless Shelter, Stephanie Rand, Ms4, Montida Fleming, Ms3, Maria Somohod, Ms3, Caitlin Callaghan, Ms2, Alexandra Strauss, Ms2, Natalie Ziegler, Ms2, Anita Modi, Ms4, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Prenatal care for the underserved is a national concern, with pregnancy rates as high as 22% in homeless women and 75% of these women reporting barriers to care during pregnancy. Inadequate prenatal care confers increased risk for gestational complications and unfavorable postnatal outcomes, including prematurity and low birth weight. Yet while many studies delineate the prevalence and health consequences of inconsistent prenatal care in the homeless population, few address healthcare barriers. To both fill this gap in the literature and design effective interventions increasing consistency of care, we explored prenatal care experiences of pregnant homeless women at Philadelphia’s primary intake …

Health Needs Assessment For Head Start Children, Gerald Gibbons

CwiC-PH

Background: Head Start Program

• Preschool program for low-income families, providing comprehensive learning and care for children ages birth through 5 years old.¹
• Receives federal funds through the Department of Health & Human Services. However, each Head Start program is a locally designed and implemented model based on local community needs and resources.¹
• One of many government requirements involves yearly health check-ups and up-to-date immunization records for all children enrolled.¹
• NSCA elicited services from Jefferson Center for Urban Health to investigate why some families have a difficult time completing the medical record requirements.

Crossmodal Encoding Of Motor Sequence Memories, Brittany Heckel, Marianne Stephan, Sunbin Song, Leonardo G. Cohen

CwiC-PH

Background

• The field of motor rehabilitation is in need of more efficient and effective rehabilitation strategies.
• Each year, almost 2.5 million Americans suffer from traumatic brain injury (TBI) and roughly 800,000 Americans experience a stroke. ^{1, 2}
• The total annual direct and indirect costs of stroke and TBI in the United States are $65.5 billion and between $48 and $56 billion, respectively.^{3, 4}
• A promising new approach may lie in using sound as a neuromodulatory tool to access motor areas of the brain.
• Pianists, for example, can improve their performance of a previously practiced musical piece just by listening …