Medicine and Health Sciences Commons^™

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

The Pulmonologist's Role In Caring For Pregnant Women With Regard To The Reproductive Risks Of Diagnostic Radiological Studies Or Radiation Therapy., Robert Brent

Department of Pediatrics Faculty Papers

Radiography of the chest, head, neck, teeth, or extremity exposes the embryo or ovary to insignificant exposures of radiation except when radionuclides are utilized. In some instances, there is no exposure at all. Pulmonologists are fortunate with regard to the specific studies they request to provide clinical care because most of the diagnostic tests do not directly expose the uterus (embryo) or ovary. This article discusses radiation risks and their evaluation and pregnancy-related issues in diagnostic radiological studies.

Urological Involvement In Renal Transplantation., Daniel D Sackett, Pooja Singh, Costas D Lallas

Department of Urology Faculty Papers

Historically, urologists were the primary surgeons in renal transplantation. Specialization and increased complexity of the field of transplantation, coupled with a de-emphasis of vascular surgical training in urology, has created a situation where many renal transplants are carried out by surgeons with a general surgery background. Because of its genitourinary nature, however, urological input in renal transplantation is still vital. For living donors, a urologist should be involved to help evaluate and prepare certain patients for eventual donation. This could involve both medical and surgical intervention. Additionally, urologists who carry out living donor nephrectomy maintain a sense of ownership in …

Epidermal Growth Factor Receptor Overexpression In Resected Pancreatic Cancer, Amit Mahipal, Mary J. Mcdonald, Agnieszka Witkiewicz, Brian I. Carr

Department of Medical Oncology Faculty Papers

Conclusions:

Membrane EGFR overexpression is associated with poorer clinical outcomes in patients with pancreatic cancer receiving adjuvant therapy post resection.

Cytoplasmic EGFR overexpression is not associated with clinical outcomes.

Year In Review, Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

If examination of journal performance is a surrogate for the vitality of a discipline, the continued ascension of Clinical Pharmacology and Therapeutics (CPT) bodes well for the evolution and practice of human therapeutics in this decade. CPT has excelled as the authoritative, cross-disciplinary journal in experimental and clinical medicine devoted to publishing advances in the nature, action, efficacy and evaluation of therapeutics in humans. Building on a foundation that established the core tenets, and a framework providing the structural integrity for the field, CPT was conceived by visionary precedent editors and editorial teams who were themselves leaders of …

Diagnosis Of Coronary Stenosis With Ct Angiography Comparison Of Automated Computer Diagnosis With Expert Readings., Ethan J Halpern, David J Halpern

Department of Radiology Faculty Papers

RATIONALE AND OBJECTIVES: To compare computer-generated interpretation of coronary computed tomography angiography (cCTA) by commercially available COR Analyzer software with expert human interpretation.

MATERIALS AND METHODS: This retrospective Health Insurance Portability and Accountability Act‑compliant study was approved by the institutional review board. Among 225 consecutive cCTA examinations, 207 were of adequate quality for automated evaluation. COR Analyzer interpretation was compared to human expert interpretation for detection of stenosis defined as ≥50% vessel diameter reduction in the left main, left anterior descending (LAD), circumflex (LCX), right coronary artery (RCA), or a branch vessel (diagonal, ramus, obtuse marginal, or posterior descending artery). …

Ercc1 And Rrm1 As Predictors Of Survival And Response In Pancreatic Ductal Adenocarcinoma Treated With Gemcitabine-Based Chemotherapy, Thomas Holdbrook, Kathleen D. Danenberg, Suneeta Satti, Jessica Kline, Charles J. Yeo, Jonathan R. Brody, Peter Mccue, Agnieszka K. Witkiewicz

Department of Surgery Faculty Papers

Conclusion:

In this study, we used RT-PCR and IHC to analyze RRM1 and ERCC1 mRNA and protein expression in PDA specimens. PDA patients with low expression of RRM1 by IHC derived benefit from gemcitabine-based chemotherapy. Assessment of RRM1 mRNA expression was limited by the small sample size. Low ERCC1 expression by RT-PCR was associated with a 2.5 times higher risk of mortality than high expression (p=0.031). There was no association between ERCC1 expression by IHC and survival; however, agreement between mRNA and protein expression was poor for ERCC1. This study demonstrates the ERCC1 and RRM1 expression have an impact on …

Kidney Injury Molecule-1 (Kim-1) As An Early Detection Tool For Acute Kidney Injury And Other Renal Diseases, John Fontanilla, Md, Won K. Han, M.D

Department of Medicine Faculty Papers

Introduction: Although serum creatinine is the standard metric tool for the detection of renal injury, its lack of sensitivity has made the early diagnosis of acute kidney injury (AKI) very difficult.  In fact, the absence of sensitive AKI biomarkers has impaired progress in the nephrology field and had a detrimental effect on the design and outcome of AKI clinical trials.  Recently, several proteins have shown potential in the early detection of acute and chronic kidney injuries.

Areas covered: This review discusses the current status of kidney injury molecule-1 (KIM-1) as a potential diagnostic tool in patients with various acute …

Development Of A Fidelity Measure For Research On The Effectiveness Of The Ayres Sensory Integration Intervention., L Diane Parham, Susanne Smith Roley, Teresa A. May-Benson, Jane Koomar, Barbara Brett-Green, Janice P Burke, Ellen S. Cohn, Zoe Mailloux, Lucy J. Miller, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

OBJECTIVE: We developed a reliable and valid fidelity measure for use in research on Ayres Sensory Integration (ASI) intervention.

METHOD: We designed a fidelity instrument to measure structural and process aspects of ASI intervention. Because scoring of process involves subjectivity, we conducted a series of reliability and validity studies on the process section. Raters were trained to score therapist strategies observed in video recordings of adult-child dyads. We examined content validity through expert ratings.

RESULTS: Reliability of the process section was strong for total fidelity score (ICC = .99, Cronbach's alpha = .99) and acceptable for most items. Total score …

Regulation Of The Androgen Receptor By Set9-Mediated Methylation., Luke Gaughan, Jacqueline Stockley, Nan Wang, Stuart R C Mccracken, Achim Treumann, Kelly Armstrong, Fadhel Shaheen, Kate Watt, Iain J Mcewan, Chenguang Wang, Richard Pestell, Craig N Robson

Kimmel Cancer Center Faculty Papers

The androgen receptor (AR) is a member of the nuclear hormone receptor family of transcription factors that plays a critical role in regulating expression of genes involved in prostate development and transformation. Upon hormone binding, the AR associates with numerous co-regulator proteins that regulate the activation status of target genes via flux to the post-translational modification status of histones and the receptor. Here we show that the AR interacts with and is directly methylated by the histone methyltransferase enzyme SET9. Methylation of the AR on lysine 632 is necessary for enhancing transcriptional activity of the receptor by facilitating both inter-domain …

Differential Subcellular Distribution Of Rat Brain Dopamine Receptors And Subtype-Specific Redistribution Induced By Cocaine., Pamela J Voulalas, John Schetz, Ashiwel S Undieh

College of Pharmacy Faculty Papers

We investigated the subcellular distribution of dopamine D(1), D(2) and D(5) receptor subtypes in rat frontal cortex, and examined whether psychostimulant-induced elevation of synaptic dopamine could alter the receptor distribution. Differential detergent solubilization and density gradient centrifugation were used to separate various subcellular fractions, followed by semi-quantitative determination of the relative abundance of specific receptor proteins in each fraction. D(1) receptors were predominantly localized to detergent-resistant membranes, and a portion of these receptors also floated on sucrose gradients. These properties are characteristic of proteins found in lipid rafts and caveolae. D(2) receptors exhibited variable distribution between cytoplasmic, detergent-soluble and detergent-resistant …

Improving Function In Age-Related Macular Degeneration: Design And Methods Of A Randomized Clinical Trial., Barry W Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions …

Expression Of Aldehyde Dehydrogenase In Dysplastic Lesions Arising From Inflammatory Bowel Disease, Adam D. Toll, Bruce M. Boman, Juan P. Palazzo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Conclusion: Our study demonstrates ALDH1 is significantly expressed in dysplatic lesions arising from IBD. ALDH1-expression in cancer stem cells suggest an important causative role in the progression to cancer in IBD. Although we found high sensitivity for dysplasia, the specificity was poor. In addition to neoplasia, ALDH1-expressing stem cells proliferate in response to chronic inflammation, accounting for the cases of inflammatory atypia with positive ALDHI1 expression.

Fus Transgenic Rats Develop The Phenotypes Of Amyotrophic Lateral Sclerosis And Frontotemporal Lobar Degeneration., Cao Huang, Hongxia Zhou, Jianbin Tong, Han Chen, Yong-Jian Liu, Dian Wang, Xiaotao Wei, Xu-Gang Xia

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Fused in Sarcoma (FUS) proteinopathy is a feature of frontotemporal lobar dementia (FTLD), and mutation of the fus gene segregates with FTLD and amyotrophic lateral sclerosis (ALS). To study the consequences of mutation in the fus gene, we created transgenic rats expressing the human fus gene with or without mutation. Overexpression of a mutant (R521C substitution), but not normal, human FUS induced progressive paralysis resembling ALS. Mutant FUS transgenic rats developed progressive paralysis secondary to degeneration of motor axons and displayed a substantial loss of neurons in the cortex and hippocampus. This neuronal loss was accompanied by ubiquitin aggregation and …

A Trial Of Simulated Breech Delivery Skills Retention For Ob/Gyn And Ed Residents, Cj Sultana, R. Hall

Department of Obstetrics and Gynecology Faculty Papers

Conclusion:

A pilot study showed that simulation using video and high fidelity simulators can substitute for clinical experience for teaching breech delivery with retention of skills at one and three month intervals.

Download Entire Pdf Interprofessional Education And Care Newsletter, Vol. 2, No. 2, Winter 2011

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

This issue includes articles on:

Interprofessional Education and Practice Implications of the Institute of Medicine Future of Nursing Report

Using an Interprofessional Clinical Skills Scenario in an Occupational Therapy Course

Column: Evaluation of Interprofessional Education Programs

Column: Developing Health Care Quality and Patient Safety Linchpins through Interprofessional Education

Announcements

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Announcements include congratulations to JCIPE's Fall 2010 Interprofessional Education and Care Practicum Pilot Award Recipients, 2011 International Essay Contest on Interprofessionalism and upcoming Faculty and Staff Development Programs.

Column: Developing Health Care Quality And Patient Safety Linchpins Through Interprofessional Education, Mary Lou Manning

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

"Every organization needs linchpins…artists, with a genius for finding a new answer, a new connection, or a new way of getting things done." - Seth Godin, Linchpin, Are You Indispensable? Seth Godin pens provocative books with witty titles such as Unleashing the Ideavirus1 and Tribes.2 His most recent book, Linchpin, Are You Indispensable?3 is about the art of connection, the art of being human and the art of making a huge difference. Health care clinicians, faculty and students are well advised to read his work as they strive to master the art of meaningful interprofessional connections, so that together, they …

Column: Evaluation Of Interprofessional Education Programs, Kevin Lyons

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this brief space, I would like to provide some general guidelines for those of you who are planning to implement an interprofessional education program, or any program for that matter. I say planning to implement a program, because it is at this stage that you must be thinking about how you are going to evaluate it, not after the program has begun. One of the worst nightmares for any program evaluator is to have someone stop by his or her office with a stack of data and say “Can you tell me what I have here?” When this happens …

Using An Interprofessional Clinical Skills Scenario In An Occupational Therapy Course, E. Adel Herge, Christine Hsieh, Tarae Waddell-Terry, Andrea Mcelroy

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Interprofessional education (IPE) is being adopted increasingly more in the health care education field. The literature cites benefits of interprofessional teamwork such as appreciation for the expertise of other health care practitioners, enhanced communication skills related to teamwork, higher quality patient care and improved patient outcomes.5,6 One of the goals of the Eastern Pennsylvania-Delaware (EPaD) Geriatric Education Center is to create geriatric interprofessional education for medical, nursing and health professions students. The Center developed an Interprofessional Clinical Skills Scenario to facilitate development of communication and collaboration skills. The Interprofessional Clinical Skills Scenario focuses on an older adult who is hospitalized …

Interprofessional Education And Practice Implications Of The Institute Of Medicine Future Of Nursing Report, Mary Lou Manning, Beth Ann Swan

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The Future of Nursing: Leading Change, Advancing Health, released by the Institute of Medicine (IOM) on October 5, 2010, is the latest in a series of reports that have had a significant impact on creating positive change to improve health care in the United States. The report provides a vision of a future health care system that would make high-quality care accessible to all, promote wellness and disease prevention, reliably improve health outcomes, and provide compassionate care throughout a person’s lifespan. This report, in concert with the provisions of the Affordable Care Act, must act as a catalyst for all …

From The Editors, Christine Arenson, Md, Molly Rose, Rn, Phd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Welcome to the latest edition of the Jefferson Interprofessional Education and Care Newsletter. We are thrilled to report that participation in interprofessional education (IPE) and collaboration by faculty and staff at Jefferson is escalating. In this issue, Drs. Manning and Swan provide an overview of the recent Institute of Medicine’s Future of Nursing report that reaffirms the importance of interprofessional collaboration in the classroom and clinical education for health care outcomes. Dr. Herge and colleagues describe a Jefferson example of how IPE can successfully be implemented in an existing discipline specific course. A clinical skills scenario (a woman hospitalized with …

Detecting Hospital Quality With Pridit., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the Temple University, Fox School of Business Department of Risk, Insurance & Healthcare Management. Robert A. Hedges Research Seminar Series, Philadelphia, PA.

25 PowerPoint slides

Associated papers available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2007.00821.x/abstract

and the 2008 Proceedings of the Joint Statistical Meeting.

Septic Shock: Current Management And New Therapeutic Frontiers, R. Phillip Dellinger, Md

Division of Pulmonary, Allergy, and Critical Care Medicine Presentations and Grand Rounds

No audio is available for this presentation.

Dr. R. Phillip Dellinger is a Professor of Medicine who holds a faculty appointment in the Division of Pulmonary and Critical Care Medicine at the Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey. He is also the Vice-Chair, Department of Medicine and the Director, Medical/Surgical/Cardiovascular Surgical Intensive Care Unit at the Cooper Medical Center in Camden New Jersey. In 2006-2007, he was selected as South Jersey Top Docs by South Jersey Magazine. Dr. Dellinger's interests are in the treatment and outcomes of septic shock.

Phase I Study Of 'Dose-Dense' Pemetrexed Plus Carboplatin/Radiotherapy For Locally Advanced Non-Small Cell Lung Carcinoma., Xinglei Shen, Albert Denittis, Maria Werner-Wasik, Rita Axelrod, Paul Gilman, Thomas Meyer, Joseph Treat, Walter J Curran, Mitchell Machtay

Department of Radiation Oncology Faculty Papers

BACKGROUND: This phase I study investigates the feasibility of carboplatin plus dose-dense (q2-week) pemetrexed given concurrently with radiotherapy (XRT) for locally advanced and oligometastatic non-small cell lung cancer (NSCLC).

METHODS: Eligible patients had Stage III or IV (oligometastatic) NSCLC. Patients received XRT to 63 Gy in standard fractionation. Patients received concurrent carboplatin (AUC = 6) during weeks 1 and 5 of XRT, and pemetrexed during weeks 1, 3, 5, and 7 of XRT. The starting dose level (level 1) of pemetrexed was 300 mg/m2. Following the finding of dose limiting toxicity (DLT) in dose level 1, an amended dose level …

Beta-Blocker Initiation And Adherence After Hospitalization For Acute Myocardial Infarction., Vittorio Maio, Pharmd, Ms, Msph, Massimiliano Marino, Phd, Mary Robeson, Md, Joshua J Gagne, Pharmd, Ms

College of Population Health Faculty Papers

Aims: We sought to: (1) estimate the proportion of patients who initiated beta-blocker therapy after acute myocardial infarction (AMI) in Regione Emilia-Romagna (RER); (2) examine predictors of post-AMI beta-blocker initiation; and (3) assess adherence to such therapy.

Methods and Results: Using healthcare claims data covering all of RER, we identified a cohort of 24,367 patients with a hospitalization for AMI between 2004 and 2007, who were discharged from the hospital alive and without contraindications to beta-blocker therapy. We estimated the proportion of eligible patients with at least one prescription for a beta-blocker following discharge and performed a multivariable logistic regression …

Defining And Assessing Organizational Culture, Jennifer Bellot Phd, Rn, Mhsa

College of Nursing Faculty Papers & Presentations

PROBLEM.  Using theories from several disciplines, the concept of organizational culture remains controversial. Conflicting definitions, lack of semantic clarity, and debate over the most appropriate methods for assessing organizational culture have led to disagreement over the value and validity of such inquiry.

METHODS.  This paper reviews development of the concept of organizational culture and methods for assessing organizational culture, focusing on the healthcare environment.

FINDINGS.  Most work on organizational culture concerns the traditional corporation. Therefore, some adaptation to the central goals and focus of a human services organization are necessary before application to healthcare settings.

Prescriptions For Excellence In Healthcare Winter 2010 Dowload Full Pdf

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

No Outcome, No Income Cms's "Meaningful Use" Initiative, Richard Jacoby Md, Bettina Berman Rn, David B. Nash Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Patient Awareness Of Practicing Hand Hygiene: An Intervention For Hospitalized Oncology Patients, Brianna Germain Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.