Medicine and Health Sciences Commons^™

Jefferson Scale Of Patient's Perceptions Of Physician Empathy: Preliminary Psychometric Data., Gregory C. Kane, Joanne L. Gotto, Salvatore Mangione, Susan West, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

AIM: To develop a brief scale for measuring patient's perceptions of their physician's empathic engagement and to provide preliminary evidence in support of aspects of the scale's psychometrics.

METHOD: Study comprised 225 patients, out of 436 patients (52% response rate) seen by 166 residents in the internal medicine residency program at the Jefferson Hospital Ambulatory Clinic as part of their ambulatory training at Thomas Jefferson University Hospital. A 5-item questionnaire entitled the Jefferson Scale of Patient's Perceptions of Physician Empathy was developed and administered to the study participants. Its factor structure, item-total score correlations, and correlations with several relevant criterion …

Convenient Care Clinics: The Future Of Accessible Health Care, Tine Hansen-Turton, Sandra Ryan, Ken Miller, Mona Counts, David B. Nash

College of Population Health Faculty Papers

The need for accessible, affordable, quality health care in the United States has never been greater. In response to this need, convenient care clinics (CCCs) are being launched across the country to help provide care to meet the basic health needs of the public. In CCCs, highly qualified health care providers diagnose and treat common health problems, triage patients to the appropriate level of care, advocate for a medical home for all patients, and reduce unnecessary visits to emergency rooms and Urgent Care Clinics. CCCs have been called a "disruptive innovation" because they are consumer driven. They serve as a …

Association Between Frequency Of Telephonic Contact And Clinical Testing For A Large, Geographically Diverse Diabetes Disease Management Population, Carter R. Coberley, Matthew Mcginnis, Patty M. Orr, Sadie S. Coberley, Adam Hobgood, Brent Hamar, Bill Gandy, James Pope, Laurel Hudson, Pam Hara, Dexter Shurney, Janice L. Clarke, Albert Crawford, Neil I. Goldfarb

College of Population Health Faculty Papers

Diabetes disease management (DM) programs strive to promote healthy behaviors, including obtaining hemoglobin A1c (A1c) and low-density lipoprotein (LDL) tests as part of standards of care. The purpose of this study was to examine the relationship between frequency of telephonic contact and A1c and LDL testing rates. A total of 245,668 members continuously enrolled in diabetes DM programs were evaluated for performance of an A1c or LDL test during their first 12 months in the programs. The association between the number of calls a member received and clinical testing rates was examined. Members who received four calls demonstrated a 24.1% …

Toward A Biopsychosocial Understanding Of The Patient-Physician Relationship: An Emerging Dialogue, Herbert M. Adler

Department of Family & Community Medicine Faculty Papers

Complexity theory has been used to view the patient-physician relationship as constituted by complex responsive processes of relating. It describes an emergent, psychosocial relational process through which patients and physicians continually and reciprocally influence each other's behavior and experience. As psychosocial responses are necessarily biopsychosocial responses, patients and physicians must likewise be influencing each other's psychobiology. This mutual influence may be subjectively experienced as empathy, and may be skillfully employed by the clinician to directly improve the patient's psychobiology.

Rad51c Deficiency In Mice Results In Early Prophase I Arrest In Males And Sister Chromatid Separation At Metaphase Ii In Females, Sergey Kuznetsov, Manuela Pellegrini, Kristy Shuda, Oscar Fernandez-Capetillo, Yilun Liu, Betty K. Martin, Sandra Burkett, Eileen Southon, Debananda Pati, Lino Tessarollo, Stephen D. West, Peter J. Donovan, Andre Nussenzweig, Shyam K. Sharan

Department of Biochemistry and Molecular Biology Faculty Papers

RAD51C is a member of the RecA/RAD51 protein family, which is known to play an important role in DNA repair by homologous recombination. In mice, it is essential for viability. Therefore, we have generated a hypomorphic allele of Rad51c in addition to a null allele. A subset of mice expressing the hypomorphic allele is infertile. This infertility is caused by sexually dimorphic defects in meiotic recombination, revealing its two distinct functions. Spermatocytes undergo a developmental arrest during the early stages of meiotic prophase I, providing evidence for the role of RAD51C in early stages of RAD51-mediated recombination. In contrast, oocytes …

The Enigma Of Struma Ovarii, Lawrence M. Roth, Aleksander Talerman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Since its first description in the early part of the twentieth century, struma ovarii has elicited considerable interest because of its many unique features; however, at present a number of aspects remain enigmatic. Although the typical presentation is that of a pelvic mass, unusual clinical manifestations such as hyperthyroidism, ascites, and Meigs' syndrome have been recognised. Uncommon macroscopic and especially histological patterns in struma can cause difficulties in diagnosis. Cystic strumas are challenging to diagnose both macroscopically and histologically. Proliferative changes within struma can be misdiagnosed as cancer. In regard to the occurrence of thyroid-type carcinoma in struma ovarii, precise …

The Fate Of The Unexpected Positive Intraoperative Cultures After Revision Total Knee Arthroplasty, Robert L. Barrack, Ajay Aggarwal, R. Stephen J. Burnett, John C. Clohisy, Elie Ghanem, Peter Sharkey, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

Of a consecutive series of 692 revision total knees at 3 centers, intraoperative cultures were unexpectedly found to be positive in 41 cases (5.9%). Of the 41, 29 (71%) cases had a single positive intraoperative culture and were determined to be a probable false positive based on absence of any other evidence of infection, of which 5 were treated with extended course of intravenous antibiotics after hospital discharge and the remaining 24 received no further treatment. None of these 24 patients manifested any sign of infection at follow-up, averaging 46 months (range, 24-74 months). Twelve patients were determined to have …

Beta Blocker Specificity: A Building Block Toward Personalized Medicine., Brent R Degeorge, Walter J Koch

Center for Translational Medicine Faculty Papers

Drugs known as beta blockers, which antagonize the beta-adrenergic receptor (beta-AR), are an important component of the treatment regimen for chronic heart failure (HF). However, a significant body of evidence indicates that genetic heterogeneity at the level of the beta(1)-AR may be a factor in explaining the variable responses of HF patients to beta blockade. In this issue of the JCI, Rochais et al. describe how a single amino acid change in beta(1)-AR alters its structural conformation and improves its functional response to carvedilol, a beta blocker currently used in the treatment of HF (see the related article beginning on …

Department Of Radiology-Annual Executive Summary Report-July 1, 2006 To June 30, 2007, Vijay M. Rao M.D.

Department of Radiology Administrative Documents and Reports

91 page Department of Radiology Annual Executive Summary Report, July 1, 2006 to June 30, 2007, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Trial And Error Versus Errorless Learning Of Functional Skills In Patients With Acute Stroke, Julie Mount, Samuel R. Pierce, Janet Parker, Rebecca Diegidio, Russell Woessner, Lenore Spiegel

Department of Physical Therapy Faculty Papers

Objective: To compare the effectiveness of errorless learning versus trial and error learning for teaching activities of daily living to patients with acute stroke with or without explicit memory impairments.

Design: Randomized crossover.

Setting: Rehabilitation hospital.

Participants: 33 adult subjects following an acute stroke.

Intervention: Subjects were taught to prepare a wheelchair for a transfer and to put on a sock with a sock-donner. Tasks were taught using errorless learning or trial and error learning. Explicit memory was assessed using the Neurobehavioral Cognitive Status Exam.

Main Outcome Measures: Days until subject was able to …

Letter To The Editor: Further Efforts To Redce The Incidence Of Neural Tube Defects, Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Triumph And/Or Tragedy: The Present Food And Drug Administration Program Of Enriching Grains With Folic Acid., Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Developmental Toxicology Drugs, And Fetal Teratogenesis, Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Robert Warwick Miller: In Memoriam., Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

How Does The Physician Avoid Prescribong Drugs And Medical Procedures That Have Reproductive And Developmental Risks?, Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Download Full Pdf Issue-Jefferson Translations, Vol. 3, No. 1, Spring/Summer 2007

Jefferson Translations

This issue includes an article on Dr. Squires and her work to study the effects of the HIV virus in women, clinical director forges new paths to health, Dr. Woulfe pioneers thrombosis research, resident updates, faculty news and awards and honors.

A Non-Pharmacological Intervention To Manage Behavioral And Psychological Symptoms Of Dementia And Reduce Caregiver Distress: Design And Methods Of Project Act3., Laura N Gitlin, Laraine Winter, Marie P Dennis, Walter W Hauck

Center for Applied Research on Aging and Health Research Papers

Project ACT is a randomized controlled trial designed to test the effectiveness of a non-pharmacological home-based intervention to reduce behavioral and psychological symptoms of dementia (BPSD) and caregiver distress. The study targets 272 stressed racially diverse family caregivers providing in-home care to persons with moderate stage dementia with one or more behavioral disturbances. All participants are interviewed at baseline, 4-months (main trial endpoint), and 6-months (maintenance). The four-month intervention involves up to 13 visits from an occupational therapist who works with families to problem-solve potential triggers (communication style, environmental clutter) contributing to behaviors, and instruct in strategies to reduce caregiver …

Evidence Against Roles For Phorbol Binding Protein Munc13-1, Adam Adaptor Eve-1, Or Vesicle Trafficking Phosphoproteins Munc18 Or Nsf As Phospho-State-Sensitive Modulators Of Phorbol/Pkc-Activated Alzheimer App Ectodomain Shedding., Annat F Ikin, Mirsada Causevic, Steve Pedrini, Lyndsey S Benson, Joseph D Buxbaum, Toshiharu Suzuki, Simon Lovestone, Shigeki Higashiyama, Tomas Mustelin, Robert D Burgoyne, Sam Gandy

Farber Institute for Neuroscience Faculty Papers

ABSTRACT: BACKGROUND: Shedding of the Alzheimer amyloid precursor protein (APP) ectodomain can be accelerated by phorbol esters, compounds that act via protein kinase C (PKC) or through unconventional phorbol-binding proteins such as Munc13-1. We have previously demonstrated that application of phorbol esters or purified PKC potentiates budding of APP-bearing secretory vesicles at the trans-Golgi network (TGN) and toward the plasma membrane where APP becomes a substrate for enzymes responsible for shedding, known collectively as alpha-secretase(s). However, molecular identification of the presumptive "phospho-state-sensitive modulators of ectodomain shedding" (PMES) responsible for regulated shedding has been challenging. Here, we examined the effects on …

Download Full Pdf Issue-Jefferson Translations, Vol. 3, No. 2, Fall 2007

Jefferson Translations

This issue includes an article on the clinical outcomes research team, an update with Dr. Most on cardiac research, a description of the hospitalist program, a visit to the sleep disorders center, faculty news and and a chief residents update.

The Folate Debate., Robert L. Brent

The Selected Works of Robert Brent

No abstract provided.

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 3, Iss.1, January 2007

Public Health Link

This issue includes a faculty spotlight on Dr. James Diamond and MPH program announcements.

Parenting Foster Children With Chronic Illness And Complex Medical Needs, Lori S. Lauver, Phd.

College of Nursing Faculty Papers & Presentations

Parenting foster children with complex health care needs is a life changing experience for the foster families as well as foster children. A multifaceted experience, it has implications not only for nursing but multiple disciplines.

Download The Pdf Of The Entire Issue: Pehc Vol. 1, Issue 2

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

Idiopathic Granulomatous Mastitis Masquerading As Carcinoma Of The Breast: A Case Report And Review Of The Literature., Richard Tuli, Brian J O'Hara, Janet Hines, Anne L Rosenberg

Department of Surgery Faculty Papers

BACKGROUND: Idiopathic granulomatous mastitis is an uncommon, benign entity with a diagnosis of exclusion. The typical clinical presentation of idiopathic granulomatous mastitis often mimics infection or malignancy. As a result, histopathological confirmation of idiopathic granulomatous mastitis combined with exclusion of infection, malignancy and other causes of granulomatous disease is absolutely necessary. CASE PRESENTATION: We present a case of a young woman with idiopathic granulomatous mastitis, initially mistaken for mastitis as well as breast carcinoma, and successfully treated with a course of corticosteroids. CONCLUSION: There is no clear clinical consensus regarding the ideal therapeutic management of idiopathic granulomatous mastitis. Treatment options …

Chronic Care At The Crossroads: Exploring Solutions For Chronic Care Management. Report On The Us Summit., Janice L Clarke

College of Population Health Faculty Papers

Report on the US Summit

A Turner Syndrome Neurocognitive Phenotype Maps To Xp22.3., Andrew R Zinn, David Roeltgen, Gerry Stefanatos, Purita Ramos, Frederick F Elder, Harvey Kushner, Karen Kowal, Judith L Ross

Department of Pediatrics Faculty Papers

BACKGROUND: Turner syndrome (TS) is associated with a neurocognitive phenotype that includes selective nonverbal deficits, e.g., impaired visual-spatial abilities. We previously reported evidence that this phenotype results from haploinsufficiency of one or more genes on distal Xp. This inference was based on genotype/phenotype comparisons of individual girls and women with partial Xp deletions, with the neurocognitive phenotype considered a dichotomous trait. We sought to confirm our findings in a large cohort (n = 47) of adult women with partial deletions of Xp or Xq, enriched for subjects with distal Xp deletions. METHODS: Subjects were recruited from North American genetics and …

Breast-Fed Low Birth Weight Premature Infants: A Description Of Nutritional Intake In The First Six Months Of Life, Ksenia Zukowsky

Selected Works of Ksenia Zukowsky, CRNP, PhD

This is a secondary analysis of a larger project entitled "Breast-feeding Services for LBW Infants-Outcomes and Costs" (L. Brown, RN, Ph.D., Principal Investigator), funded by NINR at NIH, (NR 03881). The larger project was a randomized clinical trial, of women planning to breast-feed their LBW infant. The control group received routine breast-feeding care and an intervention group received a structured program of breast-feeding services provided by an advanced practice nurse.

Healthy premature LBW infants from the control group were selected as subjects for this secondary analysis. One question of this secondary analysis was to describe the nutrition of healthy premature …

Family Medicine Predoctoral Education: 30-Something, Howard K. Rabinowitz

Department of Family & Community Medicine Faculty Papers

From the introduction:

The specialty of family medicine is now more than 30 years old. Fitting for its stage of life, family medicine predoctoral education has achieved appropriate maturity and parity with other core clinical departments and has assumed its role and responsibility in medical education within the academic health center. Of course, this wasn’t always true.

The Interplay Of Obesity And Asthma, James Plumb, Rickie Brawer, Nancy Brisbon

Department of Family & Community Medicine Faculty Papers

The relationships, interactions, and association between obesity and asthma are complex, and are active sources of hypotheses and research. An association between obesity and asthma has been reported in many studies, although considerable debate about the existence of the association and its meaning still exists. Potential associative relationships may result from genetics, immune system modifications, and mechanical mechanisms. The rising prevalence of asthma and obesity in children and adults, and the significant morbidity from both, makes it imperative that clinicians recognize the importance of weight management in patients with and without asthma.

Antenatal Risk Factors, Cytokines And The Development Of Atopic Disease In Early Childhood, Esther K. Chung, Rachel L. Miller, Michael T. Wilson, Stephen J. Mcgeady, Jennifer F. Culhane

Department of Pediatrics Faculty Papers

Atopic diseases are complex entities influenced by an array of risk factors including genetic predisposition, environmental allergens, antenatal exposures, infections and psychosocial factors. One proposed mechanism by which these risk factors contribute to the development of atopic disease is through alterations in the production of T helper type 1 (Th1) and type 2 (Th2) cytokines. The objectives of this review are to discuss antenatal exposures that are associated with pediatric atopic diseases, to discuss the influence of the intrauterine environment on neonatal immune responses, to provide an overview of the Th1 and Th2 pathways and how they relate to atopic …