Medicine and Health Sciences Commons^™

Hyaline Fibromatosis Syndrome: A Novel Mutation And Recurrent Founder Mutation In The Cmg2/Antxr2 Gene., Leila Youssefian, Hassan Vahidnezhad, Yahya Aghighi, Vahid Ziaee, Sirous Zeinali, Maryam Abiri, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 7, Number 2, 2016

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

Articles in this issue include:

Interprofessional Peer Teaching: Physical Therapy Students Teaching Dental Students to Transfer Patients

The Development of the Interprofessional Leadership Institute for Mental Health Equity

Teaching Interprofessional Practice Skills by “Saving Humanity”: An Innovative IPE Curricular Method Using a Cooperative Strategy Board Game

Reflections from the Bedsides of Dying Patients

Reflections From The Bedsides Of Dying Patients, Hannah Decleene, Patrick Kukulich

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

I walked into a room with its lights glaring and television blaring, a room where a man I had never met before would take his final breath two hours later. The attending nurse kindly dimmed the lights and turned off the television. I sat down next to him. I felt panic. I felt sadness, and I felt peace. This individual would have passed without me knowing, yet I was there with him; he wouldn’t be alone.

The No One Dies Alone (NODA) chapter at Jefferson launched in May, 2016. It launched as a vision in which students of Thomas Jefferson …

Teaching Interprofessional Practice Skills By "Saving Humanity": An Innovative Ipe Curricular Method Using A Cooperative Strategy Board Game, Emily Mccave, Phd, Msw, Lmsw

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

Statement of Issue

Increasingly, team-based interprofessional (IP) collaboration is the central model of practice for health disciplines (Khalili, Orchard, Laschinger, & Farah, 2013). Yet traditional education models can foster a uniprofessional identity that leads to “turf protection” and subsequent resistance to IP collaboration (Bronstein, 2003, p. 448). Interprofessional education (IPE) models, however, are designed to promote team competency and an IP identity (Lindgard, 2013). IPE activities often focus on building student competency in four core areas: efficient and effective teamwork, effective communication, understanding of professional roles, and shared values (Interprofessional Education Collaborative (IPEC), 2016). Innovative IPE activities provide students with …

The Development Of The Interprofessional Leadership Institute For Mental Health Equity, Cheryl L. Woods-Giscombe, Phd, Rn, Pmhnp

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

Abstract

The Interprofessional Leadership Institute for Mental Health Equity is being developed at the University of North Carolina at Chapel Hill to reduce mental health disparities by (1) engaging students in interprofessional service learning and research activities, (2) promoting integration of community-based strategies and social determinants of mental health conditions among underserved and vulnerable groups as required curricular components, (3) enhancing workforce diversity (in partnership with Racial/Ethnic Minority-Serving Colleges/Universities) by supporting students to obtain professional careers in mental health care, mental health policy, and mental health leadership, and (4) supporting current mental health providers, educators, and researchers who are working …

Interprofessional Peer Teaching: Physical Therapy Students Teaching Dental Students To Transfer Patients, Kim Dunleavy, Pt, Phd, Ocs, Venita Sposetti, Dmd

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

Background While the need for interprofessional education (IPE) has been clearly elucidated, (Interprofessional Education Collaborative, 2016), one of the major barriers is the logistical challenge of meeting curricular requirements for all involved. The organization and time required in an already full schedule are often deterrents. Ideal opportunities meet specific program curricular requirements as well as enhancing interprofessional competencies. Interprofessional competencies include developing skills to teach other health care providers about profession-specific skills and enhancing communication across the professions (Bridges, 2011; Interprofessional Education Collaborative, 2016). Active learning techniques have been advocated for adult learners to promote motivation and engagement (Knowles, 1984), …

From The Editors, Christine A. Arenson, Md, Lauren Collins Md, Shoshana Sicks, Med

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

Here at JCIPE, another semester has flown by. And again, the Center has been busy expanding and integrating our programs on campus and beyond. This fall, as we welcomed our tenth cohort into the Jefferson Health Mentors Program, we introduced a revised curriculum which is more heavily focused on the social determinants of health and integrates the Social Ecological Model. We also added an eighth profession, Medical Laboratory Sciences, to the mix, expanding our total student enrollment to more than 1400 students! Building on this foundation, this fall we also expanded our more advanced interprofessional TeamSTEPPS® training program. During the …

Jdc Quarterly Report (October-December 2016) Now Available, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

The Jefferson Digital Commons quarterly report for October-December 2016 is now available. View the report to see what assets were added this quarter and to review annual trends and statistics. As 2016 concluded the JDC reached a new milestone by passing the 3 million download mark along with the deposit of more than 12,000 assets to date.

Jefferson Digital Commons Quarterly Report: October-December 2016, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi, James Copeland, Libt

Jefferson Digital Commons Reports

This quarterly report includes:

• New departments joining the JDC
• Statistics for 2016
• Assorted assets added to the JDC in the last quarter
• What people are saying about the JDC

Small Rna Zippers Lock Mirna Molecules And Block Mirna Function In Mammalian Cells., Lingyu Meng, Cuicui Liu, Jinhui Lü, Qian Zhao, Shengqiong Deng, Guangxue Wang, Jing Qiao, Chuyi Zhang, Lixiao Zhen, Ying Lu, Wenshu Li, Yuzhen Zhang, Richard G. Pestell, Huiming Fan, Yi-Han Chen, Zhongmin Liu, Zuoren Yu

Department of Cancer Biology Faculty Papers

MicroRNAs (miRNAs) loss-of-function phenotypes are mainly induced by chemically modified antisense oligonucleotides. Here we develop an alternative inhibitor for miRNAs, termed 'small RNA zipper'. It is designed to connect miRNA molecules end to end, forming a DNA-RNA duplex through a complementary interaction with high affinity, high specificity and high stability. Two miRNAs, miR-221 and miR-17, are tested in human breast cancer cell lines, demonstrating the 70∼90% knockdown of miRNA levels by 30-50 nM small RNA zippers. The miR-221 zipper shows capability in rescuing the expression of target genes of miR-221 and reversing the oncogenic function of miR-221 in breast cancer …

Cleavage Of Dfna5 By Caspase-3 During Apoptosis Mediates Progression To Secondary Necrotic/Pyroptotic Cell Death., Corey Rogers, Teresa Fernandes-Alnemri, Lindsey Mayes, Diana Alnemri, Gino Cingolani, Emad S. Alnemri

Department of Biochemistry and Molecular Biology Faculty Papers

Apoptosis is a genetically regulated cell suicide programme mediated by activation of the effector caspases 3, 6 and 7. If apoptotic cells are not scavenged, they progress to a lytic and inflammatory phase called secondary necrosis. The mechanism by which this occurs is unknown. Here we show that caspase-3 cleaves the GSDMD-related protein DFNA5 after Asp270 to generate a necrotic DFNA5-N fragment that targets the plasma membrane to induce secondary necrosis/pyroptosis. Cells that express DFNA5 progress to secondary necrosis, when stimulated with apoptotic triggers such as etoposide or vesicular stomatitis virus infection, but disassemble into small apoptotic bodies when DFNA5 …

William Arbuthnot Lane (1856-1943): Surgical Innovator And His Theory Of Autointoxication., Mackenzie Morris, Thea Price, Scott W. Cowan, Charles J. Yeo, Benjamin Phillips

Department of Surgery Gibbon Society Historical Profiles

William Arbuthnot Lane contributed to the advancement of many fields of orthopedics, otolaryngology, and general surgery. He is credited for his "no-touch technique" and the invention of long-handled instruments, some of which are still in use today, to minimize tissue handling. He is most well known for his hypothesis that slowing of gastric contents could cause a variety of ailments and this became known as Lane's disease. Although his surgical treatment of Lane's disease is now defunct, it advanced the surgical technique in colorectal surgery. It seems likely that some of Lane's "autointoxication" patients would be classified today as patients …

Pathogenic Determinants And Mechanisms Of Als/Ftd Linked To Hexanucleotide Repeat Expansions In The C9orf72 Gene., Xinmei Wen, Thomas Westergard, Piera Pasinelli, Davide Trotti

Department of Neuroscience Faculty Papers

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are two apparently distinct neurodegenerative diseases, the former characterized by selective loss of motor neurons in the brain and spinal cord and the latter characterized by selective atrophy of frontal and temporal lobes. Over the years, however, growing evidence from clinical, pathological and genetic findings has suggested that ALS and FTD belong to the same clinic-pathological spectrum disorder. This concept has been further supported by the identification of the most common genetic cause for both diseases, an aberrantly expanded hexanucleotide repeat GGGGCC/ CCCCGG sequence located in a non-coding region of the gene …

Mortality Differences Between Traditional Medicare And Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data., Roy A. Beveridge, Sean M. Mendes, Arial Caplan, Teresa L. Rogstad, Vanessa Olson, Meredith C. Williams, Jacquelyn M. Mcrae, Stefan Varga

College of Population Health Faculty Papers

Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the …

Can Contrast Harmonic Endoscopic Ultrasonography Replace Endoscopic Ultrasonography-Guided Fine-Needle Aspiration In Patients With Solid Pancreatic Lesions? An American Perspective., Joseph Yoo, Linda H. Yan, Ali A. Siddiqui

Division of Internal Medicine Faculty Papers & Presentations

No abstract provided.

Distal Interphalangeal Joint Arthrodesis Complicated By Postoperative Infection: A Rare Presentation Of Disseminated Herpes Simplex Virus., Meredith N. Osterman, Michael P. Gaspar

Department of Orthopaedic Surgery Faculty Papers

Postoperative infection after elective arthrodesis of the interphalangeal joint is an uncommon complication often necessitating urgent debridement. We present the rare case of a female patient with a history of oral herpetic lesions, who underwent elective arthrodesis of the middle and index fingers for treatment of erosive osteoarthritis and subsequently developed a postoperative herpetic infection at the surgical site.

Characteristics Of Real-Time, Non-Critical Incident Debriefing Practices In The Emergency Department., Nur-Ain Nadir, Suzanne Bentley, Dimitrios Papanagnou, Komal Bajaj, Stephan Rinnert, Richard Sinert

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of …

Targeting The Nrf2-Heme Oxygenase-1 Axis After Intracerebral Hemorrhage., Jing Chen-Roetling, Raymond F. Regan

Department of Emergency Medicine Faculty Papers

BACKGROUND: Injury to cells adjacent to an intracerebral hemorrhage (ICH) is likely mediated at least in part by toxins released from the hematoma that initiate complex and interacting injury cascades. Pharmacotherapies targeting a single toxin or pathway, even if consistently effective in controlled experimental models, have a high likelihood of failure in a variable clinical setting. Nuclear factor erythroid-2 related factor 2 (Nrf2) regulates the expression of heme oxygenase-1 (HO-1) and multiple other proteins with antioxidant and antiinflammatory effects, and may be a target of interest after ICH.

METHODS: Studies that tested the effect of HO and Nrf2 in models …

Factors Associated With Post-Arrest Withdrawal Of Life-Sustaining Therapy., Anne V. Grossestreuer, David F. Gaieski, Benjamin S. Abella, Douglas J. Wiebe, Ari Moskowitz, Daniel J. Ikeda, Jason S. Haukoos, Sarah M. Perman

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Most successfully resuscitated cardiac arrest patients do not survive to hospital discharge. Many have withdrawal of life sustaining therapy (WLST) as a result of the perception of poor neurologic prognosis. The characteristics of these patients and differences in their post-arrest care are largely unknown.

METHODS: Utilizing the Penn Alliance for Therapeutic Hypothermia Registry, we identified a cohort of 1311 post-arrest patients from 26 hospitals from 2010 to 2014 who remained comatose after return of spontaneous circulation. We stratified patients by whether they had WLST post-arrest and analyzed demographic, arrest, and post-arrest variables.

RESULTS: In our cohort, 565 (43%) patients …

Adiponectin Partially Rescues High Glucose/High Fat-Induced Impairment Of Mitochondrial Biogenesis And Function In A Pgc-1Α Dependent Manner., H. Wang, W.-J. Yan, J.-L. Zhang, F.-Y. Zhang, C. Gao, Y.-J. Wang, W.B. Lau, L. Tao

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Plasma adiponectin (APN) levels are decreased in diabetic patients. Dysfunctional mitochondrial biogenesis is involved in type 2 diabetes (T2DM) pathogenesis, by unclear mechanisms. The present study determined (1) whether myocardial mitochondrial biogenesis was impaired in cardiomyocytes exposed to a high glucose/high fat (HGHF) medium (a T2DM in vitro model), (2) the effects of APN administration upon mitochondrial biogenesis in cardiomyocytes affected by HGHF incubation, and 3) the involved underlying mechanisms.

MATERIALS AND METHODS: Neonatal rat ventricular myocytes (NRVMs) were isolated and incubated in HGHF medium. Mitochondrial function was assessed by ATP content, and fluorescent microscopic analysis of myocardial apoptosis …

Extracorporeal Membrane Oxygenation With Multiple-Organ Failure: Can Molecular Adsorbent Recirculating System Therapy Improve Survival?, Bailey E. Sparks, Nicholas C. Cavarocchi, Hitoshi Hirose

Department of Surgery Faculty Papers

BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO.

METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase >1,000 IU/liter). Of these patients, 14 underwent MARS treatment (Group M), and 14 were supported with …

New Horizons In Spine Research: Intervertebral Disc Repair And Regeneration., James C Iatridis, James Kang, Rita Kandel, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Community Nursing: Health Care Behind Closed Doors, Mary Bouchaud, Phd, Rn, Mary Mangiaracina, Msn, Rn, 2009 Nln

College of Nursing Posters

Focus of nursing education in the 21st century is to teach students how to work with individuals & families within a community setting & to develop skills in providing nursing care that stresses community as the client.

The expectation of the APHA is that BSN students will be educationally prepared to work with & improve the health of individuals, families, & diverse populations within the community.

Teaching The Emergency Department Patient Experience: Needs Assessment From The Cord-Em Task Force., Kory S. London, Jeffrey Druck, Matthew Silver, Douglas Finefrock

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Since the creation of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction (PS) scores, patient experience (PE) has become a metric that can profoundly affect the fiscal balance of hospital systems, reputation of entire departments and welfare of individual physicians. While government and hospital mandates demonstrate the prominence of PE as a quality measure, no such mandate exists for its education. The objective of this study was to determine the education and evaluation landscape for PE in categorical emergency medicine (EM) residencies.

METHODS: This was a prospective survey analysis of the Council of Emergency Medicine Residency …

Design And Challenges Of A Randomized Clinical Trial Of Medical Expulsive Therapy (Tamsulosin) For Urolithiasis In The Emergency Department., Pamela K. Burrows, Judd E. Hollander, Allan B. Wolfson, Michael C. Kurz, Lorna Richards, Sara Difiore, Phillip Watts, Nivedita Patkar, Jeremy Brown, Stephen Jackman, Ziya Kirkali, John W. Kusek, Chloe Michel, Andrew C. Meltzer

Department of Emergency Medicine Faculty Papers

Urolithiasis or urinary stone disease has been estimated to affect about 1 in 11 Americans. Patients with urinary stone disease commonly present to the emergency department for management of their acute pain. In addition to providing analgesia, administration of drug (medical expulsive therapy) is often prescribed to assist passage of the urinary stone. In this methodology paper, we describe the design of a prospective, multi-center, randomized, double-blind placebo controlled clinical trial of the alpha-adrenergic blocker, tamsulosin, to evaluate its effectiveness as medical expulsive therapy. In addition, we describe the unique challenges of conducting a trial of this type within the …

The Mitochondrial Ca(2+) Uniporter: Structure, Function, And Pharmacology., Jyotsna Mishra, Bong Sook Jhun, Stephen Hurst, Jin O-Uchi, György Csordás, Shey-Shing Sheu

Center for Translational Medicine Faculty Papers

Mitochondrial Ca(2+) uptake is crucial for an array of cellular functions while an imbalance can elicit cell death. In this chapter, we briefly reviewed the various modes of mitochondrial Ca(2+) uptake and our current understanding of mitochondrial Ca(2+) homeostasis in regards to cell physiology and pathophysiology. Further, this chapter focuses on the molecular identities, intracellular regulators as well as the pharmacology of mitochondrial Ca(2+) uniporter complex.

Proteoglycan Neofunctions: Regulation Of Inflammation And Autophagy In Cancer Biology., Liliana Schaefer, Claudia Tredup, Maria A. Gubbiotti, Renato V. Iozzo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Inflammation and autophagy have emerged as prominent issues in the context of proteoglycan signaling. In particular, two small, leucine-rich proteoglycans, biglycan and decorin, play pivotal roles in the regulation of these vital cellular pathways and, as such, are intrinsically involved in cancer initiation and progression. In this minireview, we will address novel functions of biglycan and decorin in inflammation and autophagy, and analyze new emerging signaling events triggered by these proteoglycans, which directly or indirectly modulate these processes. We will critically discuss the dual role of proteoglycan-driven inflammation and autophagy in tumor biology, and delineate the potential mechanisms through which …

Outcomes Of An Evidence-Based, Data Driven-Model Fieldwork Experience For Occupational Therapy Students, Amy P. Carroll, E. Adel Herge, Lindsay Johnson, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

Over the past decade, there has been an increased emphasis on evidence-based practice (EBP) and the use of outcome measurement in clinical practice, however, the implementation of evidence into practice remains challenging and irregular. During fieldwork, students often experience a disconnect between the emphasis on EBP in the classroom and lack of use in the clinic. Recognizing the need to develop high-quality, evidence-based and data-driven models of practice for student training, we partnered with local fieldwork educators to develop an innovative program that guides students and simultaneously trains fieldwork educators (FWE) in the use of a systematic data driven decision …

Promoting Environments That Measure Outcomes: Partnerships For Change, Roseann C. Schaaf, Amy P. Carroll, Susan Toth-Cohen, Janice P. Burke, Caryn Johnson, E. Adel Herge

Department of Occupational Therapy Faculty Papers

This paper describes the development of the PrEMO^© (Promoting Environments that Measure Outcomes) program. PrEMO^© is an innovative model promoting evidence-based practice (EBP) while developing capacity and quality of Level II fieldwork placements. The PrEMO^© program is described from initiation to completion, including development of site-specific learning objectives, the twelve week schedule and the role of faculty mentorship. Occupational therapy (OT) students, and university OT program faculty including academic fieldwork coordinators, partner with fieldwork educators at the site to implement EBP using a data-driven decision making (DDDM) process to guide the development of evidence-based practices. PrEMO^{© …}

Text Messaging In The Patient-Centered Medical Home To Improve Glucose Control And Retinopathy Screening., Janice M Miller, Ann G. Phalen, Albert Crawford, Anthony Frisby, Barry S. Ziring

College of Nursing Faculty Papers & Presentations

Purpose: To evaluate the effectiveness of a text messaging program (TMP) to improve glucose control, retinopathy screening (RS) rates, and self-care behaviors in patients with uncontrolled type 2 diabetes.

Methods: A single-group design with a quasi-systematic random sample (n=20) received educational/exhortational text messages on their cellular phones for 3 months. Subjects, 12 of whom identified as a minority ethnicity, were mostly male, aged 27-73 years.

Results: Glucose control and RS rates improved significantly. Subjects (>70%) reported changes in self-care behaviors.

Conclusion: Leveraging ubiquitous technology, a TMP for patients with limited access to healthcare education, holds promise