Medicine and Health Sciences Commons^™

Evaluating Frequency And Quality Of Pathogen-Specific T Cells., Nadia Anikeeva, Dolores Grosso, Yuri Sykulev

Department of Microbiology and Immunology Faculty Papers

It is generally accepted that enumeration and characterization of antigen-specific T cells provide essential information about potency of the immune response. Here, we report a new technique to determine the frequency and potency of antigen-specific CD8 T cells. The assay measures changes of intracellular Ca(2+) in real time by fluorescent microscopy in individual CD8 T cells responding to cognate peptides. The T cells form continuous monolayer, enabling the cells to present the peptides to each other. This approach allows us to evaluate the kinetics of intracellular Ca(2+) signalling that characterizes the quality of T cell response. We demonstrate the usefulness …

Ictal Kissing: Occurrence And Etiology., Ali Akbar Asadi-Pooya, Elizabeth W. Fletman

Department of Neurology Faculty Papers

Ictal kissing is a rare semiological manifestation in patients with epilepsy. We tried to estimate its occurrence and characterize the underlying etiology. We retrospectively reviewed all video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "kiss". We then searched the electronic database PubMed on September 21, 2016 using the following search terms in the English language: "ictal" OR "seizure" OR "epilepsy" AND "kiss" OR "kissing". Relevant original studies were included. During the study period, 5133 patients were investigated in our epilepsy monitoring unit. One patient (0.02%) had one episode of documented …

Impossibility To Eliminate Observer Effect In The Assessment Of Adherence In Clinical Trials., Jonathan S. Myers, Scott J. Fudemberg, Robert E. Fintelmann, Lisa A. Hark, Nitasha Khanna, Benjamin E. Leiby, Michael Waisbourd

Department of Pharmacology and Experimental Therapeutics Faculty Papers

PURPOSE: To utilize the Travoprost Dosing Aid (DA) in the assessment of patient medication adherence, while also determining whether or not altering the functionality of the DA in three randomized subject groups can reduce observer effect.

METHODS: Forty-five subjects were randomized into three groups: two with monitored DAs and one without monitoring. One group of subjects was given a DA that both monitored drop usage and had visual and audible alarms, while the other monitored group included subjects given a DA that had no alarms but continued to monitor drop usage. The third group was given a DA that had …

Single-Cell Transcriptional Analysis Reveals Novel Neuronal Phenotypes And Interaction Networks Involved In The Central Circadian Clock., James Park, Haisun Zhu, Sean O'Sullivan, Babatunde A Ogunnaike, David R Weaver, James S. Schwaber, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Single-cell heterogeneity confounds efforts to understand how a population of cells organizes into cellular networks that underlie tissue-level function. This complexity is prominent in the mammalian suprachiasmatic nucleus (SCN). Here, individual neurons exhibit a remarkable amount of asynchronous behavior and transcriptional heterogeneity. However, SCN neurons are able to generate precisely coordinated synaptic and molecular outputs that synchronize the body to a common circadian cycle by organizing into cellular networks. To understand this emergent cellular network property, it is important to reconcile single-neuron heterogeneity with network organization. In light of recent studies suggesting that transcriptionally heterogeneous cells organize into distinct cellular …

Chromatin Proteins And Rna Are Associated With Dna During All Phases Of Mitosis., Kathryn L Black, Svetlana Petruk, Tyler K Fenstermaker, Jacob W Hodgson, Jeffrey L Caplan, Hugh W Brock, Alexander Mazo

Department of Biochemistry and Molecular Biology Faculty Papers

Mitosis brings about major changes to chromosome and nuclear structure. We used recently developed proximity ligation assay-based techniques to investigate the association with DNA of chromatin-associated proteins and RNAs in Drosophila embryos during mitosis. All groups of tested proteins, histone-modifying and chromatin-remodeling proteins and methylated histones remained in close proximity to DNA during all phases of mitosis. We also found that RNA transcripts are associated with DNA during all stages of mitosis. Reduction of H3K27me3 levels or elimination of RNAs had no effect on the association of the components of PcG and TrxG complexes to DNA. Using a combination of …

Correlation Of Pre-Admission Math Aptitude Test With The Medical Dosimetry Program Gpa, Shirley Ann Johnston, Ms, Rt(R)(T)Cmd, Carolyn Giordano, Phd

Department of Radiologic Sciences Faculty Papers

Who are Dosimetrists?

The Medical Dosimetrist is a member of the radiation oncology team who has knowledge of the overall characteristics and clinical relevance of radiation oncology treatment machines and equipment, is cognizant of procedures commonly used in brachytherapy and has the education and expertise necessary to generate radiation dose distributions and dose calculations in collaboration with the medical physicist and radiation oncologist.

A Prospective Evaluation Of Opioid Utilization After Upper-Extremity Surgical Procedures: Identifying Consumption Patterns And Determining Prescribing Guidelines., Nayoung Kim, Jonas L. Matzon, Jack Abboudi, Christopher M. Jones, William Kirkpatrick, Charles Leinberry, Frederic Liss, Kevin F F. Lutsky, Mark L. Wang, Mitchell Maltenfort, Asif M Ilyas

Rothman Institute Papers

BACKGROUND: Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid utilization patterns and to develop prescribing guidelines.

METHODS: All patients undergoing outpatient upper-extremity surgical procedures over a consecutive 6-month period had the following prospective data collected: patient demographic characteristics, surgical details, anesthesia type, and opioid prescription and consumption patterns. Analysis of variance and post hoc comparisons were performed using …

A Case Of Arterioportal Fistula Leading To Non-Cirrhotic Portal Hypertension, Sheela S. Reddy, Raja K. Dhanekula, Md, Warren R. Maley, Md, Colette Shaw, Md, Jesse M. Civan, Md, David A. Sass, Md, Jonathan M. Fenkel, Md, Susan Shamini Noori, Md, Dina Halegoua-De Marzio, Md

Division of Gastroenterology and Hepatology Posters

Background

• Arterioportal fistula (APF) is a rare cause of non-cirrhotic portal hypertension.

• This is a case of a hepatic artery-portal vein fistula presenting with recurrent variceal hemorrhage and ascites in a patient with no known liver disease.

Implementing A Sizing Chart For Nasal Cannula Placement To Decrease Associated Pressure Ulcers In Infants, William F. Bucher, Bs, Rrt-Nps

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

Background

The Joint Commission definition of a “Pressure Ulcer” is a broader term that includes decubitus ulcers but also includes any ulcerations associated with pressure. Over a three-month period in 2015 the Intensive Care Nursery (ICN) at Thomas Jefferson University had five patients who developed pressure ulcers due to placement of an improper size nasal cannula being used for that patient. Infant nasal cannulas are typically classified as being for micro premature, premature, neonate, infant and intermediate infant size patients. There is no instruction by manufactures for fitting a cannula to the actual size of the patient in kilograms. Cannulas …

Remote Preoperative Tonic-Clonic Seizures Do Not Influence Outcome After Surgery For Temporal Lobe Epilepsy., Ali Akbar Asadi-Pooya, Amin H. Rabiei, Edward J. Gracely, Michael R. Sperling

Department of Neurology Faculty Papers

OBJECTIVES: Tonic-clonic seizures are associated with greater chance of seizure relapse after anterior temporal lobectomy. We investigated whether the interval between the last preoperative tonic-clonic seizure and surgery relates to seizure outcome in patients with drug-resistant mesial temporal lobe epilepsy (MTLE).

METHODS: In this retrospective study, patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was categorized as seizure freedom or relapse. The relationship between surgical outcome and the interval between the last preoperative tonic-clonic seizure and surgery was investigated.

RESULTS: One-hundred seventy-one patients were studied. Seventy nine (46.2%) patients experienced tonic-clonic seizures before surgery. Receiver …

Neuromodulation, Stephen Silberstein

Department of Neurology Faculty Papers

Neuromodulation is a new promising treatment for headache disorders. It consists of peripheral nerve neurostimulation and central neurostimulation. © 2016, Touch Briefings. All rights reserved.

Identification Of Early Gene Expression Changes In Primary Cultured Neurons Treated With Topoisomerase I Poisons., Sharyn L. Rossi, Casey J. Lumpkin, Ashlee W. Harris, Jennifer Holbrook, Cinsley Gentillon, Suzanne M. Mccahan, Wenlan Wang, Matthew E.R. Butchbach

Department of Pediatrics Faculty Papers

Topoisomerase 1 (TOP1) poisons like camptothecin (CPT) are currently used in cancer chemotherapy but these compounds can have damaging, off-target effects on neurons leading to cognitive, sensory and motor deficits. To understand the molecular basis for the enhanced sensitivity of neurons to CPT, we examined the effects of compounds that inhibit TOP1-CPT, actinomycin D (ActD) and β-lapachone (β-Lap)-on primary cultured rat motor (MN) and cortical (CN) neurons as well as fibroblasts. Neuronal cells expressed higher levels of Top1 mRNA than fibroblasts but transcript levels are reduced in all cell types after treatment with CPT. Microarray analysis was performed to identify …

Fumarate Modulates The Immune/Inflammatory Response And Rescues Nerve Cells And Neurological Function After Stroke In Rats., Ruihe Lin, Jingli Cai, Eric W Kostuk, Robert H. Rosenwasswer Md, Lorraine Iacovitti

Farber Institute for Neuroscience Faculty Papers

BACKGROUND: Dimethyl fumarate (DMF), working via its metabolite monomethylfumarate (MMF), acts as a potent antioxidant and immunomodulator in animal models of neurologic disease and in patients with multiple sclerosis. These properties and their translational potential led us to investigate whether DMF/MMF could also protect at-risk and/or dying neurons in models of ischemic stroke in vitro and in vivo. Although the antioxidant effects have been partially addressed, the benefits of DMF immunomodulation after ischemic stroke still need to be explored.

METHODS: In vitro neuronal culture with oxygen-glucose deprivation and rats with middle cerebral artery occlusion were subjected to DMF/MMF treatment. Live/dead …

Cell-To-Cell Transmission Of Dipeptide Repeat Proteins Linked To C9orf72-Als/Ftd., Thomas Westergard, Brigid K Jensen, Xinmei Wen, Jingli Cai, Elizabeth Kropf, Lorraine Iacovitti, Piera Pasinelli, Davide Trotti

Farber Institute for Neuroscience Faculty Papers

Aberrant hexanucleotide repeat expansions in C9orf72 are the most common genetic change underlying amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). RNA transcripts containing these expansions undergo repeat-associated non-ATG translation (RAN-T) to form five dipeptide repeat proteins (DPRs). DPRs are found as aggregates throughout the CNS of C9orf72-ALS/FTD patients, and some cause degeneration when expressed in vitro in neuronal cultures and in vivo in animal models. The spread of characteristic disease-related proteins drives the progression of pathology in many neurodegenerative diseases. While DPR toxic mechanisms continue to be investigated, the potential for DPRs to spread has yet to be determined. …

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

Jefferson Digital Commons Reports

Highlights in this quarterly report include:

• Class Day programs from 1964-2015
• Commencement programs from the Medical College from 1870 to the present.
• Commencement programs from College of Graduate Studies
• Readership download map for the quarter
• Top 10 government and education domains accessing content in the JDC
• What people are saying about the Jefferson Digital Commons

Distinct Cell Stress Responses Induced By Atp Restriction In Quiescent Human Fibroblasts., Nirupama Yalamanchili, Andres Kriete, David Alfego, Kelli M Danowski, Csaba Kari, Ulrich Rodeck

Department of Dermatology and Cutaneous Biology Faculty Papers

Quiescence is the prevailing state of many cell types under homeostatic conditions. Yet, surprisingly little is known about how quiescent cells respond to energetic and metabolic challenges. To better understand compensatory responses of quiescent cells to metabolic stress, we established, in human primary dermal fibroblasts, an experimental 'energy restriction' model. Quiescence was achieved by short-term culture in serum-deprived media and ATP supply restricted using a combination of glucose transport inhibitors and mitochondrial uncouplers. In aggregate, these measures led to markedly reduced intracellular ATP levels while not compromising cell viability over the observation period of 48 h. Analysis of the transcription …

A Survey Of Physician Receptivity To Molecular Diagnostic Testing And Readiness To Act On Results For Early-Stage Colon Cancer Patients., Ronald E. Myers, Thomas Wolf, Phillip Shwae, Sarah E. Hegarty, Stephen C. Peiper, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption.

METHODS: We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results.

RESULTS: Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using …

Nurses Alumni Association Bulletin, Fall 2016, Susan Albrecht Curcio, Aileen Ishuin Macmillan, Ruth Huff Iuliano

Nursing Alumni Bulletins

2016 – 2017 Meeting Dates Calendar

2017 Annual Luncheon & Meeting Notice

Officers, Committee Chairs, Satellite and Volunteers

2016 President’s Message

Treasurer’s Financial Report

Resume of Minutes

Alumni Office News

Committee Reports

• Social
• Relief Trust Fund
• Satellite–Harrisburg Satellite Area
• Scholarship
• Nominating
• Bulletin
• By Laws

Annual Giving Contributors

Janet C. Hindson Award

• Janet C. Hindson 2015 Award Winner

News About and From Our Graduates

Memories

Happy Birthday – To Be 80 or More

Annual Luncheon

• 50th Anniversary Class List for 1966
• Luncheon Attendees
• 1967 – Anniversary Class List for 2017 Annual Luncheon
• Luncheon Photos

In Memoriam, Names of Deceased Graduates

Class …

Reliability And Validity Of S3 Pressure Sensation As An Alternative To Deep Anal Pressure In Neurologic Classification Of Persons With Spinal Cord Injury., Ralph J. Marino, Mary Schmidt-Read, Steven C. Kirshblum, Trevor A. Dyson-Hudson, Keith Tansey, Leslie R. Morse, Daniel E. Graves

Department of Rehabilitation Medicine Faculty Papers

OBJECTIVE: To determine whether pressure sensation at the S3 dermatome (a new test) could be used in place of deep anal pressure (DAP) to determine completeness of injury as part of the International Standards for Neurological Classification of Spinal Cord Injury.

DESIGN: Prospective, multicenter observational study.

SETTING: U.S. Spinal Cord Injury Model Systems.

PARTICIPANTS: Persons (N=125) with acute traumatic spinal cord injury (SCI), neurologic levels T12 and above, were serially examined at 1 month (baseline), 3, 6, and 12 months postinjury. There were 80 subjects with tetraplegia and 45 with paraplegia.

INTERVENTIONS: S3 pressure sensation at all time points, with …

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 65, Issue 4, Fall 2016

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• Creating the Ideal Physician-One Note at a Time: The Dean's concert series is more than a respite in the middle of a busy day at SKMC
• Tiny Bubbles, Big Future: New uses for microbubble-filled ultrasound contrast agents could reduce the need for highly invasive medical tests.
• Dean's Column
• Findings: New pathway to treat heart failure
• #Giving Tuesday: A Message from Elizabeth Dale
• On Campus
• Clara Callahan, MD: A keen eye for aspiring physicians
• Kate Sugarman, MD '88: A career guided by social justice
• Nick Benvenuto: Finding Science and Art in Both Winemaking and Medicine
• Class Notes
• In …

Assessment Of The Effects Of Mptp And Paraquat On Dopaminergic Neurons And Microglia In The Substantia Nigra Pars Compacta Of C57bl/6 Mice., Richard Jay Smeyne, Charles B. Breckenridge, Melissa Beck, Yun Jiao, Mark T. Butt, Jeffrey C. Wolf, Dan Zadory, Daniel J. Minnema, Nicholas C. Sturgess, Kim Z. Travis, Andrew R. Cook, Lewis L. Smith, Philip A. Botham

Department of Neuroscience Faculty Papers

The neurotoxicity of paraquat dichloride (PQ) was assessed in two inbred strains of 9- or 16-week old male C57BL/6 mice housed in two different laboratories and compared to the effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). PQ was administered by intraperitoneal injections; either once (20 mg/kg) or twice (10 mg/kg) weekly for 3 weeks, while MPTP-HCl was injected 4 times on a single day (20 mg/kg/dose). Brains were collected 8, 16, 24, 48, 96 or 168 hours after the last PQ treatment, and 48 or 168 hours after MPTP treatment. Dopamine neurons in the substantia nigra pars compacta (SNpc) were identified by antibodies …

An Approach Using Psa Levels Of 1.5 Ng/Ml As The Cutoff For Prostate Cancer Screening In Primary Care., E. David Crawford, Matt T. Rosenberg, Alan W. Partin, Matthew R. Cooperberg, Michael Maccini, Stacy Loeb, Curtis A. Pettaway, Neal D. Shore, Paul Arangua, John Hoenemeyer, Mike Leveridge, Michael Leapman, Peter Pinto, Ian M. Thompson, Peter Carroll, James Eastham, Leonard G. Gomella, Eric A. Klein

Department of Urology Faculty Papers

No abstract provided.

Exploring Patient And Family Satisfaction In Pediatric Neurological Surgery, Randa R. Barsoom, Todd A. Maugans, James F. Burrows, Paul Rosen

Student Papers, Posters & Projects

Introduction Patient and family satisfaction during outpatient visits is correlated with a continuance of care and likelihood to recommend the practice to others. Additionally, patient-family satisfaction can determine the success of the practice and influence medical outcomes. Utilizing a well-validated surveys instrument, patient and family satisfaction can be explored in the office setting. Methods During a consecutive 36 month period, a standardized and validated patient satisfaction survey instrument was provided to the family members of patients who presented to two pediatric neurosurgery clinics associated with Nemours Children's Health System. The completed surveys were analyzed statistically to identify correlations between overall …

Evaluation And Management Of Sleep Disorders In The Hand Surgery Patient., Michael P. Gaspar, Patrick M. Kane, Sidney M. Jacoby, Patrick S. Gaspar, A. Lee Osterman

Department of Orthopaedic Surgery Faculty Papers

Despite posing a significant public health threat, sleep disorders remain poorly understood and often underdiagnosed and mismanaged. Although sleep disorders are seemingly unrelated, hand surgeons should be mindful of these because numerous conditions of the upper extremity have known associations with sleep disturbances that can adversely affect patient function and satisfaction. In addition, patients with sleep disorders are at significantly higher risk for severe, even life-threatening medical comorbidities, further amplifying the role of hand surgeons in the recognition of this condition.

Practice Characteristics Of Emergency Department Extracorporeal Cardiopulmonary Resuscitation (Ecpr) Programs In The United States: The Current State Of The Art Of Emergency Department Extracorporeal Membrane Oxygenation (Ed Ecmo)., Joseph E. Tonna, Nicholas J. Johnson, John Greenwood, David F. Gaieski, Zachary Shinar, Joseph M. Bellezo, Lance Becker, Atman P. Shah, Scott T. Youngquist, Michael P. Mallin, James Franklin Fair, Kyle J. Gunnerson, Cindy Weng, Stephen Mckellar

Department of Emergency Medicine Faculty Papers

PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department.

METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO). Our objective was to characterize the following domains of ED ECMO practice: program characteristics, patient selection, devices and techniques, and personnel.

RESULTS: Among 99 centers queried, 70 responded. Among these, 36 centers performed ED ECMO. …

Emerging Infectious Diseases: Global To Local Implications, Mary Lou Manning, Phd, Crnp, Cic, Faan

Department of Nursing Papers

Infectious disease remains among the leading causes of death worldwide. With easy mobility and air travel, pathogens can move quickly and silently to any place around the globe in a matter of days. The recent Ebola crises in West Africa clearly demonstrated the increased risk of emerging infections in our highly connected world. Legal nurse consultants are well-positioned to provide guidance on deciphering public health laws relevant to responding to infectious disease threats.

Immunohistochemistry Successfully Uncovers Intratumoral Heterogeneity And Widespread Co-Losses Of Chromatin Regulators In Clear Cell Renal Cell Carcinoma., Wei Jiang, Essel Dulaimi, Karthik Devarajan, Theodore Parsons, Qiong Wang, Lili Liao, Eun-Ah Cho, Raymond O'Neill, Charalambos C. Solomides, Stephen C. Peiper, Joseph R Testa, Robert Uzzo, Haifeng Yang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Recent studies have shown that intratumoral heterogeneity (ITH) is prevalent in clear cell renal cell carcinoma (ccRCC), based on DNA sequencing and chromosome aberration analysis of multiple regions from the same tumor. VHL mutations were found to be universal throughout individual tumors when it occurred (ubiquitous), while the mutations in other tumor suppressor genes tended to be detected only in parts of the tumors (subclonal). ITH has been studied mostly by DNA sequencing in limited numbers of samples, either by whole genome sequencing or by targeted sequencing. It is not known whether immunohistochemistry (IHC) can be used as a tool …

Post-Transplant Outcomes In High-Risk Compared With Non-High-Risk Multiple Myeloma: A Cibmtr Analysis., Emma C. Scott, Parameswaran Hari, Manish Sharma, Jennifer Le-Rademacher, Jiaxing Huang, Dan Vogl, Muneer Abidi, Amer Beitinjaneh, Henry Fung, Siddhartha Ganguly, Gerhard Hildebrandt, Leona Holmberg, Matt Kalaycio, Shaji Kumar, Robert Kyle, Hillard Lazarus, Cindy Lee, Richard T. Maziarz, Kenneth Meehan, Joseph Mikhael, Taiga Nishihori, Muthalagu Ramanathan, Saad Usmani, Jason Tay, David Vesole, Baldeep Wirk, Jean Yared, Bipin N. Savani, Cristina Gasparetto, Amrita Krishnan, Tomer Mark, Yago Nieto, Anita D'Souza

Department of Medical Oncology Faculty Papers

Conventional cytogenetics and interphase fluorescence in situ hybridization (FISH) identify high-risk multiple myeloma (HRM) populations characterized by poor outcomes. We analyzed these differences among HRM versus non-HRM populations after upfront autologous hematopoietic cell transplantation (autoHCT). Between 2008 and 2012, 715 patients with multiple myeloma identified by FISH and/or cytogenetic data with upfront autoHCT were identified in the Center for International Blood and Marrow Transplant Research database. HRM was defined as del17p, t(4;14), t(14;16), hypodiploidy (-Y) or chromosome 1 p and 1q abnormalities; all others were non-HRM. Among 125 HRM patients (17.5%), induction with bortezomib and immunomodulatory agents (imids) was higher …

Evaluation Of The Jefferson Family Medicine Associates’ Diabetes Information And Support For Your Health (Dish) Program [Presentation], Amy Cunningham, Phd, Mph

Population Health Science Program Doctoral Dissertations

Type 2 diabetes is increasing in incidence and prevalence, and contributes to significant morbidity, mortality, and costs. Type 2 diabetes management is complex and requires continual patient self-management. However, many physicians lack the time and training to deliver comprehensive diabetes self-management training to their patients, and only 56.8% of individuals with Type 2 diabetes have received formal diabetes education.

Group medical visits (GMVs), which combine one-on-one clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management. This dissertation used a quasi-experimental nonequivalent groups design to evaluate the four-session Diabetes Information and Support …

Community Health Worker Knowledge And Management Of Pre-Eclampsia In Rural Karnataka State, India., Umesh Ramadurg, Marianne Vidler, Umesh Charanthimath, Geetanjali Katageri, Mrutyunjaya Bellad, Ashalata Mallapur, Shivaprasad Goudar, Shashidhar Bannale, Chandrashekhar Karadiguddi, Diane Sawchuck, Rahat Qureshi, Peter Von Dadelszen, Richard Derman

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: In India, the hypertensive disorders of pregnancy and postpartum haemorrhage are responsible for nearly 40 % of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care. Community health care workers are regarded as essential providers of basic maternity care; and the quality of care they provide is dependent on the level of knowledge and skills they possess. However, there is limited research regarding their ability to manage pregnancy complications. This study aims to describe the current state of …