Medicine and Health Sciences Commons^™

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Comprehensive Refugee Health Surveillance In Philadelphia: A Combined Resettlement And Clinical Patient Registry, Colleen Payton, Mph, Ches, Brittany Divito, Mph, Bsn, Rn, Gretchen Shanfeld, Mph, Zoe Agoos, Md, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Goal:

To improve the success of refugee resettlement and health outcomes in Philadelphia by establishing a multi-agency registry with social services and clinical measures.

N-Acetyl Cysteine May Support Dopamine Neurons In Parkinson's Disease: Preliminary Clinical And Cell Line Data., Daniel A. Monti, George Zabrecky, Daniel Kremens, Tsao-Wei Liang, Nancy A. Wintering, Jingli Cai, Xiatao Wei, Anthony J. Bazzan, Li Zhong, Brendan Bowen, Charles Intenzo, Lorraine Iacovitti, Andrew B. Newberg

Marcus Institute of Integrative Health Faculty Papers

BACKGOUND: The purpose of this study was to assess the biological and clinical effects of n-acetyl-cysteine (NAC) in Parkinson's disease (PD).

METHODS: The overarching goal of this pilot study was to generate additional data about potentially protective properties of NAC in PD, using an in vitro and in vivo approach. In preparation for the clinical study we performed a cell tissue culture study with human embryonic stem cell (hESC)-derived midbrain dopamine (mDA) neurons that were treated with rotenone as a model for PD. The primary outcome in the cell tissue cultures was the number of cells that survived the insult …

Expression Of Μ-Protocadherin Is Negatively Regulated By The Activation Of The Β-Catenin Signaling Pathway In Normal And Cancer Colorectal Enterocytes., Lucia Montorsi, Sandra Parenti, Lorena Losi, Fabrizio Ferrarini, Claudia Gemelli, A Rossi, Gianrocco Manco, Stefano Ferrari, Bruno Calabretta, Enrico Tagliafico, Tommaso Zanocco-Marani, Alexis Grande

Department of Cancer Biology Faculty Papers

Mu-protocadherin (MUCDHL) is an adhesion molecule predominantly expressed by colorectal epithelial cells which is markedly downregulated upon malignant transformation. Notably, treatment of colorectal cancer (CRC) cells with mesalazine lead to increased expression of MUCDHL, and is associated with sequestration of β-catenin on the plasma membrane and inhibition of its transcriptional activity. To better characterize the causal relationship between β-catenin and MUCDHL expression, we performed various experiments in which CRC cell lines and normal colonic organoids were subjected to culture conditions inhibiting (FH535 treatment, transcription factor 7-like 2 siRNA inactivation, Wnt withdrawal) or stimulating (LiCl treatment) β-catenin activity. We show here …

Medicare Reimbursement For Total Joint Arthroplasty: The Driving Forces., Eric M. Padegimas, Kushagra Verma, Benjamin Zmistowski, Richard H. Rothman, James J. Purtill, Michael Howley

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Total joint arthroplasty is a large and growing part of the U.S. Medicare budget, drawing attention to how much providers are paid for their services. The purpose of this study was to examine the variables that affect total joint arthroplasty reimbursement. Along with standard economic variables, we include unique health-care variables. Given the focus on value in the Affordable Care Act, the model examines the relationship of the quality of care to total joint arthroplasty reimbursement. We hoped to find that reimbursement patterns reward quality and reflect standard economic principles.

METHODS: Multivariable regression was performed to identify variables that …

(13)C Mrs And Lc-Ms Flux Analysis Of Tumor Intermediary Metabolism., Alexander A. Shestov, Seung-Cheol Lee, Kavindra Nath, Lili Guo, David S. Nelson, Jeffrey C. Roman, Dennis B. Leeper, Mariusz A. Wasik, Ian A. Blair, Jerry D. Glickson

Department of Radiation Oncology Faculty Papers

We present the first validated metabolic network model for analysis of flux through key pathways of tumor intermediary metabolism, including glycolysis, the oxidative and non-oxidative arms of the pentose pyrophosphate shunt, the TCA cycle as well as its anaplerotic pathways, pyruvate-malate shuttling, glutaminolysis, and fatty acid biosynthesis and oxidation. The model that is called Bonded Cumomer Analysis for application to (13)C magnetic resonance spectroscopy ((13)C MRS) data and Fragmented Cumomer Analysis for mass spectrometric data is a refined and efficient form of isotopomer analysis that can readily be expanded to incorporate glycogen, phospholipid, and other pathways thereby encompassing all the …

Outcomes And National Trends For The Surgical Treatment Of Lumbar Spine Trauma., Doniel Drazin, Miriam Nuno, Faris Shweikeh, Alex R. Vaccaro, Eli Baron, Terrence T. Kim, J. Patrick Johnson

Department of Orthopaedic Surgery Faculty Papers

Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004-2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety. Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (p < .0001). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (p ≤ .001). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6-2.5), nonroutine discharge (OR 1.6, CI: 1.6-1.7), complications (OR 1.1, CI: 1.0-1.1), and safety related events (OR 1.1, CI: 1.0-1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety. Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.

Ice (Interactive Curricula Experience) Platform & App Adoption, Use & Evaluation Across Thomas Jefferson University, Julie Phillips, Phd, Martha Langley Ankeny, Med.

Thomas Jefferson University Faculty Days

iCE or the Interactive Curricula Experience Platform and App is a content delivery system designed specifically for the iPad but available to any learner with a web-enabled device.

Poster presented at 2016 8th Annual Faculty Days at Thomas Jefferson University.

Using A Smartphone App To Teach Students Practical Epidemiological Skills, Russell K. Mcintire, Mph, Phd, Kathleen Day, Ms, Sean Dyer, Bs

Thomas Jefferson University Faculty Days

Background:

Despite the evidence that shows the pedagogical benefits of experiential education, epidemiology instructors rarely utlize experiential activities to teach epidemiological concepts and skills.

Poster presented at 8th annual 2016 Thomas Jefferson University Faculty Days.

The Sustainable Development Goals: Implications And Integration Across The Curricula, Lucille B. Pilling, Mph, Edd, Rn, Kathleen C. Ashton, Phd, Rn, Acns-Bc

Thomas Jefferson University Faculty Days

Poster presented at 8th annual Faculty Days at Thomas Jefferson University.

Grants Information Service, Helena Washington, Mls, Paul Hunter, Dmd, Mlis

Thomas Jefferson University Faculty Days

Poster presented at 8th annual Faculty Days at Thomas Jefferson University.

Authors, Monitor Your Publications And Their Impact With Scopus And Orcid, Gary E. Kaplan, Mslis, Ahip, Patricia Wynne, Bsn, Rn, Mslis

Thomas Jefferson University Faculty Days

Poster presented at 8th annual Faculty Days at Thomas Jefferson University.

Download Entire Issue- Collaborative Healthcare: Interprofessional Practice, Education, And Evaluation (Jcipe), Spring 2016, Volume 7, Issue 1

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

Download entire issue- Collaborative HealthCare: Interprofessional Practice, Education, and Evaluation (JCIPE), Spring 2016, Volume 7, Issue 1

Interprofessional Practice Increasingly Influences Jefferson Students' University Selection

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

• Data supplied by the Office of Institutional Research and drawn from its New Student Survey question “Please identify why you selected Thomas Jefferson University over other institutions.”

• Students given 29 options and asked to select the top three (3) reasons that influenced their decision.

• Five items are generally cited as major reasons that students select Jefferson, including academic reputation, quality of faculty, campus location, affiliation with Thomas Jefferson University Hospital and clinical opportunities available.

• Despite the above consistent (and expected/desired) reasons and the change in question format to require students to select only their top three …

Jcipe And The Jefferson Digital Commons, Daniel G. Kipnis, Msi

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

In June 2014, the Middle States Commission on Higher Education Review Board re-accredited Thomas Jefferson University and in their report they made sure to highlight the exemplar work being done by the Jefferson Center for InterProfessional Education (JCIPE). JCIPE, founded in 2007, was commended by the accreditation committee for its work during the committee’s most recent visit to Philadelphia in June 2014.

To help foster the mission of JCIPE, the Jefferson Digital Commons has partnered to archive the JCIPE eNewsletter. Archiving the newsletter has allowed JCIPE to continue promoting their mission to an international community and has allowed the international …

A Community College Interprofessional Nurse Managed Center Practice Model, Donna Meyer, Msn, Rn, Anef

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

Lewis and Clark Community College (L&C) has initiated an innovative interprofessional collaborative practice (IPCP) model at its Family Health Clinic (FHC), a nurse managed center, located at the main campus in Godfrey, Illinois. The FHC previously operated successfully for seven years, and has exceeded the projected impact with the numbers of individuals served in the community. The project is innovative and distinctive in providing an IPCP model in that it is inter-institutional, with several of the participating practitioners from institutions other than L&C. The core leadership of the model remains with the nursing professionals at the FHC. It is important …

From Interprofessional Education To Collaborative Practice: A Jefferson Alumna's Perspective, Chelsea (Gorman) Lytle, Bsn, Rn

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

I graduated from Jefferson College of Nursing at Thomas Jefferson University in May 2015 and began my work as a perioperative nurse the following July. During my time at Jefferson, I not only participated in the Health Mentors Program (HMP), but was also given the opportunity to work closely with JCIPE and a group of students from other health care professions to refine and expand IPE offerings. We formed a student organization, now known as Jefferson Students for Interprofessional Education (JSIPE), which had three over-arching goals:

1. Students will gain exposure to real-world collaborative practice teams

2. Students will learn …

Leveraging Online Learning And Creative Narrative To Advance Interprofessional Competency Development, Karen T. Pardue, Phd, Rn, Cne, Anef, Shelley Cohen Konrad, Phd, Lcsw, Fnap

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

The need for health profession students to engage in collaborative interprofessional education (IPE) is abundantly evident. In contemporary practice, creating clinical environments which promote healing relies not just on the dispositions of individual clinicians, but also on the collective capacities of interprofessional healthcare teams (Konrad & Browning, 2012). Health profession educators are therefore increasingly challenged to: 1. design robust pedagogical curricula that prepare students with discipline-specific competencies to care for future patients; 2. offer shared learning experiences in which students develop interprofessional, team-based capacities grounded in intentional and respectful collaboration; and 3. cultivate an interprofessional culture amongst faculty that models …

A Community College's Foray Into Interprofessional Education, Judith Blum, Ms, Otr/L, Mary Kay Demarco, Phd, Rn, Cne

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

As initiatives and innovations in interprofessional education (IPE) continue to flourish in university settings, there is limited evidence this is occurring in two-year allied health and nursing programs found in community colleges. Recent literature indicates that graduates of associate degree allied health and nursing programs account for 49% of the total healthcare workforce (Brookings Institute, 2014). Graduates of these programs will work among those coming from university programs where IPE has been well established, therefore, it is imperative that this content be addressed at the community college. To meet this need, the Community College of Baltimore County’s (CCBC) School of …

From The Editors, Christine Arenson, Md, Elizabeth T. Speakman, Edd, Rn, Anef, Fnap, Lauren Collins, Md, Shoshana Sicks, Edm

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

Happy Spring! You will notice that the Jefferson Center for Interprofessional Education (JCIPE) newsletter has undergone a name and layout change. This represents the many new directions our Center is taking in both interprofessional education (IPE) and collaborative practice (CP) training. Indeed, JCIPE has had another busy spring. We started the new year by piloting the patient version of the Jefferson Teamwork Observation Guide (JTOG) in the inpatient setting, expanding an outpatient pilot that started last fall. Thanks to many research assistants, we have been able to gather some rich and informative data and this summer we hope to have …

On-Site Test Collection Intervention Improves Lead Screening Rates At An Urban Family Medicine Practice, Krys Foster, Md, Mph, Tina Castellan, Md, Kelly Lopez, Md, Pgy-Iii, Phoebe Askie, Md, Mph, Daniel Chung, Md, Laura Parente, Md, Yury Parra, Md Pgy2, Grace Amadi, Md, Mariana R. Kuperman, Md, Mph, Bruce Reaves, Md, Marc Altshuler, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Study Aims:

Examine the effect of on-site lead screening collection on resulted lead screening rates.

The (R)- Isomer Of Isometheptene Decreases Trigeminal Sensitivity In A Rat Model Of Primary Headache, Jessica Perino, Ms, Nathan T. Fried, Phd, Michael L. Oshinsky, Phd, Bruce Daugherty, Phd, Mba, Seth Lederman, Md, Melanie B Elliott, Phd

Department of Neurosurgery Posters

Introduction

Isometheptene is thought to be the active ingredient of the commonly known headache medication, Midrin. Previously, we found only the (R) enantiomer to be effective in alleviating headache behavior in two models of headache compared to the (S) enantiomer.

Experiments using electrical and mechanical stimulation of the dura in animals with no history of head pain have been used to elucidate the mechanisms of the trigeminovascular system at the level of the trigeminal ganglion, trigeminal nucleus caudalis, periaqueductal gray, and the thalamus. The limitation of these acute models is that electrical and mechanical stimulation of the dural blood vessels …

Improving Colon Cancer Screening In Jefferson Hospital Ambulatory Practice, Rady Ho, Md, Ravi Patel, Md, Matthew Zheng, Md, Albert Lee, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

AIM:

We want to improve our colorectal screening rates for Tuesday JHAP patients to 40% by March 2016.

We will assess monthly rates of the % of patients who received CRC screening over the past 10 years.

This will improve overall health maintenance, and find/prevent pre-cancerous lesions. This potentially improves the life expectancy of our population.

At The Leading Edge Of Change: Creation Of The Housestaff Quality And Safety Leadership Council, Ruben Rhoades, Md, Adam P. Johnson, Md, Mph, Rebecca C. Jaffe, Md, Bracken Babula, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background:

The ACGME Clinical Learning Environment Review (CLER) is driving a national re-evaluation of the engagement and alignment of housestaff in institutional Quality and Safety.

In 2008, the concept of a housestaff quality and safety committee was born, as a means of driving practice change

Our CLER data suggested that we need a similar council

To Fib Or Not To Fib: Misdiagnosis Of Atrial Fibrillation On Telemetry: Case Presentation And Root Cause Analysis, Andrew W. Panakos, Md, Loheetha Ragupathi, Md, Sarah Feldman, Rn, Brittany Heckel, Susannah Eckman, Rebecca C. Jaffe, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Case presentation, current practices of telemetry management, root cause analysis, goals for improvement, proposed intervention and next steps.

Engaging In Change: Smoking Cessation In An Ambulatory Residency Clinic, Benjamin Khazan, Md, Ankita Mehta, Md, Neena Mohan, Md, Albert Lee, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

AIM:

Decrease the quantity of daily cigarettes smoked by 25% in cigarette smokers receiving their care at an ambulatory resident practice from January 2016 to May 2016.

Getting Engaged: Efforts To Increase Housestaff Event Reporting, Adam P. Johnson, Md, Mph, Ruben Rhoades, Md, Allison Greco, Md, Caitlyn Sidrane, Mph, Bracken Babula, Md, Rebecca C. Jaffe, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background:

Residents traditionally are under-engaged in event reporting through institutional channels.

The ACGME Clinical Learning Environment Review prioritizes this issue, and is establishing national benchmarks.

In 2015 the Housestaff Quality and Safety Leadership Council selected Increasing Error Reporting as their clinical quality initiative.

Got Diabetes? With Us, You'll Have Complete Diabetic Care, Mansi Shah*, Md, Hasmik Minasyan*, Md, Alison Liss*, Md, John Caruson, Md, Loren Chen, Md, Albert Lee, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

AIM:

By April 2016, we aim to improve Complete Diabetic Care of Thursday JHAP Clinic's patients with diabetes by 50%.

* These authors contributed equally

Appropriate Utilization Of Diabetic Diets For Inpatients, Neha Agarwal, Md, Tasha Kouvatsos, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

AIM:

To increase the number of diabetic patients that are ordered a diabetic diet at time of admission

So that blood sugars may be better controlled throughout admission with decreased usage of CDI

Taking The "E" Out Of Night "Mare" Rotation: Uncloaking Ghost Admissions Via Teletracking And Reducing Paper Fatigue, Ramya Punati, Md, Jaehee Kim, Md, Rebecca C. Jaffe, Md, Lakshimi Ravindran, Md, Bracken Babula, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Goal:

To improve communication at admission for patients admitted from non-ED locations so that patient care delays are minimized and provider frustration decreases.