Medicine and Health Sciences Commons^™

Evaluating The Use Of Relaxation Interventions To Promote Participation And Quality Of Life In Individuals With Cancer, Abigail Gilmore, Ots, Brianna Schwoyer, Ots, Audrey Zapletal, Ms< Otr/L

Department of Occupational Therapy Posters and Presentations

Background:

• High levels of anxiety and distress are associated with the diagnosis, treatment, and remission stages of cancer.
• Psychological symptoms have the potential to negatively influence functional performance, quality of life, overall health, and recovery of individuals with cancer.
• Improvements in occupational performance and quality of life, as well as reductions in anxiety and pain have been demonstrated in a variety of health conditions with the use of therapeutic relaxation techniques, such as:
  • Yoga/Tai Chi
  • Mindfulness based stress reduction (MBSR)
  • Relaxation Training
  • Massage
• Research continues to emerge investigating trends in use, patient experiences, and efficacy of therapeutic relaxation techniques with …

A Five Year Program Review Of Infusing Occupational Therapy Into Over-Night Camping For Children With Disabilities, Audrey Zapletal, Ms, Otr/L, Ashley Kalman-Binkowski, Ms, Otr/L, Lindsey West, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives:

• Describe an OT faculty-student training model in a nontraditional rural setting
• Provide examples of strategies to enhance campers’ participation in a variety of activities
• Discuss the impact of occupational therapy program on satisfaction and participation of campers with disabilities

Pleiotropic Effects Of Bitter Taste Receptors On [Ca2+]I Mobilization, Hyperpolarization, And Relaxation Of Human Airway Smooth Muscle Cells., Blanca Camoretti-Mercado, Susan H Pauer, Hwan Mee Yong, Dan'elle C Smith, Deepak A. Deshpande, Phd, Steven S An, Stephen B Liggett

Center for Translational Medicine Faculty Papers

Asthma is characterized by airway inflammation and airflow obstruction from human airway smooth muscle (HASM) constriction due to increased local bronchoconstrictive substances. We have recently found bitter taste receptors (TAS2Rs) on HASM, which increase [Ca2+]i and relax the muscle. We report here that some, but not all, TAS2R agonists decrease [Ca2+]i and relax HASM contracted by G-protein coupled receptors (GPCRs) that stimulate [Ca2+]i. This suggests both a second pathway by which TAS2Rs relax, and, a heterogeneity of the response phenotype. We utilized eight TAS2R agonists and five procontractile GPCR agonists in cultured HASM cells. We find that heterogeneity in the …

Genetic And Pharmacological Modulation Of Trigeminal Pain Molecules In A Model Of Traumatic Brain Injury, Brittany V. Daiutolo, Ashley L. Tyburski, Shannon W. Clark, Md, Melanie B. Elliott, Phd

Department of Neurosurgery Faculty Papers

Introduction

Headache following traumatic brain injury (TBI) is highly prevalent, and it is also the most common and persistent symptom of post-concussion syndrome [1,2]. It could arise de novo or as a pre-existing headache disorder, in which migraine was the most frequent headache phenotype in both civilian and military patients with mild TBI [1,2]. Most post-traumatic headaches will resolve within a couple of weeks following injury; however, headache in a substantial subset of patients may last more than three months and contribute to a prolonged recovery from injury, disability, and a poor quality of living [2]. Headaches can persist well …

Taranis Functions With Cyclin A And Cdk1 In A Novel Arousal Center To Control Sleep In Drosophila., Dinis J.S. Afonso, Die Liu, Daniel R. Machado, Huihui Pan, James E.C. Jepson, Dragana Rogulja, Kyunghee Koh

Department of Neuroscience Faculty Papers

Sleep is an essential and conserved behavior whose regulation at the molecular and anatomical level remains to be elucidated. Here, we identify TARANIS (TARA), a Drosophila homolog of the Trip-Br (SERTAD) family of transcriptional coregulators, as a molecule that is required for normal sleep patterns. Through a forward-genetic screen, we isolated tara as a novel sleep gene associated with a marked reduction in sleep amount. Targeted knockdown of tara suggests that it functions in cholinergic neurons to promote sleep. tara encodes a conserved cell-cycle protein that contains a Cyclin A (CycA)-binding homology domain. TARA regulates CycA protein levels and genetically …

Whole Person Orientation In Primary Care: Understanding Priorities And Assessing Performance, Shannon Doyle

Master of Public Health Capstone Presentations

The purpose of this project was to use a participatory research methodology to develop a framework for understanding the concept of whole person orientation in primary care delivery. Whole person orientation is one of the seven Joint Principles of the Patient Centered Medical Home (PCMH) authored by the American Academy of Family Physicians in partnership with several other physician organizations. Although the PCMH model of primary care has been touted as part of the solution to the U.S. healthcare system’s cost and quality issues, there are few tools available to evaluate implementation of the essential components and none at all …

Low-Income African American Women's Perceptions Of Primary Care Physician Weight Loss Counseling: A Positive Deviance Study, Elaine Seaton Banerjee, Md

Master of Public Health Capstone Presentations

The purpose of this study was to qualitatively and quantitatively evaluate the interactions between low-income, African American women who successfully lost weight and the healthcare system. This mixed methods study followed a positive deviance approach, identifying a population at high risk for obesity and then identifying positive deviants within this population. In this case, positive deviants were low-income, African American women who had been obese, and had successfully lost at least 10% of their weight and maintained this loss for at least six months. We collected data from electronic medical records (EMR) and participant surveys of both positive deviant cases, …

Deregulation Of Mir-34b/Sox2 Predicts Prostate Cancer Progression., Irene Forno, Stefano Ferrero, Maria Veronica Russo, Giacomo Gazzano, Sara Giangiobbe, Emanuele Montanari, Alberto Del Nero, Bernardo Rocco, Giancarlo Albo, Lucia R Languino, Dario C Altieri, Valentina Vaira, Silvano Bosari

Department of Cancer Biology Faculty Papers

Most men diagnosed with prostate cancer will have an indolent and curable disease, whereas approximately 15% of these patients will rapidly progress to a castrate-resistant and metastatic stage with high morbidity and mortality. Therefore, the identification of molecular signature(s) that detect men at risk of progressing disease remains a pressing and still unmet need for these patients. Here, we used an integrated discovery platform combining prostate cancer cell lines, a Transgenic Adenocarcinoma of the Mouse Prostate (TRAMP) model and clinically-annotated human tissue samples to identify loss of expression of microRNA-34b as consistently associated with prostate cancer relapse. Mechanistically, this was …

Caspase-8 Scaffolding Function And Mlkl Regulate Nlrp3 Inflammasome Activation Downstream Of Tlr3., Seokwon Kang, Teresa Fernandes-Alnemri, Corey Rogers, Lindsey Mayes, Ying Wang, Christopher Dillon, Linda Roback, William Kaiser, Andrew Oberst, Junji Sagara, Katherine A Fitzgerald, Douglas R Green, Jianke Zhang, Edward S Mocarski, Emad S Alnemri

Department of Biochemistry and Molecular Biology Faculty Papers

TLR2 promotes NLRP3 inflammasome activation via an early MyD88-IRAK1-dependent pathway that provides a priming signal (signal 1) necessary for activation of the inflammasome by a second potassium-depleting signal (signal 2). Here we show that TLR3 binding to dsRNA promotes post-translational inflammasome activation through intermediate and late TRIF/RIPK1/FADD-dependent pathways. Both pathways require the scaffolding but not the catalytic function of caspase-8 or RIPK1. Only the late pathway requires kinase competent RIPK3 and MLKL function. Mechanistically, FADD/caspase-8 scaffolding function provides a post-translational signal 1 in the intermediate pathway, whereas in the late pathway it helps the oligomerization of RIPK3, which together with …

Chromatin To Clinic: The Molecular Rationale For Parp1 Inhibitor Function., Felix Y. Feng, Johann S. De Bono, Mark A. Rubin, Karen E Knudsen

Department of Cancer Biology Faculty Papers

Poly(ADP-ribose) polymerase 1 (PARP1) inhibitors were recently shown to have potential clinical impact in a number of disease settings, particularly as related to cancer therapy, treatment for cardiovascular dysfunction, and suppression of inflammation. The molecular basis for PARP1 inhibitor function is complex, and appears to depend on the dual roles of PARP1 in DNA damage repair and transcriptional regulation. Here, the mechanisms by which PARP-1 inhibitors elicit clinical response are discussed, and strategies for translating the preclinical elucidation of PARP-1 function into advances in disease management are reviewed.

Prognosis Of Neurological Injuries In The Icu, Michael Baram, Md

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

Objectives:

1. Discuss outcomes
2. Discuss outcomes of non-anoxic injury
3. Discuss long-term function

Overall Goals and Objectives:

Following this activity, a participant should be able to:

1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice

2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans for patient care.

3. Develop areas for future research and discuss appropriate methods to address these needs.

4. Summarize and continually improve communications as a team, caring for Pulmonary/Critical Care patients.

PowerPoint slides only. No audio.

Molecular Biology Of Precision Medicine In Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

On April 29, 2015, the Computational Medicine Center, The Sidney Kimmel Cancer Center, The Wills Eye Hospital, and The Jefferson Graduate School of Biomedical Sciences presented a one-day event: The Molecular Biology of Precision Medicine: Gender, Population and Race.

Pennsylvania Research Portal Showcases Jefferson Research, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

The new Pennsylvania Research Commons (PRC), an online portal to share high-quality research conducted within the state, features content from 20 institutions, including Thomas Jefferson University. This content includes articles, book chapters, dissertations, conference proceedings, and other original scholarly work — all freely available to users anywhere in the world. Users can access university archives in addition to more current content.

Strategic Distribution Of The Mitochondrial Ca2+ Uniporter In Cardiac Mitochondria, Sergio De La Fuente, Caitlin Vail, Elorm J. Agra, Kira Holmstrom, Junhui Sun, Jyotsna Mishra, Toren Finkel, Elizabeth Murphy, Shey-Shing Sheu, György Csordás

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background:

1) Control of the mitochondrial ATP production by SR-derived Ca²⁺ signals includes local, nanodomain Ca²⁺ transfer from ryanodine receptors (RyR2) to the mitochondrial matrix (excitation-bioenergetics coupling).

2) Ca²⁺ crosses the inner mitochondrial membrane (IMM) via the mtCU, a low-affinity Ca²⁺-activated Ca²⁺ channel complex.

3) The surface area of cardiac IMM is extensively enhanced by cristae folding; however, mitoplast patch clamp studies showed mtCU current density the lowest amongst a range of tissues (Fieni 2012. Nat Commun).

Low Level Lead Exposure Impairs Attentional Set Shifting Task Performance Depending Upon Sex And Developmental Periods Of Exposure, L.S. Neuwirth, D.W. Anderson, J. S. Schneider

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Introduction

Exposure to low levels of lead (Pb) impairs a variety of cognitive processes. Although children exposed to Pb developmentally present with a variety of cognitive impairments that include deficits in learning, memory, language, and executive functioning, experimental work on Pb toxicity in rats has focused mostly on learning and memory deficits and less on executive functions. However, detrimental effects on executive functioning could lead to or even underlie a variety of other cognitive problems attributed to Pb exposure. In this study, we examined the ability of Long Evans rats (control and Pb-exposed: 150ppm Pb-acetate in food given perinatally (gestation …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Spring 2015, Volume 6, Issue 1

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

Download entire issue- Jefferson Interprofessional Education and Care Newsletter, Spring 2015, Volume 6, Issue 1

Ipe Grand Rounds Learning Activity, Adrienne Christopher

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

I attended the IPE Grand Rounds hosted by Jefferson Students for Interprofessional Education (JSIPE) with the Palliative Care Team. There were several different health care professionals present on the panel that explained their specific and individualized roles within the Palliative Care team, as well how these roles united to help them function best as a group. The panel demonstrated these specific roles with a case presentation that also helped illustrate some of the conflicts they face on a daily basis, and how they overcome these conflicts to best serve their patients.

Teamstepps® Interprofessional Learning Activity, Brady Mcguire

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

In October 2014 I participated in a TeamSTEPPS® interprofessional (IP) learning activity that has already positively affected my performance in my first clinical field-work rotation. An IP team of professors from the nursing, occupational therapy, medicine, and pharmacy programs hosted the learning activity. Potential difficulty of cross-disciplinary interaction was noted from the beginning as students from each discipline sat in groups despite encouragement to split up. However, with direction from the professors, we formed small interdisciplinary groups and participated in a teamwork-focused icebreaker followed by a lecture about the origins and techniques of the TeamSTEPPS® system. After the lecture we …

Interprofessional Student Hotspotting Project, Mariana R. Kuperman, Mph, Brooke Salzman, Md, Mary Bonnet, David Goldstein, Anna Marie Morlino, Florda Priftanji, Jennifer Shoemake

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

Background: IPE and Practice-based Learning

It is well established that there is a need for Interprofessional Education (IPE) in the current landscape of health education1 and students that participate in IPE enjoy these experiences and develop skills in interprofessional teamwork that prepare them for future team-based practice.2,3,4 IPE, however, is not standardized. It ranges from programs that teach theoretical frameworks in a classroom setting to others that allow interprofessional teams of students to work together in a clinical setting.5,6 The second form is referred to as practice-based learning (PrBL).3 PrBL is now considered by experts as one of the most …

Development Of A Cultural And Spiritual Toolbox: A High Impact Interprofessional Project, Marian Nowak, Dnp, Mph, Rn, Fcn

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

Healthcare providers may not be prepared to incorporate cultural and spiritual aspects of patient care within their practice. The cultural and spiritual toolbox project will increase the opportunity for those working in a local three campus hospital system to deliver patient-centered care at the bedside by helping them recognize the nuances of various cultures and religions. An interprofessional team convened over a one year period to explore how these aspects of care could be met.

To this end, the team researched and developed a “Cultural and Spiritual Toolbox” which offers information in an online format. This project will be fully …

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

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

As the spring semester comes to a close, we in the Jefferson Center for InterProfessional Education (JCIPE) reflect on the last year. In the Fall 2014 edition of the Interprofessional Education and Care Newsletter, we presented several innovative IPE projects from students, faculty and our colleagues overseas. The articles in this edition build on that progress, high-lighting our efforts, redefined during a January 2015 Jefferson IPE retreat facilitated by Dr. Malcolm Cox, to more closely link IPE and clinical practice. To this end, the spring semester marked the conclusion of the first administration of our revised Jefferson Health Mentors Program …

Obesity-Induced Adipokine Imbalance Impairs Mouse Pulmonary Vascular Endothelial Function And Primes The Lung For Injury., Dilip Shah, Freddy Romero, Michelle Duong, Nadan Wang, Bishnuhari Paudyal, Benjamin T Suratt, Caleb B Kallen, Jianxin Sun, Ying Zhu, Kenneth Walsh, Ross Summer

Center for Translational Medicine Faculty Papers

Obesity is a risk factor for the development of acute respiratory distress syndrome (ARDS) but mechanisms mediating this association are unknown. While obesity is known to impair systemic blood vessel function, and predisposes to systemic vascular diseases, its effects on the pulmonary circulation are largely unknown. We hypothesized that the chronic low grade inflammation of obesity impairs pulmonary vascular homeostasis and primes the lung for acute injury. The lung endothelium from obese mice expressed higher levels of leukocyte adhesion markers and lower levels of cell-cell junctional proteins when compared to lean mice. We tested whether systemic factors are responsible for …

Network-Based Stratification Analysis Of 13 Major Cancer Types Using Mutations In Panels Of Cancer Genes., Xue Zhong, Hushan Yang, Shuyang Zhao, Yu Shyr, Bingshan Li

Department of Medical Oncology Faculty Papers

BACKGROUND: Cancers are complex diseases with heterogeneous genetic causes and clinical outcomes. It is critical to classify patients into subtypes and associate the subtypes with clinical outcomes for better prognosis and treatment. Large-scale studies have comprehensively identified somatic mutations across multiple tumor types, providing rich datasets for classifying patients based on genomic mutations. One challenge associated with this task is that mutations are rarely shared across patients. Network-based stratification (NBS) approaches have been proposed to overcome this challenge and used to classify tumors based on exome-level mutations. In routine research and clinical applications, however, usually only a small panel of …

Sepsis 2015: You Say You Wanted A Revolution, R. Phillip Dellinger, Md, Mccm

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

Objectives:

1. Understand current considerations for changing definitions of sepsis
2. Understand what we should do in the early management of sepsis
3. Understand the questions still to be answered in guiding early management of sepsis
4. Know what’s going on in clinical trials in sepsis

Overall Goals and Objectives:

Following this activity, a participant should be able to:

1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice

2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans for patient care.

3. Develop areas for future research and discuss appropriate …

Trop-2 Is Up-Regulated In Invasive Prostate Cancer And Displaces Fak From Focal Contacts., Marco Trerotola, Kirat K Ganguly, Ladan Fazli, Carmine Fedele, Huimin Lu, Anindita Dutta, Qin Liu, Tiziana De Angelis, Luke W Riddell, Natalia A Riobo, Martin E Gleave, Amina Zoubeidi, Richard Pestell, Dario C Altieri, Lucia R Languino

Department of Urology Faculty Papers

In this study, we show that the transmembrane glycoprotein Trop-2 is up-regulated in human prostate cancer (PCa) with extracapsular extension (stages pT3/pT4) as compared to organ-confined (stage pT2) PCa. Consistent with this evidence, Trop-2 expression is found to be increased in metastatic prostate tumors of Transgenic Adenocarcinoma of Mouse Prostate mice and to strongly correlate with α5β1 integrin levels. Using PCa cells, we show that Trop-2 specifically associates with the α5 integrin subunit, as binding to α3 is not observed, and that Trop-2 displaces focal adhesion kinase from focal contacts. In support of the role of Trop-2 as a promoter …

Doxycycline Down-Regulates Dna-Pk And Radiosensitizes Tumor Initiating Cells: Implications For More Effective Radiation Therapy., Rebecca Lamb, Marco Fiorillo, Amy Chadwick, Bela Ozsvari, Kimberly J Reeves, Duncan L Smith, Robert B Clarke, Sacha J Howell, Anna Rita Cappello, Ubaldo E. Martinez-Outshoorn, Md, Maria Peiris-Pagès, Federica Sotgia, Michael P Lisanti

Kimmel Cancer Center Faculty Papers

DNA-PK is an enzyme that is required for proper DNA-repair and is thought to confer radio-resistance in cancer cells. As a consequence, it is a high-profile validated target for new pharmaceutical development. However, no FDA-approved DNA-PK inhibitors have emerged, despite many years of drug discovery and lead optimization. This is largely because existing DNA-PK inhibitors suffer from poor pharmacokinetics. They are not well absorbed and/or are unstable, with a short plasma half-life. Here, we identified the first FDA-approved DNA-PK inhibitor by "chemical proteomics". In an effort to understand how doxycycline targets cancer stem-like cells (CSCs), we serendipitously discovered that doxycycline …

Use Of The Delphi Technique In Instrument Development To Assess Debriefing Facilitation, E. Adel Herge, Otd, Otr/L, Susan Wainwright, Pt, Phd, Jennifer Saylor, Phd, Rn, Acns-Bc

Thomas Jefferson University Faculty Days

Debriefing is an essential part of the simulation experience because this is where most of the learning occurs (Arafah, Hansen & Nichols, 2010). To date, there are no validated instruments to measure the ability of a facilitator to effectively debrief learners after a patient simulation.

This poster describes phase one of a pilot study to develop and evaluate an instrument that assesses the effectiveness of a debriefing facilitator. The instrument is based on the current scientific literature and was tested to establish reliability and validity. In phase one, the Delphi Technique was selected as it has been shown to be …

Do I Buy It? How Aidettm Training Changes Residents’ Values About Communication Skills In Doctor-Patient Interactions, Andrea Braverman, Phd, Austin Katona, B.Sc., Elisabeth Kunkel, Md, Leo Katz, Md, Matthew Keller, Md, Constantine Daskalakis, Sc.D, Jennifer Jasmine Arfaa, Phd, Mhsa

Department of Obstetrics and Gynecology Presentations and Grand Rounds

OBJECTIVES

Acquiring communication and interpersonal skills is an important part of providing patient-centered care and improving patient satisfaction. This study explores whether residents’ own values about patient communication change over time.

College Within The College: Population Health, James Plumb, Md, Mph, Rickie Brawer, Phd, Mph, Mches, Abbie Santana, Msph, Robert Simmons, Drph, Mph, Mches, Cph, Nancy Chernett, Ma, Mph

Thomas Jefferson University Faculty Days

Rationale:

The current approach to educating health professionals has not kept pace with the needs of our growingly diverse population.

-Health Professional Education for the 21st Century-The Lancet

-Institute of Medicine

-APTR/CDC/AAMC-Patients and Populations. Public Health in Medical Education

JMC Leadership and Curriculum Committee-one year planning process-2009-2010

Implications Of The New Icsd-3 Diagnostic Criteria For Narcolepsy In Patients Diagnosed By Icsd-2, John Konikkara, Md, Robert Tavella, Mph, Rpsgt, William Breuninger, Rpsgt, Karl Doghramji, Md

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND

The ICSD-2 diagnostic criteria for narcolepsy mandated 2 sleep-onset REM periods (SOREMPs) on multiple sleep latency testing (MSLT). Subsequent data suggested that a SOREMP within 15 minutes of nocturnal sleep onset, in the absence of another sleep disorder, is a highly specific finding for narcolepsy, but with low sensitivity. Therefore, the diagnostic criteria for the ICSD-3 allow for a minimum of one SOREMP during the MSLT, provided that the preceding overnight polysomnogram (PSG) also exhibits 1 SOREMP. We sought to re-evaluate the effects of this revision on diagnostic sensitivity by retrospectively applying ICSD-3 diagnostic criteria to patients who had …